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SU-F-T-63: Dosimetric Relevance of the Valencia and Leipzig HDR Applicators Plastic Cap.

Medical Physics 2016 June
PURPOSE: Utilization of HDR brachytherapy treatment of skin lesions using collimated applicators, such as the Valencia or Leipzig is increasing. These applicators are made of cup-shaped tungsten material in order to focalize the radiation into the lesion and to protect nearby tissues. These applicators have an attachable plastic cap that removes secondary electrons generated in the applicator and flattens the treatment surface. The purpose of this study is to examine the dosimetric impact of this cap, and the effect if the cap is not placed during the HDR fraction delivery.

METHODS: Monte Carlo simulations have been done using the code Geant4 for the Valencia and Leipzig applicators. Dose rate distributions have been obtained for the applicators with and without the plastic cap. An experimental study using EBT3 radiochromic film has been realized in order to verify the Monte Carlo results.

RESULTS: The Monte Carlo simulations show that absorbed dose in the first millimeter of skin can increase up to 180% for the Valencia applicator if the plastic cap is absent and up to 1500% for the Leipzig applicators. At deeper distances the increase of dose is smaller being about 10-15%.

CONCLUSION: Important differences have been found if the plastic cap of the applicators is absent in the treatment producing an overdosage in the skin. The user should have a checklist to remind him check always before HDR fraction delivery to insure the plastic cap is placed on the applicator. This work was supported in part by Generalitat Valenciana under Project PROMETEOII/2013/010, by the Spanish Government under Project No. FIS2013-42156, and by a research agreement with Elekta Brachytherapy, Veenendaal, The Netherlands.

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