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      Monte Carlo dosimetry of a novel Yttrium‐90 disc source for episcleral brachytherapy

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          Abstract

          Purpose

          To calculate the dose distribution using Monte Carlo simulations for a novel high‐dose‐rate Yttrium‐90 (Y‐90) disc source recently developed for episcleral brachytherapy and provide a lookup table for treatment planning.

          Methods

          Monte Carlo simulations were performed to calculate the in‐water dose distribution of the Y‐90 disc source using the “GATE”, a software based on the “Geant4” Monte Carlo simulation toolkit developed by the international OpenGATE collaboration. The geometry of this novel beta source, its capsule, and the surrounding water medium were accurately modeled in the simulation input files. The standard Y‐90 element beta spectrum from ICRU 72 was used, and the physics processes for beta and photon interactions with matters were all included. The dose distribution of this Y‐90 disc source was measured in a separate study using Gafchromic EBT‐3 films and the results were reported elsewhere. To match the setup of the experiment, a Gafchromic EBT‐3 film was also included in the simulation geometry. The simulated dose profiles were exported from the 3D dose distribution results and compared with the measured dose profiles. Transverse dose profiles at different distances from the seed surface were also obtained to study the lateral coverage of the source.

          Results

          The measured percent depth dose (PDD) curves along the central axis perpendicular to the surface of the Y‐90 disc were constructed from the experimental and simulated data, and normalized to the reference point at 1 mm from the source capsule. Both PDD curves agreed well up to 4 mm from the source surface (maximum difference ± 10%) but deviated from each other beyond 4 mm. The deviation might be caused by the increased measurement uncertainty in the low‐dose region. The dose rate at the reference point calculated from the Monte Carlo simulation was 1.09 cGy/mCi‐s and agreed very well with the measured dose rate of 1.05 cGy/mCi‐s. If the 80% isodose line is selected as the lateral coverage, the lateral dose coverage is maximal (∼4.5 mm) at the plane next to the source surface, and gradually decreases with the increasing distance, approaching 3.5 mm when the plane is 5 mm from the 6‐mm diameter source surface.

          Conclusion

          Monte Carlo simulations were successfully performed to confirm the measured PDD curve of the novel Y‐90 disc source. This simulation work laid a solid foundation for characterizing the full dosimetry parameters of this source for episcleral brachytherapy applications.

          Related collections

          Most cited references18

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          The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma: V. Twelve-year mortality rates and prognostic factors: COMS report No. 28.

          (2006)
          To report refined rates of death and related outcomes by treatment arm through 12 years after primary treatment of choroidal melanoma and to evaluate characteristics of patients and tumors as predictors of relative treatment effectiveness and time to death. Randomized multicenter clinical trial of iodine 125 ((125)I) brachytherapy vs enucleation conducted as part of the Collaborative Ocular Melanoma Study. Eligible patients were free of metastasis and other cancers at enrollment. All patients were followed up for 5 to 15 years at scheduled examinations for metastasis or another cancer or until death. Decedents were classified by the independent Mortality Coding Committee as having histopathologically confirmed melanoma metastasis, suspected melanoma metastasis without histopathologic confirmation, another cancer but not melanoma metastasis, or no malignancy. Deaths from all causes and deaths with histopathologically confirmed melanoma metastasis. Within 12 years after enrollment, 471 of 1317 patients died. Of 515 patients eligible for 12 years of follow-up, 231 (45%) were alive and clinically cancer free 12 years after treatment. For patients in both treatment arms, 5- and 10-year all-cause mortality rates were 19% and 35%, respectively; by 12 years, cumulative all-cause mortality was 43% among patients in the (125)I brachytherapy arm and 41% among those in the enucleation arm. Five-, 10-, and 12-year rates of death with histopathologically confirmed melanoma metastasis were 10%, 18%, and 21%, respectively, in the (125)I brachytherapy arm and 11%, 17%, and 17%, respectively, in the enucleation arm. Older age and larger maximum basal tumor diameter were the primary predictors of time to death from all causes and death with melanoma metastasis. Longer follow-up of patients confirmed the earlier report of no survival differences between patients whose tumors were treated with (125)I brachytherapy and those treated with enucleation. Estimated mortality rates by baseline characteristics should facilitate counseling of patients who have choroidal melanoma of a size and in a location suitable for enucleation or (125)I brachytherapy and no evidence of metastasis or another malignancy.
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            Update of AAPM Task Group No. 43 Report: A revised AAPM protocol for brachytherapy dose calculations.

