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Monte Carlo simulations and analysis of transmitted gamma ray spectra through various tissue phantoms

Moradi F, Khandaker MU, Alrefae T, Ramazanian H, Bradley DA

Appl Radiat Isot, 2019 Apr;146:120-126.
PMID: 30769172 DOI: 10.1016/j.apradiso.2019.01.031

Studies of radiation interactions with tissue equivalent material find importance in efforts that seek to avoid unjustifiable dose to patients, also in ensuring quality control of for instance nuclear medicine imaging equipment. Use of the Monte Carlo (MC) simulation tool in such characterization processes allows for the avoidance of costly experiments involving transmitted X- and γ-ray spectrometry. Present work investigates MC simulations of γ-ray transmission through tissue equivalent solid phantoms. Use has been made of a range of radionuclide gamma ray sources, 99mTc, 131I, 137Cs, 60Co (offering photons in the energy range from a few keV up to low MeV), popularly applied in medicine and in some cases for gauging in industry, obtaining the transmission spectra following their interaction with various phantom materials and thicknesses. In validation of the model, the simulated values of mass attenuation coefficients (μ/ρ) for different phantom materials and thicknesses were found to be in good agreement with reference values (NIST, 2004) to within 1.1% for all material compositions. For all of the primary photon energies and medium thicknesses of interest herein, results show that multiple scattering peaks are generally located at energies lower than 100 keV, although for the larger phantom thicknesses it is more difficult to distinguish single, double and multiple scattering in the gamma spectra. Transmitted photon spectra investigated for water, soft tissue, breast, brain and lung tissue slab phantoms are demonstrated to be practically independent of the phantom material, while a significant difference is observed for the spectra transmitted through bone that was proved to be due to the density effect and not material composition.
Radiation shielding assessment for interventional radiology personnel: Geant4 dosimetry of lead-free compositions

Moradi F, Jalili M, Saraee KRE, Abdi MR, Rashid HAA

Biomed Phys Eng Express, 2024 Feb 14;10(2).
PMID: 38320327 DOI: 10.1088/2057-1976/ad26d5

The inherent biological hazards associated with ionizing radiation necessitate the implementation of effective shielding measures, particularly in medical applications. Interventional radiology, in particular, poses a unique challenge as it often exposes medical personnel to prolonged periods of high x-ray doses. Historically, lead and lead-based compounds have been the primary materials employed for shielding against photons. However, the drawbacks of lead, including its substantial weight causing personnel's inflexibility and its toxicity, have raised concerns regarding its long-term impact on both human health and the environment. Barium tantalate has emerged as a promising alternative, due to its unique attenuation properties against low-energy x-rays, specifically targeting the weak absorption area of lead. In the present study, we employ the Geant4 Monte Carlo simulation tool to investigate various formulations of barium tantalate doped with rare earth elements. The aim is to identify the optimal composition for shielding x-rays in the context of interventional radiology. To achieve this, we employ a reference x-ray spectrum typical of interventional radiology procedures, with energies extending up to 90 keV, within a carefully designed simulation setup. Our primary performance indicator is the reduction in air kerma transmission. Furthermore, we assess the absorbed doses to critical organs at risk within a standard human body phantom protected by the shield. Our results demonstrate that specific concentrations of the examined rare earth impurities can enhance the shielding performance of barium tantalate. To mitigate x-ray exposure in interventional radiology, our analysis reveals that the most effective shielding performance is achieved when using barium tantalate compositions containing 15% Erbium or 10% Samarium by weight. These findings suggest the possibility of developing lead-free shielding solutions or apron for interventional radiology personnel, offering a remarkable reduction in weight (exceeding 30%) while maintaining shielding performance at levels comparable to traditional lead-based materials.
A simulation study on the radiosensitization properties of gold nanorods

