Submitted by Claudinei Pracidelli (cpracide@ipen.br) on 2015-05-20T17:36:43Z No. of bitstreams: 0 / Made available in DSpace on 2015-05-20T17:36:43Z (GMT). No. of bitstreams: 0 / A radioterapia é uma das três principais modalidades utilizadas no tratamento de doenças malignas como o câncer; as outras duas são a quimioterapia e a radiocirurgia. Em contraste com outras especialidades médicas que necessitam principalmente do conhecimento clínico e da experiência de especialistas, a radioterapia, com a utilização da radiação ionizante no tratamento do câncer, depende do investimento pesado em tecnologias modernas e dos esforços colaborativos de diversos profissionais, cuja equipe coordenada influencia, sobremaneira, o resultado do tratamento. A Radioterapia de intensidade modulada (IMRT) com o uso de colimadores multilâminas (multileaf collimators MLCs) tem o potencial para alcançar um alto grau de conformidade da dose no alvo (tumor a ser tratado) e ainda promover a proteção de tecidos normais do que a maioria de outras técnicas de tratamento, especialmente para volumes-alvo ou órgãos de risco com formatos complexos. Entretanto, estudos recentes mostraram que baixas doses de radiação podem causar tumores secundários. Esse trabalho tem como objetivo a determinação da distribuição de dose de radiação absorvida em diversas simulações de tratamentos radioterápicos com o uso de dosímetros compostos de LiF:Mg,Ti; CaSO4:Dy e Al2O3:C, utilizando um objeto simulador de polimetilmetacrilato (PMMA) empregando as seguintes técnicas dosimétricas: termoluminescência (TL), luminescência opticamente estimulada (OSL) e detectores semicondutores (diodos). / Tese (Doutorado em Tecnologia Nuclear) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP

Submitted by Claudinei Pracidelli (cpracide@ipen.br) on 2015-11-12T10:02:52Z No. of bitstreams: 0 / Made available in DSpace on 2015-11-12T10:02:52Z (GMT). No. of bitstreams: 0 / No mundo de hoje, onde o uso da radiação de diversas naturezas está generalizado, a quantificação da energia depositada por essas diferentes radiações se tornou uma atividade de grande importância, principalmente quando a faixa de energia é considerada elevada, estas altas energias de radiação estão presentes, geralmente, em aceleradores de partículas, reatores nucleares e em irradiadores industriais, por exemplo. Este trabalho tem como objetivo medir altas doses de radiação de raios gama, feixes de elétrons e feixes de prótons utilizando duas variedades de um silicato natural (água-marinha e goshenita) e medir altas doses de nêutrons epitérmicos de alta fluência utilizando dosímetros de Fluoreto de Lítio dopados com Mg, Cu e P (MCP). A técnica utilizada para medir a dose absorvida por esses materiais foi a termoluminescência. As irradiações com raios- γ provenientes de fontes de 60Co foram de 100 kGy a 2000 kGy para a água-marinha e de 600 kGy a 2000 kGy para a goshenita, os resultados de intensidade TL vs Dose mostram que a partir de certa dose - 250 kGy e 1234,8 kGy para água-marinha e goshenita, respectivamente - o sinal TL começa a decrescer. Foi observado neste trabalho que, estes materiais quando irradiados com tais doses e posteriormente irradiados com doses baixas de alguns Gys até cerca de 400-500 Gy, o sinal TL decresce regularmente, podendo ser utilizado na dosimetria das radiações nessa faixa de dose. Para a irradiação de feixe de prótons e de feixe de elétrons foram utilizados dosímetros em placa de goshenita e dosímetros de pastilhas de água-marinha, a carga do feixe de prótons vai de 20 a 216 μC e a dose do feixe de elétrons vai de 10 kGy a 70 kGy. As irradiações com nêutrons epitérmicos utilizando LiF: Mg, Cu, P foram realizadas no reator IEA-R1/IPEN com fluências de 1014 a 1017 n/cm² e a quantificação das doses absorvidas foram realizadas utilizando o método UHTR (Ultra High Temperature Ratio). / Dissertação (Mestrado em Tecnologia Nuclear) / IPEN/D / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP

Submitted by Marco Antonio Oliveira da Silva (maosilva@ipen.br) on 2017-11-09T11:12:40Z No. of bitstreams: 0 / Made available in DSpace on 2017-11-09T11:12:40Z (GMT). No. of bitstreams: 0 / A dosimetria in vivo têm se tornado um papel importante para o tratamento da irradiação total da pele dentro de um rigoroso programa de garantia de qualidade que deve ser parte integrante nos departamentos radioterápicos. A dosimetria em TSI é difícil, devido à complexidade do tratamento em avaliar a uniformidade da dose e medir a dose absorvida em profundidades rasas em toda extensão da superfície cutânea, tendo como consequência uma ampla variação na distribuição da dose. Os TLDs tem provado ser muito úteis para a distribuição e verificação da dose prescrita para o paciente, pois a dose pode diferir de local para local devido a geometria do corpo do paciente, sobreposições de estruturas e assimetrias do campo de radiação. A utilização de TLDs in vivo pode identificar variações da