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Introduction: In this study, TLD 600 and TLD 700 pairs were used to measure the neutron dose of Elekta Precise medical linac. To this end, the optimum moderate thickness for the conversion of fast to thermal neutrons were evaluated. Materials and methods: 241Am-Be and 252Cf sources were simulated to calculate the optimum thicknesses of the moderator for the conversion of maximum fast neutrons (FN) into thermal neutrons (TN). Pair TLDs were used to measure F&TN doses for three different field sizes at four depths of the medical linac. Results: The maximum thickness of the moderator was optimized at 6 cm. The measurement results demonstrated that the TN dose increased with the expansion of field size and depth. The FN dose, which was converted TN, exhibits behaviors comparable to the TN due to its nature. Conclusion: This study presents the optimum thickness for the moderator to convert FN into TN and measure F&TN using TLDs.

Background: Considering the importance of photoneutron production in linear accelerators, it is necessary to describe and measure the photoneutrons produced around modern linear accelerators. Objective: The aim of the present research is to study photoneutron production for the 18 MV photon beam of a Siemens Primus Plus medical linear accelerator.Material and Methods: This study is an experimental study. The main components of the head of Siemens Primus Plus linac were simulated using MCNPX 2.7.0 code. The contribution of different components of the linac in photoneutron production, neutron source strength, neutron source strength and photon and electron spectra were calculated for the flattening filter and flattening filter free cases for the 18 MV photon beam, and was scored for three fields of 5 × 5 cm2, 10 × 10 cm2 and 20 × 20 cm2 in size. Results: The results show that the primary collimator has the largest contribution to production of neutrons. Moreover, the photon fluence for the flattening filter free case is 8.62, 6.51 and 4.62 times higher than the flattening filter case for the three fields, respectively. The electron fluences for the flattening filter free case are 4.62, 2.93 and 2.79 times higher than with flattening filter case for the three fields under study, respectively. In addition to these cases, by increasing the field size, the contribution of neutron production related to the jaws is reduced, so that when the field size increases from 5 × 5 cm2 to 20 × 20 cm2, a 17.93% decrease in photoneutron production was observed. Conclusion: In all of the accelerators, the neutron strength also increases with increasing energy. The calculated neutron strength was equal to 0.83×1012 neutron Gy −1 at the isocenter.

Radyoterapi, kanser tedavisinde kullanılan en önemli tedavi yöntemlerinden birisidir. Ancak, radyoterapide yüksek enerjili foton ve elektron demetlerinin kullanımı sırasında (>7 MV) lineer hızlandırıcı kafasında bulunan ağır metallerden kaynaklı nötron kirliliği oluşmaktadır. Bu durum, hedef hacimde ve çevresindeki diğer organlarda nötron kirliliğinden kaynaklı doz belirsizliğine neden olmakta ve ikincil kanser riski oluşturmaktadır. Bu çalışmada, 18 MV foton enerjisinde, Elekta Synergy lineer hızlandırıcıda Thermo Scientific Rad Eye NL marka nötron dedektörü ile alan açıklığının ve eşmerkeze olan uzaklığın nötron doz hızına olan etkisi incelenmiştir. Ayrıca, alan açıklığının nötron doz hızı üzerindeki etkisi eşmerkezde, eşmerkezden farklı uzaklıklarda, radyoterapi odası kapısının içi ve dışında, konsol odasında ölçümler alınarak araştırılmıştır. Radyoterapide, 18 MV enerjili fotonların neden olduğu nötron kirliliğinden kaynaklı doz belirsizliğinin ikincil kanser riskini artırabileceği öngörülmüştür. Bu nedenle, radyoterapide istenmeyen fotonötron dozunun dikkate alınmasının çok önemli olduğu sonucuna varılmıştır.

Propose: Spatially fractionated Grid radiation therapy (SFGRT) in an effective technique for bulky and radio-sensitive tumours. SFGRT using a constructed block has been used to evaluate the photon and photo-neutron (PN) dose measurement in 18-MV photon beam energy. Methods and materials: A mounted Grid block on to a Varian Clinac 2100c linear accelerator was used to perform photon dosimetry. The percentage depth dose, in-plane and cross-plane beam profile and output factor was measured by ionization chamber in water. The PN contamination was measured after photon dosimetry using the combination of thermoluminescence dosimetry types 600 and 700, and Polycarbonate Film dosimeters on the surface and in the maximum depth dose (dmax) of solid water™ slabs. Results: The valley-to-peak ration for 6 and 18 MV photon beams obtained from the beam profiles was ~35 and 72%, respectively. Fast and thermal PN equivalent dose decreased in the Grid field compared to an open field (without Grid). Conclusion: The Grid therapy dosimetry compared to the conventional radiotherapy (without the grid) the production of fast and thermal neutrons were reduced. Using of a Grid block in high-energy photon beams for a long period of the treatment continuously might be a new source of contamination due to the interaction of photon beam resulting the activation of the Grid block [ABSTRACT FROM AUTHOR]

