Task Group 43 Research Articles

An end-to-end deep convolutional neural network-based dose engine for parotid gland cancer seed implant brachytherapy.

Seed implant brachytherapy (SIBT) is a promising treatment modality for parotid gland cancers (PGCs). However, the current clinical standard dose calculation method based on the American Association of Physicists in Medicine (AAPM) Task Group 43 (TG-43) Report oversimplifies patient anatomy as a homogeneous water phantom medium, leading to significant dose calculation errors due to heterogeneity surrounding the parotid gland. Monte Carlo Simulation (MCS) can yield accurate dose distributions but the long computation time hinders its wide application in clinical practice. This paper aims to develop an end-to-end deep convolutional neural network-based dose engine (DCNN-DE) to achieve fast and accurate dose calculation for PGC SIBT. A DCNN model was trained using the patient's CT images and TG-43-based dose maps as inputs, with the corresponding MCS-based dose maps as the ground truth. The DCNN model was enhanced based on our previously proposed model by incorporating attention gates (AGs) and large kernel convolutions. Training and evaluation of the model were performed using a dataset comprising 188 PGC I-125 SIBT patient cases, and its transferability was tested on an additional 16 non-PGC head and neck cancers (HNCs) I-125 SIBT patient cases. Comparison studies were conducted to validate the superiority of the enhanced model over the original one and compare their overall performance. On the PGC testing dataset, the DCNN-DE demonstrated the ability to generate accurate dose maps, with percentage absolute errors (PAEs) of 0.67%±0.47% for clinical target volume (CTV) D90 and 1.04%±1.33% for skin D0.1cc. The comparison studies revealed that incorporating AGs and large kernel convolutions resulted in 8.2% (p<0.001) and 3.1% (p<0.001) accuracy improvement, respectively, as measured by dose mean absolute error. On the non-PGC HNC dataset, the DCNN-DE exhibited good transferability, achieving a CTV D90 PAE of 1.88%±1.73%. The DCNN-DE can generate a dose map in less than 10 ms. We have developed and validated an end-to-end DCNN-DE for PGC SIBT. The proposed DCNN-DE enables fast and accurate dose calculation, making it suitable for application in the plan optimization and evaluation process of PGC SIBT.

A practical method of estimating medium-heterogeneity corrected dose without a Monte Carlo calculation in ocular brachytherapy using 125I COMS plaques

To provide a practical method of estimating medium-heterogeneity corrected dose without a Monte Carlo (MC) calculation in ocular brachytherapy using 125I Collaborative Ocular Melanoma Study (COMS) plaques. Using egs_brachy, MC simulations (1) under task group-43 assumptions with fully loaded seed configurations in water (HOMO) and (2) with effects of plaque backing, insert and inter-seed interactions (HETERO) were performed for seven 125I COMS plaques (10 mm-22 mm in diameter), and homogeneous dose (DHOMO) and heterogeneous dose (DHETERO) for central-axis and off-axis points were determined. For DHOMO, 85 Gy was normalized to a depth of 5 mm. Central-axis heterogeneity correction factors (HCFs) from a depth of 0 mm (inner sclera) to 22 mm (opposite retina) were derived from a ratio of DHETERO to DHOMO. Off-axis HCFs for optic disc/macula and lens as a function of distance from optic disc/macula (DT/MT) for various basal dimensions of tumor (BD/BM) were derived from DHETERO/DHOMO. Central-axis HCF varied with a dose reduction of 10.3-19.8% by heterogeneity. Off-axis HCF for optic disc/macula varied significantly depending on DT/MT and BD/BM with a dose reduction of 11.3-38.3%. Off-axis HCF for lens had a dependence on MT and BM with its variation of 11.0-19.0%. A clinical example of using HCFs to estimate DHETERO was presented. The practical method of using depth-dependent central-axis HCF and DT/MT- and BD/BM-dependent off-axis HCF provided in this study will facilitate a heterogeneous dose estimate for 125I COMS plaques without MC calculations.

