Absorbed Dose Factors Research Articles

Determination of Radiation Absorbed Dose to Primary Liver Tumors and Normal Liver Tissue Using Post-Radioembolization (90)Y PET.

Background: Radioembolization with Yttrium-90 (90 Y) microspheres is becoming a more widely used transcatheter treatment for unresectable hepatocellular carcinoma (HCC). Using post-treatment 90 Y positron emission tomography/computerized tomography (PET/CT) scans, the distribution of microspheres within the liver can be determined and quantitatively assessed. We studied the radiation dose of 90 Y delivered to liver and treated tumors.Methods: This retrospective study of 56 patients with HCC, including analysis of 98 liver tumors, measured and correlated the dose of radiation delivered to liver tumors and normal liver tissue using glass microspheres (TheraSpheres®) to the frequency of complications with modified response evaluation criteria in solid tumors (mRECIST). 90 Y PET/CT and triphasic liver CT scans were used to contour treated tumor and normal liver regions and determine their respective activity concentrations. An absorbed dose factor was used to convert the measured activity concentration (Bq/mL) to an absorbed dose (Gy).Results: The 98 studied tumors received a mean dose of 169 Gy (mode 90–120 Gy; range 0–570 Gy). Tumor response by mRECIST criteria was performed for 48 tumors that had follow-up scans. There were 21 responders (mean dose 215 Gy) and 27 non-responders (mean dose 167 Gy). The association between mean tumor absorbed dose and response suggests a trend but did not reach statistical significance (p = 0.099). Normal liver tissue received a mean dose of 67 Gy (mode 60–70 Gy; range 10–120 Gy). There was a statistically significant association between absorbed dose to normal liver and the presence of two or more severe complications (p = 0.036).Conclusion: Our cohort of patients showed a possible dose–response trend for the tumors. Collateral dose to normal liver is non-trivial and can have clinical implications. These methods help us understand whether patient adverse events, treatment success, or treatment failure can be attributed to the dose that the tumor or normal liver received.

Measurement of ionization chamber absorbed dose factors in megavoltage photon beams

Absorbed dose beam quality conversion factors (k(Q) factors) were obtained for 27 different types of ionization chamber. The aim was to obtain objective evidence on the performance of a wide range of chambers currently available, and potentially used for reference dosimetry, and to investigate the accuracy of the k(Q) calculation algorithm used in the TG-51 protocol. Measurements were made using the 60Co irradiator and Elekta Precise linac facilities at the National Research Council of Canada. The objective was to characterize the chambers over the range of energies applicable to TG-51 and determine whether each chamber met the requirements of a reference-class instrument. Chamber settling, leakage current, ion recombination and polarity, and waterproofing sleeve effects were investigated, and absorbed dose calibration coefficients were obtained for 60Co and 6, 10, and 25 MV photon beams. Only thimble-type chambers were considered in this investigation and were classified into three groups: (i) Reference chambers ("standard" 0.6 cm3 Farmer-type chambers and their derivatives traditionally used for beam output calibration); (ii) scanning chambers (typically 0.1 cm3 volume chambers used for beam commissioning with 3-D scanning phantoms); and (iii) microchambers (very small volume ion chambers (< or = 0.01 cm3) used for small field dosimetry). As might be expected, 0.6 cm3 thimble chambers showed the most predictable performance and experimental k(Q) factors were obtained with a relative uncertainty of 0.1%. The performance of scanning and microchambers was somewhat variable. Some chambers showed very good behavior but others showed anomalous polarity and recombination corrections that are not fully explained at present. For the well-behaved chambers, agreement between measured and calculated k(Q) factors was within 0.4%; for some chambers, differences of more than 1% were seen that may be related to the recombination/polarity results. Use of such chambers could result in significant errors in the determination of reference dose in the clinic. Based on the experimental evidence obtained here, specification for a reference-class ionization chamber could be developed that would minimize the error in using a dosimetry protocol with calculated beam quality conversion factors. The experimental k(Q) data obtained here for a wide range of thimble chambers can be used when choosing suitable detectors for reference dosimetry and are intended to be used in the upcoming update/addendum to the AAPM TG-51 dosimetry protocol.

