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All sourcesNASA NTRSDOE OSTI
NASA NTRS1984

Dose rate effects in MOS microcircuits

Three read/write random access memories, AM91L24, HM1-6514, and MWS 5114, were subjected to total dose irradiation at three dose rates, with electrical testing after each increment of dosage. Annealing measurements were performed after the radiation tests were completed. The AM91L24 showed a strong dose rate effect and substantial post-irradiation annealing of radiation-induced damage. The dose rate effect was that a lower dose rate produced less net damage than an eqivalent total dose applied at a higher rate. The HM1-6514 showed essentially no dose rate effect and no annealing damage, and the MWS 5114 exhibited a moderate effect with some annealing. It was concluded that dose rate is an important parameter in radiation test procedures for MOS microcircuits and that annealing measurements may be important evaluation aids for such tests.

Cleveland, D. G.↗
NASA NTRS1990

Comparison of the effects of ionizing radiation at twelve dose rates from 0.0015 to 100 rad(Si)/s

Evidence is presented that two competing failure mechanisms exist in the Si-SiO2 system, with one mechanism dominating at low dose rates and the other at high. Much lower dose failures than expected were discovered at low dose rates (less than 0.1 rad(Si)/s) and very low dose rates (about 0.001 rad(Si)/s) in commercial SGS 4007 CMOS devices. These failure doses plotted versus dose rate have a bell-shaped curve, rather than the expected straight line (decreasing with increasing dose rate), indicating that a different failure mechanism is dominant at low dose rates than at high.

Goben, C. A.↗
NASA NTRS1995

Cosmic ray LET spectra and doses on board Cosmos-2044 biosatellite

Results of the experiments on board Cosmos-2044 (Biosatellite 9) are presented. Various nuclear track detectors (NTD) (dielectric, AgCl-based, nuclear emulsions) were used to obtain the Linear Energy Transfer (LET) spectra inside and outside the satellite. The spectra from the different NTDs have proved to be in general agreement. The results of LET spectra calculations using two different models are also presented. The resultant LET distributions are used to calculate the absorbed and equivalent doses and the orbit-averaged quality factors (QF) of the cosmic rays (CR). Absorbed dose rates inside (approximately 20 g cm (exp -2) shielding) and outside (1 g cm(exp -2) the spacecraft, omitting electrons, were found to be 4.8 and 8.6 mrad d (exp -1), respectively, while the corresponding equivalent doses were 8.8 and 19.7 mrem d(exp -1). The effects of the flight parameters on the total fluence of, and on the dose from the CR particles are analyzed. Integral dose distributions of the detected particles are also determined. The LET values which separate absorbed and equivalent doses into 50% intervals are estimated. The CR-39 dielectric NTD is shown to detect 20-30% of the absorbed dose and 60-70% of the equivalent dose in the Cosmos-2044 orbit. The influence of solar activity phase on the magnitude of CR flux is discussed.

Watts, J. W., Jr.↗
NASA NTRS1992

Cosmic ray LET spectra and doses on board Cosmos-2044 biosatellite

Results of the experiments on board Cosmos-2044 (Biosatellite 9) are presented. Various nuclear track detectors (NTD) (dielectric, AgCl-based, nuclear emulsions) were used to obtain the LET spectra inside and outside the satellite. The spectra from the different NTDs have proved to be in general agreement. The results of LET spectra calculations using two different models are also presented. The resultant LET distributions are used to calculate the absorbed and equivalent doses and the orbit-averaged quality factors (QF) of the cosmic rays (CR). Absorbed dose rates inside (approximately 20 g cm-2 shielding) and outside (1 g cm-2) the spacecraft, omitting electrons, were found to be 4.8 and 8.6 mrad d-1, respectively, while the corresponding equivalent doses were 8.8 and 19.7 mrem d-1. The effects of the flight parameters on the total fluence of, and on the dose from, the CR particles are analyzed. Integral dose distributions of the detected particles are also determined. The LET values which separate absorbed and equivalent doses into 50% intervals are estimated. The CR-39 dielectric NTD is shown to detect 20-30% of the absorbed dose and 60-70% of the equivalent dose in the Cosmos-2044 orbit. The influence of solar activity phase on the magnitude of CR flux is discussed.

