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Title: Experimental measurement of radiological penumbra associated with intermediate energy x-rays (1 MV) and small radiosurgery field sizes

Journal Article · · Medical Physics
DOI:https://doi.org/10.1118/1.2775666· OSTI ID:21032816
; ;  [1]
  1. Departments of Medical Physics and Radiation Oncology, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5 (Canada)

Stereotactic radiosurgery is used to treat intracranial lesions with a high degree of accuracy. At the present time, x-ray energies at or above Co-60 gamma rays are used. Previous Monte Carlo simulations have demonstrated that intermediate energy x-ray photons or IEPs (defined to be photons in the energy range of 0.2-1.2 MeV), combined with small field sizes, produce a reduced radiological penumbra leading to a sharper dose gradient, improved dose homogeneity and sparing of critical anatomy adjacent to the target volume. This hypothesis is based on the fact that, for small x-ray fields, a dose outside the treatment volume is dictated mainly by the range of electrons set into motion by x-ray photons. The purpose of this work is: (1) to produce intermediate energy x rays using a detuned medical linear accelerator (2) to characterize the energy of this beam (3) to measure the radiological penumbra for IEPs and small fields to compare with that produced by 6 MV x rays or Co-60, and (4) to compare these experimental measurements with Monte Carlo computer simulations. The maximum photon energy of our IEP x-ray spectrum was measured to be 1.2 MeV. Gafchromic EBT films (ISP Technologies, Wayne, NJ) were irradiated and read using a novel digital microscopy imaging system with high spatial resolution. Under identical irradiation conditions the measured radiological penumbra widths (80%-20% distance), for field sizes ranging from 0.3x0.3 to 4.0x4.0 cm{sup 2}, varied from 0.3-0.77 mm (1.2 MV) and from 1.1-2.1 mm (6 MV). Even more dramatic were the differences found when comparing the 90%-10% or the 95%-5% widths, which are in fact more significant in radiotherapy. Monte Carlo simulations agreed well with the experimental findings. The reduction in radiological penumbra could be substantial for specific clinical situations such as in the treatment of an ocular melanoma abutting the macula or for the treatment of functional disorders such as trigeminal neuralgia (a nonlethal neurological pathology) where no long-term side effect should be induced by the treatment.

OSTI ID:
21032816
Journal Information:
Medical Physics, Vol. 34, Issue 10; Other Information: DOI: 10.1118/1.2775666; (c) 2007 American Association of Physicists in Medicine; Country of input: International Atomic Energy Agency (IAEA); ISSN 0094-2405
Country of Publication:
United States
Language:
English