Paper Dan Bukti Submitted

Radiological Physics and Technology
Characterization of The Source of Gamma Knife PerfexionTM Based on Monte Carlo

Simulations
--Manuscript Draft--
Manuscript Number: RPTE-D-20-00018
Full Title: Characterization of The Source of Gamma Knife PerfexionTM Based on Monte Carlo
Simulations
Article Type: Research Article
Keywords: The Cobalt-60 source, capsule, Gamma Knife PerfexionTM, Monte Carlo simulation
Corresponding Author: Junios Junios, M.D

Institut Teknologi Bandung
Bandung, West Java INDONESIA
Corresponding Author's Institution: Institut Teknologi Bandung
First Author: Junios Junios, M.D
Order of Authors: Junios Junios, M.D
Irhas Irhas, M.D
E. Soediatmoko, M.D
F. Haryanto, Ph.D
Novitrian Novitrian, Ph.D
Z. Su’ud, Ph.D
A. L. Fielding, Ph.D
Funding Information: Kementerian Riset, Teknologi dan Mr Junios Junios

Pendidikan Tinggi
(B/1536/D3.2/KD.02.00/2019)
Abstract: The purpose of this study was to characterize a single Cobalt-60 source capsule of the
Gamma Knife Perfexion TM unit using the BEAMnrc code Monte Carlo. The Gamma
Knife Perfexion TM source capsule was modeled using the BEAMnrc user code
according to the technical details provided by the manufacturer. The modeled parts
include the source, the area around the source, and the capsule. The cylindrical source
is 1 mm in diameter and 17 mm in length, with a physical density (ρ) of 8.9 x 10 -3
Kg/m 3 . The simulation parameters used were 2.1 x 10 9 particles, ECUT of 0.7 MeV,
and PCUT of 0.01 MeV. Energy fluence is calculated on a 0.25 cm diameter scoring
plane located 3.1 cm from the source. Simulations were performed with and without the
encapsulation to investigate its effect on the spectrum and fluence of emitted gammas.
The results showed the influence of the encapsulation of the source on the gammas
with the increases in the relative number of particles in each energy bin of total
gammas at the energy of 0.23 MeV by 92.36% and at the energy of 1.10 MeV of
66.12%. In the secondary gammas were found to increases at the energy of 0.23 MeV
by 94.17% and at the energy of 1.10 MeV by 63.74%. The encapsulation of the source
attenuates the gammas, and it's changed the spectrum. The mean energy of the beam
increase as a beam hardening effect.
Author Comments: The manuscript is the Monte Carlo simulation in radiotherapy.
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Main Document
1 Characterization of The Source of Gamma Knife PerfexionTM
2 Based on Monte Carlo Simulations
4 J. Juniosa*, I. Irhasa, N. Novitriana, E. Soediatmokob, F. Haryantoa, Z. Su’uda and A. L.
5 Fieldingc
a
6 Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung,
7 Jalan Ganesha 10 Bandung 40132, Indonesia

b
8 Gamma Knife Centre Indonesia, Siloam Hospital Lippo Karawaci, Tangerang,
9 Banten 15811, Indonesia