Non-NASA Center↗
NASA NTRS2000

Effective dose equivalent on the ninth Shuttle--Mir mission (STS-91)

Organ and tissue doses and effective dose equivalent were measured using a life-size human phantom on the ninth Shuttle-Mir Mission (STS-91, June 1998), a 9.8-day spaceflight at low-Earth orbit (about 400 km in altitude and 51.65 degrees in inclination). The doses were measured at 59 positions using a combination of thermoluminescent dosimeters of Mg(2)SiO(4):Tb (TDMS) and plastic nuclear track detectors (PNTD). In correcting the change in efficiency of the TDMS, it was assumed that reduction of efficiency is attributed predominantly to HZE particles with energy greater than 100 MeV nucleon(-1). A conservative calibration curve was chosen for determining LET from the PNTD track-formation sensitivities. The organ and tissue absorbed doses during the mission ranged from 1.7 to 2.7 mGy and varied by a factor of 1.6. The dose equivalent ranged from 3.4 to 5.2 mSv and varied by a factor of 1.5 on the basis of the dependence of Q on LET in the 1990 recommendations of the ICRP. The effective quality factor (Q(e)) varied from 1.7 to 2.4. The dose equivalents for several radiation-sensitive organs, such as the stomach, lung, gonad and breast, were not significantly different from the skin dose equivalent (H(skin)). The effective dose equivalent was evaluated as 4.1 mSv, which was about 90% of the H(skin).

NASA Center JSC↗
NASA NTRS1998

Issues in the reconstruction of environmental doses on the basis of thermoluminescence measurements in the Techa riverside

The potential of thermoluminescence measurements of bricks from the contaminated area of the Techa river valley, Southern Urals, Russia, for reconstructing external exposures of affected population groups has been studied. Thermoluminescence dating of background samples was used to evaluate the age of old buildings available on the river banks. The anthropogenic gamma dose accrued in exposed samples is determined by subtracting the natural radiation background dose for the corresponding age from the accumulated dose measured by thermoluminescence. For a site in the upper Techa river region, where the levels of external exposures were extremely high, the depth-dose distribution in bricks and the dependence of accidental dose on the height of the sampling position were determined. For the same site, Monte Carlo simulations of radiation transport were performed for different source configurations corresponding to the situation before and after the construction of a reservoir on the river and evacuation of the population in 1956. A comparison of the results provides an understanding of the features of the measured depth-dose distributions and height dependencies in terms of the source configurations and shows that bricks from the higher sampling positions are likely to have accrued a larger fraction of anthropogenic dose from the time before the construction of the reservoir. The applicability of the thermoluminescent dosimetry method to environmental dose reconstruction in the middle Techa region, where the external exposure was relatively low, was also investigated.

NASA Discipline Radiation Health↗
NASA NTRS2007

Expression of Genes Associated with DNA Damage Sensing in Human Fibroblasts Exposed to Low-dose-rate Gamma Rays

Understanding of the molecular response to low-dose and low-dose-rate radiation exposure is essential for the extrapolation of high-dose radiation risks to those at dose levels relevant to space and other environmental concerns. Most of the reported studies of gene expressions induced by low-dose or low-dose-rate radiation were carried out on exponentially growing cells. In the present study, we analyzed expressions of 84 genes associated with DNA damage sensing using real time PCR in human fibroblasts in mostly G1 phase of the cell cycle. The cells were exposed continuously to gamma rays at a dose rate of 0.8 cGy/hr for 1, 2, 6 or 24 hrs at 37 C throughout the exposure. The total RNA was isolated immediately after the exposure was terminated. Of the 84 genes, only a few showed significant changes of the expression level. Some of the genes (e.g. DDit3 and BTG2) were found to be up or down regulated only after a short period of exposure, while other genes (e.g. PRKDC) displayed a highest expression level at the 24 hr time point. The expression profiles for the exposed cells which had a smaller portion of G1 cells indicated more cell cycle signaling and DNA repair genes either up or down regulated. Interestingly, the panel of genes changed from radiation exposure in G1 cells is different from the panel in cells having less G1 arrest cells. The gene expression profile of the cells responding to low-dose-radiation insult apparently depends on the cell growth stage. The response pathway in G1 cells may differ from that in exponentially growing cells.

