Dose Rate Research Articles

A review of diamond dosimeters in advanced radiotherapy techniques.

This review article synthesizes key findings from studies on the use of diamond dosimeters in advanced radiotherapy techniques, showcasing their applications, challenges, and contributions to enhancing dosimetric accuracy. The article explores various dosimeters, highlighting synthetic diamond dosimeters as potential candidates especially due to their high spatial resolution and negligible ion recombination effect. The clinically validated commercial dosimeter, PTW microDiamond (mD), faces limitations in small fields, proton and hadron therapy and ultra-high dose per pulse (UHDPP) conditions. Variability in reported values for field sizes 2 2 is noted, reflecting the competition between volume averaging and density perturbation effects. PTW's introduction of flashDiamond (fD) holds promise for dosimetric measurements in UHDPP conditions and is reliable for commissioning ultra-high dose rate (UHDR) electron beam systems, pending the clinical validation of the device. Other advancements in diamond detectors, such as in 3D configurations and real-time dose per pulse x-ray detectors, are considered valuable in overcoming challenges posed by modern radiotherapy techniques, alongside relative dosimetry and pre-treatment verifications. The studies discussed collectively provide a comprehensive overview of the evolving landscape of diamond dosimetry in the field of radiotherapy, and offer insights into future directions for research and development in thefield.

Modeling Fallout from Nuclear Weapon Detonations: Efficient Activity and Dose Calculation of Radionuclides and Their Progeny.

The purpose of this paper is to present a practical method for quick determination of potential radiological doses and contaminations by fallout from nuclear detonations, or other releases, that includes the contributions from all nuclides. We precalculate individual (total) activities of all radionuclides from any initial cocktail and all their ingrowing progeny at a set of pinpoints in time with a logarithmic time-spacing. This is combined with the set of dose conversion factors (DCC) for any exposure pathway to obtain a time-dependent cocktail for the whole release as if it is one substance. An atmospheric dispersion model then provides the thinning coefficient of the released material to give local concentrations and dose rates. Progeny ingrowth is illustrated for pure 238 U and for a nuclear reactor that has been shut down. Efficient dose assessment is demonstrated for fallout from nuclear detonations and compared with the traditional approach of preselecting nuclides for specific endpoints and periods-of-interest. The compound cocktail DCC reduces the assessment of contaminations and potential dose-effects from fallout after a nuclear detonation to (the atmospheric dispersion of) only one tracer substance, representing any cocktail of nuclides and their progeny. This removes the need to follow all separate nuclides or an endpoint-specific preselection of "most important nuclides." As the cocktail DCCs can be precalculated and the atmospheric dispersion of only one tracer substance has to be modelled, our method is fast. The model for calculating cocktail DCCs is freely available, easily coupled to any regular atmospheric dispersion model, and therefore ready for operational use by others.

Implantation of CRT pacemaker during pregnancy: estimated fetal radiation dose.

The benefits of a cardiac resynchronization therapy (CRT) implantation are known in severe heart failure and its implantation may also be considered during pregnancy to ensure safe pregnancy and delivery for both the mother and the fetus. This study on a patient case aimed to estimate the absorbed dose (AD) to the fetus during the CRT implantation of 21st week of the pregnant woman. AD measurement was done using anthropomorphic phantom, radiophotoluminescence dosemeters and Monte Carlo simulation utilizing kerma area product (KAP) of the procedures. The measured AD for a phantom's uterus and heart was 0.116 and 14.7mGy with total KAP of 27.9 Gycm2. The estimated actual AD to the fetus and the mother's heart was 0.004 and 1.2mGy, with total KAP of 1.5 Gycm2. The dose to the fetus can be minimized with the optimized procedure.

