Dosimetric evaluation of an intraoperative radiotherapy system: a measurement-based and Monte-Carlo modelling investigation

Abstract

Intraoperative radiotherapy (IORT) is a specialised subset of radiotherapy, where a high radiation dose is delivered to a surgically exposed tumour bed in order to eradicate any remaining cancer cells. The aim of this study was to examine the dose characteristics of the Zeiss Intrabeam IORT device which provides near-isotropic emission of up to 50 kV X-rays. The EGSnrc Monte Carlo (MC) code system was used to simulate the device and percentage depth dose (PDD) data measured with a soft X-ray parallel-plate ionisation chamber were used for model verification. The model provided energy spectra, isodose curves and mean photon energies. In addition, EBT3 Gafchromic film was used to verify the MC model by examining PDDs and 2D dose distributions for various applicators. The differences between MC model and ionisation chamber measurements were within 3% for most points, with a maximum deviation of ~ 9%. Most of the simulated PDD points were within 5% of the film-measured data, with a maximum deviation of ~ 10%. The mean energy of the bare probe was found to be 21.19 keV. The mean photon energy from applicators ranged from 29.00 to 30.85 keV. Results of this study may be useful for future work on creating a system for treatment planning.

Intraoperative radiation therapy with 50 kV x‐rays: A multi‐institutional review

“…The mean energy of bare probe x-rays is estimated to be ∼21 kV and those from spherical applicators between 29 and 30.85 kV. 34 For radiation protection and shielding determination, an effective energy of 30 kV is considered appropriate. 35 The advantages of INTRABEAM IORT are its ability to deliver a large radiation dose (10-20 Gy) to a target volume with rapid dose fall-off and hence limited exposure to adjacent organs at risk (OARs).…”

“…The mean energy of bare probe x‐rays is estimated to be ∼21 kV and those from spherical applicators between 29 and 30.85 kV. 34 For radiation protection and shielding determination, an effective energy of 30 kV is considered appropriate. 35 …”