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Sample records for brachytherapy radiation source

  1. The needs for brachytherapy source calibrations in the United States

    International Nuclear Information System (INIS)

    Coursey, B.M.; Goodman, L.J.; Hoppes, D.D.; Loevinger, R.; McLaughlin, W.L.; Soares, C.G.; Weaver, J.T.

    1992-01-01

    Brachytherapy sources of beta and gamma radiation ('brachy' is from the Greek, meaning 'near') have a long history of use in interstitial, intracavitary, intraluminal, and ocular radiation therapy. In the past the US national standards for these sources were often specified in activity or milligram radium equivalent. With the introduction of new radionuclide sources to replace radium, source strength calibrations are now expressed as air kerma rate at a meter. In this paper, we review the NIST standards for brachytherapy sources, list some of the common radionuclides and source encapsulations in use in the US radiology community, and describe the latest NIST work, in collaboration with several US medical institutions, on a method of two- and three-dimensional dose mapping of brachytherapy sources using radiochromic films. (orig.)

  2. Radiation safety and gynaecological brachytherapy

    International Nuclear Information System (INIS)

    Crawford, L.

    1985-01-01

    In 1983, the Radiation Control Section of the South Australian Health Commission conducted an investigation into radiation safety practices in gynaecological brachytherapy. Part of the investigation included a study of the transportation of radioactive sources between hospitals. Several deficiences in radiation safety were found in the way these sources were being transported. New transport regulations came into force in South Australia in July 1984 and since then there have been many changes in the transportation procedure

  3. Calculated and measured brachytherapy dosimetry parameters in water for the Xoft Axxent X-Ray Source: an electronic brachytherapy source.

    Science.gov (United States)

    Rivard, Mark J; Davis, Stephen D; DeWerd, Larry A; Rusch, Thomas W; Axelrod, Steve

    2006-11-01

    A new x-ray source, the model S700 Axxent X-Ray Source (Source), has been developed by Xoft Inc. for electronic brachytherapy. Unlike brachytherapy sources containing radionuclides, this Source may be turned on and off at will and may be operated at variable currents and voltages to change the dose rate and penetration properties. The in-water dosimetry parameters for this electronic brachytherapy source have been determined from measurements and calculations at 40, 45, and 50 kV settings. Monte Carlo simulations of radiation transport utilized the MCNP5 code and the EPDL97-based mcplib04 cross-section library. Inter-tube consistency was assessed for 20 different Sources, measured with a PTW 34013 ionization chamber. As the Source is intended to be used for a maximum of ten treatment fractions, tube stability was also assessed. Photon spectra were measured using a high-purity germanium (HPGe) detector, and calculated using MCNP. Parameters used in the two-dimensional (2D) brachytherapy dosimetry formalism were determined. While the Source was characterized as a point due to the small anode size, S700 Source exhibited depth dose behavior similar to low-energy photon-emitting low dose rate sources 125I and l03Pd, yet with capability for variable and much higher dose rates and subsequently adjustable penetration capabilities. This paper presents the calculated and measured in-water brachytherapy dosimetry parameters for the model S700 Source at the aforementioned three operating voltages.

  4. Current status of brachytherapy in Korea: a national survey of radiation oncologists.

    Science.gov (United States)

    Kim, Haeyoung; Kim, Joo Young; Kim, Juree; Park, Won; Kim, Young Seok; Kim, Hak Jae; Kim, Yong Bae

    2016-07-01

    The aim of the present study was to acquire information on brachytherapy resources in Korea through a national survey of radiation oncologists. Between October 2014 and January 2015, a questionnaire on the current status of brachytherapy was distributed to all 86 radiation oncology departments in Korea. The questionnaire was divided into sections querying general information on human resources, brachytherapy equipment, and suggestions for future directions of brachytherapy policy in Korea. The response rate of the survey was 88.3%. The average number of radiation oncologists per center was 2.3. At the time of survey, 28 centers (36.8%) provided brachytherapy to patients. Among the 28 brachytherapy centers, 15 (53.5%) were located in in the capital Seoul and its surrounding metropolitan areas. All brachytherapy centers had a high-dose rate system using (192)Ir (26 centers) or (60)Co (two centers). Among the 26 centers using (192)Ir sources, 11 treated fewer than 40 patients per year. In the two centers using (60)Co sources, the number of patients per year was 16 and 120, respectively. The most frequently cited difficulties in performing brachytherapy were cost related. A total of 21 centers had a plan to sustain the current brachytherapy system, and four centers noted plans to upgrade their brachytherapy system. Two centers stated that they were considering discontinuation of brachytherapy due to cost burdens of radioisotope source replacement. The present study illustrated the current status of brachytherapy in Korea. Financial difficulties were the major barriers to the practice of brachytherapy.

  5. Comparison of radiation shielding requirements for HDR brachytherapy using 169Yb and 192Ir sources

    International Nuclear Information System (INIS)

    Lymperopoulou, G.; Papagiannis, P.; Sakelliou, L.; Georgiou, E.; Hourdakis, C. J.; Baltas, D.

    2006-01-01

    169 Yb has received a renewed focus lately as an alternative to 192 Ir sources for high dose rate (HDR) brachytherapy. Following the results of a recent work by our group which proved 169 Yb to be a good candidate for HDR prostate brachytherapy, this work seeks to quantify the radiation shielding requirements for 169 Yb HDR brachytherapy applications in comparison to the corresponding requirements for the current 192 Ir HDR brachytherapy standard. Monte Carlo simulation (MC) is used to obtain 169 Yb and 192 Ir broad beam transmission data through lead and concrete. Results are fitted to an analytical equation which can be used to readily calculate the barrier thickness required to achieve a given dose rate reduction. Shielding requirements for a HDR brachytherapy treatment room facility are presented as a function of distance, occupancy, dose limit, and facility workload, using analytical calculations for both 169 Yb and 192 Ir HDR sources. The barrier thickness required for 169 Yb is lower than that for 192 Ir by a factor of 4-5 for lead and 1.5-2 for concrete. Regarding 169 Yb HDR brachytherapy applications, the lead shielding requirements do not exceed 15 mm, even in highly conservative case scenarios. This allows for the construction of a lead door in most cases, thus avoiding the construction of a space consuming, specially designed maze. The effects of source structure, attenuation by the patient, and scatter conditions within an actual treatment room on the above-noted findings are also discussed using corresponding MC simulation results

  6. Calculated and measured brachytherapy dosimetry parameters in water for the Xoft Axxent X-Ray Source: An electronic brachytherapy source

    International Nuclear Information System (INIS)

    Rivard, Mark J.; Davis, Stephen D.; DeWerd, Larry A.; Rusch, Thomas W.; Axelrod, Steve

    2006-01-01

    A new x-ray source, the model S700 Axxent trade mark sign X-Ray Source (Source), has been developed by Xoft Inc. for electronic brachytherapy. Unlike brachytherapy sources containing radionuclides, this Source may be turned on and off at will and may be operated at variable currents and voltages to change the dose rate and penetration properties. The in-water dosimetry parameters for this electronic brachytherapy source have been determined from measurements and calculations at 40, 45, and 50 kV settings. Monte Carlo simulations of radiation transport utilized the MCNP5 code and the EPDL97-based mcplib04 cross-section library. Inter-tube consistency was assessed for 20 different Sources, measured with a PTW 34013 ionization chamber. As the Source is intended to be used for a maximum of ten treatment fractions, tube stability was also assessed. Photon spectra were measured using a high-purity germanium (HPGe) detector, and calculated using MCNP. Parameters used in the two-dimensional (2D) brachytherapy dosimetry formalism were determined. While the Source was characterized as a point due to the small anode size, P (5) were 0.20, 0.24, and 0.29 for the 40, 45, and 50 kV voltage settings, respectively. For 1 125 I and 103 Pd, yet with capability for variable and much higher dose rates and subsequently adjustable penetration capabilities. This paper presents the calculated and measured in-water brachytherapy dosimetry parameters for the model S700 Source at the aforementioned three operating voltages

  7. American College of Radiology-American Brachytherapy Society practice parameter for electronically generated low-energy radiation sources.

    Science.gov (United States)

    Devlin, Phillip M; Gaspar, Laurie E; Buzurovic, Ivan; Demanes, D Jeffrey; Kasper, Michael E; Nag, Subir; Ouhib, Zoubir; Petit, Joshua H; Rosenthal, Seth A; Small, William; Wallner, Paul E; Hartford, Alan C

    This collaborative practice parameter technical standard has been created between the American College of Radiology and American Brachytherapy Society to guide the usage of electronically generated low energy radiation sources (ELSs). It refers to the use of electronic X-ray sources with peak voltages up to 120 kVp to deliver therapeutic radiation therapy. The parameter provides a guideline for utilizing ELS, including patient selection and consent, treatment planning, and delivery processes. The parameter reviews the published clinical data with regard to ELS results in skin, breast, and other cancers. This technical standard recommends appropriate qualifications of the involved personnel. The parameter reviews the technical issues relating to equipment specifications as well as patient and personnel safety. Regarding suggestions for educational programs with regard to this parameter,it is suggested that the training level for clinicians be equivalent to that for other radiation therapies. It also suggests that ELS must be done using the same standards of quality and safety as those in place for other forms of radiation therapy. Copyright © 2017 American Brachytherapy Society and American College of Radiology. Published by Elsevier Inc. All rights reserved.

  8. Determining profile of dose distribution for PD-103 brachytherapy source

    International Nuclear Information System (INIS)

    Berkay, Camgoz; Mehmet, N. Kumru; Gultekin, Yegin

    2006-01-01

    Full text: Brachytherapy is a particular radiotherapy for cancer treatments. By destructing cancerous cells using radiation, the treatment proceeded. When alive tissues are subject it is hazardous to study experimental. For brachytherapy sources generally are studied as theoretical using computer simulation. General concept of the treatment is to locate the radioactive source into cancerous area of related tissue. In computer studies Monte Carlo mathematical method that is in principle based on random number generations, is used. Palladium radioisotope is LDR (Low radiation Dose Rate) source. Main radioactive material was coated with titanium cylinder with 3mm length, 0.25 mm radius. There are two parts of Pd-103 in the titanium cylinder. It is impossible to investigate differential effects come from two part as experimental. Because the source dimensions are small compared with measurement distances. So there is only simulation method. In dosimetric studies it is aimed to determine absorbed dose distribution in tissue as radial and angular. In nuclear physics it is obligation to use computer based methods for researchers. Radiation studies have hazards for scientist and people interacted with radiation. When hazard exceed over recommended limits or physical conditions are not suitable (long work time, non economical experiments, inadequate sensitivity of materials etc.) it is unavoidable to simulate works and experiments before practices of scientific methods in life. In medical area, usage of radiation is required computational work for cancer treatments. Some computational studies are routine in clinics and other studies have scientific development purposes. In brachytherapy studies there are significant differences between experimental measurements and theoretical (computer based) output data. Errors of data taken from experimental studies are larger than simulation values errors. In design of a new brachytherapy source it is important to consider detailed

  9. Development of the Dutch primary standard for beta-emitting brachytherapy sources

    International Nuclear Information System (INIS)

    Marel, J. an der; Dijk, E. van

    2002-01-01

    The application of β-radiation emitting radioactive sources in medicine is rapidly expanding. An important new application is the use of β-radiation emitting radioactive sources in endovascular brachytherapy to avoid restenosis. Another well-known application is the use of the ophthalmic applicator (flat or concave surface source) for the treatment of tumors in the eye. Dose and dose distributions are very important characteristics of brachytherapy sources. The absorbed dose in the treated tissue should be known accurately to assure a good quality of the treatment and to develop new treatment methods and source configurations. At the Nederland s Meetinstituut (NMi) a project is going on for the development of a primary standard for betadosimetry. With this standard, dose and dose distributions of β-sources as used in brachytherapy can be measured in terms of absorbed dose to water. The primary standard is based on an extrapolation chamber. The extrapolation chamber will become part of a quality assurance system in Dutch hospitals for endovascular brachytherapy sources. The quality assurance system will further consist of transfer standards like well-type ionisation chambers, plastic scintillator systems and radiochromic film dosimetry. Apart from the endovascular sources the extrapolation chamber will be used to characterize ophthalmic applicators

  10. Invited review, recent developments in brachytherapy source dosimetry

    International Nuclear Information System (INIS)

    Meigooni, A.S.

    2004-01-01

    Application of radioactive isotopes is the treatment of choice around the globe for many cancer sites. In this technique, the accuracy of the radiation delivery is highly dependent on the accuracy of radiation dosimetry around individual brachytherapy sources. Moreover, in order to have compatible clinical results, an identical method of source dosimetry must be employed across the world. This problem has been recently addressed by task group 43 from the American Association of Medical Physics with a protocol for dosimetric characterization of brachytherapy sources. This new protocol has been further updated using published data from international sources, by a new Task Group from the American Association of Medical Physics. This has resulted in an updated protocol known as TG43U1 that has been published in March 2004 issue of Medical Physics. The goal of this presentation is to review the original Task Group 43 protocol and associated algorithms for brachytherapy source dosimetry. In addition, the shortcomings of the original protocol that has been resolved in the updated recommendation will be highlighted. I am sure that this is not the end of the line and more work is needed to complete this task. I invite the scientists to join this task and complete the project, with the hope of much better clinical results for cancer patients

  11. 137Cs - Brachytherapy sources : a technology scenario

    International Nuclear Information System (INIS)

    Varma, R.N.

    2001-01-01

    Cancer has emerged as one of the major cause of morbidity and mortality all over the world. India houses world's second largest population and registers 4-5 lakhs new cancer cases every year. Cancer of cervix is most common form of malignancy among Indian women. Radiation therapy, especially intracavity brachytherapy in conjunction with other modalities like surgery, chemotherapy has been found to be highly effective for the management and control of cervical carcinoma at all stages. A technology has been developed indigenously for the fabrication of 137 Cs sources for brachytherapy applications

  12. Radiation safety program in high dose rate brachytherapy facility at INHS Asvini

    Directory of Open Access Journals (Sweden)

    Kirti Tyagi

    2014-01-01

    Full Text Available Brachytherapy concerns primarily the use of radioactive sealed sources which are inserted into catheters or applicators and placed directly into tissue either inside or very close to the target volume. The use of radiation in treatment of patients involves both benefits and risks. It has been reported that early radiation workers had developed radiation induced cancers. These incidents lead to continuous work for the improvement of radiation safety of patients and personnel The use of remote afterloading equipment has been developed to improve radiation safety in the delivery of treatment in brachytherapy. The widespread adoption of high dose rate brachytherapy needs appropriate quality assurance measures to minimize the risks to both patients and medical staff. The radiation safety program covers five major aspects: quality control, quality assurance, radiation monitoring, preventive maintenance, administrative measures and quality audit. This paper will discuss the radiation safety program developedfor a high dose rate brachytherapy facility at our centre which may serve as a guideline for other centres intending to install a similar facility.

  13. Developing A Directional High-Dose Rate (d-HDR) Brachytherapy Source

    Science.gov (United States)

    Heredia, Athena Yvonne

    Conventional sources used in brachytherapy provide nearly isotropic or radially symmetric dose distributions. Optimizations of dose distributions have been limited to varied dwell times at specified locations within a given treatment volume, or manipulations in source position for seed implantation techniques. In years past, intensity modulated brachytherapy (IMBT) has been used to reduce the amount of radiation to surrounding sensitive structures in select intracavitary cases by adding space or partial shields. Previous work done by Lin et al., at the University of Wisconsin-Madison, has shown potential improvements in conformality for brachytherapy treatments using a directionally shielded low dose rate (LDR) source for treatments in breast and prostate. Directional brachytherapy sources irradiate approximately half of the radial angles around the source, and adequately shield a quarter of the radial angles on the opposite side, with sharp gradient zones between the treated half and shielded quarter. With internally shielded sources, the radiation can be preferentially emitted in such a way as to reduce toxicities in surrounding critical organs. The objective of this work is to present findings obtained in the development of a new directional high dose rate (d-HDR) source. To this goal, 103Pd (Z = 46) is reintroduced as a potential radionuclide for use in HDR brachytherapy. 103Pd has a low average photon energy (21 keV) and relatively short half -life (17 days), which is why it has historically been used in low dose rate applications and implantation techniques. Pd-103 has a carrier-free specific activity of 75000 Ci/g. Using cyclotron produced 103Pd, near carrier-free specific activities can be achieved, providing suitability for high dose rate applications. The evolution of the d-HDR source using Monte Carlo simulations is presented, along with dosimetric parameters used to fully characterize the source. In addition, a discussion on how to obtain elemental

  14. Radiation therapy sources, equipment and installations

    International Nuclear Information System (INIS)

    2011-03-01

    The safety code for Telegamma Therapy Equipment and Installations, (AERB/SC/MED-1) and safety code for Brachytherapy Sources, Equipment and Installations, (AERB/SC/MED-3) were issued by AERB in 1986 and 1988 respectively. These codes specified mandatory requirements for radiation therapy facilities, covering the entire spectrum of operations ranging from the setting up of a facility to its ultimate decommissioning, including procedures to be followed during emergency situations. The codes also stipulated requirements of personnel and their responsibilities. With the advent of new techniques and equipment such as 3D-conformal radiation therapy, intensity modulated radiation therapy, image guided radiation therapy, treatment planning system, stereotactic radiosurgery, stereotactic radiotherapy, portal imaging, integrated brachytherapy and endovascular brachytherapy during the last two decades, AERB desires that these codes be revised and merged into a single code titled Radiation Therapy Sources, Equipment, and Installations

  15. A brachytherapy photon radiation quality index Q(BT) for probe-type dosimetry.

    Science.gov (United States)

    Quast, Ulrich; Kaulich, Theodor W; Álvarez-Romero, José T; Carlsson Tedgren, Sa; Enger, Shirin A; Medich, David C; Mourtada, Firas; Perez-Calatayud, Jose; Rivard, Mark J; Zakaria, G Abu

    2016-06-01

    In photon brachytherapy (BT), experimental dosimetry is needed to verify treatment plans if planning algorithms neglect varying attenuation, absorption or scattering conditions. The detector's response is energy dependent, including the detector material to water dose ratio and the intrinsic mechanisms. The local mean photon energy E¯(r) must be known or another equivalent energy quality parameter used. We propose the brachytherapy photon radiation quality indexQ(BT)(E¯), to characterize the photon radiation quality in view of measurements of distributions of the absorbed dose to water, Dw, around BT sources. While the external photon beam radiotherapy (EBRT) radiation quality index Q(EBRT)(E¯)=TPR10(20)(E¯) is not applicable to BT, the authors have applied a novel energy dependent parameter, called brachytherapy photon radiation quality index, defined as Q(BT)(E¯)=Dprim(r=2cm,θ0=90°)/Dprim(r0=1cm,θ0=90°), utilizing precise primary absorbed dose data, Dprim, from source reference databases, without additional MC-calculations. For BT photon sources used clinically, Q(BT)(E¯) enables to determine the effective mean linear attenuation coefficient μ¯(E) and thus the effective energy of the primary photons Eprim(eff)(r0,θ0) at the TG-43 reference position Pref(r0=1cm,θ0=90°), being close to the mean total photon energy E¯tot(r0,θ0). If one has calibrated detectors, published E¯tot(r) and the BT radiation quality correction factor [Formula: see text] for different BT radiation qualities Q and Q0, the detector's response can be determined and Dw(r,θ) measured in the vicinity of BT photon sources. This novel brachytherapy photon radiation quality indexQ(BT) characterizes sufficiently accurate and precise the primary photon's penetration probability and scattering potential. Copyright © 2016. Published by Elsevier Ltd.

  16. 10 CFR 35.406 - Brachytherapy sources accountability.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Brachytherapy sources accountability. 35.406 Section 35....406 Brachytherapy sources accountability. (a) A licensee shall maintain accountability at all times... area. (c) A licensee shall maintain a record of the brachytherapy source accountability in accordance...

  17. Study of two different radioactive sources for prostate brachytherapy treatment

    International Nuclear Information System (INIS)

    Pereira Neves, Lucio; Perini, Ana Paula; Souza Santos, William de; Caldas, Linda V.E.; Belinato, Walmir

    2015-01-01

    In this study we evaluated two radioactive sources for brachytherapy treatments. Our main goal was to quantify the absorbed doses on organs and tissues of an adult male patient, submitted to a brachytherapy treatment with two radioactive sources. We evaluated a 192 Ir and a 125 I radioactive sources. The 192 Ir radioactive source is a cylinder with 0.09 cm in diameter and 0.415 cm long. The 125 I radioactive source is also a cylinder, with 0.08 cm in diameter and 0.45 cm long. To evaluate the absorbed dose distribution on the prostate, and other organs and tissues of an adult man, a male virtual anthropomorphic phantom MASH, coupled in the radiation transport code MCNPX 2.7.0, was employed.We simulated 75, 90 and 102 radioactive sources of 125 I and one of 192 Ir, inside the prostate, as normally used in these treatments, and each treatment was simulated separately. As this phantom was developed in a supine position, the displacement of the internal organs of the chest, compression of the lungs and reduction of the sagittal diameter were all taken into account. For the 192 Ir, the higher doses values were obtained for the prostate and surrounding organs, as the colon, gonads and bladder. Considering the 125 I sources, with photons with lower energies, the doses to organs that are far from the prostate were lower. All values for the dose rates are in agreement with those recommended for brachytherapy treatments. Besides that, the new seeds evaluated in this work present usefulness as a new tool in prostate brachytherapy treatments, and the methodology employed in this work may be applied for other radiation sources, or treatments. (authors)

  18. Study of two different radioactive sources for prostate brachytherapy treatment

    Energy Technology Data Exchange (ETDEWEB)

    Pereira Neves, Lucio; Perini, Ana Paula [Instituto de Fisica, Universidade Federal de Uberlandia, Caixa Postal 593, 38400-902, Uberlandia, MG (Brazil); Souza Santos, William de; Caldas, Linda V.E. [Instituto de Pesquisas Energeticas e Nucleares, Comissao Nacional de Energia Nuclear, IPENCNEN/SP, Av. Prof. Lineu Prestes, 2242, Cidade Universitaria, 05508-000 Sao Paulo, SP (Brazil); Belinato, Walmir [Departamento de Ensino, Instituto Federal de Educacao, Ciencia e Tecnologia da Bahia, Campus Vitoria da Conquista, Zabele, Av. Amazonas 3150, 45030-220 Vitoria da Conquista, BA (Brazil)

    2015-07-01

    In this study we evaluated two radioactive sources for brachytherapy treatments. Our main goal was to quantify the absorbed doses on organs and tissues of an adult male patient, submitted to a brachytherapy treatment with two radioactive sources. We evaluated a {sup 192}Ir and a {sup 125}I radioactive sources. The {sup 192}Ir radioactive source is a cylinder with 0.09 cm in diameter and 0.415 cm long. The {sup 125}I radioactive source is also a cylinder, with 0.08 cm in diameter and 0.45 cm long. To evaluate the absorbed dose distribution on the prostate, and other organs and tissues of an adult man, a male virtual anthropomorphic phantom MASH, coupled in the radiation transport code MCNPX 2.7.0, was employed.We simulated 75, 90 and 102 radioactive sources of {sup 125}I and one of {sup 192}Ir, inside the prostate, as normally used in these treatments, and each treatment was simulated separately. As this phantom was developed in a supine position, the displacement of the internal organs of the chest, compression of the lungs and reduction of the sagittal diameter were all taken into account. For the {sup 192}Ir, the higher doses values were obtained for the prostate and surrounding organs, as the colon, gonads and bladder. Considering the {sup 125}I sources, with photons with lower energies, the doses to organs that are far from the prostate were lower. All values for the dose rates are in agreement with those recommended for brachytherapy treatments. Besides that, the new seeds evaluated in this work present usefulness as a new tool in prostate brachytherapy treatments, and the methodology employed in this work may be applied for other radiation sources, or treatments. (authors)

  19. EVALUATION OF BRACHYTHERAPY FACILITY SHIELDING STATUS IN KOREA OBTAINED FROM RADIATION SAFETY REPORTS

    Directory of Open Access Journals (Sweden)

    MI HYUN KEUM

    2013-10-01

    Full Text Available Thirty-eight radiation safety reports for brachytherapy equipment were evaluated to determine the current status of brachytherapy units in Korea and to assess how radiation oncology departments in Korea complete radiation safety reports. The following data was collected: radiation safety report publication year, brachytherapy unit manufacturer, type and activity of the source that was used, affiliation of the drafter, exposure rate constant, the treatment time used to calculate workload and the HVL values used to calculate shielding design goal values. A significant number of the reports (47.4% included the personal information of the drafter. The treatment time estimates varied widely from 12 to 2,400 min/week. There was acceptable variation in the exposure rate constant values (ranging between 0.469 and 0.592 (R-m2/Ci·hr, as well as in the HVLs of concrete, steel and lead for Iridium-192 sources that were used to calculate shielding design goal values. There is a need for standard guidelines for completing radiation safety reports that realistically reflect the current clinical situation of radiation oncology departments in Korea. The present study may be useful for formulating these guidelines.

  20. Conceptual source design and dosimetric feasibility study for intravascular treatment: a proposal for intensity modulated brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Si Yong; Han, Eun Young; Palta, Jatinder R. [College of Medicine, Florida Univ., Florida (United States); Ha, Sung W. [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2003-06-01

    To propose a conceptual design of a novel source for intensity modulated brachytherapy. The source design incorporates both radioactive and shielding materials (stainless steel or tungsten), to provide an asymmetric dose intensity in the azimuthal direction. The intensity modulated intravascular brachytherapy was performed by combining a series of dwell positions and times, distributed along the azimuthal coordinates. Two simple designs for the beta-emitting sources, with similar physical dimensions to a {sub 90}Sr/Y Novoste Beat-Cath source, were considered in the dosimetric feasibility study. In the first design, the radioactive and materials each occupy half of the cylinder and in the second, the radioactive material occupies only a quarter of the cylinder. The radial and azimuthal dose distributions around each source were calculated using the MCNP Monte Carlo code. The preliminary hypothetical simulation and optimization results demonstrated the 87% difference between the maximum and minimum doses to the lumen wall, due to off-centering of the radiation source, could be reduced to less than 7% by optimizing the azimuthal dwell positions and times of the partially shielded intravascular brachytherapy sources. The novel brachytherapy source design, and conceptual source delivery system, proposed in this study show promising dosimetric characteristics for the realization of intensity modulated brachytherapy in intravascular treatment. Further development of this concept will center on building a delivery system that can precisely control the angular motion of a radiation source in a small-diameter catheter.

  1. Conceptual source design and dosimetric feasibility study for intravascular treatment: a proposal for intensity modulated brachytherapy

    International Nuclear Information System (INIS)

    Kim, Si Yong; Han, Eun Young; Palta, Jatinder R.; Ha, Sung W.

    2003-01-01

    To propose a conceptual design of a novel source for intensity modulated brachytherapy. The source design incorporates both radioactive and shielding materials (stainless steel or tungsten), to provide an asymmetric dose intensity in the azimuthal direction. The intensity modulated intravascular brachytherapy was performed by combining a series of dwell positions and times, distributed along the azimuthal coordinates. Two simple designs for the beta-emitting sources, with similar physical dimensions to a 90 Sr/Y Novoste Beat-Cath source, were considered in the dosimetric feasibility study. In the first design, the radioactive and materials each occupy half of the cylinder and in the second, the radioactive material occupies only a quarter of the cylinder. The radial and azimuthal dose distributions around each source were calculated using the MCNP Monte Carlo code. The preliminary hypothetical simulation and optimization results demonstrated the 87% difference between the maximum and minimum doses to the lumen wall, due to off-centering of the radiation source, could be reduced to less than 7% by optimizing the azimuthal dwell positions and times of the partially shielded intravascular brachytherapy sources. The novel brachytherapy source design, and conceptual source delivery system, proposed in this study show promising dosimetric characteristics for the realization of intensity modulated brachytherapy in intravascular treatment. Further development of this concept will center on building a delivery system that can precisely control the angular motion of a radiation source in a small-diameter catheter

  2. International Standardization of the Clinical Dosimetry of Beta Radiation Brachytherapy Sources: Progress of an ISO Standard

    Science.gov (United States)

    Soares, Christopher

    2006-03-01

    In 2004 a new work item proposal (NWIP) was accepted by the International Organization for Standardization (ISO) Technical Committee 85 (TC85 -- Nuclear Energy), Subcommittee 2 (Radiation Protection) for the development of a standard for the clinical dosimetry of beta radiation sources used for brachytherapy. To develop this standard, a new Working Group (WG 22 - Ionizing Radiation Dosimetry and Protocols in Medical Applications) was formed. The standard is based on the work of an ad-hoc working group initiated by the Dosimetry task group of the Deutsches Insitiut für Normung (DIN). Initially the work was geared mainly towards the needs of intravascular brachytherapy, but with the decline of this application, more focus has been placed on the challenges of accurate dosimetry for the concave eye plaques used to treat ocular melanoma. Guidance is given for dosimetry formalisms, reference data to be used, calibrations, measurement methods, modeling, uncertainty determinations, treatment planning and reporting, and clinical quality control. The document is currently undergoing review by the ISO member bodies for acceptance as a Committee Draft (CD) with publication of the final standard expected by 2007. There are opportunities for other ISO standards for medical dosimetry within the framework of WG22.

  3. Sci-Thur PM – Brachytherapy 04: Commissioning and Implementation of a Cobalt-60 High Dose Rate Brachytherapy Source

    Energy Technology Data Exchange (ETDEWEB)

    Dysart, Jonathan [Horizon Health Network (Canada)

    2016-08-15

    An Eckert & Ziegler Bebig Co0.A86 cobalt 60 high dose rate (HDR) brachytherapy source was commissioned for clinical use. Long-lived Co-60 HDR sources offer potential logistical and economic advantages over Ir-192 sources, and should be considered for low to medium workload brachytherapy departments where modest increases in treatment times are not a factor. In optimized plans, the Co-60 source provides a similar dose distribution to Ir-192 despite the difference in radiation energy. By switching to Co-60, source exchange frequency can be reduced by a factor of 20, resulting in overall financial savings of more than 50% compared to Ir-192 sources. In addition, a reduction in Physicist QA workload of roughly 200 hours over the 5 year life of the Co-60 source is also expected. These benefits should be considered against the modest increases in average treatment time compared to those of Ir-192 sources, as well as the centre-specific needs for operating room shielding modification.

  4. 10 CFR 35.2406 - Records of brachytherapy source accountability.

    Science.gov (United States)

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Records of brachytherapy source accountability. 35.2406... Records of brachytherapy source accountability. (a) A licensee shall maintain a record of brachytherapy source accountability required by § 35.406 for 3 years. (b) For temporary implants, the record must...

  5. Brachytherapy

    Science.gov (United States)

    ... the use of a type of energy, called ionizing radiation, to kill cancer cells and shrink tumors. External ... In all cases of brachytherapy, the source of radiation is encapsulated ... non-radioactive metallic capsule. This prevents the radioactive materials ...

  6. Radiation protection in brachytherapy

    International Nuclear Information System (INIS)

    Benitez, Manuel

    1996-02-01

    It covers technical procedures in medical applications for cancer treatment. Radiation protection principles in brachytherapy. Medical uses in therapy for Sr-90, Cs-137, Co-60, Ra-226, Ir-192, Au-198, Bi-214, Pb-214. (The author)

  7. Radioactive sources in brachytherapy:

    OpenAIRE

    Burger, Janez

    2003-01-01

    Background. In modern brachytherapy, a greast step forward was made in the 1960s in France with the introduction of new radioactive isotopes and new techniques. These innovations spread rapidly across Europe, though no single dosimetry standard had been set by then. In the new millennium, the advances in brachytherapy are further stimulated by the introduction of 3-D imaging techniques and the latest after loading irradiation equipment that use point sources. The international organiyation IC...

  8. Tracking brachytherapy sources using emission imaging with one flat panel detector

    International Nuclear Information System (INIS)

    Song Haijun; Bowsher, James; Das, Shiva; Yin Fangfang

    2009-01-01

    This work proposes to use the radiation from brachytherapy sources to track their dwell positions in three-dimensional (3D) space. The prototype device uses a single flat panel detector and a BB tray. The BBs are arranged in a defined pattern. The shadow of the BBs on the flat panel is analyzed to derive the 3D coordinates of the illumination source, i.e., the dwell position of the brachytherapy source. A kilovoltage x-ray source located 3.3 m away was used to align the center BB with the center pixel on the flat panel detector. For a test plan of 11 dwell positions, with an Ir-192 high dose rate unit, one projection was taken for each dwell point, and locations of the BB shadows were manually identified on the projection images. The 3D coordinates for the 11 dwell positions were reconstructed based on two BBs. The distances between dwell points were compared with the expected values. The average difference was 0.07 cm with a standard deviation of 0.15 cm. With automated BB shadow recognition in the future, this technique possesses the potential of tracking the 3D trajectory and the dwell times of a brachytherapy source in real time, enabling real time source position verification.

  9. Guidelines for the calibration of low energy photon sources at beta-ray brachytherapy sources

    International Nuclear Information System (INIS)

    2000-01-01

    With the development of improved methods of implanting brachytherapy sources in a precise manner for treating prostate cancer and other disease processes, there has been a tremendous growth in the use of low energy photon sources, such as 125 I and 103 Pd brachytherapy seeds. Low energy photon sources have the advantage of easier shielding and also lowering the dose to normal tissue. However, the dose distributions around these sources are affected by the details in construction of the source and its encapsulation more than other sources used for brachytherapy treatments, such as 192 Ir. With increasing number of new low energy photon sources on the market, care should be taken with regard to its traceability to primary standards. It cannot be assumed that a calibration factor for an ionization chamber that is valid for one type of low energy photon source, automatically is valid for another source even if both would use the same isotope. Moreover, the method used to calculate the dose must also take into account the structure of the source and the encapsulation. The dose calculation algorithm that is valid for one type of low energy source may not be valid for another source even if in both cases the same radionuclide is used. Simple ''point source'' approximations, i.e. where the source is modeled as a point, should be avoided, as such methods do not account for any details in the source construction. In this document, the dose calculation formalism adopted for low energy photon sources is that recommended by the American Association of Physicists in Medicine (AAPM) as outlined by Task Group-43 (TG-43). This method accounts for the source and capsule geometry. The AAPM recommends brachytherapy photon sources to be specified in terms of 'Air Kerma Strength' that is also used in the formalism mentioned above. On the other hand, the International Commission on Radiation Units and Measurements (ICRU) recommends that the specification be done in terms of Reference Air

  10. Air core detectors for Cerenkov-free scintillation dosimetry of brachytherapy β-sources.

    Science.gov (United States)

    Eichmann, Marion; Thomann, Benedikt

    2017-09-01

    Plastic scintillation detectors are used for dosimetry in small radiation fields with high dose gradients, e.g., provided by β-emitting sources like 106 Ru/ 106 Rh eye plaques. A drawback is a background signal caused by Cerenkov radiation generated by electrons passing the optical fibers (light guides) of this dosimetry system. Common approaches to correct for the Cerenkov signal are influenced by uncertainties resulting from detector positioning and calibration procedures. A different approach to avoid any correction procedure is to suppress the Cerenkov signal by replacing the solid core optical fiber with an air core light guide, previously shown for external beam therapy. In this study, the air core concept is modified and applied to the requirements of dosimetry in brachytherapy, proving its usability for measuring water energy doses in small radiation fields. Three air core detectors with different air core lengths are constructed and their performance in dosimetry for brachytherapy β-sources is compared with a standard two-fiber system, which uses a second fiber for Cerenkov correction. The detector systems are calibrated with a 90 Sr/ 90 Y secondary standard and tested for their angular dependence as well as their performance in depth dose measurements of 106 Ru/ 106 Rh sources. The signal loss relative to the standard detector increases with increasing air core length to a maximum value of 58.3%. At the same time, however, the percentage amount of Cerenkov light in the total signal is reduced from at least 12.1% to a value below 1.1%. There is a linear correlation between induced dose and measured signal current. The air core detectors determine the dose rates for 106 Ru/ 106 Rh sources without any form of correction for the Cerenkov signal. The air core detectors show advantages over the standard two-fiber system especially when measuring in radiation fields with high dose gradients. They can be used as simple one-fiber systems and allow for an almost

  11. Estimation of whole-body radiation exposure from brachytherapy for oral cancer using a Monte Carlo simulation

    International Nuclear Information System (INIS)

    Ozaki, Y.; Watanabe, H.; Kaida, A.; Miura, M.; Nakagawa, K.; Toda, K.; Yoshimura, R.; Sumi, Y.; Kurabayashi, T.

    2017-01-01

    Early stage oral cancer can be cured with oral brachytherapy, but whole-body radiation exposure status has not been previously studied. Recently, the International Commission on Radiological Protection Committee (ICRP) recommended the use of ICRP phantoms to estimate radiation exposure from external and internal radiation sources. In this study, we used a Monte Carlo simulation with ICRP phantoms to estimate whole-body exposure from oral brachytherapy. We used a Particle and Heavy Ion Transport code System (PHITS) to model oral brachytherapy with 192 Ir hairpins and 198 Au grains and to perform a Monte Carlo simulation on the ICRP adult reference computational phantoms. To confirm the simulations, we also computed local dose distributions from these small sources, and compared them with the results from Oncentra manual Low Dose Rate Treatment Planning (mLDR) software which is used in day-to-day clinical practice. We successfully obtained data on absorbed dose for each organ in males and females. Sex-averaged equivalent doses were 0.547 and 0.710 Sv with 192 Ir hairpins and 198 Au grains, respectively. Simulation with PHITS was reliable when compared with an alternative computational technique using mLDR software. We concluded that the absorbed dose for each organ and whole-body exposure from oral brachytherapy can be estimated with Monte Carlo simulation using PHITS on ICRP reference phantoms. Effective doses for patients with oral cancer were obtained.

  12. Iridium-192 sources production for brachytherapy use

    International Nuclear Information System (INIS)

    Rostelato, Maria Elisa Chuery Martins

    1997-01-01

    The incidence of cancer increases every year in Brazil and turns out to be one of the most important causes of mortality. Some of the patients are treated with brachytherapy, a form of lesion treatment which is based on the insertion of sources into tumors, in this particular case, activated iridium wires. During this process, the ionizing radiation efficiently destroys the malignant cells. These iridium wires have a nucleus made out of an iridium-platinum alloy 20-30/70-80 of 0,1 mm in diameter either coated by platinum or encased in a platinum tube. The technique consists in irradiating the wire in the reactor neutron flux in order to produce iridium-192. The linear activity goes from 1 mCi/cm to 4 mCi/cm and the basic characteristic, which is required, is the homogeneity of the activation along the wire. It should not present a dispersion exceeding 5% on a wire measuring 50 cm in length, 0.5 mm or 0.3 mm in diameter. Several experiments were carried out in order to define the activation parameters. Wires from different origins were analyzed. It was concluded that United States of America and France wires were found to be perfectly adequate for brachytherapy purposes and have therefore been sent to specialized hospitals and successfully applied to cancer patients. Considering that the major purpose of this work is to make this product more accessible in Brazil, at a cost reflecting the Brazilian reality, the IPEN is promoting the preparation of iridium-192 sources to be used in brachytherapy, on a national level. (author)

  13. Monte Carlo Simulations Validation Study: Vascular Brachytherapy Beta Sources

    International Nuclear Information System (INIS)

    Orion, I.; Koren, K.

    2004-01-01

    During the last decade many versions of angioplasty irradiation treatments have been proposed. The purpose of this unique brachytherapy is to administer a sufficient radiation dose into the vein walls in order to prevent restonosis, a clinical sequel to balloon angioplasty. The most suitable sources for this vascular brachytherapy are the β - emitters such as Re-188, P-32, and Sr-90/Y-90, with a maximum energy range of up to 2.1 MeV [1,2,3]. The radioactive catheters configurations offered for these treatments can be a simple wire [4], a fluid filled balloon or a coated stent. Each source is differently positioned inside the blood vessel, and the emitted electrons ranges therefore vary. Many types of sources and configurations were studied either experimentally or with the use of the Monte Carlo calculation technique, while most of the Monte Carlo simulations were carried out using EGS4 [5] or MCNP [6]. In this study we compared the beta-source absorbed-dose versus radial-distance of two treatment configurations using MCNP and EGS4 simulations. This comparison was aimed to discover the differences between the MCNP and the EGS4 simulation code systems in intermediate energies electron transport

  14. Brachytherapy. High dose rate brachytherapy - Radiation protection: medical sheet ED 4287

    International Nuclear Information System (INIS)

    Celier, D.; Aubert, B.; Vidal, J.P.; Biau, A.; Lahaye, T.; Gauron, C.; Barret, C.; Boisserie, G.; Branchet, E.; Gambini, D.; Gondran, C.; Le Guen, B.; Guerin, C.; Nguyen, S.; Pierrat, N.; Sarrazin, T.; Donnarieix, D.

    2010-02-01

    After having indicated the required authorization to implement brachytherapy techniques, this document presents the various aspects and measures related to radiation protection when performing high-dose-rate brachytherapy treatments. It presents the concerned personnel, describes the operational process, indicates the associated hazards and the risk related to ionizing radiation, and describes how the risk is to be assessed and how exposure levels are to be determined (elements of risk assessment, delimitation of controlled and monitored areas, personnel classification, and choice of the dose monitoring method). It describes the various components of a risk management strategy (risk reduction, technical measures regarding the installation and the personnel, training and information, prevention and medical monitoring). It briefly presents how risk management is to be assessed, and mentions other related risks (biological risk, handling and posture, handling of heavy loads, mental workload, chemical risk)

  15. Brachytherapy. Pulsed dose rate brachytherapy - Radiation protection: medical sheet ED 4250

    International Nuclear Information System (INIS)

    Celier, D.; Aubert, B.; Vidal, J.P.; Biau, A.; Lahaye, T.; Gauron, C.; Barret, C.; Boisserie, G.; Branchet, E.; Gambini, D.; Gondran, C.; Le Guen, B.; Guerin, C.; Nguyen, S.; Pierrat, N.; Sarrazin, T.; Donnarieix, D.

    2009-06-01

    After having indicated the required authorization to implement brachytherapy techniques, this document presents the various aspects and measures related to radiation protection when performing pulsed-dose-rate brachytherapy treatments. It presents the concerned personnel, describes the operational process, indicates the associated hazards and the risk related to ionizing radiation, and describes how the risk is to be assessed and how exposure levels are to be determined (elements of risk assessment, delimitation of controlled and monitored areas, personnel classification, and choice of the dose monitoring method). It describes the various components of a risk management strategy (risk reduction, technical measures regarding the installation and the personnel, training and information, prevention and medical monitoring). It briefly presents how risk management is to be assessed, and mentions other related risks (biological risk, handling and posture, handling of heavy loads, mental workload, chemical risk)

  16. The theoretical basis and clinical methodology for stereotactic interstitial brain tumor irradiation using iododeoxyuridine as a radiation sensitizer and samarium-145 as a brachytherapy source

    International Nuclear Information System (INIS)

    Goodman, J.H.; Gahbauer, R.A.; Kanellitsas, C.; Clendenon, N.R.; Laster, B.H.; Fairchild, R.G.

    1989-01-01

    High grade astrocytomas have proven resistant to all conventional therapy. A technique to produce radiation enhancement during interstitial brain tumor irradiation by using a radiation sensitizer (IdUrd) and by stimulation of Auger electron cascades through absorption of low energy photons in iodine (Photon activation) is described. Clinical studies using IdUrd, 192 Ir as a brachytherapy source, and external radiation have produced promising results. Substituting samarium-145 for 192 Ir in this protocol is expected to produce enhanced results. 15 refs

  17. Definition of medical event is to be based on the total source strength for evaluation of permanent prostate brachytherapy: A report from the American Society for Radiation Oncology.

    Science.gov (United States)

    Nag, Subir; Demanes, D Jeffrey; Hagan, Michael; Rivard, Mark J; Thomadsen, Bruce R; Welsh, James S; Williamson, Jeffrey F

    2011-10-01

    The Nuclear Regulatory Commission deems it to be a medical event (ME) if the total dose delivered differs from the prescribed dose by 20% or more. A dose-based definition of ME is not appropriate for permanent prostate brachytherapy as it generates too many spurious MEs and thereby creates unnecessary apprehension in patients, and ties up regulatory bodies and the licensees in unnecessary and burdensome investigations. A more suitable definition of ME is required for permanent prostate brachytherapy. The American Society for Radiation Oncology (ASTRO) formed a working group of experienced clinicians to review the literature, assess the validity of current regulations, and make specific recommendations about the definition of an ME in permanent prostate brachytherapy. The working group found that the current definition of ME in §35.3045 as "the total dose delivered differs from the prescribed dose by 20 percent or more" was not suitable for permanent prostate brachytherapy since the prostate volume (and hence the resultant calculated prostate dose) is dependent on the timing of the imaging, the imaging modality used, the observer variability in prostate contouring, the planning margins used, inadequacies of brachytherapy treatment planning systems to calculate tissue doses, and seed migration within and outside the prostate. If a dose-based definition for permanent implants is applied strictly, many properly executed implants would be improperly classified as an ME leading to a detrimental effect on brachytherapy. The working group found that a source strength-based criterion, of >20% of source strength prescribed in the post-procedure written directive being implanted outside the planning target volume is more appropriate for defining ME in permanent prostate brachytherapy. ASTRO recommends that the definition of ME for permanent prostate brachytherapy should not be dose based but should be based upon the source strength (air-kerma strength) administered.

  18. Primary calibration of coiled 103Pd brachytherapy sources

    International Nuclear Information System (INIS)

    Paxton, Adam B.; Culberson, Wesley S.; DeWerd, Larry A.; Micka, John A.

    2008-01-01

    Coiled 103 Pd brachytherapy sources have been developed by RadioMed Corporation for use as low-dose-rate (LDR) interstitial implants. The coiled sources are provided in integer lengths from 1 to 6 cm and address many common issues seen with traditional LDR brachytherapy sources. The current standard for determining the air-kerma strength (S K ) of low-energy LDR brachytherapy sources is the National Institute of Standards and Technology's Wide-Angle Free-Air Chamber (NIST WAFAC). Due to geometric limitations, however, the NIST WAFAC is unable to determine the S K of sources longer than 1 cm. This project utilized the University of Wisconsin's Variable-Aperture Free-Air Chamber (UW VAFAC) to determine the S K of the longer coiled sources. The UW VAFAC has shown agreement in S K values of 1 cm length coils to within 1% of those determined with the NIST WAFAC, but the UW VAFAC does not share the same geometric limitations as the NIST WAFAC. A new source holder was constructed to hold the coiled sources in place during measurements with the UW VAFAC. Correction factors for the increased length of the sources have been determined and applied to the measurements. Using the new source holder and corrections, the S K of 3 and 6 cm coiled sources has been determined. Corrected UW VAFAC data and ionization current measurements from well chambers have been used to determine calibration coefficients for use in the measurement of 3 and 6 cm coiled sources in well chambers. Thus, the UW VAFAC has provided the first transferable, primary measurement of low-energy LDR brachytherapy sources with lengths greater than 1 cm

  19. About brachytherapy for the handling of cancer

    International Nuclear Information System (INIS)

    Campos, Tarcisio P.R.; Silva, Nilton O.; Damaso, Renato S.; Costa, Helder R.; Borges, Paulo H.R.; Mendes, Bruno M.

    2000-01-01

    The technique of brachytherapy is argued in this article. The 'hardware' and 'necessary software' for the handling are summarily presented. Being the macro-dosimetry an important stage in the radiation therapy procedure, a simplified method of doses evaluation in conventional brachytherapy is presented. In an illustrative form, isodoses of a three-dimensional distribution of linear sources are drawn on a digitalized X-ray picture, exemplifying the handling of breast brachytherapy by sources of iridium

  20. Third-party brachytherapy source calibrations and physicist responsibilities: Report of the AAPM Low Energy Brachytherapy Source Calibration Working Group

    International Nuclear Information System (INIS)

    Butler, Wayne M.; Bice, William S. Jr.; DeWerd, Larry A.; Hevezi, James M.; Huq, M. Saiful; Ibbott, Geoffrey S.; Palta, Jatinder R.; Rivard, Mark J.; Seuntjens, Jan P.; Thomadsen, Bruce R.

    2008-01-01

    The AAPM Low Energy Brachytherapy Source Calibration Working Group was formed to investigate and recommend quality control and quality assurance procedures for brachytherapy sources prior to clinical use. Compiling and clarifying recommendations established by previous AAPM Task Groups 40, 56, and 64 were among the working group's charges, which also included the role of third-party handlers to perform loading and assay of sources. This document presents the findings of the working group on the responsibilities of the institutional medical physicist and a clarification of the existing AAPM recommendations in the assay of brachytherapy sources. Responsibility for the performance and attestation of source assays rests with the institutional medical physicist, who must use calibration equipment appropriate for each source type used at the institution. Such equipment and calibration procedures shall ensure secondary traceability to a national standard. For each multi-source implant, 10% of the sources or ten sources, whichever is greater, are to be assayed. Procedures for presterilized source packaging are outlined. The mean source strength of the assayed sources must agree with the manufacturer's stated strength to within 3%, or action must be taken to resolve the difference. Third party assays do not absolve the institutional physicist from the responsibility to perform the institutional measurement and attest to the strength of the implanted sources. The AAPM leaves it to the discretion of the institutional medical physicist whether the manufacturer's or institutional physicist's measured value should be used in performing dosimetry calculations

  1. A comparison study on various low energy sources in interstitial prostate brachytherapy.

    Science.gov (United States)

    Bakhshabadi, Mahdi; Ghorbani, Mahdi; Khosroabadi, Mohsen; Knaup, Courtney; Meigooni, Ali S

    2016-02-01

    Low energy sources are routinely used in prostate brachytherapy. (125)I is one of the most commonly used sources. Low energy (131)Cs source was introduced recently as a brachytherapy source. The aim of this study is to compare dose distributions of (125)I, (103)Pd, and (131)Cs sources in interstitial brachytherapy of prostate. ProstaSeed (125)I brachytherapy source was simulated using MCNPX Monte Carlo code. Additionally, two hypothetical sources of (103)Pd and (131)Cs were simulated with the same geometry as the ProstaSeed (125)I source, while having their specific emitted gamma spectra. These brachytherapy sources were simulated with distribution of forty-eight seeds in a phantom including prostate. The prostate was considered as a sphere with radius of 1.5 cm. Absolute and relative dose rates were obtained in various distances from the source along the transverse and longitudinal axes inside and outside the tumor. Furthermore, isodose curves were plotted around the sources. Analyzing the initial dose profiles for various sources indicated that with the same time duration and air kerma strength, (131)Cs delivers higher dose to tumor. However, relative dose rate inside the tumor is higher and outside the tumor is lower for the (103)Pd source. The higher initial absolute dose in cGy/(h.U) of (131)Cs brachytherapy source is an advantage of this source over the others. The higher relative dose inside the tumor and lower relative dose outside the tumor for the (103)Pd source are advantages of this later brachytherapy source. Based on the total dose the (125)I source has advantage over the others due to its longer half-life.

  2. Radiographic Control of 137-Cs Brachytherapy Sources

    International Nuclear Information System (INIS)

    Bistrovic, M.; Viculin, T.; Jurkovic, S.

    2003-01-01

    1 37C s brachytherapy sources are practical for the intracavitary application due to their relatively long lifetime (T 1/2 = 30 y). On the other hand, due to the relatively low energy (0.66 MeV) of the emitted photons, they are suitable for an efficient radiation protection. The dose distribution around the sources is usually calculated by a specific program. However this program requires the knowledge of the position of sources within the applicator as well as the distribution of activity along them. The only way to learn these data is to make an X-ray picture of applicators and sources superimposed to the autoradiography of every source. It is difficult to achieve satisfactory radiographs with high dose rate sources with standard X-ray film material because autoradiography covers the structure of the radiographic shadow. The problem can be overcome either by applying a high intensity X-ray or gamma beam (originating from a radiotherapeutic machine), or by using photographic material of very low sensitivity, for example photographic paper. Combining both possibilities one can obtain satisfactory images. (author)

  3. Calibration of photon and beta ray sources used in brachytherapy. Guidelines on standardized procedures at Secondary Standards Dosimetry Laboratories

    International Nuclear Information System (INIS)

    2004-03-01

    cardiovascular interventions. The present report includes a description of suitable detector systems that can be used for the calibration. It must be emphasized that for safe use of brachytherapy a comprehensive quality assurance (QA) programme should be developed at the radiotherapy center using this modality. A QA programme cannot rest on a source calibration alone, but in addition it should address all the different steps included in the treatment process. Such a programme is described in IAEA- TECDOC-1040, 'Design and Implementation of a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects'. As summarized in the present report, omission of a QA programme may have serious consequences for a patient undergoing brachytherapy treatment. The parts of this publication describing the calibration of low energy photon sources and beta ray sources have been written in close collaboration with members of the International Commission on Radiation Units and Measurements (ICRU)

  4. Quality assurance of Vari-source high dose rate (HDR) brachytherapy- remote after loader and cost effectiveness of Vari-source HDR- brachytherapy: NORI, Islamabad experience

    International Nuclear Information System (INIS)

    Ahmad, N.; Mahmood, H.; Jafri, S.R.A.

    2004-01-01

    A quality control of Vari-Source high dose rate (HDR) remote after loading brachytherapy machine was carried out and the cost effectiveness of HDR brachytherapy machine was also evaluated considering the cost of ten Iridium-192 wire sources at Nuclear Medicine, Oncology and Radiotherapy Institute (NORI), Islamabad, Pakistan. A total number of 253 intracavitary insertions were done in 98 patients from October 1996 to May 2001. The results of the quality control tests performed during 1996 to 2001 were within the acceptable limits. The cost effectiveness of Vari-Source HDR brachytherapy machine was also evaluated. The average cost per patient was calculated as US$ 491. Small number of patients was treated as the machine was used for gynecologic malignancies only. The objective was to assess the quality control status of HDR brachytherapy machine on patient treatment day, source exchange day and periodic day (monthly basis). It was found that the cost per patient can be minimized if other type of cancer patients are also treated on Vari-Source HDR machine. (author)

  5. A robotic device for MRI-guided prostate brachytherapy

    NARCIS (Netherlands)

    Lagerburg, V.

    2008-01-01

    One of the treatment options for prostate cancer is brachytherapy with iodine-125 sources. In prostate brachytherapy a high radiation dose is delivered to the prostate with a steep dose fall off to critical surrounding organs. The implantation of the iodine sources is currently performed under

  6. A comparison study on various low energy sources in interstitial prostate brachytherapy

    Directory of Open Access Journals (Sweden)

    Mahdi Bakhshabadi

    2016-02-01

    Full Text Available Purpose: Low energy sources are routinely used in prostate brachytherapy. 125 I is one of the most commonly used sources. Low energy 131 Cs source was introduced recently as a brachytherapy source. The aim of this study is to compare dose distributions of 125 I, 103 Pd, and 131 Cs sources in interstitial brachytherapy of prostate. Material and methods: ProstaSeed 125 I brachytherapy source was simulated using MCNPX Monte Carlo code. Additionally, two hypothetical sources of 103 Pd and 131 Cs were simulated with the same geometry as the ProstaSeed 125 I source, while having their specific emitted gamma spectra. These brachytherapy sources were simulated with distribution of forty-eight seeds in a phantom including prostate. The prostate was considered as a sphere with radius of 1.5 cm. Absolute and relative dose rates were obtained in various distances from the source along the transverse and longitudinal axes inside and outside the tumor. Furthermore, isodose curves were plotted around the sources. Results : Analyzing the initial dose profiles for various sources indicated that with the same time duration and air kerma strength, 131 Cs delivers higher dose to tumor. However, relative dose rate inside the tumor is higher and outside the tumor is lower for the 103 Pd source. Conclusions : The higher initial absolute dose in cGy/(h.U of 131 Cs brachytherapy source is an advantage of this source over the others. The higher relative dose inside the tumor and lower relative dose outside the tumor for the 103 Pd source are advantages of this later brachytherapy source. Based on the total dose the 125 I source has advantage over the others due to its longer half-life.

  7. Radiation Exposure Reduction to Brachytherapy Staff By Using Remote Afterloading

    International Nuclear Information System (INIS)

    Attalla, E.M.

    2005-01-01

    The radiation exposures to the personnel staff from patients with brachytherapy implants in a brachytherapy service were reviewed. Exposures to the brachytherapy personnel, as determined by Thermoluminescence Dosimeter (TLD) monitors, indicates a four-fold reduction in exposures after the implantation of the use of remote afterloading devices. Quarterly TLD monitor data for seven quarters prior to the use of remote afterloading devices demonstrate an average projected annual dose equivalent to the brachytherapy staff of 2543 Μ Sv. After the implantation of the remote afterloading devices, the quarterly TLD monitor data indicate an average dose equivalent per person of 153 Μ Sv. This is 76% reduction in exposure to brachytherapy personnel with the use of these devices

  8. Pulsed dose rate brachytherapy – is it the right way?

    Directory of Open Access Journals (Sweden)

    Janusz Skowronek

    2010-10-01

    Full Text Available Pulsed dose rate (PDR-BT treatment is a brachytherapy modality that combines physical advantages of high-doserate (HDR-BT technology (isodose optimization, radiation safety with the radiobiological advantages of low-dose-rate (LDR-BT brachytherapy. Pulsed brachytherapy consists of using stronger radiation source than for LDR-BT and producing series of short exposures of 10 to 30 minutes in every hour to approximately the same total dose in the sameoverall time as with the LDR-BT. Modern afterloading equipment offers certain advantages over interstitial or intracavitaryinsertion of separate needles, tubes, seeds or wires. Isodose volumes in tissues can be created flexibly by a combinationof careful placement of the catheter and the adjustment of the dwell times of the computerized stepping source.Automatic removal of the radiation sources into a shielded safe eliminates radiation exposures to staff and visitors.Radiation exposure is also eliminated to the staff who formerly loaded and unloaded multiplicity of radioactive sources into the catheters, ovoids, tubes etc. This review based on summarized clinical investigations, analyses the feasibility and the background to introduce this brachytherapy technique and chosen clinical applications of PDR-BT.

  9. Radiation safety program in a high dose rate brachytherapy facility

    International Nuclear Information System (INIS)

    Rodriguez, L.V.; Hermoso, T.M.; Solis, R.C.

    2001-01-01

    The use of remote afterloading equipment has been developed to improve radiation safety in the delivery of treatment in brachytherapy. Several accidents, however, have been reported involving high dose-rate brachytherapy system. These events, together with the desire to address the concerns of radiation workers, and the anticipated adoption of the International Basic Safety Standards for Protection Against Ionizing Radiation (IAEA, 1996), led to the development of the radiation safety program at the Department of Radiotherapy, Jose R. Reyes Memorial Medical Center and at the Division of Radiation Oncology, St. Luke's Medical Center. The radiation safety program covers five major aspects: quality control/quality assurance, radiation monitoring, preventive maintenance, administrative measures and quality audit. Measures for evaluation of effectiveness of the program include decreased unnecessary exposures of patients and staff, improved accuracy in treatment delivery and increased department efficiency due to the development of staff vigilance and decreased anxiety. The success in the implementation required the participation and cooperation of all the personnel involved in the procedures and strong management support. This paper will discuss the radiation safety program for a high dose rate brachytherapy facility developed at these two institutes which may serve as a guideline for other hospitals intending to install a similar facility. (author)

  10. Cluster pattern analysis of energy deposition sites for the brachytherapy sources 103Pd, 125I, 192Ir, 137Cs, and 60Co.

    Science.gov (United States)

    Villegas, Fernanda; Tilly, Nina; Bäckström, Gloria; Ahnesjö, Anders

    2014-09-21

    Analysing the pattern of energy depositions may help elucidate differences in the severity of radiation-induced DNA strand breakage for different radiation qualities. It is often claimed that energy deposition (ED) sites from photon radiation form a uniform random pattern, but there is indication of differences in RBE values among different photon sources used in brachytherapy. The aim of this work is to analyse the spatial patterns of EDs from 103Pd, 125I, 192Ir, 137Cs sources commonly used in brachytherapy and a 60Co source as a reference radiation. The results suggest that there is both a non-uniform and a uniform random component to the frequency distribution of distances to the nearest neighbour ED. The closest neighbouring EDs show high spatial correlation for all investigated radiation qualities, whilst the uniform random component dominates for neighbours with longer distances for the three higher mean photon energy sources (192Ir, 137Cs, and 60Co). The two lower energy photon emitters (103Pd and 125I) present a very small uniform random component. The ratio of frequencies of clusters with respect to 60Co differs up to 15% for the lower energy sources and less than 2% for the higher energy sources when the maximum distance between each pair of EDs is 2 nm. At distances relevant to DNA damage, cluster patterns can be differentiated between the lower and higher energy sources. This may be part of the explanation to the reported difference in RBE values with initial DSB yields as an endpoint for these brachytherapy sources.

  11. [Optimal intravascular brachytherapy: safety and radiation protection, reliability and precision guaranteed by guidelines, recommendations and regulatory requirements].

    Science.gov (United States)

    Quast, Ulrich; Kaulich, Theodor W; Lorenz, Joachim

    2002-02-01

    The success of intravascular brachytherapy relies entirely on the interdisciplinary approach. Interventional cardiologists, radiation oncologists and medical physicists must form a team from day 1. All members of the team need special knowledge and regular training in the field of vascular radiation therapy. Optimization of intravascular brachytherapy requires the use of standardized methods of dose specification, recording and reporting. This also implies using standardized methods of source calibration in terms of absorbed dose to water and having methods for simple internal control of the dosimetric quantities of new or replaced sources. Guidance is offered by international recommendations (AAPM TG 60, DGMP Report 16, NCS and EVA GEC-ESTRO). LEGAL REQUIREMENTS FOR RADIATION PROTECTION--WHAT'S NEW?: In Europe, new legal requirements on radiation protection issues have to be fulfilled. For Germany, the revised "Strahlenschutzverordnung" has been released recently. Nearly all organizational and medical processes are affected. For intravascular brachytherapy, several changes of requirements have to be considered. However, to follow these requirements does not cause serious problems. DGMP REPORT 16: GUIDELINES FOR MEDICAL PHYSICAL ASPECTS OF INTRAVASCULAR BRACHYTHERAPY: Evaluation of clinical results by comparison of intravascular brachytherapy treatment parameters is possible only if the prescribed dose and the applied dose distribution are reported clearly, completely and uniformly. The DGMP guidelines thus recommend to prescribe the dose to water at the system related reference point PRef at 2 mm radial distance for intracoronary application (and at 5 mm for peripheral vessels). The mean dose at 1 mm tissue depth (respectively at 2 mm) should be reported in addition. To safely define the planning target volume from the injured length, safety margins of at least 5 mm (10 mm) have to be taken into account on both ends. Safety margins have also to be considered for

  12. Radiation protection procedures and dose to the staff in brachytherapy with permanent implant of the sources

    International Nuclear Information System (INIS)

    Tosi, G.; Cattani, F.

    2002-01-01

    The treatment of intra capsular prostate cancers with the permanent implantation of low energy sealed radioactive sources (''103 Pd-''125I) offers the same probability of curing the tumours as surgery and external-beam radiotherapy with a minimum incidence of unwanted side-effects. The first attempts of using sealed sources for treating prostate cancers go back to 1917, when Barringer reported the results obtained with the implant of ''236Ra needles. Beginning from that period the interest for prostate brachytherapy has shown a fluctuating trend, due especially to the technological possibilities and to the status of the alternative treatment modalities (surgery, external radiotherapy). The main reason of the substantial failure of brachytherapy as compared to the two other treatment modalities had two main causes: the energy, too high ( E≅ 840 keV), of γ-radiation emitted by ''226 Ra in equilibrium with its decay products and the lack of imaging techniques able to visualize with sufficient accuracy both the prostate and the arrangement, inside it, of the radioactive sources. The employ of low energy γ-emitting radionuclides began in 1974, when Whitmore et al. working at the Sloan Kettering Memorial Cancer Hospital of New York suggested the use of ''125 I sealed sources for the realisation of interstitial permanent implants. Also this attempt, though reducing the side effects typical of the surgical intervention (incontinence, impotence), did non give the expected results in terms of local control of the disease and, as a consequence, of the survival's length. This partial failure was attributed to the fact that, in most cases the dose distribution inside the target volume was not homogeneous, due to the inadequacy of the available imaging techniques used for checking the real position of the sources, during their manual insertion in the tissues. In the last ten years,however, great progresses have been made in the US i maging techniques, in the manufacture of

  13. Specification of brachytherapy sources

    Energy Technology Data Exchange (ETDEWEB)

    1984-10-01

    BCRU recommends that the following specification of gamma-ray brachytherapy sources be adopted. Unless otherwise stated, the output of a cylindrical source should be specified in air kerma rate at a point in free space at a distance of 1 m from the source on the radial plane of symmetry, i.e. the plane bisecting the active length and perpendicular to the cylindrical axis of the source. For a wire source the output should be specified for a 1 cm length. For any other construction of source, the point at which the output is specified should be stated. It is also recommended that the units in which the air kerma rate is expressed should be micrograys per hour (..mu..Gy/h).

  14. Dosimetric study of a brachytherapy treatment of esophagus with Brazilian 192Ir sources using an anthropomorphic phantom

    Science.gov (United States)

    Neves, Lucio P.; Santos, William S.; Gorski, Ronan; Perini, Ana P.; Maia, Ana F.; Caldas, Linda V. E.; Orengo, Gilberto

    2014-11-01

    Several radioisotopes are produced at Instituto de Pesquisas Energéticas e Nucleares for the use in medical treatments, including the activation of 192Ir sources. These sources are suitable for brachytherapy treatments, due to their low or high activity, depending on the concentration of 192Ir, easiness to manufacture, small size, stable daughter products and the possibility of re-utilization. They may be used for the treatment of prostate, cervix, head and neck, skin, breast, gallbladder, uterus, vagina, lung, rectum, and eye cancer treatment. In this work, the use of some 192Ir sources was studied for the treatment of esophagus cancer, especially the dose determination of important structures, such as those on the mediastinum. This was carried out utilizing a FASH anthropomorphic phantom and the MCNP5 Monte Carlo code to transport the radiation through matter. It was possible to observe that the doses at lungs, breast, esophagus, thyroid and heart were the highest, which was expected due to their proximity to the source. Therefore, the data are useful to assess the representative dose specific to brachytherapy treatments on the esophagus for radiation protection purposes. The use of brachytherapy sources was studied for the treatment of esophagus cancer. FASH anthropomorphic phantom and MCNP5 Monte Carlo code were employed. The doses at lungs, breast, esophagus, thyroid and heart were the highest. The data is useful to assess the representative doses of treatments on the esophagus.

  15. Procedures for calibration of brachytherapy sources

    International Nuclear Information System (INIS)

    Alfonso Laguardia, R.; Alonso Samper, J.L.; Morales Lopez, J.L.; Saez Nunez, D.G.

    1997-01-01

    Brachytherapy source strength verification is a responsibility of the user of these source, in fact of the Medical Physicists in charge of this issue in a Radiotherapy Service. The calibration procedures in the users conditions are shown. Specifics methods for source strength determination are recommended, both for High Dose Rate (HDR) sources with Remote Afterloading equipment and for Low Dose Rate sources. The The results of the calibration of HDR Remote After loaders are indicated

  16. Interventional Radiation Oncology (IRO): Transition of a magnetic resonance simulator to a brachytherapy suite.

    Science.gov (United States)

    Anderson, Roberta; Armour, Elwood; Beeckler, Courtney; Briner, Valerie; Choflet, Amanda; Cox, Andrea; Fader, Amanda N; Hannah, Marie N; Hobbs, Robert; Huang, Ellen; Kiely, Marilyn; Lee, Junghoon; Morcos, Marc; McMillan, Paige E; Miller, Dave; Ng, Sook Kien; Prasad, Rashmi; Souranis, Annette; Thomsen, Robert; DeWeese, Theodore L; Viswanathan, Akila N

    2018-03-13

    As a core component of a new gynecologic cancer radiation program, we envisioned, structured, and implemented a novel Interventional Radiation Oncology (IRO) unit and magnetic resonance (MR)-brachytherapy environment in an existing MR simulator. We describe the external and internal processes required over a 6-8 month time frame to develop a clinical and research program for gynecologic brachytherapy and to successfully convert an MR simulator into an IRO unit. Support of the institution and department resulted in conversion of an MR simulator to a procedural suite. Development of the MR gynecologic brachytherapy program required novel equipment, staffing, infrastructural development, and cooperative team development with anesthetists, nurses, therapists, physicists, and physicians to ensure a safe and functional environment. Creation of a separate IRO unit permitted a novel billing structure. The creation of an MR-brachytherapy environment in an MR simulator is feasible. Developing infrastructure includes several collaborative elements. Unique to the field of radiation oncology, formalizing the space as an Interventional Radiation Oncology unit permits a sustainable financial structure. Copyright © 2018 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  17. Calibration of photon and beta ray sources used in brachytherapy. Guidelines on standardized procedures at Secondary Standards Dosimetry Laboratories (SSDLs) and hospitals

    International Nuclear Information System (INIS)

    2002-03-01

    cardiovascular interventions. The present report includes a description of suitable detector systems that can be used for the calibration. It must be emphasized that for safe use of brachytherapy a comprehensive quality assurance (QA) programme should be developed at the radiotherapy center using this modality. A QA programme cannot rest on a source calibration alone, but in addition it should address all the different steps included in the treatment process. Such a programme is described in IAEA- TECDOC-1040, 'Design and Implementation of a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects'. As summarized in the present report, omission of a QA programme may have serious consequences for a patient undergoing brachytherapy treatment. The parts of this publication describing the calibration of low energy photon sources and beta ray sources have been written in close collaboration with members of the International Commission on Radiation Units and Measurements (ICRU)

  18. The need for international standardization in clinical beta dosimetry for brachytherapy

    International Nuclear Information System (INIS)

    Quast, U.; Boehm, J.; Kaulich, T.W.

    2002-01-01

    Beta radiation has found increasing interest in radiotherapy. Besides the curative treatment of small and medium-sized intraocular tumors by means of ophthalmic beta radiation plaques, intravascular brachytherapy has proven to successfully overcome the severe problem of restenosis after interventional treatment of arterial stenosis in coronaries and peripheral vessels in many clinical trials with a large number of patients. Prior to initiating procedures applying beta radiation in radiotherapy, however, there is a common need to specify methods for the determination and specification of the absorbed dose to water or tissue and their spatial distributions. The IAEA-TECDOC-1274 Calibration of photon and beta ray sources used in brachytherapy (2002) is a help for photon brachytherapy calibration. But, for beta seed and line sources, IAEA recommends well type ionization chambers as working standards which are far from measuring absorbed dose to water of the radiation clinically used. Although the application of such working standards seems to be more precise, large errors can occur when the medical physicist has to convert the calibration data to absorbed dose to water of the beta radiation emitted. The user must believe that the source is equally activated and that the manufacturer did not change the design and construction of the source encapsulation. With the DGMP Report 16 (2001) Guidelines for medical physical aspects of intravascular brachytherapy a very detailed code of practice is given, especially for the calibration and clinical dosimetry of intravascular beta radiation sources. As there is a global need for standardization in clinical dosimetry for intravascular brachytherapy utilizing beta radiation, the DIN-NAR, the German committee on standardization in radiology, task group dosimetry, has initiated an international adhoc working group for a new ISO work item proposal on the standardization of procedures in clinical dosimetry to guarantee reliable

  19. Radiation exposure of nursing personnel to brachytherapy patients

    International Nuclear Information System (INIS)

    Cobb, P.D.; Kase, K.R.; Bjaerngard, B.E.

    1978-01-01

    The radiation exposure of nursing personnel to brachytherapy patients has been analyzed from data collected during the years 1973-1976, at four different hospitals. The average annual dose per exposed nurse ranged between 25 and 150 mrem. The radiation exposure per nurse was found to be proportional to the total potential exposure and was uncorrelated with the size of the nursing staff. (author)

  20. Spectroscopic characterization of low dose rate brachytherapy sources

    Science.gov (United States)

    Beach, Stephen M.

    The low dose rate (LDR) brachytherapy seeds employed in permanent radioactive-source implant treatments usually use one of two radionuclides, 125I or 103Pd. The theoretically expected source spectroscopic output from these sources can be obtained via Monte Carlo calculation based upon seed dimensions and materials as well as the bare-source photon emissions for that specific radionuclide. However the discrepancies resulting from inconsistent manufacturing of sources in comparison to each other within model groups and simplified Monte Carlo calculational geometries ultimately result in undesirably large uncertainties in the Monte Carlo calculated values. This dissertation describes experimentally attained spectroscopic outputs of the clinically used brachytherapy sources in air and in liquid water. Such knowledge can then be applied to characterize these sources by a more fundamental and metro logically-pure classification, that of energy-based dosimetry. The spectroscopic results contained within this dissertation can be utilized in the verification and benchmarking of Monte Carlo calculational models of these brachytherapy sources. This body of work was undertaken to establish a usable spectroscopy system and analysis methods for the meaningful study of LDR brachytherapy seeds. The development of a correction algorithm and the analysis of the resultant spectroscopic measurements are presented. The characterization of the spectrometer and the subsequent deconvolution of the measured spectrum to obtain the true spectrum free of any perturbations caused by the spectrometer itself is an important contribution of this work. The approach of spectroscopic deconvolution that was applied in this work is derived in detail and it is applied to the physical measurements. In addition, the spectroscopically based analogs to the LDR dosimetry parameters that are currently employed are detailed, as well as the development of the theory and measurement methods to arrive at these

  1. Review of advanced catheter technologies in radiation oncology brachytherapy procedures

    OpenAIRE

    Zhou J; Zamdborg L; Sebastian E

    2015-01-01

    Jun Zhou,1,2 Leonid Zamdborg,1 Evelyn Sebastian1 1Department of Radiation Oncology, Beaumont Health System, 2Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA Abstract: The development of new catheter and applicator technologies in recent years has significantly improved treatment accuracy, efficiency, and outcomes in brachytherapy. In this paper, we review these advances, focusing on the performance of catheter imaging and reconstruction techniques in brachytherapy ...

  2. Brachytherapy with 125-Iodine sources: transport and radiation protection

    International Nuclear Information System (INIS)

    Souza, Carla D.; Zeituni, Carlos A.; Moura, Joao A.; Moura, Eduardo S.; Nagatomi, Helio R.; Feher, Anselmo; Hilario, Katia F.; Rostelato, Maria Elisa C.M.

    2009-01-01

    The estimates for the year 2009 show that 466,730 new cancer cases will occur in Brazil. Prostate cancer is the second most incident type. Brachytherapy, a type of radiotherapy, with Iodine-125 sources are an important form of treatment for this kind of cancer. The Instituto de Pesquisas Energeticas e Nucleares (IPEN) created a project to develop a national prototype of these sources and is implementing a facility for local production. The seeds manufacture in Brazil will allow to diminish the treatment cost and make it possible for a larger number of patients. While the laboratory is not ready, the IPEN import and it distributes seeds. This work aim is to present and evaluate the transport procedures and the radiological protection applied to imported sources in order to assist the procedures for the new laboratory implementation. Before sending to hospitals, the seeds are packed by a radioprotector supervisor, in accordance with CNEN NE 5.01 standard 'Radioactive Material Transport'. Despite Iodine-125 presents low energy photons, around 29 keV, local and personal dosimeters are used during the transport process, as described in CNEN NN 3.01 standard 'Radiological Protection Basic Guideline'. All the results show no contamination and very low exposure, proving the method to be valid. The transport procedure used is correct, according to the regulations. As an result of this work, a new dosimeter should be installed and evaluate in future study. (author)

  3. Microdosimetric evaluation of relative biological effectiveness for 103PD, 125I, 241AM, and 192IR brachytherapy sources

    International Nuclear Information System (INIS)

    Wuu, C.S.; Kliauga, P.; Zaider, M.; Amols, H.I.

    1996-01-01

    Purpose: To determine the microdosimetric-derived relative biological effectiveness (RBE) of 103 Pd, 125 I, 241 Am, and 192 Ir brachytherapy sources at low doses and/or low dose rates. Methods and Materials: The Theory of Dual Radiation Action can be used to predict expected RBE values based on the spatial distribution of energy deposition at microscopic levels from these sources. Single-event lineal energy spectra for these isotopes have been obtained both experimentally and theoretically. A grid-defined wall-less proportional counter was used to measure the lineal energy distributions. Unlike conventional Rossi proportional counters, the counter used in these measurements has a conducting nylon fiber as the central collecting anode and has no metal parts. Thus, the Z-dependence of the photoelectric effect is eliminated as a source of measurement error. Single-event spectra for these brachytherapy sources have been also calculated by: (a) the Monte Carlo code MCNP to generate the electron slowing down spectrum, (b) transport of monoenergetic electron tracks, event by event, with our Monte Carlo code DELTA, (c) using the concept of associated volume to obtain the lineal energy distribution f(y) for each monoenergetic electron, and (d) obtaining the composite lineal energy spectrum for a given brachytherapy source based on the electron spectrum calculated at step (a). Results: Relative to 60 Co, the RBE values obtained from this study are: 2.3 for 103 Pd, 2.1 for 125 I, 2.1 for 241 Am, and 1.3 for 192 Ir. Conclusions: These values are consistent with available data from in vitro cell survival experiments. We suggest that, at least for these brachytherapy sources, microdosimetry may be used as a credible alternative to time-consuming (and often uncertain) radiobiological experiments to obtain information on radition quality and make reliable predictions of RBE in low dose rate brachytherapy

  4. Radiation Protection Training in Intracoronary Brachytherapy

    International Nuclear Information System (INIS)

    Prieto, C.; Vano, E.; Fernandez, J. M.; Sabate, M.; Galvan, C.; Meiggs, L.; Corral, J. M.

    2003-01-01

    To report the educational objectives and contents on Radiation Protection (RP) for the practice of Intracoronary Brachytherapy (ICB) procedures. The wide international experience on training programs for ICB as well as our own experience organizing several courses aimed at Cardiologists, Radio therapists and Medical Physicists has been used to elaborate specific RP objectives and contents. The objectives, differentiated for Cardiologists, Radio therapists, Medical Physicists, Nurses and Technicians, pretend to guarantee the safety and RP of both patient and staff in the procedures of ICB. The objectives are necessarily different because their RP formation and their role in the procedure are different. The general topics included in RP training programmes for ICB could be: general topics on RP (Interaction of radiation and matter, RP principles, radiobiology, etc), principles of operation of ICB and interventional X-ray equipment, quantification of radiation dose and risks, optimisation of protection of staff and patients, accidents and emergencies, regulations, responsibilities, quality assurance program, handling of ICB sources, installation and commissioning. Training programs based on the objectives presented in this paper would encourage positive safety culture in ICB and can also be used as a starting point by the Regulatory Authority for the authorization of new Installations and credentialing of professionals involved in this technique as well as for the continuous education of the staff involved. (Author) 10 refs

  5. Fitting and benchmarking of Monte Carlo output parameters for iridium-192 high dose rate brachytherapy source

    International Nuclear Information System (INIS)

    Acquah, F.G.

    2011-01-01

    Brachytherapy, the use of radioactive sources for the treatment of tumours is an important tool in radiation oncology. Accurate calculations of dose delivered to malignant and normal tissues are the main responsibility of the Medical Physics staff. With the use of Treatment Planning System (TPS) computers now becoming a standard practice in the Radiation Oncology Departments, Independent calculations to certify the results of these commercial TPSs are important part of a good quality management system for brachytherapy implants. There are inherent errors in the dose distributions produced by these TPSs due to its failure to account for heterogeneity in the calculation algorithms and Monte Carlo (MC) method seems to be the panacea for these corrections. In this study, a fit functional form using MC output parameters was performed to reduce dose calculation uncertainty using the Matlab software curve fitting applications. This includes the modification of the AAPM TG-43 parameters to accommodate the new developments for a rapid brachytherapy dose rate calculation. Analytical computations were performed to hybridize the anisotropy function, F(r,θ) and radial dose function, g(r) into a single new function f(r,θ) for the Nucletron microSelectron High Dose Rate 'new or v2' (mHDRv2) 192 Ir brachytherapy source. In order to minimize computation time and to improve the accuracy of manual calculations, the dosimetry function f(r,θ) used fewer parameters and formulas for the fit. Using MC outputs as the standard, the percentage errors for the fits were calculated and used to evaluate the average and maximum uncertainties. Dose rate deviation between the MC data and fit were also quantified as errors(E), which showed minimal values. These results showed that the dosimetry parameters from this study as compared to those of MC outputs parameters were in good agreement and better than the results obtained from literature. The work confirms a lot of promise in building robust

  6. The American Brachytherapy Society recommendations for low-dose-rate brachytherapy for carcinoma of the cervix

    International Nuclear Information System (INIS)

    Nag, Subir; Chao, Clifford; Erickson, Beth; Fowler, Jeffery; Gupta, Nilendu; Martinez, Alvaro; Thomadsen, Bruce

    2002-01-01

    Purpose: This report presents guidelines for using low-dose-rate (LDR) brachytherapy in the management of patients with cervical cancer. Methods: Members of the American Brachytherapy Society (ABS) with expertise in LDR brachytherapy for cervical cancer performed a literature review, supplemented by their clinical experience, to formulate guidelines for LDR brachytherapy of cervical cancer. Results: The ABS strongly recommends that radiation treatment for cervical carcinoma (with or without chemotherapy) should include brachytherapy as a component. Precise applicator placement is essential for improved local control and reduced morbidity. The outcome of brachytherapy depends, in part, on the skill of the brachytherapist. Doses given by external beam radiotherapy and brachytherapy depend upon the initial volume of disease, the ability to displace the bladder and rectum, the degree of tumor regression during pelvic irradiation, and institutional practice. The ABS recognizes that intracavitary brachytherapy is the standard technique for brachytherapy for cervical carcinoma. Interstitial brachytherapy should be considered for patients with disease that cannot be optimally encompassed by intracavitary brachytherapy. The ABS recommends completion of treatment within 8 weeks, when possible. Prolonging total treatment duration can adversely affect local control and survival. Recommendations are made for definitive and postoperative therapy after hysterectomy. Although recognizing that many efficacious LDR dose schedules exist, the ABS presents suggested dose and fractionation schemes for combining external beam radiotherapy with LDR brachytherapy for each stage of disease. The dose prescription point (point A) is defined for intracavitary insertions. Dose rates of 0.50 to 0.65 Gy/h are suggested for intracavitary brachytherapy. Dose rates of 0.50 to 0.70 Gy/h to the periphery of the implant are suggested for interstitial implant. Use of differential source activity or

  7. Afterloading techniques in brachytherapy

    International Nuclear Information System (INIS)

    Kirsch, M.; Orban, R.; Lorenz, B.

    1981-01-01

    The advantages of applying modern afterloading methods in brachytherapie of malignant diseases are outlined. They include, among other things, a considerable reduction in radiation exposure to staff involved. Furthermore, the radiation protection requirements imposed by the licensing authority on the construction, equipment and operation of remote controlled afterloading installations with gamma sources of up to 4 TBq (108 Ci) have been compiled. (author)

  8. Brachytherapy dosimetry parameters calculated for a 131Cs source

    International Nuclear Information System (INIS)

    Rivard, Mark J.

    2007-01-01

    A comprehensive analysis of the IsoRay Medical model CS-1 Rev2 131 Cs brachytherapy source was performed. Dose distributions were simulated using Monte Carlo methods (MCNP5) in liquid water, Solid TM , and Virtual Water TM spherical phantoms. From these results, the in-water brachytherapy dosimetry parameters have been determined, and were compared with those of Murphy et al. [Med. Phys. 31, 1529-1538 (2004)] using measurements and simulations. Our results suggest that calculations obtained using erroneous cross-section libraries should be discarded as recommended by the 2004 AAPM TG-43U1 report. Our MC Λ value of 1.046±0.019 cGy h -1 U -1 is within 1.3% of that measured by Chen et al. [Med. Phys. 32, 3279-3285 (2005)] using TLDs and the calculated results of Wittman and Fisher [Med. Phys. 34, 49-54 (2007)] using MCNP5. Using the discretized energy approach of Rivard [Appl. Radiat. Isot. 55, 775-782 (2001)] to ascertain the impact of individual 131 Cs photons on radial dose function and anisotropy functions, there was virtual equivalence of results for 29.461≤E γ ≤34.419 keV and for a mono-energetic 30.384 keV photon source. Comparisons of radial dose function and 2D anisotropy function data are also included, and an analysis of material composition and cross-section libraries was performed

  9. Determination of the tissue inhomogeneity correction in high dose rate Brachytherapy for Iridium-192 source

    Directory of Open Access Journals (Sweden)

    Barlanka Ravikumar

    2012-01-01

    Full Text Available In Brachytherapy treatment planning, the effects of tissue heterogeneities are commonly neglected due to lack of accurate, general and fast three-dimensional (3D dose-computational algorithms. In performing dose calculations, it is assumed that the tumor and surrounding tissues constitute a uniform, homogeneous medium equivalent to water. In the recent past, three-dimensional computed tomography (3D-CT based treatment planning for Brachytherapy applications has been popularly adopted. However, most of the current commercially available planning systems do not provide the heterogeneity corrections for Brachytherapy dosimetry. In the present study, we have measured and quantified the impact of inhomogeneity caused by different tissues with a 0.015 cc ion chamber. Measurements were carried out in wax phantom which was employed to measure the heterogeneity. Iridium-192 (192 Ir source from high dose rate (HDR Brachytherapy machine was used as the radiation source. The reduction of dose due to tissue inhomogeneity was measured as the ratio of dose measured with different types of inhomogeneity (bone, spleen, liver, muscle and lung to dose measured with homogeneous medium for different distances. It was observed that different tissues attenuate differently, with bone tissue showing maximum attenuation value and lung tissue resulting minimum value and rest of the tissues giving values lying in between those of bone and lung. It was also found that inhomogeneity at short distance is considerably more than that at larger distances.

  10. Radiation-induced circumscribed superficial morphea after brachytherapy for endometrial adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Apoorva Trivedi, BS

    2017-12-01

    Full Text Available Radiation-induced morphea (RIM is a rare and underrecognized complication of radiation therapy that most commonly occurs in women after treatment for breast cancer. Although not fully understood, RIM is hypothesized to arise from an increase in cytokines that stimulate collagen production and extracellular matrix formation. Most documented cases of RIM occur 1 year after radiation therapy and are localized to areas that were treated for breast cancer. We report on a case of a female patient with stage IB endometrial adenocarcinoma who was treated with 24 Gray of adjuvant brachytherapy. The patient developed a diffuse morpheaform, pruritic eruption only at distant sites from the brachytherapy treatment field. Although treatment for RIM is generally unsatisfactory, our patient experienced improvement in the pruritus and a regression of the lesions while applying topical 0.1% tacrolimus ointment and 0.1% triamcinolone creme. An early diagnosis of RIM can prevent extensive workup, guide treatment, and improve quality of life for patients. Keywords: radiation-induced morphea, postirradiation morphea

  11. Effect of photon energy spectrum on dosimetric parameters of brachytherapy sources.

    Science.gov (United States)

    Ghorbani, Mahdi; Mehrpouyan, Mohammad; Davenport, David; Ahmadi Moghaddas, Toktam

    2016-06-01

    The aim of this study is to quantify the influence of the photon energy spectrum of brachytherapy sources on task group No. 43 (TG-43) dosimetric parameters. Different photon spectra are used for a specific radionuclide in Monte Carlo simulations of brachytherapy sources. MCNPX code was used to simulate 125I, 103Pd, 169Yb, and 192Ir brachytherapy sources. Air kerma strength per activity, dose rate constant, radial dose function, and two dimensional (2D) anisotropy functions were calculated and isodose curves were plotted for three different photon energy spectra. The references for photon energy spectra were: published papers, Lawrence Berkeley National Laboratory (LBNL), and National Nuclear Data Center (NNDC). The data calculated by these photon energy spectra were compared. Dose rate constant values showed a maximum difference of 24.07% for 103Pd source with different photon energy spectra. Radial dose function values based on different spectra were relatively the same. 2D anisotropy function values showed minor differences in most of distances and angles. There was not any detectable difference between the isodose contours. Dosimetric parameters obtained with different photon spectra were relatively the same, however it is suggested that more accurate and updated photon energy spectra be used in Monte Carlo simulations. This would allow for calculation of reliable dosimetric data for source modeling and calculation in brachytherapy treatment planning systems.

  12. Endoscope-guided interstitial intensity-modulated brachytherapy and intracavitary brachytherapy as boost radiation for primary early T stage nasopharyngeal carcinoma.

    Directory of Open Access Journals (Sweden)

    Xiang-Bo Wan

    Full Text Available BACKGROUND: Intracavitary brachytherapy (ICBT is usually applied as boost radiotherapy for superficial residual of nasopharyngeal carcinoma (NPC after primary extern-beam radiptherapy (ERT. Here, we evaluated the outcome of endoscope-guided interstitial intensity-modulated brachytherapy (IMBT boost radiation for deep-seated residual NPC. METHODOLOGY/PRINCIPAL FINDINGS: Two hundred and thirteen patients with residual NPC who were salvaged with brachytherapy boost radiation during 2005-2009 were analyzed retrospectively. Among these patients, 171 patients had superficial residual NPC (≤1 cm below the nasopharyngeal epithelium were treated with ICBT boost radiation, and interstitial IMBT boost radiation was delivered to 42 patients with deep-seated residual NPC (>1 cm below the nasopharyngeal epithelium. We found that IMBT boost subgroup had a higher ratio of T2b (81.0% VS 34.5%, P<0.001 and stage II (90.5% VS 61.4%, P = 0.001 than that of ICBT boost subgroup. The dosage of external-beam radiotherapy in the nasopharyngeal (63.0±3.8 VS 62.6±4.3 Gray (Gy, P = 0.67 and regional lymph nodes (55.8±5.0 VS 57.5±5.7 Gy, P = 0.11 was comparable in both groups. For brachytherapy, IMBT subgroup had a lower boost radiation dosage than ICBT subgroup (11.0±2.9 VS 14.8±3.2 Gy, P<0.01. Though the IMBT group had deeper residual tumors and received lower boost radiation dosages, both subgroups had the similar 5-year actuarial overall survival rate (IMBT VS ICBT group: 96.8% VS 93.6%, P = 0.87, progression-free survival rate (92.4% VS 86.5%, P = 0.41 and distant metastasis-free survival rate (94.9% VS 92.7%, P = 0.64. Moreover, IMBT boost radiation subgroup had a similar local (97.4% VS 94.4%, P = 0.57 and regional (95.0% VS 97.2%, P = 0.34 control to ICBT subgroup. The acute and late toxicities rates were comparable between the both subgroups. CONCLUSIONS/SIGNIFICANCE: IMBT boost radiation may be a promising therapeutic

  13. An orthodontic device for retaining implanted radioactive sources during brachytherapy for cancer of the oral cavity

    International Nuclear Information System (INIS)

    Masuko, Noriko; Katsura, Kouji; Sugita, Tadashi; Sakai, Kunio; Sato, Katsurou; Kawana, Masahiro; Nonomura, Naobumi

    2000-01-01

    An orthodontic retainer was devised to keeping implanted radioactive sources in position and improve the quality of life during brachytherapy for cancer of the oral cavity. The retainer was used in 3 patients with oral cancer, one with cancer of the hard palate, one with cancer of the soft palate, and one with cancer of the floor of mouth, during brachytherapy using 198 Au grains and 137 Cs needles. These patients could speak freely. One with cancer of the hard palate could drink water and ingest semi-liquid food during treatment instead of nasal tube feeding. The plaster dental model obtained while making the retainer proved to be useful for training radiation oncologists. (author)

  14. Monte Carlo simulations and radiation dosimetry measurements of 142Pr capillary tube-based radioactive implant (CTRI). A new structure for brachytherapy sources

    International Nuclear Information System (INIS)

    Bakht, M.K.; Haddadi, A.; Sadeghi, M.; Ahmadi, S.J.; Sadjadi, S.S.; Tenreiro, C.

