BACKGROUND: Combining the sharp dose fall off feature of beta-emitting 106Ru/106Rh radionuclide with larger penetration depth feature of photon-emitting125I radionuclide in a bi-radionuclide plaque, prescribed dose to the tumor apex can be delivered while maintaining the tumor dose uniformity and sparing the organs at risk. The potential advantages of bi-radionuclide plaque could be of interest in context of ocular brachytherapy.
OBJECTIVE: The aim of the study is to evaluate the dosimetric advantages of a proposed bi-radionuclide plaque for two different designs, consisting of indigenous 125I seeds and 106Ru/106Rh plaque, using Monte Carlo technique. The study also explores the influence of other commercial 125I seed models and presence or absence of silastic/acrylic seed carrier on the calculated dose distributions. The study further included the calculation of depth dose distributions for the bi-radionuclide eye plaque for which experimental data are available.
METHODS: The proposed bi-radionuclide plaque consists of a 1.2-mm-thick silver (Ag) spherical shell with radius of curvature of 12.5 mm, 20 µm-thick-106Ru/106Rh encapsulated between 0.2 mm Ag disk, and a 0.1-mm-thick Ag window, and water-equivalent gel containing 12 symmetrically arranged 125I seeds. Two bi-radionuclide plaque models investigated in the present study are designated as Design I and Design II. In Design I, 125I seeds are placed on the top of the plaque, while in Design II 106Ru/106Rh source is positioned on the top of the plaque. In Monte Carlo calculations, the plaque is positioned in a spherical water phantom of 30 cm diameter.
RESULTS: The proposed bi-radionuclide eye plaque demonstrated superior dose distributions as compared to 125I or 106Ru plaque for tumor thicknesses ranges from 5 to 10 mm. Amongst the designs, dose at a given voxel for Design I is higher as compared to the corresponding voxel dose for Design II. This difference is attributed to the higher degree of attenuation of 125I photons in Ag as compared to beta particles. Influence of different 125I seed models on the normalized lateral dose profiles of Design I (in the absence of carrier) is negligible and within 5% on the central axis depth dose distribution as compared to the corresponding values of the plaque that has indigenous 125I seeds. In the presence of a silastic/acrylic seed carrier, the normalized central axis dose distributions of Design I are smaller by 3%-12% as compared to the corresponding values in the absence of a seed carrier. For the published bi-radionuclide plaque model, good agreement is observed between the Monte Carlo-calculated and published measured depth dose distributions for clinically relevant depths.
CONCLUSIONS: Regardless of the type of 125I seed model utilized and whether silastic/acrylic seed carrier is present or not, Design I bi-radionuclide plaque offers superior dose distributions in terms of tumor dose uniformity, rapid dose fall off and lesser dose to nearby critical organs at risk over the Design II plaque. This shows that Design I bi-radionuclide plaque could be a promising alternative to 125I plaque for treatment of tumor sizes in the range 5 to 10 mm.

OBJECTIVE: To provide a practical method of estimating medium-heterogeneity corrected dose without a Monte Carlo (MC) calculation in ocular brachytherapy using 125I Collaborative Ocular Melanoma Study (COMS) plaques.
METHODS: Using egs_brachy, MC simulations (1) under task group-43 assumptions with fully loaded seed configurations in water (HOMO) and (2) with effects of plaque backing, insert and inter-seed interactions (HETERO) were performed for seven 125I COMS plaques (10 mm-22 mm in diameter), and homogeneous dose (DHOMO) and heterogeneous dose (DHETERO) for central-axis and off-axis points were determined. For DHOMO, 85 Gy was normalized to a depth of 5 mm. Central-axis heterogeneity correction factors (HCFs) from a depth of 0 mm (inner sclera) to 22 mm (opposite retina) were derived from a ratio of DHETERO to DHOMO. Off-axis HCFs for optic disc/macula and lens as a function of distance from optic disc/macula (DT/MT) for various basal dimensions of tumor (BD/BM) were derived from DHETERO/DHOMO.
RESULTS: Central-axis HCF varied with a dose reduction of 10.3-19.8% by heterogeneity. Off-axis HCF for optic disc/macula varied significantly depending on DT/MT and BD/BM with a dose reduction of 11.3-38.3%. Off-axis HCF for lens had a dependence on MT and BM with its variation of 11.0-19.0%. A clinical example of using HCFs to estimate DHETERO was presented.
CONCLUSIONS: The practical method of using depth-dependent central-axis HCF and DT/MT- and BD/BM-dependent off-axis HCF provided in this study will facilitate a heterogeneous dose estimate for 125I COMS plaques without MC calculations.

UNASSIGNED: Most brachytherapy treatment planning system (TPS) commissioning requires data input based on the American Association of Physicists in Medicine Task Group-43 formalism. The commissioning accuracy is very important for dose calculation. The aim of this study is the implementation of a brachytherapy TPS into a clinical environment and check the TPS calculated dose accuracy.
UNASSIGNED: After introducing data of the different catheters (CIS Bio International, Saclay, France), composed of several Cesium-137 Eckert and Ziegler BEBIG CSM-11 radioactive sources; for XiO (CMS, St. Louis) brachytherapy TPS, the TPS dose calculation accuracy was investigated by comparing between the TPS calculated dose distribution (DD) for all the catheters with (1) the measuring DD using EBT3 GAFChromic film and (2) calculating DD by egs_brachy (Electron Gamma Shower, National Research Council of Canada) Monte Carlo simulation. The phantom used for this study consists of six PTW slabs 30 cm × 30 cm × 1 cm of polymethyl methacrylate with a Delouche MEDpro applicator on the top. The TPS DD was calculated on the computed tomography scan of this phantom.
UNASSIGNED: PTW VeriSoft version 6.0.1.7 (PTW-Freiburg, Germany) software was used for analyzing scanned films and to perform the comparison based on the gamma index distribution.
UNASSIGNED: For each catheter, the gamma index distribution showed agreement >95% of all pixels in both verification methods, with gamma ≤1.
UNASSIGNED: We confirm the commissioning accuracy and that the TPS can be used for clinical purposes.