Zhang, Ye↗
NASA NTRS2011

Non-Target Effect for Chromosome Aberrations in Human Lymphocytes and Fibroblasts After Exposure to Very Low Doses of High LET Radiation

The relationship between biological effects and low doses of absorbed radiation is still uncertain, especially for high LET radiation exposure. Estimates of risks from low-dose and low-dose-rates are often extrapolated using data from Japanese atomic bomb survivor with either linear or linear quadratic models of fit. In this study, chromosome aberrations were measured in human peripheral blood lymphocytes and normal skin fibroblasts cells after exposure to very low dose (.01 - 0.2 Gy) of 170 MeV/u Si-28-ions or 600 MeV/u Fe-56-ions. Chromosomes were analyzed using the whole chromosome fluorescence in situ hybridization (FISH) technique during the first cell division after irradiation, and chromosome aberrations were identified as either simple exchanges (translocations and dicentrics) or complex exchanges (involving >2 breaks in 2 or more chromosomes). The curves for doses above 0.1 Gy were more than one ion traverses a cell showed linear dose responses. However, for doses less than 0.1 Gy, Si-28-ions showed no dose response, suggesting a non-targeted effect when less than one ion traversal occurs. Additional findings for Fe-56 will be discussed.

Hada, Megumi↗
NASA NTRS2011

Modeling the effects of hydrogen and dose rate sensitivity in CMOS and bipolar technologies

Low dose rate (LDR) and high dose rate (HDR) experiments on field-oxide-field-effect-transistors (FOXFETs) and gated lateral pnp (GLPNP) bipolar transistors indicate that there is a dose rate enhancement factor (EF) associated with radiation-induced degradation. This EF is also affect by the presence of hydrogen in the oxide. In this work, we developed a one dimensional (1-D) numerical calculations code to investigate the key mechanisms that describe the dose rate sensitivity and the effect of hydrogen on dose rate effects. We used a finite-difference methodology for the numerical calculations that allow for computing solutions for the densities of the mobile species as well as for the electrostatic potential at nodes contained within a mesh superimposed on the solution domain. Results from calculations of damage EF indicate that oxide thickness, distribution of hole traps and hole capture cross-section affect dose rate sensitivity. In addition, calculations show that molecular hydrogen cracking at positively charged defects may be a key reaction relating hydrogen and dose rate response. Comparison to experimental data on bipolar and CMOS devices results in good agreement with the dose rate calculations of interface trap buildup

Barnaby, Hugh↗
NASA NTRSDate not supplied

The Sufficient Component Cause Model Explaining Low-Dose Radiobiology through an Epidemiologic Lens

One of the major challenges in understanding space radiation-induced carcinogenesis is the uncertainty from translating radiobiological research in cellular and animal models to humans, especially at doses below 100 mSv. Biological studies have shown a host of potential outcomes at low doses in animal and cellular models. The existence of non-targeted effects as bystander and abscopal effects is well-documented from clinical research and basic science1,2,3. While some studies have shown increased effects at low doses, others have shown evidence of hormetic bystander effects, where radiation exposure may be beneficial4,5,6. Despite these varied and diverse findings, epidemiologic studies largely support the linear-no threshold (LNT) assumption used by radiation protection guidance7,8. Translational animal-to-human models have predominantly considered ratio values such as the relative biological effectiveness (RBE) and dose and dose-rate effectiveness factor (DDREF) that rely on the assumption of LNT rather than implementing specific dose-response shapes in the low-dose region, and translational cell-to-human models are uncommon. The sufficient component cause model presents an opportunity to examine biological findings at low doses from an epidemiological lens9. In this model, exposures “sufficient” to cause an outcome of interest are presented in pie charts, such that when all slices of a pie chart are fulfilled, the outcome will occur. Multiple pie charts may exist for a single outcome, illustrating individual differences9. In 1988,Greenland and Poole adapted the sufficient component cause model to incorporate interaction with other exposures (such as genetics or lifestyle factors)10. They show that a range of biological processes are possible in a population, but that an epidemiologic study will only reveal the mean outcome from the population at large10,11. Using this construct, the multiple outcomes presented in radiobiological models to date can be explained in the context of epidemiologic studies. This presentation aims to demonstrate a causal framework that can integrate radiobiological and epidemiological models to date. It is intended as a conversation starter to spur future research.