Advancing Fixed-Source Reactor Analysis Through OpenNode Implementation

OpenNode, a new open-source Fortran code, enables the simulation of fixed-source reactors. Powered by the nodal expansion method (NEM) and seamless Python integration, OpenNode competes with existing nuclear reactor simulation tools. The fixed-source problem plays a crucial role in radioprotection, providing flux calculations and detailed insights into heating effects and dose rates. Users can define and configure reactor models via a JSON input file, specifying critical parameters like geometry, materials, cross-section data, boundary conditions, and fixed sources. OpenNode further empowers users with a Python interface for preprocessing and postprocessing, streamlining result analysis. Distinguishing itself from conventional NEM codes, OpenNode supports three-dimensional (3D) Cartesian geometries, facilitating intricate reactor design simulations. Customization options, including mesh sizes, polynomial orders, and calculation modes, enhance precision and efficiency. In our comprehensive study, we verified OpenNode’s fixed-source mode using the 3D-IAEA reactor, comparing it with the SANM code KOMODO. The results underscore OpenNode’s exceptional accuracy in computing critical parameters, like the effective multiplication factor, power distribution, and nodal flux, within fixed-source reactors. OpenNode stands as a reliable, user-friendly tool poised to advance nuclear reactor simulations.

Assessment of Natural Radioactivity in Cements (Local and Imported) in Mali

<i>Background</i>: In this article, the radioactivity concentrations of U-238, Th-232 and K-40 (NORM) and radiological hazard parameters in different types of cements commonly used in Mali and available on the Malian market have been analyzed. The obtained values of NORM concentrations and radiological hazards in seven (07) cements samples will permit to the AMARAP to estimate the exposure (gamma rays) from the buildings and dwellings made by these cements. It will permit also to determine any over exposure (determinist effects which are an immediate tissue reaction due to the high exposition of ionizing radiation) and minimize as well the associated risk due to low doses (stochastic effects). <i>Materials and Methods</i>: The health impact due to the exposure of radionuclides from these cements was evaluated by the determination of specific activity of radionuclides U-238, Th-232 and K-40 using gamma spectrometry analysis. The radiological hazards such as Absorbed Dose Rate (Ḋ) Annual Effective Dose (Ė) Internal and External Dose indexes (H<sub>in</sub> and H<sub>ex</sub>) were evaluated in these cements samples. <i>Results</i>: The range of specific activities for U-238 vary from 21.77 ± 1.50 to 145.31 ± 7.70 Bq/kg, for Th-232 from 8.85 ± 0.52 to 73.56 ± 3.82 Bq/kg and for K-40 from 104.27 ± 5.63 to 351.97 ± 18.08 Bq/kg. The peak of U-238 wasn’t detected only in one (01) sample (CIM04). The highest value of specific activity was reported in sample CIM07 (DANGOTE). The values of radiological hazard such as Ḋ, Ė, H<sub>in</sub> and H<sub>ex</sub> from this work were within the dose criteria limits given by international organizations (ICRP and UNSCEAR) and national standards. <i>Conclusion</i>: This study shows the analyzed cements do not pose any significant source of radiation hazard and are safe for use in the construction of dwellings even if the risk (stochastic effect) associated with low dose exists. Special attention and more analyzes must be done on them for more protection of public health.

Enhanced performance of hierarchical heterostructures CuS@ZnS-Ag-doped core–shell quantum dots towards photocatalytic degradation of pesticide contaminants in aqueous solution

ABSTRACT In recent years, the pollution of the water by pesticides has become a significant global concern due to the harmful effects these compounds have on human health and the environment. Therefore, removal of pollutants or making them ineffective is necessary for life. In this study, removal of agricultural pesticides such as Deltamethrin, Flumethrin and Phoxim was performed through photodegradation process using CuS@ZnS-Ag quantum dots as photocatalyst. The synthesised CuS@ZnS-Ag heterojunction nanocomposite has suitable charge separation and low electron–hole recombination rate with good optical properties. The synthesised photocatalyst was characterised by various techniques such as X-ray diffraction, Fourier transform infrared spectrometry, UV-Visible spectroscopy, field emission scanning electron microscopy and transmission electron microscopy. The effects of pH, temperature, photocatalyst dose and agitation rate on the degradation were investigated. The optimised conditions were obtained as follows: pH 7 (±0.5), temperature 30 (±2) °C, photocatalyst dose for Flumethrin 30 mg/L, Deltamethrin 10 mg/L and Phoxim 15 mg/mL and agitation rate 500 rpm. Results showed that under optimal conditions, the CuS@ZnS-Ag as photocatalyst can degrade 96% of the pollutants using light-emitting diode lamp. Kinetic studies indicated the pseudo-second-order model.