UNASSIGNED: As per the recommendations of the American Association of Physicists in Medicine Task Group 43, Monte Carlo (MC) investigators should reproduce previously published dose distributions whenever new features of the code are explored. The purpose of the present study is to benchmark the TG-43 dosimetric parameters calculated using the new MC user-code egs_brachy of EGSnrc code system for three different radionuclides 192Ir, 169Yb, and 125I which represent high-, intermediate-, and low-energy sources, respectively.
UNASSIGNED: Brachytherapy sources investigated in this study are high-dose rate (HDR) 192Ir VariSource (Model VS2000), 169Yb HDR (Model 4140), and 125I -low-dose-rate (LDR) (Model OcuProsta). The TG-43 dosimetric parameters such as air-kerma strength, S k, dose rate constant, Λ, radial dose function, g(r) and anisotropy function, F(r,θ) and two-dimensional (2D) absorbed dose rate data (along-away table) are calculated in a cylindrical water phantom of mass density 0.998 g/cm3 using the MC code egs_brachy. Dimensions of phantom considered for 192Ir VS2000 and 169Yb sources are 80 cm diameter ×80 cm height, whereas for 125I OcuProsta source, 30 cm diameter ×30 cm height cylindrical water phantom is considered for MC calculations.
UNASSIGNED: The dosimetric parameters calculated using egs_brachy are compared against the values published in the literature. The calculated values of dose rate constants from this study agree with the published values within statistical uncertainties for all investigated sources. Good agreement is found between the egs_brachy calculated radial dose functions, g(r), anisotropy functions, and 2D dose rate data with the published values (within 2%) for the same phantom dimensions. For 192Ir VS2000 source, difference of about 28% is observed in g(r) value at 18 cm from the source which is due to differences in the phantom dimensions.
UNASSIGNED: The study validates TG-43 dose parameters calculated using egs_brachy for 192Ir, 169Yb, and 125I brachytherapy sources with the values published in the literature.

OBJECTIVE: To update and extend the Carleton Laboratory for Radiotherapy Physics (CLRP) Eye Plaque (EP) dosimetry database for low-energy photon-emitting brachytherapy sources using egs_brachy, an open-source EGSnrc application. The previous database, CLRP_EPv1, contained datasets for the Collaborative Ocular Melanoma Study (COMS) plaques (10-22 mm diameter) with 103 Pd or 125 I seeds (BrachyDose-computed, 2008). The new database, CLRP_EPv2, consists of newly calculated three-dimensional (3D) dose distributions for 17 plaques [eight COMS, five Eckert & Ziegler BEBIG, and four others representative of models used worldwide] for 103 Pd, 125 I, and 131 Cs seeds.
UNASSIGNED: Plaque models are developed with egs_brachy, based on published/manufacturer dimensions and material data. The BEBIG plaques (modeled for the first time) are identical in dimensions to COMS plaques but differ in elemental composition and/or density. Previously benchmarked seed models are used. Eye plaques and seeds are simulated at the center of full-scatter water phantoms, scoring in (0.05 cm)3 voxels spanning the eye for scenarios: (a) \"HOMO\": simulated TG43 conditions; (b) \"HETERO\": eye plaques and seeds fully modeled; (c) \"HETsi\" (BEBIG only): one seed is active at a time with other seed geometries present but not emitting photons (inactive); summation over all i seeds in a plaque then yields \"HETsum\" (includes interseed effects). For validation, doses are compared to those from CLRP_EPv1 and published data.
UNASSIGNED: Data are available at https://physics.carleton.ca/clrp/eye_plaque_v2, http://doi.org/10.22215/clrp/EPv2. The data consist of 3D dose distributions (text-based EGSnrc \"3ddose\" file format) and graphical presentations of the comparisons to previously published data.
UNASSIGNED: The CLRP_EPv2 database provides accurate reference 3D dose distributions to advance ocular brachytherapy dose evaluations. The fully-benchmarked eye plaque models will be freely distributed with egs_brachy, supporting adoption of model-based dose evaluations as recommended by TG-129, TG-186, and TG-221.

Inverse square correction factors for wide-angle free-air chambers (WAFACs) and free-air chambers (FACs) for cylindrical, conical and square-prism detectors are required for determining the on-axis air kerma from measurements or Monte Carlo calculations made with these different shaped detectors. Values of air kerma measured with these detectors use an effective volume technique related to the inverse square correction factors. This paper presents these factors in a consistent framework and the relationships between them are made clear. Using Monte Carlo simulations, the various corrections and techniques are shown to be accurate within a statistical precision of about 0.04% or better with the exception of the published correction for square prism detectors which is shown to hold only for thin detectors which have an opening angle corresponding to the NIST and NRCC WAFAC primary standards. A more accurate correction for square prism detectors is presented which properly averages 1/d2 rather than d2 where d is the distance away from the source.