Third party brachytherapy seed calibrations and physicist responsibilities.
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Brachytherapy↗
Biomedical subjects
Larry A DeWerd
Publications and source records attributed to Larry A DeWerd.
Experimental determination of the radial dose function of 90Sr/90Y IVBT sources.
A series of measurements were undertaken using both high sensitivity radiochromic film and new lithium fluoride thermoluminescent dosimeters in a liquid water medium to define the radial dose function of 90Sr/90Y beta emitting intravascular brachytherapy sources more accurately. These measurements of a single 5 French source pellet served to verify current Monte Carlo transport models and extrapolation chamber measurements of the radial dose function, thus providing the recommended independent published measurements for g(r) of these sources. A slight deviation in the published radial dose function at depth leads the authors to recommend that treatment planning be performed using updated g(r) values from current Monte Carlo transport models verified by measurements such as those shown in this investigation.
Blood Vessel Prosthesis↗
Calibration of multiple LDR brachytherapy sources.
A trend is underway toward the use of prepackaged low dose rate brachytherapy sources, which come in the form of strands, coiled line sources, preloaded needles, and sterile cartridge packs. Since the medical physicist is responsible for verification of source strength prior to patient treatment, development of prepackaged source strength verification methods is needed. Existing guidelines are reviewed to establish the situation that medical physicists find with respect to prepackaged sources. This investigation presents an experimental evaluation of the effect of some of these multiseed geometries on source strength measurements. Multiseed strands and coils, whether 125I, 103Pd, or 192Ir can be measured in a chamber with a long, sensitive axial length with a uniform response. Sterile seed cartridge packs can also be measured but require a correction factor to be applied. Sources in needles, however, cannot be measured in the needle since there is too great a variation in needle composition and needle tolerance thickness. Removing these seeds from the needle into a sterile measurement insert, which maintains sterility is a practical source strength verification method, similar to those done for multiple seed configurations in a well chamber with adequate axial uniformity. Values are compared with individual air kerma strength calibrations, and correction factors, are presented' where needed. In each case, care must be taken to maintain sterility as multiple seeds are measured in well chamber inserts.
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Calculated and measured brachytherapy dosimetry parameters in water for the Xoft Axxent X-Ray Source: an electronic brachytherapy source.
A new x-ray source, the model S700 Axxent X-Ray Source (Source), has been developed by Xoft Inc. for electronic brachytherapy. Unlike brachytherapy sources containing radionuclides, this Source may be turned on and off at will and may be operated at variable currents and voltages to change the dose rate and penetration properties. The in-water dosimetry parameters for this electronic brachytherapy source have been determined from measurements and calculations at 40, 45, and 50 kV settings. Monte Carlo simulations of radiation transport utilized the MCNP5 code and the EPDL97-based mcplib04 cross-section library. Inter-tube consistency was assessed for 20 different Sources, measured with a PTW 34013 ionization chamber. As the Source is intended to be used for a maximum of ten treatment fractions, tube stability was also assessed. Photon spectra were measured using a high-purity germanium (HPGe) detector, and calculated using MCNP. Parameters used in the two-dimensional (2D) brachytherapy dosimetry formalism were determined. While the Source was characterized as a point due to the small anode size, < 1 mm, use of the one-dimensional (1D) brachytherapy dosimetry formalism is not recommended due to polar anisotropy. Consequently, 1D brachytherapy dosimetry parameters were not sought. Calculated point-source model radial dose functions at gP(5) were 0.20, 0.24, and 0.29 for the 40, 45, and 50 kV voltage settings, respectively. For 1<r<7 cm, measured point-source model radial dose functions were typically within 4% of calculated results. Calculated values for F(r, theta) for all operating voltages were within 15% of unity along the distal end (theta=0 degree), and ranged from F(1 cm, 160 degrees) = 0.2 to F(15 cm, 175 degrees) = 0.4 towards the catheter proximal end. For all three operating voltages using the PTW chamber, measured dependence of output as a function of azimuthal angle, psi, was typically on average +/-3% for 0 degree < or = psi < or = 360 degrees. Excluding an energy response function, measurements of normalized photon energy spectra were made for three operating voltages, and were typically within 2% agreement with the normalized Monte Carlo calculated spectra. In general, the model S700 Source exhibited depth dose behavior similar to low-energy photon-emitting low dose rate sources 125I and l03Pd, yet with capability for variable and much higher dose rates and subsequently adjustable penetration capabilities. This paper presents the calculated and measured in-water brachytherapy dosimetry parameters for the model S700 Source at the aforementioned three operating voltages.
