Biomedical subjects

A Sam Beddar

Publications and source records attributed to A Sam Beddar.

16 recordsLinked to original sources

PubMed2006

Single-use MOSFET radiation dosimeters for the quality assurance of megavoltage photon beams.

We investigated the applicability of single-use MOSFET detectors as quality-assurance devices. Using ten accelerators available at our institution, we performed output measurements in both water and solid phantoms under photon irradiation. The MOSFET detectors performed well within the manufacturer's specifications, with average deviations of 2.1% and 0.7% for the 6 and 18 MV beams, respectively. The strength of the detector's design, including its wireless set-up, factory calibration and direct read-out, makes the system an acceptable independent quality-assurance device for use in verifying machine output within an accuracy of +/-5%. The MOSFET detectors provide a quick check of machine output, which can be efficacious in detecting gross errors in machine calibrations.

Particle Accelerators↗

PubMed2006

The optimization of dose delivery for intraoperative high-dose-rate radiation therapy using curved HAM applicators.

BACKGROUND AND PURPOSE: To determine the effect of the curvature of Harrison-Anderson-Mick applicators on the dose distribution in high-dose-rate intraoperative radiation therapy (HDR-IORT). MATERIAL AND METHODS: Treatment planning was performed with flat applicators using (192)Ir as the radioactive source, and dwell times were optimized using dose-point optimization techniques. These optimized dwell times were then used for the curved applicators, and the dose distributions that would actually be delivered to patients were determined. RESULTS: The dose directly below the central catheter was strongly dependent on the curvature of the applicator. Steep parabolic curves caused underdoses of as much as 19% at a point 1cm from the convex side of the applicator. The rate of dose reduction with increasing distance from the applicator surface was also a function of the curvature of the applicator. CONCLUSIONS: The curvature of the applicator profoundly affects dosimetry and can be exploited to optimize coverage of the target during HDR-IORT procedures. To ensure accurate dose delivery, these dose perturbations must be accounted for in the planning process. We recommend maintaining a dosimetry atlas of various applicator sizes and curvatures in addition to one for flat applicators.

Brachytherapy↗

PubMed2006

Conformal radiotherapy of the dominant liver metastasis: a viable strategy for treatment of unresectable chemotherapy refractory colorectal cancer liver metastases.

OBJECTIVES: To evaluate the safety and efficacy of conformal radiotherapy (RT) of the dominant liver metastasis as palliative treatment of patients with unresectable colorectal cancer liver metastases. METHODS: We retrospectively reviewed the hospital and RT records of 17 patients with unresectable colorectal liver metastases who had been treated with palliative RT to the dominant liver metastasis at our institution. RESULTS: The median size of the dominant liver metastasis was 10 cm (range, 3-19 cm). Twelve patients (71%) had evidence of extrahepatic disease. A median of 2 (range, 0-4) prior chemotherapy regimens had been administered. Median radiation dose was 42 Gy (range, 7.5-72 Gy). Concurrent chemotherapy included celecoxib in 1 (6%), capecitabine in 6 (35%), and both agents in 9 (53%) patients. Frequencies of acute diarrhea, nausea, vomiting, fatigue, hand-foot syndrome, and neutropenia were 29%, 47%, 6%, 29%, 7%, and 0%, respectively (all grade 2 or lower; no grade 3 toxicities). No late toxicities were noted. With a median follow-up time of 9.2 months, the median actuarial overall survival time from RT was 12.6 months (95% confidence interval [CI]: 3.3-40.9 months). The actuarial in-field local control rate was 62% at 6 months. The median actuarial time to in-field, out-of-field hepatic and distant progression were 6.8, 3.9, and 4.1 month, respectively (95% CIs, 3.9-15.8, 1.8-6.3, and 1.8-11.5 months, respectively). CONCLUSIONS: Conformal RT to the dominant liver metastasis as palliative therapy for unresectable colorectal cancer liver metastases has an acceptable toxicity profile and may improve survival. This approach merits further exploration.

Adult↗

PubMed2006

Measurement accuracy and cerenkov removal for high performance, high spatial resolution scintillation dosimetry.