c
10 Science and Engineering Faculty, Queensland University of Technology, Brisbane Qld,
11 4001, Australia
12 Corresponding author: J. Junios
13 *Email: junios@s.itb.ac.id
14 Present address: Department of Physics, Faculty of Mathematics and Natural Sciences, Institut
15 Teknologi Bandung, Jalan Ganesa 10, Bandung, West Java, 40132, Indonesia
16 Phone number: +62-821-7013-5701
17
18 Abstract
19 The purpose of this study was to characterize a single Cobalt-60 source capsule of the Gamma
20 Knife PerfexionTM unit using the BEAMnrc code Monte Carlo. The Gamma Knife PerfexionTM
21 source capsule was modeled using the BEAMnrc user code according to the technical details
22 provided by the manufacturer. The modeled parts include the source, the area around the
23 source, and the capsule. The cylindrical source is 1 mm in diameter and 17 mm in length, with
24 a physical density (ρ) of 8.9 x 10-3 Kg/m3. The simulation parameters used were 2.1 x 109
25 particles, ECUT of 0.7 MeV, and PCUT of 0.01 MeV. Energy fluence is calculated on a 0.25
1
26 cm diameter scoring plane located 3.1 cm from the source. Simulations were performed with
27 and without the encapsulation to investigate its effect on the spectrum and fluence of emitted
28 gammas. The results showed the influence of the encapsulation of the source on the gammas
29 with the increases in the relative number of particles in each energy bin of total gammas at the
30 energy of 0.23 MeV by 92.36% and at the energy of 1.10 MeV of 66.12%. In the secondary
31 gammas were found to increases at the energy of 0.23 MeV by 94.17% and at the energy of
32 1.10 MeV by 63.74%. The encapsulation of the source attenuates the gammas, and it's changed
33 the spectrum. The mean energy of the beam increase as a beam hardening effect.
34 Keywords: The Cobalt-60 source, capsule, Gamma Knife PerfexionTM, Monte Carlo simulation
35
36 Introduction
37 The Gamma Knife PerfexionTM (GKP) is a stereotactic radiation delivery device that uses 192
38 Cobalt-60 sources focussed onto a single isocentre. The system is designed to enable irradiation
39 of single or multiple cranial targets [1,2]. As a treatment device, the GKP has the advantage of
40 dosimetric accuracy, position accuracy, and radiation protection. The dosimetric accuracy of
41 GKP is > 97.50% better than the previous generation (Gamma Knife 4C and Gamma Knife B
42 > 95%). Likewise, the positioning accuracy of the patient with the GKP is <0.20 mm (Gamma
43 Knife 4C <0.30 mm and Gamma Knife B <0.50 mm) [3,4,5]. As radiation protection from the
44 GKP collimator system, it provides a 120 mm tungsten shielding to attenuate out all extraneous
45 beam paths from the source to the radiation cavity. Tungsten collimator has a density of 19,600
46 Kg/m3, much denser compared to cast iron whose density of 7000 Kg/m3. This situation
47 resulted in a significantly lower dose of extra-cranial GKP compared to the previous unit
48 (Gamma Knife 4C and Gamma Knife B) [6].
49 Due to the physical arrangement and simultaneous irradiation from the 192 Cobalt-60 sources,
50 irradiations with a single source are not possible. Thus, a method other than experimental
2
51 measurement is required to characterize a single source in the GKP system. Monte Carlo (MC)
52 techniques offer a solution. MC is the gold standard for dose calculation accuracy and is a
53 powerful tool for simulating medical radiation devices [7,8].
54 Previous researchers have used the MC method to have investigated the Cobalt-60 source
55 characterization of the different devices. Miró et al. [7] used the MCNP code MC to investigate
56 the characteristics of the Cobalt-60 source carried out on the Theratron 780 radiotherapy unit
57 (MDS Nordion). In this study, the encapsulated source was modeled to calculate the energy
58 spectrum distribution and electron contamination in the scoring plane. MC calculation has been
59 shown as yet another very efficient method of determining the relative output factor (ROFs).
60 Mora et al. [9] modeled the Eldorado system and simulated both narrow and broad Cobalt-60
61 beams using the EGS/BEAM code MC to calculate the relative air-kerma output factors as a
62 function of field size. Rogers et al. [10] simulating a beam of radiation from a radiotherapy unit
63 using the BEAM code MC, the Cobalt-60 beam uses energy in the orthovoltage unit. The
64 results are calculated to show the ability of the code. The dose distribution calculated in the