Effect of model-based dose-calculation algorithms in high dose rate brachytherapy of cervical carcinoma.

Task Group 43 (TG-43) formalism does not consider the tissue and applicator heterogeneities. This study is to compare the effect of model-based dose calculation algorithms, like Advanced Collapsed Cone Engine (ACE), on dose calculation with the TG-43 dose calculation formalism in patients with cervical carcinoma. 20 patients of cervical carcinoma treated with a high dose rate of intracavitary brachytherapy were prospectively studied. The target volume and organs at risk (OARs) were contoured in the Oncentra treatment planning system (Elekta, Veenendaal, The Netherlands). All patients were planned with cobalt-60 (Co-60) and iridium-192 (Ir-192) sources with doses of 21 Gy in 3 fractions. These plans were calculated with TG-43 formalism and a model-based dose calculation algorithm ACE. The dosimetric parameters of TG-43 and ACE-based plans were compared in terms of target coverage and OAR doses. For Co-60-based plans, the percentage differences in the D90 and V100 values for high-risk clinical target volume (HR-CTV) were 0.36 ± 0.43% and 0.17 ± 0.31%, respectively. For the bladder, rectum and sigmoid, the percentage differences for D2cc volumes were -0.50 ± 0.51%, -0.16 ± 0.53% and -0.37 ± 1.21%, respectively. For Ir-192-based plans, the percentage difference in the D90 for HR-CTV was 0.54 ± 0.79%, while V100 was 0.24 ± 0.29%. For the bladder, rectum and sigmoid, the doses to 2cc volume were 0.35 ± 1.06%, 0.99 ± 0.74% and 0.74 ± 1.92%, respectively. No significant differences were found in the dosimetric parameters calculated with ACE and TG-43. The ACE algorithm reduced doses to OARs and targets. However, ACE and TG-43 did not show significant differences in the dosimetric parameters of the target and OARs with both sources.

Dosimetric Impact of Air Pockets in the Vaginal Cuff Brachytherapy Using Model-based Dose Calculation Algorithm.

Endometrial cancer is the most common disease of the female reproductive system. Vaginal cuff brachytherapy (VCB) has intrinsic advantages compared to external beam therapy when treated with radiation. A single-channel cylinder is a standard applicator in VCB. The present study aims to estimate a change in the dose to vaginal mucosa due to air pockets between the cylinder and vaginal mucosa by calculating with the Acuros BV algorithm and comparing it to the Task Group 43 (TG-43) algorithm. Patients who presented with air packets were included retrospectively. For each patient, three plans were created: the first plan used TG-43, the second plan used dose recalculation with Acuros BV, and the third plan was generated by re-optimization by Acuros BV. On the same axial computed tomography image, the point doses at the cylinder's surface and the displaced mucosa were recorded and the ratios were then estimated. The average volume of air pockets was 0.08 cc (range of 0.01-0.3 cc), and 84% of air pockets displaced the vaginal mucosa by ≥0.2 cm. The average ratios of dose were 0.77 ± 0.09 (1 standard deviation [SD]) and 0.78 ± 0.09 (1 SD) for TG-43 and Acuros BV algorithms, respectively. Due to the air pocket, mucosa received a reduced dose by an average of 22.72% and an average of 23.29% for TG-43 and Acuros BV, respectively. The maximum displacement of mucosa and the ratio of doses were negatively correlated for both. In the Optimized Acuros BV plan, total dwell time increased by 1.8% but no considerable change in the dose ratios. The calculated dose of mucous membrane forced out of the cylinder surface by air pockets by the Acuros BV algorithm was nonsignificantly different from TG-43. Therefore, even in the presence of air pockets, the TG-43 algorithm for calculating the VCB dose is appropriate.

Commissioning Validation of a Brachytherapy Treatment Planning System with EGSnrc Monte Carlo Code and EBT3 GAFChromic Film.

