Therapy Shielding Calculations

Melissa C. Martin, M.S., FACR, FACMP American College of Medical Physics 21st Annual Meeting & Workshops Scottsdale, AZ June 13, 2004

Therapy Shielding Design Traditionally Relies on NCRP Reports

s

NCRP Report 49
Primary and secondary barrier calculation methodology Applicable up to 60Cobalt and linacs up to 10 MV

NCRP Report 51
Extended NCRP 49 methodology up to 100 MV Empirical shielding requirements for maze doors

NCRP Report 79
Improved neutron shielding methodology

NCRP Report 144

Update of NCRP 51 primarily aimed at non-medical facilities

Reports reflect progress in linac design and shielding research Reports reflect progress in linac design and shielding research

Revised NCRP Report in Drafting Stage by AAPM Task Group 57, NCRP SC 46-13
s

Design of Facilities for Medical Radiation Therapy

4 MV - 50 MV (including 60Co)

s s s s

Calculation scheme generally follows NCRP 49 All shielding data (TVLs) reviewed and updated Updated for intensity modulated radiation therapy (IMRT) Improved accuracy of entrance requirements
Both with and without the use of maze

Laminated barriers for high energy x-rays

Photoneutron generation due to metal in primary barrier

Goal: Improved accuracy Goal: Improved accuracy

Linear Accelerator Energy and Workload

s

BJR #11 megavoltage (MV) definition used here

British Journal of Radiology (BJR) Supplement No. 11

Comparison of BJR #11 and BJR #17 MV definitions

4 4 6 6 10 10 15 16 18 23 20 25 24 30

BJR #11 MV BJR #17 MV

s

Workload assumptions typically used for shielding design

Workload identified by symbol W in calculations For MV 10 MV: W = 1000 Gy/wk at 1 meter from the target Based on NCRP 49 Appendix C Table 2 For MV > 10: W = 500 Gy/wk Based on NCRP 51 Appendix B Table 5

Radiation Protection Limits for People

s

Structural shielding is designed to limit exposure to people

Exposure must not exceed a specific dose equivalent limit Limiting exposure to unoccupied locations is not the goal

NCRP 116 design dose limit (P)

0.10 mSv/week for occupational exposure 0.02 mSv/week for the general public

Typical international design dose limits

0.12 mSv/week for controlled areas 0.004 mSv/week for uncontrolled areas

NCRP 116 dose limit is a factor of 5 lower than NCRP 49 value NCRP 116 dose limit is a factor of 5 lower than NCRP 49 value

Radiation Protection Limits for Locations

s s

Permissible dose outside vault depends on occupancy Occupancy factor (T): Fraction of time a particular location may be occupied Maximum shielded dose (Smax) at protected location

S max =

P T

Assuming occupancy factor T for protected location

Maximum shielded dose is traditionally referred to simply as P/T Maximum shielded dose is traditionally referred to simply as P/T

Occupancy Values from NCRP 49

s s

Full occupancy for controlled areas by convention (T=1) Full occupancy uncontrolled areas (T=1)
Offices, laboratories, shops, wards, nurses stations, living quarters, childrens play areas, and occupied space in nearby buildings

Partial occupancy for uncontrolled areas (T=1/4)

Corridors, rest rooms, elevators with operators, unattended parking lots

Occasional for uncontrolled areas (T=1/16)

Waiting rooms, toilets, stairways, unattended elevators, janitors closets, outside areas used only for pedestrian or vehicular traffic

Hourly Limit for Uncontrolled Areas

s s s

0.02 mSv hourly limit for uncontrolled areas 20 Gy/hr common assumption for calculation Implies a lower limit for occupancy factor
T 20 / ( U W ) T 0.16 for higher energy accelerators (500 Gy / wk workload) T 0.08 for lower energy accelerators (1000 Gy wk workload)

Not applied to low occupancy locations with no public access

e.g., unoccupied roof, machinery room

T = 1/10 rather than 1/16 typically used for exterior walls T = 1/10 rather than 1/16 typically used for exterior walls

NCRP 134 Impact on Linac Shielding

s

NCRP 134 distinguishes general employees from public

NCRP 134 maintains NCRP 116 limit of 0.02 mSv/wk for both Limit 25% of 0.02 mSv/wk from individual facility for general public

Occupancy assumptions proposed for general public

T=1/40 for occasional occupancy

Equivalent to T=1/10 occasional for general employees

Similar to P/T required by hourly limit for primary barriers Slightly increase from T = 1/16 used for secondary barriers T=1/16 still appropriate for locations with no public occupancy e.g., machine rooms, unoccupied roofs, etc.