    2013-01-01

    Previously, a promising β - -emitting praseodymium-142 glass seed was proposed for brachytherapy of prostate cancer. In accordance with the previous study, a 142 Pr capillary tube-based radioactive implant (CTRI) was suggested as a source with a new structure to enhance application of β - -emitting radioisotopes such as 142 Pr in brachytherapy. Praseodymium oxide powder was encapsulated in a glass capillary tube. Then, a thin and flexible fluorinated ethylene propylene Teflon layer sealed the capillary tube. The source was activated in the Tehran Research Reactor by the 141 Pr(n, γ) 142 Pr reaction. Measurements of the dosimetric parameters were performed using GafChromic radiochromic film. In addition, the dose rate distribution of 142 Pr CTRI was calculated by modeling 142 Pr source in a water phantom using Monte Carlo N-Particle Transport (MCNP5) Code. The active source was unreactive and did not leak in water. In comparison with the earlier proposed 142 Pr seed, the suggested source showed similar desirable dosimetric characteristics. Moreover, the 142 Pr CTRI production procedure may be technically and economically more feasible. The mass of praseodymium in CTRI structure could be greater than that of the 142 Pr glass seed; therefore, the required irradiation time and the neutron flux could be reduced. A 142 Pr CTRI was proposed for brachytherapy of prostate cancer. The dosimetric calculations by the experimental measurements and Monte Carlo simulation were performed to fulfill the requirements according to the American Association of Physicists in Medicine recommendations before the clinical use of new brachytherapy sources. The characteristics of the suggested source were compared with those of the previously proposed 142 Pr glass seed. (author)

  15. Contemporary Toxicity Profile of Breast Brachytherapy Versus External Beam Radiation After Lumpectomy for Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Huo, Jinhai [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D. [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Shaitelman, Simona F. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Grace L., E-mail: glsmith@mdanderson.org [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2016-03-15

    Purpose: We compared toxicities after brachytherapy versus external beam radiation therapy (EBRT) in contemporary breast cancer patients. Methods and Materials: Using MarketScan healthcare claims, we identified 64,112 women treated from 2003 to 2012 with lumpectomy followed by radiation (brachytherapy vs EBRT). Brachytherapy was further classified by multichannel versus single-channel applicator approach. We identified the risks and predictors of 1-year infectious and noninfectious postoperative adverse events using logistic regression and temporal trends using Cochran-Armitage tests. We estimated the 5-year Kaplan-Meier cumulative incidence of radiation-associated adverse events. Results: A total of 4522 (7.1%) patients received brachytherapy (50.2% multichannel vs 48.7% single-channel applicator). The overall risk of infectious adverse events was higher after brachytherapy than after EBRT (odds ratio [OR] = 1.21; 95% confidence interval [CI] 1.09-1.34, P<.001). However, over time, the frequency of infectious adverse events after brachytherapy decreased, from 17.3% in 2003 to 11.6% in 2012, and was stable after EBRT at 9.7%. Beyond 2007, there were no longer excess infections with brachytherapy (P=.97). The overall risk of noninfectious adverse events was higher after brachytherapy than after EBRT (OR=2.27; 95% CI 2.09-2.47, P<.0001). Over time, the frequency of noninfectious adverse events detected increased: after multichannel brachytherapy, from 9.1% in 2004 to 18.9% in 2012 (Ptrend = .64); single-channel brachytherapy, from 12.8% to 29.8% (Ptrend<.001); and EBRT, from 6.1% to 10.3% (Ptrend<.0001). The risk was significantly higher with single-channel than with multichannel brachytherapy (hazard ratio = 1.32; 95% CI 1.03-1.69, P=.03). Of noninfectious adverse events, 70.9% were seroma. Seroma significantly increased breast pain risk (P<.0001). Patients with underlying diabetes, cardiovascular disease, and treatment with chemotherapy had increased

  16. Contemporary Toxicity Profile of Breast Brachytherapy Versus External Beam Radiation After Lumpectomy for Breast Cancer

    International Nuclear Information System (INIS)

    Huo, Jinhai; Giordano, Sharon H.; Smith, Benjamin D.; Shaitelman, Simona F.; Smith, Grace L.

    2016-01-01

    Purpose: We compared toxicities after brachytherapy versus external beam radiation therapy (EBRT) in contemporary breast cancer patients. Methods and Materials: Using MarketScan healthcare claims, we identified 64,112 women treated from 2003 to 2012 with lumpectomy followed by radiation (brachytherapy vs EBRT). Brachytherapy was further classified by multichannel versus single-channel applicator approach. We identified the risks and predictors of 1-year infectious and noninfectious postoperative adverse events using logistic regression and temporal trends using Cochran-Armitage tests. We estimated the 5-year Kaplan-Meier cumulative incidence of radiation-associated adverse events. Results: A total of 4522 (7.1%) patients received brachytherapy (50.2% multichannel vs 48.7% single-channel applicator). The overall risk of infectious adverse events was higher after brachytherapy than after EBRT (odds ratio [OR] = 1.21; 95% confidence interval [CI] 1.09-1.34, P<.001). However, over time, the frequency of infectious adverse events after brachytherapy decreased, from 17.3% in 2003 to 11.6% in 2012, and was stable after EBRT at 9.7%. Beyond 2007, there were no longer excess infections with brachytherapy (P=.97). The overall risk of noninfectious adverse events was higher after brachytherapy than after EBRT (OR=2.27; 95% CI 2.09-2.47, P<.0001). Over time, the frequency of noninfectious adverse events detected increased: after multichannel brachytherapy, from 9.1% in 2004 to 18.9% in 2012 (Ptrend = .64); single-channel brachytherapy, from 12.8% to 29.8% (Ptrend<.001); and EBRT, from 6.1% to 10.3% (Ptrend<.0001). The risk was significantly higher with single-channel than with multichannel brachytherapy (hazard ratio = 1.32; 95% CI 1.03-1.69, P=.03). Of noninfectious adverse events, 70.9% were seroma. Seroma significantly increased breast pain risk (P<.0001). Patients with underlying diabetes, cardiovascular disease, and treatment with chemotherapy had increased

  17. Calibration of Photon Sources for Brachytherapy

    Science.gov (United States)

    Rijnders, Alex

    Source calibration has to be considered an essential part of the quality assurance program in a brachytherapy department. Not only it will ensure that the source strength value used for dose calculation agrees within some predetermined limits to the value stated on the source certificate, but also it will ensure traceability to international standards. At present calibration is most often still given in terms of reference air kerma rate, although calibration in terms of absorbed dose to water would be closer to the users interest. It can be expected that in a near future several standard laboratories will be able to offer this latter service, and dosimetry protocols will have to be adapted in this way. In-air measurement using ionization chambers (e.g. a Baldwin—Farmer ionization chamber for 192Ir high dose rate HDR or pulsed dose rate PDR sources) is still considered the method of choice for high energy source calibration, but because of their ease of use and reliability well type chambers are becoming more popular and are nowadays often recommended as the standard equipment. For low energy sources well type chambers are in practice the only equipment available for calibration. Care should be taken that the chamber is calibrated at the standard laboratory for the same source type and model as used in the clinic, and using the same measurement conditions and setup. Several standard laboratories have difficulties to provide these calibration facilities, especially for the low energy seed sources (125I and 103Pd). Should a user not be able to obtain properly calibrated equipment to verify the brachytherapy sources used in his department, then at least for sources that are replaced on a regular basis, a consistency check program should be set up to ensure a minimal level of quality control before these sources are used for patient treatment.

  18. Clinical Practice and Quality Assurance Challenges in Modern Brachytherapy Sources and Dosimetry

    International Nuclear Information System (INIS)

    Butler, Wayne M.; Merrick, Gregory S.

    2008-01-01

    Modern brachytherapy has led to effective treatments through the establishment of broadly applicable dosimetric thresholds for maximizing survival with minimal morbidity. Proper implementation of recent dosimetric consensus statements and quality assurance procedures is necessary to maintain the established level of safety and efficacy. This review classifies issues as either 'systematic' or 'stochastic' in terms of their impact on large groups or individual patients, respectively. Systematic changes affecting large numbers of patients occur infrequently and include changes in source dosimetric parameters, prescribing practice, dose calculation formalism, and improvements in calculation algorithms. The physicist must be aware of how incipient changes accord with previous experience. Stochastic issues involve procedures that are applied to each patient individually. Although ample guidance for quality assurance of brachytherapy sources exists, some ambiguities remain. The latest American Association of Physicists in Medicine guidance clarifies what is meant by independent assay, changes source sampling recommendations, particularly for sources in sterile strands and sterile preassembled needles, and modifies action level thresholds. The changing environment of brachytherapy has not changed the fact that the prime responsibility for quality assurance in brachytherapy lies with the institutional medical physicist

  19. Optical Imaging of Ionizing Radiation from Clinical Sources.

    Science.gov (United States)

    Shaffer, Travis M; Drain, Charles Michael; Grimm, Jan

    2016-11-01

    Nuclear medicine uses ionizing radiation for both in vivo diagnosis and therapy. Ionizing radiation comes from a variety of sources, including x-rays, beam therapy, brachytherapy, and various injected radionuclides. Although PET and SPECT remain clinical mainstays, optical readouts of ionizing radiation offer numerous benefits and complement these standard techniques. Furthermore, for ionizing radiation sources that cannot be imaged using these standard techniques, optical imaging offers a unique imaging alternative. This article reviews optical imaging of both radionuclide- and beam-based ionizing radiation from high-energy photons and charged particles through mechanisms including radioluminescence, Cerenkov luminescence, and scintillation. Therapeutically, these visible photons have been combined with photodynamic therapeutic agents preclinically for increasing therapeutic response at depths difficult to reach with external light sources. Last, new microscopy methods that allow single-cell optical imaging of radionuclides are reviewed. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  20. Factors affecting radiation injury after interstitial brachytherapy for brain tumors

    International Nuclear Information System (INIS)

    Leibel, S.A.; Gutin, P.H.; Davis, R.L.

    1991-01-01

    The effects of brachytherapy on normal brain tissue are not easily delineated in the clinical setting because of the presence of concurrent radiation-induced changes in the coexistent brain tumor. Sequential morphologic studies performed after the implantation of radioactive sources into the brains of experimental animals have provided a better understanding of the character and magnitude of the structural changes produced by interstitial irradiation on normal brain tissue. Furthermore, the clinical experience accumulated thus far provides not only relevant information, but also some guidelines for future treatment policies. In this paper, the authors summarize the experimental findings and review the pathologic and clinical features of brain injury caused by interstitial brachytherapy. A number of studies in the older literature examined the effects of radioisotopes such as radium-226 (38--43), radon-22 (44--46), gold-198 (29,47--50), tantalum-182 (29,51,52) yttrium-9- (50,53,54), and cobalt-60 (29,50,55). This review is restricted to low- and high-activity encapsulated iodine-125 ( 125 I) and iridium-192 ( 192 Ir), the isotopes that are most commonly used in current clinical practice

  1. American Brachytherapy Society Task Group Report: Combination of brachytherapy and external beam radiation for high-risk prostate cancer.

    Science.gov (United States)

    Spratt, Daniel E; Soni, Payal D; McLaughlin, Patrick W; Merrick, Gregory S; Stock, Richard G; Blasko, John C; Zelefsky, Michael J

    To review outcomes for high-risk prostate cancer treated with combined modality radiation therapy (CMRT) utilizing external beam radiation therapy (EBRT) with a brachytherapy boost. The available literature for high-risk prostate cancer treated with combined modality radiation therapy was reviewed and summarized. At this time, the literature suggests that the majority of high-risk cancers are curable with multimodal treatment. Several large retrospective studies and three prospective randomized trials comparing CMRT to dose-escalated EBRT have demonstrated superior biochemical control with CMRT. Longer followup of the randomized trials will be required to determine if this will translate to a benefit in metastasis-free survival, disease-specific survival, and overall survival. Although greater toxicity has been associated with CMRT compared to EBRT, recent studies suggest that technological advances that allow better definition and sparing of critical adjacent structures as well as increasing experience with brachytherapy have improved implant quality and the toxicity profile of brachytherapy. The role of androgen deprivation therapy is well established in the external beam literature for high-risk disease, but there is controversy regarding the applicability of these data in the setting of dose escalation. At this time, there is not sufficient evidence for the omission of androgen deprivation therapy with dose escalation in this population. Comparisons with surgery remain limited by differences in patient selection, but the evidence would suggest better disease control with CMRT compared to surgery alone. Due to a series of technological advances, modern combination series have demonstrated unparalleled rates of disease control in the high-risk population. Given the evidence from recent randomized trials, combination therapy may become the standard of care for high-risk cancers. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All

  2. Comprehensive brachytherapy physical and clinical aspects

    CERN Document Server

    Baltas, Dimos; Meigooni, Ali S; Hoskin, Peter J

    2013-01-01

    Modern brachytherapy is one of the most important oncological treatment modalities requiring an integrated approach that utilizes new technologies, advanced clinical imaging facilities, and a thorough understanding of the radiobiological effects on different tissues, the principles of physics, dosimetry techniques and protocols, and clinical expertise. A complete overview of the field, Comprehensive Brachytherapy: Physical and Clinical Aspects is a landmark publication, presenting a detailed account of the underlying physics, design, and implementation of the techniques, along with practical guidance for practitioners. Bridging the gap between research and application, this single source brings together the technological basis, radiation dosimetry, quality assurance, and fundamentals of brachytherapy. In addition, it presents discussion of the most recent clinical practice in brachytherapy including prostate, gynecology, breast, and other clinical treatment sites. Along with exploring new clinical protocols, ...

  3. Source position verification and dosimetry in HDR brachytherapy using an EPID

    International Nuclear Information System (INIS)

    Smith, R. L.; Taylor, M. L.; McDermott, L. N.; Franich, R. D.; Haworth, A.; Millar, J. L.

    2013-01-01

    Purpose: Accurate treatment delivery in high dose rate (HDR) brachytherapy requires correct source dwell positions and dwell times to be administered relative to each other and to the surrounding anatomy. Treatment delivery inaccuracies predominantly occur for two reasons: (i) anatomical movement or (ii) as a result of human errors that are usually related to incorrect implementation of the planned treatment. Electronic portal imaging devices (EPIDs) were originally developed for patient position verification in external beam radiotherapy and their application has been extended to provide dosimetric information. The authors have characterized the response of an EPID for use with an 192 Ir brachytherapy source to demonstrate its use as a verification device, providing both source position and dosimetric information.Methods: Characterization of the EPID response using an 192 Ir brachytherapy source included investigations of reproducibility, linearity with dose rate, photon energy dependence, and charge build-up effects associated with exposure time and image acquisition time. Source position resolution in three dimensions was determined. To illustrate treatment verification, a simple treatment plan was delivered to a phantom and the measured EPID dose distribution compared with the planned dose.Results: The mean absolute source position error in the plane parallel to the EPID, for dwells measured at 50, 100, and 150 mm source to detector distances (SDD), was determined to be 0.26 mm. The resolution of the z coordinate (perpendicular distance from detector plane) is SDD dependent with 95% confidence intervals of ±0.1, ±0.5, and ±2.0 mm at SDDs of 50, 100, and 150 mm, respectively. The response of the EPID is highly linear to dose rate. The EPID exhibits an over-response to low energy incident photons and this nonlinearity is incorporated into the dose calibration procedure. A distance (spectral) dependent dose rate calibration procedure has been developed. The

  4. The difference of scoring dose to water or tissues in Monte Carlo dose calculations for low energy brachytherapy photon sources.

    Science.gov (United States)

    Landry, Guillaume; Reniers, Brigitte; Pignol, Jean-Philippe; Beaulieu, Luc; Verhaegen, Frank

    2011-03-01

    The goal of this work is to compare D(m,m) (radiation transported in medium; dose scored in medium) and D(w,m) (radiation transported in medium; dose scored in water) obtained from Monte Carlo (MC) simulations for a subset of human tissues of interest in low energy photon brachytherapy. Using low dose rate seeds and an electronic brachytherapy source (EBS), the authors quantify the large cavity theory conversion factors required. The authors also assess whether ap plying large cavity theory utilizing the sources' initial photon spectra and average photon energy induces errors related to spatial spectral variations. First, ideal spherical geometries were investigated, followed by clinical brachytherapy LDR seed implants for breast and prostate cancer patients. Two types of dose calculations are performed with the GEANT4 MC code. (1) For several human tissues, dose profiles are obtained in spherical geometries centered on four types of low energy brachytherapy sources: 125I, 103Pd, and 131Cs seeds, as well as an EBS operating at 50 kV. Ratios of D(w,m) over D(m,m) are evaluated in the 0-6 cm range. In addition to mean tissue composition, compositions corresponding to one standard deviation from the mean are also studied. (2) Four clinical breast (using 103Pd) and prostate (using 125I) brachytherapy seed implants are considered. MC dose calculations are performed based on postimplant CT scans using prostate and breast tissue compositions. PTV D90 values are compared for D(w,m) and D(m,m). (1) Differences (D(w,m)/D(m,m)-1) of -3% to 70% are observed for the investigated tissues. For a given tissue, D(w,m)/D(m,m) is similar for all sources within 4% and does not vary more than 2% with distance due to very moderate spectral shifts. Variations of tissue composition about the assumed mean composition influence the conversion factors up to 38%. (2) The ratio of D90(w,m) over D90(m,m) for clinical implants matches D(w,m)/D(m,m) at 1 cm from the single point sources, Given

  5. A comparison of the relative biological effectiveness of low energy electronic brachytherapy sources in breast tissue: a Monte Carlo study.

    Science.gov (United States)

    White, Shane A; Reniers, Brigitte; de Jong, Evelyn E C; Rusch, Thomas; Verhaegen, Frank

    2016-01-07

    Electronic brachytherapy sources use low energy photons to treat the tumor bed during or after breast-conserving surgery. The relative biological effectiveness of two electronic brachytherapy sources was explored to determine if spectral differences due to source design influenced radiation quality and if radiation quality decreased with distance in the breast. The RBE was calculated through the number of DNA double strand breaks (RBEDSB) using the Monte Carlo damage simulator (MCDS) in combination with other Monte Carlo electron/photon spectrum calculations. 50kVp photons from the Intrabeam (Carl Zeiss Surgical) and Axxent (Xoft) through 40-mm spherical applicators were simulated to account for applicator and tissue attenuation in a variety of breast tissue compositions. 40kVp Axxent photons were also simulated. Secondary electrons (known to be responsible for most DNA damage) spectra at different distance were inputted into MCDS to calculate the RBEDSB. All RBEDSB used a cobalt-60 reference. RBEDSB data was combined with corresponding average photon spectrum energy for the Axxent and applied to model-based average photon energy distributions to produce an RBEDSB map of an accelerated partial breast irradiation (APBI) patient. Both Axxent and Intrabeam 50kVp spectra were shown to have a comparable RBEDSB of between 1.4 and 1.6 at all distances in spite of progressive beam hardening. The Axxent 40kVp also demonstrated a similar RBEDSB at distances. Most RBEDSB variability was dependent on the tissue type as was seen in rib (RBEDSB  ≈  1.4), gland (≈1.55), adipose (≈1.59), skin (≈1.52) and lung (≈1.50). RBEDSB variability between both sources was within 2%. A correlation was shown between RBEDSB and average photon energy and used to produce an RBEDSB map of a dose distribution in an APBI patient dataset. Radiation quality is very similar between electronic brachytherapy sources studied. No significant reductions in RBEDSB were observed with

  6. Development of sup 1 sup 9 sup 2 Ir radiation sources for intravascular irradiation

    CERN Document Server

    Kogure, H; Iwamoto, S; Iwata, K; Kawauchi, Y; Nagata, Y; Sorita, T; Suzuki, K

    2003-01-01

    Intravascular brachytherapy is a novel therapy for preventing the restenosis of coronary artery by use of low-dose irradiation. JAERI and Kyoto University have been developing sup 1 sup 9 sup 2 Ir radiation sources by the cooperative research project entitled as 'The research on safety and effectiveness of the intravascular brachytherapy for preventing restenosis of the coronary artery disease' since 1998. The radiation source was introduced into the stenosis through a catheter (a guide-tube to insert directly into vascular) to irradiate the diseased part. Ten sup 1 sup 9 sup 2 Ir seed sources (phi 0.4 mm x 2.5 mm) were positioned between nylon spacers (phi 0.3 mm x 1.0 mm) in a flexible covering tube and the tube was plugged with a core-wire; the tube was shrunk to fix the inside materials and the size is 0.46 mm in diameter and 3 m in length. The physically optimal design was determined to insert the radiation source easily into vascular and to get the dose uniformity in the diseased part. The production me...

  7. Study and methodologies for fixing epoxy resin in radioactive sources used for brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues, Bruna T.; Rostelato, Maria E.C.M.; Souza, Carla D.; Tozetti, Cíntia A.; Zeituni, Carlos A.; Nogueira, Beatriz R.; Silva, José T.; Júnior, Dib K.; Fernandes, Vagner; Souza, Raquel V.; Abreu, Rodrigo T., E-mail: bteigarodrigues@gmail.com, E-mail: elisaros@ipen.br, E-mail: carladdsouza@yahoo.com.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Universidade de São Paulo (USP), SP (Brazil)

    2017-07-01

    The World Health Organization (WHO) estimates that the number of new cancer cases worldwide will reach 15 million by 2020. The disease is already the second leading cause of death worldwide, being behind only cardiovascular disease. It is unquestionable that it is a public health problem, especially among developing countries. Prostate cancer is the most common among men, approximately 28.6%. The choice of type of treatment for prostate cancer should consider several factors such as: tumor size and extent, apparent aggressiveness (pathological characteristics), age, health. Among the methods applied, brachytherapy has been used in the initial and intermediate stages of the disease. Brachytherapy is a safe and effective treatment for localized prostate cancer. Brachytherapy is a form of radiotherapy in which radioactive seeds are placed in contact with or within the organ being treated. This technique allows a large dose of radiation to be released only on the target tumor that protects healthy surrounding tissues. Sources may have different shapes and sizes, but the one used for prostate cancer is usually 4.5 mm in length and 0.8 mm in diameter. About 80 to 120 seeds can be used per patient. Iodine-125 is the radioisotope most used in brachytherapy of the prostate, it emits 35,49keV X-rays in 100% of the decays, with average energy of 29 keV. The treatment of prostate cancer with permanent implantation of iodine-125 seeds has grown dramatically in the world in recent years. Most patients can return to normal life within three days with little or no pain. (author)

  8. Study and methodologies for fixing epoxy resin in radioactive sources used for brachytherapy

    International Nuclear Information System (INIS)

    Rodrigues, Bruna T.; Rostelato, Maria E.C.M.; Souza, Carla D.; Tozetti, Cíntia A.; Zeituni, Carlos A.; Nogueira, Beatriz R.; Silva, José T.; Júnior, Dib K.; Fernandes, Vagner; Souza, Raquel V.; Abreu, Rodrigo T.

    2017-01-01

    The World Health Organization (WHO) estimates that the number of new cancer cases worldwide will reach 15 million by 2020. The disease is already the second leading cause of death worldwide, being behind only cardiovascular disease. It is unquestionable that it is a public health problem, especially among developing countries. Prostate cancer is the most common among men, approximately 28.6%. The choice of type of treatment for prostate cancer should consider several factors such as: tumor size and extent, apparent aggressiveness (pathological characteristics), age, health. Among the methods applied, brachytherapy has been used in the initial and intermediate stages of the disease. Brachytherapy is a safe and effective treatment for localized prostate cancer. Brachytherapy is a form of radiotherapy in which radioactive seeds are placed in contact with or within the organ being treated. This technique allows a large dose of radiation to be released only on the target tumor that protects healthy surrounding tissues. Sources may have different shapes and sizes, but the one used for prostate cancer is usually 4.5 mm in length and 0.8 mm in diameter. About 80 to 120 seeds can be used per patient. Iodine-125 is the radioisotope most used in brachytherapy of the prostate, it emits 35,49keV X-rays in 100% of the decays, with average energy of 29 keV. The treatment of prostate cancer with permanent implantation of iodine-125 seeds has grown dramatically in the world in recent years. Most patients can return to normal life within three days with little or no pain. (author)

  9. Dosimetry audit on the accuracy of 192Ir brachytherapy source strength determinations in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Carlsson Tedgren, Aasa

    2007-11-15

    The absorbed dose delivered to the patient in brachytherapy is directly proportional to the source strength in terms of the reference air-kerma rate (RAKR). Verification of this quantity by the hospitals is widely recognized as an important part of a quality assurance program. An external audit was performed on behalf of the Secondary Standard Dosimetry Laboratory at the Swedish Radiation Protection Authority (SSI). The aim was to investigate how accurately the source-strength in 192Ir brachytherapy is determined at Swedish hospitals. The SSI reference well-type ion chamber and calibrated equipment were used to measure the RAKR of an 192Ir source in each of the 14 Swedish afterloading units. Comparisons with values determined by vendors and hospitals were made. Agreement in values of RAKR as determined by SSI, hospitals and vendors were in all cases within the +-3% uncertainty (at a coverage factor of k=2), typically guaranteed by the vendors. The good agreement reflects the robustness and easy handling of well-type chambers designed for brachytherapy in use by all Swedish hospitals. The 192Ir calibration service planned at SSI will solve the hospitals current problem with recalibration of equipment. SSI can also advise hospitals to follow the IAEA recommendations for measurement techniques and maintenance of equipment. It is worthwhile for the hospitals to establish their own ratio (or deviation) with the vendor and follow it as function of time. Such a mean-ratio embeds systematic differences of various origins and have a lower uncertainty than has the RAKR alone, making it useful for early detection of problems with equipment or routines. SSI could also define requirements for the agreement between source strengths as determined by hospitals and vendors and couple this to an action plan, dependent on level of disagreement, and some kind of reporting to SSI

  10. Dosimetry audit on the accuracy of 192Ir brachytherapy source strength determinations in Sweden

    International Nuclear Information System (INIS)

    Carlsson Tedgren, Aasa

    2007-11-01

    The absorbed dose delivered to the patient in brachytherapy is directly proportional to the source strength in terms of the reference air-kerma rate (RAKR). Verification of this quantity by the hospitals is widely recognized as an important part of a quality assurance program. An external audit was performed on behalf of the Secondary Standard Dosimetry Laboratory at the Swedish Radiation Protection Authority (SSI). The aim was to investigate how accurately the source-strength in 192 Ir brachytherapy is determined at Swedish hospitals. The SSI reference well-type ion chamber and calibrated equipment were used to measure the RAKR of an 192 Ir source in each of the 14 Swedish afterloading units. Comparisons with values determined by vendors and hospitals were made. Agreement in values of RAKR as determined by SSI, hospitals and vendors were in all cases within the ±3% uncertainty (at a coverage factor of k=2), typically guaranteed by the vendors. The good agreement reflects the robustness and easy handling of well-type chambers designed for brachytherapy in use by all Swedish hospitals. The 192 Ir calibration service planned at SSI will solve the hospitals current problem with recalibration of equipment. SSI can also advise hospitals to follow the IAEA recommendations for measurement techniques and maintenance of equipment. It is worthwhile for the hospitals to establish their own ratio (or deviation) with the vendor and follow it as function of time. Such a mean-ratio embeds systematic differences of various origins and have a lower uncertainty than has the RAKR alone, making it useful for early detection of problems with equipment or routines. SSI could also define requirements for the agreement between source strengths as determined by hospitals and vendors and couple this to an action plan, dependent on level of disagreement, and some kind of reporting to SSI

  11. Evaluation of TG-43 recommended 2D-anisotropy function for elongated brachytherapy sources

    International Nuclear Information System (INIS)

    Awan, Shahid B.; Meigooni, Ali S.; Mokhberiosgouei, Ramin; Hussain, Manzoor

    2006-01-01

    The original and updated protocols recommended by Task Group 43 from the American Association of Physicists in Medicine (i.e., TG-43 and TG-43U1, respectively), have been introduced to unify brachytherapy source dosimetry around the world. Both of these protocols are based on experiences with sources less than 1.0 cm in length. TG-43U1 recommends that for 103 Pd sources, 2D anisotropy function F(r,θ), should be tabulated at a minimum for radial distances of 0.5, 1.0, 2.0, 3.0, and 5.0 cm. Anisotropy functions defined in these protocols are only valid when the point of calculation does not fall on the active length of the source. However, for elongated brachytherapy sources (active length >1 cm), some of the calculation points with r 103 Pd source at radial distances of 2.5, 3.0, and 4.0 cm were 2.95, 1.74, and 1.19, respectively, with differences up to about a factor of 3. Therefore, the validity of the linear interpolation technique for an elongated brachytherapy source with such a large variation in F(r,θ) needs to be investigated. In this project, application of the TG-43U1 formalism for dose calculation around an elongated RadioCoil trade mark sign 103 Pd brachytherapy source has been investigated. In addition, the linear interpolation techniques as described in TG-43U1 for seed type sources have been evaluated for a 5.0 cm long RadioCoil trade mark sign 103 Pd brachytherapy source. Application of a polynomial fit to F(r,θ) has also been investigated as an alternate approach to the linear interpolation technique. The results of these investigations indicate that the TG-43U1 formalism can be extended for elongated brachytherapy sources, if the two-dimensional (2D) anisotropy function is tabulated at a minimum for radial distances of 0.2, 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 4.5, 5.0 cm, L/2, and L/2±0.2 cm. Moreover, with the addition of recommended radial distances for 2D anisotropy functions, the linear interpolation technique more closely replicates

  12. Brachytherapy - not pulsed and low rate brachytherapy. Medical radiation protection - ED 4248

    International Nuclear Information System (INIS)

    2008-06-01

    After an indication of authorizations required to perform brachytherapy, this sheet indicates the concerned personnel, indicates the different treatment steps, briefly describes the risk related to ionizing radiations, indicates the various aspects of risk assessment and of determination of exposure levels (definition of controlled and monitored areas, personnel classification, possible methods for dose monitoring), presents the strategy for risk management (rules regarding risk reduction, technical measures regarding the installation, individual technical measures, training and information, prevention and medical monitoring) and how this risk management can be assessed

  13. SU-F-T-06: Development of a Formalism for Practical Dose Measurements in Brachytherapy in the German Standard DIN 6803

    Energy Technology Data Exchange (ETDEWEB)

    Hensley, F [Ruprecht Karl University of Heidelberg, Heidelberg (Germany); Chofor, N [Carl von Ossietzky University of Oldenburg, Oldenburg (Germany); Schoenfeld, A [University of Oldenburg, Oldenburg (Germany); Harder, D [Georg-August University of Goettingen, Goettingen (Germany)

    2016-06-15

    Purpose: In the steep dose gradients in the vicinity of a radiation source and due to the properties of the changing photon spectra, dose measurements in Brachytherapy usually have large uncertainties. Working group DIN 6803-3 is presently discussing recommendations for practical brachytherapy dosimetry incorporating recent theoretical developments in the description of brachytherapy radiation fields as well as new detectors and phantom materials. The goal is to prepare methods and instruments to verify dose calculation algorithms and for clinical dose verification with reduced uncertainties. Methods: After analysis of the distance dependent spectral changes of the radiation field surrounding brachytherapy sources, the energy dependent response of typical brachytherapy detectors was examined with Monte Carlo simulations. A dosimetric formalism was developed allowing the correction of their energy dependence as function of source distance for a Co-60 calibrated detector. Water equivalent phantom materials were examined with Monte Carlo calculations for their influence on brachytherapy photon spectra and for their water equivalence in terms of generating equivalent distributions of photon spectra and absorbed dose to water. Results: The energy dependence of a detector in the vicinity of a brachytherapy source can be described by defining an energy correction factor kQ for brachytherapy in the same manner as in existing dosimetry protocols which incorporates volume averaging and radiation field distortion by the detector. Solid phantom materials were identified which allow precise positioning of a detector together with small correctable deviations from absorbed dose to water. Recommendations for the selection of detectors and phantom materials are being developed for different measurements in brachytherapy. Conclusion: The introduction of kQ for brachytherapy sources may allow more systematic and comparable dose measurements. In principle, the corrections can be

  14. Brachytherapy for prostate cancer: Comparative characteristics of procedures

    Directory of Open Access Journals (Sweden)

    S. V. Kanaev

    2015-01-01

    Full Text Available The introduction of interstitial radiation sources is the «youngest» of the radical method of treatment of patients with prostate cancer (PC. The high level of efficiency comparable to prostatectomy at a significantly lower rate of complications causes rapid growth of clinical use of brachytherapy (BT. Depending on the radiation source and the mode of administration into the prostate gland are two types BT – high-dose rate (temporary (HDR-BT and low-dose rate (permanent (LDR-BT brachytherapy. At the heart of these two methods are based on a single principle of direct effect of the quantum gamma radiation on the area of interest. However, the differences between the characteristics of isotopes used and technical aspects of the techniques cause the difference in performance and complication rates for expression HDR-BT and LDR-BT.

  15. Studies on the preparation of 103Pd inner core of seed sources for brachytherapy applications

    International Nuclear Information System (INIS)

    Saha, Sujata; Manolkar, R.B.; Vimalnath, K.V.; Dash, A.; Venkatesh, Meera

    2007-01-01

    103 Pd seed sources are used widely world over for brachytherapy applications. 103 Pd available in-house was used to study its deposition on silver wire using electro-deposition and electroless deposition techniques with an aim to developing the inner core preparation of sealed radiation sources for treatment of prostate and ocular melanoma. Various parameters such as radioactive concentration of the feed solution, current density, time, temperature and pH of the solution were optimized to achieve maximum 103 Pd deposition on Ag wire. In electroless technique, the deposited amount of Pd was found to be nearly triple compared to electro-deposition in two hours time period. Both the methods gave nonleachable and well adherent sources. (author)

  16. Audits in high dose rate brachytherapy in Brazil

    International Nuclear Information System (INIS)

    Marechal, M.H.; Rosa, L.A.; Velasco, A.; Paiva, E. de; Goncalves, M.; Castelo, L.C.

    2002-01-01

    The lack of well established dosimetry protocols for HDR sources is a point of great concern regarding the uniformity of procedures within a particular country. The main objective of this paper is to report the results of an implementation of the audit program in dosimetry of high dose rate brachytherapy sources used by the radiation therapy centers in Brazil. In Brazil, among 169 radiotherapy centers, 35 have HDR brachytherapy systems. This program started in August 2001 and until now eight radiotherapy services were audited. The audit program consists of the visit in loco to each center and the evaluation of the intensity of the source with a well type chamber specially design for HDR 192 Ir sources. The measurements was carried out with a HDR1000PLUS Brachytherapy Well Type Chamber and a MAX 4000 Electrometer, both manufactured by Standard Imaging Inc. The chamber was calibrated in air kerma strength by the Accredited Dosimetry Calibration Laboratory, Department of Medical Physics, University of Wisconsin in the USA. The same chamber was calibrated in Brazil using a 192 lr high dose rate source whose intensity was determined by 60 Co gamma rays and 250 kV x rays interpolation methodology. The Nk of 60 Co and 250 kV x rays were provided by the Brazilian National Standard Laboratory for Ionizing Radiation (LMNRI)

  17. Monte Carlo dosimetry of a tandem positioned beta-emitting intravascular brachytherapy source train

    International Nuclear Information System (INIS)

    Wallace, Steven A.; Schumer, Wendy; Horrigan, Mark

    2002-01-01

    Prevention of restenosis following interventional coronary procedures with catheter based beta-emitting sources is currently under clinical trial investigations. Systems utilizing fixed length source trains limit the clinician's ability to increase the radiation source length as required. A technique known as 'pull back' is used when the segment of artery requiring radiation is longer than the available fixed length source train. In this instance, tandem positioning of the fixed length source is used to treat the longer length of artery. The aim of this study was to examine the dosimetry of the junction region associated with pull back treatments using a commercially available 90 Sr/Y catheter based intravascular brachytherapy source train. Dose profiles were calculated, using the Monte Carlo code MCNP4B, at radial distances of 1.5, 2.0, and 2.5 mm for pull back techniques using 2.5 mm overlapping, abutting, and 2.5 mm spaced source trains. Results at the protocol prescription radius of 2 mm showed a junction dose elevated 61% above prescription for 2.5 mm overlapping source trains. For 2.5 mm spaced trains, this figure falls to 64% below prescription dose. In contrast, abutted source trains exhibited only a 1% depression below prescription dose in the junction region. The reference point dose rate per unit activity of this source was found to be consistent with previous studies

  18. Dosimetry audit on the accuracy of {sup 192}Ir brachytherapy source strength determinations in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Carlsson Tedgren, Aasa

    2007-11-15

    The absorbed dose delivered to the patient in brachytherapy is directly proportional to the source strength in terms of the reference air-kerma rate (RAKR). Verification of this quantity by the hospitals is widely recognized as an important part of a quality assurance program. An external audit was performed on behalf of the Secondary Standard Dosimetry Laboratory at the Swedish Radiation Protection Authority (SSI). The aim was to investigate how accurately the source-strength in {sup 192}Ir brachytherapy is determined at Swedish hospitals. The SSI reference well-type ion chamber and calibrated equipment were used to measure the RAKR of an {sup 192}Ir source in each of the 14 Swedish afterloading units. Comparisons with values determined by vendors and hospitals were made. Agreement in values of RAKR as determined by SSI, hospitals and vendors were in all cases within the {+-}3% uncertainty (at a coverage factor of k=2), typically guaranteed by the vendors. The good agreement reflects the robustness and easy handling of well-type chambers designed for brachytherapy in use by all Swedish hospitals. The {sup 192}Ir calibration service planned at SSI will solve the hospitals current problem with recalibration of equipment. SSI can also advise hospitals to follow the IAEA recommendations for measurement techniques and maintenance of equipment. It is worthwhile for the hospitals to establish their own ratio (or deviation) with the vendor and follow it as function of time. Such a mean-ratio embeds systematic differences of various origins and have a lower uncertainty than has the RAKR alone, making it useful for early detection of problems with equipment or routines. SSI could also define requirements for the agreement between source strengths as determined by hospitals and vendors and couple this to an action plan, dependent on level of disagreement, and some kind of reporting to SSI.

  19. Algorithms for the process management of sealed source brachytherapy

    International Nuclear Information System (INIS)

    Engler, M.J.; Ulin, K.; Sternick, E.S.

    1996-01-01

    Incidents and misadministrations suggest that brachytherapy may benefit form clarification of the quality management program and other mandates of the US Nuclear Regulatory Commission. To that end, flowcharts of step by step subprocesses were developed and formatted with dedicated software. The overall process was similarly organized in a complex flowchart termed a general process map. Procedural and structural indicators associated with each flowchart and map were critiqued and pre-existing documentation was revised. open-quotes Step-regulation tablesclose quotes were created to refer steps and subprocesses to Nuclear Regulatory Commission rules and recommendations in their sequences of applicability. Brachytherapy algorithms were specified as programmable, recursive processes, including therapeutic dose determination and monitoring doses to the public. These algorithms are embodied in flowcharts and step-regulation tables. A general algorithm is suggested as a template form which other facilities may derive tools to facilitate process management of sealed source brachytherapy. 11 refs., 9 figs., 2 tabs

  20. Design and dosimetric characteristics of a new endocavitary contact radiotherapy system using an electronic brachytherapy source.

    Science.gov (United States)

    Richardson, Susan; Garcia-Ramirez, Jose; Lu, Wei; Myerson, Robert J; Parikh, Parag

    2012-11-01

    To present design aspects and acceptance tests performed for clinical implementation of electronic brachytherapy treatment of early stage rectal adenocarcinoma. A dosimetric comparison is made between the historically used Philips RT-50 unit and the newly developed Axxent(®) Model S700 electronic brachytherapy source manufactured by Xoft (iCad, Inc.). Two proctoscope cones were manufactured by ElectroSurgical Instruments (ESI). Two custom surface applicators were manufactured by Xoft and were designed to fit and interlock with the proctoscope cones from ESI. Dose rates, half value layers (HVL), and percentage depth dose (PDD) measurements were made with the Xoft system and compared to historical RT-50 data. A description of the patient treatment approach and exposure rates during the procedure is also provided. The electronic brachytherapy system has a lower surface dose rate than the RT-50. The dose rate to water on the surface from the Xoft system is approximately 2.1 Gy∕min while the RT-50 is 10-12 Gy∕min. However, treatment times with Xoft are still reasonable. The HVLs and PDDs between the two systems were comparable resulting in similar doses to the target and to regions beyond the target. The exposure rate levels around a patient treatment were acceptable. The standard uncertainty in the dose rate to water on the surface is approximately ±5.2%. The Philips RT-50 unit is an out-of-date radiotherapy machine that is no longer manufactured with limited replacement parts. The use of a custom-designed proctoscope and Xoft surface applicators allows delivery of a well-established treatment with the ease of a modern radiotherapy device. While the dose rate is lower with the use of Xoft, the treatment times are still reasonable. Additionally, personnel may stand farther away from the Xoft radiation source, thus potentially reducing radiation exposure to the operator and other personnel.

  1. Dose determination in breast tumor in brachytherapy using Iridium-192

    International Nuclear Information System (INIS)

    Okuno, S.F.

    1984-01-01

    Thermoluminescent dosimetry studies in vivo and in vitro aiming to determing radiation dose in the breast tumor, in brachytherapy using Iridium-192 was done. The correlation between radiation doses in tumor and external surface of the breast was investigated for correcting the time interval of radiation source implantation. (author) [pt

  2. Cervical cancer. Application of MR imaging in brachytherapy

    International Nuclear Information System (INIS)

    Ebe, Kazuyu; Matsunaga, Naofumi

    1996-01-01

    For the purpose of application of MRI in arrangement of brachytherapy of cervical cancer, a method was proposed to see the radiation doses in surrounding tissues by superimposing the dose distribution pattern of the radiation source on the MR image. The applicator for the source was filled with water to get its T2-weighted image and was inserted in the patients. The MRI apparatus was Siemens Magnetom Vision (1.5T) with phased array coil. T2-weighted sagittal and coronary images were taken by turbospin echo and HASTE methods. The section thickness was 5 mm. The dose distribution pattern was superimposed on the frontal and lateral images by Siemens Mevaplan to see the doses in surrounding tissues. In 4 patients, it was possible to estimate the radiation dose in the posterior wall of bladder, anterior wall of rectum and urinary duct. The method is promising for arranging brachytherapy of cervical cancer. (K.H.)

  3. Novel high resolution 125I brachytherapy source dosimetry using Ge-doped optical fibres

    International Nuclear Information System (INIS)

    Issa, Fatma; Hugtenburg, Richard P.; Nisbet, Andrew; Bradley, David A.

    2013-01-01

    The steep dose gradients close to brachytherapy sources limit the ability to obtain accurate measurements of dose. Here we use a novel high spatial resolution dosimeter to measure dose around a 125 I source and compare against simulations. Ge-doped optical fibres, used as thermoluminescent dosimeters, offer sub-mm spatial resolution, linear response from 10 cGy to >1 kGy and dose-rate independence. For a 125 I brachytherapy seed in a PMMA phantom, doses were obtained for source-dosimeter separations from 0.1 cm up to several cm, supported by EGSnrc/DOSRZznrc Monte Carlo simulations and treatment planning system data. The measurements agree with simulations to within 2.3%±0.3% along the transverse and perpendicular axes and within 3.0%±0.5% for measurements investigating anisotropy in angular dose distribution. Measured and Veriseed™ brachytherapy treatment planning system (TPS) values agreed to within 2.7%±0.5%. Ge-doped optical fibre dosimeters allow detailed dose mapping around brachytherapy sources, not least in situations of high dose gradient. - Highlights: • We evaluate fall-off in dose for distances from an 125 I source of 1 mm to 60 mm. • The TL of optical fibres accommodate high dose gradients and doses that reduce by a factor of 10 3 across the range of separations. • We verify measured values using DOSRZnrc Monte Carlo code simulations and the Variseed™ Treatment Planning System. • Measured radial and angular dose are obtained with ≤3% uncertainty

  4. Radiobiological considerations in gynaecological HDR and LDR brachytherapy

    International Nuclear Information System (INIS)

    Bauer, M.; Schulz-Wendtland, R.

    1989-01-01

    In brachytherapy the advantages of high dose rate over low dose rate afterloading therapy were obvious. Out-patient treatment becomes possible, the position of the sources is reproducible and can be observed during the treatment and the patients have to be immobilised for only a short time, giving less psychological stress and a decreased risk of thrombosis and embolism. When changing from LDR to HDR afterloading therapy we are not yet able to evaluate its biological impact. Radiobiological considerations and our experimental data, however, give us the following clinical consequences by using HDR brachytherapy: There is a need for about 15 fractions or more and each increase in dose rate requires higher fractioning. Due to the steep dose rate decline and the inhomogeneous dose distribution, multiple equivalence factors are necessary when fractioning is not sufficiently high. Correction factors to reduce the dose close to the source are low, with increasing distance from the source they increase. If HDR radiation therapy is used, the percutaneous dose in the pelvic wall region should be reduced. The reduction of the dose in HDR brachytherapy is a compromise to limit the side effects caused by the radiation. The drawback is a small therapeutic range and reduced therapeutic effectivity at the tumour. (orig.) [de

  5. Development of a semiautomatic cutting machine for the fabrication of 137Cs-brachytherapy sources

    International Nuclear Information System (INIS)

    Avhad, B.G.; Dutta, M.L.; Saxena, S.K.; Dash, A.

    2004-01-01

    Cesium-137 sources are used in brachytherapy for the treatment of gynaecological cancers.The process of source preparation entails the vitrification of radioactive glass, its conversion into glass spheres, subsequent filling of spheres into platinum moulds and cutting of sources into the tubular form of dimension 1.5 mm(OD) x 5 mm(l). The large scale production of these sources demands the remote cutting operations within 4 inch thick lead shielded processing plants. This paper describes the development of a semi-automatic cutting machine, which can be used in the large scale production of 137 Cs brachytherapy sources. (author)

  6. American brachytherapy society (ABS) consensus guidelines for brachytherapy of esophageal cancer

    International Nuclear Information System (INIS)

    Gaspar, Laurie E.; Nag, Subir; Herskovic, Arnold; Mantravadi, Rao; Speiser, Burton

    1997-01-01

    Introduction: There is wide variation in the indications, treatment regimens, and dosimetry for brachytherapy in the treatment of cancer of the esophagus. No guidelines for optimal therapy currently exist. Methods and Materials: Utilizing published reports and clinical experience, representatives of the Clinical Research Committee of the American Brachytherapy Society (ABS) formulated guidelines for brachytherapy in esophageal cancer. Results: Recommendations were made for brachytherapy in the definitive and palliative treatment of esophageal cancer. (A) Definitive treatment: Good candidates for brachytherapy include patients with unifocal thoracic adeno- or squamous cancers ≤ 10 cm in length, with no evidence of intra-abdominal or metastatic disease. Contraindications include tracheal or bronchial involvement, cervical esophagus location, or stenosis that cannot be bypassed. The esophageal brachytherapy applicator should have an external diameter of 6-10 mm. If 5FU-based chemotherapy and 45-50-Gy external beam are used, recommended brachytherapy is either: (i) HDR 10 Gy in two weekly fractions of 5 Gy each; or (ii) LDR 20 Gy in a single course at 0.4-1 Gy/hr. All doses are specified 1 cm from the midsource or middwell position. Brachytherapy should follow external beam radiation therapy and should not be given concurrently with chemotherapy. (B) Palliative treatment: Patients with adeno- or squamous cancers of the thoracic esophagus with distant metastases or unresectable local disease progression/recurrence after definitive radiation treatment should be considered for brachytherapy with palliative intent. After limited dose (30 Gy) EBRT, the recommended brachytherapy is either: (i) HDR 10-14 Gy in one or two fractions; or (ii) LDR 20-25 Gy in a single course at 0.4-1 Gy/hr. The need for external beam radiation in newly diagnosed patients with a life expectancy of less than 3 months is controversial. In these cases, HDR of 15-20 Gy in two to four fractions or

  7. Directional interstitial brachytherapy from simulation to application

    Science.gov (United States)

    Lin, Liyong

    Organs at risk (OAR) are sometimes adjacent to or embedded in or overlap with the clinical target volume (CTV) to be treated. The purpose of this PhD study is to develop directionally low energy gamma-emitting interstitial brachytherapy sources. These sources can be applied between OAR to selectively reduce hot spots in the OARs and normal tissues. The reduction of dose over undesired regions can expand patient eligibility or reduce toxicities for the treatment by conventional interstitial brachytherapy. This study covers the development of a directional source from design optimization to construction of the first prototype source. The Monte Carlo code MCNP was used to simulate the radiation transport for the designs of directional sources. We have made a special construction kit to assemble radioactive and gold-shield components precisely into D-shaped titanium containers of the first directional source. Directional sources have a similar dose distribution as conventional sources on the treated side but greatly reduced dose on the shielded side, with a sharp dose gradient between them. A three-dimensional dose deposition kernel for the 125I directional source has been calculated. Treatment plans can use both directional and conventional 125I sources at the same source strength for low-dose-rate (LDR) implants to optimize the dose distributions. For prostate tumors, directional 125I LDR brachytherapy can potentially reduce genitourinary and gastrointestinal toxicities and improve potency preservation for low risk patients. The combination of better dose distribution of directional implants and better therapeutic ratio between tumor response and late reactions enables a novel temporary LDR treatment, as opposed to permanent or high-dose-rate (HDR) brachytherapy for the intermediate risk T2b and high risk T2c tumors. Supplemental external-beam treatments can be shortened with a better brachytherapy boost for T3 tumors. In conclusion, we have successfully finished the

  8. Evaluation of the response of polymeric gel modified MAGIC-f using a clinical brachytherapy source and Monte Carlo simulation with package PENELOPE

    International Nuclear Information System (INIS)

    Quevedo, Ana Luiza; Nicolucci, Patricia; Borges, Leandro F.

    2016-01-01

    In this work a comparison of experimental and simulated relative doses of a clinical brachytherapy source was performed. A 5 x 5 x 7 cm"3 phantom with a modified MAGIC-f gel was irradiated using a clinical "1"9"2Ir source and read using Magnetic Resonance Imaging. The Monte Carlo simulation package PENELOPE was used to simulate the dose distributions of the same radiation source. The dose distributions were obtained in two planes perpendicular to the source: one passing through the source's center and the other at 0.5 cm away from the source's center. The higher differences found between experimental and computational distributions were 12.5% at a point 0.62 cm from the source for the central plane and 8.6% at 1.3 cm from the source to the plane 0.5 cm away from the source's center. Considering the high dose gradient of these dose distributions, the results obtained show that the modified MAGIC-f gel is promising for brachytherapy dosimetry. (author)

  9. A method to combine three dimensional dose distributions for external beam and brachytherapy radiation treatments for gynecological neoplasms

    International Nuclear Information System (INIS)

    Narayana, V.; Sahijdak, W.M.; Orton, C.G.

    1997-01-01

    Purpose: Radiation treatment of gynecological neoplasms, such as cervical carcinoma, usually combines external radiation therapy with one or more intracavitary brachytherapy applications. Although the dose from external beam radiation therapy and brachytherapy can be calculated and displayed in 3D individually, the dose distributions are not combined. At most, combined point doses are calculated for select points using various time-dose models. In this study, we present a methodology to combine external beam and brachytherapy treatments for gynecological neoplasms. Material and Methods: Three dimensional bio-effect treatment planning to obtain complication probability has been outlined. CT scans of the patient's pelvis with the gynecological applicator in place are used to outline normal tissue and tumor volumes. 3D external beam and brachytherapy treatment plans are developed separately and an external beam dose matrix and a brachytherapy dose matrix was calculated. The dose in each voxel was assumed to be homogeneous. The physical dose in each voxel of the dose matrix was then converted into extrapolated response dose (ERD) based on the linear quadratic model that accounts for the dose per fraction, number of fractions, dose rate, and complete or incomplete repair of sublethal damage (time between fractions). The net biological dose delivered was obtained by summing the ERD grids from external beam and brachytherapy since there was complete repair of sublethal damage between external beam and brachytherapy treatments. The normal tissue complication probability and tumor control probability were obtained using the biological dose matrix based on the critical element model. Results: The outlined method of combining external beam and brachytherapy treatments was implemented on gynecological treatments using an applicator for brachytherapy treatments. Conclusion: Implementation of the biological dose calculation that combine different modalities is extremely useful

  10. MR-based source localization for MR-guided HDR brachytherapy

    Science.gov (United States)

    Beld, E.; Moerland, M. A.; Zijlstra, F.; Viergever, M. A.; Lagendijk, J. J. W.; Seevinck, P. R.

    2018-04-01

    For the purpose of MR-guided high-dose-rate (HDR) brachytherapy, a method for real-time localization of an HDR brachytherapy source was developed, which requires high spatial and temporal resolutions. MR-based localization of an HDR source serves two main aims. First, it enables real-time treatment verification by determination of the HDR source positions during treatment. Second, when using a dummy source, MR-based source localization provides an automatic detection of the source dwell positions after catheter insertion, allowing elimination of the catheter reconstruction procedure. Localization of the HDR source was conducted by simulation of the MR artifacts, followed by a phase correlation localization algorithm applied to the MR images and the simulated images, to determine the position of the HDR source in the MR images. To increase the temporal resolution of the MR acquisition, the spatial resolution was decreased, and a subpixel localization operation was introduced. Furthermore, parallel imaging (sensitivity encoding) was applied to further decrease the MR scan time. The localization method was validated by a comparison with CT, and the accuracy and precision were investigated. The results demonstrated that the described method could be used to determine the HDR source position with a high accuracy (0.4–0.6 mm) and a high precision (⩽0.1 mm), at high temporal resolutions (0.15–1.2 s per slice). This would enable real-time treatment verification as well as an automatic detection of the source dwell positions.

  11. Deterministic calculations of radiation doses from brachytherapy seeds

    International Nuclear Information System (INIS)

    Reis, Sergio Carneiro dos; Vasconcelos, Vanderley de; Santos, Ana Maria Matildes dos

    2009-01-01

    Brachytherapy is used for treating certain types of cancer by inserting radioactive sources into tumours. CDTN/CNEN is developing brachytherapy seeds to be used mainly in prostate cancer treatment. Dose calculations play a very significant role in the characterization of the developed seeds. The current state-of-the-art of computation dosimetry relies on Monte Carlo methods using, for instance, MCNP codes. However, deterministic calculations have some advantages, as, for example, short computer time to find solutions. This paper presents a software developed to calculate doses in a two-dimensional space surrounding the seed, using a deterministic algorithm. The analysed seeds consist of capsules similar to IMC6711 (OncoSeed), that are commercially available. The exposure rates and absorbed doses are computed using the Sievert integral and the Meisberger third order polynomial, respectively. The software also allows the isodose visualization at the surface plan. The user can choose between four different radionuclides ( 192 Ir, 198 Au, 137 Cs and 60 Co). He also have to enter as input data: the exposure rate constant; the source activity; the active length of the source; the number of segments in which the source will be divided; the total source length; the source diameter; and the actual and effective source thickness. The computed results were benchmarked against results from literature and developed software will be used to support the characterization process of the source that is being developed at CDTN. The software was implemented using Borland Delphi in Windows environment and is an alternative to Monte Carlo based codes. (author)

  12. Advancements in brachytherapy

    DEFF Research Database (Denmark)

    Tanderup, Kari; Ménard, Cynthia; Polgar, Csaba

    2017-01-01

    Brachytherapy is a radiotherapy modality associated with a highly focal dose distribution. Brachytherapy treats the cancer tissue from the inside, and the radiation does not travel through healthy tissue to reach the target as with external beam radiotherapy techniques. The nature of brachytherap...

  13. Dosimetry experience of 192IR sources used In HDR brachytherapy for cervical cancer

    International Nuclear Information System (INIS)

    Daci, Lulzime; Myrku, Rodina Cela

    2013-01-01

    Purpose/Objective: The 192IR Sources are the most commonly used in radiotherapy treatments HDR worldwide. According to international recommendations on quality assurance in HDR brachytherapy, an acceptance test based on the determination of the source strength of any new source shall be carried out before first application to verify the manufacturer’s calibration data. The present paper gives the experimental determination of the source strength for our brachytherapy sources used until now in brachytherapy treatments. Materials/Methods: At Mother Teresa University Hospital we have a cost-effective gynecological brachytherapy unit from Eckert & Ziegler BEBIG named GyneSource® that is a five channel HDR after loader equipped with an 192IR source. The software used is HDR plus™ 2.5 that delivers an optimized treatment plan and makes the process especially fast and we use intracavitary BEBIG applicators. From April 2009 up to December 2012, we have imported nine HDR 192IR Sources. The exchange of the source and acceptance test is done by the physicist of the clinic once the source is imported. The measurements are done with a Well-type ionization chamber HDR1000 Plus and the electrometer used is MAX4000. Only seven sources are compared as we miss the dosimetry data of the first source, and the forth source was not measured and not used because the machine was not working in that time. Results/Conclusions: Eight sources were accepted for clinically use as the measurement were within the tolerance. The source number four with e deviation of -1.92% has been double checked compared with a free in-air measurement with farmer type chamber that gave a deviation to source certificate of 4% that is still inside the tolerance to accept a source for clinical use. The deviations of measured Air Kerma rate to the value of the sources certificates of all our used 192IR sources are less than 2%, which are within the tolerance. The checked value of updated source strength in

  14. Radiological protection on interstitial brachytherapy and dose determination and exposure rate of an Ir-192 source through the MCNP-4B

    International Nuclear Information System (INIS)

    Morales L, M.E.

    2006-01-01

    The present work was carried out in the Neurological Sciences Institute having as objective to determine the dose and the rate of exhibition of the sources of Iridium 192, Iodine 125 and Palladium 103; which are used to carry out implant in the Interstitial Brachytherapy according to the TG43. For it we carry out a theoretical calculation, its are defined in the enter file: the geometry, materials of the problem and the radiation source, etc; in the MCNP-4B Monte Carlo code, considering a punctual source and for the dose determination we simulate thermoluminescent dosemeters (TLD): at 5 cm, 50 cm, 100 cm and 200 cm of the source. Our purpose is to analyze the radioprotection measures that should take into account in this Institute in which are carried out brain biopsies using a Micro mar stereotactic mark, and in a near future with the collaboration of a doctor and a cuban physique seeks to be carried out the Interstitial Brachytherapy technique with sources of Ir-192 for patient with tumors like glioblastoma, astrocytoma, etc. (Author)

  15. Radiation exposure after permanent prostate brachytherapy

    International Nuclear Information System (INIS)

    Cattani, Federica; Vavassori, Andrea; Polo, Alfredo; Rondi, Elena; Cambria, Raffaella; Orecchia, Roberto; Tosi, Giampiero

    2006-01-01

    Background and purpose: Limited information is available on the true radiation exposure and associated risks for the relatives of the patients submitted to prostate brachytherapy with permanent implant of radioactive sources and for any other people coming into contact with them. In order to provide appropriate information, we analyzed the radiation exposure data from 216 prostate cancer patients who underwent 125 I or 103 Pd implants at the European Institute of Oncology of Milan, Italy. Patients and methods: Between October 1999 and October 2004, 216 patients with low risk prostate carcinoma were treated with 125 I (200 patients) or 103 Pd (16 patients) permanent seed implantation. One day after the procedure, radiation exposure measurements around the patients were performed using an ionization chamber survey meter (Victoreen RPO-50) calibrated in dose rate at an accredited calibration center (calibration Centre SIT 104). Results: The mean dose rate at the posterior skin surface (gluteal region) following 125 I implants was 41.3 μSv/h (range: 6.2-99.4 μSv/h) and following 103 Pd implants was 18.9 μSv/h (range 5.0-37.3 μSv/h). The dose rate at 50 cm from the skin decreased to the mean value of 6.4 μSv/h for the 125 I implants and to the mean value of 1.7 μSv/h for the 103 Pd implants. Total times required to reach the annual dose limit (1 mSv/year) recommended for the general population by the European Directive 96/29/Euratom and by the Italian law (Decreto Legislativo 241/2000) at a distance of 50 cm from the posterior skin surface of the implanted patient would be 7.7 and 21.6 days for 125 I and for 103 Pd. Good correlation between the measured dose rates and both the total implanted activity and the distance between the most posteriorly implanted seed and the skin surface of the patients was found. Conclusions: Our data show that the dose rates at 50 cm away from the prostate brachytherapy patients are very low and that the doses possibly absorbed by the

  16. Optical fibre luminescence sensor for real-time LDR brachytherapy dosimetry

    Science.gov (United States)

    Woulfe, P.; O'Keeffe, S.; Sullivan, F. J.

    2018-02-01

    An optical fibre sensor for monitoring low dose radiation is presented. The sensor is based on a scintillation material embedded within the optical fibre core, which emits visible light when exposed to low level ionising radiation. The incident level of ionising radiation can be determined by analysing the optical emission. An optical fibre sensor is developed, based on radioluminescence whereby radiation sensitive scintillation material, terbium doped gadolinium oxysulphide (Gd2O2S:Tb), is embedded in a cavity of 700μm of a 1mm plastic optical fibre. The sensor is designed for in-vivo monitoring of the radiation dose during radio-active seed implantation for low dose rate (LDR) brachytherapy, in prostate cancer treatment, providing radiation oncologists with real-time information of the radiation dose to the target area and/or nearby organs at risk (OARs). The radiation from the brachytherapy seeds causes emission of visible light from the scintillation material through the process of radioluminescence, which penetrates the fibre, propagating along the optical fibre for remote detection using a multi-pixel photon counter. The sensor demonstrates a high sensitivity to 0.397mCi of Iodine125, the radioactive source most commonly used in brachytherapy for treating prostate cancer.

  17. Prostate cancer brachytherapy

    International Nuclear Information System (INIS)

    Abreu, Carlos Eduardo Vita; Silva, Joao L. F.; Srougi, Miguel; Nesrallah, Adriano

    1999-01-01

    The transperineal brachytherapy with 125 I/Pd 103 seed implantation guided by transurethral ultrasound must be presented as therapeutical option of low urinary morbidity in patients with localized prostate cancer. The combined clinical staging - including Gleason and initial PSA - must be encouraged, for definition of a group of low risk and indication of exclusive brachytherapy. Random prospective studies are necessary in order to define the best role of brachytherapy, surgery and external beam radiation therapy

  18. Three-dimensional tomosynthetic image restoration for brachytherapy source localization

    International Nuclear Information System (INIS)

    Persons, Timothy M.

    2001-01-01

    Tomosynthetic image reconstruction allows for the production of a virtually infinite number of slices from a finite number of projection views of a subject. If the reconstructed image volume is viewed in toto, and the three-dimensional (3D) impulse response is accurately known, then it is possible to solve the inverse problem (deconvolution) using canonical image restoration methods (such as Wiener filtering or solution by conjugate gradient least squares iteration) by extension to three dimensions in either the spatial or the frequency domains. This dissertation presents modified direct and iterative restoration methods for solving the inverse tomosynthetic imaging problem in 3D. The significant blur artifact that is common to tomosynthetic reconstructions is deconvolved by solving for the entire 3D image at once. The 3D impulse response is computed analytically using a fiducial reference schema as realized in a robust, self-calibrating solution to generalized tomosynthesis. 3D modulation transfer function analysis is used to characterize the tomosynthetic resolution of the 3D reconstructions. The relevant clinical application of these methods is 3D imaging for brachytherapy source localization. Conventional localization schemes for brachytherapy implants using orthogonal or stereoscopic projection radiographs suffer from scaling distortions and poor visibility of implanted seeds, resulting in compromised source tracking (reported errors: 2-4 mm) and dosimetric inaccuracy. 3D image reconstruction (using a well-chosen projection sampling scheme) and restoration of a prostate brachytherapy phantom is used for testing. The approaches presented in this work localize source centroids with submillimeter error in two Cartesian dimensions and just over one millimeter error in the third

  19. American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy

    International Nuclear Information System (INIS)

    Erickson, Beth A.; Demanes, D. Jeffrey; Ibbott, Geoffrey S.; Hayes, John K.; Hsu, I-Chow J.; Morris, David E.; Rabinovitch, Rachel A.; Tward, Jonathan D.; Rosenthal, Seth A.

    2011-01-01

    High-Dose-Rate (HDR) brachytherapy is a safe and efficacious treatment option for patients with a variety of different malignancies. Careful adherence to established standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced a practice guideline for HDR brachytherapy. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrists. Review of the leading indications for HDR brachytherapy in the management of gynecologic, thoracic, gastrointestinal, breast, urologic, head and neck, and soft tissue tumors is presented. Logistics with respect to the brachytherapy implant procedures and attention to radiation safety procedures and documentation are presented. Adherence to these practice guidelines can be part of ensuring quality and safety in a successful HDR brachytherapy program.

  20. Evaluation of (101)Rh as a brachytherapy source.

    Science.gov (United States)

    Pakravan, Delaram; Ghorbani, Mahdi; Meigooni, Ali Soleimani

    2015-04-01

    Recently a number of hypothetical sources have been proposed and evaluated for use in brachytherapy. In the present study, a hypothetical (101)Rh source with mean photon energy of 121.5 keV and half-life of 3.3 years, has been evaluated as an alternative to the existing high-dose-rate (HDR) sources. Dosimetric characteristics of this source model have been determined following the recommendation of the Task Group 43 (TG-43) of the American Association of the Physicist in Medicine (AAPM), and the results are compared with the published data for (57)Co source and Flexisource (192)Ir sources with similar geometries. MCNPX Monte Carlo code was used for simulation of the (101)Rh hypothetical HDR source design. Geometric design of this hypothetical source was considered to be similar to that of Flexisource (192)Ir source. Task group No. 43 dosimetric parameters, including air kerma strength per mCi, dose rate constant, radial dose function, and two dimensional (2D) anisotropy functions were calculated for the (101)Rh source through simulations. Air kerma strength per activity and dose rate constant for the hypothetical (101)Rh source were 1.09 ± 0.01 U/mCi and 1.18 ± 0.08 cGy/(h.U), respectively. At distances beyond 1.0 cm in phantom, radial dose function for the hypothetical (101)Rh source is higher than that of (192)Ir. It has also similar 2D anisotropy functions to the Flexisource (192)Ir source. (101)Rh is proposed as an alternative to the existing HDR sources for use in brachytherapy. This source provides medium energy photons, relatively long half-life, higher dose rate constant and radial dose function, and similar 2D anisotropy function to the Flexisource (192)Ir HDR source design. The longer half-life of the source reduces the frequency of the source exchange for the clinical environment.

  1. Evaluation of 101Rh as a brachytherapy source

    Science.gov (United States)

    Ghorbani, Mahdi; Meigooni, Ali Soleimani

    2015-01-01

    Purpose Recently a number of hypothetical sources have been proposed and evaluated for use in brachytherapy. In the present study, a hypothetical 101Rh source with mean photon energy of 121.5 keV and half-life of 3.3 years, has been evaluated as an alternative to the existing high-dose-rate (HDR) sources. Dosimetric characteristics of this source model have been determined following the recommendation of the Task Group 43 (TG-43) of the American Association of the Physicist in Medicine (AAPM), and the results are compared with the published data for 57Co source and Flexisource 192Ir sources with similar geometries. Material and methods MCNPX Monte Carlo code was used for simulation of the 101Rh hypothetical HDR source design. Geometric design of this hypothetical source was considered to be similar to that of Flexisource 192Ir source. Task group No. 43 dosimetric parameters, including air kerma strength per mCi, dose rate constant, radial dose function, and two dimensional (2D) anisotropy functions were calculated for the 101Rh source through simulations. Results Air kerma strength per activity and dose rate constant for the hypothetical 101Rh source were 1.09 ± 0.01 U/mCi and 1.18 ± 0.08 cGy/(h.U), respectively. At distances beyond 1.0 cm in phantom, radial dose function for the hypothetical 101Rh source is higher than that of 192Ir. It has also similar 2D anisotropy functions to the Flexisource 192Ir source. Conclusions 101Rh is proposed as an alternative to the existing HDR sources for use in brachytherapy. This source provides medium energy photons, relatively long half-life, higher dose rate constant and radial dose function, and similar 2D anisotropy function to the Flexisource 192Ir HDR source design. The longer half-life of the source reduces the frequency of the source exchange for the clinical environment. PMID:26034499

  2. Biology of dose rate in brachytherapy

    International Nuclear Information System (INIS)

    Brenner, David J.

    1995-01-01

    Purpose: This course is designed for practitioners and beginners in brachytherapy. The aim is to review biological principles underlying brachytherapy, to understand why current treatment regimes are the way they are, and to discuss what the future may hold in store. Brachytherapy has a long history. It was suggested as long ago as 1903 by Alexander Graham Bell, and the optimal application of this technique has been a subject of debate ever since. 'Brachy' means 'short', and the essential features of conventional brachytherapy are: positioning of the source a short distance from, or in, the tumor, allowing good dose distributions; short overall treatment times, to counter tumor repopulation; low dose rate, enabling a good therapeutic advantage between tumor control and damage to late-responding tissue. The advantages of good dose distributions speak for themselves; in some situations, as we shall see, computer-based dose optimization can be used to improve them still further. The advantages of short overall times stem from the fact that accelerated repopulation of the tumor typically begins a few weeks after the start of a radiation treatment. If all the radiation can be crammed in before that time, the risks of tumor repopulation can be considerably reduced. In fact even external-beam radiotherapy is moving in this direction, with the use of highly accelerated protocols. The advantages of low dose rate stem from the differential response to fractionation of early- and late-responding tissues. Essentially, lowering the dose rate spares late-responding tissue more than it does early-responding tissue such as tumors. We shall also discuss some recent innovations in the context of the general principles that have been outlined. For example, High dose rate brachytherapy, particularly for the uterine cervix: Does it work? If so, when and why? Use of Ir-192 sources, with a half life of 70 days: Should corrections be made for changing biological effectiveness as the dose

  3. WE-DE-201-08: Multi-Source Rotating Shield Brachytherapy Apparatus for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dadkhah, H; Wu, X [University of Iowa, Iowa City, Iowa (United States); Kim, Y; Flynn, R [University of Iowa Hospitals and Clinics, Iowa City, IA (United States)

    2016-06-15

    Purpose: To introduce a novel multi-source rotating shield brachytherapy (RSBT) apparatus for the precise simultaneous angular and linear positioning of all partially-shielded 153Gd radiation sources in interstitial needles for treating prostate cancer. The mechanism is designed to lower the detrimental dose to healthy tissues, the urethra in particular, relative to conventional high-dose-rate brachytherapy (HDR-BT) techniques. Methods: Following needle implantation, the delivery system is docked to the patient template. Each needle is coupled to a multi-source afterloader catheter by a connector passing through a shaft. The shafts are rotated by translating a moving template between two stationary templates. Shaft walls as well as moving template holes are threaded such that the resistive friction produced between the two parts exerts enough force on the shafts to bring about the rotation. Rotation of the shaft is then transmitted to the shielded source via several keys. Thus, shaft angular position is fully correlated with the position of the moving template. The catheter angles are simultaneously incremented throughout treatment as needed, and only a single 360° rotation of all catheters is needed for a full treatment. For each rotation angle, source depth in each needle is controlled by a multi-source afterloader, which is proposed as an array of belt-driven linear actuators, each of which drives a source wire. Results: Optimized treatment plans based on Monte Carlo dose calculations demonstrated RSBT with the proposed apparatus reduced urethral D{sub 1cc} below that of conventional HDR-BT by 35% for urethral dose gradient volume within 3 mm of the urethra surface. Treatment time to deliver 20 Gy with multi-source RSBT apparatus using nineteen 62.4 GBq {sup 153}Gd sources is 117 min. Conclusions: The proposed RSBT delivery apparatus in conjunction with multiple nitinol catheter-mounted platinum-shielded {sup 153}Gd sources enables a mechanically feasible

  4. Patient effective dose from endovascular brachytherapy with 192Ir Sources

    International Nuclear Information System (INIS)

    Perna, L.; Bianchi, C.; Novario, R.; Nicolini, G.; Tanzi, F.; Conte, L.

    2002-01-01

    The growing use of endovascular brachytherapy has been accompanied by the publication of a large number of studies in several fields, but few studies on patient dose have been found in the literature. Moreover, these studies were carried out on the basis of Monte Carlo simulation. The aim of the present study was to estimate the effective dose to the patient undergoing endovascular brachytherapy treatment with 192 Ir sources, by means of experimental measurements. Two standard treatments were taken into account: an endovascular brachytherapy of the coronary artery corresponding to the activity x time product of 184 GBq.min and an endovascular brachytherapy of the renal artery (898 GBq.min). Experimental assessment was accomplished by thermoluminescence dosemeters positioned in more than 300 measurement points in a properly adapted Rando phantom. A method has been developed to estimate the mean organ doses for all tissues and organs concerned in order to calculate the effective dose associated with intravascular brachytherapy. The normalised organ doses resulting from coronary treatment were 2.4x10 -2 mSv.GBq -1 .min -1 for lung, 0.9x10 -2 mSv.GBq -1 .min -1 for oesophagus and 0.48x10 -2 mSv.GBq -1 .min -1 for bone marrow. During brachytherapy of the renal artery, the corresponding normalised doses were 4.2x10 -2 mSv.GBq -1 .min -1 for colon, 7.8x10 -2 mSv.GBq -1 .min -1 for stomach and 1.7x10 -2 mSv.GBq -1 .min -1 for liver. Coronary treatment involved an effective dose of 0.046 mSv.GBq -1 .min -1 , whereas the treatment of the renal artery resulted in an effective dose of 0.15 mSv.GBq -1 .min -1 ; there were many similarities with data from former studies. Based on these results it can be concluded that the dose level of patients exposed during brachytherapy treatment is low. (author)

  5. High dose-rate brachytherapy source position quality assurance using radiochromic film

    International Nuclear Information System (INIS)

    Evans, M.D.C.; Devic, S.; Podgorsak, E.B.

    2007-01-01

    Traditionally, radiographic film has been used to verify high-dose-rate brachytherapy source position accuracy by co-registering autoradiographic and diagnostic images of the associated applicator. Filmless PACS-based clinics that do not have access to radiographic film and wet developers may have trouble performing this quality assurance test in a simple and practical manner. We describe an alternative method for quality assurance using radiochromic-type film. In addition to being easy and practical to use, radiochromic film has some advantages in comparison with traditional radiographic film when used for HDR brachytherapy quality assurance

  6. MO-D-BRD-03: Radiobiology and Commissioning of Electronic Brachytherapy for IORT

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, J. [Oregon Health & Science Univ (United States)

    2015-06-15

    Electronic brachytherapy (eBT) has seen an insurgence of manufacturers entering the US market for use in radiation therapy. In addition to the established interstitial, intraluminary, and intracavitary applications of eBT, many centers are now using eBT to treat skin lesions. It is important for medical physicists working with electronic brachytherapy sources to understand the basic physics principles of the sources themselves as well as the variety of applications for which they are being used. The calibration of the sources is different from vendor to vendor and the traceability of calibrations has evolved as new sources came to market. In 2014, a new air-kerma based standard was introduced by the National Institute of Standards and Technology (NIST) to measure the output of an eBT source. Eventually commercial treatment planning systems should accommodate this new standard and provide NIST traceability to the end user. The calibration and commissioning of an eBT system is unique to its application and typically entails a list of procedural recommendations by the manufacturer. Commissioning measurements are performed using a variety of methods, some of which are modifications of existing AAPM Task Group protocols. A medical physicist should be familiar with the different AAPM Task Group recommendations for applicability to eBT and how to properly adapt them to their needs. In addition to the physical characteristics of an eBT source, the photon energy is substantially lower than from HDR Ir-192 sources. Consequently, tissue-specific dosimetry and radiobiological considerations are necessary when comparing these brachytherapy modalities and when making clinical decisions as a radiation therapy team. In this session, the physical characteristics and calibration methodologies of eBt sources will be presented as well as radiobiology considerations and other important clinical considerations. Learning Objectives: To understand the basic principles of electronic

  7. Comparison of the hypothetical (57)Co brachytherapy source with the (192)Ir source.

    Science.gov (United States)

    Toossi, Mohammad Taghi Bahreyni; Ghorbani, Mahdi; Rostami, Atefeh; Khosroabadi, Mohsen; Khademi, Sara; Knaup, Courtney

    2016-01-01

    The (57)Co radioisotope has recently been proposed as a hypothetical brachytherapy source due to its high specific activity, appropriate half-life (272 days) and medium energy photons (114.17 keV on average). In this study, Task Group No. 43 dosimetric parameters were calculated and reported for a hypothetical (57)Co source. A hypothetical (57)Co source was simulated in MCNPX, consisting of an active cylinder with 3.5 mm length and 0.6 mm radius encapsulated in a stainless steel capsule. Three photon energies were utilized (136 keV [10.68%], 122 keV [85.60%], 14 keV [9.16%]) for the (57)Co source. Air kerma strength, dose rate constant, radial dose function, anisotropy function, and isodose curves for the source were calculated and compared to the corresponding data for a (192)Ir source. The results are presented as tables and figures. Air kerma strength per 1 mCi activity for the (57)Co source was 0.46 cGyh(-1) cm 2 mCi(-1). The dose rate constant for the (57)Co source was determined to be 1.215 cGyh(-1)U(-1). The radial dose function for the (57)Co source has an increasing trend due to multiple scattering of low energy photons. The anisotropy function for the (57)Co source at various distances from the source is more isotropic than the (192)Ir source. The (57)Co source has advantages over (192)Ir due to its lower energy photons, longer half-life, higher dose rate constant and more isotropic anisotropic function. However, the (192)Ir source has a higher initial air kerma strength and more uniform radial dose function. These properties make (57)Co a suitable source for use in brachytherapy applications.

  8. Design and dosimetric characteristics of a new endocavitary contact radiotherapy system using an electronic brachytherapy source

    International Nuclear Information System (INIS)

    Richardson, Susan; Garcia-Ramirez, Jose; Lu Wei; Myerson, Robert J.; Parikh, Parag

    2012-01-01

    Purpose: To present design aspects and acceptance tests performed for clinical implementation of electronic brachytherapy treatment of early stage rectal adenocarcinoma. A dosimetric comparison is made between the historically used Philips RT-50 unit and the newly developed Axxent ® Model S700 electronic brachytherapy source manufactured by Xoft (iCad, Inc.). Methods: Two proctoscope cones were manufactured by ElectroSurgical Instruments (ESI). Two custom surface applicators were manufactured by Xoft and were designed to fit and interlock with the proctoscope cones from ESI. Dose rates, half value layers (HVL), and percentage depth dose (PDD) measurements were made with the Xoft system and compared to historical RT-50 data. A description of the patient treatment approach and exposure rates during the procedure is also provided. Results: The electronic brachytherapy system has a lower surface dose rate than the RT-50. The dose rate to water on the surface from the Xoft system is approximately 2.1 Gy/min while the RT-50 is 10–12 Gy/min. However, treatment times with Xoft are still reasonable. The HVLs and PDDs between the two systems were comparable resulting in similar doses to the target and to regions beyond the target. The exposure rate levels around a patient treatment were acceptable. The standard uncertainty in the dose rate to water on the surface is approximately ±5.2%. Conclusions: The Philips RT-50 unit is an out-of-date radiotherapy machine that is no longer manufactured with limited replacement parts. The use of a custom-designed proctoscope and Xoft surface applicators allows delivery of a well-established treatment with the ease of a modern radiotherapy device. While the dose rate is lower with the use of Xoft, the treatment times are still reasonable. Additionally, personnel may stand farther away from the Xoft radiation source, thus potentially reducing radiation exposure to the operator and other personnel.

  9. Design and dosimetric characteristics of a new endocavitary contact radiotherapy system using an electronic brachytherapy source

    Energy Technology Data Exchange (ETDEWEB)

    Richardson, Susan; Garcia-Ramirez, Jose; Lu Wei; Myerson, Robert J.; Parikh, Parag [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri 63110 (United States); Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland 21201 (United States); Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri 63110 (United States)

    2012-11-15

    Purpose: To present design aspects and acceptance tests performed for clinical implementation of electronic brachytherapy treatment of early stage rectal adenocarcinoma. A dosimetric comparison is made between the historically used Philips RT-50 unit and the newly developed Axxent{sup Registered-Sign} Model S700 electronic brachytherapy source manufactured by Xoft (iCad, Inc.). Methods: Two proctoscope cones were manufactured by ElectroSurgical Instruments (ESI). Two custom surface applicators were manufactured by Xoft and were designed to fit and interlock with the proctoscope cones from ESI. Dose rates, half value layers (HVL), and percentage depth dose (PDD) measurements were made with the Xoft system and compared to historical RT-50 data. A description of the patient treatment approach and exposure rates during the procedure is also provided. Results: The electronic brachytherapy system has a lower surface dose rate than the RT-50. The dose rate to water on the surface from the Xoft system is approximately 2.1 Gy/min while the RT-50 is 10-12 Gy/min. However, treatment times with Xoft are still reasonable. The HVLs and PDDs between the two systems were comparable resulting in similar doses to the target and to regions beyond the target. The exposure rate levels around a patient treatment were acceptable. The standard uncertainty in the dose rate to water on the surface is approximately {+-}5.2%. Conclusions: The Philips RT-50 unit is an out-of-date radiotherapy machine that is no longer manufactured with limited replacement parts. The use of a custom-designed proctoscope and Xoft surface applicators allows delivery of a well-established treatment with the ease of a modern radiotherapy device. While the dose rate is lower with the use of Xoft, the treatment times are still reasonable. Additionally, personnel may stand farther away from the Xoft radiation source, thus potentially reducing radiation exposure to the operator and other personnel.

  10. Application of Gafchromic registered film in the dosimetry of an intravascular brachytherapy source

    International Nuclear Information System (INIS)

    Song Haijun; Roa, D. Eduardo; Yue Ning; D'Errico, Francesco; Chen Zhe; Nath, Ravinder

    2006-01-01

    The methodology of brachytherapy source dosimetry with Gafchromic registered MD 55-2 film (ISP Technologies, Inc.) is examined with an emphasis on the nonlinearity of the optical density-dose relation within the dynamic dose range, the radial distance-dependent measurement uncertainty, and the format of data presentation. The specific source chosen for this study was a Checkmate trade mark sign (Cordis Corporation) intravascular brachytherapy system. The two-dimensional dose distribution around the source was characterized by a comprehensive analysis of measurement uncertainties. A comparative analysis of the dosimetric data from the vendor and from the scientific literature showed a substantial consistency of the information available for the Checkmate trade mark sign source. Our two-dimensional dosimetric data for the Checkmate trade mark sign source trains is presented in the form of measured along and away dose tables

  11. Intra coronary brachytherapy

    International Nuclear Information System (INIS)

    Ghofourian, H.; Ghahremani, A.; Oliaie, A.; Taghizadeh Asl, M.

    2002-01-01

    Despite the initial promise of vasculopathy intervention restenosis- a consequence of the (normal) would healing process-has emerged as a major problem. Angiographic restenosis has been reported in 40-60% of patients after successful P TCA. The basic mechanism of restenosis, (acute recoil, negative remodeling and neo intimal hyperplasia), are only partially counteracted by endovascular prosthetic devices (s tents). The rate of in-s tent restenosis, which is primarily caused by neo intimal hyperplasia due to the (micro) trauma of the arterial wall by the s tent struts, has been reduced to 18-32%. Ionizing (beta or gamma) radiations has been established as a potent treatment for malignant disorders. In recent years, there has also been increasing interest among clinicians in the management of benign lesions with radiation. Over the past several years, there has been a growing body of evidence that endovascular brachytherapy has a major impact on the biology of the restenosis. It must be underlined that understanding the biology and pathophysiology of restenosis and assessing various treatment options should preferably be a team effort, with the three g races b eing interventional cardiologist, nuclear oncologist, and industrial partners. The vast amount of data in over 20000 patients from a wide range of randomized controlled trials, has shown that brachytherapy is the only effective treatment for in-s tent restenosis. We are learning more and more about how to improve brachytherapy. While the new coated s tents that we heard about today is fascinating and extremely promising, brachytherapy still has a very important place in difficult patients, such as those with total occlusions, osti al lesions, left main lesions, multivessel disease and diabetes. Regarding to above mentioned tips, we (a research team work, in the Nuclear Research Center Of the Atomic Energy Organization Of Iran), focused on synthesis and preparation of radioactive materials for use in I c-B T. We

  12. Radiation safety parameters following prostate brachytherapy

    International Nuclear Information System (INIS)

    Smathers, Sesalie; Wallner, Kent; Korssjoen, Tammy; Bergsagel, Carl; Hudson, Rick H.; Sutlief, Steven; Blasko, John

    1999-01-01

    Purpose: To determine the degree and variability of radiation exposure to the general public from patients after I-125 or Pd-103 prostate brachytherapy. Methods and Materials: Radiation exposure measurements were made from 38 consecutive, unselected patients with stage T1 or T2 prostatic carcinoma who had trans perineal I-125 or Pd-103 implants at the University of Washington in 1998. Results: The exposure rate at the anterior skin surface following a I-125 implant ranged from 2.2 to 8.9 mrem/hour (average: 5.0). The exposure rate at the anterior skin surface from a Pd-103 implant ranged from 0.5 to 4.9 mrem/hour (average: 1.7). Based on the current Nuclear Regulatory Commission (NRC) regulations the time required to reach the annual limit at the anterior skin surface would be 20 hours for I-125 and 59 hours for Pd-103. For exposure at the lateral skin surface, the times would exceed 500 hours for either isotope. Conclusions: This data suggest that patients need not be concerned about being a radiation risk to the general public following their procedure

  13. American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Transperineal Permanent Brachytherapy of Prostate Cancer

    International Nuclear Information System (INIS)

    Rosenthal, Seth A.; Bittner, Nathan H.J.; Beyer, David C.; Demanes, D. Jeffrey; Goldsmith, Brian J.; Horwitz, Eric M.; Ibbott, Geoffrey S.; Lee, W. Robert; Nag, Subir; Suh, W. Warren; Potters, Louis

    2011-01-01

    Transperineal permanent prostate brachytherapy is a safe and efficacious treatment option for patients with organ-confined prostate cancer. Careful adherence to established brachytherapy standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced a practice guideline for permanent prostate brachytherapy. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrist. Factors with respect to patient selection and appropriate use of supplemental treatment modalities such as external beam radiation and androgen suppression therapy are discussed. Logistics with respect to the brachtherapy implant procedure, the importance of dosimetric parameters, and attention to radiation safety procedures and documentation are presented. Adherence to these practice guidelines can be part of ensuring quality and safety in a successful prostate brachytherapy program.

  14. In vivo dosimetry thermoluminescence dosimeters during brachytherapy with a 370 GBq 192Ir source

    International Nuclear Information System (INIS)

    Cuepers, S.; Piessens, M.; Verbeke, L.; Roelstraete, A.

    1995-01-01

    When using LiF thermoluminescence dosimeters in brachytherapy, we have to take into account the properties of a high dose rate 192 Ir source (energy spectrum ranging form 9 to 885 keV, steep dose gradient in the vicinity of the source) and these of the dosimeters themselves (supralinearity, reproducibility, size). All these characteristics combine into a set of correction factors which have been determined during in phantom measurements. These results have then been used to measure the dose delivered to organs at risk (e.g. rectum, bladder, etc.) during high dose rate brachytherapy with a 370 GBq 192 Ir source for patients with gynaecological tumors

  15. The mean photon energy anti E{sub F} at the point of measurement determines the detector-specific radiation quality correction factor k{sub Q,M} in {sup 192}Ir brachytherapy dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Chofor, Ndimofor; Harder, Dietrich; Selbach, Hans-Joachim; Poppe, Bjoern [University of Oldenburg and Pius-Hospital Oldenburg (Germany). Medical Radiation Physics Group

    2016-11-01

    The application of various radiation detectors for brachytherapy dosimetry has motivated this study of the energy dependence of radiation quality correction factor k{sub Q,M}, the quotient of the detector responses under calibration conditions at a {sup 60}Co unit and under the given non-reference conditions at the point of measurement, M, occurring in photon brachytherapy. The investigated detectors comprise TLD, radiochromic film, ESR, Si diode, plastic scintillator and diamond crystal detectors as well as ionization chambers of various sizes, whose measured response-energy relationships, taken from the literature, served as input data. Brachytherapy photon fields were Monte-Carlo simulated for an ideal isotropic {sup 192}Ir point source, a model spherical {sup 192}Ir source with steel encapsulation and a commercial HDR GammaMed Plus source. The radial source distance was varied within cylindrical water phantoms with outer radii ranging from 10 to 30 cm and heights from 20 to 60 cm. By application of this semiempirical method - originally developed for teletherapy dosimetry - it has been shown that factor k{sub Q,M} is closely correlated with a single variable, the fluence-weighted mean photon energy anti E{sub F} at the point of measurement. The radial profiles of anti E{sub F} obtained with either the commercial {sup 192}Ir source or the two simplified source variants show little variation. The observed correlations between parameters k{sub Q,M} and anti E{sub F} are represented by fitting formulae for all investigated detectors, and further variation of the detector type is foreseen. The herewith established close correlation of radiation quality correction factor k{sub Q,M} with local mean photon energy anti E{sub F} can be regarded as a simple regularity, facilitating the practical application of correction factor k{sub Q,M} for in-phantom dosimetry around {sup 192}Ir brachytherapy sources. anti E{sub F} values can be assessed by Monte Carlo simulation or

  16. Management of Spent Radiation Source from Radiotherapy

    International Nuclear Information System (INIS)

    Aisyah

    2008-01-01

    Nowadays the use of radioactive source for both radiodiagnostic and radiotherapy in Indonesia hospital increases rapidly. Sealed source used in radiotherapy among others for brachytherapy, teletherapy, bone densitometry, whole blood irradiation and gamma knife (radiosurgery). In line with this, the waste of spent radiation sources will be generated in hospitals. Of course these spent radiation sources must be treated correctly in order to maintain the safety of both the public and the environment. According to the Act No. 10/1997, BATAN, in care of the Radioactive Waste Management Center is the national appointed agency for the management of radioactive waste. The option for waste management by hospitals needs to be expound, either by re-exporting to the supplier of origin, re-exporting to other supplier, re-use by other licensee or sending to the Radioactive Waste Management Center. Usually the waste sent by the hospitals to the center comprises of sealed radiation source of 60 Co, 137 Cs or 226 Ra. The management of spent radiation source in the center is carried out in several steps i.e. conditioning, temporary storage, and long-term storage (final disposal). The conditioning of non 226 Ra is carried out by placing the waste in a 200 litter drum shell, 950 or 350 litter concrete shells, depends on the activity and dimension of the spent radiation source. The conditioning of 226 Ra is carried out by encapsulating the waste in a stainless steel container for long-term storage shield which then placed in a 200 litter drum shell. The temporary storage of the conditioned spent radiation source is carried out by storing it in the center’s temporary storages, either low or medium activity waste. Finally, the conditioned spent radiation source is buried in a disposal facility. For medium half-life spent radiation source, the final disposal is burial it in a shallow-land disposal; mean while, for long half-life spent radiation source, the final disposal is burial it in

  17. Monte Carlo dosimetry of the IRAsource high dose rate 192Ir brachytherapy source

    International Nuclear Information System (INIS)

    Sarabiasl, Akbar; Ayoobian, Navid; Jabbari, Iraj; Poorbaygi, Hossein; Javanshir, Mohammad Reza

    2016-01-01

    High-dose-rate (HDR) brachytherapy is a common method for cancer treatment in clinical brachytherapy. Because of the different source designs, there is a need for specific dosimetry data set for each HDR model. The purpose of this study is to obtain detailed dose rate distributions in water phantom for a first prototype HDR 192 Ir brachytherapy source model, IRAsource, and compare with the other published works. In this study, Monte Carlo N-particle (MCNP version 4C) code was used to simulate the dose rate distributions around the HDR source. A full set of dosimetry parameters reported by the American Association of Physicists in Medicine Task Group No. 43U1 was evaluated. Also, the absorbed dose rate distributions in water, were obtained in an along-away look-up table. The dose rate constant, Λ, of the IRAsource was evaluated to be equal to 1.112 ± 0.005 cGy h −1 U −1 . The results of dosimetry parameters are presented in tabulated and graphical formats and compared with those reported from other commercially available HDR 192 Ir sources, which are in good agreement. This justifies the use of specific data sets for this new source. The results obtained in this study can be used as input data in the conventional treatment planning systems.

