<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article  PUBLIC "-//NLM//DTD Journal Publishing DTD v3.0 20080202//EN" "http://dtd.nlm.nih.gov/publishing/3.0/journalpublishing3.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="3.0" xml:lang="en" article-type="research article"><front><journal-meta><journal-id journal-id-type="publisher-id">IJMPCERO</journal-id><journal-title-group><journal-title>International Journal of Medical Physics, Clinical Engineering and Radiation Oncology</journal-title></journal-title-group><issn pub-type="epub">2168-5436</issn><publisher><publisher-name>Scientific Research Publishing</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.4236/ijmpcero.2016.54024</article-id><article-id pub-id-type="publisher-id">IJMPCERO-71529</article-id><article-categories><subj-group subj-group-type="heading"><subject>Articles</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine&amp;Healthcare</subject><subject> Physics&amp;Mathematics</subject></subj-group></article-categories><title-group><article-title>
 
 
  Generation of Dose Volume Histograms Using Voxel Structure and the Monte Carlo Method in Low Dose Rate Brachytherapy
 
</article-title></title-group><contrib-group><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Artur</surname><given-names>F. Menezes</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Hidmer</surname><given-names>Laulate</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Juraci</surname><given-names>P. Reis Junior</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Lucia</surname><given-names>H. Bardella</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Alessandro</surname><given-names>Facure</given-names></name><xref ref-type="aff" rid="aff3"><sup>3</sup></xref></contrib><contrib contrib-type="author" xlink:type="simple"><name name-style="western"><surname>Ademir</surname><given-names>X. Silva</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib></contrib-group><aff id="aff3"><addr-line>Comiss&amp;amp;atilde;o Nacional de Energia Nuclear, Rio de Janeiro, Brasil</addr-line></aff><aff id="aff1"><addr-line>Programa de Engenharia Nuclear/COPPE, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil</addr-line></aff><aff id="aff2"><addr-line>Se&amp;amp;ccedil;&amp;amp;atilde;o de F&amp;amp;iacute;sica M&amp;amp;eacute;dica, Instituto Nacional de c&amp;amp;acirc;ncer, Rio de Janeiro, Brasil</addr-line></aff><pub-date pub-type="epub"><day>30</day><month>09</month><year>2016</year></pub-date><volume>05</volume><issue>04</issue><fpage>230</fpage><lpage>241</lpage><history><date date-type="received"><day>July</day>	<month>27,</month>	<year>2016</year></date><date date-type="rev-recd"><day>Accepted:</day>	<month>October</month>	<year>24,</year>	</date><date date-type="accepted"><day>October</day>	<month>27,</month>	<year>2016</year></date></history><permissions><copyright-statement>&#169; Copyright  2014 by authors and Scientific Research Publishing Inc. </copyright-statement><copyright-year>2014</copyright-year><license><license-p>This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/</license-p></license></permissions><abstract><p>
 
 
  The Dose Volume Histograms are tools commonly used in medical physics, for the analysis of doses delivered to the tumors and organs at risk, during radiotherapy treatments. However, there are few studies in the literature showing in details the steps of its construction. This work presents the implementation and evaluation of a computational methodology, for the construction of Dose Volume histograms, generated from simulations using anthropomorphic and voxel phantoms, in conjunction with the Monte Carlo code MCNP. The methodology was evaluated considering brachytherapy planning of low dose rate, using 108 seeds of I-125 with individual activities of 0.33 mCi performed on the simulator in voxel recommended by ICRP 110. The dosimetric analysis after implantation showed that the prostate received doses ranging from 0 to 360 Gy. We found the values of 50, 145 and 160 Gy for the parameters D&lt;sub&gt;100&lt;/sub&gt;, D&lt;sub&gt;90&lt;/sub&gt; and D&lt;sub&gt;80&lt;/sub&gt; and 28%, 90%, 92% and 95% for the parameters V&lt;sub&gt;200&lt;/sub&gt;, V&lt;sub&gt;100&lt;/sub&gt;, V&lt;sub&gt;90&lt;/sub&gt; and V&lt;sub&gt;80&lt;/sub&gt;. The rectum and bladder received maximum doses equal to 41 and 60 Gy and found the values of 39 and 22 Gy and 58 and 42 Gy to the parameters D&lt;sub&gt;0.1cc&lt;/sub&gt; and D&lt;sub&gt;2cc&lt;/sub&gt;, respectively. The results after dosimetric implant proved satisfactory, which validate the methodology described above.
