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Geoffrey S Ibbott

Publications and source records attributed to Geoffrey S Ibbott.

At least 19 recordsLinked to original sources
PubMed2006

Intensity-modulated radiation therapy for gynecologic cancers: pitfalls, hazards, and cautions to be considered.

Intensity Modulated Radiation Therapy (IMRT) is considered a major advance in radiaton therapy (RT) capability. Therefore, it has been rapidly accepted and implemented in the treatment of multiple cancers in which RT plays a major role. Early reports of IMRT in gynecologic cancers have been largely favorable, particularly in terms of decreased acute morbidity. However, IMRT has not been prospectively shown to be superior to conventional 3-dimensional RT techniques when judged against criteria established in advance. Furthermore, there are many reasons to consider the possibility that outcomes might be compromised by IMRT techniques used to treat gynecologic cancers. This article reviews the potential pitfalls and hazards of IMRT techniques on patient safety and treatment efficacy. In addition, the article describes multiple technical issues with IMRT implementation, arguing for caution in IMRT use.

Calibration↗
PubMed2006

Consistency of absorbed dose to water measurements using 21 ion-chamber models following the AAPM TG51 and TG21 calibration protocols.

In 1999, the AAPM introduced a reference dosimetry protocol, known as TG51, based on an absorbed dose standard. This replaced the previous protocol, known as TG21, which was based on an air kerma standard. A significant body of literature has emerged discussing the improved accuracy and robustness of the absorbed dose standard, and quantifying the changes in baseline dosimetry with the introduction of the absorbed dose protocol. A significant component playing a role in the overall accuracy of beam output determination is the variability due to the use of different dosimeters. This issue, not adequately addressed in the past, is the focus of the present study. This work provides a comparison of absorbed dose determinations using 21 different makes and models of ion chambers for low- and high-energy photon and electron beams. The study included 13 models of cylindrical ion chambers and eight models of plane-parallel chambers. A high degree of precision (<0.25%) resulted from measurements with all chambers in a single setting, a sufficient number of repeat readings, and the use of high quality ion chambers as external monitors. Cylindrical chambers in photon beams show an improvement in chamber-to-chamber consistency with TG51. For electron dosimetry with plane-parallel chambers, the parameters Ngas and the product ND,w x k(ecal) were each determined in two ways, based on (i) an ADCL calibration, and (ii) a cross comparison with an ADCL-calibrated cylindrical chamber in a high-energy electron beam. Plane-parallel chamber results, therefore, are presented for both methods of chamber calibration. Our electron results with technique (i) show that plane-parallel chambers, as a group, overestimate the beam output relative to cylindrical chambers by 1%-2% with either protocol. Technique (ii), by definition, normalizes the plane-parallel results to the cylindrical results. In all cases, the maximum spread in output from the various cylindrical chambers is <2% implying a standard deviation of less than 0.5%. For plane-parallel chambers, the maximum spread is somewhat larger, up to 3%. A few chambers have been identified as outliers.

Journal Article↗
PubMed2006

Independent evaluations of IMRT through the use of an anthropomorphic phantom.

Intensity-modulated radiation therapy (IMRT) has gained rapid and wide-spread acceptance in the radiation oncology community for its ability to create dose distributions that conform to the convoluted shapes of many tumors. It is a complicated treatment technique, for which quality assurance procedures are correspondingly complicated and labor intensive. Several of the cooperative cancer study groups that conduct clinical trials under the auspices of the National Cancer Institute have required participating institutions to seek credentialing before enrolling patients in trials involving IMRT. The Radiological Physics Center has conducted such credentialing programs through the use of anthropomorphic phantoms that evaluate the planning and delivery of IMRT. The experience obtained through the irradiation of the phantoms by a number of institutions demonstrates that institutions vary significantly in their ability to deliver doses and dose distributions that agree with their own treatment plans.

Humans↗
PubMed2005

AAPM Task Group 103 report on peer review in clinical radiation oncology physics.

This report provides guidelines for a peer review process between two clinical radiation oncology physicists. While the Task Group's work was primarily focused on ensuring timely and productive independent reviews for physicists in solo practice, these guidelines may also be appropriate for physicists in a group setting, particularly when dispersed over multiple separate clinic locations. To ensure that such reviews enable a collegial exchange of professional ideas and productive critique of the entire clinical physics program, the reviews should not be used as an employee evaluation instrument by the employer. Such use is neither intended nor supported by this Task Group. Detailed guidelines are presented on the minimum content of such reviews, as well as a recommended format for reporting the findings of a review. In consideration of the full schedules faced by most clinical physicists, the process outlined herein was designed to be completed in one working day.