  18. Evaluation of Delivery Costs for External Beam Radiation Therapy and Brachytherapy for Locally Advanced Cervical Cancer Using Time-Driven Activity-Based Costing.

    Science.gov (United States)

    Bauer-Nilsen, Kristine; Hill, Colin; Trifiletti, Daniel M; Libby, Bruce; Lash, Donna H; Lain, Melody; Christodoulou, Deborah; Hodge, Constance; Showalter, Timothy N

    2018-01-01

    To evaluate the delivery costs, using time-driven activity-based costing, and reimbursement for definitive radiation therapy for locally advanced cervical cancer. Process maps were created to represent each step of the radiation treatment process and included personnel, equipment, and consumable supplies used to deliver care. Personnel were interviewed to estimate time involved to deliver care. Salary data, equipment purchasing information, and facilities costs were also obtained. We defined the capacity cost rate (CCR) for each resource and then calculated the total cost of patient care according to CCR and time for each resource. Costs were compared with 2016 Medicare reimbursement and relative value units (RVUs). The total cost of radiation therapy for cervical cancer was $12,861.68, with personnel costs constituting 49.8%. Brachytherapy cost $8610.68 (66.9% of total) and consumed 423 minutes of attending radiation oncologist time (80.0% of total). External beam radiation therapy cost $4055.01 (31.5% of total). Personnel costs were higher for brachytherapy than for the sum of simulation and external beam radiation therapy delivery ($4798.73 vs $1404.72). A full radiation therapy course provides radiation oncologists 149.77 RVUs with intensity modulated radiation therapy or 135.90 RVUs with 3-dimensional conformal radiation therapy, with total reimbursement of $23,321.71 and $16,071.90, respectively. Attending time per RVU is approximately 4-fold higher for brachytherapy (5.68 minutes) than 3-dimensional conformal radiation therapy (1.63 minutes) or intensity modulated radiation therapy (1.32 minutes). Time-driven activity-based costing was used to calculate the total cost of definitive radiation therapy for cervical cancer, revealing that brachytherapy delivery and personnel resources constituted the majority of costs. However, current reimbursement policy does not reflect the increased attending physician effort and delivery costs of brachytherapy. We

  19. Outcomes and toxicities in patients with intermediate-risk prostate cancer treated with brachytherapy alone or brachytherapy and supplemental external beam radiation therapy.

    Science.gov (United States)

    Schlussel Markovic, Emily; Buckstein, Michael; Stone, Nelson N; Stock, Richard G

    2018-05-01

    To evaluate the cancer control outcomes and long-term treatment-related morbidity of brachytherapy as well as combination brachytherapy and external beam radiation therapy (EBRT) in patients with intermediate-risk prostate cancer. A retrospective review was conducted in a prospectively collected database of patients with intermediate-risk prostate cancer who were treated either with brachytherapy or brachytherapy and EBRT, with or without androgen deprivation therapy (ADT), in the period 1990-2014. Urinary and erectile dysfunction symptoms were measured using the International Prostate Symptom Score (IPSS), the Mount Sinai erectile function scale and the Sexual Health Inventory for Men (SHIM). Cancer control endpoints included biochemical failure and development of distant metastases. All statistical analyses were carried out using the Statistical Package for Social Science (SPSS). Survival curves were calculated using Kaplan-Meier actuarial methods and compared using log-rank tests. Cox regression multivariate analyses were used to test the effect of multiple variables on treatment outcomes. A total of 902 patients were identified, with a median follow-up of 91 months. Of these, 390 received brachytherapy and 512 received combination therapy with EBRT. In patients with one intermediate-risk factor, the addition of EBRT did not significantly affect freedom from biochemical failure or distant metastases. Among patients with two or three intermediate-risk factors, added EBRT did not improve freedom from biochemical failure. Significant differences in late toxicity between patients treated with brachytherapy vs combination brachytherapy and EBRT were identified including urge incontinence (P actuarial methods showed that patients receiving combination therapy more frequently experienced loss of potency, as measured by the Mount Sinai erectile function scale (P = 0.040). Brachytherapy monotherapy results in equal biochemical and distant control in both patients with

  20. Aspects of the application of complementary brachytherapy for early invasive breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Homma, L.A.H. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares; Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Hospital das Clinicas]. E-mail: luciahomma@terra.com.br; Campos, T.P.R. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares]. E-mail: campos@nuclear.ufmg.br; Silva, S.Z.C. [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Hospital das Clinicas; Lima, C.F. [ECOGRAF, Belo Horizonte, MG (Brazil). Nucleo de Diagnostico

    2007-07-01

    Initial studies of brachytherapy with the 'Mammosite Radiation Therapy System', a device consisted by a catheter centered inside a inflate balloon, to perform breast brachytherapy was revised. A high activity source was applied into the balloon, exposing to the tumor bed to a high absorbed dose, while the surrounding areas receives one reduced by to a factor 1/r{sup 2}, during a short interval of time. The high acute dose provides a booster to conventional radiation therapy, resulting in a better local control. The acceptable esthetic impact achieved and an easier device setting stimulated the present dosimetric study. The brachytherapy with Ir{sup 192} was simulated through the development of a computerized digital voxels phantom, which represented the breast anatomy. The Monte Carlo Code (MCNP {sup TM}, 1977) was used to evaluate the radiation of the tumor bed and health tissues. Results from simulations shows, as example, an amount of radiation absorbed by the tumor bed of 11.30 Gy up to 5 mm around the balloon surface. Radiation selectivity is also shown, in which tumour bed absorbed more radiation than the surrounding tissues, whose maximum values were: skin (6.73 Gy), muscle (7.69 Gy), and lung (3.02 Gy), for a fifteen-minute exposure of a Ir-152 source. The simulation results are presented. Reliability of this radiotherapy technique as a postoperative booster in early breast cancer is presented and confirmed in this work. (author)

  1. Aspects of the application of complementary brachytherapy for early invasive breast cancer

    International Nuclear Information System (INIS)

    Homma, L.A.H.; Universidade Federal de Minas Gerais; Campos, T.P.R.; Silva, S.Z.C.; Lima, C.F.

    2007-01-01

    Initial studies of brachytherapy with the 'Mammosite Radiation Therapy System', a device consisted by a catheter centered inside a inflate balloon, to perform breast brachytherapy was revised. A high activity source was applied into the balloon, exposing to the tumor bed to a high absorbed dose, while the surrounding areas receives one reduced by to a factor 1/r 2 , during a short interval of time. The high acute dose provides a booster to conventional radiation therapy, resulting in a better local control. The acceptable esthetic impact achieved and an easier device setting stimulated the present dosimetric study. The brachytherapy with Ir 192 was simulated through the development of a computerized digital voxels phantom, which represented the breast anatomy. The Monte Carlo Code (MCNP TM , 1977) was used to evaluate the radiation of the tumor bed and health tissues. Results from simulations shows, as example, an amount of radiation absorbed by the tumor bed of 11.30 Gy up to 5 mm around the balloon surface. Radiation selectivity is also shown, in which tumour bed absorbed more radiation than the surrounding tissues, whose maximum values were: skin (6.73 Gy), muscle (7.69 Gy), and lung (3.02 Gy), for a fifteen-minute exposure of a Ir-152 source. The simulation results are presented. Reliability of this radiotherapy technique as a postoperative booster in early breast cancer is presented and confirmed in this work. (author)

  2. Manual on brachytherapy. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1996-01-01

    This publication is part of practical radiation safety manual series for different fields of application aimed primarily at persons handling radiation sources on a daily routine basis, which could at same time be used by the competent authorities, supporting their efforts in the radiation protection training of workers or medical assistance personnel or helping on-site management to set up local radiation protection rules. It is dedicated to brachytherapy: its application and procedures guides

  3. Development of an adjoint sensitivity field-based treatment-planning technique for the use of newly designed directional LDR sources in brachytherapy.

    Science.gov (United States)

    Chaswal, V; Thomadsen, B R; Henderson, D L

    2012-02-21

    The development and application of an automated 3D greedy heuristic (GH) optimization algorithm utilizing the adjoint sensitivity fields for treatment planning to assess the advantage of directional interstitial prostate brachytherapy is presented. Directional and isotropic dose kernels generated using Monte Carlo simulations based on Best Industries model 2301 I-125 source are utilized for treatment planning. The newly developed GH algorithm is employed for optimization of the treatment plans for seven interstitial prostate brachytherapy cases using mixed sources (directional brachytherapy) and using only isotropic sources (conventional brachytherapy). All treatment plans resulted in V100 > 98% and D90 > 45 Gy for the target prostate region. For the urethra region, the D10(Ur), D90(Ur) and V150(Ur) and for the rectum region the V100cc, D2cc, D90(Re) and V90(Re) all are reduced significantly when mixed sources brachytherapy is used employing directional sources. The simulations demonstrated that the use of directional sources in the low dose-rate (LDR) brachytherapy of the prostate clearly benefits in sparing the urethra and the rectum sensitive structures from overdose. The time taken for a conventional treatment plan is less than three seconds, while the time taken for a mixed source treatment plan is less than nine seconds, as tested on an Intel Core2 Duo 2.2 GHz processor with 1GB RAM. The new 3D GH algorithm is successful in generating a feasible LDR brachytherapy treatment planning solution with an extra degree of freedom, i.e. directionality in very little time.

  4. Development of an adjoint sensitivity field-based treatment-planning technique for the use of newly designed directional LDR sources in brachytherapy

    Science.gov (United States)

    Chaswal, V.; Thomadsen, B. R.; Henderson, D. L.

    2012-02-01

    The development and application of an automated 3D greedy heuristic (GH) optimization algorithm utilizing the adjoint sensitivity fields for treatment planning to assess the advantage of directional interstitial prostate brachytherapy is presented. Directional and isotropic dose kernels generated using Monte Carlo simulations based on Best Industries model 2301 I-125 source are utilized for treatment planning. The newly developed GH algorithm is employed for optimization of the treatment plans for seven interstitial prostate brachytherapy cases using mixed sources (directional brachytherapy) and using only isotropic sources (conventional brachytherapy). All treatment plans resulted in V100 > 98% and D90 > 45 Gy for the target prostate region. For the urethra region, the D10Ur, D90Ur and V150Ur and for the rectum region the V100cc, D2cc, D90Re and V90Re all are reduced significantly when mixed sources brachytherapy is used employing directional sources. The simulations demonstrated that the use of directional sources in the low dose-rate (LDR) brachytherapy of the prostate clearly benefits in sparing the urethra and the rectum sensitive structures from overdose. The time taken for a conventional treatment plan is less than three seconds, while the time taken for a mixed source treatment plan is less than nine seconds, as tested on an Intel Core2 Duo 2.2 GHz processor with 1GB RAM. The new 3D GH algorithm is successful in generating a feasible LDR brachytherapy treatment planning solution with an extra degree of freedom, i.e. directionality in very little time.

  5. Prototypes of phosphorus-32 sealed sources for use in Brachytherapy

    International Nuclear Information System (INIS)

    Anaya Garro, Olgger; Vela Mora, Mariano; Revilla Silva, Angel Revilla

    2005-01-01

    It has developed prototypes of phosphorus-32 sealed sources for use in Brachytherapy. This one was made in two stages, at the first one, we designed and constructed the container (capsule), the filling system and the sealed system; at the second one, we made the irradiation of the capsules containing the 'target'. The prototypes was made of aluminum in cylindrical geometry. During the irradiation test was made using two different dimensions: one of 1 mm outer diameter and 1 cm length and another one of 0.8 mm outer diameter and 5 mm length. They were radiated in the core of the RP-10 research reactor, at 7.93 x10 13 n/cm 2 .s thermal neutron flux during 27 operation cycles. Activities of 144.53 MBq (3.91 mCi) and 107.67 MBq (2.91 mCi) was obtained for each case. This activities are adequate to restenosis and for some tumors treatment. We can observed that the capsules irradiated passed visual inspection in its physical integrity (leakage and geometry). It has been demonstrated, that the beta radiation for his minor power of penetration and its high interaction, causes major local damage to the malignant tissue, minimizing the damage of the healthy surrounding tissues. It has been advisable to use for the treatment of illnesses of the circulatory system and some tumors. At the present, the source of strontium-90 are the most beta ray source used, but of this one are obtained as fission product of uranium target, where valuable radioactive waste is generated, whereas if we were using phosphorus-32 that we propose, radioactive waste would not be generated since it would take place directly as sealed source, for reaction (n, β). (author)

  6. Design and optimization of a brachytherapy robot

    Science.gov (United States)

    Meltsner, Michael A.

    Trans-rectal ultrasound guided (TRUS) low dose rate (LDR) interstitial brachytherapy has become a popular procedure for the treatment of prostate cancer, the most common type of non-skin cancer among men. The current TRUS technique of LDR implantation may result in less than ideal coverage of the tumor with increased risk of negative response such as rectal toxicity and urinary retention. This technique is limited by the skill of the physician performing the implant, the accuracy of needle localization, and the inherent weaknesses of the procedure itself. The treatment may require 100 or more sources and 25 needles, compounding the inaccuracy of the needle localization procedure. A robot designed for prostate brachytherapy may increase the accuracy of needle placement while minimizing the effect of physician technique in the TRUS procedure. Furthermore, a robot may improve associated toxicities by utilizing angled insertions and freeing implantations from constraints applied by the 0.5 cm-spaced template used in the TRUS method. Within our group, Lin et al. have designed a new type of LDR source. The "directional" source is a seed designed to be partially shielded. Thus, a directional, or anisotropic, source does not emit radiation in all directions. The source can be oriented to irradiate cancerous tissues while sparing normal ones. This type of source necessitates a new, highly accurate method for localization in 6 degrees of freedom. A robot is the best way to accomplish this task accurately. The following presentation of work describes the invention and optimization of a new prostate brachytherapy robot that fulfills these goals. Furthermore, some research has been dedicated to the use of the robot to perform needle insertion tasks (brachytherapy, biopsy, RF ablation, etc.) in nearly any other soft tissue in the body. This can be accomplished with the robot combined with automatic, magnetic tracking.

  7. MO-D-BRD-01: Clinical Implementation of An Electronic Brachytherapy Program for the Skin

    International Nuclear Information System (INIS)

    Ouhib, Z.

    2015-01-01

    Electronic brachytherapy (eBT) has seen an insurgence of manufacturers entering the US market for use in radiation therapy. In addition to the established interstitial, intraluminary, and intracavitary applications of eBT, many centers are now using eBT to treat skin lesions. It is important for medical physicists working with electronic brachytherapy sources to understand the basic physics principles of the sources themselves as well as the variety of applications for which they are being used. The calibration of the sources is different from vendor to vendor and the traceability of calibrations has evolved as new sources came to market. In 2014, a new air-kerma based standard was introduced by the National Institute of Standards and Technology (NIST) to measure the output of an eBT source. Eventually commercial treatment planning systems should accommodate this new standard and provide NIST traceability to the end user. The calibration and commissioning of an eBT system is unique to its application and typically entails a list of procedural recommendations by the manufacturer. Commissioning measurements are performed using a variety of methods, some of which are modifications of existing AAPM Task Group protocols. A medical physicist should be familiar with the different AAPM Task Group recommendations for applicability to eBT and how to properly adapt them to their needs. In addition to the physical characteristics of an eBT source, the photon energy is substantially lower than from HDR Ir-192 sources. Consequently, tissue-specific dosimetry and radiobiological considerations are necessary when comparing these brachytherapy modalities and when making clinical decisions as a radiation therapy team. In this session, the physical characteristics and calibration methodologies of eBt sources will be presented as well as radiobiology considerations and other important clinical considerations. Learning Objectives: To understand the basic principles of electronic

  8. Water equivalency evaluation of PRESAGE® dosimeters for dosimetry of Cs-137 and Ir-192 brachytherapy sources

    Science.gov (United States)

    Gorjiara, Tina; Hill, Robin; Kuncic, Zdenka; Baldock, Clive

    2010-11-01

    A major challenge in brachytherapy dosimetry is the measurement of steep dose gradients. This can be achieved with a high spatial resolution three dimensional (3D) dosimeter. PRESAGE® is a polyurethane based dosimeter which is suitable for 3D dosimetry. Since an ideal dosimeter is radiologically water equivalent, we have investigated the relative dose response of three different PRESAGE® formulations, two with a lower chloride and bromide content than original one, for Cs-137 and Ir-192 brachytherapy sources. Doses were calculated using the EGSnrc Monte Carlo package. Our results indicate that PRESAGE® dosimeters are suitable for relative dose measurement of Cs-137 and Ir-192 brachytherapy sources and the lower halogen content PRESAGE® dosimeters are more water equivalent than the original formulation.

  9. Evaluation of hypothetical (153)Gd source for use in brachytherapy.

    Science.gov (United States)

    Ghorbani, Mahdi; Behmadi, Marziyeh

    2016-01-01

    The purpose of this work is to evaluate the dosimetric parameters of a hypothetical (153)Gd source for use in brachytherapy and comparison of the dosimetric parameters with those of (192)Ir and (125)I sources. Dose rate constant, the radial dose function and the two dimensional (2D) anisotropy function data for the hypothetical (153)Gd source were obtained by simulation of the source using MCNPX code and then were compared with the corresponding data reported by Enger et al. A comprehensive comparison between this hypothetical source and a (192)Ir source with similar geometry and a (125)I source was performed as well. Excellent agreement was shown between the results of the two studies. Dose rate constant values for the hypothetical (153)Gd, (192)Ir, (125)I sources are 1.173 cGyh(-1) U(-1), 1.044 cGyh(-1) U(-1), 0.925 cGyh(-1) U(-1), respectively. Radial dose function for the hypothetical (153)Gd source has an increasing trend, while (192)Ir has more uniform and (125)I has more rapidly falling off radial dose functions. 2D anisotropy functions for these three sources indicate that, except at 0.5 cm distance, (192)Ir and (125)I have more isotropic trends as compared to the (153)Gd source. A more uniform radial dose function, and 2D anisotropy functions with more isotropy, a much higher specific activity are advantages of (192)Ir source over (153)Gd. However, a longer half-life of (153)Gd source compared to the other two sources, and lower energy of the source with respect to (192)Ir are advantages of using (153)Gd in brachytherapy versus (192)Ir source.

  10. In vivo dosimetry thermoluminescence dosimeters during brachytherapy with a 370 GBq {sup 192}Ir source

    Energy Technology Data Exchange (ETDEWEB)

    Cuepers, S; Piessens, M; Verbeke, L; Roelstraete, A [Onze-Lieve-Vrouw Hospitaal, Aalst (Belgium). Dept. of Radiotherapy and Oncology

    1995-12-01

    When using LiF thermoluminescence dosimeters in brachytherapy, we have to take into account the properties of a high dose rate {sup 192}Ir source (energy spectrum ranging form 9 to 885 keV, steep dose gradient in the vicinity of the source) and these of the dosimeters themselves (supralinearity, reproducibility, size). All these characteristics combine into a set of correction factors which have been determined during in phantom measurements. These results have then been used to measure the dose delivered to organs at risk (e.g. rectum, bladder, etc.) during high dose rate brachytherapy with a 370 GBq {sup 192}Ir source for patients with gynaecological tumors.

  11. Dose rate constant and energy spectrum of interstitial brachytherapy sources

    International Nuclear Information System (INIS)

    Chen Zhe; Nath, Ravinder

    2001-01-01

    In the past two years, several new manufacturers have begun to market low-energy interstitial brachytherapy seeds containing 125 I and 103 Pd. Parallel to this development, the National Institute of Standards and Technology (NIST) has implemented a modification to the air-kerma strength (S K ) standard for 125 I seeds and has also established an S K standard for 103 Pd seeds. These events have generated a considerable number of investigations on the determination of the dose rate constants (Λ) of interstitial brachytherapy seeds. The aim of this work is to study the general properties underlying the determination of Λ and to develop a simple method for a quick and accurate estimation of Λ. As the dose rate constant of clinical seeds is defined at a fixed reference point, we postulated that Λ may be calculated by treating the seed as an effective point source when the seed's source strength is specified in S K and its source characteristics are specified by the photon energy spectrum measured in air at the reference point. Using a semi-analytic approach, an analytic expression for Λ was derived for point sources with known photon energy spectra. This approach enabled a systematic study of Λ as a function of energy. Using the measured energy spectra, the calculated Λ for 125 I model 6711 and 6702 seeds and for 192 Ir seed agreed with the AAPM recommended values within ±1%. For the 103 Pd model 200 seed, the agreement was 5% with a recently measured value (within the ±7% experimental uncertainty) and was within 1% with the Monte Carlo simulations. The analytic expression for Λ proposed here can be evaluated using a programmable calculator or a simple spreadsheet and it provides an efficient method for checking the measured dose rate constant for any interstitial brachytherapy seed once the energy spectrum of the seed is known

  12. A comparison of radiation dose to the neurovascular bundles in men with and without prostate brachytherapy-induced erectile dysfunction

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Butler, Wayne M.; Dorsey, Anthony T.; Lief, Jonathan H.; Donzella, Joseph G.

    2000-01-01

    Purpose: The etiology of erectile dysfunction after definitive local therapy for carcinoma of the prostate gland represents a multifactorial phenomenon including neurogenic compromise, venous insufficiency, local trauma, and psychogenic causes. It has been suggested that impotence after prostate brachytherapy is a consequence of excessive radiation dose to the neurovascular bundles (NVB). Herein we evaluate the potential relationship between radiation dose to the NVB and the development of erectile dysfunction following prostate brachytherapy. Methods and Materials: The radiation dose to the NVB was evaluated for 33 patients who developed erectile dysfunction (ED) following brachytherapy plus 21 additional patients who were potent before and subsequent to brachytherapy. Of the 54 patient study group, the median follow up was 37 months, and 25 patients were managed with 125 I as a monotherapeutic approach and 29 received 103 Pd as a boost following 45 Gy of external beam radiation therapy. Radiographic localization of the NVB was performed via a two-dimensional geometric model that placed 3-NVB calculation points on the left and right posterolateral side of each 5-mm CT slice. Parameters evaluated included dose-surface histograms, dose parameters via point doses on each slice, the magnitude of the dose in relationship to the distance from the base, and the relationship between NVB radiation dose in patients with and without ED, patient response to sildenafil and case sequence number. Results: In terms of percent prescribed minimum peripheral dose (% mPD), there was no significant difference in mean neurovascular bundle dose between potent and impotent patients, between the isotopes ( 125 I or 103 Pd), mono- or boost therapy, or side of the prostate for which the overall average was 217% ± 55% of mPD. There was also no significant dosimetric difference in terms of response to sildenafil based on a multivariate analysis which included % mPD and various dose

  13. Neuro-oncology update: radiation safety and nursing care during interstitial brachytherapy

    International Nuclear Information System (INIS)

    Randall, T.M.; Drake, D.K.; Sewchand, W.

    1987-01-01

    Radiation control and safety are major considerations for nursing personnel during the care of patients receiving brachytherapy. Since the theory and practice of radiation applications are not part of the routine curriculum of nursing programs, the education of nurses and other health care professionals in radiation safety procedures is important. Regulatory agencies recommend that an annual safety course be given to all persons frequenting, using, or associated with patients containing radioactive materials. This article presents pertinent aspects of the principles and procedures of radiation safety, the role of personnel dose-monitoring devices, and the value of additional radiation control features, such as a lead cubicle, during interstitial brain implants. One institution's protocol and procedures for the care of high-intensity iridium-192 brain implants are discussed. Preoperative teaching guidelines and nursing interventions included in the protocol focus on radiation control principles

  14. Patient effective dose from endovascular brachytherapy with {sup 192}Ir Sources

    Energy Technology Data Exchange (ETDEWEB)

    Perna, L.; Bianchi, C.; Novario, R.; Nicolini, G.; Tanzi, F.; Conte, L

    2002-07-01

    The growing use of endovascular brachytherapy has been accompanied by the publication of a large number of studies in several fields, but few studies on patient dose have been found in the literature. Moreover, these studies were carried out on the basis of Monte Carlo simulation. The aim of the present study was to estimate the effective dose to the patient undergoing endovascular brachytherapy treatment with {sup 192}Ir sources, by means of experimental measurements. Two standard treatments were taken into account: an endovascular brachytherapy of the coronary artery corresponding to the activity x time product of 184 GBq.min and an endovascular brachytherapy of the renal artery (898 GBq.min). Experimental assessment was accomplished by thermoluminescence dosemeters positioned in more than 300 measurement points in a properly adapted Rando phantom. A method has been developed to estimate the mean organ doses for all tissues and organs concerned in order to calculate the effective dose associated with intravascular brachytherapy. The normalised organ doses resulting from coronary treatment were 2.4x10{sup -2} mSv.GBq{sup -1}.min{sup -1} for lung, 0.9x10{sup -2} mSv.GBq{sup -1}.min{sup -1} for oesophagus and 0.48x10{sup -2} mSv.GBq{sup -1}.min{sup -1} for bone marrow. During brachytherapy of the renal artery, the corresponding normalised doses were 4.2x10{sup -2} mSv.GBq{sup -1}.min{sup -1} for colon, 7.8x10{sup -2} mSv.GBq{sup -1}.min{sup -1} for stomach and 1.7x10{sup -2} mSv.GBq{sup -1}.min{sup -1} for liver. Coronary treatment involved an effective dose of 0.046 mSv.GBq{sup -1}.min{sup -1}, whereas the treatment of the renal artery resulted in an effective dose of 0.15 mSv.GBq{sup -1}.min{sup -1}; there were many similarities with data from former studies. Based on these results it can be concluded that the dose level of patients exposed during brachytherapy treatment is low. (author)

  15. Prostate brachytherapy seed migration to the heart seen on cardiovascular computed tomographic angiography

    Directory of Open Access Journals (Sweden)

    Shilpa Sachdeva, MD

    2017-03-01

    Full Text Available Brachytherapy consists of placing radioactive sources into or adjacent to tumors, to deliver conformal radiation treatment. The technique is used for treatment of primary malignancies and for salvage in recurrent disease. Permanent prostate brachytherapy seeds are small metal implants containing radioactive sources of I-125, Pd-103, or Cs-131 encased in a titanium shell. They can embolize through the venous system to the lungs or heart and subsequently be detected by cardiovascular computed tomography. Cardiovascular imagers should be aware of the appearance of migrated seeds, as their presence in the chest is generally benign, so that unnecessary worry and testing are avoided. We report a case of a patient who underwent brachytherapy for prostate cancer and developed a therapeutic seeds embolus to the right ventricle.

  16. Assessing patient characteristics and radiation-induced non-targeted effects in vivo for high dose-rate (HDR) brachytherapy.

    Science.gov (United States)

    Pinho, Christine; Timotin, Emilia; Wong, Raimond; Sur, Ranjan K; Hayward, Joseph E; Farrell, Thomas J; Seymour, Colin; Mothersill, Carmel

    2015-01-01

    To test whether blood, urine, and tissue based colony-forming assays are a useful clinical detection tool for assessing fractionated treatment responses and non-targeted radiation effects in bystander cells. To assess patients' responses to radiation treatments, blood serum, urine, and an esophagus explant-based in vivo colony-forming assay were used from oesophageal carcinoma patients. These patients underwent three fractions of high dose rate (HDR) intraluminal brachytherapy (ILBT). Human keratinocyte reporters exposed to blood sera taken after the third fraction of brachytherapy had a significant increase in cloning efficiency compared to baseline samples (p fractions for the blood sera data only. Patient characteristics such as gender had no statistically significant effect (p > 0.05). Large variability was observed among the patients' tissue samples, these colony-forming assays showed no significant changes throughout fractionated brachytherapy (p > 0.05). Large inter-patient variability was found in the urine and tissue based assays, so these techniques were discontinued. However, the simple blood-based assay had much less variability. This technique may have future applications as a biological dosimeter to predict treatment outcome and assess non-targeted radiation effects.

  17. Cs-137 brachytherapy sources calibration with well chamber

    International Nuclear Information System (INIS)

    Brunetto, M.; Sansogne, R.; Arbiser, S.; Duran, M.P.

    2004-01-01

    This work describes the procedures and actions developed for the identification and reference air kerma rate (S k ) verification of Cs-137 sources used in gynecological brachytherapy practices. Following the IAEA TECDOC 1151 recommendations, the first stage consisted in designing the documentation required for the inventory and shipping registry of sources, along with the digital spreadsheets for calculating the decay and S k of the sources at the moment of implantation. As a second stage, the S k of sources was measured, following the low dose rate sources protocol advise, with a Standard Imaging HDR 1000 Plus well chamber calibrated at the University of Wisconsin SSDL. The documentation generated through this procedure allows identify each source clearly and uni-vocally. No significant differences were found between the S k values obtained from the well chamber calibration procedure and those reported by the manufacturer in the corresponding certificates. The highest percent difference found was 2.3%. (author) [es

  18. Brachytherapy in the treatment of cervical cancer: a review

    Directory of Open Access Journals (Sweden)

    Banerjee R

    2014-05-01

    Full Text Available Robyn Banerjee,1 Mitchell Kamrava21Department of Radiation Oncology, Tom Baker Cancer Centre, Calgary, Alberta, Canada; 2Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA, USAAbstract: Dramatic advances have been made in brachytherapy for cervical cancer. Radiation treatment planning has evolved from two-dimensional to three-dimensional, incorporating magnetic resonance imaging and/or computed tomography into the treatment paradigm. This allows for better delineation and coverage of the tumor, as well as improved avoidance of surrounding organs. Consequently, advanced brachytherapy can achieve very high rates of local control with a reduction in morbidity, compared with historic approaches. This review provides an overview of state-of-the-art gynecologic brachytherapy, with a focus on recent advances and their implications for women with cervical cancer.Keywords: cervical cancer, brachytherapy, image-guided brachytherapy

  19. Modeling a Hypothetical 170Tm Source for Brachytherapy Applications

    International Nuclear Information System (INIS)

    Enger, Shirin A.; D'Amours, Michel; Beaulieu, Luc

    2011-01-01

    Purpose: To perform absorbed dose calculations based on Monte Carlo simulations for a hypothetical 170 Tm source and to investigate the influence of encapsulating material on the energy spectrum of the emitted electrons and photons. Methods: GEANT4 Monte Carlo code version 9.2 patch 2 was used to simulate the decay process of 170 Tm and to calculate the absorbed dose distribution using the GEANT4 Penelope physics models. A hypothetical 170 Tm source based on the Flexisource brachytherapy design with the active core set as a pure thulium cylinder (length 3.5 mm and diameter 0.6 mm) and different cylindrical source encapsulations (length 5 mm and thickness 0.125 mm) constructed of titanium, stainless-steel, gold, or platinum were simulated. The radial dose function for the line source approximation was calculated following the TG-43U1 formalism for the stainless-steel encapsulation. Results: For the titanium and stainless-steel encapsulation, 94% of the total bremsstrahlung is produced inside the core, 4.8 and 5.5% in titanium and stainless-steel capsules, respectively, and less than 1% in water. For the gold capsule, 85% is produced inside the core, 14.2% inside the gold capsule, and a negligible amount ( 170 Tm source is primarily a bremsstrahlung source, with the majority of bremsstrahlung photons being generated in the source core and experiencing little attenuation in the source encapsulation. Electrons are efficiently absorbed by the gold and platinum encapsulations. However, for the stainless-steel capsule (or other lower Z encapsulations) electrons will escape. The dose from these electrons is dominant over the photon dose in the first few millimeter but is not taken into account by current standard treatment planning systems. The total energy spectrum of photons emerging from the source depends on the encapsulation composition and results in mean photon energies well above 100 keV. This is higher than the main gamma-ray energy peak at 84 keV. Based on our

  20. Procedures for brachytherapy sources lost in a radiotherapy department; Protocolo para fontes de braquiterapia extraviadas no ambiente hospitalar

    Energy Technology Data Exchange (ETDEWEB)

    Almeida, Adelaide de [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Faculdade de Filosofia, Ciencias e Letras

    1997-12-31

    Brachytherapy sources are easily lost in a Radiotherapy Department owing to unexpected behaviour of the patient and/or inattention of the people in charge of the sources. This work reports a protocol to be used when brachytherapy sources are lost and it was based on the search of three sealed sources of Cesium 137 with activity of 37 x 10{sup 7} Bq, removed by a patient from a conventional afterloading intra-uterine system (Henscke). (author) 5 refs., 3 figs.; e-mail: dalmeida at biomag.ffclrp.usp.br

  1. Applications of the Italian protocol for the calibration of brachytherapy sources

    International Nuclear Information System (INIS)

    Piermattei, A.; Azario, L.

    1997-01-01

    The Associazione Italiana di Fisica Biomedica (AIFB; Italian Association of Biomedical Physics) has adopted the Italian protocol for the calibration of brachytherapy sources. The AIFB protocol allows measurements of the reference air kerma rate, dK/dt r , within 1.7% (1σ). To measure dK/dt r the AIFB protocol has identified a direct and an indirect procedure. The direct procedure is based on the use of spherical or cylindrical ionization chambers as local reference dosimeters positioned along the transverse bisector axis of the source. Once the source is specified by a dK/dt r value, this can be used to calibrate a field instrument, such as a well-type ionization chamber, for further source calibrations by means of an indirect procedure. This paper reports the results obtained by the Physics Laboratory of the Universita Cattolica del S Cuore (PL-UCSC), in terms of dK/dt r calibration of five types of source, 169 Yb, 192 Ir and 137 Cs. The role of the dK/dt r determination for a brachytherapy source has been underlined when a new source such as the 169 Yb seed model X1267 has been proposed for clinical use. The dK/dt r values for 137 Cs spherical sources differed by 5% from the vendor's mean value. The five types of source calibrated in terms of dK/dt r were used to obtain the calibration factor, N K r source , of an HDR-1000 well-type ionization chamber. (author)

  2. Physical aspects of endovascular brachytherapy

    International Nuclear Information System (INIS)

    Kirisits, C.

    2001-11-01

    Restenosis is severely limiting the outcome of vascular interventions. In several clinical trials endovascular brachytherapy has shown to reduce the restenosis rate. Local radiotherapy to the injured vessel wall is a promising new type of treatment in order to inhibit a complex wound healing process resulting in cell proliferation and re-obstruction of the treated vessel. Treatment planning has to be based on the dose distribution in the vicinity of the sources used. Source strength was determined in terms of air kerma rate for gamma nuclides (Iridium-192) and absorbed dose to water at reference distance of 2 mm for beta nuclides (Strontium-90/Yttrium-90, Phosphor-32), respectively. Radial dose profiles and the Reference Isodose Length (RIL) were determined using the EGSnrc code and GafChromic film. Good agreement was found between both methods. In order to treat the entire clinical target length, the (RIL) is an essential value during treatment planning. Examples are described for different levels of treatment planing including recommendations for optimal choice and positioning of the radioactive devices inside the artery. IVUS based treatment planning is illustrated with superposition of isodoses on cross-sectional images. A calculation model for radioactive stents is presented in order to determine dose volume histograms in a retrospective analysis. Radiation protection issues for endovascular brachytherapy are discussed in detail. Personal dose for the involved personnel is estimated based on calculations and measurements. Beta ray dosimetry is performed with suitable detectors. In order to estimate the exposure to the patient the dose to organs at risk is calculated and compared to the dose from angiography. There is an additional radiation exposure to patients and personnel caused by endovascular brachytherapy, but the values are much smaller than those caused by diagnostic angiography. (author)

  3. Material-specific Conversion Factors for Different Solid Phantoms Used in the Dosimetry of Different Brachytherapy Sources

    Directory of Open Access Journals (Sweden)

    Sedigheh Sina

    2015-07-01

    Full Text Available Introduction Based on Task Group No. 43 (TG-43U1 recommendations, water phantom is proposed as a reference phantom for the dosimetry of brachytherapy sources. The experimental determination of TG-43 parameters is usually performed in water-equivalent solid phantoms. The purpose of this study was to determine the conversion factors for equalizing solid phantoms to water. Materials and Methods TG-43 parameters of low- and high-energy brachytherapy sources (i.e., Pd-103, I-125 and Cs-137 were obtained in different phantoms, using Monte Carlo simulations. The brachytherapy sources were simulated at the center of different phantoms including water, solid water, poly(methyl methacrylate, polystyrene and polyethylene. Dosimetric parameters such as dose rate constant, radial dose function and anisotropy function of each source were compared in different phantoms. Then, conversion factors were obtained to make phantom parameters equivalent to those of water. Results Polynomial coefficients of conversion factors were obtained for all sources to quantitatively compare g(r values in different phantom materials and the radial dose function in water. Conclusion Polynomial coefficients of conversion factors were obtained for all sources to quantitatively compare g(r values in different phantom materials and the radial dose function in water.

  4. Stereotactic body radiation therapy via helical tomotherapy to replace brachytherapy for brachytherapy-unsuitable cervical cancer patients – a preliminary result

    Directory of Open Access Journals (Sweden)

    Hsieh CH

    2013-02-01

    Full Text Available Chen-Hsi Hsieh,1–3 Hui-Ju Tien,1 Sheng-Mou Hsiao,4 Ming-Chow Wei,4 Wen-Yih Wu,4 Hsu-Dong Sun,4 Li-Ying Wang,5 Yen-Ping Hsieh,6 Yu-Jen Chen,3,7–9 Pei-Wei Shueng1,101Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan; 2Department of Medicine, 3Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; 4Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Taipei, Taiwan; 5School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; 6Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung, Taiwan; 7Department of Radiation Oncology, 8Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan; 9Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan; 10Department of Radiation Oncology, National Defense Medical Center, Taipei, TaiwanAim: To review the experience and to evaluate the results of stereotactic body radiation therapy (SBRT via helical tomotherapy (HT, for the treatment of brachytherapy-unsuitable cervical cancer.Methods: Between September 1, 2008 to January 31, 2012, nine cervical cancer patients unsuitable for brachytherapy were enrolled. All of the patients received definitive whole pelvic radiotherapy with or without chemotherapy, followed by SBRT via HT.Results: The actuarial locoregional control rate at 3 years was 78%. The mean biological equivalent dose in 2-Gy fractions of the tumor, rectum, bladder, and intestines was 76.0 ± 7.3, 73.8 ± 13.2, 70.5 ± 10.0, and 43.1 ± 7.1, respectively. Only two had residual tumors after treatment, and the others were tumor-free. Two patients experienced grade 3 acute toxicity: one had diarrhea; and another experienced thrombocytopenia. There were no grade 3 or 4 subacute toxicities. Three patients suffered from manageable rectal bleeding in

  5. Comparison of treatment using teletherapy (external beam radiation) alone versus teletherapy combined with brachytherapy for advanced squamous cell carcinoma of the esophagus

    International Nuclear Information System (INIS)

    Samea, Renato; Lourenco, Laercio Gomes

    2011-01-01

    Background - Squamous cell carcinoma of the esophagus is still a difficult tumor to treat with very poor prognosis. Aim - To compare the response to teletherapy treatment (external beam radiotherapy) alone versus teletherapy combined with brachytherapy for patients with advanced squamous cell carcinoma of the esophagus. Methods - Were studied 49 patients with advanced squamous cell carcinoma of the esophagus on clinical stage III (TNM-1999). They were separated into two groups. The first, underwent radiation therapy alone with linear accelerator of particles, average dose of 6000 cGy and the second to external beam radiation therapy at a dose of 5040 cGy combined with brachytherapy with Iridium 192 at a dose of 1500 cGy. Brachytherapy started one to two weeks after the end of teletherapy, and it was divided into three weekly applications of 500 cGy. Age, gender, race, habits (smoking and drinking), body mass index (BMI), complications with treatment benefits (pain relief and food satisfaction) and survival were analyzed. Results - The quality of life (food satisfaction, and pain palliation of dysphagia) were better in the group treated with external beam radiation therapy combined with brachytherapy. Survival was higher in the brachytherapy combined with external beam radiation therapy alone. Conclusion - Although the cure rate of squamous cell cancer of the esophagus is almost nil when treated with irradiation alone, this therapy is a form of palliative treatment for most patients in whom surgical contraindication exists. (author)

  6. Comparison of treatment using teletherapy (external beam radiation) alone versus teletherapy combined with brachytherapy for advanced squamous cell carcinoma of the esophagus

    Energy Technology Data Exchange (ETDEWEB)

    Samea, Renato; Lourenco, Laercio Gomes, E-mail: renatosamea@globo.com [Department of Surgical Oncology of Dr. Arnaldo Vieira de Carvalho Hospital, Sao Paulo, SP (Brazil)

    2011-10-15

    Background - Squamous cell carcinoma of the esophagus is still a difficult tumor to treat with very poor prognosis. Aim - To compare the response to teletherapy treatment (external beam radiotherapy) alone versus teletherapy combined with brachytherapy for patients with advanced squamous cell carcinoma of the esophagus. Methods - Were studied 49 patients with advanced squamous cell carcinoma of the esophagus on clinical stage III (TNM-1999). They were separated into two groups. The first, underwent radiation therapy alone with linear accelerator of particles, average dose of 6000 cGy and the second to external beam radiation therapy at a dose of 5040 cGy combined with brachytherapy with Iridium 192 at a dose of 1500 cGy. Brachytherapy started one to two weeks after the end of teletherapy, and it was divided into three weekly applications of 500 cGy. Age, gender, race, habits (smoking and drinking), body mass index (BMI), complications with treatment benefits (pain relief and food satisfaction) and survival were analyzed. Results - The quality of life (food satisfaction, and pain palliation of dysphagia) were better in the group treated with external beam radiation therapy combined with brachytherapy. Survival was higher in the brachytherapy combined with external beam radiation therapy alone. Conclusion - Although the cure rate of squamous cell cancer of the esophagus is almost nil when treated with irradiation alone, this therapy is a form of palliative treatment for most patients in whom surgical contraindication exists. (author)

  7. Multihelix rotating shield brachytherapy for cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dadkhah, Hossein [Department of Biomedical Engineering, University of Iowa, 1402 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242 (United States); Kim, Yusung; Flynn, Ryan T., E-mail: ryan-flynn@uiowa.edu [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Wu, Xiaodong [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 and Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center for the Engineering Arts and Sciences, Iowa City, Iowa 52242 (United States)

    2015-11-15

    Purpose: To present a novel brachytherapy technique, called multihelix rotating shield brachytherapy (H-RSBT), for the precise angular and linear positioning of a partial shield in a curved applicator. H-RSBT mechanically enables the dose delivery using only linear translational motion of the radiation source/shield combination. The previously proposed approach of serial rotating shield brachytherapy (S-RSBT), in which the partial shield is rotated to several angular positions at each source dwell position [W. Yang et al., “Rotating-shield brachytherapy for cervical cancer,” Phys. Med. Biol. 58, 3931–3941 (2013)], is mechanically challenging to implement in a curved applicator, and H-RSBT is proposed as a feasible solution. Methods: A Henschke-type applicator, designed for an electronic brachytherapy source (Xoft Axxent™) and a 0.5 mm thick tungsten partial shield with 180° or 45° azimuthal emission angles and 116° asymmetric zenith angle, is proposed. The interior wall of the applicator contains six evenly spaced helical keyways that rigidly define the emission direction of the partial radiation shield as a function of depth in the applicator. The shield contains three uniformly distributed protruding keys on its exterior wall and is attached to the source such that it rotates freely, thus longitudinal translational motion of the source is transferred to rotational motion of the shield. S-RSBT and H-RSBT treatment plans with 180° and 45° azimuthal emission angles were generated for five cervical cancer patients with a diverse range of high-risk target volume (HR-CTV) shapes and applicator positions. For each patient, the total number of emission angles was held nearly constant for S-RSBT and H-RSBT by using dwell positions separated by 5 and 1.7 mm, respectively, and emission directions separated by 22.5° and 60°, respectively. Treatment delivery time and tumor coverage (D{sub 90} of HR-CTV) were the two metrics used as the basis for evaluation and

  8. Phantom study of radiation doses outside the target volume brachytherapy versus external radiotherapy of early breast cancer

    International Nuclear Information System (INIS)

    Johansson, Bengt; Persson, Essie; Westman, Gunnar; Persliden, Jan

    2003-01-01

    Background and purpose: Brachytherapy is sometimes suggested as an adjuvant treatment after surgery of some tumours. When introducing this, it would be useful to have an estimate of the dose distribution to different body sites, both near and distant to target, comparing conventional external irradiation to brachytherapy. The aim of the present study was to determine radiation doses with both methods at different body sites, near and distant to target, in an experimental situation on an operated left sided breast cancer on a female Alderson phantom. Methods: Five external beam treatments with isocentric tangential fields were given by a linear accelerator. A specified dose of 1.0 Gy was given to the whole left sided breast volume. Five interstitial brachytherapy treatments were given to the upper, lateral quadrant of the left breast by a two plane, 10 needles implant. A dose of 1.0 Gy specified according to the Paris system was administered by a pulsed dose rate afterloading machine. Absorbed dose in different fixed dose points were measured by thermoluminescence dosimeters. Results: Both methods yielded an absorbed dose of the same size to the bone marrow and internal organs distant to target, 1.0-1.4% of the prescribed dose. There was a trend of lower doses to the lower half of the trunk and higher doses to the upper half of the trunk, respectively, by brachytherapy. A 90% reduction of absorbed dose with brachytherapy compared to external irradiation was found in the near-target region within 5 cm from target boundary where parts of the left lung and the heart are situated. If an adjuvant dose of 50 Gy is given with the external radiotherapy and brachytherapy, the absorbed dose in a part of the myocardium could be reduced from 31.8 to 2.1 Gy. Conclusions: Near target, brachytherapy yielded a considerably lower absorbed dose which is of special importance when considering radiation effects on the myocard and lungs. We could not demonstrate any difference of

  9. Resolving the brachytherapy challenges with government funded hospital.

    Science.gov (United States)

    Nikam, D S; Jagtap, A S; Vinothraj, R

    2016-01-01

    The objective of this study is to rationalize the feasibility and cost-effectiveness of high dose rate (HDR) cobalt 60 (Co-60) source versus 192-Iridium (192-Ir) source brachytherapy in government funded hospitals and treatment interruption gap because of exchange of sources. A retrospective study of gynecological cancer patients, treated by radiotherapy with curative intent between April 2005 and September 2012 was conducted. We analyzed the total number of patients treated for external beam radiotherapy (EBRT) and brachytherapy (Intracavitary brachytherapy or cylindrical vaginal source). The dates for 192-Ir sources installation and the last date and first date of brachytherapy procedure before and after source installation respectively were also analyzed and calculated the gap in days for brachytherapy interruptions. The study was analyzed the records of 2005 to September 2012 year where eight 192-Ir sources were installed. The mean gap between treatment interruptions was 123.12 days (range 1-647 days). The Institutional incidence of gynecological cancer where radiotherapy was treatment modality (except ovary) is 34.9 percent. Around 52.25 percent of patients who received EBRT at this institute were referred to outside hospital for brachytherapy because of unavailability of Iridium source. The cost for 5 year duration for single cobalt source is approximately 20-22 lakhs while for 15 Iridium sources is approximately 52-53 lakhs. The combined HDR Co-60 brachytherapy and EBRT provide a useful modality in the treatment of gynecological cancer where radiotherapy is indicated, the treatment interruption because of source exchange is longer and can be minimized by using cobalt source as it is cost-effective and has 5 year working life. Thus, Co-60 source for brachytherapy is a feasible option for government funded hospitals in developing countries.

  10. Intensity Modulated Proton Beam Radiation for Brachytherapy in Patients With Cervical Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Clivio, Alessandro [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Kluge, Anne [Department of Radiation Oncology, Charité University Hospital, Berlin (Germany); Cozzi, Luca, E-mail: lucozzi@iosi.ch [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Köhler, Christhardt [Department of Gynecology, Charité University Hospital, Berlin (Germany); Neumann, Oliver [Department of Radiation Oncology, Charité University Hospital, Berlin (Germany); Vanetti, Eugenio [Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Wlodarczyk, Waldemar; Marnitz, Simone [Department of Radiation Oncology, Charité University Hospital, Berlin (Germany)

    2013-12-01

    Purpose: To evaluate intensity modulated proton therapy (IMPT) in patients with cervical cancer in terms of coverage, conformity, and dose–volume histogram (DVH) parameters correlated with recommendations from magnetic resonance imaging (MRI)-guided brachytherapy. Methods and Materials: Eleven patients with histologically proven cervical cancer underwent primary chemoradiation for the pelvic lymph nodes, the uterus, the cervix, and the parametric region, with a symmetric margin of 1 cm. The prescription was for 50.4 Gy, with 1.8 Gy per fraction. The prescribed dose to the parametria was 2.12 Gy up to 59.36 Gy in 28 fractions as a simultaneous boost. For several reasons, the patients were unable to undergo brachytherapy. As an alternative, IMPT was planned with 5 fractions of 6 Gy to the cervix, including the macroscopic tumor with an MRI-guided target definition, with an isotropic margin of 5 mm for planning target volume (PTV) definition. Groupe-Europeen de Curietherapie and European society for Radiotherapy and Oncology (GEC-ESTRO) criteria were used for DVH evaluation. Reference comparison plans were optimized for volumetric modulated rapid arc (VMAT) therapy with the RapidArc (RA). Results: The dose to the high-risk volume was calculated with α/β = 10 with 89.6 Gy. For IMPT, the clinical target volume showed a mean dose of 38.2 ± 5.0 Gy (35.0 ±1.8 Gy for RA). The D{sub 98%} was 31.9 ± 2.6 Gy (RA: 30.8 ± 1.0 Gy). With regard to the organs at risk, the 2Gy Equivalent Dose (EQD2) (α/β = 3) to 2 cm{sup 3} of the rectal wall, sigmoid wall, and bladder wall was 62.2 ± 6.4 Gy, 57.8 ± 6.1 Gy, and 80.6 ± 8.7 Gy (for RA: 75.3 ± 6.1 Gy, 66.9 ± 6.9 Gy, and 89.0 ± 7.2 Gy, respectively). For the IMPT boost plans in combination with external beam radiation therapy, all DVH parameters correlated with <5% risk for grades 2 to 4 late gastrointestinal and genitourinary toxicity. Conclusion: In patients who are not eligible for brachytherapy, IMPT as a boost

  11. Dosimetry of iridium-192 sources used in brachytherapy

    International Nuclear Information System (INIS)

    Henn, Keli Cristina

    1999-09-01

    The use of high dose rate brachytherapy (HDR) has been increasing in recent years, due to several advantages relative to conventional low dose rate brachytherapy, such as: shorter treatment times, the ability to fractionate treatment (and thus perform many treatments on an outpatient basis) and reduced worker exposures. Most HDR equipment uses small, high activity 192 Ir sources, which are introduced into the patient using a remote system. The dose distribution around these sources is strongly dependent on the size and shape of the active volume and on the encapsulation of the source. The objective of this work is to compare two methods of calibrating sources of 192 Ir, mamely, measurements in air with an ionization thimble chamber or with a well-type ionization chamber. In addition, we measured the anisotropy of the sources and made comparisons with values supplied by the manufacturer, since this factor is taken into account in the planning system algorithm when dose distributions are calculated. The dose was also evaluated at points of clinical interest (i.e. in the rectum and bladder) and compared to values obtained with the Nucletron PLATO-BPS planning system. The use of lead for rectal protection was evaluated in a cylindrical applicator, aiming the further development of a gynecological applicator. The results of the calibration of seven sources showed that the uncertainty in the calibration in a 'jig' system is smaller than 1%, compared to the value supplied by the source manufacturer. The differences between the results obtained with the well-type ionization camera and the 'jig' system were around 2%. The anisotropy showed good agreement with the values supplied by the manufacturer. The results show that the anisotropy factors, in air and water, are approximately constant and equal to 1.0, for angles between 70 deg and 150 deg. For angles smaller than 70 deg the anisotropy factor in water is larger than in air. Results are also presented for 180 deg, which

  12. American Society for Therapeutic Radiology and Oncology (ASTRO) Emerging Technology Committee Report on Electronic Brachytherapy

    International Nuclear Information System (INIS)

    Park, Catherine C.; Yom, Sue S.; Podgorsak, Matthew B.; Harris, Eleanor; Price, Robert A.; Bevan, Alison; Pouliot, Jean; Konski, Andre A.; Wallner, Paul E.

    2010-01-01

    The development of novel technologies for the safe and effective delivery of radiation is critical to advancing the field of radiation oncology. The Emerging Technology Committee of the American Society for Therapeutic Radiology and Oncology appointed a Task Group within its Evaluation Subcommittee to evaluate new electronic brachytherapy methods that are being developed for, or are already in, clinical use. The Task Group evaluated two devices, the Axxent Electronic Brachytherapy System by Xoft, Inc. (Fremont, CA), and the Intrabeam Photon Radiosurgery Device by Carl Zeiss Surgical (Oberkochen, Germany). These devices are designed to deliver electronically generated radiation, and because of their relatively low energy output, they do not fall under existing regulatory scrutiny of radioactive sources that are used for conventional radioisotope brachytherapy. This report provides a descriptive overview of the technologies, current and future projected applications, comparison of competing technologies, potential impact, and potential safety issues. The full Emerging Technology Committee report is available on the American Society for Therapeutic Radiology and Oncology Web site.

  13. Long-Term Results of an RTOG Phase II Trial (00-19) of External-Beam Radiation Therapy Combined With Permanent Source Brachytherapy for Intermediate-Risk Clinically Localized Adenocarcinoma of the Prostate

    Energy Technology Data Exchange (ETDEWEB)

    Lawton, Colleen A., E-mail: clawton@mcw.edu [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Yan, Yan [Radiation Therapy Oncology Group Statistical Center, Philadelphia, PA (United States); Lee, W. Robert [Department of Radiation Oncology, Duke University School of Medicine, Durham, NC (United States); Gillin, Michael [Department of Radiation Oncology, MD Anderson Cancer Center, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Firat, Selim [Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI (United States); Baikadi, Madhava [Department of Radiation Oncology, Northeast Radiation Oncology Center, Scranton, PA (United States); Crook, Juanita [Department of Radiation Oncology, University of British Columbia, Kelowna, BC (Canada); Kuettel, Michael [Department of Radiation Medicine, Roswell Park Cancer Institute, Buffalo, NY (United States); Morton, Gerald [Department of Radiation Oncology, Toronto-Sunnybrook Regional Cancer Center, Toronto, ON (Canada); Sandler, Howard [Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA (United States)

    2012-04-01

    Purpose: External-beam radiation therapy combined with low-doserate permanent brachytherapy are commonly used to treat men with localized prostate cancer. This Phase II trial was performed to document late gastrointestinal or genitourinary toxicity as well as biochemical control for this treatment in a multi-institutional cooperative group setting. This report defines the long-term results of this trial. Methods and Materials: All eligible patients received external-beam radiation (45 Gy in 25 fractions) followed 2-6 weeks later by a permanent iodine 125 implant of 108 Gy. Late toxicity was defined by the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer late radiation morbidity scoring scheme. Biochemical control was defined by the American Society for Therapeutic Radiology and Oncology (ASTRO) Consensus definition and the ASTRO Phoenix definition. Results: One hundred thirty-eight patients were enrolled from 20 institutions, and 131 were eligible. Median follow-up (living patients) was 8.2 years (range, 2.7-9.3 years). The 8-year estimate of late grade >3 genitourinary and/or gastrointestinal toxicity was 15%. The most common grade >3 toxicities were urinary frequency, dysuria, and proctitis. There were two grade 4 toxicities, both bladder necrosis, and no grade 5 toxicities. In addition, 42% of patients complained of grade 3 impotence (no erections) at 8 years. The 8-year estimate of biochemical failure was 18% and 21% by the Phoenix and ASTRO consensus definitions, respectively. Conclusion: Biochemical control for this treatment seems durable with 8 years of follow-up and is similar to high-dose external beam radiation alone or brachytherapy alone. Late toxicity in this multi-institutional trial is higher than reports from similar cohorts of patients treated with high-dose external-beam radiation alone or permanent low-doserate brachytherapy alone, perhaps suggesting further attention to strategies that limit doses to

  14. Assessment of the risks associated with Iodine-125 handling production sources for brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Souza, Daiane C.B.; Rostelato, Maria Elisa C.; Vicente, Roberto; Zeituni, Carlos A.; Tiezzi, Rodrigo; Costa, Osvaldo L.; Souza, Carla D.; Peleias Junior, Fernando S.; Rodrigues, Bruna T.; Souza, Anderson S.; Batista, Talita Q.; Melo, Emerson R.; Camargo, Anderson R., E-mail: dcsouza@usp.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Karam Junior, Dib, E-mail: dib.karam@usp.br [Universidade de Sao Paulo (USP), Sao Paulo, SP (Brazil)

    2015-07-01

    In Brazil, prostate cancer is the second most frequent disease, with an estimated 68,800 new cases in 2013. This type of cancer can be treated with brachytherapy, which uses sealed sources of Iodine-125 implanted permanently in the prostate. These sources are currently imported at a high cost, making public treatment in large scale impractical. To reduce costs and to meet domestic demand, the laboratory for production of brachytherapy sources at the Nuclear and Energy Research Institute (IPEN) is currently nationalizing the production of this radioisotope. Iodine is quite volatile making the handling of its radioactive isotopes potentially dangerous. The aim of this paper is to evaluate the risks to which workers are exposed during the production and handling of the sources. The research method consisted initially of a literature review on the toxicity of iodine, intake limits, related physical risks, handling of accidents, generation of radioactive wastes, etc. The results allowed for establishing safety and radioprotection policies in order to ensure efficient and safe production in all stages and the implementation of good laboratory practices. (author)

  15. Assessment of the risks associated with Iodine-125 handling production sources for brachytherapy

    International Nuclear Information System (INIS)

    Souza, Daiane C.B.; Rostelato, Maria Elisa C.; Vicente, Roberto; Zeituni, Carlos A.; Tiezzi, Rodrigo; Costa, Osvaldo L.; Souza, Carla D.; Peleias Junior, Fernando S.; Rodrigues, Bruna T.; Souza, Anderson S.; Batista, Talita Q.; Melo, Emerson R.; Camargo, Anderson R.; Karam Junior, Dib

    2015-01-01

    In Brazil, prostate cancer is the second most frequent disease, with an estimated 68,800 new cases in 2013. This type of cancer can be treated with brachytherapy, which uses sealed sources of Iodine-125 implanted permanently in the prostate. These sources are currently imported at a high cost, making public treatment in large scale impractical. To reduce costs and to meet domestic demand, the laboratory for production of brachytherapy sources at the Nuclear and Energy Research Institute (IPEN) is currently nationalizing the production of this radioisotope. Iodine is quite volatile making the handling of its radioactive isotopes potentially dangerous. The aim of this paper is to evaluate the risks to which workers are exposed during the production and handling of the sources. The research method consisted initially of a literature review on the toxicity of iodine, intake limits, related physical risks, handling of accidents, generation of radioactive wastes, etc. The results allowed for establishing safety and radioprotection policies in order to ensure efficient and safe production in all stages and the implementation of good laboratory practices. (author)

  16. Radiation protection after interstitial permanent prostate brachytherapy implants

    Energy Technology Data Exchange (ETDEWEB)

    Pirraco, R.; Pereira, A.; Cavaco, A. [Instituto Portugues de Oncologia Francisco Gentil - Centro R egional de Oncologia do Porto, SA, Porto (Portugal)

    2006-07-01

    Full text of publication follows: In this study we measure patients radiation exposure dose after interstitial {sup 125}I permanent prostate Brachytherapy implants, and correlate it with dose limits for public, total activity implanted, patient preoperative weight(1), distance between prostate walls and anterior skin surface. Methods and Material: We analyse 20 patients who were implanted with {sup 125}I seeds. The instrument used to measure radiation is a calibrated Berthold Umo LB 123 aco-plated to a LB 1236-H10 detector. Three measurements were taken: at the perineal and anterior pelvic zones on contact with the skin and at 1 m from the patient. The maximum value was taken for all measurements. The dose at a distance of one meter is obtained at anterior pelvic zone, perpendicular to the skin, according to the recommendations of A.A.P.M.(1). The distance between prostate walls was determined using post -operative CT images. Results: The doses at the perineal zone have determined an average of 186 {mu}Sv/h (range: 110 340 {mu}Sv/h) and at surface pelvic zone of 41 {mu}Sv/h (range: 15 103 {mu}Sv/h). The dose at a distance of 1 meter has an average value of 0.4 {mu}Sv/h (range: 0.2 1.0 {mu}Sv/h). The average total activity implanted was 25 mCi (range: 17 38 mCi). The distance between prostate walls and skin pelvic surface of the patients has an average value of 8.9 cm (range: 6.6 -11.5 cm). At a distance of 1 meter from the pelvic zone the dose measured is very low and below dose limits imposed by the European Directive EURATOM 2 and the Portuguese law. For general public to reach annual dose limit (EURATOM - 1 mSv/year) when contacting the pelvic zone, we extrapolate that 4 days (range: 1.6 11.1 days) would be needed, assuming a daily contact period of 6 hours. Conclusion: We established a correlation between the distance of prostate walls to the skin perineal surface and the total dose, but we find no correlation between measured doses, total activity implanted

  17. A national survey of HDR source knowledge among practicing radiation oncologists and residents: Establishing a willingness-to-pay threshold for cobalt-60 usage.

    Science.gov (United States)

    Mailhot Vega, Raymond; Talcott, Wesley; Ishaq, Omar; Cohen, Patrice; Small, Christina J; Duckworth, Tamara; Sarria Bardales, Gustavo; Perez, Carmen A; Schiff, Peter B; Small, William; Harkenrider, Matthew M

    Ir-192 is the predominant source for high-dose-rate (HDR) brachytherapy in United States markets. Co-60, with longer half-life and fewer source exchanges, has piloted abroad with comparable clinical dosimetry but increased shielding requirements. We sought to identify practitioner knowledge of Co-60 and establish acceptable willingness-to-pay (WTP) thresholds for additional shielding requirements for use in future cost-benefit analysis. A nationwide survey of U.S. radiation oncologists was conducted from June to July 2015, assessing knowledge of HDR sources, brachytherapy unit shielding, and factors that may influence source-selection decision-making. Self-identified decision makers in radiotherapy equipment purchase and acquisition were asked their WTP on shielding should a more cost-effective source become available. Four hundred forty surveys were completed and included. Forty-four percent were ABS members. Twenty percent of respondents identified Co-60 as an HDR source. Respondents who identified Co-60 were significantly more likely to be ABS members, have attended a national brachytherapy conference, and be involved in brachytherapy selection. Sixty-six percent of self-identified decision makers stated that their facility would switch to a more cost-effective source than Ir-192, if available. Cost and experience were the most common reasons provided for not switching. The most common WTP value selected by respondents was decision makers to establish WTP for shielding costs that source change to Co-60 may require. These results will be used to establish WTP threshold for future cost-benefit analysis. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  18. Monte Carlo Simulation of stepping source in afterloading intracavitary brachytherapy for GZP6 unit

    International Nuclear Information System (INIS)

    Toossi, M.T.B.; Abdollahi, M.; Ghorbani, M.

    2010-01-01

    Full text: Stepping source in brachytherapy systems is used to treat a target lesion longer than the effective treatment length of the source. Dose calculation accuracy plays a vital role in the outcome of brachytherapy treatment. In this study, the stepping source (channel 6) of GZP6 brachytherapy unit was simulated by Monte Carlo simulation and matrix shift method. The stepping source of GZP6 was simulated by Monte Carlo MCNPX code. The Mesh tally (type I) was employed for absorbed dose calculation in a cylindrical water phantom. 5 x 108 photon histories were scored and a 0.2% statistical uncertainty was obtained by Monte Carlo calculations. Dose distributions were obtained by our matrix shift method for esophageal cancer tumor lengths of 8 and 10 cm. Isodose curves produced by simulation and TPS were superimposed to estimate the differences. Results Comparison of Monte Carlo and TPS dose distributions show that in longitudinal direction (source movement direction) Monte Carlo and TPS dose distributions are comparable. [n transverse direction, the dose differences of 7 and 5% were observed for esophageal tumor lengths of 8 and 10 cm respectively. Conclusions Although, the results show that the maximum difference between Monte Carlo and TPS calculations is about 7%, but considering that the certified activity is given with ± I 0%, uncertainty, then an error of the order of 20% for Monte Carlo calculation would be reasonable. It can be suggested that accuracy of the dose distribution produced by TPS is acceptable for clinical applications. (author)

  19. The Meaning and Experience of Patients Undergoing Rectal High-Dose-Rate Brachytherapy.

    Science.gov (United States)

    Perez, Samara; Néron, Sylvain; Benc, Renata; Rosberger, Zeev; Vuong, Té

    2016-01-01

    High-dose-rate (HDR) brachytherapy is a precise form of radiation therapy that targets cancerous tumors by directly applying the radiation source at the site or directly next to the tumor. Patients often experience but underreport pain and anxiety related to cancer treatments. At present, there is no research available concerning the pervasiveness and intensity of patients' pain and anxiety during rectal brachytherapy. The aim of this study was to examine patients' thoughts, emotions, coping strategies, physical sensations, and needs during rectal HDR brachytherapy treatment. Twenty-five patients with rectal cancer were interviewed using a semi-structured qualitative interview following the completion of their brachytherapy treatment delivered at a Montreal-based hospital in Quebec, Canada. The experiences of pain and discomfort varied greatly between patients and were linked to the meaning patients attributed to the treatment itself, sense of time, the body's lithotomic position, insertion of the treatment applicator, and the patients' sense of agency and empowerment during the procedure. Patients drew upon a variety of internal and external resources to help them cope with discomfort. Staff need to know about the variation in the physical and emotional experiences of patients undergoing this treatment. Clinical teams can tailor their procedural behavior (eg, using certain language, psychosocial interventions) according to patients' needs to increase patients' comfort and ultimately improve their experience of HDR rectal brachytherapy.

  20. SU-F-T-32: Evaluation of the Performance of a Multiple-Array-Diode Detector for Quality Assurance Tests in High-Dose-Rate Brachytherapy with Ir-192 Source

    Energy Technology Data Exchange (ETDEWEB)

    Harpool, K; De La Fuente Herman, T; Ahmad, S; Ali, I [University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States)

    2016-06-15

    Purpose: To evaluate the performance of a two-dimensional (2D) array-diode- detector for geometric and dosimetric quality assurance (QA) tests of high-dose-rate (HDR) brachytherapy with an Ir-192-source. Methods: A phantom setup was designed that encapsulated a two-dimensional (2D) array-diode-detector (MapCheck2) and a catheter for the HDR brachytherapy Ir-192 source. This setup was used to perform both geometric and dosimetric quality assurance for the HDR-Ir192 source. The geometric tests included: (a) measurement of the position of the source and (b) spacing between different dwell positions. The dosimteric tests include: (a) linearity of output with time, (b) end effect and (c) relative dose verification. The 2D-dose distribution measured with MapCheck2 was used to perform the previous tests. The results of MapCheck2 were compared with the corresponding quality assurance testes performed with Gafchromic-film and well-ionization-chamber. Results: The position of the source and the spacing between different dwell-positions were reproducible within 1 mm accuracy by measuring the position of maximal dose using MapCheck2 in contrast to the film which showed a blurred image of the dwell positions due to limited film sensitivity to irradiation. The linearity of the dose with dwell times measured from MapCheck2 was superior to the linearity measured with ionization chamber due to higher signal-to-noise ratio of the diode readings. MapCheck2 provided more accurate measurement of the end effect with uncertainty < 1.5% in comparison with the ionization chamber uncertainty of 3%. Although MapCheck2 did not provide absolute calibration dosimeter for the activity of the source, it provided accurate tool for relative dose verification in HDR-brachytherapy. Conclusion: The 2D-array-diode-detector provides a practical, compact and accurate tool to perform quality assurance for HDR-brachytherapy with an Ir-192 source. The diodes in MapCheck2 have high radiation sensitivity and

  1. A Comparison of the Dosimetric Parameters of Cs-137 Brachytherapy Source in Different Tissues with Water Using Monte Carlo Simulation

    Directory of Open Access Journals (Sweden)

    Sedigheh Sina

    2012-03-01

    Full Text Available Introduction After the publication of Task Group number 43 dose calculation formalism by the American Association of Physicists in Medicine (AAPM, this method has been known as the most common dose calculation method in brachytherapy treatment planning. In this formalism, the water phantom is introduced as the reference dosimetry phantom, while the attenuation coefficient of the sources in the water phantom is different from that of different tissues. The purpose of this study is to investigate the effects of the phantom materials on the TG-43 dosimetery parameters of the Cs-137 brachytherapy source using MCNP4C Monte Carlo code. Materials and Methods In this research, the Cs-137 (Model Selectron brachytherapy source was simulated in different phantoms (bone, soft tissue, muscle, fat, and the inhomogeneous phantoms of water/bone of volume 27000 cm3 using MCNP4C Monte Carlo code. *F8 tally was used to obtain the dose in a fine cubical lattice. Then the TG-43 dosimetry parameters of the brachytherapy source were obtained in water phantom and compared with those of different phantoms. Results The percentage difference between the radial dose function g(r of bone and the g(r of water phantom, at a distance of 10 cm from the source center is 20%, while such differences are 1.7%, 1.6% and 1.1% for soft tissue, muscle, and fat, respectively. The largest difference of the dose rate constant of phantoms with those of water is 4.52% for the bone phantom, while the differences for soft tissue, muscle, and fat are 1.18%, 1.27%, and 0.18%, respectively. The 2D anisotropy function of the Cs-137 source for different tissues is identical to that of water. Conclusion The results of the simulations have shown that dose calculation in water phantom would introduce errors in the dose calculation around brachytherapy sources. Therefore, it is suggested that the correction factors of different tissues be applied after dose calculation in water phantoms, in order to

  2. Efficacy of phosphorus-32 brachytherapy without external-beam radiation for long-term tumor control in patients with craniopharyngioma.

    Science.gov (United States)

    Ansari, Shaheryar F; Moore, Reilin J; Boaz, Joel C; Fulkerson, Daniel H

    2016-04-01

    OBJECT Radioactive phosphorus-32 (P32) has been used as brachytherapy for craniopharyngiomas with the hope of providing local control of enlarging tumor cysts. Brachytherapy has commonly been used as an adjunct to the standard treatment of surgery and external-beam radiation (EBR). Historically, multimodal treatment, including EBR, has shown tumor control rates as high as 70% at 10 years after treatment. However, EBR is associated with significant long-term risks, including visual deficits, endocrine dysfunction, and cognitive decline. Theoretically, brachytherapy may provide focused local radiation that controls or shrinks a symptomatic cyst without exposing the patient to the risks of EBR. For this study, the authors reviewed their experiences with craniopharyngioma patients treated with P32 brachytherapy as the primary treatment without EBR. The authors reviewed these patients' records to evaluate whether this strategy effectively controls tumor growth, thus avoiding the need for further surgery or EBR. METHODS The authors performed a retrospective review of pediatric patients treated for craniopharyngioma between 1997 and 2004. This was the time period during which the authors' institution had a relatively high use of P32 for treatment of cystic craniopharyngioma. All patients who had surgery and injection of P32 without EBR were identified. The patient records were analyzed for complications, cyst control, need for further surgery, and need for future EBR. RESULTS Thirty-eight patients were treated for craniopharyngioma during the study period. Nine patients (23.7%) were identified who had surgery (resection or biopsy) with P32 brachytherapy but without initial EBR. These 9 patients represented the study group. For 1 patient (11.1%), there was a complication with the brachytherapy procedure. Five patients (55.5%) required subsequent surgery. Seven patients (77.7%) required subsequent EBR for tumor growth. The mean time between the injection of P32 and

  3. Impact of Insurance Status on Radiation Treatment Modality Selection Among Potential Candidates for Prostate, Breast, or Gynecologic Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Grant, Stephen R. [Baylor College of Medicine, Houston, Texas (United States); Walker, Gary V. [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Koshy, Matthew [Department of Radiation Oncology, The University of Chicago, Chicago, Illinois (United States); Shaitelman, Simona F.; Klopp, Ann H.; Frank, Steven J.; Pugh, Thomas J.; Allen, Pamela K. [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Mahmood, Usama, E-mail: UMahmood@mdanderson.org [Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States)

    2015-12-01

    Purpose: The Patient Protection and Affordable Care Act looks to expand both private and Medicaid insurance. To evaluate how these changes may affect the field of radiation oncology, we evaluated the association of insurance status with the use of brachytherapy in cancers for which this treatment technique is used. Methods and Materials: A total of 190,467 patients met the inclusion criteria, of whom 95,292 (50.0%) had breast cancer, 61,096 (32.1%) had prostate cancer, 28,194 (14.8%) had endometrial cancer, and 5885 (3.1%) had cervical cancer. A multivariate logistic regression model was used to determine the association between insurance status and receipt of brachytherapy among patients treated definitively for prostate and cervical cancer or postoperatively for breast and endometrial cancer. Results: The rates of non-Medicaid insurance were 49.9% (cervical), 85.3% (endometrial), 87.4% (breast), and 90.9% (prostate) (P<.001). In a logistic regression, patients who received radiation therapy were less likely to receive brachytherapy if they had Medicaid coverage (odds ratio [OR] 0.57, 95% confidence interval [CI] 0.53-0.61, P<.001) or did not have insurance coverage (OR 0.50, 95% CI 0.45-0.56, P<.001) compared with those with non-Medicaid insurance. On subset analysis, patients with Medicaid coverage or without insurance coverage were significantly less likely to receive brachytherapy than were those with non-Medicaid insurance for all 4 sites, except for patients with endometrial cancer. Conclusions: Despite being a cost-effective treatment modality, brachytherapy is less often used in the definitive or postoperative management of cancer in patients with Medicaid coverage or without insurance. Upcoming health policy changes resulting in the expansion of private insurance and Medicaid will likely increase access to and demand for brachytherapy.

  4. Impact of Insurance Status on Radiation Treatment Modality Selection Among Potential Candidates for Prostate, Breast, or Gynecologic Brachytherapy

    International Nuclear Information System (INIS)

    Grant, Stephen R.; Walker, Gary V.; Koshy, Matthew; Shaitelman, Simona F.; Klopp, Ann H.; Frank, Steven J.; Pugh, Thomas J.; Allen, Pamela K.; Mahmood, Usama

    2015-01-01

    Purpose: The Patient Protection and Affordable Care Act looks to expand both private and Medicaid insurance. To evaluate how these changes may affect the field of radiation oncology, we evaluated the association of insurance status with the use of brachytherapy in cancers for which this treatment technique is used. Methods and Materials: A total of 190,467 patients met the inclusion criteria, of whom 95,292 (50.0%) had breast cancer, 61,096 (32.1%) had prostate cancer, 28,194 (14.8%) had endometrial cancer, and 5885 (3.1%) had cervical cancer. A multivariate logistic regression model was used to determine the association between insurance status and receipt of brachytherapy among patients treated definitively for prostate and cervical cancer or postoperatively for breast and endometrial cancer. Results: The rates of non-Medicaid insurance were 49.9% (cervical), 85.3% (endometrial), 87.4% (breast), and 90.9% (prostate) (P<.001). In a logistic regression, patients who received radiation therapy were less likely to receive brachytherapy if they had Medicaid coverage (odds ratio [OR] 0.57, 95% confidence interval [CI] 0.53-0.61, P<.001) or did not have insurance coverage (OR 0.50, 95% CI 0.45-0.56, P<.001) compared with those with non-Medicaid insurance. On subset analysis, patients with Medicaid coverage or without insurance coverage were significantly less likely to receive brachytherapy than were those with non-Medicaid insurance for all 4 sites, except for patients with endometrial cancer. Conclusions: Despite being a cost-effective treatment modality, brachytherapy is less often used in the definitive or postoperative management of cancer in patients with Medicaid coverage or without insurance. Upcoming health policy changes resulting in the expansion of private insurance and Medicaid will likely increase access to and demand for brachytherapy.

  5. Brachytherapy: The need for a national metrology lab in Spain

    International Nuclear Information System (INIS)

    Aviles Lucas, P.

    2011-01-01

    Radiotherapy, along with chemotherapy and surgery, is an essential therapeutic technique for treating malignant tumours. Part of the challenge of a suitable radiotherapy treatment lies on the optimisation of the irradiated volume, which must be adapted to the tumour volume as far as possible. Depending on position of the radiation source relative to the patient, the procedure in question could be external radiotherapy, or brachytherapy. In a brachytherapy procedure, relatively small encapsulated radioactive sources are placed close to or in the tumour volume to be treated. This therapeutic treatment has two obvious advantages; on one hand the prescribed dose can be adjusted to the tumour volume, preventing unnecessary exposure of the adjacent healthy tissues, and on the other, it decreases the treatment duration compared to a radiotherapy treatment. (Author) 19 refs.

  6. Production of iridium-192 radiation sources: Indian Experience

    International Nuclear Information System (INIS)

    Sastry, K.V.S.; Kolhe, O.T.; Nagarja, P.S.; Paramr, Y.D.

    2002-01-01

    Board of Radiation and Isotope Technology (BRIT), a unit under the Department of Atomic Energy is fabricating and supplying Ir-192 industrial radiography sources for various models of radiography cameras for use in the industry for non-destructive testing. Basically these sources are fabricated by encapsulating the required quantity of the activity in stainless steel 316 L capsules using Tungsten Inert gas welding process and crimping/attaching to the respective pigtail assemblies of the radiography cameras. The inactive iridium pellets are irradiated in the DHRUVA reactor at a flux on 1.8 X 10 14 n/cm 2 /sec. The performance classification of these source encapsulation for various conditions of normal and accidental nature are tested by subjecting the prototype sources as per the standard laid down by the regulatory authority, Atomic Energy Regulatory Board, in India. The sources are fabricated as per the national and international standards. Activity of the sources varies from 37O GBq (10 Ci ) to 2.96 TBq (80 Ci ) source strength depending on the requirement of the user. The specific activity of the Ir-192 sources supplied is around 7.4 TBq/gm (200 Ci/gm ). Quality control /Assurance for the manufacture of the source begins from the procurement of the raw material and ends with the finished source. Ir- 192 in the form of -0.3 mm diameter (0.1 mm dia wire of Ir-25 % and Pt-75% sheathed in pure platinum of 0.1 mm thick) is being supplied for use in the treatment of cancer of cervix, tongue etc. by brachytherapy. This is supplied in lengths of 50 cm / 100 cm with 37 - 185 GBq/cm ( 1-5 mCi/cm) activity. Annually 925 TBq (25 kCi) of Ir-192 for industrial radiography and about 60 meters of wire for brachytherapy are being fabricated and supplied. Because of the quality of these sources BRIT not only caters to the Indian industry but also is able to export sources to the third world countries. (Author)

  7. Acute genitourinary toxicity after high-dose-rate (HDR) brachytherapy combined with hypofractionated external-beam radiation therapy for localized prostate cancer: Correlation between the urethral dose in HDR brachytherapy and the severity of acute genitourinary toxicity

    International Nuclear Information System (INIS)

    Akimoto, Tetsuo; Ito, Kazuto; Saitoh, Jun-ichi; Noda, Shin-ei; Harashima, Koichi; Sakurai, Hideyuki; Nakayama, Yuko; Yamamoto, Takumi; Suzuki, Kazuhiro; Nakano, Takashi; Niibe, Hideo

    2005-01-01

    Purpose: Several investigations have revealed that the α/β ratio for prostate cancer is atypically low, and that hypofractionation or high-dose-rate (HDR) brachytherapy regimens using appropriate radiation doses may be expected to yield tumor control and late sequelae rates that are better or at least as favorable as those achieved with conventional radiation therapy. In this setting, we attempted treating localized prostate cancer patients with HDR brachytherapy combined with hypofractionated external beam radiation therapy (EBRT). The purpose of this study was to evaluate the feasibility of using this approach, with special emphasis on the relationship between the severity of acute genitourinary (GU) toxicity and the urethral dose calculated from the dose-volume histogram (DVH) of HDR brachytherapy. Methods and Materials: Between September 2000 and December 2003, 70 patients with localized prostate cancer were treated by iridium-192 HDR brachytherapy combined with hypofractionated EBRT at the Gunma University Hospital. Hypofractionated EBRT was administered in fraction doses of 3 Gy, three times per week; a total dose of 51 Gy was delivered to the prostate gland and the seminal vesicles using the four-field technique. No elective pelvic irradiation was performed. After the completion of EBRT, all the patients additionally received transrectal ultrasonography (TRUS)-guided HDR brachytherapy. The fraction size and the number of fractions in HDR brachytherapy were prospectively changed, whereas the total radiation dose for EBRT was fixed at 51 Gy. The fractionation in HDR brachytherapy was as follows: 5 Gy x 5, 7 Gy x 3, 9 Gy x 2, administered twice per day, although the biologic effective dose (BED) for HDR brachytherapy combined with EBRT, assuming that the α/β ratio is 3, was almost equal to 138 in each fractionation group. The planning target volume was defined as the prostate gland with 5-mm margin all around, and the planning was conducted based on

  8. Patterns of care for brachytherapy in Europe. Results in Spain.

    Science.gov (United States)

    López Torrecilla, J; Guedea, F; Heeren, G; Nissin, R; Ellison, T; Cottier, B

    2006-05-01

    In 2003 ESTRO began a project whose primary objective, was to make a map in the European area of infrastructures in technology and personnel for brachytherapy. A survey and a web site were elaborated. The survey was sent to the 76 Spanish Radiation Oncology departments in May 2003. By the end of 2003, 66 (86.8%) services had responded, 40 (71.4%) of which had brachytherapy. The services with brachytherapy treated 73.5% of the total patients, an average of 1,199 patients. The mean number of patients treated with brachytherapy by department was 135.5 and the number of applications was 265 annually. The average number of specialists was 7, 4 of them trained in brachytherapy. The average weekly work load of the radiation oncologists, physicists, and technicians was 22.6 h, 13.8 h and 21.0 h, respectively. The mean time dedicated to each patient by radiation oncologists, physicists and technicians was 9.2 h; 6.19 h; 7.2 h, respectively. The total number of afterloaders was 43 (22 HDR, 18 LDR, 3 PDR). The tumours most frequently treated with brachytherapy were gynaecological (56.24%), breast (14.2%) and prostate (11.7%). High dose rate was used in 47.46% of the patients and low dose rate in 47.24%. Between 1997 and 2002 there was an increase of 50.53% in patients treated with brachytherapy. The survey shows the brachytherapy resources and activity in Spain up to 2003. Increased use of brachytherapy in prostate tumours, prevalence of gynaecology brachytherapy and similar number of treatments with HDR and LDR are demonstrated in the Patterns of Care of Brachytherapy in Europe (PCBE) study in Spain.

  9. Calibration of photon and beta ray sources used in brachytherapy. Guidelines on standardized procedures at Secondary Standards Dosimetry Laboratories; Calibracion de fuentes de fotones y rayos beta usadas en braquiterapia. Guia de procedimiento estandarizados en Laboratorios Secundarios de Calibracion Dosimetrica (LSCD) y en hospitales

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-03-01

    after cardiovascular interventions. The present report includes a description of suitable detector systems that can be used for the calibration. It must be emphasized that for safe use of brachytherapy a comprehensive quality assurance (QA) programme should be developed at the radiotherapy center using this modality. A QA programme cannot rest on a source calibration alone, but in addition it should address all the different steps included in the treatment process. Such a programme is described in IAEA- TECDOC-1040, 'Design and Implementation of a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects'. As summarized in the present report, omission of a QA programme may have serious consequences for a patient undergoing brachytherapy treatment. The parts of this publication describing the calibration of low energy photon sources and beta ray sources have been written in close collaboration with members of the International Commission on Radiation Units and Measurements (ICRU)

  10. The Adjoint Method for The Optimization of Brachytherapy and Radiotherapy Patient Treatment Planning Procedures Using Monte Carlo Calculations

    International Nuclear Information System (INIS)

    Henderson, D.L.; Yoo, S.; Kowalok, M.; Mackie, T.R.; Thomadsen, B.R.

    2001-01-01

    The goal of this project is to investigate the use of the adjoint method, commonly used in the reactor physics community, for the optimization of radiation therapy patient treatment plans. Two different types of radiation therapy are being examined, interstitial brachytherapy and radiotherapy. In brachytherapy radioactive sources are surgically implanted within the diseased organ such as the prostate to treat the cancerous tissue. With radiotherapy, the x-ray source is usually located at a distance of about 1-meter from the patient and focused on the treatment area. For brachytherapy the optimization phase of the treatment plan consists of determining the optimal placement of the radioactive sources, which delivers the prescribed dose to the disease tissue while simultaneously sparing (reducing) the dose to sensitive tissue and organs. For external beam radiation therapy the optimization phase of the treatment plan consists of determining the optimal direction and intensity of beam, which provides complete coverage of the tumor region with the prescribed dose while simultaneously avoiding sensitive tissue areas. For both therapy methods, the optimal treatment plan is one in which the diseased tissue has been treated with the prescribed dose and dose to the sensitive tissue and organs has been kept to a minimum

  11. Radiation levels in Cath Lab and occupational exposures during manual 192Ir intracoronary brachytherapy

    International Nuclear Information System (INIS)

    Sharma, S.D.; Shanta, A.; Tripathi, U.B.; Bhatt, B.C.

    2001-01-01

    Intracoronary brachytherapy is a new modality of radiation therapy and is being used to reduce the rate of restenosis after angioplasty. Clinical trials for evaluation of safety and efficacy of manually implanted 192 Ir seed ribbons are underway at various cardiology centres in India. 192 Ir emits high energy gamma rays (0.136 -1.06 MeV), which causes concern regarding safety of the personnel when these sources are manually used in the cardiac catheterization laboratory (Cath Lab) for intracoronary irradiation. Radiation levels in Cath Lab and exposures to personnel have been measured at 6 different cardiology centres in the country during 8 different clinical trials using radiation survey meter, personnel monitoring badges and pocket dosimeters. Activities of 192 Ir seed ribbons used in these clinical trials were in the range of 5.55 - 14.8 GBq. Measured radiation levels behind the mobile lead shields, at the top of lead shields, near the patient head, near the patient toes and at the main door of the Cath Lab were in the range of 2.6-20, 50-256, 385-450, 22-225 and 2-16 μSv/hr/3.7GBq, respectively. Measured effective doses to occupational workers were in range of 14-100 μSv/procedure/3.7GBq. Based on these measurements, user institutions have been advised to use lead glass mounted L-shaped mobile lead shields with proper orientation during clinical trials, avoid unwanted occupancy in the Cath Lab and around the patient during irradiation and use conveniently long forceps or tongs for implantation and removal of sources. (author)

  12. SU-E-T-284: Revisiting Reference Dosimetry for the Model S700 Axxent 50 KVp Electronic Brachytherapy Source

    International Nuclear Information System (INIS)

    Hiatt, JR; Rivard, MJ

    2014-01-01

    Purpose: The model S700 Axxent electronic brachytherapy source by Xoft was characterized in 2006 by Rivard et al. The source design was modified in 2006 to include a plastic centering insert at the source tip to more accurately position the anode. The objectives of the current study were to establish an accurate Monte Carlo source model for simulation purposes, to dosimetrically characterize the new source and obtain its TG-43 brachytherapy dosimetry parameters, and to determine dose differences between the source with and without the centering insert. Methods: Design information from dissected sources and vendor-supplied CAD drawings were used to devise the source model for radiation transport simulations of dose distributions in a water phantom. Collision kerma was estimated as a function of radial distance, r, and polar angle, θ, for determination of reference TG-43 dosimetry parameters. Simulations were run for 10 10 histories, resulting in statistical uncertainties on the transverse plane of 0.03% at r=1 cm and 0.08% at r=10 cm. Results: The dose rate distribution the transverse plane did not change beyond 2% between the 2006 model and the current study. While differences exceeding 15% were observed near the source distal tip, these diminished to within 2% for r>1.5 cm. Differences exceeding a factor of two were observed near θ=150° and in contact with the source, but diminished to within 20% at r=10 cm. Conclusions: Changes in source design influenced the overall dose rate and distribution by more than 2% over a third of the available solid angle external from the source. For clinical applications using balloons or applicators with tissue located within 5 cm from the source, dose differences exceeding 2% were observed only for θ>110°. This study carefully examined the current source geometry and presents a modern reference TG-43 dosimetry dataset for the model S700 source

  13. Benefit of Adjuvant Brachytherapy Versus External Beam Radiation for Early Breast Cancer: Impact of Patient Stratification on Breast Preservation

    International Nuclear Information System (INIS)

    Smith, Grace L.; Jiang, Jing; Buchholz, Thomas A.; Xu, Ying; Hoffman, Karen E.; Giordano, Sharon H.; Hunt, Kelly K.; Smith, Benjamin D.