dose prescrita por apresentarem uma grande exatidão e precisão nas medidas. Nos setores de radioterapia vêm sendo empregado vários tipos de dosímetros, os mais utilizados são o Flureto de Lítio (TLD-100), onde obtém uma longa história neste tipo de aplicação. Novos materiais dosímetricos vêm ganhado grande importância na aplicação da dosímetria de feixes clínicos de elétrons, como o Sulfato de Cálcio dopado com Disprósio (TL) e o Óxido de Alumínio dopado com Carbono (OSL), este trabalho avalia o desempenho dosímetrico dos respectivos dosímetros termoluminescentes e a luminescência opticamente estimulada na aplicação da dosímetria de feixes clínicos de elétrons utilizados na irradiação total da pele. / Dissertação (Mestrado em Tecnologia Nuclear) / IPEN/D / Instituto de Pesquisas Energéticas e Nucleares - IPEN-CNEN/SP

Medidas de Termoluminescência (TL), Luminescência Opticamente Estimulada (LOE), EPR (Ressonância Paramagnética de Elétron) e RL (Radioluminescência) foram obtidas de amostras de óxido de alumínio e óxido de alumínio dopado com magnésio. As amostras foram calcinadas em três diferentes temperaturas (1100, 1350 e 1600°C) para observar a variação do comportamento das propriedades luminescentes. Ao final, constatou-se que a temperatura de calcinação é um parâmetro de grande importância para a produção de materiais dosimétricos, pois a amostra com melhores resultados LOE foi o material sem dopante tratada a 1600°C. Em trabalhos anteriores, a composição de óxido de alumínio dopado com magnésio havia apresentado nanoestruturas de aluminato de magnésio, observadas através de Microscopia Eletrônica de Transmissão (MET), que influenciaram a sensibilidade do material à radiação. Amostras de aluminato de magnésio puro e dopado com terras raras foram obtidas na forma de pó e calcinadas a 1100, 1350 e 1600°C. Medidas de TL e LOE de amostras irradiadas com fonte de partículas foram analisadas e comparadas com resultados de EPR e Difração de Raios-X (DRX). Como resultado, foi concluído que, nas condições trabalhadas, somente o elemento gadolínio proporcionou aumento de emissão LOE e TL no espectro visível. DRX indicou a formação dos compostos Al5Er3O12 e Al5Yb3O12; gadolínio e európio também formaram estruturas secundárias que não puderam ser determinadas. A partir do óxido de alumínio em pó, foram produzidos alvos para deposição de filmes finos empregando um sistema de sputtering magnetron e lâminas de silício monocristalino (100) tipo P para substrato. Parâmetros de deposição e de tratamento térmico foram variados de modo a produzir amostras com diferentes características. Curvas de TL foram levantadas e analisadas com relação aos resultados de DRX. Imagens de Microscopia Eletrônica de Varredura (MEV) foram obtidas de algumas amostras para visualizar o estado dos filmes depositados após tratamentos térmicos de 500 e 1100°C. Resultados mostraram a formação de picos de difração de a-Al2O3 em algumas das amostras espessas. Medidas de TL de amostras expostas à radiação ambiente exibiram picos de emissão em posições que variaram de acordo com a composição e espessura do filme depositado. / Thermoluminecent (TL), Optically Stimulated Luminescence (OSL), EPR (Electron spin Resonance) and Radioluminescence (RL) measurements were obtained from aluminum oxide and magnesium doped aluminum oxide samples. The samples were calcinated at three different temperatures (1100, 1350 and 1600°C) in order to observe variation of luminescent properties. As results, it was found that the calcination temperature is of great importance in the production of dosimetric materials, since the undoped sample calcinated at 1600°C showed the highest sensibility. In early works, magnesium doped aluminum oxide samples exhibited the formation of nanostructured layer composed by magnesium aluminate, observed using Transmission Electron Microscopy (TEM), which induced an increase of the luminescent properties. Samples of undoped and rare-earths doped magnesium aluminate, calcinated at 1100, 1350 and 1600°C, were produced. TL and OSL measurements were obtained from irradiated aliquots, analyzed and compared to EPR and XRD results. Results showed that, under the parameters used in this work, only gadolinium doped samples exhibited increase in TL and OSL emissions. XRD indicated the formation of Al5Er3O12 and Al5Yb3O12 structures in doped samples; gadolinium and europium doped samples also showed new structures, which couldnt be identified. Powder aluminum oxide was used to produce deposition targets, which were employed in the deposition of thin films over P type monocrystalline silicon (100) wafers. Variations of deposition parameters and heat treatment induced the formation of thin films with different characteristics, observed by XRD and luminescent analysis (TL). XRD results indicated the occurrence of alpha-Al2O3 in some of the thick films. Samples exposed to natural radiation produced TL emission in the visible spectrum.

