Low-energy Brachytherapy Sources Research Articles

Validation of GPUMCD for low‐energy brachytherapy seed dosimetry

To validate GPUMCD, a new package for fast Monte Carlo dose calculations based on the GPU (graphics processing unit), as a tool for low-energy single seed brachytherapy dosimetry for specific seed models. As the currently accepted method of dose calculation in low-energy brachytherapy computations relies on severe approximations, a Monte Carlo based approach would result in more accurate dose calculations, taking in to consideration the patient anatomy as well as interseed attenuation. The first step is to evaluate the capability of GPUMCD to reproduce low-energy, single source, brachytherapy calculations which could ultimately result in fast and accurate, Monte Carlo based, brachytherapy dose calculations for routine planning. A mixed geometry engine was integrated to GPUMCD capable of handling parametric as well as voxelized geometries. In order to evaluate GPUMCD for brachytherapy calculations, several dosimetry parameters were computed and compared to values found in the literature. These parameters, defined by the AAPM Task-Group No. 43, are the radial dose function, the 2D anisotropy function, and the dose rate constant. These three parameters were computed for two different brachytherapy sources: the Amersham OncoSeed 6711 and the Imagyn IsoStar IS-12501. GPUMCD was shown to yield dosimetric parameters similar to those found in the literature. It reproduces radial dose functions to within 1.25% for both sources in the 0.5< r <10 cm range. The 2D anisotropy function was found to be within 3% at r =5 cm and within 4% at r = 1 cm. The dose rate constants obtained were within the range of other values reported in the literature. GPUMCD was shown to be able to reproduce various TG-43 parameters for two different low-energy brachytherapy sources found in the literature. The next step is to test GPUMCD as a fast clinical Monte Carlo brachytherapy dose calculations with multiple seeds and patient geometry, potentially providing more accurate results than the TG-43 formalism while being much faster than calculations using general purpose Monte Carlo codes.

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

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 the small variation with distance, using conversion factors based on the emitted photon spectrum (or its mean energy) of a given source introduces minimal error. The large differences observed between scoring schemes underline the need for guidelines on choice of media for dose reporting. Providing such guidelines is beyond the scope of this work.

Optimization of aluminum thickness for absorption of undesired Ti K X-rays in the measurement of low energy brachytherapy source strength

The contribution of Ti K X-rays to total air kerma strength for low energy brachytherapy sources ( 125I and 103Pd) are calculated for different source-to-aperture distances of an indigenously designed free air ionization chamber. For 30 cm source-to-aperture distance, calculated contribution of Ti K X-rays is 4%. The Ti K X-rays can be eliminated by a relatively thin aluminum filter, but the primary photons emitted by the source will also be attenuated. This effect should be compensated by applying a suitable correction factor. The uncertainty in the attenuation correction factor has been also calculated for different thicknesses of aluminum by a Monte Carlo uncertainty analysis algorithm programmed in FORTRAN. The results show that the optimum thickness of the aluminum absorber is 100 μm, for which the contribution of Ti K X-rays in air kerma strength is reduced to less than one hundredth of the uncertainty in the correction factor, ensuring that the uncertainty in the air kerma strength will be mainly due to the uncertainty in the correction factor. The calculated uncertainties are 1.7 × 10 −3, and 3.4 × 10 −3 for 125I and 103Pd sources, respectively.

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

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.

Sensitivity of low energy brachytherapy Monte Carlo dose calculations to uncertainties in human tissue composition