    2014-01-01

    Purpose: Brachytherapy after lumpectomy is an increasingly popular breast cancer treatment, but data concerning its effectiveness are conflicting. Recently proposed “suitability” criteria guiding patient selection for brachytherapy have never been empirically validated. Methods: Using the Surveillance, Epidemiology, and End Results–Medicare linked database, we compared women aged 66 years or older with invasive breast cancer (n=28,718) or ductal carcinoma in situ (n=7229) diagnosed from 2002 to 2007, treated with lumpectomy alone, brachytherapy, or external beam radiation therapy (EBRT). The likelihood of breast preservation, measured by subsequent mastectomy risk, was compared by use of multivariate proportional hazards, further stratified by American Society for Radiation Oncology (ASTRO) brachytherapy suitability groups. We compared 1-year postoperative complications using the χ 2 test and 5-year local toxicities using the log-rank test. Results: For patients with invasive cancer, the 5-year subsequent mastectomy risk was 4.7% after lumpectomy alone (95% confidence interval [CI], 4.1%-5.4%), 2.8% after brachytherapy (95% CI, 1.8%-4.3%), and 1.3% after EBRT (95% CI, 1.1%-1.5%) (P<.001). Compared with lumpectomy alone, brachytherapy achieved a more modest reduction in adjusted risk (hazard ratio [HR], 0.61; 95% CI, 0.40-0.94) than achieved with EBRT (HR, 0.22; 95% CI, 0.18-0.28). Relative risks did not differ when stratified by ASTRO suitability group (P=.84 for interaction), although ASTRO “suitable” patients did show a low absolute subsequent mastectomy risk, with a minimal absolute difference in risk after brachytherapy (1.6%; 95% CI, 0.7%-3.5%) versus EBRT (0.8%; 95% CI, 0.6%-1.1%). For patients with ductal carcinoma in situ, EBRT maintained a reduced risk of subsequent mastectomy (HR, 0.40; 95% CI, 0.28-0.55; P<.001), whereas the small number of patients treated with brachytherapy (n=179) precluded definitive comparison with lumpectomy alone. In

  14. BrachyTPS -Interactive point kernel code package for brachytherapy treatment planning of gynaecological cancers

    International Nuclear Information System (INIS)

    Thilagam, L.; Subbaiah, K.V.

    2008-01-01

    Brachytherapy treatment planning systems (TPS) are always recommended to account for the effect of tissue, applicator and shielding material heterogeneities exist in Intracavitary brachytherapy (ICBT) applicators. Most of the commercially available brachytherapy TPS softwares estimate the absorbed dose at a point, only taking care of the contributions of individual sources and the source distribution, neglecting the dose perturbations arising from the applicator design and construction. So the doses estimated by them are not much accurate under realistic clinical conditions. In this regard, interactive point kernel rode (BrachyTPS) has been developed to perform independent dose calculations by taking into account the effect of these heterogeneities, using two regions build up factors, proposed by Kalos. As primary input data, the code takes patients' planning data including the source specifications, dwell positions, dwell times and it computes the doses at reference points by dose point kernel formalisms, with multi-layer shield build-up factors accounting for the contributions from scattered radiation. In addition to performing dose distribution calculations, this code package is capable of displaying an isodose distribution curve into the patient anatomy images. The primary aim of this study is to validate the developed point kernel code integrated with treatment planning systems against the other tools which are available in the market. In the present work, three brachytherapy applicators commonly used in the treatment of uterine cervical carcinoma, Board of Radiation Isotope and Technology (BRIT) made low dose rate (LDR) applicator, Fletcher Green type LDR applicator and Fletcher Williamson high dose rate (HDR) applicator were studied to test the accuracy of the software

  15. Monte Carlo simulation of MOSFET dosimeter for brachytherapy sources

    International Nuclear Information System (INIS)

    Suchitra, G.; Bharanidharan, G.; Manigandan, D.; Aruna, P.; Ganesan, S.; Subbaiah, K.V.

    2008-01-01

    In vivo patient dose verification is considered to be an important part of quality assurance in radiotherapy, as there may be uncertainty between the prescribed dose and the dose actually delivered to the patients. A dose estimator method was used to calculate the dose in the extremely thin sensitive volume. This work shows the response of MOSFET detector for various brachytherapy sources at various experimental condition and the results were compared with the earlier published values. The details of computations and the results are discussed

  16. Neutron therapy coupling brachytherapy and boron neutron capture therapy (BNCT) techniques

    International Nuclear Information System (INIS)

    Chaves, Iara Ferreira.

    1994-12-01

    In the present dissertation, neutron radiation techniques applied into organs of the human body are investigated as oncologic radiation therapy. The proposal treatment consists on connecting two distinct techniques: Boron Neutron Capture Therapy (BNCT) and irradiation by discrete sources of neutrons, through the brachytherapy conception. Biological and radio-dosimetrical aspects of the two techniques are considered. Nuclear aspects are discussed, presenting the nuclear reactions occurred in tumoral region, and describing the forms of evaluating the dose curves. Methods for estimating radiation transmission are reviewed through the solution of the neutron transport equation, Monte Carlo methodology, and simplified analytical calculation based on diffusion equation and numerical integration. The last is computational developed and presented as a quickly way to neutron transport evaluation in homogeneous medium. The computational evaluation of the doses for distinct hypothetical situations is presented, applying the coupled techniques BNTC and brachytherapy as an possible oncologic treatment. (author). 78 refs., 61 figs., 21 tabs

  17. Development of brachytherapy medium doserate

    International Nuclear Information System (INIS)

    Atang Susila; Ari Satmoko; Ahmad Rifai; Kristiyanti

    2010-01-01

    Brachytherapy has proven to be an effective treatment for different types of cancers and it become a common treatment modality in most radiotherapy clinics. PRPN has had experience in development of Low Dose Rate Brachytherapy for cervix cancer treatment. However the treatment process using LDR device needs 5 hours in time that the patient feel uncomfort. Therefore PRPN develops Medium Dose Rate Brachytherapy with radiation activity not more than 5 Currie. The project is divided into two stages. Purchasing of TPS software and TDS design are held in 2010, and the construction will be in 2011. (author)

  18. American Society for Therapeutic Radiology and Oncology (ASTRO) Emerging Technology Committee report on electronic brachytherapy.

    Science.gov (United States)

    Park, Catherine C; Yom, Sue S; Podgorsak, Matthew B; Harris, Eleanor; Price, Robert A; Bevan, Alison; Pouliot, Jean; Konski, Andre A; Wallner, Paul E

    2010-03-15

    The development of novel technologies for the safe and effective delivery of radiation is critical to advancing the field of radiation oncology. The Emerging Technology Committee of the American Society for Therapeutic Radiology and Oncology appointed a Task Group within its Evaluation Subcommittee to evaluate new electronic brachytherapy methods that are being developed for, or are already in, clinical use. The Task Group evaluated two devices, the Axxent Electronic Brachytherapy System by Xoft, Inc. (Fremont, CA), and the Intrabeam Photon Radiosurgery Device by Carl Zeiss Surgical (Oberkochen, Germany). These devices are designed to deliver electronically generated radiation, and because of their relatively low energy output, they do not fall under existing regulatory scrutiny of radioactive sources that are used for conventional radioisotope brachytherapy. This report provides a descriptive overview of the technologies, current and future projected applications, comparison of competing technologies, potential impact, and potential safety issues. The full Emerging Technology Committee report is available on the American Society for Therapeutic Radiology and Oncology Web site. Copyright 2010. Published by Elsevier Inc.

  19. Spectroscopic output of {sup 125}I and {sup 103}Pd low dose rate brachytherapy sources

    Energy Technology Data Exchange (ETDEWEB)

    Usher-Moga, Jacqueline; Beach, Stephen M.; DeWerd, Larry A. [Department of Medical Physics, University of Wisconsin--Madison, Madison, Wisconsin 53705 (United States); Global Physics Solutions, St. Joseph, Michigan 49085 (United States); Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin 53705 (United States)

    2009-01-15

    The spectroscopic output of low dose rate (LDR) brachytherapy sources is dependent on the physical design and construction of the source. Characterization of the emitted photons from 12 {sup 125}I and 3 {sup 103}Pd LDR brachytherapy source models is presented. Photon spectra, both along the transverse bisector and at several polar angles, were measured in air with a high-purity reverse electrode germanium (REGe) detector. Measured spectra were corrected to in vacuo conditions via Monte Carlo and analytical methods. The tabulated and plotted spectroscopic data provide a more complete understanding of each source model's output characteristics than can be obtained with other measurement techniques. The variation in fluorescence yield of the {sup 125}I sources containing silver caused greater differences in the emitted spectra and average energies among these seed models than was observed for the {sup 103}Pd sources or the {sup 125}I sources that do not contain silver. Angular spectroscopic data further highlighted the effects of source construction unique to each model, as well as the asymmetric output of many seeds. These data demonstrate the need for the incorporation of such physically measured output characteristics in the Monte Carlo modeling process.

  20. Radiation exposure management over a decade in sealed sources fabrication

    International Nuclear Information System (INIS)

    Chougule, Nitin V.; Swaminathan, N.; Singh, P.; Sreenivas, V.; Bairwa, S.M.; Rath, D.P.; Patil, B.N.; Sastry, K.V.S.

    2008-01-01

    Radioactive sealed sources find innumerable applications in medical and industrial applications. 60 Co teletherapy sources are used for the treatment of cancer. In brachytherapy; 137 Cs and 192 Ir are used. Industrial sources using 60 Co, 137 Cs find applications in nucleonic gauges, tracer studies etc. 60 Co and 192 Ir sources are used in radiography also. In addition, 60 Co is widely used in irradiator facilities. Board of Isotopes and Radiation Technology (BRIT) has committed in supply of these sealed sources to various hospitals and industrial institutions in India. Annually, PetaBq (PBq) level of above mentioned isotopes are handled remotely in hot cells, RLG, BARC. This paper brings out a detailed account on the radiological surveillance provided during the fabrication of these sources implementing ALARA. The decrease in collective dose per activity handled is the outcome of improved operation practices which were carried out at various stages of source fabrication. (author)

  1. Dosimetric and Late Radiation Toxicity Comparison Between Iodine-125 Brachytherapy and Stereotactic Radiation Therapy for Juxtapapillary Choroidal Melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Krema, Hatem, E-mail: htmkrm19@yahoo.com [Department of Ocular Oncology, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada); Heydarian, Mostafa [Department of Radiation Medicine, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada); Beiki-Ardakani, Akbar [Department of Radiation Oncology, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada); Weisbrod, Daniel [Department of Ocular Oncology, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada); Xu, Wei [Department of Biostatistics, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada); Laperriere, Normand J.; Sahgal, Arjun [Department of Radiation Oncology, Princess Margaret Hospital/University Health Network, University of Toronto, Toronto, Ontario (Canada)

    2013-07-01

    Purpose: To compare the dose distributions and late radiation toxicities for {sup 125}I brachytherapy (IBT) and stereotactic radiation therapy (SRT) in the treatment of juxtapapillary choroidal melanoma. Methods: Ninety-four consecutive patients with juxtapapillary melanoma were reviewed: 30 have been treated with IBT and 64 with SRT. Iodine-125 brachytherapy cases were modeled with plaque simulator software for dosimetric analysis. The SRT dosimetric data were obtained from the Radionics XKnife RT3 software. Mean doses at predetermined intraocular points were calculated. Kaplan-Meier estimates determined the actuarial rates of late toxicities, and the log–rank test compared the estimates. Results: The median follow-up was 46 months in both cohorts. The 2 cohorts were balanced with respect to pretreatment clinical and tumor characteristics. Comparisons of radiation toxicity rates between the IBT and SRT cohorts yielded actuarial rates at 50 months for cataracts of 62% and 75% (P=.1), for neovascular glaucoma 8% and 47% (P=.002), for radiation retinopathy 59% and 89% (P=.0001), and for radiation papillopathy 39% and 74% (P=.003), respectively. Dosimetric comparisons between the IBT and SRT cohorts yielded mean doses of 12.8 and 14.1 Gy (P=.56) for the lens center, 17.6 and 19.7 Gy (P=.44) for the lens posterior pole, 13.9 and 10.8 Gy (P=.30) for the ciliary body, 61.9 and 69.7 Gy (P=.03) for optic disc center, and 48.9 and 60.1 Gy (P<.0001) for retina at 5-mm distance from tumor margin, respectively. Conclusions: Late radiation-induced toxicities were greater with SRT, which is secondary to the high-dose exposure inherent to the technique as compared with IBT. When technically feasible, IBT is preferred to treat juxtapapillary choroidal melanoma.

  2. Monte Carlo simulation study on dose enhancement by gold nanoparticles in brachytherapy

    International Nuclear Information System (INIS)

    Cho, Sungkoo; Jeong, Jonghwi; Kim, Chanhyeong; Yoon, Myonggeun

    2010-01-01

    Radiation dose enhancement by injection of a high atomic number (Z) material into tumor volumes has been studied for various radiation sources and different concentrations of gold nanoparticles. Brachytherapy employs low energy photons of less than ∼0.5 MeV, which indeed is the optimal energy range for radiation dose enhancement by introduction of high-Z material. The present study uses the MCNPX TM code to estimate the dose enhancement by gold nanoparticles for the four common brachytherapy sources ( 137 Cs, 192 Ir, 125 I, and 103 Pd). Additionally, cisplatin (H 6 Cl 2 N 2 Pt), a platinum-based chemotherapeutic drug, was used to evaluate the dose enhancement. The simulated source models were evaluated with reference to the calculated TG-43 parameter values. The dose enhancement in the tumor region due to the gold nanoparticles and cisplatin was evaluated according to the dose enhancement factor (DEF). The maximum values of the average DEFs were found to be 1.03, 1.11, 3.43, and 2.17 for the 137 Cs, 192 Ir, 125 I, and 103 Pd sources, respectively. The dose enhancement values for the low-energy sources were significantly higher than those for the high-energy sources. The dose enhancement due to cisplatin was calculated by using the same approach and was found to be comparable to that of the gold nanoparticles. The maximum value of the average DEF for cisplatin was 1.12 for the 5% concentration level in water and a 192 Ir source. We confirmed that cisplatin could be applied to cancer therapy that combines chemotherapeutic drugs with radiation therapy. The results presented herein will be used to study dose enhancement in tumor regions using various radiation modalities with high atomic number materials.

  3. Brachytherapy radiation doses to the neurovascular bundles

    International Nuclear Information System (INIS)

    Di Biase, Steven J.; Wallner, Kent; Tralins, Kevin; Sutlief, Steven

    2000-01-01

    Purpose: To investigate the role of radiation dose to the neurovascular bundles (NVB) in brachytherapy-related impotence. Methods and Materials: Fourteen Pd-103 or I-125 implant patients were studied. For patients treated with implant alone, the prostate and margin (clinical target volume [CTV]) received a prescription dose of 144 Gy for I-125 or 115 Gy for Pd-103. Two patients received Pd-103 (90 Gy) with 46 Gy supplemental external beam radiation (EBRT). Axial CT images were acquired 2 to 4 hours postoperatively for postimplant dosimetry. Because the NVBs cannot be visualized on CT, NVB calculation points were determined according to previously published anatomic descriptions. Bilateral NVB points were considered to lie posterior-laterally, approximately 2 mm from the prostatic capsule. NVB doses were recorded bilaterally, at 0.5-cm intervals from the prostatic base. Results: For Pd-103, the average NVB doses ranged from 150 Gy to 260 Gy, or 130% to 226% of the prescription dose. For I-125, the average NVB dose ranged from 200 Gy to 325 Gy, or 140% to 225% of the prescription dose. These was no consistent relationship between the NVB dose and the distance from the prostatic base. To examine the possible effect of minor deviations of our calculation points from the true NVB location, we performed NVB calculations at points 2 mm medial or lateral from the NVB calculation point in 8 patients. Doses at these alternate calculation points were comparable, although there was greater variability with small changes in the calculation point if sources were located outside the capsule, near the NVB calculation point. Three patients who developed early postimplant impotence had maximal NVB doses that far exceeded the average values. Conclusions: In the next few years, we hope to clarify the role of high NVB radiation doses on potency, by correlating NVB dose calculations with a large number of patients enrolled in an ongoing I-125 versus Pd-103 trial for early-stage patients

  4. Comparison of 60Cobalt and 192Iridium sources in high dose rate afterloading brachytherapy

    International Nuclear Information System (INIS)

    Richter, J.; Baier, K.; Flentje, M.

    2008-01-01

    Purpose: 60 Co sources with dimensions identical to those of 192 Ir have recently been made available in clinical brachytherapy. A longer half time reduces demands on logistics and quality assurance and perhaps costs. Material and Methods: Comparison of the physical properties of 60 Co and 192 Ir with regard to brachytherapy. Results: Required activities for the same air kerma rate are lower by a factor of 2.8 for 60 Co. Differential absorption in tissues of different densities can be neglected. Monte Carlo calculations demonstrate that integral dose due to radial dose fall off is higher for 192 Ir in comparison to 60 Co within the first 22 cm from the source (normalization at 1 cm). At larger distances this relationship is reversed. Conclusion: Clinical examples for intracavitary and interstitial applications however, show practically identical dose distributions in the treatment volume. (orig.)

  5. WE-FG-BRA-02: Docetaxel Eluting Brachytherapy Spacers for Local Chemo-Radiation Therapy in Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Belz, J [Northeastern University, Boston, MA (United States); Kumar, R; Sridhar, S [Northeastern University & Dana Farber Cancer Institute, Boston, MA (United States); Makrigiorgos, G; Nguyen, P [Dana Farber Cancer Institute, Boston, MA (United States); D’Amico, A [Brigham & Women’s Hospital, Boston, MA (United States); Cormack, R [Harvard Medical School, Boston, MA (United States)

    2016-06-15

    Purpose: We propose an innovative combinatorial treatment strategy of Local ChemoRadiation Therapy (LCRT) using a sustained drug delivery platform in the form of a spacer to locally radio-sensitize the prostate with Docetaxel (DTX) enabling a synergistic cure with the use of lower radiation doses. These biodegradable spacers are physically similar to the inert spacers routinely used in prostate brachytherapy but are now loaded with formulations of DTX. Methods: Spacers were loaded with ∼500µg Docetaxel (DTX) for prostate cancer studies. The implants were characterized in vitro using SEM and HPLC. The release kinetic studies were carried out in buffer (pH 6.0) at 37°C. Subcutaneous PC3 tumors were xenografted in nude mice. Prostate cancer studies were done with and without radiation using SARRP at 5Gy, 10Gy, and 15Gy. Drug-loaded implants were injected once intratumorally using an 18G brachytherapy needle. Results: The release study in vitro showed a highly sustained release for multiple weeks at therapeutically relevant doses. The monotherapy with local DTX spacer showed sustained tumor inhibition compared to empty implants and an equivalent DTX dose given systemically. At 40 days, 89% survival was observed for mice treated with DTX implants compared with 0% in all other treatment groups. The combined treatment with local DTX spacer and radiation (10Gy) showed the highest degree of tumor suppression (significant tumor growth inhibition by day 90). The control mice showed continuous tumor growth and were scarified by day 56. Groups of mice treated with DTX-spacer or radiation alone showed initial tumor suppression but growth continued after day 60. A larger experiment is ongoing. Conclusion: This approach provides localized delivery of the chemotherapeutic sensitizer directly to the tumor and avoids the toxicities associated with both brachytherapy and current systemic delivery of docetaxel. Sustained release of DTX is an effective chemotherapy option alone or

  6. Re-evaluation of a radiation protection cost benefit analysis study in brachytherapy

    International Nuclear Information System (INIS)

    Broek, J.G. van den; Weatherburn, H.

    1994-01-01

    This study investigates changes in the NRPB advice concerning cost benefit analysis over the last 10 years by correcting all figures for inflation and applying them to a particular radiation protection example, a previously published case of the introduction of afterloading brachytherapy equipment at the Christie Hospital, Manchester. It has been shown that for this example NRPB advice at one time led to a large cost benefit, at another time led to a large cost deficit and later still it again gives a large cost benefit. Application of cost benefit analysis to decision making in radiation protection is therefore shown to be in need of further investigation and clarification. (author)

  7. Methodology study for fixation of radioactive iodine in polymeric substrate for brachytherapy sources

    International Nuclear Information System (INIS)

    Rodrigues, Bruna T.; Rostelato, Maria Elisa C.M.; Souza, Carla D.; Tiezzi, Rodrigo; Souza, Daiane B. de; Benega, Marcos A.G.; Souza, Anderson S. de; Peleias Junior, Fernando S.; Zeituni, Calos A.; Fernandes, Vagner; Melo, Emerson Ronaldo de; Camargo, Anderson Rogerio de

    2015-01-01

    Cancer is now the second leading cause of death by disease in several countries, including Brazil. Prostate cancer is the most common among men. Brachytherapy is a modality of radiotherapy in which radioactive seeds are placed inside or in contact with the organ to be treated. The most widely used radioisotope in prostate brachytherapy is Iodine-125 which is presented fixated on a silver substrate that is subsequently placed inside a titanium capsule. A large dose of radiation is released only in the targeted tumor protecting healthy surrounding tissues. The technique requires the application of 80 - 120 seeds per patient. The implants of seeds have low impact and non-surgical procedures. Most patients can return to normal life within three days with little or no pain. This work proposes an alternative to the seeds that have already been developed, in order to reduce the cost by obtaining a better efficiency on fixing the radioactive iodine onto the epoxy resin. Methods have been developed to perform the fixation of Iodine-125 onto polymeric substrates. The parameters analyzed were the immersion time, type of static or dynamic reaction, concentration of the adsorption solution, the specific activity of the radioactive source, the need for carrier and chemical form of the radioactive Iodine. These experiments defined the most effective method to fixate the Iodine onto the polymeric material (epoxy resin), the Iodine activity in the polymeric substrate, the activity of the distribution of variation in a plot of polymeric cores and the efficiency of the epoxy resin to seal the seed. (author)

  8. Survey of brachytherapy practice in France in 1995. Definitive results

    International Nuclear Information System (INIS)

    Peiffert, D.; Simon, J.M.; Baillet, F.

    1998-01-01

    A survey questionnaire was sent to the 189 French departments of radiation Oncology and 166 responded (88%). Ninety-nine departments declared treating patients by brachytherapy and 358 shielded rooms were available. In Low Dose Rate (LDR) 81 departments used Cesium sources (159 after-loaders, 1,060 sources); Iridium wires were used by 84 departments (673 meters used). Only six departments used other elements. Twenty-six departments were equipped with high dose rate after loaders (HDR) all of them also using LDR techniques for most of the patients. A total of 9,160 patients were treated: 7,868 with LDR and 1,292 with HDR. The common sites treated by LDR were utero-vagina (4,300), breast (1,415), head and neck (1,409), skin (610), anorectal (220) and urologic (70). HDR was used for vaginal cuff (628), bronchi (371), oesophagus (232). PDR just started (33 patients) for a feasibility trial. The rate of patients treated by brachytherapy is around 6-8% of the irradiated patients, but the indications vary is each department. The diffusion of the techniques, and new indications should increase the number of patients being treated by brachytherapy. (authors)

  9. Monte Carlo modeling of 60 Co HDR brachytherapy source in water and in different solid water phantom materials

    Directory of Open Access Journals (Sweden)

    Sahoo S

    2010-01-01

    Full Text Available The reference medium for brachytherapy dose measurements is water. Accuracy of dose measurements of brachytherapy sources is critically dependent on precise measurement of the source-detector distance. A solid phantom can be precisely machined and hence source-detector distances can be accurately determined. In the present study, four different solid phantom materials such as polymethylmethacrylate (PMMA, polystyrene, Solid Water, and RW1 are modeled using the Monte Carlo methods to investigate the influence of phantom material on dose rate distributions of the new model of BEBIG 60 Co brachytherapy source. The calculated dose rate constant is 1.086 ± 0.06% cGy h−1 U−1 for water, PMMA, polystyrene, Solid Water, and RW1. The investigation suggests that the phantom materials RW1 and Solid Water represent water-equivalent up to 20 cm from the source. PMMA and polystyrene are water-equivalent up to 10 cm and 15 cm from the source, respectively, as the differences in the dose data obtained in these phantom materials are not significantly different from the corresponding data obtained in liquid water phantom. At a radial distance of 20 cm from the source, polystyrene overestimates the dose by 3% and PMMA underestimates it by about 8% when compared to the corresponding data obtained in water phantom.

  10. Acute vasculitis after endovascular brachytherapy

    International Nuclear Information System (INIS)

    Fajardo L-G, Luis F.; Prionas, Stavros D.; Kaluza, Grzegorz L.; Raizner, Albert E.

    2002-01-01

    Purpose: Angioplasty effectively relieves coronary artery stenosis but is often followed by restenosis. Endovascular radiation (β or γ) at the time of angioplasty prevents restenosis in a large proportion of vessels in swine (short term) and humans (short and long term). Little information is available about the effects of this radiation exposure beyond the wall of the coronary arteries. Methods and Materials: Samples were obtained from 76 minipigs in the course of several experiments designed to evaluate endovascular brachytherapy: 76 of 114 coronary arteries and 6 of 12 iliac arteries were exposed to endovascular radiation from 32 P sources (35 Gy at 0.5 mm from the intima). Two-thirds of the vessels had angioplasty or stenting. The vessels were systematically examined either at 28 days or at 6 months after radiation. Results: We found an unexpected lesion: acute necrotizing vasculitis in arterioles located ≤2.05 mm from the target artery. It was characterized by fibrinoid necrosis of the wall, often associated with lymphocytic exudates or thrombosis. Based on the review of perpendicular sections of tissue samples, the arterioles had received between 6 and 40 Gy. This arteriolar vasculitis occurred at 28 days in samples from 51% of irradiated coronary arteries and 100% of irradiated iliac arteries. By 6 months, the incidence of acute vasculitis decreased to 24% around the coronary arteries. However, at that time, healing vasculitis was evident, often with luminal narrowing, in 46% of samples. Vasculitis was not seen in any of 44 samples from unirradiated vessels (0%) and had no relation to angioplasty, stenting, or their sequelae. This radiation-associated vasculitis in the swine resembles the localized lymphocytic vasculitis that we have reported in tissues of humans exposed to external radiation. On the other hand, it is quite different from the various types of systemic vasculitis that occur in nonirradiated humans. Conclusion: Endoarterial brachytherapy

  11. Standardization of the calibration of brachytherapy sources at the IAEA dosimetry laboratory

    International Nuclear Information System (INIS)

    Shanta, A.; Andreo, P.

    1996-01-01

    A new service to SSDLs has been initiated at the IAEA Dosimetry Laboratory for providing calibrations of well-type ionisation chambers, used in brachytherapy applications, which are traceable to the International Measurement System. Considering that the most common radionuclide used in the developing countries is 137 Cs, two such sources of the type used for gynaecological intracavitary applications have been purchased by the Agency and calibrated at the National Institute of Standards and Technology (NIST), USA. These 137 Cs reference sources together with a well-type ionization chamber constitute the IAEA brachytherapy dosimetry standard. Based on the recommendations by a group of experts, a method has been developed for transferring calibrations to SSDLs which is described in this paper. The method is based on the acquisition by the SSDLs of sources and equipment similar to those at the IAEA. The well-type chamber is to be calibrated at the IAEA Dosimetry Laboratory, and this will be used at the SSDL to calibrate its own reference sources. These sources can in turn by used to calibrate well-type chambers from hospital users and to calibrate other type of sources by performing measurements in air. In order to standardize the procedures for the two methods and to provide guidance to the SSDLs, measurements have been carried out at the IAEA Dosimetry Laboratory. The reproducibility of the two type of measurements has been found to be better than 0.5%, and the uncertainty of calibrations estimated to be less than 1.5% (one standard deviation). (author). 8 refs, 8 figs, 2 tabs

  12. Photon spectrometry for the determination of the dose-rate constant of low-energy photon-emitting brachytherapy sources

    International Nuclear Information System (INIS)

    Chen, Zhe Jay; Nath, Ravinder

    2007-01-01

    Accurate determination of dose-rate constant (Λ) for interstitial brachytherapy sources emitting low-energy photons (<50 keV) has remained a challenge in radiation dosimetry because of the lack of a suitable absolute dosimeter for accurate measurement of the dose rates near these sources. Indeed, a consensus value of Λ taken as the arithmetic mean of the dose-rate constants determined by different research groups and dosimetry techniques has to be used at present for each source model in order to minimize the uncertainties associated with individual determinations of Λ. Because the dosimetric properties of a source are fundamentally determined by the characteristics of the photons emitted by the source, a new technique based on photon spectrometry was developed in this work for the determination of dose-rate constant. The photon spectrometry technique utilized a high-resolution gamma-ray spectrometer to measure source-specific photon characteristics emitted by the low-energy sources and determine their dose-rate constants based on the measured photon-energy spectra and known dose-deposition properties of mono-energetic photons in water. This technique eliminates many of the difficulties arising from detector size, the energy dependence of detector sensitivity, and the use of non-water-equivalent solid phantoms in absolute dose rate measurements. It also circumvents the uncertainties that might be associated with the source modeling in Monte Carlo simulation techniques. It was shown that the estimated overall uncertainty of the photon spectrometry technique was less than 4%, which is significantly smaller than the reported 8-10% uncertainty associated with the current thermo-luminescent dosimetry technique. In addition, the photon spectrometry technique was found to be stable and quick in Λ determination after initial setup and calibration. A dose-rate constant can be determined in less than two hours for each source. These features make it ideal to determine

  13. Permanent Seed Implant Dosimetry (PSID)TM 4.5 version as isodose and Treatment Planning System (TPS) programme for brachytherapy

    International Nuclear Information System (INIS)

    Indra Saptiama; Moch Subechi; Anung Pujiyanto; Hotman Lubis; Herlan Setiawan

    2014-01-01

    The medical treatment using radiation therapy for cancer diseases is increasingly developed. One of the method used in radiotherapy is brachytherapy. Brachytherapy is radiation therapy method in which a radiation source is implanted in cancer cell directly so the dose accepted by cancer cell is the highest dose and the dose accepted by normal cell is the lowest dose. I-125 Seed have been made successfully in domestic. To support the implant of I-125 seed for brachytherapy needs computer programme for the isodose calculation and Treatment Planning System (TPS). Permanent Seed Implant Dosimetry (PSID) 4.5 is one of the isodose calculation and Treatment Planning System (TPS) programme that is owned by Center for Radioisotope and Radiopharmaceutical-BATAN. In isodose calculation, PSID 4.5 uses 1D formalism and 2D formalism based on AAPM-TG43 (Association of American Physicist in Medicine- Task Group No.43). Anisotropic function on 1D formalism depend on distance function while on 2D formalism count on distance and angle function therefore 2D formalism has isodose calculation better than 1D formalism usage. PSID 4.5 can display the isodose contour of the seed I-125 radiation source in 2 dimension (2D) and 3 dimension (3D). The computer programme of isodose calculation and TPS uses PSID 4.5 is expected able to help planning for seed I-125 implantation process for brachytherapy that used by paramedics and to support the usage of seed I-125 as domestic product. (author)

  14. Electronic brachytherapy management of atypical fibroxanthoma: report of 8 lesions

    Directory of Open Access Journals (Sweden)

    Stephen Doggett

    2017-01-01

    Full Text Available Purpose : To evaluate the suitability of treating atypical fibroxanthoma (AFX, an uncommon skin malignancy, with electronic brachytherapy. Material and methods : From Feb 2013 to Sep 2014, we were referred a total of 8 cases of AFX in 7 patients, all involving the scalp. All of them were treated with electronic brachytherapy 50 Kev radiations (Xoft Axxent®, Fremont, California. All lesions received 40 Gy in two fractions per week with 5mm margins. Results : At a median follow-up of 23.7 months, the local recurrence rate is 12.5%. The single lesion that failed was not debulked surgically prior to electronic brachytherapy. Conclusions : To our knowledge, this is the first report in the literature on the use of radiation therapy as curative primary treatment for AFX. No contraindication to the use of radiations is found in the literature, with surgery being the sole treatment for AFX noted. Our recurrence rate is 0% for debulked lesions. Risk of recurrence is mitigated with surgical debulking prior to brachytherapy. Electronic brachytherapy appears to be a safe and effective treatment for debulked AFX. Multiple excisions, skin grafting, and wound care can be avoided in elderly patients by the use of electronic brachytherapy.

  15. Determination of the intrinsic energy dependence of LiF:Mg,Ti thermoluminescent dosimeters for 125I and 103Pd brachytherapy sources relative to 60Co.

    Science.gov (United States)

    Reed, J L; Rasmussen, B E; Davis, S D; Micka, J A; Culberson, W S; DeWerd, L A

    2014-12-01

    To determine the intrinsic energy dependence of LiF:Mg,Ti thermoluminescent dosimeters (TLD-100) for (125)I and (103)Pd brachytherapy sources relative to (60)Co. LiF:Mg,Ti TLDs were irradiated with low-energy brachytherapy sources and with a (60)Co teletherapy source. The brachytherapy sources measured were the Best 2301 (125)I seed, the OncoSeed 6711 (125)I seed, and the Best 2335 (103)Pd seed. The TLD light output per measured air-kerma strength was determined for the brachytherapy source irradiations, and the TLD light output per air kerma was determined for the (60)Co irradiations. Monte Carlo (MC) simulations were used to calculate the dose-to-TLD rate per air-kerma strength for the brachytherapy source irradiations and the dose to TLD per air kerma for the (60)Co irradiations. The measured and MC-calculated results for all irradiations were used to determine the TLD intrinsic energy dependence for (125)I and (103)Pd relative to (60)Co. The relative TLD intrinsic energy dependences (relative to (60)Co) and associated uncertainties (k = 1) were determined to be 0.883 ± 1.3%, 0.870 ± 1.4%, and 0.871 ± 1.5% for the Best 2301 seed, OncoSeed 6711 seed, and Best 2335 seed, respectively. The intrinsic energy dependence of TLD-100 is dependent on photon energy, exhibiting changes of 13%-15% for (125)I and (103)Pd sources relative to (60)Co. TLD measurements of absolute dose around (125)I and (103)Pd brachytherapy sources should explicitly account for the relative TLD intrinsic energy dependence in order to improve dosimetric accuracy.

  16. Determination of the intrinsic energy dependence of LiF:Mg,Ti thermoluminescent dosimeters for 125I and 103Pd brachytherapy sources relative to 60Co

    International Nuclear Information System (INIS)

    Reed, J. L.; Micka, J. A.; Culberson, W. S.; DeWerd, L. A.; Rasmussen, B. E.; Davis, S. D.

    2014-01-01

    Purpose: To determine the intrinsic energy dependence of LiF:Mg,Ti thermoluminescent dosimeters (TLD-100) for 125 I and 103 Pd brachytherapy sources relative to 60 Co. Methods: LiF:Mg,Ti TLDs were irradiated with low-energy brachytherapy sources and with a 60 Co teletherapy source. The brachytherapy sources measured were the Best 2301 125 I seed, the OncoSeed 6711 125 I seed, and the Best 2335 103 Pd seed. The TLD light output per measured air-kerma strength was determined for the brachytherapy source irradiations, and the TLD light output per air kerma was determined for the 60 Co irradiations. Monte Carlo (MC) simulations were used to calculate the dose-to-TLD rate per air-kerma strength for the brachytherapy source irradiations and the dose to TLD per air kerma for the 60 Co irradiations. The measured and MC-calculated results for all irradiations were used to determine the TLD intrinsic energy dependence for 125 I and 103 Pd relative to 60 Co. Results: The relative TLD intrinsic energy dependences (relative to 60 Co) and associated uncertainties (k = 1) were determined to be 0.883 ± 1.3%, 0.870 ± 1.4%, and 0.871 ± 1.5% for the Best 2301 seed, OncoSeed 6711 seed, and Best 2335 seed, respectively. Conclusions: The intrinsic energy dependence of TLD-100 is dependent on photon energy, exhibiting changes of 13%–15% for 125 I and 103 Pd sources relative to 60 Co. TLD measurements of absolute dose around 125 I and 103 Pd brachytherapy sources should explicitly account for the relative TLD intrinsic energy dependence in order to improve dosimetric accuracy

  17. Characteristics of the radiochromic film Gafchromictm EBT3 model for use in brachytherapy

    International Nuclear Information System (INIS)

    Luvizotto, Jessica

    2015-01-01

    Brachytherapy is a radiotherapy treatment modality using radioactive sealed sources within walking distance of the tumor, reducing the risk of applying an unwanted dose to adjacent healthy tissues. For brachytherapy is reliable, it is necessary to establish a dosimetric practices program aimed at determining the optimal dose of radiation for this radiotherapy practice. This paper presents the application of two methodologies for the dosimetry using radiochromic films. Experimental measurements were performed with EBT3 films in phantoms consisting of homogeneous and heterogeneous material (lung, bone and soft tissue) built especially for dose measurements in brachytherapy. The processing and analysis of the resulting images of the experimental procedure were performed with ImageJ software and MATLAB. The results were evaluated from comparisons dose of experimental measurements and simulations obtained by the Monte Carlo method. (author)

  18. Dosimetric characterization of the GammaClip™{sup 169}Yb low dose rate permanent implant brachytherapy source for the treatment of nonsmall cell lung cancer postwedge resection

    Energy Technology Data Exchange (ETDEWEB)

    Currier, Blake [Medical Physics, University of Massachusetts Lowell, 1 University Avenue, Lowell, Massachusetts 01854 (United States); Munro, John J. III [Source Production and Equipment Co., Inc., 113 Teal Street, St. Rose, Louisiana 70087 (United States); Medich, David C. [Department of Physics, Worcester Polytechnic Institute, 100 Institute Road, Worcester, Massachusetts 01609 (United States)

    2013-08-15

    Purpose: A novel {sup 169}Yb low dose rate permanent implant brachytherapy source, the GammaClip™, was developed by Source Production and Equipment Co. (New Orleans, LA) which is designed similar to a surgical staple while delivering therapeutic radiation. In this report, the brachytherapy source was characterized in terms of “Dose calculation for photon-emitting brachytherapy sources with average energy higher than 50 keV: Report of the AAPM and ESTRO” by Perez-Calatayud et al. [Med. Phys. 39, 2904–2929 (2012)] using the updated AAPM Task Group Report No. 43 formalism.Methods: Monte Carlo calculations were performed using Monte Carlo N-Particle 5, version 1.6 in water and air, the in-air photon spectrum filtered to remove photon energies below 10 keV in accordance with TG-43U1 recommendations and previously reviewed {sup 169}Yb energy cutoff levels [D. C. Medich, M. A. Tries, and J. M. Munro, “Monte Carlo characterization of an Ytterbium-169 high dose rate brachytherapy source with analysis of statistical uncertainty,” Med. Phys. 33, 163–172 (2006)]. TG-43U1 dosimetric data, including S{sub K}, D-dot (r,θ), Λ, g{sub L}(r), F(r, θ), φ{sub an}(r), and φ{sub an} were calculated along with their statistical uncertainties. Since the source is not axially symmetric, an additional set of calculations were performed to assess the resulting axial anisotropy.Results: The brachytherapy source's dose rate constant was calculated to be (1.22 ± 0.03) cGy h{sup −1} U{sup −1}. The uncertainty in the dose to water calculations, D-dot (r,θ), was determined to be 2.5%, dominated by the uncertainties in the cross sections. The anisotropy constant, φ{sub an}, was calculated to be 0.960 ± 0.011 and was obtained by integrating the anisotropy factor between 1 and 10 cm using a weighting factor proportional to r{sup −2}. The radial dose function was calculated at distances between 0.5 and 12 cm, with a maximum value of 1.20 at 5.15 ± 0.03 cm. Radial dose

  19. Definitive Brachytherapy for Kaposi's Sarcoma

    International Nuclear Information System (INIS)

    Williams, A.; Ezzell, G.; Zalupski, M.; Fontanesi, J.

    1996-01-01

    Purpose: To assess the efficacy and possible complications in patients diagnosed with Kaposi's sarcoma and treated with definitive brachytherapy. Methods and Materials: Between January, 1995 and December, 1995, four patients with Kaposi's sarcoma (KS) were treated with brachytherapy. Three patients, all with positive HIV status were treated using Iridium 192 (Ir-192) sources via a high-dose rate remote afterloader. One patient with endemic KS was treated using the application of catheters loaded with Californium 252. Eight sites were treated and included scalp, feet, nose, penis, hand, neck, and back. Dose rate for Ir-192 was 330cGy/fx to a total dose of 990cGy. The Californium was delivered as 100nGy/b.i.d. to a total dose of 900nGy. Follow-up as ranged from 2-6 months. Results: All four patients remain alive. Seven of eight sites have had complete clinical response and each patient has reported durable pain relief that has not subsided through last follow-up of 1/96. Two of eight sites, both treated with surface mold technique with Californium 252 developed moist desquamation. The remaining six sites did not demonstrate significant toxicity. Conclusion: Brachytherapy can offer Kaposi's sarcoma patients results that are equivalent to external beam radiation therapy, with minimal complications, a shorter treatment time and potential cost effectiveness

  20. Dose Distributions of an 192Ir Brachytherapy Source in Different Media

    Directory of Open Access Journals (Sweden)

    C. H. Wu

    2014-01-01

    Full Text Available This study used MCNPX code to investigate the brachytherapy 192Ir dose distributions in water, bone, and lung tissue and performed radiophotoluminescent glass dosimeter measurements to verify the obtained MCNPX results. The results showed that the dose-rate constant, radial dose function, and anisotropy function in water were highly consistent with data in the literature. However, the lung dose near the source would be overestimated by up to 12%, if the lung tissue is assumed to be water, and, hence, if a tumor is located in the lung, the tumor dose will be overestimated, if the material density is not taken into consideration. In contrast, the lung dose far from the source would be underestimated by up to 30%. Radial dose functions were found to depend not only on the phantom size but also on the material density. The phantom size affects the radial dose function in bone more than those in the other tissues. On the other hand, the anisotropy function in lung tissue was not dependent on the radial distance. Our simulation results could represent valid clinical reference data and be used to improve the accuracy of the doses delivered during brachytherapy applied to patients with lung cancer.

  1. American Brachytherapy Society recommendations for reporting morbidity after prostate brachytherapy

    International Nuclear Information System (INIS)

    Nag, Subir; Ellis, Rodney J.; Merrick, Gregory S.; Bahnson, Robert; Wallner, Kent; Stock, Richard

    2002-01-01

    Purpose: To standardize the reporting of brachytherapy-related prostate morbidity to guide ongoing clinical practice and future investigations. Methods: Members of the American Brachytherapy Society (ABS) with expertise in prostate brachytherapy performed a literature review and, guided by their clinical experience, formulated specific recommendations for reporting on morbidity related to prostate brachytherapy. Results: The ABS recommends using validated, patient-administered health-related quality-of-life instruments for the determination of baseline and follow-up data regarding bowel, urinary, and sexual function. Both actuarial and crude incidences should be reported, along with the temporal resolution of specific complications, and correlated with the doses to the normal tissues. The International Prostate Symptom Score is recommended to assess urinary morbidity, and any dysuria, gross hematuria, urinary retention, incontinence, or medication use should be quantified. Likewise, the ''Sexual Health Inventory for Men,'' which includes the specific erectile questions of the International Index of Erectile Function, is the preferred instrument for reporting sexual function, and the loss of sexual desire, incidence of hematospermia, painful orgasm (orgasmalgia), altered orgasm intensity, decreased ejaculatory volume, use of erectile aids, and use of hormones for androgen deprivation should be quantified. The ABS recommends adoption of the Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer acute and late radiation morbidity scoring scheme for reporting rectal morbidity and noting the incidence of rectal steroid, laser, or antidiarrheal use. Conclusion: It is important to focus on health-related quality-of-life issues in the treatment of prostate cancer, because the control rates are very similar between appropriate treatment modalities. The ABS recommends using the International Prostate Symptom Score, International Index of

  2. Influence of radioactive sources discretization in the Monte Carlo computational simulations of brachytherapy procedures: a case study on the procedures for treatment of prostate cancer

    International Nuclear Information System (INIS)

    Barbosa, Antonio Konrado de Santana; Vieira, Jose Wilson; Costa, Kleber Souza Silva; Lima, Fernando Roberto de Andrade

    2011-01-01

    Radiotherapy computational simulation procedures using Monte Carlo (MC) methods have shown to be increasingly important to the improvement of cancer fighting strategies. One of the biases in this practice is the discretization of the radioactive source in brachytherapy simulations, which often do not match with a real situation. This study had the aim to identify and to measure the influence of radioactive sources discretization in brachytherapy MC simulations when compared to those that do not present discretization, using prostate brachytherapy with Iodine-125 radionuclide as model. Simulations were carried out with 108 events with both types of sources to compare them using EGSnrc code associated to MASH phantom in orthostatic and supine positions with some anatomic adaptations. Significant alterations were found, especially regarding bladder, rectum and the prostate itself. It can be concluded that there is a need to discretized sources in brachytherapy simulations to ensure its representativeness. (author)

  3. Regulatory control for safe usage of ionizing radiation sources in Bangladesh

    International Nuclear Information System (INIS)

    Mollah, A.S.

    2008-01-01

    Full text: In Bangladesh, there is a widespread and continuos growth in the use of the ionizing radiation sources both radioactive materials and radiation generating equipment in the field of industry, medicine, agriculture, research, teaching etc. In industry, they are employed in production as well as quality control such as non-destructive testing (radiography), nucleonic gauging, radiotracer techniques and in radiation processing. Medical applications of ionizing radiation include X-ray radiography, X-ray fluoroscopy, CT scan, mammography, nuclear medicine, beam therapy and brachytherapy. Besides radioisotopes are also used for research applications, viz., scattering experiments, tracer studies, etc. In agriculture, the uptake of nutrients by soil, and parts of plants are studied using suitable radionuclides. In all the above applications radioisotopes in two forms namely sealed sources and open sources in different chemical forms are employed with source strengths varying from micro curies to mega curies. The benefits to man from the use of ionizing radiation and sources of radiation are accompanied by risks which may result from exposure of man to ionizing radiation. In order to have an effective control on the use of radiation sources and to ensure radiological safety of the user as well as the public, Government of Bangladesh has promulgated Nuclear Safety and Radiation Control (NSRC) rules 1997 under the NSRC Act 1993. The Bangladesh Atomic Energy commission (BAEC) is the competent authority for formulating rules and regulations for ensuring radiological safety. BAEC is legally responsible for developing and strengthening the necessary radiation protection infrastructure in the country through the effective enforcement and implementation of regulatory requirements, criteria, obligations, guiding, codes etc. in order to save man and the related environment from the deleterious effects of ionizing radiation. In Bangladesh, only those persons who have been

  4. Evaluation of radiation dose on people adjacent to implant patients during brachytherapy for prostate cancer using {sup 192}Ir

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Hoon; Ko, Seong Jin; Kang, Se Sik; Kim, Chang Soo [Catholic University, Busan (Korea, Republic of)

    2009-10-15

    The incidence of prostate cancer is rapidly increasing due to aging of the population and westernization of dietary habits, etc. As a result, the frequency of prostate cancer has become the fifth highest among all male cancers and the first among urological cancers. Brachytherapy is commonly used for locally progressing prostate cancers. Since the mid 1980s, therapies using radio-isotopes, such as low-invasive {sup 125}I, {sup 103}Pd and {sup 192}Ir, have been widely performed in the U.S. and Europe. However, brachytherapy involves implanting radio-isotopes into the human body which is of concern because it may expose the health care professionals administering the therapy to unnecessary radiation. Accordingly, this study intends to predict the radiation dose that people adjacent to patients implanted with a radio-isotope are exposed to during prostate cancer radiation therapy by using a mathematical anthropomorphic phantom and {sup 192}Ir.

  5. Reduction in radiation exposure to nursing personnel with the use of remote afterloading brachytherapy devices

    International Nuclear Information System (INIS)

    Grigsby, P.W.; Perez, C.A.; Eichling, J.; Purdy, J.; Slessinger, E.

    1991-01-01

    The radiation exposure to nursing personnel from patients with brachytherapy implants on a large brachytherapy service were reviewed. Exposure to nurses, as determined by TLD monitors, indicates a 7-fold reduction in exposure after the implementation of the use of remote afterloading devices. Quarterly TLD monitor data for six quarters prior to the use of remote afterloading devices demonstrate an average projected annual dose equivalent to the nurses of 152 and 154 mrem (1.5 mSv). After the implementation of the remote afterloading devices, the quarterly TLD monitor data indicate an average dose equivalent per nurse of 23 and 19 mrem (0.2 mSv). This is an 87% reduction in exposure to nurses with the use of these devices (p less than 0.01)

  6. Radiation exposure to operating room staff during prostate brachytherapy using iodine-125 seeds; Exposition radiologique de l'equipe operatoire au cours de curietherapies de prostate par implants permanents d'iode-125

    Energy Technology Data Exchange (ETDEWEB)

    Gagna, G.; Amabile, J.C.; Laroche, P. [Service de protection radiologique des armees (SPRA), 1 bis rue du Lieutenant Raoul Batany, 92141 Clamart Cedex (France); Gauron, C. [Institut national de recherche et de securite (INRS), Departement Etudes et Assistance Medicales, 30 rue Olivier Noyer, 75680 Paris Cedex 14 (France)

    2011-04-15

    The French defense radiation protection service (SPRA) and the French national institute for research and safety (INRS) conducted a joint study to assess the radiation exposure to operating room staff during prostate brachytherapy using iodine-125 seeds at the Val-de-Grace military hospital. The purpose of the study was the assessment of the effective doses, the equivalent doses to the extremities and lens received by a novice team, the different ambient dose equivalent rates measurements and the delineation of areas. After six brachy-therapies, all the recorded doses with whole-body InLight{sup R} OSL and nanoDot{sup R} dosimeters remained below the detection limit for the whole staff. The dose rate measured at the end of implantation by an AT1123{sup R} survey meter is about 170 {mu}Sv/h at the perineum of the patient. The controlled area limit is estimated to be about 20 cm from the patient perineum. From these results, the authors propose recommendations for the categorization of workers, the delineation of areas and the dose monitoring procedures. This study demonstrates that real-time ultrasound-guided trans-perineal prostate brachytherapy delivers low dose to the operators because of the radioactive source characteristics and the instrumentation providing an effective radiation protection for the surgical team. (authors)

  7. Advantages of high-dose rate (HDR) brachytherapy in treatment of prostate cancer

    Science.gov (United States)

    Molokov, A. A.; Vanina, E. A.; Tseluyko, S. S.

    2017-09-01

    One of the modern methods of preserving organs radiation treatment is brachytherapy. This article analyzes the results of prostate brachytherapy. These studies of the advantages of high dose brachytherapy lead to the conclusion that this method of radiation treatment for prostate cancer has a favorable advantage in comparison with remote sensing methods, and is competitive, preserving organs in comparison to surgical methods of treatment. The use of the method of polyfocal transperineal biopsy during the brachytherapy session provides information on the volumetric spread of prostate cancer and adjust the dosimetry plan taking into account the obtained data.

  8. American brachytherapy society (ABS) guidelines for brachytherapy of esophageal cancer

    International Nuclear Information System (INIS)

    Nag, Subir; Gaspar, Laurie; Herskovic, Arnold; Mantravadi, Prasad; Speiser, Burton

    1996-01-01

    Introduction: There is wide variation in the indications, techniques, treatment regimens and dosimetry being used to treat cancer of the esophagus and no guidelines exist for optimal therapy. Methods: The Clinical Research Committee of the ABS met to formulate consensus guidelines for brachytherapy in esophageal cancer. Results: Good candidates for brachytherapy include patients with unifocal disease, with thoracic tumor 10 cm primary regional lymph adenopathy or tumor located in the gastro-esophageal junction or cervical esophagus. Contraindications include tracheo-esophageal fistula or stenosis that cannot be by-passed. The esophageal or nasogastric tube inserted should have a diameter of 6-10 mm whenever possible. If 5FU-based chemotherapy and 50 Gy external beam (EBRT) are used, it is suggested that the low dose rate brachytherapy (LDR) dose be 20 Gy at 0.4-1 Gy/hr, prescribed at 1 cm from the source. If high dose rate (HDR) is used, the dose recommended is 10 Gy in 2 weekly fractions of 5 Gy each, given after EBRT. Chemotherapy is not usually given concurrently with brachytherapy, and when it is, the brachytherapy dose is reduced. The length of esophagus treated by brachytherapy includes the post-EBRT involved area and a 1-2 cm margin proximally and distally. Supportive care, given during EBRT includes an antifungal agent (e.g., diflucan) and carafate. Gradual dilatation of the esophagus is required post-treatment for esophageal strictures. Conclusion: Guidelines were developed for brachytherapy in esophageal cancer. As more clinical data becomes available, these guidelines will be updated by the ABS

  9. Dosimetry in intravascular brachytherapy

    International Nuclear Information System (INIS)

    Campos, Laelia Pumilla Botelho

    2000-03-01

    Among the cardiovascular diseases responsible for deaths in the adult population in almost all countries of the world, the most common is acute myocardial infarction, which generally occurs because of the occlusion of one or more coronary arteries. Several diagnostic techniques and therapies are being tested for the treatment of coronary artery disease. Balloon angioplasty has been a popular treatment which is less invasive than traditional surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment).Recently, the idea of delivering high radiation doses to coronary arteries to avoid or delay restenosis has been suggested. Known as intravascular brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis in some patient populations. In order to study the radiation dosimetry in the patient and radiological protection for the attending staff for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, o,30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several candidate radionuclides as well. Two s tent sources (metallic prosthesis that put inside of patient's artery through angioplasty) employing 32 P are also simulated. Advantages and disadvantages of the various radionuclides and source geometries are discussed. The dosimetry developed here will aid in the realization of the benefits obtained in patients for this promising new technology. (author)

  10. SU-E-T-284: Revisiting Reference Dosimetry for the Model S700 Axxent 50 KV{sub p} Electronic Brachytherapy Source

    Energy Technology Data Exchange (ETDEWEB)

    Hiatt, JR [Rhode Island Hospital, Providence, RI (United States); Rivard, MJ [Tufts University School of Medicine, Boston, MA (United States)

    2014-06-01

    Purpose: The model S700 Axxent electronic brachytherapy source by Xoft was characterized in 2006 by Rivard et al. The source design was modified in 2006 to include a plastic centering insert at the source tip to more accurately position the anode. The objectives of the current study were to establish an accurate Monte Carlo source model for simulation purposes, to dosimetrically characterize the new source and obtain its TG-43 brachytherapy dosimetry parameters, and to determine dose differences between the source with and without the centering insert. Methods: Design information from dissected sources and vendor-supplied CAD drawings were used to devise the source model for radiation transport simulations of dose distributions in a water phantom. Collision kerma was estimated as a function of radial distance, r, and polar angle, θ, for determination of reference TG-43 dosimetry parameters. Simulations were run for 10{sup 10} histories, resulting in statistical uncertainties on the transverse plane of 0.03% at r=1 cm and 0.08% at r=10 cm. Results: The dose rate distribution the transverse plane did not change beyond 2% between the 2006 model and the current study. While differences exceeding 15% were observed near the source distal tip, these diminished to within 2% for r>1.5 cm. Differences exceeding a factor of two were observed near θ=150° and in contact with the source, but diminished to within 20% at r=10 cm. Conclusions: Changes in source design influenced the overall dose rate and distribution by more than 2% over a third of the available solid angle external from the source. For clinical applications using balloons or applicators with tissue located within 5 cm from the source, dose differences exceeding 2% were observed only for θ>110°. This study carefully examined the current source geometry and presents a modern reference TG-43 dosimetry dataset for the model S700 source.

  11. Utilization of prostate brachytherapy for low risk prostate cancer: Is the decline overstated?

    OpenAIRE

    Joseph Safdieh; Andrew Wong; Joseph P. Weiner; David Schwartz; David Schreiber

    2016-01-01

    Purpose : Several prior studies have suggested that brachytherapy utilization has markedly decreased, coinciding with the recent increased utilization of intensity modulated radiation therapy, as well as an increase in urologist-owned centers. We sought to investigate the brachytherapy utilization in a large, hospital-based registry. Material and methods: Men with prostate cancer diagnosed between 2004-2012 and treated with either external beam radiation and/or prostate brachytherapy ...

  12. Radiation transmission data for radionuclides and materials relevant to brachytherapy facility shielding.

    Science.gov (United States)

    Papagiannis, P; Baltas, D; Granero, D; Pérez-Calatayud, J; Gimeno, J; Ballester, F; Venselaar, J L M

    2008-11-01

    To address the limited availability of radiation shielding data for brachytherapy as well as some disparity in existing data, Monte Carlo simulation was used to generate radiation transmission data for 60Co, 137CS, 198Au, 192Ir 169Yb, 170Tm, 131Cs, 125I, and 103pd photons through concrete, stainless steel, lead, as well as lead glass and baryte concrete. Results accounting for the oblique incidence of radiation to the barrier, spectral variation with barrier thickness, and broad beam conditions in a realistic geometry are compared to corresponding data in the literature in terms of the half value layer (HVL) and tenth value layer (TVL) indices. It is also shown that radiation shielding calculations using HVL or TVL values could overestimate or underestimate the barrier thickness required to achieve a certain reduction in radiation transmission. This questions the use of HVL or TVL indices instead of the actual transmission data. Therefore, a three-parameter model is fitted to results of this work to facilitate accurate and simple radiation shielding calculations.

  13. Relocation of a nucletron microselectron-HDR brachytherapy system

    Energy Technology Data Exchange (ETDEWEB)

    Bartrum, T; Tran, T; Freeman, N; Morales, J [St Vincents Hospital, Darlinghurst, NSW (Australia)

    2004-12-15

    Full text: For a period of four weeks, our clinical Nucletron microSelectron high dose rate (HDR) brachytherapy system was pulled out of clinical use and relocated to a new building. During this period decommission tests, de-wiring of the treatment unit and its associated safety system (such as radiation detector, emergency off circuits and door interlocks), transportation of all equipment, re-wiring of this equipment in the new location and recommission tests were carried out. The decommission and recommission test program was designed upon consultation with the manufacturer's (Nucletron) acceptance test procedures and work carried out by others. The ACPSEM tolerances for remote afterloaders was used as a guideline. In addition to mandatory dosimetry, positional, workstation database and safety tests, two Australian Standard compliance tests were carried out. The compliance tests involved one for remote afterloaders and another for treatment room design. This testing program was designed and implemented with the aim of ensuring ongoing safe delivery of brachytherapy doses to the patient. The testing program consisted of two parts. The first involved a series of decommissioning tests that consisted of dosimetry tests such as source and check cable positional accuracy and source calibration tests. In addition to these tests an inventory of standard plans, patient records and system configuration information was catalogued. The second part involved a series of recommission tests and involved carrying out dosimetry tests on the brachytherapy system (positional accuracy and calibration tests), simulating common treatment scenarios (prostate, cervical, vaginal and bile duct) and checking standard plans; patient records and system configuration had remained unchanged. During this period, other tests were carried out. These included Nucletron acceptance and preventative maintenance tests, Australian Standards compliance testing and integrity of network transfer of

  14. Relocation of a nucletron microselectron-HDR brachytherapy system

    International Nuclear Information System (INIS)

    Bartrum, T.; Tran, T.; Freeman, N.; Morales, J.

    2004-01-01

    Full text: For a period of four weeks, our clinical Nucletron microSelectron high dose rate (HDR) brachytherapy system was pulled out of clinical use and relocated to a new building. During this period decommission tests, de-wiring of the treatment unit and its associated safety system (such as radiation detector, emergency off circuits and door interlocks), transportation of all equipment, re-wiring of this equipment in the new location and recommission tests were carried out. The decommission and recommission test program was designed upon consultation with the manufacturer's (Nucletron) acceptance test procedures and work carried out by others. The ACPSEM tolerances for remote afterloaders was used as a guideline. In addition to mandatory dosimetry, positional, workstation database and safety tests, two Australian Standard compliance tests were carried out. The compliance tests involved one for remote afterloaders and another for treatment room design. This testing program was designed and implemented with the aim of ensuring ongoing safe delivery of brachytherapy doses to the patient. The testing program consisted of two parts. The first involved a series of decommissioning tests that consisted of dosimetry tests such as source and check cable positional accuracy and source calibration tests. In addition to these tests an inventory of standard plans, patient records and system configuration information was catalogued. The second part involved a series of recommission tests and involved carrying out dosimetry tests on the brachytherapy system (positional accuracy and calibration tests), simulating common treatment scenarios (prostate, cervical, vaginal and bile duct) and checking standard plans; patient records and system configuration had remained unchanged. During this period, other tests were carried out. These included Nucletron acceptance and preventative maintenance tests, Australian Standards compliance testing and integrity of network transfer of

  15. Utilization of prostate brachytherapy for low risk prostate cancer: Is the decline overstated?

    Science.gov (United States)

    Safdieh, Joseph; Wong, Andrew; Weiner, Joseph P; Schwartz, David; Schreiber, David

    2016-08-01

    Several prior studies have suggested that brachytherapy utilization has markedly decreased, coinciding with the recent increased utilization of intensity modulated radiation therapy, as well as an increase in urologist-owned centers. We sought to investigate the brachytherapy utilization in a large, hospital-based registry. Men with prostate cancer diagnosed between 2004-2012 and treated with either external beam radiation and/or prostate brachytherapy were abstracted from the National Cancer Database. In order to be included, men had to be clinically staged as T1c-T2aNx-0Mx-0, Gleason 6, PSA ≤ 10.0 ng/ml. Descriptive statistics were used to analyze brachytherapy utilization over time and were compared via χ(2). Multivariate logistic regression was used to assess for covariables associated with increased brachytherapy usage. There were 89,413 men included in this study, of which 37,054 (41.6%) received only external beam radiation, and 52,089 (58.4%) received prostate brachytherapy. The use of brachytherapy declined over time from 62.9% in 2004 to 51.3% in 2012 (p facilities (60.8% in 2004 to 47.0% in 2012, p facilities (63.7% in 2004 to 53.0% in 2012, p facilities than those who lived further. The use of intensity modulated radiation therapy increased during this same time period from 18.4% in 2004 to 38.2% in 2012 (p usage. In this hospital-based registry, prostate brachytherapy usage has declined for low risk prostate cancer as intensity modulated radiation therapy usage has increased. However, it still remains the treatment of choice for 51.3% of patients as of 2012.

  16. Image Guided Cervical Brachytherapy: 2014 Survey of the American Brachytherapy Society

    Energy Technology Data Exchange (ETDEWEB)

    Grover, Surbhi, E-mail: Surbhi.grover@uphs.upenn.edu [Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Harkenrider, Matthew M. [Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois (United States); Cho, Linda P. [Department of Radiation Oncology, Brigham & Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Erickson, Beth [Department Radiation Oncology, Froedtert Hospital and Medical College of Wisconsin, Milwaukee, Wisconsin (United States); Small, Christina [Department of Public Health Sciences, Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois (United States); Small, William [Department of Radiation Oncology, Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois (United States); Viswanathan, Akila N. [Department of Radiation Oncology, Brigham & Women' s Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

    2016-03-01

    Purpose: To provide an update of the 2007 American brachytherapy survey on image-based brachytherapy, which showed that in the setting of treatment planning for gynecologic brachytherapy, although computed tomography (CT) was often used for treatment planning, most brachytherapists used point A for dose specification. Methods and Materials: A 45-question electronic survey on cervical cancer brachytherapy practice patterns was sent to all American Brachytherapy Society members and additional radiation oncologists and physicists based in the United States between January and September 2014. Responses from the 2007 survey and the present survey were compared using the χ{sup 2} test. Results: There were 370 respondents. Of those, only respondents, not in training, who treat more than 1 cervical cancer patient per year and practice in the United States, were included in the analysis (219). For dose specification to the target (cervix and tumor), 95% always use CT, and 34% always use MRI. However, 46% use point A only for dose specification to the target. There was a lot of variation in parameters used for dose evaluation of target volume and normal tissues. Compared with the 2007 survey, use of MRI has increased from 2% to 34% (P<.0001) for dose specification to the target. Use of volume-based dose delineation to the target has increased from 14% to 52% (P<.0001). Conclusion: Although use of image-based brachytherapy has increased in the United States since the 2007 survey, there is room for further growth, particularly with the use of MRI. This increase may be in part due to educational initiatives. However, there is still significant heterogeneity in brachytherapy practice in the United States, and future efforts should be geared toward standardizing treatment.

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

    Science.gov (United States)

    Almansa, Julio F; Guerrero, Rafael; Torres, Javier; Lallena, Antonio M

    60 Co sources have been commercialized as an alternative to 192 Ir 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. 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. 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 60 Co, usually neglected in this kind of simulations, is significant up to the distances of 0.25 cm from the source. 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. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  18. Study of Different Tissue Density Effects on the Dose Distribution of a 103Pd Brachytherapy Source Model MED3633

    Directory of Open Access Journals (Sweden)

    Ali Asghar Mowlavi

    2010-09-01

    Full Text Available Introduction: Clinical application of encapsulated radioactive brachytherapy sources has a major role in cancer treatment. In the present research, the effects of different tissue densities on the dose distribution of a 103Pd brachytherapy source in a spherical phantom of 50 cm radius have been studied. Material and Methods: As is well known, absorbed dose in tissue depends to its density, but this difference is not clear in measurements. Therefore, we applied the MCNP code to evaluate the effect of density on the dose distribution. 103Pd brachytherapy sources are used to treat prostate, breast and other cancers. Results: Absorbed dose has been calculated and presented around a source placed in the center of the phantom for different tissue densities. Also, we derived anisotropy and radial dose functions and compared our Monte Carlo results with experimental results of Rivard and Li et al. for F(1, θ and g(r in 1.040 g/cm3 tissue. Conclusion: The results of this study show that relative dose variations around the source center are very considerable at different densities, because of the presence of a photoabsorber (Au-Cu alloy in the source core. Dose variation exceeds 80% at the point (Z = 2.4 mm, Y = 0 mm. Computed values of anisotropy and radial dose functions are in good agreement with the experimental results of Rivard and Li et al.

  19. Experiences with alanine dosimetry in afterloading brachytherapy

    International Nuclear Information System (INIS)

    Eberhardt, H.-J.; Gohs, U.

    1996-01-01

    At the present, the most commonly used dosimetry for radiotherapy applications are ionisation chambers and thermoluminescent dosimeters (TLD). However, there are some undesirable characteristics of these dosimetry systems, such as large detection volume (ionisation chamber) as well as fading of the radiation induced signal with time and destructive readout (TLG). The present study is an investigation into the use of the alanine/ESR dosimetry in fractionated afterloading brachytherapy during the whole radiotherapy course. There are some qualities which make alanine dosimetry attractive. These are the linear energy response, low fading under standard conditions, and the nondestructive readout. Thus the alanine dosimetry makes possible cumulative dose measurements during the radiotherapy course and an archival storage. By ionizing radiation (gamma, e, n, p, charged particles) free radicals (unpaired electrons) are produced in the amino acid alanine. The continuous wave electron spin resonance (ESR) spectroscopy is used to determine the number of free radicals, which is proportional to the absorbed dose and the alanine content of the dosimeter. The ESR measurements were made at room temperature using a Bruker EPR analyzer EMS-104. The dosimeters used in the test are alanine pellets (23.72 mg weight, 4.9 mm diameter, 1 mm height) as well as flexible alanine film dosimeters (thickness about 500 μm). The dosimeters consist of a blend of L-alpha-alanine and a binder. The alanine content of the pellets and the film dosimeters is about 88 % and 50 % by weight, respectively. The dosimeters for the calculation of the dose-effect-relationship were irradiated at the Physical-Technical Bundesanstalt in Braunschweig by a standard 60Co source. The maximum deviation from the calculated linear function is about 0.12 Gy in the dose range up to 80 Gy. The goal of medical applications was the superficial dose measurement in afterloading brachytherapy during the radiotherapy course in

  20. External beam radiation therapy and a low-dose-rate brachytherapy boost without or with androgen deprivation therapy for prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Strom, Tobin J.; Hutchinson, Sean Z.; Shrinath, Kushagra; Cruz, Alex A.; Figura, Nicholas B.; Nethers, Kevin; Biagioli, Matthew C.; Fernandez, Daniel C.; Heysek, Randy V.; Wilder, Richard B., E-mail: richard.wilder@moffitt.org [Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL (United States)

    2014-07-15

    Purpose: To assess outcomes with external beam radiation therapy (EBRT) and a low-dose-rate (LDR) brachytherapy boost without or with androgen deprivation therapy (ADT) for prostate cancer. Materials and Methods: From January 2001 through August 2011, 120 intermediate-risk or high-risk prostate cancer patients were treated with EBRT to a total dose of 4,500 cGy in 25 daily fractions and a palladium-103 LDR brachytherapy boost of 10,000 cGy (n = 90) or an iodine-125 LDR brachytherapy boost of 11,000 cGy (n = 30). ADT, consisting of a gonadotropin-releasing hormone agonist ± an anti-androgen, was administered to 29/92 (32%) intermediate-risk patients for a median duration of 4 months and 26/28 (93%) high-risk patients for a median duration of 28 months. Results: Median follow-up was 5.2 years (range, 1.1-12.8 years). There was no statistically-significant difference in biochemical disease-free survival (bDFS), distant metastasis-free survival (DMFS), or overall survival (OS) without or with ADT. Also, there was no statistically-significant difference in bDFS, DMFS, or OS with a palladium-103 vs. an iodine-125 LDR brachytherapy boost. Conclusions: There was no statistically-significant difference in outcomes with the addition of ADT, though the power of the current study was limited. The Radiation Therapy Oncology Group 0815 and 0924 phase III trials, which have accrual targets of more than 1,500 men, will help to clarify the role ADT in locally-advanced prostate cancer patients treated with EBRT and a brachytherapy boost. Palladium-103 and iodine-125 provide similar bDFS, DMFS, and OS. (author)

  1. Investigations into the Optimization of Multi-Source Strength Brachytherapy Treatment Procedures

    CERN Document Server

    Henderson, D L; Yoo, S

    2002-01-01

    The goal of this project is to investigate the use of multi-strength and multi-specie radioactive sources in permanent prostate implant brachytherapy. In order to fulfill the requirement for an optimal dose distribution, the prescribed dose should be delivered to the target in a nearly uniform dose distribution while simultaneously sparing sensitive structures. The treatment plan should use a small number of needles and sources while satisfying the treatment requirements. The hypothesis for the use of multi-strength and/or multi-specie sources is that a better treatment plan using fewer sources and needles could be obtained than by treatment plans using single-strength sources could reduce the overall number of sources used for treatment. We employ a recently developed greedy algorithm based on the adjoint concept as the optimization search engine. The algorithm utilizes and ''adjoint ratio'', which provides a means of ranking source positions, as the pseudo-objective function. It ha s been shown that the gre...

  2. Novel treatment options for nonmelanoma skin cancer: focus on electronic brachytherapy

    Directory of Open Access Journals (Sweden)

    Kasper ME

    2015-11-01

    Full Text Available Michael E Kasper,1,2 Ahmed A Chaudhary3 1Department of Radiation Oncology, Lynn Cancer Institute at Boca Raton Regional Hospital, Boca Raton, 2Charles E. Schmidt College of Medicine, Florida Atlantic University, FL, 3North Main Radiation Oncology, Warren Alpert School of Medicine, Brown University, RI, USA Abstract: Nonmelanoma skin cancer (NMSC is an increasing health care issue in the United States, significantly affecting quality of life and impacting health care costs. Radiotherapy has a long history in the treatment of NMSC. Shortly after the discovery of X-rays and 226Radium, physicians cured patients with NMSC using these new treatments. Both X-ray therapy and brachytherapy have evolved over the years, ultimately delivering higher cure rates and lower toxicity. Electronic brachytherapy for NMSC is based on the technical and clinical data obtained from radionuclide skin surface brachytherapy and the small skin surface applicators developed over the past 25 years. The purpose of this review is to introduce electronic brachytherapy in the context of the history, data, and utilization of traditional radiotherapy and brachytherapy. Keywords: electronic brachytherapy, superficial radiotherapy, skin surface brachytherapy, electron beam therapy, nonmelanoma skin cancer, basal cell carcinoma, squamous cell carcinoma

  3. LOW POWER BRACHYTHERAPY IN COMBINED TREATMENT IN PATIENTS WITH INTERMEDIATE RISK OF LOCALIZED PROST ATE CANCER

    Directory of Open Access Journals (Sweden)

    V. A. Biryukov

    2014-01-01

    Full Text Available Objective. Estimation of the effectiveness of low power brachytherapy sources I-125 in the combined treatment in group of patients of intermediate risk of localized prostate cancer.Material and methods. The study included 126 patients with prostate cancer of intermediate risk. 104 patients (83,9% were conducted low power brachytherapy I‑125 in combination with hormone therapy by analogues of LHWG. 22 patients (16.1% received external beam irradiation in combination with brachytherapy I‑125 and hormonal treatment. Relapse-free survival of patients was evaluated in accordance with the criteria Phoenix (Nadir PSA + ng/ml. Evaluation of side effects of radiation treatment were carried out according to the RTOG criteria.Results. PSA relapse-free survival in the group of brachytherapy and hormone treatment at the time of observation 5 years amounted to 97.1%. In the group of combined radiation therapy with brachytherapy, and hormonal treatment PSA relapse-free survival rate was 95.5%.In both groups, relapse-free survival was noted in 96,8% of cases. Tumor-specific and overall survival in bothgroups was 100%. The major complications of treatment in both groups were radiation urethritis 1 to 2 degrees in 9.5% of cases (12 patients, urethral stricture in 5 patients (3.9% of cases, acute urinary retention in 1 patient (0.8% of cases and late radiation rectitis of 2 degree in 1.58% of cases (2 patients.Conclusions. It is possible to draw tentative conclusions about the high rate of survival without progression in both treatment groups on the background of the relatively low frequency of adverse reactions. It is necessary further follow-up for patients with estimating of survival for a longer period.

  4. Use of Monte Carlo Methods for determination of isodose curves in brachytherapy

    International Nuclear Information System (INIS)

    Vieira, Jose Wilson

    2001-08-01

    Brachytherapy is a special form of cancer treatment in which the radioactive source is very close to or inside the tumor with the objective of causing the necrosis of the cancerous tissue. The intensity of cell response to the radiation varies according to the tissue type and degree of differentiation. Since the malign cells are less differentiated than the normal ones, they are more sensitive to the radiation. This is the basis for radiotherapy techniques. Institutes that work with the application of high dose rates use sophisticated computer programs to calculate the necessary dose to achieve the necrosis of the tumor and the same time, minimizing the irradiation of tissues and organs of the neighborhood. With knowledge the characteristics of the source and the tumor, it is possible to trace isodose curves with the necessary information for planning the brachytherapy in patients. The objective of this work is, using Monte Carlo techniques, to develop a computer program - the ISODOSE - which allows to determine isodose curves in turn of linear radioactive sources used in brachytherapy. The development of ISODOSE is important because the available commercial programs, in general, are very expensive and practically inaccessible to small clinics. The use of Monte Carlo techniques is viable because they avoid problems inherent to analytic solutions as, for instance , the integration of functions with singularities in its domain. The results of ISODOSE were compared with similar data found in the literature and also with those obtained at the institutes of radiotherapy of the 'Hospital do Cancer do Recife' and of the 'Hospital Portugues do Recife'. ISODOSE presented good performance, mainly, due to the Monte Carlo techniques, that allowed a quite detailed drawing of the isodose curves in turn of linear sources. (author)

  5. Utilization of prostate brachytherapy for low risk prostate cancer: Is the decline overstated?

    Directory of Open Access Journals (Sweden)

    Joseph Safdieh

    2016-08-01

    Full Text Available Purpose : Several prior studies have suggested that brachytherapy utilization has markedly decreased, coinciding with the recent increased utilization of intensity modulated radiation therapy, as well as an increase in urologist-owned centers. We sought to investigate the brachytherapy utilization in a large, hospital-based registry. Material and methods: Men with prostate cancer diagnosed between 2004-2012 and treated with either external beam radiation and/or prostate brachytherapy were abstracted from the National Cancer Database. In order to be included, men had to be clinically staged as T1c-T2aNx-0Mx-0, Gleason 6, PSA ≤ 10.0 ng/ml. Descriptive statistics were used to analyze brachytherapy utilization over time and were compared via χ2. Multivariate logistic regression was used to assess for covariables associated with increased brachytherapy usage. Results : There were 89,413 men included in this study, of which 37,054 (41.6% received only external beam radiation, and 52,089 (58.4% received prostate brachytherapy. The use of brachytherapy declined over time from 62.9% in 2004 to 51.3% in 2012 (p < 0.001. This decline was noted in both academic facilities (60.8% in 2004 to 47.0% in 2012, p < 0.001 as well as in non-academic facilities (63.7% in 2004 to 53.0% in 2012, p < 0.001. The decline was more pronounced in patients who lived closer to treatment facilities than those who lived further. The use of intensity modulated radiation therapy increased during this same time period from 18.4% in 2004 to 38.2% in 2012 (p < 0.001. On multivariate analysis, treatment at an academic center, increasing age, decreasing distance from the treatment center, and years of diagnosis from 2006-2012 were significantly associated with reduced brachytherapy usage. Conclusions : In this hospital-based registry, prostate brachytherapy usage has declined for low risk prostate cancer as intensity modulated radiation therapy usage has increased. However, it still

  6. Low dose rate 137Cs Brachytherapy source calibration with farmer type ionisation chamber and specialised fabricated jig in Korle-Bu Teaching Hospital

    International Nuclear Information System (INIS)

    Opare-Asare, K.

    2013-06-01

    An important part of a general quality assurance (QA) program for brachytherapy dosimetry is the source calibration because wide ranges of uncertainties are quoted by manufactures. This research is aimed at calibrating LDR 137 Cs brachytherapy source in the Korle-Bu Teaching Hospital by multiple-distance air kerma measurement technique using a specialized designed jig and a calibrated therapy ionization chamber. Specialized jig was fabricated with source holder positions and ionization chamber positions on the jig. Farmer type ionization chamber of volume 0.6cm 3 was used with and without build up cap. The results were validated using well type ionization chamber on channels on 1 and 5 taking into account decay correction. Air Kerma rates were determined at multiple distances between 8cm to 12cm from measured charges recorded by Max 4000 electrometer. The scatter dose relationship described by Ezzell [1992] was used to determine scattered radiation. The analytical method of determining air kerma calibration factor of 137 Cs described by Sharma et.al [2011] was used to determine beam quality correction factor for the 137 Cs. Beam attenuation was determined. Experimental data were compared with manufacturer's quoted source strength for verification. Well type ionization chamber results and experimental results on channel V1 and V5 deviated by 2.39% and 1.58% respectively. Experimental data deviated by 4.73% and 1.24% from theoretical data on channels V1 and V5 respectively. The mean of the experimental data deviated from the theoretical data by ±3.1% and from the well type measurements data by ±1.98%. The well type chamber results compared well with the experimental data. This is an indication that the method used for source calibration is a reliable alternative method of source calibration. The method used in this work has proven to be an efficient way of determining the actual source strength of the LDR brachytherapy 137 Cs source in Korle-Bu Radiotherapy Centre

  7. Radiological protection of patients in brachytherapy

    International Nuclear Information System (INIS)

    Sacc, Ricardo; Herrero, Flavia

    2008-01-01

    Full text: The prefix 'brachy' means short-range, so brachytherapy is the administration of radiation therapy using small radioactive sources in the form of needles, tubes, wires or seeds, which are placed within the tumor -interstitial form- or very near of it, superficially or in an endo-cavity form. This technique, which was limited by the size of the primary tumor, has the advantage, that the radiation, can be adjusted to the size and shape of the tumor volume and the radioisotope used, - short range -, is selected with the criteria of getting the dose in the organs at risk, as low as possible, making what it is known as conformal radiotherapy. Radioactive sources may be permanent or temporary implants. The application of radioactive material, can be manually or automatically. In the first case, a major breakthrough from the radioprotection point of view, was the use of afterloading devices, methodology highly recommended to reduce the radiation exposure to staff. With the development of technology, remotely controlled afterloading devices were introduced, which in addition to complying with the above requirement, allow the source to move in different positions along catheters housed in one or more channels, making therapeutic brachytherapy treatments in tumor volumes possible, that due to its length, decades ago would have been an unthinkable deal. In all cases, sources, which may vary from the 3 mm in length, 125 Iodine or 198 Gold seeds, to extensive wires of 192 Iridium, are encapsulated for two main purposes: preventing leakage of radioactive material and absorption of unwanted radiation, alpha and beta, produced by the radioactive decay. Consequently, it should be highly unlikely that the radioactive material, could be lost or located in the patient, in a different place of the one that was planned. However, history shows us the opposite. Its is known the kind of deterministic effect that radiation is going to produce in the tumor, where the severity of

  8. Non-uniform dwell times in line source high dose rate brachytherapy: physical and radiobiological considerations

    International Nuclear Information System (INIS)

    Jones, B.; Tan, L.T.; Freestone, G.; Bleasdale, C.; Myint, S.; Littler, J.

    1994-01-01

    The ability to vary source dwell times in high dose rate (HDR) brachytherapy allows for the use of non-uniform dwell times along a line source. This may have advantages in the radical treatment of tumours depending on individual tumour geometry. This study investigates the potential improvements in local tumour control relative to adjacent normal tissue isoeffects when intratumour source dwell times are increased along the central portion of a line source (technique A) in radiotherapy schedules which include a relatively small component of HDR brachytherapy. Such a technique is predicted to increase the local control for tumours of diameters ranging between 2 cm and 4 cm by up to 11% compared with a technique in which there are uniform dwell times along the line source (technique B). There is no difference in the local control rates for the two techniques when used to treat smaller tumours. Normal tissue doses are also modified by the technique used. Technique A produces higher normal tissue doses at points perpendicular to the centre of the line source and lower dose at points nearer the ends of the line source if the prescription point is not in the central plane of the line source. Alternatively, if the dose is prescribed at a point in the central plane of the line source, the dose at all the normal tissue points are lower when technique A is used. (author)

  9. Radiation absorbed doses in the event of balloon rupture (BR) during endovascular brachytherapy (EB) using 188Re-perrhenate

    International Nuclear Information System (INIS)

    Angelides, S.; Hetherington, E.; Karolis, C.; Walker, B.; Jackson, T.; Knittel, T.; Friend, C.; Pitney, M.; Jepson, N.; Milross, C.; Lonergan, D.

    2000-01-01

    Full text: endovascular brachytherapy (EB) using liquid or solid radiation sources, is an effective emerging therapy for coronary artery disease. Liquid sources provide uniform radiation dose to the vessel wall. However the radiation burden in the unlikely event of BR is not insignificant. The aims of this study were to determine i) absorbed dose for various 188 Re radiopharmaceuticals in the event of BR, and ii) effects of thyroid uptake blocking agent, Lugol's iodine (Ll) and/or bladder catheterisation (BC). Dose calculations were based on MIRDOSE 3.1 with dynamic bladder model and MIRD Dose Estimate Report No.8 for 99 Tc m -pertechnetate, which has similar biokinetic properties to 188 Re-perrhenate. Normal renal function and a bladder voiding interval of 4.8h (1 minute with catheter) were assumed. BR was simulated ex-vivo by puncturing a Solaris angioplasty balloon filled with normal saline at 4 atm. LI, MAG3 and DTPA substantially reduces the radiation dose following BR, particularly to the thyroid, and BC reduces the bladder wall dose. Only the contents of the balloon leaked; 0.4 ml of the total volume of 1.8ml. As binding of 188 Re to ligands is cumbersome, we opted to use LI. Twenty five patients with in-stent re-stenosis have been treated using 188 Re-perrhenate (8 GBq/ml), with no BR. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  10. Erectile function after prostate brachytherapy

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Butler, Wayne M.; Wallner, Kent E.; Galbreath, Robert W.; Anderson, Richard L.; Kurko, Brian S.; Lief, Jonathan H.; Allen, Zachariah A.

    2005-01-01

    Purpose: To evaluate erectile function after permanent prostate brachytherapy using a validated patient-administered questionnaire and to determine the effect of multiple clinical, treatment, and dosimetric parameters on penile erectile function. Methods and materials: A total of 226 patients with preimplant erectile function determined by the International Index of Erectile Function (IIEF) questionnaire underwent permanent prostate brachytherapy in two prospective randomized trials between February 2001 and January 2003 for clinical Stage T1c-T2c (2002 American Joint Committee on Cancer) prostate cancer. Of the 226 patients, 132 were potent before treatment and, of those, 128 (97%) completed and returned the IIEF questionnaire after brachytherapy. The median follow-up was 29.1 months. Potency was defined as an IIEF score of ≥13. The clinical, treatment, and dosimetric parameters evaluated included patient age; preimplant IIEF score; clinical T stage; pretreatment prostate-specific antigen level; Gleason score; elapsed time after implantation; preimplant nocturnal erections; body mass index; presence of hypertension or diabetes mellitus; tobacco consumption; the volume of the prostate gland receiving 100%, 150%, and 200% of the prescribed dose (V 100/150/200 ); the dose delivered to 90% of the prostate gland (D 90 ); androgen deprivation therapy; supplemental external beam radiotherapy (EBRT); isotope; prostate volume; planning volume; and radiation dose to the proximal penis. Results: The 3-year actuarial rate of potency preservation was 50.5%. For patients who maintained adequate posttreatment erectile function, the preimplant IIEF score was 29, and in patients with brachytherapy-related ED, the preimplant IIEF score was 25. The median time to the onset of ED was 5.4 months. After brachytherapy, the median IIEF score was 20 in potent patients and 3 in impotent patients. On univariate analysis, the preimplant IIEF score, patient age, presence of nocturnal

  11. Auger Electron Therapy And Brachytherapy Tumor Treatment

    International Nuclear Information System (INIS)

    Laster, B.H.; Shani, G.

    2002-01-01

    Auger Electron Therapy (AET) is a binary approach for improving cancer radiotherapy. It involves the selective targeting of an atom to tumor cells using physiological pathway. The atom is then irradiated by a specific radiation that produces secondary radiation called Auger electrons. One of the problems associated with the clinical application of AET, is that the energy of the photons required for stimulating photoelectric absorption in most of the available high Z target atoms, is too low to achieve penetration through normal surrounding tissues to the depth of the tumor, when an external source is used. The solution is therefore the use of a brachytherapy technique. There are two other problems associated with the use of radiation as a cancer treatment. The first is the limitation on radiation dose to the normal tissue within the treatment volume. The second problem is the limitation imposed by the miniscule size of the critical target of the cell, namely the DNA (0.25% of the cell mass). The solution to the first problem can be achieved by using the brachytherapy technique. The second problem can be resolved by placing the radiation source in close position to the DNA. AET, as we apply it, provides the two solutions to the two problems. When a photon is absorbed by an electron in the K or L shell of an high Z atom, the electron is ejected from the atom, creating a vacancy in the shell. This vacancy is immediately filled with an electron from an upper shell. The energy difference between the two shells is sometimes emitted as an x-ray, however, frequently the energy is transferred to an outer shell electron that is emitted as an Auger electron. These electrons are emitted at energies of up to ∼30 keV and therefore have a very short range in the cell. They will deposit all their energy within 20-30 nm from the point of emission. i.e. all the energy is deposited in the DNA. In our work indium is used as the high Z atom

  12. SU-E-T-155: Calibration of Variable Longitudinal Strength 103Pd Brachytherapy Sources

    International Nuclear Information System (INIS)

    Reed, J; Radtke, J; Micka, J; Culberson, W; DeWerd, L

    2015-01-01

    Purpose: Brachytherapy sources with variable longitudinal strength (VLS) allow for a customized intensity along the length of the source. These have applications in focal brachytherapy treatments of prostate cancer where dose boosting can be achieved through modulation of intra-source strengths. This work focused on development of a calibration methodology for VLS sources based on measurements and Monte Carlo (MC) simulations of five 1 cm 10 3 Pd sources each containing four regions of variable 103 Pd strength. Methods: The air-kerma strengths of the sources were measured with a variable-aperture free-air chamber (VAFAC). Source strengths were also measured using a well chamber. The in-air azimuthal and polar anisotropy of the sources were measured by rotating them in front of a NaI scintillation detector and were calculated with MC simulations. Azimuthal anisotropy results were normalized to their mean intensity values. Polar anisotropy results were normalized to their average transverse axis intensity values. The relative longitudinal strengths of the sources were measured via on-contact irradiations with radiochromic film, and were calculated with MC simulations. Results: The variable 103 Pd loading of the sources was validated by VAFAC and well chamber measurements. Ratios of VAFAC air-kerma strengths and well chamber responses were within ±1.3% for all sources. Azimuthal anisotropy results indicated that ≥95% of the normalized values for all sources were within ±1.7% of the mean values. Polar anisotropy results indicated variations within ±0.3% for a ±7.6° angular region with respect to the source transverse axis. Locations and intensities of the 103 Pd regions were validated by radiochromic film measurements and MC simulations. Conclusion: The calibration methodology developed in this work confirms that the VLS sources investigated have a high level of polar uniformity, and that the strength and longitudinal intensity can be verified experimentally and

  13. Brachytherapy Application With In Situ Dose Painting Administered by Gold Nanoparticle Eluters

    International Nuclear Information System (INIS)

    Sinha, Neeharika; Cifter, Gizem; Sajo, Erno; Kumar, Rajiv; Sridhar, Srinivas; Nguyen, Paul L.; Cormack, Robert A.; Makrigiorgos, G. Mike; Ngwa, Wilfred

    2015-01-01

    Purpose: Recent studies show promise that administering gold nanoparticles (GNP) to tumor cells during brachytherapy could significantly enhance radiation damage to the tumor. A new strategy proposed for sustained administration of the GNP in prostate tumors is to load them into routinely used brachytherapy spacers for customizable in situ release after implantation. This in silico study investigated the intratumor biodistribution and corresponding dose enhancement over time due to GNP released from such GNP-loaded brachytherapy spacers (GBS). Method and Materials: An experimentally determined intratumoral diffusion coefficient (D) for 10-nm nanoparticles was used to estimate D for other sizes by using the Stokes-Einstein equation. GNP concentration profiles, obtained using D, were then used to calculate the corresponding dose enhancement factor (DEF) for each tumor voxel, using dose painting-by-numbers approach, for times relevant to the considered brachytherapy sources' lifetimes. The investigation was carried out as a function of GNP size for the clinically applicable low-dose-rate brachytherapy sources iodine-125 (I-125), palladium-103 (Pd-103), and cesium-131 (Cs-131). Results: Results showed that dose enhancement to tumor voxels and subvolumes during brachytherapy can be customized by varying the size of GNP released or eluted from the GBS. For example, using a concentration of 7 mg/g GNP, significant DEF (>20%) could be achieved 5 mm from a GBS after 5, 12, 25, 46, 72, 120, and 195 days, respectively, for GNP sizes of 2, 5, 10, 20, 30, and 50 nm and for 80 nm when treating with I-125. Conclusions: Analyses showed that using Cs-131 provides the highest dose enhancement to tumor voxels. However, given its relatively longer half-life, I-125 presents the most flexibility for customizing the dose enhancement as a function of GNP size. These findings provide a useful reference for further work toward development of potential new brachytherapy application

  14. Brachytherapy Application With In Situ Dose Painting Administered by Gold Nanoparticle Eluters

    Energy Technology Data Exchange (ETDEWEB)

    Sinha, Neeharika [Department of Sciences, Wentworth Institute of Technology, Boston, Massachusetts (United States); Cifter, Gizem [Department of Physics and Applied Physics, University of Massachusetts, Lowell, Massachusetts (United States); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital and Harvard Medical School, Boston, Massachusetts (United States); Sajo, Erno [Department of Physics and Applied Physics, University of Massachusetts, Lowell, Massachusetts (United States); Kumar, Rajiv; Sridhar, Srinivas [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital and Harvard Medical School, Boston, Massachusetts (United States); Electronic Materials Research Institute and Department of Physics, Northeastern University, Boston, Massachusetts (United States); Nguyen, Paul L.; Cormack, Robert A.; Makrigiorgos, G. Mike [Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital and Harvard Medical School, Boston, Massachusetts (United States); Ngwa, Wilfred, E-mail: wngwa@lroc.harvard.edu [Department of Physics and Applied Physics, University of Massachusetts, Lowell, Massachusetts (United States); Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women' s Hospital and Harvard Medical School, Boston, Massachusetts (United States)

    2015-02-01

    Purpose: Recent studies show promise that administering gold nanoparticles (GNP) to tumor cells during brachytherapy could significantly enhance radiation damage to the tumor. A new strategy proposed for sustained administration of the GNP in prostate tumors is to load them into routinely used brachytherapy spacers for customizable in situ release after implantation. This in silico study investigated the intratumor biodistribution and corresponding dose enhancement over time due to GNP released from such GNP-loaded brachytherapy spacers (GBS). Method and Materials: An experimentally determined intratumoral diffusion coefficient (D) for 10-nm nanoparticles was used to estimate D for other sizes by using the Stokes-Einstein equation. GNP concentration profiles, obtained using D, were then used to calculate the corresponding dose enhancement factor (DEF) for each tumor voxel, using dose painting-by-numbers approach, for times relevant to the considered brachytherapy sources' lifetimes. The investigation was carried out as a function of GNP size for the clinically applicable low-dose-rate brachytherapy sources iodine-125 (I-125), palladium-103 (Pd-103), and cesium-131 (Cs-131). Results: Results showed that dose enhancement to tumor voxels and subvolumes during brachytherapy can be customized by varying the size of GNP released or eluted from the GBS. For example, using a concentration of 7 mg/g GNP, significant DEF (>20%) could be achieved 5 mm from a GBS after 5, 12, 25, 46, 72, 120, and 195 days, respectively, for GNP sizes of 2, 5, 10, 20, 30, and 50 nm and for 80 nm when treating with I-125. Conclusions: Analyses showed that using Cs-131 provides the highest dose enhancement to tumor voxels. However, given its relatively longer half-life, I-125 presents the most flexibility for customizing the dose enhancement as a function of GNP size. These findings provide a useful reference for further work toward development of potential new brachytherapy application

  15. Dosimetric comparison of vaginal vault ovoid brachytherapy versus intensity-modulated radiation therapy plans in postoperative patients of cervical carcinoma following whole pelvic radiotherapy

    Directory of Open Access Journals (Sweden)

    Divya Khosla

    2014-01-01

    Full Text Available Introduction: Dosimetric study to compare high dose rate (HDR vaginal vault ovoid brachytherapy plan versus intensity-modulated radiation therapy (IMRT boost plan for doses delivered to target volume and organs at risk (OAR in postoperative patients of cervical carcinoma following whole pelvic radiotherapy (WPRT. Materials and Methods: Fifteen postoperative patients of cervical carcinoma suitable for vaginal ovoid brachytherapy following WPRT of 46 Gy/23 fractions/4.5 weeks were included. All were treated with brachytherapy (two sessions of 8.5 Gy each. The equivalent dose for IMRT was calculated by computing biologically effective dose of brachytherapy by linear quadratic model. Dose of brachytherapy (two sessions of 8.5 Gy was equivalent to IMRT dose of 26 Gy/13 fractions. Doses to target volume and OAR were compared between HDR and IMRT plans. Results: Target volume was well covered with both HDR and IMRT plans, but dose with brachytherapy was much higher (P < 0.05. Mean doses, doses to 0.1, 1, 2, and 5cc, 1/3 rd , 1/2, and 2/3 rd volume of bladder and rectum were significantly lower with HDR plans. Conclusion: In postoperative patients of cervical carcinoma, HDR brachytherapy following WPRT appears to be better than IMRT for tumor coverage and reducing dose to critical organs.

