Atualmente a maior parte dos tratamentos radioterápicos é feita através de irradiações com feixes de fótons de alta energia. Esses feixes se originam em fontes radioativas (de nuclídeos como o cobalto 60) ou são gerados em aceleradores lineares de elétrons. Para as medidas dosimétricas nesses feixes, uma das técnicas mais utilizada é a termoluminescência (TL) e, para a correta utilização dos dosímetros termoluminescentes (TLDs), é necessário conhecer suas características dosimétricas como, por exemplo, a variação da sua resposta com a energia do feixe de radiação. O objetivo desse trabalho foi estudar essa dependência energética da resposta TL de diversos materiais quando irradiados em feixes de fótons de alta energia. Para isso, foram obtidas curvas de resposta TL em função da dose absorvida em água para os LDs de LiF:Mg, Ti (TLD-100), fluorita natural brasileira, CaSO4:Dy, Mg2SiO4:Tb e l2O3:C irradiados em feixes gama de 60Co e de raios X de aceleradores lineares com potenciais de aceleração nominais de 6, 10, 15 e 18 MV. O estudo foi feito em uma faixa de doses equivalente à utilizada em fracionamentos padrão de tratamentos de radioterapia e os resultados demonstram que, nessas condições, não há variação maior que 3% na resposta TL em função da energia dos fótons. A relação entre a deposição e doses nos TLDs e a deposição de doses na água em função da variação da energia oi estudada por simulação de Monte Carlo (MC), através do código PENELOPE, e os resultados foram coerentes com os resultados experimentais. Os TLDs também foram irradiados com nêutrons térmicos e epitérmicos e apresentaram sensibilidade a esse tipo de radiação. No entanto, a coerência dos resultados experimentais e de MC (que não levaram em conta a presença de nêutrons), o estudo da variação da sensibilidade relativa com a energia e a análise das curvas de emissão dos TLDs levam à conclusão e que a influência na resposta TL devida a nêutrons que contaminam os feixes de fótons estudados, é desprezível para todos os materiais. Os resultados desse trabalho indicam que, para a faixa de doses e energias utilizadas rotineiramente na radioterapia, os TLDs de LiF:Mg, Ti (TLD-100), fluorita natural brasileira, CaSO4:Dy, Mg2SiO4:Tb e Al2O3:C podem ser utilizados sem a aplicação de fatores de correção para a energia do feixe. / Currently the majority of radiotherapy treatments are done by irradiation with high energy photon beams. These beams are emitted by radioactive sources (of nuclides such as cobalt 60) or generated in electron linear accelerators. For dosimetric measurements on these beams, one of the most used techniques is the thermoluminescence (TL). For the correct use of the thermoluminescent dosimeters (TLDs), it is necessary to know their dosimetric properties like, for example, the variation of their response with the energy of the radiation beam. The purpose of this study was to assess the energy response of various TL materials when irradiated with high energy photon beams. So, curves relating the TL response and absorbed dose to water were obtained for LiF:Mg, Ti (TLD-100), Brazilian natural fluorite, CaSO4:Dy, g2SiO4:Tb and Al2O3:C TLDs irradiated with gamma rays from a 60Co source and linear accelerator X ray beams with nominal accelerating potential of 6, 10, 15 and 18 MV. The study was done in a dose range similar to that used in standard fractionated radiotherapy treatments and the results show that under these conditions, there is no variation larger than 3% in the TL response as a function of photon energy. The relationship between the dose deposition in the TLD and the dose deposition in water in function of the photon energy was studied by Monte Carlo method (MC), using the PENELOPE code system, and the results were consistent with the experimental outcomes. The TLDs were also irradiated with thermal and epithermal neutrons and proved to be sensitive to them. However, the consistency of the experimental and MC results (which did not take into account the presence of neutrons), the study of the variation in TL relative sensitivity with the beam energy, and the TLD glow curve shape analysis lead to the conclusion that the influence on TL response due to neutron contamination in the therapeutic photon beams is negligible for all materials. The results indicate that for the range of doses and energies used routinely in radiotherapy, the LiF:Mg, Ti (TLD-100), Brazilian natural fluorite, CaSO4:Dy, Mg2SiO4:Tb and Al2O3:C TLDs can be used without applying any correction factors for the beam energy.

