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Background: Diffusing alpha-emitters radiation therapy (DaRT) is a novel brachytherapy technique that leverages the diffusive flow of 224 Ra progeny within the tumor volume over the course of the treatment. Cell killing is achieved by the emitted alpha particles that have a short range in tissue and high linear energy transfer. The current proposed absorbed dose calculation method for DaRT is based on a diffusion-leakage (DL) model that neglects absorbed dose from beta particles., Purpose: This work aimed to couple the DL model with dose point kernels (DPKs) to account for dose from beta particles as well as to consider the non-local deposition of energy., Methods: The DaRT seed was modeled using COMSOL multiphysics and the DL model was implemented to extract the spatial information of the diffusing daughters. Using Monte-Carlo (MC) methods, DPKs were generated for 212 Pb, 212 Bi, and their progenies since they were considered to be the dominant beta emitters in the 224 Ra radioactive decay chain. A convolution operation was performed between the integrated number densities of the diffusing daughters and DPKs to calculate the total absorbed dose over a 30-day treatment period. Both high-diffusion and low-diffusion cases were considered., Results: The calculated DPKs showed non-negligible energy deposition over several millimeters from the source location. An absorbed dose >10 Gy was deposited within a 1.8 mm radial distance for the low diffusion case and a 2.2 mm radial distance for the high diffusion case. When the DPK method was compared with the local energy deposition method that solely considered dose from alpha particles, differences above 1 Gy were found within 1.3 and 1.8 mm radial distances from the surface of the source for the low diffusion and high diffusion cases, respectively., Conclusions: The proposed method enhances the accuracy of the dose calculation method used for the DaRT technique., (© 2024 The Authors. Medical Physics published by Wiley Periodicals LLC on behalf of American Association of Physicists in Medicine.)

Since the publication of the 2004 update to the American Association of Physicists in Medicine (AAPM) Task Group No. 43 Report (TG-43U1) and its 2007 supplement (TG-43U1S1), several new low-energy photon-emitting brachytherapy sources have become available. Many of these sources have satisfied the AAPM prerequisites for routine clinical purposes and are posted on the Brachytherapy Source Registry managed jointly by the AAPM and the Imaging and Radiation Oncology Core Houston Quality Assurance Center (IROC Houston). Given increasingly closer interactions among physicists in North America and Europe, the AAPM and the Groupe Européen de Curiethérapie-European Society for Radiotherapy & Oncology (GEC-ESTRO) have prepared another supplement containing recommended brachytherapy dosimetry parameters for eleven low-energy photon-emitting brachytherapy sources. The current report presents consensus datasets approved by the AAPM and GEC-ESTRO. The following sources are included: 125 I sources (BEBIG model I25.S17, BEBIG model I25.S17plus, BEBIG model I25.S18, Elekta model 130.002, Oncura model 9011, and Theragenics model AgX100); 103 Pd sources (CivaTech Oncology model CS10, IBt model 1031L, IBt model 1032P, and IsoAid model IAPd-103A); and 131 Cs (IsoRay Medical model CS-1 Rev2). Observations are included on the behavior of these dosimetry parameters as a function of radionuclide. Recommendations are presented on the selection of dosimetry parameters, such as from societal reports issuing consensus datasets (e.g., TG-43U1, AAPM Report #229), the joint AAPM/IROC Houston Registry, the GEC-ESTRO website, the Carleton University website, and those included in software releases from vendors of treatment planning systems. Aspects such as timeliness, maintenance, and rigor of these resources are discussed. Links to reference data are provided for radionuclides (radiation spectra and half-lives) and dose scoring materials (compositions and mass densities). The recent literature is examined on photon energy response corrections for thermoluminescent dosimetry of low-energy photon-emitting brachytherapy sources. Depending upon the dosimetry parameters currently used by individual physicists, use of these recommended consensus datasets may result in changes to patient dose calculations. These changes must be carefully evaluated and reviewed with the radiation oncologist prior to their implementation., (© 2017 American Association of Physicists in Medicine.)

