Application of Monte Carlo calculations for validation of a treatment planning system in high dose rate brachytherapy

AbstractAimThe accuracy of treatment planning systems is of vital importance in treatment outcomes in brachytherapy. In the current study the accuracy of dose calculations of a high dose rate (HDR) brachytherapy treatment planning system (TPS) was validated using the Monte Carlo method.Materials and methodsThree 60Co sources of the GZP6 afterloading brachytherapy system were modelled using MCNP4C Monte Carlo (MC) code. The dose distribution around all the sources was calculated by MC and a dedicated treatment planning system. The results of both methods were compared.ResultsThere was good agreement (<2%) between TPS and MC calculated dose distributions except at a point near the sources (<1cm) and beyond the tip of the sources.ConclusionsOur study confirmed the accuracy of TPS calculated dose distributions for clinical use in HDR brachytherapy

In-air calibration of new high dose rate Co brachytherapy sources: results of measurements on a GZP6 brachytherapy afterloading unit

BackgroundThe air kerma rate of brachytherapy sources should be determined accurately by the manufacturer and medical physicists before clinical use.AimIn the current study the air kerma rate of three new 60Co high dose rate (HDR) brachytherapy sources was obtained by in-air measurements and a Farmer type ionization chamber.Materials/MethodsThree 60Co sources of a brachytherapy afterloading unit, GZP6, were calibrated in free air using a Farmer type chamber which was calibrated in terms of air kerma in an external teletherapy 60Co beam. Several correction factors including scatter correction and non-uniformity correction factors were derived and used for in-air calibrations.ResultsThe measured air kerma rates for all sources were in good agreement (less than 2.5%) with manufacturer-provided data, and the reliability of the air kerma rates of sources was validated for clinical application.ConclusionIn-air calibration of 60Co HDR sources can be performed using a Farmer type ionization chamber with acceptable accuracy. However, accurate distance measurement and reproducible measurement setup are required

A review on photoneutrons characteristics in radiation therapy with high-energy photon beams

In radiation therapy with high-energy photon beams (E[[ce:hsp sp="0.25"/]]>[[ce:hsp sp="0.25"/]]10[[ce:hsp sp="0.25"/]]MeV) neutrons are generated mainly in linacs head thorough (γ,n) interactions of photons with nuclei of high atomic number materials that constitute the linac head and the beam collimation system. These neutrons affect the shielding requirements in radiation therapy rooms and also increase the out-of-field radiation dose of patients undergoing radiation therapy with high-energy photon beams. In the current review, the authors describe the factors influencing the neutron production for different medical linacs based on the performed measurements and Monte Carlo studies in the literature

European Position Paper on Rhinosinusitis and Nasal Polyps 2020

The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise. The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included.Peer reviewe

Validation of a prototype optical computed tomography system

In radiation cancer treatments, the most of the side effects could be minimized using a proper dosimeter. Gel dosimeter is the only three-dimensional dosimeter and magnetic resonance imaging (MRI) is the gold standard method for gel dosimeter readout. Because of hard accessibility and high cost of sample reading by MRI systems, some other alternative methods were developed. The optical computed tomography (OCT) method could be considered as the most promising alternative method that has been studied widely. In the current study, gel dosimeter scanning using a prototype optical scanner and validation of this optical scanner was performed. Optical absorbance of the irradiated gel samples was determined by both of conventional spectrophotometer and the fabricated OCT system at 632 nm. Furthermore, these irradiated vials were scanned by a 1.5 T MRI. The slope of the curves was extracted as the dose-response sensitivity. The R2-dose sensitivity measured by MRI method was 0.1904 and 0.113 for NIPAM and PAGAT gels, respectively. The optical dose sensitivity obtained by conventional spectrophotometer and the fabricated optical scanner was 0.0453 and 0.0442 for NIPAM gels and 0.0244 and 0.0242 for PAGAT gels, respectively. The scanning results of the absorbed dose values showed that the new OCT and conventional spectrophotometer were in fair agreement. From the results, it could be concluded that the fabricated system is able to quantize the absorbed dose values in polymer gel samples with acceptable accuracy