Impact increases if higher occupancy than T=1/40 adopted Impact increases if higher occupancy than T=1/40 adopted

Basic Primary Barrier Calculation Unchanged from NCRP 49

s

Unshielded dose calculation

S pri
s

WU 2 d pri

Door T a rg e t R o ta tio n a l P la n e D'

A'

Attenuation in tenth-value layers

n =
s

S pri log10 P / T TVL1 + (n 1) TVLe

M aze

*
tC C

T arget Is o c e n te r

p ri

Barrier thickness (tc) calculation

C'

tC =

1 ft

Margin in primary barrier thickness is recommended to Margin in primary barrier thickness is recommended to compensate for potential concrete density variation compensate for potential concrete density variation

Primary Barrier Photon Tenth-Value Layers (mm) Come from a Variety of Sources
MV 0.2 0.25 0.3 0.4 0.5 1 2 4 6 10 15 18 20 24 Lead TVL1 TVLe 1.7 1.7 2.9 2.9 4.8 4.8 8.3 8.3 11.9 11.9 26 26 42 42 53 53 56 56 56 56 56 56 56 56 56 56 56 56 NCRP 51 Concrete TVL1 TVLe 84 84 94 94 104 104 109 109 117 117 147 147 210 210 292 292 367 323 410 377 445 416 462 432 470 442 483 457 Steel TVL1 TVLe 15 15 19 19 22 22 29 29 33 33 54 51 76 69 91 91 100 100 104 104 108 108 109 109 110 110 110 110 Earth TVL1 TVLe 135 135 151 151 167 167 175 175 188 188 236 236 336 336 468 468 572 572 648 648 720 720 740 740 752 752 773 773 Borated Poly TVL1 TVLe 84 84 94 94 104 104 109 109 117 117 147 147 210 210 292 292 343 343 379 379 379 379 379 379 390 390 401 401

NCRP 49

Nelson & LaRiviere

McGinley

Estimated from Concrete

Anticipate upcoming NCRP report to review and update TVL data Anticipate upcoming NCRP report to review and update TVL data

Primary Barrier Width

s

0.3 meter margin on each side of beam rotated 45 degrees

Barrier width required assuming 40 cm x 40 cm field size

wC =
s

0.4 2 d C ' + 1.0 ft

Field typically not perfectly square (corners are clipped)

35 cm x 35 cm field size typically used to account for this

T a r g e t to N a r r o w P o in t D is t a n c e ( d C ')

*
w C
C

T a rg e t Is o c e n te r
T a r g e t to N a r r o w P o in t D is t a n c e ( d C ')

*
w C
C

T a rg e t Is o c e n te r
T a r g e t to N a r r o w P o in t D is t a n c e ( d C ')

T a rg e t Is o c e n te r

1 ft

1 ft

1 ft
M e ta l

1 ft

C'
1 ft

C'
1 ft

Slant Factor and Obliquity Factor

s

Slant Factor
Path from target to protected location diagonally through barrier Incident angle of line with respect to perpendicular Required barrier thickness reduced by cos( ) Same total distance through barrier to protected location

Scatter causes slant factor to underestimate exit dose

Multiplying thickness by obliquity factor compensates for this
Angle 0 30 45 60 70 4 MV 1.00 1.03 1.07 1.21 1.44 Lead 10 MV 1.00 1.02 1.07 1.21 1.47 18 MV 1.00 1.03 1.10 1.22 1.52 Concrete 4 MV 10 MV 1.00 1.00 1.02 1.00 1.07 1.04 1.20 1.14 1.47 1.28 18 MV 1.00 1.00 1.04 1.08 1.22 4 MV 1.00 1.02 1.07 1.20 1.48 Steel 10 MV 1.00 1.02 1.07 1.17 1.42 18 MV 1.00 1.04 1.08 1.20 1.45