Background: Nowadays, radiotherapy has an important role in the treatment of cancer. The use of medical linacs in radiotherapy can have risks for patients. When radiotherapy is performed with photons with energies higher than 8 MeV, due to the photonuclear reaction of photons with various components in the head of the accelerator, the neutron is produced. This imposes an unwanted neutron dose to the patient. The purpose of this study is evaluation and comparison of fast-neutron contamination with increasing of field size and depth for Siemens Primus (15 MV), Siemens Primus Plus (18 MV), and Siemens Artiste (15 MV) linacs. Materials and Methods: Neutron dosimetry was carried out with CR-39 films, as a fast-neutron dosimeter, using chemical etching technique. Measurements were performed in depths of 0.5, 2, 3, and 4 cm and source-to-surface distance of 100 cm. Field sizes were 10 cm × 10 cm and 30 cm × 30 cm. Results: The results of measurements showed that, with increasing depth, equivalent dose is reduced. In addition, fast-neutron equivalent dose decreases with increasing the field size. Conclusion: Siemens Primus Plus had the highest neutron contamination in comparison with the two other linacs. Deeper tissues receive less fast-neutron doses. In radiation therapy with high-energy photon beams, neutron dose delivered to the patients should be taking into account. [ABSTRACT FROM AUTHOR]

Background: One of the main causes of induction of secondary cancer in radiation therapy is neutron contamination received by patients during treatment. Objective: In the present study the impact of wedge and block on neutron contamination production is investigated. The evaluations are conducted for a 15 MV Siemens Primus linear accelerator. Methods: Simulations were performed using MCNPX Monte Carlo code. 30˚, 45˚ and 60˚ wedges and a cerrobend block with dimensions of 1.5 × 1.5 × 7 cm3 were simulated. The investigation were performed in the 10 × 10 cm2 field size at source to surface distance of 100 cm for depth of 0.5, 2, 3 and 4 cm in a water phantom. Neutron dose was calculated using F4 tally with flux to dose conversion factors and F6 tally. Results: Results showed that the presence of wedge increases the neutron contamination when the wedge factor was considered. In addition, 45˚ wedge produced the most amount of neutron contamination. If the block is in the center of the field, the cerrobend block caused less neutron contamination than the open field due to absorption of neutrons and photon attenuation. The results showed that neutron contamination is less in steeper depths. The results for two tallies showed practically equivalent results. Conclusion: Wedge causes neutron contamination hence should be considered in therapeutic protocols in which wedge is used. In terms of clinical aspects, the results of this study show that superficial tissues such as skin will tolerate more neutron contamination than the deep tissues.

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In head and neck radiation therapy, the presence of dental restorations can increase unwanted neutron dose to the patient. This study aimed at the measurement of secondary neutron production induced by irradiation of a healthy tooth, Amalgam, Ni-Cr alloy and Ceramco with a photon beam generated in the treatment head of a Siemens Primus linac at a voltage of 15 MV. The irradiation field amounted to 10 × 10 cm2. The measurements of thermal and fast-neutron equivalent doses were performed by means of CR-39 detectors positioned in various depths of a Perspex (polymethyl methacrylate) phantom as at open field as at presence of corresponding dental restorations. The general trend of thermal neutron as well as fast-neutron equivalent dose behind the denture samples reveals their reduction with increasing depth. The maximum values of thermal-neutron dose related to Amalgam, Ceramco and Ni-Cr alloy amount to 1.45 mSv/100 MU, 1.38 mSv/100 MU and 1.32 mSv/100 MU, whereas the corresponding maximum values of fast-neutron dose at the depth of 1.8 cm amount to 0.19 mSv/100 MU, 1.04 mSv/100 MU and 0.97 mSv/100 MU, respectively. The present study investigates the neutron dose accompanied with radiotherapy. It is recommended that attempts have to be made to ensure that dental restorations are not in the path of the primary high-energy photon beam. Considering treatment planning, the guidelines of radiation protection should be improved. • Presence of dental restorations in path of photon beam in radiotherapy of head and neck cancer. • Amalgam, Ni-Cr alloy, and Ceramco are the most common dental restoration in cancerous patients. • Thermal and fast neutron production in radiotherapy with high energy photon due to their high density. • Amalgam, Ceramco, and Ni-Cr alloy have the dominant contribution in the total neutron dose, respectively. [ABSTRACT FROM AUTHOR]

