Low-dose radiotherapy to the lungs using an interventional radiology C-arm fluoroscope: Monte Carlo treatment planning and dose measurements in a postmortem subject.

Autor:	Leon S; Department of Radiology, University of Florida, Gainesville, FL 32610, United States of America., Paucar O; Facultad de Ingenieria Electrica y Electronica, Universidad Nacional de Ingenieria-Lima, Peru., Correa N; Department of Radiology, University of Florida, Gainesville, FL 32610, United States of America., Glassell M; Department of Radiology, University of Florida, Gainesville, FL 32610, United States of America., Gonzales A; Facultad de Ciencias, Universidad Nacional de Ingenieria-Lima, Peru., Olguin E; Department of Radiology, Beth Israel Beaconess Medical Center, Boston, MA 02215, United States of America., Shankar A; Department of Radiology, University of Florida, Gainesville, FL 32610, United States of America., Moskvin V; Department of Radiation Oncology, St. Judes Children's Research Hospital, Memphis, TN 38105, United States of America., Schwarz B; Department of Radiology, University of Florida, Gainesville, FL 32610, United States of America., Alva-Sanchez M; Department of Exact and Applied Sciences, University of Health Sciences of Porto Alegre-Porto Alegre, Brazil., Moyses H; Department of Radiation Oncology, University of California, Irvine Health, Orange, CA 92868, United States of America., Hamrick B; Environmental Health and Safety, University of California, Irvine Health, Orange, CA 92868, United States of America., Sarria GR; University Hospital Bonn, Department of Radiation Oncology, University of Bonn, Bonn, Germany., Li B; Department of Radiation Oncology, University of California, San Francisco, CA 94115, United States of America., Tajima T; Department of Physics and Astronomy, University of California, Irvine, CA 92697, United States of America., Necas A; TAE Technologies, Foothill Ranch, CA 92610, United States of America., Guzman C; Facultad de Medicina Humana, Universidad Ricardo Palma-Lima, Peru., Challco R; Facultad de Ciencias, Universidad Nacional de Ingenieria-Lima, Peru., Montoya M; Facultad de Ciencias, Universidad Nacional de Ingenieria-Lima, Peru., Meza Z; Facultad de Ciencias, Universidad Nacional de Ingenieria-Lima, Peru., Zapata M; Facultad de Ciencias, Universidad Nacional de Ingenieria-Lima, Peru., Gonzales A; Universidad Tecnológica del Peru-Lima, Peru.; Aliada Centro Oncologico-Lima, Peru., Marquina J; Aliada Centro Oncologico-Lima, Peru., Quispe K; Aliada Centro Oncologico-Lima, Peru., Chavez T; Aliada Centro Oncologico-Lima, Peru., Castilla L; Aliada Centro Oncologico-Lima, Peru., Moscoso J; Aliada Centro Oncologico-Lima, Peru., Ramirez J; Aliada Centro Oncologico-Lima, Peru., Marquez F; Facultad de Ciencias Físicas, Universidad Nacional Mayor de San Marcos-Lima, Peru., Neira R; Instituto Nacional de Enfermedades Neoplasicas-Lima, Peru., Vilca W; Instituto Nacional de Enfermedades Neoplasicas-Lima, Peru., Mendez J; Facultad de Ciencias Naturales y Matemática, Universidad Nacional del Callao-Callao, Peru., Hernandez J; HRS Oncology International, Las Vegas, NV 89119, United States of America., Roa D; Department of Radiation Oncology, University of California, Irvine Health, Orange, CA 92868, United States of America.
Jazyk:	angličtina
Zdroj:	Biomedical physics & engineering express [Biomed Phys Eng Express] 2022 Sep 05; Vol. 8 (6). Date of Electronic Publication: 2022 Sep 05.
DOI:	10.1088/2057-1976/ac8939
Abstrakt:	Objective. The goal of this study was to use Monte Carlo (MC) simulations and measurements to investigate the dosimetric suitability of an interventional radiology (IR) c-arm fluoroscope to deliver low-dose radiotherapy to the lungs. Approach. A previously-validated MC model of an IR fluoroscope was used to calculate the dose distributions in a COVID-19-infected patient, 20 non-infected patients of varying sizes, and a postmortem subject. Dose distributions for PA, AP/PA, 3-field and 4-field treatments irradiating 95% of the lungs to a 0.5 Gy dose were calculated. An algorithm was created to calculate skin entrance dose as a function of patient thickness for treatment planning purposes. Treatments were experimentally validated in a postmortem subject by using implanted dosimeters to capture organ doses. Main results. Mean doses to the left/right lungs for the COVID-19 CT data were 1.2/1.3 Gy, 0.8/0.9 Gy, 0.8/0.8 Gy and 0.6/0.6 Gy for the PA, AP/PA, 3-field, and 4-field configurations, respectively. Skin dose toxicity was the highest probability for the PA and lowest for the 4-field configuration. Dose to the heart slightly exceeded the ICRP tolerance; all other organ doses were below published tolerances. The AP/PA configuration provided the best fit for entrance skin dose as a function of patient thickness (R 2  = 0.8). The average dose difference between simulation and measurement in the postmortem subject was 5%. Significance. An IR fluoroscope should be capable of delivering low-dose radiotherapy to the lungs with tolerable collateral dose to nearby organs. (© 2022 IOP Publishing Ltd.)
Databáze:	MEDLINE
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