Health Physics↗
PubMed2005

Design and implementation of an anthropomorphic quality assurance phantom for intensity-modulated radiation therapy for the Radiation Therapy Oncology Group.

PURPOSE: To design, construct, and evaluate an anthropomorphic phantom for evaluation of intensity-modulated radiation therapy (IMRT) dose planning and delivery, for protocols developed by the Radiation Therapy Oncology Group (RTOG) and other cooperative groups. METHODS AND MATERIALS: The phantom was constructed from a plastic head-shaped shell and water-equivalent plastics. Internal structures mimic planning target volumes and an organ at risk. Thermoluminescent dosimeters (TLDs) and radiochromic film were used to measure the absolute dose and the dose distribution, respectively. The reproducibility of the phantom's dosimeters was verified for IMRT treatments, and the phantom was then imaged, planned, and irradiated by 10 RTOG institutions. RESULTS: The TLD results from three identical irradiations showed a percent standard deviation of less than 1.6%, and the film-scanning system was reproducible to within 0.35 mm. Data collected from irradiations at 10 institutions showed that the TLD agreed with institutions' doses to within +/-5% standard deviation in the planning target volumes and +/-13% standard deviation in the organ at risk. Shifts as large as 8 mm between the treatment plan and delivery were detected with the film. CONCLUSIONS: An anthropomorphic phantom using TLD and radiochromic film can verify dose delivery and field placement for IMRT treatments.

Benchmarking↗
PubMed2005

Reference photon dosimetry data and reference phase space data for the 6 MV photon beam from varian clinac 2100 series linear accelerators.

The current study presents the reference photon dosimetry data (RPDD) and reference phase space data (RPSD) for the 6 MV photon beam from Varian 2100 series linear accelerators. The RPDD provide the basic photon dosimetry data, typically collected during the initial commissioning of a new linear accelerator, including output factors, depth dose data, and beam profile data in air and in water. The RPSD provide the full phase space information, such as position, direction, and energy for each particle generated inside the head of any particular linear accelerator in question. The dosimetric characteristics if the 6 MV photon beam from the majority of the aforementioned accelerators, which are unaltered from the manufacturer's original specifications, can be fully described with these two data sets within a clinically acceptable uncertainty (approximately +/-2 %). The current study also presents a detailed procedure to establish the RPDD and RPSD using measured data and Monte Carlo calculations. The RPDD were constructed by compiling our own measured data and the average data based on the analysis of more than 50 sets of measured data from the Radiological Physics Center (RPC) and 10 sets of clinical dosimetry data obtained from 10 different institutions participating in the RPC's quality assurance monitoring program. All the measured data from the RPC and the RPC-monitored institutions were found to be within a statistically tight range (i.e., 1sigma approximately 1% or less) for each dosimetric quantity. The manufacturer's standard data, except for in-air off-axis factors that are available only from the current study, were compared with the RPDD, showing that the manufacturer's standard data could also be used as the RPDD for the photon beam studied in this study. The RPSD were obtained from Monte Carlo calculations using the BEAMnrc/ DOSXYZnrc code system with 6.2 MeV (a spread of 3% full width at half maximum) and 1.0 mm full width at half maximum as the values of the energy and radial spread of a Gaussian electron pencil beam incident on the target, respectively. The RPSD were capable of generating Monte Carlo data that agreed with the RPDD within the acceptance criteria adopted in the current study (e.g., 1% or 1 mm for depth dose). A complete set of the RPDD and RPSD from the current study is available from the RPC website (http://rpc.mdanderson.org) or via mass storage media such as DVD or CD-ROM upon request.

Electrons↗
PubMed2005

Recommendations of the American Association of Physicists in Medicine regarding the impact of implementing the 2004 task group 43 report on dose specification for 103Pd and 125I interstitial brachytherapy.