Objective: Undesired neutron contamination imposed to patients during treatment is among the main factors increasing the risk of secondary cancer in radiotherapy. This additional undesirable dose is due to neutron contamination production in high-energy accelerators. In this study, neutron contamination is investigated in the presence of wedge and block in 15 MV photon fields of Siemens Primus linear accelerator. Materials and Methods: Neutron production by 30°, 45°, and 60° wedges and cerrobend block was investigated. Measurements were conducted in a 10 cm × 10 cm field at the source to -surface distance of 100 cm at 0.5, 2, 3, and 4 cm depths of a 30 cm × 30 cm × 30 cm Perspex phantom using the CR-39 passive film detectors. Chemical etching was performed using sodium hydroxide solution with 6.25 M concentration as the etchant at 85°C for 3 h. Results: The neutron dosimetry results reveal that the presence of wedge and block increases the neutron contamination. However, the 45° wedge is most effective in producing neutron contamination. The results also show that the fast neutron contamination is lower in the steeper depths. Conclusion: The presence of a wedge in a therapeutic high-energy photon field is a source of neutron contamination and may be of concern regarding clinical aspects. The results of this study show that superficial tissues such as skin will incur higher fast neutron contamination than the deep tissues. [ABSTRACT FROM AUTHOR]

Abstract The 241Am gamma-ray source has a number of medical and industrial applications. In addition to the gamma-rays the source also could yield neutrons due to the (α,xn) reactions with other materials such as oxygen, aluminium etc. While using this source one needs to be aware of the possible unwanted exposure to neutrons and also of wrong results. We have investigated the neutron yield from a 1.85 × 1010 Bq 241Am source and found that the source has a neutron yield of 3350 ± 79 neutrons/s. The variation of neutron dose rate and neutron flux with distance from the source is also obtained using superheated droplet detectors. The neutron dose is found to be about two orders of magnitude lower than the gamma-ray dose. Highlights • The 241Am gamma-ray source could yield neutrons due to the (α,xn) reactions with other materials. • While using this source one needs to be aware of the possible unwanted exposure to neutrons and also of wrong results. • The neutron yield for a 1.85 × 1010 Bq 241Am gamma-ray source is found to be 3350 ± 79 neutrons/s. [ABSTRACT FROM AUTHOR]

Background: One of the main causes of induction of secondary cancer in radiation therapy is neutron contamination received by patients during treatment. Objective: In the present study the impact of wedge and block on neutron contamination production is investigated. The evaluations are conducted for a 15 MV Siemens Primus linear accelerator. Methods: Simulations were performed using MCNPX Monte Carlo code. 30°, 45° and 60° wedges and a cerrobend block with dimensions of 1.5 × 1.5 × 7 cm3 were simulated. The investigation were performed in the 10 × 10 cm2 field size at source to surface distance of 100 cm for depth of 0.5, 2, 3 and 4 cm in a water phantom. Neutron dose was calculated using F4 tally with flux to dose conversion factors and F6 tally. Results: Results showed that the presence of wedge increases the neutron contamination when the wedge factor was considered. In addition, 45° wedge produced the most amount of neutron contamination. If the block is in the center of the field, the cerrobend block caused less neutron contamination than the open field due to absorption of neutrons and photon attenuation. The results showed that neutron contamination is less in steeper depths. The results for two tallies showed practically equivalent results. Conclusion: Wedge causes neutron contamination hence should be considered in therapeutic protocols in which wedge is used. In terms of clinical aspects, the results of this study show that superficial tissues such as skin will tolerate more neutron contamination than the deep tissues. [ABSTRACT FROM AUTHOR]