Os avanços nas técnicas de tratamento com radiação ionizante estão gerando distribuições de dose muito complexas que precisam ser verificadas antes da aplicação do tratamento no paciente. Diversos dosímetros já foram propostos para esta verificação, mas o que vem apresentando os melhores resultados são os géis poliméricos que permitem a visualização tridimensional da dose. Neste trabalho desenvolvemos um gel dosimétrico do tipo MAGIC com componentes nacionais, para baratear o custo e assim, facilitar a sua aplicação na rotina clínica. Nós adicionamos formaldeído ao gel para aumentar seu ponto de fusão e facilitar seu manuseio em temperatura ambiente. A avaliação das doses foi feita através da relaxometria em imagens de ressonância magnética nuclear (IRMN). Foi encontrada uma resposta linear para dose de até 15Gy e uma dependência energética significativa para feixes de baixa energia (kVp), enquanto que para alta energia (MV) a dependência encontrada foi pequena. A variação da resposta do dosímetro em função da taxa de dose da irradiação foi menor que 5% nas taxas de 100 a 600cGy/min. A adição de formaldeído não eliminou a dependência da resposta do dosímetro para variações na temperatura durante a aquisição das IRMN, já a integridade da distribuição de dose se manteve inalterada por um período de três meses na irradiação de um campo blindado ao meio. Medidas tridimensionais de distribuição de dose foram realizadas para dois planos de radioterapia com intensidade modulada de feixe o primeiro em um acelerador linear e o segundo em um equipamento de tomoterapia, grande semelhança entre a sobreposição das isodoses e dos perfis de dose das imagens medidas com o gel e esperadas pelo sistema de planejamento (TPS) foi encontrada. A avaliação realmente tridimensional foi feita com os histogramas dose-volume (DVH), sendo que uma sobreposição entre os DVHs calculados para o volume planejado e os esperados pelo TPS foi encontrada nos dois planejamentos. Por tudo o que foi estudado, pode-se concluir que a modificação realizada no gel MAGIC resultou em um dosímetro de fácil manuseio que pode ser aplicado para medidas tridimensionais. / Advances in the treatment techniques with ionizing radiation are resulting in complex dose distributions that need to be verified before the application of the treatment in the patient. Several dosimeters have been suggested for this application, but polymeric gel dosimeters are presenting the best results so far, since they allow three dimensional dose visualization, are tissue equivalent, don\'t have dependence with angular distribution of the incident radiation and have a high spatial resolution. In this work a polymeric gel dosimeter with national components, to reduce de costs and facilitate its introduction in the clinical practice was developed. Formaldehyde was added to the gel formulation to increase its melting temperature and facilitate its use in typical room temperatures found in our country. Dose response analysis was done using nuclear magnetic resonance relaxometry. All the dosimetric characterization was done. We found a linear dose-response curve for doses until 15Gy and significant energy dependence for low energy beams (kVp), but for high energy beams (MV) this dependence is smaller. The response variation when varying the dose rate of irradiation was smaller than 5% in the dose rate range of clinical use in teletherapy (100-600cGy/min). The addition of formaldehyde did not eliminate the dosimeter dependence with variation of the scanning temperature; the integrity of dose distribution was unaltered at least for a tree month period of time in a half beam irradiation phantom. Tri-dimensional dose distributions were measured in two radiotherapy systems using intensity modulated beams, the first one in a linear accelerator and the second in a tomotherapy machine. A high similarity was found between the overlapping of isodoses and dose profiles of the dose distribution measured with the gel and expected by the treatment planning. The real tri- dimensional analysis was done with dose-volume histograms (DVH) and the DVHs measured for the planning volume and expected by the treatment planning were in good agreement. Our results show that the modification done in the gel formulation resulted in a dosimeter easy to handle and feasible for tri-dimensional measurements.

