Eurados Strategic Research Agenda 2020: Vision for the Dosimetry of Ionising Radiation

Harrison, R. M.; Ainsbury, Elizabeth A.; Alves, José L. D.; Bottollier-Depois, J.-F.; Breustedt, B.; Caresana, M.; Clairand, I.; Fantuzzi, E.; Fattibene, P.; Gilvin, P. J.; Hupe, O.; Knežević, Željka; López, M. A.; Olko, P.; Olšovcová, Veronika; Rabus, Hans; Rühm, W.; Silari, M.; Stolarczyk, Liliana; Tanner, R.J.; Vanhavere, F.; Vargas, Arturo; Woda, Clemens

doi:10.1093/rpd/ncab063

Cited by 19 publications

(8 citation statements)

References 63 publications

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“…Some medical physicists are cautious that the existing knowledge and understanding of the out-of-field doses and associated risk of inducing secondary malignant neoplasms (SMNs) is not sufficiently mature to justify the use of modern techniques, such as PT, for treating children or pregnant women ( 4 ). Therefore, a full characterization of the out-of-field doses, particularly at the PT field edge, requires special attention for the radiation protection and prevention of SMNs ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Validation of a Monte Carlo Framework for Out-of-Field Dose Calculations in Proton Therapy

et al. 2022

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Proton therapy enables to deliver highly conformed dose distributions owing to the characteristic Bragg peak and the finite range of protons. However, during proton therapy, secondary neutrons are created, which can travel long distances and deposit dose in out-of-field volumes. This out-of-field absorbed dose needs to be considered for radiation-induced secondary cancers, which are particularly relevant in the case of pediatric treatments. Unfortunately, no method exists in clinics for the computation of the out-of-field dose distributions in proton therapy. To help overcome this limitation, a computational tool has been developed based on the Monte Carlo code TOPAS. The purpose of this work is to evaluate the accuracy of this tool in comparison to experimental data obtained from an anthropomorphic phantom irradiation. An anthropomorphic phantom of a 5-year-old child (ATOM, CIRS) was irradiated for a brain tumor treatment in an IBA Proteus Plus facility using a pencil beam dedicated nozzle. The treatment consisted of three pencil beam scanning fields employing a lucite range shifter. Proton energies ranged from 100 to 165 MeV. A median dose of 50.4 Gy(RBE) with 1.8 Gy(RBE) per fraction was prescribed to the initial planning target volume (PTV), which was located in the cerebellum. Thermoluminescent detectors (TLDs), namely, Li-7-enriched LiF : Mg, Ti (MTS-7) type, were used to detect gamma radiation, which is produced by nuclear reactions, and secondary as well as recoil protons created out-of-field by secondary neutrons. Li-6-enriched LiF : Mg,Cu,P (MCP-6) was combined with Li-7-enriched MCP-7 to measure thermal neutrons. TLDs were calibrated in Co-60 and reported on absorbed dose in water per target dose (μGy/Gy) as well as thermal neutron dose equivalent per target dose (μSv/Gy). Additionally, bubble detectors for personal neutron dosimetry (BD-PND) were used for measuring neutrons (>50 keV), which were calibrated in a Cf-252 neutron beam to report on neutron dose equivalent dose data. The Monte Carlo code TOPAS (version 3.6) was run using a phase-space file containing 1010 histories reaching an average standard statistical uncertainty of less than 0.2% (coverage factor k = 1) on all voxels scoring more than 50% of the maximum dose. The primary beam was modeled following a Fermi–Eyges description of the spot envelope fitted to measurements. For the Monte Carlo simulation, the chemical composition of the tissues represented in ATOM was employed. The dose was tallied as dose-to-water, and data were normalized to the target dose (physical dose) to report on absorbed doses per target dose (mSv/Gy) or neutron dose equivalent per target dose (μSv/Gy), while also an estimate of the total organ dose was provided for a target dose of 50.4 Gy(RBE). Out-of-field doses showed absorbed doses that were 5 to 6 orders of magnitude lower than the target dose. The discrepancy between TLD data and the corresponding scored values in the Monte Carlo calculations involving proton and gamma contributions was on average 18%. The comparison between the neutron equivalent doses between the Monte Carlo simulation and the measured neutron doses was on average 8%. Organ dose calculations revealed the highest dose for the thyroid, which was 120 mSv, while other organ doses ranged from 18 mSv in the lungs to 0.6 mSv in the testes. The proposed computational method for routine calculation of the out-of-the-field dose in proton therapy produces results that are compatible with the experimental data and allow to calculate out-of-field organ doses during proton therapy.

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Section: Introductionmentioning

confidence: 99%

Validation of a Monte Carlo Framework for Out-of-Field Dose Calculations in Proton Therapy

et al. 2022

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“…Personalized medicine is an important facet of medical radiation research programs and roadmaps of strategic research agendas (EURADOS or EURAMED) [1,2]. Indeed, patient-specific dosimetry in radiopharmaceutical therapy (RPT) and particularly for treatment planning is progressively implemented in clinical practice (ICRU report 96 and ICRP Publication 140 [3,4]).…”

Section: Introductionmentioning

confidence: 99%

An EANM position paper on advancing radiobiology for shaping the future of nuclear medicine

Pouget,

Konijnenberg,

Eberlein

et al. 2022

Eur J Nucl Med Mol Imaging

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“…Third, as example, the dose heterogeneity in bone tissues in case of Xofigo treatment of bone metastases was summarized. Based on this review, in the following several research proposals in the radiation research and radiation dosimetry field related to radiopharmaceutical therapy are recommended, all consistent with the SRAs of MELODI and EURADOS (Harrison et al 2021 ; MELODI 2021 ).…”

Section: Discussion and Recommendationsmentioning

confidence: 99%

Heterogeneity of dose distribution in normal tissues in case of radiopharmaceutical therapy with alpha-emitting radionuclides

Bouvier‐Capely

Vargas

et al. 2022

Radiat Environ Biophys

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Heterogeneity of dose distribution has been shown at different spatial scales in diagnostic nuclear medicine. In cancer treatment using new radiopharmaceuticals with alpha-particle emitters, it has shown an extensive degree of dose heterogeneity affecting both tumour control and toxicity of organs at risk. This review aims to provide an overview of generalized internal dosimetry in nuclear medicine and highlight the need of consideration of the dose heterogeneity within organs at risk. The current methods used for patient dosimetry in radiopharmaceutical therapy are summarized. Bio-distribution and dose heterogeneities of alpha-particle emitting pharmaceutical 223Ra (Xofigo) within bone tissues are presented as an example. In line with the strategical research agendas of the Multidisciplinary European Low Dose Initiative (MELODI) and the European Radiation Dosimetry Group (EURADOS), future research direction of pharmacokinetic modelling and dosimetry in patient radiopharmaceutical therapy are recommended.

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Eurados Strategic Research Agenda 2020: Vision for the Dosimetry of Ionising Radiation

Cited by 19 publications

References 63 publications

Validation of a Monte Carlo Framework for Out-of-Field Dose Calculations in Proton Therapy

Validation of a Monte Carlo Framework for Out-of-Field Dose Calculations in Proton Therapy

An EANM position paper on advancing radiobiology for shaping the future of nuclear medicine

Heterogeneity of dose distribution in normal tissues in case of radiopharmaceutical therapy with alpha-emitting radionuclides

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