 
</p></abstract><kwd-group><kwd>DVHs</kwd><kwd> Voxel</kwd><kwd> ICRP 110</kwd><kwd> MCNPX</kwd></kwd-group></article-meta></front><body><sec id="s1"><title>1. Introduction</title><p>Today, the Monte Carlo method has become a tool commonly used in various segments of science and engineering to simulate problems that can be represented by stochastic processes, like simulations involving the transport of radiation applied to medical physics [<xref ref-type="bibr" rid="scirp.71529-ref1">1</xref>] [<xref ref-type="bibr" rid="scirp.71529-ref2">2</xref>] . These codes can be used for photon, electron and neutron transport and can be applied to radiation protection and dosimetry, radiation shielding, medical physics among other areas [<xref ref-type="bibr" rid="scirp.71529-ref3">3</xref>] .</p><p>The use of the Monte Carlo method, in conjunction with voxels phantoms made possible the reproduction of some radiotherapy treatment planning in computing environments, simulating more realistic scenarios of the different structures of the human body. In this sense, for performing simulation involving the Monte Carlo method it is necessary to use voxel structure recognized by the MCNP radiation transport code. For this purpose, Boia et al. [<xref ref-type="bibr" rid="scirp.71529-ref4">4</xref>] developed a computational methodology to convert the patient DICOM image in a voxel structure recognized by MCNP code. Alternatively, there are studies [<xref ref-type="bibr" rid="scirp.71529-ref5">5</xref>] using voxel simulator MAX and others [<xref ref-type="bibr" rid="scirp.71529-ref6">6</xref>] using REX simulator published by Kramer et al. [<xref ref-type="bibr" rid="scirp.71529-ref7">7</xref>] and for the ICRP110 [<xref ref-type="bibr" rid="scirp.71529-ref8">8</xref>] , respectively.</p><p>For the analysis of the doses tools called Dose Volume Histograms (DVHs) have been used that are tools made available by different radiotherapy treatment planning systems, which are used to assess the radiation dose for each specific volume, and represent the frequency distribution of the dose values obtained in a three-dimensional voxel matrix, even for the target volume or to the critical adjacent structures [<xref ref-type="bibr" rid="scirp.71529-ref9">9</xref>] .</p><p>Studies related to DVHs have been conducted by some researchers considering different methodologies. Pyakuryal et al. [<xref ref-type="bibr" rid="scirp.71529-ref10">10</xref>] developed a MatLab program to analyze plans of exported doses of Pinacco treatment planning system. Bruno et al. [<xref ref-type="bibr" rid="scirp.71529-ref11">11</xref>] conducted a dosimetric comparative study of implants using I-125 and Pd-103 sources based on the analyses of the DVHs in conjunction with SISCODES program (Computer System for Dosimetry by Neutrons and Photons by Stochastic Methodos) and MCNP code.</p><p>Although there are studies in the literature reporting the use of the dose volume histogram (DVHs), it can be seen that there is a lack of detail showing how these tools are built through simulation treatments using in voxels simulators and MCNP transport code. In this context, the application of a computational methodology will assist users in the construction of the DVHs, from simulations using anthropomorphic phantoms in voxels and the Monte Carlo method is justified. For this purpose, we used the MCNPX code to obtain a digital output file, with the dosimetric data to be evaluated, enabling the construction of Dose Volumes Histograms for organs that are the objects of this study considering an implant of low dose rate brachytherapy using <sup>125</sup>I sources.</p></sec><sec id="s2"><title>2. Methodology</title><sec id="s2_1"><title>2.1. Modeling and Validation of I-125 Source</title><p>The first step in this work consisted in to model and validate a brachytherapy source containing <sup>125</sup>I, Amersham, model 6711 [<xref ref-type="bibr" rid="scirp.71529-ref12">12</xref>] .</p><p>The validation was performed by the evaluation of the parameters dose rate constant, anisotropy function and radial dose function, recommended by the dosimetry protocol TG43U1 [<xref ref-type="bibr" rid="scirp.71529-ref13">13</xref>] . This source is constituted by two cylinders, the inner is composed of silver, 𝜌 = 10.5 g/cm<sup>3</sup>, and has a length of 3 mm and basis of 0.5 mm coated by an emmiter thickness of 1 μm, containing <sup>125</sup>I in the form of silver iodide (𝜌 = 6.2 g/cm<sup>3</sup>). The outer cylinder is composed of titanium (𝜌 = 4.54 g/cm<sup>3</sup>), has a length of 4.5 mm and basis of 0.81 mm closed by two ellipsoides [<xref ref-type="bibr" rid="scirp.71529-ref12">12</xref>] . The energy distribution of the photons emitted by the simulated <sup>125</sup>I source, used as an input parameter for the simulation, is presented in <xref ref-type="table" rid="table1">Table 1</xref>.