Journal Articles
2020
Enger, Shirin A.; Vijande, Javier; Rivard, Mark J.
Model-Based Dose Calculation Algorithms for Brachytherapy Dosimetry Journal Article
In: Seminars in Radiation Oncology, vol. 30, no. 1, pp. 77–86, 2020, ISSN: 1532-9461.
Abstract | Links | BibTeX | Tags: Algorithms, Brachytherapy, Computer-Assisted, Female, Humans, Male, Medical, Models, Neoplasms, Photons, Practice Guidelines as Topic, Radiometry, Radiotherapy Dosage, Radiotherapy Planning, Societies, Theoretical
@article{enger_model-based_2020,
title = {Model-Based Dose Calculation Algorithms for Brachytherapy Dosimetry},
author = {Shirin A. Enger and Javier Vijande and Mark J. Rivard},
doi = {10.1016/j.semradonc.2019.08.006},
issn = {1532-9461},
year = {2020},
date = {2020-01-01},
journal = {Seminars in Radiation Oncology},
volume = {30},
number = {1},
pages = {77--86},
abstract = {The purpose of this study was to review the limitations of dose calculation formalisms for photon-emitting brachytherapy sources based on the American Association of Physicists in Medicine (AAPM) Task Group No. 43 (TG-43) report and to provide recommendations to transition to model-based dose calculation algorithms. Additionally, an overview of these algorithms and approaches is presented. The influence of tissue and seed/applicator heterogeneities on brachytherapy dose distributions for breast, gynecologic, head and neck, rectum, and prostate cancers as well as eye plaques and electronic brachytherapy treatments were investigated by comparing dose calculations based on the TG-43 formalism and model-based dose calculation algorithms.},
keywords = {Algorithms, Brachytherapy, Computer-Assisted, Female, Humans, Male, Medical, Models, Neoplasms, Photons, Practice Guidelines as Topic, Radiometry, Radiotherapy Dosage, Radiotherapy Planning, Societies, Theoretical},
pubstate = {published},
tppubtype = {article}
}
The purpose of this study was to review the limitations of dose calculation formalisms for photon-emitting brachytherapy sources based on the American Association of Physicists in Medicine (AAPM) Task Group No. 43 (TG-43) report and to provide recommendations to transition to model-based dose calculation algorithms. Additionally, an overview of these algorithms and approaches is presented. The influence of tissue and seed/applicator heterogeneities on brachytherapy dose distributions for breast, gynecologic, head and neck, rectum, and prostate cancers as well as eye plaques and electronic brachytherapy treatments were investigated by comparing dose calculations based on the TG-43 formalism and model-based dose calculation algorithms.2011
Enger, Shirin A.; D’Amours, Michel; Beaulieu, Luc
Modeling a hypothetical 170Tm source for brachytherapy applications Journal Article
In: Medical Physics, vol. 38, no. 10, pp. 5307–5310, 2011, ISSN: 0094-2405.
Abstract | Links | BibTeX | Tags: Algorithms, Brachytherapy, Computer Simulation, Computer-Assisted, Electrons, Equipment Design, Gold, Humans, Models, Monte Carlo Method, Photons, Platinum, Radioisotopes, Radiotherapy Planning, Stainless Steel, Theoretical, Thulium, Titanium
@article{enger_modeling_2011,
title = {Modeling a hypothetical 170Tm source for brachytherapy applications},
author = {Shirin A. Enger and Michel D'Amours and Luc Beaulieu},
doi = {10.1118/1.3626482},
issn = {0094-2405},
year = {2011},
date = {2011-10-01},
journal = {Medical Physics},
volume = {38},
number = {10},
pages = {5307--5310},
abstract = {PURPOSE: To perform absorbed dose calculations based on Monte Carlo simulations for a hypothetical (170)Tm source and to investigate the influence of encapsulating material on the energy spectrum of the emitted electrons and photons.
METHODS: GEANT4 Monte Carlo code version 9.2 patch 2 was used to simulate the decay process of (170)Tm and to calculate the absorbed dose distribution using the GEANT4 Penelope physics models. A hypothetical (170)Tm source based on the Flexisource brachytherapy design with the active core set as a pure thulium cylinder (length 3.5 mm and diameter 0.6 mm) and different cylindrical source encapsulations (length 5 mm and thickness 0.125 mm) constructed of titanium, stainless-steel, gold, or platinum were simulated. The radial dose function for the line source approximation was calculated following the TG-43U1 formalism for the stainless-steel encapsulation.