65 water phantom is irradiated by various accelerator electron beams. All of them were found in
66 good agreement with measurements of level 2 to 3%. Sandro et al. [11] describe BEAMnrc
67 models of a Siemens Gammatron's treatment head geometry. This work was carried out at the
68 Swedish Radiation Protection Authority (SSI) to characterize the beam of the Cobalt-60
69 therapy unit. The beam characterization results shown the FWHM of the dose profiles in air
70 and water differ by less than 4.3%. These deviations are probably most affected by the fact that
71 a larger field than the true field was simulated.
72 This current study aims to investigate the source characteristics of Cobalt-60 in the GKP using
73 the MC method. The important parameters studied are primary particles, scattering particles,
74 and contamination particles. To achieve this goal, the source geometry is modeled with and
75 without capsulation.
3
76 Methods and Material
77 Figure 1 shows the Cobalt-60 source packaged in cylindrical stainless-steel capsules, and the
78 encapsulation is a leakage prevention measure. The source consists of small pellets of Co-60,
79 modeled as if homogeneously distributed. The source is modelled to have anisotropic emission
80 of gamma-ray photons with energies from the Cobalt-60 spectrum supplied with the BEAMnrc
81 code. The source geometry model in BEAMnrc was built using technical details from the
82 manufacturer under a non-disclosure agreement.
83
capsule
source
84 Figure 1. The geometry of the source and capsules
85 Ref: Siloam Hospital Karawaci Tangerang, Banten, Indonesia
86
87 The study carried out an investigation of the output of the radiation source. The primary and
88 secondary output was studied with the source encapsulated and unencapsulated. The BEAMnrc
89 source geometry type used was ISOURC=3a, which is modeling the Cobalt-60 source with a
90 cylindrical geometry emitting a user-defined spectrum of energies [10]. Two energies of
91 gamma photons are emitted with the energy of 1.17 MeV and 1.33 MeV. These are modeled
92 as Gaussian peaks with a width of 0.010 MeV.
93 The Cobalt-60 source is cylindrical with a diameter of 1 mm, a density (ρ) of 8.9x10-3 Kg/m3
94 packed in stainless steel capsules. The area around the cylinder and the stainless steel capsules
4
95 was modeled with a diameter of 2.8 cm and a length of 3.1 cm using the BEAMnrc FLATFILT
96 component module.
97 As well as the physical geometry defined in BEAMnrc, the materials have to be also specified.
98 The GKP BEAMnrc model required some new materials not defined in the default PEGS4 list
99 to be created. The PEGS4 user code [11] was used to define the new materials in the GKP
100 model. The cross-sections for the materials are derived by Pegs4 when the materials are
101 defined. The user-defined material had the composition of Fe (0.673%), Ni (0 .133%), Cr
102 (0.2%), and Mo (0.012%), with density (ρ) is 7.95x10-3 Kg/m3.
103 The BEAMnrc simulation output is stored in phase space files. The scoring plane in this study,
104 as shown in Figure 2. is located at a distance of 3.1 cm from the source and has a diameter of
105 0.25 cm. This program has an option to analyze the results of phase space files in various ways.
106 The LATCH functionality of the BEAMnrc code was used to identify if and where particles
107 interacted as they passed through the simulation geometry. The BEAMDP (Beam Data
108 Processor) [12], analysis code was used to analyze the phase space files and calculate energy
109 spectra, and particle and energy fluence profiles.
Source
Source
Capsule
Scoring plane and Scoring plane and
Phase space file Phase space file
(a) (b)
110 Figure 2. Source model of Gamma Knife PerfexionTM with EGSnrc Monte Carlo (a)
111 unencapsulated (b) encapsulated
112
5
113 The spectra were also derived using BEAMdp, which extracts the necessary information from
114 the phase space files. The spectra were calculated for different regions in the phase space plane.
115 Central-axis spectra were derived considering a central area in the phase space plane with a
116 radius of 0.25 cm. When these spectra were extracted, the LATCH variable was used to
117 calculate spectra for primary gamma’s and scattered gamma’s from specific components or
118 regions of the source model. Equation 1 was used to determine the relative difference between
119 the number of particles in each energy bin of the spectra for the encapsulated and
120 unencapsulated source.
𝑁𝑒𝐾 (𝐸)−𝑁𝑢𝐾 (𝐸) (1)

