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Biomedical subjects

K R Kase

Publications and source records attributed to K R Kase.

At least 19 recordsLinked to original sources

Neutron fluence and energy spectra around the Varian Clinac 2100C/2300C medical accelerator.

We have simulated the head geometry of a Varian Clinac 2100C/2300C medical accelerator in a Monte Carlo calculation to produce photoneutrons and transport them through the head shielding into a typical therapy room (modeled by a test cell at Varian Associates). The fast neutron leakage fluence and energy spectra have been calculated at 7 positions around the linac head for typical beam operation at 10, 15, 18 and 20 MV. The results of these calculations have been compared with limited measurements made using the same model accelerator operating in a Varian test cell. Calculations were also made for the fluence and energy spectra outside the head with no surrounding concrete walls, floor or ceiling to eliminate the effects of scattering from concrete. Comparisons were also made with calculations using a much simplified head geometry. The results indicate that the calculations using the complex head geometry compare, within the uncertainties, with the measurements. The simple head geometry leads to differences of a factor of 2 from the complex geometry. Results of these calculations can be used to calculate fast neutron transmission through various shielding configurations and through labyrinths.

Monte Carlo Method

Neutron sources in the Varian Clinac 2100C/2300C medical accelerator calculated by the EGS4 code.

The photoneutron yields produced in different components of the medical accelerator heads evaluated in these studies (24-MV Clinac 2500 and a Clinac 2100C/2300C running in the 10-MV, 15-MV, 18-MV and 20-MV modes) were calculated by the EGS4 Monte Carlo code using a modified version of the Combinatorial Geometry of MORSE-CG. Actual component dimensions and materials (i.e., targets, collimators, flattening filters, jaws and shielding for specific accelerator heads) were used in the geometric simulations. Calculated relative neutron yields in different components of a 24-MV Clinac 2500 were compared with the published measured data, and were found to agree to within +/-30%. Total neutron yields produced in the Clinac 2100/2300, as a function of primary electron energy and field size, are presented. A simplified Clinac 2100/2300C geometry is presented to calculate neutron yields, which were compared with those calculated by using the fully-described geometry.

Computer Simulation

Giant dipole resonance neutron yields produced by electrons as a function of target material and thickness.

This paper characterizes the functional dependence of the giant dipole resonance neutron yield produced by electrons in terms of the atomic number (Z) and thickness (T) of the target. The yields were calculated by integrating, over the photon energy, the product of the differential photon track length and published photoneutron cross sections. The EGS4 Monte Carlo code and analytical formulas were used to calculate the differential photon track length. In thick targets, the Giant Dipole Resonance neutron yield approaches a saturation value as target thickness T increases to 10 radiation lengths. A formula, 8 x 10(-6) x (Z1/2 + 0.12 Z3/2 - 0.001 Z5/2) n electron-1 MeV-1, developed from EGS4 calculations, estimates thick-target neutron yields for incident electron energies Eo above 50 MeV. Giant dipole resonance neutron yields, calculated by several analytic formulas for the differential photon track length, are compared with EGS4 calculations. Modifications to the analytic formulas are suggested. A scaling function is derived to estimate, from the thick-target formula, neutron yields produced in thin targets.

Electrons

Gas bremsstrahlung and associated photon-neutron shielding calculations for electron storage rings.

The EGS4 electron-photon Monte Carlo code has been used to study the characteristics of the bremsstrahlung x rays generated from the interaction of circulating electrons with the residual gas in accelerator storage rings. Gas bremsstrahlung dose rates are given for various opening angles as a function of the electron beam energy ranging from 0.5-10 GeV. Photon and neutron dose rates, generated from various devices struck by gas bremsstrahlung in a synchrotron radiation beamline, are also presented along with the photon spectral and transmission results. The EGS4-predicted results are found to be in basic agreement with the measurements made at the Stanford Synchrotron Radiation Laboratory. Figures, equations, and a simple method useful for the photon-neutron shielding design for beamlines are provided.

Neutrons

Tolerances in setup and dosimetric errors in the radiation treatment of breast cancer.