Most brachytherapy treatment planning system (TPS) commissioning requires data input based on the American Association of Physicists in Medicine Task Group-43 formalism. The commissioning accuracy is very important for dose calculation. The aim of this study is the implementation of a brachytherapy TPS into a clinical environment and check the TPS calculated dose accuracy. After introducing data of the different catheters (CIS Bio International, Saclay, France), composed of several Cesium-137 Eckert and Ziegler BEBIG CSM-11 radioactive sources; for XiO (CMS, St. Louis) brachytherapy TPS, the TPS dose calculation accuracy was investigated by comparing between the TPS calculated dose distribution (DD) for all the catheters with (1) the measuring DD using EBT3 GAFChromic film and (2) calculating DD by egs_brachy (Electron Gamma Shower, National Research Council of Canada) Monte Carlo simulation. The phantom used for this study consists of six PTW slabs 30 cm × 30 cm × 1 cm of polymethyl methacrylate with a Delouche MEDpro applicator on the top. The TPS DD was calculated on the computed tomography scan of this phantom. PTW VeriSoft version 6.0.1.7 (PTW-Freiburg, Germany) software was used for analyzing scanned films and to perform the comparison based on the gamma index distribution. For each catheter, the gamma index distribution showed agreement >95% of all pixels in both verification methods, with gamma ≤1. We confirm the commissioning accuracy and that the TPS can be used for clinical purposes.

Simplified method for determining dose to a non-water phantom through the use of ND,w and IAEA TRS 483 for the GammaPod.

GammaPod, a breast stereotactic radiosurgery device, utilizes 25 rotating Co-60 sources to deliver highly conformal dose distributions. The GammaPod system requires that reference dosimetry be performed in a specific vendor-supplied poly-methylmethacrylate (PMMA) phantom. The nonstandard nature of GammaPod dosimetry, in both the phantom material and machine-specific reference (msr), prohibits use of the American Association of Physicists in Medicine Task Group 51 (TG-51) protocol. This study proposes a practical method using TRS 483 to make the reference dosimetry procedure simpler and to reduce overall uncertainties. The dose to PMMA (DPMMA) is determined under msr conditions using TRS 483 with an Exradin A1SL chamber placed in a PMMA phantom. The conversion factor, which converts from the dose-to-water (Dw) in broad-beam Co-60 reference geometry to DPMMA in the msr small field Co-60 (Qmsr) geometry, is derived using the Monte Carlo simulations and procedure described in TRS 483. The new conversion factor value for an Exradin A1SL chamber is 0.974. When combined with ND,w, DPMMA differs by 0.5% from the TG-21/Nx method and 0.2% from the IROC values. Uncertainty decreased from 2.2% to 1.6%. We successfully implemented TRS 483 reference dosimetry protocols utilizing ND,w for the GammaPod in the PMMA phantom. These results show not only agreement between measurements performed with the previously published method and independent thermoluminescent dosimetry measurements but also reductions in uncertainty. This also provides readers with a pathway to develop their own IAEA TRS 483 factor for any new small field machine that may be developed.

PP24 Presentation Time: 4:10 PM: RapidBrachyTG43: A Geant4-Based TG-43 Parameter Calculation Engine for Brachytherapy Applications

Purpose: Dosimetry calculations in clinical brachytherapy are performed according to the American Association of Physicists in Medicine's Task Group 43 (TG-43) formalism, approximating the patient as a uniform water phantom with the dose rate distribution equal to a product of source-specific parameters. While TG-43 parameter data is widely available in the literature for many commercial brachytherapy sources, presently there is no software package which can facilitate user-friendly, accurate, and flexible TG-43 parameter calculations for novel brachytherapy source models and isotopes.

PO09: Model-Based Dose Calculations for Post-Mastectomy Chestwall HDR Plesiotherapy: Should Bolus Be Used and How Much?

