Limited information has been reported on the dosimetry achieved with the MammoSite breast brachytherapy applicator. We present our results regarding the volume of treatment and a comparison of a ...single prescription point, single dwell position optimization technique with a six prescription point, multiple dwell position method.
Between October 14, 2002 and February 28, 2003, 21 patients with early-stage breast cancer were treated using the MammoSite device. The treatment was delivered in 10 fractions of 3.4 Gy/fraction, b.i.d., with a minimum of 6 hours between the daily fractions. CT of the lumpectomy cavity was obtained both with and without the inflated balloon. A planning target volume was constructed using a three-dimensional planning system. A three-dimensional expansion of the balloon surface was performed using the chest wall and skin as limiting structures. The volume of the inflated balloon was removed from this volume, and the volume of tissue treated in each patient was determined. A sequential expansion in 1-mm increments around the empty lumpectomy cavity was performed until the closest equivalent volume to the planning target volume was obtained. The treatment for the patients in this study was planned using both a single prescription point, single dwell position optimization technique and a six-prescription point, multiple dwell position technique. The single prescription point method has been described in a previous publication. The six-prescription point method used six points placed 1 cm from the balloon surface. Four points are in a plane transverse to the balloon axis perpendicular to the axis of the catheter, and two points are placed along the axis of the catheter. The prescription points along the catheter axis are used to compensate for the decreased dose coverage owing to anisotropy dose distribution of the source. The Nucletron HDR Plato Brachytherapy planning system was used to optimize the source positions and dwell times.
The volume of breast tissue treated by the MammoSite device was equal to the volume encompassed by a mean 1.6-cm (SD, 0.1) margin around the empty lumpectomy cavity. Compared with the single prescription point optimization method, the six prescription point method provided better dose coverage, with a mean percentage of volume receiving 90% of the prescription dose of 97.2% (SD = 2.1) vs. 89.5% (SD = 4.6) for the single-point method. The mean percentage of volume receiving 100% of the prescription dose was 88.9% (SD = 3.3) for the six-point method vs. 77.6% (SD = 6.1) for the single-point method. However, compared with the single-point method, the six-point optimization method resulted in treatment that was less uniform, with a mean dose homogeneity index of 0.62 (SD = .07) vs. 0.66 (SD = .08) for the single-point method.
The volume of normal breast tissue treated by the MammoSite device is comparable to other methods of interstitial brachytherapy that treat a 1–2-cm margin of tissue around the excision cavity. The six-prescription point, multiple dwell position method improved dose coverage with a slight decrease in dose homogeneity. The six-point method offers greater reliability of dose coverage compared with the single-point method by providing an increased number of reference points.
The nucletron Leipzig applicator is designed for (HDR)
Ir
192
brachy radiotherapy of surface lesions. The dosimetric characteristics of this applicator were investigated using simulation method based ...on Monte Carlo N-particle (MCNP) code and phantom measurements. The simulation method was validated by comparing calculated dose rate distributions of nucletron microSelectron HDR
Ir
192
source against published data. Radiochromic films and metal-oxide-semiconductor field-effect transistor (MOSFET) detectors were used for phantom measurements. The double exposure technique, correcting the nonuniform film sensitivity, was applied in the film dosimetry. The linear fit of multiple readings with different irradiation times performed for each MOSFET detector measurement was used to obtain the dose rate of each measurement and to correct the source transit-time error. The film and MOSFET measurements have uncertainties of 3%–7% and 3%–5%, respectively. The dose rate distributions of the Leipzig applicator with
30
mm
opening calculated by the validated MC method were verified by measurements of film and MOSFET detectors. Calculated two-dimensional planar dose rate distributions show similar patterns as the film measurement. MC calculated dose rate at a reference point defined at depth
5
mm
on the applicator’s central axis is 7% lower than the film and 3% higher than the MOSFET measurements. The dose rate of a Leipzig applicator with
30
mm
opening at reference point is
0.241
±
3
%
cGy
h
−
1
U
−
1
. The MC calculated depth dose rates and profiles were tabulated for clinic use.
Excitation-energy-gated two-fragment correlation functions have been studied between E(*)/A = (2-9)A MeV for equilibriumlike sources formed in 8-10 GeV/c pi(-) and p+197Au reactions. Comparison with ...an N-body Coulomb-trajectory code shows an order of magnitude decrease in the fragment emission time in the interval E(*)/A = (2-5)A MeV, followed by a nearly constant breakup time at higher excitation energy. The decrease in emission time is strongly correlated with the onset of multifragmentation and thermally induced radial expansion, consistent with a transition from surface-dominated to bulk emission expected for spinodal decomposition.
Multi-fragment decays of
129Xe,
197Au and
238U projectiles in collisions with Be, C, Al, Cu, In, Au and U targets at energies between
E
A
= 400
and 1000 MeV have been studied with the ALADIN ...forward-spectrometer at SIS. By adding an array of 84 SiCsI(Tl) telescopes the solid-angle coverage of the setup was extended to
θ
lab = 16°. This permitted the complete detection of fragments from the projectile-spectator source.
The dominant feature of the systematic set of data is the
Z
bound universality that is obeyed by the fragment multiplicities and correlations. These observables are invariant with respect to the entrance channel if plotted as a function of
Z
bound, where
Z
bound is the sum of the atomic numbers
Z
i
of all projectile fragments with
Z
i
⩾ 2. No significant dependence on the bombarding energy nor on the target mass is observed. The dependence of the fragment multiplicity on the projectile mass follows a linear scaling law.
