Dose Measurements Research Articles

Statistical-based modeling strategy for entrance skin dose estimation in patient undergoing body interventional radiology

Abstract Interventional radiology (IR) provides significant advancements in diagnostic and therapeutic procedures, yet concerns persist regarding radiological risks such as erythema, burns, and epilation. Direct dose measurements observed difficulties regarding the perturbation of the detector probe in X-ray images during fluoroscopy-guided procedures, high-cost expenses, and non-compliant patients. This study aims to develop a statistical-based model for estimating entrance skin dose (ESD) in body IR procedures using patient radiation-dose recording data. Models are categorized into vascular and non-vascular procedures. This study demonstrates that the simplified models are sufficient in estimating patient ESDs for both IR groups, with a 95% confidence interval. This user-friendly method enables radiologists to calculate doses without complex parameters such as the backscatter factor and mass-energy absorption coefficient, as required in conventional calculation methods. It not only does this support to radiologists in effectively refining treatment protocols, but also enables patients to monitor their received doses immediately after treatment ends.

Optimized Scintillation Imaging in low dose rate and bright room light conditions

Abstract Objective. To develop a robust method for non-contact surface dosimetry during Total Body Irradiation (TBI) that uses an optimally paired choice of scintillator material with camera photocathode and can work insensitively to the normal ambient room lighting conditions (~500 Lux). 
Approach: This goal was approached by assessing the emission contrast of scintillator signal to background room ratio (SBR) detected by the camera, in the challening conditions of low dose rate TBI with high room lights. A total of 9 fast-response scintillators, 3 wavelength shifters, and 2 camera photocathodes were systematically tested to determine the optimal combination. The effects of room lights on the scintillator signal and the background signal were assessed to avoid signal saturation while retaining accurate dose measurement. A bandpass wavelength filter was then applied to reduce the effects on room lights and scintillator signal.
Main Results: One scintillator (EJ262) combined with a blue-green sensitive photocathode camera and a 500nm band pass filter produced the greatest available scintillator SBR of 95 with maximal room lights on. The caveat is that this design rejects all patient Cherenkov light, which can be useful for visualizing the patient treatment. Another option which retained the Cherenkov signal but produced less available scintillator signal was found with another scintillator (EJ-260) and a red photocathode camera with SBR of 35, but a narrow bandpass filter is required to make it work in ambient room lights, which addition will also remove most of the Cherenkov signal. 
Significance: Non-contact scintillator imaging can be used for surface dosimetry in TBI with appropriate pairing of scintillator emission spectrum and camera photocathode sensitivity or optical filtering range.

RBIO-03. A SMALL ANIMAL RADIATION RESEARCH PLATFORM (FLASH-SARRP) TO MEASURE IMMUNOLOGICAL EFFECT OF ULTRA HIGH DOSE RATE (FLASH) RADIOTHERAPY

Abstract Patients who undergo radiation therapy (RT), particularly fractionated courses, often develop lymphopenia. Clinical outcome for various cancer types, including brain tumors, identifies lymphopenia as a negative prognostic factor. The mechanism for RT induced lymphopenia is unclear. Simulated models suggest the volume of blood flowing through a radiation field could play a crucial role in death of radiosensitive lymphocytes. FLASH RT is ultrahigh dose rate administration of RT, >100 times faster dose rate than standard RT that has been observed to improve the therapeutic ratio in preclinical models by preferential normal tissue sparing. Hypothesized mechanisms include chemical reactions depleting oxygen in well oxygenated normal cells creating radioresistance, differing pro-inflammatory signaling impacting tumor and normal tissue, and less impact on circulating immune cells consequent to decreased proportion exposed during a treatment session which may enhance antineoplastic response. We designed the novel FLASH kV x-ray cabinet system for preclinical laboratory research (FLASH-SARRP) to deliver ultra-high dose rates up to 100 Gy/s as well as conventional dose rates of 1.0 Gy/s to facilitate comparative studies. A custom designed docking system was developed to reproducibly position and immobilize mouse for stereotactic radiation of the brain. Dose and dose rate measurements were performed with calibrated Gafchromic EBT3 film in solid water with 0.025 mm additional copper filter. FLASH-SARRP system delivered kV x-rays at an average dose-rate of 79.2±2.1Gy/s corresponding to 10 mm depth in the immobilized mouse brain. For the delivery of 15 Gy, treatment duration was 0.2 seconds for FLASH RT administration whereas it was 244 seconds for conventional dose rate. We successfully designed a high-precision platform to study partial brain x-ray FLASH effects in mice and studies are ongoing to assess differential impact on normal brain tissue, circulating cytokines, and immune cell populations for single dose and fractionated administration of FLASH and standard radiotherapy.