  16. Proposal of a postal system for Ir-192 sources calibration used in high dose rate brachytherapy with LiF:Mn:Ti thermoluminescent dosemeters

    International Nuclear Information System (INIS)

    Vieira, W.S.; Borges, J.C.; Almeida, C.E.V.

    1998-01-01

    A proposal in order to improve the brachytherapy quality control and to allow postal intercomparison of Ir-192 sources used in high dose rate brachytherapy has been presented. The LiF: Mn: Ti (TLD 100) detector has been selected for such purpose. The experimental array and the TLDs irradiation and calibration techniques, at the treatment units, have been specified in the light of more recent methodology of Ir-192 calibration sources. (Author)

  17. Study of dosimetric parameters for iodine-125 brachytherapy sources development from IPEN-CNEN/SP using Monte Carlo method

    International Nuclear Information System (INIS)

    Oliveira, Tiago Batista de

    2016-01-01

    Expectations of the World Health Organization for the year 2030 are that the number of cancer deaths is approximately 13.2 million, reflecting the high proportion of this disease in global health issue. With respect to prostate cancer, according to the National Cancer Institute, the number of cases diagnosed worldwide in 2012 was approximately 1.1 million, while in Brazil the data demonstrated the incidence of 68,000 new cases. The treatment of cancer can be performed with surgery (prostatectomy) or radiation therapy. Among radiotherapy, we can highlight the brachytherapy technique, which consists in the introduction of small radioactive sources (seeds) within the prostate, which is delivered a high dose value in the treatment volume and low dose in the surrounding tissues. In Brazil, the medical profession estimates a demand of approximately 8000 seeds / month, and the unit cost of each seed at least US $ 26.00. The AAPM protocol TG-43 recommend the dose-rate constant, radial dose function and anisotropy function for dosimetric analysis LDR brachytherapy seeds. In this work, Monte Carlo simulations were performed in order to assess the dosimetric parameters of the OncoSeed-6711, manufactured by Oncura-GEHealthcare, and a seed developed by Radiation Technology Center, using the MCNP5 code. A 6711 seed, an IPEN seed and the 30 x 30 x 30cm 3 phantom filled with water were modeled to simulate the dose distribution. The 6711 seed parameters were compared with literature, and the results presented relative error less than 0.1% for Λ. In comparison with the 6711 seed, the IPEN model seed dosimetric parameters were similar, account the statistical uncertainty. (author)

  18. Prostate-specific antigen bounce after high-dose rate brachytherapy with external beam radiation therapy for prostate cancer patients

    International Nuclear Information System (INIS)

    Sakamoto, Naotaka; Kakinoki, Hiroaki; Tsutsui, Akio; Yoshikawa, Masahiro; Iguchi, Atsushi; Matsunobu, Toru; Uehara, Satoru

    2008-01-01

    Prostate-specific antigen (PSA) bounce after high-dose rate (HDR) brachytherapy with external beam radiation therapy (EBRT) for prostate cancer patients was evaluated. Sixty-one patients treated with HDR-brachytherapy followed by EBRT had a minimum follow-up of 12 months (median, 24 months) in our institute. A PSA bounce was defined as a rise of at least 0.1 ng/ml greater than a previous PSA level, with a subsequent decline equal to, or less than, the initial nadir. A PSA bounce was noted in 16 (26.2%) of 61 patients (one patient had a PSA bounce twice). Median time to develop a PSA bounce was 18 months, but 23.5% developed a PSA bounce after 24 months. Median duration of PSA bounce was 6 months and 11.8% had increased PSA within a period of 12 months. Median bounce height was 0.2 ng/ml (range, 0.1 to 3.39 ng/ml). A bounce height of gerater than 2 ng/ml was seen in 11.8%. Clinical characteristics (age, prostate volume, neoadjuvant endocrine therapy, risk classification, stage, pretreatment PSA, Gleason score) do not predict whether or not there will be a PSA bounce. In patients treated with HDR-brachytherapy followed by EBRT, the incidence and characteristics of PSA bounce were similar to those in patients treated with low-dose rate brachytherapy. Physicians should be aware of the possibility of PSA bounce following HDR-brachytherapy with EBRT. (author)

  19. Quality audits of the remote-controlled automatically-driven gamma ray afterloading equipment used in brachytherapy in the Czech Republic

    International Nuclear Information System (INIS)

    Zackova, H.; Horakova, I.

    2001-01-01

    To reach safety and precise application of ionisation radiation to patients Atomic act declares, in its Article no. 7, requirements for medical exposure. There are also given -among others -the demands to i nstall the quality assurance programmes (QA) for medical actions and functions . Since 1997, when the act has been adopted, a set of five Recommendations of State Office for Nuclear Safety (SONS ) for radiotherapy has been prepared to instruct users how to prepare quality control system (i.e. system of tests required by of the regulation no.184/1997 Sb. -acceptance, status and constancy tests) for main types of sources used in radiotherapy for treatment of the patients. Among them also the Recommendation on QA in brachytherapy has been issued by SONS in 1998. National Radiation Protection Institute (NRPI) has been performing the regular in situ quality audits in which the chosen parameters (which could seriously influence the dose to the patients -i.e. absorbed dose, main geometrical and radiation parameters etc ) are independently checked by the NRPI experts. System of Quality Audits on the sources used in teletherapy has been introduced in 1997 and at present time they are smoothly carried out according the SONS's demands. This work describes the process of installing of the Quality Audit system on brachytherapy. The work described here forms the only part of the activities, which have been carrying out by the department of dosimetry gamma and X-rays of NRPI to support supervisions of SONS in the field of radiation protection in radiotherapy .Quality audits in brachytherapy will extend the possibilities of NRPI. The Methods NRPI 43-01.30 prepared by NRPI could be used as documentation for all types of test which are at present time required by Czech legislation for the remote-controlled automatically-driven gamma-ray afterloading equipment used in brachytherapy. (authors)

  20. Computational model of Amersham I-125 source model 6711 and Prosper Pd-103 source model MED3633 using MCNP

    Energy Technology Data Exchange (ETDEWEB)

    Menezes, Artur F.; Reis Junior, Juraci P.; Silva, Ademir X., E-mail: ademir@con.ufrj.b [Coordenacao dos Programas de Pos-Graduacao de Engenharia (PEN/COPPE/UFRJ), RJ (Brazil). Programa de Engenharia Nuclear; Rosa, Luiz A.R. da, E-mail: lrosa@ird.gov.b [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Facure, Alessandro [Comissao Nacional de Energia Nuclear (CNEN), Rio de Janeiro, RJ (Brazil); Cardoso, Simone C., E-mail: Simone@if.ufrj.b [Universidade Federal do Rio de Janeiro (IF/UFRJ), RJ (Brazil). Inst. de Fisica. Dept. de Fisica Nuclear

    2011-07-01

    Brachytherapy is used in cancer treatment at shorter distances through the use of small encapsulated source of ionizing radiation. In such treatment, a radiation source is positioned directly into or near the target volume to be treated. In this study the Monte Carlo based MCNP code was used to model and simulate the I-125 Amersham Health source model 6711 and the Pd-103 Prospera source model MED3633 in order to obtain the dosimetric parameter dose rate constant ({Lambda}) . The sources geometries were modeled and implemented in MCNPX code. The dose rate constant is an important parameter prostate LDR brachytherapy's treatments planning. This study was based on American Association of Physicists in Medicine (AAPM) recommendations which were produced by its Task Group 43. The results obtained were 0.941 and 0.65 for the dose rate constants of I-125 and Pd-103 sources, respectively. They present good agreement with the literature values based on different Monte Carlo codes. (author)

  1. Applications of tissue heterogeneity corrections and biologically effective dose volume histograms in assessing the doses for accelerated partial breast irradiation using an electronic brachytherapy source

    Science.gov (United States)

    Shi, Chengyu; Guo, Bingqi; Cheng, Chih-Yao; Eng, Tony; Papanikolaou, Nikos

    2010-09-01

    A low-energy electronic brachytherapy source (EBS), the model S700 Axxent™ x-ray device developed by Xoft Inc., has been used in high dose rate (HDR) intracavitary accelerated partial breast irradiation (APBI) as an alternative to an Ir-192 source. The prescription dose and delivery schema of the electronic brachytherapy APBI plan are the same as the Ir-192 plan. However, due to its lower mean energy than the Ir-192 source, an EBS plan has dosimetric and biological features different from an Ir-192 source plan. Current brachytherapy treatment planning methods may have large errors in treatment outcome prediction for an EBS plan. Two main factors contribute to the errors: the dosimetric influence of tissue heterogeneities and the enhancement of relative biological effectiveness (RBE) of electronic brachytherapy. This study quantified the effects of these two factors and revisited the plan quality of electronic brachytherapy APBI. The influence of tissue heterogeneities is studied by a Monte Carlo method and heterogeneous 'virtual patient' phantoms created from CT images and structure contours; the effect of RBE enhancement in the treatment outcome was estimated by biologically effective dose (BED) distribution. Ten electronic brachytherapy APBI cases were studied. The results showed that, for electronic brachytherapy cases, tissue heterogeneities and patient boundary effect decreased dose to the target and skin but increased dose to the bones. On average, the target dose coverage PTV V100 reduced from 95.0% in water phantoms (planned) to only 66.7% in virtual patient phantoms (actual). The actual maximum dose to the ribs is 3.3 times higher than the planned dose; the actual mean dose to the ipsilateral breast and maximum dose to the skin were reduced by 22% and 17%, respectively. Combining the effect of tissue heterogeneities and RBE enhancement, BED coverage of the target was 89.9% in virtual patient phantoms with RBE enhancement (actual BED) as compared to 95

  2. Applications of tissue heterogeneity corrections and biologically effective dose volume histograms in assessing the doses for accelerated partial breast irradiation using an electronic brachytherapy source

    Energy Technology Data Exchange (ETDEWEB)

    Shi Chengyu; Guo Bingqi; Eng, Tony; Papanikolaou, Nikos [Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, TX 78229 (United States); Cheng, Chih-Yao, E-mail: shic@uthscsa.ed [Radiation Oncology Department, Oklahoma University Health Science Center, Oklahoma, OK 73104 (United States)

    2010-09-21

    A low-energy electronic brachytherapy source (EBS), the model S700 Axxent(TM) x-ray device developed by Xoft Inc., has been used in high dose rate (HDR) intracavitary accelerated partial breast irradiation (APBI) as an alternative to an Ir-192 source. The prescription dose and delivery schema of the electronic brachytherapy APBI plan are the same as the Ir-192 plan. However, due to its lower mean energy than the Ir-192 source, an EBS plan has dosimetric and biological features different from an Ir-192 source plan. Current brachytherapy treatment planning methods may have large errors in treatment outcome prediction for an EBS plan. Two main factors contribute to the errors: the dosimetric influence of tissue heterogeneities and the enhancement of relative biological effectiveness (RBE) of electronic brachytherapy. This study quantified the effects of these two factors and revisited the plan quality of electronic brachytherapy APBI. The influence of tissue heterogeneities is studied by a Monte Carlo method and heterogeneous 'virtual patient' phantoms created from CT images and structure contours; the effect of RBE enhancement in the treatment outcome was estimated by biologically effective dose (BED) distribution. Ten electronic brachytherapy APBI cases were studied. The results showed that, for electronic brachytherapy cases, tissue heterogeneities and patient boundary effect decreased dose to the target and skin but increased dose to the bones. On average, the target dose coverage PTV V{sub 100} reduced from 95.0% in water phantoms (planned) to only 66.7% in virtual patient phantoms (actual). The actual maximum dose to the ribs is 3.3 times higher than the planned dose; the actual mean dose to the ipsilateral breast and maximum dose to the skin were reduced by 22% and 17%, respectively. Combining the effect of tissue heterogeneities and RBE enhancement, BED coverage of the target was 89.9% in virtual patient phantoms with RBE enhancement (actual BED) as

  3. Applications of tissue heterogeneity corrections and biologically effective dose volume histograms in assessing the doses for accelerated partial breast irradiation using an electronic brachytherapy source

    International Nuclear Information System (INIS)

    Shi Chengyu; Guo Bingqi; Eng, Tony; Papanikolaou, Nikos; Cheng, Chih-Yao

    2010-01-01

    A low-energy electronic brachytherapy source (EBS), the model S700 Axxent(TM) x-ray device developed by Xoft Inc., has been used in high dose rate (HDR) intracavitary accelerated partial breast irradiation (APBI) as an alternative to an Ir-192 source. The prescription dose and delivery schema of the electronic brachytherapy APBI plan are the same as the Ir-192 plan. However, due to its lower mean energy than the Ir-192 source, an EBS plan has dosimetric and biological features different from an Ir-192 source plan. Current brachytherapy treatment planning methods may have large errors in treatment outcome prediction for an EBS plan. Two main factors contribute to the errors: the dosimetric influence of tissue heterogeneities and the enhancement of relative biological effectiveness (RBE) of electronic brachytherapy. This study quantified the effects of these two factors and revisited the plan quality of electronic brachytherapy APBI. The influence of tissue heterogeneities is studied by a Monte Carlo method and heterogeneous 'virtual patient' phantoms created from CT images and structure contours; the effect of RBE enhancement in the treatment outcome was estimated by biologically effective dose (BED) distribution. Ten electronic brachytherapy APBI cases were studied. The results showed that, for electronic brachytherapy cases, tissue heterogeneities and patient boundary effect decreased dose to the target and skin but increased dose to the bones. On average, the target dose coverage PTV V 100 reduced from 95.0% in water phantoms (planned) to only 66.7% in virtual patient phantoms (actual). The actual maximum dose to the ribs is 3.3 times higher than the planned dose; the actual mean dose to the ipsilateral breast and maximum dose to the skin were reduced by 22% and 17%, respectively. Combining the effect of tissue heterogeneities and RBE enhancement, BED coverage of the target was 89.9% in virtual patient phantoms with RBE enhancement (actual BED) as compared to 95

  4. High dose-rate brachytherapy source localization: positional resolution using a diamond detector

    International Nuclear Information System (INIS)

    Nakano, T; Suchowerska, N; Bilek, M M; McKenzie, D R; Ng, N; Kron, T

    2003-01-01

    A potential real-time source position verification process for high dose-rate (HDR) brachytherapy treatment is described. This process is intended to provide immediate confirmation that a treatment is proceeding according to plan, so that corrective action can be taken if necessary. We show that three dosimeters are in principle sufficient and demonstrate the feasibility of the process using a diamond detector and an Ir-192 source. An error analysis including all identified sources of error shows that this detector is capable of locating the distance to the source to within 2 mm for distances up to 12 cm. This positional accuracy is less than the diameter of typical HDR catheters indicating that a diamond detector can be used to accurately determine the distance to the source. The uncertainty in the distance is found to increase with distance

  5. Energy spectrum based calculation of the half and the tenth value layers for brachytherapy sources using a semiempirical parametrized mass attenuation coefficient formulism

    International Nuclear Information System (INIS)

    Yue, Ning J.

    2008-01-01

    As different types of radionuclides (e.g., 131 Cs source) are introduced for clinical use in brachytherapy, the question is raised regarding whether a relatively simple method exists for the derivation of values of the half value layer (HVL) or the tenth value layer (TVL). For the radionuclide that has been clinically used for years, such as 125 I and 103 Pd, the sources have been manufactured and marketed by several vendors with different designs and structures. Because of the nature of emission of low energy photons for these radionuclides, energy spectra of the sources are very dependent on their individual designs. Though values of the HVL or the TVL in certain commonly used shielding materials are relatively small for these low energy photon emitting sources, the question remains how the variations in energy spectra affect the HVL (or TVL) values and whether these values can be calculated with a relatively simple method. A more fundamental question is whether a method can be established to derive the HVL (TVL) values for any brachytherapy sources and for different materials in a relatively straightforward fashion. This study was undertaken to answer these questions. Based on energy spectra, a well established semiempirical mass attenuation coefficient computing scheme was utilized to derive the HVL (TVL) values of different materials for different types of brachytherapy sources. The method presented in this study may be useful to estimate HVL (TVL) values of different materials for brachytherapy sources of different designs and containing different radionuclides

  6. Overview of brachytherapy resources in Europe: A survey of patterns of care study for brachytherapy in Europe

    International Nuclear Information System (INIS)

    Guedea, Ferran; Ellison, Tracey; Venselaar, Jack; Borras, Josep Maria; Hoskin, Peter; Poetter, Richard; Heeren, Germaine; Nisin, Roselinne; Francois, Guy; Mazeron, Jean Jacques; Limbergen, Erik Van; Ventura, Montserrat; Taillet, Michel; Cottier, Brian

    2007-01-01

    Background and purpose: The Patterns of Care for Brachytherapy in Europe (PCBE) study is aimed at establishing a detailed information system on brachytherapy throughout Europe. Materials and methods: The questionnaire was web-based and the analysis used data from each radiotherapy department with brachytherapy. There were three groups: Group I with 19 countries (15 initial European Community (EC) countries plus Iceland, Monaco, Norway and Switzerland -EC+4-), Group II with 10 countries (New European Community countries -NEC-) and Group III with 14 countries (Other European Countries -OEC-). Results: In the European area there are 36 of 43 countries (85%) which achieved data collection from at least 50% of centres, and were included in the analysis. The tumour site that had the largest number of treated patients was gynaecological tumours. Several variations have been found in the mean number of patients treated per consultant radiation oncologist and physicist; and in the proportion of brachytherapy patients with gynaecology, prostate and breast tumours, by country and by European area. The provided data showed that the average number of brachytherapy patients per centre increased by 10% between 1997 and 2002. Conclusions: A European wide evaluation of brachytherapy practice using a web-based questionnaire is feasible and that there is considerable variation in both patterns of practice and available resources

  7. Decommissioning of a brachytherapy facility at the Oncology Hospital in Havana

    International Nuclear Information System (INIS)

    Benitez, J.C.; Salgado, M.; Madrazo, S.; Castillo, R.; Marcos, J.; Flores, J.

    2001-01-01

    In the past the National Institute of Oncology and Radiobiology (INOR) used 226 Ra sealed sources for brachytherapy service. For technical obsolescence and safety considerations the brachytherapy facility was shutdown. Most 226 Ra sources were collected from the hospital in 1996, but for different reasons, not all radium sources could be evacuated by this time. Some of them were leaking which caused contamination of the place. In May 1997 the Direction of the Hospital requested the Center for Radiation Protection and Hygiene (CPHR) to evaluate the radiological situation in the contaminated areas and to carry out the decontamination of the rooms and the decommissioning of the brachytherapy facility for unrestricted use. Contamination surveys conducted during this year confirmed the contamination of the facility. Once all necessary conditions were in place the decontamination of rooms and the decommissioning of this facility took place as in June 1999. In order to perform such a work the Hospital received the authorization from the National Centre for Nuclear Safety (Cuban's Regulatory Body) as a License for Decommissioning. The decommissioning process greatly benefited from early planning. This included an assessment of available documentation and operational history of the brachytherapy facility, the definition of responsibilities for each activity, technical seminars with personnel from the hospital and specialist from CPHR in charge of the decommissioning activities, safety assessment of the radiological and non-radiological hazards, the evaluation of available waste management provisions, the availability of financial resources as well as the review of lessons learned from previous projects. The characterization of the facility was a very important task in the selection of decommissioning alternative. During decommissioning operations, radiation monitoring of workers was carried out. In order to evaluate the radiological situation in the contaminated rooms

  8. Toward a 'all high rate' brachytherapy: organisation, biology and perspectives after treatment of 192 patients

    International Nuclear Information System (INIS)

    Hannoun-Levi, J.M.; Ferre, M.; Gautier, M.; Marcie, S.

    2007-01-01

    As a result of radiation protection regulations aimed at reducing the exposure to ionizing radiation from care-givers, low dose rate brachytherapy is usually replaced by a pulsed rate brachytherapy. The center Antoine Lacassagne has directed the outset to the use of a high-dose rate brachytherapy. The implications in terms of organization, biology and the prospects for such a change are the principal questions studied. (N.C.)

  9. National audit of a system for rectal contact brachytherapy

    Directory of Open Access Journals (Sweden)

    Laia Humbert-Vidan

    2017-01-01

    Full Text Available Background and purpose: Contact brachytherapy is used for the treatment of early rectal cancer. An overview of the current status of quality assurance of the rectal contact brachytherapy systems in the UK, based on a national audit, was undertaken in order to assist users in optimising their own practices. Material and methods: Four UK centres using the Papillon 50 contact brachytherapy system were audited. Measurements included beam quality, output and radiation field size and uniformity. Test frequencies and tolerances were reviewed and compared to both existing recommendations and published reviews on other kV and electronic brachytherapy systems. External validation of dosimetric measurements was provided by the National Physical Laboratory. Results: The maximum host/audit discrepancy in beam quality determination was 6.5%; this resulted in absorbed dose variations of 0.2%. The host/audit agreement in absorbed dose determination was within 2.2%. The median of the radiation field uniformity measurements was 2.7% and the host/audit agreement in field size was within 1 mm. Test tolerances and frequencies were within the national recommendations for kV units. Conclusions: The dosimetric characterisation of the Papillon 50 was validated by the audit measurements for all participating centres, thus providing reassurance that the implementation had been performed within the standards stated in previously published audit work and recommendations for kV and electronic brachytherapy units. However, optimised and standardised quality assurance testing could be achieved by reducing some methodological differences observed. Keywords: Contact brachytherapy, Electronic brachytherapy, Audit

  10. Modeling volume effects of experimental brachytherapy in the rat rectum: uncovering the limitations of a radiobiologic concept

    International Nuclear Information System (INIS)

    Johannessen, Hans-Olaf; Dale, Einar; Hellebust, Taran P.; Olsen, Dag R.; Nesland, Jahn M.; Giercksky, Karl-Erik

    2002-01-01

    Purpose: To analyze the significance of volume effects in experimental brachytherapy, based on modeling normal tissue complication probability. Methods and Materials: Experimental brachytherapy in the rat rectum was based on an eight-step 2.5-mm step size source configuration for 192 Ir, afterloaded into an unshielded polystyrene applicator. Volume effects were studied using a half-circumferential lead-shielded applicator and a shorter (two-step) source configuration. The main end point was rectal stenosis. Results: Rectal stenosis was always caused by a radiation ulcer. With the shielded configuration, single-dose ED 50 (50% incidence of rectal stenosis) increased from 23 Gy to 36.5 Gy. Single-dose ED 50 for the short configuration was 77.9 Gy. The data showed a reasonable fit to a three-parameter version of the biophysical model described by Jackson et al. (1995). This model assumes that organs consist of a large number of radiobiologically independent subunits and that radiation causes a complication if the fraction of the organ damaged is greater than its functional reserve. The fraction of the organ damaged is calculated summing over fractions of the organ damaged at each dose level. The calculated mean functional reserve (ν 50 ) of the rat rectum, assuming a cumulative functional reserve distribution in the group of experimental rats, was 0.53. Conclusions: The volume effect observed within small brachytherapy volumes agreed well with clinical experience of large tolerance doses in contact X-ray therapy. However, the ν 50 value was comparable to the high functional reserve value reported for liver. Experimental volume effects probably reflect repair processes originating in the areas adjacent to small radiation fields of brachytherapy more than the radiobiologic characteristics of the cells in the irradiated volume

  11. WE-F-BRD-01: HDR Brachytherapy II: Integrating Imaging with HDR

    International Nuclear Information System (INIS)

    Craciunescu, O; Todor, D; Leeuw, A de

    2014-01-01

    In recent years, with the advent of high/pulsed dose rate afterloading technology, advanced treatment planning systems, CT/MRI compatible applicators, and advanced imaging platforms, image-guided adaptive brachytherapy treatments (IGABT) have started to play an ever increasing role in modern radiation therapy. The most accurate way to approach IGABT treatment is to provide the infrastructure that combines in a single setting an appropriate imaging device, a treatment planning system, and a treatment unit. The Brachytherapy Suite is not a new concept, yet the modern suites are incorporating state-of-the-art imaging (MRI, CBCT equipped simulators, CT, and /or US) that require correct integration with each other and with the treatment planning and delivery systems. Arguably, an MRI-equipped Brachytherapy Suite is the ideal setup for real-time adaptive brachytherapy treatments. The main impediment to MRI-IGABT adoption is access to MRI scanners. Very few radiation oncology departments currently house MRI scanners, and even fewer in a dedicated Brachytherapy Suite. CBCT equipped simulators are increasingly offered by manufacturers as part of a Brachytherapy Suite installation. If optimized, images acquired can be used for treatment planning, or can be registered with other imaging modalities. This infrastructure is relevant for all forms of brachytherapy, especially those utilizing multi-fractionated courses of treatment such as prostate and cervix. Moreover, for prostate brachytherapy, US imaging systems can be part of the suite to allow for real-time HDR/LDR treatments. Learning Objectives: Understand the adaptive workflow of MR-based IGBT for cervical cancer. Familiarize with commissioning aspects of a CBCT equipped simulator with emphasis on brachytherapy applications Learn about the current status and future developments in US-based prostate brachytherapy

  12. WE-F-BRD-01: HDR Brachytherapy II: Integrating Imaging with HDR

    Energy Technology Data Exchange (ETDEWEB)

    Craciunescu, O [Duke University Medical Center, Durham, NC (United States); Todor, D [Virginia Commonwealth University, Richmond, VA (United States); Leeuw, A de

    2014-06-15

    In recent years, with the advent of high/pulsed dose rate afterloading technology, advanced treatment planning systems, CT/MRI compatible applicators, and advanced imaging platforms, image-guided adaptive brachytherapy treatments (IGABT) have started to play an ever increasing role in modern radiation therapy. The most accurate way to approach IGABT treatment is to provide the infrastructure that combines in a single setting an appropriate imaging device, a treatment planning system, and a treatment unit. The Brachytherapy Suite is not a new concept, yet the modern suites are incorporating state-of-the-art imaging (MRI, CBCT equipped simulators, CT, and /or US) that require correct integration with each other and with the treatment planning and delivery systems. Arguably, an MRI-equipped Brachytherapy Suite is the ideal setup for real-time adaptive brachytherapy treatments. The main impediment to MRI-IGABT adoption is access to MRI scanners. Very few radiation oncology departments currently house MRI scanners, and even fewer in a dedicated Brachytherapy Suite. CBCT equipped simulators are increasingly offered by manufacturers as part of a Brachytherapy Suite installation. If optimized, images acquired can be used for treatment planning, or can be registered with other imaging modalities. This infrastructure is relevant for all forms of brachytherapy, especially those utilizing multi-fractionated courses of treatment such as prostate and cervix. Moreover, for prostate brachytherapy, US imaging systems can be part of the suite to allow for real-time HDR/LDR treatments. Learning Objectives: Understand the adaptive workflow of MR-based IGBT for cervical cancer. Familiarize with commissioning aspects of a CBCT equipped simulator with emphasis on brachytherapy applications Learn about the current status and future developments in US-based prostate brachytherapy.

  13. Absolute measurement of LDR brachytherapy source emitted power: Instrument design and initial measurements.

    Science.gov (United States)

    Malin, Martha J; Palmer, Benjamin R; DeWerd, Larry A

    2016-02-01

    Energy-based source strength metrics may find use with model-based dose calculation algorithms, but no instruments exist that can measure the energy emitted from low-dose rate (LDR) sources. This work developed a calorimetric technique for measuring the power emitted from encapsulated low-dose rate, photon-emitting brachytherapy sources. This quantity is called emitted power (EP). The measurement methodology, instrument design and performance, and EP measurements made with the calorimeter are presented in this work. A calorimeter operating with a liquid helium thermal sink was developed to measure EP from LDR brachytherapy sources. The calorimeter employed an electrical substitution technique to determine the power emitted from the source. The calorimeter's performance and thermal system were characterized. EP measurements were made using four (125)I sources with air-kerma strengths ranging from 2.3 to 5.6 U and corresponding EPs of 0.39-0.79 μW, respectively. Three Best Medical 2301 sources and one Oncura 6711 source were measured. EP was also computed by converting measured air-kerma strengths to EPs through Monte Carlo-derived conversion factors. The measured EP and derived EPs were compared to determine the accuracy of the calorimeter measurement technique. The calorimeter had a noise floor of 1-3 nW and a repeatability of 30-60 nW. The calorimeter was stable to within 5 nW over a 12 h measurement window. All measured values agreed with derived EPs to within 10%, with three of the four sources agreeing to within 4%. Calorimeter measurements had uncertainties ranging from 2.6% to 4.5% at the k = 1 level. The values of the derived EPs had uncertainties ranging from 2.9% to 3.6% at the k = 1 level. A calorimeter capable of measuring the EP from LDR sources has been developed and validated for (125)I sources with EPs between 0.43 and 0.79 μW.

  14. Treatment of bulky stage IB and IIB cervical cancers with outpatient neutron brachytherapy, external pelvic radiation and extrafascial hysterectomy

    International Nuclear Information System (INIS)

    Van Nagell, J.R.; Maruyama, Y.; Yoneda, J.; Donaldson, E.S.; Hanson, M.B.; Gallion, H.H.; Powell, D.E.; Kryscio, R.J.

    1986-01-01

    From January, 1977, to December, 1982, twenty-nine patients with bulky (>4 cms diameter) Stage IB or IIB cervical cancer were treated at the University of Kentucky Medical Center by a combination of out-patient neutron brachytherapy (Cf-252) and external pelvic radiation followed by extrafascial hysterectomy. Residual tumor was present in the hysterectomy specimens of 25 per cent. Complications during and following radiation therapy and surgery were minimal and included vaginal stenosis, proctitis, and hemorrhagic cystitis. The mean duration of hospitalization for surgery in these patients was 6.6 days (range 5-15 days) and postoperative morbidity was low. No patient required blood transfusion. Four patients developed urinary tract infections and two had superficial wound separations. Following treatment, patients were seen at monthly intervals for one year, every three months for two years, and every six months thereafter. No patient has been lost to follow-up. Two patients (7 per cent) developed tumor recurrence and have died of disease (1 of distant metastases; 1 local). The remaining 27 patients (93 per cent) are alive and well with no evidence of disease 24-89 months (mean 48 months) after therapy. No radiogenic fistulae or bowel obstruction were observed. These preliminary results suggest that the combination of outpatient neutron brachytherapy, external pelvic radiation, and extrafascial hysterectomy for patients with Stage IB and IIB cervical cancer is well tolerated. Complications associated with this treatment regimen have been minimal, and the recurrence rate is low. The duration of intracavitary neutron brachytherapy was short, and outpatient therapy was well received by patients

  15. Reirradiation of nasopharyngeal carcinoma with intracavitary mold brachytherapy: an effective means of local salvage

    International Nuclear Information System (INIS)

    Law, Stephen C.K.; Lam, W.-K.; Ng, M.-F.; Au, S.-K.; Mak, W.-T.; Lau, W.-H.

    2002-01-01

    Purpose: To assess the role of intracavitary mold brachytherapy in salvaging local failure of nasopharyngeal carcinoma (NPC). Methods and Materials: The outcomes of 118 consecutive NPC patients with local failure treated with mold brachytherapy between 1989 and 1996 were retrospectively reviewed. Eleven patients received additional external radiotherapy. Results: All molds were tailor-made, and the whole procedure was performed under local anesthesia. Pharyngeal recess dissection was routinely performed to allow direct contact of the radioactive source with the pharyngeal recess, a common site of local failure. Initially, the molds were preloaded with 192 Ir wires, but since 1992, the sources have been manually afterloaded; the mold has also been redesigned for better conformity, ease of insertion, and radiation safety. Using brachytherapy alone, 50-55 Gy was given for recurrence in 4-7 days; for persistence, 40 Gy was administered. The overall complete remission rate was 97%. The rates of 5-year local control, relapse-free survival, disease-specific survival, overall survival, and major complication were 85%, 68.3%, 74.8%, 61.3%, and 46.9%, respectively. Major complications included nasopharyngeal necrosis with headache, necrosis of cervical vertebrae with atlantoaxial instability, temporal lobe necrosis, and palsy of the cranial nerves. The afterloaded mold was as effective as the preloaded version, but with fewer complications. Conclusions: Intracavitary mold brachytherapy was effective in salvaging NPC with early-stage local persistence or first recurrence

  16. Investigation of the Effects of Tissue Inhomogeneities on the Dosimetric Parameters of a Cs-137 Brachytherapy Source using the MCNP4C Code

    Directory of Open Access Journals (Sweden)

    Mehdi Zehtabian

    2010-09-01

    Full Text Available Introduction: Brachytherapy is the use of small encapsulated radioactive sources in close vicinity of tumors. Various methods are used to obtain the dose distribution around brachytherapy sources. TG-43 is a dosimetry protocol proposed by the AAPM for determining dose distributions around brachytherapy sources. The goal of this study is to update this protocol for presence of bone and air inhomogenities.  Material and Methods: To update the dose rate constant parameter of the TG-43 formalism, the MCNP4C simulations were performed in phantoms composed of water-bone and water-air combinations. The values of dose at different distances from the source in both homogeneous and inhomogeneous phantoms were estimated in spherical tally cells of 0.5 mm radius using the F6 tally. Results: The percentages of dose reductions in presence of air and bone inhomogenities for the Cs-137 source were found to be 4% and 10%, respectively. Therefore, the updated dose rate constant (Λ will also decrease by the same percentages.   Discussion and Conclusion: It can be easily concluded that such dose variations are more noticeable when using lower energy sources such as Pd-103 or I-125.

  17. SU-F-T-54: Determination of the AAPM TG-43 Brachytherapy Dosimetry Parameters for A New Titanium-Encapsulated Yb-169 Source by Monte Carlo Calculations

    Energy Technology Data Exchange (ETDEWEB)

    Reynoso, F [UT MD Anderson Cancer Center, Houston, TX (United States); Washington University School of Medicine, St. Louis, MO (United States); Munro, J [Source Production & Equipment Co., Inc., St. Rose, LA (United States); Cho, S [UT MD Anderson Cancer Center, Houston, TX (United States)

    2016-06-15

    Purpose: To determine the AAPM TG-43 brachytherapy dosimetry parameters of a new titanium-encapsulated Yb-169 source designed to maximize the dose enhancement during gold nanoparticle-aided radiation therapy (GNRT). Methods: An existing Monte Carlo (MC) model of the titanium-encapsulated Yb-169 source, which was described in the current investigators’ published MC optimization study, was modified based on the source manufacturer’s detailed specifications, resulting in an accurate model of the titanium-encapsulated Yb-169 source that was actually manufactured. MC calculations were then performed using the MCNP5 code system and the modified source model, in order to obtain a complete set of the AAPM TG-43 parameters for the new Yb-169 source. Results: The MC-calculated dose rate constant for the new titanium-encapsulated Yb-169 source was 1.05 ± 0.03 cGy per hr U, indicating about 10% decrease from the values reported for the conventional stainless steel-encapsulated Yb-169 sources. The source anisotropy and radial dose function for the new source were found similar to those reported for the conventional Yb-169 sources. Conclusion: In this study, the AAPM TG-43 brachytherapy dosimetry parameters of a new titanium-encapsulated Yb-169 source were determined by MC calculations. The current results suggested that the use of titanium, instead of stainless steel, to encapsulate the Yb-169 core would not lead to any major change in the dosimetric characteristics of the Yb-169 source, while it would allow more low energy photons being transmitted through the source filter thereby leading to an increased dose enhancement during GNRT. Supported by DOD/PCRP grant W81XWH-12-1-0198 This investigation was supported by DOD/PCRP grant W81XWH-12-1- 0198.

  18. High dose rate brachytherapy for oral cancer.

    Science.gov (United States)

    Yamazaki, Hideya; Yoshida, Ken; Yoshioka, Yasuo; Shimizutani, Kimishige; Furukawa, Souhei; Koizumi, Masahiko; Ogawa, Kazuhiko

    2013-01-01

    Brachytherapy results in better dose distribution compared with other treatments because of steep dose reduction in the surrounding normal tissues. Excellent local control rates and acceptable side effects have been demonstrated with brachytherapy as a sole treatment modality, a postoperative method, and a method of reirradiation. Low-dose-rate (LDR) brachytherapy has been employed worldwide for its superior outcome. With the advent of technology, high-dose-rate (HDR) brachytherapy has enabled health care providers to avoid radiation exposure. This therapy has been used for treating many types of cancer such as gynecological cancer, breast cancer, and prostate cancer. However, LDR and pulsed-dose-rate interstitial brachytherapies have been mainstays for head and neck cancer. HDR brachytherapy has not become widely used in the radiotherapy community for treating head and neck cancer because of lack of experience and biological concerns. On the other hand, because HDR brachytherapy is less time-consuming, treatment can occasionally be administered on an outpatient basis. For the convenience and safety of patients and medical staff, HDR brachytherapy should be explored. To enhance the role of this therapy in treatment of head and neck lesions, we have reviewed its outcomes with oral cancer, including Phase I/II to Phase III studies, evaluating this technique in terms of safety and efficacy. In particular, our studies have shown that superficial tumors can be treated using a non-invasive mold technique on an outpatient basis without adverse reactions. The next generation of image-guided brachytherapy using HDR has been discussed. In conclusion, although concrete evidence is yet to be produced with a sophisticated study in a reproducible manner, HDR brachytherapy remains an important option for treatment of oral cancer.

  19. Attenuation measurements show that the presence of a TachoSil surgical patch will not compromise target irradiation in intra-operative electron radiation therapy or high-dose-rate brachytherapy

    International Nuclear Information System (INIS)

    Sarmento, Sandra; Costa, Filipa; Pereira, Alexandre; Lencart, Joana; Dias, Anabela; Cunha, Luís; Sousa, Olga; Silva, José Pedro; Santos, Lúcio

    2015-01-01

    Surgery of locally advanced and/or recurrent rectal cancer can be complemented with intra-operative electron radiation therapy (IOERT) to deliver a single dose of radiation directly to the unresectable margins, while sparing nearby sensitive organs/structures. Haemorrhages may occur and can affect the dose distribution, leading to an incorrect target irradiation. The TachoSil (TS) surgical patch, when activated, creates a fibrin clot at the surgical site to achieve haemostasis. The aim of this work was to determine the effect of TS on the dose distribution, and ascertain whether it could be used in combination with IOERT. This characterization was extended to include high dose rate (HDR) intraoperative brachytherapy, which is sometimes used at other institutions instead of IOERT. CT images of the TS patch were acquired for initial characterization. Dosimetric measurements were performed in a water tank phantom, using a conventional LINAC with a hard-docking system of cylindrical applicators. Percentage Depth Dose (PDD) curves were obtained, and measurements made at the depth of dose maximum for the three clinically used electron energies (6, 9 and 12MeV), first without any attenuator and then with the activated patch of TS completely covering the tip of the IOERT applicator. For HDR brachytherapy, a measurement setup was improvised using a solid water phantom and a Farmer ionization chamber. Our measurements show that the attenuation of a TachoSil patch is negligible, both for high energy electron beams (6 to 12MeV), and for a HDR 192 Ir brachytherapy source. Our results cannot be extrapolated to lower beam energies such as 50 kVp X-rays, which are sometimes used for breast IORT. The TachoSil surgical patch can be used in IORT procedures using 6MeV electron energies or higher, or HDR 192 Ir brachytherapy

  20. Attenuation measurements show that the presence of a TachoSil surgical patch will not compromise target irradiation in intra-operative electron radiation therapy or high-dose-rate brachytherapy.

    Science.gov (United States)

    Sarmento, Sandra; Costa, Filipa; Pereira, Alexandre; Lencart, Joana; Dias, Anabela; Cunha, Luís; Sousa, Olga; Silva, José Pedro; Santos, Lúcio

    2015-01-09

    Surgery of locally advanced and/or recurrent rectal cancer can be complemented with intra-operative electron radiation therapy (IOERT) to deliver a single dose of radiation directly to the unresectable margins, while sparing nearby sensitive organs/structures. Haemorrhages may occur and can affect the dose distribution, leading to an incorrect target irradiation. The TachoSil (TS) surgical patch, when activated, creates a fibrin clot at the surgical site to achieve haemostasis. The aim of this work was to determine the effect of TS on the dose distribution, and ascertain whether it could be used in combination with IOERT. This characterization was extended to include high dose rate (HDR) intraoperative brachytherapy, which is sometimes used at other institutions instead of IOERT. CT images of the TS patch were acquired for initial characterization. Dosimetric measurements were performed in a water tank phantom, using a conventional LINAC with a hard-docking system of cylindrical applicators. Percentage Depth Dose (PDD) curves were obtained, and measurements made at the depth of dose maximum for the three clinically used electron energies (6, 9 and 12MeV), first without any attenuator and then with the activated patch of TS completely covering the tip of the IOERT applicator. For HDR brachytherapy, a measurement setup was improvised using a solid water phantom and a Farmer ionization chamber. Our measurements show that the attenuation of a TachoSil patch is negligible, both for high energy electron beams (6 to 12MeV), and for a HDR (192)Ir brachytherapy source. Our results cannot be extrapolated to lower beam energies such as 50 kVp X-rays, which are sometimes used for breast IORT. The TachoSil surgical patch can be used in IORT procedures using 6MeV electron energies or higher, or HDR (192)Ir brachytherapy.

  1. Experimental and theoretical determination of dosimetric characteristics of IsoAid ADVANTAGETM125I brachytherapy source

    International Nuclear Information System (INIS)

    Meigooni, Ali S.; Hayes, Joshua L.; Zhang Hualin; Sowards, Keith

    2002-01-01

    125 I brachytherapy sources are being used for interstitial implants in tumor sites such as the prostate. Recently, the ADVANTAGE TM 125 I, Model IAI-125, source became commercially available for interstitial brachytherapy treatment. Dosimetric characteristics (dose rate constant, radial dose function, and anisotropy function) of this source were experimentally and theoretically determined, following the AAPM Task Group 43 recommendations. Derivation of the dose rate constant was based on recent NIST WAFAC calibration performed in accordance with their 1999 standard. Measurements were performed in Solid Water TM phantom using LiF thermoluminescent dosimeters. The theoretical calculations were performed in both Solid Water TM and water using the PTRAN Monte Carlo code. The results indicated that a dose rate constant of the new source in water was 0.98±0.03 cGy h -1 U -1 . The radial dose function of the new source was measured in Solid Water TM and calculated both in water and Solid Water TM at distances up to 10.0 cm. The anisotropy function, F(r,θ), of the new source was measured and calculated in Solid Water TM at distances of 2 cm, 3 cm, 5 cm, and 7 cm and also was calculated in water at distances ranging from 1 cm to 7 cm from the source. From the anisotropy function, the anisotropy factors and anisotropy constant were derived. The anisotropy constant of the ADVANTAGE TM 125 I source in water was found to be 0.97±0.03. The dosimetric characteristics of this new source compared favorably with those from the Amersham Health Model 6711 source. Complete dosimetric parameters of the new source are presented in this paper

  2. On the use of multi-dimensional scaling and electromagnetic tracking in high dose rate brachytherapy

    Science.gov (United States)

    Götz, Th I.; Ermer, M.; Salas-González, D.; Kellermeier, M.; Strnad, V.; Bert, Ch; Hensel, B.; Tomé, A. M.; Lang, E. W.

    2017-10-01

    High dose rate brachytherapy affords a frequent reassurance of the precise dwell positions of the radiation source. The current investigation proposes a multi-dimensional scaling transformation of both data sets to estimate dwell positions without any external reference. Furthermore, the related distributions of dwell positions are characterized by uni—or bi—modal heavy—tailed distributions. The latter are well represented by α—stable distributions. The newly proposed data analysis provides dwell position deviations with high accuracy, and, furthermore, offers a convenient visualization of the actual shapes of the catheters which guide the radiation source during the treatment.

  3. [Developments in brachytherapy].

    Science.gov (United States)

    Ikeda, H

    1995-09-01

    Brachytherapy is one of the ideal methods of radiotherapy because of the concentration of a high dose on the target. Recent developments, including induction of afterloading method, utilization of small-sized high-activity sources such as Iridium-192, and induction of high technology and computerization, have made for shortening of irradiation time and source handling, which has led to easier management of the patient during treatment. Dose distribution at high dose rate (HDR) is at least as good as that of low dose rate (LDR), and selection of fractionation and treatment time assures even greater biological effects on hypoxic tumor cells than LDR. Experience with HDR brachytherapy in uterine cervix cancer using Cobalt-60 during the past 20 years in this country has gradually been evaluated in U.S. and Europe. The indications for HDR treatment have extended to esophagus, bronchus, bile duct, brain, intraoperative placement of source guide, and perineal region using templates, as well as the conventional use for uterus, tongue and so on.

  4. SU-E-T-447: Electronic Brachytherapy (EBT) Treatment of Cervical Cancer - First Clinical Experience

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, D; Johnson, M; Thompson, J; Ahmad, S [University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma (United States); Chan, L; Hausen, H [Xoft Inc., San Jose, CA (United States)

    2014-06-01

    Purpose: To study the first trial patient in which an electronic brachytherapy (EBT) x-ray source is utilized for treatment of cervical cancer. Methods: During patient treatment, a miniaturized x-ray source was used in combination with a customized titanium tandem and ovoid applicator set. The semi-specialized source was modeled with formalisms outlined by AAMP Task Group 43. Multiple models were used to compensate for variable attenuation conditions as a function of source positions. Varian Brachyvision treatment planning software was utilized on CT data sets for dose calculations prior to treatment delivery. The dose was prescribed to “point A” as defined by American Brachytherapy society. Additional treatments plans were created from those clinically utilized in patient care and were recalculated for an existing Ir-192 source model. Dose volume histograms (DVH) and point dose calculations were compared between the modalities for the clinical condition present in patients treated with EBT. Results: Clinical treatment times, though longer than those typically experienced by Ir-192 users, were manageable. Instantaneous dose rates at personal positions within the treatment vault were lower than those measured during intra operative radiation therapy and breast EBT treatments. Due to lower average photon energy in EBT, dose gradients within the treatment plans were as expected steeper than those observed in Ir-192 based brachytherapy. DVH comparisons between Ir-192 and EBT treatments showed an expected decrease in the integral dose to normal tissues of interest for EBT. In comparing plans created for EBT delivery with those calculated for Ir-192, average dose values for EBT were more than 4%, 11%, and 9% lower at predefined bladder, rectum and “point B” positions, respectively. Conclusion: For the first time, we have demonstrated that the utilizing electronic brachytherapy system for tandem and ovoid based treatment of cancer of the cervix is feasible, and

  5. Calculated neutron air kerma strength conversion factors for a generically encapsulated Cf-252 brachytherapy source

    CERN Document Server

    Rivard, M J; D'Errico, F; Tsai, J S; Ulin, K; Engler, M J

    2002-01-01

    The sup 2 sup 5 sup 2 Cf neutron air kerma strength conversion factor (S sub K sub N /m sub C sub f) is a parameter needed to convert the radionuclide mass (mu g) provided by Oak Ridge National Laboratory into neutron air kerma strength required by modern clinical brachytherapy dosimetry formalisms indicated by Task Group No. 43 of the American Association of Physicists in Medicine (AAPM). The impact of currently used or proposed encapsulating materials for sup 2 sup 5 sup 2 Cf brachytherapy sources (Pt/Ir-10%, 316L stainless steel, nitinol, and Zircaloy-2) on S sub K sub N /m sub C sub f was calculated and results were fit to linear equations. Only for substantial encapsulation thicknesses, did S sub K sub N /m sub C sub f decrease, while the impact of source encapsulation composition is increasingly negligible as Z increases. These findings are explained on the basis of the non-relativistic kinematics governing the majority of sup 2 sup 5 sup 2 Cf neutron interactions. Neutron kerma and energy spectra resul...

  6. Evaluation of resins for use in brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Carvalho, Luiz Claudio F.M. Garcia; Ferraz, Wilmar Barbosa; Chrcanovic, Bruno Ramos; Santos, Ana Maria M., E-mail: ferrazw@cdtn.b, E-mail: amms@cdtn.b [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2011-07-01

    Brachytherapy is an advanced cancer treatment where radioactive seeds or sources are placed near or directly into the tumor thus reducing the radiation exposure in the surrounding healthy tissues. Prostate cancer can be treated with interstitial brachytherapy in initial stage of the disease in which tiny radioactive seeds with cylindrical geometry are used. Several kinds of seeds have been developed in order to obtain a better dose distribution around them and with a lower cost manufacturing. These seeds consist of an encapsulation, a radionuclide carrier, and X-ray marker. Among the materials that have potential for innovation in the construction of seeds, biocompatible resins appear as an important option. In this paper, we present some characterization results with Fourier transform infrared spectroscopic (FTIR) and ultraviolet-visible spectroscopy (UV-vis) performed on two types of resins in which curing temperatures for each one were varied as also the results of coatings with these resins under titanium substrates. Interactions of these resins in contact with the simulated body fluid were evaluated by atomic force microscopy, scanning electron microscopy, and energy dispersive X-ray spectroscopy. (author)

  7. Manual on brachytherapy. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1992-01-01

    In addition to a basic guide to the principles of the production of ionizing radiation and to methods of radiation protection and dosimetry, this booklet includes information about radiation protection procedures for brachytherapy

  8. 3D dosimetry study of 188Re liquid balloon for intravascular brachytherapy using BANG polymer gel dosemeters

    International Nuclear Information System (INIS)

    Wuu, S.; Schiff, P.B.; Maryanski, M.; Liu, T.; Borzillary, S.; Weinberger, J.

    2002-01-01

    It has been suggested that the combination of intravascular brachytherapy and coronary stent implantation may result in further reduction of restenosis after percutaneous balloon angioplasty. The use of an angioplasty balloon filled with a P 188 Re liquid beta source for intravascular brachytherapy provides the advantage of accurate source positioning and uniform dose distribution to the coronary vessel wall. The effect of source edge and stent on the dose distribution of the target tissue may be clinically important. In BANG gels, the absorbed radiation produces free-radical chain polymerisation of acrylic monomers that are initially dissolved in the gel. The number of polymer particles is proportional to the absorbed dose. In this study, 3D dose distributions are presented for 188 Re balloons, with and without stents, using a prototype He-Ne laser CT scanner and the proprietary BANG polymer gel dosemeters. (author)

  9. Calculation of integrated biological response in brachytherapy

    International Nuclear Information System (INIS)

    Dale, Roger G.; Coles, Ian P.; Deehan, Charles; O'Donoghue, Joseph A.

    1997-01-01

    Purpose: To present analytical methods for calculating or estimating the integrated biological response in brachytherapy applications, and which allow for the presence of dose gradients. Methods and Materials: The approach uses linear-quadratic (LQ) formulations to identify an equivalent biologically effective dose (BED eq ) which, if applied to a specified tissue volume, would produce the same biological effect as that achieved by a given brachytherapy application. For simple geometrical cases, BED multiplying factors have been derived which allow the equivalent BED for tumors to be estimated from a single BED value calculated at a dose reference point. For more complex brachytherapy applications a voxel-by-voxel determination of the equivalent BED will be more accurate. Equations are derived which when incorporated into brachytherapy software would facilitate such a process. Results: At both high and low dose rates, the BEDs calculated at the dose reference point are shown to be lower than the true values by an amount which depends primarily on the magnitude of the prescribed dose; the BED multiplying factors are higher for smaller prescribed doses. The multiplying factors are less dependent on the assumed radiobiological parameters. In most clinical applications involving multiple sources, particularly those in multiplanar arrays, the multiplying factors are likely to be smaller than those derived here for single sources. The overall suggestion is that the radiobiological consequences of dose gradients in well-designed brachytherapy treatments, although important, may be less significant than is sometimes supposed. The modeling exercise also demonstrates that the integrated biological effect associated with fractionated high-dose-rate (FHDR) brachytherapy will usually be different from that for an 'equivalent' continuous low-dose-rate (CLDR) regime. For practical FHDR regimes involving relatively small numbers of fractions, the integrated biological effect to

  10. Estimation of distance error by fuzzy set theory required for strength determination of HDR (192)Ir brachytherapy sources.

    Science.gov (United States)

    Kumar, Sudhir; Datta, D; Sharma, S D; Chourasiya, G; Babu, D A R; Sharma, D N

    2014-04-01

    Verification of the strength of high dose rate (HDR) (192)Ir brachytherapy sources on receipt from the vendor is an important component of institutional quality assurance program. Either reference air-kerma rate (RAKR) or air-kerma strength (AKS) is the recommended quantity to specify the strength of gamma-emitting brachytherapy sources. The use of Farmer-type cylindrical ionization chamber of sensitive volume 0.6 cm(3) is one of the recommended methods for measuring RAKR of HDR (192)Ir brachytherapy sources. While using the cylindrical chamber method, it is required to determine the positioning error of the ionization chamber with respect to the source which is called the distance error. An attempt has been made to apply the fuzzy set theory to estimate the subjective uncertainty associated with the distance error. A simplified approach of applying this fuzzy set theory has been proposed in the quantification of uncertainty associated with the distance error. In order to express the uncertainty in the framework of fuzzy sets, the uncertainty index was estimated and was found to be within 2.5%, which further indicates that the possibility of error in measuring such distance may be of this order. It is observed that the relative distance li estimated by analytical method and fuzzy set theoretic approach are consistent with each other. The crisp values of li estimated using analytical method lie within the bounds computed using fuzzy set theory. This indicates that li values estimated using analytical methods are within 2.5% uncertainty. This value of uncertainty in distance measurement should be incorporated in the uncertainty budget, while estimating the expanded uncertainty in HDR (192)Ir source strength measurement.

  11. MO-A-BRB-00: Electronic Charting in EBRT and Brachytherapy

    International Nuclear Information System (INIS)

    2015-01-01

    The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiation therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy

  12. Dosimetric effects of saline- versus water-filled balloon applicators for IORT using the model S700 electronic brachytherapy source.

    Science.gov (United States)

    Redler, Gage; Templeton, Alistair; Zhen, Heming; Turian, Julius; Bernard, Damian; Chu, James C H; Griem, Katherine L; Liao, Yixiang

    The Xoft Axxent Electronic Brachytherapy System (Xoft, Inc., San Jose, CA) is a viable option for intraoperative radiation therapy (IORT) treatment of early-stage breast cancer. The low-energy (50-kVp) X-ray source simplifies shielding and increases relative biological effectiveness but increases dose distribution sensitivity to medium composition. Treatment planning systems typically assume homogenous water for brachytherapy dose calculations, including precalculated atlas plans for Xoft IORT. However, Xoft recommends saline for balloon applicator filling. This study investigates dosimetric differences due to increased effective atomic number (Z eff ) for saline (Z eff  = 7.56) versus water (Z eff  = 7.42). Balloon applicator diameters range from 3 to 6 cm. Monte Carlo N-Particle software is used to calculate dose at the surface (D s ) of and 1 cm away (D 1cm ) from the water-/saline-filled balloon applicator using a single dwell at the applicator center as a simple estimation of the dosimetry and multiple dwells simulating the clinical dose distributions for the atlas plans. Single-dwell plans show a 4.4-6.1% decrease in D s for the 3- to 6-cm diameter applicators due to the saline. Multidwell plans show similar results: 4.9% and 6.4% D s decrease, for 4-cm and 6-cm diameter applicators, respectively. For the single-dwell plans, D 1cm decreases 3.6-5.2% for the 3- to 6-cm diameter applicators. For the multidwell plans, D 1cm decreases 3.3% and 5.3% for the 4-cm and 6-cm applicators, respectively. The dosimetric effect introduced by saline versus water filling for Xoft balloon applicator-based IORT treatments is ∼5%. Users should be aware of this in the context of both treatment planning and patient outcome studies. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  13. High dose rate brachytherapy for oral cancer

    International Nuclear Information System (INIS)

    Yamazaki, Hideya; Yoshida, Ken; Yoshioka, Yasuo; Shimizutani, Kimishige; Koizumi, Masahiko; Ogawa, Kazuhiko; Furukawa, Souhei

    2013-01-01

    Brachytherapy results in better dose distribution compared with other treatments because of steep dose reduction in the surrounding normal tissues. Excellent local control rates and acceptable side effects have been demonstrated with brachytherapy as a sole treatment modality, a postoperative method, and a method of reirradiation. Low-dose-rate (LDR) brachytherapy has been employed worldwide for its superior outcome. With the advent of technology, high-dose-rate (HDR) brachytherapy has enabled health care providers to avoid radiation exposure. This therapy has been used for treating many types of cancer such as gynecological cancer, breast cancer, and prostate cancer. However, LDR and pulsed-dose-rate interstitial brachytherapies have been mainstays for head and neck cancer. HDR brachytherapy has not become widely used in the radiotherapy community for treating head and neck cancer because of lack of experience and biological concerns. On the other hand, because HDR brachytherapy is less time-consuming, treatment can occasionally be administered on an outpatient basis. For the convenience and safety of patients and medical staff, HDR brachytherapy should be explored. To enhance the role of this therapy in treatment of head and neck lesions, we have reviewed its outcomes with oral cancer, including Phase I/II to Phase III studies, evaluating this technique in terms of safety and efficacy. In particular, our studies have shown that superficial tumors can be treated using a non-invasive mold technique on an outpatient basis without adverse reactions. The next generation of image-guided brachytherapy using HDR has been discussed. In conclusion, although concrete evidence is yet to be produced with a sophisticated study in a reproducible manner, HDR brachytherapy remains an important option for treatment of oral cancer. (author)

  14. Severe rectal complications after prostate brachytherapy

    International Nuclear Information System (INIS)

    Wallner, Kent; Sutlief, Stephen; Bergsagel, Carl; Merrick, Gregory S.

    2015-01-01

    Purpose: Some investigators have reported severe rectal complications after brachytherapy. Due to the low number of such events, their relationship to dosimetric parameters has not been well characterized. Methods and materials: A total of 3126 patients were treated with low dose rate brachytherapy from 1998 through 2010. 2464 had implant alone, and 313 had implant preceded by 44–46 Gy supplemental external beam radiation (EBRT). Post-implant dosimetry was based on a CT scan obtained on the day of implant, generally within 30 min of the procedure. Every patient’s record was reviewed for occurrence of rectal complications. Results: Eight of 2464 patients (0.32%) treated with brachytherapy alone developed a radiation-related rectal fistula. Average prostatic and rectal dose parameters were moderately higher for fistula patients than for patients without a severe rectal complication. For instance, the average R100 was 1.2 ± 0.75 cc for fistula patients, versus 0.37 ± 0.88 cc for non-fistula patients. However, the fistula patients’ values were well within the range of values for patients without a rectal complication. Four patients had some attempt at repair or reconstruction, but long-term functional outcomes were not favorable. Conclusions: Rectal fistulas are a very uncommon potential complication of prostate brachytherapy, which can occur even in the setting of acceptable day 0 rectal doses. Their occurrence is not easily explained by standard dosimetric or clinical factors

  15. Brachytherapy treatment with high dose rate

    International Nuclear Information System (INIS)

    Santana Rodriguez, Sergio Marcelino; Rodriguez Rodriguez, Lissi Lisbet; Ciscal Chiclana, Onelio Alberto

    2009-01-01

    Retrospectively analyze results and prognostic factors of cervical cancer patients treated with radio concomitant cisplatin-based chemotherapy, radiation therapy combined modality. Methods: From January 2003 to December 2007, 198 patients with invasive cervical cancer were treated at the Oncology Department of Hospital Robau Celestino Hernandez (brachytherapy performed at INOR). The most common age group was 31 to 40 years. The histology in squamous cell carcinoma accounted for 84.3% of cases. The treatment consisted of external pelvic irradiation and vaginal brachytherapy, high dose rate. Concomitant chemotherapy consisted of cisplatin 40 mg/m2 weekly with a maximum of 70 mg for 5 weeks. Results: 66.2% of patients completed 5 cycles of chemotherapy. The median overall survival was 39 months, overall survival, disease-free survival and survival free of locoregional recurrence at 5 years of 78%, 76% and 78.6% respectively .. We found that clinical stage, histological type (adenocarcinoma worst outcome) were statistically related to level of response. Conclusions: Treatment with external pelvic radiation, brachytherapy and concurrent weekly cisplatin in patients with stage IIIB cervical cancer is feasible in the Chilean public health system, well tolerated and results comparable to international literature. (Author)

  16. Comparison of TG-43 and TG-186 in breast irradiation using a low energy electronic brachytherapy source

    International Nuclear Information System (INIS)

    White, Shane A.; Landry, Guillaume; Reniers, Brigitte; Fonseca, Gabriel Paiva; Holt, Randy; Rusch, Thomas; Beaulieu, Luc; Verhaegen, Frank

    2014-01-01

    Purpose: The recently updated guidelines for dosimetry in brachytherapy in TG-186 have recommended the use of model-based dosimetry calculations as a replacement for TG-43. TG-186 highlights shortcomings in the water-based approach in TG-43, particularly for low energy brachytherapy sources. The Xoft Axxent is a low energy ( w,m ) and dose to medium (D m,m ), for the heterogeneous simulations. All results were compared against TG-43-based dose distributions and evaluated using dose ratio maps and DVH metrics. Changes in skin and PTV dose were highlighted. Results: All simulated heterogeneous models showed a reduced dose to the DVH metrics that is dependent on the method of dose reporting and patient geometry. Based on a prescription dose of 34 Gy, the average D 90 to PTV was reduced by between ∼4% and ∼40%, depending on the scoring method, compared to the TG-43 result. Peak skin dose is also reduced by 10%–15% due to the absence of backscatter not accounted for in TG-43. The balloon applicator also contributed to the reduced dose. Other ROIs showed a difference depending on the method of dose reporting. Conclusions: TG-186-based calculations produce results that are different from TG-43 for the Axxent source. The differences depend strongly on the method of dose reporting. This study highlights the importance of backscatter to peak skin dose. Tissue heterogeneities, applicator, and patient geometries demonstrate the need for a more robust dose calculation method for low energy brachytherapy sources

  17. Loss and recovery of radiation sources in India

    International Nuclear Information System (INIS)

    Mishra, U.C.; Pradhan, A.S.

    1998-01-01

    Loss of radioisotope sources occurs as a result of the violation of safe work practices and non-compliance with rules and guidelines. The main causes are human error, negligence in source handling and storage as well as mismanagement and lack of supervision. The failure to adequately supervise and manage leads to a breakdown in communication and differences among workers, supervisors and managers. Recovery of lost sources is generally a tedious task. In India, apart from the efforts of the user institution, a team of scientists from the Bhabha Atomic Research Centre (BARC) undertakes searches and supervises recovery operations. Sources have been lost in brachytherapy and nuclear medicine departments of hospitals and in industrial institutions. For brachytherapy source losses, hospital garbage, dustbins, passages and lifts were the main targets for searches. While gamma ray and neutron sources could be traced for the most part, pure beta ray sources, such as Sr-90 used in ophthalmic applicators or as check sources, could not be recovered. In industrial radiography, the search for sources was more problematic, especially when the sources were stolen or lost in transport. Lost materials could not be traced in only two out of eleven instances of loss of Ir-192 sources since 1986. In a separate incident, sources which had been stolen were found in a deep river: this necessitated an elaborate fishing operation at a cost of some US$100,000. Each occurrence provided lessons calling for the introduction of new control measures. (author)

  18. Importance of brachytherapy technique in the management of primary carcinoma of the vagina

    International Nuclear Information System (INIS)

    Stock, R.G.; Mychalczak, B.; Armstrong, J.G.; Hoskins, W.; Harrison, L.B.

    1991-01-01

    Primary vaginal carcinoma is a rare malignancy. There is little information regarding the optimal treatment. Management has primarily been with external-beam radiation therapy and brachytherapy. This paper examines the importance of brachytherapy and the significance of its techniques in the treatment of this disease. Brachytherapy plays an important part in the management of primary vaginal carcinoma. External-beam radiation therapy alone is not an adequate treatment for this disease. For stages II and III disease, there is a trend toward improved disease-free survival with the use of a temporary interstitial implant compared to an intracavitary application

  19. Physics and quality assurance for brachytherapy - Part II: Low dose rate and pulsed dose rate

    International Nuclear Information System (INIS)

    Williamson, Jeffrey F.

    1997-01-01

    Purpose: A number of recent developments have revitalized brachytherapy including remote afterloading, implant optimization, increasing use of 3D imaging, and advances in dose specification and basic dosimetry. However, the core physical principles underlying the classical methods of dose calculation and arrangement of multiple sources remain unchanged. The purpose of this course is to review these principles and their applications to low dose-rate interstitial and intracavitary brachytherapy. Emphasis will be placed upon the classical implant systems along with classical and modern methods of dose specification. The level of presentation is designed for radiation oncology residents and beginning clinical physicists. A. Basic Principles (1) Radium-substitute vs. low-energy sealed sources (2) Dose calculation principles (3) The mysteries of source strength specification revealed: mgRaEq, mCi and air-kerma strength B. Interstitial Brachytherapy (1) Target volume, implanted volume, dose specification in implants and implant optimization criteria (2) Classical implant systems: Manchester Quimby and Paris a) Application of the Manchester system to modern brachytherapy b) Comparison of classical systems (3) Permanent interstitial implants a) Photon energy and half life b) Dose specification and pre-operative planning (4) The alphabet soup of dose specification: MCD (mean central dose), minimum dose, MPD (matched peripheral dose), MPD' (minimum peripheral dose) and DVH (dose-volume histogram) quality indices C. Intracavitary Brachytherapy for Carcinoma of the Cervix (1) Basic principles a) Manchester System: historical foundation of U.S. practice patterns b) Principles of applicator design (2) Dose specification and treatment prescription a) mg-hrs, reference points, ICRU Report 38 reference volume -- Point A dose vs mg-hrs and IRAK (Integrated Reference Air Kerma) -- Tissue volume treated vs mg-hrs and IRAK b) Practical methods of treatment specification and prescription

  20. Physics and quality assurance for brachytherapy - Part II: Low dose rate and pulsed dose rate

    International Nuclear Information System (INIS)

    Williamson, Jeffrey F.

    1996-01-01

    Purpose: A number of recent developments have revitalized brachytherapy including remote afterloading, implant optimization, increasing use of 3D imaging, and advances in dose specification and basic dosimetry. However, the core physical principles underlying the classical methods of dose calculation and arrangement of multiple sources remain unchanged. The purpose of this course is to review these principles and their applications to low dose-rate interstitial and intracavitary brachytherapy. Emphasis will be placed upon the classical implant systems along with classical and modern methods of dose specification. The level of presentation is designed for radiation oncology residents and beginning clinical physicists. A. Basic Principles (1) Radium-substitute vs. low-energy sealed sources (2) Dose calculation principles (3) The mysteries of source strength specification revealed: mgRaEq, mCi and air-kerma strength B. Interstitial Brachytherapy (1) Target volume, implanted volume, dose specification in implants and implant optimization criteria (2) Classical implant systems: Manchester Quimby and Paris a) Application of the Manchester system to modern brachytherapy b) Comparison of classical systems (3) Permanent interstitial implants a) Photon energy and half life b) Dose specification and pre-operative planning (4) The alphabet soup of dose specification: MCD (mean central dose), minimum dose, MPD (matched peripheral dose), MPD' (minimum peripheral dose) and DVH (dose-volume histogram) quality indices C. Intracavitary Brachytherapy for Carcinoma of the Cervix (1) Basic principles a) Manchester System: historical foundation of U.S. practice patterns b) Principles of applicator design (2) Dose specification and treatment prescription a) mg-hrs, reference points, ICRU Report 38 reference volume --Point A dose vs mg-hrs and IRAK (Integrated Reference Air Kerma) --Tissue volume treated vs mg-hrs and IRAK b) Practical methods of treatment specification and prescription

  1. Safety assessment plans for authorization and inspection of radiation sources

    International Nuclear Information System (INIS)

    2002-05-01

    The objective of this TECDOC is to enhance the efficacy, quality and efficiency of the whole regulatory process. It provides advice on good practice administrative procedures for the regulatory process for preparation of applications, granting of authorizations, inspection, and enforcement. It also provides information on the development and use of standard safety assessment plans for authorization and inspection. The plans are intended to be used in conjunction with more detailed advice related to specific practices. In this sense, this TECDOC provides advice on a systematic approach to evaluations of protection and safety while other IAEA Safety Guides assist the user to distinguish between the acceptable and the unacceptable. This TECDOC covers administrative advice to facilitate the regulatory process governing authorization and inspection. It also covers the use of standard assessment and inspection plans and provides simplified plans for the more common, well established uses of radiation sources in medicine and industry, i.e. sources for irradiation facilities, industrial radiography, well logging, industrial gauging, unsealed sources in industry, X ray diagnosis, nuclear medicine, teletherapy and brachytherapy

  2. Safety assessment plans for authorization and inspection of radiation sources

    International Nuclear Information System (INIS)

    1999-09-01

    The objective of this TECDOC is to enhance the efficacy, quality and efficiency of the whole regulatory process. It provides advice on good practice administrative procedures for the regulatory process for preparation of applications, granting of authorizations, inspection, and enforcement. It also provides information on the development and use of standard safety assessment plans for authorization and inspection. The plans are intended to be used in conjunction with more detailed advice related to specific practices. In this sense, this TECDOC provides advice on a systematic approach to evaluations of protection and safety while other IAEA Safety Guides assist the user to distinguish between the acceptable and the unacceptable. This TECDOC covers administrative advice to facilitate the regulatory process governing authorization and inspection. It also covers the use of standard assessment and inspection plans and provides simplified plans for the more common, well established uses of radiation sources in medicine and industry, i.e. sources for irradiation facilities, industrial radiography, well logging, industrial gauging, unsealed sources in industry, X ray diagnosis, nuclear medicine, teletherapy and brachytherapy

  3. Paddle-based rotating-shield brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yunlong; Xu, Weiyu [Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center, Iowa City, Iowa 52242 (United States); Flynn, Ryan T.; Kim, Yusung; Bhatia, Sudershan K.; Buatti, John M. [Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States); Dadkhah, Hossein [Department of Biomedical Engineering, University of Iowa, 1402 Seamans Center, Iowa City, Iowa 52242 (United States); Wu, Xiaodong, E-mail: xiaodong-wu@uiowa.edu [Department of Electrical and Computer Engineering, University of Iowa, 4016 Seamans Center, Iowa City, Iowa 52242 and Department of Radiation Oncology, University of Iowa, 200 Hawkins Drive, Iowa City, Iowa 52242 (United States)

    2015-10-15

    Purpose: The authors present a novel paddle-based rotating-shield brachytherapy (P-RSBT) method, whose radiation-attenuating shields are formed with a multileaf collimator (MLC), consisting of retractable paddles, to achieve intensity modulation in high-dose-rate brachytherapy. Methods: Five cervical cancer patients using an intrauterine tandem applicator were considered to assess the potential benefit of the P-RSBT method. The P-RSBT source used was a 50 kV electronic brachytherapy source (Xoft Axxent™). The paddles can be retracted independently to form multiple emission windows around the source for radiation delivery. The MLC was assumed to be rotatable. P-RSBT treatment plans were generated using the asymmetric dose–volume optimization with smoothness control method [Liu et al., Med. Phys. 41(11), 111709 (11pp.) (2014)] with a delivery time constraint, different paddle sizes, and different rotation strides. The number of treatment fractions (fx) was assumed to be five. As brachytherapy is delivered as a boost for cervical cancer, the dose distribution for each case includes the dose from external beam radiotherapy as well, which is 45 Gy in 25 fx. The high-risk clinical target volume (HR-CTV) doses were escalated until the minimum dose to the hottest 2 cm{sup 3} (D{sub 2cm{sup 3}}) of either the rectum, sigmoid colon, or bladder reached their tolerance doses of 75, 75, and 90 Gy{sub 3}, respectively, expressed as equivalent doses in 2 Gy fractions (EQD2 with α/β = 3 Gy). Results: P-RSBT outperformed the two other RSBT delivery techniques, single-shield RSBT (S-RSBT) and dynamic-shield RSBT (D-RSBT), with a properly selected paddle size. If the paddle size was angled at 60°, the average D{sub 90} increases for the delivery plans by P-RSBT on the five cases, compared to S-RSBT, were 2.2, 8.3, 12.6, 11.9, and 9.1 Gy{sub 10}, respectively, with delivery times of 10, 15, 20, 25, and 30 min/fx. The increases in HR-CTV D{sub 90}, compared to D-RSBT, were 16

  4. Interstitial prostate brachytherapy. LDR-PDR-HDR

    International Nuclear Information System (INIS)

    Kovacs, Gyoergy; Hoskin, Peter

    2013-01-01

    The first comprehensive overview of interstitial brachytherapy for the management of local or locally advanced prostate cancer. Written by an interdisciplinary team who have been responsible for the successful GEC-ESTRO/EAU Teaching Course. Discusses in detail patient selection, the results of different methods, the role of imaging, and medical physics issues. Prostate brachytherapy has been the subject of heated debate among surgeons and the proponents of the various brachytherapy methods. This very first interdisciplinary book on the subject provides a comprehensive overview of innovations in low dose rate (LDR), high dose rate (HDR), and pulsed dose rate (PDR) interstitial brachytherapy for the management of local or locally advanced prostate cancer. In addition to detailed chapters on patient selection and the use of imaging in diagnostics, treatment guidance, and implantation control, background chapters are included on related medical physics issues such as treatment planning and quality assurance. The results obtained with the different treatment options and the difficult task of salvage treatment are fully discussed. All chapters have been written by internationally recognized experts in their fields who for more than a decade have formed the teaching staff responsible for the successful GEC-ESTRO/EAU Prostate Brachytherapy Teaching Course. This book will be invaluable in informing residents and others of the scientific background and potential of modern prostate brachytherapy. It will also prove a useful source of up-to-date information for those who specialize in prostate brachytherapy or intend to start an interstitial brachytherapy service.

  5. Radium organisation and radiation protection

    International Nuclear Information System (INIS)

    Goyal, D.R.; Negi, P.S.; Dutta, T.K.; Gupta, B.D.

    1977-01-01

    In India, the brachytherapy sources used are mostly 226 Ra, 137 Cs and 60 CO. Radiotherapy of patients with these sources may also result in some degree of radiation exposure of radiologists, technologists, radiation source porters and even other workers in rooms around radiotherapy unit. Proper organization of radiotherapy unit leads to accuracy in treatment and protection to patients as well as medical and paramedical personnel. With this objective in view, a set of instructions to be followed while working with radiation sources, particularly radium; guidelines for the physical layout of the unit and staffing and a list of essential monitoring instruments are given. (M.G.B.)

  6. Oncentra brachytherapy planning system.

    Science.gov (United States)

    Yang, Jack

    2018-03-27

    In modern cancer management, treatment planning has progressed as a contemporary tool with all the advances in computing power in recent years. One of the advanced planning tools uses 3-dimensional (3D) data sets for accurate dose distributions in patient prescription. Among these planning processes, brachytherapy has been a very important part of a successful cancer management program, offering clinical benefits with specific or combined treatments with external beam therapy. In this chapter, we mainly discussed the Elekta Oncentra planning system, which is the main treatment planning tool for high-dose rate (HDR) modality in our facility and in many other facilities in the United States. HDR is a technically advanced form of brachytherapy; a high-intensity radiation source (3.6 mm in length) is delivered with step motor in submillimeter precision under computer guidance directly into the tumor areas while minimizing injury to surrounding normal healthy tissue. Oncentra planning is the key component to generate a deliverable brachytherapy procedure, which is executed on the microSelectron V3 remote afterloader treatment system. Creating a highly conformal plan can be a time-consuming task. The development of Oncentra software (version 4.5.3) offers a variety of useful tools that facilitate many of the clinical challenging tasks for planning, such as contouring and image reconstruction, as well as rapid planning calculations with dose and dose volume histogram analysis. Oncentra Brachy module creates workflow and optimizes the planning accuracy for wide varieties of clinical HDR treatments, such as skin, gynecologic (GYN), breast, prostate, and many other applications. The treatment file can also be transferred to the afterloader control station for speedy delivery. The design concept, calculation algorithms, and optimization modules presented some key characteristics to plan and treat the patients effectively and accurately. The dose distribution and accuracy of

  7. An overview of interstitial brachytherapy and hyperthermia

    International Nuclear Information System (INIS)

    Brandt, B.B.; Harney, J.

    1989-01-01

    Interstitial thermoradiotherapy, an experimental cancer treatment that combines interstitial radiation implants (brachytherapy) and interstitial hyperthermia, is in the early stages of investigation. In accordance with the procedure used in a current national trial protocol, a 60-minute hyperthermia treatment is administered after catheters are placed into the tumor area while the patient is under general anesthesia. This is immediately followed by loading of radioactive Iridium-192 seeds into the catheters for a defined period of time. Once the prescribed radiation dose is delivered, the radioactive sources are removed and a second, 60-minute hyperthermia treatment is administered. Clinical trials with hyperthermia in combination with radiation have increased in recent years. Nurses caring for these patients need to become more knowledgeable about this investigational therapy. This paper provides an overview of the biologic rationale for this therapy, as well as a description of the delivery method and clinical application. Specific related nursing interventions are defined in a nursing protocol.23 references

  8. Protocol-based image-guided salvage brachytherapy. Early results in patients with local failure of prostate cancer after radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Lahmer, G.; Lotter, M.; Kreppner, S.; Fietkau, R.; Strnad, V. [University Hospital Erlangen (Germany). Dept. of Radiation Oncology

    2013-08-15

    Purpose: To assess the overall clinical outcome of protocol-based image-guided salvage pulsed-dose-rate brachytherapy for locally recurrent prostate cancer after radiotherapy failure particularly regarding feasibility and side effects. Patients and methods: Eighteen consecutive patients with locally recurrent prostate cancer (median age, 69 years) were treated during 2005-2011 with interstitial PDR brachytherapy (PDR-BT) as salvage brachytherapy after radiotherapy failure. The treatment schedule was PDR-BT two times with 30 Gy (pulse dose 0.6 Gy/h, 24 h per day) corresponding to a total dose of 60 Gy. Dose volume adaptation was performed with the aim of optimal coverage of the whole prostate (V{sub 100} > 95 %) simultaneously respecting the protocol-based dose volume constraints for the urethra (D{sub 0.1} {sub cc} < 130 %) and the rectum (D{sub 2} {sub cc} < 50-60 %) taking into account the previous radiation therapy. Local relapse after radiotherapy (external beam irradiation, brachytherapy with J-125 seeds or combination) was confirmed mostly via choline-PET and increased PSA levels. The primary endpoint was treatment-related late toxicities - particularly proctitis, anal incontinence, cystitis, urinary incontinence, urinary frequency/urgency, and urinary retention according to the Common Toxicity Criteria. The secondary endpoint was PSA-recurrence-free survival. Results: We registered urinary toxicities only. Grade 2 and grade 3 toxicities were observed in up to 11.1 % (2/18) and 16.7 % (3/18) of patients, respectively. The most frequent late-event grade 3 toxicity was urinary retention in 17 % (3/18) of patients. No late gastrointestinal side effects occurred. The biochemical PSA-recurrence-free survival probability at 3 years was 57.1 %. The overall survival at 3 years was 88.9 %; 22 % (4/18) of patients developed metastases. The median follow-up time for all patients after salvage BT was 21 months (range, 8-77 months). Conclusion: Salvage PDR-brachytherapy

  9. Clinical experience with the MammoSite[reg] radiation therapy system for brachytherapy of breast cancer: Results from an international phase II trial

    International Nuclear Information System (INIS)

    Niehoff, Peter; Polgar, Csaba; Ostertag, Horst; Major, Tibor; Sulyok, Zoltan; Kimmig, Bernhard; Kovacs, Gyoergy

    2006-01-01

    Background and purpose: In a prospective multi-center phase II trial, we investigated the MammoSite[reg] Radiation Therapy System, a new device for delivering intracavitary brachytherapy following breast conserving surgery. The MammoSite[reg] is a dual lumen, closed ended catheter with a small, spherical inflatable balloon and a port for connecting a remote afterloader to the central lumen. We analyzed the surgical procedure and placement of the MammoSite[reg], treatment planning and radiation delivery complications and cosmesis, as well the comfort for the patients. Patients and methods: Between 2002 and 2004 a total of 32 patients (pts) were implanted using the MammoSite[reg]. The reference isodose was defined 1 cm from the balloon surface. We analyzed the post-implant anatomic position of the applicator and the geometric form of the balloon via ultrasound, CT and X-ray, related side effects, cosmetic outcome and patient quality of life. Results: Twenty-three out of 32 patients (72%) were eligible for MammoSite[reg] intracavitary brachytherapy. Twenty-eight percentage had to be excluded because of different reasons. Eleven patients were treated with primary brachytherapy with a total dose of 34 Gy (2x3.4 Gy) and 12 had a boost with a mean dose of 13.3 Gy (range: 7.5-15 Gy; 2x2.5 Gy) combined with EBRT and doses ranged between 46 and 50 Gy. In three cases a balloon rupture occurred. We observed two abscesses within 3 months of implantation and serious seroma development in 10 patients (39%). Skin related side effects were erythema in 21 patients (91%), hyperpigmentation in 13 patients (56%) and teleangiectasia in six patients (26%) after mean follow-up 20 months. Conclusions: The MammoSite[reg] Radiation Therapy System is a feasible treatment modality for intracavitary brachytherapy of breast cancer after breast conserving surgery. The advantage of the system is only one applicator is necessary for the delivery of a fractionated radiotherapy. In addition, patient

  10. WE-A-17A-02: BEST IN PHYSICS (THERAPY) - Development of a Calorimeter for the Measurement of the Power Emitted From LDR Brachytherapy Sources

    Energy Technology Data Exchange (ETDEWEB)

    Malin, M; Palmer, B; DeWerd, L [University of WI-Madison, Madison, WI (United States)

    2014-06-15

    Purpose: Model-based dose calculation algorithms for brachytherapy sources are designed to compute dose per particle or dose per unit energy leaving the encapsulation of a brachytherapy source. As such, the power leaving the encapsulation of a source, called emitted power (EP), would be a natural source strength metric for these new algorithms. However, no instrument is currently capable of an absolute measurement of EP. A calorimeter operating with a liquid helium thermal sink was designed and constructed to measure the EP of low-dose rate (LDR) I-125 and Pd-103 brachytherapy sources. Methods: Calorimeter design was optimized through thermal and Monte Carlo (MC) modeling. Thermal modeling showed that specific thermal conditions would be necessary for accurate calorimeter measurements. These conditions were experimentally verified. The EP of two LDR I-125 source models was measured. An air-kermastrength (AKS)-to-EP conversion coefficient was determined through MC simulations and applied to well-type ionization chamber measurements of AKS to enable comparison with EP measurements. Results: MCdetermined EP per unit AKS conversion coefficients were source model dependent and are on the order of 0.1 μW/U. The signal-to-noise ratio was a function of source strength, and was 294 for a 0.5 μW source. Measurements were repeatable to within 3.6% for a 0.5 μW source. Initial EP measurements were made with two I-125 source models, a 5.7 U Oncura 6711 and a 2.9 U Best Medical 2301. Model 2301 results agreed with the MC-converted AKS value to within the measurement uncertainty of 4.3% at k=1. The Model 6711 results were systematically high and are under investigation. Conclusion: A calorimeter was designed to provide an absolute measurement of the EP for LDR brachytherapy sources and preliminary EP measurements have been made. This new calorimeter design shows promise of providing a more fundamentally useful source strength standard.

  11. Investigation of source position uncertainties & balloon deformation in MammoSite brachytherapy on treatment effectiveness

    International Nuclear Information System (INIS)

    Bensaleh, S.

    2010-01-01

    The MammoSite ® breast high dose rate brachytherapy is used in treatment of early-stage breast cancer. The tumour bed volume is irradiated with high dose per fraction in a relatively small number of fractions. Uncertainties in the source positioning and MammoSite balloon deformation will alter the prescribed dose within the treated volume. They may also expose the normal tissues in balloon proximity to excessive dose. The purpose of this work is to explore the impact of these two uncertainties on the MammoSite dose distribution in the breast using dose volume histograms and Monte Carlo simulations. The Lyman–Kutcher and relative seriality models were employed to estimate the normal tissues complications associated with the MammoSite dose distributions. The tumour control probability was calculated using the Poisson model. This study gives low probabilities for developing heart and lung complications. The probability of complications of the skin and normal breast tissues depends on the location of the source inside the balloon and the volume receiving high dose. Incorrect source position and balloon deformation had significant effect on the prescribed dose within the treated volume. A 4 mm balloon deformation resulted in reduction of the tumour control probability by 24%. Monte Carlo calculations using EGSnrc showed that a deviation of the source by 1 mm caused approximately 7% dose reduction in the treated target volume at 1 cm from the balloon surface. In conclusion, accurate positioning of the 192 Ir source at the balloon centre and minimal balloon deformation are critical for proper dose delivery with the MammoSite brachytherapy applicator. On the basis of this study, we suggest that the MammoSite treatment protocols should allow for a balloon deformation of ≤2 mm and a maximum source deviation of ≤1 mm.

  12. Brachytherapy in the treatment of head and neck cancer

    International Nuclear Information System (INIS)

    Yoo, Seong Yul

    1999-01-01

    Brachytherapy has been proved to be an effective method for the purpose of increasing radiation dose to the tumor and reducing the dose to the surrounding normal tissue. In head and neck cancer, the rationale of brachytherapy is as follows; Firstly, early small lesion is radiocurative and the major cause of failure is local recurrence. Secondly, it can diminish evidently the dose to the normal tissue especially masseteric muscle and salivary gland. Thirdly, the anatomy of head and neck is suitable to various technique of brachytherapy. On background of accumulated experience of LDR iridium brachytherapy of head and neck cancer for the last 15 years, the author reviewed the history of radioisotope therapy, the characteristics of radionuclides, and some important things in the method, clinical technique and treatment planning. The author analyzed the clinical result of 185 cases of head and neck cancer treated in the Korea Cancer Center Hospital. Finally the future prospect of brachytherapy of head and neck cancer is discussed

  13. Effect of brachytherapy technique and patient characteristics on cervical cancer implant dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Anker, Christopher J., E-mail: chris.anker@hci.utah.edu [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT (United States); O' Donnell, Kristen [Department of Radiation Oncology, The University of Arizona, Tucson, AZ (United States); Boucher, Kenneth M. [Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT (United States); Gaffney, David K. [Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT (United States)

    2013-01-01

    Our purpose was to evaluate the relationship between brachytherapy technique and patient characteristics on dose to organs-at-risk (OARs) in patients undergoing high dose rate (HDR) brachytherapy for cervical cancer. From 1998 to 2008, 31 patients with cervical cancer with full dosimetric data were identified who received definitive external-beam radiation and HDR brachytherapy with tandem and ovoid applicators. Doses were recorded at point A, the International Commission on Radiation Units and Measurements (ICRU)-38 rectal point, the ICRU-38 bladder point, the vaginal surface, and the pelvic sidewall. Generalized estimating equations were used to determine the significance of changes in OAR to point A dose ratios with differences in brachytherapy technique or patient characteristics. Patients underwent a median of 5 brachytherapy procedures (range, 3 to 5), with a total of 179 procedures for 31 patients. For all brachytherapy treatments, the average ratios between the doses for the rectal, bladder, vaginal surface, and pelvic sidewall reference points to those at point A were 0.49, 0.59, 1.15, and 0.17, respectively. In general, decreased OAR dose was associated with a lower stage, younger age, increased ovoid size, increased tandem length, and earlier implant number. Increased tandem curvature significantly increased bladder dose and decreased rectal dose. Intravenous anesthesia usage was not correlated with improved dosimetry. This study allowed identification of patient and procedure characteristics influencing OAR dosing. Although the advent of 3-dimensional (3D) image-guided brachytherapy will bring new advances in treatment optimization, the actual technique involved at the time of the brachytherapy implant procedure will remain important.