A dosimetria de pacientes associada à avaliação das condições de funcionamento dos equipamentos médicos e aos procedimentos empregados na realização dos exames, desempenha um papel fundamental no sistema de proteção radiológica das exposições médicas. Nesse sentido, foi realizado um levantamento em grande escala das doses recebidas pelos pacientes submetidos a exames radiológicos convencionais realizados em uma amostra representativa de estabelecimentos de saúde do estado de São Paulo. Nesse levantamento foi empregado um kit dosimétrico postal originalmente desenvolvido, que permitiu a determinação da dose de entrada na pele (DEP) através da técnica de dosimetria termoluminescente. Paralelamente foram realizadas visitas in-loco a uma sub-amostra de estabelecimentos, onde as condições de funcionamento dos equipamentos de raios X médicos e do sistema de imagem foram avaliadas empregando-se procedimentos e equipamentos já estabelecidos em protocolos de controle de qualidade. O estudo completou-se com a elaboração de um catálogo de espectros na faixa de energia do radiodiagnóstico, que, através de procedimento desenvolvido, permitiu inferir espectros equivalentes em equipamentos médicos. Na determinação dos espectros foi empregado um detector semicondutor de telureto de cádmio e zinco (CdZnTe), cujas curvas de eficiência e escape foram determinadas experimentalmente para realização do processo de correção dos espectros (stripping procedure). O processo de amostragem de estabelecimentos de saúde realizado neste estudo permitiu verificar a distribuição de equipamentos de diagnóstico por imagem e a freqüência de exames radiológicos no estado de São Paulo. A partir desses resultados foram escolhidos os exames de tórax, crânio (e seios da face) e coluna para avaliação de DEP, uma vez que os mesmos apresentam as maiores freqüências anuais de exames por 1.000 habitantes: 100, 46 e 29, respectivamente. Na técnica de amostragem dos estabelecimentos de saúde incluídos neste estudo foi empregado como critério de estratificação a quantidade anual de exames radiológicos associados ao município de localização do estabelecimento. Do total de 200 estabelecimentos sorteados, 50 participaram da primeira etapa e 38 da segunda. Um total de 83 salas de exames (ou equipamentos) e 868 pacientes foram incluídos, e um conjunto de 1415 valores de DEP foi determinado. O resultado da distribuição dos valores de DEP permitiu determinar os chamados níveis de referência, que, no caso de pacientes adultos, se mostraram bastante semelhantes aos encontrados em outros estudos internacionais. No caso de pacientes infantis, a situação é bem diferente, obtendo-se valores pelo menos 2 vezes superiores a outros recomendados internacionalmente para a radiografia infantil mais freqüente (tórax). Esse fato sugere que as práticas empregadas na realização dos exames devem ser revisadas e que recomendações específicas a esse grupo de pacientes, a partir de estudos dirigidos, sejam publicadas. Constatou-se também alguns casos de DEP elevada pelo uso desnecessário de radioscopia de localização. Os testes de desempenho dos equipamentos e a avaliação das imagens realizadas sugerem que há possibilidade de melhoria das condições de realização dos exames, sem perda de informação diagnóstica presente na imagem e com redução das doses. Alguns espectros de raios X determinados experimentalmente apresentaram divergência em relação a outros catálogos já estabelecidos, numa faixa específica de energia do espectro (entre 25 e 40 keV). Para a sua utilização em situações práticas há necessidade de algumas correções na curva de eficiência, o que não inviabiliza a metodologia e os procedimentos estabelecidos. De forma geral, os resultados encontrados neste estudo permitem traçar um panorama das exposições médicas em radiologia convencional no estado de São Paulo, contribuindo para o aperfeiçoamento de futuras pesquisas que sejam realizadas na área, ou mesmo, para a implementação de políticas públicas. / Patients dosimetry, associated with the assessment of the performance of the radiological equipment and of the series of procedures employed in the accomplishment of the examinations, plays fundamental role in the radiation protection system of medical exposures. Therefore, a large-scale survey of absorbed doses was carried out in health services localized in the state of São Paulo, including patients submitted to conventional radiological examinations. In this survey a postal dosimetric kit, originally developed, was employed. It allows the evaluation of the entrance surface dose (ESD) to patients with thermoluminescence dosimeters. Also a series visits to a sub-sample of services was carried out, giving rise to the in-loco evaluation of the performance of the medical x-ray equipment and of the image system, using procedures and equipments already established in protocols of quality control. The study is completed with the elaboration of a catalogue of x-ray spectra, which provides means to infer the spectra generated by medical x-ray equipments. Measurements of x-ray spectra were carried out with a cadmium zinc telluride detector (CdZnTe), and the stripping procedure was performed taking into account both the contributions of efficiency and x-ray escape fraction, experimentally determined in this work. The stratified sampling technique furnished important data on the distribution of equipments and the annual frequency of examinations performed in the state of São Paulo. From these results radiological examinations of the chest, skull and sinus, and spine were selected for the evaluation of ESD, as their annual frequencies are the highest observed: 100, 46 and 29 per thousand inhabitants, respectively. The number of x-ray examinations carried out annually in the cities of the state was employed as the stratification criterion to construct the sample. From a total of 200 health services sampled, 50 agreed to participate of the first stage, and 38 of the second. A total of 83 rooms (or x-ray equipments) and 868 patients was included, and a set of 1415 values of ESD was measured. Diagnostic reference levels were determined with the outcomes of the distribution of ESD. For adult patients, the reference levels achieved are very similar to others obtained in international surveys. However, as far as pediatric patients are concerned, the situation is very different: the values found in this survey are twice larger than the international recommendations to chest radiography of children. This points out that the practices need to be revised and that specific recommendations to this patient group, following specific surveys, should be provided. Also, a series of high ESD values due to unnecessary localizing radioscopy were detected among our data. The results of the equipment performance tests and of the evaluation of image quality suggest that it is possible to improve the conditions of the examinations and to reduce doses to patients, without impairment of the diagnostic information. Some of the experimentally determined x-ray spectra show a discrepancy, when compared to other catalogue spectra, in a particular energy range 25 to 40 keV. The practical application of them will require some corrections in the efficiency curve, but the established methodology and procedures remain legitimate. In an extensive approach, the results of this study supply a panorama of medical exposures in conventional radiology in the state of São Paulo, contributing with resources to future research in the field and also to governmental actions.