Brachytherapy↗
Calibration of the photon component of 198Au stents.
PURPOSE: 198Au has promising characteristics for radioactive stent material, having properties as a mixed beta-particle and gamma emitter. Calibration of these radioactive stents is required to provide accurate clinical dosimetry. METHODS AND MATERIALS: We have developed an electroplating technique to incorporate stable gold onto stents followed by activation to 198Au in the University of Wisconsin nuclear reactor. The calibration method is a modification of the NIST traceable, in-air calibration technique for high-dose-rate (HDR) 192Ir sources. RESULTS: The air-kerma strength of HDR and low-dose-rate (LDR) sources was measured for proof of principle and found to agree to within 3% of values obtained with other NIST traceable calibration techniques. The photon component of two 198Au radioactive stents was measured over a period of 3 days. CONCLUSION: The air-kerma strength of HDR and LDR sources was measured for proof of principle and found to agree to within 3% of values obtained with other NIST traceable calibration techniques.
Calibration↗
The effect of ambient pressure on well chamber response: Monte Carlo calculated results for the HDR 1000 plus.
The determination of the air kerma strength of a brachytherapy seed is necessary for effective treatment planning. Well ionization chambers are used on site at therapy clinics to determine the air kerma strength of seeds. In this work, the response of the Standard Imaging HDR 1000 Plus well chamber to ambient pressure is examined using Monte Carlo calculations. The experimental work examining the response of this chamber as well as other chambers is presented in a companion paper. The Monte Carlo results show that for low-energy photon sources, the application of the standard temperature pressure PTP correction factor produces an over-response at the reduced air densities/pressures corresponding to high elevations. With photon sources of 20 to 40 keV, the normalized PTP corrected chamber response is as much as 10% to 20% over unity for air densities/pressures corresponding to an elevation of 3048 m (10000 ft) above sea level. At air densities corresponding to an elevation of 1524 m (5000 ft), the normalized PTP-corrected chamber response is 5% to 10% over unity for these photon sources. With higher-energy photon sources (>100 keV), the normalized PTP corrected chamber response is near unity. For low-energy beta sources of 0.25 to 0.50 MeV, the normalized PTP-corrected chamber response is as much as 4% to 12% over unity for air densities/pressures corresponding to an elevation of 3048 m (10000 ft) above sea level. Higher-energy beta sources (>0.75 MeV) have a normalized PTP corrected chamber response near unity. Comparing calculated and measured chamber responses for common 103Pd- and 125I-based brachytherapy seeds show agreement to within 2.7% and 1.9%, respectively. Comparing MCNP calculated chamber responses with EGSnrc calculated chamber responses show agreement to within 3.1% at photon energies of 20 to 40 keV. We conclude that Monte Carlo transport calculations accurately model the response of this well chamber. Further, applying the standard PTP correction factor for this well chamber is insufficient in accounting for the change in chamber response with air pressure for low-energy (<100 keV) photon and low-energy (<0.75 MeV)beta sources.
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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↗
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.
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Brachytherapy dosimetry of 125I and 103Pd sources using an updated cross section library for the MCNP Monte Carlo transport code.
Permanent implantation of low energy (20-40 keV) photon emitting radioactive seeds to treat prostate cancer is an important treatment option for patients. In order to produce accurate implant brachytherapy treatment plans, the dosimetry of a single source must be well characterized. Monte Carlo based transport calculations can be used for source characterization, but must have up to date cross section libraries to produce accurate dosimetry results. This work benchmarks the MCNP code and its photon cross section library for low energy photon brachytherapy applications. In particular, we calculate the emitted photon spectrum, air kerma, depth dose in water, and radial dose function for both 125I and 103Pd based seeds and compare to other published results. Our results show that MCNP's cross section library differs from recent data primarily in the photoelectric cross section for low energies and low atomic number materials. In water, differences as large as 10% in the photoelectric cross section and 6% in the total cross section occur at 125I and 103Pd photon energies. This leads to differences in the dose rate constant of 3% and 5%, and differences as large as 18% and 20% in the radial dose function for the 125I and 103Pd based seeds, respectively. Using a partially updated photon library, calculations of the dose rate constant and radial dose function agree with other published results. Further, the use of the updated photon library allows us to verify air kerma and depth dose in water calculations performed using MCNP's perturbation feature to simulate updated cross sections. We conclude that in order to most effectively use MCNP for low energy photon brachytherapy applications, we must update its cross section library. Following this update, the MCNP code system will be a very effective tool for low energy photon brachytherapy dosimetry applications.
Brachytherapy↗