A radiation treatment delivery technique, intensity modulated radiation therapy (IMRT), has found widespread use in the treatment of cancers. One of IMRT implementing methods is IMRT compensator based, which the modulation are done by high Z materials. When photons with energies higher than 8 MV interact with high Z material in path, Photoneutrons are produced. In this study, the effect of compensator on photoneutron production was investigated. The Monte Carlo code MCNPX was used to calculate the neutron dose equivalent as a function of the depth in phantom with and without compensator. Measurements were made using CR-39 track-etched detectors. CR-39 detectors, were cut in dimensions of 2.5×2.5 cm 2 by laser, placed in different depths of slab phantom and then irradiated by 18 MV photons. Same procedure was performed with the compensator present and absent. The measured data were compared with MCNP calculations. In both experimental and simulation results, neutron dose equivalent when compensator used, was less than non-compensator field. The calculated neutron dose equivalent was maximum at surface and decreased exponentially by increasing depth, but in experimental data, the neutron dose equivalent reached a maximum at approximately 3 cm depth in the phantom and beyond which decreased with depth.CR-39 calibration was carried out in air, by considering that neutron energy spectrum changes toward thermal neutrons by depth in phantom increasing, it is suggested that for measuring equivalent neutron dose at phantom depth, should have proper neutron calibration in terms of energy spectrum. [ABSTRACT FROM AUTHOR]

Background and purpose: High-energy photon beams above 8-10 MV used in external radiation therapy produce neutron in dealing with the linear accelerator components and other parts in radiation field. The weakening of neutrons due to the closing jaws collimator angle, in smaller field sizes can also be a contributing factor in changing the neutron spectrum. Since a direct measurement of the neutron flux and spectrum require complex measurements in treatment room, the Monte Carlo is an alternative method for determining the true environmental neutron spectrum. Materials and methods: Geometry of linear accelerator Elekta SL75/25 was designed in FLUKA simulation code and its validation was tested. Spectrum of neutrons produced in the accelerator was determined in the center of four field sizes of 20 × 20, 15 × 15, 10 × 10, and 5 × 5 cm2. Data analysis was done applying Mann-Whitney test. Results: In the condition with flattening filter, significant differences was found in the neutron spectrum only in 5 × 5 to 15 × 15 cm2 and 5 × 5 to 20 × 20 cm2 field sizes (P<0.05). Conclusion: Our results of the neutron spectrum using FLUKA simulation code are in a good conformity with the results of practical dosimetry of other researchers; therefore, checking the neutron flux in radiotherapy by simulation can be an appropriate solution to improve patient treatment and protection issues. Since neutron dose increases with an increase in field size, so, we can conclude that field size influences secondary effects of treatment. [ABSTRACT FROM AUTHOR]

In this study, the neutron contamination due to the 2300C/D Varian medical linac has been calculated by using the long counter. In doing so, the energy response of the long counter in wide energy ranges (1keV–7MeV) of the neutron has been flattened and its effective center and directional sensitivity has been determined. All calculations have been performed by using the simulation of the measurable arrangement with the Monte Carlo N-Particle MCNPX code at isocenter for different photon field sizes. The obtained results showed that the inverse square formula for determining the neutron fluence needs to be corrected so that in the power value of d , the distance from the source to the point of interest, the value 1.88 ± 0.08 is substituted with 2 at inverse square law in the field size 10 × 10 cm 2 . Therefore, the values of the neutron strength, neutron fluence and the ambient dose equivalent, H*(10) have been obtained by using the above correction. Finally, the obtained results have been compared with other published results. On the other hand, it is found that the flattening filter caused to sharp the energy fluence at the center of the beam by using the point detector tally and consequently the high dose delivered to the patient. [ABSTRACT FROM AUTHOR]