  14. Balloon brachytherapy for brain tumor-radiation safety experiences at the University of Medicine and Dentistry of New Jersey.

    Science.gov (United States)

    Lanka, Venkata K

    2006-11-01

    Balloon brachytherapy is a technique for the removal of a brain tumor in which an inflatable balloon is placed in a resection cavity and then filled with liquid I, delivering low energy dose to the cancerous cells surrounding the cavity. After preparing a patient room to mitigate any spills or contamination, liquid 125I (Iotrex) was assayed with a dose calibrator and injected into the balloon placed in the patient's brain. Approximately 98.6% of the isotope was recovered at the end of the procedure. Approximately 1.4% remained unrecovered and is assumed to have diffused through the balloon membrane. Each day, the patient's urine was collected and the total urine activity measured was less than 7% of the unrecovered activity. The remainder of the unrecovered activity was not evaluated. It was assumed to be distributed in the patient's body, and a tiny quantity of liquid spilled from an IV line while injecting. Training was conducted for radiation oncologists, neurosurgeons, and participating residents regarding balloon brachytherapy radiation safety precautions. Precautions during treatment included safe handling of body fluids. General radiation safety precautions and nursing care instructions were posted on the patient door. Air monitoring was conducted to detect any airborne iodine. At the time of balloon removal, the radiation safety department monitored the operating room and staff for contamination. Waste, including the balloon, was held for decay on site prior to disposal.

  15. Predictive factors for acute and late urinary toxicity after permanent interstitial brachytherapy in Japanese patients

    International Nuclear Information System (INIS)

    Tanimoto, Ryuta; Bekku, Kensuke; Katayama, Norihisa

    2013-01-01

    The objectives of this study were to describe the frequency of and to determine predictive factors associated with Radiation Therapy Oncology Group urinary toxicity in prostate brachytherapy patients. From January 2004 to April 2011, 466 consecutive Japanese patients underwent permanent iodine-125-seed brachytherapy (median follow up 48 months). International Prostate Symptom Score and Radiation Therapy Oncology Group toxicity data were prospectively collected. Prostate volume, International Prostate Symptom Score before and after brachytherapy, and postimplant analysis were examined for an association with urinary toxicity, defined as Radiation Therapy Oncology Group urinary toxicity of Grade 1 or higher. Logistic regression analysis was used to examine the factors associated with urinary toxicity. The rate of Radiation Therapy Oncology Group urinary toxicity grade 1 or higher at 1, 6, 12, 24, 36 and 48 months was 67%, 40%, 21%, 31%, 27% and 28%, respectively. Grade 2 or higher urinary toxicity was less than 1% at each time-point. International Prostate Symptom Score was highest at 3 months and returned to normal 12 months after brachytherapy. On multivariate analysis, patients with a larger prostate size, greater baseline International Prostate Symptom Score, higher prostate V100, higher prostate V150, higher prostate D90 and a greater number of seeds had more acute urinary toxicities at 1 month and 12 months after brachytherapy. On multivariate analysis, significant predictors for urinary toxicity at 1 month and 12 months were a greater baseline International Prostate Symptom Score and prostate V100. Most urinary symptoms are tolerated and resolved within 12 months after prostate brachytherapy. Acute and late urinary toxicity after brachytherapy is strongly related to the baseline International Prostate Symptom Score and prostate V100. (author)

  16. Development of a irradiator for brachytherapy: preliminary evaluation of accuracy and repeatability; Desenvolvimento de um irradiador para braquiterapia: avaliacao preliminar de precisao e repetibilidade

    Energy Technology Data Exchange (ETDEWEB)

    Damaso, Renato S.; Campos, Tarcisio P.R. [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Dept. de Engenharia Nuclear]. E-mail: damaso@nuclear.ufmg.br; campos@nuclear.ufmg.br

    2000-07-01

    Brachytherapy is a technique of treatment for cancer which that provides the placement of sources near the tumor region, reducing the exposure of healthy regions. We are developing a project of a irradiator that move several discrete gamma sources assembled on the extremity of flexible shafts. The irradiator has the capacity to achieve the individual placement of the sources automatically, reducing the radiation exposure of the clinical body. The equipment is constituted by a mechanic body which produces the displacement of the shafts, a shielding cylinder repository of sources and electronic system of monitoring and control. The present work illustrates the use of the equipment to simulate the placement of sources foreseen in clinical treatment for cancer by intracavitary or interstitial brachytherapy. Precision and repeatability of placement will be discussed. (author)

  17. Utilization and Outcomes of Breast Brachytherapy in Younger Women

    International Nuclear Information System (INIS)

    Smith, Grace L.; Huo, Jinhai; Giordano, Sharon H.; Hunt, Kelly K.; Buchholz, Thomas A.; Smith, Benjamin D.

    2015-01-01

    Purpose: To directly compare (1) radiation treatment utilization patterns; (2) risks of subsequent mastectomy; and (3) costs of radiation treatment in patients treated with brachytherapy versus whole-breast irradiation (WBI), in a national, contemporary cohort of women with incident breast cancer, aged 64 years and younger. Methods and Materials: Using MarketScan health care claims data, we identified 45,884 invasive breast cancer patients (aged 18-64 years), treated from 2003 to 2010 with lumpectomy, followed by brachytherapy (n=3134) or whole-breast irradiation (n=42,750). We stratified patients into risk groups according to age (Age<50 vs Age≥50) and endocrine therapy status (Endocrine− vs Endocrine+). “Endocrine+” patients filled an endocrine therapy prescription within 1 year after lumpectomy. Pathologic hormone receptor status was not available in this dataset. In brachytherapy versus WBI patients, utilization trends and 5-year subsequent mastectomy risks were compared. Stratified, adjusted subsequent mastectomy risks were calculated using proportional hazards regression. Results: Brachytherapy utilization increased from 2003 to 2010: in patients Age<50, from 0.6% to 4.9%; patients Age≥50 from 2.2% to 11.3%; Endocrine− patients, 1.3% to 9.4%; Endocrine+ patients, 1.9% to 9.7%. Age influenced treatment selection more than endocrine status: 17% of brachytherapy patients were Age<50 versus 32% of WBI patients (P<.001); whereas 41% of brachytherapy patients were Endocrine–versus 44% of WBI patients (P=.003). Highest absolute 5-year subsequent mastectomy risks occurred in Endocrine−/Age<50 patients (24.4% after brachytherapy vs 9.0% after WBI (hazard ratio [HR] 2.18, 95% confidence interval [CI] 1.37-3.47); intermediate risks in Endocrine−/Age≥50 patients (8.6% vs 4.9%; HR 1.76, 95% CI 1.26-2.46); and lowest risks in Endocrine+ patients of any age: Endocrine+/Age<50 (5.5% vs 4.5%; HR 1.18, 95% CI 0.61-2.31); Endocrine+/Age≥50 (4.2% vs 2

  18. Utilization and Outcomes of Breast Brachytherapy in Younger Women

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Grace L. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Huo, Jinhai [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Giordano, Sharon H. [Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hunt, Kelly K. [Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Buchholz, Thomas A. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Smith, Benjamin D., E-mail: bsmith3@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2015-09-01

    Purpose: To directly compare (1) radiation treatment utilization patterns; (2) risks of subsequent mastectomy; and (3) costs of radiation treatment in patients treated with brachytherapy versus whole-breast irradiation (WBI), in a national, contemporary cohort of women with incident breast cancer, aged 64 years and younger. Methods and Materials: Using MarketScan health care claims data, we identified 45,884 invasive breast cancer patients (aged 18-64 years), treated from 2003 to 2010 with lumpectomy, followed by brachytherapy (n=3134) or whole-breast irradiation (n=42,750). We stratified patients into risk groups according to age (Age<50 vs Age≥50) and endocrine therapy status (Endocrine− vs Endocrine+). “Endocrine+” patients filled an endocrine therapy prescription within 1 year after lumpectomy. Pathologic hormone receptor status was not available in this dataset. In brachytherapy versus WBI patients, utilization trends and 5-year subsequent mastectomy risks were compared. Stratified, adjusted subsequent mastectomy risks were calculated using proportional hazards regression. Results: Brachytherapy utilization increased from 2003 to 2010: in patients Age<50, from 0.6% to 4.9%; patients Age≥50 from 2.2% to 11.3%; Endocrine− patients, 1.3% to 9.4%; Endocrine+ patients, 1.9% to 9.7%. Age influenced treatment selection more than endocrine status: 17% of brachytherapy patients were Age<50 versus 32% of WBI patients (P<.001); whereas 41% of brachytherapy patients were Endocrine–versus 44% of WBI patients (P=.003). Highest absolute 5-year subsequent mastectomy risks occurred in Endocrine−/Age<50 patients (24.4% after brachytherapy vs 9.0% after WBI (hazard ratio [HR] 2.18, 95% confidence interval [CI] 1.37-3.47); intermediate risks in Endocrine−/Age≥50 patients (8.6% vs 4.9%; HR 1.76, 95% CI 1.26-2.46); and lowest risks in Endocrine+ patients of any age: Endocrine+/Age<50 (5.5% vs 4.5%; HR 1.18, 95% CI 0.61-2.31); Endocrine+/Age≥50 (4.2% vs 2

  19. Dosimetry in high dose rate endoluminal brachytherapy

    International Nuclear Information System (INIS)

    Uno, Takashi; Kotaka, Kikuo; Itami, Jun

    1994-01-01

    In endoluminal brachytherapy for the tracheobronchial tree, esophagus, and bile duct, a reference point for dose calculation has been often settled at 1 cm outside from the middle of source travel path. In the current study, a change in the ratio of the reference point dose on the convex to concave side (Dq/Dp) was calculated, provided the source travel path bends as is the case in most endoluminal brachytherapies. Point source was presumed to move stepwise at 1 cm interval from 4 to 13 locations. Retention time at each location was calculated by personal computer so as to deliver equal dose at 1 cm from the linear travel path. With the retention time remaining constant, the change of Dq/Dp was assessed by bending the source travel path. Results indicated that the length of the source travel path and radius of its curve influenced the pattern of change in Dq/Dp. Therefore, it was concluded that the difference in reference dose on the convex and concave side of the curved path is not negligible under certain conditions in endoluminal brachytherapy. In order to maintain the ratio more than 0.9, relatively greater radius was required when the source travel path was decreased. (author)

  20. Radiotherapy and brachytherapy

    International Nuclear Information System (INIS)

    2007-02-01

    This presentation first defines the radiotherapy and brachytherapy techniques, indicates the used ionizing radiations (electromagnetic and particles), describes the mechanisms and processes of action of ionizing radiations: they can be physical by photon-matter interactions (Compton effect and photoelectric effect) or due to electron-matter interactions (excitation, ionization), physical-chemical by direct or indirect action (DNA damage), cellular (mitotic or apoptotic death), tissue (sane and tumorous tissues and differential effect). It discusses the biological efficiency of these treatments which depends on different parameters: intrinsic radio-sensitivity, time (session fractioning and organisation in time), oxygen, radiation quality, cellular cycle, dose rate, temperature. It presents the different types of radiotherapy: external radiotherapy (general sequence, delineation, dosimetry, protection of critical organs, treatment session, quality control, monitoring consultation) and briefly presents some specific techniques (total body irradiation, total cutaneous electron therapy, pre-operation radiotherapy, radio-surgery, hadron-therapy). It proposes an overview of the main indications for this treatment: brain tumours, upper aero digestive tract tumours, bronchial tumours, oesophagus, stomach and pancreas tumours, breast tumours, cervix cancer, rectum tumour, and so on, and indicates the possible associated treatments. The next part addresses brachytherapy. It presents the principles and comments the differences with radiotherapy. It indicates the used radio-elements (Caesium 137, Iridium 192, Iodine 125), describes the implementation techniques (plastic tubes, use of iodine 125, intracavitary and endo-luminal radiation therapy). It proposes an overview of the different treated tumours (skin, breast, prostates, bronchial, oesophagus, ENT) and indicates possible early and late secondary effects for different organs

  1. Mechanical Design of the Radio-Isotope Source Driver Module for an Initial Prototype of Medium Dose Rate Brachytherapy

    International Nuclear Information System (INIS)

    Ari Satmoko; Tri Harjanto; Hendra Prasetia

    2012-01-01

    High dose rate brachytherapy equipment for therapy against cervical cancer is developed by empowering local products. An Iridium-192 with 5 Curies of energy is used. The source is wrapped in a capsule and combined with a wire diameter of 1 mm and length 1800 mm. The therapy is carried out by inserting the radiation source into the patient's body through an applicator. The system for loading-unloading the isotope source is divided into three modules: the source driver module, the source container modules, and channel distributor module. In this paper, the discussion is focused on engineering activities of the first module that serves to drive forward and backward position of the Iridium-192 isotope sources. The activity begins with the development of preliminary design sketches that produces drawings of mechanical components required. Furthermore, the calculations are carried out in order to establish the main component specifications. From this stage, a stepper motor type M66-A50K-G10 as a mechanical driver is chosen. The next stage is developing the detailed design and producing detailed drawings for all components. The fabrication of each component refers to the detailed design drawings. All components are assembled completely into the source driver module. Test also shows that the module works manually well. By rotating the manual handle in both directions, the tip of the wire moves alternately in forward and backward directions. (author)

  2. Evaluation of the response of polymeric gel modified MAGIC-f using a clinical brachytherapy source and Monte Carlo simulation with package PENELOPE; Avaliacao da resposta do gel polimerico MAGIC-f modificado utilizando uma fonte clinica de braquiterapia e simulacao Monte Carlo com o pacote PENELOPE

    Energy Technology Data Exchange (ETDEWEB)

    Quevedo, Ana Luiza; Nicolucci, Patricia [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Filosofia Ciencias e Letras. Dept. de Fisica; Borges, Leandro F. [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Hospital das Clinicas. Setor de Radioterapia

    2016-07-01

    In this work a comparison of experimental and simulated relative doses of a clinical brachytherapy source was performed. A 5 x 5 x 7 cm{sup 3} phantom with a modified MAGIC-f gel was irradiated using a clinical {sup 192}Ir source and read using Magnetic Resonance Imaging. The Monte Carlo simulation package PENELOPE was used to simulate the dose distributions of the same radiation source. The dose distributions were obtained in two planes perpendicular to the source: one passing through the source's center and the other at 0.5 cm away from the source's center. The higher differences found between experimental and computational distributions were 12.5% at a point 0.62 cm from the source for the central plane and 8.6% at 1.3 cm from the source to the plane 0.5 cm away from the source's center. Considering the high dose gradient of these dose distributions, the results obtained show that the modified MAGIC-f gel is promising for brachytherapy dosimetry. (author)

  3. Implementation of microsource high dose rate (mHDR) brachytherapy in developing countries

    International Nuclear Information System (INIS)

    2001-11-01

    Brachytherapy using remote afterloading of a single high dose rate 192 Ir microsource was developed in the 1970s. After its introduction to clinics, this system has spread rapidly among developed Member States and has become a highly desirable modality in cancer treatment. This technique is now gradually being introduced to the developing Member States. The 192 Ir sources are produced with a high specific activity. This results in a high dose rate (HDR) to the tumour and shorter treatment times. The high specific activity simultaneously results in a much smaller source (so-called micro source, around I mm in diameter) which may be easily inserted into tissue through a thin delivery tube, the so-called interstitial treatment, as well as easily inserted into body cavities, the so-called intracavitary or endoluminal treatment. Another advantage is the ability to change dwell time (the time a source remains in one position) of the stepping source which allows dose distribution to match the target volume more closely. The purpose of this TECDOC is to advise radiation oncologists, medical physicists and hospital administrators in hospitals which are planning to introduce 192 Ir microsource HDR (mHDR) remote afterloading systems. The document supplements IAEA-TECDOC-1040, Design and Implementation of a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects, and will facilitate implementation of this new brachytherapy technology, especially in developing countries. The operation of the system, 'how to use the system', is not within the scope of this document. This TECDOC is based on the recommendations of an Advisory Group meeting held in Vienna in April 1999

  4. SU-E-T-564: Multi-Helix Rotating Shield Brachytherapy for Cervical Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Dadkhah, H; Wu, X [University of Iowa, Iowa City, IA (United States); Flynn, R; Kim, Y [University of Iowa Hospitals and Clinics, Iowa City, IA (United States)

    2015-06-15

    Purpose: To present a novel and practical brachytherapy technique, called multi-helix rotating shield brachytherapy (H-RSBT), for the precise positioning of a partial shield in a curved applicator. H-RSBT enables RSBT delivery using only translational motion of the radiation source/shield combination. H-RSBT overcomes the challenges associated with previously proposed RSBT approaches based on a serial (S-RSBT) step-and-shoot delivery technique, which required independent translational and rotational motion. Methods: A Fletcher-type applicator, compatible with the combination of a Xoft Axxent™ electronic brachytherapy source and a 0.5 mm thick tungsten shield, is proposed. The wall of the applicator contains six evenly-spaced helical keyways that rigidly define the emission direction of the shield as a function of depth. The shield contains three protruding keys and is attached to the source such that it rotates freely. S-RSBT and H-RSBT treatment plans with 180° and 45° azimuthal emission angles were generated for five cervical cancer patients representative of a wide range of high-risk clinical target volume (HR-CTV) shapes and applicator positions. The number of beamlets used in the treatment planning process was nearly constant for S-RSBT and H-RSBT by using dwell positions separated by 5 and 1.7 mm, respectively, and emission directions separated by 22.5° and 60°, respectively. For all the treatment plans the EQD2 of the HR-CTV was escalated until the EQD{sub 2cc} tolerance of either the bladder, rectum, or sigmoid colon was reached. Results: Treatment times for H-RSBT tended to be shorter than for S-RSBT, with changes of −38.47% to 1.12% with an average of −8.34%. The HR-CTV D{sub 90} changed by −8.81% to 2.08% with an average of −2.46%. Conclusion: H-RSBT is a mechanically feasible technique in the curved applicators needed for cervical cancer brachytherapy. S-RSBT and H-RSBT dose distributions were clinically equivalent for all patients

  5. Evaluation of Wall Correction Factor of INER's Air-Kerma Primary Standard Chamber and Dose Variation by Source Displacement for HDR 192Ir Brachytherapy

    Directory of Open Access Journals (Sweden)

    J. H. Lee

    2013-01-01

    Full Text Available The aim of the present study was to estimate the wall effect of the self-made spherical graphite-walled cavity chamber with the Monte Carlo method for establishing the air-kerma primary standard of high-dose-rate (HDR 192Ir brachytherapy sources at the Institute of Nuclear Energy Research (INER, Taiwan. The Monte Carlo method established in this paper was also employed to respectively simulate wall correction factors of the 192Ir air-kerma standard chambers used at the National Institute of Standards and Technology (NIST, USA and the National Physical Laboratory (NPL, UK for comparisons and verification. The chamber wall correction calculation results will be incorporated into INER's HDR 192Ir primary standard in the future. For the brachytherapy treatment in the esophagus or in the bronchi, the position of the isotope may have displacement in the cavity. Thus the delivered dose would differ from the prescribed dose in the treatment plan. We also tried assessing dose distribution due to the position displacement of HDR 192Ir brachytherapy source in a phantom with a central cavity by the Monte Carlo method. The calculated results could offer a clinical reference for the brachytherapy within the human organs with cavity.

  6. Results of the intestitial brachytherapy and of the combination external radiation-brachytherapy in 150 patients with carcinoma of the oral tongue and floor of the mouth

    Energy Technology Data Exchange (ETDEWEB)

    Sannazzari, G L; Negri, G L; Ozzello, F

    1986-01-01

    The authors report their experience on the treatment of carcinoma of the oral tongue and floor of the mouth with interstitial brachytherapy, alone or in conbination with external irradiation. One hundred and fifty patients were treated; among these, 116 with brachytherapy alone, 34 with combined treatment. The five years local control in those patients treated with brachytherapy alone was 72.5% in T1, 61.2% in T2 and 35% in T3; in those patients treated with external irradiation and brachytherapy the global five years control was 42.5%. The global five years survival was 64% in the patients treated with brachytherapy alone 48% in the patients treated with combined therapy. 42 refs.

  7. Results of the intestitial brachytherapy and of the combination external radiation-brachytherapy in 150 patients with carcinoma of the oral tongue and floor of the mouth

    International Nuclear Information System (INIS)

    Sannazzari, G.L.; Negri, G.L.; Ozzello, F.

    1986-01-01

    The authors report their experience on the treatment of carcinoma of the oral tongue and floor of the mouth with interstitial brachytherapy, alone or in conbination with external irradiation. One hundred and fifty patients were treated; among these, 116 with brachytherapy alone, 34 with combined treatment. The five years local control in those patients treated with brachytherapy alone was 72.5% in T1, 61.2% in T2 and 35% in T3; in those patients treated with external irradiation and brachytherapy the global five years control was 42.5%. The global five years survival was 64% in the patients treated with brachytherapy alone 48% in the patients treated with combined therapy

  8. MO-A-BRB-02: Considerations and Issues in Electronic Charting for Brachytherapy

    International Nuclear Information System (INIS)

    Richardson, S.

    2015-01-01

    The process of converting to an electronic chart for radiation therapy can be daunting. It requires a dedicated committee to first research and choose appropriate software, to review the entire documentation policy and flow of the clinic, to convert this system to electronic form or if necessary, redesign the system to more easily conform to the electronic process. Those making the conversion and those who already use electronic charting would benefit from the shared experience of those who have been through the process in the past. Therefore TG262 was convened to provide guidance on electronic charting for external beam radiation therapy and brachytherapy. This course will present the results of an internal survey of task group members on EMR practices in External Beam Radiation Therapy as well as discuss important issues in EMR development and structure for both EBRT and brachytherapy. Learning Objectives: Be familiarized with common practices and pitfalls in development and maintenance of an electronic chart in Radiation Oncology Be familiarized with important issues related to electronic charting in External Beam Radiation Therapy Be familiarized with important issues related to electronic charting in Brachytherapy

  9. MO-A-BRC-00: TG167: Clinical Recommendations for Innovative Brachytherapy Devices and Applicators

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2016-06-15

    requirements of the U.S. NRC, FDA, Department of Transportation, International Electrotechnical Commission Medical Electrical Equipment Standard 60601, European Commission for CE Marking, and institutional review boards and radiation safety committees. Learning Objectives: Understand the necessary dosimetric considerations for clinical implementation (including calibrations, dose calculations, and radiobiological aspects) to comply with existing societal dosimetric prerequisites for sources in routine clinical use. Evaluate risks and benefits from regulatory and safety perspectives. Identify necessary resources and create a plan for clinical introduction of innovative brachytherapy device or applications. Consultant for Theragenics Corp.; R. Nath, Consultant to Theragenics Corp.

  10. MO-A-BRC-00: TG167: Clinical Recommendations for Innovative Brachytherapy Devices and Applicators

    International Nuclear Information System (INIS)

    2016-01-01

    requirements of the U.S. NRC, FDA, Department of Transportation, International Electrotechnical Commission Medical Electrical Equipment Standard 60601, European Commission for CE Marking, and institutional review boards and radiation safety committees. Learning Objectives: Understand the necessary dosimetric considerations for clinical implementation (including calibrations, dose calculations, and radiobiological aspects) to comply with existing societal dosimetric prerequisites for sources in routine clinical use. Evaluate risks and benefits from regulatory and safety perspectives. Identify necessary resources and create a plan for clinical introduction of innovative brachytherapy device or applications. Consultant for Theragenics Corp.; R. Nath, Consultant to Theragenics Corp.

  11. Three dimensional implementation of anisotropy corrected fast fourier transform dose calculation around brachytherapy seeds

    International Nuclear Information System (INIS)

    Kyeremeh, P.O.

    2011-01-01

    Current-available brachytherapy dose computation algorithms ignore heterogeneities such as tissue-air interfaces, shielded gynaecological colpostats, and tissue-composition variations in source implants despite dose computation errors as large as 40%. A convolution kernel, which takes into consideration anisotropy of the dose distribution around a brachytherapy source, and to compute dose in the presence of tissue and applicator heterogeneities, has been established. Resulting from the convolution kernel are functions with polynomial and exponential terms. the solution to the convolution integral was represented by the Fast Fourier transform. The Fast Fourier transform has shown enough potency in accounting for errors due to these heterogeneities and the versatility of this Fast Fourier transform is evident from its capability of switching in between fields. Thus successful procedures in external beam could be adopted in brachytherapy to a yield similar effect. A dose deposition kernel was developed for a 64x64x64 matrix size with wrap around ordering and convoluted with the distribution of the sources in 3D. With MatLab's inverse Fast Fourier transform, dose rate distribution for a given array of interstitial sources, typical of brachytherapy was calculated. The shape of the dose rate distribution peaks appeared comparable with the output expected from computerized treatment planning systems for brachytherapy. Subsequently, the study confirmed the speed and accuracy of dose computation using the FFT convolution as well juxtaposed. Although, dose rate peaks from both the FFT convolution and the TPS(TG43) did not compare quantitatively, which was mainly due to the TPS(TG43) initiation computations from the origin (0,0,0) unlike the FFT convolution which uses sampling points; N=1,2,3..., there is a strong basis for establishing parity since the dose rate peaks compared qualitatively. With both modes compared, the discrepancies in the dose rates ranged between 3.6% to

  12. Topical application of β-radiation to reduce intimal hyperplasia after carotid artery balloon injury in rabbit A possible application for brachytherapy in vascular surgery

    International Nuclear Information System (INIS)

    Rosenthal, David; Stevens, Scott L.; Skillern, C.S.; Wellons, Eric D.; Robinson, Keith; Matsuura, John H.; Gannon, Brian J.

    2002-01-01

    Purpose: Endovascular brachytherapy for the prevention of intimal hyperplasia (IH) and restenosis after balloon/stent angioplasty has proven effective both in animal preparations and clinical trials. A variety of β-emitting isotopes and catheter-based devices have been developed for the delivery of low-dose radiation in clinical coronary and peripheral trials. No platform, however, has yet been developed for brachytherapy in concert with vascular surgical operations. The purpose of this study was to evaluate the vascular histopathologic response following balloon injury to rabbit carotid arteries with and without topically applied low-dose β-radiation. Methods: The β-emitting isotope strontium-90 (Sr-90) was conjugated onto the matrix of polypropylene (PLYP) mesh. Rabbit carotid arteries were balloon-injured with a no. 2 embolectomy catheter. Six carotid arteries were wrapped with nonradioactive PLYP mesh (controls) and Sr-90 (∼90 μCi) PLYP mesh in order to deliver low-dose radiation to the vessel wall from the external (adventitial) surface. Tissue was harvested at 6 weeks and processed for histologic examination. Results: There was consistent blockade of fibrocellular neointima formation with virtually no neointima present in all treated segments, compared to moderate neointima formation in controls. Medial thinning and smooth muscle cell (SMC) necrosis were also associated with topical brachytherapy. Conclusion: β-Radiation applied by an externally wrapped PLYP mesh labeled with Sr-90 markedly suppressed neointima formation in an animal vascular surgical injury model. Further studies, however, are necessary to determine a suitable isotope and dosage for clinical application

  13. Brachytherapy for oral cancer

    International Nuclear Information System (INIS)

    Monzen, Yoshio; Ajimu, Akira; Morikawa, Minoru; Hayashi, Nobuyuki; Yoshida, Shintarou; Ashizawa, Kazuto; Hayashi, Kuniaki; Ikenaga, Kouji; Sakamoto, Ichirou.

    1988-01-01

    13 cases with oral cancer were treated using brachytherapy at the Department of Radiology, Nagasaki University Hospital from September 1985 to February 1988. Among 11 cases of tongue cancer, T1 and T2 cases were well controlled by radiation therapy using 226 Ra needles. Cancer of oral floor and buccal mucosa were controlled by the use of 192 Au grains. (author)

  14. Determining the distribution of the absorbed dose for a body exposed to Cs-137 using the Monte Carlo method and application in a brachytherapy treatment planning

    International Nuclear Information System (INIS)

    Randriantsizafy, R.D.

    2014-01-01

    Brachytherapy is a means of precise and effective cancer treatment. This is due to the nearby sources of ionizing radiation. The precision and efficiency requires a good dosimetry and a good knowledge of the dose distribution in the patient. The aim is to give the right dose of ionizing radiation to destroy the tumor while reducing the dose to sensitive organs such as the bladder , liver, .... The Monte Carlo is a recognized model method for the distribution of radiation in the material. It is used in this work to determine the doses to organs during treatment planning for Cesium -137 brachytherapy. The programming language used is Python . Library outcome of this work is used in a web application BrachyPy, we designed to replace the manual processing in the Cs-137 brachytherapy planning. Model validation is done by comparing the isodose curves of the model with the isodose curves abacus NUCLETRON and the last report of the American Association of Medical Physics (AAPM) on the amendment to the algorithm TG43. [fr

  15. Simulation evaluation of NIST air-kerma rate calibration standard for electronic brachytherapy.

    Science.gov (United States)

    Hiatt, Jessica R; Rivard, Mark J; Hughes, H Grady

    2016-03-01

    Dosimetry for the model S700 50 kV electronic brachytherapy (eBT) source (Xoft, Inc., a subsidiary of iCAD, San Jose, CA) was simulated using Monte Carlo (MC) methods by Rivard et al. ["Calculated and measured brachytherapy dosimetry parameters in water for the Xoft Axxent x-ray source: An electronic brachytherapy source," Med. Phys. 33, 4020-4032 (2006)] and recently by Hiatt et al. ["A revised dosimetric characterization of the model S700 electronic brachytherapy source containing an anode-centering plastic insert and other components not included in the 2006 model," Med. Phys. 42, 2764-2776 (2015)] with improved geometric characterization. While these studies examined the dose distribution in water, there have not previously been reports of the eBT source calibration methods beyond that recently reported by Seltzer et al. ["New national air-kerma standard for low-energy electronic brachytherapy sources," J. Res. Natl. Inst. Stand. Technol. 119, 554-574 (2014)]. Therefore, the motivation for the current study was to provide an independent determination of air-kerma rate at 50 cm in air K̇air(d=50 cm) using MC methods for the model S700 eBT source. Using CAD information provided by the vendor and disassembled sources, an MC model was created for the S700 eBT source. Simulations were run using the mcnp6 radiation transport code for the NIST Lamperti air ionization chamber according to specifications by Boutillon et al. ["Comparison of exposure standards in the 10-50 kV x-ray region," Metrologia 5, 1-11 (1969)], in air without the Lamperti chamber, and in vacuum without the Lamperti chamber. K̇air(d=50 cm) was determined using the *F4 tally with NIST values for the mass energy-absorption coefficients for air. Photon spectra were evaluated over 2 π azimuthal sampling for polar angles of 0° ≤ θ ≤ 180° every 1°. Volume averaging was averted through tight radial binning. Photon energy spectra were determined over all polar angles in both air and vacuum using

  16. Radiation-Induced Leiomyosarcoma of the Prostate after Brachytherapy for Prostatic Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Hiroto Horiguchi

    2014-08-01

    Full Text Available Radiation therapy (RTx has been employed as a curative therapy for prostatic adenocarcinoma. RTx-induced sarcomas (RISs are rare, late adverse events, representing less than 0.2% of all irradiated patients. RISs are more aggressive tumors than prostatic adenocarcinomas. Herein, we present a case with RTx-induced prostatic leiomyosarcoma after permanent brachytherapy for prostatic adenocarcinoma. A 69-year-old male presented with dysuria and gross hematuria. Six years previously, he had been diagnosed with localized prostate cancer and was treated by permanent brachytherapy. Urethroscopy showed stenosis by a tumor at the prostate. Transurethral prostatectomy was performed for a diagnosis. Based on pathological findings, the diagnosis was leiomyosarcoma of the prostate. He was treated with three cycles of neoadjuvant chemotherapy (CTx that consisted of doxorubicin and ifosfamide (AI, followed by a prostatocystectomy with intrapelvic lymphadenectomy. The tumor extended from the prostate and infiltrated the bladder wall and serosa with lymphatic and venous invasion. The surgical margin was negative, and no residual prostatic adenocarcinoma was observed. The proportion of necrotic tumor cells by neoadjuvant CTx was around 50%. Subsequently, adjuvant CTx was offered, but the patient chose a follow-up without CTx. Local recurrence and lung metastasis were detected by computed tomography 3 months after the surgery. He was treated again with AI. However, CTx was not effective and he died 6 months after the operation. In conclusion, an effective treatment strategy for prostatic sarcoma should be developed in the near future, although the clinical feature of prostatic sarcoma remains unclear due to its rare incidence.

  17. Calculated organ doses using Monte Carlo simulations in a reference male phantom undergoing HDR brachytherapy applied to localized prostate carcinoma

    International Nuclear Information System (INIS)

    Candela-Juan, Cristian; Perez-Calatayud, Jose; Ballester, Facundo; Rivard, Mark J.

    2013-01-01

    Purpose: The aim of this study was to obtain equivalent doses in radiosensitive organs (aside from the bladder and rectum) when applying high-dose-rate (HDR) brachytherapy to a localized prostate carcinoma using 60 Co or 192 Ir sources. These data are compared with results in a water phantom and with expected values in an infinite water medium. A comparison with reported values from proton therapy and intensity-modulated radiation therapy (IMRT) is also provided. Methods: Monte Carlo simulations in Geant4 were performed using a voxelized phantom described in International Commission on Radiological Protection (ICRP) Publication 110, which reproduces masses and shapes from an adult reference man defined in ICRP Publication 89. Point sources of 60 Co or 192 Ir with photon energy spectra corresponding to those exiting their capsules were placed in the center of the prostate, and equivalent doses per clinical absorbed dose in this target organ were obtained in several radiosensitive organs. Values were corrected to account for clinical circumstances with the source located at various positions with differing dwell times throughout the prostate. This was repeated for a homogeneous water phantom. Results: For the nearest organs considered (bladder, rectum, testes, small intestine, and colon), equivalent doses given by 60 Co source were smaller (8%–19%) than from 192 Ir. However, as the distance increases, the more penetrating gamma rays produced by 60 Co deliver higher organ equivalent doses. The overall result is that effective dose per clinical absorbed dose from a 60 Co source (11.1 mSv/Gy) is lower than from a 192 Ir source (13.2 mSv/Gy). On the other hand, equivalent doses were the same in the tissue and the homogeneous water phantom for those soft tissues closer to the prostate than about 30 cm. As the distance increased, the differences of photoelectric effect in water and soft tissue, and appearance of other materials such as air, bone, or lungs, produced

  18. Investigation of palladium-103 production and IR07-103Pd brachytherapy seed preparation

    International Nuclear Information System (INIS)

    Saidi, Pooneh; Sadeghi, Mahdi; Enferadi, Milad; Aslani, Gholamreza

    2011-01-01

    Highlights: → We report the cyclotron production of 103-palladium via 103 Rh(p,n) 103 Pd reaction. → 103 Pd was absorbed on resin beads for brachytherapy seed preparation. → The optimum absorption of 103 Pd in resin was achieved at 0.5 M HCl. → Version 5 of MCNP code was employed to model a new 103 Pd brachytherapy seed. - Abstract: In this study, design and fabrication of 103 Pd brachytherapy seed was investigated. The excitation functions of 103 Rh(p,n) 103 Pd and 103 Rh(d,2n) 103 Pd reactions were calculated using EMPIRE (version 3.1 Rivoli), ALICE/ASH and TALYS-1.2 codes, the TENDL-2010 database and compared with the published data. Production of 103 Pd was done via 103 Rh(p,n) 103 Pd nuclear reaction. The target was bombarded with 18 MeV protons at 200 μA beam current for 15 h. After irradiation and radiochemical separation of the electroplated rhodium target, the optimum condition for absorption of 103 Pd into Amberlite (registered) IR-93 resin was achieved at 0.5 M HCl. Version 5 of the (MCNP) Monte Carlo radiation transport code was employed to calculate the dosimetric parameters around the 103 Pd brachytherapy seed. Finally the calculated results were compared with published results for other commercial sources.

  19. Comparison of TG-43 dosimetric parameters of brachytherapy sources obtained by three different versions of MCNP codes.

    Science.gov (United States)

    Zaker, Neda; Zehtabian, Mehdi; Sina, Sedigheh; Koontz, Craig; Meigooni, Ali S

    2016-03-08

    Monte Carlo simulations are widely used for calculation of the dosimetric parameters of brachytherapy sources. MCNP4C2, MCNP5, MCNPX, EGS4, EGSnrc, PTRAN, and GEANT4 are among the most commonly used codes in this field. Each of these codes utilizes a cross-sectional library for the purpose of simulating different elements and materials with complex chemical compositions. The accuracies of the final outcomes of these simulations are very sensitive to the accuracies of the cross-sectional libraries. Several investigators have shown that inaccuracies of some of the cross section files have led to errors in 125I and 103Pd parameters. The purpose of this study is to compare the dosimetric parameters of sample brachytherapy sources, calculated with three different versions of the MCNP code - MCNP4C, MCNP5, and MCNPX. In these simulations for each source type, the source and phantom geometries, as well as the number of the photons, were kept identical, thus eliminating the possible uncertainties. The results of these investigations indicate that for low-energy sources such as 125I and 103Pd there are discrepancies in gL(r) values. Discrepancies up to 21.7% and 28% are observed between MCNP4C and other codes at a distance of 6 cm for 103Pd and 10 cm for 125I from the source, respectively. However, for higher energy sources, the discrepancies in gL(r) values are less than 1.1% for 192Ir and less than 1.2% for 137Cs between the three codes.

  20. The mechanical system design of the iridium-192 isotope wire in cervical cancer brachytherapy with medium dose rate

    International Nuclear Information System (INIS)

    Ari Satmoko; Sanda; Tri Harjanto; Atang Susila

    2010-01-01

    In 2010, brachytherapy engineering activities have a purpose to establish a detailed design of the cervical cancer brachytherapy with medium dose rate. The brachytherapy will use an Iridium-92 source with the emiting radiation of 5 to 10 Curies. The source is wrapped in SS-316 capsule and carried by a SS-316 wire having diameter of about 1 mm dan length of 1800 mm. As part of this activity, the preliminary design of the mechanical drive systems for the isotope source has been developed. The technical specifications for the main components of the mechanical drive system have been successfully determined. This is started by studying the concept design, performing calculations, determining technical specifications, and finally defining the main components. From the evaluation, some components were decided: a stepper motor PK264A1-SG10, needle bearing NKI-10/20, spiral tube in SS316-1/8'' with 120 mm in diameter, rubber-based belts with a width of 20 mm, and aluminium drum with a diameter of 100 mm. Not all components could be identified in detail, especially for the components that do not exist in the market place and have to be created ourself. Since the main components have been identified, the detailed design step of the mechanical drive systems for the isotope source can be performed. (author)

  1. A mechanical system design of the iridium-192 isotope wire in cervical cancer brachytherapy with medium dose rate

    International Nuclear Information System (INIS)

    Ari Satmoko; Sanda; Tri Harjanto; Atang Susila

    2010-01-01

    In 2010, brachytherapy engineering development activities have a purpose to establish a detailed design of the cervical cancer brachytherapy with medium dose rate. The brachytherapy will use an Iridium-92 source with the emitting radiation of 5 to 10 Curies. The source is wrapped in SS-316 capsule and carried by a SS-316 wire having diameter of about 1 mm dan length of 1800 mm. As part of this activity, the preliminary design of the mechanical drive systems for the isotope source has been developed. The technical specifications for the main components of the mechanical drive system have been successfully determined. This is started by studying the concept design, performing calculations, determining technical specifications, and finally defining the main components. From the evaluation, some components were decided: a stepper motor PK264A1-SG10, needle bearing NKI-10/20, spiral tube in SS316-1/8'' with 120 mm in diameter, rubber-based belts with a width of 20 mm, and aluminium drum with a diameter of 100 mm. Not all components could be identified in detail, especially for the components that do not exist in the marketplace and have to be created ourself Since the main components have been identified, the detailed design step of the mechanical drive systems for the isotope source can be performed. (author)

  2. Three-dimensional brachytherapy optimization techniques in the treatment of patients with cervix cancer

    International Nuclear Information System (INIS)

    Haie-Meder, C.; Mazeron, R.; Verezesan, O.; Monnier, L.; Vieillot, S.; Dumas, I.; Lhomme, C.; Morice, P.; Barillot, I.

    2009-01-01

    Traditionally, prescription and treatment planning in intracavitary brachytherapy for cervix cancer have used either reference points (mainly points A and B) or reference isodoses (60 Gy according to ICRU recommendations) to report doses to the target volume. Doses to critical organs were reported at bladder and rectum ICRU points. This practice has been supported by a long-standing clinical experience that has yielded an acceptable therapeutic ratio. The recent development of imaging has contributed to the improvement in target and organs at risk knowledge. In 2005 and 2006, the European group of brachytherapy -European Society for therapeutic radiology and oncology (GEC-E.S.T.R.O.) recommendations publications on 3-D based image brachytherapy have defined the different volumes of interest. These recommendations have been validated with intercomparison delineation studies. With the concomitant development of remote after-loading projectors, provided with miniaturized sources, it is now possible to plan radiation doses by adjusting dwell positions and relative dwell time values. These procedures allow better coverage of the targets while sparing O.A.R.. The recent literature data evidence a significant improvement in local control with no increase in complications. Further studies are needed to better define the dose recommended in both tumour and organs at risk. This is one of the goals of the European study on MRI-guided brachytherapy in locally advanced cervical cancer (E.M.B.R.A.C.E.) protocol (meaning of acronym: an international study on MRI-guided brachytherapy in locally advanced cervical cancer). (authors)

  3. Brachytherapy source calibration, reviews, and consistency of 192Ir high-dose rate afterloading sources supplied over the period of 10 years: a retrospective analysis

    International Nuclear Information System (INIS)

    Nagappan, Balasubramanian; Kumar, Yogesh; Patel, Narayan P.; Dhull, Anil Kumar; Kaushal, Vivek

    2015-01-01

    Measurement and verification of strength of monomodal high-dose rate (mHDR) 192 Ir source supplied by the vendor is a major part of quality assurance program. Reference air kerma rate (RAKR) or air kerma strength (AKS) is the recommended quantity to specify the strength of gamma emitting brachytherapy sources. Physicist in our institution performed the source calibration as soon as each 192 Ir new source was loaded on the mHDR afterloading machine. The AKS accurately measured using a physikalisch technische werkstatten (PTW) re-entrant chamber-electrometer system in a scatter-free geometry was used to compute the air kerma rate (AKR) at one-meter distance in the air. To ensure accurate dose delivery to brachytherapy patients, measured AKS or RAKR should be entered correctly in both HDR treatment console station (TCS) as well as treatment planning system (TPS) associated with it. The clinical outcome mainly depends not only on the accuracy of the source strength measurement in the hospital but also on the correct source strength entered into both TCS and TPS software. A retrospective study on 22 mHDR V2 sources supplied by the vendor for the period of 10 years was taken up to access the accuracy of source strength supplied to the Radiotherapy department. The results are analyzed and reported. The accuracy in measured RAKR of all 22 sources supplied by vendor was well within the tolerance limits set by the national regulatory body and international recommendations. The deviations observed between measured RAKR versus manufacturer's quoted RAKR were in the range from -1.71% to +1.15%. In conclusion, the measured RAKR have good agreement with vendor quoted RAKR values. (author)

  4. SU-F-T-49: Dosimetry Parameters and TPS Commissioning for the CivaSheet Directional Pd-103 Brachytherapy Source

    Energy Technology Data Exchange (ETDEWEB)

    Rivard, MJ [Tufts University School of Medicine, Boston, MA (United States)

    2016-06-15

    Purpose: The CivaSheet is a new LDR Pd-103 brachytherapy device offering directional-radiation for preferentially irradiating malignancies with healthy-tissue sparing. Observations are presented on dosimetric characterization, TPS commissioning, and evaluation of the dosesuperposition- principle for summing individual elements comprising a planar CivaSheet Methods: The CivaSheet comprises individual sources (CivaDots, 0.05cm thick and 0.25cm diam.) inside a flexible bioabsorbable substrate with a 0.8cm center-to-center rectangular array. All non-radioactive components were measured to ensure accuracy of manufacturer-provided dimensional information. The Pd spatial distribution was gleaned from radioactive and inert samples, then modeled with the MCNP6 radiation-transport-code. A 6×6 array CivaSheet was modeled to evaluate the dose superposition principle for treatment planning. Air-kerma-strength was estimated using the NIST WAFAC geometry. Absorbed dose was estimated in water with polar sampling covering 0.05≤r≤15cm in 0.05cm increments and 0°≤θ≤180° in 1° increments. These data were entered into VariSeed9.0 and tested for the dose-superposition-principle. Results: The dose-rate-constant was 0.579 cGy/h/U with g(r) determined along the rotational-axis of symmetry (0°) instead of 90°. gP(r) values at 0.1, 0.5, 2, 5, and 10cm were 1.884, 1.344, 0.558, 0.088, and 0.0046. F(r,θ) decreased between 0° and 180° by factors of 270, 23, and 5.1 at 0.1, 1, and 10cm. The highest dose-gradient was at 92°, changing by a factor of 3 within 1° due to Au-foil shielding. TPS commissioning from 0.1≤r≤11cm and 0°≤θ≤180° demonstrated 2% reproducibility of input data except at the high-dose-gradient where interpolations caused 3% differences. Dose superposition of CivaDots replicated a multi-source CivaSheet array within 2% except where another CivaDot was present. Following implantation, the device is not perfectly planar. TPS accuracy utilizing the dose

  5. Acute genitourinary toxicity after high dose rate (HDR) brachytherapy combined with hypofractionated external-beam radiation therapy for localized prostate cancer: Second analysis to determine the correlation between the urethral dose in HDR brachytherapy and the severity of acute genitourinary toxicity

    International Nuclear Information System (INIS)

    Akimoto, Tetsuo; Katoh, Hiroyuki; Noda, Shin-ei; Ito, Kazuto; Yamamoto, Takumi; Kashiwagi, Bunzo; Nakano, Takashi

    2005-01-01

    Purpose: We have been treating localized prostate cancer with high-dose-rate (HDR) brachytherapy combined with hypofractionated external beam radiation therapy (EBRT) at our institution. We recently reported the existence of a correlation between the severity of acute genitourinary (GU) toxicity and the urethral radiation dose in HDR brachytherapy by using different fractionation schema. The purpose of this study was to evaluate the role of the urethral dose in the development of acute GU toxicity more closely than in previous studies. For this purpose, we conducted an analysis of patients who had undergone HDR brachytherapy with a fixed fractionation schema combined with hypofractionated EBRT. Methods and Materials: Among the patients with localized prostate cancer who were treated by 192-iridium HDR brachytherapy combined with hypofractionated EBRT at Gunma University Hospital between August 2000 and November 2004, we analyzed 67 patients who were treated by HDR brachytherapy with the fractionation schema of 9 Gy x two times combined with hypofractionated EBRT. Hypofractionated EBRT was administered at a fraction dose of 3 Gy three times weekly, and a total dose of 51 Gy was delivered to the prostate gland and seminal vesicles using the four-field technique. No elective pelvic irradiation was performed. After the completion of EBRT, all the patients additionally received transrectal ultrasonography-guided HDR brachytherapy. The planning target volume was defined as the prostate gland with a 5-mm margin all around, and the planning was conducted based on computed tomography images. The tumor stage was T1c in 13 patients, T2 in 31 patients, and T3 in 23 patients. The Gleason score was 2-6 in 12 patients, 7 in 34 patients, and 8-10 in 21 patients. Androgen ablation was performed in all the patients. The median follow-up duration was 11 months (range 3-24 months). The toxicities were graded based on the Radiation Therapy Oncology Group and the European Organization

  6. Brachytherapy for carcinoma of the cervix: A Canadian survey of practice patterns in a changing era

    International Nuclear Information System (INIS)

    Pearce, Andrew; Craighead, Peter; Kay, Ian; Traptow, Laurel; Doll, Corinne

    2009-01-01

    Background and purpose: This survey aimed to document practices of Canadian radiation oncologists performing gynecologic brachytherapy for carcinoma of the cervix and to determine what the effect of the phasing-out of LDR after-loading systems from the commercial market is having on practice. Materials and methods: A 26-item questionnaire was developed to survey various aspects of brachytherapy practice to include: number of patients treated, prescription points/volume, dose and fractionation, timing, critical structure delineation, expected changes due to the phasing-out of support for low dose rate systems, and support for the development of national guidelines. A link to a web-based survey collection instrument was emailed to each radiation oncologist in Canada practicing gynecologic brachytherapy. Results: A 67% response rate was achieved in this web-based survey. Radiation oncologists currently using HDR brachytherapy are most commonly delivering 5 fractions of 6 Gy in addition to an EBRT dose of 45 Gy in 25 fractions. The median total dose equivalents to Point A was 82.9 Gy for both early and advanced disease. In response to the announcement by a major vendor that they would be phasing-out service for a popular LDR after-loader, 49% of Canadian radiation oncologists who practice brachytherapy for cervix cancer are changing to an HDR technique with a further 9% changing to a PDR technique. Eighty-six percent of respondents would support the development of national guidelines for cervix brachytherapy in Canada. Conclusions: Variation in practice exists in Canada in brachytherapy for cervix cancer. Many centers are in the process of phasing-out LDR techniques in response to the withdrawal of commercial support for these systems. Support for the development of Canadian national guidelines is high.

  7. Comparison of TG-43 and TG-186 in breast irradiation using a low energy electronic brachytherapy source

    Energy Technology Data Exchange (ETDEWEB)

    White, Shane A.; Landry, Guillaume; Reniers, Brigitte, E-mail: brigitte.reniers@maastro.nl [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center (MUMC), Maastricht 6201 BN (Netherlands); Fonseca, Gabriel Paiva [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center (MUMC), Maastricht 6201 BN, The Netherlands and Instituto de Pesquisas Energéticas e Nucleares – IPEN-CNEN/SP, São Paulo CP 11049, 05422-970 (Brazil); Holt, Randy; Rusch, Thomas [Xoft, A Subsidiary of iCAD, Sunnyvale, California 94085-4115 (United States); Beaulieu, Luc [Centre Hospitalier Universitaire de Québec Université Laval, Radio-Oncologie et Centre de Recherche en Cancérologie de l’Université Laval, Québec, Québec G1R 2J6 Canada (Canada); Verhaegen, Frank [Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Center (MUMC), Maastricht 6201 BN, The Netherlands and Department of Oncology, McGill University, Montreal, Quebec H3G 1A4 (Canada)

    2014-06-15

    Purpose: The recently updated guidelines for dosimetry in brachytherapy in TG-186 have recommended the use of model-based dosimetry calculations as a replacement for TG-43. TG-186 highlights shortcomings in the water-based approach in TG-43, particularly for low energy brachytherapy sources. The Xoft Axxent is a low energy (<50 kV) brachytherapy system used in accelerated partial breast irradiation (APBI). Breast tissue is a heterogeneous tissue in terms of density and composition. Dosimetric calculations of seven APBI patients treated with Axxent were made using a model-based Monte Carlo platform for a number of tissue models and dose reporting methods and compared to TG-43 based plans. Methods: A model of the Axxent source, the S700, was created and validated against experimental data. CT scans of the patients were used to create realistic multi-tissue/heterogeneous models with breast tissue segmented using a published technique. Alternative water models were used to isolate the influence of tissue heterogeneity and backscatter on the dose distribution. Dose calculations were performed using Geant4 according to the original treatment parameters. The effect of the Axxent balloon applicator used in APBI which could not be modeled in the CT-based model, was modeled using a novel technique that utilizes CAD-based geometries. These techniques were validated experimentally. Results were calculated using two dose reporting methods, dose to water (D{sub w,m}) and dose to medium (D{sub m,m}), for the heterogeneous simulations. All results were compared against TG-43-based dose distributions and evaluated using dose ratio maps and DVH metrics. Changes in skin and PTV dose were highlighted. Results: All simulated heterogeneous models showed a reduced dose to the DVH metrics that is dependent on the method of dose reporting and patient geometry. Based on a prescription dose of 34 Gy, the average D{sub 90} to PTV was reduced by between ∼4% and ∼40%, depending on the

  8. Determination of dosimetric characteristics of OptiSeedTM a plastic brachytherapy 103Pd source

    International Nuclear Information System (INIS)

    Wang Zhonglu; Hertel, Nolan E.

    2005-01-01

    A new 103 Pd plastic brachytherapy source, OptiSeed TM Model 1032P, is being introduced by International Brachytherapy sa (IBt). Measurements of the dose distributions about the source were performed using LiF thermoluminescent dosimeters (TLD-100) in Virtual Water TM . MCNP5 calculations were performed to determine the dose distributions in Virtual Water TM and liquid water. The source dose rate constant, radial dose function, anisotropy function and anisotropy factor have been determined following the updated AAPM TG-43 recommendations. The measured dose rate constant in the Virtual Water TM phantom was determined to be 0.727±6.9% cGy h -1 U -1 , and the computed value is 0.716±2.1% cGy h -1 U -1 . The Monte-Carlo simulation yielded a dose rate constant of 0.665±2.1% cGy h -1 U -1 in water. The measured dose rate constant in water is 0.675±7.5% cGy h -1 U -1 . It is determined by multiplying the dose rate constant measured in the Virtual Water TM phantom with the ratio of the value calculated in water to that in Virtual Water TM . The average of the measured and calculated dose rate constant is 0.670±5.5% cGy h -1 U -1 . The radial dose functions of the new source were measured for distances ranging from 1 to 7 cm in a Virtual Water TM phantom. The anisotropy functions in Virtual Water TM phantom were measured for distances of 2, 3, 5, and 7 cm. The Monte-Carlo computed radial dose functions, anisotropy functions, and anisotropy factors in both Virtual Water TM phantom and water are reported

  9. Adherence to Vaginal Dilation Following High Dose Rate Brachytherapy for Endometrial Cancer

    International Nuclear Information System (INIS)

    Friedman, Lois C.; Abdallah, Rita; Schluchter, Mark; Panneerselvam, Ashok; Kunos, Charles A.

    2011-01-01

    Purpose: We report demographic, clinical, and psychosocial factors associated with adherence to vaginal dilation and describe the sexual and marital or nonmarital dyadic functioning of women following high dose rate (HDR) brachytherapy for endometrial cancer. Methods and Materials: We retrospectively evaluated women aged 18 years or older in whom early-stage endometrial (IAgr3-IIB) cancers were treated by HDR intravaginal brachytherapy within the past 3.5 years. Women with or without a sexual partner were eligible. Patients completed questionnaires by mail or by telephone assessing demographic and clinical variables, adherence to vaginal dilation, dyadic satisfaction, sexual functioning, and health beliefs. Results: Seventy-eight of 89 (88%) eligible women with early-stage endometrial cancer treated with HDR brachytherapy completed questionnaires. Only 33% of patients were adherers, based on reporting having used a dilator more than two times per week in the first month following radiation. Nonadherers who reported a perceived change in vaginal dimension following radiation reported that their vaginas were subjectively smaller after brachytherapy (p = 0.013). Adherers reported more worry about their sex lives or lack thereof than nonadherers (p = 0.047). Patients reported considerable sexual dysfunction following completion of HDR brachytherapy. Conclusions: Adherence to recommendations for vaginal dilator use following HDR brachytherapy for endometrial cancer is poor. Interventions designed to educate women about dilator use benefit may increase adherence. Although sexual functioning was compromised, it is likely that this existed before having cancer for many women in our study.

  10. Miniature X-ray Tube for Electric Brachytherapy using Carbon Nanotube Field Emitter

    International Nuclear Information System (INIS)

    Heo, Sung Hwan; Kim, Hyun Jin; Ha, Jun Mok; Cho, Sung Oh

    2011-01-01

    An electric brachytherapy using a miniature x-ray tube has a major advantage to reduce the x-ray exposure of human body during the cancer radiation therapy by optimal positioning of x-ray radiation source and treatment objectives. In the view of a smaller electronic x-ray source, the CNT field emitter based xray tube can be more minimized than thermionic filament emitter based one because of a simple power supplier connection of cold field emission in diode type as well as a higher electron emission brightness of CNT. This abstract is for introducing the design of a prototype CNT field emitter based miniature x-ray tube. We have vacuum sealed CNT miniature x-ray tube with 7∼10 mm diameter, and characteristics of electron emission and x-ray transportation using MCNP5 code are surveyed

  11. SU-E-T-279: Dose Enhancement Effect Due to Cerium Oxide Nanoparticles Employed as Radiation Protectants

    Energy Technology Data Exchange (ETDEWEB)

    Ouyang, Z; Altundal, Y; Sajo, E [Univ Massachusetts Lowell, Lowell, MA (United States); Ngwa, W [Univ Massachusetts Lowell, Lowell, MA (United States); Brigham and Women’s Hospital, Dana Farber Cancer Institute, Harvard Medical, Boston, MA (United States)

    2015-06-15

    Purpose: The goal of radiotherapy is to maximize radiation dose to diseased cells while minimizing radiation damage to normal tissues. In order to minimize damage to normal tissues, cerium oxide nanoparticles (nanoceria) are currently considered as a radioprotectant. However, some studies have reported concerns that nanoceria can also lead to radiotherapy dose enhancement due to the high atomic number of cerium, especially when used in conjunction with kV energy and brachytherapy sources. In this study, this concern is investigated to determine if the concentrations of nanoceria employed in in-vivo studies to confer radioprotection can engender a significant dose enhancement. Methods: Radiation with energies ranging from 50kVp to 140kVp is investigated in this work along with brachytherapy sources Pd-103 and I-125. A previously established theoretical model is used to calculate the dose enhancement factor (DEF). In this model, each cell is assumed to be a voxel of size (10 µm, 10 µm, 10 µm) with nanoceria homogeneously distributed among them. Electron energy loss formula of Cole is used to calculate energy (and hence dose) deposited by photoelectrons and Auger electrons in each tissue voxel due to irradiation of nanoceria. The DEF is defined as the ratio of the dose with and without nanoparticles. Results: DEF calculation results are smaller than 1.02 with dosages of nanoceria smaller than 0.645 mg/g, which is shown to be sufficiently protective by some previous in-vitro and in-vivo experiments. The brachytherapy sources show higher DEF’s than kVp radiations. DEF peaks are consistent with K shell and L shell energies of cerium, 40 keV and 6 keV, respectively. Conclusion: The results show that for sufficiently radioprotective concentrations of nanoceria, there will be minimal DEF when used in conjunction with clinically applicable kV energy radiotherapy sources or brachytherapy sources.

  12. Proceedings of the Second Congress of Radiochemotherapy and Brachytherapy and the Fifth Meeting of Medical Physics

    International Nuclear Information System (INIS)

    Zunino, Silvia; Venencia, Daniel; Martinez, Monica; Garrigo, Edgardo

    2009-01-01

    The Marie Curie Foundation in the city of Cordoba in Argentina, has organized the Second Congress of radiochemotherapy and brachytherapy and the Fifth Meeting of Medical Physics in order to collaborate with the scientific growth of radiation oncology and medical physics. The main topics covered were: patient's radioprotection, brachytherapy with iodine, radiation protection regulatory issues in Argentina, risk analysis in radiotherapy, medical radiation therapy, EPID dosimetry (Electronic Portal Image Device), accidents in radiotherapy, among others. [es

  13. Preliminary results of concurrent chemotherapy and radiation therapy using high-dose-rate brachytherapy for cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Ja; Lee, Ji Hye; Lee, Re Na; Suh, Hyun Suk [Ewha Womans University College of Medicine, Seoul (Korea, Republic of)

    2006-09-15

    To determine the efficacy and safety of concurrent chemotherapy and radiation therapy with high-dose-rate brachytherapy for cervical cancer. From January 2001 to December 2002, 30 patients with cervical cancer were treated with concurrent chemotherapy (cisplatin and 5-FU) and definitive radiation therapy. The median age was 58 (range 34 {approx} 74) year old. The pathology of the biopsy sections was squamous cell carcinoma in 29 patients and one was adenocarcinoma. The distribution to FIGO staging system was as follow: stage IB, 7 (23%); IIA, 3 (10%); IIB, 12 (40%); IIIA, 3 (10%); IIIB, 5 (17%). All patients received pelvic external beam irradiation (EBRT) to a total dose of 45 {approx} 50.4 Gy (median: 50.4 Gy) over 5 {approx} 5.5 weeks. Ir-192 HDR intracavity brachytherapy (ICBT) was given after a total dose of 41.1 Gy. HDR-ICBT was performed twice a week, with a fraction point. A dose of 4 Gy and median dose to point A was 28 Gy (range: 16 {approx} 32 Gy) in 7 fractions. The median cumulative biologic effective dose (BED) at point A (EBRT + ICBT) was 88 Gy{sub 10} (range:77 {approx} 94 Gy{sub 10}). The median cumulative BED at ICRU 38 reference point (EBRT + ICBT) was 131 Gy{sub 3} (range: 122 {approx} 140 Gy{sub 3}) at point A, 109 Gy{sub 3} (range:88{approx} 125 Gy{sub 3}) at the rectum and 111 Gy{sub 3} (range: 91 {approx} 123 Gy{sub 3}) at the urinary bladder. Cisplatin (60 mg/m{sup 2}) and 5-FU (1,000 mg/m{sup 2}) was administered intravenously at 2 weeks interval from the first day of radiation for median 5 (range:2 {approx} 6) cycles. The assessment was performed at 1 month after completion of radiation therapy by clinical examination and CT scan. The median follow-up time was 36 months (range:8{approx} 50 months). The complete response rate after concurrent chemo radiation therapy was 93.3%. The 3-yr actuarial pelvic control rate was 87% and 3-yr actuarial overall survival and disease-free survival rate was 93% and 87%, respectively. The local failure

  14. Preliminary results of concurrent chemotherapy and radiation therapy using high-dose-rate brachytherapy for cervical cancer

    International Nuclear Information System (INIS)

    Lee, Kyung Ja; Lee, Ji Hye; Lee, Re Na; Suh, Hyun Suk

    2006-01-01

    To determine the efficacy and safety of concurrent chemotherapy and radiation therapy with high-dose-rate brachytherapy for cervical cancer. From January 2001 to December 2002, 30 patients with cervical cancer were treated with concurrent chemotherapy (cisplatin and 5-FU) and definitive radiation therapy. The median age was 58 (range 34 ∼ 74) year old. The pathology of the biopsy sections was squamous cell carcinoma in 29 patients and one was adenocarcinoma. The distribution to FIGO staging system was as follow: stage IB, 7 (23%); IIA, 3 (10%); IIB, 12 (40%); IIIA, 3 (10%); IIIB, 5 (17%). All patients received pelvic external beam irradiation (EBRT) to a total dose of 45 ∼ 50.4 Gy (median: 50.4 Gy) over 5 ∼ 5.5 weeks. Ir-192 HDR intracavity brachytherapy (ICBT) was given after a total dose of 41.1 Gy. HDR-ICBT was performed twice a week, with a fraction point. A dose of 4 Gy and median dose to point A was 28 Gy (range: 16 ∼ 32 Gy) in 7 fractions. The median cumulative biologic effective dose (BED) at point A (EBRT + ICBT) was 88 Gy 10 (range:77 ∼ 94 Gy 10 ). The median cumulative BED at ICRU 38 reference point (EBRT + ICBT) was 131 Gy 3 (range: 122 ∼ 140 Gy 3 ) at point A, 109 Gy 3 (range:88∼ 125 Gy 3 ) at the rectum and 111 Gy 3 (range: 91 ∼ 123 Gy 3 ) at the urinary bladder. Cisplatin (60 mg/m 2 ) and 5-FU (1,000 mg/m 2 ) was administered intravenously at 2 weeks interval from the first day of radiation for median 5 (range:2 ∼ 6) cycles. The assessment was performed at 1 month after completion of radiation therapy by clinical examination and CT scan. The median follow-up time was 36 months (range:8∼ 50 months). The complete response rate after concurrent chemo radiation therapy was 93.3%. The 3-yr actuarial pelvic control rate was 87% and 3-yr actuarial overall survival and disease-free survival rate was 93% and 87%, respectively. The local failure rate was 13% and distant metastatic rate was 3.3%. The crude rate of minor hematologic

  15. The present state of brachytherapy practice in the Czech Republic

    Energy Technology Data Exchange (ETDEWEB)

    Zackova, H; Drabkova, A [National Radiation Protection Institute, Prague (Czech Republic)

    1996-12-31

    In spite of the fact that radiotherapy departments in the Czech republic have been following the general European and world trends in brachytherapy techniques and that they are installing the new remote AFL systems, the reserves of radium sources are still considerably high and not all professionals carry out their applications of radioactive sources by (at least) manual AFL. In near future the attention should be paid to the diminution of the unnecessary radium reserves at that radiotherapy departments where the small number of applications is executed or where the new remote AFL systems are used. For professionals practically thorough radiation protection is assured when new remote AFL systems are used. But in this case an attention should be paid to the radiation safety of the patient because of the potential exposures when high dose rate systems would failed. The likelihood of this unwanted cases can only be decreased when Quality Assurance programs is introduced into practice.

  16. Long duration mild temperature hyperthermia and brachytherapy.

    Science.gov (United States)

    Armour, E P; Raaphorst, G P

    2004-03-01

    Combining long duration mild temperature hyperthermia (LDMH) and low dose-rate (LDR) brachytherapy to enhance therapeutic killing of cancer cells was proposed many years ago. The cellular and tumour research that supports this hypothesis is presented in this review. Research describing LDMH interaction with pulsed brachytherapy and high dose-rate brachytherapy using clinically relevant parameters are compared with LDMH/LDR brachytherapy. The mechanism by which LDMH sensitizes LDR has been established as the inhibition of sublethal damage repair. The molecular mechanisms have been shown to involve DNA repair enzymes, but the exact nature of these processes is still under investigation. The relative differences between LDMH interactions with human and rodent cells are presented to help in the understanding of possible roles of LDMH in clinical application. The role of LDMH in modifying tumour blood flow and its possible role in LDR sensitization of tumours is also presented. The positive aspects of LDMH-brachytherapy for clinical application are sixfold; (1) the thermal goals (temperature, time and volume) are achievable with currently available technology, (2) the hyperthermia by itself has no detectable toxic effects, (3) thermotolerance appears to play a minor if any role in radiation sensitization, (4) TER of around 2 can be expected, (5) hypoxic fraction may be decreased due to blood flow modification and (6) simultaneous chemotherapy may also be sensitized. Combined LDMH and brachytherapy is a cancer therapy that has established biological rationale and sufficient technical and clinical advancements to be appropriately applied. This modality is ripe for clinical testing.

  17. Endobronchial brachytherapy: the Saint-Louis Hospital experience

    International Nuclear Information System (INIS)

    Hennequin, C.; Durdux, C.; Housset, M.; Maylin, C.; Tredaniel, J.; Zalcman, G.; Hirsch, A.; Dray, M.; Manoux, D.; Perret, M.

    1997-01-01

    During the evolution of lung cancer, bronchial obstruction is often noticed and is sometimes responsible for serious symptoms. Several methods of des-obstruction can be proposed, including brachytherapy. Materials and methods: One hundred forty-nine patients, presenting with endobronchial brachytherapy were included into the study. Seventy-three were treated with curative intent, 47 with palliative intent and 29 with a combination of external irradiation and brachytherapy. We usually delivered a series of two 7-Gy fractions (1 cm from the catheter), the treatment being repeated one, two or three times. Results: When all symptoms were taken into account, respiratory function improvement was present in 79% of the patients. Among the 132 tumors that could be evaluated via a new endoscopy 2 months after treatment, 64 (48.5%) were in complete histological remission. The median survival was 14.4 months for the patients treated with curative intent. Eleven massive hemoptyses and 13 radiation bronchitides were observed. Conclusion: These results confirm the feasibility and good results related to endobronchial brachytherapy, though controlled studies are needed to better define its place in the therapeutic strategy of bronchial carcinomas. (authors)

  18. Calibration of {sup 192}Ir high dose rate brachytherapy sources

    Energy Technology Data Exchange (ETDEWEB)

    Marechal, M H [Instituto de Radioprotecao e Dozimetria, Rio de Jainero (Brazil); Almeida, C.E. de [Laboratorio de Ciencias Radiologicas, UERL, Rio de Janeiro (Brazil); Sibata, C H [Roswell Park Cancer Inst., Buffalo, NY (United States)

    1996-08-01

    A method for calibration of high dose rate sources used in afterloading brachytherapy systems is described. The calibration for {sup 192}Ir is determined by interpolating {sup 60}Co gamma-rays and 250 kV x-rays calibration factors. All measurements were done using the same build up caps as described by Goetsch et al and recommended by AAPM. The attenuation correction factors were determined to be 0.9903, 0.9928 and 0.9993 for {sup 192}Ir, {sup 60}Co and 250 kV x-ray, respectively. A wall + cap thickness of 0.421 g.cm{sup -2} is recommended for all measurements to ensure electronic equilibrium for {sup 60}Co and {sup 192}Ir gamma-ray beams. A mathematical formalism is described for determination of (N{sub x}){sub Ir}. (author). 5 refs, 1 fig.

  19. Implants with 32P-foils for LDR-brachytherapy of benign stenosis in urology and gastroenterology

    International Nuclear Information System (INIS)

    Assmann, Walter; Becker, Ricarda; Otto, Henrike

    2013-01-01

    For LDR-brachytherapy, a limited number of implant geometries and materials are available. To avoid wound healing related hyper-proliferation (stenosis, keloids) a novel radioactive foil system was developed based on beta emitting 32 P, which can be easily integrated in existing implants such as urethral catheters or bile duct stents. As substrate material for these foils PEEK (polyetherethercetone) was chosen because of its radiation hardness during neutron activation of 32 P. The activity was determined by liquid scintillation counting and gamma spectroscopy, dose distributions were measured with scintillation detectors and radiochromic films. The correlation between activity and dose was checked by Monte-Carlo-simulations (Geant4). Prototypes of the 32 P-implants have shown in wash-out tests the required tightness for sealed radioactive sources. In animal tests on urethra and bile duct, the uncomplicated and save application of 32 P-foils mounted on standard implants has been demonstrated, which is almost unchanged due to the simple radiation protection with plexiglass. This concept of radioactive implants with integrated 32 P-foils could extend essentially the application possibilities of LDR-brachytherapy. (orig.)

  20. High-dose-rate interstitial brachytherapy for the treatment of penile carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Petera, J.; Odrazka, K.; Zouhar, M.; Bedrosova, J.; Dolezel, M. [Dept. of Oncology and Radiotherapy, Charles Univ. Medical School and Teaching Hospital, Hradec Kralove (Czech Republic)

    2004-02-01

    Background: interstitial low-dose-rate (LDR) brachytherapy allows conservative treatment of T1-T2 penile carcinoma. High-dose-rate (HDR) is often considered to be dangerous for interstitial implants because of a higher risk of complications, but numerous reports suggest that results may be comparable to LDR. Nevertheless, there are no data in the literature available regarding HDR interstitial brachytherapy for carcinoma of the penis. Case report: a 64-year-old man with T1 NO MO epidermoid carcinoma of the glans is reported. Interstitial HDR brachytherapy was performed using the stainless hollow needle technique and a breast template for fixation and good geometry. The dose delivered was 18 x 3 Gy twice daily. Results: after 232 days from brachytherapy, the patient was without any evidence of the tumor, experienced no serious radiation-induced complications, and had a fully functional organ. Conclusion: HDR interstitial brachytherapy is feasible in selected case of penis carcinoma, when careful planning and small single fractions are used. (orig.)

  1. Brachytherapy: The need for a national metrology lab in Spain; Branquiterapia: la necesidad de un laboratorio nacional de metrologia en Espana

    Energy Technology Data Exchange (ETDEWEB)

    Aviles Lucas, P.

    2011-07-01

    Radiotherapy, along with chemotherapy and surgery, is an essential therapeutic technique for treating malignant tumours. Part of the challenge of a suitable radiotherapy treatment lies on the optimisation of the irradiated volume, which must be adapted to the tumour volume as far as possible. Depending on position of the radiation source relative to the patient, the procedure in question could be external radiotherapy, or brachytherapy. In a brachytherapy procedure, relatively small encapsulated radioactive sources are placed close to or in the tumour volume to be treated. This therapeutic treatment has two obvious advantages; on one hand the prescribed dose can be adjusted to the tumour volume, preventing unnecessary exposure of the adjacent healthy tissues, and on the other, it decreases the treatment duration compared to a radiotherapy treatment. (Author) 19 refs.

  2. Comparison of TG‐43 dosimetric parameters of brachytherapy sources obtained by three different versions of MCNP codes

    Science.gov (United States)

    Zaker, Neda; Sina, Sedigheh; Koontz, Craig; Meigooni1, Ali S.

    2016-01-01

    Monte Carlo simulations are widely used for calculation of the dosimetric parameters of brachytherapy sources. MCNP4C2, MCNP5, MCNPX, EGS4, EGSnrc, PTRAN, and GEANT4 are among the most commonly used codes in this field. Each of these codes utilizes a cross‐sectional library for the purpose of simulating different elements and materials with complex chemical compositions. The accuracies of the final outcomes of these simulations are very sensitive to the accuracies of the cross‐sectional libraries. Several investigators have shown that inaccuracies of some of the cross section files have led to errors in  125I and  103Pd parameters. The purpose of this study is to compare the dosimetric parameters of sample brachytherapy sources, calculated with three different versions of the MCNP code — MCNP4C, MCNP5, and MCNPX. In these simulations for each source type, the source and phantom geometries, as well as the number of the photons, were kept identical, thus eliminating the possible uncertainties. The results of these investigations indicate that for low‐energy sources such as  125I and  103Pd there are discrepancies in gL(r) values. Discrepancies up to 21.7% and 28% are observed between MCNP4C and other codes at a distance of 6 cm for  103Pd and 10 cm for  125I from the source, respectively. However, for higher energy sources, the discrepancies in gL(r) values are less than 1.1% for  192Ir and less than 1.2% for  137Cs between the three codes. PACS number(s): 87.56.bg PMID:27074460

  3. Intravascular brachytherapy: a model for the calculation of the dose

    International Nuclear Information System (INIS)

    Pirchio, Rosana; Martin, Gabriela; Rivera, Elena; Cricco, Graciela; Cocca, Claudia; Gutierrez, Alicia; Nunez, Mariel; Bergoc, Rosa; Guzman, Luis; Belardi, Diego

    2002-01-01

    In this study we present the radiation dose distribution for a theoretical model with Montecarlo simulation, and based on an experimental model developed for the study of the prevention of restenosis post-angioplasty employing intravascular brachytherapy. In the experimental in vivo model, the atherosclerotic plaques were induced in femoral arteries of male New Zealand rabbits through surgical intervention and later administration of cholesterol enriched diet. For the intravascular irradiation we employed a 32P source contained within the balloon used for the angioplasty. The radiation dose distributions were calculated using the Monte Carlo code MCNP4B according to a segment of a simulated artery. We studied the radiation dose distribution in the axial and radial directions for different thickness of the atherosclerotic plaques. The results will be correlated with the biologic effects observed by means of histological analysis of the irradiated arteries (Au)

  4. The American brachytherapy society survey of brachytherapy practice for carcinoma of the cervix in the United States.

    Science.gov (United States)

    Nag, S; Orton, C; Young, D; Erickson, B

    1999-04-01

    The purpose of this study was to survey the brachytherapy practice for cervical cancer in the United States. The Clinical Research Committee of the American Brachytherapy Society (ABS) performed a retrospective survey of individual physicians of the ABS and American Society of Therapeutic Radiologists and Oncologists regarding the details of the brachytherapy techniques they personally used in the treatment of cervical cancer patients for the year 1995. The replies (some of which may have been an estimate only) were tabulated. The scope of this survey did not allow us to verify the data by chart audits. A total of about 3500 questionnaires were mailed out; 521 responses were received. Of these responders, 206 (40%) did not perform any brachytherapy for carcinoma of the cervix in 1995. Of the other 315 responders reporting a total of 4892 patients treated in 1995, 88% used low dose rate (LDR) while 24% used high dose rate (HDR). There was a wide variation in the doses used. For LDR treatments, the median total external beam radiation therapy (EBRT) dose was 45 and 50 Gy and the LDR dose was 42 and 45 Gy for early and advanced cancers, respectively. For HDR treatments, the median EBRT dose was 48 and 50 Gy and the median HDR dose was 29 and 30 Gy for early and advanced cancers, respectively. The median dose per fraction was 6 Gy for a median of five fractions. Interstitial brachytherapy was used as a component of the treatment in 6% of the patients by 21% of responders. Very few responders treated with pulsed or medium dose rates. This retrospective survey showed the current brachytherapy practice pattern in the treatment of cervical cancer in the United States and can serve as a basis for future prospective national brachytherapy data registry. There was wide variation in the practice pattern, emphasizing the urgent need for consensus on these issues. Copyright 1999 Academic Press.

  5. A study of Brachytherapy for Intraocular Tumor

    International Nuclear Information System (INIS)

    Ji, Kwang Soo; Yoo, Dae Hyun; Lee, Sung Goo; Kim, Jae Hu; Ji, Young Hun

    1996-01-01

    The eye enucleation or external-beam radiation therapy that has been commonly used for the treatment of intraocular tumor have demerits of visual loss and in deficiency of effective tumor dose. Recently, brachytherapy using the plaques containing radioisotope-now treatment method that decrease the demerits of the above mentioned treatment methods and increase the treatment effect-is introduced and performed in the countries, Our purpose of this research is to design suitable shape of plaque for the ophthalmic brachytherapy, and to measure absorbed doses of Ir-192 ophthalmic plaque and thereby calculate the exact radiation dose of tumor and it's adjacent normal tissue. In order to brachytherapy for intraocular tumor, 1. to determine the eye model and selected suitable radioisotope 2. to design the suitable shape of plaque 3. to measure transmission factor and dose distribution for custom made plaques 4. to compare with the these data and results of computer dose calculation models. The result were as followed. 1. Eye model was determined as a 25 mm diameter sphere, Ir-192 was considered the most appropriate as radioisotope for brachytherapy, because of the size, half, energy and availability. 2. Considering the biological response with human tissue and protection of exposed dose, we made the plaques with gold, of which size were 15 mm, 17 mm and 20 mm in diameter, and 1.5 mm in thickness. 3. Transmission factor of plaques are all 0.71 with TLD and film dosimetry at the surface of plaques and 0.45, 0.49 at 1.5 mm distance of surface, respectively. 4. As compared the measured data for the plaque with Ir-192 seeds to results of computer dose calculation model by Gary Luxton et al. and CAP-PLAN (Radiation Treatment Planning System), absorbed doses are within ±10% and distance deviations are within 0.4 mm Maximum error is -11.3% and 0.8 mm, respectively. As a result of it, we can treat the intraocular tumor more effectively by using custom made gold plaque and Ir-192

  6. Influence of the profile of Iridium-192 wire in measurements of quality control for use in brachytherapy

    International Nuclear Information System (INIS)

    Costa, Osvaldo L.; Zeituni, Carlos A.; Rostelato, Maria Elisa C.M.; Moura, Joao A.; Feher, Anselmo; Moura, Eduardo S.; Souza, Carla D.; Somessari, Samir L.; Peleias Junior, Fernando S.; Mattos, Fabio R.

    2013-01-01

    Brachytherapy is a method used in the treatment of cancerous tumors, by ionizing radiation produced by sources, introduced into the tumor area, this method seeks a more direct to the tumor, thereby maximizing the radiation dose to diseased tissue, while minimizing the dose to healthy tissues. One of the radionuclides used in brachytherapy is iridium-192. The Radiation Technology Center (CTR), of the Nuclear and Energy Research Institute (IPEN), has produced commercially, since 1998, iridium-192 wires used in low dose rate (LDR) brachytherapy. To produce this radionuclides, firstly an iridium-platinum wire is irradiated in the nuclear reactor IEA-R1 for 30 hours, with a neutron flux of 5x 10 13 n cm -2 s -1 , the wire is left to decay by 30 days to remove the main contaminants, and then goes through a quality control, before being sent to the hospital. In this quality control is checked the radiation homogeneity along each centimeter of the wire. To implement this procedure, is used a device, consisting of an ionization chamber, surrounded by a lead shield, with a samol 1 cm wide slit, linked to the ionization chamber is a voltage source, and a Keithley 617 electrometer, 2 minutes is the range used to measure the charge by the electrometer. The iridium wire is considered in accordance, when there is no variation higher than 5%, between the average measures and the maximum and minimum values. However, due to design features of the measurement system, the wire may appear to the detector through the slit in larger sizes than the ideal, improperly influencing the final quality control. This paper calculates the difference in size of these variations in profile, and their influence on the final count, it compares the actual values obtained, and describes the improvements, made in quality control procedures, that provided more accurate measurement data, analyzes the results, and suggests changes in devices, aimed at further improving the quality control of iridium-192

  7. CyberKnife Boost for Patients with Cervical Cancer Unable to Undergo Brachytherapy

    International Nuclear Information System (INIS)

    Haas, Jonathan Andrew; Witten, Matthew R.; Clancey, Owen; Episcopia, Karen; Accordino, Diane; Chalas, Eva

    2012-01-01

    Standard radiation therapy for patients undergoing primary chemosensitized radiation for carcinomas of the cervix usually consists of external beam radiation followed by an intracavitary brachytherapy boost. On occasion, the brachytherapy boost cannot be performed due to unfavorable anatomy or because of coexisting medical conditions. We examined the safety and efficacy of using CyberKnife stereotactic body radiotherapy (SBRT) as a boost to the cervix after external beam radiation in those patients unable to have brachytherapy to give a more effective dose to the cervix than with conventional external beam radiation alone. Six consecutive patients with anatomic or medical conditions precluding a tandem and ovoid boost were treated with combined external beam radiation and CyberKnife boost to the cervix. Five patients received 45 Gy to the pelvis with serial intensity-modulated radiation therapy boost to the uterus and cervix to a dose of 61.2 Gy. These five patients received an SBRT boost to the cervix to a dose of 20 Gy in five fractions of 4 Gy each. One patient was treated to the pelvis to a dose of 45 Gy with an external beam boost to the uterus and cervix to a dose of 50.4 Gy. This patient received an SBRT boost to the cervix to a dose of 19.5 Gy in three fractions of 6.5 Gy. Five percent volumes of the bladder and rectum were kept to ≤75 Gy in all patients (i.e., V75 Gy ≤ 5%). All of the patients remain locally controlled with no evidence of disease following treatment. Grade 1 diarrhea occurred in 4/6 patients during the conventional external beam radiation. There has been no grade 3 or 4 rectal or bladder toxicity. There were no toxicities observed following SBRT boost. At a median follow-up of 14 months, CyberKnife radiosurgical boost is well tolerated and efficacious in providing a boost to patients with cervix cancer who are unable to undergo brachytherapy boost. Further follow-up is required to see if these results remain durable.

  8. Assessment of Absorbed Dose in Persons close to the Patients during 192Ir brachytherapy for Cervical Cancer

    International Nuclear Information System (INIS)

    Jung, Joo Young; Kang, Se Sik

    2010-01-01

    According to the 2007 Annual Report of the National Cancer Registry, cervical cancer showed an occurring frequency of 7th in female cancers and 4rd in females with an age of 35-64 years. Both radiotherapy and chemotherapy are mainly used for the treatment of cervical cancer. In case of radiotherapy, brachytherapy using radioisotopes in conjunction with external-beam radiation therapy (EBRT) using a linear accelerator is used in most cases to improve the outcome of cancer treatment. Brachytherapy, one of the cervical cancer radiotherapies, is a method that can minimize the damage of normal tissues restricting absorbed dose to uterus. It is, however, necessary to conduct a quantitative assessment on brachytherapy because it may cause radiation exposure to medical care providers during the radiotherapy. Therefore, the study provides the basic research data regarding brachytherapy for cervical cancer, estimating the absorbed dose in persons close to the patients using a mathematical phantom during 192Ir brachytherapy for cervical cancer

  9. Dose heterogeneity correction for low-energy brachytherapy sources using dual-energy CT images

    Science.gov (United States)

    Mashouf, S.; Lechtman, E.; Lai, P.; Keller, B. M.; Karotki, A.; Beachey, D. J.; Pignol, J. P.

    2014-09-01

    Permanent seed implant brachytherapy is currently used for adjuvant radiotherapy of early stage prostate and breast cancer patients. The current standard for calculation of dose around brachytherapy sources is based on the AAPM TG-43 formalism, which generates the dose in a homogeneous water medium. Recently, AAPM TG-186 emphasized the importance of accounting for tissue heterogeneities. We have previously reported on a methodology where the absorbed dose in tissue can be obtained by multiplying the dose, calculated by the TG-43 formalism, by an inhomogeneity correction factor (ICF). In this work we make use of dual energy CT (DECT) images to extract ICF parameters. The advantage of DECT over conventional CT is that it eliminates the need for tissue segmentation as well as assignment of population based atomic compositions. DECT images of a heterogeneous phantom were acquired and the dose was calculated using both TG-43 and TG-43 × \\text{ICF} formalisms. The results were compared to experimental measurements using Gafchromic films in the mid-plane of the phantom. For a seed implant configuration of 8 seeds spaced 1.5 cm apart in a cubic structure, the gamma passing score for 2%/2 mm criteria improved from 40.8% to 90.5% when ICF was applied to TG-43 dose distributions.

  10. Separation of fission produced 106Ru from simulated high level nuclear wastes for production of brachytherapy sources

    International Nuclear Information System (INIS)

    Blicharska, Magdalena; Bartoś, Barbara; Krajewski, Seweryn; Bilewicz, Aleksander

    2014-01-01

    Brachytherapy is the common method for treating various tumors, and currently 106 Ru and 125 I applicators are the most frequently used. Considering that 106 Ru is a β emitter with maximum energy of 3.54 MeV, it is best indicated in the treatment of small melanomas, with up to 20 mm tissue range. 106 Ru is commercially obtained from neutron irradiated high enrichment 235 U target in process of production 99 Mo. At present, there are only a handful of ageing reactors worldwide capable of producing the 99 Mo, therefore alternative strategies for production of this key medical isotope are explored. In our work, we propose to use liquid high-level radioactive waste as a source of high activity of 106 Ru. Simple calculations indicate that 1 dm 3 of HLLW solution after 4 years of cooling contains about 500 GBq of 106 Ru. This amount of activity is enough for production of about few thousands of brachytherapy sources. Present communication reports results of our process development studies on the recovery of ruthenium radioisotopes from simulated solution of high level radioactive waste using oxidation-extraction method

  11. Brachytherapy in head and neck cancers; Curietherapie des cancers de la sphere ORL

    Energy Technology Data Exchange (ETDEWEB)

    Mazeron, J.J.; Noel, G.; Simon, J.M.; Racadot, S.; Jauffret, E. [Groupe Hospitalier la Pitie-Salpetriere, Centre des Tumeurs, 75 - Paris (France)

    2003-02-01

    Experience accumulated over several decades with radiation of Head and Neck tumours by irradiation has demonstrated the need for a high tumour dose to achieve local control. With external beam irradiation alone, it is difficult to spare adjacent normal tissues, resulting in undesirable late effects on the salivary glands; mandible, and muscles of mastication. Interstitial implantation is ideally suited to deliver a high dose limited to the volume of the primary tumor, thus minimizing sequels. A large experience has been accumulated with low dose rate (LDR) brachytherapy in treatment of carcinoma of oral cavity, oropharynx, and nasopharynx. Recent analysis of large clinical series provided data indicating that modalities of low dose rate brachytherapy should be optimized in treating these tumors for increasing therapeutic ratio. Low dose rate brachytherapy is now challenged by high dose rate (HDR) brachytherapy and pulsed dose rate (PDR) brachytherapy. Preliminary results obtained with these two last modalities are discussed regarding to those of low dose rate brachytherapy. (authors)

  12. Determination of the chemical yield on the Fricke dosimetry for 192Ir sources used in brachytherapy

    International Nuclear Information System (INIS)

    David, M.G.; Albuquerque, M.A.G.; Almeida, C.E. de; Rosado, P.H.

    2015-01-01

    With the aim of developing a primary standard for the absorbed dose to water, for the 192 Ir sources used in high dose rate brachytherapy, this work focuses on the determination of the chemical yield, G(Fe +3 ), using Fricke dosimetry, for the energy of those sources . The G(Fe +3 ) were determined the for three qualities of x-ray beams (150, 250 and 300 kV ) and for 60 Co energy. The G(Fe +3 ) value for the average energy of 192 Ir was obtained by linear fit, the found value was 1,555 ± 0,015 μmol/J. (author)

  13. Source of hope [El Salvador’s only brachytherapy centre

    International Nuclear Information System (INIS)

    Falcon Castro, Nancy

    2010-01-01

    Set up in 2008 with the IAEA’s support, the Cancer Institute 'Dr. Narciso Diaz Bazan' is El Salvador’s only brachytherapy treatment facility for women affected by uterine cancer. To date, over 1000 women affected by cervical cancer have received treatment in the centre

  14. Packing effects on the intracavitary radiation therapy of the uterine cervix cancer

    International Nuclear Information System (INIS)

    Cho, Jung Kun; Lee, Du Hyun; Si, Chang Kun; Choi, Yoon Kyung; Kim, Tae Yoon

    2004-01-01

    Purpose of the radio-therapy is maximize the radiation dose to the tumor while minimizing the dose to the critical organ. Carcinoma of the uterine cervix treatment are external irradiation or an interstitial brachytherapy make use of isotope. Brachytherapy is a method of radiotherapy in advantage to achieve better local control with minimum radiation toxicity in comparison with external irradiation because radiation dose is distributed according to the inverse square low of gamma-ray emitted from the implanted sources. Authors make use of the patients data which 192 Ir gives medical treatment intracavity. Intracavitary radiation of the uterine cervix cancer, critical organ take 20% below than exposure dose of A point in the ICRU report. None the less of the advice, Radiation proctitis and radiation cystitis are frequent and problematic early complications in patients treated with radiation for the uterine cervix cancer. In brachytherapy of uterine cervical cancer using a high dose rate remote afterloading system, it is of prime importance to deliver a accurate dose in each fractionated treatment by minimizing the difference between the pre-treatment planned and post-treatment calculated doses. Use of packing to reduce late complications intracavitary radiation of the uterine cervix cancer. Bladder and rectum changes exposure dose rate by radiotherapy make use of packing.