The objective of this work is to assess the sensitivity of Monte Carlo (MC) dose calculations to uncertainties in human tissue composition for a range of low photon energy brachytherapy sources: 125I, 103Pd, 131Cs, and an electronic brachytherapy source (EBS). The low energy photons emitted by these sources make the dosimetry sensitive to variations in tissue atomic number due to the dominance of the photoelectric effect. This work reports dose to a small mass of water in medium D(w,m) as opposed to dose to a small mass of medium in medium D(m,m). Mean adipose, mammary gland, and breast tissues (as uniform mixture of the aforementioned tissues) are investigated as well as compositions corresponding to one standard deviation from the mean. Prostate mean compositions from three different literature sources are also investigated. Three sets of MC simulations are performed with the GEANT4 code: (1) Dose calculations for idealized TG-43-like spherical geometries using point sources. Radial dose profiles obtained in different media are compared to assess the influence of compositional uncertainties. (2) Dose calculations for four clinical prostate LDR brachytherapy permanent seed implants using 125I seeds (Model 2301, Best Medical, Springfield, VA). The effect of varying the prostate composition in the planning target volume (PTV) is investigated by comparing PTV D90 values. (3) Dose calculations for four clinical breast LDR brachytherapy permanent seed implants using 103Pd seeds (Model 2335, Best Medical). The effects of varying the adipose/gland ratio in the PTV and of varying the elemental composition of adipose and gland within one standard deviation of the assumed mean composition are investigated by comparing PTV D90 values. For (2) and (3), the influence of using the mass density from CT scans instead of unit mass density is also assessed. Results from simulation (1) show that variations in the mean compositions of tissues affect low energy brachytherapy dosimetry. Dose differences between mean and one standard deviation of the mean composition increasing with distance from the source are observed. It is established that the 125I and 131Cs sources are the least sensitive to variations in elemental compositions while 103Pd is most sensitive. The EBS falls in between and exhibits complex behavior due to significant spectral hardening. Results from simulation (2) show that two prostate compositions are dosimetrically equivalent to water while the third shows D90 differences of up to 4%. Results from simulation (3) show that breast is more sensitive than prostate with dose variations of up to 30% from water for 70% adipose/30% gland breast. The variability of the breast composition adds a +/- 10% dose variation. Low energy brachytherapy dose distributions in tissue differ from water and are influenced by density, mean tissue composition, and patient-to-patient composition variations. The results support the use of a dose calculation algorithm accounting for heterogeneities such as MC. Since this work shows that variations in mean tissue compositions affect MC dosimetry and result in increased dose uncertainties, the authors conclude that imaging tools providing more accurate estimates of elemental compositions such as dual energy CT would be beneficial.

SU‐GG‐T‐438: Dose to Medium or Dose to a Water Cavity Embedded in Medium? A Monte Carlo Study

Purpose: The target for radiotherapy is to sterilize cells by imposing damage to their DNA content. It is therefore of interest to study the relations between the dose calculated to a tissue medium, Dm,m, with an representative average atomic composition versus the dose Dn,m specifically absorbed by the cell nuclei, and the dose Dw,m to a cell nuclei surrogate represented as a water cavity embedded into tissue. The simulations were performed for six types of tissues and three different brachytherapy sources. Methods and Materials: Absorbed dose calculations were performed by GEANT4 MC code version 9.2 using the Penelope physics package. Three different sources, 192Ir to represent high energy conditions, 169Yb for intermediate energies and a low energy brachytherapy source 125I, were simulated. The photon spectra used in this study were taken from http://www.physics.carleton.ca/clrp/seed_database. The 192Ir spectra was from Nucletron, microSelectron‐HDR v2 and for 125I from Nucletron, SelectSeed, 130.002. Particle spectra for 192Ir and energy spectra for 192I were also scored to calculate the dose with different cavity theories and compare it with MC calculated doses. Results: The MC calculated Dm,m, Dw,m and Dn,m ratio shows the largest value for 125I brachytherapy source and the cortical bone material, adipose tissue and prostate tissues(ICRU). The difference between Dw,m and Dn,m is also largest for the cortical bone and 125I source. For the 192Ir source, the ratio was 1 for the soft tissues while for the cortical bone it was higher. Conclusion: Monte Carlo calculations made it possible to report the dose as absorbed dose to medium. Accurate reporting of treatment planning requires a stringent standard for dose definition. MC calculations can be used to develop conversion factors to convert dose according to different definitions for different brachytherapy sources.