Exploring Aqueous Solution-Processed Pseudohalide Rare-Earth Double Perovskite Ferroelectrics toward X-ray Detection with High Sensitivity.

Three-dimensional (3D) pseudohalide rare-earth double perovskites (PREDPs) have garnered significant attention for their versatile physical properties, including ferroelectricity, ferroelasticity, large piezoelectric responses, and circularly polarized luminescence. However, their potential for X-ray detection remains unexplored, and the low Curie temperature (TC) limits the performance window for PREDP ferroelectrics.Here, by applying the chemical regulation strategies involving halogen substitution on the organic cation and Rb/Cs substitution to the PREDP [(R)-M3HQ]2RbEu(NO3)6 [(R)-M3HQ = (R)-N-methyl-3-hydroxylquinuclidinium] with a low TC of 285 K, a novel 3D PREDP ferroelectric [(R)-CM3HQ]2CsEu(NO3)6 [(R)-CM3HQ = (R)-N-chloromethyl-3-hydroxylquinuclidinium] are successfully synthesized, for which the TC reaches 344 K. More importantly, such a strategy endowed [(R)-CM3HQ]2CsEu(NO3)6 with notable X-ray detection capabilities. Centimeter-sized [(R)-CM3HQ]2CsEu(NO3)6 single crystals fabricated from aqueous solutions demonstrated a sensitivity of 1307 µC Gyair-1 cm-2 and a low detectable dose rate of 152 nGyair s-1, the highest sensitivity reported for hybrid double perovskite ferroelectric detectors. This work positions PREDPs as promising candidates for the next generation of eco-friendly optoelectronic materials and also offers substantial insights into the interaction between structure, composition, and functionality in ferroelectric materials.

A high-density multi-electrode platform examining the effects of radiation on in vitro cortical networks.

Radiation therapy and stereotactic radiosurgery are common treatments for brain malignancies. However, the impact of radiation on underlying neuronal circuits is poorly understood. In the prefrontal cortex (PFC), neurons communicate via action potentials that control cognitive processes, thus it is important to understand the impact of radiation on these circuits. Here we present a novel protocol to investigate the effect of radiation on the activity and survival of PFC networks in vitro. Escalating doses of radiation were applied to PFC slices using a robotic radiosurgery platform at a standard dose rate of 10Gy/min. High-density multielectrode array recordings of radiated slices were collected to capture extracellular activity across 4,096 channels. Radiated slices showed an increase in firing rate, functional connectivity, and complexity. Graph-theoretic measures of functional connectivity were altered following radiation. These results were compared to pharmacologically induced epileptic slices where neural complexity was markedly elevated, and functional connections were strong but remained spatially focused. Finally, propidium iodide staining revealed a dose-dependent effect of radiation on apoptosis. These findings provide a novel assay to investigate the impacts of clinically relevant doses of radiation on brain circuits and highlight the acute effects of escalating radiation doses on PFC neurons.

Real-Time Radiation Beam Monitoring by Flexible Perovskite Thin Film Arrays.

