Primary Photons Research Articles

SU-E-T-110: Development of An Independent, Monte Carlo, Dose Calculation, Quality Assurance Tool for Clinical Trials

Purpose: To develop a comprehensive end-to-end test for Varian's TrueBeam linear accelerator for head and neck IMRT using a custom phantom designed to utilize multiple dosimetry devices. Purpose: To commission a multiple-source Monte Carlo model of Elekta linear accelerator beams of nominal energies 6MV and 10MV. Methods: A three source, Monte Carlo model of Elekta 6 and 10MV therapeutic x-ray beams was developed. Energy spectra of two photon sources corresponding to primary photons created in the target and scattered photons originating in the linear accelerator head were determined by an optimization process that fit the relative fluence of 0.25 MeV energy bins to the product of Fatigue-Life and Fermi functions to match calculated percent depth dose (PDD) data with that measured in a water tank for a 10×10cm2 field. Off-axis effects were modeled by a 3rd degree polynomial used to describe the off-axis half-value layer as a function of off-axis angle and fitting the off-axis fluence to a piecewise linear function to match calculated dose profiles with measured dose profiles for a 40×40cm2 field. The model was validated by comparing calculated PDDs and dose profiles for field sizes ranging from 3×3cm2 to 30×30cm2 to those obtained from measurements. A benchmarking study compared calculated data to measurements for IMRT plans delivered to anthropomorphic phantoms. Results: Along the central axis of the beam 99.6% and 99.7% of all data passed the 2%/2mm gamma criterion for 6 and 10MV models, respectively. Dose profiles at depths of dmax, through 25cm agreed with measured data for 99.4% and 99.6% of data tested for 6 and 10MV models, respectively. A comparison of calculated dose to film measurement in a head and neck phantom showed an average of 85.3% and 90.5% of pixels passing a 3%/2mm gamma criterion for 6 and 10MV models respectively. Conclusion: A Monte Carlo multiple-source model for Elekta 6 and 10MV therapeutic x-ray beams has been developed as a quality assurance tool for clinical trials.

MO‐D‐BRD‐02: In Memoriam of Bengt Bjarngard: SBRT II: Small Field Dosimetry – TG155

Specialized radiation treatment such as SRS/SRT. SBRT, IMRT, VMAT, Tomotherapy, CyberKnife and Gamma Knife use small fields or combination of small fields where dosimetry is challenging and uncertain due to non‐equilibrium conditions such as longitudinal and lateral disequilibrium. Additionally the primary photon fluence is greatly affected by the obstruction of the source size by the jaws creating a large dose gradient across the field. Electronic equilibrium is a phenomenon associated with the range of secondary particles which depend on the beam energy, photon spectrum and the composition of the medium. Additionally, the finite size of detectors creates volume averaging and fluence perturbations especially in small fields. The IAEA/AAPM has provided a frame work for non‐compliant reference dosimetry in small fields1. The AAPM TG‐1552 has adopted this frame work to provide guidelines in relative dosimetry. This course provides the insight of TG‐155 that defines small field, provides recommendations for suitable detectors and associated correction factors to convert reading to dose. Recommendations of a good working practice for relative dosimetry measurements (PDD, TMR, output factor, etc.) and dose calculations based on the new formulation is are elaborated. It also discusses beam modeling and dose calculations as a critical step in clinical utilization of small field radiotherapy. Small errors in beam data, approximations in dose algorithms, or misaligned of detectors and field settings can propagate into large errors in planned and delivered dose. The modeling and treatment planning aspects of small field dosimetry are reviewed with emphasis on the most critical parts for ensuring accurate and safe radiation therapy. Discussion on k(fmsr, fclin) for commercially available detectors are also provided.1 P. Alfonso, P. Andreo, R. Capote, M. S. Huq, W. Kilby, P. Kjall, T. R. Mackie, H. Palmans, K. Rosser, J. Seuntjens, W. Ullrich and S. Vatnitsky, “A new formalism for reference dosimetry of small and nonstandard fields,” Med Phys 35, 5179–5186 (2008).2 I. J. Das, P. Francescon, A. Ahnesjo, M. M. Aspradakis, C. W. Cheng, G. X. Ding, G. S. Ibbott, M. Oldham, M. S. Huq, C. S. Reft and S. O.A., “Task Group 155 report: Small fields and non‐equilibrium condition photon beam dosimetry,” Med Phys (under review).Learning Objectives: Physics of cavity theory for non‐equilibrium condition and definition of small fields Description of absolute and relative dosimetry in the context of TG‐155 Choice of detector in small field dosimetry, perturbations and corrections (K(fmsr, fclin)) for accurate dosimetry Understand the advantages and limitations of commercially available detectors for small field dosimetry

