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Calibration of low-energy electron beams from a mobile linear accelerator with plane-parallel chambers using both TG-51 and TG-21 protocols.

A new approach to intraoperative radiation therapy led to the development of mobile linear electron accelerators that provide lower electron energy beams than the usual conventional accelerators commonly encountered in radiotherapy. Such mobile electron accelerators produce electron beams that have nominal energies of 4, 6, 9 and 12 MeV. This work compares the absorbed dose output calibrations using both the AAPM TG-51 and TG-21 dose calibration protocols for two types of ion chambers: a plane-parallel (PP) ionization chamber and a cylindrical ionization chamber. Our results indicate that the use of a 'Markus' PP chamber causes 2-3% overestimation in dose-output determination if accredited dosimetry-calibration laboratory based chamber factors (N(60Co)(D,w,) Nx) are used. However, if the ionization chamber factors are derived using a cross-comparison at a high-energy electron beam, then a good agreement is obtained (within 1%) with a calibrated cylindrical chamber over the entire energy range down to 4 MeV. Furthermore, even though the TG-51 does not recommend using cylindrical chambers at the low energies, our results show that the cylindrical chamber has a good agreement with the PP chamber not only at 6 MeV but also down to 4 MeV electron beams.

Calibration↗

Dose properties of x-ray beams produced by laser-wakefield-accelerated electrons.

Given that laser wakefield acceleration (LWFA) has been demonstrated experimentally to accelerate electron beams to energies beyond 25 MeV, it is reasonable to assess the ability of existing LWFA technology to compete with conventional radiofrequency linear accelerators in producing electron and x-ray beams for external-beam radiotherapy. We present calculations of the dose distributions (off-axis dose profiles and central-axis depth dose) and dose rates of x-ray beams that can be produced from electron beams that are generated using state-of-the-art LWFA. Subsets of an LWFA electron energy distribution were propagated through the treatment head elements (presuming an existing design for an x-ray production target and flattening filter) implemented within the EGSnrc Monte Carlo code. Three x-ray energy configurations (6 MV, 10 MV and 18 MV) were studied, and the energy width deltaE of the electron-beam subsets varied from 0.5 MeV to 12.5 MeV. As deltaE increased from 0.5 MeV to 4.5 MeV, we found that the off-axis and central-axis dose profiles for x-rays were minimally affected (to within about 3%), a result slightly different from prior calculations of electron beams broadened by scattering foils. For deltaE of the order of 12 MeV, the effect on the off-axis profile was of the order of 10%, but the central-axis depth dose was affected by less than 2% for depths in excess of about 5 cm beyond d(max). Although increasing deltaE beyond 6.5 MeV increased the dose rate at d(max) by more than 10 times, the absolute dose rates were about 3 orders of magnitude below those observed for LWFA-based electron beams at comparable energies. For a practical LWFA-based x-ray device, the beam current must be increased by about 4-5 orders of magnitude.

Electrons↗

The importance of accurate linear accelerator head modelling for IMRT Monte Carlo calculations.

Two Monte Carlo dose engines for radiotherapy treatment planning, namely a beta release of Peregrine and MCDE (Monte Carlo dose engine), were compared with Helax-TMS (collapsed cone superposition convolution) for a head and neck patient for the Elekta SLi plus linear accelerator. Deviations between the beta release of Peregrine and MCDE up to 10% were obtained in the dose volume histogram of the optical chiasm. It was illustrated that the differences are not caused by the particle transport in the patient, but by the modelling of the Elekta SLi plus accelerator head and more specifically the multileaf collimator (MLC). In MCDE two MLC modules (MLCQ and MLCE) were introduced to study the influence of the tongue-and-groove geometry, leaf bank tilt and leakage on the actual dose volume histograms. Differences in integral dose in the optical chiasm up to 3% between the two modules have been obtained. For single small offset beams though the FWHM of lateral profiles obtained with MLCE can differ by more than 1.5 mm from profiles obtained with MLCQ. Therefore, and because the recent version of MLCE is as fast as MLCQ, we advise to use MLCE for modelling the Elekta MLC. Nevertheless there still remains a large difference (up to 10%) between Peregrine and MCDE. By studying small offset beams we have shown that the profiles obtained with Peregrine are shifted, too wide and too flat compared with MCDE and phantom measurements. The overestimated integral doses for small beam segments explain the deviations observed in the dose volume histograms. The Helax-TMS results are in better agreement with MCDE, although deviations exceeding 5% have been observed in the optical chiasm. Monte Carlo dose deviations of more than 10% as found with Peregrine are unacceptable as an influence on the clinical outcome is possible and as the purpose of Monte Carlo treatment planning is to obtain an accuracy of 2%. We would like to emphasize that only the Elekta MLC has been tested in this work, so it is certainly possible that alpha releases of Peregrine provide more accurate results for other accelerators.