Photoneutron Generation Due to Metal in Primary Barrier (Linacs 10 MV)

s

Dose-equivalent 0.3 m beyond barrier (McGinley) WU NF t / TVL t / TVL 1 P = SN 10 10 3 N t2 + t + 0.305 3 2

N is neutron production constant (Sv neutron per Gy workload) 1.9 x 10-3 for lead, 1.7 x 10-4 for steel at 18 MV (from McGinley)
s

Recent safety survey indicated somewhat higher 3.8 x 10-4 value for steel at 18 MV is appropriate

N adjusted versus MV based on neutron leakage fraction vs MV F is field size (conventionally 0.16 m2), t2 is metal thickness (m) X-Ray attenuation prior to metal layer: 10^(-t1 / TVLp) Neutron attenuation after metal layer: 10^(-t3 / TVLN)

Patient Photonuclear Dose Due to Metal in Primary Barrier for MV > 10

s

Metal in primary barrier can increase patient total body dose if MV > 10
Lead inside layer approximately doubles patient total body dose Increases risk of secondary cancer

Concrete or borated polyethylene inside metal in primary barrier is recommended if MV >10

Each inch of borated poly decreases patient dose from metal barrier photoneutron by approximately factor of 2

Impact of IMRT on patient photonuclear dose is addressed later Avoid metal as inside layer of primary barrier if MV > 10 Avoid metal as inside layer of primary barrier if MV > 10

Secondary Barrier
s

Patient scatter unshielded dose

Sp

a W ( F / 400) 2 2 d sca d sec

Door T a rg e t R o ta tio n a l D' P la n e

A'

F is field size in cm2 typically 1600

= scatter fraction for 20 x 20 cm beam

M aze

sca

*
C

T a rg e t Is o c e n te r

sec

Leakage unshielded dose

Assumes 0.1% leakage fraction

tB 1 ft C'

SL

W 10 2 d sec

Leakage Photon Tenth-Value Layers (mm) Also Come from a Variety of Sources

MV 4 6 10 15 18 20 24

Lead TVL1 TVLe 53 53 56 56 56 56 56 56 56 56 56 56 56 56

Concrete TVL1 TVLe 292 292 341 284 351 320 361 338 363 343 366 345 371 351

Steel TVL1 TVLe 91 91 96 96 96 96 96 96 96 96 96 96 96 96

Earth TVL1 TVLe 468 468 546 455 562 512 578 541 581 549 586 552 594 562

Borated Poly TVL1 TVLe 292 292 341 284 351 320 361 338 363 343 366 345 371 351

NCRP 49

Nelson & LaRiviere

Kleck & Varian Average

Estimated from Concrete

Neutron Leakage
s s

Same form as photon leakage calculation Based on dose-equivalent neutron leakage fraction vs MV
0.002%, 0.04%, 0.10%, 0.15% and 0.20% for 10, 15, 18, 20 and 24 MV Based on Varian and Siemens neutron leakage data Assumes quality factor of 10 for absorbed dose

Shielded dose equivalent based on leakage neutron TVLs

211 mm for concrete 96 mm for borated polyethylene

Intensity Modulated Radiation Therapy (IMRT)

s

IMRT requires increased monitor units per cGy at isocenter

Typical IMRT ratio is 5 MU per cGy, as high as 10 for some systems

Percent workload with IMRT impacts shielding

50% typically assumed; 100% if vault is dedicated to IMRT

Account for IMRT by multiplying x-ray leakage by IMRT factor

IMRT Factor = % IMRT x IMRT ratio + (1 - % IMRT) 3 is typical IMRT factor (50% workload with IMRT ratio of 5)

IMRT factor lower for neutrons if machine is dual energy

e.g., 1.5 if dual energy linac with 50% of treatments below 10 MV Pessimistic since most IMRT is performed at 6 MV (next chart)

IMRT above 10 MV Significantly Increases Patient Photonuclear Dose

s

Neutrons dominate patient total body dose for high energy linacs
Neutron dose equivalent as high as ten times photon dose Potentially 1% of workload vs 0.1% photon leakage
s

0.05% required absorbed neutron dose x 20 quality factor

Typical neutron dose equivalent is lower than requirement 0.1 to 0.2% of workload
s

IMRT factor of 5 increases patient incidental dose 5X

Results in typical neutron total body exposure of 0.5 to 1.0% of WL Significantly increases risk of secondary cancer

