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• Dose measurements around 50 kVp electronic brachytherapy source. • Radiochromic film linear response function. • Impact of beam hardening effect around 50 kVp sources. We investigate the effect of the GafChromic™ film EBT3 model absorbed dose energy response when used for dose measurements around low-energy photon sources. Monte Carlo based correction procedure in synergy with appropriate calibration curves was shown to provide more accurate absorbed dose (either relative or absolute). An assessment was made of possible dose errors that might be encountered if such energy dependent response is ignored. We measured PDDs in water from a Xoft 50 kVp source using EBT3 film, and compared to PDD measurements acquired with a PTW-TN34013 parallel-plate ionization chamber. For the x-ray source, we simulated spectra using the EGSnrc (BEAMnrc) Monte Carlo code, and calculated Half Value Layer (HVL) at different distances from the source in water. Measurement strips of EBT3 film were positioned at distances of 2–6 cm from the Xoft source in a water phantom using a custom-made holder and irradiated simultaneously. Our results show that film calibration curves obtained at beam qualities near the effective energy of the Xoft 50 kVp source in water lead to variation in absorbed dose energy dependence of the response of around 5%. However, if the calibration curve was established in an MV beam quality, the error in absorbed dose could be as large as 20%. Accurate dose measurements using radiochromic films at low photon energies require that the radiochromic film dosimetry system be calibrated at appropriate corresponding low energies, as large absorbed dose errors are expected when film calibration is performed in MV beam qualities. [ABSTRACT FROM AUTHOR]

We describe methods to improve dose delivery for patients with rectal cancer receiving boost brachytherapy after external beam radiotherapy. Patients with rectal cancer who were ineligible or refusing surgery are treated with external beam radiotherapy and subsequently with three weekly image-guided volume-adapted high-dose-rate brachytherapy boosts of 10 Gy to the residual clinical target volume, for a total of 30 Gy in three fractions. Tungsten shielding placed at the center of intracavitary mold applicator and double-balloon technique was used to improve dose conformity to the target. Our results show that the use of tungsten shield and double balloon reduces the dose gradient within the target volume to receive the prescription boost dose of 10 Gy from maximum dose of 60 Gy down to 20 Gy. We outlined two methods for achieving higher high-dose-rate brachytherapy dose conformity using the tungsten shielding rods (to spare contralateral healthy tissues) and double-balloon technique (to decrease dose gradient within the target to minimize dose to the proximal mucosa). [ABSTRACT FROM AUTHOR]

• Radiochromic film CTDI measurements using film strips within modified CTDI phantom. • Impact of beam quality changes within CTDI phantom on radiochromic film dosimetry. • Monte Carlo simulated diagnostic radiology beam spectra within CTDI phantom. In this work we use Monte Carlo simulations to investigate change in Computed tomography (CT) X-ray energy spectra between exposures in air and within CT dose index (CTDI) phantom. While the results of these simulations will be relevant when measuring CTDI with any dosimeter, we apply the appropriate beam quality change correction for CTDI measurements using XR-QA2 model GafChromic™ film. Dose profiles were measured with film strips, sandwiched between acrylic rods cut in half, placed within CTDI phantoms and scanned before and after irradiation with document scanner in reflective mode. Reference dosimetry system was calibrated in terms of air kerma in air, which was converted into absorbed dose using ratio of mass-energy absorption coefficients water-to-air for a given beam quality, following the AAPM TG-61 protocol. Beam qualities for all film positions within CTDI phantom show beam softening for HVLs above 6 mm Al and beam hardening for HVLs bellow 6 mm Al. Calculated CTDI values using HVL in air for all CTDI positions, and those calculated using the appropriate calibration curves based on beam quality correction show for Head CTDI phantom differences ranging from 0.3% to 2.1% and for Body CTDI phantom from 2.5% to 5.7%. We describe method for CTDI measurements using radiochromic film dosimetry protocol corrected by the beam quality change within the phantom. Our results show differences in CTDI measurements of up to 5.7% when compared to using film calibration curves for beam quality in air. [ABSTRACT FROM AUTHOR]