SU-E-T-90: Concrete Forward-Scatter Fractions for Radiotherapy Shielding Applications

Purpose: There is little instruction within the primary shielding guidance document NCRP 151 for vault designs where the primary beam intercepts the maze. We have conducted a Monte-Carlo study to characterize forward-scattered radiation from concrete barriers with the intent of quantifying what amount of additional shielding outside the primary beam is needed in this situation. Methods: We reproduced our vault in MCNP 5 and simulated spectra obtained from the literature and from our treatment planning system for 10 and 18 MV beams. Neutron and gamma-capture contributions were not simulated. Energy deposited was scored at isocenter in a water phantom, within various cells that comprised the maze, and within cells that comprised the vault door. Tracks were flagged that scattered from within the maze to the door and their contributions were tallied separately. Three different concrete mixtures found in the literature were simulated. An empirically derived analytic equation was used for comparison, utilizing patient scatter fractions to approximate the scatter from concrete. Results: Our simulated data confirms that maze-scattered radiation is a significant contribution to total photon dose at the door. It contributes between 20-35% of the photon shielding workload. Forward-scatter fractions for concrete were somewhat dependent on concrete composition and the relative abundance of higher-Z elements. Scatter fractions were relatively insensitive to changes in the primary photon spectrum. Analytic results were of the same magnitude as simulated results. Conclusions: Forward-scattered radiation from the maze barrier needs to be included in the photon workload for shielding calculations in non-standard vault designs. Scatter fractions will vary with concrete composition, but should be insensitive to spectral changes between machine manufacturers. Further plans for investigation include refined scatter fractions for various concrete compositions, scatter fraction measurement, and simulation of photo-nuclear interaction within the maze barrier for high-energy beams.

SU‐E‐J‐46: Development of a Compton Camera Prototype for Online Range Verification of Laser‐Accelerated Proton Beams

Purpose:Development of a photon detection system designed for online range verification of laser‐accelerated proton beams via prompt‐gamma imaging of nuclear reactions.Methods:We develop a Compton camera for the position‐sensitive detection of prompt photons emitted from nuclear reactions between the proton beam and biological samples. The detector is designed to be capable to reconstruct the photon source origin not only from the Compton scattering kinematics of the primary photon, but also to allow for tracking of the Compton‐scattered electrons.Results:Simulation studies resulted in the design of the Compton camera based on a LaBr3(Ce) scintillation crystal acting as absorber, preceded by a stacked array of 6 double‐sided silicon strip detectors as scatterers. From the design simulations, an angular resolution of ≤ 2° and an image reconstruction efficiency of 10−3 −10−5 (at 2–6 MeV) can be expected. The LaBr3 crystal has been characterized with calibration sources, resulting in a time resolution of 273 ps (FWHM) and an energy resolution of about 3.8% (FWHM). Using a collimated (1 mm diameter) 137Cs calibration source, the light distribution was measured for each of 64 pixels (6×6 mm2). Data were also taken with 0.5 mm collimation and 0.5 mm step size to generate a reference library of light distributions that allows for reconstructing the interaction position of the initial photon using a k‐nearest neighbor (k‐NN) algorithm developed by the Delft group.Conclusion:The Compton‐camera approach for prompt‐gamma detection offers promising perspectives for ion beam range verification. A Compton camera prototype is presently being developed and characterized in Garching. Furthermore, an arrangement of, e.g., 4 camera modules could even be used in a ‘gamma‐PET’ mode to detect delayed annihilation radiation from positron emitters in the irradiation interrupts (with improved performance in the presence of an additional third (prompt) photon (as in 10C and 14O).This work was supported by the DFG Cluster of Excellence MAP (Munich‐Centre for Advanced Photonics)