Most IMRT is performed at 6 MV to mitigate increased secondary Most IMRT is performed at 6 MV to mitigate increased secondary cancer risk from photoneutrons cancer risk from photoneutrons

Patient Scatter Significant Adjacent to Primary Barrier

s

Scatter traditionally neglected for lateral barriers

Generally a good assumption 90 degree scatter has low energy
Door T a rg e t R o ta tio n a l P la n e D'

A'

Scatter is significant adjacent to primary barrier

Calculations indicate comparable to leakage Slant thickness through barrier compensates for the increase in unshielded dose due to scatter Barrier thickness comparable to lateral is adequate for same P/T

M aze

sca

T a rg e t Is o c e n te r
S c a tte r A n g le

S la n t t h ic k n e s s u s e d t o c a lc u l a t e a tte n u a tio n

sec

C'
A c tu a l b a r r ie r t h ic k n e s s

1 ft

Patient Scatter Fraction for 400 cm2 Field

s s s

Based on recent simulation work by Taylor et.al. Scatter fraction increases as angle decreases Scatter fraction vs MV may increase or decrease
Tends to increase with MV at small scatter angles Decreases with increasing MV at large scatter angles
MV 4 6 10 15 18 20 24 10 1.04E-02 1.04E-02 1.66E-02 1.51E-02 1.42E-02 1.52E-02 1.73E-02 20 6.73E-03 6.73E-03 5.79E-03 5.54E-03 5.39E-03 5.66E-03 6.19E-03 30 2.77E-03 2.77E-03 3.18E-03 2.77E-03 2.53E-03 2.59E-03 2.71E-03 Angle (degrees) 45 60 2.09E-03 1.24E-03 1.39E-03 8.24E-04 1.35E-03 7.46E-04 1.05E-03 5.45E-04 8.64E-04 4.24E-04 8.54E-04 4.13E-04 8.35E-04 3.91E-04 90 6.39E-04 4.26E-04 3.81E-04 2.61E-04 1.89E-04 1.85E-04 1.76E-04 135 4.50E-04 3.00E-04 3.02E-04 1.91E-04 1.24E-04 1.23E-04 1.21E-04 150 4.31E-04 2.87E-04 2.74E-04 1.78E-04 1.20E-04 1.18E-04 1.14E-04

Patient Scatter Energy

s

Mean Scatter Energy

MV 6 10 18 24 0 1.7 2.8 5.0 5.7 Scatter Angle (degrees) 20 45 1.2 0.6 1.4 0.6 2.2 0.7 2.7 0.9 90 0.25 0.25 0.3 0.3

No standardized scatter Tenth-Value Layer

Primary MV rating based on peak MV in spectrum, not mean energy Primary TVL at slightly higher MV (e.g, 50%) appears reasonable % increase little more than wild guess; more research is needed

Ambiguity remains as to TVL to use for scatter Ambiguity remains as to TVL to use for scatter

Maze Calculation Likely Revised in Upcoming NCRP Report

s

New method identifies and evaluates specific mechanisms

Patient Scatter, Wall Scatter, Leakage scatter Direct leakage Neutrons, capture gammas

Mechanisms calculated at most stressing orientation

Scatter calculations multiplied by 2/3 to compensate for this

Scatter energy relatively low at maze door

Primary 0.3 MV TVLs used for patient and wall scatter (2 bounces) Primary 0.5 MV TVLs used for leakage scatter (1 bounce) Scatter is significant typically only for low energy linacs

Goal: More-precise calculation avoiding over or under-shielding Goal: More-precise calculation avoiding over or under-shielding

Maze: Patient Scatter

s

Unshielded dose

Sp =
s

a W ( F / 400) 0.5 AC 2 2 2 d P1 d P 2 d P 3
D

Door T a rg e t R o ta tio n a l P la n e D'

A'

where
0.5 is 0.5 MV scatter fraction Second bounce fraction 0.02 per m2 typically used Other constants as before, e.g., a = patient scatter fraction F = field size in cm^2 h = room height

d
P3

P1

*
C

T arg et Is o c e n te r

d A w
C

P2

= w

Maze: Wall Scatter

s

Unshielded dose

SS
where

f W 1 A1 0.5 AM 2 2 2 d S1 d S 2 d S 3
D

Door T a rg e t R o ta tio n a l P la n e D'

