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AAPM Physics Review – July 19, 2014
Basic Principles of Radiation
Therapy Shielding Design
Peter J. Biggs Ph.D.,
Massachusetts General Hospital,
Harvard Medical School,
Boston, MA 02114
AAPM Physics Review – July 19, 2014
Outline
1 Basic principles and definitions
2 Calculations
3 Workload, use and occupancy factors
4 Shielding materials
5 Tenth value layers (TVL)
6 Room layout & features, construction details
7 Neutrons & laminated barriers
8 Mazes and doors
9 Ducts
AAPM Physics Review – July 19, 2014
Definitions
P: Weekly design dose limit (Sv/wk)
d: Distance from target to measurement point
W: Workload (Gy/wk)
U: Use Factor
T: Occupancy factor
a: Scatter fraction; (, E)
dsec: Distance from scatterer to measurement point
dsca: Distance from target to scatterer
dl: Distance from the target to measurement point
F: Area of the beam in the plane of the scatterer (cm2)
B: Barrier transmission factor
AAPM Physics Review – Aug 3, 2013
Also IPEM
Report #75
AAPM Physics Review – July 19, 2014
Basic Principles
The purpose of radiation shielding is to reduce the
effective equivalent dose from a linear accelerator to a
point outside the room to a level that is determined by
individual states.
Public or uncontrolled area - 0.02 mSv per week
- 0.02 mSv in any one hour
Controlled area - 1 mSv/wk (in practice 0.1 mSv/wk)
AAPM Physics Review – July 19, 2014
Basic Shielding Equations: NCRP
#151 Methodology
Primary:
Scatter:
Leakage:
WUT
Pd
B
2
p 
F
400
d
d
aWT
P
B 2
sca
2
sec
s 
WT
Pd
*
1000
B
2
l
l 
Bx is the barrier
transmission
factor
The factor 1000 is
due to the 0.1%
leakage requirement
Iin Iout
out
x
in
I
B
I

AAPM Physics Review – July 19, 2014
Number of Tenth Value Layers
(Primary & Leakage)
The number, n, of tenth value layers (TVLs)
required to reduce the dose to the value P is
given by:
and the thickness for primary and leakage
radiation is given by:
 
B
n 10
log


e
l
p
l
p TVL
n
TVL
T ,
1
, )
1
( 


NCRP report No. 151 Table B.2
AAPM Physics Review – July 19, 2014
Number of Tenth Value Layers for
Scattered Radiation
Scatter TVLs are dependent only on energy
and scattering angle, so:
NCRP report No. 151, Table B.5a
 

s
s
s TVL
n
T 
AAPM Physics Review – July 19, 2014
Tenth Value Layers
Primary TVLs (cm)*
Energy (MV) 4 6 10 15 18 20
Concrete 35(30) 37(33) 41(37) 44(41) 45(43) 46(44)
Steel 9.9 10 11 11 11 11
Lead 5.7 5.7 5.7 5.7 5.7 5.7
Leakage TVLs at 90°* (cm)
Energy (MV) 4 6 10 15 18 20
Concrete 33(28) 34(29) 35(31) 36(33) 36(34) 36(34)
Steel** 8 8.5 8.7 8.7
Lead** 4.5 4.6 4.7 4.7
* First term is 1st TVL and term in brackets is for all other TVLs.
Data from NCRP #151
** Data from McGinley
AAPM Physics Review – July 19, 2014
Obliquity Factor - I
P
AAPM Physics Review – July 19, 2014
Obliquity factor - II
Rule of thumb:
- for >45°
- and B<0.001
- Add ~2 HVL for low-energy photons
- And ~1 HVL for high-energy photons
AAPM Physics Review – July 19, 2014
Obliquity factor - III
- Experimental data by Kirn et. al. (1954)
- verified by Biggs (1996) using the Monte Carlo for a
large range of clinical energies
- Monte Carlo results are in good agreement with
previous recommendations at low energy, but more
detail is given
- Caveat: beware of applying obliquity factor
corrections for large angles!!
AAPM Physics Review – July 19, 2014
Conventional Workload
- Number of patients treated per week multiplied
by the average dose (MU)/patient at isocenter
- Include calibration, service, if indicated
- Recommended values: 500 or 1000 Gy wk-1
- Survey shows values from 250 to 450 Gy wk-1
- Balance between high energy and low energy
use? Using high energy is conservative approach
- Electron-only (IORT) machines?
AAPM Physics Review – July 19, 2014
Workload TBI
- Workload for TBI >> workload for
conventional therapy due to the extended
distances:
- Leakage workload is also higher, but
patient- and wall-scattered workload is
not.
- Radiation is usually directed at one barrier
2
TBI
TBI
TBI d
D
W 
AAPM Physics Review – July 19, 2014
Workload IMRT (1)
- Workload for IMRT is complicated by the fact
that the #MU is much larger than for
conventional therapy. The IMRT factor is
defined as:
and varies between 2 and 10 or more
- This only affects leakage radiation, not primary
or scattered radiation.
conv
IMRT
I
MU
MU
C 
AAPM Physics Review – July 19, 2014
Workload IMRT (2)
- Helical tomotherapy has the highest “C” values, >10.
- Linac based IMRT at MGH gives an average “C” value
of about 5
- Impact of IMAT on MUs (VMAT, Rapid Arc) –
reduction of MUs
- Anecdote: For a 6/18 MV machine the energy use prior
to IMRT was 20%/80% (MU). With 28% IMRT patient
load, the use was 70%/30%. Hence need to consider
balancing the workload for two energies
AAPM Physics Review – July 19, 2014
Conventional Use Factors
90° interval:
- 0° (31%); 90° and 270° (21.3 % each); 180° (26.3 %)
- previously, all barriers were assigned 0.25
45° interval:
- 0° (25.6 %); 45° and 315° (5.8 % each); 90° and 270°
(15.9 % each); 135° and 225° (4 % each); 180° (23 %)
AAPM Physics Review – July 19, 2014
Use Factor for Conventional Therapy
AAPM Physics Review – July 19, 2014
Use Factors – Special Cases
- A significant TBI load will require one
wall to have an increased use factor
- IMRT may also require a change in the
values assigned to the use factor for the
primary barrier
AAPM Physics Review – July 19, 2014
Use Factor – Dedicated Machines
- One should pay attention to the types of
procedures to be carried out in new room
- A room dedicated to SRS and SRT requires
different considerations from a general therapy
room
- A room dedicated to breast treatments will use
specific ranges of primary beam angles
AAPM Physics Review – July 19, 2014
Example: Use Factor for Stereotactic
Radiosurgery
AAPM Physics Review – July 19, 2014
Workload - Summation (1)
Primary:
Patient scatter:
(note that the TBI contribution is calculated
separately – source not at isocenter)
.....)
( 





