Iodine-125 is a widely used interstitial brachytherapy source employed in the treatment of cancer, especially in eye cancer and prostate cancer treatment [1]. Its radiation characteristics including the 27–32 keV X-ray and 35 keV γ-ray, with a comparatively long half-life (about 60 days) guarantee 125I a recognized status in the radiation therapy modality through interstitial implantation [2]. Currently, the preparations of these implantation sources provided by commercial manufacturers mainly focus on the adsorption of 125I on matrices made of palladium wires, ceramic beads, ion exchange resins, etc. [3, 4, 5]. However, due to the Intellectual Property Rights concerns and the commercial interests, little information about these techniques has been disclosed in the literature. In Majali
In this work, to fabricate a new category of 125I brachytherapy source with required properties such as the dosimetric accuracy and the dosage-uniformity, the 125I seeds with a core-shell structure were synthesized by a newly developed microfluidic device with two coaxial capillaries [7]. The core material is sodium iodine solution containing 125I and the shell material is tri(propylene glycol) diacrylate (TPGDA) with photosensitizer. During micro-fluidic and core-shell structure droplets formation processes, the diameters of cores and shells can be precisely controlled at a range of 100–500 μm and at 600 μm, respectively, by adjusting the flow rates [8]. During ultraviolet curing process, the shell phase of core-shell structure droplets is solidified by ultraviolet irradiation, which forms core-shell structure particles and that liquid cores containing 125I are enclosed by solidified poly(tri(propylene glycol) diacrylate) (PTPGDA) shells (this particle hereinafter 125I seed or seed). Then, a couple of 125I seeds are arranged collinearly within a cylindrical titanium capsule (hereinafter 125I brachytherapy source). By this means, the dose of 125I in each 125I seed can be controlled precisely, and the nonuniform dose distribution as a result of the existence of dose gradient during the adsorption process could be eliminated. In addition, it is relatively convenient for physicians to alter the radiological dose by adding or reducing the number of 125I seeds, or by changing the volume of the core. Also, the efficiency of 125I could be raised to nearly 100%. Here, the dose distribution of this new 125I brachytherapy source was simulated by Monte Carlo modelling, and, the influences of the motion of 125I seeds motion within the titanium capsule and the size of core phase on the dose distribution were studied to a greater extent [9, 10].
The experimental facilities includes capillaries with hydrophilic (fused silica tubing, Polymicro Technologies, INNOSEP Company, Zheng-Zhou, China) or hydrophobic (PEEK or PTFE tubings, Upchurch Scientific, INNOSEP Company, Zheng-Zhou, China) inner walls, gas-tight syringes, syringe pumps (PHD 2000, Harvard Apparatus), tubings (Polytetrafluoroethylene, Fisher Scientific Bioblock), T-junctions (P-728-01, Upchurch Scientific), line junction, and UV light (Lightning-cure LC8, Hamamatsu), as shown in Fig. 1. Two coaxial capillaries were inserted inside T-junction 1 along its main axis. The coaxial capillaries’ tips exit the T-junction 2 at the center of an outlet PTFE tubing.
Schematic drawing of capillary-based microfluidic device for synthesis of core-shell microspheres. Inner/outer diameter of the outside capillary (1) is 255 μm/510 μm, and inner/outer diameter of the inner capillary (2) is 100 μm/167 μm.
There are two types of disperse phase and one type of continuous phase which are mutually immiscible. Simethicone was used in continuous phase, and one of the disperse phase termed as the shell phase used TPGDA (Aldrich), 96 wt%: 1-hydroxycyclohexyl phenyl ketone (HCPK) as photoinitiator (Aldrich), 4 wt% [11]. The encapsulated phase used the core of the droplets consisted of sodium iodide solution (8 wt%) containing radioactive 125I (5 mCi). The mass densities of titanium, TPGDA, and dry air were 4.50, 1.03, and 1.20 × 10−3g/cm3, respectively, and air composition by mass of nitrogen, oxygen, argon, and carbon, was 75.520, 23.176, 1.288, and 0.016%, respectively, were used for computational purposes [12]. Water consisted of two parts hydrogen, one part oxygen, with a mass density of 0.998 g/cm3.
An optical microscope (XSP-30E, Shanghai Halibut Instrument Limited Company, China) equipped with a charge-coupled device (CCD) camera (uEye, UI-2220SE, IDS) was used to observe the formation of the core-shell structure droplets directly. The camera captures up to 52 ftps at a full resolution of 768 pixels × 576 pixels. Then during the flowing in the tube, droplets were polymerized under the explosion of UV irradiation by means of an UV source operating at λ = 365 nm online. The overall diameter and the core diameter of the 125I seed were measured with an image analysis software (uEye Cockpit) operating the CCD camera. The dosimetry parameters of the new source were calculated by Version 5 of Monte Carlo N-Particle Transport (MCNP5) code. The results of the tally were fed to a plotting software, SURFER 11.0, used to construct the isodose curves against dose values calculated above.
For the preparation of 125I seeds, core-shell structure droplets are produced first. A flexible coaxial capillaries microfluidic device was designed by us to produce core-shell droplets consisted of liquid core surrounded by a layer of TPGDA. The main part or element of the liquid core was sodium iodide solution containing radioactive 125I. As shown in Fig. 2b, sodium iodide solution and TPGDA were delivered by the inner capillary and the outside capillary, respectively, with the inner one was fixed inside of the outside one.