Real-time and in-line transversal monitoring of ionizing radiation beams is a crucial task for several applications which span from medical treatments to particle accelerators in high energy physics. Here a flexible and large area device based on 2D hybrid perovskite thin films (phenylethylammonium lead bromide), fabricated onto a thin flexible polyimide substrate, able to map the transversal beam profile of high energy radiation beams is reported. The performance of this novel tool is here compared with the one offered by standard commercial large-area technology, namely radiochromic sheets. The great potential of this class of devices is demonstrated by successfully mapping in real-time a 5 MeV proton beam at fluxes between 108 and 1010 H+ s-1 cm-2, confirming the capability to operate in a radiation-harsh environment without output signal saturation issues. The versatility and scalability of here proposed detecting system are demonstrated by the development of a multipixel array able to map in real-time a 40 kVp X-ray beam spot (dose rate 8 mGy s-1). Perovskite thin film-based detectors are thus assessed as a very promising class of thin, flexible devices for real-time, in-line, large-area, conformable, reusable, transparent, and low-cost transversal beam monitoring of different ionizing radiation.

Review and statistical analysis of activity values reported for coastal sands worldwide

The activity of natural radionuclides is unevenly distributed across the Earth´s crust, with certain areas exhibiting significantly higher levels than others, known as High Background Radiation Areas (HBRAs). This study presents a statistical analysis of reported activity values for coastal sands globally. Through this statistical analysis, costal sands were classified into four categories based on their activity levels, providing a standardized framework to compare the natural radioactivity of these sands. This classification is a valuable tool for identifying populations exposed to different radiation levels, which is essential for the study of stochastic effects. The study proposes thresholds to define HBRAs as regions with activity values exceeding 203 Bq/kg for 238U, 517 Bq/kg for 232Th, or 960 Bq/kg for 40K. Regions with lower values are classified as NonHBRAs. Further subdivision of these categories resulted in four distinct regions: NonHBRA−, NonHBRA+, HBRA−, and HBRA+. The activity values for these subdivisions are 92 Bq/kg and 2,903 Bq/kg for 238U, 94 Bq/kg and 7,230 Bq/kg for 232Th, and 901 Bq/kg and 2,298 Bq/kg for 40K. By calculating the external dose rates from the reported activity data, a threshold of 357 nGy/h was identified as the dose boundary separating NonHBRAs from HBRAs. The values for the subdivisions resulted 101 nGy/h and 3,867 nGy/h. The study also explores the content of these natural radionuclides in relation to their bearing minerals and discusses correlations between the reported activity values and the characteristics of the sands. Additionally, the activity of the anthropogenic radionuclide 137Cs (reported values ranging from the detection limit to 63 Bq/kg) is examined.

Optimization and shielding design of a thermal neutron device based on D-D neutron generator with Geant4 toolkit

Neutron activation analysis is a highly sensitive non-destructive testing technique with important applications in industry, geoscience, medical therapy, etc. This work designed and optimized a thermal neutron device that utilized a portable D-D neutron generator, and the Monte Carlo method with the Geant4 toolkit was applied to simulation. The objective of the optimized design is to maximize the thermal neutron flux at the output surface and increase the utilization efficiency of the neutron generator. A parameter K was defined as a measure of the device's slowing capacity for neutrons and was used to determine the optimized device geometry. The simulation considered the contribution of different types and sizes of moderators and reflectors to the thermal neutron intensity to obtain the optimal size. The shielding protection of the device was then designed. The effectiveness of shielding with different thicknesses was evaluated using three dose reference points. The results indicated that the optimized device can achieve a maximum thermal neutron flux of 1.97 × 105 n∙cm−2∙s−1 at the output surface by using high-density polyethylene (HDPE) as the moderator and nickel as the reflector. It was determined that using 45 cm of HDPE and 9 cm of lead protection in sequence along the neutron head axis would reduce the dose rate at the reference point, located 5 cm from the surface of the device, below the safety limit of 2.5 μSv/h.

