DOSIMETRY OF BRACHYTHERAPY SOURCES IN MILLIMETER RANGE
Project Number1R01HL058022-01
Contact PI/Project LeaderNATH, RAVINDER
Awardee OrganizationYALE UNIVERSITY
Description
Abstract Text
DESCRIPTION: (Adapted from the applicant's abstract): Restenosis is the
major limitation of coronary angioplasty. Recently brachytherapy has
emerged as a potential treatment for restenosis using photon emitters such
as 192Ir, 125I, 103Pd and beta emitters such as 32P, 90Sr, and 90Y. Two
approaches under investigation for intravascular brachytherapy are: (i) use
of a radioactive source at the end of a catheter, (ii) permanent
implantation of a radioactive stent at the occlusion site. The first is an
example of temporary intracavitary brachytherapy where radioactive sources
are placed in a body cavity near the target lesion; the other is an example
of permanent brachytherapy where radioactive sources are implanted in the
target lesion. It is well known that dose gradients in the immediate
vicinity of the radioactive sources are very high because of the geometric
and tissue attenuation effects. Traditionally, the dose to the target is
specified at a distance of 1 cm from the source. At this reference distance
the dosimetry of brachytherapy sources is reasonably well established.
However, the intended target for irradiation in intravascular brachytherapy
is much smaller, in the range of 1 - 3 mm. At these short distances, the
dosimetry is highly uncertain and needs improvement. One of the major
reasons for dose uncertainty at short distances may be the contribution from
low energy secondary radiations, such as fluorescent x rays, beta particles,
secondary electrons etc., which are primarily absorbed in the source
encapsulation or the first few mm of tissue around the source. Their
effects are largely ignored in traditional brachytherapy dosimetry because
only a small fraction of the target volume is affected by them. This is,
however, not true for intravascular brachytherapy where the entire target
may be within millimeters of the source. With many investigations currently
underway, mostly with commercial support, to determine the efficacy of
intravascular brachytherapy, there is a tremendous need to not only
standardize the prescription of dose, but importantly to also determine the
dose delivered over short distances. This dosimetry may well be
significantly different depending on specific radionuclide as well as design
of source and applicators. In this project, the physics of intravascular
brachytherapy dosimetry for treatment of restenosis will be investigated
using thermoluminescent dosimeter chips and sheets, radiochromic film,
polymer gel dosimeters, Rossi-type proportional chamber for microdosimetry,
and Monte Carlo simulations. Finally, effects of tissue heterogeneity and
self-shielding effects of catheters and stents for photons and beta
particles will also be investigated.
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