Purpose: The novel application of HDR plesiotherapy for post-mastectomy chestwall boost irradiation offers dosimetric advantages over conventional therapy via electrons due to the skin mould's ability to conform to highly curved and large surface areas while delivering a localized dose to a superficial target. Most brachytherapy dose calculation algorithms compute dose to homogenous water medium following the AAPM Task Group-43 (TG-43) formalism. For HDR plesiotherapy, TG-43-based dose calculation overestimates the coverage to a superficial target by ignoring the loss of backscatter at the target-air interface.

A practical approach to estimating optic disc dose and macula dose without treatment planning in ocular brachytherapy using 125I COMS plaques

BackgroundIt has been reported that proximity of the tumor to the optic disc and macula, and radiation dose to the critical structures are substantial risk factors for vision loss following plaque brachytherapy. However, there is little dosimetry data published on this. In this study, therefore, the relationship between distance from tumor margin and radiation dose to the optic disc and macula in ocular brachytherapy using 125I Collaborative Ocular Melanoma Study (COMS) plaques was comprehensively investigated. From the information, this study aimed to allow for estimation of optic disc dose and macula dose without treatment planning.MethodsAn in-house brachytherapy dose calculation program utilizing the American Association of Physicists in Medicine Task Group-43 U1 formalism with a line source approximation in a homogenous water phantom was developed and validated against three commercial treatment planning systems (TPS). Then optic disc dose and macula dose were calculated as a function of distance from tumor margin for various tumor basal dimensions for seven COMS plaques (from 10 mm to 22 mm in 2 mm increments) loaded with commercially available 125I seeds models (IAI-125A, 2301 and I25.S16). A prescribed dose of 85 Gy for an irradiation time of 168 h was normalized to a central-axis depth of 5 mm. Dose conversion factors for each seed model were obtained by taking ratios of total reference air kerma per seed at various prescription depths (from 1 mm to 10 mm in 1 mm intervals) to that at 5 mm.ResultsThe in-house program demonstrated relatively similar accuracy to commercial TPS. Optic disc dose and macula dose decreased as distance from tumor margin and tumor basal dimension increased. Dose conversion factors increased with increasing prescription depth. There existed dose variations (<8%) among three 125I seed models. Optic disc dose and macula dose for each COMS plaque and for each seed model are presented in a figure format. Dose conversion factors for each seed model are presented in a tabular format.ConclusionsThe data provided in this study would enable clinicians in any clinic using 125I COMS plaques to estimate optic disc dose and macula dose without dose calculations.

Dosimetric Implications of Air within Channels of Brachytherapy Applicators

Water-based dose calculations, such as those described in AAPM Task Group-43, are commonly used for brachytherapy planning. These methodologies assume uniform applicators. However, the effect of assuming water-equivalence for air within applicator channels may impact dose calculations. The purpose of this work is to quantify the dosimetric impact that a non-water equivalent material, specifically intra-channel air, can have in vaginal HDR cylinder applicators.

Experimental assessment of the Advanced Collapsed-cone Engine for scalp brachytherapy treatments

PurposeTo experimentally assess the performance of the Advanced Collapsed-cone Engine (ACE) for 192Ir high-dose-rate brachytherapy treatment planning of nonmelanoma skin cancers of the scalp. Methods and MaterialsA layered slab phantom was designed to model the head (skin, skull, and brain) and surface treatment mold using tissue equivalent materials. Six variations of the phantom were created by varying skin thickness, skull thickness, and size of air gap between the mold and skin. Treatment planning was initially performed using the Task Group 43 (TG-43) formalism with CT images of each phantom variation. Doses were recalculated using standard and high accuracy modes of ACE. The plans were delivered to Gafchromic EBT3 film placed between different layers of the phantom. ResultsDoses calculated by TG-43 and ACE and those measured by film agreed with each other at most locations within the phantoms. For a given phantom variation, average TG-43– and ACE-calculated doses were similar, with a maximum difference of (3 ± 12)% (k = 2). Compared to the film measurements, TG-43 and ACE overestimated the film-measured dose by (13 ± 12)% (k = 2) for one phantom variation below the skull layer. ConclusionsTG-43– and ACE-calculated and film-measured doses were found to agree above the skull layer of the phantom, which is where the tumor would be located in a clinical case. ACE appears to underestimate the attenuation through bone relative to that measured by film; however, the dose to bone is below tolerance levels for this treatment.