A novel 3D-printed brachytherapy applicator and monte Carlo model for the treatment of conjunctival tumors

PurposeTo develop a custom low dose rate brachytherapy applicator for the treatment of conjunctival malignancies which leverages 3D-printing technology to provide enhanced design flexibility and availability. MethodsAn elliptical shell applicator inspired by the ocular surgery post-operation conformer shells was developed for the placement of the applicator around the cornea of the eye, with a central hole provide patient comfort. The applicator featured two concentric circles of slots for iodine-125 seeds, providing customization of the dose distribution depending on the location of the target. The applicator was modeled using computer-aided design software. The resultant model STL file was used for 3D printing of the applicator and the development of a Monte Carlo model of the applicator and its dose distribution. ResultsThe applicator was successfully 3D printed using biocompatible resin, which could be sterilized for treatment after manual source loading. A Geant4 model of the applicator was created directly from the STL model and was applied to a phantom to estimate the dose distribution delivered by the applicator. The toroidal dose distribution allowed for treatment of the conjunctiva while reducing dose to the cornea compared to traditional eye plaque designs. ConclusionsA custom 3D-printed applicator was successfully developed and modeled for the treatment of conjunctival malignancies. This novel applicator design potentially provides higher quality, more customizable dose distributions for patients and the simplicity of the design makes it accessible for any clinic with 3D-printing technology.

Evaluation of radiation leakage in X-ray security inspection machine using a CZT spectrometer

Leakage radiation from X-ray security inspection machines is important, and measurement based on ionization chamber or scintillator detector is widely used. The leakage radiation is closely related to the size and the passing time of the luggage, the lead equivalent, the opening angle of the lead curtain, and the response time of the measuring instrument. To characterize the distribution of leakage radiation from the X-ray security inspection machine accurately, a small-volume CZT(CdZnTe) spectrometer was used to measure the energy spectra at a distance of 5 cm from the surface of the inspection machine. By designing and controlling the opening angle of the lead curtain according to the size of the luggage passing through the entrance and exit, the radiation dose was determined based on the measured energy spectra combined with the G(E)-function method. The results show that the maximum relative deviation between the air kerma rate and the ambient dose equivalent rate calculated by the G(E) function method with the standard dose rate does not exceed ±5%. The maximum relative deviation of the dose rate linear verification in the 137Cs radiation field is less than 2.5%. A calibrated CZT detector was utilized to measure the radiation leakage on the surface of the X-ray security inspection machine. It was discovered that the presence of the luggage items and the opening angle of the lead curtain will increase the leakage radiation dose on the surface of the security inspection machine system. This study provides a new approach for measuring scattered radiation of X-ray security inspection machines.

Robotic MR-guided high dose rate brachytherapy needle implantation in the prostate (ROBiNSon)—a proof-of-concept study

Objective. A robotic needle implant device for MR-guided high-dose-rate (HDR) prostate brachytherapy was developed. This study aimed to assess the feasibility and spatial accuracy of HDR brachytherapy using the robotic device, for a single intraprostatic target point. Approach. Five patients were treated from November 2019–June 2022 with the robot. The robot fits a 1.5 T MR scanner and the needle can be shifted and angulated. An intraprocedural MR scan was fused with the diagnostic MR and one preplanned needle position was selected for robotic insertion. The needle entry point and angles were set for a needle tip target point within the intraprostatic target volume. The needle was tapped stepwise towards the target point pneumatically. Final needle position was verified with MR, followed by plan optimization and dose delivery. Any remaining planned needles were inserted manually. Needle tip to geometrical target error (NTG-error) was defined as the deviation of the actual tip position relative to the predefined geometric target point, using MR-coordinates. Needle tip to treatment target error (NTT-error) was defined as the deviation of the actual tip position relative to the treatment target point, using fused MR-images pre- and post-needle implantation taking into account prostate deformation. Difference between NTT-error and NTG-error and fiducial marker shifts indicated prostate movement. For determining prostate deformation, the Jaccard index and prostate volumes were assessed. Main results. The robotic device was able to tap the needle to the planned depth for all patients. Mean robotic procedure duration was 142 min. NTG-error was 3.2 (range 1.1–6.7) mm and NTT-error 4.5 (range 2.6–9.6) mm. Marker displacements were smaller than 3 mm. No treatment-related acute toxicity was reported. Feasibility of needle placement within the prostate was considered adequate. Significance. MR-guided robotic needle insertion is feasible with a mean geometric accuracy of 3.2 mm and <3 mm prostate movement.