PURPOSE: Treatment failure in radiation therapy, as well as unexpected complications, can be associated with set up changes or variations that can cause deviations from the prescribed radiation dose distribution both inside and outside the target volume. The effect of various deviations from the planned setup on the delivery of the prescribed radiation dose to the desired treatment volume was studied. METHODS AND MATERIALS: Adding a second simulation was investigated as means of minimizing setup changes on treatment. The first simulation was used for planning the treatment and the second simulation was essentially a mock treatment. Dosimetric evaluations based on dose volume histograms were analyzed for each deviation in the setup. RESULTS: In 95% of the patients, the frequency of the changes in the setup parameters between the second simulation and the treatment setup were reduced significantly from the changes that occurred between the first simulation and the second simulation. The changes in isocenter coordinates up to +/- 1.0 cm have minimal effects (+/- 2%) on the dose distributions. Gantry angle variations up to +/- 4 degrees produce a change of less than +/- 5% in the dose distribution within the target volume. However, this angular variation resulted in additional tissue irradiation outside of the desired treatment field (about 10 cm3 for a large patient). A gantry angle variation of +/- 6 degrees can change the volume of tissue that receives the prescribed dose by at least +/- 10%. In addition, such a change can increase the volume of tissue outside the desired treatment field that is irradiated. CONCLUSION: It is concluded that individually, deviations in one of the parameters from the planned setup of +/- 1.0 cm in isocenter position and +/- 4 degrees in gantry angle do not produce significant deviations from the planned dose distribution. However, a significant change in dose distribution is observed if the setup parameters are concurrently changed. A second simulation may minimize the deviations of the treatment setup from the planned setup and maximize the precision in dose delivery to the target volume.

Breast Neoplasms

The v-src oncogene may not be responsible for the increased radioresistance of hematopoietic progenitor cells expressing v-src.

Infection of the IL-3-dependent, myeloid progenitor cell line 32D cl 3 with murine retroviruses that contain either the wild-type or a temperature-sensitive mutant v-src can render these cells growth-factor independent. These cells also became resistant to gamma irradiation administered at the low-dose rate of 0.05 Gy/min, which is used clinically. The v-src-dependent nature of resistance to gamma irradiation was examined by studying four clones of 32D cl 3 cells that had been infected with a retrovirus carrying the tsLA31A mutant of v-src. The tyrosine-specific kinase activity of this mutant is dramatically reduced at the nonpermissive temperature of 39 degrees C. Cells transformed by v-src and grown at either 34 or 39 degrees C, in the presence or absence of IL-3, demonstrated a significantly higher D0 compared to parental cells examined under identical conditions. In addition, expression of v-src abrogated the synergistic killing effect of heat and gamma irradiation. The D0 of parental 32D cl 3 cells kept at 39 degrees C after gamma irradiation was reduced significantly compared to the D0 of these cells kept at 34 degrees C. This contrasts with data from 32D cl 3 cells infected with either the wild-type v-src or the temperature-sensitive mutant, neither exhibited a synergistic effect in the D0 at either 34 or 39 degrees C. Therefore, while continuous expression of a v-src gene product is required for maintenance of the growth-factor-independent state, v-src does not appear to be responsible for the increased gamma-radiation resistance of these cells at low dose rate.

Animals

Electron beam modifications for the treatment of superficial malignancies.

For the treatment of superficial tumors, the surface dose should be high; unfortunately, because of pronounced dose buildup in low energy electron beams, their efficacy for such treatment is reduced. Electron beams can be modified by placing a low atomic number material called a beam spoiler in the beam. In general, the surface dose is a function of electron energy, source to surface distance, field size, thickness of beam spoiler, distance of beam spoiler from surface, atomic number of beam spoiler, and angle of the beam. The effects of these parameters are evaluated with respect to surface dose, bremsstrahlung dose, and field size changes for small fields at standard SSD and electron energies from 6 to 17 MeV. It was found that the use of a beam spoiler can generally increase the surface dose to values exceeding 90% of the maximum buildup value while maintaining a bremsstrahlung dose less than 3%. Changes in field size related to the placement of the beam spoiler were considerable in some cases.

Electrons

Dosimetric accuracy at low monitor unit settings.

Dosimetric accuracies at low monitor units are evaluated for linear accelerators from various manufacturers. A large error is observed in the majority of the accelerators. The error can be positive or negative. Although the error can exceed 20% for the first few monitor units, it is usually less than 5% when more than 10 monitor units are delivered. When low doses are required proper precautions should be taken for dosimetric accuracy including the beam energy, beam flatness and dose per monitor unit.

Humans

Study of dose perturbation parameters for eye shielding in megavoltage photon beam therapy.

Shielding blocks are frequently used to minimize dose and shield sensitive organs in radiation therapy. The blocks, which are made of high atomic number materials, produce significant dose perturbations in megavoltage photon beams. The effects of these perturbations are studied with special interest in the eye shielding in the treatment of head and neck malignancies. Optimum parameters for the treatment are suggested.

Eye Injuries

Patient biodistribution of intraperitoneally administered yttrium-90-labeled antibody.

