HDR Brachytherapy

Session 2; Topic 2:
Bunker Design and Shielding Calculations
6th Feb 2022

Claire Dempsey, PhD

Australia
 Learning Objectives

o Understand radiation safety and protection requirements

related to HDR brachytherapy sources

• Describe the shielding design requirements for HDR

brachytherapy treatment rooms
• Describe the key concepts for shielding construction for
HDR brachytherapy treatment rooms

• Determine barrier thicknesses and expected exposure

levels for HDR brachytherapy treatment rooms
2
 Shielding - Attenuation
o Linear Attenuation is commonly used to
determine radiation transmission

o Unfortunately, this is only valid for narrow

beam geometry. For broad beam geometry,
you must account for the build-up of scatter
o Tables of build-up factors are used to correct
for scatter when calculating shielding
transmission
o Barrier Transmission factors (B) account for
build-up
 Types of barriers

o Primary barriers
• Attenuates the primary (direct) beam

o Secondary barriers
• Attenuates leakage, patient scatter, wall scatter

o All barriers in brachytherapy are considered primary barriers

• Due to the isotropic radiative nature of brachytherapy sources
Shielding considerations

o Machine workload
• How many patients per day
• How many days per week

o Type of person to be protected from radiation

• Staff
• Public

o Type of space that needs to be protected

• Public areas (uncontrolled)
• Restricted/controlled areas
 Basic Concepts

o Establish a maximum allowed exposure at a

certain point outside of the brachytherapy
bunker

o Calculate the barrier/wall thickness necessary

to meet the maximum dose-rate/exposure
requirements
 Calculation
o Shielding calculations should be based on a broad beam barrier
transmission factor (B)
𝑃𝑑 !
𝐵=
𝑊𝑈𝑇
• d = Distance from the point of interest to the brachytherapy
source
• P = Design dose or dose rate required (public/staff)
• W = Workload
• T = Occupancy
• U = Usage factor (U). This is considered to be 1 as all
walls/floor/ceiling will be irradiated at the same time due to the
isotropic radiative nature of the brachytherapy source
Shielding design dose rate (P)- Instantaneous Dose Rate
o Assume 1 mSv = 1 mGy = 100 mrem = 100 mR
o Assume treating 50 weeks/year, 5 days/week, 8 hours/day (40 hours/wk)
o Shielding design goal for uncontrolled areas (1 mSv per year)
• 1 mSv/year = 0.02 mSv/week = 0.02 mGy/week = 20 μGy/week

• IDR 20 μGy/week = 0.5 μGy/hr = 0.5 μSv/hr

o Shielding design goal for controlled areas (5 mSv per year)

• 5 mSv/year = 0.1 mSv/week = 0.1 mGy/week = 100 μGy/week

• 100 μGy/week = 2.5 μGy/hr = 2.5 μSv/hr

 Workload (W)
o Workload is the average total dose produced by the source
per week
o Is a function of source strength (Air Kerma Strength) and
treatment time

o The concept of Total Reference Air Kerma (TRAK) should be

used for the calculations
• Total Reference Air Kerma (TRAK) is the Air Kerma Strength
multiplied by the overall treatment time (at the time of
treatment)

o This is helpful because we are evaluating dose rates

 Workload (W)_ 1

o To estimate workload in (mGy per week) in air:

• Multiply the maximum Total Reference Air Kerma (TRAK) for a
patient treatment
– Assume a value of 0.7 cGy @ 1 meter
– This is an over-estimation for most patients

• By the number of fractions treated per week

– eg. 4 fractions per day x 5 days per week

o Eg: 0.7 cGy @ 1m x 4 x 5 = 14 cGy @ 1m

 Workload (W)_ 2

o To estimate workload in (mGy per week) in water:

• Multiply the workload per week in air (mGy per week)
– Eg. 14 cGy @ 1m

• By the Dose Rate Constant (Λ) for water

– This value is specific to an individual source type
(manufacturer)
– Can be found at Imaging and Radiation Oncology Core --IROC
Website (mdanderson.org) source registry
– Eg. 1.113 cGy/h (for Ir-192, Flexitron - Elekta)

o Eg: 14 cGy @ 1m x 1.113 = 15.58 cGy @ 1m (per week)