IPEM topical report: the first UK survey of cone beam CT dose indices in radiotherapy verification imaging for adult patients

Cone beam CT is integral to most modern radiotherapy treatments. The application of daily and repeat CBCT imaging can lead to high imaging doses over a large volume of tissue that extends beyond the treatment site. Hence, it is important to ensure exposures are optimised to keep doses as low as reasonably achievable, whilst ensuring images are suitable for the clinical task. This IPEM topical report presents the results of the first UK survey of dose indices in radiotherapy CBCT. Dose measurements, as defined by the cone beam dose index (CBDIw), were collected along with protocol information for seven treatment sites. Where a range of optimised protocols were available in a centre, a sample of patient data demonstrating the variation in protocol use were requested. Protocol CBDIwvalues were determined from the average dosimetry data for each type of linear accelerator, and median CBDIwand scan length were calculated for each treatment site at each centre. Median CBDIwvalues were compared and summary statistics derived that enable the setting of national dose reference levels (DRLs). A total of 63 UK radiotherapy centres contributed data. The proposed CBDIwDRLs are; prostate 20.6 mGy, gynaecological 20.8 mGy, breast 5.0 mGy, 3D-lung 6.0 mGy, 4D-lung 11.8 mGy, brain 3.5 mGy and head/neck 4.2 mGy. However, large differences between models of imaging system were noted. Where centres had pro-active optimisation strategies in place, such as sized based protocols with selection criteria, dose reductions on the 'average' patient were possible compared with vendor defaults. Optimisation of scan length was noted in some clinical sites, with Elekta users tending to fit different collimators for prostate imaging (relatively short) compared with gynaecological treatments (longest). This contrasts with most Varian users who apply the default scan length in most cases.

DETERMINATION OF DIAGNOSTIC REFERENCE LEVEL (DRL) AND STUDY OF EXPOSURE PARAMETER SELECTION IN HEAD AND ABDOMEN CT SCAN AT BANGIL REGIONAL HOSPITAL

A study has been conducted to determine the local diagnostic reference level (DRL) value of CT scans at Bangil Regional Hospital. The determination and calculation of the DRL value are based on the measurement of the patient's dose, namely using the CT scan examination results in the form of CTDIVol values and DLP values. The DRL value is determined from the CTDIVol and DLP data distribution in quartile 3. Patient dose data uses a Toshiba 16-slice CT scan and a Canon 160-slice CT scan. Seven hundred twenty data were obtained, distinguished by 680 adults and 40 children. The local DRL value at Bangil Regional Hospital for CT scans of the Head without contrast for the adult group CTDIVol 47.5 mGy and DLP 1162 mGy.cm. CT scans of the Head with contrast for the adult group CTDIVol 47.22 mGy and DLP 2784.38 mGy.cm. DRL on CT scan Abdomen without contrast adult age group at Bangil Hospital CTDIVol 3.7 mGy and DLP 179.9 mGy.cm. CT scan of Abdomen with contrast CTDIVol 3.9 mGy and DLP 774.92 mGy.cm. When compared to the National DRL value, this value is still below the National DRL value. However, the nature of DRL is dynamic, so each period is expected to be lower. Efforts should focus on achieving lower DRL values by considering the selection of parameters and the skills of radiographers that influence the dose administered to patients. Values that exceed the DRL value are evaluated using the choice of parameters. Factors that affect the DRL value include kV, mAs, rotation time, pitch, iterative reconstruction, and number of phases. The parameters used in CT scans at Bangil Hospital must be adjusted to provide optimal doses to patients. Keywords: diagnostic reference level (DRL), dose length product (DLP), CT dose index (CTDI), CT Head, CT Abdomen, dose delivery parameters.

