A systematic evaluation of the dose-rate constant determined by photon spectrometry for 21 different models of low-energy photon-emitting brachytherapy sources

Abstract

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 (CONΛ) 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 125I (14 models), 103Pd (6 models) or 131Cs (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 (PSTΛ) for each source model. Source-dependent variations in PSTΛ were analyzed systematically against the spectral characteristics of the emitted photons and the consensus values recommended by the AAPM brachytherapy subcommittee. The values of PSTΛ for the encapsulated sources of 103Pd, 125I and 131Cs varied from 0.661 to 0.678 cGyh−1 U−1, 0.959 to 1.024 cGyh−1U−1 and 1.066 to 1.073 cGyh−1U−1, respectively. The relative variation in PSTΛ among the six 103Pd 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 PSTΛ were observed among the 14 125I source models; the maximum relative difference was over 6%. These variations were caused primarily by the presence of silver in some 125I 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 PSTΛ value to vary from 0.959 to 1.019 cGyh−1U−1 depending on the amount of silver used by a given source model. For those 125I sources that contain no silver, their PSTΛ was less variable and had values within 1% of 1.024 cGyh−1U−1. For the 16 source models that currently have an AAPM recommended CONΛ value, the agreement between PSTΛ and CONΛ was less than 2% for 15 models and was 2.6% for 1 103Pd source model. Excellent agreement between PSTΛ and CONΛ was observed for all source models that currently have an AAPM recommended consensus dose-rate constant value. These results demonstrate that the PST is an accurate and robust technique for the determination of the dose-rate constant for low-energy brachytherapy sources.