RESULTS: For the titanium and stainless-steel encapsulation, 94% of the total bremsstrahlung is produced inside the core, 4.8 and 5.5% in titanium and stainless-steel capsules, respectively, and less than 1% in water. For the gold capsule, 85% is produced inside the core, 14.2% inside the gold capsule, and a negligible amount (textless1%) in water. Platinum encapsulation resulted in bremsstrahlung effects similar to those with the gold encapsulation. The range of the beta particles decreases by 1.1 mm with the stainless-steel encapsulation compared to the bare source but the tissue will still receive dose from the beta particles several millimeters from the source capsule. The gold and platinum capsules not only absorb most of the electrons but also attenuate low energy photons. The mean energy of the photons escaping the core and the stainless-steel capsule is 113 keV while for the gold and platinum the mean energy is 160 keV and 165 keV, respectively.
CONCLUSIONS: A (170)Tm source is primarily a bremsstrahlung source, with the majority of bremsstrahlung photons being generated in the source core and experiencing little attenuation in the source encapsulation. Electrons are efficiently absorbed by the gold and platinum encapsulations. However, for the stainless-steel capsule (or other lower Z encapsulations) electrons will escape. The dose from these electrons is dominant over the photon dose in the first few millimeter but is not taken into account by current standard treatment planning systems. The total energy spectrum of photons emerging from the source depends on the encapsulation composition and results in mean photon energies well above 100 keV. This is higher than the main gamma-ray energy peak at 84 keV. Based on our results, the use of (170)Tm as a brachytherapy source presents notable challenges.},
keywords = {Algorithms, Brachytherapy, Computer Simulation, Computer-Assisted, Electrons, Equipment Design, Gold, Humans, Models, Monte Carlo Method, Photons, Platinum, Radioisotopes, Radiotherapy Planning, Stainless Steel, Theoretical, Thulium, Titanium},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: To perform absorbed dose calculations based on Monte Carlo simulations for a hypothetical (170)Tm source and to investigate the influence of encapsulating material on the energy spectrum of the emitted electrons and photons.
METHODS: GEANT4 Monte Carlo code version 9.2 patch 2 was used to simulate the decay process of (170)Tm and to calculate the absorbed dose distribution using the GEANT4 Penelope physics models. A hypothetical (170)Tm source based on the Flexisource brachytherapy design with the active core set as a pure thulium cylinder (length 3.5 mm and diameter 0.6 mm) and different cylindrical source encapsulations (length 5 mm and thickness 0.125 mm) constructed of titanium, stainless-steel, gold, or platinum were simulated. The radial dose function for the line source approximation was calculated following the TG-43U1 formalism for the stainless-steel encapsulation.
RESULTS: For the titanium and stainless-steel encapsulation, 94% of the total bremsstrahlung is produced inside the core, 4.8 and 5.5% in titanium and stainless-steel capsules, respectively, and less than 1% in water. For the gold capsule, 85% is produced inside the core, 14.2% inside the gold capsule, and a negligible amount (textless1%) in water. Platinum encapsulation resulted in bremsstrahlung effects similar to those with the gold encapsulation. The range of the beta particles decreases by 1.1 mm with the stainless-steel encapsulation compared to the bare source but the tissue will still receive dose from the beta particles several millimeters from the source capsule. The gold and platinum capsules not only absorb most of the electrons but also attenuate low energy photons. The mean energy of the photons escaping the core and the stainless-steel capsule is 113 keV while for the gold and platinum the mean energy is 160 keV and 165 keV, respectively.