∆𝑁𝑟𝑒𝑙𝑎𝑡𝑖𝑣𝑒 (𝐸) = x100%
𝑁𝑒𝐾
121 Where the relative number of particles in each energy bin is∆𝑁𝑟𝑒𝑙𝑎𝑡𝑖𝑣𝑒 (𝐸), the relative number
122 of particles in each energy bin for encapsulated source 𝑁𝑒𝐾 (𝐸), and the relative number of
123 particles in each energy bin for unencapsulated source𝑁𝑢𝐾 (𝐸).
124 When a photon experiences Compton scattering, its energy is divided between secondary
125 photons and recoil electrons depending on the scattering angle. For cases where the scattering
126 angle θ ∞ 0, a small amount of energy is transferred to the electron, and the photons only
127 slightly deviate. For other extreme cases where θ = π photons are backscattered and transfer,
128 the maximum energy to the electron is Compton edge [13,14,15].
1 (2)
𝐸𝑒𝑑𝑔𝑒 = 𝐸 − 𝐸 ′ = 𝐸 − 𝐸
ℎ𝜐
1+ (1 − 𝑐𝑜𝑠𝜋)
𝑚𝑒 𝑐 2
129 In theory, at an energy of 1.33 MeV, the Cobalt-60 source obtained backscatter energy of 0.23
130 MeV and Compton Edge at 1.10 MeV.
131 The BEAMnrc program has the advantage of being able to preview geometry to verify the
132 model. This program has an option to analyze the results of phase space files in various ways.
133 One way is to apply LATCH (from 1-23) to the region in geometry. Information about particles
6
134 will be stored in phase space files. The stored information can then be used to understand in
135 which regions particles are interacting. LATCH is also inherited by secondary photons and
136 electrons so as to provide the specific history of each particle. The LATCH functionality was
137 used to tag particles if they interacted in a particular region and the capsule model [12]. Figure
138 3 shows how the LATCH numbers were assigned.
139
140 Figure 3. The LATCH numbers were assigned
141 All simulations used 2.1 x 109 gamma particle histories to achieve uncertainties below 1%.
142 Electron cut off energy (ECUT) of 0.7 MeV, and photon cut off energy (PCUT) of 0.01 MeV.
143 BEAMDP was used to derive the energy fluence (MeV/cm2/incident particle) and fluence
144 (incident particle/cm2), a function of lateral location across the scoring plane, and also the mean
145 energy of gammas as a function of lateral location across the scoring plane.
146
147 Results
148 Figure 4 shows the energy spectrum for all gamma’s in the phase space file. At energy 0.23
149 MeV at energy fluence in encapsulated sources is 0.01216 particles/cm2 versus unencapsulated
150 sources is 0.00093 particles/cm2. At energy 1.10 MeV at energy fluence in encapsulated
151 sources is 0.00552 particles/cm2 versus unencapsulated sources is 0.00187 particles/cm2.
7
152 Figure 4. Spectral distribution of the total photon (primary and secondary photon) of the source
153 unencapsulated vs. encapsulated.
154
155 Table 1 shows spectral value distribution for the total photons.
156 Figure 5 shows the characteristics of an energy fluence profile and fluence profile of total
157 photon as a function of location across the phase space scoring plane. Figure 5 (a) is the energy
158 fluence with an unencapsulated source higher 34.79% than the encapsulated source. Figure 5
159 (b) is the fluence with an unencapsulated source higher 13.69% than the encapsulated source.
(a) (b)
160 Figure 5. Energy fluence profile and fluence profile for the total photon of the source
161 unencapsulated vs. encapsulated.
8
162 Figure 6 shows the energy spectra of the secondary photon at the scoring plane. At an energy
163 of 0.23 MeV, the energy fluence in the encapsulated source is 0.01237 particles/cm2 compared
164 to 0.00072 particles/cm2 in the unencapsulated source. At an energy of 1.10 MeV, the energy
165 fluence in the encapsulated sources is 0.00549 particles/cm2 compared to is 0.00199
166 particles/cm2 in the unencapsulated source. Table 2 shows spectral value distribution for the
167 secondary photons.