Purpose Current high-dose-rate brachytherapy skin treatments with the Freiburg flap (FF) applicator are planned with treatment planning systems based on the American Association of Physicists in Medicine TG-43 data sets, which assume full backscatter conditions in dose calculations. The aim of this work is to describe an experimental method based on radiochromic film dosimetry to evaluate dose calculation accuracy during surface treatments with the FF applicator at different depths and bolus thicknesses. Methods and Materials Absolute doses were measured using a reference EBT3 radiochromic film dosimetry system within a Solid Water phantom at different depths (0, 0.5, 1, 2, and 3 cm) with respect to the phantom surface. The impact of bolus (up to 3-cm thickness) placed on top of the applicator was investigated for two clinical loadings created using Oncentra MasterPlan: 5 cm × 5 cm and 11 cm × 11 cm. Results For smaller loading and depths beyond 2 cm and for larger loading and depths beyond 1 cm, the dose difference was less than 3% (±4%). At shallower depths, differences of up to 6% (±4%) at the surface were observed if no bolus was added. The addition of 2-cm bolus for the smaller loading and 1 cm for larger loading minimized the difference to less than 3% (±4%). Conclusions For typical FF applicator loading sizes, the actual measured dose was 6% (±4%) lower at the skin level when compared with TG-43. Additional bolus above the FF was shown to decrease the dose difference. The consideration of change in clinical practice should be carefully investigated in light of clinical reference data. [ABSTRACT FROM AUTHOR]

• G-value was simulated with varying incoming electron energies and phantom sizes. • G-value of hydrated electrons decreases with increasing cluster size and LET. • GEANT4-DNA G-value simulations can be used for clinically relevant energies. In hydrated electron (e− aq) dosimetry, absorbed radiation dose to water is measured by monitoring the concentration of radiation-induced e− aq. However, to obtain accurate dose, the radiation chemical yield of e− aq , G(e− aq) , is needed for the radiation quality/setup under investigation. The aim of this study was to investigate the time-evolution of the G-values for the main generated reactive species during water radiolysis using GEANT4-DNA. The effects of cluster size and linear energy transfer (LET) on G(e− aq) were examined. Validity of GEANT4-DNA for calculation of G(e− aq) for clinically relevant energies was studied. Three scenarios were investigated with different phantom sizes and incoming electron energies (1 keV to 1 MeV). The time evolution of G(e− aq) was in good agreement with published data and did not change with decreasing phantom size. The time-evolution of the G-values increases with increasing LET for all radiolytic species. The particle tracks formed with high-energy electrons are separated and the resulting reactive species develop independently in time. With decreasing energy, the mean separation distance between reactive species decreases. The particle tracks might not initially overlap but will overlap shortly thereafter due to diffusion of reactive species, increasing the probability of e− aq recombination with other species. This also explains the decrease of G(e− aq) with cluster size and LET. Finally, if all factors are kept constant, as the incoming electron energy increases to clinically relevant energies, G(e− aq) remains similar to its value at 1 MeV, hence GEANT4-DNA can be used for clinically relevant energies. [ABSTRACT FROM AUTHOR]

Purpose In the past, film dosimetry was developed into a powerful tool for external beam radiotherapy treatment verification and quality assurance. The objective of this work was the development and clinical testing of the EBT3 model GafChromic film based brachytherapy quality assurance (QA) system. Methods and Materials Retrospective dosimetry study was performed to test a patient-specific QA system for preoperative endorectal brachytherapy that uses a radiochromic film dosimetry system. A dedicated phantom for brachytherapy applicator used for rectal cancer treatment was fabricated enabling us to compare calculated-to-measured dose distributions. Starting from the same criteria used for external beam intensity-modulated radiation therapy QA (3%, 3 mm), passing criteria for high- and low-dose gradient regions were subsequently determined. Finally, we investigated the QA system's sensitivity to controlled source positional errors on selected patient plans. Results In low-dose gradient regions, measured dose distributions with criteria of 3%, 3 mm barely passed the test, as they showed 95% passing pixels. However, in the high-dose gradient region, a more stringent condition could be established. Both criteria of 2%, 3 mm and 3%, 2 mm with gamma function calculated using normalization to the same absolute dose value in both measured and calculated dose distributions, and matrix sizes rescaled to match each other showed more than 95% of pixels passing, on average, for 15 patient plans analyzed. Conclusions Although the necessity of the patient-specific brachytherapy QA needs yet to be justified, we described a radiochromic film dosimetry–based QA system that can be a part of the brachytherapy commissioning process, as well as yearly QA program. [ABSTRACT FROM AUTHOR]