  15. Implementation of 'early alert system' area detector at patient from entrance in afterloading brachytherapy

    International Nuclear Information System (INIS)

    Videla Valdebenito, R.

    2001-01-01

    A system of area monitors to detect the involuntary exit of the radiation sources used in low dose rate deferred brachytherapy treatment is being implemented in all facilities in Chile. The first implementation of this system, named 'Early Alert', was 5 years ago as a complement to the administrative procedures and verification measures by the medical physics carried out through visual verifications and by means of portable radiation detectors. This detector of the system should be located preferentially at the exit of the treatment room at a height not smaller than two meters. This has resulted in an increase of facilities safety in this practice. (author) [es

  16. The Activity Check of Brachytherapy Isotope

    International Nuclear Information System (INIS)

    Kim, Gun Oh; Lee, Byung Koo; Kwon, Young Ho

    2004-01-01

    An isotope Ir-192, which is used in brachytherapy depends on import in whole quantities. There are a few ways for its activity. measurement using Welltype chamber or the way to rely on authentic decay table of manufacturer. In-air dosimetry using Farmer Chamber, etc. In this paper, let me introduce the way using Farmer chamber which is easier and simple. With the Farmer chamber and source calibration jig, take a measurement the activity of an isotope Ir-192 and compare the value with the value from decay table of manufacturer and check the activity of source. The result of measurement, compared the value from decay table, by ±2.1. (which belongs to recommendable value for AAPM ±5% as difference of error range). It is possible to use on clinical medicine. With the increase in use of brachytherapy, the increase of import is essential. And an accurate activity check of source is compulsory. For the activity check of source, it was possible to use Farmer chamber and source calibration jig without additional purchase of Well type chamber.

  17. Interstitial brachytherapy with 192-IR in treatment of recurrent malignant primary brain tumors

    International Nuclear Information System (INIS)

    Cardenes, R.; Martinez, R.; Victoria, C.; Nunez, L.; Clavo, B.; Sancedo, G.

    1994-01-01

    Seven patients with recurrent malignant primary brain tumors after surgery and radiation therapy were treated at the Clinica Puerta de Hierro (Madrid) by interstitial brachytherapy with 192-Ir sources. Implantations were performed using computerized tomography and dose prescription were determined following the Paris system rules for interstitial implants. The means dose deliberated was 50 to 65 Gy to the reference isodoses. At the last follow-up all patients except for one are alive and without evidence of progression of the disease. (Author) 35 refs

  18. Ionizing radiation, radiation sources, radiation exposure, radiation effects. Pt. 2

    International Nuclear Information System (INIS)

    Schultz, E.

    1985-01-01

    Part 2 deals with radiation exposure due to artificial radiation sources. The article describes X-ray diagnosis complete with an analysis of major methods, nuclear-medical diagnosis, percutaneous radiation therapy, isotope therapy, radiation from industrial generation of nucler energy and other sources of ionizing radiation. In conclusion, the authors attempt to asses total dose, genetically significant dose and various hazards of total radiation exposure by means of a summation of all radiation impacts. (orig./WU) [de

  19. BRIT manual after loading brachytherapy kit for intracavitary: initial experience

    International Nuclear Information System (INIS)

    Aggarwal, Lalit M.; Mandal, Abhijit; Asthana, Anupam K.; Shahi, Uday P.; Pradhan, Satyajit

    2007-01-01

    Brachytherapy continues to serve as an important and rapidly evolving tool in the management of cancer. Technological developments in the last two decades have dramatic impact on the safe practice of brachytherapy. A wide range of brachytherapy sources and equipment are available for new therapeutic possibilities. However, decision making with regard to new brachytherapy facilities are need based and depend on the patient load, socioeconomic status of the patients, and funds available with the institution. Remote afterloading equipments are fast replacing the Manual After Loading (MAL) systems. However, keeping in view the large number of patients, who can not afford expensive treatment, the utility of manual after loading system which is inexpensive, cannot be ignored

  20. Dosimetry in intravascular brachytherapy; Calculos dosimetricos em braquiterapia intravascular

    Energy Technology Data Exchange (ETDEWEB)

    Campos, Laelia Pumilla Botelho

    2000-03-01

    Among the cardiovascular diseases responsible for deaths in the adult population in almost all countries of the world, the most common is acute myocardial infarction, which generally occurs because of the occlusion of one or more coronary arteries. Several diagnostic techniques and therapies are being tested for the treatment of coronary artery disease. Balloon angioplasty has been a popular treatment which is less invasive than traditional surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment).Recently, the idea of delivering high radiation doses to coronary arteries to avoid or delay restenosis has been suggested. Known as intravascular brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis in some patient populations. In order to study the radiation dosimetry in the patient and radiological protection for the attending staff for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, o,30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several candidate radionuclides as well. Two s tent sources (metallic prosthesis that put inside of patient's artery through angioplasty) employing {sup 32} P are also simulated. Advantages and disadvantages of the various radionuclides and source geometries are discussed. The dosimetry developed here will aid in the realization of the benefits obtained in patients for this promising new technology. (author)

  1. Dosimetry in intravascular brachytherapy; Calculos dosimetricos em braquiterapia intravascular

    Energy Technology Data Exchange (ETDEWEB)

    Campos, Laelia Pumilla Botelho

    2000-03-01

    Among the cardiovascular diseases responsible for deaths in the adult population in almost all countries of the world, the most common is acute myocardial infarction, which generally occurs because of the occlusion of one or more coronary arteries. Several diagnostic techniques and therapies are being tested for the treatment of coronary artery disease. Balloon angioplasty has been a popular treatment which is less invasive than traditional surgeries involving revascularization of the myocardium, thus promising a better quality of life for patients. Unfortunately, the rate of restenosis (re-closing of the vessel) after balloon angioplasty is high (approximately 30-50% within the first year after treatment).Recently, the idea of delivering high radiation doses to coronary arteries to avoid or delay restenosis has been suggested. Known as intravascular brachytherapy, the technique has been used with several radiation sources, and researchers have obtained success in decreasing the rate of restenosis in some patient populations. In order to study the radiation dosimetry in the patient and radiological protection for the attending staff for this therapy, radiation dose distributions for monoenergetic electrons and photons (at nine discrete energies) were calculated for blood vessels of diameter 0.15, o,30 and 0.45 cm with balloon and wire sources using the radiation transport code MCNP4B. Specific calculations were carried out for several candidate radionuclides as well. Two s tent sources (metallic prosthesis that put inside of patient's artery through angioplasty) employing {sup 32} P are also simulated. Advantages and disadvantages of the various radionuclides and source geometries are discussed. The dosimetry developed here will aid in the realization of the benefits obtained in patients for this promising new technology. (author)

  2. Patterns of brachytherapy practice for patients with carcinoma of the cervix (1996-1999): A Patterns of Care Study

    International Nuclear Information System (INIS)

    Erickson, Beth; Eifel, Patricia; Moughan, Jennifer; Rownd, Jason M.S.; Iarocci, Thomas; Owen, Jean

    2005-01-01

    Purpose/Objective: To analyze the details of brachytherapy practice in patients treated for carcinoma of the cervix in the United States between 1996 and 1999. Methods and Materials: Radiation facilities were selected from a stratified random sample. Patients were randomly selected from lists of eligible patients treated at each facility. A total of 442 patients' records were reviewed in 59 facilities to obtain data about patients' characteristics, evaluation, tumor extent, and treatment. National estimates were made using weights that reflected the relative contribution of each institution and of each patient within the sampled institutions. From our survey we estimate that 16,375 patients were treated in the United States during this study period. Unless otherwise specified, brachytherapy practice was based on the 408 patients who had their brachytherapy or all their treatment at the surveyed facility. Results: A total of 91.5% of patients underwent brachytherapy at the initial treating institution; 8.5% were referred to a second site for brachytherapy. Forty-two percent of U.S. facilities referred at least some patients to a second facility for brachytherapy. Of U.S. facilities that treated ≤2 eligible patients per year, 61% referred all of their patients to a second facility for brachytherapy or treated with external RT alone; none of the U.S. facilities with larger experience (>2 eligible patients per year) referred all their patients to a second facility for brachytherapy treatment, but 28% referred some patients to an outside facility for brachytherapy. Overall, 94% of patients who completed treatment with curative intent received brachytherapy. Of these patients who had brachytherapy, 77.8%, 13.3%, and 0.9%, respectively, were treated with low-dose-rate (LDR), high-dose-rate (HDR), or a combination of HDR and LDR brachytherapy; 7.9% had interstitial brachytherapy (5.7% LDR and 1.9% HDR, 0.3% mixed). In facilities that treated >2 patients per year, 15

  3. Radiological protection on interstitial brachytherapy and dose determination and exposure rate of an Ir-192 source through the MCNP-4B; Proteccion radiologica en braquiterapia intersticial y determinacion de la dosis y tasa de exposicion de una fuente de Ir-192 mediante el MCNP-4B

    Energy Technology Data Exchange (ETDEWEB)

    Morales L, M.E. [INEN, Av. Angamos Este 2520- Surquillo, Lima (Peru)

    2006-07-01

    The present work was carried out in the Neurological Sciences Institute having as objective to determine the dose and the rate of exhibition of the sources of Iridium 192, Iodine 125 and Palladium 103; which are used to carry out implant in the Interstitial Brachytherapy according to the TG43. For it we carry out a theoretical calculation, its are defined in the enter file: the geometry, materials of the problem and the radiation source, etc; in the MCNP-4B Monte Carlo code, considering a punctual source and for the dose determination we simulate thermoluminescent dosemeters (TLD): at 5 cm, 50 cm, 100 cm and 200 cm of the source. Our purpose is to analyze the radioprotection measures that should take into account in this Institute in which are carried out brain biopsies using a Micro mar stereotactic mark, and in a near future with the collaboration of a doctor and a cuban physique seeks to be carried out the Interstitial Brachytherapy technique with sources of Ir-192 for patient with tumors like glioblastoma, astrocytoma, etc. (Author)

  4. Evaluation of interpolation methods for TG-43 dosimetric parameters based on comparison with Monte Carlo data for high-energy brachytherapy sources.

    Science.gov (United States)

    Pujades-Claumarchirant, Ma Carmen; Granero, Domingo; Perez-Calatayud, Jose; Ballester, Facundo; Melhus, Christopher; Rivard, Mark

    2010-03-01

    The aim of this work was to determine dose distributions for high-energy brachytherapy sources at spatial locations not included in the radial dose function g L ( r ) and 2D anisotropy function F ( r , θ ) table entries for radial distance r and polar angle θ . The objectives of this study are as follows: 1) to evaluate interpolation methods in order to accurately derive g L ( r ) and F ( r , θ ) from the reported data; 2) to determine the minimum number of entries in g L ( r ) and F ( r , θ ) that allow reproduction of dose distributions with sufficient accuracy. Four high-energy photon-emitting brachytherapy sources were studied: 60 Co model Co0.A86, 137 Cs model CSM-3, 192 Ir model Ir2.A85-2, and 169 Yb hypothetical model. The mesh used for r was: 0.25, 0.5, 0.75, 1, 1.5, 2-8 (integer steps) and 10 cm. Four different angular steps were evaluated for F ( r , θ ): 1°, 2°, 5° and 10°. Linear-linear and logarithmic-linear interpolation was evaluated for g L ( r ). Linear-linear interpolation was used to obtain F ( r , θ ) with resolution of 0.05 cm and 1°. Results were compared with values obtained from the Monte Carlo (MC) calculations for the four sources with the same grid. Linear interpolation of g L ( r ) provided differences ≤ 0.5% compared to MC for all four sources. Bilinear interpolation of F ( r , θ ) using 1° and 2° angular steps resulted in agreement ≤ 0.5% with MC for 60 Co, 192 Ir, and 169 Yb, while 137 Cs agreement was ≤ 1.5% for θ energy brachytherapy sources, and was similar to commonly found examples in the published literature. For F ( r , θ ) close to the source longitudinal-axis, polar angle step sizes of 1°-2° were sufficient to provide 2% accuracy for all sources.

  5. High-dose-rate brachytherapy using molds for oral cavity cancer. The technique and its limitations

    International Nuclear Information System (INIS)

    Nishimura, Yasumasa; Yokoe, Yoshihiko; Nagata, Yasushi; Okajima, Kaoru; Nishida, Mitsuo; Hiraoka, Masahiro

    1998-01-01

    With the availability of a high-dose-rate (HDR) remote afterloading device, a Phase I/II protocol was initiated at our institution to assess the toxicity and efficacy of HDR intracavitary brachytherapy, using molds, in the treatment of squamous cell carcinomas of the oral cavity. Eight patients with squamous cell carcinoma of the oral cavity were treated by the technique. The primary sites of the tumors were the buccal mucosa, oral floor, and gingiva. Two of the buccal mucosal cancers were located in the retromolar trigon. For each patient, a customized mold was fabricated, in which two to four afterloading catheters were placed for an 192 Ir HDR source. Four to seven fractions of 3-4 Gy, 5 mm below the mold surface, were given following external radiation therapy of 40-60 Gy/ 2 Gy. The total dose of HDR brachytherapy ranged from 16 to 28Gy. Although a good initial complete response rate of 7/8 (88%) was achieved, there was local recurrence in four of these seven patients. Both of the retromolar trigon tumors showed marginal recurrence. No serious (e.g., ulcer or bone exposure) late radiation damage has been observed thus far in the follow up period of 15-57 months. High-dose-rate brachytherapy using the mold technique seems a safe and useful method for selected early and superficial oral cavity cancer. However, it is not indicated for thick tumors and/or tumors located in the retromolar trigon. (author)

  6. A systematic evaluation of the dose-rate constant determined by photon spectrometry for 21 different models of low-energy photon-emitting brachytherapy sources.

    Science.gov (United States)

    Chen, Zhe Jay; Nath, Ravinder

    2010-10-21

    The aim of this study was to perform a systematic comparison of the dose-rate constant (Λ) determined by the photon spectrometry technique (PST) with the consensus value ((CON)Λ) recommended by the American Association of Physicists in Medicine (AAPM) for 21 low-energy photon-emitting interstitial brachytherapy sources. A total of 63 interstitial brachytherapy sources (21 different models with 3 sources per model) containing either (125)I (14 models), (103)Pd (6 models) or (131)Cs (1 model) were included in this study. A PST described by Chen and Nath (2007 Med. Phys. 34 1412-30) was used to determine the dose-rate constant ((PST)Λ) for each source model. Source-dependent variations in (PST)Λ were analyzed systematically against the spectral characteristics of the emitted photons and the consensus values recommended by the AAPM brachytherapy subcommittee. The values of (PST)Λ for the encapsulated sources of (103)Pd, (125)I and (131)Cs varied from 0.661 to 0.678 cGyh(-1) U(-1), 0.959 to 1.024 cGyh(-1)U(-1) and 1.066 to 1.073 cGyh(-1)U(-1), respectively. The relative variation in (PST)Λ among the six (103)Pd source models, caused by variations in photon attenuation and in spatial distributions of radioactivity among the source models, was less than 3%. Greater variations in (PST)Λ were observed among the 14 (125)I source models; the maximum relative difference was over 6%. These variations were caused primarily by the presence of silver in some (125)I source models and, to a lesser degree, by the variations in photon attenuation and in spatial distribution of radioactivity among the source models. The presence of silver generates additional fluorescent x-rays with lower photon energies which caused the (PST)Λ value to vary from 0.959 to 1.019 cGyh(-1)U(-1) depending on the amount of silver used by a given source model. For those (125)I sources that contain no silver, their (PST)Λ was less variable and had values within 1% of 1.024 cGyh(-1)U(-1). For the 16

  7. Characteristics of the radiochromic film Gafchromictm EBT3 model for use in brachytherapy; Caracterizacao do filme radiocromico Gafchromictm modelo EBT3 para uso em braquiterapia

    Energy Technology Data Exchange (ETDEWEB)

    Luvizotto, Jessica

    2015-07-01

    Brachytherapy is a radiotherapy treatment modality using radioactive sealed sources within walking distance of the tumor, reducing the risk of applying an unwanted dose to adjacent healthy tissues. For brachytherapy is reliable, it is necessary to establish a dosimetric practices program aimed at determining the optimal dose of radiation for this radiotherapy practice. This paper presents the application of two methodologies for the dosimetry using radiochromic films. Experimental measurements were performed with EBT3 films in phantoms consisting of homogeneous and heterogeneous material (lung, bone and soft tissue) built especially for dose measurements in brachytherapy. The processing and analysis of the resulting images of the experimental procedure were performed with ImageJ software and MATLAB. The results were evaluated from comparisons dose of experimental measurements and simulations obtained by the Monte Carlo method. (author)

  8. [Role of the technician in a brachytherapy department].

    Science.gov (United States)

    Bélot-Cheval, V; Lemoine, L; Cuisinier, C; Gensse, M-C; Lasbareilles, O

    2013-04-01

    The role of the technician in a brachytherapy department is essential for the cohesion of the treatment team made up of the radiation oncologist, the physicist, and the technician. He/she collaborates in the different treatment steps such as taking care of the patients, training of the professionals and research studies in collaboration with the team. He participates in all steps of the treatment such as preparation, technician's consultation, catheters/templates and radioactives sources implant, dose distribution analysis and treatment. He looks after the management of planning, radioactive sources and chemist's equipments. He takes part in the training of the junior technician, and support doctors and physicists in different studies. The procedure writing and the presentation of professional practices are also part of the technician task. Copyright © 2013 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  9. MO-B-BRC-01: Introduction [Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Prisciandaro, J. [University of Michigan (United States)

    2016-06-15

    Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra- or post-operative setting. During intra-operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra-operative prostate HDR is U/S. Alternatively, in the post-operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations. Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting. Learning Objectives: Review prostate HDR techniques based on the imaging modality Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions.

  10. Changes in the micromorphology of the corneal subbasal nerve plexus in patients after plaque brachytherapy

    International Nuclear Information System (INIS)

    Zhivov, Andrey; Winter, Karsten; Peschel, Sabine; Stachs, Oliver; Wree, Andreas; Hildebrandt, Guido; Guthoff, Rudolf

    2013-01-01

    To quantify the development of radiation neuropathy in corneal subbasal nerve plexus (SNP) after plaque brachytherapy, and the subsequent regeneration of SNP micromorphology and corneal sensation. Nine eyes of 9 melanoma patients (ciliary body: 3, iris: 2, conjunctiva: 4) underwent brachytherapy (ruthenium-106 plaque, dose to tumour base: 523 ± 231 Gy). SNP micromorphology was assessed by in-vivo confocal microscopy. Using software developed in–house, pre-irradiation findings were compared with those obtained after 3 days, 1, 4 and 7 months, and related to radiation dose and corneal sensation. After 3 days nerve fibres were absent from the applicator zone and central cornea, and corneal sensation was abolished. The earliest regenerating fibres were seen at the one-month follow-up. By 4 months SNP structures had increased to one-third of pre-treatment status (based on nerve fibre density and nerve fibre count), and corneal sensation had returned to approximately two-thirds of pre-irradiation values. Regeneration of SNP and corneal sensation was nearly complete 7 months after plaque brachytherapy. The evaluation of SNP micromorphology and corneal sensation is a reliable and clinically useful method for assessing neuropathy after plaque brachytherapy. Radiation-induced neuropathy of corneal nerves develops quickly and is partly reversible within 7 months. The clinical impact of radiation-induced SNP damage is moderate

  11. Methods for prostate stabilization during transperineal LDR brachytherapy.

    Science.gov (United States)

    Podder, Tarun; Sherman, Jason; Rubens, Deborah; Messing, Edward; Strang, John; Ng, Wan-Sing; Yu, Yan

    2008-03-21

    In traditional prostate brachytherapy procedures for a low-dose-rate (LDR) radiation seed implant, stabilizing needles are first inserted to provide some rigidity and support to the prostate. Ideally this will provide better seed placement and an overall improved treatment. However, there is much speculation regarding the effectiveness of using regular brachytherapy needles as stabilizers. In this study, we explored the efficacy of two types of needle geometries (regular brachytherapy needle and hooked needle) and several clinically feasible configurations of the stabilization needles. To understand and assess the prostate movement during seed implantation, we collected in vivo data from patients during actual brachytherapy procedures. In vitro experimentation with tissue-equivalent phantoms allowed us to further understand the mechanics behind prostate stabilization. We observed superior stabilization with the hooked needles compared to the regular brachytherapy needles (more than 40% in bilateral parallel needle configuration). Prostate movement was also reduced significantly when regular brachytherapy needles were in an angulated configuration as compared to the parallel configuration (more than 60%). When the hooked needles were angulated for stabilization, further reduction in prostate displacement was observed. In general, for convenience of dosimetric planning and to avoid needle collision, all needles are desired to be in a parallel configuration. In this configuration, hooked needles provide improved stabilization of the prostate. On the other hand, both regular and hooked needles appear to be equally effective in reducing prostate movement when they are in angulated configurations, which will be useful in seed implantation using a robotic system. We have developed nonlinear spring-damper model for the prostate movement which can be used for adapting dosimetric planning during brachytherapy as well as for developing more realistic haptic devices and

  12. Methods for prostate stabilization during transperineal LDR brachytherapy

    International Nuclear Information System (INIS)

    Podder, Tarun; Yu Yan; Sherman, Jason; Rubens, Deborah; Strang, John; Messing, Edward; Ng, Wan-Sing

    2008-01-01

    In traditional prostate brachytherapy procedures for a low-dose-rate (LDR) radiation seed implant, stabilizing needles are first inserted to provide some rigidity and support to the prostate. Ideally this will provide better seed placement and an overall improved treatment. However, there is much speculation regarding the effectiveness of using regular brachytherapy needles as stabilizers. In this study, we explored the efficacy of two types of needle geometries (regular brachytherapy needle and hooked needle) and several clinically feasible configurations of the stabilization needles. To understand and assess the prostate movement during seed implantation, we collected in vivo data from patients during actual brachytherapy procedures. In vitro experimentation with tissue-equivalent phantoms allowed us to further understand the mechanics behind prostate stabilization. We observed superior stabilization with the hooked needles compared to the regular brachytherapy needles (more than 40% in bilateral parallel needle configuration). Prostate movement was also reduced significantly when regular brachytherapy needles were in an angulated configuration as compared to the parallel configuration (more than 60%). When the hooked needles were angulated for stabilization, further reduction in prostate displacement was observed. In general, for convenience of dosimetric planning and to avoid needle collision, all needles are desired to be in a parallel configuration. In this configuration, hooked needles provide improved stabilization of the prostate. On the other hand, both regular and hooked needles appear to be equally effective in reducing prostate movement when they are in angulated configurations, which will be useful in seed implantation using a robotic system. We have developed nonlinear spring-damper model for the prostate movement which can be used for adapting dosimetric planning during brachytherapy as well as for developing more realistic haptic devices and

  13. Medical physics aspects of ophthalmic brachytherapy

    International Nuclear Information System (INIS)

    Sharma, S.D.; Shanta, A.; Palani Selvam, T.; Tripathi, U.B.; Bhatt, B.C.

    2004-11-01

    Intraocular melanoma is the most common primary malignancy of the eye. Radiation therapy using ophthalmic plaque has proved successful in the management of various ocular lesions. Although a few centres were using 90 Sr/ 90 Y plaques for shallow turtlours some years ago, eye plaque therapy was not a common practice in India. A revived interest in the use of eye plaque therapy and very high cost of imported sources has led to the development and production of 125 I seed sources by the Radiopharmaceuticals Division, BARC. This report presents a brief description on the clinical, dosimetry and radiation safety aspects of 90 Sr/ 90 Y and 106 Ru/ 106 Rh beta ray and 125 I gamma ray eye plaque applicators. This report has been divided in five Sections. Section I presents general introduction of ophthalmic brachytherapy including the structure of a human eye, types of ophthalmic plaques and characteristics of radioisotopes commonly used in such applications. A brief review of sources, applicators and dosimetry of 90 Sr/ 90 Y and 106 Ru/ 106 Rh beta and 125 I gamma ophthalmic plaques are given in Section II and Section III, respectively. Section IV contains the single seed dosimetry data of BARC OcuProsta 125 I seed as well as dosimetry data of typical eye plaques loaded with BARC OcuProsta 125 I seed. Quality assurance and radiation safety aspects of these eye applicators are described in Section V. A proforma of the application required to be filled in by the user institution for obtaining regulatory consent to start eye plaque therapy has also been appended to this report. (author)

  14. Pulsed Dose Rate (PDR - BT) brachytherapy in treatment of breast cancer

    International Nuclear Information System (INIS)

    Skowronek, J.

    2007-01-01

    Breast conserving surgery (BCS) and radiotherapy (EBRT) of the conserved breast became widely accepted in the last decades for the treatment of early invasive breast cancer. The standard technique of RT after breast conservation is to treat the whole breast up to a total dose of 45 to 50 Gy. Initially brachytherapy for breast cancer was used in addition of external radiation to boost a portion of the breast to higher doses. However, over the past 10 years, the application of brachytherapy in breast cancer has changed. In early stage breast cancer, research has shown that the area that requires radiation treatment to prevent the cancer from returning is the breast tissue that surrounds the area where the initial cancer was removed. Because this typically includes only a part of the breast, brachytherapy is now being used to treat the targeted portion of the breast and as a result allows accelerated delivery of the radiation dose so that treatment is completed in four to five days. Another indications for PDR - BT as a part of treatment in locally advanced breast cancer or as a palliative treatment are discussed in the paper, too. Preliminary results with PDR - BT boost technique are promising. However, more experience and longer follow-up are required to define whether these methods might improve local tumor control for breast cancer patients. In this article the current status, indications, technical aspects and published results of PDR brachytherapy (PDR - BT) in breast cancer treatment are reviewed. (author)

  15. Computed tomography in brachytherapy

    International Nuclear Information System (INIS)

    Mansfield, C.M.; Lee, K.R.; Dwyer, S.; Zellmer, D.; Cook, P.

    1983-01-01

    CT scanning adds to the ability to evaluate brachytherapy techniques. It provides an additional method in the assessment of patients who are candidates for or who are being treated by brachytherapy. The CT scan can give information regarding the position of the sources and their relation to the tumor and normal structures with greater ease than do orthogonal views. This makes it possible to accurately calculate areas of high or low dose. Potential areas of overdose can be recognized, thereby decreasing the chances of postbrachytherapy complications. CT scanning can be used at various levels of complexity in dosimetry evaluation. Adequate brachytherapy dosimetry information is obtainable from CT slices through one or more levels of the implanted volume. In some instances it is possible to obtain additional information by reconstructing the scans in other planes, e.g., coronal or sagittal. Three-dimensional viewing of the implant is desirable, but it should be pointed out that this approach is time-consuming and beyond the capabilities of most institutions at present. It will be necessary to continue work on three-dimensional treatment planning to make it readily available

  16. Curative high dose rate vaginal apex brachytherapy in stage I papillary serous carcinoma of the endometrium

    International Nuclear Information System (INIS)

    Turner, B.C.; Kacinski, B.M.; Gumbs, A.; Peschel, R.E.; Haffty, B.G.; Wilson, L.D.

    1996-01-01

    Introduction: Uterine papillary serous carcinoma (UPSC) is a morphologically distinct variant of endometrial carcinoma that is associated with a poor prognosis, high recurrence rate, clinical understaging, and poor response to salvage treatment. We describe the presentation, local and distant control, survival, salvage rate, and complications for patients undergoing whole abdominal radiation therapy (WART), low dose rate (LDR) intracavitary brachytherapy, or high dose rate (HDR) vaginal brachytherapy in patients with stage I UPSC. Methods: Between 1976 and 1994 more than 1700 patients with endometrial carcinoma were treated with radiation therapy, 30 patients with stage I UPSC (1.8%) were treated with radiation before or following TAH/BSO. All patients underwent either preoperative Simon's packing or tandem and plaque which delivered 30-40 Gy to the serosa, WART, or HDR Ir-192 vaginal apex brachytherapy to a total dose of 21 Gy in 3 fractions at 0.5 cm from the vaginal mucosa. A total of 14 patients received HDR vaginal brachytherapy and (5(14)) patients received systemic chemotherapy. All patients presented with vaginal bleeding at a median age of 67 years (range 34-88). The group of 30 patients underwent TAH/BSO, 17 patients were completely staged pathologically (pelvic and para-aortic lymph nodes, omentectomy, and pelvic washings), and 2 patients underwent omental biopsy and pelvic washings only. All specimens revealed UPSC, nuclear grade 3, and lymphovascular invasion (23%). The pathologic stage was IA: 23% (7), IB: 67% (20), and IC: 10% (3). The median follow-up for all patients was 49 months (range 13-187 months). For the patients receiving postoperative HDR vaginal brachytherapy the median time from surgery to radiation was 42 days (range 29-91). Results: The 5-year actuarial disease free survival for Figo stage I UPSC patients treated with postoperative HDR vaginal brachytherapy and systemic chemotherapy was 100% compared to 74% for stage I UPSC patient

  17. Focal low-dose rate brachytherapy for the treatment of prostate cancer

    Directory of Open Access Journals (Sweden)

    Tong WY

    2013-09-01

    Full Text Available William Y Tong, Gilad Cohen, Yoshiya Yamada Memorial Sloan-Kettering Cancer Center, Department of Radiation Oncology, New York, NY, USA Abstract: Whole-gland low-dose rate (LDR brachytherapy has been a well-established modality of treating low-risk prostate cancer. Treatment in a focal manner has the advantages of reduced toxicity to surrounding organs. Focal treatment using LDR brachytherapy has been relatively unexplored, but it may offer advantages over other modalities that have established experiences with a focal approach. This is particularly true as prostate cancer is being detected at an earlier and more localized stage with the advent of better detection methods and newer imaging modalities. Keywords: prostate cancer, focal, low dose rate, brachytherapy

  18. Study and development of methodology for radioactive iodine fixation in polymeric substrate for manufacturing sources used in brachytherapy

    International Nuclear Information System (INIS)

    Rodrigues, Bruna T.; Souza, Carla D.; Benega, Marcos A.G. and others

    2014-01-01

    According global estimates of Globocan 2012 project of the International Agency for Research of Cancer, of the World Health Organization, there were 14,1 million new cases of cancer and a total of 8,2 million deaths from cancer. Also show that in 2030, the overall load will be 21,4 million new cases and 13,2 million cancer deaths. One of the prostate cancer therapy is brachytherapy, used in early and middle stages of the disease. It is made with the introduction of seeds with radioactive material within the tumor or in nearby regions, affecting the minimum surrounding tissues. The aim of this work is the study and developing the deposition of radioactive iodine on the polymeric substrate method, and an analysis relating the efficiency of the method to implementation in the laboratory of brachytherapy from IPEN. Iodine-125 is adsorbed on an epoxy resin solution. The objective of this study is to offer a new proposal for seeds. The results will give the data for the radiation protection and the procedures for radioactive waste management

  19. Implants with {sup 32}P-foils for LDR-brachytherapy of benign stenosis in urology and gastroenterology; {sup 32}P-haltige Folien als Implantate fuer die LDR-Brachytherapie gutartiger Stenosen in der Urologie und Gastroenterologie

    Energy Technology Data Exchange (ETDEWEB)

    Assmann, Walter [Ludwig-Maximilians-Univ., Muenchen (Germany). Fakultaet fuer Physik; Becker, Ricarda; Otto, Henrike [Klinikum der Universitaet Muenchen, Campus Grosshadern (Germany). Laser-Forschungslabor] [and others

    2013-03-01

    For LDR-brachytherapy, a limited number of implant geometries and materials are available. To avoid wound healing related hyper-proliferation (stenosis, keloids) a novel radioactive foil system was developed based on beta emitting {sup 32}P, which can be easily integrated in existing implants such as urethral catheters or bile duct stents. As substrate material for these foils PEEK (polyetherethercetone) was chosen because of its radiation hardness during neutron activation of {sup 32}P. The activity was determined by liquid scintillation counting and gamma spectroscopy, dose distributions were measured with scintillation detectors and radiochromic films. The correlation between activity and dose was checked by Monte-Carlo-simulations (Geant4). Prototypes of the {sup 32}P-implants have shown in wash-out tests the required tightness for sealed radioactive sources. In animal tests on urethra and bile duct, the uncomplicated and save application of {sup 32}P-foils mounted on standard implants has been demonstrated, which is almost unchanged due to the simple radiation protection with plexiglass. This concept of radioactive implants with integrated {sup 32}P-foils could extend essentially the application possibilities of LDR-brachytherapy. (orig.)

  20. High dose rate brachytherapy for superficial cancer of the esophagus

    International Nuclear Information System (INIS)

    Maingon, Philippe; D'Hombres, Anne; Truc, Gilles; Barillot, Isabelle; Michiels, Christophe; Bedenne, Laurent; Horiot, Jean Claude

    2000-01-01

    Purpose: We analyzed our experience with external radiotherapy, combined modality treatment, or HDR brachytherapy alone to limited esophageal cancers. Methods and Materials: From 1991 to 1996, 25 patients with limited superficial esophagus carcinomas were treated by high dose rate brachytherapy. The mean age was 63 years (43-86 years). Five patients showed superficial local recurrence after external radiotherapy. Eleven patients without invasion of the basal membrane were staged as Tis. Fourteen patients with tumors involving the submucosa without spreading to the muscle were staged as T1. Treatment consisted of HDR brachytherapy alone in 13 patients, external radiotherapy and brachytherapy in 8 cases, and concomitant chemo- and radiotherapy in 4 cases. External beam radiation was administered to a total dose of 50 Gy using 2 Gy daily fractions in 5 weeks. In cases of HDR brachytherapy alone (13 patients), 6 applications were performed once a week. Results: The mean follow-up is 31 months (range 24-96 months). Twelve patients received 2 applications and 13 patients received 6 applications. Twelve patients experienced a failure (48%), 11/12 located in the esophagus, all of them in the treated volume. One patient presented an isolated distant metastasis. In the patients treated for superficial recurrence, 4/5 were locally controlled (80%) by brachytherapy alone. After brachytherapy alone, 8/13 patients were controlled (61%). The mean disease-free survival is 14 months (1-36 months). Overall survival is 76% at 1 year, 37% at 2 years, and 14% at 3 years. Overall survival for Tis patients is 24% vs. 20% for T1 (p 0.83). Overall survival for patients treated by HDR brachytherapy alone is 43%. One patient presented with a fistula with local failure after external radiotherapy and brachytherapy. Four stenosis were registered, two were diagnosed on barium swallowing without symptoms, and two required dilatations. Conclusion: High dose rate brachytherapy permits the treating

  1. Recommendations of the EVA GEC ESTRO Working Group: prescribing, recording, and reporting in endovascular brachytherapy. Quality assurance, equipment, personnel and education

    International Nuclear Information System (INIS)

    Poetter, Richard; Limbergen, Erik van; Dries, Wim; Popowski, Youri; Coen, Veronique; Fellner, Claudia; Georg, Dietmar; Kirisits, Christian; Levendag, Peter; Marijnissen, Hans; Marsiglia, Hugo; Mazeron, Jean-Jaques; Pokrajac, Boris; Scalliet, Pierre; Tamburini, Vittorio

    2001-01-01

    Endovascular brachytherapy is a new, rapidly growing field of interest in radiotherapy for the prevention of neointimal hyperplasia after angioplasty in both coronary and peripheral arteries. Many physics aspects of these treatments have already been addressed in the report of the American Association of Physicists in Medicine task group on 'Intravascular brachytherapy', but up to now there are no generally accepted recommendations for recording and reporting radiation doses and volumes. The terminology to be used by all individuals involved in such treatments (radiation oncologists, physicists, and interventionalists) is not clearly defined. The Endovascular Groupe Europeen de Curietherapie/European Society for Therapeutic Radiology and Oncology Working Group in this document presents recommendations for a common language for general use in endovascular brachytherapy. This proposal addresses general terms and concepts for target and dose specification as well as detailed recommendations for dose prescription, recording and reporting in endovascular brachytherapy for both peripheral and coronary arteries. Additionally, quality assurance and radiation safety aspects are briefly addressed, as are aspects related to equipment, personnel, and training and education related to endovascular brachytherapy

  2. Custom-made micro applicators for high-dose-rate brachytherapy treatment of chronic psoriasis

    Directory of Open Access Journals (Sweden)

    Ivan M. Buzurovic

    2017-06-01

    Full Text Available Purpose: In this study, we present the treatment of the psoriatic nail beds of patients refractory to standard therapies using high-dose-rate (HDR brachytherapy. The custom-made micro applicators (CMMA were designed and constructed for radiation dose delivery to small curvy targets with complicated topology. The role of the HDR brachytherapy treatment was to stimulate the T cells for an increased immune response. Material and methods: The patient diagnosed with psoriatic nail beds refractory to standard therapies received monthly subunguinal injections that caused significant pain and discomfort in both hands. The clinical target was defined as the length from the fingertip to the distal interphalangeal joint. For the accurate and reproducible setup in the multi-fractional treatment delivery, the CMMAs were designed. Five needles were embedded into the dense plastic mesh and covered with 5 mm bolus material for each micro applicator. Five CMMAs were designed, resulting in the usage of 25 catheters in total. Results: The prescription dose was planned to the depth of the anterior surface of the distal phalanx, allowing for the sparing of the surrounding tissue. The total number of the active dwell positions was 145 with step size of 5 mm. The total treatment time was 115 seconds with a 7.36 Ci activity of the 192Ir source. The treatment resulted in good pain control. The patient did not require further injections to the nail bed. After this initial treatment, additional two patients with similar symptoms received HDR brachytherapy. The treatment outcome was favorable in all cases. Conclusions : The first HDR brachytherapy treatment of psoriasis of the nail bed is presented. The initial experience revealed that brachytherapy treatment was well-tolerated and resulted in adequate control of the disease. A larger cohort of patients will be required for additional conclusions related to the long-term clinical benefits.

  3. Randomized comparison between intracoronary β-radiation brachytherapy and implantation of paclitaxel-eluting stents for the treatment of diffuse in-stent restenosis

    International Nuclear Information System (INIS)

    Schukro, Christoph; Syeda, Bonni; Kirisits, Christian; Schmid, Rainer; Pichler, Philipp; Pokrajac, Boris; Lang, Irene; Poetter, Richard; Glogar, Dietmar

    2007-01-01

    Background and purpose: Intracoronary brachytherapy was the primary therapeutic option for the treatment of in-stent restenosis (ISR) during the last years. Especially for the treatment of diffuse ISR (lesions >10 mm), β-source brachytherapy was significantly superior to singular balloon angioplasty. Despite lacking clinical database, the implantation of drug eluting stents recently became a common procedure for the treatment of ISR. This randomized trial aimed to compare the efficacy of β-brachytherapy with β-radioisotopes 90 Sr/ 90 Y and paclitaxel-eluting stent implantation for the treatment of diffuse ISR. Material and methods: Thirty-seven patients with diffuse ISR were randomly assigned to β-brachytherapy after balloon angioplasty (Beta-Cath TM in 17 patients) or paclitaxel-eluting stent implantation (Taxus-Express2 TM in 20 patients). Six-month clinical follow-up was obtained for all patients, while angiographic follow-up was available for 30 patients. Results: Binary ISR (restenosis >50%) within target segment was observed in three patients treated with Beta-Cath TM , of which one needed target segment revascularisation for recurrent ISR, whereas no significant restenosis occurred in the patients treated with Taxus-Express2 TM (P = 0.037). No further major adverse cardiac (target segment revascularisation, myocardial infarction, death) was found in either group (P = NS). Stent implantation was the more time-saving (31 ± 11 min versus 60 ± 23 min, P TM arm, we found no difference in clinical outcome after implantation of paclitaxel-eluting stents for the treatment of diffuse ISR when compared to β-brachytherapy

  4. Proficiency-based cervical cancer brachytherapy training.

    Science.gov (United States)

    Zhao, Sherry; Francis, Louise; Todor, Dorin; Fields, Emma C

    2018-04-25

    also be created for other technically challenging radiation oncology procedures. Copyright © 2018 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  5. Comparison between methods for fixing radioactive iodine in silver substrate for manufacturing brachytherapy sources

    International Nuclear Information System (INIS)

    Souza, Carla Daruich

    2012-01-01

    Among the different ways to treat prostate cancer, brachytherapy with iodine- 125 seeds is an option that provides good results and fewer side effects. In the present study several deposition methods of radioactive iodine in a silver substrate were compared in order to choose the most suitable alternative for the routine production to be implemented at IPEN's laboratory. The methodology used was chosen based on the available infrastructure and experience of the researchers present. Therefore, the 131 I was used for testing (same chemical behavior as 131 I). Four methods were selected: Method 1 (test based on electrodeposition method developed by D.Kubiatowicz) presented 65.16% efficiency; Method 2 (chemical reaction based on the method developed by D. Kubiatowicz - HCl) with the result of 70.80% efficiency; method 3 (chemical reaction based on the method developed by Dr. Maria Elisa Rostelato) with 55.80% efficiency; Method 4 (IQ-IPEN) resulted in 99% efficiency. Since this method has more radioactive material fixation (which represents virtually the entire cost of the seed), the final price is the cheapest. This method is the suggested one to be implemented in the IPEN's laboratory for brachytherapy sources production. Besides, the method is the fasted one. (author)

  6. [Implants with 32P-foils for LDR-brachytherapy of benign stenosis in urology and gastroenterology].

    Science.gov (United States)

    Assmann, Walter; Becker, Ricarda; Otto, Henrike; Bader, Markus; Clemente, Lucas; Reinhardt, Sabine; Schäfer, Claus; Schirra, Jörg; Uschold, Stephanie; Welzmüller, Andreas; Sroka, Ronald

    2013-02-01

    For LDR-brachytherapy, a limited number of implant geometries and materials are available. To avoid wound healing related hyper-proliferation (stenosis, keloids) a novel radioactive foil system was developed based on beta emitting (32)P, which can be easily integrated in existing implants such as urethral catheters or bile duct stents. As substrate material for these foils PEEK (polyetherethercetone) was chosen because of its radiation hardness during neutron activation of (32)P. The activity was determined by liquid scintillation counting and gamma spectroscopy, dose distributions were measured with scintillation detectors and radiochromic films. The correlation between activity and dose was checked by Monte-Carlo-simulations (Geant4). Prototypes of the (32)P-implants have shown in wash-out tests the required tightness for sealed radioactive sources. In animal tests on urethra and bile duct, the uncomplicated and save application of (32)P-foils mounted on standard implants has been demonstrated, which is almost unchanged due to the simple radiation protection with plexiglass. This concept of radioactive implants with integrated (32)P-foils could extend essentially the application possibilities of LDR-brachytherapy. Copyright © 2012. Published by Elsevier GmbH.

  7. Perioperative high dose rate (HDR brachytherapy in unresectable locally advanced pancreatic tumors

    Directory of Open Access Journals (Sweden)

    Brygida Białas

    2011-07-01

    Full Text Available Purpose: The aim of the study was to present an original technique of catheter implantation for perioperative HDR-Ir192 brachytherapy in patients after palliative operations of unresectable locally advanced pancreatic tumors and to estimate the influence of perioperative HDR-Ir192 brachytherapy on pain relief in terminal pancreatic cancer patients. Material and methods: Eight patients with pancreatic tumors located in the head of pancreas underwent palliative operations with the use of HDR-Ir192 brachytherapy. All patients qualified for surgery reported pain of high intensity and had received narcotic painkillers prior to operation. During the last phase of the surgery, the Nucletron® catheters were implanted in patients to prepare them for later perioperative brachytherapy. Since the 6th day after surgery HDR brachytherapy was performed. Before each brachytherapy fraction the location of implants were checked using fluoroscopy. A fractional dose was 5 Gy and a total dose was 20 Gy in the area of radiation. A comparative study of two groups of patients (with and without brachytherapy with stage III pancreatic cancer according to the TNM scale was taken in consideration. Results and Conclusions: The authors claim that the modification of catheter implantation using specially designed cannula, facilitates the process of inserting the catheter into the tumor, shortens the time needed for the procedure, and reduces the risk of complications. Mean survival time was 5.7 months. In the group of performed brachytherapy, the mean survival time was 6.7 months, while in the group of no brachytherapy performed – 4.4 months. In the group of brachytherapy, only one patient increased the dose of painkillers in the last month of his life. Remaining patients took constant doses of medicines. Perioperative HDR-Ir192 brachytherapy could be considered as a practical application of adjuvant therapy for pain relief in patients with an advanced pancreatic cancer.

  8. The IPEM code of practice for determination of the reference air kerma rate for HDR 192Ir brachytherapy sources based on the NPL air kerma standard

    International Nuclear Information System (INIS)

    Bidmead, A M; Sander, T; Nutbrown, R F; Locks, S M; Lee, C D; Aird, E G A; Flynn, A

    2010-01-01

    This paper contains the recommendations of the high dose rate (HDR) brachytherapy working party of the UK Institute of Physics and Engineering in Medicine (IPEM). The recommendations consist of a Code of Practice (COP) for the UK for measuring the reference air kerma rate (RAKR) of HDR 192 Ir brachytherapy sources. In 2004, the National Physical Laboratory (NPL) commissioned a primary standard for the realization of RAKR of HDR 192 Ir brachytherapy sources. This has meant that it is now possible to calibrate ionization chambers directly traceable to an air kerma standard using an 192 Ir source (Sander and Nutbrown 2006 NPL Report DQL-RD 004 (Teddington: NPL) http://publications.npl.co.uk). In order to use the source specification in terms of either RAKR, .K R (ICRU 1985 ICRU Report No 38 (Washington, DC: ICRU); ICRU 1997 ICRU Report No 58 (Bethesda, MD: ICRU)), or air kerma strength, S K (Nath et al 1995 Med. Phys. 22 209-34), it has been necessary to develop algorithms that can calculate the dose at any point around brachytherapy sources within the patient tissues. The AAPM TG-43 protocol (Nath et al 1995 Med. Phys. 22 209-34) and the 2004 update TG-43U1 (Rivard et al 2004 Med. Phys. 31 633-74) have been developed more fully than any other protocol and are widely used in commercial treatment planning systems. Since the TG-43 formalism uses the quantity air kerma strength, whereas this COP uses RAKR, a unit conversion from RAKR to air kerma strength was included in the appendix to this COP. It is recommended that the measured RAKR determined with a calibrated well chamber traceable to the NPL 192 Ir primary standard is used in the treatment planning system. The measurement uncertainty in the source calibration based on the system described in this COP has been reduced considerably compared to other methods based on interpolation techniques.

  9. Inverse planning in brachytherapy from radium to high rate 192 iridium afterloading

    International Nuclear Information System (INIS)

    Lahanas, M.; Mould, R.F.; Baltas, D.; Karauzakis, K.; Giannouli, S.; Baltas, D.

    2004-01-01

    We consider the inverse planning problem in brachytherapy, i.e. the problem to determine an optimal number of catheters, number of sources for low-dose rate brachytherapy (LDR) and the optimal dwell times for high-dose rate brachytherapy (HDR) necessary to obtain an optimal as possible dose distribution. Starting from the 1930s, inverse planning for LDR brachytherapy used geometrically derived rules to determine the optimal placement of sources in order to achieve a uniform dose distribution of a specific level in planes, spheres and cylinders. Rules and nomograms were derived which still are widely used. With the rapid development of 3D imaging technologies and the rapidly increasing computer power we have now entered the new era of computer-based inverse planning in brachytherapy. The inverse planning is now an optimisation process adapted to the individual geometry of the patient. New inverse planning optimisation algorithms are anatomy-based that consider the real anatomy of the tumour and the organs at risk (OAR). Computer-based inverse planning considers various effects such as stability of solutions for seed misplacements which cannot ever be solved analytically without gross simplifications. In the last few years multiobjective (MO) inverse planning algorithms have been developed which recognise the MO optimisation problem which is inherent in inverse planning in brachytherapy. Previous methods used a trial and error method to obtain a satisfactory solution. MO optimisation replaces this trial and error process by presenting a representative set of dose distributions that can be obtained. With MO optimisation it is possible to obtain information that can be used to obtain the optimum number of catheters, their position and the optimum distribution of dwell times for HDR brachytherapy. For LDR brachytherapy also the stability of solutions due to seed migration can also be improved. A spectrum of alternative solutions is available and the treatment planner

  10. Determination of factors through Monte Carlo method for Fricke dosimetry from 192Ir sources for brachytherapy

    International Nuclear Information System (INIS)

    David, Mariano Gazineu; Salata, Camila; Almeida, Carlos Eduardo

    2014-01-01

    The Laboratorio de Ciencias Radiologicas develops a methodology for the determination of the absorbed dose to water by Fricke chemical dosimetry method for brachytherapy sources of 192 Ir high dose rate and have compared their results with the laboratory of the National Research Council Canada. This paper describes the determination of the correction factors by Monte Carlo method, with the Penelope code. Values for all factors are presented, with a maximum difference of 0.22% for their determination by an alternative way. (author)

  11. Monte Carlo characterization of the Gamma-Med Hdr plus Ir-192 brachytherapy source

    Energy Technology Data Exchange (ETDEWEB)

    Reyes, E.; Sosa, M. A.; Gil V, A. [Universidad de Guanajuato, Division de Ciencias e Ingenierias, Av. Insurgentes 2354, 37150 Leon, Guanajuato (Mexico); Monzon, E., E-mail: eric_1985@fisica.ugto.mx [IMSS, Unidad Medica de Alta Especialidad No. 1, Av. Adolfo Lopez Mateos 1813, 37340 Leon, Guanajuato (Mexico)

    2015-10-15

    Full text: The MCNP4C Monte Carlo code was used to simulate the dosimetry around the Gamma-Med Hdr Plus iridium-192 brachytherapy source in both air/vacuum and water environments. Dosimetry data in water was calculated and are presented into an away-along table. All dosimetric quantities recommended by the AAPM Task Group 43 report have been also calculated. These quantities are air kerma strength, dose rate constant, radial dose function and anisotropy function. The obtained data are compared to this source reference data, finding results in good agreement with them. In this study, recommendations of the AAPM TG-43U1 report have been followed and comply with the most recent AAPM and ESTRO physics committee recommendations about Monte Carlo techniques. The data in the present study complement published data and can be used as input in the Tps or as benchmark data to verify the results of the treatment planning systems as well as a means of comparison with other datasets from this source. (Author)

  12. Monte Carlo characterization of the Gamma-Med Hdr plus Ir-192 brachytherapy source

    International Nuclear Information System (INIS)

    Reyes, E.; Sosa, M. A.; Gil V, A.; Monzon, E.

    2015-10-01

    Full text: The MCNP4C Monte Carlo code was used to simulate the dosimetry around the Gamma-Med Hdr Plus iridium-192 brachytherapy source in both air/vacuum and water environments. Dosimetry data in water was calculated and are presented into an away-along table. All dosimetric quantities recommended by the AAPM Task Group 43 report have been also calculated. These quantities are air kerma strength, dose rate constant, radial dose function and anisotropy function. The obtained data are compared to this source reference data, finding results in good agreement with them. In this study, recommendations of the AAPM TG-43U1 report have been followed and comply with the most recent AAPM and ESTRO physics committee recommendations about Monte Carlo techniques. The data in the present study complement published data and can be used as input in the Tps or as benchmark data to verify the results of the treatment planning systems as well as a means of comparison with other datasets from this source. (Author)

  13. Trends in the Utilization of Brachytherapy in Cervical Cancer in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Han, Kathy, E-mail: Kathy.Han@rmp.uhn.on.ca [Radiation Medicine Program, Princess Margaret Hospital, University Health Network, Toronto, Ontario (Canada); Milosevic, Michael; Fyles, Anthony [Radiation Medicine Program, Princess Margaret Hospital, University Health Network, Toronto, Ontario (Canada); Pintilie, Melania [Department of Biostatistics, Princess Margaret Hospital, Toronto, Ontario (Canada); Viswanathan, Akila N. [Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women' s Hospital, Boston, Massachusetts (United States)

    2013-09-01

    Purpose: To determine the trends in brachytherapy use in cervical cancer in the United States and to identify factors and survival benefits associated with brachytherapy treatment. Methods and Materials: Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified 7359 patients with stages IB2-IVA cervical cancer treated with external beam radiation therapy (EBRT) between 1988 and 2009. Propensity score matching was used to adjust for differences between patients who received brachytherapy and those who did not from 2000 onward (after the National Cancer Institute alert recommending concurrent chemotherapy). Results: Sixty-three percent of the 7359 women received brachytherapy in combination with EBRT, and 37% received EBRT alone. The brachytherapy utilization rate has decreased from 83% in 1988 to 58% in 2009 (P<.001), with a sharp decline of 23% in 2003 to 43%. Factors associated with higher odds of brachytherapy use include younger age, married (vs single) patients, earlier years of diagnosis, earlier stage and certain SEER regions. In the propensity score-matched cohort, brachytherapy treatment was associated with higher 4-year cause-specific survival (CSS; 64.3% vs 51.5%, P<.001) and overall survival (OS; 58.2% vs 46.2%, P<.001). Brachytherapy treatment was independently associated with better CSS (hazard ratio [HR], 0.64; 95% confidence interval [CI], 0.57-0.71), and OS (HR 0.66; 95% CI, 0.60 to 0.74). Conclusions: This population-based analysis reveals a concerning decline in brachytherapy utilization and significant geographic disparities in the delivery of brachytherapy in the United States. Brachytherapy use is independently associated with significantly higher CSS and OS and should be implemented in all feasible cases.

  14. Gadolinium neutron capture brachytherapy (GdNCB), a new treatment method for intravascular brachytherapy

    International Nuclear Information System (INIS)

    Enger, Shirin A.; Rezaei, Arash; Munck af Rosenschoeld, Per; Lundqvist, Hans

    2006-01-01

    Restenosis is a major problem after balloon angioplasty and stent implantation. The aim of this study is to introduce gadolinium neutron capture brachytherapy (GdNCB) as a suitable modality for treatment of stenosis. The utility of GdNCB in intravascular brachytherapy (IVBT) of stent stenosis is investigated by using the GEANT4 and MCNP4B Monte Carlo radiation transport codes. To study capture rate, Kerma, absorbed dose and absorbed dose rate around a Gd-containing stent activated with neutrons, a 30 mm long, 5 mm diameter gadolinium foil is chosen. The input data is a neutron spectrum used for clinical neutron capture therapy in Studsvik, Sweden. Thermal neutron capture in gadolinium yields a spectrum of high-energy gamma photons, which due to the build-up effect gives an almost flat dose delivery pattern to the first 4 mm around the stent. The absorbed dose rate is 1.33 Gy/min, 0.25 mm from the stent surface while the dose to normal tissue is in order of 0.22 Gy/min, i.e., a factor of 6 lower. To spare normal tissue further fractionation of the dose is also possible. The capture rate is relatively high at both ends of the foil. The dose distribution from gamma and charge particle radiation at the edges and inside the stent contributes to a nonuniform dose distribution. This will lead to higher doses to the surrounding tissue and may prevent stent edge and in-stent restenosis. The position of the stent can be verified and corrected by the treatment plan prior to activation. Activation of the stent by an external neutron field can be performed days after catherization when the target cells start to proliferate and can be expected to be more radiation sensitive. Another advantage of the nonradioactive gadolinium stent is the possibility to avoid radiation hazard to personnel

  15. SU-F-T-05: Dosimetric Evaluation and Validation of Newlydeveloped Well Chamber for Use in the Calibration of Brachytherapy Sources

    Energy Technology Data Exchange (ETDEWEB)

    Saminathan, S; Godson, H; Ponmalar, R; Manickam, R [Kidwai Memorial Institute of Oncology, Bangalore, Karnataka (India); Mazarello, J [Rosalina India private limited, Mumbai, Maharastra (India)

    2016-06-15

    Purpose: To evaluate the dosimetric characteristics of newly developed well type ionization chamber and to validate the results with the commercially available calibrated well chambers that are being used for the calibration of brachytherapy sources. Methods: The newly developed well type ionization chamber (BDS 1000) has been designed for the convenient use in brachytherapy which is open to atmospheric condition. The chamber has a volume of 240 cm3 and weight of 2.5 Kg. The calibration of the radioactive source with activities from 0.01 mCi to 20 Ci can be carried out using this chamber. The dosimetric parameters such as leakage current, stability, scattering effect, ion collection efficiency, reference air kerma rate and nominal response with energy were carried out with the BDS 1000 well type ion chamber. The evaluated dosimetric characteristics of BDS1000 well chamber were validated with two other commercially available well chambers (HDR 1000 plus and BTC/3007). Results: The measured leakage current observed was negligible for the newly developed BDS 1000 well type ion chamber. The ion collection efficiency was close to 1 and the response of the chamber was found to be very stable. The determined sweet spot was at 42 mm from bottom of the chamber insert. The reference air kerma rate was found to be 4.634 × 105 Gym2hr-1A-1 for the BDS 1000 well chamber. The overall dosimetric characteristics of BDS 1000 well chamber was in good agreement with the dosimetric properties of other two well chambers. Conclusion: The dosimetric study shows that the newly developed BDS 1000 well type ionization chamber is high sensitive and reliable chamber for reference air kerma strength calibration. The results obtained confirm that this chamber can be used for the calibration of HDR and LDR brachytherapy sources.

  16. A new applicator design for endocavitary brachytherapy of cancer in the nasopharynx

    International Nuclear Information System (INIS)

    Levendag, Peter C.; Peters, Rob; Meeuwis, Cees A.; Visch, Leo L.; Sipkema, Dick; Pan, Connie de; Schmitz, Paul I.M.

    1997-01-01

    Introduction: In attempting to improve local tumor control by higher doses of radiation, there has been a resurgence of interest in the implementation of brachytherapy in the management of primary and recurrent cancers of the nasopharynx. Brachytherapy with its steep dose fall-off is of particular interest because of the proximity of critical dose limiting structures. Recent developments in brachytherapy, such as the introduction of pulsed-dose-rate and high-dose-rate computerized afterloaders, have encouraged further evolution of brachytherapy techniques. Materials and methods: We have designed an inexpensive, re-usable and flexible silicone applicator, tailored to the shape of the soft tissues of the nasopharynx, which can be used with either low-dose-rate brachytherapy or high (pulsed)-dose-rate remote controlled afterloaders. Results and conclusions: This Rotterdam nasopharynx applicator proved to be easy to introduce, patient friendly and can remain in situ for the duration of the treatment (2-6 days). The design, technique of application and the first consecutive 5 years of clinical experience in using this applicator are presented

  17. Underuse of brachytherapy for the treatment of dysphagia owing to esophageal cancer. An Italian survey.

    Science.gov (United States)

    Fuccio, Lorenzo; Guido, Alessandra; Hassan, Cesare; Frazzoni, Leonardo; Arcelli, Alessandra; Farioli, Andrea; Giaccherini, Lucia; Galuppi, Andrea; Mandolesi, Daniele; Cellini, Francesco; Mantello, Giovanna; Macchia, Gabriella; de Bortoli, Nicola; Repici, Alessandro; Valentini, Vincenzo; Bazzoli, Franco; Morganti, Alessio Giuseppe

    2016-10-01

    International guidelines strongly recommend brachytherapy as valid alternative or in addition to stenting in patients with dysphagia owing to esophageal cancer. However, for not well understood reasons, brachytherapy is definitively underused for the palliative treatment of malignant dysphagia. Aim of the current survey was to investigate the use of brachytherapy for the treatment of malignant dysphagia in Italy. A structured questionnaire was submitted to the 1510 members of the Italian Association of Radiation Oncologists (AIRO). These members refer to 177 centres of radiotherapy across Italy and in 68 (38.4%) of them brachytherapy is routinely performed. Of the 1510 invited members, 178 completed the survey (11.7%). The answers provided by the 178 participants allowed to get information on 40 out of 68 brachytherapy centres (58.8%). Seven out of 40 (17.5%) centres perform brachytherapy of the oesophagus, in 3 out of 40 (7.5%) centres brachytherapy represents the first line of treatment. The main reason why brachytherapy is not routinely performed is the lack of experience. Despite the strong recommendations of the international guidelines and the wide diffusion of brachytherapy centres across Italy, only very few of them routinely considered brachytherapy for the treatment of dysphagia due to esophageal cancer. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  18. Comparison of TG-43 and TG-186 in breast irradiation using a low energy electronic brachytherapy source.

    Science.gov (United States)

    White, Shane A; Landry, Guillaume; Fonseca, Gabriel Paiva; Holt, Randy; Rusch, Thomas; Beaulieu, Luc; Verhaegen, Frank; Reniers, Brigitte

    2014-06-01

    The recently updated guidelines for dosimetry in brachytherapy in TG-186 have recommended the use of model-based dosimetry calculations as a replacement for TG-43. TG-186 highlights shortcomings in the water-based approach in TG-43, particularly for low energy brachytherapy sources. The Xoft Axxent is a low energy (S700, was created and validated against experimental data. CT scans of the patients were used to create realistic multi-tissue/heterogeneous models with breast tissue segmented using a published technique. Alternative water models were used to isolate the influence of tissue heterogeneity and backscatter on the dose distribution. Dose calculations were performed using Geant4 according to the original treatment parameters. The effect of the Axxent balloon applicator used in APBI which could not be modeled in the CT-based model, was modeled using a novel technique that utilizes CAD-based geometries. These techniques were validated experimentally. Results were calculated using two dose reporting methods, dose to water (Dw,m) and dose to medium (Dm,m), for the heterogeneous simulations. All results were compared against TG-43-based dose distributions and evaluated using dose ratio maps and DVH metrics. Changes in skin and PTV dose were highlighted. All simulated heterogeneous models showed a reduced dose to the DVH metrics that is dependent on the method of dose reporting and patient geometry. Based on a prescription dose of 34 Gy, the average D90 to PTV was reduced by between ~4% and ~40%, depending on the scoring method, compared to the TG-43 result. Peak skin dose is also reduced by 10%-15% due to the absence of backscatter not accounted for in TG-43. The balloon applicator also contributed to the reduced dose. Other ROIs showed a difference depending on the method of dose reporting. TG-186-based calculations produce results that are different from TG-43 for the Axxent source. The differences depend strongly on the method of dose reporting. This study

  19. MCNP modelling of vaginal and uterine applicators used in intracavitary brachytherapy and comparison with radiochromic film measurements

    Science.gov (United States)

    Ceccolini, E.; Gerardy, I.; Ródenas, J.; van Dycke, M.; Gallardo, S.; Mostacci, D.

    Brachytherapy is an advanced cancer treatment that is minimally invasive, minimising radiation exposure to the surrounding healthy tissues. Microselectron© Nucletron devices with 192Ir source can be used for gynaecological brachytherapy, in patients with vaginal or uterine cancer. Measurements of isodose curves have been performed in a PMMA phantom and compared with Monte Carlo calculations and TPS (Plato software of Nucletron BPS 14.2) evaluation. The isodose measurements have been performed with radiochromic films (Gafchromic EBT©). The dose matrix has been obtained after digitalisation and use of a dose calibration curve obtained with a 6 MV photon beam provided by a medical linear accelerator. A comparison between the calculated and the measured matrix has been performed. The calculated dose matrix is obtained with a simulation using the MCNP5 Monte Carlo code (F4MESH tally).

  20. Time dependence of energy spectra of brachytherapy sources and its impact on the half and the tenth value layers

    International Nuclear Information System (INIS)

    Yue, Ning J.; Chen Zhe; Hearn, Robert A.; Rodgers, Joseph J.; Nath, Ravinder

    2009-01-01

    Purpose: Several factors including radionuclide purity influence the photon energy spectra from sealed brachytherapy sources. The existence of impurities and trace elements in radioactive materials as well as the substrate and encapsulation may not only alter the spectrum at a given time but also cause change in the spectra as a function of time. The purpose of this study is to utilize a semiempirical formalism, which quantitatively incorporates this time dependence, to calculate and evaluate the shielding requirement impacts introduced by this time dependence for a 103 Pd source. Methods: The formalism was used to calculate the NthVL thicknesses in lead for a 103 Pd model 200 seed. Prior to 2005, the 103 Pd in this source was purified to a level better than 0.006% of the total 103 Pd activity, the key trace impurity consisting of 65 Zn. Because 65 Zn emits higher energy photons and has a much longer half-life of 244 days compared to 103 Pd, its presence in 103 Pd seeds led to a time dependence of the photon spectrum and other related physical quantities. This study focuses on the time dependence of the NthVL and the analysis of the corresponding shielding requirements. Results: The results indicate that the first HVL and the first TVL in lead steadily increased with time for about 200 days and then reached a plateau. The increases at plateau were more than 1000 times compared to the corresponding values on the zeroth day. The second and third TVLs in lead reached their plateaus in about 100 and 60 days, respectively, and the increases were about 19 and 2.33 times the corresponding values on the zeroth day, respectively. All the TVLs demonstrated a similar time dependence pattern, with substantial increases and eventual approach to a plateau. Conclusions: The authors conclude that the time dependence of the emitted photon spectra from brachytherapy sources can introduce substantial variations in the values of the NthVL with time if certain impurities are present

  1. Tuned sources of submillimetre radiation

    International Nuclear Information System (INIS)

    Berezhnyj, V.L.

    1981-01-01

    The main present directions of development of sources of frequency coherent tuned radiation of electromagnetic waves in the submillimeter range: nonlinear mixing of different frequencies; semiconductor lasers; molecular lasers with optical pumping; relativistic electron beams in a magnetic field as submillimeter radiation sources; submillimeter radiation sources on the basis of SHF classical electrovacuum devices - are considered. The designs of generator systems and their specifications are presented. The main parameters of electromagnetic radiation of different sources, such as: power, stability, frequency, tuning range - are presented. The methods of improving sources and electromagnetic radiation parameters are proposed. The examples of possible applications of submillimeter radiation in different spheres of science and technology are given [ru

  2. Dose calculation for photon-emitting brachytherapy sources with average energy higher than 50 keV: report of the AAPM and ESTRO.

    Science.gov (United States)

    Perez-Calatayud, Jose; Ballester, Facundo; Das, Rupak K; Dewerd, Larry A; Ibbott, Geoffrey S; Meigooni, Ali S; Ouhib, Zoubir; Rivard, Mark J; Sloboda, Ron S; Williamson, Jeffrey F

    2012-05-01

    Recommendations of the American Association of Physicists in Medicine (AAPM) and the European Society for Radiotherapy and Oncology (ESTRO) on dose calculations for high-energy (average energy higher than 50 keV) photon-emitting brachytherapy sources are presented, including the physical characteristics of specific (192)Ir, (137)Cs, and (60)Co source models. This report has been prepared by the High Energy Brachytherapy Source Dosimetry (HEBD) Working Group. This report includes considerations in the application of the TG-43U1 formalism to high-energy photon-emitting sources with particular attention to phantom size effects, interpolation accuracy dependence on dose calculation grid size, and dosimetry parameter dependence on source active length. Consensus datasets for commercially available high-energy photon sources are provided, along with recommended methods for evaluating these datasets. Recommendations on dosimetry characterization methods, mainly using experimental procedures and Monte Carlo, are established and discussed. Also included are methodological recommendations on detector choice, detector energy response characterization and phantom materials, and measurement specification methodology. Uncertainty analyses are discussed and recommendations for high-energy sources without consensus datasets are given. Recommended consensus datasets for high-energy sources have been derived for sources that were commercially available as of January 2010. Data are presented according to the AAPM TG-43U1 formalism, with modified interpolation and extrapolation techniques of the AAPM TG-43U1S1 report for the 2D anisotropy function and radial dose function.

  3. Examination of the consistency and accuracy of computerized brachytherapy dose predictions

    International Nuclear Information System (INIS)

    Tolbert, D.D.; Reed, S.A.

    1981-01-01

    Four brachytherapy test cases were sent to representatives of commercial and non-commercial, computerized radiation oncology treatment planning systems. Four commercial systems are represented herein. The non-commercial, state-of-the-art systems represented are (in alphabetical order) BRACHY, ISODOS and RADCOMP. Mutual comparisons were made to examine consistency and a comparison with experimental measurements around a single source was made to examine accuracy. The systems represented are most consistent within 5 cm from the center of a single source, and within rays from the center making angles of greater than or equal to 20 0 relative to the source axis. Taking into account tissue absorption and scatter, the spatial uncertainty in the location of a particular isodose rate value is less than or equal to 0.7 mm for commercial systems and less than or equal to 0.5 mm for non-commercial systems

  4. The Impact of Brachytherapy on Prostate Cancer–Specific Mortality for Definitive Radiation Therapy of High-Grade Prostate Cancer: A Population-Based Analysis

    International Nuclear Information System (INIS)

    Shen Xinglei; Keith, Scott W.; Mishra, Mark V.; Dicker, Adam P.; Showalter, Timothy N.

    2012-01-01

    Purpose: This population-based analysis compared prostate cancer–specific mortality (PCSM) in a cohort of patients with high-risk prostate cancer after nonsurgical treatment with external beam radiation therapy (EBRT), brachytherapy (BT), or combination (BT + EBRT). Methods and Materials: We identified from the Surveillance, Epidemiology and End Results database patients diagnosed from 1988 through 2002 with T1–T3N0M0 prostate adenocarcinoma of poorly differentiated grade and treated with BT, EBRT, or BT + EBRT. During this time frame, the database defined high grade as prostate cancers with Gleason score 8–10, or Gleason grade 4–5 if the score was not recorded. This corresponds to a cohort primarily with high-risk prostate cancer, although some cases where only Gleason grade was recorded may have included intermediate-risk cancer. We used multivariate models to examine patient and tumor characteristics associated with the likelihood of treatment with each radiation modality and the effect of radiation modality on PCSM. Results: There were 12,745 patients treated with EBRT (73.5%), BT (7.1%), or BT + EBRT (19.4%) included in the analysis. The median follow-up time for all patients was 6.4 years. The use of BT or BT + EBRT increased from 5.1% in 1988–1992 to 31.4% in 1998–2002. Significant predictors of use of BT or BT + EBRT were younger age, later year of diagnosis, urban residence, and earlier T-stage. On multivariate analysis, treatment with either BT (hazard ratio, 0.66; 95% confidence interval, 0.49–0.86) or BT + EBRT (hazard ratio, 0.77; 95% confidence ratio, 0.66–0.90) was associated with significant reduction in PCSM compared with EBRT alone. Conclusion: In patients with high-grade prostate cancer, treatment with brachytherapy is associated with reduced PCSM compared with EBRT alone. Our results suggest that brachytherapy should be investigated as a component of definitive treatment strategies for patients with high-risk prostate cancer.

  5. Ultrasonography-guided cobalt-60 brachytherapy for malignant glioma

    International Nuclear Information System (INIS)

    Sakai, Noboru; Takenaka, Katsunobu; Ueda, Tatsuya

    1989-01-01

    Brachytherapy with cobalt-60 source is reported. In this method it is characterized that the source is inserted interstitially with remote control system by after-loading method via outer catheter (using tandem tube), which was established in the center of residual tumor, using ultrasonography guide with trepanation, or intraoperatively put within the dead space after tumor resection. Six cases of deep-seated and recurrent malignant glioma, were treated with this method. A total dose of 20 to 45 Gy (10 to 15 Gy/day for 2 to 3 days) was delivered to the target. Additionally conventional external irradiation was followed. The effect of cobalt-60 brachytherapy on such tumors were favorable especially for well-circumscribed glioma less than 3 cm on CT scan. (author)

  6. Image guided, adaptive, accelerated, high dose brachytherapy as model for advanced small volume radiotherapy

    International Nuclear Information System (INIS)

    Haie-Meder, Christine; Siebert, Frank-Andre; Poetter, Richard

    2011-01-01

    Brachytherapy has consistently provided a very conformal radiation therapy modality. Over the last two decades this has been associated with significant improvements in imaging for brachytherapy applications (prostate, gynecology), resulting in many positive advances in treatment planning, application techniques and clinical outcome. This is emphasized by the increased use of brachytherapy in Europe with gynecology as continuous basis and prostate and breast as more recently growing fields. Image guidance enables exact knowledge of the applicator together with improved visualization of tumor and target volumes as well as of organs at risk providing the basis for very individualized 3D and 4D treatment planning. In this commentary the most important recent developments in prostate, gynecological and breast brachytherapy are reviewed, with a focus on European recent and current research aiming at the definition of areas for important future research. Moreover the positive impact of GEC-ESTRO recommendations and the highlights of brachytherapy physics are discussed what altogether presents a full overview of modern image guided brachytherapy. An overview is finally provided on past and current international brachytherapy publications focusing on 'Radiotherapy and Oncology'. These data show tremendous increase in almost all research areas over the last three decades strongly influenced recently by translational research in regard to imaging and technology. In order to provide high level clinical evidence for future brachytherapy practice the strong need for comprehensive prospective clinical research addressing brachytherapy issues is high-lighted.

  7. Australian high-dose-rate brachytherapy protocols for gynaecological malignancy

    International Nuclear Information System (INIS)

    MacLeod, C.; Dally, M.; Stevens, M.; Thornton, D.; Carruthers, S.; Jeal, P.

    2001-01-01

    There is no consensus over the optimal dose fractionation schedules for high-dose-rate (HDR) brachytherapy used for gynaecological malignancy. In Australian public hospital departments of radiation oncology, HDR brachytherapy for gynaecological cancer is being more commonly used. A survey of public departments that are using this technology, or that plan to introduce this technology, was performed. Their current protocols are presented. In general, protocols are similar biologically; however, the practical aspects such as the number of fractions given do vary and may reflect resource restrictions or, alternatively, differences in interpretations of the literature and of the best protocols by clinicians. Copyright (2001) Blackwell Science Pty Ltd

  8. Prospective Phase II Study of Brachytherapy Boost as a Component of Neo-Adjuvant Chemotherapy and External Beam Radiation Therapy in Locally Advanced Rectal Cancer

    International Nuclear Information System (INIS)

    EL-SAYED, M.E.; EL-TAHER, Z.H.

    2008-01-01

    The aim of the current study is to assess the response rate and toxicity profile in patients with locally advanced rectal cancer using brachytherapy (BT) boost following external beam radiotherapy (EBRT), concomitant with chemotherapy as a component of the neoadjuvant treatment. Patients and Methods: This is a prospective phase II study of neoadjuvant chemo-radiation therapy for patients with locally advanced rectal cancer who presented to the department of radiation oncology, King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia. Seventeen patients had been included in the study. Radiation therapy was given as: phase I,45 Gy/25 fractions/5 weeks of EBRT, followed by brachytherapy boost (within one week after the end of EBRT) using high dose rate iridium 192 (Ir 192 ) aiming at 800 c Gy given in 2 fractions (each 400 c Gy) separated by 1 week. All patients received the same concomitant chemotherapy in the form of Capecitabine and Oxaliplatin. The clinical and pathological response rates, together with the toxicity profile were assessed. Results: Seventeen patients had been studied; the majority (14; 82%) were males, while 3 only (18%) were females, their mean age was 57.4 years. All patients had low anterior resection (LAR). The clinical response rate, assessed by digital rectal examination ± endoscopy examination 4 weeks after the end of EBRT and BT, revealed that complete clinical response (cCR) was noted in 3 patients (18%), clinical partial response (cPR) in 14 patients (82%); while the pathological response rate was: complete pathological response (pCR) in 8 patients (47%), pathological partial response (pPR) in 9 patients (53%). The toxicity profile showed that grade III radiation proctitis was seen in one patient (6%), grade III dermatitis in 2 (12%), while no patients developed grade III cystitis. For chemotherapy toxicities, three patients (18%) developed grade III nausea and/or vomiting, 2 (12%) developed grade III diarrhea. Conclusion

  9. Verification and analysis of the positioning of a source of brachytherapy high dose within an applicator gynecological interstitial fletcher Utrecht TC/RM

    International Nuclear Information System (INIS)

    Panedo Cobos, J. M.; Garcia castejon, M. A.; Huertas Martinez, C.; Gomez-Tejedor Alonso, S.; Rincon Perez, M.; Luna Tirado, J.; Perez Casas, A. M.

    2013-01-01

    Applicators are guides that circulate and are located within the patient brachytherapy sources. Applicators can suffer mechanical deformations due to processes of sterilization or shock, which may result in that the source do not place within these very precise and coincides with the planned. In these cases the planned treatment deviate actually managed. The object of this study is to verify that the position of the source into the dispenser coincides with the planned position, with a procedure that is described. (Author)

  10. Automation system for quality control in manufacture of iodine-125 sealed sources used in brachytherapy

    International Nuclear Information System (INIS)

    Somessari, Samir L.; Feher, Anselmo; Sprenger, Francisco E.; Rostellato, Maria E.C.M.; Moura, Joao A.; Costa, Osvaldo L.; Calvo, Wilson A.P.

    2011-01-01

    The objective of this work is to develop an automation system for Quality Control in the production of Iodine-125 sealed sources, after undergoing the process of laser beam welding. These sources, also known as Iodine-125 seeds are used, successfully, in the treatment of cancer by brachytherapy, with low-dose rates. Each small seed is composed of a welded titanium capsule with 0.8 mm diameter and 4.5 mm in length, containing Iodine-125 adsorbed on an internal silver wire. The seeds are implanted in the human prostate to irradiate the tumor and treat the cancerous cells. The technology to automate the quality control system in the manufacture of Iodine-125 seeds consists in developing and associate mechanical parts, electronic components and pneumatic circuits to control machines and processes. The automation technology for Iodine-125 seed production developed in this work employs programmable logic controller, step motors, drivers of control, electrical-electronic interfaces, photoelectric sensors, interfaces of communication and software development. Industrial automation plays an important role in the production of Iodine-125 seeds, with higher productivity and high standard of quality, facilitating the implementation and operation of processes with good manufacturing practices. Nowadays, the Radiation Technology Center at IPEN-CNEN/SP imports and distributes 36,000 Iodine-125 seeds per year for clinics and hospitals in the whole country. However, the Brazilian potential market is of 8,000 Iodine-125 seeds per month. Therefore, the local production of these radioactive seeds has become a priority for the Institute, aiming to reduce the price and increase the supply to the population in Brazil. (author)

  11. Automation system for quality control in manufacture of iodine-125 sealed sources used in brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Somessari, Samir L.; Feher, Anselmo; Sprenger, Francisco E.; Rostellato, Maria E.C.M.; Moura, Joao A.; Costa, Osvaldo L.; Calvo, Wilson A.P., E-mail: somessar@ipen.b, E-mail: afeher@ipen.b, E-mail: sprenger@ipen.b, E-mail: elisaros@ipen.b, E-mail: olcosta@ipen.b, E-mail: wapcalvo@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2011-07-01

    The objective of this work is to develop an automation system for Quality Control in the production of Iodine-125 sealed sources, after undergoing the process of laser beam welding. These sources, also known as Iodine-125 seeds are used, successfully, in the treatment of cancer by brachytherapy, with low-dose rates. Each small seed is composed of a welded titanium capsule with 0.8 mm diameter and 4.5 mm in length, containing Iodine-125 adsorbed on an internal silver wire. The seeds are implanted in the human prostate to irradiate the tumor and treat the cancerous cells. The technology to automate the quality control system in the manufacture of Iodine-125 seeds consists in developing and associate mechanical parts, electronic components and pneumatic circuits to control machines and processes. The automation technology for Iodine-125 seed production developed in this work employs programmable logic controller, step motors, drivers of control, electrical-electronic interfaces, photoelectric sensors, interfaces of communication and software development. Industrial automation plays an important role in the production of Iodine-125 seeds, with higher productivity and high standard of quality, facilitating the implementation and operation of processes with good manufacturing practices. Nowadays, the Radiation Technology Center at IPEN-CNEN/SP imports and distributes 36,000 Iodine-125 seeds per year for clinics and hospitals in the whole country. However, the Brazilian potential market is of 8,000 Iodine-125 seeds per month. Therefore, the local production of these radioactive seeds has become a priority for the Institute, aiming to reduce the price and increase the supply to the population in Brazil. (author)

  12. ANALYSIS OF COMPLICATIONS DUE TO INTRATISSUE RADIOTHERAPY USING CONSTANT SOURCES IN PATIENTS WITH PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    A. V. Petrovsky

    2011-01-01

    Full Text Available Brachytherapy is a standard treatment for localized advanced prostate cancer (PC. Complications due to interstitial radiotherapy using permanent sources were analyzed in 149 patients. The incidence of early grade 3 radiation urethritis was 7.4 % and that of rectitis was 3.4%. Late radiation urethritis and rectitis were recorded in 3.4 and 0.7 %, respectively. Sexual function 12 months later was preserved in 86.6 % of the patients. Studies established no statistically significant factors that influenced the frequency of complications. The patients with a prostate volume of > 50 cm3, a preoperative international prostate symptom score of > 15, a urine flow rate of < 15 ml/min, and urethral andrectal radiation doses of > 210 and > 180 Gy, respectively, tended to have more common radiation reactions. Thus, brachytherapy is a reasonably safe treatment for PC.

  13. ANALYSIS OF COMPLICATIONS DUE TO INTRATISSUE RADIOTHERAPY USING CONSTANT SOURCES IN PATIENTS WITH PROSTATE CANCER

    Directory of Open Access Journals (Sweden)

    A. V. Petrovsky

    2014-07-01

    Full Text Available Brachytherapy is a standard treatment for localized advanced prostate cancer (PC. Complications due to interstitial radiotherapy using permanent sources were analyzed in 149 patients. The incidence of early grade 3 radiation urethritis was 7.4 % and that of rectitis was 3.4%. Late radiation urethritis and rectitis were recorded in 3.4 and 0.7 %, respectively. Sexual function 12 months later was preserved in 86.6 % of the patients. Studies established no statistically significant factors that influenced the frequency of complications. The patients with a prostate volume of > 50 cm3, a preoperative international prostate symptom score of > 15, a urine flow rate of < 15 ml/min, and urethral andrectal radiation doses of > 210 and > 180 Gy, respectively, tended to have more common radiation reactions. Thus, brachytherapy is a reasonably safe treatment for PC.

  14. Dose calculation in brachytherapy with microcomputers

    International Nuclear Information System (INIS)

    Elbern, A.W.

    1989-01-01

    The computer algorithms, that allow the calculation of brachytherapy doses and its graphic representation for implants, using programs developed for Pc microcomputers are presented. These algorithms allow to localized the sources in space, from their projection in radiographics images and trace isodose counter. (C.G.C.) [pt

  15. Orbital rhabdomyosarcoma of the child: the role of PDR brachytherapy in eye preservation

    International Nuclear Information System (INIS)

    Kovacs, G.; Rochels, R.; Mehdorn, H.M.; Werner, J.; Wilhelm, R.; Kohr, P.; Kimmig, B. N.

    1996-01-01

    Material and Methods: There were four children (8-7-5 years and(15(12)) months old) with recurrent/primary embryonal rhabdomyosarcoma treated with curative intention by peroperative PDR boost brachytherapy in combination with radio-chemotherapy and/or surgery. PDR brachytherapy according to the Kiel protocol: daily five pulses, two hours each, with 1 Gy on the reference isodose which is usually 2-3 mm close to the applicator surface. CT simulation based conformal treatment planning was carried out in each case. The implant was done intraoperatively using the free-hand plastic tube method, after a macroscopically complete excision of the tumor. Due to treatment planning individual target volume, eye with N, opticus and bone structures, as well as the applicators and other regions of interest were visualized. Manual volume optimisation was practiced and natural volumen-dose histograms were analysed in 'classic' graphic mode as well as in a special colour coded three-dimensional visualization in cine mode on the screen. One child received, three months before the recurrence was operated, 50 Gy hyperfractionated external beam radiation (2 Gy fractions) and was irradiated with 20 Gy brachytherapy in four days. The second patient received ten days after 20 Gy brachytherapy 32 Gy hyperfractionated external beam radiation. The third child (external beam treatment outside of our clinic), received conventional fractionated irradiation with 1.6 Gy fraction dose instead of a prescribed hyperfractionated external beam therapy and her brachytherapy dose was 25 Gy. At the (15(12)) months old child with primary embryonal rhabdomyosarcoma we applied 20 Gy brachytherapy and 24 Gy hyperfractionated external beam irradiation. All patients received multidrug chemotherapy according to the German Study Protocol (CWS-91). Results: Follow-up is 34, 28, 22, and 6 months for recurrent embryonal rhabdomyosarcoma patients (stand February 96). We observed at 9 months one rhabdomyosarcoma

  16. Incidents with hazardous radiation sources

    International Nuclear Information System (INIS)

    Schoenhacker, Stefan

    2016-01-01

    Incidents with hazardous radiation sources can occur in any country, even those without nuclear facilities. Preparedness for such incidents is supposed to fulfill globally agreed minimum standards. Incidents are categorized in incidents with licensed handling of radiation sources as for material testing, transport accidents of hazardous radiation sources, incidents with radionuclide batteries, incidents with satellites containing radioactive inventory, incidents wit not licensed handling of illegally acquired hazardous radiation sources. The emergency planning in Austria includes a differentiation according to the consequences: incidents with release of radioactive materials resulting in restricted contamination, incidents with release of radioactive materials resulting in local contamination, and incidents with the hazard of e@nhanced exposure due to the radiation source.

  17. A Monte Carlo dosimetry study using Henschke applicator for cervical brachytherapy

    International Nuclear Information System (INIS)

    Yu, Pei-Chieh; Chao, Tsi-Chian; Lee, Chung-Chi; Wu, Ching-Jung; Tung, Chuan-Jong

    2010-01-01

    In recent years the Henschke applicator has been widely used for gynecologic patients treated by brachytherapy in Taiwan. However, the commercial brachytherapy planning system did not properly evaluate the dose perturbation caused by the Henschke applicator. Since the European Society for Therapeutic Radiology and Oncology advised that the effect of source shielding should be incorporated into the brachytherapy planning system, it required calculation and comparison of the dose distribution around the applicator. This study used the Monte Carlo MCNP code to simulate the dose distribution in a water phantom that contained the Henschke applicator with one tandem and two ovoids. Three dwell positions of a high dose rate 192 Ir source were simulated by including and excluding the applicator. The mesh tally option of the MCNP was applied to facilitate the calculation of a large number of tallies in the phantom. The voxel size effect and the charge particle equilibrium were studied by comparing the results calculated with different tally options. The calculated results showed that the brachytherapy planning system overestimated the rectal dose and that the shielding material in the applicator contributed more than 40% to the rectal dose.

  18. Prostate Brachytherapy Case Volumes by Academic and Nonacademic Practices: Implications for Future Residency Training

    International Nuclear Information System (INIS)

    Orio, Peter F.; Nguyen, Paul L.; Buzurovic, Ivan; Cail, Daniel W.; Chen, Yu-Wei

    2016-01-01

    Purpose: The use of prostate brachytherapy has continued to decline in the United States. We examined the national practice patterns of both academic and nonacademic practices performing prostate brachytherapy by case volume per year to further characterize the decline and postulate the effect this trend might have on training the next generation of residents. Methods and Materials: Men diagnosed with prostate cancer who had undergone radiation therapy in 2004 to 2012 were identified. The annual brachytherapy case volume at each facility was determined and further categorized into ≤12 cases per year (ie, an average of ≤1 cases per month), 13 to 52 cases per year, and ≥53 cases per year (ie, an average of ≥1 cases per week) in academic practices versus nonacademic practices. Results: In 2004 to 2012, academic practices performing an average of ≤1 brachytherapy cases per month increased from 56.4% to 73.7%. In nonacademic practices, this percentage increased from 60.2% to 77.4% (P<.0001 for both). Practices performing an average of ≥1 cases per week decreased among both academic practices (from 6.7% to 1.5%) and nonacademic practices (from 4.5% to 2.7%). Conclusions: Both academic and nonacademic radiation oncology practices have demonstrated a significant reduction in the use of prostate brachytherapy from 2004 to 2012. With the case volume continuing to decline, it is unclear whether we are prepared to train the next generation of residents in this critical modality.

  19. Radioactive seed immobilization techniques for interstitial brachytherapy

    International Nuclear Information System (INIS)

    Yan, K.; Podder, T.; Buzurovic, I.; Hu, Y.; Dicker, A.; Valicenti, R.; Yu, Y.; Messing, E.; Rubens, D.; Sarkar, N.; Ng, W.

    2008-01-01

    In prostate brachytherapy, seeds can detach from their deposited sites and move locally in the pelvis or migrate to distant sites including the pulmonary and cardiac regions. Undesirable consequences of seed migration include inadequate dose coverage of the prostate and tissue irradiation effects at the site of migration. Thus, it is clinically important to develop seed immobilization techniques. We first analyze the possible causes for seed movement, and propose three potential techniques for seed immobilization: (1) surgical glue, (2) laser coagulation and (3) diathermy coagulation. The feasibility of each method is explored. Experiments were carried out using fresh bovine livers to investigate the efficacy of seed immobilization using surgical glue. Results have shown that the surgical glue can effectively immobilize the seeds. Evaluation of the radiation dose distribution revealed that the non-immobilized seed movement would change the planned isodose distribution considerably; while by using surgical glue method to immobilize the seeds, the changes were negligible. Prostate brachytherapy seed immobilization is necessary and three alternative mechanisms are promising for addressing this issue. Experiments for exploring the efficacy of the other two proposed methods are ongoing. Devices compatible with the brachytherapy procedure will be designed in future. (orig.)

  20. Comparison between methods for fixing radioactive iodine in silver substrate for manufacturing brachytherapy sources

    Energy Technology Data Exchange (ETDEWEB)

    Peleias Junior, Fernando S.; Zeituni, Carlos A.; Rostelato, Maria Elisa C.M., E-mail: fernandopeleias@gmail.com, E-mail: czeituni@ipen.br, E-mail: elisaros@ipen.br; and others

    2013-07-01

    Cancer is a term used generically to represent a group of more than 100 illnesses, including malignant tumors from different locations. According to World Health Organization (WHO), is a leading cause of death worldwide, accounted for 7.6 million deaths. Prostate cancer is the sixth most common type in the world, representing about 10% of all cases of cancer and its treatment may be by surgery, radiotherapy or even vigilant observation. A method of radiotherapy which has been extensively used in the early and intermediate stages of the illness is brachytherapy, where radioactive seeds are placed inside or next to the area requiring treatment, which reduces the probability of unnecessary damage to surrounding healthy tissues. Currently, the radioactive isotope Iodine-125, adsorbed on silver substrate, is one of the most used in prostate brachytherapy. The present study compares several deposition methods of radioactive Iodine on silver substrate, in order to choose the most suitable one to be implemented at the laboratory of radioactive sources production of IPEN. The methodology used was chosen based on the available infrastructure and experience of the researchers of the institute. Therefore, Iodine-131 was used for testing (same chemical behavior of Iodine -125). Three methods were selected: method 1 (test based on electrodeposition method, developed by David Kubiatowicz) which presented efficiency of 65.16% ; method 2 (chemical reaction based on the method developed by David Kubiatowicz -HCl) which presented efficiency of 70.80%; method 3 (chemical reaction based on the method developed by Dr. Maria Elisa Rostelato) which presented efficiency of 55.80% . Based on the results, the second method is the suggested one to be implemented at the laboratory of radioactive sources production of IPEN. (author)

  1. Comparison between methods for fixing radioactive iodine in silver substrate for manufacturing brachytherapy sources

    International Nuclear Information System (INIS)

    Peleias Junior, Fernando S.; Zeituni, Carlos A.; Rostelato, Maria Elisa C.M.