Taheri A, Khandaker MU, Moradi F, Bradley DA

Phys Med Biol, 2024 Feb 15;69(4).
PMID: 38286017 DOI: 10.1088/1361-6560/ad2380

Objective. Gold nanorods (GNRs) have emerged as versatile nanoparticles with unique properties, holding promise in various modalities of cancer treatment through drug delivery and photothermal therapy. In the rapidly evolving field of nanoparticle radiosensitization (NPRS) for cancer therapy, this study assessed the potential of gold nanorods as radiosensitizing agents by quantifying the key features of NPRS, such as secondary electron emission and dose enhancement, using Monte Carlo simulations.Approach. Employing the TOPAS track structure code, we conducted a comprehensive evaluation of the radiosensitization behavior of spherical gold nanoparticles and gold nanorods. We systematically explored the impact of nanorod geometry (in particular size and aspect ratio) and orientation on secondary electron emission and deposited energy ratio, providing validated results against previously published simulations.Main results. Our findings demonstrate that gold nanorods exhibit comparable secondary electron emission to their spherical counterparts. Notably, nanorods with smaller surface-area-to-volume ratios (SA:V) and alignment with the incident photon beam proved to be more efficient radiosensitizing agents, showing superiority in emitted electron fluence. However, in the microscale, the deposited energy ratio (DER) was not markedly influenced by the SA:V of the nanorod. Additionally, our findings revealed that the geometry of gold nanoparticles has a more significant impact on the emission of M-shell Auger electrons (with energies below 3.5 keV) than on higher-energy electrons.Significance. This research investigated the radiosensitization properties of gold nanorods, positioning them as promising alternatives to the more conventionally studied spherical gold nanoparticles in the context of cancer research. With increasing interest in multimodal cancer therapy, our findings have the potential to contribute valuable insights into the perspective of gold nanorods as effective multipurpose agents for synergistic photothermal therapy and radiotherapy. Future directions may involve exploring alternative metallic nanorods as well as further optimizing the geometry and coating materials, opening new possibilities for more effective cancer treatments.
Interventions in Reducing Caesarean Section in the World: A Systematic Review

Moradi F, Aryankhesal A, Heidari M, Soroush A, Sadr SR

Malays J Med Sci, 2019 Sep;26(5):21-37.
PMID: 31728116 DOI: 10.21315/mjms2019.26.5.3

Caesarean section without medical indication imposes many problems to families, personnel and medical equipment causing some side effects to pregnant woman and foetus, compared to natural childbirth. The present study aimed to evaluate the interventions in reducing caesarean section in the world. This study was a systematic review using Embase, PubMed, Scopus, Web of Science, Science Direct, Magiran and SID databases and grey literature. All studies conducted during 2000-2018 were reviewed and finally the studies with inclusion and exclusion criteria were selected. A total of 19 studies were selected among 5,559 studies. The interventions conducted for reducing caesarean section included training the specialists and women by using Six Sigma method, changing the guidelines, reviewing the definition of natural childbirth various stages, encouraging the natural childbirth and expanding painless childbirth. All interventions were divided into educational strategy and managerial strategy. The interventions can be implemented to change the behaviour of physicians and attitude of pregnant women in order to reduce caesarean section. In this regard, the authorities are recommended to make more efforts.
Evaluation of Ge-doped silica fibre TLDs for in vivo dosimetry during intraoperative radiotherapy

Moradi F, Ung NM, Mahdiraji GA, Khandaker MU, See MH, Taib NA, et al.

Phys Med Biol, 2019 04 12;64(8):08NT04.
PMID: 30840946 DOI: 10.1088/1361-6560/ab0d4e

Ge-doped silica fibre (GDSF) thermoluminescence dosimeters (TLD) are non-hygroscopic spatially high-resolution radiation sensors with demonstrated potential for radiotherapy dosimetry applications. The INTRABEAM® system with spherical applicators, one of a number of recent electronic brachytherapy sources designed for intraoperative radiotherapy (IORT), presents a representative challenging dosimetry situation, with a low keV photon beam and a desired rapid dose-rate fall-off close-up to the applicator surface. In this study, using the INTRABEAM® system, investigations were made into the potential application of GDSF TLDs for in vivo IORT dosimetry. The GDSFs were calibrated over the respective dose- and depth-range 1 to 20 Gy and 3 to 45 mm from the x-ray probe. The effect of different sizes of spherical applicator on TL response of the fibres was also investigated. The results show the GDSF TLDs to be applicable for IORT dose assessment, with the important incorporated correction for beam quality effects using different spherical applicator sizes. The total uncertainty in use of this type of GDSF for dosimetry has been found to range between 9.5% to 12.4%. Subsequent in vivo measurement of skin dose for three breast patients undergoing IORT were performed, the measured doses being below the tolerance level for acute radiation toxicity.
Monte Carlo skin dose simulation in intraoperative radiotherapy of breast cancer using spherical applicators

Moradi F, Ung NM, Khandaker MU, Mahdiraji GA, Saad M, Abdul Malik R, et al.

