Monte-Carlo dosimetry for intraoperative radiotherapy using a low energy x-ray source

Acta Oncol. 2015 Nov;54(10):1788-95. doi: 10.3109/0284186X.2015.1016623. Epub 2015 Mar 24.

Abstract

Intraoperative radiotherapy (IORT) is continuously gaining ground in cancer treatment. However, there is currently no planning system associated with these devices, which precludes patient-specific dose delivery optimization. The objective of this study was the development and validation of a Monte Carlo simulation (MCS)-based dosimetry platform using the Intrabeam™ system.

Methods: After surgical resection of the tumor this system delivers a single dose fraction at the surface of an applicator irradiating the tumor bed through a 50 kV x-ray beam. The GATE MCS platform was used in this study combining the phase space obtained by modeling the x-ray source and the detailed modeling of the additional parts of the Intrabeam™ system. The model was validated by comparing simulated versus experimental measurements of depth dose curves (DDC) and isotropy. A clinical validation study was also carried out using patient computed tomography images.

Results: The mean deviation between measured and simulated DDC was 2.9% ± 4.4% and 5.9% ± 5.7% for the bare needle and the use of applicators, respectively. A good agreement with experimental measurements was also found in terms of dose isotropy with a maximum difference of 2.04% for the 40 mm diameter applicator. A patient study revealed a mean absolute deviation of 0.06 Gy between simulated and thermoluminescent dosimeters (TLD) measured skin doses.

Conclusion: This study shows the potential of using the GATE MCS platform to model three-dimensional dose distributions of the Intrabeam™ system for use in IORT.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / radiotherapy*
  • Breast Neoplasms / surgery*
  • Computer Simulation
  • Female
  • Humans
  • Intraoperative Care
  • Mastectomy, Segmental
  • Models, Theoretical*
  • Monte Carlo Method
  • Phantoms, Imaging
  • Radiotherapy / instrumentation
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted / instrumentation
  • Radiotherapy Planning, Computer-Assisted / methods*
  • Radiotherapy, Computer-Assisted
  • Skin
  • Thermoluminescent Dosimetry
  • Tomography, X-Ray Computed