title: Quantification of dose perturbation by plaque in vascular brachytherapy.
abstract: BACKGROUND
  Dose prescription and reporting in vascular brachytherapy (VBT) is based on the assumption that the vessel wall is water equivalent, which does not consider a possible dose perturbation by plaque. As the extent of this perturbation is unknown, we aimed to quantify dose attenuation by atherosclerotic plaque for beta- and gamma-radiation.
  
  
  METHODS
  The dose delivered from Strontium-90/Yttrium-90 ((90)Sr/Y) and Iridium-192 ((192)Ir) sources with and without human peripheral arteries ((90)Sr/Y: n = 38, (192)Ir: n = 7) surrounding the respective delivery catheter was determined with radiochromic films. Plaque and vessel wall thickness were measured using light microscopy. From the ratio-attenuated doseunattenuated dose (dose perturbation factor: DPF) we determined averaged attenuation coefficients for atherosclerotic plaque (micro(P)) and the residual part of the vessel wall (micro(W)) by regression analysis based on the function DPF = exp(-micro(P) * plaque thickness -micro(W) * residual wall thickness).
  
  
  RESULTS
  Attenuation in case of (192)Ir was less than the measurement uncertainties. For beta-radiation correlation was found by discrimination between calcified and noncalcified plaque. Classifying noncalcified plaque as normal arterial tissue, the regression coefficient was r = 0.845 at micro(P)= 0.5356 mm(-1) and micro(W) = 0.0663 mm(-1).
  
  
  CONCLUSIONS
  Vascular brachytherapy with beta radiation in calcified arteries results in significant dose attenuation within the vessel wall, which can be calculated on knowing the vascular morphometry. Thus, plaque thickness should be taken into account in treatment planning and retrospective analyses.
authors.affiliation: Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. paul.wexburg@meduniwien.ac.at
authors.forename: P
authors.initials: P
authors.lastname: Wexberg
authors.forename: C
authors.initials: C
authors.lastname: Kirisits
authors.forename: D
authors.initials: D
authors.lastname: Berger
authors.forename: I
authors.initials: I
authors.lastname: Sulzbacher
authors.forename: G
authors.initials: G
authors.lastname: Maurer
authors.forename: R
authors.initials: R
authors.lastname: Potter
authors.forename: D
authors.initials: D
authors.lastname: Georg
authors.forename: D
authors.initials: D
authors.lastname: Glogar
mesh_terms: D001161:Arteriosclerosis / Q000473:pathology / Q000532:radiotherapy*; D001610:Beta Particles / Q000627:therapeutic use; D001918:Brachytherapy / Q000379:methods*; D002114:Calcinosis / Q000473:pathology / Q000532:radiotherapy; D005263:Femoral Artery / Q000473:pathology; D005720:Gamma Rays; D006801:Humans; D019047:Phantoms, Imaging; D011874:Radiometry / Q000379:methods; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted