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A new method for characterizing beta-ray ophthalmic applicator sources.

A technique is described which enables one to obtain detailed dose characteristics of 90Sr beta-ray ophthalmic applicators. A radiochromic radiation detector which is a solid-state solution of hexahydroxyethyl pararosaniline cyanide in a nylon polymer (i.e., thin foil), has been used to determine the surface dose rate and dose distribution of these sources. The detectors are rugged, easily handled, have an equivalent response (optical density per unit absorbed dose) to photons and electrons, and produce high-resolution images. They have been found useful for this application due to the high surface dose rates [0.10-1.0 Gy (H2O)/s] and their low sensitivity (approximately 10(4) Gy for an optical density of 1.0). The foils have been evaluated on a He-Ne scanning laser densitometer with a resolution of 0.3 mum. Comparison with NIST (formerly NBS) extrapolation ionization chamber measurements indicates surface dose-rate agreement within 6%. Spectral dosimetric characteristics are presented and discussed.

Beta Particles↗

Surface dose rate calibration of Sr-90 plane ophthalmic applicators.

Calibration of an imported strontium-90 ophthalmic applicator at the U.S. National Bureau of Standards (now the National Institute of Standards and Technology) has disclose a significant discrepancy in dose rate calibration (32%-35%) with that quoted by the manufacturer. The University of Wisconsin has investigated this discrepancy and found that both laboratories use similar techniques and a version of the Bragg-Gray equation to yield dose rate estimates. Experimental results indicate a strong relationship between the size of the collecting electrode used in the extrapolation chamber and the resulting estimate of absorbed dose rate. Calibration of these applicators is reviewed and suggestions for improvement and further research are proposed.

Beta Particles↗

Dosimetry of ruthenium-106 eye applicators.

In view of the importance of clinical applications of ruthenium-106 beta-ray sources for the treatment of choroidal melanoma, experimental, and theoretical approaches are presented for the dosimetry of such sources. The absolute dose and percentage depth dose of ruthenium applicators have been measured with an extrapolation ionization chamber. For a special flat applicator the absolute dose could be measured with an accuracy of +/- 5%, which is determined by the collection efficiency of the extrapolation chamber. The percentage depth dose of concave applicators, employed in the clinical situation, could only be measured at a distance larger than 5 mm due to their geometry and the outer dimensions of the extrapolation chamber. A computer simulation was therefore developed for the absorption and scattering of electrons, taking into account the geometry and materials of the applicator, to predict the percentage depth dose at distances smaller than 5 mm. The calculated and experimentally determined depth doses are in good agreement. With the aid of the computer simulation a depth dose determination for concave applicators can be made for clinically relevant distances less than 10 mm from the source surface with an absolute accuracy of +/- 10%.

Beta Particles↗

An evaluation of the EGS4 and CYLTRAN Monte Carlo codes with regard to boundary beta-ray dosimetry by comparison with experimental beta-ray dose backscatter factors.

Beta-ray dose backscatter factors or dose ratios at planar soft-tissue boundaries were calculated using the EGS4/RESTA and CYLTRAN (version 2.1) Monte Carlo codes and these data were compared with experimental results. Since the beta-ray source was 32P, this work addressed the transport of, and energy deposition by, electrons less energetic than 2 MeV. In particular, the simulations targeted the codes' performances with regard to the transport of low energy electrons across material boundaries and the backscattering of low energy electrons. In general, backscatter factors calculated at 7.25 mg/cm2 from several soft-tissue interfaces agreed with experimental values to within about five percent. CYLTRAN was also used to calculate the variation of backscatter factor with distance from aluminum/soft-tissue and air/soft-tissue interfaces and was found to reproduce the shapes of experimental backscatter factor depth profiles.

Beta Particles↗

Calculation of beta dosimetry in radiation synovectomy using Monte Carlo simulation (EGS4).

Using the EGS4 Monte Carlo code, absorbed dose rate factors were estimated for four radionuclides of interest in radiation synovectomy, an intra-articular radiation therapy to treat rheumatoid arthritis. The treatment consists of the injection of a beta-emitting radionuclide into the joint capsule in order to eliminate diseased synovium through irradiation. The radionuclides investigated are 32P, 90Y, 165Dy, and 198Au. Calculations reveal the absorbed dose factor (cGy cm2/MBq s) as a function of distance (mm) in an EGS4 model of the rheumatic joint. The model incorporates bone, articular cartilage, joint capsule, and tissue (synovium) components found in all synovial joints, with dimensions in the model corresponding to dimensions typically found in larger joints, e.g., the knee, shoulder, or hip. Results are compared with previous, analytical approaches to beta dosimetry in radiation synovectomy. In addition, radiation backscatter due to the presence of bone is investigated and determined to have a negligible enhancement effect on absorbed dose to synovium.