Advanced Monte Carlo simulations and benchmark of residual dose rate assessments in the ATLAS detector at CERN LHC

Background The European Organization for Nuclear Research (CERN) pushes the frontiers of physics through the Large Hadron Collider (LHC), a 27-kilometre hadron accelerator capable of producing proton-proton collisions at a center-of-mass energy of up to 13.6 TeV. Its four main detectors (ALICE, ATLAS, CMS, LHCb) are unique examples of advanced particle detection technology and complexity. Ensuring radiological safety throughout the LHC’s environments and lifecycle is a critical task managed by the CERN Radiation Protection group. In this context, assessing residual dose rates is crucial for planning exposure situations, such as maintenance and upgrade projects during LHC shutdowns. Methods This work presents advanced Monte Carlo techniques developed at CERN to predict residual dose rates in the LHC experimental caverns, focusing on the ATLAS detector. Predictions are made using the FLUKA Monte Carlo code and the SESAME toolkit for two-step simulations. The simulation results are benchmarked against experimental residual dose rate measurements collected during LHC Long Shutdown 2 at ATLAS. Additionally, forecasts for Long Shutdown 3 are also presented. Results The FLUKA benchmark for the ATLAS detector demonstrates a general agreement within a factor of 1.5. This consistency validates both the FLUKA geometry model of the ATLAS detector and the reliability of the Monte Carlo techniques used to predict residual dose rates in such complex environments. Conclusions The study highlights the predictive capabilities of the FLUKA and SESAME coupling for simulating residual dose rates in large LHC experiments. This method plays a crucial role in ensuring radiological safety, primarily for dose prediction and optimization. The reliability of this approach is significantly supported by the benchmark results obtained at ATLAS and presented in this paper.

Evaluation of ion recombination and polarity effect on photon depth dose measurements using mini- and micro-ion chamber.

To investigate the effect of ion recombination ( ) and polarity ( ) correction factors on percentage depth dose (PDD) curves for three ion chambers, using flat and flattening filter free (FFF) beams, across different broad field sizes. A method to assess these effects and their corresponding corrections is proposed. and were evaluated following the IAEA TRS-398 protocol for three ion chambers: PTW Semiflex-3D-31021, PinPoint-3D-31022, and Semiflex-31010. PDD measurements were acquired from dmax to 32cm depth at four voltages (±400V or±300V, and±100V) for field sizes 4×4, 10×10, 20×20, and 40×40 cm2. The values were computed after the correction at each applied voltage. This study aimed to assess the variation of the factors along scanning depths for different field sizes, to evaluate the need for correcting the scanning data. was independent of depth and field size for Semiflex-3D, while it presented an increasing value with depth for the PinPoint-3D. increased with dose rate, i.e., decreased with depth. The variation of this perturbation effect over the PDD range was about 0.1% for flat beams with all three ion chambers. With FFF beams, it was around 0.3% with PinPoint-3D, and 0.8% for 10FFF with Semiflex-3D. A second-order polynomial fit can be determined to directly correct the raw data scanned along the beam axis for both and . can significantly affect the PDD scanning measurements in FFF beams acquired with Semiflex-3D. An error close to 1% at large depths could be present, meaning an error of less than 0.3% relative to the dose at the depth of dmax.