O Relatório Mundial do Câncer, a Agência Internacional Para Pesquisa no Câncer e a Organização Mundial da Saúde estimam que, a cada ano há 12,4 milhões de novos casos de câncer no mundo, havendo 7,6 milhões de mortes causadas pela doença, onde para os homens o mais recorrente é o câncer de próstata. Por isso, o tratamento de câncer de próstata, neste caso, por radioterapia deve apresentar elevada precisão. Um complicador para tal precisão pode ser a presença de próteses metálicas no fêmur e na pélvis, podendo ser unilateral ou bilateral. O objetivo deste trabalho foi analisar e comparar o tratamento radioterápico de próstata para três situações diferentes, com duas próteses, com uma prótese e sem nenhuma prótese através da dosimetria por Ressonância Paramagnética (EPR) utilizando o aminoácido alanina com dosímetro, que se baseia na determinação de radicais livres produzidos pela interação entre a radiação e a alanina através do registro do espectro da alanina irradiada. Para tal análise foi construído um simulador físico (phantom), com as medidas reais de um ser humano, feito de acrílico e água, simulando o tecido mole, e ossos humanos. Na região da próstata foi feita uma abertura cilíndrica onde foram inseridos os dosímetros de alanina compostos 95% de DL-alanina e 5% de Polivinil Álcool (PVA) com 3mm de diâmetro, 4 mm de comprimento e massa de 0,05 g. O phantom foi irradiado para cada situação, nas condições de tratamento em um acelerador linear Oncor Plus da Siemens com feixe de raios X de 6MV para quatro campos 10x10cm2 e uma dose de 2 Gy, onde as mesmas condições foram utilizadas para a calibração dos dosímetros. Os dosímetros foram analisados em um espectrômetro de banda X JEOL JES-FA200 (9.5 GHz). Através da curva de calibração e a amplitude da linha central do espectro foi possível calcular a dose obtida em cada dosímetro de DL-alanina obtendo uma variação de até 6,15% para as medidas da dose prescrita de 2 Gy. Os resultados mostraram-se semelhantes para as três situações estudadas, assim como calculado no sistema de planejamento. / The World Cancer Report, the International Agency for Research on Cancer and the World Health Organization estimates that each year there are 12.4 million new cases of cancer worldwide, with 7.6 million deaths from the disease, for which men is the most recurrent prostate cancer. Therefore, the treatment of prostate cancer, in this case by radiotherapy should have a high accuracy. A complicating factor for such precision may be the presence of metallic prosthesis in the femur and pelvis and may be unilateral or bilateral. The objective of this study was to analyze and compare the radiotherapy of prostate for three different situations, with two prostheses, with one prosthesis and without a prosthesis through dosimetry Paramagnetic Resonance (EPR) using the amino acid alanine with dosimeter, which is based on determining free radicals produced by the interaction between radiation and alanine by recording the spectrum of irradiated alanine. For this analysis we built a physical simulator (phantom), with the real measurements of a human being, made of acrylic and water, simulating soft tissue, and human bones. In the region of the prostate was made a cylindrical opening in which the dosimeters were inserted alanine compounds 95% DL-alanine and 5% Polyvinyl Alcohol (PVA) with 3mm diameter, 4 mm in length and mass of 0.05 g. The phantom was irradiated for each situation, the conditions of treatment in a linear accelerator Oncor Plus Siemens X-ray beam with 6mV for four fields of 10x10cm2 and a dose of 2 Gy, where the same conditions were used for calibration of the dosimeter. The dosimeters were analyzed in a JEOL X-band spectrometer JES-FA200 (9.5 GHz). Through the calibration curve and the amplitude of the centerline of the spectrum was possible to calculate the dose obtained in each of DL-alanine dosimeter obtaining a variation of up to 6.15% for the measurements of the prescribed dose of 2 Gy. The results were similar for the three cases studied, as calculated in the planning system.