Laboratory of Medical Physics, Istituto Regina Elena, via Elio Chianesi 53, 00144 Rome, Italy.
Med Phys. 2010 Mar;37(3):995-1003. doi: 10.1118/1.3298012.
The aim of this study is to investigate radioprotection issues that must be addressed when dedicated accelerators for intraoperative radiotherapy (IORT) are used in operating rooms. Recently, a new version of a mobile IORT accelerator (LIAC Sordina SpA, Italy) with 12 MeV electron beam has been implemented. This energy is necessary in some specific pathology treatments to allow a better coverage of thick lesions. At an electron energy of 10 MeV, leakage and scattered x-ray radiation (stray radiation) coming from the accelerator device and patient must be considered. If the energy is greater than 10 MeV, the x-ray component will increase; however, the most meaningful change should be the addition of neutron background. Therefore, radiation exposure of personnel during the IORT procedure needs to be carefully evaluated.
In this study, stray x-ray radiation was measured and characterized in a series of spherical projections by means of an ion chamber survey meter. To simulate the patient during all measurements, a polymethylmethacrylate (PMMA) slab phantom with volume 30 x 30 x 15 cm3 and density 1.19 g / cm3 was used. The PMMA phantom was placed along the central axis of the beam in order to absorb the electron beams and the tenth value layer (TVL) and half value layer (HVL) of scattered radiation (at 0 degrees, 90 degrees, and 180 degrees scattering angles) were also measured at 1 m of distance from the phantom center. Neutron measurements were performed using passive bubble dosimeters and a neutron probe, specially designed to evaluate ambient dose equivalent H*(10).
The x-ray equivalent dose measured at 1 m along the beam axis at 12 MeV was 260 microSv/Gy. The value measured at 1 m at 90 degrees scattering angle was 25 microSv/Gy. The HVL and TVL values were 1.1 and 3.5 cm of lead at 0 degrees, and 0.4 and 1 cm at 90 degrees, respectively. The highest equivalent dose of fast neutrons was found to be at the surface of the phantom on the central beam axis (2.9 +/- 0.6 microSv/Gy), while a lower value was observed below the phantom (1.6 +/- 0.3 microSv/Gy). The neutron dose equivalent at 90 degrees scattering angle and on the floor plane on the beam axis below the beam stopper was negligible.
Our data confirm that neutron exposure levels around the new dedicated IORT accelerator are very low. Mobile shielding panels can be used to reduce x-ray levels to below regulatory levels without necessarily providing permanent shielding in the operating room.
本研究旨在探讨术中放疗(IORT)专用加速器在手术室使用时必须解决的辐射防护问题。最近,一种新型的移动 IORT 加速器(LIAC Sordina SpA,意大利)已投入使用,其电子束能量为 12 MeV。在某些特定的病理治疗中,需要这种能量来更好地覆盖厚病变。在电子能量为 10 MeV 时,必须考虑来自加速器设备和患者的泄漏和散射 X 射线辐射(散射线)。如果能量大于 10 MeV,X 射线分量将会增加;然而,最有意义的变化应该是增加中子背景。因此,需要仔细评估 IORT 过程中人员的辐射暴露。
在这项研究中,通过离子室测量仪对一系列球形投影中的散射线辐射进行了测量和特征描述。为了在所有测量中模拟患者,使用了一个 30 x 30 x 15 cm3 体积和 1.19 g / cm3 密度的聚甲基丙烯酸甲酯(PMMA)平板体模。PMMA 体模放置在光束的中心轴线上,以吸收电子束,并且还在距体模中心 1 米处测量了散射辐射的第十值层(TVL)和半值层(HVL)(在 0 度、90 度和 180 度散射角)。使用被动气泡剂量计和专门设计用于评估环境剂量当量 H*(10)的中子探头进行了中子测量。
在 12 MeV 沿光束轴在 1 米处测量的 X 射线当量剂量为 260 微Sv / Gy。在 90 度散射角处 1 米处测量的数值为 25 微Sv / Gy。0 度时 HVL 和 TVL 值分别为 1.1 和 3.5 cm 铅,90 度时分别为 0.4 和 1 cm。在体模中心束轴的表面上发现快中子的当量剂量最高(2.9 +/- 0.6 微Sv / Gy),而在体模下方则观察到较低的剂量(1.6 +/- 0.3 微Sv / Gy)。在 90 度散射角和光束轴下方光束截止器下方的地板平面上的中子剂量当量可忽略不计。
我们的数据证实,新型专用 IORT 加速器周围的中子辐射水平非常低。可以使用移动屏蔽板将 X 射线水平降低到监管水平以下,而无需在手术室中提供永久性屏蔽。