KATANA - water activation facility at JSI TRIGA, Part II: First experiments

Water as a primary coolant will play an important role in the performance of fusion reactors, as after being irradiated and activated, it causes an ionising radiation field throughout the facility. In direct support of ITER, the KATANA irradiation facility, which utilises a closed-water activation loop and serves as a well-defined and stable high-energy γ and neutron source, was commissioned in 2024 at the TRIGA Mark II research reactor at the Jožef Stefan Institute in Slovenia.A series of first experiments using the KATANA irradiation facility were performed to determine the operational characteristics of the KATANA, i.e. characterisation of the neutron flux within the irradiation component, dose rate measurements, spectrum characterisation of the activated water, and response to a change in reactor power & flow rate. The KATANA facility demonstrated the desired operational characteristics in terms of high and stable water flow rates and high activity values of the observed isotopes 16N, 17N and 19O, which is essential for minimising the experimental uncertainties.The first experiments performed at KATANA provided in-depth knowledge into the operation and capabilities of the facility and essential data to serve as a basis for further, more detailed/benchmark experiments.

Exploring the impact of filament density on the responsiveness of 3D-Printed bolus materials for high-energy photon radiotherapy

Background3D-printed boluses in radiation therapy receive consideration for their ability to enhance treatment precision and patient comfort. Yet, thorough validation of 3D-printed boluses using various validation procedures and statistical analysis is missing. This study aims to determine the effectiveness of using 3D-printed boluses in radiation therapy. MethodThe CT Hounsfield Unit (HU) profiles of the 3D-printed materials were compared to those of the commercial bolus using the Eclipse Treatment Planning System (TPS) unit. Furthermore, absolute dose measurements were carried out to assess the efficacy of the 3D-printed samples by using concordance correlation coefficient to assess the agreement between 3D materials and the commercial bolus. ResultsThe average HU profiles of 3D-printed materials were: −144.53 (ABS), −124.40 (ASA), 9.55 (PLA-P), −140.79 (Polycarbonate), −68.58 (PLA-S), and −113.159 (PET-G), respectively. PDD scans showed that air gaps between the bolus and surface shifted the maximum dose depth. Whereas dosimetry has shown that ASA and Polycarbonate are different in attenuation from other tested filaments. This limitation could affect their performance in specific applications within radiation therapy. The final analysis, using the TPS-generated datasets to assess the area under the dose curve in the build-up zone of each 3D-bolus, excluded ABS. ConclusionsThe results from PDD scans and dose assessments offer compelling proof that 3D-printed boluses are effective for delivering surface dosage and are like commercially available boluses. Moreover, specific materials showed a statistically significant improvement in delivering the dose. The results highlight the capability of 3D-printed boluses to enhance the effectiveness of radiation therapy.

160 kW beam commissioning for the Rapid Cycling Synchrotron of the China Spallation Neutron Source

Abstract For the China Spallation Neutron Source (CSNS), the rapid cycling synchrotron (RCS) accumulates and accelerates the injection beam to the design energy of 1.6 GeV and then extracts the high energy beam to the target. In this paper, the 160 kW beam power commissioning for the CSNS RCS has been comprehensively studied, including: increase in the pulse width of the injection beam to optimize the transverse painting, commissioning of the two dual harmonic radio frequency (RF) cavities, optimization of the transverse and momentum collimators, longitudinal dynamic optimization, beam instability suppression, global closed orbit correction, local closed orbit correction, optimization of the RCS occasional large beam loss, optimization of the extraction mode and extraction occasional large beam loss, and so on. In order to meet the requirements of beam power increase and stable operation of the accelerator, the RCS beam losses from different sources are studied and optimized. With the aid of weekly radiation dose measurement, the hot spots of the RCS are studied in depth to explore the causes.

