Design optimization of intraoperative radiotherapy cones.

Purpose: Electron intraoperative cones (EIORCs) commonly used for intraoperative radiation therapy (IORT) often generate high-dose regions at superficial depths. This study was performed to optimize the use of rings in the EIORC design that reduces the high-dose region while minimizing the loss of the treatment volume at the prescribed depth.

Methods And Materials: Monte Carlo simulations were performed to study the dosimetry properties of various EIORC designs. Simulations were conducted with EIORCs of various internal radii, lengths, and material compositions irradiated by available electron beam energies. The data were analyzed in terms of volume receiving > 105% and < 90% of the prescription dose, respectively.

Results: The high-dose volume increases with the EIORC size and the electron beam energy. The use of a ring inside the EIORC reduces the 105% dose volume but also increases the sub-90% volume. The degree of change of these volumes depends on the ring thickness and position.

Conclusion: The optimal ring position is about 10 cm from the bottom of the EIORC, regardless of the EIORC material, geometry, or electron energy. The optimal thickness of the ring is dependent on its material composition, the beam energy, and the preferred compromise between a uniform dose profile and a loss of treatment volume.