NOTE The report of the Committee without its annexes appears as Official Records of the General Assembly, Sixty-third Session, Supplement No. 46. The designations employed and the presentation of material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area, or of its authorities, or concerning the delimitation of its frontiers or boundaries. The country names used in this document are, in most cases, those that were in use at the time the data were collected or the text prepared. In other cases, however, the names have been updated, where this was possible and appropriate, to reflect political changes. Scientific Annexes Annex A. Medical radiation exposures Annex B. Exposures of the public and workers from various sources of radiation INTROdUCTION 1. In the course of the research and development for and the application of atomic energy and nuclear technologies, a number of radiation accidents have occurred. Some of these accidents have resulted in significant health effects and occasionally in fatal outcomes. The application of technologies that make use of radiation is increasingly widespread around the world. Millions of people have occupations related to the use of radiation, and hundreds of millions of individuals benefit from these uses. Facilities using intense radiation sources for energy production and for purposes such as radiotherapy, sterilization of products, preservation of foodstuffs and gamma radiography require special care in the design and operation of equipment to avoid radiation injury to workers or to the public. Experience has shown that such technology is generally used safely, but on occasion controls have been circumvented and serious radiation accidents have ensued. 2. Reviews of radiation exposures from accidents have been presented in previous UNSCEAR reports. The last report containing an exclusive chapter on exposures from accidents was the UNSCEAR 1993 Report [U6]. 3. This annex is aimed at providing a sound basis for conclusions regarding the number of significant radiation accidents that have occurred, the corresponding levels of radiation exposures and numbers of deaths and injuries, and the general trends for various practices. Its conclusions are to be seen in the context of the Committee's overall evaluations of the levels and effects of exposure to ionizing radiation. 4. The Committee's evaluations of public, occupational and medical diagnostic exposures are mostly concerned with chronic exposures of …

sources and effects of ionizing radiation

Since publication of the American Association of Physicists in Medicine (AAPM) Task Group No. 43 Report in 1995 (TG-43), both the utilization of permanent source implantation and the number of low-energy interstitial brachytherapy source models commercially available have dramatically increased. In addition, the National Institute of Standards and Technology has introduced a new primary standard of air-kerma strength, and the brachytherapy dosimetry literature has grown substantially, documenting both improved dosimetry methodologies and dosimetric characterization of particular source models. In response to these advances, the AAPM Low-energy Interstitial Brachytherapy Dosimetry subcommittee (LIBD) herein presents an update of the TG-43 protocol for calculation of dose-rate distributions around photon-emitting brachytherapy sources. The updated protocol (TG-43U1) includes (a) a revised definition of air-kerma strength; (b) elimination of apparent activity for specification of source strength; (c) elimination of the anisotropy constant in favor of the distance-dependent one-dimensional anisotropy function; (d) guidance on extrapolating tabulated TG-43 parameters to longer and shorter distances; and (e) correction for minor inconsistencies and omissions in the original protocol and its implementation. Among the corrections are consistent guidelines for use of point- and line-source geometry functions. In addition, this report recommends a unified approach to comparing reference dose distributions derived from different investigators to develop a single critically evaluated consensus dataset as well as guidelines for performing and describing future theoretical and experimental single-source dosimetry studies. Finally, the report includes consensus datasets, in the form of dose-rate constants, radial dose functions, and one-dimensional (1D) and two-dimensional (2D) anisotropy functions, for all low-energy brachytherapy source models that met the AAPM dosimetric prerequisites [Med. Phys. 25, 2269 (1998)] as of July 15, 2001. These include the following 125I sources: Amersham Health models 6702 and 6711, Best Medical model 2301, North American Scientific Inc. (NASI) model MED3631-A/M, Bebig/Theragenics model I25.S06, and the Imagyn Medical Technologies Inc. isostar model IS-12501. The 103Pd sources included are the Theragenics Corporation model 200 and NASI model MED3633. The AAPM recommends that the revised dose-calculation protocol and revised source-specific dose-rate distributions be adopted by all end users for clinical treatment planning of low energy brachytherapy interstitial sources. Depending upon the dose-calculation protocol and parameters currently used by individual physicists, adoption of this protocol may result in changes to patient dose calculations. These changes should be carefully evaluated and reviewed with the radiation oncologist preceding implementation of the current protocol.

Update of AAPM Task Group No. 43 Report: A revised AAPM protocol for brachytherapy dose calculations.

Ion acceleration driven by superintense laser pulses is attracting an impressive and steadily increasing effort. Motivations can be found in the applicative potential and in the perspective to investigate novel regimes as available laser intensities will be increasing. Experiments have demonstrated, over a wide range of laser and target parameters, the generation of multi-MeV proton and ion beams with unique properties such as ultrashort duration, high brilliance, and low emittance. An overview is given of the state of the art of ion acceleration by laser pulses as well as an outlook on its future development and perspectives. The main features observed in the experiments, the observed scaling with laser and plasma parameters, and the main models used both to interpret experimental data and to suggest new research directions are described.