    2013-01-01

    Cancer is a term used generically to represent a group of more than 100 illnesses, including malignant tumors from different locations. According to World Health Organization (WHO), is a leading cause of death worldwide, accounted for 7.6 million deaths. Prostate cancer is the sixth most common type in the world, representing about 10% of all cases of cancer and its treatment may be by surgery, radiotherapy or even vigilant observation. A method of radiotherapy which has been extensively used in the early and intermediate stages of the illness is brachytherapy, where radioactive seeds are placed inside or next to the area requiring treatment, which reduces the probability of unnecessary damage to surrounding healthy tissues. Currently, the radioactive isotope Iodine-125, adsorbed on silver substrate, is one of the most used in prostate brachytherapy. The present study compares several deposition methods of radioactive Iodine on silver substrate, in order to choose the most suitable one to be implemented at the laboratory of radioactive sources production of IPEN. The methodology used was chosen based on the available infrastructure and experience of the researchers of the institute. Therefore, Iodine-131 was used for testing (same chemical behavior of Iodine -125). Three methods were selected: method 1 (test based on electrodeposition method, developed by David Kubiatowicz) which presented efficiency of 65.16% ; method 2 (chemical reaction based on the method developed by David Kubiatowicz -HCl) which presented efficiency of 70.80%; method 3 (chemical reaction based on the method developed by Dr. Maria Elisa Rostelato) which presented efficiency of 55.80% . Based on the results, the second method is the suggested one to be implemented at the laboratory of radioactive sources production of IPEN. (author)

  2. Regulation for radiation protection in applications of radiation sources

    International Nuclear Information System (INIS)

    Sonawane, Avinash U.

    2016-01-01

    Applications of ionising radiation in multifarious field are increasing in the country for the societal benefits. The national regulatory body ensures safety and security of radiation sources by enforcing provisions in the national law and other relevant rules issued under the principle law. In addition, the enforcement of detailed requirements contained in practice specific safety codes and standard and issuance of safety directives brings effectiveness in ensuring safe handling and secure management of radiation sources. The regulatory requirements for control over radiation sources throughout their life-cycle have evolved over the years from experience gained. Nevertheless, some of the regulatory activities which require special attention have been identified such as the development of regulation to deal with advance emerging radiation technology in applications of radiation in medicine and industry; sustaining continuity in ensuring human resource development programme; inspections of category 3 and 4 disused sources and their safe disposal; measures for controlling transboundary movement of radiation sources. The regulatory measures have been contemplated and are being enforced to deal with the above issues in an effective manner. The complete involvement of the management of radiation facilities, radiation workers and their commitment in establishing and maintaining safety and security culture is essential to handle the radiation sources safely and efficiently at all times

  3. A Monte Carlo Study on the Effect of Various Neutron Capturers on Dose Distribution in Brachytherapy with 252Cf Source

    Directory of Open Access Journals (Sweden)

    Firoozabadi M. M.

    2017-03-01

    Full Text Available Background: In neutron interaction with matter and reduction of neutron energy due to multiple scatterings to the thermal energy range, increasing the probability of thermal neutron capture by neutron captures makes dose enhancement in the tumors loaded with these materials. Objective: The purpose of this study is to evaluate dose distribution in the presence of 10B, 157Gd and 33S neutron capturers and to determine the effect of these materials on dose enhancement rate for 252Cf brachytherapy source. Methods: Neutron-ray flux and energy spectra, neutron and gamma dose rates and dose enhancement factor (DEF are determined in the absence and presence of 10B, 157Gd and 33S using Monte Carlo simulation. Results: The difference in the thermal neutron flux rate in the presence of 10B and 157Gd is significant, while the flux changes in the fast and epithermal energy ranges are insensible. The dose enhancement factor has increased with increasing distance from the source and reached its maximum amount equal to 258.3 and 476.1 cGy/h/µg for 157Gd and 10B, respectively at about 8 cm distance from the source center. DEF for 33S is equal to one. Conclusion: Results show that the magnitude of dose augmentation in tumors containing 10B and 157Gd in brachytherapy with 252Cf source will depend not only on the capture product dose level, but also on the tumor distance from the source. 33S makes dose enhancement under specific conditions that these conditions depend on the neutron energy spectra of source, the 33S concentration in tumor and tumor distance from the source.

  4. Validation of MRI to TRUS registration for high-dose-rate prostate brachytherapy.

    Science.gov (United States)

    Poulin, Eric; Boudam, Karim; Pinter, Csaba; Kadoury, Samuel; Lasso, Andras; Fichtinger, Gabor; Ménard, Cynthia

    The objective of this study was to develop and validate an open-source module for MRI to transrectal ultrasound (TRUS) registration to support tumor-targeted prostate brachytherapy. In this study, 15 patients with prostate cancer lesions visible on multiparametric MRI were selected for the validation. T2-weighted images with 1-mm isotropic voxel size and diffusion weighted images were acquired on a 1.5T Siemens imager. Three-dimensional (3D) TRUS images with 0.5-mm slice thickness were acquired. The investigated registration module was incorporated in the open-source 3D Slicer platform, which can compute rigid and deformable transformations. An extension of 3D Slicer, SlicerRT, allows import of and export to DICOM-RT formats. For validation, similarity indices, prostate volumes, and centroid positions were determined in addition to registration errors for common 3D points identified by an experienced radiation oncologist. The average time to compute the registration was 35 ± 3 s. For the rigid and deformable registration, respectively, Dice similarity coefficients were 0.87 ± 0.05 and 0.93 ± 0.01 while the 95% Hausdorff distances were 4.2 ± 1.0 and 2.2 ± 0.3 mm. MRI volumes obtained after the rigid and deformable registration were not statistically different (p > 0.05) from reference TRUS volumes. For the rigid and deformable registration, respectively, 3D distance errors between reference and registered centroid positions were 2.1 ± 1.0 and 0.4 ± 0.1 mm while registration errors between common points were 3.5 ± 3.2 and 2.3 ± 1.1 mm. Deformable registration was found significantly better (p < 0.05) than rigid registration for all parameters. An open-source MRI to TRUS registration platform was validated for integration in the brachytherapy workflow. Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  5. Calibration services for medical applications of radiation

    Energy Technology Data Exchange (ETDEWEB)

    DeWerd, L.A.

    1993-12-31

    Calibration services for the medical community applications of radiation involve measuring radiation precisely and having traceability to the National Institute of Standards and Technology (NIST). Radiation therapy applications involve the use of ionization chambers and electrometers for external beams and well-type ionization chamber systems as well as radioactive sources for brachytherapy. Diagnostic x-ray applications involve ionization chamber systems and devices to measure other parameters of the x-ray machine, such as non-invasive kVp meters. Calibration laboratories have been established to provide radiation calibration services while maintaining traceability to NIST. New radiation applications of the medical community spur investigation to provide the future calibration needs.

  6. Calibration services for medical applications of radiation

    International Nuclear Information System (INIS)

    DeWerd, L.A.

    1993-01-01

    Calibration services for the medical community applications of radiation involve measuring radiation precisely and having traceability to the National Institute of Standards and Technology (NIST). Radiation therapy applications involve the use of ionization chambers and electrometers for external beams and well-type ionization chamber systems as well as radioactive sources for brachytherapy. Diagnostic x-ray applications involve ionization chamber systems and devices to measure other parameters of the x-ray machine, such as non-invasive kVp meters. Calibration laboratories have been established to provide radiation calibration services while maintaining traceability to NIST. New radiation applications of the medical community spur investigation to provide the future calibration needs

  7. Current status of brachytherapy in cancer treatment – short overview

    Directory of Open Access Journals (Sweden)

    Janusz Skowronek

    2017-12-01

    Full Text Available Cancer incidence and mortality depend on a number of factors, including age, socio-economic status and geographical location, and its prevalence is growing around the world. Most of cancer treatments include external beam radiotherapy or brachytherapy. Brachytherapy, a type of radiotherapy with energy from radionuclides inserted directly into the tumor, is increasingly used in cancer treatment. For cervical and skin cancers, it has become a standard therapy for more than 100 years as well as an important part of the treatment guidelines for other malignancies, including head and neck, skin, breast, and prostate cancers. Compared to external beam radiotherapy, brachytherapy has the potential to deliver an ablative radiation dose over a short period of time directly to the altered tissue area with the advantage of a rapid fall-off in dose, and consequently, sparing of adjacent organs. As a result, the patient is able to complete the treatment earlier, and the risks of occurrence of another cancer are lower than in conventional radiotherapy treatment. Brachytherapy has increased its use as a radical or palliative treatment, and become more advanced with the spread of pulsed-dose-rate and high-dose-rate afterloading machines; the use of new 3D/4D planning systems has additionally improved the quality of the treatment. The aim of the present study was to present short summaries of current studies on brachytherapy for the most frequently diagnosed tumors. Data presented in this manuscript should help especially young physicians or physicists to explore and introduce brachytherapy in cancer treatments.

  8. Synchrotron radiation sources

    Energy Technology Data Exchange (ETDEWEB)

    van Steenbergen, A.

    1979-01-01

    As a result of the exponential growth of the utilization of synchrotron radiation for research in the domain of the material sciences, atomic and molecular physics, biology and technology, a major construction activity has been generated towards new dedicated electron storage rings, designed optimally for synchrotron radiation applications, also, expansion programs are underway at the existing facilities, such as DORIS, SPEAR, and VEPP. In this report the basic properties of synchrotron radiation will be discussed, a short overview will be given of the existing and new facilities, some aspects of the optimization of a structure for a synchrotron radiation source will be discussed and the addition of wigglers and undulators for spectrum enhancement will be described. Finally, some parameters of an optimized synchrotron radiation source will be given.

  9. Investigation of Anisotropy Caused by Cylinder Applicator on Dose Distribution around Cs-137 Brachytherapy Source using MCNP4C Code

    Directory of Open Access Journals (Sweden)

    Sedigheh Sina

    2011-06-01

    Full Text Available Introduction: Brachytherapy is a type of radiotherapy in which radioactive sources are used in proximity of tumors normally for treatment of malignancies in the head, prostate and cervix. Materials and Methods: The Cs-137 Selectron source is a low-dose-rate (LDR brachytherapy source used in a remote afterloading system for treatment of different cancers. This system uses active and inactive spherical sources of 2.5 mm diameter, which can be used in different configurations inside the applicator to obtain different dose distributions. In this study, first the dose distribution at different distances from the source was obtained around a single pellet inside the applicator in a water phantom using the MCNP4C Monte Carlo code. The simulations were then repeated for six active pellets in the applicator and for six point sources.  Results: The anisotropy of dose distribution due to the presence of the applicator was obtained by division of dose at each distance and angle to the dose at the same distance and angle of 90 degrees. According to the results, the doses decreased towards the applicator tips. For example, for points at the distances of 5 and 7 cm from the source and angle of 165 degrees, such discrepancies reached 5.8% and 5.1%, respectively.  By increasing the number of pellets to six, these values reached 30% for the angle of 5 degrees. Discussion and Conclusion: The results indicate that the presence of the applicator causes a significant dose decrease at the tip of the applicator compared with the dose in the transverse plane. However, the treatment planning systems consider an isotropic dose distribution around the source and this causes significant errors in treatment planning, which are not negligible, especially for a large number of sources inside the applicator.

  10. Human error in remote Afterloading Brachytherapy

    International Nuclear Information System (INIS)

    Quinn, M.L.; Callan, J.; Schoenfeld, I.; Serig, D.

    1994-01-01

    Remote Afterloading Brachytherapy (RAB) is a medical process used in the treatment of cancer. RAB uses a computer-controlled device to remotely insert and remove radioactive sources close to a target (or tumor) in the body. Some RAB problems affecting the radiation dose to the patient have been reported and attributed to human error. To determine the root cause of human error in the RAB system, a human factors team visited 23 RAB treatment sites in the US. The team observed RAB treatment planning and delivery, interviewed RAB personnel, and performed walk-throughs, during which staff demonstrated the procedures and practices used in performing RAB tasks. Factors leading to human error in the RAB system were identified. The impact of those factors on the performance of RAB was then evaluated and prioritized in terms of safety significance. Finally, the project identified and evaluated alternative approaches for resolving the safety significant problems related to human error

  11. Evaluation of high-energy brachytherapy source electronic disequilibrium and dose from emitted electrons.

    Science.gov (United States)

    Ballester, Facundo; Granero, Domingo; Pérez-Calatayud, José; Melhus, Christopher S; Rivard, Mark J

    2009-09-01

    The region of electronic disequilibrium near photon-emitting brachytherapy sources of high-energy radionuclides (60Co, 137CS, 192Ir, and 169Yb) and contributions to total dose from emitted electrons were studied using the GEANT4 and PENELOPE Monte Carlo codes. Hypothetical sources with active and capsule materials mimicking those of actual sources but with spherical shape were examined. Dose contributions due to source photons, x rays, and bremsstrahlung; source beta-, Auger electrons, and internal conversion electrons; and water collisional kerma were scored. To determine if conclusions obtained for electronic equilibrium conditions and electron dose contribution to total dose for the representative spherical sources could be applied to actual sources, the 192Ir mHDR-v2 source model (Nucletron B.V., Veenendaal, The Netherlands) was simulated for comparison to spherical source results and to published data. Electronic equilibrium within 1% is reached for 60Co, 137CS, 192Ir, and 169Yb at distances greater than 7, 3.5, 2, and 1 mm from the source center, respectively, in agreement with other published studies. At 1 mm from the source center, the electron contributions to total dose are 1.9% and 9.4% for 60Co and 192Ir, respectively. Electron emissions become important (i.e., > 0.5%) within 3.3 mm of 60Co and 1.7 mm of 192Ir sources, yet are negligible over all distances for 137Cs and 169Yb. Electronic equilibrium conditions along the transversal source axis for the mHDR-v2 source are comparable to those of the spherical sources while electron dose to total dose contribution are quite different. Electronic equilibrium conditions obtained for spherical sources could be generalized to actual sources while electron contribution to total dose depends strongly on source dimensions, material composition, and electron spectra.

  12. Biological effect of Pulsed Dose Rate brachytherapy with stepping sources

    International Nuclear Information System (INIS)

    Limbergen, Erik F.M. van; Fowler, Jack F.

    1996-01-01

    Purpose: To explore the possible increase of radiation effect in tissues irradiated by pulsed brachytherapy (PDR), for local tissue dose-rates between those 'averaged over the whole pulse' and the instantaneous high dose rates close to the dwell positions. An earlier publication (Fowler and Mount 1992) had shown that, for dose rates (averaged for the duration of the pulse) up to 3 Gy/h, little change of isoeffect doses from continuous low dose rate (CLDR) are expected, unless larger doses per fraction than 1 Gy are used, and especially if components of very rapid repair are present with half-times of less than about 0.5 hours. However, local and transient dose rates close to stepping sources can be up to several Gy per minute. Methods: Calculations were done assuming the linear quadratic formula for radiation damage, in which only the dose-squared term is subject to repair, at a constant exponential rate. The formula developed by Dale for fractionated low-dose-rate radiotherapy was used. A constant overall time of 140 hours and constant total dose of 70 Gy were assumed throughout, the continuous low dose-rate of 0.5 Gy/h (CLDR) providing the unitary standard effects for each PDR condition. Effects of dose-rates ranging from 4 Gy/h to 120 Gy/h (HDR at 2 Gy/min) were studied, and T (1(2)) from 4 minutes to 1.5 hours. Results: Curves are presented relating the ratio of increased biological effect (proportional to log cell kill) calculated for PDR relative to CLDR. Ratios as high as 1.5 can be found for large doses per pulse (> 1 Gy) at high instantaneous dose-rates if T (1(2)) in tissues is as short as a few minutes. The major influences on effect are dose per pulse, half-time of repair in the tissue, and - when T (1(2)) is short - the instantaneous dose-rate. Maximum ratios of PDR/CLDR effect occur when the dose-rate is such that pulse duration is approximately equal to T (1(2)) of repair. Results are presented for late-responding tissues, the differences from CLDR

  13. Dose reduction in LDR brachytherapy by implanted prostate gold fiducial markers.

    Science.gov (United States)

    Landry, Guillaume; Reniers, Brigitte; Lutgens, Ludy; Murrer, Lars; Afsharpour, Hossein; de Haas-Kock, Danielle; Visser, Peter; van Gils, Francis; Verhaegen, Frank

    2012-03-01

    The dosimetric impact of gold fiducial markers (FM) implanted prior to external beam radiotherapy of prostate cancer on low dose rate (LDR) brachytherapy seed implants performed in the context of combined therapy was investigated. A virtual water phantom was designed containing a single FM. Single and multi source scenarios were investigated by performing Monte Carlo dose calculations, along with the influence of varying orientation and distance of the FM with respect to the sources. Three prostate cancer patients treated with LDR brachytherapy for a recurrence following external beam radiotherapy with implanted FM were studied as surrogate cases to combined therapy. FM and brachytherapy seeds were identified on post implant CT scans and Monte Carlo dose calculations were performed with and without FM. The dosimetric impact of the FM was evaluated by quantifying the amplitude of dose shadows and the volume of cold spots. D(90) was reported based on the post implant CT prostate contour. Large shadows are observed in the single source-FM scenarios. As expected from geometric considerations, the shadows are dependent on source-FM distance and orientation. Large dose reductions are observed at the distal side of FM, while at the proximal side a dose enhancement is observed. In multisource scenarios, the importance of shadows appears mitigated, although FM at the periphery of the seed distribution caused underdosage (LDR brachytherapy seed implant dose distributions. Therefore, reduced tumor control could be expected from FM implanted in tumors, although our results are too limited to draw conclusions regarding clinical significance.

  14. Suitability of point kernel dose calculation techniques in brachytherapy treatment planning

    Directory of Open Access Journals (Sweden)

    Lakshminarayanan Thilagam

    2010-01-01

    Full Text Available Brachytherapy treatment planning system (TPS is necessary to estimate the dose to target volume and organ at risk (OAR. TPS is always recommended to account for the effect of tissue, applicator and shielding material heterogeneities exist in applicators. However, most brachytherapy TPS software packages estimate the absorbed dose at a point, taking care of only the contributions of individual sources and the source distribution, neglecting the dose perturbations arising from the applicator design and construction. There are some degrees of uncertainties in dose rate estimations under realistic clinical conditions. In this regard, an attempt is made to explore the suitability of point kernels for brachytherapy dose rate calculations and develop new interactive brachytherapy package, named as BrachyTPS, to suit the clinical conditions. BrachyTPS is an interactive point kernel code package developed to perform independent dose rate calculations by taking into account the effect of these heterogeneities, using two regions build up factors, proposed by Kalos. The primary aim of this study is to validate the developed point kernel code package integrated with treatment planning computational systems against the Monte Carlo (MC results. In the present work, three brachytherapy applicators commonly used in the treatment of uterine cervical carcinoma, namely (i Board of Radiation Isotope and Technology (BRIT low dose rate (LDR applicator and (ii Fletcher Green type LDR applicator (iii Fletcher Williamson high dose rate (HDR applicator, are studied to test the accuracy of the software. Dose rates computed using the developed code are compared with the relevant results of the MC simulations. Further, attempts are also made to study the dose rate distribution around the commercially available shielded vaginal applicator set (Nucletron. The percentage deviations of BrachyTPS computed dose rate values from the MC results are observed to be within plus/minus 5

  15. Use of Monte Carlo Methods for determination of isodose curves in brachytherapy; Uso de tecnicas Monte Carlo para determinacao de curvas de isodose em braquiterapia

    Energy Technology Data Exchange (ETDEWEB)

    Vieira, Jose Wilson

    2001-08-01

    Brachytherapy is a special form of cancer treatment in which the radioactive source is very close to or inside the tumor with the objective of causing the necrosis of the cancerous tissue. The intensity of cell response to the radiation varies according to the tissue type and degree of differentiation. Since the malign cells are less differentiated than the normal ones, they are more sensitive to the radiation. This is the basis for radiotherapy techniques. Institutes that work with the application of high dose rates use sophisticated computer programs to calculate the necessary dose to achieve the necrosis of the tumor and the same time, minimizing the irradiation of tissues and organs of the neighborhood. With knowledge the characteristics of the source and the tumor, it is possible to trace isodose curves with the necessary information for planning the brachytherapy in patients. The objective of this work is, using Monte Carlo techniques, to develop a computer program - the ISODOSE - which allows to determine isodose curves in turn of linear radioactive sources used in brachytherapy. The development of ISODOSE is important because the available commercial programs, in general, are very expensive and practically inaccessible to small clinics. The use of Monte Carlo techniques is viable because they avoid problems inherent to analytic solutions as, for instance , the integration of functions with singularities in its domain. The results of ISODOSE were compared with similar data found in the literature and also with those obtained at the institutes of radiotherapy of the 'Hospital do Cancer do Recife' and of the 'Hospital Portugues do Recife'. ISODOSE presented good performance, mainly, due to the Monte Carlo techniques, that allowed a quite detailed drawing of the isodose curves in turn of linear sources. (author)

  16. Use of Monte Carlo Methods for determination of isodose curves in brachytherapy; Uso de tecnicas Monte Carlo para determinacao de curvas de isodose em braquiterapia

    Energy Technology Data Exchange (ETDEWEB)

    Vieira, Jose Wilson

    2001-08-01

    Brachytherapy is a special form of cancer treatment in which the radioactive source is very close to or inside the tumor with the objective of causing the necrosis of the cancerous tissue. The intensity of cell response to the radiation varies according to the tissue type and degree of differentiation. Since the malign cells are less differentiated than the normal ones, they are more sensitive to the radiation. This is the basis for radiotherapy techniques. Institutes that work with the application of high dose rates use sophisticated computer programs to calculate the necessary dose to achieve the necrosis of the tumor and the same time, minimizing the irradiation of tissues and organs of the neighborhood. With knowledge the characteristics of the source and the tumor, it is possible to trace isodose curves with the necessary information for planning the brachytherapy in patients. The objective of this work is, using Monte Carlo techniques, to develop a computer program - the ISODOSE - which allows to determine isodose curves in turn of linear radioactive sources used in brachytherapy. The development of ISODOSE is important because the available commercial programs, in general, are very expensive and practically inaccessible to small clinics. The use of Monte Carlo techniques is viable because they avoid problems inherent to analytic solutions as, for instance , the integration of functions with singularities in its domain. The results of ISODOSE were compared with similar data found in the literature and also with those obtained at the institutes of radiotherapy of the 'Hospital do Cancer do Recife' and of the 'Hospital Portugues do Recife'. ISODOSE presented good performance, mainly, due to the Monte Carlo techniques, that allowed a quite detailed drawing of the isodose curves in turn of linear sources. (author)

  17. About the value of Ruthenium 106 brachytherapy in the treatment of uveal melanomas

    International Nuclear Information System (INIS)

    Langmann, G.; Mosboeck, G.; Stuecklschwaiger, G.; Muellner, K.; Lechner, H.; Faulborn, J.

    2002-01-01

    Background: to investigate the clinical course, sequelae and visual function of uveal melanomas treated with Ruthenium 106 brachytherapy. Patients and method: 47 patients who underwent Ruthenium 106 brachytherapy between 1985 and 2000 were evaluated using Kaplan Meier statistical method. Mean follow up interval was 22 month (range 8 - 152 months). Results: Local tumor control rate was 85 %, 5 years possibility to avoid enucleation was 75 %. The most important sequelae were radiation optic neuropathy (29 %), maculopathy (37 %) and radiation retinopathy (32 %). After terminating the study the 34 % of the patients achieved a visual acuity of 20/40 and more, another 34 % had a visual function of 20/200 and lower. Conclusion: Ruthenium 106 brachytherapy is our method of choice in small medium sized uveal melanomas and a maximum tumor prominence of 6 mm. Tumors have to be located in the midperiphery and outer periphery of the fundus including the ciliary body. In addition to the indications introduced by Lommatzsch we treated ciliary body melanomas with a tumor base more than 3 clock hours (by shifting the plaque) as an alternative therapy to enucleation. (author)

  18. Physics and quality assurance for high dose rate brachytherapy

    International Nuclear Information System (INIS)

    Anderson, Lowell L.

    1995-01-01

    Purpose: To review the physical aspects of high dose rate (HDR) brachytherapy, including commissioning and quality assurance, source calibration and dose distribution measurements, and treatment planning methods. Following the introduction of afterloading in brachytherapy, development efforts to make it 'remote' culminated in 1964 with the near-simultaneous appearance of remote afterloaders in five major medical centers. Four of these machines were 'high dose rate', three employing 60Co and one (the GammaMed) using a single, cable-mounted 192Ir source. Stepping-motor source control was added to the GammaMed in 1974, making it the precursor of modern remote afterloaders, which are now suitable for interstitial as well as intracavitary brachytherapy by virtue of small source-diameter and indexer-accessed multiple channels. Because the 192Ir sources currently used in HDR remote afterloaders are supplied at a nominal air-kerma strength of 11.4 cGy cm2 s-1 (10 Ci), are not collimated in clinical use, and emit a significant fraction (15%) of photons at energies greater than 600 keV, shielding and facility design must be undertaken as carefully and thoroughly as for external beam installations. Licensing requirements of regulatory agencies must be met with respect both to maximum permissible dose limits and to the existence and functionality of safety devices (door interlocks, radiation monitors, etc.). Commissioning and quality assurance procedures that must be documented for HDR remote afterloading relate to (1) machine, applicator, guide-tube, and facility functionality checks, (2) source calibration, (3) emergency response readiness, (4) planning software evaluation, and (5) independent checks of clinical dose calculations. Source calibration checks must be performed locally, either by in-air measurement of air kerma strength or with a well ionization chamber calibrated (by an accredited standards laboratory) against an in-air measurement of air kerma strength for the

  19. Dose rate constants for 125I, 103Pd, 192Ir and 169Yb brachytherapy sources: an EGS4 Monte Carlo study

    International Nuclear Information System (INIS)

    Mainegra, Ernesto; Capote, Roberto; Lopez, Ernesto

    1998-01-01

    An exhaustive revision of dosimetry data for 192 Ir, 125 I, 103 Pd and 169 Yb brachytherapy sources has been performed by means of the EGS4 simulation system. The DLC-136/PHOTX cross section library, water molecular form factors, bound Compton scattering and Doppler broadening of the Compton-scattered photon energy were considered in the calculations. The absorbed dose rate per unit contained activity in a medium at 1 cm in water and air-kerma strength per unit contained activity for each seed model were calculated, allowing the dose rate constant (DRC) Λ to be estimated. The influence of the calibration procedure on source strength for low-energy brachytherapy seeds is discussed. Conversion factors for 125 I and 103 Pd seeds to obtain the dose rate in liquid water from the dose rate measured in a solid water phantom with a detector calibrated for dose to water were calculated. A theoretical estimate of the DRC for a 103 Pd model 200 seed equal to 0.669±0.002 cGy h -1 U -1 is obtained. Comparison of obtained DRCs with measured and calculated published results shows agreement within 1.5% for 192 Ir, 169 Yb and 125 I sources. (author)

  20. Nanoparticle-Based Brachytherapy Spacers for Delivery of Localized Combined Chemoradiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Rajiv, E-mail: r.kumar@neu.edu [Nanomedicine Science and Technology Center, Northeastern University, Boston, Massachusetts (United States); Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts (United States); Belz, Jodi [Nanomedicine Science and Technology Center, Northeastern University, Boston, Massachusetts (United States); Markovic, Stacey [Department of Electrical and Computer Engineering, Northeastern University, Boston, Massachusetts (United States); Jadhav, Tej; Fowle, William [Nanomedicine Science and Technology Center, Northeastern University, Boston, Massachusetts (United States); Niedre, Mark [Department of Electrical and Computer Engineering, Northeastern University, Boston, Massachusetts (United States); Cormack, Robert; Makrigiorgos, Mike G. [Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts (United States); Sridhar, Srinivas [Nanomedicine Science and Technology Center, Northeastern University, Boston, Massachusetts (United States); Department of Radiation Oncology, Brigham and Women' s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts (United States)

    2015-02-01

    Purpose: In radiation therapy (RT), brachytherapy-inert source spacers are commonly used in clinical practice to achieve high spatial accuracy. These implanted devices are critical technical components of precise radiation delivery but provide no direct therapeutic benefits. Methods and Materials: Here we have fabricated implantable nanoplatforms or chemoradiation therapy (INCeRT) spacers loaded with silica nanoparticles (SNPs) conjugated containing a drug, to act as a slow-release drug depot for simultaneous localized chemoradiation therapy. The spacers are made of poly(lactic-co-glycolic) acid (PLGA) as matrix and are physically identical in size to the commercially available brachytherapy spacers (5 mm × 0.8 mm). The silica nanoparticles, 250 nm in diameter, were conjugated with near infrared fluorophore Cy7.5 as a model drug, and the INCeRT spacers were characterized in terms of size, morphology, and composition using different instrumentation techniques. The spacers were further doped with an anticancer drug, docetaxel. We evaluated the in vivo stability, biocompatibility, and biodegradation of these spacers in live mouse tissues. Results: The electron microscopy studies showed that nanoparticles were distributed throughout the spacers. These INCeRT spacers remained stable and can be tracked by the use of optical fluorescence. In vivo optical imaging studies showed a slow diffusion of nanoparticles from the spacer to the adjacent tissue in contrast to the control Cy7.5-PLGA spacer, which showed rapid disintegration in a few days with a burst release of Cy7.5. The docetaxel spacers showed suppression of tumor growth in contrast to control mice over 16 days. Conclusions: The imaging with the Cy7.5 spacer and therapeutic efficacy with docetaxel spacers supports the hypothesis that INCeRT spacers can be used for delivering the drugs in a slow, sustained manner in conjunction with brachytherapy, in contrast to the rapid clearance of the drugs when

  1. Nanoparticle-Based Brachytherapy Spacers for Delivery of Localized Combined Chemoradiation Therapy

    International Nuclear Information System (INIS)

    Kumar, Rajiv; Belz, Jodi; Markovic, Stacey; Jadhav, Tej; Fowle, William; Niedre, Mark; Cormack, Robert; Makrigiorgos, Mike G.; Sridhar, Srinivas

    2015-01-01

    Purpose: In radiation therapy (RT), brachytherapy-inert source spacers are commonly used in clinical practice to achieve high spatial accuracy. These implanted devices are critical technical components of precise radiation delivery but provide no direct therapeutic benefits. Methods and Materials: Here we have fabricated implantable nanoplatforms or chemoradiation therapy (INCeRT) spacers loaded with silica nanoparticles (SNPs) conjugated containing a drug, to act as a slow-release drug depot for simultaneous localized chemoradiation therapy. The spacers are made of poly(lactic-co-glycolic) acid (PLGA) as matrix and are physically identical in size to the commercially available brachytherapy spacers (5 mm × 0.8 mm). The silica nanoparticles, 250 nm in diameter, were conjugated with near infrared fluorophore Cy7.5 as a model drug, and the INCeRT spacers were characterized in terms of size, morphology, and composition using different instrumentation techniques. The spacers were further doped with an anticancer drug, docetaxel. We evaluated the in vivo stability, biocompatibility, and biodegradation of these spacers in live mouse tissues. Results: The electron microscopy studies showed that nanoparticles were distributed throughout the spacers. These INCeRT spacers remained stable and can be tracked by the use of optical fluorescence. In vivo optical imaging studies showed a slow diffusion of nanoparticles from the spacer to the adjacent tissue in contrast to the control Cy7.5-PLGA spacer, which showed rapid disintegration in a few days with a burst release of Cy7.5. The docetaxel spacers showed suppression of tumor growth in contrast to control mice over 16 days. Conclusions: The imaging with the Cy7.5 spacer and therapeutic efficacy with docetaxel spacers supports the hypothesis that INCeRT spacers can be used for delivering the drugs in a slow, sustained manner in conjunction with brachytherapy, in contrast to the rapid clearance of the drugs when

  2. Preliminary results of interstitial [sup 192]Ir brachytherapy for malignant gliomas

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Kengo; Nakagawa, Minoru; Higashi, Hisato [Okayama Univ. (Japan). School of Medicine; and others

    1992-09-01

    Twenty-six patients with recurrent or unremovable malignant gliomas were treated by interstitial brachytherapy with iridium-192 seeds. Stereotactic implantation of the afterloading catheters using the Brown-Roberts-Wells computed tomography (CT)-guided stereotactic system was performed in 24 patients and surgical CT, magnetic resonance imaging, and clinical examination. Tumor regression was seen in 17 patients 1-3 months after implantation. Tumor progression was seen in only three patients. After interstitial brachytherapy, the most commonly observed CT finding was central low density. Median survival time was 18 months after implantation. Autopsies in five patients revealed the delayed effects of radiation injury such as typical vascular changes, microcalcification, and coagulative necrosis in the implant area and tumor recurrence at the periphery. The results suggest that brachytherapy is not curative but prolonged the median survival time by 6 months. (author).

  3. Design and implementation of an intravascular brachytherapy installation in cardiology

    International Nuclear Information System (INIS)

    Prieto, C.; Vano, E.; Fernandez, J.M.; Sabate, M.; Galvan, Y.C.

    2001-01-01

    Intravascular Brachytherapy (IVB) is a very promising technique for reducing restenosis rates. However, neither the exact absolute dose needed nor the optimal spatial and temporal distribution of dose inside the vessel wall for a successful treatment, nor the physical dosimetry of the various radioactive sources and devices for dose delivery, are well known. In this paper, an overview will be given of the design strategy, the dosimetric and radiation protection-related problems that we have met during the implementation of this technique at San Carlos hospital, adopted or foreseen solutions, and future research fields that we intend to carry out in order to reduce uncertainties and to achieve a deeper knowledge of the parameters that have an influence on the treatment. (author)

  4. Safe handling of radiation sources

    International Nuclear Information System (INIS)

    Abd Nasir Ibrahim; Azali Muhammad; Ab Razak Hamzah; Abd Aziz Mohamed; Mohammad Pauzi Ismail

    2004-01-01

    This chapter discussed the subjects related to the safe handling of radiation sources: type of radiation sources, method of use: transport within premises, transport outside premises; Disposal of Gamma Sources

  5. Quality control of Ir-192, Cs-137 and Ra-226 sources for use in brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Oyrzun Cortes, C H; Palma D, A M; Penaloza C, H; Tomicic, M [Comision Chilena de Energia Nuclear, Santiago (Chile)

    1996-08-01

    In order to establish a certain degree of reliability in the use and managing of radioactive material in brachytherapy, a minimal quality control to each source was implemented. The purpose was to estimate the degree of radioactive leak, resistance to the mechanic traction and stress of use. Through a physical control of the radioactive material (a simple dip test and using a photon scanner or auto-radiography) the minimal conditions that guarantee safe use are established. This information is transmitted to a calibration laboratory for certification in exposure rate and/or activity. Systematic use of these tests, enables discovery of radioactive material leakage due to faults in the seal. (author).

  6. Quality control of Ir-192, Cs-137 and Ra-226 sources for use in brachytherapy

    International Nuclear Information System (INIS)

    Oyrzun Cortes, C.H.; Palma D, A.M.; Penaloza C, H.; Tomicic, M.

    1996-01-01

    In order to establish a certain degree of reliability in the use and managing of radioactive material in brachytherapy, a minimal quality control to each source was implemented. The purpose was to estimate the degree of radioactive leak, resistance to the mechanic traction and stress of use. Through a physical control of the radioactive material (a simple dip test and using a photon scanner or auto-radiography) the minimal conditions that guarantee safe use are established. This information is transmitted to a calibration laboratory for certification in exposure rate and/or activity. Systematic use of these tests, enables discovery of radioactive material leakage due to faults in the seal. (author)

  7. Manual method for dose calculation in gynecologic brachytherapy

    International Nuclear Information System (INIS)

    Vianello, Elizabeth A.; Almeida, Carlos E. de; Biaggio, Maria F. de

    1998-01-01

    This paper describes a manual method for dose calculation in brachytherapy of gynecological tumors, which allows the calculation of the doses at any plane or point of clinical interest. This method uses basic principles of vectorial algebra and the simulating orthogonal films taken from the patient with the applicators and dummy sources in place. The results obtained with method were compared with the values calculated with the values calculated with the treatment planning system model Theraplan and the agreement was better than 5% in most cases. The critical points associated with the final accuracy of the proposed method is related to the quality of the image and the appropriate selection of the magnification factors. This method is strongly recommended to the radiation oncology centers where are no treatment planning systems available and the dose calculations are manually done. (author)

  8. Characterization of TLD-100 in powders for dosimetric quality control of 192 Ir sources used in brachytherapy of high dose rate

    International Nuclear Information System (INIS)

    Loaiza C, S.P.

    2007-01-01

    The Secondary Standard Dosimetric at the National Institute of Nuclear Research (ININ) calibrated a lot of powdered TLD-100 (LiF:Mg,Ti) in terms of absorbed dose to water D w for the energy of: 60 Co, 137C s, X rays of 250 and 50 kVp. Later on, it is carried out an interpolation of the calibration for the energy of the 192 Ir. This calibration is part of a dosimetric quality control program, to solve the problems of traceability for the measurements carried out by the users of 192 Ir sources employed in the treatments of High Dose Rate Brachytherapy (HDR) at the Mexican Republic. The calibrations of the radiation beams are made with the following protocols: IAEA TRS-398 for the 60 Co for D w , using a secondary standard ionization chamber PTW N30013 calibrated in D w by the National Research Council (NRC, Canada). AAPM TG-43 for D w in terms of the strength kerma Sk, calibrating this last one quantity for the 137 Cs radioactive source, with a well chamber HDR 1000 PLUS traceable to the University of Wisconsin (US). AAPM TG-61 for X ray of 250 and 50 kVp for D w start to Ka using field standard a Farmer chamber PTW 30001 traceable to K for the Central Laboratory of Electric Industries (CLEI, France). The calibration curves (CC) they built for the response of the powder TLD: R TLD vs D w : For the energy of 60 Co, 137 Cs, X rays of 250 and 50 kVp. Fitting them with the least square method weighed by means of a polynomial of second grade that corrects the supra linearity of the response. iii. Each one of the curves was validated with a test by lack of fitting and for the Anderson Darling normality test, using the software MINITAB in both cases. iv. The sensibility factor (F s ) for each energy corresponds to the slope of the CC, v. The F s for the two 192 Ir sources used are interpolated: one for a Micro Selectron source and the other one a Vari Source source. Finally, a couple of capsules were sent to two hospitals that have the HDR Brachytherapy with sources of 192

  9. Erectile function after permanent prostate brachytherapy

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Butler, Wayne M.; Galbreath, Robert W.; Stipetich, Robin L.; Abel, Laurie J.; Lief, Jonathan H.

    2002-01-01

    Purpose: To determine the incidence of potency preservation after permanent prostate brachytherapy using a validated patient-administered questionnaire and to evaluate the effect of multiple clinical and treatment parameters on penile erectile function. Methods and Materials: Four hundred twenty-five patients underwent permanent prostate brachytherapy from April 1995 to October 1999. Two hundred nine patients who were potent before brachytherapy and who at the time of the survey were not receiving hormonal therapy were mailed the specific erectile questions of the International Index of Erectile Function (IIEF) questionnaire with a self-addressed stamped envelope. The questionnaire consisted of 5 questions, with a maximal score of 25. Of the 209 patients, 181 (87%) completed and returned the questionnaire. The mean and median follow-up was 40.4±14.9 and 40.6 months, respectively (range 19-75). Preimplant erectile function was assigned using a three-tiered scoring system (2 = erections always or nearly always sufficient for vaginal penetration; 1 = erections sufficient for vaginal penetration but considered suboptimal; 0 = the inability to obtain erections and/or erections inadequate for vaginal penetration). Postimplant potency was defined as an IIEF score ≥11. The clinical parameters evaluated for erectile function included patient age, preimplant potency, clinical T-stage, pretreatment prostate-specific antigen level, Gleason score, elapsed time after implantation, hypertension, diabetes mellitus, and tobacco consumption. Treatment parameters included radiation dose to the prostate gland, use of hormonal manipulation, use of supplemental external beam radiotherapy (EBRT), choice of isotope, prostate volume, and planning volume. The efficacy of sildenafil citrate in brachytherapy-induced erectile dysfunction (ED) was also evaluated. Results: Pretreatment erectile function scores of 2 and 1 were assigned to 125 and 56 patients, respectively. With a 6-year follow

  10. Importance of the neutrons kerma coefficient in the planning of Brachytherapy treatments with Cf-252 sources

    International Nuclear Information System (INIS)

    Paredes G, L.; Balcazar G, M.; Azorin N, J.; Francois L, J.L.

    2006-01-01

    The Cf-252 is a fast neutrons emitting radioisotope by spontaneous fission that can be used as sealed source in medicine applications, industry and research. Commercially its offer sources of different sizes, compact and with a fast neutrons emission of the order of 10 6 n/s-μg and an energy spectra that presents respectively maxim and average energy in 2.1 MeV and 0.7 MeV. In medicine new applications are being developed for the treatment of patient with hypoxic and voluminous tumors, where the therapy with photons has not given positive results, as well as for the protocols of therapy treatment by boron neutron capture, where very small sources of Cf-252 will be used with the interstitial brachytherapy technique of high and low dose rate. In this work an analysis of how the small differences that exist in the elementary composition of 4 wicked tumors, 4 ICRU healthy tissues and 3 substitute materials of ICRU tissue used in dosimetry are presented, its generate changes in the neutrons kerma coefficient in function of the energy and consequently in the absorbed dose in the interval of 11 eV to 29 MeV. These differences can produce maximum variations of the neutron kerma coefficients ratio for E n > 1 keV of the one: 15% tumor/ICRU guest healthy tissue, 12% ICRU tumor/muscle, 12% ICRU healthy tissues ICRU/ICRU muscle, 22% substitutes tissue/tumor and 22% ICRU substitutes tissue/muscle. Also, it was found that the average value of the neutrons kerma coefficient for the 4 wicked tumors is from 6% to 7% smaller that the average value for the soft tissue in the interval energy of interest for therapy with fast neutrons with E n > 1 MeV. These results have a special importance during the planning process of brachytherapy treatments with sources of 252 Cf, to optimize and to individualize the patients treatments. (Author)

  11. Risk analysis of brachytherapy events

    International Nuclear Information System (INIS)

    Buricova, P.; Zackova, H.; Hobzova, L.; Novotny, J.; Kindlova, A.

    2005-01-01

    For prevention radiological events it is necessary to identify hazardous situation and to analyse the nature of committed errors. Though the recommendation on the classification and prevention of radiological events: Radiological accidents has been prepared in the framework of Czech Society of Radiation Oncology, Biology and Physics and it was approved by Czech regulatory body (SONS) in 1999, only a few reports have been submitted up to now from brachytherapy practice. At the radiotherapy departments attention has been paid more likely to the problems of dominant teletherapy treatments. But in the two last decades the usage of brachytherapy methods has gradually increased because .nature of this treatment well as the possibilities of operating facility have been completely changed: new radionuclides of high activity are introduced and sophisticate afterloading systems controlled by computers are used. Consequently also the nature of errors, which can occurred in the clinical practice, has been changing. To determine the potentially hazardous parts of procedure the so-called 'process tree', which follows the flow of entire treatment process, has been created for most frequent type of applications. Marking the location of errors on the process tree indicates where failures occurred and accumulation of marks along branches show weak points in the process. Analysed data provide useful information to prevent medical events in brachytherapy .The results strength the requirements given in Recommendations of SONS and revealed the need for its amendment. They call especially for systematic registration of the events. (authors)

  12. Sources of pulsed radiation

    International Nuclear Information System (INIS)

    Sauer, M.C. Jr.

    1981-01-01

    Characteristics of various sources of pulsed radiation are examined from the viewpoint of their importance to the radiation chemist, and some examples of uses of such sources are mentioned. A summary is given of the application of methods of physical dosimetry to pulsed sources, and the calibration of convenient chemical dosimeters by physical dosimetry is outlined. 7 figures, 1 table

  13. Accuracy Evaluation of Oncentra™ TPS in HDR Brachytherapy of Nasopharynx Cancer Using EGSnrc Monte Carlo Code

    Science.gov (United States)

    Hadad, K.; Zohrevand, M.; Faghihi, R.; Sedighi Pashaki, A.

    2015-01-01

    Background HDR brachytherapy is one of the commonest methods of nasopharyngeal cancer treatment. In this method, depending on how advanced one tumor is, 2 to 6 Gy dose as intracavitary brachytherapy is prescribed. Due to high dose rate and tumor location, accuracy evaluation of treatment planning system (TPS) is particularly important. Common methods used in TPS dosimetry are based on computations in a homogeneous phantom. Heterogeneous phantoms, especially patient-specific voxel phantoms can increase dosimetric accuracy. Materials and Methods In this study, using CT images taken from a patient and ctcreate-which is a part of the DOSXYZnrc computational code, patient-specific phantom was made. Dose distribution was plotted by DOSXYZnrc and compared with TPS one. Also, by extracting the voxels absorbed dose in treatment volume, dose-volume histograms (DVH) was plotted and compared with Oncentra™ TPS DVHs. Results The results from calculations were compared with data from Oncentra™ treatment planning system and it was observed that TPS calculation predicts lower dose in areas near the source, and higher dose in areas far from the source relative to MC code. Absorbed dose values in the voxels also showed that TPS reports D90 value is 40% higher than the Monte Carlo method. Conclusion Today, most treatment planning systems use TG-43 protocol. This protocol may results in errors such as neglecting tissue heterogeneity, scattered radiation as well as applicator attenuation. Due to these errors, AAPM emphasized departing from TG-43 protocol and approaching new brachytherapy protocol TG-186 in which patient-specific phantom is used and heterogeneities are affected in dosimetry. PMID:25973408

  14. SU-E-T-212: Comparison of TG-43 Dosimetric Parameters of Low and High Energy Brachytherapy Sources Obtained by MCNP Code Versions of 4C, X and 5

    Energy Technology Data Exchange (ETDEWEB)

    Zehtabian, M; Zaker, N; Sina, S [Shiraz University, Shiraz, Fars (Iran, Islamic Republic of); Meigooni, A Soleimani [Comprehensive Cancer Center of Nevada, Las Vegas, Nevada (United States)

    2015-06-15

    Purpose: Different versions of MCNP code are widely used for dosimetry purposes. The purpose of this study is to compare different versions of the MCNP codes in dosimetric evaluation of different brachytherapy sources. Methods: The TG-43 parameters such as dose rate constant, radial dose function, and anisotropy function of different brachytherapy sources, i.e. Pd-103, I-125, Ir-192, and Cs-137 were calculated in water phantom. The results obtained by three versions of Monte Carlo codes (MCNP4C, MCNPX, MCNP5) were compared for low and high energy brachytherapy sources. Then the cross section library of MCNP4C code was changed to ENDF/B-VI release 8 which is used in MCNP5 and MCNPX codes. Finally, the TG-43 parameters obtained using the MCNP4C-revised code, were compared with other codes. Results: The results of these investigations indicate that for high energy sources, the differences in TG-43 parameters between the codes are less than 1% for Ir-192 and less than 0.5% for Cs-137. However for low energy sources like I-125 and Pd-103, large discrepancies are observed in the g(r) values obtained by MCNP4C and the two other codes. The differences between g(r) values calculated using MCNP4C and MCNP5 at the distance of 6cm were found to be about 17% and 28% for I-125 and Pd-103 respectively. The results obtained with MCNP4C-revised and MCNPX were similar. However, the maximum difference between the results obtained with the MCNP5 and MCNP4C-revised codes was 2% at 6cm. Conclusion: The results indicate that using MCNP4C code for dosimetry of low energy brachytherapy sources can cause large errors in the results. Therefore it is recommended not to use this code for low energy sources, unless its cross section library is changed. Since the results obtained with MCNP4C-revised and MCNPX were similar, it is concluded that the difference between MCNP4C and MCNPX is their cross section libraries.

  15. Dose mapping of the rectal wall during brachytherapy with an array of scintillation dosimeters

    International Nuclear Information System (INIS)

    Cartwright, L. E.; Suchowerska, N.; Yin, Y.; Lambert, J.; Haque, M.; McKenzie, D. R.

    2010-01-01

    Purpose: In pelvic brachytherapy treatments, the rectum is an organ at risk. The authors have developed an array of scintillation dosimeters suitable for in vivo use that enables quality assurance of the treatment delivery and provides an alert to potential radiation accidents. Ultimately, this will provide evidence to direct treatment planning and dose escalation and correlate dose with the rectal response. Methods: An array of 16 scintillation dosimeters in an insertable applicator has been developed. The dosimeters were calibrated simultaneously in a custom designed circular jig before use. Each dosimeter is optically interfaced to a set of pixels on a CCD camera located outside the treatment bunker. A customized software converts pixel values into dose rate and accumulates dose for presentation during treatment delivery. The performance of the array is tested by simulating brachytherapy treatments in a water phantom. The treatment plans were designed to deliver a known dose distribution on the surface of the rectal applicator, assumed to represent the dose to the rectal wall. Results: The measured doses were compared to those predicted by the treatment plan and found to be in agreement to within the uncertainty in measurement, usually within 3%. The array was also used to track the progression of the source as it moved along the catheter. The measured position was found to agree with the position reported by the afterloader to within the measurement uncertainty, usually within 2 mm. Conclusions: This array is capable of measuring the actual dose received by each region of the rectal wall during brachytherapy treatments. It will provide real time monitoring of treatment delivery and raise an alert to a potential radiation accident. Real time dose mapping in the clinical environment will give the clinician additional confidence to carry out dose escalation to the tumor volume while avoiding rectal side effects.

  16. A phase I/II study of external beam radiation, brachytherapy and concurrent chemotherapy in localized cancer of the esophagus (RTOG 9207)

    International Nuclear Information System (INIS)

    Gaspar, L.E.; Qian, C.; Kocha, W.I.; Coia, L.R.; Herskovic, A.; Graham, M.

    1996-01-01

    Introduction: A multi-institutional, prospective study was designed to determine the feasibility and toxicity of chemotherapy, external beam irradiation and esophageal brachytherapy (EB) in a potentially curable group of patients with adenocarcinoma or squamous cell carcinoma of the esophagus. Methods: Planned treatment was 50 Gy external beam radiation (25 fractions/5 wks) followed 2 weeks later by EB (either HDR 5 Gy wks 8,9 and 10 for a total of 15 Gy or LDR 20 Gy wk 8). The protocol was later revised to delete the LDR alternative due to poor accrual and decrease the HDR dose to 10 Gy, ie 5 Gy wks 8 and 9. Chemotherapy was given wks 1,5,8 and 11 with DDP 75 mg/m2 and 5-FU 1000 mg/m2/24 hrs, 96 hour infusion. Data is available on 50 patients (46 squamous, 3 adenocarcinoma) treated on the HDR alternative (EB dose 15 Gy and 10 Gy in 40 and 10 patients, respectively. Results: Thirty-five patients (70%) were able to complete external beam, EB and at least 2 courses of chemotherapy. Estimated survival rate at 12 months is 48%. Life-threatening toxicity or death occurred in 13 (26%) and 4 (8%) patients, respectively. Treatment-related esophageal fistulas occurred in 6 patients (12%) at 0.5 to 6.2 months from the first day of brachytherapy, leading to death in 3. So far all treatment-related fistulas occurred in the 15 Gy EB group. Conclusions: Survival following this combination of chemotherapy, external beam radiation and EB does not appear to be different from survival seen following chemotherapy and external beam radiation only. Based on the high incidence of fistulas, we urge extreme caution in employing EB as a boost following concurrent chemotherapy and external beam radiation with the schema utilized in this prospective study

  17. Applying gold nanoparticles as tumor-vascular disrupting agents during brachytherapy: estimation of endothelial dose enhancement

    International Nuclear Information System (INIS)

    Ngwa, Wilfred; Makrigiorgos, G Mike; Berbeco, Ross I

    2010-01-01

    Tumor vascular disrupting agents (VDAs) represent a promising approach to the treatment of cancer, in view of the tumor vasculature's pivotal role in tumor survival, growth and metastasis. VDAs targeting the tumor's dysmorphic endothelial cells can cause selective and rapid occlusion of the tumor vasculature, leading to tumor cell death from ischemia and extensive hemorrhagic necrosis. In this study, the potential for applying gold nanoparticles (AuNPs) as VDAs, during brachytherapy, is examined. Analytic calculations based on the electron energy loss formula of Cole were carried out to estimate the endothelial dose enhancement caused by radiation-induced photo/Auger electrons originating from AuNPs targeting the tumor endothelium. The endothelial dose enhancement factor (EDEF), representing the ratio of the dose to the endothelium with and without gold nanoparticles was calculated for different AuNP local concentrations, and endothelial cell thicknesses. Four brachytherapy sources were investigated, I-125, Pd-103, Yb-169, as well as 50 kVp x-rays. The results reveal that, even at relatively low intra-vascular AuNP concentrations, ablative dose enhancement to tumor endothelial cells due to photo/Auger electrons from the AuNPs can be achieved. Pd-103 registered the highest EDEF values of 7.4-271.5 for local AuNP concentrations ranging from 7 to 350 mg g -1 , respectively. Over the same concentration range, I-125, 50 kVp and Yb-169 yielded values of 6.4-219.9, 6.3-214.5 and 4.0-99.7, respectively. Calculations of the EDEF as a function of endothelial cell thickness showed that lower energy sources like Pd-103 reach the maximum EDEF at smaller thicknesses. The results also reveal that the highest contribution to the EDEF comes from Auger electrons, apparently due to their shorter range. Overall, the data suggest that ablative dose enhancement to tumor endothelial cells can be achieved by applying tumor vasculature-targeted AuNPs as adjuvants to brachytherapy, with

  18. Applying gold nanoparticles as tumor-vascular disrupting agents during brachytherapy: estimation of endothelial dose enhancement

    Science.gov (United States)

    Ngwa, Wilfred; Makrigiorgos, G. Mike; Berbeco, Ross I.

    2010-11-01

    Tumor vascular disrupting agents (VDAs) represent a promising approach to the treatment of cancer, in view of the tumor vasculature's pivotal role in tumor survival, growth and metastasis. VDAs targeting the tumor's dysmorphic endothelial cells can cause selective and rapid occlusion of the tumor vasculature, leading to tumor cell death from ischemia and extensive hemorrhagic necrosis. In this study, the potential for applying gold nanoparticles (AuNPs) as VDAs, during brachytherapy, is examined. Analytic calculations based on the electron energy loss formula of Cole were carried out to estimate the endothelial dose enhancement caused by radiation-induced photo/Auger electrons originating from AuNPs targeting the tumor endothelium. The endothelial dose enhancement factor (EDEF), representing the ratio of the dose to the endothelium with and without gold nanoparticles was calculated for different AuNP local concentrations, and endothelial cell thicknesses. Four brachytherapy sources were investigated, I-125, Pd-103, Yb-169, as well as 50 kVp x-rays. The results reveal that, even at relatively low intra-vascular AuNP concentrations, ablative dose enhancement to tumor endothelial cells due to photo/Auger electrons from the AuNPs can be achieved. Pd-103 registered the highest EDEF values of 7.4-271.5 for local AuNP concentrations ranging from 7 to 350 mg g-1, respectively. Over the same concentration range, I-125, 50 kVp and Yb-169 yielded values of 6.4-219.9, 6.3-214.5 and 4.0-99.7, respectively. Calculations of the EDEF as a function of endothelial cell thickness showed that lower energy sources like Pd-103 reach the maximum EDEF at smaller thicknesses. The results also reveal that the highest contribution to the EDEF comes from Auger electrons, apparently due to their shorter range. Overall, the data suggest that ablative dose enhancement to tumor endothelial cells can be achieved by applying tumor vasculature-targeted AuNPs as adjuvants to brachytherapy, with lower

  19. Early observed transient prostate-specific antigen elevations on a pilot study of external beam radiation therapy and fractionated MRI guided High Dose Rate brachytherapy boost

    International Nuclear Information System (INIS)

    Singh, Anurag K; Godette, Denise J; Stall, Bronwyn R; Coleman, C Norman; Camphausen, Kevin; Ménard, Cynthia; Guion, Peter; Susil, Robert C; Citrin, Deborah E; Ning, Holly; Miller, Robert W; Ullman, Karen; Smith, Sharon; Crouse, Nancy Sears

    2006-01-01

    To report early observation of transient PSA elevations on this pilot study of external beam radiation therapy and magnetic resonance imaging (MRI) guided high dose rate (HDR) brachytherapy boost. Eleven patients with intermediate-risk and high-risk localized prostate cancer received MRI guided HDR brachytherapy (10.5 Gy each fraction) before and after a course of external beam radiotherapy (46 Gy). Two patients continued on hormones during follow-up and were censored for this analysis. Four patients discontinued hormone therapy after RT. Five patients did not receive hormones. PSA bounce is defined as a rise in PSA values with a subsequent fall below the nadir value or to below 20% of the maximum PSA level. Six previously published definitions of biochemical failure to distinguish true failure from were tested: definition 1, rise >0.2 ng/mL; definition 2, rise >0.4 ng/mL; definition 3, rise >35% of previous value; definition 4, ASTRO defined guidelines, definition 5 nadir + 2 ng/ml, and definition 6, nadir + 3 ng/ml. Median follow-up was 24 months (range 18–36 mo). During follow-up, the incidence of transient PSA elevation was: 55% for definition 1, 44% for definition 2, 55% for definition 3, 33% for definition 4, 11% for definition 5, and 11% for definition 6. We observed a substantial incidence of transient elevations in PSA following combined external beam radiation and HDR brachytherapy for prostate cancer. Such elevations seem to be self-limited and should not trigger initiation of salvage therapies. No definition of failure was completely predictive

  20. Inverse planning and class solutions for brachytherapy treatment planning

    International Nuclear Information System (INIS)

    Trnkova, P.

    2010-01-01

    Brachytherapy or interventional radiooncology is a method of radiation therapy. It is a method, where a small encapsulated radioactive source is placed near to / in the tumour and therefore delivers high doses directly to the target volume. Organs at risk (OARs) are spared due to the inverse square dose fall-off. In the past years there was a slight stagnation in the development of techniques for brachytherapy treatment. While external beam radiotherapy became more and more sophisticated, in brachytherapy traditional methods have been still used. Recently, 3D imaging was considered also as the modality for brachytherapy and more precise brachytherapy could expand. Nowadays, an image guided brachytherapy is state-of-art in many centres. Integration of imaging methods lead to the dose distribution individually tailored for each patient. Treatment plan optimization is mostly performed manually as an adaptation of a standard loading pattern. Recently, inverse planning approaches have been introduced into brachytherapy. The aim of this doctoral thesis was to analyze inverse planning and to develop concepts how to integrate inverse planning into cervical cancer brachytherapy. First part of the thesis analyzes the Hybrid Inverse treatment Planning and Optimization (HIPO) algorithm and proposes a workflow how to safely work with this algorithm. The problem of inverse planning generally is that only the dose and volume parameters are taken into account and spatial dose distribution is neglected. This fact can lead to unwanted high dose regions in a normal tissue. A unique implementation of HIPO into the treatment planning system using additional features enabled to create treatment plans similar to the plans resulting from manual optimization and to shape the high dose regions inside the CTV. In the second part the HIPO algorithm is compared to the Inverse Planning Simulated Annealing (IPSA) algorithm. IPSA is implemented into the commercial treatment planning system. It

  1. ACPSEM brachytherapy working group recommendations for quality assurance in brachytherapy

    International Nuclear Information System (INIS)

    Dempsey, Claire; Smith, Ryan; Nyathi, Thulani; Ceylan, Abdurrahman; Howard, Lisa; Patel, Virendra; Dam, Ras; Haworth, Annette

    2013-01-01

    The Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) Radiation Oncology Specialty Group (ROSG) formed a series of working groups in 2011 to develop recommendation papers for guidance of radiation oncology medical physics practice within the Australasian setting. These recommendations are intended to provide guidance for safe work practices and a suitable level of quality control without detailed work instructions. It is the responsibility of the medical physicist to ensure that locally available equipment and procedures are sufficiently sensitive to establish compliance to these recommendations. The recommendations are endorsed by the ROSG, have been subject to independent expert reviews and have also been approved by the ACPSEM Council. For the Australian audience, these recommendations should be read in conjunction with the Tripartite Radiation Oncology Practice Standards. This publication presents the recommendations of the ACPSEM Brachytherapy Working Group (BTWG) and has been developed in alignment with other international associations. However, these recommendations should be read in conjunction with relevant national, state or territory legislation and local requirements, which take precedence over the ACPSEM recommendation papers. It is hoped that the users of this and other ACPSEM recommendation papers will contribute to the development of future versions through the Radiation Oncology Specialty Group of the ACPSEM.

  2. The Preliminary Prototype of Medium Dose Rate Brachytherapy Equipment

    Directory of Open Access Journals (Sweden)

    A. Satmoko

    2013-08-01

    Full Text Available A preliminary prototype of a brachytherapy equipment has been constructed. The work started by developing conceptual design, followed by basic design and detailed design. In the conceptual design, design requirements are stated. In the basic design, technical specifications for main components are determined. In detailed design, general drawings are discussed. The prototype consists of three main systems: a mechanical system, an instrumentation system, and a safety system. The mechanical system assures the movement mechanism of the isotope source position beginning from the standby position until the applicators. It consists of three main modules: a position handling module, a container module, and a channel distribution module. The position handling module serves to move the isotope source position. As shielding, the second module is to store the source when the equipment is in standby position. The prototype provides 12 output channels. The channel selection is performed by the third module. The instrumentation system controls the movement of source position by handling motor operations. It consists of several modules. A microcontroller module serves as a control center whose task includes both controlling motors and communicating with computer. A motor module serves to handle motors. 10 sensors, including their signal conditionings, are introduced to read the environment conditions of the equipment. LEDs are used to display these conditions. In order to facilitate the operators’ duty, communication via RS232 is provided. The brachytherapy equipment can therefore be operated by using computer. Interface software is developed using C# language. To complete both mechanical and instrumentation systems performance, a safety system is developed to make sure that the safety for operator and patients from receiving excessive radiation. An interlock system is introduced to guard against abnormal conditions. In the worst case, a manual intervention

  3. In-phantom dosimetric measurements as quality control for brachytherapy. System check and constancy check; Messungen im Festkoerperphantom als Qualitaetskontrolle in der Brachytherapie. Systempruefung und Konstanzpruefung

    Energy Technology Data Exchange (ETDEWEB)

    Kollefrath, Michael; Bruggmoser, Gregor; Nanko, Norbert; Gainey, Mark [Universitaetsklinik Freiburg (Germany). Klinik fuer Strahlenheilkunde

    2015-09-01

    In brachytherapy dosimetric measurements are difficult due to the inherent dose-inhomogeneities. Typically in routine clinical practice only the nominal dose rate is determined for computer controlled afterloading systems. The region of interest lies close to the source when measuring the spatial dose distribution. In this region small errors in the positioning of the detector, and its finite size, lead to large measurement uncertainties that exacerbate the routine dosimetric control of the system in the clinic. The size of the measurement chamber, its energy dependence, and the directional dependence of the measurement apparatus are the factors which have a significant influence on dosimetry. Although ionisation chambers are relatively large, they are employed since similar chambers are commonly found on clinical brachytherapy units. The dose is determined using DIN 6800 [11] since DIN 6809-2 [12], which deals with dosimetry in brachytherapy, is antiquated and is currently in the process of revision. Further information regarding dosimetry for brachytherapy can be found in textbooks [1] and [2]. The measurements for this work were performed with a HDR (High-Dose-Rate) {sup 192}Ir source, type mHDR V2, and a Microselectron Afterloader V2 both from Nucletron/Elekta. In this work two dosimetric procedures are presented which, despite the aforemention difficulties, should assist in performing checks of the proper operation of the system. The first is a system check that measures the dose distribution along a line and is to be performed when first bringing the afterloader into operation, or after significant changes to the system. The other is a dosimetric constancy check, which with little effort can be performed monthly or weekly. It simultaneously verifies the positioning of the source at two positions, the functionality of the system clock and the automatic re-calculation of the source activity.

  4. Demonstration of brachytherapy boost dose-response relationships in glioblastoma multiforme

    International Nuclear Information System (INIS)

    Sneed, Penny K.; Lamborn, Kathleen R.; Larson, David A.; Prados, Michael D.; Malec, Mary K.; McDermott, Michael W.; Weaver, Keith A.; Phillips, Theodore L.; Wara, William M.; Gutin, Philip H.

    1996-01-01

    Purpose: To evaluate brachytherapy dose-response relationships in adults with glioblastoma undergoing temporary 125 I implant boost after external beam radiotherapy. Methods and Materials: Since June 1987, orthogonal radiographs using a fiducial marker box have been used to verify brain implant source positions and generate dose-volume histograms at the University of California, San Francisco. For adults who underwent brachytherapy boost for glioblastoma from June 1987 through December 1992, tumor volumes were reoutlined to ensure consistency and dose-volume histograms were recalculated. Univariate and multivariate analyses of various patient and treatment parameters were performed evaluating for influence of dose on freedom from local failure (FFLF) and actuarial survival. Results: Of 102 implant boosts, 5 were excluded because computer plans were unavailable. For the remaining 97 patients, analyses with adjustment for known prognostic factors (age, KPS, extent of initial surgical resection) and prognostic factors identified on univariate testing (adjuvant chemotherapy) showed that higher minimum brachytherapy tumor dose was strongly associated with improved FFLF (p = 0.001). A quadratic relationship was found between total biological effective dose and survival, with a trend toward optimal survival probability at 47 Gy minimum brachytherapy tumor dose (corresponding to about 65 Gy to 95% of the tumor volume); survival decreased with lower or higher doses. Two patients expired and one requires hospice care because of brain necrosis after brachytherapy doses > 63 Gy to 95% of the tumor volume with 60 Gy to > 18 cm 3 of normal brain. Conclusion: Although higher minimum brachytherapy tumor dose was strongly associated with better local control, a brachytherapy boost dose > 50-60 Gy may result in life-threatening necrosis. We recommend careful conformation of the prescription isodose line to the contrast enhancing tumor volume, delivery of a minimum brachytherapy

  5. Intravascular brachytherapy for peripheral vascular disease

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2008-09-01

    Full Text Available Scientific background: Percutaneous transluminal angioplasties (PTA through balloon dilatation with or without stenting, i.e. vessel expansion through balloons with or without of implantation of small tubes, called stents, are used in the treatment of peripheral artery occlusive disease (PAOD. The intravascular vessel irradiation, called intravascular brachytherapy, promises a reduction in the rate of repeated stenosis (rate of restenosis after PTA. Research questions: The evaluation addresses questions on medical efficacy, cost-effectiveness as well as ethic, social and legal implications in the use of brachytherapy in PAOD patients. Methods: A systematic literature search was conducted in August 2007 in the most important medical electronic databases for publications beginning from 2002. The medical evaluation included randomized controlled trials (RCT. The information synthesis was performed using meta-analysis. Health economic modeling was performed with clinical assumptions derived from the meta-analysis and economical assumptions derived from the German Diagnosis Related Groups (G-DRG-2007. Results: Medical evaluation: Twelve publications about seven RCT on brachytherapy vs. no brachytherapy were included in the medical evaluation. Two RCT showed a significant reduction in the rate of restenosis at six and/or twelve months for brachytherapy vs. no brachytherapy after successful balloon dilatation, the relative risk in the meta-analysis was 0.62 (95% CI: 0.46 to 0.84. At five years, time to recurrence of restenosis was significantly delayed after brachytherapy. One RCT showed a significant reduction in the rate of restenosis at six months for brachytherapy vs. no brachytherapy after PTA with optional stenting, the relative risk in the meta-analysis was 0.76 (95% CI: 0.61 to 0.95. One RCT observed a significantly higher rate of late thrombotic occlusions after brachytherapy in the subgroup of stented patients. A single RCT for brachytherapy

  6. Synchroton Radiation Sources

    International Nuclear Information System (INIS)

    Hulbert, S.L.; Williams, G.P.

    1998-01-01

    Synchrotron radiation is a very bright, broadband, polarized, pulsed source of light extending from the infrared to the x-ray region. It is an extremely important source of Vacuum Ultraviolet radiation. Brightness is defined as flux per unit area per unit solid angle and is normally a more important quantity than flux alone particularly in throughput limited applications which include those in which monochromators are used. It is well known from classical theory of electricity and magnetism that accelerating charges emit electromagnetic radiation. In the case of synchrotron radiation, relativistic electrons are accelerated in a circular orbit and emit electromagnetic radiation in a broad spectral range. The visible portion of this spectrum was first observed on April 24, 1947 at General Electric's Schenectady facility by Floyd Haber, a machinist working with the synchrotron team, although the first theoretical predictions were by Lienard in the latter part of the 1800's. An excellent early history with references was presented by Blewett and a history covering the development of the utilization of synchrotron radiation was presented by Hartman. Synchrotron radiation covers the entire electromagnetic spectrum from the infrared region through the visible, ultraviolet, and into the x-ray region up to energies of many 10's of kilovolts. If the charged particles are of low mass, such as electrons, and if they are traveling relativistically, the emitted radiation is very intense and highly collimated, with opening angles of the order of 1 milliradian. In electron storage rings there are three possible sources of synchrotron radiation; dipole (bending) magnets; wigglers, which act like a sequence of bending magnets with alternating polarities; and undulators, which are also multi-period alternating magnet systems but in which the beam deflections are small resulting in coherent interference of the emitted light

  7. Argon plasma coagulation for rectal bleeding after prostate brachytherapy

    International Nuclear Information System (INIS)

    Smith, Stephen; Wallner, Kent; Dominitz, Jason A.; Han, Ben; True, Lawrence; Sutlief, Steven; Billingsley, Kevin

    2001-01-01

    Purpose: To better define the efficacy and safety of argon plasma coagulation (APC), specifically for brachytherapy-related proctitis, we reviewed the clinical course of 7 patients treated for persistent rectal bleeding. Approximately 2-10% of prostate cancer patients treated with 125 I or 103 Pd brachytherapy will develop radiation proctitis. The optimum treatment for patients with persistent bleeding is unclear from the paucity of available data. Prior reports lack specific dosimetric information, and patients with widely divergent forms of radiation were grouped together in the analyses. Methods and Materials: Seven patients were treated with APC at the Veterans Affairs Puget Sound Health Care System and the University of Washington from 1997 to 1999 for persistent rectal bleeding due to prostate brachytherapy-related proctitis. Four patients received supplemental external beam radiation, delivered by a four-field technique. A single gastroenterologist at the Veterans Affairs Puget Sound Health Care System treated 6 of the 7 patients. If the degree of proctitis was limited, all sites of active bleeding were coagulated in symptomatic patients. An argon plasma coagulator electrosurgical system was used to administer treatments every 4-8 weeks as needed. The argon gas flow was set at 1.6 L/min, with an electrical power setting of 40-45 W. Results: The rectal V100 (the total rectal volume, including the lumen, receiving the prescription dose or greater) for the 7 patients ranged from 0.13 to 4.61 cc. Rectal bleeding was first noticed 3-18 months after implantation. APC (range 1-3 sessions) was performed 9-22 months after implantation. Five patients had complete resolution of their bleeding, usually within days of completing APC. Two patients had only partial relief from bleeding, but declined additional APC therapy. No patient developed clinically evident progressive rectal wall abnormalities after APC, (post-APC follow-up range 4-13 months). Conclusions: Most

  8. Iodine-125 seed implantation (permanent brachytherapy) for clinically localized prostate cancer

    International Nuclear Information System (INIS)

    Ebara, Shin; Katayama, Yoshihisa; Tanimoto, Ryuta

    2008-01-01

    From January 2004 to March 2007, 308 patients with clinically localized prostate cancer were treated using iodine-125 ( 125 I) seed implantation (permanent brachytherapy) at Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences. We evaluated the treatment's efficacy and morbidity in 300 prostate cancer patients who were followed up for more than 1 month after brachytherapy. Based on the National Comprehensive Cancer Network (NCCN) guidelines, patients with a prostate volume of less than 40 ml in transrectal ultrasound imaging were classified as low or intermediate risk. The median patient age was 67 years (range 50 to 79 years), the median prostate-specific antigen (PSA) value before biopsy was 6.95 ng/ml (range 1.13 to 24.7 ng/ml), and the median prostate volume was 24.33 ml (range 9.3 to 41.76 ml). The median follow-up was 18 months (range 1 to 36 months) and the PSA levels decreased in almost all patients after brachytherapy. Although 194 of 300 patients (64.7%) complained of difficulty in urination, pollakisuria/urgency, miction pain, and/or urinary incontinence, all of which might be associated with radiation prostatitis during the first month after brachytherapy, these symptoms gradually improved. 125 I seed implantation brachytherapy is safe and effective for localized prostate cancer within short-term follow up. (author)

  9. Monte Carlo calculated microdosimetric spread for cell nucleus-sized targets exposed to brachytherapy 125I and 192Ir sources and 60Co cell irradiation.

    Science.gov (United States)

    Villegas, Fernanda; Tilly, Nina; Ahnesjö, Anders

    2013-09-07

    The stochastic nature of ionizing radiation interactions causes a microdosimetric spread in energy depositions for cell or cell nucleus-sized volumes. The magnitude of the spread may be a confounding factor in dose response analysis. The aim of this work is to give values for the microdosimetric spread for a range of doses imparted by (125)I and (192)Ir brachytherapy radionuclides, and for a (60)Co source. An upgraded version of the Monte Carlo code PENELOPE was used to obtain frequency distributions of specific energy for each of these radiation qualities and for four different cell nucleus-sized volumes. The results demonstrate that the magnitude of the microdosimetric spread increases when the target size decreases or when the energy of the radiation quality is reduced. Frequency distributions calculated according to the formalism of Kellerer and Chmelevsky using full convolution of the Monte Carlo calculated single track frequency distributions confirm that at doses exceeding 0.08 Gy for (125)I, 0.1 Gy for (192)Ir, and 0.2 Gy for (60)Co, the resulting distribution can be accurately approximated with a normal distribution. A parameterization of the width of the distribution as a function of dose and target volume of interest is presented as a convenient form for the use in response modelling or similar contexts.

  10. Calculating of Dose Distribution in Tongue Brachytherapy by Different Radioisotopes using Monte Carlo Simulation and Comparing by Experimental Data

    Directory of Open Access Journals (Sweden)

    Banafsheh Zeinali Rafsanjani

    2011-06-01

    Full Text Available Introduction: Among different kinds of oral cavity cancers, the frequency of tongue cancer occurrence is more significant. Brachytherapy is the most common method to cure tongue cancers. Long sources are used in different techniques of tongue brachytherapy. The objective of this study is to asses the dose distribution around long sources, comparing different radioisotopes as brachytherapy sources, measuring the homogeneity of delivered dose to treatment volume and also comparing mandible dose and dose of tongue in the regions near the mandible with and without using shield. Material and Method: The Monte Carlo code MCNP4C was used for simulation. The accuracy of simulation was verified by comparing the results with experimental data. The sources like Ir-192, Cs-137, Ra-226, Au-198, In-111 and Ba-131 were simulated and the position of sources was determined by Paris system. Results: The percentage of mandible dose reduction with use of 2 mm Pb shield for the sources mentioned above were: 35.4%, 20.1%, 86.6%, 32.24%, 75.6%, and 36.8%. The tongue dose near the mandible with use of shied did not change significantly. The dose homogeneity from the most to least was obtained from these sources: Cs-137, Au-198, Ir-192, Ba-131, In-111 and Ra-226. Discussion and Conclusion: Ir-192 and Cs-137 were the best sources for tongue brachytherapy treatment but In-111 and Ra-226 were not suitable choices for tongue brachytherapy. The sources like Au-198 and Ba-131 had rather the same performance as Ir-192

  11. Salvage high-dose-rate brachytherapy for local prostate cancer recurrence after radical radiotherapy

    Directory of Open Access Journals (Sweden)

    V. A. Solodkiy

    2016-01-01

    Full Text Available Studies salvage interstitial radiation therapy for recurrent prostate cancer, launched at the end of the XX century. In recent years, more and more attention is paid to high-dose-rate brachytherapy (HDR-BT as a method of treating local recurrence.The purpose of research – preliminary clinical results of salvage high-dose-rate brachytherapy applied in cases of suspected local recurrence or of residual tumour after radiotherapy.Preliminary findings indicate the possibility of using HDR-BT, achieving local tumor control with low genitourinary toxicity.

  12. Experimental determination of dosimetric characterization of a newly designed encapsulated interstitial brachytherapy source of 103Pd-model Pd-1

    International Nuclear Information System (INIS)

    Nath, Ravinder; Yue Ning; Roa, Eduardo

    2002-01-01

    A newly designed encapsulated 103 Pd source has been introduced (BrachySeed trade mark sign -Pd-103, also named Model Pd-1, manufactured by DRAXIMAGE Inc. and distributed by Cytogen Corp.) for interstitial brachytherapy to provide more isotropic dose distributions. In this work, the dosimetric characteristics of the 103 Pd source were measured with micro LiF TLD chips and dosimetry parameters were characterized based upon the American Association of Physicists in Medicine (AAPM) Task Group No. 43 formalism. The dose rate constant of the sources was determined to be 0.66±0.05 cGy h-1 U-1. The radial dose function was measured and was found to be similar to that of the Theragenics Model 200 103 Pd source. The anisotropy constant for the Model Pd-1 source was determined to be 1.03

  13. Gynecological brachytherapy - from low-dose-rate to high-tech. Gynaekologische Brachytherapie - von Low-dose-rate zu High-tech

    Energy Technology Data Exchange (ETDEWEB)

    Herrmann, T. (Abt. Strahlenthgerapie, Klinik und Poliklinik fuer Radiologie, Medizinische Akademie ' Carl Gustav Carus' , Dresden (Germany)); Christen, N. (Abt. Strahlenthgerapie, Klinik und Poliklinik fuer Radiologie, Medizinische Akademie ' Carl Gustav Carus' , Dresden (Germany)); Alheit, H.D. (Abt. Strahlenthgerapie, Klinik und Poliklinik fuer Radiologie, Medizinische Akademie ' Carl Gustav Carus' , Dresden (Germany))

    1993-03-01

    The transition from low-dose-rate (LDR) brachytherapy to high-dose-rate (HDR) afterloading treatment is in progress in most centres of radiation therapy. First reports of studies comparing HDR and LDR treatment in cervix cancer demonstrate nearly equal local control. In our own investigations on 319 patients with primary irradiated carcinoma of the cervix (125 HDR/194 LDR) we found the following control rates: Stage FIGO I 95.4%/82.9% (HDR versus LDR), stage FIGO II 71.4%/73.7%, stage FIGO III 57.9%/38.5%. The results are not significant. The side effects - scored after EORT/RTOG criteria - showed no significant differences between both therapies for serious radiogenic late effects on intestine, bladder and vagina. The study and findings from the literature confirm the advantage of the HDR-procedure for patient and radiooncologist and for radiation protection showing at least the same results as in the LDR-area. As for radiobiolgical point of view it is important to consider that the use of fractionation in the HDR-treatment is essential for the sparing of normal tissues and therefore a greater number of small fractionation doses in the brachytherapy should be desirable too. On the other hand the rules, which are true for fractionated percutaneous irradiation therapy (overall treatment time as short as possible to avoid reppopulation of tumor cells) should be taken into consideration in combined brachy-teletherapy regime in gynecologic tumors. The first step in this direction may be accelerated regime with a daily application of both treatment procedures. The central blocking of the brachytherapy region from the whole percutaneous treatment target volume should be critically reflected, especially in the case of advanced tumors. (orig.)

  14. Vascular brachytherapy with 90Sr/Y versus 192Ir: A health physics perspective

    International Nuclear Information System (INIS)

    Elder, E.S.; Butker, E.K.; Miner, M.S.; Wang, C.K.; Crocker, I.R.

    1997-01-01

    Purpose: Currently there are two ongoing trials of catheter based radiation therapy in the United States, the BERT Trial (Emory University, Atlanta, GA) and the SCRIPPS Trial (Scripps Clinic, La Jolla, CA). The BERT method involved the use of a treatment system to manually deliver a source train consisting of 12, encapsulated 90 Sr/Y seeds of 3 cm total active length. The total activity of the source train was approximately 3.7 GBq. The SCRIPPS trial involved the use of a hand delivered 192 Ir (BEST Industries) source train of either 5 or 9 sources with 1 mm spacing between the sources. The average total activity of the source train was 3.6 GBq ± 1.08 GBq. It is the purpose of this study to compare the patient dose and staff exposures from the above source trains. A comparison with exposures from use of fluoroscopy in the catheterization laboratory will also be made. Materials and Methods: Measurements made with a GM meter at specified locations around the BERT patients during the insertion of the seeds were compared with published information from the SCRIPPS Trial. Monte Carlo modeled measurements of the equivalent dose in humans from insertion of the source trains were also compared for both methods. The above were contrasted with GM measurements from use of fluoroscopy in the catheterization laboratory. Results: Average exposure rates recorded at the patient's chest and groin from the BERT method were 4.9x10 -4 and 1.29x10 -4 C/kg·hr respectively. Average exposures to the operator from the BERT method and the SCRIPPS method were 8.6x10 -6 and 1.03x10 -3 C/kg respectively. A typical exposure rate for conventional cardiac fluoroscopy is 3.9x10 -3 C/kg·hr. Monte Carlo modeled calculations of patient dose equivalent for the BERT method and the SCRIPPS method were 0.43 μSv and 6.41 mSv respectively. Conclusions: Vascular brachytherapy performed with 90 Sr/Y sources resulted in staff exposures of at least a factor of 120 less and patient doses of a factor of

  15. Minimal percentage of dose received by 90% of the urethra (%UD90) is the most significant predictor of PSA bounce in patients who underwent low-dose-rate brachytherapy (LDR-brachytherapy) for prostate cancer.

    Science.gov (United States)

    Tanaka, Nobumichi; Asakawa, Isao; Fujimoto, Kiyohide; Anai, Satoshi; Hirayama, Akihide; Hasegawa, Masatoshi; Konishi, Noboru; Hirao, Yoshihiko

    2012-09-14

    To clarify the significant clinicopathological and postdosimetric parameters to predict PSA bounce in patients who underwent low-dose-rate brachytherapy (LDR-brachytherapy) for prostate cancer. We studied 200 consecutive patients who received LDR-brachytherapy between July 2004 and November 2008. Of them, 137 patients did not receive neoadjuvant or adjuvant androgen deprivation therapy. One hundred and forty-two patients were treated with LDR-brachytherapy alone, and 58 were treated with LDR-brachytherapy in combination with external beam radiation therapy. The cut-off value of PSA bounce was 0.1 ng/mL. The incidence, time, height, and duration of PSA bounce were investigated. Clinicopathological and postdosimetric parameters were evaluated to elucidate independent factors to predict PSA bounce in hormone-naïve patients who underwent LDR-brachytherapy alone. Fifty patients (25%) showed PSA bounce and 10 patients (5%) showed PSA failure. The median time, height, and duration of PSA bounce were 17 months, 0.29 ng/mL, and 7.0 months, respectively. In 103 hormone-naïve patients treated with LDR-brachytherapy alone, and univariate Cox proportional regression hazard model indicated that age and minimal percentage of the dose received by 30% and 90% of the urethra were independent predictors of PSA bounce. With a multivariate Cox proportional regression hazard model, minimal percentage of the dose received by 90% of the urethra was the most significant parameter of PSA bounce. Minimal percentage of the dose received by 90% of the urethra was the most significant predictor of PSA bounce in hormone-naïve patients treated with LDR-brachytherapy alone.

  16. Interstitial high-dose-rate brachytherapy in the treatment of base of tongue carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Takacsi-Nagy, Z.; Polgar, C.; Somogyi, A.; Major, T.; Fodor, J.; Nemeth, G. [Dept. of Radiotherapy, National Inst. of Oncology, Budapest (Hungary); Oberna, F. [Dept. of Maxillofacial Surgery, St. Rokus Hospital, Budapest (Hungary); Remenar, E.; Kasler, M. [Dept. of Head and Neck, Maxillofacial and Reconstructive Plastic Surgery, National Inst. of Oncology, Budapest (Hungary)

    2004-12-01

    Background and purpose: to date none of the studies examined the feasibility and efficacy of interstitial high-dose-rate (HDR) brachytherapy in the treatment of carcinoma of the tongue base. Therefore the aim of this study was to contribute to this issue. Patients and methods: between 1992 and 2000 37 patients (mean age 55 years) with T1-4 and NO-3 carcinoma of the base of tongue were presented. Neck dissection was carried out in twelve cases (32%). 30 patients with advanced stage received brachytherapy boost after 50-66.5 Gy (mean, 60 Gy) locoregional external beam irradiation (EBI) and 7 patients with early stage (T1-2, NO) were managed locally with wide tumor excision and sole brachytherapy. 4 of them underwent neck dissection and the others were subjected to 50 Gy regional EBI. The mean dose of boost and sole brachytherapy was 18 Gy and 28 Gy, respectively. Results: the median follow-up time for surviving patients was 51 months. The 7 sole brachytherapy patients are living with no evidence of disease. For patients treated with EBI and brachytherapy boost, the 5-year actuarial rate of local, locoregional recurrence-free and overall survival was 60%, 52% and 46%, respectively. For all patients in univariate analysis larger tumor size (T4 vs. T1-3) was significant negative predictor of local (RR: 7.23) and locoregional control (RR: 3.87), but nodal involvement was not. Delayed soft tissue ulceration and osteoradionecrosis occurred in 4 (13%) EBI and brachytherapy treated patients. None of the sole brachytherapy patients experienced severe late radiation toxicity. Conclusion: EBI combined with interstitial HDR brachytherapy boost result in acceptable local tumor control with low incidence of late side effects in patients with advanced disease. Fractionated sole HDR brachytherapy following tumor excision is a feasible treatment option for patients with early stage cancer and gives excellent local results. (orig.)

  17. How one institution overcame the challenges to start an MRI-based brachytherapy program for cervical cancer

    Directory of Open Access Journals (Sweden)

    Matthew M. Harkenrider

    2017-03-01

    Full Text Available Purpose : Adaptive magnetic resonance imaging (MRI-based brachytherapy results in improved local control and decreased high-grade toxicities compared to historical controls. Incorporating MRI into the workflow of a department can be a major challenge when initiating an MRI-based brachytherapy program. This project aims to describe the goals, challenges, and solutions when initiating an MRI-based cervical cancer brachytherapy program at our institution. Material and methods : We describe the 6-month multi-disciplinary planning phase to initiate an MRI-based brachytherapy program. We describe the specific challenges that were encountered prior to treating our first patient. Results : We describe the solutions that were realized and executed to solve the challenges that we faced to establish our MRI-based brachytherapy program. We emphasize detailed coordination of care, planning, and communication to make the workflow feasible. We detail the imaging and radiation physics solutions to safely deliver MRI-based brachytherapy. The focus of these efforts is always on the delivery of optimal, state of the art patient care and treatment delivery within the context of our available institutional resources. Conclusions : Previous publications have supported a transition to MRI-based brachytherapy, and this can be safely and efficiently accomplished as described in this manuscript.

  18. The evolution of brachytherapy treatment planning

    International Nuclear Information System (INIS)

    Rivard, Mark J.; Venselaar, Jack L. M.; Beaulieu, Luc

    2009-01-01

    Brachytherapy is a mature treatment modality that has benefited from technological advances. Treatment planning has advanced from simple lookup tables to complex, computer-based dose-calculation algorithms. The current approach is based on the AAPM TG-43 formalism with recent advances in acquiring single-source dose distributions. However, this formalism has clinically relevant limitations for calculating patient dose. Dose-calculation algorithms are being developed based on Monte Carlo methods, collapsed cone, and solving the linear Boltzmann transport equation. In addition to improved dose-calculation tools, planning systems and brachytherapy treatment planning will account for material heterogeneities, scatter conditions, radiobiology, and image guidance. The AAPM, ESTRO, and other professional societies are working to coordinate clinical integration of these advancements. This Vision 20/20 article provides insight into these endeavors.

  19. Preparation and determination of kerma for Iridium 192 sources of low dose rate for brachytherapy

    International Nuclear Information System (INIS)

    Tendilla, J.I.; Tovar M, V.; Mitsoura, E.; Aguilar H, F.; Alanis M, J.

    2000-01-01

    The practice of Brachytherapy with Iridium-192 sources of low dose rate (0.4 - 0.8 Gy/h) is a technique used in the treatment of diverse illnesses. in this work the preparation, quality control and calibration are presented in terms of kerma in air of Iridium-192 using as target these recycled Iridium-Platinum wires. The targets were obtained as decayed sources of different radio therapeutical centers in the country and they were characterized by Scanning electron microscopy in order to determine their chemical composition. Subsequently it was developed an experimental design to establish the effect of neutron flux, geometrical array and irradiation time over the activity and percentage of the sources homogeneity. The homogeneity was determined by auto radiography and by Gamma spectroscopy. Once the optimal irradiation conditions were established, it is determined the apparent activity and kerma in air using a well type ionization chamber with traceability to a primary laboratory. Iridium-192 sources were obtained with an average homogeneity 96 %, apparent activity 282.129 ± 0.531 M Bq and kerma in air 0.03200 ± 0.00006 m Gy m/h A. (Author)

  20. Brachytherapy dose measurements in heterogeneous tissues

    International Nuclear Information System (INIS)

    Paiva F, G.; Luvizotto, J.; Salles C, T.; Guimaraes A, P. C.; Dalledone S, P. de T.; Yoriyaz, H.; Rubo, R.

    2014-08-01

    Recently, Beau lieu et al. published an article providing guidance for Model-Based Dose Calculation Algorithms (MBDCAs), where tissue heterogeneity considerations are addressed. It is well-known that T G-43 formalism which considers only water medium is limited and significant dose differences have been found comparing both methodologies. The aim of the present work is to experimentally quantify dose values in heterogeneous medium using different dose measurement methods and techniques and compare them with those obtained with Monte Carlo simulations. Experiments have been performed using a Nucletron micro Selectron-Hdr Ir-192 brachytherapy source and a heterogeneous phantom composed by PMMA and different tissue equivalent cylinders like bone, lungs and muscle. Several dose measurements were obtained using tissue equivalent materials with height 1.8 cm and 4.3 cm positioned between the radiation source and the detectors. Radiochromic films, TLDs and MOSFET S have been used for the dose measurements. Film dosimetry has been performed using two methodologies: a) linearization for dose-response curve based on calibration curves to create a functional form that linearize s the dose response and b) 177 multichannel analysis dosimetry where the multiple color channels are analyzed allowing to address not only disturbances in the measurements caused by thickness variation in the film layer, but also, separate other external influences in the film response. All experiments have been simulated using the MCNP5 Monte Carlo radiation transport code. Comparison of experimental results are in good agreement with calculated dose values with differences less than 6% for almost all cases. (Author)