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Wedge filters for megavoltage roentgen ray beams.

The aim of this investigation, to construct a range of fixed wedge filters and to simulate these with a motorized wedge, led to the derivation of 5 equations. These equations can be used to construct and test a consistent set of fixed wedge filters, eliminating elaborate trial and error experiments. The fixed wedge filters already in existence for the Philips SL75-10 and SL75-20 linear accelerators fitted these equations rather well. After adapting the motorized wedge of the SL75-14 according to these equations, it simulated the fixed wedges accurately.

Equipment Design↗

Immunization by particle bombardment of antigen-loaded poly-(DL-lactide-co-glycolide) microspheres in mice.

In the present study, we investigated whether poly-(DL-lactide-co-glycolide) (50:50) microspheres (PLG MS) containing a model antigen, ovalbumin (OVA), were delivered into mouse skin and the immune responses induced using a microparticulate bombardment system, Helios gene gun system, which can painlessly deliver the powdered drug through the stratum corneum to the epidermal-dermal interface using a high velocity supersonic flow of helium gas to accelerate the particles. The introduction of OVA-loaded PLG MS shows helium pressure-dependence, so that improved introduction can be achieved by a higher helium pressure used, thereby inducing sufficient anti-OVA IgG level. Moreover, in order to determine the type of immune system induced using particle bombardment, we investigated helper T-cell response characterized by the cytokine production in the isolated splenocytes 6 weeks after immunization and consequent production of the anti-OVA IgG subclasses in the serum in mice. As a result, IL-4 production in splenocytes and anti-OVA IgG1 level were preferentially elicited by particle bombardment with OVA-loaded PLG MS compared with IFN-gamma and anti-OVA IgG2a level. It seemed likely that particle bombardment using this system led to a Th-2 type immune response, i.e. a humoral immune response. In conclusion, this microparticulate bombardment system is a promising immunization method, expected to become an alternative to needle injection used to administer a broad range of vaccines for the treatment of various diseases.

Air Pressure↗

Linear accelerator output variability.

The Wellington Cancer Centre is equipped with two matched linear accelerators (Varian 2100CD) linear accelerators (identified as SN1027 and SN42). Each morning, before treatments commence, a radiation therapist carries out an output constancy check of the radiation output and every fortnight a physicist measures, in a phantom, the delivered radiation dose to check on the machine calibration. The daily output checks have been recorded into a database (Argus QA for Radiation Oncology) since August 1997 and in June 1998 the fortnightly calibration measurements were added. The information in the database, up to April 2003, has been analysed to consider the quality of the daily constancy checks as compared with the fortnightly calibration measurements and whether the data contains useful information on machine performance. After allowance for the effects of machine recalibration the fortnightly calibration measurements had an average standard deviation of 0.4% and the daily constancy checks 0.8%. The daily constancy checks had a greater number of large deviations than would be expected assuming a normal distribution and were not a good predictor of the need for a recalibration. The fortnightly calibration measurements with a much lower spread give a reliable indication of the need for a recalibration allowing the adoption of a +/- 1% tolerance. Over the period analysed one accelerator (SN42) was relatively stable with the output generally drifting between +/- 1% while the other (SN1027) had a consistent increase in the average output of about 2.5% per year.

Calibration↗

A noninvasive eye fixation and computer-aided eye monitoring system for linear accelerator-based stereotactic radiotherapy of uveal melanoma.

PURPOSE: To introduce a noninvasive eye fixation and computer-aided eye monitoring system for linear accelerator-based stereotactic radiotherapy for uveal melanoma. METHODS AND MATERIALS: At the Department of Radiotherapy and Radiobiology, University of Vienna, stereotactic radiotherapy is offered to patients with uveal melanoma considered unsuitable for (106)Ru brachytherapy or local resection. For the present feasibility study, 8 patients were carefully selected according to their ability to fixate a small light source with the diseased eye and whether they had a rather small head to meet the limited geometric space available. A polymethyl methacrylate tube was attached to a stereotactic mask system in craniocaudal orientation supporting a 45 degrees mirror, which was placed in front of the diseased eye. At the other end of the tube, the patient was given a small fixation light, and a small camera was positioned beneath, which was shielded for use during MRI. A computer interface calculated and visualized the spatial difference of the actual and a given reference pupil position, which was defined before CT scanning, during the MRI sequences, and during treatment delivery at the linear accelerator. RESULTS: The described system can be attached to a conventional stereotactic mask system with minor modifications. Because of the large distance between the eye and the fixation light, the optical fixation system was well tolerated by all patients, and a stable position of the eye was obtained. The camera system can be used during CT and MRI without interference. Absorption of the 6-MV photon beam by the mirror and the polymethyl methacrylate tube was negligible. The computer interface designed to determine the pupil position uses an image-processing algorithm that correlates a template of the reference image with the actual image of the eye. Provided sufficient illumination of the pupil, the correlation function showed a pronounced minimum at the reference position. The precision of the algorithm was tested by phantom measurements. For a given 1 mm or 2 mm displacement, the interface reported a mean shift of 0.96 +/- 0.18 mm or 2.07 +/- 0.11 mm, respectively. CONCLUSION: The results of this study demonstrated the feasibility of a new optical fixation system for linear accelerator-based stereotaxis. The artifact-free application of the camera system during image acquisition and irradiation and the use of the computer interface, which automatically monitored eye movements with submillimeter precision, provided large improvements compared with existing techniques. Given well-defined interruption criteria and accelerated image processing, the described system has a high potential to perform automatically gated treatment beam delivery in the near future.