Monte Carlo Simulations of the Primary Air-Kerma Strength Standard for Low-Energy Photon-Emitting Brachytherapy Sources

Monte Carlo Simulations of the Primary Air-Kerma Strength Standard for Low-Energy Photon-Emitting Brachytherapy Sources

Dependence of Dose Enhancement on Radial Distances during Gold Nanoparticle-aided Radiation Therapy with Low Energy Brachytherapy Sources

Dependence of Dose Enhancement on Radial Distances during Gold Nanoparticle-aided Radiation Therapy with Low Energy Brachytherapy Sources

SU-FF-T-77: Measurement of the Average Seed Strength in a Mick Cartridge

Purpose: Develop an efficient method for the measurement of the average strength of brachytherapy seeds according to the 2008 recommendations of the AAPM Low Energy Brachytherapy Source Calibration Working Group. Method and Materials: The reentrant well ionization chamber is calibrated, at ADCL, for a single radioactive seed in a single-seed holder. When the seeds, loaded in Mick cartridges, are received from the manufacturer, it is necessary, only one time, to open only one cartridge. The strength of each seed in this cartridge is measured in the reentrant well chamber using the single-source holder and the ADCL calibration factor. As the seeds are removed from the Mick cartridge, one by one, the well chamber measurement is taken of the Mick cartridge, with the remaining seeds, in the Mick cartridge holder. Since the strength of each seed has been measured, the total strength of these remaining seeds in the Mick cartridge can be calculated. Results: Calibration coefficients have been determined for a Mick cartridge containing any number from 1 to 15 125I or 103Pd seeds. Using these coefficients the average strength of the seeds in the cartridge, with any number of seeds, can be determined with one single measurement in the reentrant well chamber. After the initial process, used to calculate the calibration coefficients, there is no more need to remove any seed from any cartridge. Typically, one-minute measurements of the electric charge generated in the reentrant well chamber are used for each Mick cartridge. Conclusion: A time-saving method for measurement of the average activity of 125I and 103Pd seeds has been developed. Only a one-minute measurement of the electric charge generated in a reentrant well chamber is needed to calculate the average strength of the radioactive seeds in the Mick cartridge loaded with any number from 1 to 15 seeds.

Ice as a water-equivalent solid medium for brachytherapy dosimetric measurements

Precise positioning of source and dosimeters is essential in the experimental determination of dosimetric characteristics of brachytherapy sources. Various near-water equivalent solid phantoms have been used to achieve the necessary precision in the positioning. However, the uncertainties in their chemical compositions may lead to non-negligible uncertainties in the determined doses. It is proposed here that ice may be used as an alternative to the conventional solid phantoms, since its chemical composition is identical to water while the positioning advantage associated with solid phantoms is retained. In this work, the feasibility of using ice as a solid phantom for brachytherapy dosimetry is investigated. Ice-to-water conversion factors are calculated at distances of 0.2-10 cm from the source, for six high- and low-energy photon-emitting brachytherapy sources and mono-energetic photons between 10 keV to 2.0 MeV. Practical issues and challenges associated with measuring dose in an ice phantom are discussed.

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

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.

Photon energy spectrum emitted by a novel polymer‐encapsulated source and its effect on the dose rate constant