QA
QA
IMRT
IMRT
TBI
TBI
conv
conv
scat
wall
p
U
W
U
W
U
W
U
W
WU
WU
...)
(
, 


 QA
IMRT
conv
iso
scatter W
W
W
W
AAPM Physics Review – July 19, 2014
Workload - Summation (2)
Leakage:
....)
( 



 QA
QA
IMRT
I
TBI
conv
L W
C
W
C
W
W
W
AAPM Physics Review – July 19, 2014
Occupancy Factors
- Occupancy factors down to 1/40 are now allowed
- This is the limiting factor to permit 0.02 mSv in any one
hour using an MPD of 0.02 mSv/wk
- Area beyond vault door can now have an occupancy of 1/8
- Caveat: be sure to check not only the occupancy of the
immediately adjacent area, but also the area beyond. For
example, an office beyond a corridor becomes the
dominant factor in the calculation. Also future
development plans foreseen.
AAPM Physics Review – July 19, 2014
If the Dose Rate is High, Should I
Freak Out?
Note that even for a weekly limit of 0.02 mSv/wk,
the dose rate outside a barrier could be quite high.
e.g. for a primary barrier, an occupancy of 1/40
would imply a weekly dose of 3.8 mSv and for a
beam on time of 2.8 hr, the instantaneous dose
rate is 1.34 mSv/hr!!
Moral: Choose factors wisely!!
AAPM Physics Review – July 19, 2014
Instantaneous Dose Rate (IDR)
- NCRP recommends use of 1 hr as the minimum period for
measuring IDR
- Compares with many places (e.g., Europe) where the
instantaneous dose rate at the highest dose delivery rate is
used
- Not an issue for occupancy of 1 for uniformly spaced
treatments
- Only an issue when treatments are not given uniformly
throughout the 40 hr week or occupancy is <1
AAPM Physics Review – July 19, 2014
Shielding Materials
Materials Density Comments
(g/cm2
)
Concrete 2.35; 3.85 High density concrete is very expensive
Concrete blocks 2.35; 3.85; 4.62 Lack structural integrity of concrete
Lead 11.35 Great for photons; bad for neutrons.
Needs structural support
Steel 7.87 Not as efficient as lead for photons, but better for
neutrons
Earth 1.5 Cheap! Therefore, build underground
Brick 1.65 - 2.05
Polyethylene; ~1.0 Used to shield against neutrons in doors, ducts etc.
borated polyethylene
AAPM Physics Review – July 19, 2014
Width of Primary Barrier - I
- Allow 1 foot (0.3 m) either side of the primary beam
- allow for fixed primary collimator diameter (0.5 m)
- Allow for greater width at the top of the wall
6
.
0
5
.
0 
 d
w
6
.
0
2
4
.
0 
 d
w
0.5 ' 0.6
w d
 
AAPM Physics Review – Aug 3, 2013
A
C
D
B
Width evaluated
in elevated
plane
AAPM Physics Review – July 19, 2014
Contouring the Primary Shielding in the
Ceiling
AAPM Physics Review – July 19, 2014
Lead-Only Room: Groundshine
“McGinley”
effect
AAPM Physics Review – July 19, 2014
A - wall B - ceiling
C - ceiling
for primary barriers,
laser support should
be attached to the
steel channel
AAPM Physics Review – July 19, 2014
Neutron Spectra from Medical Linacs
- Neutrons produced in the head of the linac are
first moderated by the x-ray shielding
- Neutrons are further moderated by scattering off
the concrete walls of the therapy room
- Walls with only regular density concrete that are
sufficient for x-ray protection will be adequate for
neutrons.
AAPM Physics Review – July 19, 2014
Neutron Spectra from Medical Linacs
- The total neutron fluence therefore consists of
direct (‘fast’) neutrons, scattered neutrons and
thermal neutrons
- Fast neutrons obey the inverse law, but scattered
and thermal neutrons are isotropically distributed;
hence the neutron fluence drops off less fast than
inverse square
   
total dir sca th
= + +
AAPM Physics Review – July 19, 2014
Shielding Thickness Required to Halve
the Average Neutron Energy
most probable
energy
E (MeV)
Half
Energy
Layer
(cm)
AAPM Physics Review – July 19, 2014
Production of Neutrons by Primary
Beam in a Laminated Barrier
1
t 2
t
m
t
For high energy
x-ray beams,
the x-ray dose is
enhanced by a
factor of 2.7 to
be conservative
Incoming
photon
neutron
Capture  ray
AAPM Physics Review – July 19, 2014
Production of Neutrons by Primary
Beam in a Laminated Barrier
n
x TVL
t
TVL
t
m
t
t
F
R
D
H /
/
2
max
0 2
1
10
*
10
*
)
3
.
0
2