C M Milder↗
DOE OSTI2019

Detailed Radiation Dose Rate Evaluations of Commercial Spent Nuclear Fuel Canisters

Electronic devices that are being designed for continuous monitoring of spent nuclear fuel (SNF) canister internal integrity may be subjected to very high radiation levels depending on their placement. Components of electronic devices (e.g., silicon semiconductors, optical glasses, insulators) have a limited tolerance to ionizing radiation. For selected locations on the inner and outer surfaces of a representative dry storage pressurized water reactor (PWR) SNF canister and a representative dry storage boiling water reactor (BWR) SNF canister, this paper provides (1) the dose rate in silicon as a function of decay time and (2) the time-integrated dose in silicon. The analyzed decay time interval is from 5 to 70 years after fuel discharge. Each representative canister contained identical SNF assemblies with bounding radiation sources. Surface dose rates varied significantly as a function of location and SNF assembly decay time. At a 5-year decay time, the estimated maximum dose rate values were 480 Gy/h (PWR canister) and ~366 Gy/h (BWR canister), and the estimated minimum dose rate was ~0.2 Gy/h for both canisters. Over a 65-year period, the dose rate decreased by a factor between 13 and 580, depending on location. The total dose over a time interval could be very large (e.g., estimated maximum value over a 5-year interval is 1.5E+07 Gy) depending on location and the time interval over which dose is accumulated.

Radulescu, Georgeta↗
DOE OSTI2013

Predicting Pneumonitis Risk: A Dosimetric Alternative to Mean Lung Dose

Purpose: To determine whether the association between mean lung dose (MLD) and risk of severe (grade {>=}3) radiation pneumonitis (RP) depends on the dose distribution pattern to normal lung among patients receiving 3-dimensional conformal radiation therapy for non-small-cell lung cancer. Methods and Materials: Three cohorts treated with different beam arrangements were identified. One cohort (2-field boost [2FB]) received 2 parallel-opposed (anteroposterior-posteroanterior) fields per fraction initially, followed by a sequential boost delivered using 2 oblique beams. The other 2 cohorts received 3 or 4 straight fields (3FS and 4FS, respectively), ie, all fields were irradiated every day. The incidence of severe RP was plotted against MLD in each cohort, and data were analyzed using the Lyman-Kutcher-Burman (LKB) model. Results: The incidence of grade {>=}3 RP rose more steeply as a function of MLD in the 2FB cohort (N=120) than in the 4FS cohort (N=138), with an intermediate slope for the 3FS group (N=99). The estimated volume parameter from the LKB model was n=0.41 (95% confidence interval, 0.15-1.0) and led to a significant improvement in fit (P=.05) compared to a fit with volume parameter fixed at n=1 (the MLD model). Unlike the MLD model, the LKB model with n=0.41 provided a consistent description of the risk of severe RP in all three cohorts (2FB, 3FS, 4FS) simultaneously. Conclusions: When predicting risk of grade {>=}3 RP, the mean lung dose does not adequately take into account the effects of high doses. Instead, the effective dose, computed from the LKB model using volume parameter n=0.41, may provide a better dosimetric parameter for predicting RP risk. If confirmed, these findings support the conclusion that for the same MLD, high doses to small lung volumes ('a lot to a little') are worse than low doses to large volumes ('a little to a lot').