Radiação gama com energias maiores que 1,25 MeV são usualmente encontradas em ambientes de reatores, aceleradores de partículas e campos de radiação de origem cósmica. Nestas energias, a resposta de um dosímetro varia fortemente com a espessura de material absorvedor, até atingir um valor máximo conhecido como espessura de equibl^rio de partículas carregadas. O objetivo principal do presente trabalho foi a determinação experimental do perfil de dose absorvida por uma amostra de alumínio, para várias energias de feixes de raios gama, de forma a obter uma relação entre a energia média do campo de radiação gama e a espessura de equilíbrio de partículas carregadas para o alumínio. Os dosímetros foram irradiados com radiação gama produzida pela captura de neutrons térmicos em 23 materiais alvos no arranjo experimental montado no canal tangencial do reator do IPEN-CNEN/SP. Na determinação da camada de equilíbrio de partículas carregadas, foi ajustada aos dados experimentais uma função semi-empirica que permitiu obter a espessura de ETPC (Equilíbrio Transitório de Partículas Carregadas) para cada espectro de radiação gama utilizado neste trabalho, com energia média variando no intervalo de 3,26 a 7,85 MeV. Os resultados experimentais do presente trabalho permitiram obter uma relação entre a energia média do campo de radiação gama e a espessura de ETPC, que apresenta uma excelente concordância com o alcance corrigido dos elétrons gerados naquela energia. / Gamma radiation with energies greater than 1.25 MeV are usually produced in reactor environments, particle accelerators and in cosmic radiation fields. For these energies, the response of a dosimeter heavily vary with the absorber material thickness, up to attain a maximum value named as charged particle equilibrium thickness. The main gol of this paper was the experimental determination of the absorbed dose profile in an aluminum sample for several energies of gamma ray beam, in order to obtain a relationship between the average energy of the gamma radiation field and the charged particle equilibrium thickness. The dosimeters were irradiated with gamma radiation produced by thermal neutron capture in 23 target materials in the experimental arrangement mounted at the tangential beam hole of the BPEN-CNEN/SP reactor. For the determination of the charged particle equilibrium thickness, it was fitted to the experimental data a semi-empirical fimction which allowed to obtain the thickness of CTPE ( Charged Particle Transient Equilibrium ) for each gamma radiation spectrum used in this work, with average energy varying in the interval from 3.26 to 7.85 MeV. The experimental results of the present paper allowed to obtain a relationship between average energy of the radiation field and the CTPE thickness, which presents an excellent agreement with the corrected range for electrons produced in that energy.

Radiação gama com energias maiores que 1,25 MeV são usualmente encontradas em ambientes de reatores, aceleradores de partículas e campos de radiação de origem cósmica. Nestas energias, a resposta de um dosímetro varia fortemente com a espessura de material absorvedor, até atingir um valor máximo conhecido como espessura de equibl^rio de partículas carregadas. O objetivo principal do presente trabalho foi a determinação experimental do perfil de dose absorvida por uma amostra de alumínio, para várias energias de feixes de raios gama, de forma a obter uma relação entre a energia média do campo de radiação gama e a espessura de equilíbrio de partículas carregadas para o alumínio. Os dosímetros foram irradiados com radiação gama produzida pela captura de neutrons térmicos em 23 materiais alvos no arranjo experimental montado no canal tangencial do reator do IPEN-CNEN/SP. Na determinação da camada de equilíbrio de partículas carregadas, foi ajustada aos dados experimentais uma função semi-empirica que permitiu obter a espessura de ETPC (Equilíbrio Transitório de Partículas Carregadas) para cada espectro de radiação gama utilizado neste trabalho, com energia média variando no intervalo de 3,26 a 7,85 MeV. Os resultados experimentais do presente trabalho permitiram obter uma relação entre a energia média do campo de radiação gama e a espessura de ETPC, que apresenta uma excelente concordância com o alcance corrigido dos elétrons gerados naquela energia. / Gamma radiation with energies greater than 1.25 MeV are usually produced in reactor environments, particle accelerators and in cosmic radiation fields. For these energies, the response of a dosimeter heavily vary with the absorber material thickness, up to attain a maximum value named as charged particle equilibrium thickness. The main gol of this paper was the experimental determination of the absorbed dose profile in an aluminum sample for several energies of gamma ray beam, in order to obtain a relationship between the average energy of the gamma radiation field and the charged particle equilibrium thickness. The dosimeters were irradiated with gamma radiation produced by thermal neutron capture in 23 target materials in the experimental arrangement mounted at the tangential beam hole of the BPEN-CNEN/SP reactor. For the determination of the charged particle equilibrium thickness, it was fitted to the experimental data a semi-empirical fimction which allowed to obtain the thickness of CTPE ( Charged Particle Transient Equilibrium ) for each gamma radiation spectrum used in this work, with average energy varying in the interval from 3.26 to 7.85 MeV. The experimental results of the present paper allowed to obtain a relationship between average energy of the radiation field and the CTPE thickness, which presents an excellent agreement with the corrected range for electrons produced in that energy.