where H is the neutron dose equiv.(Sv wk-1)
D0 is the x-ray dose at isocenter (cGy wk-1)
R is the neutron prodn. rate (Sv cGy-1 m-2)
and Fmax is the max. beam area at isocenter (m2)
AAPM Physics Review – July 19, 2014
Total Dose Behind a Laminated
Barrier
Htot = Hn + Hph = Hn +2.7*Htr
The 2.7 factor accounts for the production of capture
gamma rays by the photo-produced neutrons. This is an
conservative, empirical figure given by McGinley
AAPM Physics Review – July 19, 2014
Contributions to the Dose at the
End of a Maze
1. Primary scatter
2. Patient scatter
3. Leakage along maze
4. Leakage through maze wall
AAPM Physics Review – July 19, 2014
Secondary Radiation at Door due to
Wall Scatter of Primary Beam
 2
2
1
2
2
1
1
r
r
i
B
s
d
d
d
A
A
U
W
S



AAPM Physics Review – July 19, 2014
Secondary Radiation at Door due to
Patient Scatter
 
 2
sec
1
1
400
/
s
sca
B
p
d
d
d
A
F
U
aW
S


AAPM Physics Review – July 19, 2014
Secondary Radiation at Door due to
Leakage
 2
1
1
1
0
d
d
A
U
W
L
L
s
B 

AAPM Physics Review – July 19, 2014
Secondary Radiation at Door due to
Leakage Through Maze Wall
 2
)
/
(
0 10
d
l
TVL
t
B
d
d
U
W
L
L



Note that this radiation
is more energetic than
radiation along the
maze
AAPM Physics Review – July 19, 2014
Mazes
The total dose when the beam is directed towards the wall
is the sum of the four components:
Dt = f*Ss + Sp + L + Ld
Note that the Ss component is reduced by a factor “f” to
account for patient attenuation. Assuming use factors of ¼
for the 4 gantry angles, McGinley gives an average total
dose of:
DT = 2.64 Dt
AAPM Physics Review – July 19, 2014
Comments on NCRP Formalism
• Several authors† have noted that the foregoing formalism
underestimates the true dose at the door.
• This problem has been partly rectified by redefining the
geometry of the scatter and assuming lower energies for the
scattered radiation which, in turn, increase the scatter
coefficients
† Numark & Kase; Al-Affan; McGinley & James
AAPM Physics Review – July 19, 2014
Reflection Coefficients for Monoenergetic X-
Rays on Concrete
AAPM Physics Review – July 19, 2014
Door Inside Room
AAPM Physics Review – July 19, 2014
Door Outside Room
AAPM Physics Review – July 19, 2014
Edge Effect for Direct Shielded Doors
AAPM Physics Review – July 19, 2014
High Energy
Direction of door
Isocenter
Good
direction
Bad
direction
Isocenter
AAPM Physics Review – July 19, 2014
Parameters for Calculation of Neutron Dose
at Door
AAPM Physics Review – July 19, 2014
Neutron Fluence Entering the
Maze
The total neutron fluence is given by (McCall
et. al, 1999)
The addition of (2) in the scattered and
thermal terms accounts for the directionality of
the neutrons and Qn is the #neutrons/photon
Gy
r
n
r
n
n
S
Q
S
Q
d
Q





2
3
.
1
2
4
.
5
4 2
1




AAPM Physics Review – July 19, 2014
Neutron Dose at Door of Maze
Kersey formula:
where H0 is the total neutron head leakage at 1.4 m from
the target, d1 is the distance from the target to the maze
entrance and d2 is the length of the maze. S0/S is the ratio
of the inner to outer maze areas (rationale for lintel). The
TVL for neutrons along the maze is 5 m.
2
0
0
2 5
1
1
10
d
S
H H
S d


AAPM Physics Review – July 19, 2014
Modified Kersey Formula
Wu & McGinley’s formula:
is a modification of McGinley’s 2-component
model and is based on an analysis of a number of
facilities.
























 TVD
d
d
A
D
n x
S
S
x
H
2
2
10
10
64
.
1
10
4
.
2 9
.
1
1
0
15
, 
AAPM Physics Review – July 19, 2014
Dose at Maze Door due to Capture 
Rays
Capture rays follow the same formalism for photoneutron
attenuation in the maze. For mazes >3 m, the first term
disappears and a single exponential term is left.
where K is the  dose/n fluence ratio at the maze entrance
is the neutron fluence at the maze entrance
d2 is the distance along the maze
and TVD is the TVL for ’s down the maze
TVD
d
total
K
D /
2
10