CONCLUSIONS: A (170)Tm source is primarily a bremsstrahlung source, with the majority of bremsstrahlung photons being generated in the source core and experiencing little attenuation in the source encapsulation. Electrons are efficiently absorbed by the gold and platinum encapsulations. However, for the stainless-steel capsule (or other lower Z encapsulations) electrons will escape. The dose from these electrons is dominant over the photon dose in the first few millimeter but is not taken into account by current standard treatment planning systems. The total energy spectrum of photons emerging from the source depends on the encapsulation composition and results in mean photon energies well above 100 keV. This is higher than the main gamma-ray energy peak at 84 keV. Based on our results, the use of (170)Tm as a brachytherapy source presents notable challenges.2006
Enger, Shirin A.; Rezaei, Arash; af Rosenschöld, Per Munck; Lundqvist, Hans
Gadolinium neutron capture brachytherapy (GdNCB), a new treatment method for intravascular brachytherapy Journal Article
In: Medical Physics, vol. 33, no. 1, pp. 46–51, 2006, ISSN: 0094-2405.
Abstract | Links | BibTeX | Tags: Biological, Blood Vessel Prosthesis, Brachytherapy, Computer Simulation, Computer-Assisted, Gadolinium, Graft Occlusion, Humans, Models, Monte Carlo Method, Neutron Capture Therapy, Radiometry, Radiotherapy Dosage, Radiotherapy Planning, Relative Biological Effectiveness, Statistical, Stents, Vascular
@article{enger_gadolinium_2006,
title = {Gadolinium neutron capture brachytherapy (GdNCB), a new treatment method for intravascular brachytherapy},
author = {Shirin A. Enger and Arash Rezaei and Per Munck af Rosenschöld and Hans Lundqvist},
doi = {10.1118/1.2146050},
issn = {0094-2405},
year = {2006},
date = {2006-01-01},
journal = {Medical Physics},
volume = {33},
number = {1},
pages = {46--51},
abstract = {Restenosis is a major problem after balloon angioplasty and stent implantation. The aim of this study is to introduce gadolinium neutron capture brachytherapy (GdNCB) as a suitable modality for treatment of stenosis. The utility of GdNCB in intravascular brachytherapy (IVBT) of stent stenosis is investigated by using the GEANT4 and MCNP4B Monte Carlo radiation transport codes. To study capture rate, Kerma, absorbed dose and absorbed dose rate around a Gd-containing stent activated with neutrons, a 30 mm long, 5 mm diameter gadolinium foil is chosen. The input data is a neutron spectrum used for clinical neutron capture therapy in Studsvik, Sweden. Thermal neutron capture in gadolinium yields a spectrum of high-energy gamma photons, which due to the build-up effect gives an almost flat dose delivery pattern to the first 4 mm around the stent. The absorbed dose rate is 1.33 Gy/min, 0.25 mm from the stent surface while the dose to normal tissue is in order of 0.22 Gy/min, i.e., a factor of 6 lower. To spare normal tissue further fractionation of the dose is also possible. The capture rate is relatively high at both ends of the foil. The dose distribution from gamma and charge particle radiation at the edges and inside the stent contributes to a nonuniform dose distribution. This will lead to higher doses to the surrounding tissue and may prevent stent edge and in-stent restenosis. The position of the stent can be verified and corrected by the treatment plan prior to activation. Activation of the stent by an external neutron field can be performed days after catherization when the target cells start to proliferate and can be expected to be more radiation sensitive. Another advantage of the nonradioactive gadolinium stent is the possibility to avoid radiation hazard to personnel.},
keywords = {Biological, Blood Vessel Prosthesis, Brachytherapy, Computer Simulation, Computer-Assisted, Gadolinium, Graft Occlusion, Humans, Models, Monte Carlo Method, Neutron Capture Therapy, Radiometry, Radiotherapy Dosage, Radiotherapy Planning, Relative Biological Effectiveness, Statistical, Stents, Vascular},
pubstate = {published},
tppubtype = {article}
}
Restenosis is a major problem after balloon angioplasty and stent implantation. The aim of this study is to introduce gadolinium neutron capture brachytherapy (GdNCB) as a suitable modality for treatment of stenosis. The utility of GdNCB in intravascular brachytherapy (IVBT) of stent stenosis is investigated by using the GEANT4 and MCNP4B Monte Carlo radiation transport codes. To study capture rate, Kerma, absorbed dose and absorbed dose rate around a Gd-containing stent activated with neutrons, a 30 mm long, 5 mm diameter gadolinium foil is chosen. The input data is a neutron spectrum used for clinical neutron capture therapy in Studsvik, Sweden. Thermal neutron capture in gadolinium yields a spectrum of high-energy gamma photons, which due to the build-up effect gives an almost flat dose delivery pattern to the first 4 mm around the stent. The absorbed dose rate is 1.33 Gy/min, 0.25 mm from the stent surface while the dose to normal tissue is in order of 0.22 Gy/min, i.e., a factor of 6 lower. To spare normal tissue further fractionation of the dose is also possible. The capture rate is relatively high at both ends of the foil. The dose distribution from gamma and charge particle radiation at the edges and inside the stent contributes to a nonuniform dose distribution. This will lead to higher doses to the surrounding tissue and may prevent stent edge and in-stent restenosis. The position of the stent can be verified and corrected by the treatment plan prior to activation. Activation of the stent by an external neutron field can be performed days after catherization when the target cells start to proliferate and can be expected to be more radiation sensitive. Another advantage of the nonradioactive gadolinium stent is the possibility to avoid radiation hazard to personnel.