Dose-Response Relationship, Radiation↗

Analysis of quality control data of eight modern radiotherapy linear accelerators: the short- and long-term behaviours of the outputs and the reproducibility of quality control measurements.

Quality control (QC) data of radiotherapy linear accelerators, collected by Helsinki University Central Hospital between the years 2000 and 2004, were analysed. The goal was to provide information for the evaluation and elaboration of QC of accelerator outputs and to propose a method for QC data analysis. Short- and long-term drifts in outputs were quantified by fitting empirical mathematical models to the QC measurements. Normally, long-term drifts were well (< or =1%) modelled by either a straight line or a single-exponential function. A drift of 2% occurred in 18 +/- 12 months. The shortest drift times of only 2-3 months were observed for some new accelerators just after the commissioning but they stabilized during the first 2-3 years. The short-term reproducibility and the long-term stability of local constancy checks, carried out with a sealed plane parallel ion chamber, were also estimated by fitting empirical models to the QC measurements. The reproducibility was 0.2-0.5% depending on the positioning practice of a device. Long-term instabilities of about 0.3%/month were observed for some checking devices. The reproducibility of local absorbed dose measurements was estimated to be about 0.5%. The proposed empirical model fitting of QC data facilitates the recognition of erroneous QC measurements and abnormal output behaviour, caused by malfunctions, offering a tool to improve dose control.

Calibration↗

Radiological safety assessment of Brazilian industrial facilities with electron accelerators.

Industrial electron accelerators are used by eight installations in Brazil, with a total of 14 machines generating electron beams. These facilities are classified into categories I or II, according to the International Atomic Energy Agency (IAEA) system. In category I are included the facilities with an integrally shielded unit with interlocks, where human access during operation is not physically possible owing to the configuration of the shielding. In category II are included the facilities with a unit housed in a shielded room that is kept inaccessible during operation by an entry control system. Of the 14 accelerators operational in Brazil, 11 belong to category I and three to category II. In the present work a methodology for the assessment of the radiological safety of these accelerator facilities was developed and applied, mainly on the basis of specific recommendations from the IAEA. The main safety items were evaluated at those eight installations. According to the results obtained here, no inadequacies were observed at the three installations in category II, from the radiological safety and radioprotection points of view. Nevertheless, two out of the five installations in category I showed several deficiencies. Most of these inadequacies have been corrected during this work, and the rest are in the course of being corrected.

Brazil↗

A new model for diffuse brain injury by rotational acceleration: I model, gross appearance, and astrocytosis.

Rapid head rotation is a major cause of brain damage in automobile crashes and falls. This report details a new model for rotational acceleration about the center of mass of the rabbit head. This allows the study of brain injury without translational acceleration of the head. Impact from a pneumatic cylinder was transferred to the skull surface to cause a half-sine peak acceleration of 2.1 x 10(5) rad/s2 and 0.96-ms pulse duration. Extensive subarachnoid hemorrhages and small focal bleedings were observed in the brain tissue. A pronounced reactive astrogliosis was found 8-14 days after trauma, both as networks around the focal hemorrhages and more diffusely in several brain regions. Astrocytosis was prominent in the gray matter of the cerebral cortex, layers II-V, and in the granule cell layer and around the axons of the pyramidal neurons in the hippocampus. The nuclei of cranial nerves, such as the hypoglossal and facial nerves, also showed intense astrocytosis. The new model allows study of brain injuries from head rotation in the absence of translational influences.