Monte Carlo Calculation of LiF:Mg,Cu,P Thermoluminescent Dosimeter Correction Factors for 18F, 131I and 90Y Submersion Dosimetry

Accurate measurement of absorbed dose from beta-emitting therapeutic radionuclides is important to ensure safe and effective delivery to patients. Thermoluminescent dosimeters (TLDs) are a commercially available option to measure dose, but several confounding factors complicate this process. To preserve their integrity during the measurement, it is necessary to enclose TLDs in a waterproof envelope, which unavoidably attenuates the beta particles. Additionally, the exclusion of radioactivity in the volume occupied by the TLD, the finite volume effect, further complicates the measurement. The purpose of this study is to calculate the correction factors to convert the TLD measured dose to the absorbed dose in water, Dw, for three common radionuclides and the LiF:Mg,Cu,P TLD (Thermo Fisher Scientific™, Waltham, MA). Correction factors were calculated for four different size LiF:Mg,Cu,P TLD dosimeters inside a PMMA cylindrical phantom with 90YCl3, C6H1118FO5, and Na131I aqueous solutions. Specific correction factors are required to account for finite volume, energy, and geometry for each LiF:Mg,Cu,P TLD size, radionuclide, and phantom geometry combination. Additionally, for the PMMA phantom, specific material correction factors are also required to account for the additional materials inside the phantom. The absorbed dose calculations performed with LiF:Mg,Cu,P TLDs showed good agreement with Monte Carlo simulations. Overall, these findings contribute to improving the accuracy of absorbed dose measurements from beta-emitting radionuclides in liquid solutions using TLDs.

A multi-institutional trial evaluating the use of an integrated quality assurance phantom for frameless single-isocenter multitarget stereotactic radiosurgery

BackgroundBrain radiosurgery treatments require multiple quality-assurance (QA) procedures to ensure accurate and precise treatment delivery of ablative doses. As single-isocenter multitarget radiosurgery treatments become more popular for treating patients with multiple brain metastases, quantifying off-axis accuracy of linear accelerators is crucial. In this study, we developed a novel brain radiosurgery integrated phantom and validated this phantom at multiple institutions to enable radiosurgery QA with a single phantom to facilitate implementation of a frameless single-isocenter, multitarget radiosurgery program. The phantom combines multiple independent verification system tests including the Winston-Lutz test, off-axis accuracy evaluation (i.e., off-axis Winston-Lutz), as well as dosimetric measurements utilizing both point dose and film measurement.Methods and materialsA novel 3D-printed phantom, coined OneIso, was designed with a movable insert which can switch between Winston-Lutz test targets and dose measurement without moving the phantom itself. In total, four phantoms were printed, and eight institutions participated in this study, which included both Varian TrueBeam (n=6) and Elekta Versa (n=2) linear accelerators. For off-axis Winston-Lutz measurements, a row of off-axis ball-bearings (BBs) was integrated into the OneIso. To quantify the spatial accuracy versus distance from isocenter, two-dimensional displacements were calculated between the planned and delivered BB locations relative to their respective MLC-defined field borders. For dose verification, brain radiosurgery clinical treatment plans previously treated were delivered at multiple cancer centers (six of eight centers). Radiochromic film and pinpoint ion chamber comparison measurements were obtained with OneIso.ResultsDose verification performed using the OneIso phantom across the different centers were all within on average 3% agreement, for both film and point-dose measurements. OneIso identified a reduction in spatial accuracy further away from isocenter for all eight radiosurgery machines. Differences increased as distance from isocenter increased, exceeding recommended radiosurgery accuracy tolerances (<1mm) at different distances for each machine (2-7cm), indicating that the tolerance is machine-dependent.ConclusionOneIso provides a streamlined, single-setup workflow for single-isocenter multitarget frameless linac-based radiosurgery QA that can be easily translated to multiple institutions. Additionally, quantifying off-axis spatial discrepancies allows for determination of the maximum distance between targets and iso that meet single-isocenter multitarget radiosurgery program recommendations.

