Scattered fractions of dose from 6,10,18, and 25 MV linear accelerator x rays in radiotherapy facilities

Tenth value layers for 60Co gamma rays and for 4, 6, 10, 15, and 18 MV x rays in concrete for beams of cone angles between 0 degrees and 14 degrees calculated by Monte Carlo simulation

The calculation of shielding barrier thicknesses for radiation therapy facilities according to the NCRP formalism is based on the use of broad beams (that is, the maximum possible field sizes). However, in practice, treatment fields used in radiation therapy are, on average, less than half the maximum size. Indeed, many contemporary treatment techniques call for reduced field sizes to reduce co-morbidity and the risk of second cancers. Therefore, published tenth value layers (TVLs) for shielding materials do not apply to these very small fields. There is, hence, a need to determine the TVLs for various beam modalities as a function of field size. The attenuation of (60)Co gamma rays and photons of 4, 6, 10, 15, and 18 MV bremsstrahlung x ray beams by concrete has been studied using the Monte Carlo technique (MCNP version 4C2) for beams of half-opening angles of 0 degrees , 3 degrees , 6 degrees , 9 degrees , 12 degrees , and 14 degrees . The distance between the x-ray source and the distal surface of the shielding wall was fixed at 600 cm, a distance that is typical for modern radiation therapy rooms. The maximum concrete thickness varied between 76.5 cm and 151.5 cm for (60)Co and 18 MV x rays, respectively. Detectors were placed at 630 cm, 700 cm, and 800 cm from the source. TVLs have been determined down to the third TVL. Energy spectra for 4, 6, 10, 15, and 18 MV x rays for 10 x 10 cm(2) and 40 x 40 cm(2) field sizes were used to generate depth dose curves in water that were compared with experimentally measured values.

Minimizing entrance door thickness for direct-entry radiotherapy rooms

When medical linear accelerator rooms are constructed without entrance mazes, the entrance doors can be as thick as 50 cm, weigh 10,000 kg, and cost 50-60 thousand dollars. We describe a method of room design in which the therapy unit is positioned 180 degrees from the usual orientation. A short stub wall that attenuates the leakage component of the secondary radiation protects the door. Using this approach, the door can be reduced to approximately half the usual thickness with a significant impact on cost. For these motor-driven doors, there are also long-term benefits related to maintenance of the operating hardware.

Medical health physics: a review

Medical health physics is the profession dedicated to the protection of healthcare providers, members of the public, and patients from unwarranted radiation exposure. Medical health physicists must be knowledgeable in the principles of health physics and in the applications of radiation in medicine. Advances in medical health physics require the definition of problems, testing of hypotheses, and gathering of evidence to defend changes in health physics practice and to assist medical practitioners in making changes in their practices as appropriate. Advances in radiation medicine have resulted in new modalities and procedures, some of which have significant potential to cause serious harm. Examples included in this review include radiologic procedures that require very long fluoroscopy times, radiolabeled monoclonal antibodies, and intravascular brachytherapy. This review summarizes evidence that supports changes in consensus recommendations, regulations, and health physics practices associated with recent advances in radiology, nuclear medicine, and radiation oncology. Medical health physicists must continue to gather evidence to support intelligent but practical methods for protection of personnel, the public, and patients as modalities and applications evolve in the practice of medicine.

Medical health physics: a review

Medical health physics is the profession dedicated to the protection of healthcare providers, members of the public, and patients from unwarranted radiation exposure. Medical health physicists must be knowledgeable in the principles of health physics and in the applications of radiation in medicine. Advances in medical health physics require the definition of problems, testing of hypotheses, and gathering of evidence to defend changes in health physics practice and to assist medical practitioners in making changes in their practices as appropriate. Advances in radiation medicine have resulted in new modalities and procedures, some of which have significant potential to cause serious harm. Examples included in this review include radiologic procedures that require very long fluoroscopy times, radiolabeled monoclonal antibodies, and intravascular brachytherapy. This review summarizes evidence that supports changes in consensus recommendations, regulations, and health physics practices associated with recent advances in radiology, nuclear medicine, and radiation oncology. Medical health physicists must continue to gather evidence to support intelligent but practical methods for protection of personnel, the public, and patients as modalities and applications evolve in the practice of medicine.

Measurement of scatter factors for 4, 6, 10, and 23 MV x rays at scattering angles between 30 degrees and 135 degrees

NCRP Report No. 49, published in 1976, describes how to calculate the shielding for the medical use of x rays and gamma rays for energies up to 10 MV, including primary, scattered, and leakage radiation. However, in that report, data for scattered radiation for linear accelerators exist only for 6 MV, and leakage radiation is assumed, incorrectly, to be equivalent to primary radiation. Since the publication of that report, linear accelerators with energies up to 25 MV have been widely used in the radiation therapy community. Thus, there is a need to measure additional data for all energies in the range 4-25 MV. In this study, measurements were made of the "a" factor for 4, 6, 10, and 23 MV x rays at scattering angles between 30 degrees and 135 degrees. The results show that the 6 and 10 MV "a" factor data are consistent with published data, and the 23 MV data are also consistent with recently published data at 18 and 25 MV. The data show that, in general, the "a" factor decreases with energy; the exception is that 23 MV data show a sharp increase at low scattering angles, much greater than at other energies.

Scatter fractions from linear accelerators with x-ray energies from 6 to 24 MV

Computation of shielding requirements for a linear accelerator must take into account the amount of radiation scattered from the patient to areas outside the primary beam. Currently, the most frequently used data are from NCRP 49 that only includes data for x-ray energies up to 6 MV and angles from 30 degrees to 135 degrees. In this work we have determined by Monte Carlo simulation the scattered fractions of dose for a wide range of energies and angles of clinical significance including 6, 10, 18, and 24 MV and scattering angles from 10 degrees to 150 degrees. Calculations were made for a 400 cm2 circular field size impinging onto a spherical phantom. Scattered fractions of dose were determined at 1 m from the phantom. Angles from 10 degrees to 30 degrees are of concern for higher energies where the scatter is primarily in the forward direction. An error in scatter fraction may result in too little secondary shielding near the junction with the primary barrier. The Monte Carlo code ITS (Version 3.0) developed at Sandia National Laboratory and NIST was used to simulate scatter from the patient to the barrier. Of significance was the variation of calculated scattered dose with depth of measurement within the barrier indicating that accurate values may be difficult to obtain. Mean energies of scatter x-ray spectra are presented.