Modified Geometry of ¹⁰⁶Ru Asymmetric Eye Plaques to Improve Dosimetric Calculations in Ophthalmic Brachytherapy

Ru/Rh asymmetric plaques for ophthalmic brachytherapy have special geometric designs with a cutout intended to prevent irradiation of critical ocular structures proximal to the tumor. In this work, we present new geometric models for PENELOPE+PenEasy Monte Carlo simulations of these applicators, differing from the vendor-reported geometry, that better match their real geometry to assess their dosimetric impact. Simulation results were benchmarked to experimental dosimetric data from radiochromic film measurements, data provided by the manufacturer in the calibration certificates, and other experimental results published in the literature, obtaining, in all cases, better agreement with the modified geometries. The clinical impact of the new geometric models was evaluated by simulating real clinical cases using patient-specific eye models. The cases calculated using the modified geometries presented higher doses to the critical structures proximal to the cutout region. The modified geometric models presented in this work provide a more accurate representation of the asymmetric plaques, greatly improving the agreement between Monte Carlo calculations and experimental measurements. Lack of consideration of accurate geometric models has been shown to be translated into notable increases in dose to organs at risk in clinical cases.