Kakino Ryo, Hu Naonori, Tanaka Hiroki, Takeno Satoshi, Aihara Teruhito, Nihei Keiji, Ono Koji
Kansai BNCT Medical Center, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.
Institute for Integrated Radiation and Nuclear Science, Kyoto University, Osaka, Japan.
Med Phys. 2024 Feb;51(2):1351-1363. doi: 10.1002/mp.16916. Epub 2023 Dec 28.
The out-of-field radiation dose for boron neutron capture therapy (BNCT), which results from both neutrons and γ-rays, has not been extensively evaluated. To safely perform BNCT, the neutron and γ-ray distributions inside the treatment room and the whole-body dose should be evaluated during commissioning. Although, certain previous studies have evaluated the whole-body dose in the clinical research phase, no institution providing BNCT covered by health insurance has yet validated the neutron distribution inside the room and the whole-body dose.
To validate the Monte Carlo model of the BNCT irradiation room extended for the whole-body region and evaluate organ-at-risk (OAR) doses using the validated model with a human-body phantom.
First, thermal neutron distribution inside the entire treatment room was measured by placing Au samples on the walls of the treatment room. Second, neutron and gamma-ray dose-rate distributions inside a human-body water phantom were measured. Both lying and sitting positions were considered. Bare Au, Au covered by Cd (Au+Cd), In, Al, and thermoluminescent dosimeters were arranged at 11 points corresponding to locations of the OARs inside the phantom. After the irradiation, γ-ray peaks emitted from the samples were measured by a high-purity germanium detector. The measured counts were converted to the reaction rate per unit charge of the sample. These measurements were compared with results of simulations performed with the Particle and Heavy Ion Transport code System (PHITS). A male adult mesh-type reference computational phantom was used to evaluate OAR doses in the whole-body region. The relative biological effectiveness (RBE)-weighted doses and dose-volume histograms (DVHs) for each OAR were evaluated. The median dose (D ) and near-maximum dose (D ) were evaluated for 14 OARs in a 1-h-irradiation process. The evaluated RBE-weighted doses were converted to equivalent doses in 2 Gy fractions.
Experimental results within 60 cm from the irradiation center agreed with simulation results within the error bars except at ±20, 30 cm, and those over 70 cm corresponded within one digit. The experimental results of reaction rates or γ-ray dose rate for lying and sitting positions agreed well with the simulation results within the error bars at 8, 4, 11, 7 and 7, 4, 7, 6, 5, 6 out of 11 points, respectively, for Au, Au+Cd, In, Al, and TLD. Among the detectors, the discrepancies in reaction rates between experiment and simulation were most common for Au+Cd, but were observed randomly for measurement points (brain, lung, etc.). The experimental results of γ-ray dose rates were systematically lower than simulation results at abdomen and waist regions for both positions. Extending the PHITS model to the whole-body region resulted in higher doses for all OARs, especially 0.13 Gy-eq increase for D of the left salivary gland.
The PHITS model for clinical BNCT for the whole-body region was validated, and the OAR doses were then evaluated. Clinicians and medical physicists should know that the out-of-field radiation increases the OAR dose in the whole-body region.
硼中子俘获疗法(BNCT)的野外辐射剂量,源于中子和γ射线,尚未得到广泛评估。为安全实施BNCT,在调试期间应评估治疗室内的中子和γ射线分布以及全身剂量。尽管之前有一些研究在临床研究阶段评估了全身剂量,但尚无提供医保覆盖的BNCT机构验证过室内中子分布和全身剂量。
验证扩展至全身区域的BNCT照射室的蒙特卡洛模型,并使用经过验证的模型和人体模型评估危及器官(OAR)的剂量。
首先,通过在治疗室墙壁上放置金样品来测量整个治疗室内的热中子分布。其次,测量人体水模内的中子和γ射线剂量率分布。考虑了平躺和坐姿两种情况。在与模型内OAR位置相对应的11个点处布置裸金、镉覆盖金(Au + Cd)、铟、铝和热释光剂量计。照射后,用高纯锗探测器测量样品发射的γ射线峰。将测量的计数转换为样品每单位电荷的反应率。将这些测量结果与使用粒子与重离子输运代码系统(PHITS)进行的模拟结果进行比较。使用男性成人网格型参考计算模型评估全身区域的OAR剂量。评估每个OAR的相对生物效应(RBE)加权剂量和剂量体积直方图(DVH)。在1小时照射过程中,评估了14个OAR的中位剂量(D)和近最大剂量(D)。将评估的RBE加权剂量转换为2 Gy分次的当量剂量。
距照射中心60 cm以内的实验结果与误差范围内的模拟结果一致,但在±20、30 cm处以及超过70 cm处的结果相差一位数。平躺和坐姿下反应率或γ射线剂量率的实验结果,在11个点中的8、4、11、7和7、4、7、6、5、6点,分别与Au、Au + Cd、铟、铝和热释光剂量计的误差范围内的模拟结果良好吻合。在这些探测器中,Au + Cd的实验与模拟反应率差异在测量点(脑、肺等)中最为常见,但为随机出现。两种姿势下腹部和腰部区域的γ射线剂量率实验结果均系统地低于模拟结果。将PHITS模型扩展到全身区域导致所有OAR的剂量更高,尤其是左唾液腺的D增加了0.13 Gy - eq。
验证了用于全身区域临床BNCT的PHITS模型,并评估了OAR剂量。临床医生和医学物理学家应了解野外辐射会增加全身区域的OAR剂量。