A'

S3

*
C

T arg et Is o c e n te r

f = patient transmission 1 = first reflection coefficient 0.005 per m2 for 6 MV 0.004 per m2 for 10 MV
d d
M S2

S1

A1 = beam area (m2) at wall AM = Maze cross section (m2) dM x room height

Maze: Leakage Scatter

s

Unshielded dose

S LS
where

W 10 3 1 AC 2 2 d L1 d L 2

D oor T a rg e t R o ta tio n a l P la n e

A'

D' d
L2

*
C

T arget Is o c e n te r

Constants as previously defined

A w
C C

L1

= w

Maze: Direct Leakage

s

Unshielded dose
Door

SL
s

W 10 10 2 dL

t D ' / TVL

A tD ' D'

A'
T a rg e t R o ta tio n a l P la n e

d D

Same as standard secondary photon leakage calculation Standard neutron leakage not typically used
Use only if it exceeds the maze neutron calculation e.g., if maze wall not sufficiently thick

*
C

T a rg e t Is o c e n te r

C'

Maze Neutron Calculation Based on Modified Kersey Method

s

Unshielded dose equivalent

H NT
where

W Ln [1+ ( d N 2 3) / 5 ] 2 d N 1 10
D

D oor T a rg e t R o ta tio n a l P la n e D'

A'

N2

*
C

T arget Is o c e n te r

Ln is neutron leakage fraction Same as used for secondary neutron leakage calculation Modification to Kersey is assuming first tenth-value distance is 3 m instead of 5 m
C'

N1

Upcoming NCRP report may recommend a more-complex approach Upcoming NCRP report may recommend a more-complex approach than this than this

Maze Neutron Shielding

s s

Modeled as 50% thermal neutrons and 50% fast neutrons 1 inch borated poly effectively eliminates all thermal neutrons Fast neutron TVL is 2.4 inches for the first 4 inches Fast neutron TVL is 3.6 inches beyond 4 inches thickness

s s

Maze Capture Gammas from Concrete

s

Gamma rays generated by neutron capture in the maze

Very significant for high energy linacs

Unshielded dose is a factor of 0.2 to 0.5 of the neutron dose equivalent at the treatment room door
Use the conservative factor (0.5)

Capture gammas have moderate energy (3.6 MeV)

TVL of 61 mm for lead Limited attenuation also provided by polyethylene (278 mm TVL)

Dominates X-Ray dose at maze entrance for high energy linacs Dominates X-Ray dose at maze entrance for high energy linacs

Direct-Shielded Door
s

Neutron Door is simply a secondary barrier

Typically more layers and different materials than a wall Lead to attenuate leakage photons Borated polyethylene to attenuate leakage neutrons
s

Typically sandwiched between layers of lead

Steel covers
s

Specialized shielding procedure adjacent to door

Compensates for relatively small slant thickness in this location Vault entry toward isocenter similar to maze Vault entry away from isocenter is secondary barrier But with specialized geometry

Direct-Shielded Door: Far Side of Entrance

s

Extra material added to corner

Lead to entrance wall Borated polyethylene or concrete beyond wall
P r o te c te d P o in t (1 ft b e y o n d d o o r e n c lo s u re )
I s o c e n te r to F a r S id e o f E n tr a n c e D i s ta n c e Is o c e n te r to D o o r S e c o n d a ry D i s ta n c e

Uses standard secondary barrier calculation Goal: provide same protection as wall or door for path through corner

D o o r O v e r la p B e y o n d F a r S id e o f E n tr a n c e 7 .5 " O v e r la p T y p ic a l T y p ic a l Gap 0 .5 "

Is o c e n te r T a rg e t R o ta tio n a l P la n e

Direct-Shielded Door: Near Side of Entrance

s

Geometry similar to short maze

Maze calculation can be used but is likely pessimistic
T y p ic a l G ap 0 .5 " 7 .5 " T y p ic a l Door O v e r la p
N1

Requires less material than far side of entrance

Lower unshielded dose Lower energy
Is o c e n te r T arg et

N2

T a rg e t R o ta tio n a l P la n e

P ro te c te d P o in t (1 ft b e y o n d door e n c lo s u r e )

