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Biomedical subjects

G Luxton

Publications and source records attributed to G Luxton.

64 records · Page 4Linked to original sources

Backscatter measurements from a single seed of 125I for ophthalmic plaque dosimetry.

To determine the dosimetric effect of a gold plaque applicator used in 125I ophthalmic irradiation, relative dose rates at points 2-18 mm transverse to the axis of a single seed of 125I were measured in an acrylic phantom under three different measurement conditions. The detectors were 1-mm diameter X 3-mm length LiF thermoluminescent dosimeters (TLD's). Conditions corresponded to the following: (i) full scatter, (ii) the presence of an ophthalmic gold plaque, and (iii) no scatter material on the side of the seed opposite to the TLD's. The dose rate with the gold plaque is less than that with full scatter phantom. There is no significant decrease in dose rate at 2.2 mm from the seed. Dose rate is significantly reduced at greater distances. The does rate decrease ranges from 4% at 5 mm to 10% at 18 mm. The 125I seed in the gold plaque gives 3%-5% higher dose rate than in the absence of backscatter material.

Brachytherapy↗

Output factor constituents of a high-energy photon beam.

Measurements designed to separate primary and various scatter components of central axis dose of the highest energy photon beam of the CGR Saturne 25 linear accelerator are described. This beam has an unusually large output variation with field size. The measurements are performed both in air and in a water phantom, with and without an aperture external to the collimator system. Results are presented in the form of relative output factors for different field sizes due to (i) flattening filter scatter, (ii) water phantom scatter, (iii) collimator backscatter into the monitor chamber, and (iv) collimator forward scatter onto the central axis. It is found that the flattening filter is the single largest scatter component, but that each of the other factors is significant in determining the output dose per monitor unit as a function of field size.

Humans↗

Optimization of 125I ophthalmic plaque brachytherapy.

Episcleral plaques containing 125I sources are often used in the treatment of ocular melanoma. Within four years post-treatment, however, the majority of patients experience some visual loss due to radiation retinopathy. The high incidence of late complications suggests that careful treatment optimization may lead to improved outcome. The goal of optimization would be to reduce the magnitude of vision-limiting complications without compromising tumor control. We have developed a three-dimensional computer model for ophthalmic plaque therapy which permits us to explore the potential of various optimization strategies. One simple strategy which shows promise is to maximize the ratio of dose to the tumor apex (T) compared to dose to the macula (M). By modifying the parameters of source location, activity distribution, source orientation, and shielding we find that the calculated T:M ratio can be varied by a factor of 2 for a common plaque design and posterior tumor location. Margins and dose to the tumor volume remain essentially unchanged.

Biophysical Phenomena↗

Algorithm for dosimetry of multiarc linear-accelerator stereotactic radiosurgery.

Treatment planning for multiarc radiosurgery is an inherently complex three-dimensional dosimetry problem. Characteristics of small-field x-ray beams suggest that major simplification of the dose computation algorithm is possible without significant loss of accuracy compared to calculations based on large-field algorithms. The simplification makes it practical to efficiently implement accurate multiplanar dosimetry calculations on a desktop computer. An algorithm is described that is based on data from fixed-beam tissue-maximum-ratio (TMR) and profile measurements at isocenter. The profile for each fixed beam is scaled geometrically according to distance from the x-ray source. Beam broadening due to scatter is taken into account by a simple formula that interpolates the full width at half maximum (FWHM) between profiles at isocenter at different depths in phantom. TMR and profile data for two representative small-field collimators (10- and 25-mm projected diameter) were obtained by TLD and film measurements in a phantom. The accuracy of the calculational method and the associated computer program were verified by TLD and film measurements of noncoplanar multiarc irradiations from these collimators on a 4-MV linear accelerator. Comparison of film measurements in two orthogonal planes showed close agreement with calculations in the shape of the dose distribution. Maximal separation of measured and calculated 90%, 80%, and 50% isodose curves was less than or equal to 0.5 mm for all planes and collimators. All TLD and film measurements of dose to isocenter agreed with calculations to within 2%.

Algorithms↗

A 500 KHz localized current field hyperthermia system for use with ophthalmic plaque radiotherapy.

Ophthalmic plaque radiotherapy has been demonstrated to be a useful alternative to enucleation in the treatment of small choroidal melanomas. The prognosis for tumours larger than 8 mm in height, however, continues to be poor. Treatment complications limit the radiation dose which may be delivered to these larger tumours. Hyperthermia has been shown to enhance the effectiveness of radiotherapy for many tumours, particularly malignant melanoma. The use of hyperthermia in conjunction with plaque radiotherapy may improve local tumour control for larger choroidal melanomas, allowing patients to maintain useful vision. We have developed an instrument which enables the combination of localized current field hyperthermia with radiotherapy using an episcleral plaque. The system is simple and inexpensive. We have measured temperature distributions in tissue-like phantoms, in excised bovine eyes, and in vivo in normal rabbits. In each of the cases studied, temperature varied by less than 1 degree C within 3 mm of, and across the concave surface of the plaque. At distances greater than 3 mm, the temperature gradient was approximately -0.3 degree C per millimetre.

