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J B Smathers

Publications and source records attributed to J B Smathers.

At least 19 recordsLinked to original sources
PubMed1999

CT-based dosimetry calculations for 125I prostate implants.

PURPOSE: To evaluate the Monte Carlo code MCNP4B for low-energy brachytherapy calculations, including the effects of interseed attenuation and patient specific heterogeneities, on the calculated dose distribution from transperineal implantation of 125I. METHODS AND MATERIALS: The Monte Carlo code MCNP4B was used to model and benchmark the absolute dose distribution from two 125I brachytherapy seeds (model 6711 and 6702). Based upon the physical source model, the total photon intensity and differential energy spectrum were evaluated as a function of angle from the transverse bisector of the source. These spectral and intensity data were reformatted to produce probability distributions for sampling from a virtual point source. The virtual source model and a modified version of MCNP4B is then used for simulating arbitrary brachytherapy source configurations within a homogeneous or heterogeneous patient specific computed tomography (CT)-based lattice geometry. RESULTS AND CONCLUSION: Comparison with TG-43 data and the Monte Carlo calculations is excellent with MCNP4B predicting the radial dose function for the 125I 6711 and 6702 sources within 6% for all data points tested. Attenuation effects from neighboring seeds were investigated for pre- and postimplant seed distributions and found to be negligible. Preliminary dosimetry analysis of postimplant seed distributions comparing homogeneous water versus heterogeneous CT simulation geometries indicates an average decrease of approximately 5.6% for the volume of tissue irradiated to a prescription isodose line of 144 Gy.

Brachytherapy↗
PubMed1999

Dose distributions using kilovoltage x-rays and dose enhancement from iodine contrast agents.

In x-ray phototherapy of brain tumours, the tumour is loaded with iodine and exposed to kilovoltage x-rays. Due to the high photoelectric cross sections of iodine, substantial photoelectric interactions occur. The flux of photoelectrons, characteristic x-rays and Auger electrons produce a localized dose enhancement. A modified computed tomography scanner, CTRx, can be used both for tumour localization and delivery of the dose enhancement therapy. Monte Carlo methods were employed to simulate the treatment of iodinated brain tumours with a CTRx. The calculated results reveal the effect of tumour iodine concentration on dose distribution, the degree of skull bone sparing with the application of multiple arcs, and the homogeneity of tumour dose distribution versus iodine concentration. A comparison with 10 MV stereotactic radiosurgery treatment shows the potential of CTRx treatment relative to conventional treatment modalities.

Algorithms↗
PubMed1998

Monte Carlo treatment planning for stereotactic radiosurgery.

OBJECTIVES: In radiosurgery treatment planning there is general acceptance that the target volume can be assumed to be homogeneous and that corrections for variations in contour are unnecessary. Thus, dose algorithms employed in radiosurgery treatment planning are quite unsophisticated; in almost every case the algorithms are the simple product of tissue-maximum and off-axis ratios and an output factor. In small photon beams, however, the lack of side scatter equilibrium compromises these assumptions. METHODS: In this work we have employed Monte Carlo techniques in an attempt to obtain a more accurate representation of radiosurgical dose distributions. Specifically, the Monte Carlo system which we have devised traces the paths of primary and secondary radiation through a patient-specific anatomical representation defined by computed tomography data. In this manner the perturbation effects from external contour changes and internal tissue heterogeneities are accounted for completely. The ability to precisely mimic multi-beam multi-arc stereotactic delivery has been incorporated into our Monte Carlo treatment planning interface. RESULTS: Subsequent calculations show that substantial differences can exist when homogeneity is not assumed. Tissue heterogeneities produce a lateral broadening of the beam, resulting in a smaller volume contained within the higher isodose levels (80-90%) with a corresponding increase in the volume treated at the lower isodose levels (<50%). CONCLUSIONS: These results suggest that further investigation and refinement of radiosurgery dose algorithms is in order.

Humans↗
PubMed1998

Fractionated stereotactic radiotherapy: rationale and methods.

Stereotactic radiosurgery (SRS) has become a widely accepted technique for the treatment intracranial neoplasms. Combined with modern imaging modalities, SRS has established its efficacy in a variety of indications. From the outset, however, it was recognized that the delivery of a single large dose of radiation was essentially "bad biology made better by good physics." To achieve the accuracy required to compensate for this biological shortcoming, the application of SRS has required that a neurosurgical head frame of some sort be rigidly attached to the patients head. Historically, this prerequisite has, primarily for practical reasons, precluded the delivery of multiple fractions over multiple days. With recent improvements in immobilization and repeat fixation, the good biology of fractionated delivery has been realized. This technique, which has come to be known as stereotactic radiotherapy (SRT), has significantly expanded the efficacy of the technique through the use of accurate physical targeting coupled with the basic radiobiological principles gleaned from decades of clinical experience.