Historicamente a radioterapia é divida em radioterapia externa, braquiterapia e radioisotopoterapia sistemática. As diferenças entre as três está no posicionamento da fonte de radiação com respeito ao corpo humano. Na radioterapia externa a fonte fica a uma certa distância do paciente, já no caso da braquiterapia as fontes podem ser inseridas dentro de cavidades do corpo ou implantadas diretamente nos tecidos. Na radioisotopoterapia sistemática isótopos radiativos são administrados por via oral ou venosa. Dessas três a radioterapia externa é a mais usada pois, ela permite realizar planejamentos de radioterapia em três dimensões (3D), partindo inicialmente de uma tomografia computadorizada da região do tumor. O planejamento baseado na tomografia computadorizada permite que a distribuição da radiação nos tecidos seja feito com mais precisão evitando assim, que os tecidos sadios sejam afetados. Nesse trabalho a radioterapia externa convencional, foi implementada e executada para um tratamento de próstata com implantes metálicos, usando 4 campos de irradiação (0, 90, 180, 270 graus) e uma dose total planejada de 70 Gy fracionada em 35 sessões, cada uma com 2 Gy. Em qualquer tipo de tratamento que envolva a radiação ionizante é exigido um controle de qualidade para assim, determinar se a dose inicialmente planejada será entregue ou não ao tumor. Idealmente deveria ser implementado um controle de qualidade em três dimensões mas, até o momento não há um dosímetro 3D consolidado na rotina clinica. No entanto, o uso de géis poliméricos associados à técnica de leitura de dose com imagem de ressonância magnética (IRM) possibilita a dosimetria tridimensional. Nesse contexto, é aplicada a dosimetria 3D usando para isso, o gel magic com formaldeído (magic-f). Além da dosimetria 3D, foram realizadas medidas de dose absorvida por meio de dosimetria pontual, para tal fim são utilizados dosímetros termoluminescentes e de alanina. Na avaliação da distribuição de dose feita pelo planejamento e a medida com o gel é usado a análise gama (3%/3mm), neste caso, a distribuição de dose medida concorda com a distribuição de dose planejada TPS. A análise gama apresenta um porcentagem de aprovação do 93%. Os valores de dose absorvida na interface osso-metal determinados pelos dosímetros TL apresentam um aumento de 1,73 Gy na região do osso sacro e outros aumentos entre o 0,16 e 0,33 Gy foram encontrados em regiões como a cabeça do fêmur e quadril. Esses aumentos na dose foram só para duas sessões com doses entregadas ao fantom de 2 Gy. De igual maneira para os dosímetros de alanina se encontro um aumento na dose de 1,22 e 2,42 Gy na região do osso sacro. O planejamento feito nesse caso foi de 6 Gy. Os resultados evidentemente mostram como as inomogeneidades de um material com número atómico alto, gera perturbações sobre as distribuições de dose inicialmente planejadas. / Historically, Radiotherapy is divided into external radiotherapy, brachytherapy and systemic radioisotopotherapy. The difference between the three lies in the position of the radiation source regarding the human body. In external radiotherapy the source is at a certain distances of patient, and in the case of brachytherapy, this source can be inserted into cavities of body or implanted directly in the tissues. In systemic radiotherapy radioisotopes are administered orally or intravenously. Of these three, external radiotherapy is the most used because it allows planning of radiotherapy in three dimensions (3D), starting from a CT scan of the tumor region. Computed tomography planning allows the distribution of radiation in the tissues to be more accurate thus avoiding, that healthy tissues are affected. In our case, conventional external radiotherapy was implemented and executed for a prostate treatment with metal implants, using 4 irradiation fields (0, 90, 180, 270 degrees) and a total planned dose of 70 Gy fractioned in 35 sessions each with 2 Gy. In any type of treatment involving ionizing radiation, quality control (QC) is required to determine if the dose initially planned is delivered or not to the tumor. Ideally, a quality control should be implemented in three dimensions but to date there is no consolidated 3D dosimeter system in the clinic routine. However, the used of polymeric gels associated with magnetic resonance image (IRM) allow three-tridimensional dosimetry. In this context, the 3D dosimetry is applied using the magic gel with formaldehyde (magic-f). In addition to 3D dosimetry, absorbed dose measurements were performed by means of a dose in a point, using thermoluminescent and alanine dosimeters. The comparison of dose distributions calculated by TPS and measured in the gel was made using by gamma analysis (3% / 3mm), in this case, the distribution of dose measurement agrees with the distributions expected by TPS. The analysis shows a percentage of approval of 93%. The absorbed dose values at the bone-metal interface determined by the TL dosimeters, presented a 1.73 Gy increase in the region of the sacral bone, and another increases between 0,16 and 0,33 Gy were found in the regions as the head of the femur and the hip. These dose increases were only for two sessions with doses delivered to the phanton of 2 Gy. Similarly for alanine dosimeters were found increases in the dose of 1.22 and 2.42 Gy in the region of sacral bone. The planning done in this case was 6 Gy. The results evidently show how the inomogeneities of a material with a high atomic number generate disturbances over the initially planned dose distributions.