With highly conformal radiation therapy techniques such as intensity-modulated radiation therapy, radiosurgery, and tomotherapy becoming more common in clinical practice, the use of these narrow beams requires a higher level of precision in quality assurance and dosimetry. Plastic scintillators with their water equivalence, energy independence, and dose rate linearity have been shown to possess excellent qualities that suit the most complex and demanding radiation therapy treatment plans. The primary disadvantage of plastic scintillators is the presence of Cerenkov radiation generated in the light guide, which results in an undesired stem effect. Several techniques have been proposed to minimize this effect. In this study, we compared three such techniques-background subtraction, simple filtering, and chromatic removal-in terms of reproducibility and dose accuracy as gauges of their ability to remove the Cerenkov stem effect from the dose signal. The dosimeter used in this study comprised a 6-mm(3) plastic scintillating fiber probe, an optical fiber, and a color charge-coupled device camera. The whole system was shown to be linear and the total light collected by the camera was reproducible to within 0.31% for 5-s integration time. Background subtraction and chromatic removal were both found to be suitable for precise dose evaluation, with average absolute dose discrepancies of 0.52% and 0.67%, respectively, from ion chamber values. Background subtraction required two optical fibers, but chromatic removal used only one, thereby preventing possible measurement artifacts when a strong dose gradient was perpendicular to the optical fiber. Our findings showed that a plastic scintillation dosimeter could be made free of the effect of Cerenkov radiation.

Artifacts↗

PubMed2006

Intraoperative radiation therapy using mobile electron linear accelerators: report of AAPM Radiation Therapy Committee Task Group No. 72.

Intraoperative radiation therapy (IORT) has been customarily performed either in a shielded operating suite located in the operating room (OR) or in a shielded treatment room located within the Department of Radiation Oncology. In both cases, this cancer treatment modality uses stationary linear accelerators. With the development of new technology, mobile linear accelerators have recently become available for IORT. Mobility offers flexibility in treatment location and is leading to a renewed interest in IORT. These mobile accelerator units, which can be transported any day of use to almost any location within a hospital setting, are assembled in a nondedicated environment and used to deliver IORT. Numerous aspects of the design of these new units differ from that of conventional linear accelerators. The scope of this Task Group (TG-72) will focus on items that particularly apply to mobile IORT electron systems. More specifically, the charges to this Task Group are to (i) identify the key differences between stationary and mobile electron linear accelerators used for IORT, (ii) describe and recommend the implementation of an IORT program within the OR environment, (iii) present and discuss radiation protection issues and consequences of working within a nondedicated radiotherapy environment, (iv) describe and recommend the acceptance and machine commissioning of items that are specific to mobile electron linear accelerators, and (v) design and recommend an efficient quality assurance program for mobile systems.

Electrons↗

PubMed2006

Surface preparation and coupling in plastic scintillator dosimetry.

One way to improve the performance of scintillation dosimeters is to increase the light-collection efficiency at the coupling interfaces of the detector system. We performed a detailed study of surface preparation of scintillating fibers and their coupling with clear optical fibers to minimize light loss and increase the amount of light collected. We analyzed fiber-surface polishing with aluminum oxide sheets, coating fibers with magnesium oxide, and the use of eight different coupling agents (air, three optical gels, an optical curing agent, ultraviolet light, cyanoacrylate glue, and acetone). We prepared 10 scintillating fiber and clear optical fiber light guide samples to test different coupling methods. To test the coupling, we first cut both the scintillating fiber and the clear optical fiber. Then, we cleaned and polished both ends of both fibers. Finally, we coupled the scintillating fiber with the clear optical fiber in either a polyethylene jacket or a V-grooved support depending on the coupling agent used. To produce more light, we used an ultraviolet lamp to stimulate scintillation. A typical series of similar couplings showed a standard deviation in light-collection efficiency of 10%. This can be explained by differences in the surface preparation quality and alignment of the scintillating fiber with the clear optical fiber. Absence of surface polishing reduced the light collection by approximately 40%, and application of magnesium oxide on the proximal end of the scintillating fiber increased the amount of light collected from the optical fiber by approximately 39%. Of the coupling agents, we obtained the best results using one of the optical gels. Because a large amount of the light produced inside a scintillator is usually lost, better light-collection efficiency will result in improved sensitivity.

Artifacts↗

PubMed2005

Intraoperative radiotherapy using a mobile electron LINAC: a retroperitoneal sarcoma case.