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2017-07-14T13:38:53Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Dissertação (versão final) Leoncio.pdf: 3177730 bytes, checksum: 3ae8af6eb5ff1a7f234df372ba6107db (MD5) / Made available in DSpace on 2017-07-14T13:38:53Z (GMT). No. of bitstreams: 2 license_rdf: 811 bytes, checksum: e39d27027a6cc9cb039ad269a5db8e34 (MD5) Dissertação (versão final) Leoncio.pdf: 3177730 bytes, checksum: 3ae8af6eb5ff1a7f234df372ba6107db (MD5) Previous issue date: 2016-06-30 / FACEPE / Nos últimos anos, a crescente dificuldade para aquisição e transporte internacional de irradiadores de raios gama, como o irradiador de Co-60 GammaCell 220 da Nordion, levou ao desenvolvimento de irradiadores de altas taxas de dose com base em feixes de raios-X, que operam na faixa de 150kV. Uma das aplicações deste tipo de irradiador é a irradiação de insetos, de amostras de sangue, etc. Para estes procedimentos, é importante que se tenha dosímetros que possam monitorar os processos de irradiação. O objetivo deste trabalho é o estudo e caracterização da alanina para que possa ser aplicada em dosimetria de irradiadores de raios-X de altas taxas de dose. A alanina é um aminoácido com número atômico efetivo próximo ao do tecido humano e é utilizada para dosimetria por ressonância paramagnética eletrônica (RPE) para aplicações em radioterapia. Neste trabalho, foram produzidas pastilhas de alanina com diferentes aglutinantes, bem como pastilhas puras revestidas com duas camadas de verniz, para serem utilizadas como dosímetros. Foram utilizados como aglutinantes parafina, teflon e estearina em concentrações de 1 %, 2 % e 5 % da massa total das pastilhas. Testes mecânicos, como ultrassom e rot-up, foram realizados para avaliar a resistência mecânica das pastilhas produzidas. Após os testes mecânicos, verificou-se que as pastilhas preparadas com alanina pura apresentavam resistência mecânica suficiente para serem utilizadas como dosímetros. A reprodutibilidade de sua resposta RPE foi avaliada a partir da irradiação de dez dosímetros com dose de 100 Gy com uma fonte de Co-60. Para investigar a estabilidade da resposta da alanina-RPE com o tempo, três dosímetros foram irradiados com uma dose de 200 Gy com uma fonte de Co-60, sendo a leitura realizada após cinco horas da irradiação e releituras após 15, 40, 87, 110 e 137 dias da irradiação. Para obter as curvas de calibração para raios gama e raios – X, amostras foram irradiadas, respectivamente, com doses de 0 a 1 kGy e de 18,7 Gy a 206 Gy. Os resultados mostram que a resposta dos dosímetros de alanina-RPE apresentou reprodutibilidade com um coeficiente de variação de 1,2%. O estudo do desvanecimento da resposta dos dosímetros mostrou uma variação de 0,8% em 137 dias. De acordo com os resultados obtidos, o sistema de dosimetria alanina-RPE pode ser utilizado, de forma confiável, como um sistema padrão de transferência para as aplicações do irradiador de raios-X de baixa energia, o RS 2400. / In recent years, the increasing difficulty in acquisition and international transport of gamma ray radiators, as irradiator Co-60 Gammacell 220 of Nordion led to the development of high dose rate irradiators based on X-ray beams that they are operating in the 150kV range. One application of this type of irradiator and irradiation of insects, blood samples, etc. For these procedures, it is important to have dosimeters that can monitor the irradiation processes. The objective of this work is the study and characterization of alanine that can be applied in dosimetry irradiating X-ray of high dose rates. Alanine is an amino acid in effective atomic number close to that of human tissue and is used for dosimetry for electron paramagnetic resonance (EPR) for applications in radiotherapy. In this work, alanine pellets were produced with different binders as well as pure tablets coated with two coats of varnish to be used as dosimeters. They were used as binders paraffin, teflon and stearin in concentrations of 1%, 2% and 5% of the total mass of the pastilles. Mechanical tests, such as ultrasound and rot-up were conducted to evaluate the mechanical strength of the tablets produced. After mechanical testing, it was found that the tablets prepared with pure alanine had sufficient mechanical strength to be used as dosimeters. The reproducibility of EPR response was evaluated from the irradiation ten dosimeters with dose 100 Gy with a source of Co-60. To investigate the stability of alanine EPR response over time of three dosimeters were irradiated with a dose of 200 Gy with a source of Co-60, the reading being performed after five hours of irradiation and readings after 15, 40, 87, 110 and 137 days of irradiation. To obtain the calibration curves for gamma rays and X - ray irradiated samples were, respectively, at doses from 0 to 1 kGy and 18.7 Gy to 206 Gy. The results show that the response of EPR-alanine dosimeters showed reproducibility with a coefficient of variation 1.2%. The study fading dosimeters response showed a variation of 0.8% in 137 days. According to the results, the system alanine EPR dosimetry can be used reliably as a pattern transferring system for irradiating the applications of low-energy X-rays, the RS 2400.

