In radiation therapy (RT) for skin cancer, tissue-equivalent substances called boluses are widely used to ensure the delivery of an adequate dose to the skin surface and to provide a radioprotective effect for normal tissue. The aim of this study was to develop a new type of three-dimensional (3D) bolus for RT involving body parts with irregular geometries and to evaluate its clinical feasibility. Two 3D-printed boluses were designed for two patients with squamous cell carcinoma (SCC) of their distal extremities based on computed tomography (CT) images and printed with polylactic acid (PLA). The clinical feasibility of the boluses was evaluated by measuring the in vivo skin dose at the tumor site with optically stimulated luminescence detectors (OSLDs) and comparing the results with the prescribed and calculated doses from the Eclipse treatment planning system (TPS). The average measured dose distribution for the two patients was 94.75% of the prescribed dose and 98.8% of the calculated dose. In addition, the average measured dose during repeated treatments was 189.5 ± 3.7 cGy, thus demonstrating the excellent reproducibility of the proposed approach. Overall, the customized 3D-printed boluses for the RT of distal extremities accurately delivered doses to skin tumors with improved reproducibility.
A full-energy-peak (FEP) efficiency correction is required through a Monte Carlo simulation for accurate radioactivity measurement, considering the geometrical characteristics of the detector and the sample. However, a relative deviation (RD) occurs between the measurement and calculation efficiencies when modeling using the data provided by the manufacturers due to the randomly generated dead layer. This study aims to optimize the structure of the detector by determining the dead layer thickness based on Monte Carlo simulation. Methods:The high-purity germanium (HPGe) detector used in this study was a coaxial p-type GC2518 model, and a certified reference material (CRM) was used to measure the FEP efficiency. Using the MC N-Particle Transport Code (MCNP) code, the FEP efficiency was calculated by increasing the thickness of the outer and inner dead layer in proportion to the thickness of the electrode.Results: As the thickness of the outer and inner dead layer increased by 0.1 mm and 0.1 μm, the efficiency difference decreased by 2.43% on average up to 1.0 mm and 1.0 μm and increased by 1.86% thereafter. Therefore, the structure of the detector was optimized by determining 1.0 mm and 1.0 μm as thickness of the dead layer. Conclusions:The effect of the dead layer on the FEP efficiency was evaluated, and an excellent agreement between the measured and calculated efficiencies was confirmed with RDs of less than 4%. It suggests that the optimized HPGe detector can be used to measure the accurate radioactivity using in dismantling and disposing medical linear accelerators.
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