Humans↗

The multi-disciplinary role of 'pion factories'.

The multi-disciplinary role of intermediate energy proton accelerators in pure and applied nuclear physics is discussed with particular reference to the experimental programmes at LAMPF (Los Alamos Meson Physics Facility) and SIN (Swiss Institute for Nuclear Research, Zurich).

Elementary Particles↗

Neutron dose rate evaluation for medical linear accelerators.

During X-ray therapeutic irradiation with energies above the threshold of (X,n) reactions in the structural materials of medical accelerators, a photoneutron fluence is generated. In Brazil, no measurements of neutron doses in radiotherapy rooms are being done yet, when licensing these equipment. Consequently, it is very important to obtain accurate analytical formulae and/or simulation of these dose rates, in order to estimate the increase in dose received by the patient and staff, as well as to correctly project the additional shielding for the treatment room. In this work, we present MCNP simulation of dosimetric quantities at the isocentre of some models of high-energy linear accelerators, and compare it with the values given by the manufacturers, finding good agreement between both.

Algorithms↗

Shielding design for the front end of the CERN SPL.

CERN is designing a 2.2-GeV Superconducting Proton Linac (SPL) with a beam power of 4 MW, to be used for the production of a neutrino superbeam. The SPL front end will initially accelerate 2 x 10(14) negative hydrogen ions per second up to an energy of 120 MeV. The FLUKA Monte Carlo code was employed for shielding design. The proposed shielding is a combined iron-concrete structure, which also takes into consideration the required RF wave-guide ducts and access labyrinths to the machine. Two beam-loss scenarios were investigated: (1) constant beam loss of 1 Wm(-1) over the whole accelerator length and (2) full beam loss occurring at various locations. A comparison with results based on simplified approaches is also presented.

Computer Simulation↗

Evaluation of the photoneutron field produced in a medical linear accelerator.

The doses and spectra of photoneutrons produced in a medical linear accelerator with photon energies of 10 and 15 MV were evaluated. The Monte Carlo code, MCNPX, was used to simulate the transport of these photoneutrons around the head for 10 and 15 MV photons. The fully-described geometry of the accelerator head was used in this calculation. The photoneutron energy spectra and doses for various photon field sizes were calculated at each of 20 positions. The results indicate that the maximum dose equivalents are observed in 20 x 20 cm(2) case among photon fields. It was found the neutron average energy at isocenter for a 0 x 0 cm(2) field is 0.38 MeV for 10 MV and is 0.45 MeV for 15 MV. The neutron doses at 10 positions around the head in the treatment room of the operation facility at 10 and 15 MV were measured using the bubble detectors. Measurements were compared with the calculations under the same geometry in the experiment. It was found that the majority of the calculated results agreed to within the standard deviations of the measurements. These above results can be applied in the verification of maximum allowed neutron leakage percentage of treatment dose defined in the IEC. We have been employing them to derive the empirical formula for neutron dose equivalent level at the maze entrance of medical accelerator treatment rooms in a study that is still underway.

Algorithms↗

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↗

Design of a target system for producing clinically useful quantities of oxygen-15 using an electron linear accelerator.

The nuclear medicine uses of short-lived positron emitters, such as 15O and 11C, rely primarily on the cyclotron production of these radionuclides. This paper presents an alternate approach to production of 15O by the use of photonuclear reactions on 16O, using bremsstrahlung radiation produced by an electron linear accelerator. Methods are described which produce useable quantities of relatively high specific activity 15O (25.1 mCi/4 min at 27.9 Ci/g), using a reboiling H2O target, with an electron linear accelerator having an electron beam energy of 26 MeV and a beam current of 100 microamperemeter. Results of this target system are compared to those of a target system developed recently by other investigators.

Methods↗

Asymmetric field arc rotations.