Two independent groups have published intrinsic dosimetry parameters for the recently introduced OptiSeed103 interstitial brachytherapy source which contains 103Pd encapsulated by a novel polymer shell. The dose rate constant (Lambda) reported by the two groups, however, differed by more than 6% and there is currently no AAPM recommended consensus value for this source in clinical dosimetry. The aim of this work was to perform an independent determination of Lambda for the OptiSeed103 source using a recently developed photon spectrometry technique. Three OptiSeed103 sources (model 1032P) with known air-kerma strength were used in this study. The photon energy spectrum emitted along the radial direction on the source's bisector was measured in air using a high-resolution intrinsic germanium spectrometer designed and established for low-energy brachytherapy source spectrometry. The dose rate constant of each source was determined from its emitted energy spectrum and the spatial distribution of radioactivity in the source. Unlike other sources made with traditional titanium encapsulation, the photons emitted by the OptiSeed103 sources exhibited only slight spectral hardening, yielding a relative energy spectrum closer to that emitted by bare 103Pd. The dose rate constant determined by the photon spectrometry technique for water was 0.664 +/- 0.025 cGy h(-1) U(-1). This value agreed, within experimental uncertainties, with the Monte Carlo-calculated value (MCLambda) of 0.665 +/- 0.014 cGy h(-1) U(-1) and the TLD-measured value (with a Monte Carlo-calculated solid-phantom-to-water conversion factor) of 0.675 +/- 0.051 cGy h(-1) U(-1) reported by Wang and Hertel [Appl. Radiat. Isot. 63, 311-321 (2005)]. However, it differed by -6.7% from the McLambda of 0.712 +/- 0.043 cGy h(-1) U(-1) reported by Bernard and Vynckier [Phys. Med. Biol. 50, 1493-1504 (2005)]. The results obtained in this work provide additional information needed for establishing a consensus value for the dose rate constant for the OptiSeed103 source. It suggests that an eventual consensus value of Lambda for the OptiSeed103 source is likely to be closer to a value of 0.668 cGy h(-1) U(-1) rather than 0.693 cGy h(-1) U(-1) as initially recommended by the source manufacturer based on the two previously published results.

Characterization of the Theorectical Radiation Dose Enhancement from Nanoparticles

Recently, nanoparticles have been considered as a method of providing radiation dose enhancement in tumors. In order to quantify this affect, a dose enhancement factor (DEF) is defined that represents the ratio of the dose deposited in tumor with nanoparticles, divided by the dose deposited in the tumor without nanoparticles. Materials with atomic numbers (Z) ranging from 25 to 90 are considered in this analysis. In addition, the energy spectrum for a number of external beam x-ray sources and common radionuclides are evaluated. For a nanoparticle concentration of 5 mg/ml, the DEF is < 1.05 for Co-60, Ir-192, Au-198, Cs-137, 6, 18, and 25 MV x-rays for all materials considered. However, relatively large increases in the DEF are observed for 50, 80, 100, and 140 KVp x-rays as well as Pd-103 and I-125. The DEF increases for all sources as Z varies from 25-35. From Z = 40-60, the DEF plateaus or slightly decreases. For higher Z materials (Z>70), the DEF increases and is a maximum for the highest Z materials. High atomic number nanoparticles coupled with low energy external beam x-rays or brachytherapy sources offer the potential of significantly enhancing the delivered dose.

Silver fluorescent x‐ray yield and its influence on the dose rate constant for nine low‐energy brachytherapy source models

The physical characteristics of the photons emitted by a low-energy brachytherapy source are strongly dependent on the source's construction. Aside from absorption and scattering caused by the internal structures and the source encapsulation, the photoelectric interactions occurred in certain type of source-construction materials can generate additional energetic characteristic x rays with energies different from those emitted by the bare radionuclide. As a result, the same radionuclide encapsulated in different source models can result in dose rate constants and other dosimetric parameters that are strikingly different from each other. The aim of this work was to perform a systematic study on the yield of silver fluorescent x rays produced in nine 125I sources that are known to contain silver and its impact on the dose-rate constant. Using a high-resolution germanium spectrometer, the relative 125I spectra emitted by the nine sources on its bisector were measured and found to be similar to each other (the maximum variation in the 125I-Kbeta relative intensity was less than 4%). On the other hand, the measured silver fluorescent x-ray spectra exhibited much greater variations from model to model; the maximum change in the measured Ag-Kalpha relative intensity was over 95%. This larger variation in the measured silver fluorescent x-ray yield was caused by (1) the different amount of silver that was directly exposed to the 125I radionuclide in different source models and (2) the stronger influence of the source's internal geometry on the silver fluorescent x rays. Because the addition of silver fluorescent x rays can significantly alter the photon characteristics emitted by the radioactive sources, a precise knowledge on the silver fluorescent x-ray yield is needed in theoretical calculations of the sources' intrinsic dosimetric properties. This study concludes that the differences in silver fluorescent yield are the primary causes of the variable dose rate constant observed among these source models.