The Bebig Valencia-type skin applicators: Dosimetric study and implementation of a dosimetric hybrid technique

PurposeTo determine the relative dose rate distribution in water for the Bebig 20 mm and 30 mm skin applicators and report results in a form suitable for potential clinical use. Results for both skin applicators are also provided in the form of a hybrid Task Group 43 (TG-43) dosimetry technique. Furthermore, the radiation leakage around both skin applicators from the radiation protection point of view and the impact of the geometrical source position uncertainties are studied and reported. Methods and MaterialsMonte Carlo simulations were performed using the MCNP 6.1 general purpose code, which was benchmarked against published dosimetry data for the Bebig Ir2.A85-2 high-dose-rate iridium-192 source, as well as the dosimetry data for the two Elekta skin applicators. Both Bebig skin applicators were modeled, and the dose rate distributions in a water phantom were calculated. The dosimetric quantities derived according to a hybrid TG-43 dosimetry technique are provided with their corresponding uncertainty values. The air kerma rate in air was simulated in the vicinity of each skin applicator to assess the radiation leakage. Results and ConclusionsResults from the Monte Carlo simulations of both skin applicators are presented in the form of figures and relative dose rate tables, and additionally with the aid of the quantities defined in the hybrid TG-43 dosimetry technique and their corresponding uncertainty values. Their output factors, flatness, and penumbra values were found comparable to the Elekta skin applicators. The radiation shielding was evaluated to be adequate. The effect of potential uncertainties in source positioning on dosimetry should be investigated as part of applicator commissioning.

Evaluation of (101)Rh as a brachytherapy source.

PurposeRecently a number of hypothetical sources have been proposed and evaluated for use in brachytherapy. In the present study, a hypothetical 101Rh source with mean photon energy of 121.5 keV and half-life of 3.3 years, has been evaluated as an alternative to the existing high-dose-rate (HDR) sources. Dosimetric characteristics of this source model have been determined following the recommendation of the Task Group 43 (TG-43) of the American Association of the Physicist in Medicine (AAPM), and the results are compared with the published data for 57Co source and Flexisource 192Ir sources with similar geometries.Material and methodsMCNPX Monte Carlo code was used for simulation of the 101Rh hypothetical HDR source design. Geometric design of this hypothetical source was considered to be similar to that of Flexisource 192Ir source. Task group No. 43 dosimetric parameters, including air kerma strength per mCi, dose rate constant, radial dose function, and two dimensional (2D) anisotropy functions were calculated for the 101Rh source through simulations.ResultsAir kerma strength per activity and dose rate constant for the hypothetical 101Rh source were 1.09 ± 0.01 U/mCi and 1.18 ± 0.08 cGy/(h.U), respectively. At distances beyond 1.0 cm in phantom, radial dose function for the hypothetical 101Rh source is higher than that of 192Ir. It has also similar 2D anisotropy functions to the Flexisource 192Ir source.Conclusions101Rh is proposed as an alternative to the existing HDR sources for use in brachytherapy. This source provides medium energy photons, relatively long half-life, higher dose rate constant and radial dose function, and similar 2D anisotropy function to the Flexisource 192Ir HDR source design. The longer half-life of the source reduces the frequency of the source exchange for the clinical environment.

Experimental determination of the Task Group-43 dosimetric parameters of the new I25.S17plus (125)I brachytherapy source.