168 Figure 6. Spectral distribution of the secondary photon of the source unencapsulated vs.
169 encapsulated.
170
171 Figure 7 shows the energy fluence and particle fluence profile of secondary photons as a
172 function location across the scoring plane. Figure 8 (a) shows the energy fluence with an
173 encapsulated source to be 85.84% higher than the unencapsulated source. Figure 8 (b) shows
174 the fluence with an encapsulated source to be 88.49% higher than the unencapsulated source.
9
(a) (b)
175 Figure 7. Energy fluence profile and fluence profile for secondary photon
176
177 Figure 8 shows the energy spectra for gamma's that have interacted in regions 1 and 0, the inner
178 and outer regions, respectively. The relative number of particles in each energy bin from the
179 area of origin of the photon that interacts versus the outer region only different at an energy
180 below 0.511 MeV. There is a difference in the energy fluence of 5x10-5 particles/cm2. At
181 energies above 0.511 MeV, there is no difference in energy fluence.
182
183 Figure 8. Spectral distribution of the photon region interact
10
184 Discussion
185 The effect of the use of encapsulated sources in this research increases the relative number of
186 particles in each energy bin. The increase in the relative number of particles in each energy bin
187 occurs due to the interaction of photons in the source geometry resulting in Compton scattering.
188 In Figures 4 and 6, the increase of the relative number of particles in each energy bin in the
189 Compton region of the spectra for all photons and the secondary photon was due to the
190 interaction of photons within the capsule material. The highest increase of the relative number
191 of particles in each energy bin occurs when photons interact with the encapsulation geometry
192 of the source. The increase in the relative number of particles in each energy bin for the spectra
193 of all photons in the Compton region was 92.36 %, and for the scattered photons was 94.17%.
194 The resulting energy spectra resemble the spectrum of energy for Cobalt-60 sources presented
195 by Mora et al. [9].
196 In Figures 5 and 7, there are two factors that influence the profiles, one is the energy of the
197 gammas, and the other is a number of particles. All gammas begin with narrow energy with
198 energies 1.17 MeV, and 1.33 MeV are produced, before interactions in the source, it’s
199 encapsulation causing a reduction in the gamma energy. The result is a broader spectrum of
200 gamma energies. At a particular location on the scoring plane, there will be a primary fluence,
201 gamma's that have traveled directly from the source (high energy) and scattered fluence (lower
202 energy).
203 In Figures 8, the spectra of particles interacting within region 1 is shown. The spectra show a
204 peak of 0.511 MeV. This energy is the rest mass energy of the electron. Annihilation peaks
205 from annihilation events due to positrons produced by pair production annihilating with
206 electrons producing two gammas of 0.511 MeV.
207
11
208 Conclusion
209 In this study, we presented the characterization of the source of Knife Perfexion TM based on
210 Monte Carlo simulations. A model of the Gamma Knife PerfexionTM source has been built
211 using the BEAMnrc code Monte Carlo. The effect of the use of encapsulated sources is shown
212 to broaden the energy spectra due to the Compton scattering of the Gammas in the
213 encapsulation geometry.
214 Future work will focus on modeling the collimator system for the GKP and then using the
215 source/collimator model to calculate dose distributions in CT-based models of phantoms and
216 patients.
217
218 Compliance with Ethical Standards
219 Acknowledgment
220 This study was funded by the Ministry of Research, Technology and Higher Education,