Optimum phantum material for dosimetric evaluation of low energy brachytherapy sources

Purpose: The updated TG-43U1 recommends determination of the consensus of low energy brachytherapy source parameters using experimental and Monte Carlo Simulated data. As per this recommendation, the measured parameters in water equivalent materials are converted into water data for clinical application by using appropriate conversion factors. Various investigators quoted different chemical composition of phantom materials utilized in Monte Carlo and experimental determinations. Impact of different phantom materials and accurate chemical composition on dose rate constant and radial dose function needs to be evaluated for low energy brachytherapy sources.

Monte Carlo aided design of an improved well-type ionization chamber for low energy brachytherapy sources

The determination of the air kerma strength of a brachytherapy seed is necessary for effective treatment planning. Well-type ionization chambers are used on site at therapy clinics to determine the air kerma strength of seeds. In this work, an improved well-type ionization chamber for low energy, low dose rate brachytherapy sources is designed using Monte Carlo transport calculations to aid in the design process. The design improvements are the elimination of the air density induced over-response effect seen in other air-communicating chambers for low energy photon sources, and a larger signal strength (response or current) for 103Pd and 125I based seeds. A prototype well chamber based on the Monte Carlo aided design but using graphite coated acrylic walls rather than the design basis air equivalent plastic (C-552) walls was constructed and experimentally evaluated. The prototype chamber produced an 85% stronger signal when measuring a commonly used 103Pd seed and a 26% stronger signal when measuring a commonly used 125I seed when compared to another commonly used well chamber. The normalized PTP corrected chamber response is, at most, 1.3% and 2.4% over unity for air densities/pressures corresponding to an elevation of 3048 m (10000 feet) above sea level for the commonly used 103Pd and 125I based seeds respectively. Comparing calculated and measured chamber responses for common 103Pd and 125I based brachytherapy seeds show agreement within 0.6% and 0.2%, respectively. We conclude that Monte Carlo transport calculations accurately model the response of this new well chamber and in general can be used to predict the response of well chambers. The prototype chamber built in this work responds as predicted by the Monte Carlo calculations.

SU‐FF‐T‐441: Updated Solid Water™ to Water Conversion Factors for 125I and 103Pd Brachytherapy Sources

Purpose: The updated TG‐43U1 recommends determination of the consensus of low energy brachytherapy source parameters using experimental and Monte Carlo Simulated data. As per this recommendation, the measured parameters in Solid Water™ are converted into water data for clinical application. However, the published conversion factors may have been obtained using Monte Carlo simulations with a cross section files that may have errors for low energy photons, and also for inaccurate chemical composition of the phantom material. In this project impact of different calcium composition in Solid Water™ phantom on dose rate constant, radial dose function of 103Pd and 125I brachytherapy sources have been investigated. Method and Materials: Conversion factor of Solid water™ to water has been determined using MCNP5 Monte Carlo code. In these simulations two different calcium compositions in Solid Water™ of 2.3% (SWa) and 1.7% (SWb) were utilized. Monte Carlo simulations were performed for 125I sources, with and without silver marker, in order to investigate the impact of characteristic x‐rays (emitted by silver marker) on dosimetric parameters. However, the simulation for 103Pd was performed only on one type of the source. Each simulation was run for a total of 20M histories to keep statistical fluctuation less than 0.3%. Results: For 2.3% calcium content phantom material the calculated conversion factor was found to be 1.027 and 1.045 for 125I and 103Pd sources respectively. However, for 1.7% calcium these values were found to be 0.989 and 0.963, respectively. Conclusion: The Solid water‐to‐water conversion factors for 125I and 103Pd sources are found to be 0.989 and 0.963 respectively as compared to the published value of 1.05 and 1.048. In addition, presence of silver marker had no significant impact on conversion factor for I‐125 sources. Moreover, conversion for g(r) was also introduced for clinical application of measured data.

