Dosimetric characterization of two radium sources for retrospective dosimetry studies

• Published in: Medical physics (Lancaster) 2015-05, Vol.42 (5), p.2132-2142
• Main Authors: Candela‐Juan, C., Karlsson, M., Lundell, M., Ballester, F., Tedgren, Å. Carlsson
• Format: Article
• Language: English
• Subjects: 07 ISOTOPES AND RADIATION SOURCES; 60 APPLIED LIFE SCIENCES; ABSORBED RADIATION DOSES; BRACHYTHERAPY; Brachytherapy - instrumentation; Brachytherapy - methods; cancer; Circuit arrangements not adapted to a particular type of detector; COMPARATIVE EVALUATIONS; Computer Simulation; DOSE RATES; Dose-Response Relationship, Radiation; DOSIMETRY; Dosimetry/exposure assessment; Equipment Design; Glass; Humans; Medicin och hälsovetenskap; Models, Biological; MONTE CARLO METHOD; Monte Carlo methods; Needles; PHANTOMS; Phantoms, Imaging; RADIATION EFFECTS; radiation monitoring; Radiation monitoring, control, and safety; Radiation therapy; radioactive sources; Radioactive sources other than neutron sources (radioactive dressings A61M36/14); radioisotopes; Radiometry - methods; Radiotherapy Dosage; RADIUM; Radium - adverse effects; Radium - therapeutic use; RADIUM 226; retrospective dosimetry; Retrospective Studies; Scintigraphy; SWEDEN; Sweden - epidemiology; TG‐43 formalism; THERMOLUMINESCENT DOSEMETERS; Time Factors; WATER
• ISSN: 0094-2405; 2473-4209; 2473-4209
• DOI: 10.1118/1.4916685

Purpose: During the first part of the 20th century, 226Ra was the most used radionuclide for brachytherapy. Retrospective accurate dosimetry, coupled with patient follow up, is important for advancing knowledge on long‐term radiation effects. The purpose of this work was to dosimetrically characterize two 226Ra sources, commonly used in Sweden during the first half of the 20th century, for retrospective dose–effect studies. Methods: An 8 mg 226Ra tube and a 10 mg 226Ra needle, used at Radiumhemmet (Karolinska University Hospital, Stockholm, Sweden), from 1925 to the 1960s, were modeled in two independent Monte Carlo (MC) radiation transport codes: geant4 and mcnp5. Absorbed dose and collision kerma around the two sources were obtained, from which the TG‐43 parameters were derived for the secular equilibrium state. Furthermore, results from this dosimetric formalism were compared with results from a MC simulation with a superficial mould constituted by five needles inside a glass casing, placed over a water phantom, trying to mimic a typical clinical setup. Calculated absorbed doses using the TG‐43 formalism were also compared with previously reported measurements and calculations based on the Sievert integral. Finally, the dose rate at large distances from a 226Ra point‐like‐source placed in the center of 1 m radius water sphere was calculated with geant4. Results: TG‐43 parameters [including gL(r), F(r, θ), Λ, and sK] have been uploaded in spreadsheets as additional material, and the fitting parameters of a mathematical curve that provides the dose rate between 10 and 60 cm from the source have been provided. Results from TG‐43 formalism are consistent within the treatment volume with those of a MC simulation of a typical clinical scenario. Comparisons with reported measurements made with thermoluminescent dosimeters show differences up to 13% along the transverse axis of the radium needle. It has been estimated that the uncertainty associated to the absorbed dose within the treatment volume is 10%–15%, whereas uncertainty of absorbed dose to distant organs is roughly 20%–25%. Conclusions: The results provided here facilitate retrospective dosimetry studies of 226Ra using modern treatment planning systems, which may be used to improve knowledge on long term radiation effects. It is surely important for the epidemiologic studies to be aware of the estimated uncertainty provided here before extracting their conclusions.