221 Directorate General of Resources for Science, Technology, and Higher Education (grant
222 number B/1536/D3.2/KD.02.00/2019). We would like to thank the Indonesian Education
223 Scholarship (LPDP), Ministry of Finance of the Republic of Indonesia, The Science and
224 Engineering Faculty of QUT for hosting for my scientific visit and the High-Performance
225 Computing Unit of QUT for use of the supercomputer for simulations.
226
227 Conflict of Interest
228 Author Junios Junios declares that he has no conflict of interest. Author Irhas irhas declares
229 that he has no conflict of interest. Author Elias Soediatmoko declares that he has no conflict of
230 interest. Author Freddy Haryanto declares that he has no conflict of interest. Author Novitrian
231 Novitrian declares that he has no conflict of interest. Author Zaki Su’ud declares that he has
12
232 no conflict of interest, and Author Andrew L. Fielding declares that he has no conflict of
233 interest.
234
235 Ethical approval
236 This article does not contain any studies with human participants or animals performed by any
237 of the authors.
238
239 References
240 1. Matthias Fippel. Monte Carlo Dose Calculation for Treatment Planning. Med Radiol
241 Diagn Imaging Radiat Oncol. 2006:197-206.
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243 Gamma Knife PerfexionTM. Phys Med Biol. 2014;59:7609–7623. doi:10.1088/0031-
244 9155/59/24/7609
245 3. Niranjan A, Novotny Jr. J, Bhatnagar J, Flickinger JC, Kondziolka D, Lunsford LD.
246 Efficiency and Dose Planning Comparisons between the Perfexion and 4C Leksell
247 Gamma Knife Units. Stereotact Funct Neurosurg. 2009;87(3):191-198.
248 doi:10.1159/000222663
249 4. Tlachacova D, Schmitt M, Novotny J, Novotny J, Majali M, Liscak R. A comparison of
250 the gamma knife model C and the Automatic Positioning System with Leksell model B.
251 J Neurosurg. 2005;102:25-28. doi:10.3171/jns.2005.102.s_supplement.0025
252 5. Josef Novotný Jr. Leksell Gamma Knife Past, Present, and Future. nstitute of Biophysics
253 and Informatics, First Faculty of Medicine, Charles University in Prague, Salmovská 1,
254 Prague 2, 120 00, Czech Republic; :1-13.
255 6. Lindquist C. Leksell Gamma Knife® PerfexionTM Instructions for Use. April 30 2007. 61.
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256 7. Miró R, Soler J, Gallardo S, Campayo JM, Díez S, Verdú G. MCNP simulation of a
257 Theratron 780 radiotherapy unit. Radiat Prot Dosimetry. 2005;116(1-4):65-68.
258 doi:10.1093/rpd/nci125
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260 J Iptek Terap. 2016;10(3). doi:10.22216/jit.2016.v10i3.587
261 9. G. M. Mora, A. Maio, and D. W. O. Rogers. Monte Carlo simulation of a typical 60Co
262 therapy source. Med Phys. 1999;26:2494-2502.
263 10. D. W. O. Rogers, B. A. Faddegon, et al. BEAM: A Monte Carlo code to simulate
264 radiotherapy treatment units. Med Phys. 1995;22:503-524.
265 11. D.W.O. Rogers, B. Walters, I. Kawrakow. BEAMnrc Users Manual. NRCC Report PIRS-
266 0509(A)revL; 2017.
267 12. C.-M. Ma and D.W.O. Rogers. BEAMDP Users Manual. NRCC Report PIRS-
268 0509(C)revA; 2017.
269 13. Knoll GF. Radiation Detection and Measurement. Oxford: Wiley & Son; 2010.
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272 15. Faiz M. Khan, John P. Gibbons. The Physics of Radiation Therapy. Fifth.; 2014.
273
274 Table 1. Value spectral distribution of Compton area for the total photon
Energy (MeV) Source model The relative number of particles Difference (%)
0.23 unencapsulated 0.00093
92.36
encapsulated 0.01216
66.12
275
276
277
14
278 Table 2. Value spectral distribution of Compton area for the secondary photons
Energy Source model The relative number of Difference (%)
(MeV) particles
94.17
63.74
279
15
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Radiological Physics and Technology

