Radiation protection measurements around a 12 MeV mobile dedicated IORT accelerator

Soriani, A.; Felici, G.; Fantini, M.; Paolucci, M.; Borla, Oscar; Evangelisti, Giovanna; Benassi, Marcello; Strigari, Lidia

doi:10.1118/1.3298012

Cited by 28 publications

(35 citation statements)

References 15 publications

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“…Typical stray doses from IORT at a 1 m distance from the patient are around 6 µSv per Gy of patient dose (42). Radiation safety regulations usually require shielding which reduces dose below the permitted constraints at any position around the OR under the assumption that the highest dose of stray radiation occurs in the direction of the beam during the complete workload.…”

Section: Challenges and Future Directions In Iort For Hncmentioning

confidence: 99%

Intraoperative Radiation Therapy: A Promising Treatment Modality in Head and Neck Cancer

et al. 2017

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Every year, almost 62,000 are diagnosed with a head and neck cancer (HNC) and 13,000 will succumb to their disease. In the primary setting, intraoperative radiation therapy (IORT) can be used as a boost in select patients in order to optimize local control. Addition of external beam radiation to limited volumes results in improved disease control over surgery and IORT alone. In the recurrent setting, IORT can improve outcomes from salvage surgery especially in patients previously treated with external beam radiation. The use of IORT remains limited to select institutions with various modalities being currently employed including orthovoltage, electrons, and high-dose rate brachytherapy. Practically, execution of IORT requires a coordinated effort and careful planning by a multidisciplinary team involving the head and neck surgeon, radiation oncologist, and physicist. The current review summarizes common uses, outcomes, toxicities, and technical aspects of IORT in HNC patients.

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Section: Challenges and Future Directions In Iort For Hncmentioning

confidence: 99%

Intraoperative Radiation Therapy: A Promising Treatment Modality in Head and Neck Cancer

et al. 2017

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“…Moreover, due to the low sensitivity, high‐dose irradiations per measurement point are required (at least 40 Gy for the ferrous sulfate dosimeters provided by ENEA‐INMRI, higher than the clinical range of the prescribed doses). The high number of monitor units increases the measurement time and, potentially, the required thickness of the shielding barriers …”

Section: Introductionmentioning

confidence: 99%

Use of parallel‐plate ionization chambers in reference dosimetry of NOVAC and LIAC^® mobile electron linear accelerators for intraoperative radiotherapy: a multi‐center survey

Scalchi

Ciccotelli²,

Felici³

et al. 2017

Medical Physics

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The present study confirms that parallel-plate ionization chambers can properly and accurately substitute ferrous sulphate detectors in reference dosimetry of LIAC and NOVAC mobile linear accelerators. Therefore, we hope that the most commonly used protocols for reference dosimetry in external-beam radiotherapy will be updated in order to provide guidance in the calibration of electron beams from linear accelerators dedicated to IORT, so that users may benefit from specific, authoritative and up-to-date recommendations.

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“…Treatment can also be delivered intra-operatively as a single fraction soon after surgical excision of the tumour. Electron-only linear accelerators have been used for this approach, and recent mobile devices can be used in unmodified theatres if the workload is limited or thick mobile shielding panels are used [2][3][4]. The Intrabeam system (Carl Zeiss Surgical, Oberkochen, Germany) is a compact X-ray unit used for intra-operative partial breast irradiation [5][6][7][8], currently in an international randomised controlled trial (Targit) [9,10].…”

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confidence: 99%

Radiation protection for an intra-operative X-ray device

Eaton

Gonzalez²,

Duck³

et al. 2011

BJR

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Objectives: Therapeutic partial breast irradiation can be delivered intra-operatively using the Intrabeam 50 kVp compact X-ray device. Spherical applicators are added to the source to give an isotropic radiation dose. The low energy of this unit leads to rapid attenuation with distance, but dose rates are much greater than for diagnostic procedures. Methods: To investigate the shielding requirements for this unit, attenuation measurements were carried out with manufacturer-provided tungsten-rubber sheets, lead, plasterboard and bricks. A prospective environmental dose rate survey was also conducted in the designated theatre. Results: As a result of isotropic geometry, the scattered dose around shielding can be 1% of primary and thus often dominates measured dose rates compared with transmission. The absorbed dose rate of the unshielded source at 1 m was 11.6 mGy h 21 but this was reduced by 95% with the shielding sheets. Measured values for the common shielding materials were similar to reference data for the attenuation of a 50 kVp diagnostic X-ray beam. Two lead screens were constructed to shield operators remaining in the theatre and an air vent into a service corridor. A lead apron would also provide suitable attenuation, although a screen allows greater flexibility for treatment operators. With these measures, staff doses were reduced to negligible quantities. Survey measurements taken during patient treatments confirmed no additional measures were required, but the theatre should be a controlled area and access restricted.

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Radiation protection measurements around a 12 MeV mobile dedicated IORT accelerator

Abstract: Our data confirm that neutron exposure levels around the new dedicated IORT accelerator are very low. Mobile shielding panels can be used to reduce x-ray levels to below regulatory levels without necessarily providing permanent shielding in the operating room.

Cited by 28 publications

References 15 publications

Intraoperative Radiation Therapy: A Promising Treatment Modality in Head and Neck Cancer

Intraoperative Radiation Therapy: A Promising Treatment Modality in Head and Neck Cancer

Use of parallel‐plate ionization chambers in reference dosimetry of NOVAC and LIAC^® mobile electron linear accelerators for intraoperative radiotherapy: a multi‐center survey

Radiation protection for an intra-operative X-ray device

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Radiation protection measurements around a 12 MeV mobile dedicated IORT accelerator

Abstract: Our data confirm that neutron exposure levels around the new dedicated IORT accelerator are very low. Mobile shielding panels can be used to reduce x-ray levels to below regulatory levels without necessarily providing permanent shielding in the operating room.

Cited by 28 publications

References 15 publications

Intraoperative Radiation Therapy: A Promising Treatment Modality in Head and Neck Cancer

Intraoperative Radiation Therapy: A Promising Treatment Modality in Head and Neck Cancer

Use of parallel‐plate ionization chambers in reference dosimetry of NOVAC and LIAC® mobile electron linear accelerators for intraoperative radiotherapy: a multi‐center survey

Radiation protection for an intra-operative X-ray device

Contact Info

Product

Resources

About

Use of parallel‐plate ionization chambers in reference dosimetry of NOVAC and LIAC^® mobile electron linear accelerators for intraoperative radiotherapy: a multi‐center survey