Design and Development of Energy Particle Detector on China’s Chang’e-7

Particle radiation on the Moon is influenced by a combination of galactic cosmic rays, high-energy solar particles, and secondary particles interacting on the lunar surface. When China’s Chang’e-7 lander lands at the Moon’s South Pole, it will encounter this complex radiation environment. Therefore, a payload detection technology was developed to comprehensively measure the energy spectrum, direction, and radiation effects of medium- and high-energy charged particles on the lunar surface. During the ground development phase, the payload performance was tested against the design specifications. The verification results indicate that the energy measurement ranges are 30 keV to 300 MeV for protons, 30 keV to 12 MeV for electrons, and 8 to 400 MeV/n for heavy ions. The energy resolution is 10.81% for 200 keV electrons of the system facing the lunar surface; the dose rate measurement sensitivity is 7.48 µrad(Si)/h; and the LET spectrum measurement range extends from 0.001 to 37.014 MeV/(mg/cm2). These comprehensive measurements are instrumental in establishing a lunar surface particle radiation model, enhancing the understanding of the lunar radiation environment, and supporting human lunar activities.

Time-resolved observation of DHR123 nano-clay radio-fluorogenic gel dosimeters by photoluminescence-detected pulse radiolysis

The importance of real-time dose evaluation has increased for recent advanced radiotherapy. However, conventional methods for real-time dosimetry using gel dosimeters face challenges owing to the delayed dose response caused by the slow completion of radiation-induced chemical reactions. In this study, a novel technique called photoluminescence-detected pulse radiolysis (PLPR) was developed, and its potential to allow real-time dose measurements using nano-clay radio-fluorogenic gel (NC-RFG) dosimeters was investigated. PLPR is a time-resolved observation method, and enables time-resolved fluorescence measurement. NC-RFG dosimeters were prepared, typically consisting of 100 μM dihydrorhodamine 123 (DHR123) and 2.0 wt.% nano-clay, along with catalytic and dissolving additives. We successfully achieved time-resolved observation of the increase in fluorescence intensity upon irradiation of the dosimeter. Dose evaluation was possible at 1 s after irradiation. The dose-rate effect was not observed for the deoxygenated dosimeter, but was observed for the aerated dosimeter. Besides the dose-rate effect, linear dose responses were obtained for both conditions. Furthermore, we made a novel observation of a decay in the fluorescence intensity over time in the early stages which named fluorescence secondary loss (FSL) and elucidated the conditions under which this phenomenon occurs.

A Million Person Study Innovation: Evaluating Cognitive Impairment and other Morbidity Outcomes from Chronic Radiation Exposure Through Linkages with the Centers for Medicaid and Medicare Services Assessment and Claims Data.

The study of One Million U.S. Radiation Workers and Veterans, the Million Person Study (MPS), examines the health consequences, both cancer and non-cancer, of exposure to ionizing radiation received gradually over time. Recently the MPS has focused on mortality patterns from neurological and behavioral conditions, e.g., Parkinson's disease, Alzheimer's disease, dementia, and motor neuron disease such as amyotrophic lateral sclerosis. A fuller picture of radiation-related late effects comes from studying both mortality and the occurrence (incidence) of conditions not leading to death. Accordingly, the MPS is identifying neurocognitive diagnoses from fee-for-service insurance claims from the Centers for Medicare and Medicaid Services (CMS), among Medicare beneficiaries beginning in 1999 (the earliest date claims data are available). Linkages to date have identified ∼540,000 workers with available health information. Such linkages provide individual information on important co-factor and confounding variables such as smoking, alcohol consumption, blood pressure, obesity, diabetes and many other health and demographic characteristics. The total person-level set of time-dependent variables, outcomes, organ-specific dose measures, co-factors, and demographics will be massive and much too large to be evaluated with standard software. Thus, development of specialized open-source software designed for large datasets (Colossus) is nearly complete. The wealth of information available from CMS claims data, coupled with individual dose reconstructions, will thus greatly enhance the quality and precision of health evaluations for this new field of low-dose radiation and neurocognitive effects.