Abstract: The high-latitude ionosphere interfaces with the hot, tenuous, magnetospheric plasma, and a heat flow into the ionosphere is expected, which has a large impact on the plasma densities and temperatures in the high-latitude ionosphere. The value of this magnetospheric heat flux is unknown. In an effort to estimate the value of the magnetospheric heat flux into the high-latitude ionosphere, and show its effect on the high-latitude ionospheric plasma densities, we ran an ensemble of model runs using the Ionosphere Forecast Model (IFM) with different values of the heat flux through the upper boundary. These model runs included heating from both auroral and solar sources. Then, for each heat flux value, the plasma densities obtained from the model runs, at 840km, were compared to the corresponding values measured by the DMSP F13 satellite. The heat flux value that gave the best comparison between the measured and calculated plasma densities was considered to be the best estimate for the topside heat flux. The comparison was conducted for a 1-year data set of the DMSP F13 measured plasma densities (4300 consecutive orbits). Our systematic IFM/DMSP plasma density comparisons indicate that when a zero magnetospheric downward heat flux is assumed at the upper boundary of the IFM model, on the average, the IFM underestimates the measured plasma densities by a factor of 2. A good IFM/DMSP plasma density comparison was achieved for each month in 1998 when for each month a constant heat flux was assumed at the upper boundary of the model. For the 12-month period, the heat flux values that gave the best IFM/DMSP plasma density comparisons varied on the average from −0.5×1010 to −1.5×1010 eVcm−2 s−1. [Copyright &y& Elsevier]

Abstract: The Assimilative Mapping of Ionospheric Electrodynamics (AMIE) model has been used in a wide range of studies pertaining to the magnetosphere, ionosphere and thermosphere. In these studies historical data from several different data sources (electric fields from radars and satellites, electric currents from satellites, magnetic perturbations from satellites and ground-based magnetometers) have been assimilated. In its real-time mode (rt-AMIE), only data from an array of ground-based magnetometers are assimilated and convection patterns are produced in 1-min increments. However, the reliability of these real-time patterns for applications involving ionosphere–thermosphere specifications and forecasts has never been systematically tested. To address this issue, a comparison of a 1-year dataset of DMSP F13 cross-track ion drift velocities with AMIE convection patterns, based on data from 80 ground-based magnetometers, has been conducted. First, for each high-latitude DMSP velocity observation, the corresponding AMIE value was calculated. Then, the measured and calculated cross-track ion drift velocities along the high-latitude pass were compared and criteria were established to determine whether or not the AMIE patterns adequately fit the measurements. The comparisons were done for a full year (1998) of satellite crossings of the northern polar region (4300 consecutive satellite crossings). The comparisons indicate that the AMIE patterns adequately represented the DMSP observations about 32% of the time, which is a significant improvement over statistical convection patterns (6% of the time). This is particularly impressive in view of the fact that only a limited number of ground-based magnetometers were included in the AMIE patterns used in this study. [Copyright &y& Elsevier]

Purpose The Papillon technique using 50-kVp soft X-rays to treat rectal adenocarcinomas was developed and clinically implemented in the 1960s. We describe differences between accurate dosimetry and clinical implementation of this technique that is extending from its very inception to date. Methods and Materials A renaissance of the Papillon technique occurred with two recently introduced 50-kVp systems: Papillon+ by Ariane and a custom-made rectal applicator (consisting of a surface applicator inserted into a proctoscope) by iCAD's Xoft Axxent Electronic Brachytherapy (eBT) System (iCad, Inc., Sunnyvale, CA). In contrast to the initial design, we investigated the impact of introducing a plastic lid, which would provide more reproducible and more accurate dose delivery across the rectal adenocarcinoma patient population. We use both parallel-plate chamber and radiochromic film dosimeters to determine differences in basic dosimetry characteristics (beam half-value layers, outputs, percent depth doses, and profiles) between the Xoft Electronic Brachytherapy rectal applicator system with and without the plastic lid in place. Results Compared to the open-cone applicator, the proposed applicator with the plastic lid produces a slightly harder (more penetrating) beam quality (half-value layer of 1.4 vs. 1.3-mm Al), but with reduced output (by 33%), and a slightly broader beam with flatness not worse than 3% and symmetry not worse than 2%. Conclusions In addition to characterizing beam properties modified by the possible introduction of the plastic cap, we also pointed out and addressed misconceptions in the use of radiochromic films for dose measurements at low-energy photon beams. [ABSTRACT FROM AUTHOR]