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Dose specification for Ir-192 high dose rate brachytherapy in terms of dose-to-water-in-medium and dose-to-medium-in-medium
IPEN CNEN SP, Brazil; Maastricht University, Netherlands.
Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Radiation Physics. Karolinska University Hospital, Sweden.
Maastricht University, Netherlands; Hasselt University, Belgium.
Karolinska University Hospital, Sweden.
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2015 (English)In: Physics in Medicine and Biology, ISSN 0031-9155, E-ISSN 1361-6560, Vol. 60, no 11, 4565-4579 p.Article in journal (Refereed) Published
Abstract [en]

Dose calculation in high dose rate brachytherapy with Ir-192 is usually based on the TG-43U1 protocol where all media are considered to be water. Several dose calculation algorithms have been developed that are capable of handling heterogeneities with two possibilities to report dose: dose-to-medium-inmedium (D-m,D-m) and dose-to-water-in-medium (D-w,D-m). The relation between D-m,D-m and D-w,D-m for Ir-192 is the main goal of this study, in particular the dependence of D-w,D-m on the dose calculation approach using either large cavity theory (LCT) or small cavity theory (SCT). A head and neck case was selected due to the presence of media with a large range of atomic numbers relevant to tissues and mass densities such as air, soft tissues and bone interfaces. This case was simulated using a Monte Carlo (MC) code to score: D-m,D-m, D-w,D-m (LCT), mean photon energy and photon fluence. D-w,D-m (SCT) was derived from MC simulations using the ratio between the unrestricted collisional stopping power of the actual medium and water. Differences between D-m,D-m and D-w,D-m (SCT or LCT) can be negligible (less than1%) for some tissues e.g. muscle and significant for other tissues with differences of up to 14% for bone. Using SCT or LCT approaches leads to differences between D-w,D-m (SCT) and D-w,D-m (LCT) up to 29% for bone and 36% for teeth. The mean photon energy distribution ranges from 222 keV up to 356 keV. However, results obtained using mean photon energies are not equivalent to the ones obtained using the full, local photon spectrum. This work concludes that it is essential that brachytherapy studies clearly report the dose quantity. It further shows that while differences between D-m,D-m and D-w,D-m (SCT) mainly depend on tissue type, differences between D-m,D-m and D-w,D-m (LCT) are, in addition, significantly dependent on the local photon energy fluence spectrum which varies with distance to implanted sources.

Place, publisher, year, edition, pages
IOP Publishing: Hybrid Open Access , 2015. Vol. 60, no 11, 4565-4579 p.
Keyword [en]
brachytherapy; Ir-192; dose-to-water-in-medium; dose-to-medium-in-medium
National Category
Clinical Medicine
URN: urn:nbn:se:liu:diva-119572DOI: 10.1088/0031-9155/60/11/4565ISI: 000355210600023PubMedID: 26009538OAI: diva2:825327

Funding Agencies|Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP) [2011/01913-4, 2011/23765-7, 2011/22778-8]; Swedish Cancer Foundation [CF 14 064]

Available from: 2015-06-23 Created: 2015-06-22 Last updated: 2015-06-23

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Carlsson Tedgren, Åsa
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Division of Radiological SciencesFaculty of Medicine and Health SciencesDepartment of Radiation Physics
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