Optimisation of cone beam CT radiotherapy imaging protocols using a novel 3D printed head and neck anthropomorphic phantom

Objective.This study aimed to optimise Cone Beam Computed Tomography (CBCT) protocols for head and neck (H&N) radiotherapy treatments using a 3D printed anthropomorphic phantom. It focused on precise patient positioning in conventional treatment and adaptive radiotherapy (ART).Approach.Ten CBCT protocols were evaluated with the 3D-printed H&N anthropomorphic phantom, including one baseline protocol currently used at our centre and nine new protocols. Adjustments were made to milliamperage and exposure time to explore their impact on radiation dose and image quality. Additionally, the effect on image quality of varying the scatter correction parameter for each of the protocols was assessed. Each protocol was compared against a reference CT scan. Usability was assessed by three Clinical Scientists using a Likert scale, and statistical validation was performed on the findings.Main results. The work revealed variability in the effectiveness of protocols. Protocols optimised for lower radiation exposure maintained sufficient image quality for patient setup in a conventional radiotherapy pathway, suggesting the potential for reducing patient radiation dose by over 50% without compromising efficacy. Optimising ART protocols involves balancing accuracy across brain, bone, and soft tissue, as no single protocol or scatter correction parameter achieves optimal results for all simultaneously.Significance.This study underscores the importance of optimising CBCT protocols in H&N radiotherapy. Our findings highlight the potential to maintain the usability of CBCT for bony registration in patient setup while significantly reducing the radiation dose, emphasizing the significance of optimising imaging protocols for the task in hand (registering to soft tissue or bone) and aligning with the as low as reasonably achievable principle. More studies are needed to assess these protocols for ART, including CBCT dose measurements and CT comparisons. Furthermore, the novel 3D printed anthropomorphic phantom demonstrated to be a useful tool when optimising CBCT protocols.

Design of Moderator Assemblies for Fast, Epithermal, or Thermal Neutron–Dominated n-γ Mixed Fields Using a D-D Neutron Source

The treatment field of boron neutron capture therapy (BNCT) is a n-γ mixed field. In the Osaka University BNCT project, a material-filtered radio-photoluminescence glass dosimeter (RPLGD) was proposed for the simultaneous measurement of neutron and gamma-ray doses. In this study, to validate the material-filtered RPLGD, various types of n-γ mixed fields are designed by irradiating different moderator assemblies with a D-D neutron source at the OKTAVIAN facility, Osaka University, Japan. The n-γ mixed fields are classified into fast neutron–, epithermal neutron–, or thermal neutron–dominated fields and a gamma-ray-only field with the specific characteristics as follows: (1) the dose ratios of gamma ray to neutron are 1.0% to 977.0% for the fast neutron–dominated field, 5.0% to 921.1% for the epithermal neutron–dominated field, 5.0% to 921.1% for the thermal neutron–dominated field, and 11880.6% for the gamma-ray-only field; (2) the proportions of fast, epithermal, and thermal neutron doses to total neutron dose are 98.4% to 100.0% for the fast neutron–dominated field, 74.0% to 85.4% for the epithermal neutron–dominated field, and 90.1% to 90.8% for the thermal neutron–dominated field, respectively; and (3) the maximum gamma-ray energy is up to 12 MeV.