Acceleration↗

Cognitive impairment and synaptosomal choline uptake in rats following impact acceleration injury.

Traumatic brain injury is well known to cause deficits in learning and memory, which typically improve with time. Animal studies with fluid percussion or controlled cortical impact injury have identified transient disturbances in forebrain cholinergic innervation which may contribute to such cognitive problems. This study examines the extent to which water maze performance and forebrain synaptosomal choline uptake are affected one week after injury using the newly developed impact acceleration injury model. Injury or sham injury was delivered to adult male Sprague-Dawley rats under halothane anesthesia using a 500-g 2.1-m weight drop. Based on righting reflex, injured rats were divided into moderate (< or = 12 min) or severe (>12 min) groups. Water maze testing was performed on days 5-7 postinjury. On day 7, choline uptake was determined in synaptosomes from hippocampus, a parietal cortex, and entorhinal cortex. Maze learning was severely impaired in the severe injury group but not in the moderate injury group. Learning retention was slightly impaired in the moderate injury group and severely affected in the severe injury group. There was a very strong correlation between the severity of injury as determined by prolongation of righting times and disruption of maze learning at 1 week postinjury. There was no change in synaptosomal choline uptake in any of the forebrain regions in the severe injury group, but a slight (14%) decrease in the hippocampus and parietal cortex of the moderate injury group. Correlation analysis showed no relationship between synaptosomal choline uptake in any brain region and performance in either water maze learning or retention. This study shows that the impact acceleration model produces cognitive impairments equivalent to those seen with fluid percussion injury and controlled cortical impact. Compared with those models, the impact acceleration model does not produce a similar disruption of forebrain cholinergic nerve terminals.

Acceleration↗

Effect of dihydroergotamine on +Gz acceleration tolerance.

Dihydroergotamine is a potent vasoconstrictor of the venous capacitance vessels and has been shown to decrease blood pooling in patients with orthostatic hypotension. Acceleration acting on the long axis of the body (+Gz) pools blood into the lower body of the subject. Nine healthy men received an injection of 1 mg dihydroergotamine and 1 ml of saline intramuscularly in a randomised, double blind fashion, and had their Gz acceleration tolerances measured. Dihydroergotamine significantly increased Gz tolerance by 0.24 G and narrowed the difference between the maximum heart rate during the acceleration epoch and resting baseline by 10%. The drug had no effect on blood pressure and heart rate when the subjects changed from the supine to standing position. The increase in Gz tolerance was not sufficient for operational use.

Acceleration↗

Radiation protection at high energy proton accelerators.

The radiological problems associated with proton accelerators having maximum energies higher than a few GeV are discussed. Examples are given from accelerators where the authors have had practical experience for a number of years. The main focus will be on those problems which are unique to high energy proton accelerators, and which may not be necessarily associated with the proton beam operation itself.

Humans↗

Radiation protection at high energy electron accelerators.

An overview is presented of radiation protection at high energy electron accelerator facilities. By 'high energy' is meant the energy domain beyond a few tens of MeV, where electromagnetic showers are the determining and dominant factor for beam interactions with matter. The basic components of electron accelerators are described and their potential impact on radiation safety. The paper then concentrates on sources of prompt radiation which distinguish these machines from other accelerator facilities and briefly describe other features such as shielding or safety systems as relevant to electron machines. A more comprehensive description of these aspects can be found elsewhere in these proceedings. In addition, general concepts presented in this review are complemented and illustrated by specific examples in the authors' synchrotron radiation work in these proceedings.

Electromagnetic Fields↗

Shielding evaluation of a medical linear accelerator vault in preparation for installing a high-dose rate 252Cf remote afterloader.