The general context of this work is the use of low energy photon sealed sources in brachytherapy. We have worked in particular on two isotopes: I-125 (mean energy of 27 keV) and Pd-103 (mean energy of 21 keV). The sealed sources are prepared as cylindrical seeds 4.5 mm in length and 0.8 mm in radius. Even if the external dimensions are standard, the internal design can be extremely different from one model to the other as the manufacturers try to improve the dosimetric characteristics of their sources. These isotopes are used mainly as permanent implants for prostate tumours but can also be used in the treatment of eye tumours. Compared to the higher energy photon sources, they offer the physical advantages of a safer manipulation from a radioprotection point of view and of the reduction of the dose to the surrounding healthy tissues. When performing a clinical treatment, it is absolutely mandatory to be able to report very precisely various parameters that can have an impact on the patient treatment outcomes. These parameters are, for example, the prescribed dose, the doses at different organs, the degree of uniformity that has been achieved on the target or some dose-volume information. The brachytherapy treatment planning systems (TPS) also permit more and more to conform the treatment to the patient anatomy, like in external treatments. In the case of prostate tumours, it has been possible for a few years, using ultrasound imaging, to check the positioning of the seeds and to calculate the dose distribution in real time during the implantation procedure. It is clear that to achieve a good precision in the treatment itself, the sources dosimetric characteristics must be known with a maximum of precision. As at these low energies the dosimetric characteristics are very dependant on the internal design, this implies a thorough study of any new source design. This is the subject of the first part of this work with the determination of the dosimetric characteristics of two new models of seed produced by the IBt Company. That determination has been done using measurements with thermoluminescent detectors and Monte Carlo calculations with two codes: MCNP4C and EGSnrc. The comparison of these two codes with the measurements has brought into evidence the necessity to use up to date cross section libraries during the calculations and to take into account the presence of the detectors during the measurements. However, the dosimetry is only one part of the problem when dealing with these low energy sources in radiotherapy. The irradiated materials are complex living tissues, composed of many substructures on which radiations have not always the same impact. It is now largely accepted that the most radiosensitive part of a living cell is the DNA. When photons interact with matter, they produce electrons that deposit their energy as ionisations and excitations of the atoms. These ionisations, if they occur with or close to the DNA molecule, are responsible for damaging it. That structure can support a certain amount of damage and stay functional thanks to repair mechanisms, but these mechanisms have limits in the way they can handle multiple breaks in the DNA strands. If these breaks are too close in space and time, repair is not possible and the cell dies. The density of ionisations increases when the energy of the incoming photon decreases so it is expected that low energy photons will have a higher efficiency at killing cells and so a higher Relative Biological Effect than high energy photons. To study that subject, one must reduce the volume of matter considered during energy deposition events to reach the sizes relevant for cells, micron or even nanometre volumes. That is why the part of radiation physics dealing with that problem is called microdosimetry. The second part of this work is dedicated to a theoretical microdosimetric study of these low energy photon sources using the microdosimetric functions for volumes of 1µm and a cluster analysis study for nanometric volumes. The two types of studies show that the photons of 20-30 keV are effectively more biologically efficient than high energy photons. The microdosimetric results give a ratio of the relative to Co-60 of 2.6 for Pd-103 and 2.2 for I-125, which is concordant with the experimental values published by Wuu et al. (1996). The cluster analysis also shows that the electrons generated by photons of 20-30 keV produce more high order clusters than electrons of 300 keV. The mean cluster order for clusters of 10 nm is 3.0 for Pd-103 and is 3.3 for I-125 compared to 2.1 for electrons of 300 keV. In this case, I-125 shows a higher mean cluster order, which is related to a potentially higher biological efficiency. This is explained by the fact that I-125 photons interact with a probability of 51% by Compton Effect, when that probability decreases to 27% for Pd-103. Compton interactions generate a high number of very low electrons that deposit their energy very locally with a very high density of ionisations. More radiobiological studies are needed to determine which volume site is more relevant and therefore which kind of study better reflects the reality. / Le cadre général de ce travail est l'utilisation de sources scellées de photons de basse énergie en curiethérapie. Nous avons travaillé en particulier avec deux isotopes : I-125 (énergie moyenne de 27 keV) et le Pd-103 (énergie moyenne de 21 keV). Les sources scellées se présentent sous la forme de grains cylindriques de 4.5 mm de long et 0.8 mm de