In March 2004, the recommendations of the American Association of Physicists in Medicine (AAPM) on the interstitial brachytherapy dosimetry using 125I and 103Pd were reported in Medical Physics [TG-43 Update: Rivard et al., 31, 633-674 (2004)]. These recommendations include some minor changes in the dose-calculation formalism and a major update of the dosimetry parameters for eight widely used interstitial brachytherapy sources. A full implementation of these recommendations could result in unintended changes in delivered dose without corresponding revisions in the prescribed dose. Because most published clinical experience with permanent brachytherapy is based upon two widely used source models, the 125I Model 6711 and 103Pd Model 200 sources, in this report we present an analysis of the dosimetric impact of the 2004 TG-43 dosimetry parameters on the history of dose delivery for these two source models. Our analysis indicates that the currently recommended prescribed dose of 125 Gy for Model 200 103Pd implants planned using previously recommended dosimetry parameters [AAPM 103Pd dose prescription: Williamson et al., Med. Phys. 27, 634-642 (2000)] results in a delivered dose of 120 Gy according to dose calculations based on the 2004 TG-43 update. Further, delivered doses prior to October 1997 varied from 113 to 119 Gy for a prescribed dose of 115 Gy compared to 124 Gy estimated by the AAPM 2000 report. For 125I implants using Model 6711 seeds, there are no significant changes (less than 2%). Practicing physicians should take these results into account when selecting the clinically appropriate prescribed dose for 103Pd interstitial implant patients following implementation of the 2004 TG-43 update dose-calculation recommendations. The AAPM recommends that the radiation oncology community review this report and consider whether the currently recommended dose level (125 Gy) needs to be revised.

Anisotropy↗
PubMed2005

Comparison of Monte Carlo calculations around a Fletcher Suit Delclos ovoid with radiochromic film and normoxic polymer gel dosimetry.

The Fletcher Suit Delclos (FSD) ovoids employed in intracavitary brachytherapy (ICB) for cervical cancer contain shields to reduce dose to the bladder and rectum. Many treatment planning systems (TPS) do not include the shields and other ovoid structures in the dose calculation. Instead, TPSs calculate dose by summing the dose contributions from the individual sources and ignoring ovoid structures such as the shields. The goal of this work was to calculate the dose distribution with Monte Carlo around a Selectron FSD ovoid and compare these calculations with radiochromic film (RCF) and normoxic polymer gel dosimetry. Monte Carlo calculations were performed with MCNPX 2.5.c for a single Selectron FSD ovoid with and without shields. RCF measurements were performed in a plane parallel to and displaced laterally 1.25 cm from the long axis of the ovoid. MAGIC gel measurements were performed in a polymethylmethacrylate phantom. RCF and MAGIC gel were irradiated with four 33 microGy m2 h(-1) Cs-137 pellets for a period of 24 h. Results indicated that MCNPX calculated dose to within +/- 2% or 2 mm for 98% of points compared with RCF measurements and to within +/- 3% or 3 mm for 98% of points compared with MAGIC gel measurements. It is concluded that MCNPX 2.5.c can calculate dose accurately in the presence of the ovoid shields, that RCF and MAGIC gel can demonstrate the effect of ovoid shields on the dose distribution and the ovoid shields reduce the dose by as much as 50%.

Brachytherapy↗
PubMed2004

Proposed guidelines for image-based intracavitary brachytherapy for cervical carcinoma: report from Image-Guided Brachytherapy Working Group.