</p></sec><sec id="s2_2"><title>2.2. Dose Volume Histogram (DVH)</title><p>For the generation and evaluation of the DVHs using the MCNP Monte Carlo code, a prostate treatment plan consisting of 108 <sup>125</sup>I seeds was elaborated, with seed activities of 0.33 mCi, using the male phantom model recommended by ICRP110 [<xref ref-type="bibr" rid="scirp.71529-ref8">8</xref>] . Considering that the prostate of the simulator has very small volume, the seeds were inserted with spacing of 5 mm.</p><p><xref ref-type="fig" rid="fig1">Figure 1</xref> shows the mentioned model, that represents an adult of 38 years, with a height of 176 cm and weight of about 73 kg. This simulator has voxels dimension of 2.137 &#215; 2.137 &#215; 8 mm<sup>3</sup>, which corresponds to a volume equal to 36.53 mm<sup>3</sup> and contains a total of 122 segmented structures.</p><p>The distribution of the <sup>125</sup>I seeds inside the prostate was obtained using the automatic replication program developed by Boia et al. [<xref ref-type="bibr" rid="scirp.71529-ref14">14</xref>] . The dose in each voxel of interest was obtained setting some plans, in order to define volumetrically the volume of each organ and using the MCNP code tools, that allow the individual calculation of the dose for all voxels delimited by the plans.</p><p>The absorbed dose in the volume studied was obtained using the command tally * F8 (MeV) of the MCNP code, applied in each voxel of interest, considering the number (N) of the used sources divided by the mass (g) of each voxel, taking in account the integration of the activity throughout the life of the source (Equation (1)). All simulations were performed considering the transport of photons and electrons (mode p e) with a cutoff energy of 5 keV and the dose of the prostate, bladder and rectum were evaluated using the methodology described above.</p><table-wrap id="table1" ><label><xref ref-type="table" rid="table1">Table 1</xref></label><caption><title> Energy distribution of the fotons emitted by <sup>125</sup>I sources [<xref ref-type="bibr" rid="scirp.71529-ref12">12</xref>] </title></caption><table><tbody><thead><tr><th align="center" valign="middle" >Energy (MeV)</th><th align="center" valign="middle" >Photons per disintegration</th></tr></thead><tr><td align="center" valign="middle" >0.035492</td><td align="center" valign="middle" >0.0668</td></tr><tr><td align="center" valign="middle" >0.03171</td><td align="center" valign="middle" >0.0439</td></tr><tr><td align="center" valign="middle" >0.03098</td><td align="center" valign="middle" >0.202</td></tr><tr><td align="center" valign="middle" >0.027472</td><td align="center" valign="middle" >0.757</td></tr><tr><td align="center" valign="middle" >0.027202</td><td align="center" valign="middle" >0.406</td></tr><tr><td align="center" valign="middle" >Total</td><td align="center" valign="middle" >1.4757</td></tr></tbody></table></table-wrap><fig id="fig1"  position="float"><label><xref ref-type="fig" rid="fig1">Figure 1</xref></label><caption><title> Visualization of the different structures present in the male anthropomorphic simulator, recommended by ICRP110</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/2-2660214x2.png"/></fig><disp-formula id="scirp.71529-formula130"><label>(1)</label><graphic position="anchor" xlink:href="http://html.scirp.org/file/2-2660214x3.png"  xlink:type="simple"/></disp-formula><p>Through the analysis of the doses obtained for all voxels in the organ of interest, it became possible to generate the Dose Volume Histogram, taking into account the class interval for the desired dose level and the frequency distribution of voxels for these dose levels. The simulation was performed using the MCNPX code, with uncertainties below 5%, thus guaranteeing satisfactory results according to the limits of reliability presented by the relative error interpretation guidelines of MCNP like can be seen in <xref ref-type="table" rid="table2">Table 2</xref> [<xref ref-type="bibr" rid="scirp.71529-ref15">15</xref>] .</p><p><xref ref-type="fig" rid="fig2">Figure 2</xref> illustrates the computational diagram of the metotology for DVHs generation using the MCNP radiation transport code applied to Low Dose Rate Brachytherapy implant using <sup>125</sup>I sources.