AAPM Physics Review – July 19, 2014
Combined Dose at Maze Door
The neutron and capture  ray components are
calculated and shielding thicknesses to meet the
required effective dose equivalent are derived
using the following TVLs:
neutrons (100 keV) - 4.5 cm polyethylene
capture  rays - 6.1 cm lead
As a rule, for high energy machines only these
components and the photon leakage components
need be considered. Generally, for 15 & 18 MV
photons, Dn >Dcapture  rays
AAPM Physics Review – Aug 3, 2013
Ducts
AAPM Physics Review – July 19, 2014
Practical Problems with NCRP #151
- Use of dual energy workloads, dual TVLs,
laminated barriers creates confusion in the
calculations
- Use of the obliquity factor for scattered radiation
(not leakage) is unclear – two examples in the text
give opposing views. Experts are divided on this
issue, but it can be used, but with caution!
AAPM Physics Review – July 19, 2014
Handling Dual Energies in NCRP #151
- A dual energy machine having say 6 and 18 MV
will have different workloads for (P,S) and L
radiation for 3D CRT and IMRT (6 MV assumed).
In general, a conservative approach assumes:
- use of the maximum energy in a full 3D CRT
environment for the primary and …
- the IMRT workload for the secondary barrier
orthogonal to the plane of gantry rotation
AAPM Physics Review – July 19, 2014
Handling Dual Energies in NCRP #151
- in the secondary barrier region adjacent to the
primary, the dominance of 3D CRT vs 3D
CRT+IMRT depends on the explicit workloads
and room geometry
- one should be careful to consider 20° scatter
radiation for laminated barriers since the primary
beam angle is only 14° (exclusive of extra 2’
barrier width recommended by NCRP)
AAPM Physics Review – July 19, 2014
Handling Dual Energies in NCRP #151
- In that same angular zone in the secondary barrier,
there will be be TVLs for two energies for
scattered and leakage radiation
- Rule is that:
- scatter should be added to scatter to determine if an
extra HVL is required
- leakage should be added to leakage to determine if
an extra HVL is required
- Scatter is then compared to leakage to determine if
an additional HVL is required
AAPM Physics Review – July 19, 2014
Handling Dual Energies in NCRP #151
- To recap:
(i) S1 + S2  S
(ii) L1 + L2  L
(iii) S + L  Total secondary thickness
- Question remains as to which of the TVLs to use;
higher or lower for L (ii); S or L for (iii)
- However, because of these multiple additions, this
may overestimate the required shielding
AAPM Physics Review – July 19, 2014
Example: Barrier Adjacent to
Primary
N
o
t
e
Note: … and only one shielding material is used!
Energy Radiation Workload (Gy) Thickness Comment
________________________________________________________________________________
15 MV Leakage 225 36.1”
6 MV Leakage 1775 42.9”
Combined 6 +15 MV Leakage 2000 47.2” Use TVL1 for 15 MV
15 MV Scatter 225 45.6”
6 MV Scatter 525 42.0”
Combined 6 +15 MV Scatter 750 49.3” Use TVLsca for 15 MV
Combined 6 + 15 MV Leakage + scatter 53.3” Use TVL1 for 15 MV
AAPM Physics Review – July 19, 2014
Example: Barrier Orthogonal to
Gantry Rotation Plane
Energy Radiation Workload (Gy) Thickness Comment
_______________________________________________________________________________________
15 MV Leakage 225 37.3”
6 MV Leakage 1775 43.9”
Combined 6 +15 MV Leakage 2000 47.8” Use TVL1 for 15 MV
15 MV Scatter 225 19.8”
6 MV Scatter 525 22.6”
Combined 6 +15 MV Scatter 750 24.7” Use TVLsca for 15 MV
Combined 6 + 15 MV Leakage + scatter 47.8” Use TVL1 for 15 MV
AAPM Physics Review – July 19, 2014
Thank you for your attention!
AAPM Physics Review – July 19, 2014
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AAPM Physics Review – July 19, 2014
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electron accelerators” M.S. thesis, San Jose State University, 1994.
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AAPM Physics Review – July 19, 2014
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AAPM Physics Review – July 19, 2014
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Shielding calculation