Journal Articles
2020
Enger, Shirin A.; Vijande, Javier; Rivard, Mark J.
Model-Based Dose Calculation Algorithms for Brachytherapy Dosimetry Journal Article
In: Seminars in Radiation Oncology, vol. 30, no. 1, pp. 77–86, 2020, ISSN: 1532-9461.
Abstract | Links | BibTeX | Tags: Algorithms, Brachytherapy, Computer-Assisted, Female, Humans, Male, Medical, Models, Neoplasms, Photons, Practice Guidelines as Topic, Radiometry, Radiotherapy Dosage, Radiotherapy Planning, Societies, Theoretical
@article{enger_model-based_2020,
title = {Model-Based Dose Calculation Algorithms for Brachytherapy Dosimetry},
author = {Shirin A. Enger and Javier Vijande and Mark J. Rivard},
doi = {10.1016/j.semradonc.2019.08.006},
issn = {1532-9461},
year = {2020},
date = {2020-01-01},
journal = {Seminars in Radiation Oncology},
volume = {30},
number = {1},
pages = {77--86},
abstract = {The purpose of this study was to review the limitations of dose calculation formalisms for photon-emitting brachytherapy sources based on the American Association of Physicists in Medicine (AAPM) Task Group No. 43 (TG-43) report and to provide recommendations to transition to model-based dose calculation algorithms. Additionally, an overview of these algorithms and approaches is presented. The influence of tissue and seed/applicator heterogeneities on brachytherapy dose distributions for breast, gynecologic, head and neck, rectum, and prostate cancers as well as eye plaques and electronic brachytherapy treatments were investigated by comparing dose calculations based on the TG-43 formalism and model-based dose calculation algorithms.},
keywords = {Algorithms, Brachytherapy, Computer-Assisted, Female, Humans, Male, Medical, Models, Neoplasms, Photons, Practice Guidelines as Topic, Radiometry, Radiotherapy Dosage, Radiotherapy Planning, Societies, Theoretical},
pubstate = {published},
tppubtype = {article}
}
The purpose of this study was to review the limitations of dose calculation formalisms for photon-emitting brachytherapy sources based on the American Association of Physicists in Medicine (AAPM) Task Group No. 43 (TG-43) report and to provide recommendations to transition to model-based dose calculation algorithms. Additionally, an overview of these algorithms and approaches is presented. The influence of tissue and seed/applicator heterogeneities on brachytherapy dose distributions for breast, gynecologic, head and neck, rectum, and prostate cancers as well as eye plaques and electronic brachytherapy treatments were investigated by comparing dose calculations based on the TG-43 formalism and model-based dose calculation algorithms.
2011
Enger, Shirin A.; D’Amours, Michel; Beaulieu, Luc
Modeling a hypothetical 170Tm source for brachytherapy applications Journal Article
In: Medical Physics, vol. 38, no. 10, pp. 5307–5310, 2011, ISSN: 0094-2405.