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

MRI-Guided High–Dose-Rate Intracavitary Brachytherapy for Treatment of Cervical Cancer: The University of Pittsburgh Experience

Purpose: Image-based brachytherapy is increasingly used for gynecologic malignancies. We report early outcomes of magnetic resonance imaging (MRI)-guided brachytherapy. Methods and Materials: Consecutive patient cases with FIGO stage IB1 to IVA cervical cancer treated at a single institution were retrospectively reviewed. All patients received concurrent cisplatin with external beam radiation therapy along with interdigitated high–dose-rate intracavitary brachytherapy. Computed tomography or MRI was completed after each application, the latter acquired for at least 1 fraction. High-risk clinical target volume (HRCTV) and organs at risk were identified by Groupe Européen de Curiethérapie and European SocieTy for Radiotherapy and Oncology guidelines. Doses were converted to equivalent 2-Gy doses (EQD{sub 2}) with planned HRCTV doses of 75 to 85 Gy. Results: From 2007 to 2013, 128 patients, median 52 years of age, were treated. Predominant characteristics included stage IIB disease (58.6%) with a median tumor size of 5 cm, squamous histology (82.8%), and no radiographic nodal involvement (53.1%). Most patients (67.2%) received intensity modulated radiation therapy (IMRT) at a median dose of 45 Gy, followed by a median brachytherapy dose of 27.5 Gy (range, 25-30 Gy) in 5 fractions. At a median follow up of 24.4 months (range, 2.1-77.2 months), estimated 2-year local control, disease-free survival, and cancer-specific survival rates were 91.6%, 81.8%, and 87.6%, respectively. Predictors of local failure included adenocarcinoma histology (P<.01) and clinical response at 3 months (P<.01). Among the adenocarcinoma subset, receiving HRCTV D{sub 90} EQD{sub 2} ≥84 Gy was associated with improved local control (2-year local control rate 100% vs 54.5%, P=.03). Grade 3 or greater gastrointestinal or genitourinary late toxicity occurred at a 2-year actuarial rate of 0.9%. Conclusions: This study constitutes one of the largest reported series of MRI-guided brachytherapy in North America, demonstrating excellent local control with acceptable morbidity. Dose escalation may be warranted when feasible for adenocarcinomas to offset the risk of local failure.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Near Real-Time Assessment of Anatomic and Dosimetric Variations for Head and Neck Radiation Therapy via Graphics Processing Unit–based Dose Deformation Framework

Purpose: The purpose of this study was to systematically monitor anatomic variations and their dosimetric consequences during intensity modulated radiation therapy (IMRT) for head and neck (H&N) cancer by using a graphics processing unit (GPU)-based deformable image registration (DIR) framework. Methods and Materials: Eleven IMRT H&N patients undergoing IMRT with daily megavoltage computed tomography (CT) and weekly kilovoltage CT (kVCT) scans were included in this analysis. Pretreatment kVCTs were automatically registered with their corresponding planning CTs through a GPU-based DIR framework. The deformation of each contoured structure in the H&N region was computed to account for nonrigid change in the patient setup. The Jacobian determinant of the planning target volumes and the surrounding critical structures were used to quantify anatomical volume changes. The actual delivered dose was calculated accounting for the organ deformation. The dose distribution uncertainties due to registration errors were estimated using a landmark-based gamma evaluation. Results: Dramatic interfractional anatomic changes were observed. During the treatment course of 6 to 7 weeks, the parotid gland volumes changed up to 34.7%, and the center-of-mass displacement of the 2 parotid glands varied in the range of 0.9 to 8.8 mm. For the primary treatment volume, the cumulative minimum and mean and equivalent uniform doses assessed by the weekly kVCTs were lower than the planned doses by up to 14.9% (P=.14), 2% (P=.39), and 7.3% (P=.05), respectively. The cumulative mean doses were significantly higher than the planned dose for the left parotid (P=.03) and right parotid glands (P=.006). The computation including DIR and dose accumulation was ultrafast (∼45 seconds) with registration accuracy at the subvoxel level. Conclusions: A systematic analysis of anatomic variations in the H&N region and their dosimetric consequences is critical in improving treatment efficacy. Nearly real-time assessment of anatomic and dosimetric variations is feasible using the GPU-based DIR framework. Clinical implementation of this technology may enable timely plan adaptation and improved outcome.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Dosimetry Modeling for Focal Low-Dose-Rate Prostate Brachytherapy