  • 1. AAPM Physics Review – July 19, 2014 Basic Principles of Radiation Therapy Shielding Design Peter J. Biggs Ph.D., Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
  • 2. AAPM Physics Review – July 19, 2014 Outline 1 Basic principles and definitions 2 Calculations 3 Workload, use and occupancy factors 4 Shielding materials 5 Tenth value layers (TVL) 6 Room layout & features, construction details 7 Neutrons & laminated barriers 8 Mazes and doors 9 Ducts
  • 3. AAPM Physics Review – July 19, 2014 Definitions P: Weekly design dose limit (Sv/wk) d: Distance from target to measurement point W: Workload (Gy/wk) U: Use Factor T: Occupancy factor a: Scatter fraction; (, E) dsec: Distance from scatterer to measurement point dsca: Distance from target to scatterer dl: Distance from the target to measurement point F: Area of the beam in the plane of the scatterer (cm2) B: Barrier transmission factor
  • 4. AAPM Physics Review – Aug 3, 2013 Also IPEM Report #75
  • 5. AAPM Physics Review – July 19, 2014 Basic Principles The purpose of radiation shielding is to reduce the effective equivalent dose from a linear accelerator to a point outside the room to a level that is determined by individual states. Public or uncontrolled area - 0.02 mSv per week - 0.02 mSv in any one hour Controlled area - 1 mSv/wk (in practice 0.1 mSv/wk)
  • 6. AAPM Physics Review – July 19, 2014 Basic Shielding Equations: NCRP #151 Methodology Primary: Scatter: Leakage: WUT Pd B 2 p  F 400 d d aWT P B 2 sca 2 sec s  WT Pd * 1000 B 2 l l  Bx is the barrier transmission factor The factor 1000 is due to the 0.1% leakage requirement Iin Iout out x in I B I 
  • 7. AAPM Physics Review – July 19, 2014 Number of Tenth Value Layers (Primary & Leakage) The number, n, of tenth value layers (TVLs) required to reduce the dose to the value P is given by: and the thickness for primary and leakage radiation is given by:   B n 10 log   e l p l p TVL n TVL T , 1 , ) 1 (    NCRP report No. 151 Table B.2
  • 8. AAPM Physics Review – July 19, 2014 Number of Tenth Value Layers for Scattered Radiation Scatter TVLs are dependent only on energy and scattering angle, so: NCRP report No. 151, Table B.5a    s s s TVL n T 
  • 9. AAPM Physics Review – July 19, 2014 Tenth Value Layers Primary TVLs (cm)* Energy (MV) 4 6 10 15 18 20 Concrete 35(30) 37(33) 41(37) 44(41) 45(43) 46(44) Steel 9.9 10 11 11 11 11 Lead 5.7 5.7 5.7 5.7 5.7 5.7 Leakage TVLs at 90°* (cm) Energy (MV) 4 6 10 15 18 20 Concrete 33(28) 34(29) 35(31) 36(33) 36(34) 36(34) Steel** 8 8.5 8.7 8.7 Lead** 4.5 4.6 4.7 4.7 * First term is 1st TVL and term in brackets is for all other TVLs. Data from NCRP #151 ** Data from McGinley
  • 10. AAPM Physics Review – July 19, 2014 Obliquity Factor - I P
  • 11. AAPM Physics Review – July 19, 2014 Obliquity factor - II Rule of thumb: - for >45° - and B<0.001 - Add ~2 HVL for low-energy photons - And ~1 HVL for high-energy photons
  • 12. AAPM Physics Review – July 19, 2014 Obliquity factor - III - Experimental data by Kirn et. al. (1954) - verified by Biggs (1996) using the Monte Carlo for a large range of clinical energies - Monte Carlo results are in good agreement with previous recommendations at low energy, but more detail is given - Caveat: beware of applying obliquity factor corrections for large angles!!
  • 13. AAPM Physics Review – July 19, 2014 Conventional Workload - Number of patients treated per week multiplied by the average dose (MU)/patient at isocenter - Include calibration, service, if indicated - Recommended values: 500 or 1000 Gy wk-1 - Survey shows values from 250 to 450 Gy wk-1 - Balance between high energy and low energy use? Using high energy is conservative approach - Electron-only (IORT) machines?
  • 14. AAPM Physics Review – July 19, 2014 Workload TBI - Workload for TBI >> workload for conventional therapy due to the extended distances: - Leakage workload is also higher, but patient- and wall-scattered workload is not. - Radiation is usually directed at one barrier 2 TBI TBI TBI d D W 
  • 15. AAPM Physics Review – July 19, 2014 Workload IMRT (1) - Workload for IMRT is complicated by the fact that the #MU is much larger than for conventional therapy. The IMRT factor is defined as: and varies between 2 and 10 or more - This only affects leakage radiation, not primary or scattered radiation. conv IMRT I MU MU C 
  • 16. AAPM Physics Review – July 19, 2014 Workload IMRT (2) - Helical tomotherapy has the highest “C” values, >10. - Linac based IMRT at MGH gives an average “C” value of about 5 - Impact of IMAT on MUs (VMAT, Rapid Arc) – reduction of MUs - Anecdote: For a 6/18 MV machine the energy use prior to IMRT was 20%/80% (MU). With 28% IMRT patient load, the use was 70%/30%. Hence need to consider balancing the workload for two energies
  • 17. AAPM Physics Review – July 19, 2014 Conventional Use Factors 90° interval: - 0° (31%); 90° and 270° (21.3 % each); 180° (26.3 %) - previously, all barriers were assigned 0.25 45° interval: - 0° (25.6 %); 45° and 315° (5.8 % each); 90° and 270° (15.9 % each); 135° and 225° (4 % each); 180° (23 %)
  • 18. AAPM Physics Review – July 19, 2014 Use Factor for Conventional Therapy
  • 19. AAPM Physics Review – July 19, 2014 Use Factors – Special Cases - A significant TBI load will require one wall to have an increased use factor - IMRT may also require a change in the values assigned to the use factor for the primary barrier