The reasons for and the limits of the observed universality of spectator fragmentation are explored within the realm of the available data and with model studies. It is found that the universal properties should persist up to much higher bombarding energies than explored in this work and that they are consistent with universal features exhibited by the intranuclear cascade and statistical multifragmentation models.
We present a technique to optimize the dwell times and positions of a high-dose-rate (192)Ir source using the MammoSite breast brachytherapy applicator. The surface optimization method used multiple ...dwell positions and optimization points to conform the 100% isodose line to the surface of the planning target volume (PTV).
The study population consisted of 20 patients treated using the MammoSite device between October 2002 and February 2004. Treatment was delivered in 10 fractions of 3.4 Gy/fraction, twice daily, with a minimum of 6 h between fractions. The treatment of each patient was planned using three optimization techniques. The dosimetric characteristics of the single-point, six-point, and surface optimization techniques were compared.
The surface optimization technique increased the PTV coverage compared with the single- and six-point methods (mean percentage of PTV receiving 100% of the prescription dose was 94%, 85%, and 91%, respectively). The surface method, single-point, and six-point method had a mean dose homogeneity index of 0.62, 0.68, and 0.63 and a mean full width at half maximum value of 189, 190, and 192 cGy/fraction, respectively.
The surface technique provided greater coverage of the PTV than did the single- and six-point methods. Using the FWHM method, the surface, single-, and six-point techniques resulted in equivalent dose homogeneity.
A percolation model of nuclear fragmentation is used to interpret 10.2 GeV/c p+197Au multifragmentation data. Emphasis is put on finding signatures of a continuous nuclear matter phase transition in ...finite nuclear systems. Based on model calculations, corrections accounting for physical constraints of the fragment detection and sequential decay processes are derived. Strong circumstantial evidence for a continuous phase transition is found, and the values of two critical exponents, sigma = 0.5+/-0.1 and tau = 2.35+/-0.05, are extracted from the data. A critical temperature of T(c) = 8.3+/-0.2 MeV is found.
Phantom measurements and Monte Carlo calculations have been performed for the purpose of characterizing the dose perturbation caused by radiographic contrast inside the MammoSite breast brachytherapy ...applicator. Specifically, the dose perturbation is quantified as a heterogeneity correction factor (HCF) for various balloon radii and contrast concentration levels. The dose perturbation is larger for larger balloon radii and higher contrast concentrations. Based on a validated Monte Carlo simulation, the calculated HCF values are 0.99 for a 2 cm radius balloon and 0.98 for a 3 cm radius balloon at 6% contrast concentration levels, and 0.89 and 0.87 for 2 and 3 cm radius balloons, respectively, at 100% contrast concentrations. For a typical implanted balloon radius of 2.4 cm, the HCF values decrease from 0.99 at 6% contrast concentration to 0.90 at 100% contrast concentration. For balloons implanted in patients at our institution, the mean HCF is 0.99, corresponding to a dose reduction of approximately 1%. The contrast effect results in a systematic reduction in the delivered dose, therefore the minimal amount of radiographic contrast necessary should be used.
: We present our results regarding the cosmetic outcome achieved and the rate of infection using the MammoSite breast brachytherapy applicator to treat patients with partial breast irradiation. In ...addition, factors associated with cosmetic outcome and infection are analyzed. The study population consisted of 30 patients with early stage breast cancer treated using the MammoSite device from October 28, 2002, to February 13, 2004. Cosmetic outcome was analyzed for its association with the following parameters: volume of the balloon, balloon‐to‐skin distance, maximal skin point dose per fraction, V100 (percent of volume that received 100% of the prescription dose), V150 (percent of volume that received 150% of the prescription dose), and V200 (percent of volume that received 200% of the prescription dose). The occurrence of infection at the time of treatment and during follow‐up was also recorded. At a median follow‐up of 13 months (range 1–16 months), 53.3% of the patients (16/30) were reported to have an excellent cosmetic outcome and 40.0% (12/30) had a good cosmetic outcome. Excellent cosmetic outcome was associated with a greater mean balloon‐to‐skin distance compared to those who achieved a good cosmetic outcome (1.5 cm versus 1.2 cm) (p = 0.164). The mean V100, V150, and V200 of those in the excellent cosmetic outcome group were 92.1%, 34.5%, and 7.6% versus 93.0%, 34.7%, and 7.6% in the good cosmetic outcome group (p = 0.642, 0.926, and 0.853), The mean balloon volumes were 47.7 cm3 and 56.9 cm3, respectively (p = 0.063) in the excellent and good outcome groups. The mean maximal skin doses per fraction in the excellent and good outcome groups were 354.8 cGy and 422.3 cGy (p = 0.286), respectively. Infection occurred in 13.3% of the patients (4/30). An excellent or good cosmetic outcome was achieved in 93.3% of patients and infection occurred in 13.3% of patients treated with the MammoSite breast brachytherapy applicator. Excellent cosmetic outcome was associated with a greater balloon‐to‐skin distance, lower maximal skin dose per fraction, and smaller mean balloon volume; however, the results did not reach statistical significance.
Multifragment disintegrations, measured for central Au + Au collisions at
E
A
= 35
MeV
, are analyzed with the Statistical Multifragmentation Model. Charge distributions, mean fragment energies, and ...two-fragment correlation functions are well reproduced by the statistical breakup of a large, diluted and thermalized system slightly above the multifragmentation threshold.
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