Orientador: Celso Dario Ramos / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-26T18:27:04Z (GMT). No. of bitstreams: 1 Takahashi_MariaEmiliaSeren_M.pdf: 16141939 bytes, checksum: 42dea31b2ec345da45284f3ac4086cfc (MD5) Previous issue date: 2015 / Resumo: Contexto: Apesar do importante potencial dos cálculos dosimétricos para uso clínico em radiosinoviortese (RSV), há poucos dados na literatura sobre este assunto. Neste trabalho, é proposta uma metodologia para dosimetria beta paciente-específica utilizando imagens SPECT/CT para avaliar a dose absorvida por RSV em articulações tratadas com hidroxiapatita marcada com samário-153 (HA-153Sm) e hidroxiapatita marcada com ítrio-90 (HA-90Y). Metodologia: Uma análise voxel-por-voxel foi realizada para construir um mapa de dose absorvida tridimensional para três pacientes tratados com HA-90Y (185MBq) ou HA-153Sm (740MBq). Uma equação genérica de dose absorvida foi utilizada para calcular a dose absorvida no voxel, a partir da atividade intra-voxel obtida da quantificação da imagem SPECT e a sua massa correspondente obtida a partir da imagem CT. Considerando o tamanho do voxel (7.79mmX7.79mmX7.79mm), a energia média e o alcance terapêutico das partículas beta emitidas do 90Y e 153Sm, é assumido que a dose em cada voxel não é afetada pela atividade dos voxels vizinhos. Dados sobre a razão de dose entre HA-90Y e HA-153Sm foram comparados. Resultados: Foram obtidas distribuição espacial da dose absorvida, dose absorvida total e dose absorvida por atividade injetada para cada paciente. A dose absorvida relativa entre HA-90Y e HA- 153Sm foi cerca de 5.5:1. Conclusão: Dosimetria paciente-específica em RSV pode ser uma poderosa ferramenta, especialmente em distribuições heterogêneas de radiotraçadores intra-articulares, quando doses terapêuticas complementares podem ser necessárias. Usando esta metodologia, foi possível demonstrar que podem ser obtidos efeitos terapêuticos comparáveis entre as RSVs realizadas com HA-90Y e HA-153Sm se for utilizada uma atividade cerca 5.5 vezes maior de HA-153Sm / Abstract: Background: Despite the potential clinical importance of dosimetric calculations in radiosynovectomy (RSV), there are very few data in the literature about this topic. In this study, we propose a patient-specific methodology for beta dosimetry using SPECT/CT images to evaluate the absorbed dose of RSV in human joints treated with HA-90Y and HA-153Sm. Methods: A voxel-by-voxel analysis was performed to build a 3D absorbed dose map for three patients treated with HA-90Y (185MBq) or HA-153Sm (740MBq). A generic absorbed dose equation was used to calculate the voxel dose, supported by the voxel activity obtained from quantified SPECT image and the corresponding voxel mass obtained from CT image. Considering the voxel size (7.79mmX7.79mmX7.79mm), the average energy and the therapeutic range of emitted beta particles from 90Y and 153Sm, we assumed that the dose in each voxel is not affected by the activity of neighboring voxels. Data about ratio of absorbed dose between HA-90Y and HA-153Sm were compared. Results: Spatial distribution of absorbed dose, total absorbed dose and absorbed dose per injected activity were obtained for each patient. The calculated relative absorbed dose between HA-90Y to HA-153Sm was about 5.5:1. Conclusions: Patient-specific dosimetry in RSV can be a powerful tool, especially in heterogeneous intra-articular distributions of radiotracer when additional therapeutic doses can be administered. Using this methodology we estimated that it is possible to achieve comparable therapeutic effects for RSV using HA-90Y if one uses activities about 5.5 times greater of HA-153Sm / Mestrado / Clinica Medica / Mestra em Clínica Médica