Purpose: Focal brachytherapy targeted to an individual lesion(s) within the prostate may reduce side effects experienced with whole-gland brachytherapy. The outcomes of a consensus meeting on focal prostate brachytherapy were used to investigate optimal dosimetry of focal low-dose-rate (LDR) prostate brachytherapy targeted using multiparametric magnetic resonance imaging (mp-MRI) and transperineal template prostate mapping (TPM) biopsy, including the effects of random and systematic seed displacements and interseed attenuation (ISA). Methods and Materials: Nine patients were selected according to clinical characteristics and concordance of TPM and mp-MRI. Retrospectively, 3 treatment plans were analyzed for each case: whole-gland (WG), hemi-gland (hemi), and ultra-focal (UF) plans, with 145-Gy prescription dose and identical dose constraints for each plan. Plan robustness to seed displacement and ISA were assessed using Monte Carlo simulations. Results: WG plans used a mean 28 needles and 81 seeds, hemi plans used 17 needles and 56 seeds, and UF plans used 12 needles and 25 seeds. Mean D90 (minimum dose received by 90% of the target) and V100 (percentage of the target that receives 100% dose) values were 181.3 Gy and 99.8% for the prostate in WG plans, 195.7 Gy and 97.8% for the hemi-prostate in hemi plans, and 218.3 Gy and 99.8% for the focal target in UF plans. Mean urethra D10 was 205.9 Gy, 191.4 Gy, and 92.4 Gy in WG, hemi, and UF plans, respectively. Mean rectum D2 cm{sup 3} was 107.5 Gy, 77.0 Gy, and 42.7 Gy in WG, hemi, and UF plans, respectively. Focal plans were more sensitive to seed displacement errors: random shifts with a standard deviation of 4 mm reduced mean target D90 by 14.0%, 20.5%, and 32.0% for WG, hemi, and UF plans, respectively. ISA has a similar impact on dose-volume histogram parameters for all plan types. Conclusions: Treatment planning for focal LDR brachytherapy is feasible. Dose constraints are easily met with a notable reduction to organs at risk. Treating smaller targets makes seed positioning more critical.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2017

Adjuvant Radiation Therapy for Margin-Positive Vulvar Squamous Cell Carcinoma: Defining the Ideal Dose-Response Using the National Cancer Data Base

Purpose: Positive surgical margins after radical vulvectomy for vulvar cancer portend a high risk for local relapse, which may be challenging to salvage. We assessed the impact of adjuvant radiation therapy (aRT) on overall survival (OS) and the dose-response relationship using the National Cancer Data Base. Methods and Materials: Patients with vulvar squamous cell carcinoma who underwent initial extirpative surgery with positive margins from 1998 to 2012 were included. Factors associated with aRT and specific dose levels were analyzed using logistic regression. Log-rank and multivariable Cox proportional hazards modeling were used for OS analysis. Results: We identified 3075 patients with a median age of 66 years (range, 22-90 years); the median follow-up time was 36.4 months (interquartile range [IQR] 15.4-71.0 months). Stage IA/B disease represented 41.2% of the cohort. Sixty-three percent underwent lymph node assessment, with a 45% positivity rate. In total, 1035 patients (35.3%) received aRT, with a median dose of 54.0 Gy (IQR 48.6-60.0 Gy). The 3-year OS improved from 58.5% to 67.4% with aRT (P<.001). On multivariable analysis, age, Charlson-Deyo score ≥1, stage ≥II, tumors ≥4 cm, no aRT, and adverse nodal characteristics led to inferior survival. Dose of aRT was positively associated with OS as a continuous variable on univariate analysis (P<.001). The unadjusted 3-year OS for dose subsets 30.0 to 45.0 Gy, 45.1 to 53.9 Gy, 54.0 to 59.9 Gy, and ≥60 Gy was 54.3%, 55.7%, 70.1%, and 65.3%, respectively (P<.001). Multivariable analysis using a 4-month conditional landmark revealed that the greatest mortality reduction occurred in cumulative doses ≥54 Gy: 45.1 to 53.9 Gy (hazard ratio [HR] 0.94, P=.373), 54.0 to 59.9 Gy (HR 0.75, P=.024), ≥60 Gy (HR 0.71, P=.015). No survival benefit was seen with ≥60 Gy compared with 54.0 to 59.9 Gy (HR 0.95, P=.779). Conclusions: Patients with vulvar squamous cell carcinoma and positive surgical margins derive an OS benefit from aRT with a seemingly optimal dose in the range of 54.0 to 59.9 Gy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2017