Arthritis, Rheumatoid↗

Multicellular dosimetry for beta-emitting radionuclides: autoradiography, thermoluminescent dosimetry and three-dimensional dose calculations.

Inhomogeneities in activity distributions over distances from 10 to 10(4) microns are observed in many tumors treated with radiolabeled antibodies. Resulting nonuniformities in absorbed dose may have consequences for the efficacy of radioimmunotherapy. Activity variations may be directly studied with quantitative autoradiography (ARG). Converting these data to absorbed dose distributions requires additional information about pharmacokinetics, the use of a point source function and consideration of the complete three-dimensional activity distribution, as obtained from sequential autoradiographic slices. Thermoluminescent dosimetry with specially prepared CaSO4:Dy dosimeters implanted into tissue can directly measure absorbed dose in selected regions. The conditions under which thermoluminescent dosimeters (TLD) are used differ markedly from "normal" use conditions in external beam radiotherapy. Therefore special calibration and quality assurance precautions are needed to assure the precision of this technique. Procedures and pitfalls in the use of both techniques in radioimmunotherapy are described.

Autoradiography↗

Intraoperative beta probe: a device for detecting tissue labeled with positron or electron emitting isotopes during surgery.

An intraoperative beta probe was designed, built, and tested for detection of radio-labeled malignant tissues that has the advantage of being selectively sensitive to beta while insensitive to gamma radiation. Since beta radiation (electrons or positrons) has a short range in tissue, this probe is ideal for detecting tracers in tumors at the surface of the surgical field. This probe contains a plastic scintillation detector sensitive to beta rays and to a lesser degree some background gamma rays. A second detector counts spurious gamma rays and allows for their subtraction from the activity measured by the first detector. Sensitivity of the dual probe for I-131 and F-18 was measured to be 108 counts/s/kBq (4000 counts/s/microCi). The dual-detector probe faithfully measured the 10:1 "tumor" to background ratio of radioactivity concentrations in a simulated environment of a tumor in the presence of intense background 511 keV photons. In another phantom experiment, simulating abdominal tumor deposits with various realistic I-131 radioactive concentrations, the probe was able to accurately identify tumors of approximately 50 mg with a tumor/normal radioactivity concentration of 3/1 in 10 s.

Abdominal Neoplasms↗

Physical and biological doses produced from neutron capture in a 235U foil.

As a follow-on study to the feasibility of neutron capture therapy (NCT) with 235U brachytherapy seeds, physical doses were calculated and measured for the radiation from a 235U foil in a lucite phantom which was irradiated at the epithermal neutron irradiation port of the Brookhaven Medical Research Reactor. In addition, cell survival experiments were performed to obtain the relative biological effectiveness (RBE) for the neutron part of the radiation. The calculated absorbed doses agree with the measured ones. From cell survival experiments, it is deduced that the fission neutrons from the 235U foil have a RBE of 3.0 while the fast neutrons in the beam have a RBE of 3.8. Also observed is that, with the cells 7 mm from the foil, a significant amount of absorbed dose comes from the beta rays of 235U fission events. This absorbed dose from beta rays is a significant addition to the therapeutic dose. Due to the limited ranges of beta rays in tissue, this absorbed dose is restricted to the vicinity of the foil. This is the first demonstration of beta rays as part of NCT.

Beta Particles↗

A displacement model for thermoluminescent dosimetry in radioimmunotherapy.

A model is developed to enable dose determination for thermoluminescent dosimeters immersed in a radioactive solution such as used in radioimmunotherapy. For low energy beta emitters used in such therapy the size of the dosimeter results in a much lower light output than when irradiated with an external Cobalt-60 (60Co) beam to the same dose as delivered to the medium. The model takes the size of the dosimeter into account and hence allows calculation of the dose in the actual medium. The application to different dosimeter sizes as well as different radionuclide energies is also illustrated. Finally, the model can be extended to dose calculation in a mixed gamma and beta irradiation geometry.

Beta Particles↗

Evaluation of ion-implanted-silicon detectors for use in intraoperative positron-sensitive probes.