Aggregation of Albumins under Reductive Radical Stress.

The reactions of radicals with human serum albumin (HSA) under reductive stress conditions were studied using pulse radiolysis and photochemical methods. It was proved that irradiation of HSA solutions under reductive stress conditions results in the formation of stable protein aggregates. HSA aggregates induced by ionizing radiation are characterized by unique emission, different from the UV emission of non-irradiated solutions. The comparison of transient absorption spectra and the reactivity of hydrated electrons (eaq-) with amino acids or HSA suggests that electron attachment to disulfide bonds is responsible for the transient spectrum recorded in the case of albumin solutions. The reactions of eaq- and CO2•- with HSA lead to the formation of the same products. Recombination of sulfur-centered radicals plays a crucial role in the generation of HSA nanoparticles, which are stabilized by intermolecular disulfide bonds. The process of creating disulfide bridges under the influence of ionizing radiation is a promising method for the synthesis of biocompatible protein nanostructures for medical applications. Our Raman spectroscopy studies indicate strong modification of disulfide bonds and confirm the aggregation of albumins as well. Low-temperature measurements indicate the possibility of electron tunneling through the HSA protein structure to specific CyS-SCy bridges. The current study showed that the efficiency of HSA aggregation depends on two main factors: dose rate (number of pulses per unit time in the case of pulse radiolysis) and the temperature of the irradiated solution.

Effect of Spectral Filtering and Segmental X-ray Tube Current Switch-Off on Interventionalist's Scatter Exposure during CT Fluoroscopy.

Dose optimization in computed tomography (CT) is crucial, especially in CT fluoroscopy (fluoro-CT) used for real-time navigation, affecting both patient and operator safety. This study evaluated the impact of spectral X-ray filtering using a tin filter (Sn filter), and a method called partial-angle computed tomography (PACT), which involves segmentally switching off the X-ray tube current at the ambient dose rate H˙*(10) at the interventional radiologist's (IR) position. Measurements were taken at two body regions (upper body: head/neck; lower body: lower legs/feet) using a 120 kV X-ray tube voltage, 3 × 5.0 mm CT collimation, 0.5 s rotation speed, and X-ray tube currents of 43 Eff.mAs (without Sn filter) and 165 Eff.mAs (with Sn filter). The study found significant dose reductions in both body regions when using the Sn filter and PACT together. For instance, in the upper body region, the combination protocol reduced H˙*(10) from 11.8 µSv/s to 6.1 µSv/s (p < 0.0001) compared to the protocol without using these features. Around 8% of the reduction (about 0.5 µSv/s) is attributed to the Sn filter (p = 0.0005). This approach demonstrates that using the Sn filter along with PACT effectively minimizes radiation exposure for the IR, particularly protecting areas like the head/neck, which can only be insufficiently covered by (standard) radiation protection material.

Readout circuit for a ZnO bulk-acoustic-wave X-ray dose rate detector

Bulk Acoustic Wave (BAW) resonators based on piezoelectric semiconductors are radio frequency devices that can convert X-ray dose rate into resonant frequency offset, which exhibit strong anti-interference capabilities and low power consumption and are suitable for wireless sensing systems. In this study, we designed a readout circuit for a ZnO BAW X-ray dose rate detector. (0001)-oriented ZnO single crystals were used to fabricate the high-quality BAW X-ray detector. Under dark field and X-ray irradiation conditions, the resonant frequency offset of the detector was recorded via the readout circuit. The readout circuit consists of an oscillator circuit based on a Pierce oscillator circuit structure, a frequency mixing circuit, and an STM32 microcontroller. This design offers higher frequency stability and lower phase noise. In practical applications, it can replace the expensive and bulky vector network analyzer for detecting and storing the resonant frequency of BAW resonators with the advantages of fast readout speed and portability.