Purpose: The use of 106Ru eye plaques for the treatment of intraocular malignancies has produced inconsistent clinical outcomes and has even resulted in treatment failures. I hypothesized that inconsistent clinical results were attributable to high uncertainties in 106Ru eye plaque dosimetry. Furthermore, I hypothesized that more accurate methods for assessing radiation dose from eye plaques would lead to more reliable treatment planning and therefore better overall clinical outcomes. Methods: A Solid Water “eye” phantom with several novel features was developed for radiochromic film eye plaque dosimetry. Films perpendicular to the central axis of the eye plaques were sandwiched between inserts in the phantom. Small holes in the inserts enabled the film to be marked with respect to the eye plaques, assuring exact geometrical co-registration. In cooperation with the manufacturer, special thin radiochromic films were developed and utilized to permit dosimetric measurements almost at the eye plaque surface. Precise film punches were developed for the purpose of cutting films with diameters as small as 8.5 mm and making cutouts in films without damaging the cut edges. Findings from a secondary dosimetry system, utilizing a small silicon diode in a water tank, were compared to film data. In addition to testing the new dosimetry methods with 106Ru eye plaques, which utilize high energy (MeV) β emissions, this approach was also applied to 125I containing eye plaques, which due to their inherently lower energy (keV) γ emission spectrum, raised additional dosimetric complications. In the latter case dosimetry, films and the diode were calibrated for absolute dosimetry using calibrated 125I seeds in Solid Water and water, respectively, applying the TG-43 formalism. A novel calibration method of radiochromic film for low-energy photon dosimetry was introduced. Monte Carlo simulations were used to convert the results measured in Solid Water to liquid water, and to compare measured and simulated dosimetric results. Results: Dosimetric characterization of both 106Ru eye plaques and a novel concept 125I eye plaque are described. Furthermore, dosimetry of a 20 mm 125I Collaborative Ocular Melanoma Study (COMS) eye plaque validated the presumed substantial dose reduction resulting from its gold alloy backing and seed carrier insert predicted by Monte Carlo simulations. Dose distributions measured with radiochromic film were in good agreement with diode measurements and Monte Carlo simulations. Replicate film results were reproducible from 0.9% to 5.5%. As little as 4% non-uniformities in planar dose rates were easily detected using 106Ru eye plaques. The novel 125I eye plaques had uniform dose distributions. Dosimetric characterization of the 20 mm COMS plaque demonstrated that the plaque’s dose rate was 15% lower than that predicted by homogenous TG-43 calculations. Lastly, Monte Carlo simulations indicated dose conversion factors between water and film in Solid Water compared to water and Solid Water alone differed by as much as 16.8%. Change in the calcium content of Solid Water from 2.3% to 1.7% resulted in a 3.3% calculated difference in dose to film and in an 8.7% difference in dose to Solid Water. Conclusions: Precise and reproducible 106Ru and 125I eye plaque dosimetry was achieved utilizing radiochromic film in a water equivalent phantom and a small semiconductor diode in water. Co-registration of eye plaques and films permitted not only precise treatment planning calculations along the central axis of the plaque, but also made it possible to account for dosimetric non-uniformities using 2D or 3D methodologies. A calibrated 125I seed enabled calibration of the film and the diode for absolute dosimetry of 125I containing eye plaques. Dose measurements on the inner surface of the plaques provided precise assessment of the scleral dose, its homogeneity, and of the active area of the plaques for coverage determination. Monte Carlo simulations facilitated conversion of doses measured in various media to liquid water.

