Photon energy-fluence correction factor in low energy brachytherapy

Abstract

The AAPM TG-43 brachytherapy dosimetry formalism has become a standard for brachytherapy dosimetry worldwide; it implicitly assumes that charged-particle equilibrium (CPE) exists for the determination of absorbed dose to water at different locations. At the time of relating dose to tissue and dose to water, or vice versa, it is usually assumed that the photon fluence in water and in tissues are practically identical, so that the absorbed dose in the two media can be related by their ratio of mass energy-absorption coefficients. The purpose of this work is to study the influence of photon energy-fluence in different media and to evaluate a proposal for energy-fluence correction factors for the conversion between dose-to-tissue ( ) tis D and dose-to-water ( ) w D .State-of-the art Monte Carlo (MC) calculations are used to score photon fluence differential in energy in water and in various human tissues (muscle, adipose and bone) in two different codes, MCNP and PENELOPE, which in all cases include a realistic modeling of the 125I low-energy brachytherapy seed in order to benchmark the formalism proposed. A correction is introduced that is based on the ratio of the water-to-tissue photon energy-fluences using the large-cavity theory. In this work, an efficient way to correlate absorbed dose to water and absorbed dose to tissue in brachytherapy calculations at clinically relevant distances for low-energy photon emitting seed is proposed. The energy-fluence based corrections given in this work are able to correlate absorbed dose to tissue and absorbed dose to water with an accuracy better than 0.5% in the most critical cases.