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  1. Aziz MZ, Yusoff AL, Osman ND, Abdullah R, Rabaie NA, Salikin MS
    J Med Phys, 2015 Jul-Sep;40(3):150-5.
    PMID: 26500401 DOI: 10.4103/0971-6203.165080
    It has become a great challenge in the modern radiation treatment to ensure the accuracy of treatment delivery in electron beam therapy. Tissue inhomogeneity has become one of the factors for accurate dose calculation, and this requires complex algorithm calculation like Monte Carlo (MC). On the other hand, computed tomography (CT) images used in treatment planning system need to be trustful as they are the input in radiotherapy treatment. However, with the presence of metal amalgam in treatment volume, the CT images input showed prominent streak artefact, thus, contributed sources of error. Hence, metal amalgam phantom often creates streak artifacts, which cause an error in the dose calculation. Thus, a streak artifact reduction technique was applied to correct the images, and as a result, better images were observed in terms of structure delineation and density assigning. Furthermore, the amalgam density data were corrected to provide amalgam voxel with accurate density value. As for the errors of dose uncertainties due to metal amalgam, they were reduced from 46% to as low as 2% at d80 (depth of the 80% dose beyond Zmax) using the presented strategies. Considering the number of vital and radiosensitive organs in the head and the neck regions, this correction strategy is suggested in reducing calculation uncertainties through MC calculation.
  2. Ying CK, Bolst D, Rosenfeld A, Guatelli S
    J Med Phys, 2019 12 11;44(4):263-269.
    PMID: 31908385 DOI: 10.4103/jmp.JMP_40_19
    Purpose: The main advantages of charged particle radiotherapy compared to conventional X-ray external beam radiotherapy are a better tumor conformality coupled with the capability of treating deep-seated radio-resistant tumors. This work investigates the possibility to use oxygen beams for hadron therapy, as an alternative to carbon ions.

    Materials and Methods: Oxygen ions have the advantage of a higher relative biological effectiveness (RBE) and better conformality to the tumor target. This work describes the mixed radiation field produced by an oxygen beam in water and compares it to the one produced by a therapeutic carbon ion beam. The study has been performed using Geant4 simulations. The dose is calculated for incident carbon ions with energies of 162 MeV/u and 290 MeV/u, and oxygen ions with energies of 192 MeV/u and 245 MeV/u, and hence that the range of the primary oxygen ions projectiles in water was located at the same depth as the carbon ions.

    Results: The results show that the benefits of oxygen ions are more pronounced when using lower energies because of a slightly higher peak-to-entrance ratio, which allows either providing higher dose in tumor target or reducing it in the surrounding healthy tissues. It is observed that, per incident particle, oxygen ions deliver higher doses than carbon ions.

    Conclusions: This result coupled with the higher RBE shows that it may be possible to use a lower fluence of oxygen ions to achieve the same therapeutic dose in the patient as that obtained with carbon ion therapy.

  3. Chuah KW, Abdul Aziz MZ, Jayamani J
    J Med Phys, 2022;47(3):301-308.
    PMID: 36684700 DOI: 10.4103/jmp.jmp_40_22
    Accuracy of ionization chamber (IC) to measure the scatter output factor (Scp) of a linear accelerator (linac) is crucial, especially in small field (<4 cm × 4 cm). The common IC volume of 0.6 cc is not adequate for small-field measurement and not all radiotherapy centers can afford to purchase additional IC due to the additional cost. This study aimed to determine the efficiency of the EGSnrc Monte Carlo (MC) to calculate the Scp for various field sizes including small field in Elekta Synergy (Agility multileaf collimator) linac. The BEAMnrc and DOSXYZnrc user codes were used to simulate a 6 MV linac model for various field sizes and calculate the radiation dose output in water phantom. The modeled linac treatment head was validated by comparing the percentage depth dose (PDD), beam profile, and beam quality (Tissue Phantom Ratio (TPR)20,10) with the IC measurement. The validated linac model was simulated to calculate the Scp consisting of collimator scatter factor (Sc) and phantom scatter factor (Sp). The PDD and beam profile of the simulated field sizes were within a good agreement of ±2% compared with the measured data. The TPR20,10 value was 0.675 for field size 10 cm × 10 cm. The Scp, Sc, and Sp simulated values were close to the IC measurement within ±2% difference. The simulation for Sc and Sp in 3 cm × 3 cm field size was calculated to be 0.955 and 0.884, respectively. In conclusion, this study validated the efficiency of the MC simulation as a promising tool for the Scp calculation including small-field size for linac.
  4. Zuber SH, Hadi MFRA, Samson DO, Jayamani J, Rabaiee NA, Aziz MZA, et al.
    J Med Phys, 2023;48(4):358-364.
    PMID: 38223797 DOI: 10.4103/jmp.jmp_75_23
    PURPOSE: This study aims to determine the percentage depth dose (PDD) of a phantom material made from soy-lignin bonded Rhizophora spp. particleboard coated with a gloss finish by using Monte Carlo Geant4 Application for Tomographic Emission (GATE) simulation.

    MATERIALS AND METHODS: The particleboard was fabricated using a hot pressing technique at target density of 1.0 g·cm-3 and the elemental fraction was recorded for the simulation. The PDD was simulated in the GATE simulation using the linear accelerator Elekta Synergy model for the water phantom and Rhizophora phantom, and the results were compared with the experimental PDD performed by several studies. Beam flatness and beam symmetry were also measured in this study.

    RESULTS: The simulated PDD for Rhizophora and water was in agreement with the experimental PDD of water with overall discrepancies of 0% to 8.7% at depth ranging from 1.0 to 15.0 cm. In the GATE simulation, all the points passed the clinical 3%/3 mm criterion in comparison with water, with the final percentage of 2.34% for Rhizophora phantom and 2.49% for the water phantom simulated in GATE. Both the symmetries are all within the range of an acceptable value of 2.0% according to the recommendation, with the beam symmetry of the water phantom and Rhizophora phantom at 0.58% and 0.28%, respectively.

    CONCLUSIONS: The findings of this study provide the necessary foundation to confidently use the phantom for radiotherapy purposes, especially in treatment planning.

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