Brain Neoplasms↗
PubMed1998

A CT-based Monte Carlo simulation tool for dosimetry planning and analysis.

The Los Alamos code MCNP4A (Monte Carlo N-Particle version 4A) is currently used to simulate a variety of problems ranging from nuclear reactor analysis to boron neutron capture therapy. A graphical user interface has been developed that automatically sets up the MCNP4A geometry and radiation source requirements for a three-dimensional Monte Carlo simulation using computed tomography data. The major drawback for this dosimetry system is the amount of time to obtain a statistically significant answer. A specialized patch file has been developed that optimizes photon particle transport and dose scoring within the standard MCNP4A lattice geometry. The transport modifications produce a performance increase (number of histories per minute) of approximately 4.7 based upon a 6 MV point source centered within a 30 x 30 x 30 cm3 lattice water phantom and 1 x 1 x 1 mm3 voxels. The dose scoring modifications produce a performance increase of approximately 470 based upon a tally section of greater than 1 x 10(4) lattice elements and a voxel size of 5 mm3. Homogeneous and heterogeneous benchmark calculations produce good agreement with measurements using a standard water phantom and a high- and low-density heterogeneity phantom. The dose distribution from a typical mediastinum treatment planning setup is presented for qualitative analysis and comparison versus a conventional treatment planning system.

Algorithms↗
PubMed1995

Biologically effective dose distribution based on the linear quadratic model and its clinical relevance.

PURPOSE: Radiotherapy plans based on physical dose distributions do not necessarily entirely reflect the biological effects under various fractionation schemes. Over the past decade, the linear-quadratic (LQ) model has emerged as a convenient tool to quantify biological effects for radiotherapy. In this work, we set out to construct a mechanism to display biologically oriented dose distribution based on the LQ model. METHODS AND MATERIALS: A computer program that converts a physical dose distribution calculated by a commercially available treatment planning system to a biologically effective dose (BED) distribution has been developed and verified against theoretical calculations. This software accepts a user's input of biological parameters for each structure of interest (linear and quadratic dose-response and repopulation kinetic parameters), as well as treatment scheme factors (number of fractions, fractional dose, and treatment time). It then presents a two-dimensional BED display in conjunction with anatomical structures. Furthermore, to facilitate clinicians' intuitive comparison with conventional fractionation regimen, a conversion of BED to normalized isoeffective dose (NID) is also allowed. RESULTS: Two sample cases serve to illustrate the application of our tool in clinical practice. (a) For an orthogonal wedged pair of x-ray beams treating a maxillary sinus tumor, the biological effect at the ipsilateral mandible can be quantified, thus illustrates the so-called "double-trouble" effects very well. (b) For a typical four-field, evenly weighted prostate treatment using 10 MV x-rays, physical dosimetry predicts a comparable dose at the femoral necks between an alternate two-fields/day and four-fields/day setups. However, our BED display reveals an approximate 21% higher BED for the two-fields/day scheme. This excessive dose to the femoral necks can be eliminated if the treatment is delivered with a 3:2 (anterio-posterior/posterio-anterior (AP/PA): bilaterally opposed (BLO)) dose weighting. With Co-60 beams, the increase of BED with alternate two-fields/day, 1:1 setup was even more pronounced (26%). CONCLUSION: We have demonstrated the feasibility of constructing a biologically oriented dose distribution for clinical practice of radiotherapy. The discordance between physical dose distributions and the biological counterparts based on the given treatment schemes was quantified. The computerized display of BED at nonprescription points greatly enhanced the versatility of this tool. Although the routine use of this implementation in clinical radiotherapy should be cautiously done, depending largely on the accuracy of the published biological parameters, it may, nevertheless, help the clinicians derive an optimal treatment plan with a particular fractionation scheme or use it as a quantitative tool for outcome analysis in clinical research.

Feasibility Studies↗
PubMed1995

Implications of tissue heterogeneity for radiosurgery in head and neck tumors.