Shielding for Heating, Ventilation, and Air Conditioning (HVAC) Ducts

s

HVAC penetration is located at ceiling level in the vault

For vaults with maze, typically located immediately above door For direct-shielded doors, located in a lateral wall as far away from isocenter as possible

s s

Ducts shielded with material similar to the door at entrance Material thickness 1/2 to 1/3 that required of the door
Path through material is at a very oblique angle due to penetration location with slant factor between 2 and 3 Factor of at least 5 reduction in dose at head level (the protected location) vs. at the HVAC duct opening

NCRP 49 recommends that shielding extend at least a factor of three times the width of the HVAC penetration

Photon Skyshine
s

Unshielded dose

S sky =
where

0.0249 W U 1.3 2 d Y21 d Y 2

d

2 m e te r s

(steradians) = 0.122 for 40 x 40 cm beam

Y1

h
Is o c e n te r

Multiplying by additional factor of two is recommended Primary TVLs used to calculate attenuation

*
F lo o r

T a rg e t

h
Y2

New construction seldom shields solely for skyshine due to New construction seldom shields solely for skyshine due to vigilance required to prevent unauthorized roof access vigilance required to prevent unauthorized roof access

Neutron Skyshine
s

Unshielded dose

H sky =
where

5.4 10

H pri

= 2.71 (steradians) typical (target above isocenter)

*
F lo o r

T arg et Is o c e n te r

Hpri is neutron dose-eq in beam (0.00013, 0.002, 0.0039, 0.0043, and 0.014 times W for 10, 15, 18, 20, and 24 MV, respectively)
s

U p to 2 0 m e te r s la te r a l d is ta n c e

Use factor is not applied since neutrons in all orientations Multiplying by additional factor of two is recommended

Primary Goal of Upcoming NCRP Report is Improved Shielding Calculation Accuracy

s

Very little impact for low energy accelerators

Primary and secondary barrier calculation method unchanged Very little impact to calculated shielding for given protection limit

Improved accuracy for high-energy accelerators

Avoids extra cost of over design due to pessimistic calculations Avoid extra cost of retrofitting if inaccurate calculations underestimate required shielding

References
s

Biggs, Peter J. Obliquity factors for 60Co and 4, 10, 18 MV X rays for concrete, steel, and lead and angles of incidence between 0 and 70, Health Physics. Vol. 70, No 4, 527-536, 1996. British Journal of Radiology (BJR) Supplement No. 11. Central axis depth dose data for use in radiotherapy, 1972. Chibani, Omar and C.C. Ma. Photonuclear dose calculations for high-energy beams from Siemens and Varian linacs, Medical Physics, Vol 30, No. 8:1990-2000, August 2003. Kleck, J. Radiation therapy facility shielding design. 1998 AAPM Annual Meeting

References (Continued)
s

McGinley, P.H. Shielding Techniques for Radiation Oncology Facilities, 2nd ed. Madison, WI: Medical Physics Publishing, 2002. National Council on Radiation Protection and Measurements. Structural shielding design and evaluation for medical use of x-ray and gamma rays of energies up to 10 MeV. Washington, DC: NCRP, NCRP Report 49, 1976. National Council on Radiation Protection and Measurements. Radiation protection design guidelines for 0.1-100 MeV particle accelerator facilities. Washington, DC: NCRP, NCRP Report 51, 1977.

References (Continued)
s

National Council on Radiation Protection and Measurements. Neutron Contamination from Medical Accelerators. Bethesda, MD: NCRP, NCRP Report 79, 1984. Nelson, W.R., and P.D. LaRiviere. Primary and leakage radiation calculations at 6, 10, and 25 MeV, Health Physics. Vol. 47, No. 6: 811-818, 1984. Rodgers, James E. IMRT Shielding Symposium AAPM Annual Meeting, 2001. Shobe, J., J.E. Rodgers, and P.L. Taylor. Scattered fractions of dose from 6, 10, 18, and 25 MV linear accelerator X rays in radiotherapy facilities, Health Physics, Vol. 76, No. 1, 27-35, 1999.

References (Continued)
s

Taylor, P.L., J.E. Rodgers, and J. Shobe. Scatter fractions from linear accelerators with x-ray energies from 6 to 24 MV," Medical Physics, Vol. 26, No. 8, 1442-46, 1999.