Browsing by Author "Trauernicht, Christoph Jan"

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    Characterization of a 6 MV photon beam in terms of primary and scattered dose components
    (2009) Trauernicht, Christoph Jan; Hering, E R; Nieto-Camero, Jaime
    The purpose of this work was to partition the 6 MV photon beam of a Philips SL75-5 linear accelerator into primary and scattered dose components in water. The two quantities that are necessary to define the primary beam component are a reference dose DR and a primary linear attenuation coefficient μ 0. DR describes the magnitude of the primary dose as a fraction of the total dose in a reference field at a reference depth, while μ 0 describes how the primary dose changes with depth in a medium. The scattered component is the difference between the primary and total dose. μ 0 for the beam in water was determined in four different ways, namely through the extrapolation of measured TMRs to zero field size, through linear attenuation measurements, through the fit of a convolution model to CAPDD data and through a method involving a central axis attenuator. The primary dose component was determined in two ways, namely by the extrapolation of the phantom scatter correction factor to zero field size and also by the central axis attenuator method. μ 0 varied from 0.0445 cm-1 to 0.0469 cm-1 with an average of 0.0455 +- 0.0012 cm-1. DR for a 10 cm x 10 cm field at the depth of maximum dose was found to vary between 0.933 Gy/ 100 MU and 0.935 Gy/ 100 MU, with an average of 0.934 Gy/ 100 MU. These values agree very well with values published in the literature. It has thus been shown that the 6 MV photon beam is separable into primary and scattered dose components.
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    Measured and calculated dose distributions in the “claws” – a specially designed gold applicator loaded with I-125 seeds
    (2020) Trauernicht, Christoph Jan; Hering, Egbert; Du Plessis, Frederik
    Introduction: The “Claws” is a unique gold applicator for whole-eye radiotherapy that was designed at Groote Schuur Hospital. It is used to treat retinoblastoma. Under general anaesthesia, a pericorneal ring is attached to the four extraocular muscles, and four legs, each loaded with I125 seeds, are inserted beneath the conjunctiva in-between each pair of muscles and attached anteriorly to the ring. The four legs that are now sutured onto the ring give it a claw-like appearance, hence the name for the applicator. The applicator was designed in such a way that the dose is directed towards the middle of the eye, while sparing surrounding tissues. The dose to the organs at risk could never be determined accurately, because the treatment planning system (TPS) is not able to take into account the gold shielding. Additionally, the TPS approximates each seed as a point source and not as a line source, therefore not taking any anisotropy into account. Aims: The first aim of this project was to accurately determine various dosimetric and physical characteristics of a single I-125 seed and to then compare these to published data. Spectral measurements of the OncoSeed 6711 using various detectors were also done. The next aim was to formalize the model of the “Claws” so that the applicator can potentially also be manufactured elsewhere. The next aim was to describe the “Claws” dosimetrically. This was done - Using thermoluminescent dosimeters in a solid water phantom - Using gafchromic film in a solid water phantom - Using treatment planning systems TheraPlan Plus and BrachyVision - Using Monte Carlo simulations – egs_brachy The final aim of the thesis was the comparison of measured and calculated data. The Monte Carlo simulations take into account the seed anisotropy as well as the gold shielding; therefore the relative dose to critical structures can be estimated more reliably. Method and Materials: Gafchromic film and thermoluminescent dosimeters (TLDs) were used for measurements in various specially designed phantoms to determine the seed parameters, as well as dose distributions in the eye. Dose distributions were calculated on two treatment planning systems. A CAD drawing of the “Claws” was created and used to create the input file for Monte Carlo simulations using egs_brachy. The final Monte Carlo calculation simulated 64.000.000.000 particle histories at voxel sizes of 0.1 mm x 0.1 mm x 0.1 mm. Results: Measured seed data matched published seed data. Significant dose distribution changes were found when comparing measured and Monte Carlo data to planned data, especially near the periphery of the eye between adjacent legs. The Monte Carlo calculated dose to the optic nerve is 64.8 % of the central dose in the eye, while the planned dose is 93.7 %. The Monte Carlo lens dose varies from 72.0 % - 86.1 %, while the planned dose varies from 73.0 % - 84.3 %. Monte Carlo calculated dose to the bony orbit is 11.3 %, while the planned dose is 54.7 %. Conclusion: Measured seed data matched published seed data. The “Claws” were formalized with CAD drawings. Measured and Monte Carlo simulated dose distributions matched well, while planned dose distributions showed discrepancies in certain regions of the eye and outside of the eye. This clearly indicates that the gold shielding of the applicator walls must be taken into account during dose calculations. It can be concluded that the “Claws” were extensively described and characterized in this work.
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    Radiation dose optimization in interventional radiology and cardiology using diagnostic reference levels
    (2016) De Vos, Hendrik Johannes; Trauernicht, Christoph Jan; Kotzé, T C
    The International Commission of Radiological Protection (ICRP) advises that in principle Diagnostic Reference Levels (DRL) could be used in fluoroscopically guided interventional procedures to avoid unnecessary stochastic radiation risk. The increase in complexity of interventional procedures, combined with a lack of specialist training on radiation techniques, poses a significant risk to patients. These risks have not gone unnoticed by government authorities worldwide and in 2015 the South African Department of Health: Directorate Radiation Control issued requirements to license holders of interventional fluoroscopy units, requiring that a medical physicist optimize their radiation usage using DRLs. The Dose Area Product (DAP) quantity measured for each patient represents a dosimetry index, the value of which for the purpose of improvement should be optimized against the DRL. In this dissertation, I aim to establish if DRLs in the South African private healthcare interventional theatres are high compared to international levels and whether DRLs will optimize the doses used.