Optimal treatment planning of target volume that surrounds a vital critical structure is often very difficult. Treatment techniques using moving beam therapy with fields asymmetric with respect to rotational axis of the collimator head allow treatment of such target volumes with minimal dose to critical structures. The availability of independent motion of the collimator jaws on new medical accelerators allows easy setting up of asymmetric treatment portals. Therefore, treatment techniques utilizing asymmetric field arc rotations with acceptable dose distributions have been possible.

Bone Neoplasms↗

The use of independent collimation in the treatment of Graves' ophthalmopathy.

Graves' ophthalmopathy is an infiltrative disease of the orbit and randomized trials show that radiotherapy should be the first treatment of choice. This article describes how linear accelerators with independent collimation can be used for setting up purposes, in place of lead blocks, to shield the lens. This benefits the patient and radiographer by being quicker, more accurate and easier to set up.

Graves Disease↗

[Shielding design and detection of neutrons from medical and industrial electron accelerators--simple method of design calculation for neutron shielding].

The neutron leakage from medical and industrial electron accelerators has become an important problem and its detection and shielding is being performed in their facilities. This study provides a new simple method of design calculation for neutron shielding of those electron accelerator facilities by dividing into the following five categories; neutron dose distribution in the accelerator room, neutron attenuation through the wall and the door in the accelerator room, neutron and secondary photon dose distributions in the maze, neutron and secondary photon attenuation through the door at the end of the maze, neutron leakage outside the facility-skyshine.

Electrons↗

[Dual sieve-mesh collimator].

In this paper is advanced a new type of collimator-dual sieve-mesh collimator. Its principle is to use scanned electronic beam to attack 400 matrix-arranged wolfram targets of the square holes on the upper side of the main collimator and created 400 small X-ray fields sized by 10 mm x 10 mm. These X-ray fields will leave on its center 400 smaller X-ray fields sized by 5 mm x 5 mm after being further collimated by a sub-collimator. What's more, 16 different groups of such X-ray fields can be left on the center of the same field by controlling the all-round movement of the main collimator and sub-collimator in proper order and by scanning it round by round and mesh by mesh with electronic beams. It is these ting fields groups that make up various treatment fields with different energy (Dosage). This type of collimator can replace and simplify all other present collimators on accelerators and conformal-intensity modulation radiotherapy equipment. It has advantage of reducing the costs of radio-therapy equipment and making conformal and intensity modulation radiotherapy easier to perform.

Equipment Design↗

Comparison of a micro-multileaf collimator with a 5-mm-leaf-width collimator for intracranial stereotactic radiotherapy.

PURPOSE: To dosimetrically compare a micro-multileaf collimator (minimum leaf width of 3 mm) with the 5-mm-leaf multileaf collimator (MLC) of a standard linear accelerator for stereotactic conformal radiotherapy treatment of intracranial lesions. MATERIALS AND METHODS: Fourteen patients previously treated for a variety of irregularly shaped intracranial lesions using BrainLAB's micro-MLC were retrospectively replanned using the Varian Millennium MLC (5 mm leaf width). All planning was performed with the BrainSCAN v 5.1 software. The same fixed, noncoplanar beam arrangement was used for both plans, and identical target coverage was achieved by adjusting the MLC shape around the planning target volume (PTV). The isodose distributions and dose-volume histograms (DVH) were computed and plans were compared in terms of conformity of the prescription isodose to the PTV and dose received by surrounding normal tissue. RESULTS: Equivalent PTV coverage was achieved using the 5-mm collimator by adjusting the MLC shape around the target in every case. There was a statistically significant increase in the conformity index for the Varian MLC compared with the micro-MLC (p < 0.001), indicating a worse conformity of the prescription isodose to the PTV, but this parameter was within our (and Radiation Therapy Oncology Group) clinical criterion in all cases. There was no statistically significant difference in the maximum dose to critical structures, but DVH curves demonstrated an increased volume of normal tissue irradiated to the lower isodose levels. The mean increase in the volume of critical structure enclosed within the 50% and 70% isodose surfaces was 5.7% and 4.9%, respectively. CONCLUSIONS: The micro-MLC consistently improves both PTV conformity and surrounding tissue sparing when compared to that of a standard linear accelerator. However, when viewed quantitatively, the improvements are small enough that individual centers may question their choice of equipment when outfitting a stereotactic radiotherapy service.

Brain Neoplasms↗

MCNPX vs. DORT for SNS shielding design studies.

Radiation transport occurs through the 18 m long access way adjacent to the Spallation Neutron Source accelerator tunnel and the 2.2 m thick massive shielding door which closes the access way. A variety of typical materials for accelerator shielding, such as concrete and steel, were used for construction of the door to study radiation penetration. A comparison was carried out using both Monte Carlo (code MCNPX) and discrete ordinates (code DORT) methods. The beam losses during the accelerator operation are the sources for the radiation calculations. Analyses show that the results from the two methods are in good agreement.

Computer Simulation↗