An algorithm for kilovoltage x-ray dose calculations with applications in kV-CBCT scans and 2D planar projected radiographs

A new model-based dose calculation algorithm is presented for kilovoltage x-rays and is tested for the cases of calculating the radiation dose from kilovoltage cone-beam CT (kV-CBCT) and 2D planar projected radiographs. This algorithm calculates the radiation dose to water-like media as the sum of primary and scattered dose components. The scatter dose is calculated by convolution of a newly introduced, empirically parameterized scatter dose kernel with the primary photon fluence. Several approximations are introduced to increase the scatter dose calculation efficiency: (1) the photon energy spectrum is approximated as monoenergetic; (2) density inhomogeneities are accounted for by implementing a global distance scaling factor in the scatter kernel; (3) kernel tilting is ignored. These approximations allow for efficient calculation of the scatter dose convolution with the fast Fourier transform. Monte Carlo simulations were used to obtain the model parameters. The accuracy of using this model-based algorithm was validated by comparing with the Monte Carlo method for calculating dose distributions for real patients resulting from radiotherapy image guidance procedures including volumetric kV-CBCT scans and 2D planar projected radiographs. For all patients studied, mean dose-to-water errors for kV-CBCT are within 0.3% with a maximum standard deviation error of 4.1%. Using a medium-dependent correction method to account for the effects of photoabsorption in bone on the dose distribution, mean dose-to-medium errors for kV-CBCT are within 3.6% for bone and 2.4% for soft tissues. This algorithm offers acceptable accuracy and has the potential to extend the applicability of model-based dose calculation algorithms from megavoltage to kilovoltage photon beams.

Systematic survey of the dose enhancement in tissue-equivalent materials facing medium- and high-Z backscatterers exposed to X-rays with energies from 5 to 250 keV

The present study has been inspired by the results of earlier dose measurements in tissue-equivalent materials adjacent to thin foils of aluminum, copper, tin, gold, and lead. Large dose enhancements have been observed in low-Z materials near the interface when this ensemble was irradiated with X-rays of qualities known from diagnostic radiology. The excess doses have been attributed to photo-, Compton, and Auger electrons released from the metal surfaces. Correspondingly, high enhancements of biological effects have been observed in single cell layers arranged close to gold surfaces. The objective of the present work is to systematically survey, by calculation, the values of the dose enhancement in low-Z media facing backscattering materials with a variety of atomic numbers and over a large range of photon energies. Further parameters to be varied are the distance of the point of interest from the interface and the kind of the low-Z material. The voluminous calculations have been performed using the PHOTCOEF algorithm, a proven set of interpolation functions fitted to long-established Monte Carlo results, for primary photon energies between 5 and 250 keV and for atomic numbers varying over the periodic system up to Z = 100. The calculated results correlate well with our previous experimental results. It is shown that the values of the dose enhancement (a) vary strongly in dependence upon Z and photon energy; (b) have maxima in the energy region from 40 to 60 keV, determined by the K and L edges of the backscattering materials; and (c) are valued up to about 130 for "International Commission on Radiological Protection (ICRP) soft tissue" (soft tissue composition recommended by the ICRP) as the adjacent low-Z material. Maximum dose enhancement associated with the L edge occurs for materials with atomic numbers between 50 and 60, e.g., barium (Z = 56) and iodine (Z = 53). Such materials typically serve as contrast media in medical X-ray diagnostics. The gradual reduction in the dose enhancement with increasing distance from the material interface, owed to the limited ranges of the emitted secondary electrons, has been documented in detail. The discussion is devoted to practical radiological aspects of the dose enhancement phenomenon. Cytogenetic effects in cell layers closely proximate to surfaces of medium-Z materials might vary over two orders of magnitude, because the dose enhancement is accompanied by the earlier observed about twofold increase in the low-dose RBEM at a tissue-to-gold interface.

