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Biomedical subjects

K R Hogstrom

Publications and source records attributed to K R Hogstrom.

At least 19 recordsLinked to original sources

Dosimetric evaluation of a two-dimensional, arc electron, pencil-beam algorithm in water and PMMA.

The accuracy of dose calculations from a pencil-beam algorithm developed specifically for arc electron beam therapy was evaluated at 10 and 15 MeV. Mid-arc depth-doses were measured for 0 degrees and 90 degrees arcs using 12 and 15 cm radius cylindrical water phantoms. Calculated depth-doses for the 90 degrees arced beams in the build-up region were as much as 3% less than measured values; the maximum dose was similar in magnitude but at a greater depth; and the therapeutic depth, R80, was 2-4 mm deeper. Calculated values of output (dose per monitor unit) at the depth of the maximum calculated dose were compared with measured values; for arcs ranging from 0-90 degrees, 12 and 15 cm radius water phantoms, and collimator widths of 4, 5 and 6 cm, results showed differences as great as 7%. Isodose countours for a 90 degrees arc were also measured in a 15 cm radius PMMA phantom. At the depth of maximum dose the algorithm predicted doses in the penumbral regions, both with and without collimation, which agreed within a few per cent of measured values. The largest discrepancies were 5%, which occurred in the penumbral portion of the depth-dose fall-off region. Differences between measurement and calculation are not believed to be clinically significant and are believed to be primarily due to the fact that the algorithm models neither large-angle scattering nor the effects of range straggling on the pencil-beam dose distribution.

Algorithms

Dose in bone and tissue near bone-tissue interface from electron beam.

This work has quantitatively studied the variation of dose both within bone and in unit density tissue near bone-tissue interfaces. Dose upstream of a bone-tissue interface is increased because of an increase in the backscattered electrons from the bone. The magnitude of this effect was measured using a thin parallel-plate ionization chamber upstream of a polymethyl methacrylate (PMMA)-hard bone interface. The electron backscatter factor (EBF) increased rapidly with bone thickness until a full EBF was achieved. This occurred at approximately 3.5 mm at 2 MeV and 6 mm at 13.1 MeV. The full EBF at the interface ranged from approximately 1.018 at 13.1 MeV to 1.05 at 2 MeV. It was also observed that the EBF had a dependence on the energy spectrum at the interface. The penetration of the backscattered electrons in the upstream direction of PMMA was also measured. The dose penetration fell off rapidly in the upstream direction of the interface. Dose enhancement to unit density tissue in bone was measured for an electron beam by placing thermoluminescent dosimeters (TLDs) in a PMMA-bone-PMMA phantom. The maximum dose enhancement in bone was approximately 7% of the maximum dose in water. However, the pencil-beam algorithm of Hogstrom et al. predicted an increase of only 1%, primarily owing to the inverse-square correction. Film was also used to measure the dose enhancement in bone. The film plane was aligned either perpendicular or parallel to the central axis of the beam. The film data indicated that the maximum dose enhancement in bone was approximately 8% for the former film alignment (which was similarly predicted by the TLD measurements) and 13% for the latter film alignment. These results confirm that the X ray film is not suitable to be irritated "edge on" in an inhomogeneous phantom without making perturbation corrections resulting from the film acting as a long narrow inhomogeneous cavity within the bone. In addition, the results give the radiotherapist a basis for clinical judgment when electron beams are used to treat lesions behind bone or near bony structures. We feel these data enhance the ability to recognize the shortcomings of the current dose calculation algorithm used clinically.

Bone and Bones

Evaluation of a total scalp electron irradiation technique.

