Dosimetry for an Sr90/Y90 source train used for intravascular radiation of a hemodialysis graft.
OBJECTIVE
Vascular access for hemodialysis is often achieved with an arterial-venous graft (AVG). Brachytherapy is being explored for prevention of stenosis within these grafts. The objective was to develop treatment planning (TP) capability for dialysis implants.


METHODS
Fluoroscopic images are used to identify position of sources and irradiated vessel. An Sr(90)/Y(90) beta source, jacketed in a CO(2)-filled balloon, is used to irradiate the AVG. A single-seed Sr(90) dose kernel was generated using Monte Carlo. The single-seed dose kernel was employed to calculate the dose surrounding the implant accounting for the path length of the beta particles through the gas-filled balloon.


RESULTS
Dose distributions are displayed superimposed on the fluoroscopic image of the AVG. Dose-area histograms were also generated.


CONCLUSIONS
TP for dialysis implants can be performed using radiographic localization of the graft. The TP tools could be used to correlate clinical outcome with dose delivery.
Department of Radiation Oncology, University of Pennsylvania Medical Center, 19104, Philadelphia, PA, USA. bloch@xrt.upenn.edu
Peter
P
Bloch
Raoul
R
Bonan
Paul
P
Wallner
John
J
Lobdell
D000465:Algorithms; D000800:Angioplasty, Balloon; D001132:Arm / Q000098:blood supply / Q000000981:diagnostic imaging; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D001918:Brachytherapy / Q000295:instrumentation*; D005471:Fluoroscopy; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000209:etiology / Q000532:radiotherapy*; D006801:Humans; D009010:Monte Carlo Method; D011874:Radiometry / Q000379:methods*; D006435:Renal Dialysis