Dose perturbation effects in prostate seed implant brachytherapy with I-125

EGSnrc Monte Carlo simulation was used to investigate dose perturbation effects in prostate seed implant brachytherapy using I-125 radioactive seeds used in implant brachytherapy. Dose perturbation effects resulting from the seed mutual attenuation in a prostate seed implant consisting of 27 seeds were investigated. The results showed that for I-125 seeds implanted into the prostate at 1.00 cm, 0.75 cm and 0.50 cm apart (uniform spacing), the dose perturbation effects are up to 10%. The volume of the target occupied by the 10% dose difference between the full Monte Carlo simulation and the single seed superposition model decreases with increasing seed spacing. Despite the differences between the Monte Carlo simulation and the simple superposition, there was no significant change in the dose volume histogram for 1 cm and 0.75 cm seed spacing. However, there was a significant change in the dose volume histogram when the seed spacing was 0.5 cm. An analysis of the external volume index (El), coverage index (CI) and homogeneity index (HI) also showed that there is no difference in these indexes for the 1.00 cm and 0.75 cm seed spacing between the simple superposition model and the full Monte Carlo simulation. Compared to the full Monte Carlo simulations, the simple superposition model overestimated El, CI and HI by 7%, 5% and 4% respectively for the 0.50 cm seed spacing.