</p></sec></sec><sec id="s3"><title>3. Results and Discussion</title><sec id="s3_1"><title>3.1. Computational Modeling and Validation of <sup>125</sup>I Source</title><p><xref ref-type="fig" rid="fig3">Figure 3</xref> shows two-dimensional cuts, obtained with the Moritz graphic viewer [<xref ref-type="bibr" rid="scirp.71529-ref16">16</xref>] illustrating the shape of different structures constituting the simulated <sup>125</sup>I source. The titanium encapsulation and silver cylinder of the <sup>125</sup>I sources are illustrated. The use of</p><table-wrap id="table2" ><label><xref ref-type="table" rid="table2">Table 2</xref></label><caption><title> Guidelines for interpretation of the relative errors (R) obtained for MCNP [<xref ref-type="bibr" rid="scirp.71529-ref15">15</xref>] </title></caption><table><tbody><thead><tr><th align="center" valign="middle" >Range of R</th><th align="center" valign="middle" >Tally Quality</th></tr></thead><tr><td align="center" valign="middle" >0.5 - 1.0</td><td align="center" valign="middle" >Not Reliable</td></tr><tr><td align="center" valign="middle" >0.2 - 0.5</td><td align="center" valign="middle" >Hardly Reliable</td></tr><tr><td align="center" valign="middle" >0.1 - 0.2</td><td align="center" valign="middle" >Questionably</td></tr><tr><td align="center" valign="middle" >&lt;0.1</td><td align="center" valign="middle" >Generally Reliable</td></tr><tr><td align="center" valign="middle" >&lt;0.05</td><td align="center" valign="middle" >Reliable</td></tr></tbody></table></table-wrap><fig id="fig2"  position="float"><label><xref ref-type="fig" rid="fig2">Figure 2</xref></label><caption><title> Diagram of the computational methodology for the generation of Dose Volume Histograms</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/2-2660214x4.png"/></fig><fig id="fig3"  position="float"><label><xref ref-type="fig" rid="fig3">Figure 3</xref></label><caption><title> <sup>125</sup>I sources modeled using MCNP code: (a) Two-dimensional view; (b) Photons emitted by the source</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/2-2660214x5.png"/></fig><p>the ptrack card, provided by the MCNP code, permitted the illustration of the particle being emitted by modeled sources in the <xref ref-type="fig" rid="fig3">Figure 3</xref>(b).</p><p><xref ref-type="table" rid="table3">Table 3</xref> shows the results obtained in this work for the dose rate constant, in comparison with the results taken from the literature [<xref ref-type="bibr" rid="scirp.71529-ref17">17</xref>] - [<xref ref-type="bibr" rid="scirp.71529-ref19">19</xref>] . The good agreement is an indication of computational effectiveness of the performed modeling.</p><p>The results presented in this work (<xref ref-type="table" rid="table3">Table 3</xref>) showed a better agreement with those obtained in references [<xref ref-type="bibr" rid="scirp.71529-ref19">19</xref>] . It should be mentioned that the value associated with the TG-43 report is higher than those obtained in the other references, 4% higher when compared to the present work.</p><p>In <xref ref-type="fig" rid="fig4">Figure 4</xref> the results for the anisotropy function are shown for 1 cm distance, compared with other workers results obtained from the literature [<xref ref-type="bibr" rid="scirp.71529-ref13">13</xref>] [<xref ref-type="bibr" rid="scirp.71529-ref18">18</xref>] [<xref ref-type="bibr" rid="scirp.71529-ref19">19</xref>] . It Can be seen a good agreement with the literature results.</p><p><xref ref-type="fig" rid="fig5">Figure 5</xref> is showed the result for the radial dose functions obtained for <sup>125</sup>I. They are compared with the results of several studies reported in the literature [<xref ref-type="bibr" rid="scirp.71529-ref13">13</xref>] [<xref ref-type="bibr" rid="scirp.71529-ref18">18</xref>] [<xref ref-type="bibr" rid="scirp.71529-ref19">19</xref>] . It can be seen a good agreement with the literature results.</p><p>Based on the results obtained for dosimetric parameters it can be concluded that the I-125 irradiation source is validated and can be used for the next steps for this study.</p><table-wrap id="table3" ><label><xref ref-type="table" rid="table3">Table 3</xref></label><caption><title> Dose rate constant of <sup>125</sup>I source</title></caption><table><tbody><thead><tr><th align="center" valign="middle" >References</th><th align="center" valign="middle" >Dose Rate Constant (cGy/hU)</th></tr></thead><tr><td align="center" valign="middle" >TG-43 Consensus Value (Rivard et al.) [<xref ref-type="bibr" rid="scirp.71529-ref17">17</xref>]</td><td align="center" valign="middle" >0.965</td></tr><tr><td align="center" valign="middle" >J. Dolan et al. (extrap/WAFAC (PTRAN)) [<xref ref-type="bibr" rid="scirp.71529-ref18">18</xref>]</td><td align="center" valign="middle" >0.942</td></tr><tr><td align="center" valign="middle" >R. E. Taylor, D. W. O. Rogers (WAFAC) [<xref ref-type="bibr" rid="scirp.71529-ref19">19</xref>]</td><td align="center" valign="middle" >0.924</td></tr><tr><td align="center" valign="middle" >R. E. P. Taylor. D. W. Rogers (Point) [<xref ref-type="bibr" rid="scirp.71529-ref19">19</xref>]</td><td align="center" valign="middle" >0.942</td></tr><tr><td align="center" valign="middle" >This Study</td><td align="center" valign="middle" >0.928</td></tr></tbody></table></table-wrap><fig id="fig4"  position="float"><label><xref ref-type="fig" rid="fig4">Figure 4</xref></label><caption><title> Anisotropy function from 1 cm irradiation source</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/2-2660214x6.png"/></fig><fig id="fig5"  position="float"><label><xref ref-type="fig" rid="fig5">Figure 5</xref></label><caption><title> Radial dose function of I-125 source</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/2-2660214x7.png"/></fig></sec><sec id="s3_2"><title>3.2. Dose Volume Histogram</title><p>This section presents the DVHs results for the prostate, bladder and rectum using the methodology described above. In <xref ref-type="table" rid="table4">Table 4</xref> the distributions of the Dose Volume Fre- quency are presented, considering all voxels of the prostate volume and intervals classes interval equal to 50 Gy. The prostate gland received doses ranging between 0 and 360 Gy when 108 seeds of <sup>125</sup>I were simulated. The parameters F<sub>Vol</sub>, F<sub>ac</sub>, represent the volumetric and accumulated frequency, respectively. The volumetric frequency (F<sub>Vol</sub>) was obtained by multiplying the number of voxels belonging to a range of dose and the volume of individual voxel. The accumulated frequency (F<sub>ac</sub>) was obtained through the sum of the accumulated volumes to the levels of doses considered.</p><p><xref ref-type="fig" rid="fig6">Figure 6</xref> shows the DVH obtained through the distributions of frequency presented in <xref ref-type="table" rid="table4">Table 4</xref>. We found the values of 50, 145 and 160 Gy for parameters D<sub>100</sub>, D<sub>90</sub> and D<sub>80</sub>,</p><table-wrap id="table4" ><label><xref ref-type="table" rid="table4">Table 4</xref></label><caption><title> Dose volume frequency for the prostate grand</title></caption><table><tbody><thead><tr><th align="center" valign="middle" >Classes (Gy)</th><th align="center" valign="middle" >Voxels/Classes</th><th align="center" valign="middle" >F<sub>Vol</sub> (cm<sup>3</sup>)</th><th align="center" valign="middle" >Dose (Gy)</th><th align="center" valign="middle" >F<sub>ac</sub> (cm<sup>3</sup>)</th><th align="center" valign="middle" >Volume (%)</th></tr></thead><tr><td align="center" valign="middle" >0 - 50</td><td align="center" valign="middle" >1</td><td align="center" valign="middle" >0.04</td><td align="center" valign="middle" >350</td><td align="center" valign="middle" >0.77</td><td align="center" valign="middle" >4.7</td></tr><tr><td align="center" valign="middle" >50 - 100</td><td align="center" valign="middle" >10</td><td align="center" valign="middle" >0.37</td><td align="center" valign="middle" >300</td><td align="center" valign="middle" >3.73</td><td align="center" valign="middle" >22.6</td></tr><tr><td align="center" valign="middle" >100 - 150</td><td align="center" valign="middle" >41</td><td align="center" valign="middle" >1.50</td><td align="center" valign="middle" >250</td><td align="center" valign="middle" >8.04</td><td align="center" valign="middle" >48.8</td></tr><tr><td align="center" valign="middle" >150 - 200</td><td align="center" valign="middle" >105</td><td align="center" valign="middle" >3.84</td><td align="center" valign="middle" >200</td><td align="center" valign="middle" >10.74</td><td align="center" valign="middle" >65.2</td></tr><tr><td align="center" valign="middle" >200 - 250</td><td align="center" valign="middle" >74</td><td align="center" valign="middle" >2.70</td><td align="center" valign="middle" >150</td><td align="center" valign="middle" >14.58</td><td align="center" valign="middle" >88.5</td></tr><tr><td align="center" valign="middle" >250 - 300</td><td align="center" valign="middle" >118</td><td align="center" valign="middle" >4.31</td><td align="center" valign="middle" >100</td><td align="center" valign="middle" >16.08</td><td align="center" valign="middle" >97.6</td></tr><tr><td align="center" valign="middle" >300 - 350</td><td align="center" valign="middle" >81</td><td align="center" valign="middle" >2.96</td><td align="center" valign="middle" >50</td><td align="center" valign="middle" >16.44</td><td align="center" valign="middle" >99.8</td></tr><tr><td align="center" valign="middle" >350 - 400</td><td align="center" valign="middle" >21</td><td align="center" valign="middle" >0.77</td><td align="center" valign="middle" >0</td><td align="center" valign="middle" >16.48</td><td align="center" valign="middle" >100</td></tr><tr><td align="center" valign="middle" >Total</td><td align="center" valign="middle" >451</td><td align="center" valign="middle" >16.48</td><td align="center" valign="middle" ></td><td align="center" valign="middle" ></td><td align="center" valign="middle" ></td></tr></tbody></table></table-wrap><fig id="fig6"  position="float"><label><xref ref-type="fig" rid="fig6">Figure 6</xref></label><caption><title> Dose volume histogram for the prostate gland</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/2-2660214x8.png"/></fig><p>and 28%, 90%, 92% and 95% for volumetric parameters V<sub>200</sub>, V<sub>100</sub>, V<sub>90</sub> and V<sub>80</sub>, respectively. The DVH shows that 90% of the volume of the prostate receives a value of dose equal to 145 Gy, which is typically used as a reference [<xref ref-type="bibr" rid="scirp.71529-ref20">20</xref>] - [<xref ref-type="bibr" rid="scirp.71529-ref22">22</xref>] for the prescription dose in Low Dose Brachytherapy using <sup>125</sup>I sources. Based on these dosimetric parameters the implant was considered satisfactory for the purpose of this study.</p><p><xref ref-type="fig" rid="fig7">Figure 7</xref> illustrates the DVHs for the rectum and bladder, using class intervals of 5 Gy. It can be seen that the rectum and bladder received maximum doses equal to 41 and 60 Gy, respectively. The DVH show that 0.1 and 2 cm<sup>3</sup> (D<sub>0.1cc</sub> and D<sub>2cc</sub>) of the rectum received doses of 39 and 22 Gy. The bladder received doses of 58 and 42 Gy in 0.1 and 2 cm<sup>3</sup> of volume. These values are in agreement with reference values presented in the literature [<xref ref-type="bibr" rid="scirp.71529-ref20">20</xref>] - [<xref ref-type="bibr" rid="scirp.71529-ref22">22</xref>] .</p><p>The isodose curves were obtained in a region of the prostate using the MCNP command mesh tally. The mesh tally was used to quantify the absorbed dose in a matrix of dose defined by voxels of dimensions 0.12 &#215; 0.12 &#215; 0.12 cm<sup>3</sup>.</p><p>The absorbed dose obtained for each voxel of the mesh tally array was recorded in a binary file. The values of doses were obtained primarily in rem/h and subsequently converted to Gy/s per particle emitted by the source. For the construction of the isodose curves a program in MATLAB was developed.</p><p><xref ref-type="fig" rid="fig8">Figure 8</xref> shows that the curve of 145 Gy was used as prescription cover all volumetric extension of the prostate gland.</p></sec></sec><sec id="s4"><title>4. Conclusions</title><p>The results generated to the DVHs applying the methodology adopted for the implan-</p><fig id="fig7"  position="float"><label><xref ref-type="fig" rid="fig7">Figure 7</xref></label><caption><title> Dose volume histogram for the rectum and bladder</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/2-2660214x9.png"/></fig><fig id="fig8"  position="float"><label><xref ref-type="fig" rid="fig8">Figure 8</xref></label><caption><title> Isodose curves using the Matlab program</title></caption><graphic mimetype="image"   position="float"  xlink:type="simple"  xlink:href="http://html.scirp.org/file/2-2660214x10.png"/></fig><p>tation of 108 seeds of <sup>125</sup>I proved satisfactory for the assessment of doses in the prostate gland and in adjacent organs of males’ anthropomorphic phantom of the ICRP.</p><p>The prostate gland received doses between 0 and 360 Gy. We found the values of 50, 145 and 160 Gy for the parameters D<sub>100</sub>, D<sub>90</sub> and D<sub>80</sub> and 28%, 90%, 92% and 95% for the parameters V<sub>200</sub>, V<sub>100</sub>, V<sub>90</sub> and V<sub>80</sub>.</p><p>The rectum and bladder received maximum doses equal to 41 and 60 Gy and found the values of 39 and 22 Gy and 58 and 42 Gy to the parameters D<sub>0.1cc </sub>and D<sub>2cc</sub>, respectively.</p><p>Taking into account the results found for the prostate gland and for the adjacent organs, it was concluded that the implants present the requirements indicative of good quality for <sup>125</sup>I implants in treatment using Low Dose Rate brachytherapy. Given this fact, the methodology for the construction of Dose Volume Histogram using the MCNP radiation transport code and in voxel structure proved to be satisfactory for the purpose of this work.