Abstract | Links | BibTeX | Tags: Algorithms, Brachytherapy, Computer Simulation, Computer-Assisted, Electrons, Equipment Design, Gold, Humans, Models, Monte Carlo Method, Photons, Platinum, Radioisotopes, Radiotherapy Planning, Stainless Steel, Theoretical, Thulium, Titanium
@article{enger_modeling_2011,
title = {Modeling a hypothetical 170Tm source for brachytherapy applications},
author = {Shirin A. Enger and Michel D'Amours and Luc Beaulieu},
doi = {10.1118/1.3626482},
issn = {0094-2405},
year = {2011},
date = {2011-10-01},
journal = {Medical Physics},
volume = {38},
number = {10},
pages = {5307--5310},
abstract = {PURPOSE: To perform absorbed dose calculations based on Monte Carlo simulations for a hypothetical (170)Tm source and to investigate the influence of encapsulating material on the energy spectrum of the emitted electrons and photons.
METHODS: GEANT4 Monte Carlo code version 9.2 patch 2 was used to simulate the decay process of (170)Tm and to calculate the absorbed dose distribution using the GEANT4 Penelope physics models. A hypothetical (170)Tm source based on the Flexisource brachytherapy design with the active core set as a pure thulium cylinder (length 3.5 mm and diameter 0.6 mm) and different cylindrical source encapsulations (length 5 mm and thickness 0.125 mm) constructed of titanium, stainless-steel, gold, or platinum were simulated. The radial dose function for the line source approximation was calculated following the TG-43U1 formalism for the stainless-steel encapsulation.
RESULTS: For the titanium and stainless-steel encapsulation, 94% of the total bremsstrahlung is produced inside the core, 4.8 and 5.5% in titanium and stainless-steel capsules, respectively, and less than 1% in water. For the gold capsule, 85% is produced inside the core, 14.2% inside the gold capsule, and a negligible amount (textless1%) in water. Platinum encapsulation resulted in bremsstrahlung effects similar to those with the gold encapsulation. The range of the beta particles decreases by 1.1 mm with the stainless-steel encapsulation compared to the bare source but the tissue will still receive dose from the beta particles several millimeters from the source capsule. The gold and platinum capsules not only absorb most of the electrons but also attenuate low energy photons. The mean energy of the photons escaping the core and the stainless-steel capsule is 113 keV while for the gold and platinum the mean energy is 160 keV and 165 keV, respectively.
CONCLUSIONS: A (170)Tm source is primarily a bremsstrahlung source, with the majority of bremsstrahlung photons being generated in the source core and experiencing little attenuation in the source encapsulation. Electrons are efficiently absorbed by the gold and platinum encapsulations. However, for the stainless-steel capsule (or other lower Z encapsulations) electrons will escape. The dose from these electrons is dominant over the photon dose in the first few millimeter but is not taken into account by current standard treatment planning systems. The total energy spectrum of photons emerging from the source depends on the encapsulation composition and results in mean photon energies well above 100 keV. This is higher than the main gamma-ray energy peak at 84 keV. Based on our results, the use of (170)Tm as a brachytherapy source presents notable challenges.},
keywords = {Algorithms, Brachytherapy, Computer Simulation, Computer-Assisted, Electrons, Equipment Design, Gold, Humans, Models, Monte Carlo Method, Photons, Platinum, Radioisotopes, Radiotherapy Planning, Stainless Steel, Theoretical, Thulium, Titanium},
pubstate = {published},
tppubtype = {article}
}
PURPOSE: To perform absorbed dose calculations based on Monte Carlo simulations for a hypothetical (170)Tm source and to investigate the influence of encapsulating material on the energy spectrum of the emitted electrons and photons.
METHODS: GEANT4 Monte Carlo code version 9.2 patch 2 was used to simulate the decay process of (170)Tm and to calculate the absorbed dose distribution using the GEANT4 Penelope physics models. A hypothetical (170)Tm source based on the Flexisource brachytherapy design with the active core set as a pure thulium cylinder (length 3.5 mm and diameter 0.6 mm) and different cylindrical source encapsulations (length 5 mm and thickness 0.125 mm) constructed of titanium, stainless-steel, gold, or platinum were simulated. The radial dose function for the line source approximation was calculated following the TG-43U1 formalism for the stainless-steel encapsulation.