Tolerance of the Brachial Plexus to High-Dose Reirradiation

Purpose: To study the tolerance of the brachial plexus to high doses of radiation exceeding historically accepted limits by analyzing human subjects treated with reirradiation for recurrent tumors of the head and neck. Methods and Materials: Data from 43 patients who were confirmed to have received overlapping dose to the brachial plexus after review of radiation treatment plans from the initial and reirradiation courses were used to model the tolerance of this normal tissue structure. A standardized instrument for symptoms of neuropathy believed to be related to brachial plexus injury was utilized to screen for toxicity. Cumulative dose was calculated by fusing the initial dose distributions onto the reirradiation plan, thereby creating a composite plan via deformable image registration. The median elapsed time from the initial course of radiation therapy to reirradiation was 24 months (range, 3-144 months). Results: The dominant complaints among patients with symptoms were ipsilateral pain (54%), numbness/tingling (31%), and motor weakness and/or difficulty with manual dexterity (15%). The cumulative maximum dose (Dmax) received by the brachial plexus ranged from 60.5 Gy to 150.1 Gy (median, 95.0 Gy). The cumulative mean (Dmean) dose ranged from 20.2 Gy to 111.5 Gy (median, 63.8 Gy). The 1-year freedom from brachial plexus–related neuropathy was 67% and 86% for subjects with a cumulative Dmax greater than and less than 95.0 Gy, respectively (P=.05). The 1-year complication-free rate was 66% and 87%, for those reirradiated within and after 2 years from the initial course, respectively (P=.06). Conclusion: The development of brachial plexus–related symptoms was less than expected owing to repair kinetics and to the relatively short survival of the subject population. Time-dose factors were demonstrated to be predictive of complications.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2017

Dose distribution characteristic study of the Rotating Gamma Knife (RGK) by using the geometry analytic method

The purpose of this study was to realize the processing of dose distribution of RGK at the treatment isocenter at any gantry rotational angle by using an analytic geometry method to avoid inadequate arc therapy angles when implementing the treatment plan. Gaf chromic film was used for dose evaluation. A calibration curve was first obtained using linear accelerator irradiation. The 50% dose relative to the central axis at fixed gantry angles at the x-, y- and z-axes was obtained using Gaf chromic film and was compared to the analytic geometry method. The full width half maximum (FWHM) on the x-, y- and z-axes was predicted for the RGK dose distribution characteristic analysis. The FWHM on the x-, y-, and z-axes varies with different gantry and rotational plate angles. The most dramatic intersection variation appeared at a static gantry angle of 25°. The ratio of the FWHM of the y- and z-axes to that of the x-axis was up to 9 and 10. The geometric analytic method can be used for an accurate analysis of dose distribution in RGK replacing the actual film exposure experiment. It is essential to select the best arc irradiation angle to prescribe the dose to avoid excess irradiation of normal tissue. The geometric method used in this study can also be applied for rotational arc therapy dose analysis such as tomotherapy, linear-based stereotactic radiotherapy, or volume matrices arc therapy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