</p><p>This methodology is not restricted to brachytherapy and can be used to construct Dose Volume Histogram using dose data file generated with external beam irradiation and patient DICOM image. Although it is necessary for the user to model and validate the irradiation source and convert the patient DICOM image in voxel structure file recognized by MCNP Monte Carlo Code. However, the user should only make comparative studies between DVHs generated by simulation and the respective obtained using treatment planning systems if it guarantees the same volumes for organs studied.</p></sec><sec id="s5"><title>Acknowledgements</title><p>The authors wish to thank Cecilia Khalil Haddad and Tatiana Midori of SirioLibanes Hospital for the collaboration and the financial support of the Funda&#231;&#227;o Carlos Chagas Filho de Amparo &#224; Pesquisa do Estado do Rio de Janeiro (FAPERJ), the Coordena&#231;&#227;o de Aperfei&#231;oamento de Pessoal de N&#237;vel Superior (CAPES) and the Conselho Nacional de Desenvolvimento Cient&#237;fico e Tecnol&#243;gico (CNPQ), Brazil.</p></sec><sec id="s6"><title>Cite this paper</title><p>Menezes, A.F., Laulate, H., Junior, J.P.R., Bardella, L.H., Facure, A. and Silva, A.X. (2016) Generation of Dose Volume Histograms Using Voxel Structure and the Monte Carlo Method in Low Dose Rate Brachytherapy. International Journal of Medical Physics, Clinical Engi- neering and Radiation Oncology, 5, 230-241. http://dx.doi.org/10.4236/ijmpcero.2016.54024</p></sec></body><back><ref-list><title>References</title><ref id="scirp.71529-ref1"><label>1</label><mixed-citation publication-type="journal" xlink:type="simple"><name name-style="western"><surname>Yoriyaz</surname><given-names> H. </given-names></name>,<etal>et al</etal>. (<year>2009</year>)<article-title>Monte Carlo Method: Principles and Application in Medical Physics</article-title><source> Revista Brasileira de Física Médica</source><volume> 3</volume>,<fpage> 141</fpage>-<lpage>149</lpage>.<pub-id pub-id-type="doi"></pub-id></mixed-citation></ref><ref id="scirp.71529-ref2"><label>2</label><mixed-citation publication-type="other" xlink:type="simple">Reis Junior, J.P., Menezes, A.F., Souza, E.M., Facure, A. Medeiros, J.A.C. and Silva, A.X. (2012) Dose Optimization in 125I Permanent Seed Implants Using the Monte Carlo Method. Computer Physics Communications, 183, 847-852. http://dx.doi.org/10.1016/j.cpc.2011.12.005</mixed-citation></ref><ref id="scirp.71529-ref3"><label>3</label><mixed-citation publication-type="other" xlink:type="simple">Pelowitz, D.B. (2005) MCNPXTM User’s Manual, Version 2.5.0. Los Alamos National Laboratory Report LA-CP-05-0369.</mixed-citation></ref><ref id="scirp.71529-ref4"><label>4</label><mixed-citation publication-type="other" xlink:type="simple">Boia, L.S., Menezes, A.F., Cardoso, M.A.C., et al. (2012) Application of Digital Image Processing for the Generation of Voxels Phantoms for Monte Carlo Simulation. Applied Radiation and Isotopes, 70, 144-148. http://dx.doi.org/10.1016/j.apradiso.2011.08.017</mixed-citation></ref><ref id="scirp.71529-ref5"><label>5</label><mixed-citation publication-type="other" xlink:type="simple">Thalhofer, J.L., Rebello, W.F., Correa, S.C.A., Silva, A.X., Souza, E.M. and Batista, D.V.S. (2013) Calculation of Dose in Healthy Organs, during Radiotherapy 4-Field Box 3D Conformal for Prostate Cancer, Simulation of the Linac 2300, Radiotherapy Room and MAX Phantom. International Journal of Medical Physics, Clinical Engineering and Radiation Oncology, 2, 61-68. http://dx.doi.org/10.4236/ijmpcero.2013.22009</mixed-citation></ref><ref id="scirp.71529-ref6"><label>6</label><mixed-citation publication-type="other" xlink:type="simple">Martins, M.C., Cordeiro, T.P.V., Silva, A.X., Souza-Santos, D., Queiroz-Filho, P.P. and Huant, J.G. (2013) Dose Conversion Coefficients for ICRP 110 Voxel Phantom in the Geant4 Monte Carlo Code. Radiation Physics and Chemistry, 95, 309-312. http://dx.doi.org/10.1016/j.radphyschem.2013.04.030</mixed-citation></ref><ref id="scirp.71529-ref7"><label>7</label><mixed-citation publication-type="other" xlink:type="simple">Kramer, R., Vieira, J.W., Khoury, H.J., Lima, F.R.A. and Fuelle, D. (2003) All about MAX: A Male Adult Voxel Phantom for Monte Carlo Calculations in Radiation Protection Dosimetry. Physics in Medicine and Biology, 48, 1239-1262. http://dx.doi.org/10.1088/0031-9155/48/10/301</mixed-citation></ref><ref id="scirp.71529-ref8"><label>8</label><mixed-citation publication-type="other" xlink:type="simple">ICRP (2009) Adult Reference Computational Phantom. International Commission on Radiological Protection. Pergamon Press, Oxford.