In this work, we have developed a robust daily quality assurance (QA) system for pencil-beam scanning (PBS) dosimetry. A novel phantom and multi-PTV PBS plan were used in conjunction with the Sun Nuclear Daily QA3 multichamber detector array to verify output, range, and spot position. The sensitivity to detect change in these parameters with our designed tests was determined empirically. Associated tolerance levels were established based on these sensitivities and guidelines published in recent American Association of Physics in Medicine (AAPM) task group reports. The output has remained within the 3% tolerance and the range was within ±1mm. Spot position has remained within ±2mm. This daily QA procedure is quick and efficient with the time required for setup and delivery at less than 10 minutes. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection

Student Number : 8802466H - MSc research report - School of Physics - Faculty of Science / Medical ionising radiation sources give by far the largest contribution to the population dose from man-made sources. About 90% of this contribution is due to x-ray diagnostic procedures. Doses from diagnostic radiology procedures are nevertheless small and usually do not approach thresholds for deterministic effects. However, they must be accurately determined in order to maintain a reasonable balance between image quality and patient exposure. There is, thus, a need to establish quality assurance for diagnostic procedures that will provide the required clinical information in its optimal form and with minimum dose to the patient. In order to achieve this, dose measurements must be reproducible and the uncertainties associated with that measurement should be known. One of key factors for ensuring that appropriate levels of accuracy and long-term reproducibility of dose measurements are maintained is a calibration of the measuring equipment. The IEC (International Electrotechnical Commission) issued a standard IEC 61267 that deals with methods for generating radiation beams with radiation conditions which can be used under test conditions typically found in test laboratories for the determination of characteristics of medical diagnostic X-ray equipment. The document is currently being revised and publication of the new version is expected soon. Standard radiation qualities were established at a laboratory following the new IEC 61267 standard. Radiation qualities that characterize radiation beams emerging from the X-ray target (RQR qualities) were established. They were further filtered by Copper to obtain RQT beam qualities that simulate those used in Computed Tomography (CT). The spatial uniformity of a commercial CT dosimeter was then determined.

No description available.

Purpose/Objectives: Intensity Modulated Radiation Therapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) provide advantages in delivery of radiation allowing conformality of delivered dose to the planning target and reducing dose to organs at risk (OAR), however, at the potential cost of low dose spread. Due to the central location of the esophagus and GE junction, dose to lungs, heart, spinal cord, liver, and kidneys must be considered. Low dose spread is of particular concern with respect to healthy lung tissue. This study comprehensively compares volumetric dose statistics of the standard three-dimensional conformal radiation therapy (3D-CRT) compared with VMAT and IMRT for distal esophageal cancer treatment. Materials/Methods: Forty patients who underwent pre-operative radiation therapy for esophageal cancer between 2012-2014 were retrieved from our database. Pinnacle planning software was used to create 3D-CRT, VMAT and IMRT radiation plans for all patients. Forty-five (45) Gy was prescribed for each patient with D95% > 42.75Gy for the planning target volume (PTV). All plans were optimized to maintain PTV coverage while reducing dose to OAR with specific emphasis on lung and heart dose. Volumetric dose statistics were obtained, and Wilcoxon signed rank test was used to compare 3D-CRT vs IMRT and VMAT for Conformity Index, Integral Dose, Monitor Units, lung (V5Gy, V20Gy, mean, max), heart (V30Gy, mean, max), spinal cord max, bilateral kidneys (V20Gy, mean) and liver mean dose. Comparison was also made for IMRT vs VMAT. Results: For both IMRT and VMAT compared with 3D-CRT, statistically significant pairwise differences were noted for Conformity Index (-28.51%, -30.70%, P<.001), Integral Dose (-14.0%, -14.8%, P<.001), Monitor Units (107.2%, 80.4%, P<.001), lung (V20Gy: -49.7%,-57.4%, mean: -20.3%,-24.9%, P <.001), heart (V30Gy : -10.1%,-14.3%, mean -10.4%,-13.4%, P <.001), spinal cord (max 13.3%,9.5%, P <.001) and liver (mean -29.9%,-24.3%, P <.001). No significant differences were noted for VMAT and IMRT compared with 3D-CRT for lung (V5Gy, max dose), heart (max dose) and bilateral kidneys (mean). VMAT did offer statistically significant improvement in Conformity Index, Monitor Units, lung V20Gy and mean dose as well as heart V30Gy and mean dose compared to IMRT. Conclusion: VMAT and IMRT offer excellent sparing of key organs (lung, heart) with respect to volumetric constraints. Max point doses as well as lung V5Gy, which can be an indication of low dose spread for esophageal treatment, were not conclusively different. While 3D-CRT offers acceptable treatment, VMAT should be the standard modality of radiation treatment where facilities exist. / Thesis / Master of Science (MSc)