To present experimental dosimetry results for the new IsoSeed I25.S17plus (125)I brachytherapy source, in fulfillment of the American Association of Physicists in Medicine recommendation for, at least one, experimental dosimetry characterization of new low-energy seeds before their clinical implementation. A batch of 100 LiF thermoluminescent dosimeter (TLD)-100 microcubes was used for the experimental determination of the dose-rate constant, radial dose, and anisotropy functions, in irradiations performed using two Solid Water phantoms. Monte Carlo (MC) simulations were used to determine appropriate correction factors that account for the use of Solid Water as a phantom material instead of liquid water and for the different energy response of the TLD dosimeters in the experimental (125)I photon energies relative to the 6MV x-ray photon beam used for the TLD calibration. Measurements were performed for four I25.S17plus seeds; one with direct traceability of air-kerma strength calibration to National Institute of Standards and Technology and three with secondary National Institute of Standards and Technology traceability. A mean dose-rate constant, Λ, of 0.956±0.043 cGy h(-1) U(-1) was experimentally determined for the I25.S17plus source, which agrees within uncertainties with the MC result of 0.925±0.013 cGy h(-1) U(-1) calculated independently for the same seed model in a previous study. Agreement was also observed between the measured and the MC-calculated radial dose and anisotropy function values. Experimental dosimetry results for the I25.S17plus (125)I source verify corresponding independent MC results in the form of Task Group-43 dosimetry parameters. The latter are found in agreement within uncertainties with sources of similar design incorporating a silver marker, such as the Oncura OncoSeed Model6711.

SU-E-T-223: Investigation of the Accuracy of Two-Dimensional Dose Distributions Measurement From High-Dose-Rate Brachytherapy Ir-192 Source Using Multiple-Diode-Array Detector (MapCheck2)

Purpose: To investigate the dosimetric accuracy of multiple-diode-array detector (Mapcheck2) for high-dose-rate brachytherapy Ir-192 source. The two-dimensional (2D) dose distributions measured with MapCheck2 were validated with EBT2 Gafchromic film measurement and AAPM task-group- 43 (TG-43) modeling. Methods: 2D-dose distributions from Ir-192 source were measured with MapCheck2 and EBT2-films. MapCheck2 response was corrected for effects: directional dependence, diode and phantom heterogeneity. Optical density growth of the film was controlled by synchronized scanning of the film exposed to Ir-192 and calibration films exposed to 6 MV linac beams. Similarly, MapCheck2 response was calibrated to dose using 6 MV beams. An empirical model was developed for the dose distributions measured with Mapcheck2 that considered directional, diode and phantom heterogeneity corrections. The dose deposited in solid-state-detectors was modeled using a cavity theory model for the diode. This model was then validated with measurements using EBT2-films and calculations with TG-43. Results: The response of MapCheck2 has been corrected for different effects including: (a) directional dependence of 0–20% over angular range 0o–90o, (b) phantom heterogeneity (3%) and (c) diode heterogeneity (9%). The corrected dose distributions measured with MapCheck2 agreed well with the measured dose distributions from EBT2-film and with calculations using TG-43 within 5% over a wide range of dose levels and rates. The advantages of MapCheck2 include less noisy, linear and stable response compared with film. The response of MapCheck2 exposed to 192Ir-source showed no energy dependence similar to its response to MV energy beam. Detection spatial-resolution of individual diodes was 0.8×0.8 mm2, however, 2DMapCheck2 resolution is limited by distance between diodes (7.07 mm). Conclusion: The dose distribution measured with MapCheck2 agreed well within 5% with that measured using EBT2-films; and calculations with TG- 43. Considering correction of artifacts, MapCheck2 provides a compact, practical and accurate dosimetric tool for measurement of 2D-dose distributions for brachytherapy Ir-192.