Characterization of The Source of Gamma Knife PerfexionTM Based on Monte Carlo

Manuscript Number: RPTE-D-20-00018

Article Type: Research Article

Corresponding Author: Junios Junios, M.D

Corresponding Author's Institution: Institut Teknologi Bandung

First Author: Junios Junios, M.D

Order of Authors: Junios Junios, M.D

Irhas Irhas, M.D

Novitrian Novitrian, Ph.D

Funding Information: Kementerian Riset, Teknologi dan Mr Junios Junios

Author Comments: The manuscript is the Monte Carlo simulation in radiotherapy.

1 Characterization of The Source of Gamma Knife PerfexionTM

2 Based on Monte Carlo Simulations

4 J. Juniosa*, I. Irhasa, N. Novitriana, E. Soediatmokob, F. Haryantoa, Z. Su’uda and A. L.

7 Jalan Ganesha 10 Bandung 40132, Indonesia

9 Banten 15811, Indonesia

12 Corresponding author: J. Junios

16 Phone number: +62-821-7013-5701

48 (Gamma Knife 4C and Gamma Knife B) [6].

53 powerful tool for simulating medical radiation devices [7,8].

71 a larger field than the true field was simulated.

79 modeled as if homogeneously distributed. The source is modelled to have anisotropic emission

82 manufacturer under a non-disclosure agreement.

84 Figure 1. The geometry of the source and capsules

85 Ref: Siloam Hospital Karawaci Tangerang, Banten, Indonesia

90 cylindrical geometry emitting a user-defined spectrum of energies [10]. Two energies of

92 as Gaussian peaks with a width of 0.010 MeV.

102 (0.2%), and Mo (0.012%), with density (ρ) is 7.95x10-3 Kg/m3.

109 spectra, and particle and energy fluence profiles.

111 unencapsulated (b) encapsulated

120 unencapsulated source.

𝑁𝑒𝐾 (𝐸)−𝑁𝑢𝐾 (𝐸) (1)

123 particles in each energy bin for unencapsulated source𝑁𝑢𝐾 (𝐸).

128 the maximum energy to the electron is Compton edge [13,14,15].

130 MeV and Compton Edge at 1.10 MeV.

138 3 shows how the LATCH numbers were assigned.

140 Figure 3. The LATCH numbers were assigned

151 sources is 0.00552 particles/cm2 versus unencapsulated sources is 0.00187 particles/cm2.

153 unencapsulated vs. encapsulated.

161 unencapsulated vs. encapsulated.

165 fluence in the encapsulated sources is 0.00549 particles/cm2 compared to is 0.00199

167 secondary photons.

181 energies above 0.511 MeV, there is no difference in energy fluence.

183 Figure 8. Spectral distribution of the photon region interact

195 by Mora et al. [9].

206 electrons producing two gammas of 0.511 MeV.

213 encapsulation geometry.

218 Compliance with Ethical Standards

222 number B/1536/D3.2/KD.02.00/2019). We would like to thank the Indonesian Education

227 Conflict of Interest

235 Ethical approval

237 of the authors.

241 Diagn Imaging Radiat Oncol. 2006:197-206.

243 Gamma Knife PerfexionTM. Phys Med Biol. 2014;59:7609–7623. doi:10.1088/0031-

247 Gamma Knife Units. Stereotact Funct Neurosurg. 2009;87(3):191-198.

249 4. Tlachacova D, Schmitt M, Novotny J, Novotny J, Majali M, Liscak R. A comparison of

251 J Neurosurg. 2005;102:25-28. doi:10.3171/jns.2005.102.s_supplement.0025

254 Prague 2, 120 00, Czech Republic; :1-13.

257 Theratron 780 radiotherapy unit. Radiat Prot Dosimetry. 2005;116(1-4):65-68.

260 J Iptek Terap. 2016;10(3). doi:10.22216/jit.2016.v10i3.587

262 therapy source. Med Phys. 1999;26:2494-2502.

264 radiotherapy treatment units. Med Phys. 1995;22:503-524.

Manuscript No. (if you know it) .PTED-&O-6or$