The continuing development of probes for use with beta (positron and electron) emitting radionuclides may result in more complete excision of tracer-avid tumors. Perhaps one of the most promising radiopharmaceuticals for this task is 18F-labeled-Fluoro-2-Deoxy-D-Glucose (FDG). This positron-emitting agent has been demonstrated to be avidly and rapidly absorbed by many human cancers. We have investigated the use of ion-implanted-silicon detectors in intraoperative positron-sensitive surgical probes for use with FDG. These detectors possess very high positron detection efficiency, while the efficiency for 511 keV photon detection is low. The spatial resolution, as well as positron and annihilation photon detection sensitivity, of an ion-implanted-silicon detector used with 18F was measured at several energy thresholds. In addition, the ability of the device to detect the presence of relatively small amounts of FDG during surgery was evaluated by simulating a surgical field in which some tumor was left intact following lesion excision. The performance of the ion-implanted-silicon detector was compared to the operating characteristics of a positron-sensitive surgical probe which utilizes plastic scintillator. In all areas of performance the ion-implanted-silicon detector proved superior to the plastic scintillator-based probe. At an energy threshold of 14 keV positron sensitivity measured for the ion-implanted-silicon detector was 101.3 cps/kBq, photon sensitivity was 7.4 cps/kBq. In addition, spatial resolution was found to be relatively unaffected by the presence of distant sources of annihilation photon flux. Finally, the detector was demonstrated to be able to localize small amounts of FDG in a simulated tumor bed; indicating that this device has promise as a probe to aid in FDG-guided surgery.

Beta Particles↗

An investigation of the physical characteristics of 66Ga as an isotope for PET imaging and quantification.

Isotopes commonly used for PET imaging and quantification have a straightforward decay scheme involving "pure" positron (beta +) emission, i.e., 95%-100% beta + abundance, with no additional gamma rays. 66Ga (Emax = 4.2 MeV, T1/2 = 9.5 h) is a member of a category of isotopes with a lower abundance of beta +'s (57%) and a more complicated spectrum involving combinations of gamma rays that are emitted in cascade. These additional gamma rays tend to cause a higher singles rate, resulting in more random coincidence events. The most abundant positron (51.5%) in the spectrum has one of the highest energies considered for PET imaging. For the purpose of monoclonal antibody dosimetry using 66Ga, it is important to verify the quantification in phantoms prior to initiating human studies. A series of quantitative phantom measurements were performed on the PC4600, a head-optimized BGO based scanner with multiple detector rings. Count rate linearity was verified over concentrations ranging from 4.0 kBq/cc to 37 kBq/cc (0.11-1.0 microCi/cc); resolution averaged 16 mm full width half-maximum in the x and y directions in both the direct and cross planes. Axial resolution was 14 mm. The range of the energetic positrons (up to 4.153 MeV, range 7.6 mm in tissue) was verified as a primary source of resolution degradation. Within the limits outlined above, 66Ga is a suitable isotope for use as 66Ga citrate or with monoclonal antibodies in the detection and staging of tumors and other lesions. In addition, the energetic positrons have possible therapeutic applications when used as a monoclonal antibody label.

Beta Particles↗

The determination of dose characteristics of ruthenium ophthalmic applicators using radiochromic film.

Ruthenium ophthalmic applicators are energetic beta ray sources, supplied in several shapes and dimensions, and used in intraocular tumor therapy. Because of their small dimensions, the determination of dosimetric characteristics represents a technical challenge. We developed a semiautomatic method to define surface dose, dose distribution, and percentage depth dose of such applicators using radiochromic dosimetric media. These detectors consist of a thin (7 microns) radiation sensitive layer on polyester base (100 microns total thickness) changing color as a function of radiation exposure. Transmission images of exposed films were then grabbed with a TV-digitizer system to obtain a gray-level image from which dosimetric characteristics such as isodose distribution, dose values, and homogeneity of nuclide distribution were derived. Good agreement between experimental results and Monte Carlo simulation performed using the GEANT 3 code, appear to be a confirmation of the validity of the method. Moreover while manufacturer specifications of absolute and relative dose rates present a standard deviation error of +/- 30% on dose rate and +/- 6% on accuracy of relative dose values, the proposed method reduces the errors to +/- 10% and +/- 4%, respectively.

Beta Particles↗

A statistical investigation of the scaling factor method of beta-ray dose distribution derivation: the scaling factor for water to bone.

Reliable methods of estimating doses are essential for the use of beta emitting radionuclides for radiotherapy. The passage of electrons through matter is a very complex phenomenon due to the large number of elastic and inelastic interactions resulting in scattering and energy losses. The analytical solution for the electron transport being intractable, the problem has been addressed by the Monte Carlo technique. Empirical or semiempirical less time consuming methods, such as the scaling factor method, may appear more preferable in practice when dealing with complicated source distributions. The method, proposed by Cross and co-workers [AECL Report Nos. AECL-1617 (1982), AECL 10521 (1992)] consists in the derivation of beta-ray dose distribution in other media from those in water by using a "scaling factor" or "relative attenuation factor" on distance and a closely related renormalization factor imposed by the energy conservation. This work investigates the accuracy of the scaling factor method using a statistical approach, a generalized chi 2 test, focusing on the particular case of potential interest, the scaling factor for water to bone. The direct comparison of the shapes of the depth dose deposition curves in the two media indicates discrepancies of less than 5% up to at least 60% of the range in bone, a depth within which 95% of the initial energy is deposited. The scaling factor derived by this method, 0.9720 +/- 0.0012, confirms the existing experimentally determined value of 0.973 +/- 1% [AECL Report No. AECL-10521 (1992)]. The accuracy of the determination is increased by almost a factor of 10. A way of improving the scaling method, especially for depth over the 60% continuous slowing down approximation range, by using a modulation function is also proposed.