RESULTS: For the titanium and stainless-steel encapsulation, 94% of the total bremsstrahlung is produced inside the core, 4.8 and 5.5% in titanium and stainless-steel capsules, respectively, and less than 1% in water. For the gold capsule, 85% is produced inside the core, 14.2% inside the gold capsule, and a negligible amount (textless1%) in water. Platinum encapsulation resulted in bremsstrahlung effects similar to those with the gold encapsulation. The range of the beta particles decreases by 1.1 mm with the stainless-steel encapsulation compared to the bare source but the tissue will still receive dose from the beta particles several millimeters from the source capsule. The gold and platinum capsules not only absorb most of the electrons but also attenuate low energy photons. The mean energy of the photons escaping the core and the stainless-steel capsule is 113 keV while for the gold and platinum the mean energy is 160 keV and 165 keV, respectively.
CONCLUSIONS: A (170)Tm source is primarily a bremsstrahlung source, with the majority of bremsstrahlung photons being generated in the source core and experiencing little attenuation in the source encapsulation. Electrons are efficiently absorbed by the gold and platinum encapsulations. However, for the stainless-steel capsule (or other lower Z encapsulations) electrons will escape. The dose from these electrons is dominant over the photon dose in the first few millimeter but is not taken into account by current standard treatment planning systems. The total energy spectrum of photons emerging from the source depends on the encapsulation composition and results in mean photon energies well above 100 keV. This is higher than the main gamma-ray energy peak at 84 keV. Based on our results, the use of (170)Tm as a brachytherapy source presents notable challenges.
METHODS: GEANT4 Monte Carlo code version 9.2 patch 2 was used to simulate the decay process of (170)Tm and to calculate the absorbed dose distribution using the GEANT4 Penelope physics models. A hypothetical (170)Tm source based on the Flexisource brachytherapy design with the active core set as a pure thulium cylinder (length 3.5 mm and diameter 0.6 mm) and different cylindrical source encapsulations (length 5 mm and thickness 0.125 mm) constructed of titanium, stainless-steel, gold, or platinum were simulated. The radial dose function for the line source approximation was calculated following the TG-43U1 formalism for the stainless-steel encapsulation.
RESULTS: For the titanium and stainless-steel encapsulation, 94% of the total bremsstrahlung is produced inside the core, 4.8 and 5.5% in titanium and stainless-steel capsules, respectively, and less than 1% in water. For the gold capsule, 85% is produced inside the core, 14.2% inside the gold capsule, and a negligible amount (textless1%) in water. Platinum encapsulation resulted in bremsstrahlung effects similar to those with the gold encapsulation. The range of the beta particles decreases by 1.1 mm with the stainless-steel encapsulation compared to the bare source but the tissue will still receive dose from the beta particles several millimeters from the source capsule. The gold and platinum capsules not only absorb most of the electrons but also attenuate low energy photons. The mean energy of the photons escaping the core and the stainless-steel capsule is 113 keV while for the gold and platinum the mean energy is 160 keV and 165 keV, respectively.
CONCLUSIONS: A (170)Tm source is primarily a bremsstrahlung source, with the majority of bremsstrahlung photons being generated in the source core and experiencing little attenuation in the source encapsulation. Electrons are efficiently absorbed by the gold and platinum encapsulations. However, for the stainless-steel capsule (or other lower Z encapsulations) electrons will escape. The dose from these electrons is dominant over the photon dose in the first few millimeter but is not taken into account by current standard treatment planning systems. The total energy spectrum of photons emerging from the source depends on the encapsulation composition and results in mean photon energies well above 100 keV. This is higher than the main gamma-ray energy peak at 84 keV. Based on our results, the use of (170)Tm as a brachytherapy source presents notable challenges.
2006
Enger, Shirin A.; Rezaei, Arash; af Rosenschöld, Per Munck; Lundqvist, Hans
Gadolinium neutron capture brachytherapy (GdNCB), a new treatment method for intravascular brachytherapy Journal Article
In: Medical Physics, vol. 33, no. 1, pp. 46–51, 2006, ISSN: 0094-2405.
