title: Dose evaluation of boron neutron capture synovectomy using the THOR epithermal neutron beam: a feasibility study.
abstract: Rheumatoid arthritis is one of the most common epidemic diseases in the world. For some patients, the treatment with steroids or nonsteroidal anti-inflammatory drugs is not effective, thus necessitating physical removal of the inflamed synovium. Alternative approaches other than surgery will provide appropriate disease control and improve the patient's quality of life. In this research, we evaluated the feasibility of conducting boron neutron capture synovectomy (BNCS) with the Tsing Hua open-pool reactor (THOR) as a neutron source. Monte Carlo simulations were performed with arthritic joint models and uncertainties were within 5%. The collimator, reflector and boron concentration were optimized to reduce the treatment time and normal tissue doses. For the knee joint, polyethylene with 40%-enriched Li(2)CO(3) was used as the collimator material, and a rear reflector of 15 cm thick graphite and side reflector of 10 cm thick graphite were chosen. The optimized treatment time was 5.4 min for the parallel-opposed irradiation. For the finger joint, polymethyl methacrylate was used as the reflector material. The treatment time can be reduced to 3.1 min, while skin and bone doses can be effectively reduced by approximately 9% compared with treatment using the graphite reflector. We conclude that using THOR as a treatment modality for BNCS could be a feasible alternative in clinical practice.
authors.affiliation: Department of Radiological Technology, Central Taiwan University of Science and Technology, Taiwan, Republic of China.
authors.forename: Jay
authors.initials: J
authors.lastname: Wu
authors.forename: Shu-Jun
authors.initials: SJ
authors.lastname: Chang
authors.forename: Keh-Shih
authors.initials: KS
authors.lastname: Chuang
authors.forename: Yen-Wan
authors.initials: YW
authors.lastname: Hsueh
authors.forename: Kuan-Chuan
authors.initials: KC
authors.lastname: Yeh
authors.forename: Jeng-Ning
authors.initials: JN
authors.lastname: Wang
authors.forename: Wen-Pin
authors.initials: WP
authors.lastname: Tsai
mesh_terms: D001168:Arthritis / Q000473:pathology; D001172:Arthritis, Rheumatoid / Q000532:radiotherapy*; D016754:Boron Neutron Capture Therapy / Q000295:instrumentation* / Q000379:methods*; D004307:Dose-Response Relationship, Radiation; D005240:Feasibility Studies; D006801:Humans; D009010:Monte Carlo Method; D009502:Neutrons; D019047:Phantoms, Imaging; D017785:Photons; D020959:Polyethylene / Q000737:chemistry; D011788:Quality of Life; D011874:Radiometry / Q000379:methods*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*
chemical_list: D020959:Polyethylene