An Investigation of the Dose Distribution from LDR Ir-192 Wires in the Triangular Implants of the Paris System using Polymer Gel Dosimetry

Introduction: Polymer gels are modern dosimeters providing three dimensional dose distributions. These dosimeters can be used in brachytherapy in which the tumor dimension is relatively small and the dose gradient is high. In this study, the ability of the MAGICA polymer gel was investigated for assessing the absolute dose values as well as the dose distribution of low dose rate (LDR) Ir-192 wires in interstitial brachytherapy based in triangular implants of the Paris system. Material and Methods: A suitable phantom was made from Perspex. Glass tubes were used as the external tubes for holding the Ir-192 wires in the phantom. The MAGICA polymer gel was made and placed in the phantom. The phantom and the calibration tubes were irradiated using LDR Ir-192 wires and a Co-60 teletherapy unit respectively. They were subsequently imaged using an MRI scanner. The R2 (=1/T2) maps were extracted from several sequential T2-weighted MRI images. The dose values resulting from the polymer gel measurements at the reference points were compared with those from the common calculation method at the same points. In addition, the isodose curves resulting from gel dosimetry were compared with those from a brachytherapy treatment planning system (Flexiplan). Results: The average of the dose values measured with the gel at the reference points was 62.75% higher than those calculated at the same points. Investigating the isodose curves revealed that the maximum distance to agreement (DTAmax) between the isodoses resulting from the gel and those obtained from the treatment planning system was less than 3 mm at different dose levels. Discussion and Conclusion: Although the MAGICA gel indicates a higher absolute dose value than those calculated commonly, it can give the relative dose values accurately. Therefore, it can be recommended to be used for the assessment of dose distributions for the treatment of tissues as well as quality control of the treatment planning systems

Technical Considerations of Phosphorous-32 Bremsstrahlung SPECT Imaging after Radioembolization of Hepatic Tumors: A Clinical Assessment with a Review of Imaging Parameters

Background. Bremsstrahlung (BS) imaging during radioembolization (RE) confirms the deposition of radiotracer in hepatic/extrahepatic tumors. The aim of this study is to demonstrate 32P images and to optimize the imaging parameters. Materials and Methods. Thirty-nine patients with variable types of hepatic tumors, treated with the intra-arterial injection of 32P, were included. All patients underwent BS SPECT imaging 24–72 h after tracer administration, using low energy high resolution (LEHR) (18 patients) or medium energy general purpose (MEGP) (21 patients) collimators. A grading scale from 1 to 4 was used to express the compatibility of the 32P images with those obtained from CT/MRI. Results. Although the image quality obtained with the MEGP collimator was visually and quantitatively better than with the LEHR (76% concordance score versus 71%, resp.), there was no statistically significant difference between them. Conclusion. The MEGP collimator is the first choice for BS SPECT imaging. However, if the collimator change is time consuming (as in a busy center) or an MEGP collimator is not available, the LEHR collimator could be practical with acceptable images, especially in a SPECT study. In addition, BS imaging is a useful method to confirm the proper distribution of radiotherapeutic agents and has good correlation with anatomical findings

Silastic Thickness Optimization in Uveal Melanoma Brachytherapy by Monte Carlo Method

Introduction In order to treat uveal Melanoma , first, radioactive seeds are laid on a silicone- made substance which is called Silastic after that they are inserted in the plaque, and finally, this plaque containing silicone-made substance is stitched to the sclera surface. The dose gradient within the tumor and healthy tissues can be varied due to changing the Silastic thickness between sclera surface and radioactive seeds. In turn, this leads to difference in the amount of absorbed dose of tumor and healthy tissues. Present study is to investigate the optimum Silastic thickness in uveal Melanoma brachytherapy.  Materials and Methods To measure changes of depth dose of the plaque in a sphere with a radius of 12 mm, MCNP4C code was applied. Exact specifications of a 20-mm Collaborative Ocular Melanoma Study (COMS) plaque, Silastic and three I-125 seed sources, 6711 model were integrated in simulation. Dose calculations were performed using F6 tally in spheres with a radius of 0.2 mm. Results By measuring the changes of dose rate of plaque in distances of 0.2 to 18 mm from the sclera surface and having the prescribed dose for the absolute treatment of eye melanoma, final absorbed doses by tumor and healthy tissues for each different Silastic thicknesses of 0, 0.5, 1, 1.5, and 2 were calculated. Conclusion Considering the results and sclera tolerance, it was concluded that the thickness of Silastic must not exceed 0.5 mm, because increasing the Silastic thickness from this area, increases absorbed dose by healthy tissues and also the treatment time