REEVALUATION OF THE AAPM TG-43 BRACHYTHERAPY DOSIMETRY PARAMETERS FOR AN 125I SEED, AND THE INFLUENCE OF EYE PLAQUE DESIGN ON DOSE DISTRIBUTIONS AND DOSE-VOLUME HISTOGRAMS

The TG-43 dosimetry parameters of the AdvantageTM 125I model IAI-125A brachytherapy seed were studied. An investigation using modern MCNP radiation transport code with updated cross-section libraries was performed. Twelve different simulation conditions were studied for a single seed by varying the coating thickness, mass density, photon energy spectrum and cross-section library. The dose rate was found to be 6.3% lower at 1 cm in comparison to published results. New TG-43 dosimetry parameters are proposed.The dose distribution for a brachytherapy eye plaque, model EP917, was investigated, including the effects of collimation from high-Z slots. Dose distributions for 26 slot designs were determined using Monte Carlo methods and compared between the published literature, a clinical treatment planning system, and physical measurements.The dosimetric effect of the composition and mass density of the gold backing was shown to be less than 3%. Slot depth, width, and length changed the central axis (CAX) dose distributions by < 1% per 0.1 mm in design variation. Seed shifts in the slot towards the eye and shifts of the 125I-laden silver rod within the seed had the greatest impact on the CAX dose distribution, changing it by 14%, 9%, 4.3%, and 2.7% at 1, 2, 5, and 10 mm, respectively, from the inner scleral surface.The measured, full plaque slot geometry delivered 2.4% ± 1.1% higher dose along the plaque’s CAX than the geometry provided by the manufacturer and 2.2%±2.3% higher than Plaque SimulatorTM (PS) treatment planning software (version 5.7.6). The D10 for the simulated tumor, inner sclera, and outer sclera for the measured slot plaque to manufacturer provided slot design was 9%, 10%, and 19% higher, respectively. In comparison to the measured plaque design, a theoretical plaque having narrow and deep slots delivered 30%, 37%, and 62% lower D10 doses to the tumor, inner sclera, and outer sclera, respectively. CAX doses at –1, 0, 1, and 2 mm were also lower by a factor of 2.6, 1.72, 1.50, and 1.39, respectively. The study identified substantial sensitivity of the EP917 plaque dose distributions to slot design.