Influence of polarization and a source model for dose calculation in MRT

Microbeam Radiation Therapy (MRT), an alternative preclinical treatment strategy using spatially modulated synchrotron radiation on a micrometer scale, has the great potential to cure malignant tumors (e.g., brain tumors) while having low side effects on normal tissue. Dose measurement and calculation in MRT is challenging because of the spatial accuracy required and the arising high dose differences. Dose calculation with Monte Carlo simulations is time consuming and their accuracy is still a matter of debate. In particular, the influence of photon polarization has been discussed in the literature. Moreover, it is controversial whether a complete knowledge of phase space trajectories, i.e., the simulation of the machine from the wiggler to the collimator, is necessary in order to accurately calculate the dose. With Monte Carlo simulations in the Geant4 toolkit, the authors investigate the influence of polarization on the dose distribution and the therapeutically important peak to valley dose ratios (PVDRs). Furthermore, the authors analyze in detail phase space information provided by Martínez-Rovira et al. ["Development and commissioning of a Monte Carlo photon model for the forthcoming clinical trials in microbeam radiation therapy," Med. Phys. 39(1), 119-131 (2012)] and examine its influence on peak and valley doses. A simple source model is developed using parallel beams and its applicability is shown in a semiadjoint Monte Carlo simulation. Results are compared to measurements and previously published data. Polarization has a significant influence on the scattered dose outside the microbeam field. In the radiation field, however, dose and PVDRs deduced from calculations without polarization and with polarization differ by less than 3%. The authors show that the key consequences from the phase space information for dose calculations are inhomogeneous primary photon flux, partial absorption due to inclined beam incidence outside the field center, increased beam width and center to center distance due to the beam propagation from the collimator to the phantom surface and imperfect absorption in the absorber material of the Multislit Collimator. These corrections have an effect of approximately 10% on the valley dose and suffice to describe doses in MRT within the measurement uncertainties of currently available dosimetry techniques. The source for the first clinical pet trials in MRT is characterized with respect to its phase space and the photon polarization. The results suggest the use of a presented simplified phase space model in dose calculations and hence pave the way for alternative and fast dose calculation algorithms. They also show that the polarization is of minor importance for the clinical important peak and valley doses inside the microbeam field.

Monte Carlo method used to determine scatter fractions for estimating secondary gamma-ray and X-ray photon dose equivalent rates

The Monte Carlo MCNPX code is used to calculate the scatter fraction, making it possible to assess the scattered dose equivalent rate. Two materials are considered for the phantom: water and steel. The calculations are performed by considering beams of monoenergetic photons (in the range 10 keV to 10 MeV) and bremsstrahlung photons resulting from the interaction of electrons (30–900 keV) on a tungsten target. The variation of the scatter fraction is investigated as a function of the primary photon energy, the beam area at the phantom surface, the scattering angle, and filtration of the bremsstrahlung radiation. We note the shortcomings of the ISO standard issued in 2011, which does not take into account the beam area at the phantom surface, the scattering angle or the scattering materials, thus producing inconsistencies with the computed values given in this study and in the literature. Our values for the scatter fraction are comparable with those given in the literature (e .g. NCRP). As regards the bremsstrahlung radiation, we note the influence of filtration, in particular at low energies. The scatter fractions given here are compatible with the calculation of the ambient dose equivalent, whereas in the literature, they are systematically used for the calculation of air kerma rates. We also obtain scatter fractions for water that are higher by a factor of 5 compared with steel.

SPIN CORRELATIONS OF THE FINAL LEPTONS IN THE TWO-PHOTON PROCESSES γγ → e+e-, μ+μ-, τ+τ-

The spin structure of the process γγ → e+e- is theoretically investigated. It is shown that, if the primary photons are unpolarized, the final electron and positron are unpolarized as well but their spins are strongly correlated. For the final (e+e-) system, explicit expressions for the components of the correlation tensor are derived, and the relative fractions of singlet and triplet states are found. It is demonstrated that in the process γγ → e+e- one of the Bell-type incoherence inequalities for the correlation tensor components is always violated and, thus, spin correlations of the electron and positron in this process have the strongly pronounced quantum character. Analogous consideration can be wholly applied as well to the two-photon processes γγ → μ+μ- and γγ → τ+τ-, which become possible at considerably higher energies.