Dosimetric comparison between intra-cavitary breast brachytherapy techniques for accelerated partial breast irradiation and a novel stereotactic radiotherapy device for breast cancer: GammaPod™

The GammaPod™ device, manufactured by Xcision Medical Systems, is a novel stereotactic breast irradiation device. It consists of a hemispherical source carrier containing 36 Cobalt-60 sources, a tungsten collimator with two built-in collimation sizes, a dynamically controlled patient support table and a breast immobilization cup also functioning as the stereotactic frame for the patient. The dosimetric output of the GammaPod™ was modelled using a Monte Carlo based treatment planning system. For the comparison, three-dimensional (3D) models of commonly used intra-cavitary breast brachytherapy techniques utilizing single lumen and multi-lumen balloon as well as peripheral catheter multi-lumen implant devices were created and corresponding 3D dose calculations were performed using the American Association of Physicists in Medicine Task Group-43 formalism. Dose distributions for clinically relevant target volumes were optimized using dosimetric goals set forth in the National Surgical Adjuvant Breast and Bowel Project Protocol B-39. For clinical scenarios assuming similar target sizes and proximity to critical organs, dose coverage, dose fall-off profiles beyond the target and skin doses at given distances beyond the target were calculated for GammaPod™ and compared with the doses achievable by the brachytherapy techniques. The dosimetric goals within the protocol guidelines were fulfilled for all target sizes and irradiation techniques. For central targets, at small distances from the target edge (up to approximately 1 cm) the brachytherapy techniques generally have a steeper dose fall-off gradient compared to GammaPod™ and at longer distances (more than about 1 cm) the relation is generally observed to be opposite. For targets close to the skin, the relative skin doses were considerably lower for GammaPod™ than for any of the brachytherapy techniques. In conclusion, GammaPod™ allows adequate and more uniform dose coverage to centrally and peripherally located targets with an acceptable dose fall-off and lower relative skin dose than the brachytherapy techniques considered in this study.

SU-E-T-108: Comparison of Absorbed-Dose to Water in High-Energy Photon Beams Due to Differences in Beam Quality Conversion Factor

Purpose: In September 2012, the Japan Society of Medical Physics published a new absorbed-dose to water clinical reference dosimetry method for external beam radiation therapy (JSMP12). In JSMP12, the use of corrections based on ionization chambers according to absorbed-dose to water references was initiated, and the values of beam quality conversion factor were updated. In this study, whether differences among the absorbed-dose to water values of JSMP12 and American Association of Physicists in Medicine Task Group 51 (TG-51) and International Atomic Energy Agency Technical Report Series No. 398 (TRS-398) arise due to differences in the respective beam quality conversion factors was examined. Methods: The differences in basic data present in JSMP12, TG-51 and TRS-398 were analyzed in detail.The photon beam absorbed-dose to water dosimetry protocols recommended by the three parties were performed, and the respective absorbed-dose to water was measured. PTW30013 was used as the Farmer-type chamber. A 6 MV photon beam was used as the radiation beam. Results: The absorbed-dose to water ratio of the 6 MV photon beam was 0.999 in TG-51/JSMP12 and 1.002 in TRS-398/JSMP12. Beam quality conversion factors agreed within 0.2%, despite differences in the basic data included in beam quality index and beam quality conversion factor. Conclusion: Despite the differences in the ion recombination correction method and in the basic data present in beam quality index and beam quality conversion factor in the beam quality conversion factor, no major differences were seen in absorbed dose. However, energy sources other than a 6 MV photon beam were not assessed, and it was therefore considered necessary to investigate whether differences in absorbed-dose to water arise due to other sources of energy.

SU-E-T-551: A Novel Analytical Model to Determine Inhomogeneity Correction Factor in TG-43U1 Low Dose Rate Brachytherapy