At present, high energy electron linear accelerators (LINACs) producing photons with energies higher than 10 MeV have a wide use in radiotherapy (RT). However, in these beams fast neutrons could be generated, which results in undesired contamination of the therapeutic beams. These neutrons affect the shielding requirements in RT rooms and also increase the out-of-field radiation dose to patients. The neutron flux becomes even more important when high numbers of monitor units are used, as in the intensity modulated radiotherapy. Herein, to evaluate the exposure of patients and medical personnel, it is important to determine the full radiation field correctly. A model of the dual photon beam medical LINAC, Siemens ONCOR, used at the University Hospital Centre of Osijek was built using the MCNP611 code. We tuned the model according to measured photon percentage depth dose curves and profiles. Only 18 MV photon beams were modeled. The dependence of neutron dose equivalent and energy spectrum on field size and off-axis distance in the patient plane was analyzed. The neutron source strength (Q) defined as a number of neutrons coming from the head of the treatment unit per x-ray dose (Gy) delivered at the isocenter was calculated and found to be 1.12 × 10 12 neutrons per photon Gy at isocenter. The simulation showed that the neutron flux increases with increasing field size but field size has almost no effect on the shape of neutron dose profiles. The calculated neutron dose equivalent of different field sizes was between 1 and 3 mSv per photon Gy at isocenter. The mean energy changed from 0.21 MeV to 0.63 MeV with collimator opening from 0 × 0 cm 2 to 40 × 40 cm 2 . At the 50 cm off-axis the change was less pronounced. According to the results, it is reasonable to conclude that the neutron dose equivalent to the patient is proportional to the photon beam-on time as suggested before. Since the beam-on time is much higher when advanced radiotherapy techniques are used to fulfill high conformity demands, this makes the neutron flux determination even more important. We also showed that the neutron energy in the patient plane significantly changes with field size. This can introduce significant uncertainty in dosimetry of neutrons due to strong dependence of the neutron detector response on the neutron energy in the interval 0.1–5 MeV. [ABSTRACT FROM AUTHOR]

Purpose: Photon fields with energies above ~7 MeV are contaminated by neutrons due to photonuclear reactions. Their influence on dosimetry--although considered to be very low--is widely unexplored. Methods: In this work, Monte Carlo based investigations into this issue performed with FLUKA and EGSNRC are presented. A typical Linac head in 18 MV-X mode was modeled equivalently within both codes. EGSNRC was used for the photon and FLUKA for the neutron production and transport simulation. Water depth dose profiles and the response of different detectors (Farmer chamber, TLD-100, TLD-600H, and TLD-700H chip) in five representative depths were simulated and the neutrons' impact (neutron absorbed dose relative to photon absorbed dose) was calculated. To take account of the neutrons' influence, a theoretically required correction factor was defined and calculated for five representative water depths. Results: The neutrons' impact on the absorbed dose to water was found to be below 0.1% for all depths and their impact on the response of the Farmer chamber and the TLD-700H chip was found to be even less. For the TLD-100 and the TLD-600H chip it was found to be up to 0.3% and 0.7%, respectively. The theoretical correction factors to be applied to absorbed dose to water values measured with these four detectors in a depth different from the reference/calibration depth were calculated and found to be below 0.05% for the Farmer chamber and the TLD-700H chip, but up to 0.15% and 0.35% for the TLD-100 and TLD-600H chips, respectively. In thermoluminescence dosimetry the neutrons' influence (and therefore the additional inaccuracy in measurement) was found to be higher for TLD materials whose 6Li fraction is high, such as TLD-100 and TLD-600H, resulting from the thermal neutron capture reaction on 6Li. Conclusions: The impact of photoneutrons on the absorbed dose to water and on the response of a typical ionization chamber as well as three different types of TLD chips was quantified and was as expected found to be very low relative to that of the primary photons. For most practical reasons the neutrons' influence on dosimetry might be neglected while for absolute precise thermoluminescence dosimetry in high energy photon fields, the use of TLD-700H (<0.03% 6Li) instead of the commonly used TLD-100 (7.4% 6Li) or even the extra neutron sensitive TLD-600H is recommended (95.6% 6Li) due to the additional inaccuracy in measurement for TLD materials with a high 6Li fraction. [ABSTRACT FROM AUTHOR]

Purpose We analysed the effects of field size, depth, beam modifier and beam type on the amount of in-field and out-of-field neutron contamination for medical linear accelerators (linacs). Methods Measurements were carried out for three high-energy medical linacs of Elekta Synergy Platform, Varian Clinac DHX High Performance and Philips SL25 using bubble detectors. The photo-neutron measurements were taken in the first two linacs with 18 MV nominal energy, whereas the electro-neutrons were measured in the three linacs with 9 MeV, 10 MeV, 15 MeV and 18 MeV. Results The central neutron doses increased with larger field sizes as a dramatic drop off was observed in peripheral areas. Comparing with the jaws-shaped open-field of 10 × 10 cm, the motorised and physical wedges contributed to neutron contamination at central axis by 60% and 18%, respectively. The similar dose increment was observed in MLC-shaped fields. The contributions of MLCs were in the range of 55–59% and 19–22% in Elekta and Varian linacs comparing with 10 × 10 and 20 × 20 cm open fields shaped by the jaws, respectively. The neutron doses at shallow depths were found to be higher than the doses found at deeper regions. The electro-neutron dose at the 18 MeV energy was higher than the doses at the electron energies of 15 MeV and 9 MeV by a factor of 3 and 50, respectively. Conclusion The photo- and electro-neutron dose should be taken into consideration in the radiation treatment with high photon and electron energies. [ABSTRACT FROM AUTHOR]