Occupancy (T)
o Weekly Factors (from NCRP 151)
 Distance (d)
o Need a copy of the department
floor plan to determine distances to
the areas of interest for your 0.3m
shielding calculation
o Distances should be to about (0.3m)
from the wall
o You may need to estimate this
initially if your bunker
design hasn’t been finalised due to
the fact that the width
of the shielding is not yet known
 Worked example

o Determine the thickness of concrete required for a brachytherapy

bunker wall

• The wall is 3 metres from an Ir-192 brachytherapy afterloader

and adjoins an uncontrolled attended public waiting area

• The maximum Total Reference Air Kerma (TRAK) per patient is

0.7 cGy @ 1 meter

• The department will treat 4 fractions per day, 5 days per week
 Worked example

o P = 0.02 mGy per week (Uncontrolled design goal)

o d = 2.3 m (3m to the wall and 30cm beyond the wall, need to subtract
1m as the workload is determined 1m from the source
o W = 15.58 cGy/wk @ 1m (see previous slides) = 155.8 mGy/wk @ 1m
o T = 1 (attended waiting room)
o U = 1 (isotropic radiation)

𝑃𝑑 ! 0.02 𝑥 2.3!
𝐵= = = 0.00068 (~7 x 10"# )
𝑊𝑈𝑇 155.8 𝑥 1 𝑥 1
Worked example- Concrete and Ir-192

• Graph taken from

NCRP Report No. 49

• From the graph, the

thickness of concrete
required is
approximately 45cm
Worked example-Lead and Ir-192

o What if we used lead instead

of concrete?

o Graph taken from NCRP

B
Report No. 49

o We would need
approximately 4.5 cm of lead
 o For Iridium-192, ~4cm of lead or ~35cm of concrete is typical;
+15cm concrete for Cobalt-60

Strohmaier, Stefan, and Grzegorz Zwierzchowski. “Comparison of

(60)Co and (192)Ir sources in HDR brachytherapy.” Journal of
contemporary brachytherapy vol. 3,4 (2011): 199-208.
doi:10.5114/jcb.2011.26471
 Room survey
o Remember you will need to perform
a room survey to check the shielding
once the afterloader is installed

o The workload used in these

calculations must be the same
workload used in shielding estimates

o Keep the units of dosage consistent

(mrem, mSv, µGy, etc) all across the
documentation to make things less
confusing
 Poll Question #1

When considering shielding design for a HDR brachytherapy bunker,

both primary and secondary barriers must be determined? Why?

a) Yes, like a linac bunker there needs to be primary and secondary

shielding
b) Yes, this takes into account both controlled and un-controlled
areas
c) No, the patient will reduce radiation in certain directions
d) No, all barriers are primary barriers due to the isotropic nature
of the radiation source

20
 Poll Question #1

When considering shielding design for a HDR brachytherapy bunker,

both primary and secondary barriers must be determined? Why?

a) Yes, like a linac bunker there needs to be primary and secondary

shielding
b) Yes, this takes into account both controlled and un-controlled
areas
c) No, the patient will reduce radiation in certain directions
d) No, all barriers are primary barriers due to the isotropic nature
of the radiation source

