Low-energy photons in high-energy photon fields--Monte Carlo generated spectra and a new descriptive parameter.

The varying low-energy contribution to the photon spectra at points within and around radiotherapy photon fields is associated with variations in the responses of non-water equivalent dosimeters and in the water-to-material dose conversion factors for tissues such as the red bone marrow. In addition, the presence of low-energy photons in the photon spectrum enhances the RBE in general and in particular for the induction of second malignancies. The present study discusses the general rules valid for the low-energy spectral component of radiotherapeutic photon beams at points within and in the periphery of the treatment field, taking as an example the Siemens Primus linear accelerator at 6 MV and 15 MV. The photon spectra at these points and their typical variations due to the target system, attenuation, single and multiple Compton scattering, are described by the Monte Carlo method, using the code BEAMnrc/EGSnrc. A survey of the role of low energy photons in the spectra within and around radiotherapy fields is presented. In addition to the spectra, some data compression has proven useful to support the overview of the behaviour of the low-energy component. A characteristic indicator of the presence of low-energy photons is the dose fraction attributable to photons with energies not exceeding 200 keV, termed P(D)(200 keV). Its values are calculated for different depths and lateral positions within a water phantom. For a pencil beam of 6 or 15 MV primary photons in water, the radial distribution of P(D)(200 keV) is bellshaped, with a wide-ranging exponential tail of half value 6 to 7 cm. The P(D)(200 keV) value obtained on the central axis of a photon field shows an approximately proportional increase with field size. Out-of-field P(D)(200 keV) values are up to an order of magnitude higher than on the central axis for the same irradiation depth. The 2D pattern of P(D)(200 keV) for a radiotherapy field visualizes the regions, e.g. at the field margin, where changes of detector responses and dose conversion factors, as well as increases of the RBE have to be anticipated. Parameter P(D)(200 keV) can also be used as a guidance supporting the selection of a calibration geometry suitable for radiation dosimeters to be used in small radiation fields.

[1]  Timothy C Zhu,et al.  Energy dependence of commercially available diode detectors for in-vivo dosimetry. , 2007, Medical physics.

[2]  U Titt,et al.  A flattening filter free photon treatment concept evaluation with Monte Carlo. , 2006, Medical physics.

[3]  D. Harder,et al.  Spectra of scattered photons in large absorbers and their importance for the values of radiation weighting factor wR. , 2004, Radiation protection dosimetry.

[4]  I. Kawrakow,et al.  Large efficiency improvements in BEAMnrc using directional bremsstrahlung splitting. , 2004, Medical physics.

[5]  H. Roos,et al.  The depth-dependence of the biological effectiveness of 60Co gamma rays in a large absorber determined by dicentric chromosomes in human lymphocytes. , 2008, Radiation protection dosimetry.

[6]  Analytical scatter kernels for portal imaging at 6 MV. , 2001, Medical physics.

[7]  Karin Eklund,et al.  Fast modelling of spectra and stopping-power ratios using differentiated fluence pencil kernels , 2008, Physics in medicine and biology.

[8]  R. Nath,et al.  Photon energy dependence of the sensitivity of radiochromic film and comparison with silver halide film and LiF TLDs used for brachytherapy dosimetry. , 1991, Medical physics.

[9]  D. Georg,et al.  Experimental determination of peripheral photon dose components for different IMRT techniques and linear accelerators. , 2009, Zeitschrift fur medizinische Physik.

[10]  Harald Paganetti,et al.  A review of dosimetry studies on external-beam radiation treatment with respect to second cancer induction , 2008, Physics in medicine and biology.

[11]  T. Straume,et al.  High-energy gamma rays in Hiroshima and Nagasaki: implications for risk and WR. , 1995, Health physics.

[12]  Mapping radiation quality inside photon-irradiated absorbers by means of a twin-chamber method. , 2009, Zeitschrift fur medizinische Physik.

[13]  Modell für das Ansprechen radiographischer Filme und Folgerungen für die Qualitätssicherung , 2007 .

[14]  D. Followill,et al.  A Monte Carlo model for out-of-field dose calculation from high-energy photon therapy. , 2007, Medical physics.

[15]  M A Hill,et al.  The variation in biological effectiveness of X-rays and gamma rays with energy. , 2004, Radiation protection dosimetry.

[16]  P. Mcdermott The physical basis for empirical rules used to determine equivalent fields for phantom scatter. , 1998, Medical physics.

[17]  C Field,et al.  Relative biological damage and electron fluence in and out of a 6 MV photon field , 2009, Physics in medicine and biology.

