Stephen J McMahon et al 2008 Phys. Med. Biol. 53 5635 doi:10.1088/0031-9155/53/20/005
Stephen J McMahon1, Marcus H Mendenhall2, Suneil Jain3 and Fred Currell1
Show affiliationsDelivering sufficient dose to tumours while sparing surrounding tissue is one of the primary challenges of radiotherapy, and in common practice this is typically achieved by using highly penetrating MV photon beams and spatially shaping dose. However, there has been a recent increase in interest in the possibility of using contrast agents with high atomic number to enhance the dose deposited in tumours when used in conjunction with kV x-rays, which see a significant increase in absorption due to the heavy element's high-photoelectric cross-section at such energies. Unfortunately, the introduction of such contrast agents significantly complicates the comparison of different source types for treatment efficacy, as the dose deposited now depends very strongly on the exact composition of the spectrum, making traditional metrics such as beam quality less valuable. To address this, a 'figure of merit' is proposed, which yields a value which enables the direct comparison of different source types for tumours at different depths inside a patient. This figure of merit is evaluated for a 15 MV LINAC source and two 150 kVp sources (both of which make use of a tungsten target, one with conventional aluminium filtration, while the other uses a more aggressive thorium filter) through analytical methods as well as numerical models, considering tissue treated with a realistic concentration and uptake ratio of gold nanoparticle contrast agents (10 mg ml −1 concentration in 'tumour' volume, 10:1 uptake ratio). Finally, a test case of human neck phantom is considered with a similar contrast agent to compare the abstract figure to a more realistic treatment situation. Good agreement was found both between the different approaches to calculate the figure of merit, and between the figure of merit and the effectiveness in a more realistic patient scenario. Together, these observations suggest that there is the potential for contrast-enhanced kilovoltage radiation to be a useful therapeutic tool for a number of classes of tumour on dosimetric considerations alone, and they point to the need for further research in this area.
87.53.Bn Dosimetry/exposure assessment
Issue 20 (21 October 2008)
Received 18 June 2008, in final form 1 August 2008
Published 23 September 2008
Stephen J McMahon et al 2008 Phys. Med. Biol. 53 5635
P Blaudeck et al 1992 J. Phys.: Condens. Matter 4 6389
P F Sharp et al 2004 Phys. Med. Biol. 49 1085
Jiang-Hui Ji et al 2009 Res. Astron. Astrophys. 9 703
A R Hamilton et al 2008 J. Phys.: Condens. Matter 20 164205
Jean-Noël Aqua and Michael E Fisher 2004 J. Phys. A: Math. Gen. 37 L241
D J Smith et al 2003 J. Phys. D: Appl. Phys. 36 1519
Leonid Polterovich and Zeev Rudnick 2001 Nonlinearity 14 1331
Zhang Jing-Tao and Xu Zhi-Zhan 2001 Chinese Phys. Lett. 18 1069
G A Bonvallet and J E Lawler 2003 J. Phys. D: Appl. Phys. 36 1510