PURPOSE: To present issues to be considered in, and make proposals for, image-based brachytherapy for cervical cancer. METHODS AND MATERIALS: The Image-Guided Brachytherapy Working Group, consisting of representatives from the Gynecology Oncology Group (GOG), Radiologic Physics Center (RPC), American Brachytherapy Society (ABS), American College of Radiology (ACR), American College of Radiology Imaging Network (ACRIN), American Association of Physicists in Medicine (AAPM), Radiation Therapy Oncology Group (RTOG), and American Society for Therapeutic Radiology and Oncology (ASTRO), proposed guidelines for image-based brachytherapy for cervical cancer. This report was based on their aggregate clinical experience and a review of the literature. It reflects only the personal opinions of the authors and is not meant to be an endorsement from any of the above organizations. RESULTS: The Group recommended T(2)-weighted MRI using a pelvic surface coil with MRI-compatible brachytherapy applicators in place for image-based intracavitary brachytherapy for cervical cancer. Imaging must be performed with the patient in the treatment position, with all other treatment conditions duplicated as closely as possible. Future use of positron emission tomography or positron emission tomography/CT may obviate the need for special applicators. The group proposed the following terminology for image-based brachytherapy. The GTV((I)) is defined as the gross tumor volume as defined through imaging, GTV is defined as the GTV((I)) plus any clinically visualized or palpable tumor extensions, and GTV + cx is defined as the GTV plus the entire cervix. The dose-volume histograms (DVH) of the GTV, GTV((I)), GTV + cx should be performed, and the dose to 100%, 95%, or 90% of the GTV (D(100), D(95), and D(90), respectively) and the percentage of the GTV covered by Point A dose (V(100)) should be reported. Similarly, the DVH of the bladder and rectum wall should be performed, and the maximal dose at any point within the bladder and rectal wall should be reported, along with the maximal dose to a contiguous 1, 2, and 5 cm(3) volume of the bladder and rectum, respectively. In addition, the dose at the International Commission on Radiation Units and Measurements reference point for the bladder and rectum should be reported. The Group thought that the current dose prescription method in use for cervical cancer brachytherapy (i.e., to prescribe to Point A in most institutions) should not be changed as yet, because image-based dosimetry is not ready for routine practice. The Group proposes that for research purposes, individual centers and cooperative groups (e.g., GOG, RTOG, ACRIN) collect image-based dosimetry information and perform DVHs and correlate these data with the clinical outcome to determine which of the above parameters are relevant. The Group encourages external funding for image-based dosimetry and recommends that brachytherapy manufacturers develop image-compatible applicators. CONCLUSION: Although current institutional brachytherapy prescription for cervical cancer should continue, image-based data collection and analysis are needed to optimize cervical cancer brachytherapy. Proposals are made for research in image-based brachytherapy for cervical cancer.

Brachytherapy↗
PubMed2004

Comparison of electron beam characteristics from multiple accelerators.

PURPOSE: To determine the relationships between electron beam depth dose characteristics, depth of maximum dose (d(max)), depth of 80% dose (d(80)), and depth of 50% dose (d(50)), and the nominal energy designation of electron beams from multiple linear accelerators for the purpose of electron beam treatment planning and quality assurance. METHODS: The Radiological Physics Center Staff, during its on-site dosimetry review visits to institutions participating in clinical trials, measured depth dose characteristics for more than 2000 electron beams. Measurements were performed on Varian, Siemens, and Elekta/Philips accelerators generating beams with nominal energy values ranging from 4-22 MeV. The depth dose data were determined at the nominal source-to-skin distance with the reference cone size in accordance with recommendation of the American Association of Physicists in Medicine Task Group 25 report. RESULTS: The important depth dose characteristics d(max), d(80), and d(50) varied in a predictable fashion when plotted against the true beam quality indicator, R(50). However, d(80) and d(50) values overlapped considerably when plotted against the manufacturers' nominal electron energy values. For a specific nominal electron energy value, the values of d(max), d(80), and d(50) varied by as little as 3 mm for low energy levels to nearly as much as 20 mm for high energies. CONCLUSIONS: The manufacturer's nominal electron energy value does not adequately describe the depth dose characteristics of an electron beam for treatment planning purposes. Clinicians and physicists should determine and use only the specific depth dose data for their clinical beams and not the manufacturer's nominal value.

Electrons↗
PubMed2004

Anthropomorphic breast phantoms for quality assurance and dose verification.

An evaluation of two anthropomorphic breast phantoms, which have been designed for quality assurance and dose verification of radiotherapy treatment of breast cancer patients, is presented. These phantoms are identical in terms of their dimensions and shape, and composed of several layers of either Plastic Water or tissue-equivalent material. Both water- and tissue-equivalent phantoms include lung- and rib-equivalent components. The phantoms simulate large, medium and small breasts. The value of the phantoms as breast treatment quality assurance tools was assessed by dose measurements with ionization chamber and thermoluminescence dosimeters (TLD), at different points inside the phantom. Measurements were made by irradiating the phantoms under conditions representing the different treatment techniques, found by the Radiological Physics Center (RPC) during its dosimetry quality audits. Most irradiations were performed with the water-equivalent breast phantom. One experiment was performed under consistent irradiation conditions to compare the tissue-equivalent phantom with the water-equivalent phantom. Measurements were compared with the dose estimated by the RPC's manual calculations used to check clinical charts of patients entered in a National Surgical Adjuvant Breast and Bowel Project (NSABP) protocol. Measurements were also compared with isodose distributions generated by a commercial radiation treatment planning (RTP) system. In the homogeneous three-dimensional (3-D) phantom, fairly good agreement (within 5%) was observed at the NSABP dose prescription point between measurements and 2-D dose estimation by manual calculations. At the same dose prescription point, but located in the heterogeneous 3-D phantom, agreement between measurements and a 3-D RTP system was within about 3%. Manual calculation resulted in overestimation of up to 6%. The general agreement between the TLD measurements and the 2-D RTP values was within 3% at various off-axis points, with the exception of a few points far off-axis, near the high-dose gradient region at the surface of the phantom.