A dosimetric evaluation of a total scalp electron-beam irradiation technique that uses six stationary fields was performed. The initial treatment plan specified a) that there be a 3-mm gap between abutted fields and b) that the field junctions be shifted 1 cm after 50% of the prescribed dose had been delivered. Dosimetric measurements were made at the scalp surface, scalp-skull interface, and the skull-brain interface in an anthropomorphic head phantom using both film and thermoluminescent dosimeters (TLD-100). The measurements showed that the initial technique yields areas of increased and decreased dose ranging from -50% to +70% in the region of the field junctions. To reduce regions of nonuniform dose, the treatment protocol was changed by eliminating the gap between the coronal borders of abutted fields and by increasing the field shift from 1 cm to 2 cm for all borders. Subsequent measurements showed that these changes in treatment protocol resulted in a significantly more uniform dose to the scalp and decreased variation of doses near field junctions (-10% to +50%).

Electrons

Dosimetry characteristics of metallic cones for intraoperative radiotherapy.

Dosimetry data were obtained on the first dedicated linear accelerator of its type designed for electron intraoperative radiotherapy (IORT) within an operating room. The linear accelerator uses a high dose rate, 9 Gy.min-1, to reduce the treatment time. Its chrome-plated brass treatment cones, designed with straight ends and 22.5 degrees beveled ends, are not mechanically attached to the collimator head, but are aligned using a laser projection system. Dosimetry measurements were made for each combination of energy (6, 9, 12, 15, and 16 MeV), cone size (diameters range from 5 to 12 cm), and cone type (22.5 degrees beveled or straight). From these data, depth-dose curves, cone output, and air-gap correction factors were generated that allow the calculation of the monitor setting for delivering a prescribed dose at any depth for any irradiation condition (energy, cone, air gap). Isodose data were measured for every cone using film in a solid water phantom. Scatter off the inside wall of the cone resulted in peripheral dose horns near the surface that were energy and cone dependent, being as large as 120%.

Electrons

Effect of dimensionality of heterogeneity corrections on the implementation of a three-dimensional electron pencil-beam algorithm.

Electron beam dose distributions were calculated on a three-dimensional grid using three pencil-beam algorithms, each taking into account irregularities in field shape. The algorithms differ in that patient anatomy in either one, two, or three dimensions is used in the calculation of dose to a point. Algorithms were optimized for speed by such techniques as precalculation and storage of several quantities, reordering of pencil-beam and grid-point loops, selection of cut-off values for some calculated quantities, and invoking error function symmetries. Execution times for optimized versions of each of the algorithms as implemented on a three-dimensional treatment planning system were comparable for both the one- and two-dimensional heterogeneity correction requires an additional calculational loop over fan lines. Execution times for the three-dimensional heterogeneity correction were approximately a factor of four longer than those for the two-dimensional correction. For certain geometries, three-dimensional heterogeneity corrections were necessary to calculate dose distributions accurately, in spite of the additional cost in calculation times.

Algorithms

Design of metallic electron beam cones for an intraoperative therapy linear accelerator.

A set of circular collimators and treatment cones from 5 to 12 cm diameter has been designed for an intraoperative accelerator (6-18 MeV) that has an optical docking system. Electron beam scattering theory has been used to minimize their weight while minimizing leakage radiation. Both acrylic and brass were evaluated as possible materials; however, because of substantial electron leakage through the lateral cone wall for acrylic, we have concluded that 2 mm thick brass walls are more desirable than acrylic walls. At 18 MeV, isodose measurements beneath the cones showed hot spots as great as 120% for both materials. The placement and dimension of an internal trimmer ring inside the brass cone was studied as a method for reducing the hot spots, and it was found this could only be accomplished at the expense of decreasing coverage of the 90% isodose surface. The effects of 1 degree cone misalignment on the dose distribution has been studied and found to generate changes of less than 5% in the dose and 3 mm in position of the 90% isodose surface. In a study of the contribution of the cone and its matching collimator assembly to x-ray room leakage, it was noted that although the treatment cone had a negligible contribution, the upper annuli of the upper collimator assembly contributed as much as 80% of the leakage at 16 MeV for the 5-cm cone.

Humans

A two-dimensional pencil-beam algorithm for calculation of arc electron dose distributions.

