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Lookup NU author(s): Dr Roger Harrison
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The increasing use of imaging for localization and verification in radiotherapy has raised issues concerning the justifiable doses to critical organs and tissues from concomitant exposures, particularly when extensive image-guided radiotherapy is indicated. Doses at positions remote from the target volume include components from high-energy leakage and scatter, as well as from concomitant imaging. In this paper, simulated prostate, breast and larynx treatments are used to compare doses from both high-energy and concomitant exposures as a function of distance from the target volume. It is suggested that the fraction, R, of the total dose at any point within the patient that is attributable to concomitant exposures may be a useful aid in their justification. R is small within the target volume and at large distances from it. However, there is a critical region immediately adjacent to the planning target volume where the dose from concomitant imaging combines with leakage and scatter to give values of R that approach 0.5 in the examples given here. This is noteworthy because the regions just outside the target volume will receive total doses in the order of 1 Gy, where commensurately high risk factors may not be substantially reduced because of cell kill. Other studies have identified these regions as sites of second cancers. The justification of an imaging regimen might therefore usefully take into account the maximum value of R encountered from the combination of imaging and radiotherapy for particular treatment sites. (C) 2008 The British Institute of Radiology
Author(s): Harrison RM
Publication type: Article
Publication status: Published
Journal: British Journal of Radiology
Year: 2008
Volume: 81
Issue: 972
Pages: 970-974
ISSN (print): 0007-1285
ISSN (electronic): 0961-2653
Publisher: British Institute of Radiology
URL: http://dx.doi.org/10.1259/bjr/77088613
DOI: 10.1259/bjr/77088613
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