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      Dosimetric evaluation of an intraoperative radiotherapy system: a measurement-based and Monte-Carlo modelling investigation

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          Abstract

          Intraoperative radiotherapy (IORT) is a specialised subset of radiotherapy, where a high radiation dose is delivered to a surgically exposed tumour bed in order to eradicate any remaining cancer cells. The aim of this study was to examine the dose characteristics of the Zeiss Intrabeam IORT device which provides near-isotropic emission of up to 50 kV X-rays. The EGSnrc Monte Carlo (MC) code system was used to simulate the device and percentage depth dose (PDD) data measured with a soft X-ray parallel-plate ionisation chamber were used for model verification. The model provided energy spectra, isodose curves and mean photon energies. In addition, EBT3 Gafchromic film was used to verify the MC model by examining PDDs and 2D dose distributions for various applicators. The differences between MC model and ionisation chamber measurements were within 3% for most points, with a maximum deviation of ~ 9%. Most of the simulated PDD points were within 5% of the film-measured data, with a maximum deviation of ~ 10%. The mean energy of the bare probe was found to be 21.19 keV. The mean photon energy from applicators ranged from 29.00 to 30.85 keV. Results of this study may be useful for future work on creating a system for treatment planning.

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          Most cited references24

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          A review of the use and potential of the GATE Monte Carlo simulation code for radiation therapy and dosimetry applications.

          In this paper, the authors' review the applicability of the open-source GATE Monte Carlo simulation platform based on the GEANT4 toolkit for radiation therapy and dosimetry applications. The many applications of GATE for state-of-the-art radiotherapy simulations are described including external beam radiotherapy, brachytherapy, intraoperative radiotherapy, hadrontherapy, molecular radiotherapy, and in vivo dose monitoring. Investigations that have been performed using GEANT4 only are also mentioned to illustrate the potential of GATE. The very practical feature of GATE making it easy to model both a treatment and an imaging acquisition within the same framework is emphasized. The computational times associated with several applications are provided to illustrate the practical feasibility of the simulations using current computing facilities.
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            Intraoperative Radiotherapy With INTRABEAM: Technical and Dosimetric Considerations

            Purpose We evaluate dose characteristics and clinical applications of treatment accessories used in intraoperative radiotherapy (IORT) and make site-specific recommendations for their optimal use. Methods and materials Dose measurements were performed for a low energy (50 kV) X-ray INTRABEAM source. For spherical, flat, surface, and needle applicators, the following dosimetric parameters were measured: depth-dose (DD) profiles, surface dose (Ds), output factors (OF), and target dose homogeneity (DH). Optical density versus exposure calibration films were employed to obtain 2-dimensional dose distributions in planes parallel and perpendicular to beam direction. Film results were verified via repeat dose measurements with a parallel-plate ionization chamber in a custom water tank. The impact of applicator design on dose distributions was evaluated. Results Spherical applicators are commonly used for treating the inner-surface of breast lumpectomy cavity. Flat and surface applicators provide uniform planar dose for head and neck, abdomen, and pelvis targets. Needle applicators are designed for kypho-IORT of spinal metastasis. Typically, larger applicators produce a more homogeneous target dose region with lower surface dose, but require longer treatment times. For 4-cm diameter spherical, flat, and surface applicators, dose rates (DR) at their respective prescription points were found to be: 0.8, 0.3, and 2.2 Gy/min, respectively. The DR for a needle applicator was 7.04 Gy/min at 5 mm distance from the applicator surface. Overall, film results were in excellent agreement with ion-chamber data. Conclusion IORT may be delivered with a variety of site-specific applicators. Appropriate applicator use is paramount for safe, effective, and efficient IORT delivery. Results of this study should help clinicians assure optimized target dose coverage and reduced normal tissue exposure.
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              Absorption spectra time evolution of EBT-2 model GAFCHROMIC film.

              One of the major drawbacks of the current radiochromic film dosimetry protocols is the postirradiation waiting time. In this article, the authors study the postirradiation time evolution of the absorption spectrum of radiochromic EBT-2 GAFCHROMIC film model.
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                Author and article information

                Contributors
                22465928@student.uwa.edu.au
                Journal
                Phys Eng Sci Med
                Phys Eng Sci Med
                Physical and Engineering Sciences in Medicine
                Springer International Publishing (Cham )
                2662-4729
                2662-4737
                23 March 2023
                23 March 2023
                2023
                : 46
                : 2
                : 687-701
                Affiliations
                [1 ]GRID grid.1012.2, ISNI 0000 0004 1936 7910, School of Physics, Mathematics and Computing, , University of Western Australia, ; 35 Stirling Highway, Mailbag M013, CRAWLEY, Perth, WA 6009 Australia
                [2 ]GRID grid.3521.5, ISNI 0000 0004 0437 5942, Department of Radiation Oncology, , Sir Charles Gairdner Hospital, ; Nedlands, WA Australia
                Author information
                http://orcid.org/0000-0002-2463-5970
                http://orcid.org/0000-0001-8306-7742
                http://orcid.org/0000-0002-6875-0719
                http://orcid.org/0000-0002-1071-6614
                Article
                1243
                10.1007/s13246-023-01243-6
                10209310
                36952208
                1d94798c-e369-4ffc-97aa-ee2a90c49a91
                © The Author(s) 2023

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 25 July 2022
                : 9 March 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001170, Cancer Council Western Australia;
                Funded by: FundRef http://dx.doi.org/10.13039/501100006065, Department of Health, Government of Western Australia;
                Funded by: University of Western Australia
                Categories
                Scientific Paper
                Custom metadata
                © Australasian College of Physical Scientists and Engineers in Medicine 2023

                intraoperative radiotherapy,intrabeam,monte carlo,dosimetry

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