Animals↗

The accuracy of temperature measurement from within an interstitial microwave antenna.

Temperature measurement from within microwave interstitial antennas is a promising new development for hyperthermia. These antennas could enable the development of multipoint temperature regulation, leading to improved control of temperature distributions and therefore more effective hyperthermia treatments. In the complex environment of an antenna within a plastic catheter, measured temperatures were found to differ from the estimated local tissue temperature by up to 8 degrees C. In the design evaluated in this report the primary source of this error appears to be self-heating distal to the antenna junction, particularly in the outer copper conductor. The magnitude of self-heating is directly proportional to applied microwave power. Catheter wall thickness, tissue perfusion, and longitudinal temperature gradient also influence the measured temperature.

Humans↗

Interstitial thermoradiotherapy for recurrent or persistent tumours.

Between 1984 and 1986, 31 sites in 27 patients with biopsy proven tumours were treated with a combination of interstitial microwave hyperthermia (HT) and iridium 192 implants (RT). The 31 sites treated included fifteen (48 per cent) head and neck, six (20 per cent) breast, four (13 per cent) vagina and cervix, and six (20 per cent) others. All patients had prior surgery, RT, or chemotherapy. Of the 31 sites treated, 19 (61 per cent) had complete response (CR) with no recurrence in the volume treated. Additionally, eight patients remained free of tumour from 3 to 24 months. Partial response (PR) was seen in 11 (36 per cent) sites while one (3 per cent) had lesser degree tumour regression. Tumour control rate correlated well with the dose of radiation, p = 0.02, and tumour volume, p = 0.02, but not with thermal dose. Treatment complications of significance occurred in one (3 per cent) site, which developed soft tissue necrosis. This study again has demonstrated the effectiveness of RT-HT combination in treatment of recurrent tumours.

Adult↗

A technique for combining microwave hyperthermia with intraluminal brachytherapy of the oesophagus.

A technique for combining microwave hyperthermia with 192Ir brachytherapy for the treatment of oesophageal carcinoma is described. This approach uses an intraluminal afterloading applicator and up to six microwave antennae to deliver both hyperthermia and brachytherapy, with minimal modification of the existing procedure for brachytherapy alone. Each microwave antenna includes a built-in thermistor to control temperature and balance power. Longitudinal temperature distributions were measured in situ from within the applicator, and at the applicator-tissue interface in vivo. Two-dimensional SAR and steady-state temperature distributions measured in muscle-equivalent phantom are presented and discussed. The technique appears to be capable of elevating tissue temperature to greater than 42 degrees C in a radially symmetric volume of length greater than 5 cm, with radial penetration of 0.5 cm. The clinical technique is relatively simple and well tolerated.

Brachytherapy↗

Microwave applicator for transurethral hyperthermia of benign prostatic hyperplasia.

An applicator for heating the prostate gland using a transurethral approach is described. This technique uses three microwave antennas and a thermometry sensor attached to the outer surface of a balloon (Foley) type urological catheter. Each microwave antenna also includes a built-in thermistor to control temperature and balance power. The balloon catheter assures rapid and reproducible localization of the antennas in the prostatic urethra. The two-dimensional SAR and steady-state temperature distributions surrounding the applicator in tissue equivalent phantom are reported. Longitudinal temperature distributions measured in situ at the applicator-urethral interface and the longitudinal and radial temperature distributions measured in normal canine prostate are presented and discussed. The technique appears to be capable of elevating temperature to greater than 42 degrees C in a cylindrically symmetrical volume up to 5 cm length and 0.5 cm radial penetration surrounding the applicator.

Hot Temperature↗

Mammalian cell survival studies characterizing multiport negative pi-meson irradiation with the Stanford Medical Pion Generator (SMPG).

Radiobiological measurements have been made under various conditions of muliport pion irradiation using the Stanford Medical Pion Generator (SMPG). Chinese hamster cells (HA-1) were suspended in a tissue-equivalent 25% gelatin/medium solution. Hypoxic and aerobic HA-1 cells were irradiated simultaneously in a cylindrical water tank at either 4 or 16 degrees C. Irradiation at the focus of 60 converging pion beams, at a peak dose rate of 6 rads/min, gave relative biological effectiveness (RBEs) of 2.8, 1.8 and 1.4 at 50, 20 and 5% survival, respectively, and an oxygen enhancement ratio (OER) of 1.7. Plateau irradiation with crossing pion beams, at a peak dose-rate of 3 rads/min, resulted in survival values very close to those obtained with similar doses of 85 kV X-rays. Preliminary studies with large irradiation volumes in broadened pion stopping regions indicate RBEs significantly > 1 for survival > 50%. Supporting microdosimetric data with the SMPG are consistent with the radiobiological results.

Animals↗