Despite the importance of photoneutrons doses produced in the high-energy linear accelerators, currently they are not considered in the treatment planning systems. Therefore, it is necessary to characterize the photoneutrons produced around the linacs. For this purpose, the main components of head of 15 MV Siemens Primus were simulated using MCNPX 2.6. Neutron contamination was calculated in the treatment room at the isocenter. The maximum dose equivalent of neutrons was found in 25 cm × 25 cm field size. Neutron spectrum was also measured applying the Bonner sphere with gold foils and artificial neural network as unfolding method. [ABSTRACT FROM AUTHOR]

The use of high-energy ( > 8 MeV ) LINear ACcelerators (LINACs) for medical cancer treatments causes the photoproduction of secondary neutrons, whose unwanted dose to the patient has to be calculated. The characterization of the neutron spectra is necessary to allow the dosimetric evaluation of the neutron beam contamination. The neutron spectrum in a hospital environment is usually measured with integrating detectors such as bubble dosimeters, Thermo Luminescent Dosimeters (TLDs) or Bonner Spheres, which integrate the information over a time interval and an energy one. This paper presents the development of a neutron spectrometer based on the Time of Flight (ToF) technique in order to perform a real time characterization of the neutron contamination. The detector measures the neutron spectrum exploiting the fact that the LINAC beams are pulsed and arranged in bunches with a rate of 100–300 Hz depending on the beam type and energy. The detector consists of boron loaded scintillating fibers readout by a MultiAnode PhotoMultiplier Tube (MAPMT). A detailed description of the detector and the acquisition system together with the results in terms of ToF spectra and number of neutrons with a Varian Clinac iX are presented. [ABSTRACT FROM AUTHOR]

In a high-energy medical linear accelerator (linac), if the interaction of photon energy is higher than the neutron binding energy of high atomic material, it emits a neutron field through a photonuclear reaction. The objective of this current study is to measure the photoneutron dose equivalent produces in a motorized wedge field and open field of 10 MV and 15 MV photon beams in Elekta Versa HD™ linac. The PNDE values were recorded at various positions along the patient plane using the Bubble Detector-Personal Neutron Dosimeter (BD-PND). The results revealed that the PNDE values are higher in 20 × 20 cm2 than 10 × 10 cm2 field sizes for both the 60° wedge and open fields of 10 MV and 15 MV beams. In addition, the 60° wedge fields generate higher photoneutron contamination when compared with the 45°, 30° wedge fields and open field sizes. Hence, on average PNDE values produced by the 15 MV beam were higher by a factor of 1.98 and 2.11 times for open and 60° wedge fields than the 10 MV beam, respectively. • The effect of wedge and open field on photoneutron production in 10 MV and 15 MV beams was measured using Bubble Detector. • Neutrons are generated through photonuclear reactions with high atomic material. • At in-fields, the PNDE values were higher for larger field sizes for both wedge and open fields. • The universal wedge field yields higher photoneutron contamination than the open field. • The 10 MV beam produces a lesser photoneutron dose equivalent than the 15 MV beam. [ABSTRACT FROM AUTHOR]

Abstract: Radiotherapy treatments with high-energy ( ) photon beams are a standard procedure in clinical practice, given the skin and near-target volumes sparing effect, the accurate penetration and the uniform spatial dose distribution. On the other hand, despite these advantages, neutrons may be produced via the photo-nuclear (γ,n) reactions of the high-energy photons with the high-Z materials in the accelerator head, in the treatment room and in the patient, resulting in an unwanted dose contribution which is of concern, given its potential to induce secondary cancers, and which has to be monitored. This work presents the design and the test of a portable Dysprosium dosimeter to be used during clinical treatments to estimate the “in vivo” dose to the patient. The dosimeter has been characterized and validated with tissue-equivalent phantom studies with a Varian Clinical iX 18MV photon beam, before using it with a group of patients treated at the S. Anna Hospital in Como. The working principle of the dosimeter together with the readout chain and the results in terms of delivered dose are presented. [Copyright &y& Elsevier]

