The absorbed radiation dose to human organs has been estimated, following intravenous administration of (67)Ga-labelled adrenocorticotrophic hormone (ACTH) using distribution data from injected normal rats. Four rats were sacrificed at exact time intervals and the percentage of injected dose per gram of each organ was measured by direct counting from rat data. The Medical Internal Radiation Dose formulation was applied to extrapolate from rat to human and to project the absorbed radiation dose for various organs in a human. From rat data, it is estimated that a 185-MBq injection of (67)Ga-diethylenetriaminepentaacetic acid-ACTH into a human might result in an estimated absorbed dose of 2.22 mGy to the whole body; the highest absorbed dose was in the bladder wall with 82.1 mGy and the organs that received the next highest doses were the lungs 31.8, liver 22.6 and spleen 8.72 mGy. These results suggest that it should be possible to perform early imaging of the lung anomalies.
The aim of this study was to assess the actual dose delivered to the rectum and compare it with the treatment planning system (TPS) reports. In this study, the dose delivered to the rectum was measured by semiconductor diode detectors (PTW, Germany). The factors that influence diode response were investigated as well. Calibration factors of diodes were measured weekly to investigate the effect of time interval on the accuracy of calibration. Then 40 applications of patients with cervix carcinoma were evaluated. Rectum dose was measured by means of rectal dosemeter and compared with the TPS-calculated dose. In this research, the differences between the measured and the calculated dose were investigated. The mean difference between the TPS-calculated dose and the measured dose was 6.5% (range: -22 to +39) for rectum. The TPS-calculated maximum dose was typically higher than the measured maximum dose. The study showed that the main reason for the difference was due to the movements of the patient and applicator shift in the elapsed time between the imaging and treatment stage. It is recommended that in vivo dosimetry should be performed in addition to treatment planning computation. In vivo dosimetry is a reliable solution to compare the planned and actual dose delivered to organs at risk.
Despite all advantages associated with high-energy radiotherapy to improve therapeutic gain, the production of photoneutron via interaction of high-energy photons with high atomic number (Z) materials increases undesired dose to the patient and staff. Owing to the limitation and complication of experimental neutron dosimetry in mixed beam environment, including photon and neutron, the Monte Carlo (MC) simulation is a gold standard method for calculation of photoneutron contaminations. On the other hand, the complexity of treatment head makes the MC simulation more difficult and time-consuming. In this study, the possibility of using a simplified MC model for the simulation of treatment head has been investigated using MCNP4C general purpose MC code. As a part of comparative assessment strategy, the fluence, average energy and dose equivalent of photoneutrons were estimated and compared with other studies for several fields and energies at different points in treatment room and maze. The mean energy of photoneutrons was 0.17, 0.19 and 0.2 MeV at the patient plan for 10, 15 and 18 MeV, respectively. The calculated values differed, respectively, by a factor of 1.4, 0.7 and 0.61 compared with the reported measured data for 10, 15 and 18 MeV. Our simulation results in the maze showed that the neutron dose equivalent is attenuated by a factor of 10 for every 4.6 m of maze length while the related factor from Kersey analytical method is 5 m. The neutron dose equivalent was 4.1 mSv Gy(-1) at the isocentre and decreased to 0.79 mSv Gy(-1) at a distance of 100 cm away from the isocentre for 40 x 40 cm(2). There is good agreement between the data calculated using simplified model in this study and measurements. Considering the reported high uncertainties (up to 50%) in experimental neutron dosimetry, it can be concluded that the simplified model can be used as a useful tool for estimation of photoneutron contamination associated with high-energy photon radiotherapy.
ObjectGlomus jugulare tumors (GJT) have traditionally been treated by surgery or fractionated external-beam radiotherapy. The aim of this retrospective study was to determine the tumor control rate, clinical outcome, and short-term complications of stereotactic radiosurgery in subsets of patients who are poor candidates for these procedures, based on age, medical problems, tumor size, or prior treatment failure.MethodsThe Leksell Gamma Knife was used to treat 16 patients harboring symptomatic, residual, recurrent, or unresectable GJTs. The age of the patients ranged from 12 to 77 years (median 46.5 years). Gamma Knife surgery (GKS) was performed as primary treatment in five patients (31.3%). Microsurgery preceded radiosurgery in 10 patients (62.5%) and fractionated radiotherapy in three patients (18.8%). The median tumor volume was 9.8 cm3 (range 1.7–20.6 cm3). The median marginal dose applied to a mean isodose volume of 50% (range 37–70%) was 18 Gy (range 14–20 Gy).Neurological follow-up examinations revealed improved clinical status in 10 patients (62.5%), a stable neurological status in six (37.5%), and no complications. After radiosurgery, follow-up imaging was conducted in 14 patients; the median interval from GKS to the last follow up was 18.5 months (range 4–28 months). Tumor size had decreased in six patients (42.9%), and the volume remained unchanged in the remaining eight (57.1%). None of the tumors increased in volume during the observation period.Conclusions According to the authors' experience, GKS represents a useful therapeutic option to control symptoms and may be safely conducted in patients with primary or recurrent GJTs with no death and no acute morbidity. Because of the tumor's naturally slow growth rate, however, long-term follow-up data are needed to establish a cure rate after radiosurgery.
Epoxy resin phantom materials have been available for some time and are widely used for dosimetry purposes, not least in audit phantoms. Information on their behaviour is partly available in the literature, but there are different mixes and formulations often given similar names and it may not be appropriate to transfer information from one material to another. Five commercially available water substitute materials have been evaluated for use in megavoltage photon beams: WT1, WTe, RMI 451, RMI 457 and 'plastic water'. Four independent experiments were carried out to compare these materials with water in megavoltage photon beams ranging in energy from cobalt 60 to nominal 16 MV x-rays, and some general conclusions are drawn from the results as to their use. All are suitable for relative dosimetry in megavoltage photon beams. However, differences of up to 1% are observed for absolute measurements. The newer formulations, developed for electron beam use, are also closer to water for megavoltage photon beams.
The main reason for the differences between the measured and calculated doses was patient movement. To reduce the risk of large errors in the dose delivered, in vivo dosimetry should be performed in addition to treatment planning system computations.
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