Anthropometry↗
PubMed2004

Procedures for establishing and maintaining consistent air-kerma strength standards for low-energy, photon-emitting brachytherapy sources: recommendations of the Calibration Laboratory Accreditation Subcommittee of the American Association of Physicists in Medicine.

Low dose rate brachytherapy is being used extensively for the treatment of prostate cancer. As of September 2003, there are a total of thirteen 125I and seven 103Pd sources that have calibrations from the National Institute of Standards and Technology (NIST) and the Accredited Dosimetry Calibration Laboratories (ADCLs) of the American Association of Physicists in Medicine (AAPM). The dosimetry standards for these sources are traceable to the NIST wide-angle free-air chamber. Procedures have been developed by the AAPM Calibration Laboratory Accreditation Subcommittee to standardize quality assurance and calibration, and to maintain the dosimetric traceability of these sources to ensure accurate clinical dosimetry. A description of these procedures is provided to the clinical users for traceability purposes as well as to provide guidance to the manufacturers of brachytherapy sources and ADCLs with regard to these procedures.

Air↗
PubMed2004

Update of AAPM Task Group No. 43 Report: A revised AAPM protocol for brachytherapy dose calculations.

Since publication of the American Association of Physicists in Medicine (AAPM) Task Group No. 43 Report in 1995 (TG-43), both the utilization of permanent source implantation and the number of low-energy interstitial brachytherapy source models commercially available have dramatically increased. In addition, the National Institute of Standards and Technology has introduced a new primary standard of air-kerma strength, and the brachytherapy dosimetry literature has grown substantially, documenting both improved dosimetry methodologies and dosimetric characterization of particular source models. In response to these advances, the AAPM Low-energy Interstitial Brachytherapy Dosimetry subcommittee (LIBD) herein presents an update of the TG-43 protocol for calculation of dose-rate distributions around photon-emitting brachytherapy sources. The updated protocol (TG-43U1) includes (a) a revised definition of air-kerma strength; (b) elimination of apparent activity for specification of source strength; (c) elimination of the anisotropy constant in favor of the distance-dependent one-dimensional anisotropy function; (d) guidance on extrapolating tabulated TG-43 parameters to longer and shorter distances; and (e) correction for minor inconsistencies and omissions in the original protocol and its implementation. Among the corrections are consistent guidelines for use of point- and line-source geometry functions. In addition, this report recommends a unified approach to comparing reference dose distributions derived from different investigators to develop a single critically evaluated consensus dataset as well as guidelines for performing and describing future theoretical and experimental single-source dosimetry studies. Finally, the report includes consensus datasets, in the form of dose-rate constants, radial dose functions, and one-dimensional (1D) and two-dimensional (2D) anisotropy functions, for all low-energy brachytherapy source models that met the AAPM dosimetric prerequisites [Med. Phys. 25, 2269 (1998)] as of July 15, 2001. These include the following 125I sources: Amersham Health models 6702 and 6711, Best Medical model 2301, North American Scientific Inc. (NASI) model MED3631-A/M, Bebig/Theragenics model I25.S06, and the Imagyn Medical Technologies Inc. isostar model IS-12501. The 103Pd sources included are the Theragenics Corporation model 200 and NASI model MED3633. The AAPM recommends that the revised dose-calculation protocol and revised source-specific dose-rate distributions be adopted by all end users for clinical treatment planning of low energy brachytherapy interstitial sources. Depending upon the dose-calculation protocol and parameters currently used by individual physicists, adoption of this protocol may result in changes to patient dose calculations. These changes should be carefully evaluated and reviewed with the radiation oncologist preceding implementation of the current protocol.