Abstract | Links | BibTeX | Tags: Biological, Blood Vessel Prosthesis, Brachytherapy, Computer Simulation, Computer-Assisted, Gadolinium, Graft Occlusion, Humans, Models, Monte Carlo Method, Neutron Capture Therapy, Radiometry, Radiotherapy Dosage, Radiotherapy Planning, Relative Biological Effectiveness, Statistical, Stents, Vascular
@article{enger_gadolinium_2006,
title = {Gadolinium neutron capture brachytherapy (GdNCB), a new treatment method for intravascular brachytherapy},
author = {Shirin A. Enger and Arash Rezaei and Per Munck af Rosenschöld and Hans Lundqvist},
doi = {10.1118/1.2146050},
issn = {0094-2405},
year = {2006},
date = {2006-01-01},
journal = {Medical Physics},
volume = {33},
number = {1},
pages = {46--51},
abstract = {Restenosis is a major problem after balloon angioplasty and stent implantation. The aim of this study is to introduce gadolinium neutron capture brachytherapy (GdNCB) as a suitable modality for treatment of stenosis. The utility of GdNCB in intravascular brachytherapy (IVBT) of stent stenosis is investigated by using the GEANT4 and MCNP4B Monte Carlo radiation transport codes. To study capture rate, Kerma, absorbed dose and absorbed dose rate around a Gd-containing stent activated with neutrons, a 30 mm long, 5 mm diameter gadolinium foil is chosen. The input data is a neutron spectrum used for clinical neutron capture therapy in Studsvik, Sweden. Thermal neutron capture in gadolinium yields a spectrum of high-energy gamma photons, which due to the build-up effect gives an almost flat dose delivery pattern to the first 4 mm around the stent. The absorbed dose rate is 1.33 Gy/min, 0.25 mm from the stent surface while the dose to normal tissue is in order of 0.22 Gy/min, i.e., a factor of 6 lower. To spare normal tissue further fractionation of the dose is also possible. The capture rate is relatively high at both ends of the foil. The dose distribution from gamma and charge particle radiation at the edges and inside the stent contributes to a nonuniform dose distribution. This will lead to higher doses to the surrounding tissue and may prevent stent edge and in-stent restenosis. The position of the stent can be verified and corrected by the treatment plan prior to activation. Activation of the stent by an external neutron field can be performed days after catherization when the target cells start to proliferate and can be expected to be more radiation sensitive. Another advantage of the nonradioactive gadolinium stent is the possibility to avoid radiation hazard to personnel.},
keywords = {Biological, Blood Vessel Prosthesis, Brachytherapy, Computer Simulation, Computer-Assisted, Gadolinium, Graft Occlusion, Humans, Models, Monte Carlo Method, Neutron Capture Therapy, Radiometry, Radiotherapy Dosage, Radiotherapy Planning, Relative Biological Effectiveness, Statistical, Stents, Vascular},
pubstate = {published},
tppubtype = {article}
}
Restenosis is a major problem after balloon angioplasty and stent implantation. The aim of this study is to introduce gadolinium neutron capture brachytherapy (GdNCB) as a suitable modality for treatment of stenosis. The utility of GdNCB in intravascular brachytherapy (IVBT) of stent stenosis is investigated by using the GEANT4 and MCNP4B Monte Carlo radiation transport codes. To study capture rate, Kerma, absorbed dose and absorbed dose rate around a Gd-containing stent activated with neutrons, a 30 mm long, 5 mm diameter gadolinium foil is chosen. The input data is a neutron spectrum used for clinical neutron capture therapy in Studsvik, Sweden. Thermal neutron capture in gadolinium yields a spectrum of high-energy gamma photons, which due to the build-up effect gives an almost flat dose delivery pattern to the first 4 mm around the stent. The absorbed dose rate is 1.33 Gy/min, 0.25 mm from the stent surface while the dose to normal tissue is in order of 0.22 Gy/min, i.e., a factor of 6 lower. To spare normal tissue further fractionation of the dose is also possible. The capture rate is relatively high at both ends of the foil. The dose distribution from gamma and charge particle radiation at the edges and inside the stent contributes to a nonuniform dose distribution. This will lead to higher doses to the surrounding tissue and may prevent stent edge and in-stent restenosis. The position of the stent can be verified and corrected by the treatment plan prior to activation. Activation of the stent by an external neutron field can be performed days after catherization when the target cells start to proliferate and can be expected to be more radiation sensitive. Another advantage of the nonradioactive gadolinium stent is the possibility to avoid radiation hazard to personnel.