Skip to main content
Log in

Characterisation of out-of-field dose at shallow depths for external beam radiotherapy: implications for eye lens dose

  • Scientific Paper
  • Published:
Australasian Physical & Engineering Sciences in Medicine Aims and scope Submit manuscript

Abstract

Re-evaluation of the eye lens radio-sensitivity by the ICRP in 2011 resulted in a significant reduction of the threshold for lens opacities from 8 Gy to 0.5 Gy. This has led to an increase in concern for eye lens doses from treatment sites further from the eye than previously considered. The aim of this study was to examine the out-of-field dose far from the field edge and develop an effective method to accurately characterise the constituent components of this dose at varying depths. Dose profile scans using a 0.6 cm3 cylindrical ionisation chamber in a motorised water tank were compared with previous studies and displayed good agreement. At points more than 20 cm from the field edge patient scatter becomes insignificant, and the dose is dominated by head leakage and collimator scatter. Point depth-dose measurements made with a Roos parallel plate chamber in solid water at distances of 52 cm and 76 cm from central axis showed that the highest dose is at the surface. Since the sensitive region of the eye can be as shallow as 3 mm, in vivo measurements carried out with a detector with buildup more than 3 mm water equivalent thickness may be underestimating the dose to the lens. It is therefore recommended that for in vivo measurements for the eye lens further than 20 cm from the field edge the detector should have only 3 mm build-up material over the effective point of measurement.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. International Commission on Radiological Protection (ICRP) (2011) Statement on tissue reactions. Tech Rep

  2. Harrison R (2017) Out-of-field dose in radiotherapy: input to epidemiological studies and dose-risk models. Phys Med 42:239–246

    Article  PubMed  Google Scholar 

  3. Mulrooney DA, Yeazel MW, Kawashima T, Mertens AC, Mitby P, Stovall M, Donaldson SS, Green DM, Sklar CA, Robison LL, Leisenring WM (2009) Cardiac outcomes in a cohort of adult survivors of childhood and adolescent cancer: retrospective analysis of the Childhood Cancer Survivor Study cohort. Br Med J. https://doi.org/10.1136/bmj.b4606

    Article  Google Scholar 

  4. Behrens R, Dietze G, Zankl M (2009) Dose conversion coefficients for electron exposure of the human eye lens. Phys Med Biol 54(13):4069–4087

    Article  CAS  PubMed  Google Scholar 

  5. Das IJ, Cheng C (2008) Accelerator beam data commissioning equipment and procedures: report of the TG-106 of the Therapy Physics Committee of the AAPM. Med Phys 35(9):4186–4215

    Article  PubMed  Google Scholar 

  6. Howell RM, Scarboro SB, Kry SF, Yaldo DZ (2010) Accuracy of out-of-field dose calculations by a commercial treatment planning system. Phys Med Biol 55(23):6999–7008

    Article  PubMed  PubMed Central  Google Scholar 

  7. Joosten F, Bochud S, Baechler F, Levi R-O, Mirimanoff R, Moeckli R (2011) Variability of a peripheral dose among various linac geometries for second cancer risk assessment. Phys Med Biol 56:5131–5151

    Article  CAS  PubMed  Google Scholar 

  8. Joosten O, Matzinger W, Jeanneret-Sozzi F, Bochud R, Moeckli R (2013) Evaluation of organ-specific peripheral doses after 2-dimensional, 3-dimensional and hybrid intensity modulated radiation therapy for breast cancer based on Monte Carlo and convolution/superposition algorithms: implications for secondary cancer risk asses. Radiother Oncol 106(1):33–41

    Article  PubMed  Google Scholar 

  9. Huang JY, Followill DS (2013) Accuracy and sources of error of out-of field dose calculations by a commercial treatment planning system for intensity modulated radiation therapy treatments. J Appl Clin Med Phys 14(2):186–197

    Article  PubMed Central  Google Scholar 

  10. Heuvel FVD, Defraene G, Crijns W, Bogaerts R (2012) Out-of-field contributions for IMRT and volumetric modulated arc therapy measured using gafchromic films and compared to calculations using a superposition/convolution-based treatment planning system. Radiother Oncol 105:127–132

    Article  PubMed  Google Scholar 

  11. Wang L, Ding GX (2014) The accuracy out-of-field dose calculations using a model based algorithm in a commercial treatment planning system. Phys Med Biol 59:N113–N128

    Article  PubMed  Google Scholar 

  12. Stovall M, Blackwell CR, Cundiff J, Novack DH, Palta JR, Wagner LK, Webster EW, Shalek RJ (1995) Fetal dose from radiotherapy with photon beams: report of AAPM radiation therapy committe task group. 36. Med Phys 22(1):63–82

    Article  CAS  PubMed  Google Scholar 

  13. Starkschall G, St George FJ, Zellmer DL (1983) Surface dose for megavoltage photon beams outside the treatment field. Med Phys 10(6):906–910

    Article  CAS  PubMed  Google Scholar 

  14. Kry SF, Titt U, Ponisch F, Followill D, Vassiliev ON, White RA, Mohan R, Salehpour M (2006) A Monte Carlo model for calculating out-of-field dose from a Varian 6 MV beam. Med Phys 33(11):4405–4413

    Article  PubMed  Google Scholar 

  15. Ruben JD, Lancaster CM, Jones P, Smith RL (2011) A comparison of out-of- field dose and its constituent components for intensity-modulated radiation therapy versus conformal radiation therapy: implications for carcinogenesis. Int J Rad Oncol Biol Phys 81(5):1458–1464

    Article  Google Scholar 

  16. Kry SF, Bednarz B, Howell RM, Dauer L, Followill D, Klein E, Paganetti H, Wang B, Wuu C-S, Xu X (2017) AAPM TG 158 measurement and calculation of doses outside the treated volume from external-beam radiation therapy. Med Phys 44(10):e391–e429

    Article  PubMed  Google Scholar 

  17. Kry SF, Smith SA, Weathers R, Stovall M (2012) Skin dose during radiotherapy: a summary and general estimation technique. J Appl Clin Med Phys 13(3):20–34

    Article  PubMed Central  Google Scholar 

  18. Peet SC, Wilks R, Kairn T, Crowe SB (2016) Measuring dose from radiotherapy treatments in the vicinity of a cardiac pacemaker. Phys Med 32(12):1529–1536

    Article  PubMed  Google Scholar 

  19. Constantin M, Hsu H, Mansfield S, Svatos M (2013) Mitigation strategies to reduce the relative extrafocal dose (RED). Med Phys 40(6):322

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tina C. Baradaran.

Ethics declarations

Conflict of interest

We the authors confirm there is no conflict of interest and no human/animal testing involved in this research.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Baradaran, T.C., Cutajar, D.L., Qi, Y. et al. Characterisation of out-of-field dose at shallow depths for external beam radiotherapy: implications for eye lens dose. Australas Phys Eng Sci Med 42, 671–676 (2019). https://doi.org/10.1007/s13246-019-00764-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13246-019-00764-3

Keywords

Navigation