A two-dimensional pencil-beam algorithm is presented for the calculation of arc electron dose distributions in any plane that is perpendicular to the axis of rotation. The dose distributions are calculated by modelling the arced beam as a single broad beam defined by the irradiated surface of the patient. The algorithm is two-dimensional in that the anatomical cross section of the patient and the skin collimators are assumed identical in parallel planes outside the plane of calculation. The broad beam is modelled as a collection of strip beams, each strip beam being characterised by its planar fluence, mean projected angular direction and a root-mean-square spread about the mean direction. Using these parameters, the dose distribution is calculated using pencil-beam theory. Examples of strip-beam parameters and resulting dose distributions for patient geometries are presented. Features of the algorithm, which include (1) incorporation of pencil-beam theory for the calculation of dose in heterogeneous tissue, (2) run times of only about twice that of comparable-sized fixed electron fields and (3) the input requirement of only a single depth dose and four off-axis dose profiles of measured data, make the algorithm practical for clinical use.

Algorithms

Radionuclide production and partial radiochemical characterization following fast neutron irradiation of mouse spleens.

When radiotherapy patients are irradiated with fast neutron beams (energies greater than 20 MeV), positron emitting radionuclides (15O, 13N, 11C) are created in their tissues. Capillary blood flow can be determined in the irradiated tissue by measuring the washout of the 15O. The chemical form of these positron emitting nuclides is important when assumptions about their transport in the development of a blood flow model are being made. In the present work, normal mouse spleen tissue was used as a model system for these studies. The mouse spleen was activated by whole mouse irradiation using the M.D. Anderson Hospital neutron beam produced by 42 MeV protons impinging on a beryllium target. Results of cellular studies and large molecule precipitation measurements (1) show that at least 65% of 15O created in situ in mouse spleen is capable of being transported out of the spleen by the blood supply, (2) suggest that 13N may be 100% biologically mobile, and (3) indicate that 11C appears to be evenly divided between a population associated with small biologically mobile molecules and a population associated with larger, biologically trapped or immobile molecules.

Animals

Technique for verifying treatment fields using portal images with diagnostic quality.

The image quality of portal films for megavoltage photon beams, when using the double-exposure technique, is poor compared to diagnostic quality, X ray images. A technique is described to record on a single film a megavoltage portal image superimposed upon a diagnostic X ray image, which provides the radiotherapist with "diagnostic quality" portal images. The technique uses a commercially available X ray tube mounted on the head of a 60Co unit. The alignment procedure, which uses a leveling device to ensure that the X ray focal spot and 60Co source are at the same location for each exposure, is confirmed by registering on film the image of an alignment marker. An evaluation of film-screen combination showed therapy verification film in a rare earth intensifying screen cassette to be best suited for this technique. The relationship between off-axis dose and the penumbral region of the portal image has been evaluated and should be useful in the interpretation of portal verification film relative to the treatment volume.

Cobalt Radioisotopes

15O and 11C production in neutron radiotherapy patients.

In order to establish the feasibility of performing blood flow measurements following therapeutic neutron irradiation by determining increased 15O disappearance rate from a volume of tissue, knowledge of the probabilities of 15O, 11C and 13N production in tissue by a p(42)Be neutron-beam irradiation is required. Isotope production probability per unit dose (defined as the isotope-yield coefficient) is determined from the measured production of 15O, 13N and 11C in irradiated H2O. Measured isotope-yield coefficients average 1.20 x 10(-16), 2.85 x 10(-18) and 5.56 x 10(-18) Gy-1 per 16O nucleus, respectively, at depths between 1 and 15 cm in a water phantom. The isotope yield coefficients for 11C production from 12C (polyethylene) average 1.04 x 10(-16) Gy-1 per 12C nucleus at depths between 1 and 15 cm in a water phantom. From these yield coefficients, the creation of 9700 Bq 15O and 450 Bq 11C per cubic centimetre of human soft tissue (chemical composition of soft tissue of Reference Man) is calculated assuming a 0.65 Gy neutron irradiation given at a dose rate of 40 cGy min-1 and assuming no perfusion of the activity. These results agree with those calculated using published neutron cross sections and neutron energy spectra, indicating that (n, 2n) reactions are the predominant activation mechanisms.