PURPOSE: This study was undertaken to investigate the perturbation of small radiation beams by low density heterogeneities and to evaluate the ability of a Monte Carlo code to account for such perturbation. Performance of an inexpensive film scanning system was also evaluated. METHODS AND MATERIALS: Film and diode measurements were made in an acrylic phantom in which the size and position of an air gap were varied. Monte Carlo analysis was used to obtain additional verification of the measurements, to provide insight into photon and electron transport phenomena not directly measurable, and as a benchmark for the code. RESULTS: With 10 MV photons and a 1 cm circular field, a small 3-mm air cavity placed 2.6 cm deep in acrylic (full buildup) results in a reduction in central axis dose of 21% immediately following the cavity. Equilibrium is then reestablished over the next centimeter, after which the dose exceeds that of the homogeneous case by 3-4%. The loss in central axis equilibrium is highly field-size dependent, with some loss occurring even for the largest (32 mm) collimator. In addition, the presence of the air cavity produces a significant increase in dose up to 2 cm lateral and outside the primary field. CONCLUSIONS: Tissue heterogeneities are not presently accounted for in radiosurgery calculations, yet have the ability to perturb dose significantly. Targets may potentially be underdosed, and adjacent critical structures overdosed. Inability to account for tissue heterogeneities may limit the use of the radiosurgery approach in some areas. A Monte Carlo approach may be the method of choice for small field dose calculation when tissue heterogeneities are encountered.

Air↗
PubMed1995

A verification of the Monte Carlo code MCNP for thick target bremsstrahlung calculations.

The bremsstrahlung spectra from thick targets of Be, Al, and Pb are calculated using the Monte Carlo code MCNP (Monte Carlo N-particle). The current version of MCNP (v.4A) incorporates a coupled electron-photon transport scheme that allows the user to estimate the photon fluence produced from primary electron interactions. The simulation parameters are based on bremsstrahlung measurements of 15 MeV electrons incident on thick targets of Be, Al, and Pb at various angles between 0 degree and 90 degrees. The integrated yield and mean energy of each bremsstrahlung spectrum is calculated for the three targets at these angles. For angles less than 60 degrees the integrated yield calculated by MCNP4A is within 6% of measured values for the three targets. Furthermore, predicted mean energy is within 7% of the values derived from measurement for all angles tested. Also compared are the performances of two MCNP4A fluence tallies; a next-event estimator (detector tally) and a track length estimator (cell tally). Timing studies indicate the detector tally will perform the integrated yield calculations to a precision of 1% approximately 10 to 50 times faster than the conventional cell tally for an emission angle of 0 degree.

Aluminum↗
PubMed1993

Dose-survival curves, alpha/beta ratios, RBE values, and equal effect per fraction for neutron irradiation of jejunal crypt cells.

Jejunal crypt cell survival after regimens of one, two, three and five fractions was used to reconstruct composite single-dose survival curves for neutrons of five different energies. There is no obvious shoulder, but there is a gradual divergence from linearity that is most evident at low levels of cell survival (high doses). The effect of dose fractionation is relatively small, especially at the low doses characteristic of each treatment session in neutron radiotherapy. The alpha/beta values for the linear-quadratic survival curves range from 27 to 40 Gy. The curves for neutrons are different from the curves for gamma rays mainly in their alpha coefficients, as predicted by Kellerer and Rossi's theory of dual radiation action, but both alpha and beta values are higher the lower the mean neutron energy, which is not consistent with the theory. The ratio of alpha coefficients reported here for various neutron beams to those for gamma rays reported elsewhere ranges between 3.2 and 4.6. This range of values represents the maximum limits for RBEn/gamma values (at very low doses), and is sometimes referred to as RBEm. These values increase with decreasing neutron energy. The ratios of beta coefficients for neutron and gamma-ray survival curves were lower than the alpha ratios, ranging between 0.9 and 1.9, although not reliably distinguished from 1.0. Each of a series of equal dose fractions given at 3-h intervals produced a constant (logarithmic) decrease in cell survival as evidenced by the consistency of the estimate of cell survival from a certain single dose fraction, regardless of the level of cell survival (number of dose fractions) from which the estimate was made. Even more significant than the overlap of individual data points is the excellent fit of all the data to survival curves reconstructed on the assumption of an equal effect per fraction. An implication of these results is that, with neutrons, too little unrepaired injury persists at 3 h to influence the response to a subsequent exposure measurably.

Animals↗
PubMed1989

Adhesion formation in experimental chronic radiation enteropathy.

We have studied the late changes associated with radiation enteropathy in mice over a period of 224 days following single or split doses of gamma radiation delivered to the total abdomen (TAI). We focused on the importance of adhesion formation as a cause of strictures and gut-associated deaths following TAI. Gut-associated peritoneal adhesions were found in mice 2-7 months after receiving 13.5-17.5 Gy TAI and appeared to constitute the most consistent serious late effect of irradiation. There was a good correlation between adhesion formation and death for both the single and split-doses of radiation. Adhesions primarily involved the large gut, normally near the cecum. They appeared to result from serosal breakdown and were the major cause of partial gut obstruction. Submucosal fibrosis was present but seemed to be a comparatively minor cause of strictures. Local lymphoid hyperreactivity was also seen following TAI and may have contributed to the late sequelae. The complexity of the pathogenesis of chronic radiation enteropathy was indicated by finding three successive waves of non-scheduled deaths following TAI. The first wave (28-70 days) was not related to adhesion formation and may have been due to localized failure of mucosa to regenerate after irradiation with consequent ulceration. The second wave (98-140 days) occurred over the period when adhesion formation and fibrosis were most marked. In the third wave (168-224 days), the additional complication of fluid exudation was seen. Further experimentation is obviously needed to better define the complex pathogenesis of radiation enteropathy with dose and time after radiation but our data strongly support a multifactorial causation with an important role for adhesion formation in the disease complex.