Photon management in nanostructured solar cells

The unique geometry and intriguing physical properties of nanostructure-based solar cells gives them great potential to achieve the goals of cost-effectiveness and high-efficiency. With nanostructured solar cells it is expected to be possible to break the Shockley–Queisser limit. This potential has driven widespread research and development in photon management to enhance light absorption over the past decade. However, efficiency is not proportional to light absorption. Nowadays, researchers are starting to address this issue. A thorough understanding of the advantages and the scope of the application of each photon management scheme is critical to finding a breakthrough for this predicament. In this review, we present the theorems and describe recent progresses in primary photon management schemes for nanostructures, including antireflection, light scattering, and resonance (e.g., metallic resonance, dielectric resonance, and photonic crystals). The antireflection effect allows more light to enter the solar cell. Light scattering enhances the interaction between the light and the nanostructure, extending the light propagation paths in the devices. Resonance effects can redirect and precisely confine the light to the region where efficient photoelectric conversion efficiency occurs. Finally, we discuss the challenges of nanostructured solar cells, and indicate potential routes to overcome the performance-limiting problems.

Evaluation of dead-time corrections for post-radionuclide-therapy 177Lu quantitative imaging with low-energy high-resolution collimators

Dead-time (DT) effects rarely cause problems in diagnostic single-photon emission computed tomography (SPECT) studies; however, in post-radionuclide-therapy imaging, DT can be substantial. Therefore, corrections may be necessary if quantitative images are used in image-based dosimetry or for evaluation of therapy outcomes. This task is particularly challenging if low-energy collimators are used. Our goal was to design a simple method to determine the dead-time correction factor (DTCF) without the need for phantom experiments and complex calculations. Planar and SPECT/CT scans of a water phantom containing a 70 ml bottle filled with lutetium-177 (Lu) were acquired over 60 days. Two small Lu markers were used in all scans. The DTCF based on the ratio of observed to true count rates measured over the entire spectrum and using photopeak primary photons only was estimated for phantom (DT present) and marker (no DT) scans. In addition, variations in counts in SPECT projections (potentially caused by varying bremsstrahlung and scatter) were investigated. For count rates that were about two-fold higher than typically seen in post-therapy Lu scans, the maximum DTCF reached a level of about 17%. The DTCF values determined directly from the phantom experiments using the total energy spectrum and photopeak counts only were equal to 13 and 16%, respectively. They were closely matched by those from the proposed marker-based method, which uses only two energy windows and measures photopeak primary photons (15-17%). A simple, marker-based method allowing for determination of the DTCF in high-activity Lu imaging studies has been proposed and validated using phantom experiments.

Development of a Compton Camera for Online Range Monitoring of Laser-Accelerated Proton Beams via Prompt-Gamma Detection

Presently large efforts are conducted in Munich towards the development of proton beams for bio-medical applications, generated via the technique of particle acceleration from high-power, short-pulse lasers. While so far mostly offline diagnostics tools are used in this context, we aim at developing a reliable and accurate online range monitoring technique, based on the position-sensitive detection of prompt ? rays emitted from nuclear reactions between the proton beam and the biological sample. For this purpose, we develop a Compton camera, designed to be able to track not only the Compton scattering of the primary photon, but also to detect the secondary Compton electron, thus reducing the Compton cone to an arc segment and by this increasing the source reconstruction efficiency. Design specifications and the status of the protype system are discussed.

Receiver Architecture for Channel-Aided, OOK, APD-based FSO Communications Through Turbulent Atmosphere

The problem of optimum signal detection for the channel-aided free-space optics (FSO) communications is addressed. It is assumed that the avalanced-photo-detection (APD) is utilized for the direct-detection (DD) of on-off-keying (OOK) signals impaired by optical turbulence. The average primary photon count due to the background radiation is assumed to be large enough to allow for a Gaussian operation for the APD receiver. In the presence of large signal fluctuations, it is shown that the optimum structure, motivated by the maximum a-posteriori (MAP) rule, is a dual-threshold architecture where the thresholds are functions of the channel state. To remedy the channel effects, the channel state is estimated and the estimates are used to set the receiver thresholds, thereby resulting in a channel-aided scenario. Performance of the proposed optimum receiver is assessed in terms of the overall bit error rate. To assess performance, it is assumed that the turbulent channel obeys a Gamma-Gamma (GG) distribution and that the channel estimator yields an unbiased and efficient estimate of the channel state. This study shows that channel-aided reception reduces the error floor. Further, channel-aided receivers have error-floor-free signal ranges that are larger than those of the standard receivers'.

