NOVEL 'PHOTONEUTRON VOLUME DOSE EQUIVALENT' HYPOTHESIS AND METHODOLOGY FOR SECOND PRIMARY CANCER RISK ESTIMATION IN HIGH-ENERGY X-RAY MEDICAL ACCELERATORS

Breakthrough electroneutron multi-response miniature dosimetry/spectrometry in medical accelerator

Breakthrough multi-response miniature dosimetry/spectrometry of electroneutrons (EN) was made on surface and in-depths of whole-body polyethylene phantom under 10 cm × 10 cm electron beam of 20 MV Varian Clinac 2100C electron medical accelerator commonly applied for prostate treatment. While dosimetry/spectrometry of photoneutrons (PN) has been well characterized for decades, those of ENs lagged behind due to very low EN reaction cross section and lack of sensitive neutron dosimeters/spectrometers meeting neutron dosimetry requirements. Recently, Sohrabi "miniature neutron dosimeter/spectrometer" and "Stripe polycarbonate dosimeter" have broken this barrier and determined seven EN ambient dose equivalent (ENDE) (µSv.Gy-1) responses from electron beam and from albedo ENs including beam thermal (21 ± 2.63), albedo thermal (43 ± 3.70), total thermal (64 ± 6.33), total epithermal (32 ± 3.90), total fast (112.00), total thermal + epithermal (l96 ± 10), and total thermal + epithermal + fast (208 ± 10.23) ENs. Having seven ENDE responses of this study and seven PNDE responses of previous study with the same accelerator obtained at identical conditions by the same principle author provided the opportunity to compare the two sets of responses. The PNDE (µSv.Gy-1) responses have comparatively higher values and 22.60 times at isocenter which provide for the first time breakthrough ENDE responses not yet reported in any studies before worldwide.

Evaluating the Necessity and Radiation Risk of Brain CT Scans Requested by the Trauma Emergency Department

Background

Numerous Computed Tomography (CT) scan requests for trauma patients have raised serious concern about the impacts of radiation such as radiation-induced cancers.

Objective

This study aimed to evaluate the necessity rate of requested head CT scans for traumatic patients and to ultimately estimate the risk of radiation-induced brain cancer.

Material and Methods

In this retrospective analytical study, traumatic patients, who had undergone a head CT scan in a two-month period from August 23 to October 22, 2018, were considered as the study population. Two radiologists reviewed each patient individually to evaluate the rate of normal and abnormal cases. Dose length product in milligrays (mGy) was utilized to calculate the effective dose (ED) in millisieverts (mSv), resulting in an assessment of the risk of radiation-induced brain cancer using ICRP 103.

Results

Among 523 scans, 460 patients (88%) received normal reviews, while only 47 patients (9%) had findings related to their current trauma. The mean effective dose value was 1.05±0.36 mSv. Risk of the radiation induced brain cancer was calculated to be 0.037 and 0.030 new cancer cases in 10000 males and females per Gy, respectively.

Conclusion

Final results demonstrated that a significant number of traumatic patients undergoing a CT scan are in fact, healthy. Such reckless usage of CT and consequently the excess exposure could result in a dramatic rise in cancer rates. The need to limit unnecessary CT scan usage and keeping the radiation given to patients as low as reasonably achievable (ALARA) when collecting essential diagnostic data is more critical than ever.

Whole-body photoneutron 360° angular distribution dosimetry by novel "Sohrabi neutron dosimetry methods"

PURPOSE

Whole-body photoneutron (PN) energy-specific dosimetry on phantom surfaces and 360°angular fast PN distribution dosimetry on and around polyethylene (PE) phantom organs for prostate cancer in 10 cm × 10 cm and 20 cm × 20 cm field sizes of 18 MV X-rays of Varian Clinac 2100C linear accelerator.

METHODS

Novel "Sohrabi neutron dosimetry methods" including "miniature passive neutron dosimeter/spectrometer" and "strip polycarbonate neutron dosimeters" were applied. Energy-specific PN dose equivalents on surface as well as 360°fast PN dose equivalent angular distributions on and around PE phantom organs; head, neck, thorax, arms, pelvis, thighs and legs were determined.

