Monte Carlo iodine brachytherapy dosimetry: study for a clinical application

At present, all clinical algorithms used in brachytherapy are based on the TG-43 algorithm, which has the advantage to offer very fast calculation time. However, this formalism has many simplifications, assuming for example the patient tissue composition equivalent to water. For low energy brachytherapy seeds such as iodine seeds, it is of interest to evaluate the dosimetric differences between calculations based on Monte Carlo simulations (considered the gold standard) and the TG-43 formalism. For a 6711 model 125I seed calculated photon spectra were compared to spectra measured with a CdTe spectrometer. Good agreement was found except for the lowest energy peak which seems to be over-estimated by the experiment due to the contribution of the spectrometer CdTe diode to the measurement. Dose distributions in water are measured with EBT Gafchromic film and compared to the Monte Carlo calculation. A very good agreement is found. Finally, the method to create a MCNPX input file from computed tomography (CT) scanner images is explained and some preliminary isodose distributions are presented.