Reactor radiation skyshine calculations with TRIPOLI-4 code for Baikal-1 experiments

*Neutron and photon fluxes generated from the operation of fission reactors and fuel cycle facilities are normally well attenuated with the shielding and ceiling walls. However, skyshine dose rates were observed at 1.5 - 2 km away from the JCO criticality accident site at Tokai-mura. In this study reactor neutron and photon skyshine calculations of Baikal-1 experiments have been performed with the TRIPOLI-4 Monte Carlo transport code. Baikal-1 experiments were carried out with the 300 kW RA research reactor. The 85 cm thick concrete shielding plug in the upper direction of the RA reactor was removed during the experiments. Various distances up to 1500 m from the reactor were considered for skyshine radiation measurements. To study the neutron and photon skyshine dose rates off the reactor with TRIPOLI-4 code, both photon and coupled neutron-photon calculations were performed so as to include primary photons, primary neutrons, and secondary photons contributions. TRIPOLI-4 perturbation calculations on the ground density and on the hydrogen concentration contained in the ground composition were also applied to study the groundshine.

Upper limit on the flux of photons with energies above1019 eVusing the Telescope Array surface detector

We search for ultra-high energy photons by analyzing geometrical properties of shower fronts of events registered by the Telescope Array surface detector. By making use of an event-by-event statistical method, we derive upper limits on the absolute flux of primary photons with energies above 10^19, 10^19.5 and 10^20 eV based on the first three years of data taken.

Estimate of the fraction of primary photons in the cosmic-ray flux at energies ∼1017 eV from the EAS-MSU experiment data

We reanalyze archival EAS-MSU data in order to search for events with an anomalously low content of muons with energies E μ > 10 GeV in extensive air showers with the number of particles N e ≳ 2 × 107. We confirm the first evidence for a nonzero flux of primary cosmic gamma rays at energies E ∼ 1017 eV. The estimated fraction of primary gamma rays in the flux of cosmic particles with energies E ≳ 5.4 × 1016 eV is εγ = (0.43 +0.12−0.11 )%, which corresponds to the intensity I γ = (1.2 +0.4−0.3 ) × 10−16 cm−2 s−1 sr−1. The study of arrival directions does not favor any particular mechanism of the origin of the photon-like events.

The role of Compton scattering in the low-Zelements X-ray fluorescence formation

The paper reviews the ionization of elements with low atomic numbers (boron, carbon, nitrogen, oxygen, and fluorine) by incoherent scattering of primary radiation and under the influence of Compton electrons. It is shown that at high energy of primary photons, the total contribution of these processes to X-ray fluorescence formation becomes significant; at the energy of 80 keV, it becomes dominant. Copyright © 2013 John Wiley & Sons, Ltd.

A Monte Carlo study on electron and neutron contamination caused by the presence of hip prosthesis in photon mode of a 15 MV Siemens PRIMUS linac

Several investigators have pointed out that electron and neutron contamination from high‐energy photon beams are clinically important. The aim of this study is to assess electron and neutron contamination production by various prostheses in a high‐energy photon beam of a medical linac. A 15 MV Siemens PRIMUS linac was simulated by MCNPX Monte Carlo (MC) code and the results of percentage depth dose (PDD) and dose profile values were compared with the measured data. Electron and neutron contaminations were calculated on the beam's central axis for Co‐Cr‐Mo, stainless steel, Ti‐alloy, and Ti hip prostheses through MC simulations. Dose increase factor (DIF) was calculated as the ratio of electron (neutron) dose at a point for 10×10 cm2 field size in presence of prosthesis to that at the same point in absence of prosthesis. DIF was estimated at different depths in a water phantom. Our MC‐calculated PDD and dose profile data are in good agreement with the corresponding measured values. Maximum dose increase factor for electron contamination for Co‐Cr‐Mo, stainless steel, Ti‐alloy, and Ti prostheses were equal to 1.18, 1.16, 1.16, and 1.14, respectively. The corresponding values for neutron contamination were respectively equal to: 184.55, 137.33, 40.66, and 43.17. Titanium‐based prostheses are recommended for the orthopedic practice of hip junction replacement. When treatment planning for a patient with hip prosthesis is performed for a high‐energy photon beam, attempt should be made to ensure that the prosthesis is not exposed to primary photons.PACS numbers: 87.56.bd, 87.55.kh, 87.55.Gh