Purpose: The aim of this study is to investigate radioprotection issues that must be addressed when dedicated accelerators for intraoperative radiotherapy (IORT) are used in operating rooms. Recently, a new version of a mobile IORT accelerator (LIAC™ Sordina SpA, Italy) with 12 MeV electron beam has been implemented. This energy is necessary in some specific pathology treatments to allow a better coverage of thick lesions. At an electron energy of 10 MeV, leakage and scattered x-ray radiation (stray radiation) coming from the accelerator device and patient must be considered. If the energy is greater than 10 MeV, the x-ray component will increase; however, the most meaningful change should be the addition of neutron background. Therefore, radiation exposure of personnel during the IORT procedure needs to be carefully evaluated. Methods: In this study, stray x-ray radiation was measured and characterized in a series of spherical projections by means of an ion chamber survey meter. To simulate the patient during all measurements, a polymethylmethacrylate (PMMA) slab phantom with volume 30×30×15 cm3 and density 1.19 g/cm3 was used. The PMMA phantom was placed along the central axis of the beam in order to absorb the electron beams and the tenth value layer (TVL) and half value layer (HVL) of scattered radiation (at 0°, 90°, and 180° scattering angles) were also measured at 1 m of distance from the phantom center. Neutron measurements were performed using passive bubble dosimeters and a neutron probe, specially designed to evaluate ambient dose equivalent H*(10). Results: The x-ray equivalent dose measured at 1 m along the beam axis at 12 MeV was 260 μSv/Gy. The value measured at 1 m at 90° scattering angle was 25 μSv/Gy. The HVL and TVL values were 1.1 and 3.5 cm of lead at 0°, and 0.4 and 1 cm at 90°, respectively. The highest equivalent dose of fast neutrons was found to be at the surface of the phantom on the central beam axis (2.9±0.6 μSv/Gy), while a lower value was observed below the phantom (1.6±0.3 μSv/Gy). The neutron dose equivalent at 90° scattering angle and on the floor plane on the beam axis below the beam stopper was negligible. Conclusions: Our data confirm that neutron exposure levels around the new dedicated IORT accelerator are very low. Mobile shielding panels can be used to reduce x-ray levels to below regulatory levels without necessarily providing permanent shielding in the operating room. [ABSTRACT FROM AUTHOR]

Abstract: Recent studies on flattening filter (FF) free beams have shown increased dose rate and less out-of-field dose for unflattened photon beams. On the other hand, changes in contamination electrons and neutron spectra produced through photon (E>10MV) interactions with linac components have not been completely studied for FF free beams. The objective of this study was to investigate the effect of removing FF on contamination electron and neutron spectra for an 18-MV photon beam using Monte Carlo (MC) method. The 18-MV photon beam of Elekta SL-25 linac was simulated using MCNPX MC code. The photon, electron and neutron spectra at a distance of 100cm from target and on the central axis of beam were scored for 10×10 and 30×30cm2 fields. Our results showed increase in contamination electron fluence (normalized to photon fluence) up to 1.6 times for FF free beam, which causes more skin dose for patients. Neuron fluence reduction of 54% was observed for unflattened beams. Our study confirmed the previous measurement results, which showed neutron dose reduction for unflattened beams. This feature can lead to less neutron dose for patients treated with unflattened high-energy photon beams. [Copyright &y& Elsevier]

High-energy medical linear accelerator (Linac) has been widely used for treating cancer patients. However, with its effectiveness, high-energy linac yields an undesirable amount of neutron contamination. An MCNPX code version 2.6.0 was used for calculating photoneutron contamination from Varian Clinac iX 15 MV linac heads in this study. The fast neutrons were dominantly produced inside the linac head. The neutron fluence, absorbed dose, and dose equivalent calculations occurred inside a linac head and a water phantom model. The fast neutrons begin to be moderated after 1 cm inside the water phantom by calculating the energy spectra. Variations in the field sizes from 2 × 2, 5 × 5, 10 × 10, and 15 × 15 cm 2 show that the neutron production yield would increase for larger field sizes. The maximum neutron dose equivalents are 3.745; 7.687; 11.794 and 14.197 μ Sv/MU for 2 × 2, 5 × 5, 10 × 10 and 15 × 15 cm 2 field sizes, respectively. These calculations predict the photoneutron characteristics with more detail inside a treated patient during radiation therapy procedures., (© 2021 IOP Publishing Ltd.)