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 Room survey
o Take measurements using a survey meter at various key locations
around the bunker
• Include areas above and below the bunker if necessary– always ask for
elevation plans!
 Room survey
o Your survey meter should give you a reading in mrem/hr, µSv/hr
µGy/hr or some other meaningful unit. If the units are mR, check
this is equal to mrem or corrected for exposure to dose conversion
for your energy range
o This reading is the MAXIMUM INSTANTANEOUS DOSE RATE (IDR)
o You will need to convert this to the maximum dose in
• 1 hour
• 1 week
• 1 year
to make sure they are within the regulation tolerance doses for your
country
 Survey readings
o The survey meter gives a dose rate per hour
“Don’t I just use this value as the maximum dose for 1 hour?” NO!!!
o The maximum instantaneous dose (from your survey meter) is not
equal to the maximum dose in any 1 hour because when a patient
is treated, the source is not out of the afterloader for the entire
hour:
o How many patients could you treat in a single hour?
• Usually a maximum of 2 patients
o What is the source strength when the measurement is being done?
• The readings will be lower for a cooler source
 Dose in 1 hour
o You need to multiply the instantaneous dose rate (in mrem/hr or µGy/hr) by
the time (in hours) that the source will be outside of the afterloader
o For example:
• Maximum instantaneous dose rate (survey meter reading)
0.6 µGy/hr
• Reference Air Kerma Rate at the time of the measurement
33 mGy/hr = 33000µGy/hr (@ 1m)
• Assume a Total Reference Air Kerma per patient of:
0.7 cGy = 7000 µGy (@ 1m)
• Exposure time per patient (at the time of measurement):
= 7000/33000 = 0.21 hours
Maximum dose in 1 hour = 0.6 x 0.21 = 0.126 µGy
Limit = 0.5 µGy for general public (uncontrolled area)
Dose in 1 week
o For this, you need to consider how many patients/fractions you
would treat in 1 day (and multiply this by 5 days per week)
• Might be an overestimation but it is always better to overestimate

o Worked example:
• Department treats 4 fractions per day, 5 days per week
– Exposure time for 1 patient was 0.21 hours
– Add an extra half an hour per week for QA purposes
– Source is out of the afterloader for approximately:
(0.21 x 4 x 5) + 0.5 = 4.7 hours/week
– Maximum dose in 1 hour was 0.126 µGy

Maximum dose in 1 week = 0.126 x 4.7 = 0.59 µGy (limit 20 µGy)

 Dose in 1 year
o For this, you need to consider how many weeks per year you
are using the HDR afterloader
• Remember overestimation is better
• Let’s assume we treat 50 weeks per year

o Worked example:
• Department treats 50 weeks per year:
– Maximum dose in 1 week was 0.59 µGy

Maximum dose in 1 year = 0.49 x 50 = 24.5 µGy (limit 1 mGy)

 And so on….
o Repeat these calculations for all measurement points around
the bunker

• Remember to adjust the dose calculation depending on the

occupancy of the area you are measuring in
• This is only required for weekly and yearly dose
– You can assume that it’s possible a person may spend an hour
at any point around the bunker
• Eg. measurement in a corridor (occupancy (T) = 1/5)
– Multiply your maximum dose in 1 week by 0.2
– Worked example: Maximum dose in 1 week was 0.59 µGy
– Dose in 1 week corrected for occupancy = 0.59 x 0.2 = 0.12 µGy
(limit 20 µGy)
Where exactly do I measure for occupied areas?
Use the provided excel spreadsheet
 Poll Question #2
When performing a radiation survey of a brachytherapy treatment
room, what corrections need to be applied to the survey meter
reading?

a) No corrections, but the survey meter value must be below the

recommended radiation limit
b) Corrections for source decay, overall treatment time and
occupancy
c) Corrections for source decay, overall treatment time, occupancy
and patient numbers
d) Corrections for overall treatment time and occupancy

31
 Poll Question #2
When performing a radiation survey of a brachytherapy treatment
room, what corrections need to be applied to the survey meter
reading?

a) No corrections, but the survey meter value must be below the

recommended radiation limit
b) Corrections for source decay, overall treatment time and
occupancy
c) Corrections for source decay, overall treatment time, occupancy
and patient numbers
d) Corrections for overall treatment time and occupancy
This is basically the same as workload, although workload is generally given as a dose
rate (mGy/hr, mGy/wk, mGy/year) and the treatment time is a time value (time radiation
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source is out of the afterloader per hr/wk/yr)
What happens if a reading is too high?
o Firstly – double check the measurement and correction
values!!!

o If deficiencies are found, they must be fixed before any

further work can occur:
• add additional shielding to bunker walls/floor/ceiling
• change room or exterior design to increase distance from
source in affected areas
• change an “uncontrolled” area to a “controlled” area
References

o NCRP Reports 49 and 151

o IAEA Safety Guides, Reports and TecDocs
https://www.iaea.org/publications
Questions?

[email protected]