RESULTS

Matrix of surface (skin) energy-specific PN dose equivalents including total thermal, total epithermal, total fast, sum total thermal + epithermal and sum total thermal + epithermal + fast, and 360°angular fast PN dose equivalent responses were determined. The results indicate that data matrix of 20 cm × 20 cm field size provides higher PN dose equivalent values than those of 10 cm × 10 cm field size for surface points even remote from the central axis and for all 360°angular fast PN dose equivalent distributions on organs studied.

CONCLUSIONS

Matrix of energy-specific PN dose equivalents was obtained demonstrating that the Sohrabi neutron dosimetry methods applied are unique for energy-specific PN dose equivalent studies as well as for 360°angular PN dose equivalent distribution data for PN-SPC risk estimation. The dosimetry methods can be specifically applied to many other exotic applications in health physics, medical physics, space flight dosimetry, and nuclear science and technology.

Breakthrough whole body energy-specific and tissue-specific photoneutron dosimetry by novel miniature neutron dosimeter/spectrometer

Breakthrough whole body energy-specific photoneutron (PN) dosimetry was made in/out-of-field in polyethylene phantom organ surface/depths remote from isocenter of 10 × 10 cm2 field prostate cancer therapy in 18 MV X-rays Varian Clinac 2100C medical linear accelerator for PN tissue-specific second primary cancer (PN-SPC) risk estimation. A novel miniature neutron dosimeter/spectrometer with polycarbonate/10B/cadmium inserts was invented and applied. Each dosimeter determines seven tissue-specific dose equivalent (mSv)/Gy X-ray dose at each measurement point providing seven major energy-specific responses for beam thermal, albedo thermal, total thermal, total epithermal, total fast, sum of totals (thermal + epithermal) and sum of totals (thermal + epithermal + fast) PNs dose equivalents. The neutron dosimeter is simple, efficient, and unique with high spatial resolution and provides matrix of energy-specific PN dose equivalent (mSv)/Gy X-ray dose on surface and organ depths for tissue-specific PN-SPC risk estimation. The dosimeter also performs like a "miniature neutron spectrometer" and is unique for other applications in health physics in particular individual neutron dosimetry, medical physics, space flights, science and technology.

Photoneutron spectrometry by novel multi-directional spherical neutron spectrometry system

Neutron spectrometry in science and technology applications in general and accurate exotic photoneutron (PN) dosimetry of cancer patients undergoing high-dose high-energy X-rays therapy in medical accelerators in particular is of vital need. In this study, a novel passive multi-directional multi-detector neutron spectrometry system was developed and home-made using 6 polycarbonate/10B detectors on 6 sides of polyethylene (PE) cubes used bare and also embedded at center of PE spheres of 8 different diameters. The system provided well-resolved unfolded directional PN spectra showing thermal and fast PN peaks of 6 sides and mean spectrum in 5 field sizes at isocenter and other locations in 18 MV Siemens ONCOR medical linear accelerator bunker. The neutron spectrometry system developed has unique characteristics such as being simple, efficient, low cost, practical, and insensitive to low-LET radiation with well-resolved directional and mean spectra easily applicable in medicine, health, environment, science and technology in developing and developed laboratories.

Photon and photon–neutron experimental dosimetry in Grid therapy with 18 MV photon beams

Propose:

Spatially fractionated Grid radiation therapy (SFGRT) in an effective technique for bulky and radio-sensitive tumours. SFGRT using a constructed block has been used to evaluate the photon and photo-neutron (PN) dose measurement in 18-MV photon beam energy.

Methods and materials:

A mounted Grid block on to a Varian Clinac 2100c linear accelerator was used to perform photon dosimetry. The percentage depth dose, in-plane and cross-plane beam profile and output factor was measured by ionization chamber in water. The PN contamination was measured after photon dosimetry using the combination of thermoluminescence dosimetry types 600 and 700, and Polycarbonate Film dosimeters on the surface and in the maximum depth dose (dmax) of solid water™ slabs.

Results:

The valley-to-peak ration for 6 and 18 MV photon beams obtained from the beam profiles was ~35 and 72%, respectively. Fast and thermal PN equivalent dose decreased in the Grid field compared to an open field (without Grid).

Conclusion:

The Grid therapy dosimetry compared to the conventional radiotherapy (without the grid) the production of fast and thermal neutrons were reduced. Using of a Grid block in high-energy photon beams for a long period of the treatment continuously might be a new source of contamination due to the interaction of photon beam resulting the activation of the Grid block