  • 20. AAPM Physics Review – July 19, 2014 Use Factor – Dedicated Machines - One should pay attention to the types of procedures to be carried out in new room - A room dedicated to SRS and SRT requires different considerations from a general therapy room - A room dedicated to breast treatments will use specific ranges of primary beam angles
  • 21. AAPM Physics Review – July 19, 2014 Example: Use Factor for Stereotactic Radiosurgery
  • 22. AAPM Physics Review – July 19, 2014 Workload - Summation (1) Primary: Patient scatter: (note that the TBI contribution is calculated separately – source not at isocenter) .....) (       QA QA IMRT IMRT TBI TBI conv conv scat wall p U W U W U W U W WU WU ...) ( ,     QA IMRT conv iso scatter W W W W
  • 23. AAPM Physics Review – July 19, 2014 Workload - Summation (2) Leakage: ....) (      QA QA IMRT I TBI conv L W C W C W W W
  • 24. AAPM Physics Review – July 19, 2014 Occupancy Factors - Occupancy factors down to 1/40 are now allowed - This is the limiting factor to permit 0.02 mSv in any one hour using an MPD of 0.02 mSv/wk - Area beyond vault door can now have an occupancy of 1/8 - Caveat: be sure to check not only the occupancy of the immediately adjacent area, but also the area beyond. For example, an office beyond a corridor becomes the dominant factor in the calculation. Also future development plans foreseen.
  • 25. AAPM Physics Review – July 19, 2014 If the Dose Rate is High, Should I Freak Out? Note that even for a weekly limit of 0.02 mSv/wk, the dose rate outside a barrier could be quite high. e.g. for a primary barrier, an occupancy of 1/40 would imply a weekly dose of 3.8 mSv and for a beam on time of 2.8 hr, the instantaneous dose rate is 1.34 mSv/hr!! Moral: Choose factors wisely!!
  • 26. AAPM Physics Review – July 19, 2014 Instantaneous Dose Rate (IDR) - NCRP recommends use of 1 hr as the minimum period for measuring IDR - Compares with many places (e.g., Europe) where the instantaneous dose rate at the highest dose delivery rate is used - Not an issue for occupancy of 1 for uniformly spaced treatments - Only an issue when treatments are not given uniformly throughout the 40 hr week or occupancy is <1
  • 27. AAPM Physics Review – July 19, 2014 Shielding Materials Materials Density Comments (g/cm2 ) Concrete 2.35; 3.85 High density concrete is very expensive Concrete blocks 2.35; 3.85; 4.62 Lack structural integrity of concrete Lead 11.35 Great for photons; bad for neutrons. Needs structural support Steel 7.87 Not as efficient as lead for photons, but better for neutrons Earth 1.5 Cheap! Therefore, build underground Brick 1.65 - 2.05 Polyethylene; ~1.0 Used to shield against neutrons in doors, ducts etc. borated polyethylene
  • 28. AAPM Physics Review – July 19, 2014 Width of Primary Barrier - I - Allow 1 foot (0.3 m) either side of the primary beam - allow for fixed primary collimator diameter (0.5 m) - Allow for greater width at the top of the wall 6 . 0 5 . 0   d w 6 . 0 2 4 . 0   d w 0.5 ' 0.6 w d  
  • 29. AAPM Physics Review – Aug 3, 2013 A C D B Width evaluated in elevated plane
  • 30. AAPM Physics Review – July 19, 2014 Contouring the Primary Shielding in the Ceiling
  • 31. AAPM Physics Review – July 19, 2014 Lead-Only Room: Groundshine “McGinley” effect
  • 32. AAPM Physics Review – July 19, 2014 A - wall B - ceiling C - ceiling for primary barriers, laser support should be attached to the steel channel
  • 33. AAPM Physics Review – July 19, 2014 Neutron Spectra from Medical Linacs - Neutrons produced in the head of the linac are first moderated by the x-ray shielding - Neutrons are further moderated by scattering off the concrete walls of the therapy room - Walls with only regular density concrete that are sufficient for x-ray protection will be adequate for neutrons.
  • 34. AAPM Physics Review – July 19, 2014 Neutron Spectra from Medical Linacs - The total neutron fluence therefore consists of direct (‘fast’) neutrons, scattered neutrons and thermal neutrons - Fast neutrons obey the inverse law, but scattered and thermal neutrons are isotropically distributed; hence the neutron fluence drops off less fast than inverse square     total dir sca th = + +
  • 35. AAPM Physics Review – July 19, 2014 Shielding Thickness Required to Halve the Average Neutron Energy most probable energy E (MeV) Half Energy Layer (cm)
  • 36. AAPM Physics Review – July 19, 2014 Production of Neutrons by Primary Beam in a Laminated Barrier 1 t 2 t m t For high energy x-ray beams, the x-ray dose is enhanced by a factor of 2.7 to be conservative Incoming photon neutron Capture  ray
  • 37. AAPM Physics Review – July 19, 2014 Production of Neutrons by Primary Beam in a Laminated Barrier n x TVL t TVL t m t t F R D H / / 2 max 0 2 1 10 * 10 * ) 3 . 0 2            where H is the neutron dose equiv.(Sv wk-1) D0 is the x-ray dose at isocenter (cGy wk-1) R is the neutron prodn. rate (Sv cGy-1 m-2) and Fmax is the max. beam area at isocenter (m2)
  • 38. AAPM Physics Review – July 19, 2014 Total Dose Behind a Laminated Barrier Htot = Hn + Hph = Hn +2.7*Htr The 2.7 factor accounts for the production of capture gamma rays by the photo-produced neutrons. This is an conservative, empirical figure given by McGinley
  • 39. AAPM Physics Review – July 19, 2014 Contributions to the Dose at the End of a Maze 1. Primary scatter 2. Patient scatter 3. Leakage along maze 4. Leakage through maze wall
  • 40. AAPM Physics Review – July 19, 2014 Secondary Radiation at Door due to Wall Scatter of Primary Beam  2 2 1 2 2 1 1 r r i B s d d d A A U W S   
  • 41. AAPM Physics Review – July 19, 2014 Secondary Radiation at Door due to Patient Scatter    2 sec 1 1 400 / s sca B p d d d A F U aW S  