Phys Med Biol, 2017 Jul 28;62(16):6550-6566.
PMID: 28708603 DOI: 10.1088/1361-6560/aa7fe6

The relatively new treatment modality electronic intraoperative radiotherapy (IORT) is gaining popularity, irradiation being obtained within a surgically produced cavity being delivered via a low-energy x-ray source and spherical applicators, primarily for early stage breast cancer. Due to the spatially dramatic dose-rate fall off with radial distance from the source and effects related to changes in the beam quality of the low keV photon spectra, dosimetric account of the Intrabeam system is rather complex. Skin dose monitoring in IORT is important due to the high dose prescription per treatment fraction. In this study, modeling of the x-ray source and related applicators were performed using the Monte Carlo N-Particle transport code. The dosimetric characteristics of the model were validated against measured data obtained using an ionization chamber and EBT3 film as dosimeters. By using a simulated breast phantom, absorbed doses to the skin for different combinations of applicator size (1.5-5 cm) and treatment depth (0.5-3 cm) were calculated. Simulation results showed overdosing of the skin (>30% of prescribed dose) at a treatment depth of 0.5 cm using applicator sizes larger than 1.5 cm. Skin doses were significantly increased with applicator size, insofar as delivering 12 Gy (60% of the prescribed dose) to skin for the largest sized applicator (5 cm diameter) and treatment depth of 0.5 cm. It is concluded that the recommended 0.5-1 cm distance between the skin and applicator surface does not guarantee skin safety and skin dose is generally more significant in cases with the larger applicators.
HIGHLIGHTS: • Intrabeam x-ray source and spherical applicators were simulated and skin dose was calculated. • Skin dose for constant skin to applicator distance strongly depends on applicator size. • Use of larger applicators generally results in higher skin dose. • The recommended 0.5-1 cm skin to applicator distance does not guarantee skin safety.
Fulltext Thermoluminescence Response of Ge-Doped Cylindrical-, Flat- and Photonic Crystal Silica-Fibres to Electron and Photon Radiation

Entezam A, Khandaker MU, Amin YM, Ung NM, Bradley DA, Maah J, et al.

PLoS One, 2016;11(5):e0153913.
PMID: 27149115 DOI: 10.1371/journal.pone.0153913

Study has been made of the thermoluminescence (TL) response of silica-based Ge-doped cylindrical, flat and photonic crystal fibres (referred to herein as PCF-collapsed) to electron (6, 12 and 20 MeV) and photon (6, 10 MV) irradiation and 1.25 MeV γ-rays, for doses from 0.1 Gy to 100 Gy. The electron and photon irradiations were delivered through use of a Varian Model 2100C linear accelerator located at the University of Malaya Medical Centre and γ-rays delivered from a 60Co irradiator located at the Secondary Standard Dosimetry Laboratory (SSDL), Malaysian Nuclear Agency. Tailor-made to be of various dimensions and dopant concentrations (6-10% Ge), the fibres were observed to provide TL yield linear with radiation dose, reproducibility being within 1-5%, with insensitivity to energy and angular variation. The sensitivity dependency of both detectors with respect to field size follows the dependency of the output factors. For flat fibres exposed to 6 MV X-rays, the 6% Ge-doped fibre provided the greatest TL yield while PCF-collapsed showed a response 2.4 times greater than that of the 6% Ge-doped flat fibres. The response of cylindrical fibres increased with core size. The fibres offer uniform response, high spatial resolution and sensitivity, providing the basis of promising TL systems for radiotherapy applications.