rayon. Bien que les dimensions externes soient standards, la configuration interne peut être extrêmement différente d'un modèle à l'autre vu que les fabricants essaient d'améliorer les caractéristiques dosimétriques de leurs sources. Ces isotopes sont utilisés comme implants permanents pour les tumeurs de la prostate mais peuvent aussi être utilisés dans le traitement des tumeurs ophtalmiques. Comparés aux sources de plus haute énergie, ils offrent l'avantage physique d'une manipulation plus facile du point de vue de la radioprotection et d'une réduction de la dose aux tissus sains avoisinants. Lors d'un traitement clinique, il est important de pouvoir rapporter précisément certains paramètres qui peuvent avoir un impact sur les résultats du traitement pour le patient. Ces paramètres sont par exemple la dose prescrite, les doses à différents organes, le degré d'uniformité atteint sur le volume cible ou certaines information dose-volume. Les systèmes de calcul de dose pour la curiethérapie permettent également de mieux en mieux de conformer le traitement à l'anatomie du patient, comme en radiothérapie externe. Dans le cas des tumeurs de la prostate, il est possible depuis quelques années de vérifier la position des sources et de calculer les distributions de dose en temps réel lors de l'implantation grâce à l'utilisation d'une sonde ultrason. Il est clair que pour arriver à une bonne précision lors du traitement lui-même, il est indispensable de connaître les caractéristiques dosimétriques des sources avec un maximum de précision. Vu que, à ces basses énergies, les caractéristiques dosimétriques sont très dépendantes de la structure interne de sources, cela implique une étude minutieuse et complète de chaque nouveau modèle de grain mis sur le marché. Ceci forme le cadre de la première partie de ce travail qui est la détermination des caractéristiques dosimétriques de deux nouveaux modèles de grains produits par la compagnie IBt. Cette détermination a été réalisée grâce à l'utilisation de détecteurs thermoluminescents et de calculs de Monte Carlo avec deux codes : MCNP4C et EGSnrc. La comparaison de ces deux codes avec les mesures a permit de mettre en évidence la nécessité d'utiliser des bibliothèques de sections efficaces récentes lors des calculs et de prendre en compte la présence des détecteurs lors des mesures. Cependant, la dosimétrie est seulement une partie du problème de l'étude des sources de basse énergie utilisée en radiothérapie. Les milieux irradiés sont des tissus vivants complexes, composés de plusieurs sous-structures sur lesquelles les radiations n'ont pas toujours le même effet. Il est maintenant largement accepté que la partie la plus radiosensible d'une cellule vivante est la molécule d'ADN. Lorsque des photons interagissent avec la matière, ils produisent des électrons qui eux-mêmes déposent leur énergie sous forme d'ionisation et d'excitations des atomes. Ces ionisations, si elles se passent à proximité ou dans la molécule d'ADN, peuvent endommager celle-ci. Cette structure peut supporter une certaine quantité de dommages tout en restant fonctionnelle grâce à des mécanismes de réparation, mais ces mécanismes connaissent des limitations dans la manière dont ils peuvent gérer les cassures multiples des brins d'ADN. Si ces cassures sont trop proches dans le temps et l'espace, la réparation n'est plus possible et la cellule meurt. La densité d'ionisation augmente lorsque l'énergie du photon décroît. Il est donc attendu que les photons de basse énergie auront un efficacité accrue pour tuer les cellules et donc une plus haute Efficacité Biologique Relative que les photons de haute énergie. Pour étudier cet effet, il faut réduire le volume de matière considéré lors des évènements responsables du dépôt d'énergie afin d'atteindre des dimensions d'un ordre représentatif pour les cellules, microns ou même nanomètres. C'est pourquoi la partie de la physique des radiations dédiée à ce problème est appelée microdosimétrie. La seconde partie de ce travail est dédiée à une étude microdosimétrique théorique des ces sources de photons de basse énergie utilisant le concept de fonctions microdosimétriques pour des volumes de 1 µm et une analyse de cluster pour des volumes de l'ordre du nanomètre. Les deux types d'étude montrent que les photons de 20-30 keV sont effectivement plus efficaces radiobiologiquement que les photons de hautes énergie. Les résultats microdosimétriques donnent un rapport de yD relatif au Co-60 de 2.6 pour le Pd-103 et de 2.2 pour l'I-125, ce qui est concordant avec les valeurs expérimentales publiées par Wuu et al. (1996). L'analyse de cluster montre aussi que les électrons générés par les photons de 20-30 keV produisent plus de clusters d'ordre élevé que les électrons de 300 keV. L'ordre de cluster moyen pour des clusters de 10 nm est de 3.0 pour le 103Pd et de 3.3 pour l'I-125 comparé à 2.1 pour des électrons de 300keV. Dans ce cas, l'I-125 montre un ordre de cluster moyen plus élevé, ce qui est lié à une efficacité biologique potentiellement plus élevée. Ceci est expliqué par le fait que les photons de l'I-125 interagissent par effet Compton avec une probabilité de 51 %, cette probabilité tombe à 27 % dans le cas du Pd-103. Les interactions Compton génèrent un grand nombre d'électrons de très basse énergie qui déposent leur énergie très localement avec une très haute densité d'ionisations. D'autres études biologiques sont nécessaires pour déterminer quel volume est plus adapté et donc quel type d'étude reflète le mieux la réalité.