/pdf/ion-acceleration-by-superintense-laser-plasma-interaction-2jqzeizem7.pdf

Ion acceleration by superintense laser-plasma interaction

For many years, laser-driven ion acceleration, mainly proton acceleration, has been proposed and a number of proof-of-principle experiments have been carried out with lasers whose pulse duration was in the nanosecond range. In the 1990s, ion acceleration in a relativistic plasma was demonstrated with ultra-short pulse lasers based on the chirped pulse amplification technique which can provide not only picosecond or femtosecond laser pulse duration, but simultaneously ultra-high peak power of terawatt to petawatt levels. Starting from the year 2000, several groups demonstrated low transverse emittance, tens of MeV proton beams with a conversion efficiency of up to several percent. The laser-accelerated particle beams have a duration of the order of a few picoseconds at the source, an ultra-high peak current and a broad energy spectrum, which make them suitable for many, including several unique, applications. This paper reviews, firstly, the historical background including the early laser-matter interaction studies on energetic ion acceleration relevant to inertial confinement fusion. Secondly, we describe several implemented and proposed mechanisms of proton and/or ion acceleration driven by ultra-short high-intensity lasers. We pay special attention to relatively simple models of several acceleration regimes. The models connect the laser, plasma and proton/ion beam parameters, predicting important features, such as energy spectral shape, optimum conditions and scalings under these conditions for maximum ion energy, conversion efficiency, etc. The models also suggest possible ways to manipulate the proton/ion beams by tailoring the target and irradiation conditions. Thirdly, we review experimental results on proton/ion acceleration, starting with the description of driving lasers. We list experimental results and show general trends of parameter dependences and compare them with the theoretical predictions and simulations. The fourth topic includes a review of scientific, industrial and medical applications of laser-driven proton or ion sources, some of which have already been established, while the others are yet to be demonstrated. In most applications, the laser-driven ion sources are complementary to the conventional accelerators, exhibiting significantly different properties. Finally, we summarize the paper.

https://iopscience.iop.org/article/10.1088/0034-4885/75/5/056401/pdf

Review of laser-driven ion sources and their applications.

AAPM Task Group 119 has produced quantitative confidence limits as baseline expectation values for IMRT commissioning. A set of test cases was developed to assess the overall accuracy of planning and delivery of IMRT treatments. Each test uses contours of targets and avoidance structures drawn within rectangular phantoms. These tests were planned, delivered, measured, and analyzed by nine facilities using a variety of IMRT planning and delivery systems. Each facility had passed the Radiological Physics Center credentialing tests for IMRT. The agreement between the planned and measured doses was determined using ion chamber dosimetry in high and low dose regions, film dosimetry on coronal planes in the phantom with all fields delivered, and planar dosimetry for each field measured perpendicular to the central axis. The planar dose distributions were assessed using gamma criteria of 3%/3 mm. The mean values and standard deviations were used to develop confidence limits for the test results using the concept confidence limit = /mean/ + 1.96sigma. Other facilities can use the test protocol and results as a basis for comparison to this group. Locally derived confidence limits that substantially exceed these baseline values may indicate the need for improved IMRT commissioning.

/pdf/imrt-commissioning-multiple-institution-planning-and-218ulaexas.pdf

IMRT commissioning: Multiple institution planning and dosimetry comparisons, a report from AAPM Task Group 119

Recommendations of the American Association of Physicists in Medicine (AAPM) for the radiochromic film dosimetry are presented. These guidelines were prepared by a task group of the AAPM Radiation Therapy Committee and have been reviewed and approved by the AAPM Science Council.

Radiochromic film dosimetry: Recommendations of AAPM Radiation Therapy Committee Task Group 55

Approximately 4000 women per year in the United States require radiotherapy during pregnancy. This report presents data and techniques that allow the medical physicist to estimate the radiation dose the fetus will receive and to reduce this dose with appropriate shielding. Out-of-beam data are presented for a variety of photon beams, including cobalt-60 gamma rays and x rays from 4 to 18 MV. Designs for simple and inexpensive to more complex and expensive types of shielding equipment are described. Clinical examples show that proper shielding can reduce the radiation dose to the fetus by 50%. In addition, a review of the biological aspects of irradiation enables estimates of the risks of lethality, growth retardation, mental retardation, malformation, sterility, cancer induction, and genetic defects to the fetus.

Fetal dose from radiotherapy with photon beams: report of AAPM Radiation Therapy Committee Task Group No. 36.

Fetal Dose from Radiotherapy with Photon Beams

The depth dependence (up to 25 cm) of the in-phantom wedge transmission factor (WTF) has been determined for three medical linear accelerator x-ray beams with energies of 4, 6, and 10 MV containing 15 degrees-60 degrees (nominal) brass wedges. All measurements were made with a cylindrical ionization chamber in water, for a field size of 10 X 10 cm2 with a source-skin distance of 80 or 100 cm. We conclude that, for the accelerators studied, the WTF factor at depth is less than 2% different from that determined at dmax (for the nominal wedge angles and photon energies studied) unless the depth of interest is greater than 10 cm. Up to the maximum depth studied (25 cm) the relative wedge factor--that is, wedge factor at depth compared to that determined at dmax--was about equal to or less than 1.02 for the 15 degrees and 30 degrees wedges and any of the photon beam energies studied. For the seldom utilized combination of a nominal wedge angle in excess of 45 degrees with a depth greater than 10 cm, the WTF at depth can differ from the WTF determined at dmax, by up to 5%. Since the wedge transmission factor is reflective of relative percent dose data, our results also indicate that it is in error to use open field percent depth doses for certain combinations of wedge angle, photon energy, and depth.

Charles Robert Blackwell

Papers

Radiochromic film dosimetry: Recommendations of AAPM Radiation Therapy Committee Task Group 55

Fetal dose from radiotherapy with photon beams: report of AAPM Radiation Therapy Committee Task Group No. 36.

Fetal Dose from Radiotherapy with Photon Beams

A depth dependence determination of the wedge transmission factor for 4-10 MV photon beams.

Erratum: “Fetal dose from radiotherapy with photon beams: Report of AAPM Radiation Therapy Committee Task Group No. 36” [Med. Phys. 22. 63-82 (1995)]