Applied radioactivity in radiation synovectomy with [188Re]rhenium sulfide suspension

Early experience demonstrated absorbed dose in radiation synovectomy is about 100 Gy. For reaching this dose, the applied radioactivity should be calculated. Twenty-nine synovitic models of rabbit were treated by intra-articular injection of [(188)Re]rhenium sulfide and histological changes of synovium and cartilage were examined. The applied radioactivity was calculated by method of absorbed dose factor. In clinical, eleven haemophilic patients with haemarthrosis were performed radiation synovectomy with treated [(188)Re]rhenium sulfide. The synovial thickness was evaluated by MR and its value was used to calculate the applied radioactivity. After radiation synovectomy, all patients were followed up by synovial thickness, regional inflammation, and clinical course including bleeding frequency. In rabbit models, the synovitic membrane can be eliminated by calculated radioactivity as planed without damaging the joint cartilage. In patients study, all patients exhibited significant reductions in synovial thickness and inflammation after radiation synovectomy with the planed radioactivities of [(188)Re]rhenium sulfide. Post-procedure bleeding frequency reduction in excellent and good reached to 63.6% by 18 months. In the cases of joint bleeding, the need for antihaemophilic factor treatment decreased immensely. Most of the recurrent episodes of bleeding were mild, subsiding with local means. The applied radioactivity in radiation synovectomy could be calculated according to thickness of inflamed synovium. Further study including comparison therapeutic results from calculated individual activities with results from fixed activities and long-term follow-up is warranted.

Radiation synovectomy by 188Re-Sulfide in haemophilic synovitis.

Radiation synovectomy is a safe and effective treatment for chronic haemophilic synovitis causing recurrent haemarthroses. This study reports results of 29 188Re-sulfide radiation synovectomies in knee joint with a follow-up 18 months. Using the absorbed dose factor, three groups of radioactivity dose (555 MBq, 687 MBq and 917 MBq) were used according to the synovium thickness that measured by MRI. Excellent and good results (haemarthrosis reduction from 75 to 100%) were obtained in 71% of cases at 18 months. Comparison of the results, no significant difference was found among the radioactivity dose groups. Radiation was well contained within the knee. There were no observed or identified complications including the detectable harm to the articular cartilage, as shown by MRI.

Beta-particle dosimetry in radiation synovectomy.

Beta-particle dosimetry of various radionuclides used in the treatment of rheumatoid arthritis was estimated using Monte Carlo radiation transport simulation coupled with experiments using reactor-produced radionuclides and radiachromic film dosimeters inserted into joint phantoms and the knees of cadavers. Results are presented as absorbed dose factors (cGy-cm2/MBq-s) versus depth in a mathematical model of the rheumatoid joint which includes regions of bone, articular cartilage, joint capsule, and tissue (synovium) found in all synovial joints. The factors can be used to estimate absorbed dose and dose rate distributions in treated joints. In particular, guidance is provided for those interested in (a) a given radionuclide's therapeutic range, (b) the amount of radioactivity to administer on a case-by-case basis, (c) the expected therapeutic dose to synovium, and (d) the radiation dose imparted to other, nontarget components in the joint, including bone and articular cartilage.

Calculation of beta dosimetry in radiation synovectomy using Monte Carlo simulation (EGS4).

Using the EGS4 Monte Carlo code, absorbed dose rate factors were estimated for four radionuclides of interest in radiation synovectomy, an intra-articular radiation therapy to treat rheumatoid arthritis. The treatment consists of the injection of a beta-emitting radionuclide into the joint capsule in order to eliminate diseased synovium through irradiation. The radionuclides investigated are 32P, 90Y, 165Dy, and 198Au. Calculations reveal the absorbed dose factor (cGy cm2/MBq s) as a function of distance (mm) in an EGS4 model of the rheumatic joint. The model incorporates bone, articular cartilage, joint capsule, and tissue (synovium) components found in all synovial joints, with dimensions in the model corresponding to dimensions typically found in larger joints, e.g., the knee, shoulder, or hip. Results are compared with previous, analytical approaches to beta dosimetry in radiation synovectomy. In addition, radiation backscatter due to the presence of bone is investigated and determined to have a negligible enhancement effect on absorbed dose to synovium.