  • 42. AAPM Physics Review – July 19, 2014 Secondary Radiation at Door due to Leakage  2 1 1 1 0 d d A U W L L s B  
  • 43. AAPM Physics Review – July 19, 2014 Secondary Radiation at Door due to Leakage Through Maze Wall  2 ) / ( 0 10 d l TVL t B d d U W L L    Note that this radiation is more energetic than radiation along the maze
  • 44. AAPM Physics Review – July 19, 2014 Mazes The total dose when the beam is directed towards the wall is the sum of the four components: Dt = f*Ss + Sp + L + Ld Note that the Ss component is reduced by a factor “f” to account for patient attenuation. Assuming use factors of ¼ for the 4 gantry angles, McGinley gives an average total dose of: DT = 2.64 Dt
  • 45. AAPM Physics Review – July 19, 2014 Comments on NCRP Formalism • Several authors† have noted that the foregoing formalism underestimates the true dose at the door. • This problem has been partly rectified by redefining the geometry of the scatter and assuming lower energies for the scattered radiation which, in turn, increase the scatter coefficients † Numark & Kase; Al-Affan; McGinley & James
  • 46. AAPM Physics Review – July 19, 2014 Reflection Coefficients for Monoenergetic X- Rays on Concrete
  • 47. AAPM Physics Review – July 19, 2014 Door Inside Room
  • 48. AAPM Physics Review – July 19, 2014 Door Outside Room
  • 49. AAPM Physics Review – July 19, 2014 Edge Effect for Direct Shielded Doors
  • 50. AAPM Physics Review – July 19, 2014 High Energy Direction of door Isocenter Good direction Bad direction Isocenter
  • 51. AAPM Physics Review – July 19, 2014 Parameters for Calculation of Neutron Dose at Door
  • 52. AAPM Physics Review – July 19, 2014 Neutron Fluence Entering the Maze The total neutron fluence is given by (McCall et. al, 1999) The addition of (2) in the scattered and thermal terms accounts for the directionality of the neutrons and Qn is the #neutrons/photon Gy r n r n n S Q S Q d Q      2 3 . 1 2 4 . 5 4 2 1    
  • 53. AAPM Physics Review – July 19, 2014 Neutron Dose at Door of Maze Kersey formula: where H0 is the total neutron head leakage at 1.4 m from the target, d1 is the distance from the target to the maze entrance and d2 is the length of the maze. S0/S is the ratio of the inner to outer maze areas (rationale for lintel). The TVL for neutrons along the maze is 5 m. 2 0 0 2 5 1 1 10 d S H H S d  
  • 54. AAPM Physics Review – July 19, 2014 Modified Kersey Formula Wu & McGinley’s formula: is a modification of McGinley’s 2-component model and is based on an analysis of a number of facilities.                          TVD d d A D n x S S x H 2 2 10 10 64 . 1 10 4 . 2 9 . 1 1 0 15 , 
  • 55. AAPM Physics Review – July 19, 2014 Dose at Maze Door due to Capture  Rays Capture rays follow the same formalism for photoneutron attenuation in the maze. For mazes >3 m, the first term disappears and a single exponential term is left. where K is the  dose/n fluence ratio at the maze entrance is the neutron fluence at the maze entrance d2 is the distance along the maze and TVD is the TVL for ’s down the maze TVD d total K D / 2 10  
  • 56. AAPM Physics Review – July 19, 2014 Combined Dose at Maze Door The neutron and capture  ray components are calculated and shielding thicknesses to meet the required effective dose equivalent are derived using the following TVLs: neutrons (100 keV) - 4.5 cm polyethylene capture  rays - 6.1 cm lead As a rule, for high energy machines only these components and the photon leakage components need be considered. Generally, for 15 & 18 MV photons, Dn >Dcapture  rays
  • 57. AAPM Physics Review – Aug 3, 2013 Ducts
  • 58. AAPM Physics Review – July 19, 2014 Practical Problems with NCRP #151 - Use of dual energy workloads, dual TVLs, laminated barriers creates confusion in the calculations - Use of the obliquity factor for scattered radiation (not leakage) is unclear – two examples in the text give opposing views. Experts are divided on this issue, but it can be used, but with caution!
  • 59. AAPM Physics Review – July 19, 2014 Handling Dual Energies in NCRP #151 - A dual energy machine having say 6 and 18 MV will have different workloads for (P,S) and L radiation for 3D CRT and IMRT (6 MV assumed). In general, a conservative approach assumes: - use of the maximum energy in a full 3D CRT environment for the primary and … - the IMRT workload for the secondary barrier orthogonal to the plane of gantry rotation
  • 60. AAPM Physics Review – July 19, 2014 Handling Dual Energies in NCRP #151 - in the secondary barrier region adjacent to the primary, the dominance of 3D CRT vs 3D CRT+IMRT depends on the explicit workloads and room geometry - one should be careful to consider 20° scatter radiation for laminated barriers since the primary beam angle is only 14° (exclusive of extra 2’ barrier width recommended by NCRP)
  • 61. AAPM Physics Review – July 19, 2014 Handling Dual Energies in NCRP #151 - In that same angular zone in the secondary barrier, there will be be TVLs for two energies for scattered and leakage radiation - Rule is that: - scatter should be added to scatter to determine if an extra HVL is required - leakage should be added to leakage to determine if an extra HVL is required - Scatter is then compared to leakage to determine if an additional HVL is required
  • 62. AAPM Physics Review – July 19, 2014 Handling Dual Energies in NCRP #151 - To recap: (i) S1 + S2  S (ii) L1 + L2  L (iii) S + L  Total secondary thickness - Question remains as to which of the TVLs to use; higher or lower for L (ii); S or L for (iii) - However, because of these multiple additions, this may overestimate the required shielding