Beta Particles↗

Application of the scaling factor method to estimation of beta dose distributions for dissimilar media separated by a planar interface.

The most accurate method of calculating beta dose distribution currently relies on the Monte Carlo technique. The major drawback of the method is the long computing time required to follow a large number of "electron histories" in order to achieve good statistics, which makes the method unattractive for practical radiation therapy. A way to avoid the Monte Carlo calculations for homogeneous media was suggested by Cross and co-workers (AECL Report Nos. 7617, 1982; 10521, 1992), and is known as the "scaling factor" method. It consists of the determination of the depth dose distribution in a medium based on known data about the dose distribution in an arbitrary reference medium (e.g., air, water) by the use of a scaling factor on distance and a closely related renormalization factor imposed by energy conservation. This work is an attempt to extend the applicability of the scaling factor method to dissimilar media to a planar interface. The investigation was done for an isotropic source of the radioisotope 32P and an interface between water and medium "i," where medium "i" could be any medium with atomic number in the range 8 < Z < 50. The method was checked using three randomly chosen elements 40Zr, 32Ge, and 26Fe, each forming planar interfaces with water at either 100 or 350 mg/cm2. Discrepancies of less than 5% were detected (acceptable for practical radiotherapy) for the depth within which at least 95% of the initial energy is deposited.

Beta Particles↗

Radiochromic film dosimetry of a high dose rate beta source for intravascular brachytherapy.

Good clinical physics practice requires that dose rates of brachytherapy sources be checked by the institution using them, as recommended by American Association of Physicists in Medicine Task Group 56 and The American College of Radiology. For intravascular brachytherapy with catheter-based systems, AAPM Task Group 60 recommends that the dose rate be measured at a reference point located at a radial distance of 2 mm from the center of the catheter axis. AAPM Task Group 60 also recommends that the dose rate along the catheter axis at a radial distance of 2 mm should be uniform to within +/- 10% in the center two-thirds of the treated length, and the relative dose rate in the plane perpendicular to the catheter axis through the center of the source should be measured at distances from 0.5 mm to R90 (the distance from a point source within which 90% of the energy is deposited) at intervals of 0.5 mm. Radiochromic film dosimetry has been used to measure the dose distribution in a plane parallel to and at a radial distance of 2 mm from the axis of a novel, catheter-based, beta source for intravascular brachytherapy. The dose rate was averaged along a line parallel to the catheter axis at a radial distance of 2 mm, in the centered 24.5 mm of the treated length. This average dose rate agreed with the dose rate measured with a well ionization chamber by the replacement method using source trains calibrated with an extrapolation chamber at the National Institute of Standards and Technology. All of the dose rates in the centered 24.5 mm of a line parallel to the axis at a distance of 2 mm were within +/-10% of the average.

Beta Particles↗

Dosimetric perturbations of linear array of beta-emitter seeds and metallic stent in intravascular brachytherapy.

The radiation treatment with catheter-based beta-emitter sources is under clinical trials to prevent restenosis following interventional coronary procedures. There are still large uncertainties in the dose calculation due to the complicated treatment geometry. We present the Monte Carlo simulations to account for the dosimetric perturbations due to neighboring trained seeds, proximal/distal gold markers, and a stainless steel stent. A catheter-based beta-emitter system is modeled using the Monte Carlo code, MCNP4B. Dose distributions and dose rates are calculated in voxels (0.64x0.64x0.5 mm3) around the long cylindrical trains of 90Sr/Y source with and without the stent (at 1.92 mm from the source axis). For the total activity of 70 mCi (2.59x10(9) Bq), the dose around most of the source length (except for edge seeds and gold markers) varies from 40 to 0.23 cGy/s as the radial distance from the source axis (r) increases from 0.64 to 6.4 mm. At the prescription range of r = 1.5-4.0 mm, the dose gradient is very steep and the contribution of neighboring seeds to the dose is significant. The dose enhancement due to neighboring seeds (the so-called "train effect") varies from 9% to 64% as r increases from 0.64 to 5.2 mm. The doses at r = 2 mm from the last edge seed and the gold marker are about 80% and 40% of that of the nonedge seed (8.7 cGy/s), respectively. The dose enhancement due to the secondary electrons and the primary electrons scattered with the stent is shown to be about 9.3% in the voxel including the stent. However, as r increases beyond the stent (r = 2.0-6.4 mm), the dose is slightly reduced by 4%-12%, compared to that without the stent.

Beta Particles↗