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Biomedical subjects

S L Breen

Publications and source records attributed to S L Breen.

7 recordsLinked to original sources

A comparison of conventional, conformal and intensity-modulated coplanar radiotherapy plans for posterior fossa treatment.

Radiotherapy of the posterior fossa for medulloblastoma treatment can induce ototoxicity, especially when combined with cisplatin chemotherapy. Sensorineural hearing loss can be severe enough to cause permanent disability, which may compromise cognitive development in paediatric patients. This study evaluates the sparing of the cochlea in conventional radiotherapy, three-dimensional conformal radiotherapy (3D-CRT), and intensity-modulated radiotherapy (IMRT). CT scans of three patients were used to plan posterior fossa radiotherapy using coplanar beam arrangements. The posterior fossa and the cochlea were contoured as well as other organs-at-risk (non-posterior fossa brain, lenses, optic nerves, pituitary and cervical spinal cord). Three treatment plans were compared: conventional two-dimensional treatment (parallel-opposed lateral pair); 3D-CRT (two wedged posterior oblique fields); and a four-field coplanar IMRT plan. 3D-CRT and IMRT reduced cochlear doses to less than 70% of the mean target dose. These plans also reduced dose to the non-posterior fossa brain and cervical spinal cord. IMRT showed no advantage over 3D-CRT in sparing the optic nerves and lenses, compared with 3D-CRT. Normal tissue doses were higher in both conformal techniques than in the IMRT plans. Conformal techniques reduced the dose to the cochlea, non-posterior fossa brain and cervical spinal cord. The small size and proximity to the planning target volume (PTV) of the cochlea limited the effectiveness of the IMRT plan. Coplanar 3D-CRT was judged superior to coplanar IMRT, particularly in children, because it achieved adequate sparing of the cochlea and anterior cranial structures, such as the lenses and optic nerves, without compromising the dose to the posterior fossa.

Cerebellar Neoplasms↗

Cavity theory applied to the dosimetry of systemic radiotherapy of bone metastases.

A two-component model of an osteoblastic metastatic lesion has been developed to determine the absorbed dose delivered to soft tissue during systemic radiotherapy of osseous metastases. Doses to soft tissue from radioisotopes distributed in bone were calculated using Burlin's general cavity theory. A correction term was used to account for the absence of charged particle equilibrium within the metastatic lesion. Radiation doses for 153Sm, 186Re, 89Sr and 32P were calculated for several physiologically realistic lesion structures. Burlin's cavity weighting factor was greatest for higher energy isotopes and it decreased as the soft tissue cavity size increased. The correction for the absence of charged particle equilibrium also decreased with soft tissue pathlength, but increased with average bone pathlengths. Doses to soft tissue cavities ranged from 0.1 to 0.2 Gy MBq(-1) d(-1) for 153Sm to 0.5 to 0.6 Gy MBq(-1) d(-1) for 32P. Using the factors calculated in this work, the dose to soft tissue cavities within bone metastases can be calculated when the dose to adjacent bone has been determined, perhaps by autoradiography or electron paramagnetic resonance dosimetry. The doses calculated with this more accurate model of bone metastases demonstrate errors of 20% to 50% in previous calculations of the average dose to homogeneous metastatic lesions.

Algorithms↗

Feasibility of reading LiF thermoluminescent dosimeters by electron spin resonance.

Lithium fluoride is a commonly used solid state dosimeter. During irradiation, electrons and holes become trapped in crystal imperfections; thermoluminescence dosimetry measures their thermally induced recombination. Electron paramagnetic resonance (EPR) spectroscopy can be used to measure the resonant absorption of microwaves by the unpaired electrons trapped in LiF. In an effort to extend the use of LiF dosimeters to smaller sizes and to the harsh environments encountered in internal dosimetry, EPR was evaluated as an alternative technique to read the radiation dose delivered to TLD-100 dosimeters. TLD-100 rods were irradiated with a 60Co source to doses of 10 Gy to 100 Gy. A radiation-induced signal (with a g-value of 2.002) could be detected only at liquid nitrogen temperatures at doses above 20 Gy. The EPR spectrum of irradiated LiF contains three components, one of which correlates positively with dose. However, the low sensitivity of the technique, and difficulty in interpreting the EPR spectrum from polycrystalline dosimeters, preclude its use as a dosimetry technique.

Crystallization↗

Radiation dosimetry in human bone using electron paramagnetic resonance.

Accurate measurements of dose in bone are required in order to improve the dosimetry of systemic radiotherapy for osseous metastases. Bone is an integrating dosimeter which records the radiation history of the skeleton. During irradiation, electrons become trapped in the crystalline component of bone mineral (hydroxyapatite). The traps are very stable; at room temperature, emptying of the traps occurs with a half-life of many years. The population of trapped unpaired electrons is proportional to the radiation dose administered to the bone and can be measured in excised bone samples using electron paramagnetic resonance (EPR). EPR spectra of synthetic hydroxyapatite, irradiated with Co-60, were obtained at room temperature and at 77 K. At room temperature, the radiation-induced signal, with a g-value of 2.001 +/- 0.001, increased linearly with absorbed dose above a lower threshold of 3 Gy, up to doses of 200 Gy. In contrast with pure hydroxyapatite, EPR spectra of excised human bone showed a broad "native' signal, due to the organic component of bone, which masks the dosimetrically important signal. This native signal is highly variable from sample to sample and precludes the use of EPR as an absolute dosimetry technique. However, after subtraction of the background signal, irradiated human bone showed a linear response with a lower limit of measurement similar to that of synthetic hydroxyapatite. Bone is an in vivo linear dosimeter which can be exploited to develop accurate estimates of the radiation dose delivered during systemic radiotherapy and teletherapy. However, improved sensitivity of the EPR dosimetry technique is necessary before it can be applied reliably in clinical situations.

Biophysical Phenomena↗

Dose estimation in strontium-89 radiotherapy of metastatic prostatic carcinoma.

Strontium-89 radiotherapy is becoming an important treatment in the palliation of bone pain from osteoblastic metastases. The absorbed dose delivered to bone metastases during 89Sr radiotherapy has been estimated in four patients with metastatic prostatic carcinoma. Patients were injected with a tracer dose of 85Sr-chloride. Blood and urine samples were obtained during the week following injection. Strontium-85 scintigrams of metastases and normal bone were obtained up to 8 wk postinjection. Half of the patients showed elevated whole-body retention; plasma-strontium concentrations were decreased from normal values. Uptake of strontium in metastases was 2-25 times that in normal bone but rates of washout of strontium from metastases were similar to those from normal bone. Absorbed doses delivered in infinite time to the metastases by 89Sr ranged from 21 +/- 4 to 231 +/- 56 cGy/MBq with a median value of 68 cGy/MBq. Doses to red marrow were less by a factor of 2 to 50. These absorbed doses are sufficiently large to be expected to produce a therapeutic benefit.

Bone Neoplasms↗