In support of the effort to begin high-dose rate 252Cf brachytherapy treatments at Tufts-New England Medical Center, the shielding capabilities of a clinical accelerator vault against the neutron and photon emissions from a 1.124 mg 252Cf source were examined. Outside the clinical accelerator vault, the fast neutron dose equivalent rate was below the lower limit of detection of a CR-39 etched track detector and below 0.14 +/- 0.02 muSv h(-1) with a proportional counter, which is consistent, within the uncertainties, with natural background. The photon dose equivalent rate was also measured to be below background levels (0.1 muSv h(-1)) using an ionisation chamber and an optically stimulated luminescence dosemeter. A Monte Carlo simulation of neutron transport through the accelerator vault was performed to validate measured values and determine the thermal-energy to low-energy neutron component. Monte Carlo results showed that the dose equivalent rate from fast neutrons was reduced by a factor of 100,000 after attenuation through the vault wall, and the thermal-energy neutron dose equivalent rate would be an additional factor of 1000 below that of the fast neutrons. Based on these findings, the shielding installed in this facility is sufficient for the use of at least 5.0 mg of 252Cf.

Brachytherapy↗

High Intensity Proton Accelerator Project in Japan (J-PARC).

The High Intensity Proton Accelerator Project, named as J-PARC, was started on 1 April 2001 at Tokai-site of JAERI. The accelerator complex of J-PARC consists of three accelerators: 400 MeV Linac, 3 GeV rapid cycle synchrotron and 50 GeV synchrotron; and four major experimental facilities: Material and Life Science Facility, Nuclear and Particle Physics Facility, Nuclear Transmutation Experiment Facility and Neutrino Facility. The outline of the J-PARC is presented with the current status of construction.

Biological Science Disciplines↗

Secondary photon fields produced in accelerator-based sources for neutron generation.

Neutrons can be produced with low-energy ion accelerators for many applications, such as the characterisation of neutron detectors, the irradiation of biological samples and the study of the radiation damage in electronic devices. Moreover, accelerator-based neutron sources are under development for boron neutron capture therapy (BNCT). Thin targets are used for generating monoenergetic neutrons, while thick targets are usually employed for producing more intense neutron fields. The associated photon field produced by the target nuclei may have a strong influence on the application under study. For instance, these photons can play a fundamental role in the design of an accelerator-based neutron source for BNCT. This work focuses on the measurement of the photon field associated with neutrons that are produced by 4.0-6.8 MeV protons striking both a thin 7LiF target (for generating monoenergetic neutrons) and a thick beryllium target. In both cases, very intense photon fields are generated with energy distribution extending up to several MeV.

Beryllium↗

Neutron dose measurements with the GSI ball at high-energy accelerators.

A moderator-type neutron monitor containing pairs of TLD 600/700 elements (Harshaw) modified with the addition of a lead layer (GSI ball) for the measurement of the ambient dose equivalent from neutrons at medium- and high-energy accelerators, is introduced in this work. Measurements were performed with the Gesellschaft für Schwerionenforschung (GSI) ball as well as with conventional polyethylene (PE) spheres at the high-energy accelerator SPS at European Organization for Nuclear Research [CERN (CERF)] and in Cave A of the heavy-ion synchrotron SIS at GSI. The measured dose values are compared with dose values derived from calculated neutron spectra folded with dose conversion coefficients. The estimated reading of the spheres calculated by means of the response functions and the neutron spectra is also included in the comparison. The analysis of the measurements shows that the PE/Pb sphere gives an improved estimate on the ambient dose equivalent of the neutron radiation transmitted through shielding of medium- and high-energy accelerators.

Equipment Design↗

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↗

Forces, moments, and acceleration acting on a restrained dummy during simulation of three possible accidents involving a wheelchair negotiating a curb: comparison between lap belt and four-point belt.