            Since publication of the American Association of Physicists in Medicine (AAPM) Task Group No. 43 Report in 1995 (TG-43), both the utilization of permanent source implantation and the number of low-energy interstitial brachytherapy source models commercially available have dramatically increased. In addition, the National Institute of Standards and Technology has introduced a new primary standard of air-kerma strength, and the brachytherapy dosimetry literature has grown substantially, documenting both improved dosimetry methodologies and dosimetric characterization of particular source models. In response to these advances, the AAPM Low-energy Interstitial Brachytherapy Dosimetry subcommittee (LIBD) herein presents an update of the TG-43 protocol for calculation of dose-rate distributions around photon-emitting brachytherapy sources. The updated protocol (TG-43U1) includes (a) a revised definition of air-kerma strength; (b) elimination of apparent activity for specification of source strength; (c) elimination of the anisotropy constant in favor of the distance-dependent one-dimensional anisotropy function; (d) guidance on extrapolating tabulated TG-43 parameters to longer and shorter distances; and (e) correction for minor inconsistencies and omissions in the original protocol and its implementation. Among the corrections are consistent guidelines for use of point- and line-source geometry functions. In addition, this report recommends a unified approach to comparing reference dose distributions derived from different investigators to develop a single critically evaluated consensus dataset as well as guidelines for performing and describing future theoretical and experimental single-source dosimetry studies. Finally, the report includes consensus datasets, in the form of dose-rate constants, radial dose functions, and one-dimensional (1D) and two-dimensional (2D) anisotropy functions, for all low-energy brachytherapy source models that met the AAPM dosimetric prerequisites [Med. Phys. 25, 2269 (1998)] as of July 15, 2001. These include the following 125I sources: Amersham Health models 6702 and 6711, Best Medical model 2301, North American Scientific Inc. (NASI) model MED3631-A/M, Bebig/Theragenics model I25.S06, and the Imagyn Medical Technologies Inc. isostar model IS-12501. The 103Pd sources included are the Theragenics Corporation model 200 and NASI model MED3633. The AAPM recommends that the revised dose-calculation protocol and revised source-specific dose-rate distributions be adopted by all end users for clinical treatment planning of low energy brachytherapy interstitial sources. Depending upon the dose-calculation protocol and parameters currently used by individual physicists, adoption of this protocol may result in changes to patient dose calculations. These changes should be carefully evaluated and reviewed with the radiation oncologist preceding implementation of the current protocol.
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              Uveal Melanoma: 5-Year Update on Incidence, Treatment, and Survival (SEER 1973-2013)

              Purpose: To analyze trends in incidence, treatment, and survival of uveal melanoma in the United States from 1973 to 2013 using the Surveillance, Epidemiology, and End Results database. Materials and Methods: Patients were identified using International Classification of Disease for Oncology codes: C69.3 (choroid), C69.4 (ciliary body and iris), and C69.2 (retina). Trends in age-adjusted incidence, treatment (surgery or radiation), and 5-year relative survival were calculated. Results: There were 4,999 cases of uveal melanoma. The majority (97.8%) were reported by hospital inpatient/outpatient clinics. Histopathologic confirmation was available in 67.8%. The mean age-adjusted incidence was 5.2 per million (95% CI 5.0-5.4). When the incidence was standardized for race, a small but statistically significant ( p < 0.05) annual percentage change of 0.5% was detected in Whites. There was a decline in patients treated with surgery alone (94.2% from 1973 to 1975 vs. 24.7% from 2012 to 2013). A corresponding increase was observed in radiation as primary treatment selection (1.3% from 1973 to 1975 vs. 68.3% from 2012 to 2013). No change in the 5-year relative survival (80.9%) was observed. Conclusions: The age-adjusted incidence of uveal melanoma has remained stable with a minor increase in Whites. Despite a shift towards globe-preserving treatment, there has not been a concomitant improvement in survival.
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                Author and article information

                Contributors
                jchang24@northwell.edu
                Journal
                J Appl Clin Med Phys
                J Appl Clin Med Phys
                10.1002/(ISSN)1526-9914
                ACM2
                Journal of Applied Clinical Medical Physics
                John Wiley and Sons Inc. (Hoboken )
                1526-9914
                14 September 2023
                December 2023
                : 24
                : 12 ( doiID: 10.1002/acm2.v24.12 )
                : e14140
                Affiliations
                [ 1 ] MS in Medical Physics Program, Department of Physics and Astronomy Hofstra University Hempstead New York USA
                [ 2 ] Radiation Medicine Northwell Health Lake Success New York USA
                [ 3 ] Radiation Oncology Rhode Island Hospital Providence Rhode Island USA
                [ 4 ] Radiation Medicine Zucker School of Medicine at Hofstra/Northwell Lake Success New York USA
                Author notes
                [*] [* ] Correspondence

                Jenghwa Chang, Department of Radiation Medicine, Northwell Health, 450 Lakeville Road, Lake Success, NY 11042, USA.

                Email: jchang24@ 123456northwell.edu

                Author information
                https://orcid.org/0000-0003-4957-0306
                https://orcid.org/0000-0003-1736-9712
                https://orcid.org/0000-0002-9632-6317
                Article
                ACM214140
                10.1002/acm2.14140
                10691622
                37708092
                bc2c2c43-5912-407d-b4c7-77ffc56afe8b
                © 2023 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 10 August 2023
                : 24 February 2023
                : 11 August 2023
                Page count
                Figures: 9, Tables: 3, Pages: 9, Words: 5087
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                Custom metadata
                2.0
                December 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.5 mode:remove_FC converted:01.12.2023

                hdr brachytherapy,monte carlo,y‐90
                hdr brachytherapy, monte carlo, y‐90

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