Assessment of the skin contamination dose coefficients for 252Cf radionuclide: Monte Carlo approach

Handling the 252Cf radionuclide source poses a potential hazard of skin surface contamination in case of an unexpected occurrence. Consequently, there is a growing need to establish precise dose conversion coefficients tailored to each type of emitted primary particle and various radionuclides. Nevertheless, the current body of literature does not provide specific data or methodologies for evaluating skin contamination dose and its associated coefficients, particularly with regard to the 252Cf source. Thus, this study aims to quantify the dose rate received by the skin and its associated coefficients after contamination scenario. Utilizing the established MCNPX environment, the Equivalent dose rate and Absorbed dose, along with Skin contamination dose coefficient (SCDC), have been calculated within the skin tissue. Two methodologies, specifically Watt Fission distribution and the Doppler Effect, are proposed to analyze particle spectra within skin phantom, enabling the calculation of Equivalent dose rate. In accordance with ICRP recommendations regarding the optimal depth for assessing skin doses, the designated scoring volume within the skin is located between depths of 50–100 μm. This volume is tasked with evaluating the dose. The SCDC results were entirely consistent with previously published data from MCNPX, with statistical uncertainties of less than 15%, demonstrating the efficacy of the methodologies employed in this study. This research presents an innovative method for generating data related to skin contamination doses. The novel outcomes in the current research facilitate the assessment of skin dose contamination for the targeted radionuclides and radiotherapy purposes due to staff oversight and radiobiological effects.

Feasibility of Remotely Controlled Capsule to Enable Directionality and Higher Dose Rates for Conventional Low Dose Rate Brachytherapy Using Topas

With low dose radiation (LDR) brachytherapy, thus far, only low dose rates could be used with low energy level radiation sources at 30 keV or less due to the risk of radiation to healthy cells, tissue, and organs. The radiation seeds are placed in the location of the tumor and is left in the body for the total dose to be continuously administered throughout the decay period of the radiation seed. However, the amount of time to deliver the total dose can take up to several months depending on the type of radiation source, tumor size and location, due to the low dose rate of <2 Gy/hr. In contrast, high dose radiation (HDR) is defined as a dose delivered at a rate >12 Gy/hr, although usually much higher, often in excess of 1 Gy/min, with a higher energy radiation source close to 0.5 MeV.For the first time, a remotely controllable, implanted radiation capsule is introduced, to enable a very high dose rate of 10 Gy/min for 30 keV I-125 radiation source. Until now, this combination of low energy and high dose rate for implanted radiation seeds for LDR was not possible due to the risk of radiation. The implantable capsule is designed to control this risk of radiation by remotely controlling the opening of the capsule hole. In the open case, the high dose rate of I-125 is delivered for a duration of 1 minute and then closed to stop emission.For feasibility, a simulation study was conducted using TOPAS for Monte Carlo simulation of radiotherapy. In the top right figures, a cylindrical capsule of height 6 mm, diameter 3 mm, and wall thickness 0.9 mm is designed using gold to contain the radiation and prevent leakage radiation. An opening of 30 degrees was made in the middle of the capsule wall where the radiation was to be emitted. For the radiation source, a 30 keV I-125 was used with a specific activity of 6.42 x 1014 Bq/gram. With a wall thickness of 0.9 mm, calculations showed that 4.4 micrograms of I-125 was needed to increase the source activity for 1.454 x 1020 Bq per second for a high dose rate of 10 Gy/min.The yellow and red colors in the capsule are both gold with wall thickness of 0.9 mm. The red portion of the cylinder is where the 30 degree opening was defined. The green lines show the paths of the radiation particles.TOPAS simulation results successfully show that the capsule contains the radiation and the only direction of radiation is through the defined opening in the capsule. The bottom three graphs show the x, y, and z plane cuts showing a directional radiation beam that drops in intensity, from a range of 1.0 to 0, over distance and slightly widens over distance.To control the opening and closing of the hole in the radiation capsule, an inner cylinder and outer cylinder is used, where the inner cylinder can move up and down. A permanent magnet is attached to the bottom of the inner cylinder and an electromagnet is attached to the base at the bottom of the capsule. An implantable inductive coil receives an AC current from the external inductive coil, which is rectified using a diode and capacitor circuit. This DC current powers the electromagnet, which repels the inner cylinder, moving it up to align the windows of the inner and outer cylinders. This alignment opens the hole and radiation is emitted towards the target tumor. After the dose is delivered, the current is turned off, which turns off the electromagnet. With no repelling force from the electromagnet, the permanent magnet reattaches itself to the base, and the inner cylinder slides down and the windows are no longer aligned. This blocks the radiation from being emitted. The dimensions of the capsule and the windows depend on the radiation source and tumor size. Micromachining and micro 3D printing techniques can be applied for fabrication of the device.In conclusion, a feasibility study using TOPAS demonstrated that a 0.9 mm gold wall with a hole can contain a very high source activity of I-125 radiation for a very high dose rate of 10 Gy/min and emit a directional beam through the hole. A remotely controllable capsule can enable a high dose rate with LDR brachytherapy that combines the advantages of LDR and HDR, which is minimum radiation risk and minimum treatment time, simultaneously. Potential applications for this is intracavitary cancer treatment such as esophageal or cervical cancer. Figure 1

