The contribution from transit dose for Ir-192 HDR brachytherapy treatments

Author(s)

Fonseca, G. P. ^{[1, 2]} ; Landry, G. ^[2] ; Reniers, B. ^[2] ; Hoffmann, A. ^[2] ; Rubo, R. A. ^[3] ; Antunes, P. C. G. ^[1] ; Yoriyaz, H. ^[1] ; Verhaegen, F. ^{[2, 4]}

Affiliation

^[1] Inst Pesquisas Energet & Nucl IPEN CNEN SP, Sao Paulo - Brazil

^[2] Maastricht Univ Med Ctr, GROW Sch Oncol & Dev Biol, Dept Radiat Oncol MAASTRO, NL-6201 BN Maastricht - Netherlands

^[3] Univ Sao Paulo HC FMUSP, Hosp Clin, Sao Paulo - Brazil

^[4] McGill Univ, Dept Oncol, Med Phys Unit, Montreal, PQ H3G 1A4 - Canada

• Document type: Journal article
• Source: Physics in Medicine and Biology; v. 59, n. 7, p. 1831-1844, APR 7 2014.
• Web of Science Citations: 9

Abstract

Brachytherapy treatment planning systems that use model-based dose calculation algorithms employ a more accurate approach that replaces the TG43-U1 water dose formalism and adopt the TG-186 recommendations regarding composition and geometry of patients and other relevant effects. However, no recommendations were provided on the transit dose due to the source traveling inside the patient. This study describes a methodology to calculate the transit dose using information from the treatment planning system (TPS) and considering the source's instantaneous and average speed for two prostate and two gynecological cases. The trajectory of the 192Ir HDR source was defined by importing applicator contour points and dwell positions from the TPS. The transit dose distribution was calculated using the maximum speed, the average speed and uniform accelerations obtained from the literature to obtain an approximate continuous source distribution simulated with a Monte Carlo code. The transit component can be negligible or significant depending on the speed profile adopted, which is not clearly reported in the literature. The significance of the transit dose can also be due to the treatment modality; in our study interstitial treatments exhibited the largest effects. Considering the worst case scenario the transit dose can reach 3% of the prescribed dose in a gynecological case with four catheters and up to 11.1% when comparing the average prostate dose for a case with 16 catheters. The transit dose component increases by increasing the number of catheters used for HDR brachytherapy, reducing the total dwell time per catheter or increasing the number of dwell positions with low dwell times. This contribution may become significant (>5%) if it is not corrected appropriately. The transit dose cannot be completely compensated using simple dwell time corrections since it may have a non-uniform distribution. An accurate measurement of the source acceleration and maximum speed should be incorporated in clinical practice or provided by the manufacturer to determine the transit dose component with high accuracy. (AU)

• FAPESP's process: 11/22778-8 - 3D dosimetry based on medical images and Monte Carlo codes to use in brachytherapy
• Grantee: Hélio Yoriyaz
• Support Opportunities: Regular Research Grants
• FAPESP's process: 11/23765-7 - Dose-volume relationship in planning systems for 3D brachytherapy using mcnp5 code, brachyvision and oncentra
• Grantee: Gabriel Paiva Fonseca
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• FAPESP's process: 11/01913-4 - Monte Carlo modelling of the patient and treatment delivery complexities for high dose rate brachytherapy
• Grantee: Gabriel Paiva Fonseca
• Support Opportunities: Scholarships in Brazil - Doctorate