Air↗
PubMed2003

A reanalysis of the Collaborative Ocular Melanoma Study Medium Tumor Trial eye plaque dosimetry.

PURPOSE: To recalculate the radiation doses delivered to structures of interest within the eye, i.e., the lens, tumor apex, 5-mm point, optic disk, and macula for patients treated with eye plaque radiotherapy on the Collaborative Ocular Melanoma Study (COMS) Medium Tumor Trial, using updated dosimetric data. METHODS AND MATERIALS: Using the Plaque Simulator planning system, doses were recalculated for a sampling of COMS patients for each plaque size. Dosimetry parameters incorporated into the recalculation were line source approximation, a 90% Silastic transmission factor, and a 0% gold transmission factor. Generic solutions were generated from the dose recalculations for each plaque size and structures of interest combination. Doses for the remainder of the patient population were recalculated using the generic solutions and compared with the originally reported COMS doses. RESULTS: Doses to all structures of interest were reduced 7%-21%, depending on the plaque size and structure combination. The reduction in dose for the macula, optic disc, lens, tumor apex, and 5-mm point was on average 10%, 18%, 8%, 11%, and 12%, respectively. The closer the macula and optic disk were to the plaque rim, the greater the dose reduction. Incorporation of the Silastic transmission factor accounted for a large part of the dose reduction. CONCLUSIONS: Incorporating anisotropy, line source approximation, and Silastic and gold shield attenuation into dose recalculations resulted in a significant and consistent reduction of doses to structures of interest within the eyes.

Algorithms↗
PubMed2003

Differences in electron beam dosimetry using two commercial ionization chambers and the TG-21 protocol: another reason to switch to TG-51.

Two of the most popular dosimetry systems used for calibration of megavoltage photon and electron beams in radiation therapy are (i) cylindrical Farmer-type chambers in liquid water and (ii) Holt Memorial parallel-plate chambers in clear polystyrene. Since implementation of the AAPM TG-21 calibration protocol, the Radiological Physics Center (which uses the Farmer in-water system) has compared machine calibrations on two occasions with those of Memorial Sloan-Kettering Cancer Center (which uses the Holt in-polystyrene system). Two years post publication of the TG-51 protocol, 70% of the clinics monitored by the RPC still use TG-21. Seventeen photon beams from cobalt-60 to 18 MV and 31 electron beams from 6 to 20 MeV were compared using the TG-21 protocol. These data represent the most comprehensive comparison of the two most popular systems in use. Based on the average percent difference, the two systems yielded the same absorbed dose to water at the reference point in phantom to within 1.5% for both modalities. No energy dependence was evident in the results; however, a systematic average percent difference between photons and electrons was seen, with the Farmer in-water system consistently predicting a dose 1.3% lower for electrons than the Holt in-polystyrene system. For photons both systems predicted the same dose to within 0.3% on average. When a physicist converts from TG-21 to TG-51, these data may be of assistance in explaining unexpected changes in output that are different from previously published values. Implementation of the TG-51 protocol should eliminate any of the observed differences in electron beam dosimetry between the two dosimetry systems because the Holt system cannot be used with TG-51.

Calibration↗
PubMed2003

Neutron source strength measurements for Varian, Siemens, Elekta, and General Electric linear accelerators.

The shielding calculations for high energy (>10 MV) linear accelerators must include the photoneutron production within the head of the accelerator. Procedures have been described to calculate the treatment room door shielding based on the neutron source strength (Q value) for a specific accelerator and energy combination. Unfortunately, there is currently little data in the literature stating the neutron source strengths for the most widely used linear accelerators. In this study, the neutron fluence for 36 linear accelerators, including models from Varian, Siemens, Elekta/Philips, and General Electric, was measured using gold-foil activation. Several of the models and energy combinations had multiple measurements. The neutron fluence measured in the patient plane was independent of the surface area of the room, suggesting that neutron fluence is more dependent on the direct neutron fluence from the head of the accelerator than from room scatter. Neutron source strength, Q, was determined from the measured neutron fluences. As expected, Q increased with increasing photon energy. The Q values ranged from 0.02 for a 10 MV beam to 1.44(x10(12)) neutrons per photon Gy for a 25 MV beam. The most comprehensive set of neutron source strength values, Q, for the current accelerators in clinical use are presented for use in calculating room shielding.

Elementary Particles↗