Carbon Radioisotopes

Thermoluminescence of 7LiF in therapeutic high linear energy transfer (LET) charged-particle beams.

The thermoluminescence of the 200 and 260 degrees C peaks of 7LiF has been measured and compared with off-axis dose and depth-dose distributions for three therapeutic high-LET beams: negative pions, helium ions and neon ions. The methods of analysis consisted of both a single-peak analysis and the dual-peak analysis methods of Hogstrom and Irifune and Hoffmann et al. The results indicate that 7LiF, analysed by the dual-peak analysis methods, is potentially useful for extracting total dose, high-LET dose, and beam quality of helium-ion and negative-pion beams. For the higher-LET neon beam, differences in sensitivity between the 200 and 260 degrees C peaks of 7LiF were found to be independent of variations in LET within the beam; consequently, only the single-peak analysis method is applicable in which case the dosemeter at best can only estimate total dose.

Fluorides

Improving the therapeutic ratio of craniospinal irradiation in medulloblastoma.

Radiation therapy delivered to the entire cerebrospinal axis is indicated for a number of pediatric brain tumors, especially medulloblastoma. Improved radiotherapy techniques have changed the near fatal prognosis for children with medulloblastoma to a 50%, 5-year survival. Nevertheless, the treatment results in substantial acute toxicity, and many survivors have serious sequelae. Further improvement in survival with optimal surgery and radiotherapy is not expected unless chemotherapy is added. Refinements in radiotherapy technique, however, can improve the therapeutic ratio of the treatment by lowering its side effects. In the last year children who required craniospinal irradiation at M. D. Anderson Hospital were treated with 6 MV photons to the brain and primary tumor and with 15-17 MeV electrons to the spinal canal. The elective dose to the whole brain was 30 Gy in 17 fractions and 30 Gy in 20 fractions to the spine. The primary tumor received an additional 20-25 Gy. An electron-beam dose distribution was drawn on a computerized tomography (CT) reconstructed sagittal plane. The electron energy was selected so that the 90% isodose line was at least 3 mm anterior to the cord after correction for bone heterogeneity. The treatment was well tolerated in the first five patients. It is projected that the current technique will cause fewer late effects and improve the tolerance to chemotherapy.

Brain

Comparative late effects of X-rays and negative pimesons on the mouse kidney.

A system is described for comparing various modalities and fractionation schedules of radiation by means of their long-term morphologic effects upon the mouse kidney. The comparison system utilizes a grading scale for histopathologic changes in which a given histologic grade depends upon meeting defined threshold criteria, rather than quantitation of a particular measurement. Renal tubular alterations served as the basis for comparison, since they appeared more reliably defined than glomerular changes. The radiation dose that induced a specific threshold effect in kidneys from 50% of the animals at 6 months was defined as the effective dose-50%, or ED50.ED50 was found for x-rays and negative pimesons administered in 1, 2, or 5 fractions. From these data, the relative biologic effectiveness (RBE) of negative pi-mesons with respect to x-rays was determined for each fractionation schedule.

Animals

Computer dosimetry for flattened and wedged fast-neutron beams.

Beam flattening by the use of polyethylene filters has been developed for the 50-MeV d in equilibrium Be fast-neutron therapy beam at the Texas A&M Variable-Energy Cyclotron (TAMVEC) as a result of the need for a more uniform dose distribution at depth within the patient. A computer algorithm has been developed that allows the use of a modified decrement line method to calculate dose distributions; standards decrement line methods do not apply because of off-axis peaking. The dose distributions for measured flattened beams are transformed into distributions that are physically equivalent to an unflattened distribution. In the transformed space, standard decrement line theory yields a distribution for any field size which, by applying the inverse transformation, generates the flattened dose distribution, including the off-axis peaking. A semiempirical model has been constructed that allows the calculation of dose distributions for wedged beams from open-beam data.

Computers