The advent of mobile LINACs for use in intraoperative radiation therapy (IORT) promises to make IORT more accessible than before and easier to deliver to patients undergoing surgery. Although mobile IORT systems have been available since 1999, few treatment centers currently use them. Here, we present the case of a typical patient undergoing IORT for retroperitoneal sarcoma to show how easy these mobile systems are to use and how adaptable they are within the operating room (OR) environment. We also discuss the roles and coordination of multidisciplinary team members during IORT and the feasibility of using mobile LINACs for IORT.

Electrons↗

PubMed2005

Monte Carlo calculations of the absorbed dose and energy dependence of plastic scintillators.

Detector systems using plastic scintillators can provide instantaneous measurements with high spatial resolution in many applications including small field and high dose gradient field applications. Energy independence and water equivalence are important dosimetric properties that determine whether a detector will be useful in a clinical setting. Using Monte Carlo simulations, we calculated the energy dependence of plastic scintillators when exposed to photon beams in the radiotherapeutic range. These calculations were performed for a detector comprised of a BC-400 plastic scintillator surrounded by a polystyrene wall. Our results showed the plastic scintillation detector to be nearly energy independent over a range of energies from 0.5 to 20 MeV. The ratio of the dose absorbed by the scintillator to that absorbed by water was nearly a constant, approximately equal to 0.98 over the entire energy range of interest. These results confirm the water equivalence of the plastic scintillation detector and are in very good agreement with earlier results obtained using Burlin cavity theory.

Computer Simulation↗

PubMed2005

Plastic scintillation dosimetry: optimal selection of scintillating fibers and scintillators.

Scintillation dosimetry is a promising avenue for evaluating dose patterns delivered by intensity-modulated radiation therapy plans or for the small fields involved in stereotactic radiosurgery. However, the increase in signal has been the goal for many authors. In this paper, a comparison is made between plastic scintillating fibers and plastic scintillator. The collection of scintillation light was measured experimentally for four commercial models of scintillating fibers (BCF-12, BCF-60, SCSF-78, SCSF-3HF) and two models of plastic scintillators (BC-400, BC-408). The emission spectra of all six scintillators were obtained by using an optical spectrum analyzer and they were compared with theoretical behavior. For scintillation in the blue region, the signal intensity of a singly clad scintillating fiber (BCF-12) was 120% of that of the plastic scintillator (BC-400). For the multiclad fiber (SCSF-78), the signal reached 144% of that of the plastic scintillator. The intensity of the green scintillating fibers was lower than that of the plastic scintillator: 47% for the singly clad fiber (BCF-60) and 77% for the multiclad fiber (SCSF-3HF). The collected light was studied as a function of the scintillator length and radius for a cylindrical probe. We found that symmetric detectors with nearly the same spatial resolution in each direction (2 mm in diameter by 3 mm in length) could be made with a signal equivalent to those of the more commonly used asymmetric scintillators. With augmentation of the signal-to-noise ratio in consideration, this paper presents a series of comparisons that should provide insight into selection of a scintillator type and volume for development of a medical dosimeter.

Computer-Aided Design↗

PubMed2005

Stability of a mobile electron linear accelerator system for intraoperative radiation therapy.

The flexibility of mobile electron accelerators, which are designed to be transported to an operating room and plugged into a normal 3-phase outlet, make them ideal for use in intraoperative radiation therapy. However, their transportability may cause trepidation among potential users, who may question the stability of such an accelerator over a period of use. In order to address this issue, we have studied the short-term stability of the Mobetron system over 20 daily quality assurance trials. Variations in output generally varied within +/-2% for the four energies produced by the unit (4, 6, 9, and 12 MeV) and changes in energy produced an equivalent shift of less than 1 mm on the depth-dose curve. Hours of inactivity, with the Mobetron powered on for use either throughout the day or overnight, led to variations in output of about 1%. Finally, we have tested the long-term stability of the absolute dose output of the Mobetron, which showed a change of about 1% per year.

Electrons↗

PubMed2005

Evaluation of precalibrated implantable MOSFET radiation dosimeters for megavoltage photon beams.

We have studied the response of factory calibrated implantable MOSFET detectors to absorbed doses from 100 to 400 cGy. The average measured dose is quite close to the true delivered dose, with the standard deviation falling between 1.4 and 3.6%. The measured dose tends to be slightly underestimated for smaller doses, while it tends to be slightly overestimated for larger doses. Thus, although the calibration of the detector is most accurate for doses close to the calibration dose of 200 cGy, it may be used over the range of commonly used doses in fractionated radiotherapy.