Although 90Y is one of the best radionuclides for radioimmunotherapeutic applications, the lack of gamma rays in its decay complicates the estimation of radiation dose since its biodistribution cannot be accurately determined by external imaging. A limited clinical trial has been conducted with tracer doses (1 mCi) of 90Y in five patients who then received second-look surgery such that tissue samples were obtained for accurate radioactivity quantitation by in vitro counting. The anti-ovarian antibody OC-125 as the F(ab')2 fragment was coupled with diethylenetriaminepentaacetic acid, radiolabeled with 90Y and administered intraperitoneally to patients with suspected or documented ovarian cancer. Size exclusion and ion exchange high performance liquid chromatography analysis of patient ascitic fluid and serum samples showed no evidence of radiolabel instability although a high molecular weight species (presumably immune complex) was observed in three patients. Total urinary excretion of radioactivity prior to surgery averaged 7% of the administered radioactivity while at surgery the mean organ accumulation was 8% of the administered radioactivity in serum, 10% in liver, 7% in bone marrow, and 19% in bone with large patient to patient variation. The mean tumor/normal tissue radioactivity ratio varied between 3 and 25. On the assumption that the above radioactivity levels were achieved immediately following administration, that the radioactivity remained in situ until decayed and that the dimensions of tumor were sufficient to completely attenuate the emissions of 90Y, the dose to tumor for a 1-mCi administration would be approximately 50 rad with normal tissues receiving approximately 8 rad.

Animals

Measurements of dose from secondary radiation outside a treatment field: effects of wedges and blocks.

Radiation dose outside the radiotherapy treatment field can be significant and therefore is of clinical interest in estimating organ doses. In a previous paper we reported the results of measurements made using unmodified radiation fields. We have extended this study to include the effects of wedge filters and blocks. For a given dose on the central axis of a radiation field, wedges can cause a factor of 2 to 4 increase in dose at any point outside the field compared with the dose when no wedge is used. Adding blocks to a treatment field can cause an increase in dose at points outside the field, but the effect is much smaller than the effect of a wedge, and generally less than a factor of 2. From the results of these measurements, doses to selected organs outside the field for specified treatment geometries were estimated, and the potential for reducing these organ doses by additional shielding was assessed.

Humans

Radiation transmission and scattering for medical linacs producing x rays of 6 and 15 MV: comparison of calculations with measurements.

We present comparisons of calculated and measured dose equivalent rates outside the shielding and in the entry mazes of 2 medical linac facilities producing x rays at 6 and 15 MV. Calculations were made using the NCRP recommendations for estimating transmission of radiation through a shielding wall and scattering of radiation in a maze. We found that, for walls made of high-density concrete, the x-ray dose rate outside the shield was estimated within 50% if transmission factors measured in the appropriate high-density concrete were used. The dose rate was overestimated by a factor of 2-4 when transmission factors for normal concrete were scaled using a density ratio. Dose equivalent rates calculated for x rays and neutrons in the entry mazes agreed within a factor of 2 with the measurements.

Neutrons

Orthovoltage intraoperative radiotherapy: a new look at an old idea.

A 300 kvp orthovoltage machine has been permanently installed in an operating room for delivering intraoperative radiation therapy (IORT). A historical review of orthovoltage IORT and our present approach are described. The preliminary experience with 38 patients treated with orthovoltage IORT indicates that this technique is feasible, has low acute morbidity, and can be useful for palliation. "Radical" radiation therapy consisting of IORT "boost" treatment combined with external beam was used in 24 patients with primary or recurrent cancer. Local failure in 27 patients treated with IORT +/- external beam radiation therapy was 56%, but varied from 11% (1/9) for patients with resected disease to 78% (14/18) for patients with unresected disease. Complications occurred in nine patients (24%) and have been acceptable. There are 17 patients alive and six are NED, with follow-up of 4-18 months. There appears to be a role for orthovoltage IORT especially when combined with surgical resection for local control of advanced cancer arising in the abdomen where the use of high doses of external radiation therapy are hazardous.

Adolescent

Measurements of dose from secondary radiation outside a treatment field.

Radiation dose to organs outside the radiotherapy treatment field can be significant and therefore is of clinical interest. We have made measurements of dose at distances up to 70 cm from the central axes of 5 X 5, 15 X 15 and 25 X 25 cm radiation fields of 300 kVp, 4 MV and 8 MV X rays, and 60Co gamma rays, at the surface and at depths in water of 5 and 10 cm. Contributions to the total secondary radiation dose from water scatter, machine (collimator) scatter and leakage radiation have been separated. We have found that the component of dose from water scatter can be described by a simple exponential function of distance from the central axis of the radiation field for all energies and field sizes. Machine scatter contributes 20 to 40% of the total secondary dose depending on machine, field size and distance from the field. Leakage radiation contributes very little dose, but becomes the dominant component at distances beyond 60 cm from the central axis. Estimates of the risk of second tumors in long term survivors indicate a small incremental increase above the natural incidence rate based on information from the 1980 BEIR Committee report.

Adult

Radiation transmission study of silicone elastomer for mammary prosthesis.

Photon and electron transmission measurements were made for silicone elastomer and water, used in mammary prostheses. Photon energies used ranged from 100 kVp, 1.0-mm AI HVL, to 8 MV, and electron energies ranged from 3 to 11 MeV. Transmission of photons above 150 keV and electrons above 2 MeV through the silicone and water is identical, as expected from calculations of mass attenuation coefficients and mass stopping power.

Breast