Characterization of brass mesh bolus for electron beam therapy

Purpose. Bolus is often required for targets close to or on skin surface, however, standard bolus on complex surfaces can result in air gaps that compromise dosimetry. Brass mesh boluses (RPD, Inc., Albertville, MN) are designed to conform to the patient's surface and reduce air gaps. While they have been well characterized for their use with photons, minimal characterization exists in literature for their use with electrons.Methods and materials.Dosimetric characteristics of brass mesh bolus was investigated for use with 6, 9 and 12 MeV electrons using a 10×10 cm2applicator on standard multi-energy LINAC. Measurements for bolus equivalence and percentage depth doses (PDDs) under brass mesh, as well as surface dose measurements were performed on solid water and a 3D printed resin breast phantom (Anycubic Photon MonoX, Shenzhen, China) using Markus®parallel-plate ionization chamber (Model 34045, PTW Freiburg, Germany), thermoluminescent detectors (TLD) and EBRT film. After obtaining surface dose measurements, these were compared to dose calculated on the Pinnacle3 treatment planning system (TPS, 16.2, Koninklijke Philips N.V.).Results. Measurements of surface dose under brass mesh showed consistently higher dose than without bolus, confirming that brass mesh can increase the PDD at surface up to ∼ 94% of dose at dmax, depending on incident electron energy. This increase is equivalent to using ∼ 7.2 mm water equivalent bolus for 6 MeV, ∼ 3.6 mm for 9 MeV and ∼ 2.2 mm bolus for 12 MeV electrons. TPS results showed close agreement within-vivomeasurements, confirming the potential for brass mesh as bolus for electron irradiation, provided blousing effect is correctly modelled.Conclusions. To increase electron surface dose, a brass mesh can be used with equivalent effect of water-density bolus varying with electron energy. Proper implementation could allow for ease of treatment, as well as increase bolus conformality in electron-only plans.

The NEW Soul Study: Implementation and Evaluation Impact From the Secular Trend of the COVID-19 Pandemic.

In process evaluation research, secular trends refer to external factors unrelated to an intervention that impact implementation. The COVID-19 pandemic was a secular trend that affected the implementation of the Nutritious Eating with Soul (NEW Soul) study. This paper describes steps taken in modifying intervention delivery due to the secular trend of the pandemic. This paper also addresses process evaluation measures of dose delivered, dose received, and satisfaction. This study is a longitudinal study. The study took place in Columbia, SC, from 2018 to 2021. African American adults between 18 and 65years old. The NEW Soul study, a dietary lifestyle intervention, lasted 24months. Process evaluation variables of dose delivered, dose received, and satisfaction. The study team shifted intervention delivery and maintained the timeline of classes for participants and intervention activities. Dose delivered was higher in-person (7.0 out of 8) compared to online (6.4 out of 8; t =-3.92, P =.002). Attendance was higher in-person compared to online (t =2.80, P =.006). Overall, satisfaction of the intervention was favorable in-person and online. Helpfulness of nutrition information in the class was rated lower online compared to in-person (t =2.05, P =.04). Even though the study team successfully shifted intervention delivery online, dose delivered was higher in-person. Evaluations of classes remained high across cohorts and for in-person and online classes. Future lifestyle interventions working with African American adults requires consistent flexibility in intervention delivery.

Influence of X-ray spectrum and bowtie filter characterisation on the accuracy of Monte Carlo simulated organ doses: Validation in a whole-body CT scanning mode

PurposeFor patient-specific CT dosimetry, Monte Carlo dose simulations require an accurate description of the CT scanner. However, quantitative spectral information and information on the bowtie filter material and shape from the manufacturer is often not available. In this study, the influence of different X-ray spectra and bowtie filter characterisation methods on simulated CT organ doses is studied. MethodsUsing ImpactMC, organ doses of whole-body CTs were simulated in twenty adult whole-body voxel models, generated from PET/CT examinations previously conducted in these patients. Simulated CT organ doses based on the manufacturer X-ray spectra and bowtie filter data were compared with those obtained using alternative characterisation models, including spectrum generators and experimentally measured dose data. A total of four different X-ray spectra and one bowtie filter model were defined based on these data. ResultsFor all X-ray spectra and bowtie filter combinations, estimated CT organ doses are within 6% from those resulting from simulations with the CT characterisation models provided by the manufacturer. While varying the bowtie filter model results in CT organ dose differences smaller than 1%, dose differences up to 6% are observed when X-ray spectra are not based on the quantitative data from the manufacturer. ConclusionsEstimated organ doses slightly depend on the applied CT characterisation model. When manufacturer’s data are not available, half-value layer and dose measurements provide sufficient input to obtain equivalent X-ray spectra and bowtie filter profiles, respectively.