Animals↗
PubMed1989

Comparison of the gastrointestinal syndrome after total-body or total-abdominal irradiation.

In pathogen-free mice, but not standard conventionally housed laboratory rodents, two distinctly different modes of early radiation lethality can be identified by modifying the irradiation technique (total-body versus abdominal irradiation) or by therapeutic intervention such as rescue of total-body-irradiated mice with syngeneic bone marrow or spleen. While damage to the gastrointestinal tract is usually designated as the predominant cause of death occurring within 10 days of radiation exposure, it was demonstrated that damage to the hematopoietic/lymphopoietic system can result in animal lethality over the same period as the gastrointestinal syndrome and that this target cell population is more radiation-sensitive than the gastrointestinal epithelium.

Abdomen↗
PubMed1988

Uses of ionizing radiation and medical-care-related problems.

The uses of ionizing radiation in medicine are currently undergoing changes due to at least four major influences: (1) the constantly changing public perception of the hazards of radiation, (2) continuing technical innovation and development in equipment, (3) the imposition of diagnosis-related group funding by government health-care funding agencies, and (4) an increase in the average age of the U.S. population. The combined effect of these influences will probably result in a major increase in biplanar fluoroscopic examinations to support nonsurgical approaches such as percutaneous transluminal coronary angioplasty, percutaneous transluminal neuroembolism, and lithotripsy (the fracturing of kidney stones). As some of these examinations can result in 1.5 h of fluoroscopy, major doses to the patient and to the clinical staff can be expected. In addition, improved diagnostic techniques, such as using positron emission tomography (a combination of biochemistry and positron-emitting isotopes), can be expected to increase the number of small cyclotrons installed in medical centers. Counteracting these increases in radiation exposure is the development of digital radiography, which generally results in a lowering of the dose per diagnostic procedure. In the realm of therapeutic uses, one can expect higher-energy treatment accelerators, more patients being released from the hospital on therapeutic doses of isotopes, and a potential acceptance of neutron therapy as a cancer treatment modality. The latter treatment may take the form of boron capture therapy, 252Cf implant therapy, or external beam therapy using high-energy cyclotrons and the p,Be or the d,Be reaction to create the neutrons. To summarize, the cost of medicine and the fear of cancer may result in an increased use of radiation in the treatment of specific maladies and an increased potential for exposure of the general public to ionizing radiation. In contrast, there is a definite trend toward reducing exposure of the public as a result of general radiographic examinations.

Diagnosis-Related Groups↗
PubMed1984

Verification timer for AECL 780 Cobalt unit.

To obtain verification of the proper time setting of the motorized run down timer for a AECL 780 Cobalt Unit, a digital timer is described, which can be added to the system for under $300.

Cobalt Radioisotopes↗
PubMed1980

Lymphatic clearance of radioactive sulfur colloid.

Lymphatic clearance of radioactive sulfur colloid is measured in the hind limb of five mongrel dogs. A solid state Si(Li) detector is placed onto the skin to continuously record activity over the site of subcutaneous injection. Decrease in activity follows an exponential decay which is modeled as a dual decay occurring from both the radioactive decay of the tracer and the lymph clearance of the tagged sulfur colloid. The calculated decay constants for lymph clearance flow per tissue volume result in a mean value of 0.233 +/- 0.077 ml/hr/ml which is consistent with results of other investigators. Adjacent lymph nodes are monitored with a scintillation detector to show that the colloid is absorbed by the lymph vessels. The carotid artery and liver are similarly monitored to show that there is little or no capillary absorption of the tagged colloid.

Animals↗
PubMed1978

A heavy particle comparative study. Part I: depth-dose distributions.

The results of a comparative study of heavy particles of interest in radiotherapy, with peaks spread over a depth of 10 cm, are reported in four parts. The introduction to this study and the depth-dose distributions of the particles, (n, pi-, p, He, C, Ne, and Ar ions) are reported herein. The results indicate that protons give the best localization of dose. The degree of localization of dose with heavy ions is reduced with increasing charge on the ion. For ranges less than 15cm, heavier ions such as neon and argon still have favourable dose localization; however, for ranges in excess of 15 cm, heavy ions such as argon are unfavourable but superior to fast neutrons because penetration can be controlled by modulation of energy or range.

Argon↗