Patient-specific scatter correction in clinical cone beam computed tomography imaging made possible by the combination of Monte Carlo simulations and a ray tracing algorithm

Purpose. Cone beam computed tomography (CBCT) image quality is limited by scattered photons. Monte Carlo (MC) simulations provide the ability of predicting the patient-specific scatter contamination in clinical CBCT imaging. Lengthy simulations prevent MC-based scatter correction from being fully implemented in a clinical setting. This study investigates the combination of using fast MC simulations to predict scatter distributions with a ray tracing algorithm to allow calibration between simulated and clinical CBCT images. Material and methods. An EGSnrc-based user code (egs_cbct), was used to perform MC simulations of an Elekta XVI CBCT imaging system. A 60keV x-ray source was used, and air kerma scored at the detector plane. Several variance reduction techniques (VRTs) were used to increase the scatter calculation efficiency. Three patient phantoms based on CT scans were simulated, namely a brain, a thorax and a pelvis scan. A ray tracing algorithm was used to calculate the detector signal due to primary photons. A total of 288 projections were simulated, one for each thread on the computer cluster used for the investigation. Results. Scatter distributions for the brain, thorax and pelvis scan were simulated within 2% statistical uncertainty in two hours per scan. Within the same time, the ray tracing algorithm provided the primary signal for each of the projections. Thus, all the data needed for MC-based scatter correction in clinical CBCT imaging was obtained within two hours per patient, using a full simulation of the clinical CBCT geometry. Conclusions. This study shows that use of MC-based scatter corrections in CBCT imaging has a great potential to improve CBCT image quality. By use of powerful VRTs to predict scatter distributions and a ray tracing algorithm to calculate the primary signal, it is possible to obtain the necessary data for patient specific MC scatter correction within two hours per patient.

Clinical simulations of prostate radiotherapy using BOMAB-like phantoms: Results for neutrons

This paper presents in-phantom photoneutron equivalent doses induced by external radiotherapy, these are necessary to assess organ-averaged equivalent doses to derive the risk of secondary cancer development, associated with non-target organ exposures. The measurements were performed by Working Group 9 “Radiation Protection Dosimetry in Medicine” of the European Radiation Dosimetry Group (EURADOS) for simulations of clinical radiotherapy treatments of prostate cancer. The photoneutron dose measurements were carried out in a BOMAB-like water-filled phantom, by means of superheated emulsions (superheated drop detectors SDD and bubble damage BTI® detectors) and Poly-Allyl-Diglicol-Carbonate (PADC) solid state nuclear track detectors. Dose data were acquired in a three-dimensional matrix of reproducible measurement points, which are spaced according to detectors size. Four clinical protocols for the treatment of the prostate tumor were considered and compared, by measuring the doses delivered to the planning target volume (PTV) and to peripheral radiosensitive regions (i.e. colon-rectum and bladder). The clinical irradiations were performed in two clinical radiotherapy facilities based on Varian Clinac 2300 CD accelerator: Santa Chiara University Hospital (Pisa, Italy) and Centre of Oncology M. Skłodowska-Curie Memorial Institute (Krakow, Poland). An additional tomotherapy prostate cancer treatment was also simulated in Campo di Marte Hospital (Lucca, Italy). Radiation qualities of 6, 12, 15, 18 and 20 MV were used; all of these are capable of producing photoneutrons. Data from this work span most of the X-ray beam energies and prostate treatment modalities used in the current clinical practice. These data permit the assessment of doses absorbed by a radiotherapy patient either at the treatment volume or at out-of-field organs. Comparison of different dosimeters, under the same irradiation conditions, showed that dosimeters generally agreed within their 20% 1 SD uncertainty. Comparison of different treatment modalities in the two contributing clinical centers (Pisa and Krakow) were also possible, as well as a comparison of dose profiles resulting from the different treatment techniques, delivered at the same primary photon energy. It was in particular found that photon acceleration energies as low as 6 MV are able to produce a non-negligible photoneutron component, which causes an undue dose to the patient of the order of tens microsievert per unit photon dose delivered at the target volume.