<p>Traditional dosimetric devices are inherently point dose dosimeters (PDDs) and can only measure the magnitude of the radiation exposure; hence, they are one-dimensional (1D). To measure the magnitude and spatial location of dose within a volume either several PDDs must be used at one time, or one PDD must be translated from point-to-point. Using PDDs for spatially distributed, two-dimensional (2D), dosimetry is laborious, time consuming, limited in spatial resolution, susceptible to positioning errors, and the currently accepted approach to measuring dose distribution in 2D. This work seeks to expand the current limits of indirectly ionizing radiation dosimetry by using radiochromic film (RCF) for a high-resolution, accurate dosimetry system. Using RCF will extend the current field of radiation dosimetry to spatially quantitative 2D and three-dimensional (3D) measurements. </p> <p>This work was generalized into two aims. The first aim was the development of the RCF dosimetry system; it was accomplished by characterizing the film and the readout devices and developing a method to calibrate film response for absolute dose measurements. The second aim was to apply the RCF dosimetry system to three areas of dosimetry that were inherently volumetric and could benefit from multiple dimensional (2D or 3D) dose analysis. These areas were representative of a broad range of radiation energy levels and were: low-mammography, intermediate-computed tomography (CT), and high-radiobiologcal small animal irradiation and cancer patient treatment verification. The application of a single dosimeter over a broad range of energy levels is currently unavailable for most traditional dosimeters, and thus, was used to demonstrate the robustness and flexibility of the RCF dosimetry system.</p> <p>Two types of RCF were characterized for this work: EBT and XRQA film. Both films were investigated for: radiation interaction with film structure; light interaction with film structure for optimal film readout (densitometry) sensitivity; range of absorbed dose measurements; dependence of film dose measurement response as a function of changing radiation energy; fractionation and dose rate effects on film measurement response; film response sensitivity to ambient factors; and stability of measured film response with time. EBT film was shown to have the following properties: near water equivalent atomic weight (Z_eff); dynamic dose range of (10<super>-1</super>-10<super>2</super>) Gy; 3% change in optical density (OD) response for a single exposure level when exposed to radiation energies from (75-18,000) kV; and best digitized using transmission densitometry. XRQA film was shown to have: a Zeff of ~25; a 12 fold increase in sensitivity at lower photon energies for a dynamic dose range of 10-3-100 Gy, a difference of 25% in OD response when comparing 120 kV to 320 kV, and best digitized using reflective densitometry. Both XRQA and EBT films were shown to have: a temporal stability (&#916;OD) of ~1% for t > 24 hr post film exposure for up to ~20 days; a change in dose response of ~0.03 mGy hr-1 when exposed to fluorescent room lighting at standard room temperature and humidity levels; a negligible dose rate and fractionation effect when operated within the optimal dose ranges; and a light wavelength dependence with dose for film readout.</p> <p>The flat bed scanner was chosen as the primary film digitizer due to its availability, cost, OD range, functionality (transmission and reflection scanning), and digitization speed. As a cost verses functionality comparison, the intrinsic and operational limitations were determined for two flat bed scanners. The EPSON V700 and 10000XL exhibited equal spatial and OD accuracy. The combined precision of both the scanner light sources and CCD sensors measured < 2% and < 7% deviation in pixel light intensities for 50 consecutive scans, respectively. Both scanner light sources were shown to be uniform in transmission and reflection scan modes along the center axis of light source translation. Additionally, RCFs demonstrated a larger dynamic range in pixel light intensities, and to be less sensitive to off axis light inhomogeneity, when scanned in landscape mode (long axis of film parallel with axis of light source translation). The EPSON 10000XL demonstrated slightly better light source/CCD temporal stability and provided a capacity to scan larger film formats at the center of the scanner in landscape mode. However, the EPSON V700 only measured an overall difference in accuracy and precision by 2%, and though smaller in size, at the time of this work, was one sixth the cost of the 10000XL. A scan protocol was developed to maximize RCF digitization accuracy and precision, and a calibration fitting function was developed for RCF absolute dosimetry. The fitting function demonstrated a superior goodness of fit for both RCF types over a large range of absorbed dose levels as compared to the currently accepted function found in literature.</p> <p>The RCF dosimetry system was applied to three novel areas from which a benefit could be derived for 2D or 3D dosimetric information. The first area was for a 3D dosimetry of a pendant breast in 3D-CT mammography. The novel method of developing a volumetric image of the breast from a CT acquisition technique was empirically measured for its dosimetry and compared to standard dual field digital mammography. The second area was dose reduction in CT for pediatric and adult scan protocols. In this application, novel methodologies were developed to measure 3D organ dosimetry and characterize a dose reduction scan protocol for pediatric and adult body habitus. The third area was in the field of small animal irradiation for radiobiology purposes and cancer patient treatment verification. Two methods for small animal irradiation were analyzed for their dosimetry. The first technique was within a gamma irradiator environment using a <super>137</super>Cs source (663 keV), and the second, a novel approach to mouse irradiation, was developed for fast neutron (10 MeV) irradiated by a Tandem Van de Graff accelerator in a <super>2</super>H(d,n)<super>3</super>He reaction. For the patient cancer treatment, RCF was used to verify a 3D radiochromic plastic, PRESAGETM, using multi-leaf collimation (MLC) on a medical linear accelerator (LINAC) with 6 MV x-rays. The RCF and PRESAGE<super>TM</super> dosimeters were employed to verify a simple respiratory-gated lung treatment for a small nodule; the film was considered the gold standard. In every case, the RCF dosimetry system was verified for accuracy using a traditional PDD as the golden standard. When considering all areas of radiation energy applications, the RCF dosimetry system agreed to better than 7% of the golden standard, and in some cases within better than 1%. In many instances, this work provided vital dosimetric information that otherwise was not captured using the PDD in similar geometry. This work demonstrates the need for RCF to more accurately measure volumetric dose.</p> / Dissertation