The objective of this study was to determine the effect of two types of restraining belts (lap belt and a four-point belt) on an instrumented dummy during three situations: wheelchair hitting straight into curb (SIC); wheelchair falling straight off a curb (SOC); wheelchair falling diagonally off a curb (DOC). A fully instrumented (50th percentile Hybrid III) dummy was seated in a standard wheelchair and restrained with one of the belts. The wheelchair rolled down a ramp reaching a platform at 2.4 miles per hour (comfortable walking speed). Three types of experiments were performed: SIC, SOC, DOC. Each experiment was repeated at least three times. Forces, moments, and acceleration were monitored and recorded via 48 sensors placed at the head, spine, and limbs. All experiments were videotaped and photographed. The data were averaged and compared with standards that have been previously established in car crash testing and with data recently obtained in a similar study using a nonrestrained dummy. Our results showed that in the SIC experiments, low magnitude forces, moments, and acceleration of no clinical significance were recorded with both types of belts. The wheelchair remained upright and the dummy safely seated. In the SOC experiments, the two belts prevented the dummy's ejection from the chair and, thus, have been effective in lowering the forces, moments, and acceleration and preventing significant injuries to the head and neck regions. In the DOC experiments, the lap belt proved to be somewhat more effective than the four-point belt in lowering the extension forces at the upper neck and the moments at the lower neck below injury levels. It also kept the head injury criteria well below injury level. We postulate that the four-point belt was less effective because of its more extensive body fixation, which leads to concentration of moments and forces at the head and lower neck regions. The results of this study show that restraining systems can enhance the safety of wheelchair occupants in certain incidents. It has been demonstrated that the lap belt is as effective as the four-point belt system in SIC and SOC incidents. In DOC falls, neither belt could prevent falls and trauma to the head and neck region. The lap belt, however, was somewhat superior. We recommend that wheelchairs be equipped with a lap belt and patients be encouraged to buckle-up while using the wheelchair outdoors.

Acceleration↗

Measurements of radionuclides induced in the accelerator structure of the KEK-PS.

Radionuclides induced in accelerator structures were measured during each long shut-down by using a pure Ge detector and a portable multichannel pulse height analyzer. Variation in the nuclide composition for various points in the accelerator tunnel was investigated. The decay of the exposure rate was calculated using the measured nuclide composition. Radionuclide measurements of the vacuum chamber removed from the accelerator were also performed. The relation between the variation of the residual exposure rate and that of the nuclide composition was examined and it was found that the proportion of 48V, 54Mn and 56Co corresponds to variation in the beam loss pattern.

Particle Accelerators↗

Accelerator mass spectrometry of 63Ni at the Munich Tandem Laboratory for estimating fast neutron fluences from the Hiroshima atomic bomb.

After the release of the present dosimetry system DS86 in 1987, measurements have shown that DS86 may substantially underestimate thermal neutron fluences at large distances (>1,000 m) from the hypocenter in Hiroshima. This discrepancy casts doubts on the DS86 neutron source term and, consequently, the survivors' estimated neutron doses. However, the doses were caused mainly by fast neutrons. To determine retrospectively fast neutron fluences in Hiroshima, the reaction 63Cu(n, p)63Ni can be used, if adequate copper samples can be found. Measuring 63Ni (half life 100 y) in Hiroshima samples requires a very sensitive technique, such as accelerator mass spectrometry (AMS), because of the relatively small amounts of 63Ni expected (approximately 10(5)-10(6) atoms per gram of copper). Experiments performed at Lawrence Livermore National Laboratory have demonstrated in 1996 that AMS can be used to measure 63Ni in Hiroshima copper samples. Subsequently, a collaboration was established with the Technical University of Munich in view of its potential to perform more sensitive measurements of 63Ni than the Livermore facility and in the interest of interlaboratory validation. This paper presents the progress made at the Munich facility in the measurement of 63Ni by AMS. The Munich accelerator mass spectrometry facility is a combination of a high energy tandem accelerator and a detection system featuring a gas-filled magnet. It is designed for high sensitivity measurements of long-lived radioisotopes. Optimization of the ion source setup has further improved the sensitivity for 63Ni by reducing the background level of the 63Cu isobar interference by about two orders of magnitude. Current background levels correspond to a ratio of 63Ni/Ni<2x10(-14) and suggest that, with adequate copper samples, the assessment of fast neutron fluences in Hiroshima and Nagasaki is possible for ground distances of up to 1500 m, and--under favorable conditions--even beyond. To demonstrate this capability, we have measured successfully 6Ni/Ni ratios as low as (3.5 +/- 0.6) x 10(-13). The latter are, based on DS86, representative of a ratio expected from a typical Hiroshima copper sample at about 1,300-m ground range.

Body Burden↗