[18]  M. Karlsson,et al.  Measured lung dose correction factors for 50 MV photons. , 1998, Physics in medicine and biology.

[19]  How much does film sensitivity increase at depth for larger field sizes? , 1999, Medical physics.

[20]  F. Sánchez-Doblado,et al.  Automatic determination of primary electron beam parameters in Monte Carlo simulation. , 2007, Medical physics.

[21]  P. Andreo,et al.  Absorbed Dose Determination in External Beam Radiotherapy: An International Code of Practice for Dosimetry based on Standards of Absorbed Dose to Water , 2001 .

[22]  W. Dörr,et al.  Cancer induction by radiotherapy: dose dependence and spatial relationship to irradiated volume. , 2002, Journal of radiological protection : official journal of the Society for Radiological Protection.

[23]  P. V. D. Giessen A simple and generally applicable method to estimate the peripheral dose in radiation teletherapy with high energy x-rays or gamma radiation. , 1996 .

[24]  C. R. Edwards,et al.  Near surface photon energy spectra outside a 6 MV field edge. , 2004, Physics in medicine and biology.

[25]  C. Ma,et al.  BEAM: a Monte Carlo code to simulate radiotherapy treatment units. , 1995, Medical physics.

[26]  Jean Chavaudra,et al.  Frequency distribution of second solid cancer locations in relation to the irradiated volume among 115 patients treated for childhood cancer. , 2009, International journal of radiation oncology, biology, physics.

[27]  R Mohan,et al.  Energy and angular distributions of photons from medical linear accelerators. , 1985, Medical physics.

[28]  D. Georg,et al.  Experimental Determination of Peripheral Doses for Different IMRT Techniques Delivered by a Siemens Linear Accelerator , 2008, Strahlentherapie und Onkologie.

[29]  J. W. Vieira,et al.  CALDose_X—a software tool for the assessment of organ and tissue absorbed doses, effective dose and cancer risks in diagnostic radiology , 2008, Physics in medicine and biology.

[30]  F. Verhaegen,et al.  Calculation of relative biological effectiveness of a low-energy electronic brachytherapy source , 2008, Physics in medicine and biology.

[31]  R. Stern Peripheral dose from a linear accelerator equipped with multileaf collimation. , 1999, Medical physics.

[32]  A. Ahnesjö,et al.  Modeling silicon diode energy response factors for use in therapeutic photon beams , 2009, Physics in medicine and biology.

[33]  Jack Valentin,et al.  Relative biological effectiveness (RBE), quality factor (Q), and radiation weighting factor (wR) , 2003 .

[34]  Dietrich Harder,et al.  Dosimetric characteristics of an unshielded p-type Si diode: linearity, photon energy dependence and spatial resolution. , 2008, Zeitschrift fur medizinische Physik.

[35]  Thomas LoSasso,et al.  Predicting energy response of radiographic film in a 6 MV x-ray beam using Monte Carlo calculated fluence spectra and absorbed dose. , 2004, Medical physics.

[36]  M. Butson,et al.  Dose response of various radiation detectors to synchrotron radiation. , 1998, Physics in medicine and biology.

[37]  M. Tubiana Can we reduce the incidence of second primary malignancies occurring after radiotherapy? A critical review. , 2009, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[38]  Javier Pena,et al.  The change of response of ionization chambers in the penumbra and transmission regions: impact for IMRT verification , 2007, Medical & Biological Engineering & Computing.

[39]  C Field,et al.  A Monte Carlo study of the variation of electron fluence in water from a 6 MV photon beam outside of the field , 2007, Physics in medicine and biology.

[40]  I. Kawrakow,et al.  Efficient photon beam dose calculations using DOSXYZnrc with BEAMnrc. , 2006, Medical physics.

[41]  N Petoussi-Henss,et al.  Organ dose conversion coefficients for external photon irradiation of male and female voxel models , 2002, Physics in medicine and biology.

[42]  B Faddegon,et al.  Comparison of beam characteristics of a gold x-ray target and a tungsten replacement target. , 2004, Medical physics.

[43]  A. Keller,et al.  Erhöhung der Genauigkeit der Laplace-Transformationsmethode zur Bestimmung des Bremsstrahlungsspektrums klinischer Linearbeschleuniger , 2003 .

[44]  B. Poppe,et al.  Experimental study on photon-beam peripheral doses, their components and some possibilities for their reduction , 2010, Physics in medicine and biology.

[46]  Off-axis chamber response in the depth of photon dose maximum. , 2005, Physics in medicine and biology.