  • 63. AAPM Physics Review – July 19, 2014 Example: Barrier Adjacent to Primary N o t e Note: … and only one shielding material is used! Energy Radiation Workload (Gy) Thickness Comment ________________________________________________________________________________ 15 MV Leakage 225 36.1” 6 MV Leakage 1775 42.9” Combined 6 +15 MV Leakage 2000 47.2” Use TVL1 for 15 MV 15 MV Scatter 225 45.6” 6 MV Scatter 525 42.0” Combined 6 +15 MV Scatter 750 49.3” Use TVLsca for 15 MV Combined 6 + 15 MV Leakage + scatter 53.3” Use TVL1 for 15 MV
  • 64. AAPM Physics Review – July 19, 2014 Example: Barrier Orthogonal to Gantry Rotation Plane Energy Radiation Workload (Gy) Thickness Comment _______________________________________________________________________________________ 15 MV Leakage 225 37.3” 6 MV Leakage 1775 43.9” Combined 6 +15 MV Leakage 2000 47.8” Use TVL1 for 15 MV 15 MV Scatter 225 19.8” 6 MV Scatter 525 22.6” Combined 6 +15 MV Scatter 750 24.7” Use TVLsca for 15 MV Combined 6 + 15 MV Leakage + scatter 47.8” Use TVL1 for 15 MV
  • 65. AAPM Physics Review – July 19, 2014 Thank you for your attention!
  • 66. AAPM Physics Review – July 19, 2014 Abrath, F. G.; Bello, J.; Purdy, J. A. Attenuation of primary and scatter radiation in concrete and steel for 18 MV x-rays from a Clinac-20 linear accelerator. Health Physics. 45: 969-973; 1983. Al-Affan, I.A.M. “Estimation of the dose at the maze entrance for x-rays from radiotherapy linear accelerators” Med. Phys. 27:231-238;2000 Almond, P. Neutron leakage from current machines. Proceedings of a conference on neutrons from medical accelerators (NBS Special Publication 554, Gaithersburg, MD, 1979), pp. 129-138. Barish, R.J. “Evaluation of a new high-density shielding material” Health Physics 64:412-416;1993 Biggs, P.J. “An interactive computer graphics program for determining the shielding for a megavoltage radiotherapy facility” Health Physics 43:601-607; 1982 Biggs, P.J. “Shielding design for the ceiling of a 6-MV accelerator in an existing facility” Health Physics 52:491-493; 1987 Biggs, P.J. “Calculation of shielding door thicknesses for radiation therapy facilities using the ITS Monte Carlo program” Health Physics 61:465-472; 1991
  • 67. AAPM Physics Review – July 19, 2014 Biggs, P.J. “Obliquity factors for 60 Co and 4, 10 and 18 MV x-rays for concrete, steel and lead and angles of incidence between 0° and 70°” Health Physics 70:527-536; 1995 Chiltern, A.B., Shultis, J.K. and Faw, R.E. “Principles of Radiation Shielding” Prentice Hall, Englewood Cliffs, New Jersey, 1984. Elsalim, M.M. “Characterization of the neutron environment around Varian medical electron accelerators” M.S. thesis, San Jose State University, 1994. Ipe, N.E., McCall, R.C., Jenkins, T.M. and Benson, E. “Shielding of radiation fields generated by 252 Cf in a concrete maze, part I – experiment” SLAC-PUB-7695, February 1998. Karzmark, C. J.; Capone, T. “Measurements of 6 MV x-rays, Part I Primary radiation absorption in lead, steel and concrete, and Part II Characteristics of secondary radiation” Brit. J. Radiol. 41:33-39: 222-226; 1968. Kersey, R.W. “Estimation of neutron and gamma radiation doses in the entrance mazes of SL75-20 linear accelerator treatment rooms” Medicamundi 24, 150-155 (1979) Lo, Y.C. “Dose albedos for 4, 10 and 18 MV bremsstrahlung beams on concrete, iron and lead – normally incident” Med. Phys. 19:659-666; 1992.
  • 68. AAPM Physics Review – July 19, 2014 McCall, R.C., Jenkins, T.M. and Shore, R.A. “Transport of accelerator produced neutrons in a concrete room” IEEE Trans. Nucl. Sci. NS-26, #1, 1593 (1979) McGinley, P.H. “Photoneutron production in the primary barriers of meddical accelerator rooms” Health Physics 62:359-363;1992 McGinley, P.H., Miner, M.S. and Mitchum, M.L. “A method for calcualting the dose due to capture gamma rays in accelerator mazes” Phys. Med. Biol. 40:1467-1473;1995 McGinley, P.H. and James, J.L. “Maze design methods for 6- and 10-MeV Accelerators” Rad. Prot. Management. 14:59-64;1997 McGinley, P.H. “Shielding techniques for radiation oncology facilities” Medical Physics Publishing, Madison, Wisconsin, 1998. Nogueira, I.P. and Biggs P.J. “Measurement of scatter factors for 4, 6, 10 and 23 MV x- rays at scattering angles between 30° and 135°” Health Physics, 81:330-340; 2001. NCRP report #49, National Council on Radiation Protection and Measurements. Structural shielding design and evaluation for medical use of x-rays and gamma rays of energies up to 10 MV. Bethesda, MD: NCRP; NCRP Report No. 49; 1976.
  • 69. AAPM Physics Review – July 19, 2014 NCRP report #51, National Council on Radiation Protection and Measurements. Radiation protection guidelines for 0.1-100 MeV particle accelerator facilities. Bethesda, MD: NCRP; NCRP Report No. 51; 1977. NCRP report #79, National Council on Radiation Protection and Measurements. Neutron contamination from medical electron accelerators. Bethesda, MD: NCRP; NCRP Report No. 79; 1984. NCRP report # 151, National Council on Radiation Protection and Measurements. Structural shielding design evaluation for megavoltage x-and gamma-ray radiotherapy facilities. Bethesda, MD: NCRP; NCRP Report No. 151; 2005. Numark, N.J. and Kase, K.R. “Radiation transmission and scattering for medical linacs producing x-rays of 6- and 15-MV: comparison with measurements” Health Physics 48:289-295;1985 Shobe J; Rodgers J. E.; Taylor P. L. Scatter fractions of dose from 6, 10, 18 and 25 MV linear accelerator x-rays in radiotherapy facilities. Health Physics 76:27-35; 1999.