Algorithms↗

PubMed2004

Plastic scintillation dosimetry for radiation therapy: minimizing capture of Cerenkov radiation noise.

Over the last decade, there has been an increased interest in scintillation dosimetry using small water-equivalent plastic scintillators, because of their favourable characteristics when compared with other more commonly used detector systems. Although plastic scintillators have been shown to have many desirable dosimetric properties, as yet there is no successful commercial detector system of this type available for routine clinical use in radiation oncology. The main factor preventing this new technology from realizing its full potential in commercial applications is the maximization of signal coupling efficiency and the minimization of noise capture. A principal constituent of noise is Cerenkov radiation. This study reports the calculated capture of Cerenkov radiation by an optical fibre in the special case where the radiation is generated by a relativistic particle on the fibre axis and the fibre axis is parallel to the Cerenkov cone. The fraction of radiation captured is calculated as a function of the fibre core refractive index and the refractive index difference between the core and the cladding of the fibre for relativistic particles. This is then used to deduce the relative intensity captured for a range of fibre core refractive indices and fibre core-cladding refractive index differences. It is shown that the core refractive index has little effect on the amount of radiation captured compared to the refractive index difference. The implications of this result for the design of radiation therapy plastic scintillation dosimeters are considered.

Anisotropy↗

PubMed2004

AAPM TG-43 formalism for brachytherapy dose calculation of a 137Cs tube source.

We present a development of the use of the AAPM TG-43 dose formalism applied to 137Cs gynecological implant sources. The geometry factor, radial dose function, and anisotropy function of a 137Cs source modeled after the Nuclear Associates 67-809 series stainless steel jacketed tube source were derived following the AAPM TG-43 formalism. The dose rate distribution through the center of the source using the AAPM TG-43 dose formalism is calculated and compared with the calculations obtained using the Sievert summation and Monte Carlo simulation. The three methods resulted in an agreement within less than 5%, or an isodose rate line agreement within 2 mm. We demonstrate that the AAPM TG-43 formalism can be applied to 137Cs linear sources and is capable of serving as a 137Cs dose calculation algorithm that can be used for treatment planning purpose.

Brachytherapy↗

PubMed2003

Plastic scintillation dosimetry: optimization of light collection efficiency.

Practical contemporary radiotherapy dosimetry systems used for dose measurement and verification are ionization chambers (which typically have at least a 0.1 cm3 air cavity volume), thermoluminescent dosimeters (TLDs) and silicon diodes. However, during the last decade, there has been an increased interest in scintillation dosimetry using small water-equivalent plastic scintillators, due to their favourable characteristics when compared with other more commonly used detector systems. Although plastic scintillators have been shown to have many desirable dosimetric properties, as yet there is no successful commercial detector system of this type available for routine clinical use in radiation oncology. The objectives of this study are to identify the factors preventing this new technology from realizing its full potential in commercial applications. A definition of signal to noise ratio (S/N) will be proposed for this category of detectors. In doing so the S/N ratio for an early prototype design has been calculated and/or measured. Criteria to optimize the response and sensitivity of this category of detectors are presented.

Cobalt Isotopes↗

PubMed2003

Using intraoperative radiation therapy--a case study.

The introduction of a mobile linear accelerator in the OR has made intraoperative radiation therapy (IORT) more plausible. An IORT treatment can deliver a single high dose of radiation to a tumor or tumor bed after surgical resection or surgical exposure of high risk areas. This article details a case study in which IORT was used on a patient with sigmoid carcinoma and the procedure outcomes.

Adenosarcoma↗

PubMed2003

The role of intraoperative radiotherapy in pancreatic cancer.

In single-institution studies, IORT at appropriate doses seems to safely improve local control in patients who have locally advanced pancreatic cancer, compared with historical controls. IORT also has been a component of adjuvant treatment programs that have led to excellent local control in resected patients. When considering the use of IORT, it is essential to have an understanding of the physical characteristics of the electron beam and how it can differ with the use of flat and beveled applicators. Although apparent improvement in local control with the use of IORT seems to have produced some improvement in median survival rates, high rates of distant failure continues to prevent a significant improvement in long-term survival. Because effective local control in patients with unresectable pancreatic cancer is a prerequisite to the development of curative therapies, the development of improved systemic therapies in patients with locally advanced pancreatic cancer will likely make local therapies such as the use of IORT even more important in the future.

Adenocarcinoma↗