Retrospective evaluation of the predictive value of tumour burden at baseline [68 Ga]Ga-DOTA-TOC or -TATE PET/CT and tumour dosimetry in GEP-NET patients treated with PRRT

PurposeThere is a lack of validated imaging biomarkers for prediction of response to peptide receptor radionuclide therapy (PRRT). The primary objective was to evaluate if tumour burden at baseline PET/CT could predict treatment outcomes to PRRT with [177Lu]Lu-DOTA-TATE. Secondary objectives were to evaluate if there was a correlation between tumour burden and mean tumour absorbed dose (AD) during first cycle, and if mean tumour AD or the relative change of tumour burden at first follow-up PET/CT could predict progression free survival (PFS) or overall survival (OS).MethodsPatients with gastroenteropancreatic neuroendocrine tumour (GEP-NET) treated with [177Lu]Lu-DOTA-TATE PRRT were retrospectively included. Tumour burden was quantified from [68 Ga]Ga-DOTA-TOC/TATE PET/CT-images at baseline and first follow-up and expressed as; whole-body somatostatin receptor expressing tumour volume (SRETVwb), total lesion somatostatin receptor expression (TLSREwb), largest tumour lesion diameter and highest SUVmax. The relative change of tumour burden was evaluated in three categories. Mean tumour AD was estimated from the first cycle of PRRT. PFS was defined as time from start of PRRT to radiological or clinical progression. OS was evaluated as time to death. Kaplan Meier survival curves and log-rank test were used to compare PFS and OS between different groups.ResultsThirty-one patients had a baseline PET/CT < 6 months before treatment and 25 had a follow-up examination. Median tumour burden was 132 ml (IQR 61–302) at baseline and 71 ml (IQR 36–278) at follow-up. Twenty-two patients had disease progression (median time to progression 17.2 months) and 9 patients had no disease progression (median follow-up 28.7 months). SRETVwb dichotomized by the median at baseline was not associated with longer PFS (p = 0.861) or OS (p = 0.937). Neither TLSREwb, largest tumour lesion or SUVmax showed significant predictive value. There was a moderately strong correlation, however, between SUVmax and mean tumour AD r = 0.705, p < 0.001, but no significant correlation between SRETVwb nor TLSREwb and mean tumour AD. An increase of SRETVwb, TLSREwb or largest tumour lesion at first follow-up PET/CT was significantly correlated with shorter PFS/OS.ConclusionTumour burden at baseline showed no predictive value of PFS/OS after PRRT in this small retrospective study. An increase of tumour burden was predictive of worse outcome.