Purpose: Three-dimensional (3D) dosimeters are particularly useful for verifying the commissioning of treatment planning and delivery systems, especially with the ever-increasing implementation of complex and conformal radiotherapy techniques such as volumetric modulated arc therapy. However, currently available 3D dosimeters require extensive experience to prepare and analyze, and are subject to large measurement uncertainties. This work aims to provide a more readily implementable 3D dosimeter with the development and characterization of a radiochromic film stack dosimeter for megavoltage photon beam dosimetry., Methods: A film stack dosimeter was developed using Gafchromic(®) EBT2 films. The dosimeter consists of 22 films separated by 1 mm-thick spacers. A Virtual Water™ phantom was created that maintains the radial film alignment within a maximum uncertainty of 0.3 mm. The film stack dosimeter was characterized using simulations and measurements of 6 MV fields. The absorbed-dose energy dependence and orientation dependence of the film stack dosimeter were investigated using Monte Carlo simulations. The water equivalence of the dosimeter was determined by comparing percentage-depth-dose (PDD) profiles measured with the film stack dosimeter and simulated using Monte Carlo methods. Film stack dosimeter measurements were verified with thermoluminescent dosimeter (TLD) microcube measurements. The film stack dosimeter was also used to verify the delivery of an intensity-modulated radiation therapy (IMRT) procedure., Results: The absorbed-dose energy response of EBT2 film differs less than 1.5% between the calibration and film stack dosimeter geometries for a 6 MV spectrum. Over a series of beam angles ranging from normal incidence to parallel incidence, the overall variation in the response of the film stack dosimeter is within a range of 2.5%. Relative to the response to a normally incident beam, the film stack dosimeter exhibits a 1% under-response when the beam axis is parallel to the film planes. Measured and simulated PDD profiles agree within a root-mean-square difference of 1.3%. In-field film stack dosimeter and TLD measurements agree within 5%, and measurements in the field penumbra agree within 0.5 mm. Film stack dosimeter and TLD measurements have expanded (k = 2) overall measurement uncertainties of 6.2% and 5.8%, respectively. Film stack dosimeter measurements of an IMRT dose distribution have 98% agreement with the treatment planning system dose calculation, using gamma criteria of 3% and 2 mm., Conclusions: The film stack dosimeter is capable of high-resolution, low-uncertainty 3D dose measurements, and can be readily incorporated into an existing film dosimetry program.

A thermoluminescent dosimetry (TLD) postal dose inter-comparison was carried out amongst radiotherapy centres in Malaysia. The aim of this TLD inter-comparison was to compare the uniformity involved in the measurement of absorbed dose among the participating centres. A set of 5 TLD chips placed within acrylic trays were mailed to all participating centres for irradiation to an absorbed dose to water of 2 Gy. Measurements were made for 6 MV and 60Co photon beams. Results show an agreement of +/- 5% for all but three radiotherapy centres. The ratios of the TLD readings to that of the reference centre are comparable with other national/regional dose inter-comparisons. The importance of a proper ongoing quality assurance program is essential in maintaining the consistency and uniformity of doses delivered.

The accuracy of the point source approximation used in dose calculations for an implant comprised of multiple high dose rate (HDR) Ir-192 source dwell positions is investigated. First, a single dwell position implant is modeled. The exposure rate about the source is calculated using both the point source approximation and the more rigorous line source formalism. A comparison of these calculated exposure rates is made. It is found that for each HDR Ir-192 source dwell position, the point source approximation results in a dose overestimation of 1% at a distance of 1 cm on the source transverse axis, while dose underestimations of more than 2% can be found at a distance of 1 cm on the source longitudinal axis. Even larger errors occur closer to the source. The results of this academic study are then extended to two clinical cases--an endobronchial treatment and a tandem and ovoids setup, both involving multiple source dwell positions. Since clinical HDR Ir-192 implants are comprised of many individual source dwell positions, there will be inaccuracy in the calculated overall dose distribution leading to dose delivery errors. For example, the dose delivered to a prescription point located 0.5 cm from an endobronchial applicator will be 3% lower than prescribed. Similar errors are produced in gynecologic implants. To decrease below 0.5% the dose delivery error resulting from the point source approximation, prescription points should be at a distance of at least 1 cm from any applicator. Since the dosimetry error is a direct result of the choice of model used to describe the source, the use of anisotropy factors accounting for the variation of photon fluence around the HDR Ir-192 source will not completely correct the calculation.

An insert for a well ionization chamber is described for quality assurance tests for high dose rate remote afterloaders. The use of this insert over time has shown its applicability for efficient QA tests for the high dose rate afterloader. The measurement results are six times greater than the uncertainties involved for the measurements. Checks on position can be made better than 1 mm and dwell times better than 1 s. The overall measurements can be done to better than 1.5%. QA checks can be accomplished in a shorter time period with as great or better accuracy than prior film techniques.

High dose rate (HDR) iridium sources must be calibrated regularly because of the short half-life of Ir-192. High dose rate sources can now be calibrated using a new well-type chamber that allows easy, reproducible source calibrations. The chamber includes a styrofoam insulator that surrounds the source in the well. A study of the radiation sensitivity of the well chamber exposed to an HDR Ir-192 source at two different activities (300 and 230 GBq) revealed that the sensitivity of the chamber varies by as much as 1.1% as the chamber is moved toward a scattering surface. Second, with the styrofoam insulator removed, the air temperature within the ion collecting volume increased during exposure, causing a gradual decrease in chamber sensitivity of 0.15% in 30 min. This temperature increase was caused by heat transfer from radiation emitted by the Ir-192 source, and diminished as the source decayed. However, with the styrofoam insulator around the central aluminum tube in the well, the source cannot heat the collecting volume and thus thermal equilibrium between the ion collecting volume and its environment is maintained throughout an exposure. The radiation sensitivity of the commercial well chamber was found to be constant for exposure times of 30 min.

The six Centers for Radiological Physics performed periodic thermoluminescent dosimetry (TLD) reviews for photon beams at 276 facilities across the country. The purpose of the reviews and the techniques in use are briefly described. Results from 2413 mailed reviews of megavoltage units indicate that, in 92% of the reviews, a specified dose was delivered within +/- 5% of the TLD-measured dose. A comparison is made to other mailed TLD review systems.