Purpose: The American Association of Physicists in Medicine (AAPM) Task Group 43 (TG‐43) recommended dosimetric parameters of sources, in homogenous water phantom. However brachytherapy implant volumes are shown large error due to inhomogeneous mediums respect to homogenous water. The goal of this project is to determine a novel fast analytical method to evaluate the impact of the dose Inhomogeneity Correction Factor (DICF). This new method was validated for low (125I) and high (137Cs) energy brachytherapy sources. Methods: The novel analytical DICF is defined as the ratio of dose delivered into heterogeneous media in water to the dose delivered in homogenous water. The DICF is calculated as a function of the media linear attenuation coefficient, mass energy absorption coefficient, water equivalent path length of heterogenic layer, buildup factor coefficients, and media electron density. The actual dose is equal to multiply the TG‐43U1 dose by the DICF of the heterogenic layer in any phantom voxel. This approach was validated using TLD measurement and full Monte Carlo (FMC) simulation techniques. FMC simulations were used for several different air and aluminum heterogenic thickness. The dose data were compared for TG‐43U1 using DICF model and the values, which are directly, obtained using FMC for same Implants. The advantage of this model to FMCS for daily clinical application is the speed of the calculations and ease of the implementations in treatment planning system. Results: For different configurations, the analytical DICF formalism model agrees with FMC simulations up to 4.4% and 3.5% for 125I and 137Cs sources, respectively. The maximum differences of the DICF model in comparison to TLD measurement were 5% for 137CS. Conclusion: This new model can provide inputs for brachytherapy planning software to consider the ICF effect in dose calculations based on TG‐43U1 algorithm and CT images.

An analytical model to determine interseed attenuation effect in low‐dose‐rate brachytherapy

Brachytherapy treatment planning systems (BTPS) are employing the American Association of Physicists in Medicine (AAPM) Task Group 43 (TG‐43)‐recommended dosimetric parameters of sources, which are measured in water. The majority of brachytherapy implant volumes are not homogeneous media. Particularly, an implant with multiple seeds significantly changes homogeneity of the implant volume. Heterogeneities, such as attenuation by adjacent seeds or interseed attenuation (ISA), are neglected to this day in all BTPS. The goal of this project is to determine a novel analytical method to evaluate the impact of the dose perturbations (P‐value) and/or interseed attenuation effect (ISA‐value). This method will be validated for low‐ and high‐energy brachytherapy seeds such as 125I and 192Ir using Monte Carlo (MC) simulation techniques. In this analytical model, determination of dose perturbation and interseed attenuation in a multisource brachytherapy implant is based on MC‐simulated 3D kernels of P‐values and ISA data for single active and single dummy configurations, arranged at different distances and orientations relative to each other. The accuracy of the final model in multisource implant configurations has been examined by a comparison of the calculated P‐values and ISA‐values with full Monte Carlo water simulations (FMCWS). This model enabled us to determine the total perturbation and ISA values for any multisource implant, and the results are in excellent agreement with the FMCWS data. The advantage of this model to FMCWS for daily clinical application is the speed of the calculations and ease of the implementation. The new perturbation and ISA formulism have shown a better accuracy for 192Ir than 125I due to Compton scattering and its independence of the atomic number of the chemical composition of the phantom materials. The maximum difference between the ISA model and FMCWS for all cases was less than 5%. This new model can provide inputs for brachytherapy planning software to consider the ISA effect in dose calculations based on TG‐43U1 algorithm. This approach is applicable for energy range of 125I to 192Ir sources.PACS number: 87.53.Jw

ALGEBRA: ALgorithm for the heterogeneous dosimetry based on GEANT4 for BRAchytherapy

Task group 43 (TG43)-based dosimetry algorithms are efficient for brachytherapy dose calculation in water. However, human tissues have chemical compositions and densities different than water. Moreover, the mutual shielding effect of seeds on each other (interseed attenuation) is neglected in the TG43-based dosimetry platforms. The scientific community has expressed the need for an accurate dosimetry platform in brachytherapy. The purpose of this paper is to present ALGEBRA, a Monte Carlo platform for dosimetry in brachytherapy which is sufficiently fast and accurate for clinical and research purposes. ALGEBRA is based on the GEANT4 Monte Carlo code and is capable of handling the DICOM RT standard to recreate a virtual model of the treated site. Here, the performance of ALGEBRA is presented for the special case of LDR brachytherapy in permanent prostate and breast seed implants. However, the algorithm is also capable of handling other treatments such as HDR brachytherapy.