(a1–a3) Formation of core-shell structure droplet,
The droplet formation from two continuous flowing liquids was achieved through either dripping or jetting mode [15], and the key parameters for mastering the droplet formation mode are the flow rates of the continuous and dispersed phase. In this work, by adjusting the fluid flow rate, the droplets were formed in the dripping mode which ensured the formation of highly monodisperse core-shell structure droplets [16]. The formation of the core-shell structure droplet and the as-prepared 125I seeds with uniform core size and overall seed size were shown in Fig. 2.
For the treatment of different tumour sites, a source with various radiation doses for brachytherapy is required. The dose delivered by as-prepared 125I brachytherapy source is controlled by the dosage of 125I in each 125I seed and the number of the seeds sealed in the titanium capsule. Because of the limitation on the length of the source in practical utilization, controlling the content of 125I in each seed precisely to meet the radiation dose requirements has to be approached realistically. The 125I content of each seed is related to the 125I concentration in feed solution of the core and the core size of as-designed seed. By keeping size of the core droplet constant, it is easy to understand that the proportional increase of radiation dose rate of the seeds with the increase of the 125I concentration in core feed solution. While keeping the concentration of 125I in core feed solution fixed, the content of 125I in each seed can be controlled by changing the size of core droplet, and increases as the core size increases. In our previous work, the control of overall core-shell structure’s droplet size, core size, and shell size were studied in detail by adjusting the flow rates of different phase in the coaxial capillary microfluidic device and the relationship between core size and flow rate of the related fluids can be described by the formula:
Optical images of 125I seeds with a various core diameter and the same overall diameter of 600 μm. (a) Core diameter of 400 μm,
A structured source with a titanium capsule size of 800 μm outer diameter, 700 μm inner diameter, and 4 mm length was used in clinical medicine conventionally and the capsules filled with six as-prepared seeds of 600 μm diameter (shown in Fig. 4) were used for an evaluation of its dose distribution, and the dosimetry parameters of the source were calculated by MCNP5 code [17]. The simulation considered a spherical water phantom and the dose values in water were calculated at radial distances of 0–2 cm. The DLC-189 cross section was used for transport calculations and the Integrated TIGER Series (ITS) three-dimensional (3D) code system was used for coupled photon–electron transport. In order to determine relevant dose distribution accurately, different size of voxel computational cells were placed in select positions. The total number of photons transported per calculation run was 109 with statistical uncertainties below 3.6%. A plotting software, SURFER 11.0 was used to construct the isodose curves.
Isodose curves of the 125I brachytherapy sources with different orientation of cores in the sources. Overall diameter of the 125I seeds was 600 μm, and core diameter was 300 μm. (a) Each seed of core and shell is of homocentricity. (b–d) Each seed of core and shell was of nonhomocentricity.
If the core and shell of each seed have concentricity, a 125I brachytherapy source containing six seeds that lined the capsule appears to have an ellipsoid-like uniform dose distribution, as shown in Fig. 4a. In fact, it is difficult to synthesize a homocentric seed in the microfluidic system since the core droplet is free to move in the double droplet before polymerization of the seed shell, which will induce nonuniform distribution of the dose.
The core center usually deviates from the seed center in microfluidic fabrication of the seed with a core-shell structure. The maximum deviation of the core center from shell center, in that the core tangent to surface of the seed, was modelled for exploring the influence of the core position on dose distribution of the source. The position of six cores was described by setting
The isodose curves of cores with diameter of 150, 300, 400, and 500 μm constructed by SURFER 11.0 were shown in Fig. 5, respectively, and found that when the diameter of core was 150 μm, the dose distribution had a less uniformity within ±5 mm in
Isodose curves of the 125I brachytherapy sources with different core size under the same orientation in the source. Each seed diameter was 600 μm, and core diameter was (a) 150 μm, (b) 300 μm, (c) 400 μm, and (d) 500 μm.
By keeping the core diameter of 500 μm, the dose distribution of other modelled sources with a different orientation of the cores was also computed, as shown in Fig. 6. The results indicated that the dose distribution of the 125I brachytherapy sources with various orientations of the cores exhibited negligible differences or variations and so we can conclude that all of them were uniform even within ±5 mm in
Isodose curves of the 125I brachytherapy sources with a different orientation of the cores. Overall diameter of the 125I seeds was 600 μm, and the diameter of core was 500 μm.
Optical image of a 125I brachytherapy source consisted of six 125I seeds within a glass tubing. The overall diameter of the seeds was 600 μm, and the diameter of core was 500 μm.
A new 125I seeds with core-shell structure for 125I brachytherapy source was fabricated in a capillary-based microfluidic device. In comparison with the conventional adsorption methods for the fabrication of 125I seed, an encapsulating approach provided a precise load of the quantity-demanded 125I in a seed with a close to 100% of encapsulation efficiency. The 125I seed and its core size can be controlled by simply adjusting the flow rates of the fluids in the microfluidic system. The dose distribution of the 125I brachytherapy source consisted of the as-prepared seeds and titanium capsule was calculated by MCNP5, and the results showed that the nonuniformity of the dose distribution induced by the deviation of the core from the center of the whole seed could be eliminated by increasing the core size for a size-prescribed capsule.