Interstitial brachytherapy dosimetry update

In March 2004, the American Association of Physicists in Medicine (AAPM) published an update to the AAPM Task Group No. 43 Report (TG-43) which was initially published in 1995. This update was pursued primarily due to the marked increase in permanent implantation of low-energy photon-emitting brachytherapy sources in the United States over the past decade, and clinical rationale for the need of accurate dosimetry in the implementation of interstitial brachytherapy. Additionally, there were substantial improvements in the brachytherapy dosimetry formalism, accuracy of related parameters and methods for determining these parameters. With salient background, these improvements are discussed in the context of radiation dosimetry. As an example, the impact of this update on the administered dose is assessed for the model 200 (103)Pd brachytherapy source.

TH-C-T-617-06: Error Analysis in Monte Carlo Simulation of Low Energy Brachytherapy Sources

Purpose: The AAPM recommends two independent investigators to determine the dosimetric characteristics of any new brachytherapy sources before their clinical applications. In this recommendation, it is suggested that one of the two investigators must include Monte Carlo simulation technique. The accuracy of Monte Carlo simulation technique is highly dependent on accuracy of the source geometry and material information that is provided by the manufacturers, and the approximations taken during the simulations. In the present work, the effects of various parameters like configuration of active pellets, outer wall thickness and end cap thickness on the accuracy of the dosimetric characteristics of the brachytherapy sources have been investigated. Also, studies were performed to determine the effect of embedded radioactive elements within the source, and effect of number of histories used for calculating the dosimetric parameters. Method and Materials: Monte Carlo simulation code PTRAN version 7.43 was used to simulate the source designs in water medium. The photon cross section used for these simulations was DLC-146, distributed by the Radiation Sciences Information Computing Center at Oak Ridge National Laboratory. The variations of dosimetric characteristics of different brachytherapy source design with a fixed radionuclide were obtained following the AAPM TG-43U1 recommendations. Results: The results of these investigations showed that the anisotropy function and anisotropy factors of the source were considerably affected by the thickness of the outer wall and end caps. Whereas, the radial dose function and the dose rate constant were not significantly affected by these parameters. Moreover larger histories are required to obtain dosimetric characteristics at larger distances with acceptable (< ± 2%) statistical uncertainty range. Conclusion: This study suggests that the Monte Carlo simulated 2D anisotropy functions for low energy brachytherapy sources are very sensitive to the geometric parameters of the source and number of histories used in simulation.

The effect of ambient pressure on well chamber response: Experimental results with empirical correction factors

For some air-communicating well-type chambers used for low-energy brachytherapy source assay, deviations from expected values of measured air kerma strength were observed at low pressures associated with high altitudes. This effect is consistent with an overcompensation by the air density correction to standard atmospheric temperature and pressure (P(TP)). This work demonstrates that the P(TP) correction does not fully compensate for the high altitude pressure effects that are seen with air-communicating chambers at low photon energies in the range of 20-100 keV. Deviations of up to 18% at a pressure corresponding to an approximate elevation of 8500 ft for photon energies of 20 keV are possible. For high-energy photons and for high-energy beta emitters in air-communicating chambers the P(TP) factor is applicable. As expected, the ambient pressure does not significantly affect the response of pressurized well chambers (within 1%) to either low- or high-energy photons. However, when used with beta emitters, pressurized chambers appear to exhibit a slight dependence on the ambient pressure. Using measured data, the response and correction factors were determined for three models of air-communicating well chambers for low-energy photon sources at various pressures corresponding to elevations above sea level. Monte Carlo calculations were also performed which were correlated with the experimental findings. A more complete study of the Monte Carlo calculations is presented in the accompanying paper, "The effect of ambient pressure on well chamber response: Monte Carlo calculated results for the HDR1000 Plus."