</mixed-citation></ref><ref id="scirp.71529-ref9"><label>9</label><mixed-citation publication-type="other" xlink:type="simple">Drzymala, R.E., Mohan, R., Brewster, L., et al. (1991) Dose-Volume Histograms. International Journal of Radiation Oncology, Biology and Physics, 21, 71-78. http://dx.doi.org/10.1016/0360-3016(91)90168-4</mixed-citation></ref><ref id="scirp.71529-ref10"><label>10</label><mixed-citation publication-type="other" xlink:type="simple">Pyakuryal, A., Myint, W.K., Gopalakrishnan, M., Jang, S., Logemann, J.A. and Mittal, B.B. (2010) A Computational Tool for the Efficient Analysis of Dose-Volume Histograms for Radiation Therapy Treatment Plans. Journal of Applied Clinical Medical Physics, 11, 3013-3041.</mixed-citation></ref><ref id="scirp.71529-ref11"><label>11</label><mixed-citation publication-type="other" xlink:type="simple">Trinidade, B.M., Chist&amp;oacute;v&amp;atilde;o, M.T., Trindade, D. de F.M., Falc&amp;atilde;o, P.L. and de Campos, T.P.R. (2012) Comparative Dosimetry of Prostate Brachytherapy with I-125 and Pd-103 Seeds via SISCODES/MCNP. Radiologia Brasileira, 45, 1443-1450.</mixed-citation></ref><ref id="scirp.71529-ref12"><label>12</label><mixed-citation publication-type="other" xlink:type="simple">Duggan, D.M. (2004) Improved Radial Dose Function Estimation Using Current Version MCNP Monte-Carlo Simulation: Model 6711 and ISC3500 125I Brachytherapy Sources. Applied Radiation and Isotopes, 61, 1443-1450. http://dx.doi.org/10.1016/j.apradiso.2004.05.070</mixed-citation></ref><ref id="scirp.71529-ref13"><label>13</label><mixed-citation publication-type="other" xlink:type="simple">Rivard, M.J. (1999) Refinements to the Geometry Factor Used in the AAPM Task Group Report No. 43 Necessary for Brachytherapy Dosimetry Calculations. Medical Physics, 26, 2445-2450. http://dx.doi.org/10.1118/1.598764</mixed-citation></ref><ref id="scirp.71529-ref14"><label>14</label><mixed-citation publication-type="other" xlink:type="simple">Boia, L.S., Junior, J.P.R., Menezes, A.F. and Silva, A.X. (2014) Computational System to Create an Entry File for Replicating I-125 Seeds Simulating Brachytherapy Case Studies Using the MCNPX Code. International Journal of Cancer Therapy and Oncology, 2, 2445-2450. http://dx.doi.org/10.14319/ijcto.0202.3</mixed-citation></ref><ref id="scirp.71529-ref15"><label>15</label><mixed-citation publication-type="other" xlink:type="simple">Briesmeister, J.F. (1997) MCNP—A General Monte Carlo N-Particle Transporte Code, Version 4B. Report No. LA12625-M. Los Alamos National Laboratory, Los Alamos.</mixed-citation></ref><ref id="scirp.71529-ref16"><label>16</label><mixed-citation publication-type="other" xlink:type="simple">Riper, K.A.V. (2004) MORITZ—Geometry Tool User’ Guide. White Rock Science, Los Alamos.</mixed-citation></ref><ref id="scirp.71529-ref17"><label>17</label><mixed-citation publication-type="other" xlink:type="simple">Rivard, M.J., Coursey, B.M., DeWerd, L.A., et al. (2004) Update of AAPM Task Group No. 43 Report: A Revised AAPM Protocol for Brachytherapy Dose Calculations. Medical Physics, 31, 633-674. http://dx.doi.org/10.1118/1.1646040</mixed-citation></ref><ref id="scirp.71529-ref18"><label>18</label><mixed-citation publication-type="other" xlink:type="simple">Dolan, J., Li, Z. and Williamson, J.F. (2006) Monte Carlo and Experimental Dosimetry of an 125I Brachytherapy Seed. Medical Physics, 33, 4675-4684. http://dx.doi.org/10.1118/1.2388158</mixed-citation></ref><ref id="scirp.71529-ref19"><label>19</label><mixed-citation publication-type="other" xlink:type="simple">Taylor, R.E.P. and Rogers, D.W.O. (2008) An EGSnrc Monte Carlo-Calculated Database of TG-43 Parameters. Medical Physics, 35, 4228-4242. http://dx.doi.org/10.1118/1.2965360</mixed-citation></ref><ref id="scirp.71529-ref20"><label>20</label><mixed-citation publication-type="other" xlink:type="simple">Nath, R., Bice, W.S., Butler, W.M., et al. (2009) AAPM Recommendations on Dose Prescription and Reporting Methods for Permanent Interstitial Brachytherapy for Prostate Cancer: Report of the American Association of Physicists in Medicine Task Group 137. Medical Physics, 36, 5310-5322. 2445-2450.</mixed-citation></ref><ref id="scirp.71529-ref21"><label>21</label><mixed-citation publication-type="other" xlink:type="simple">Marcu, L. and Quach, K. (2006) The Role of Post-Implant Dosimetry in the Quality Assessment of Prostate Implants. The RAH Experience. Australasian Physical and Engineering Science in Medicine, 29, 310-314. http://dx.doi.org/10.1007/BF03178396</mixed-citation></ref><ref id="scirp.71529-ref22"><label>22</label><mixed-citation publication-type="other" xlink:type="simple">Yu, Y, Anderson, L.L., Li, Z., et al. (1999) Permanent Prostate Seed Implant Brachytherapy: Report of the American Association of Physicists in Medicine Task Group No. 64. Medical Physics, 26, 2054-2076. http://dx.doi.org/10.1118/1.598721</mixed-citation></ref></ref-list></back></article>