Point-by-point responses to the reviewers comments on the manuscript

"Cylindrical Coordinate Based TG-43U Parameters !or "ose Calculation around #lon$ated Brachytherapy %ources"
The authors would like to thank Reviewers for careful review of our manuscript and providing us with their comments and suggestion to improve the quality of the manuscript. The following responses have been prepared to address all of the reviewers comments in a point by-point fashion.

&eviewer '() General Comments

Comment !This manuscript is actually a continuation on the of "onte calculations around elongated RadioCoil
#$%

&d brachytherapy sources 'ref. #() using a

cylindrical coordinate system instead of the T*-+% proposed polar coordinate system. ,t demonstrates that the use of a cylindrical coordinate system requires less data than the polar one and more important improves significantly the dosimetric calculation accuracy around elongated sources. ,n addition the -.. model with the cylindrical coordinate based dosimetric parameters was found to accurately reproduce the dose distributions around elongated sources. ,n this respect the manuscript is interesting and could be accepted for publication after minor revision taking into consideration the following points./ &esponse* 0uthors would like to thank Reviewer !0/ for the considering our manuscript interesting and accepting it for publication after minor revision. 1e have incorporated the following reviewers specific comments in preparation of revised version of manuscript.

%peci!ic Comments

Comment + #
(A-14)

Comments and response 2,t is well known from previously published works concerning intravascular applications 'ref #%) that the use of a cylindrical coordinate system along with the associated anisotropy function of equation '0-#+) is more suitable for dose calculations at radial distances close elongated sources. This must be clear in the abstract./ ($reed* te3t revised as per suggestions. 2... 5igure #a and figure #b. The authors should superimpose dose distributions or remove the figure.2 "isa$ree* 1e believe that these figures visually demonstrate the differences of dose distribution around the two source models. The overlapping these two figures will destroy the purpose of the figures. Therefore6 we request the Reviewer !0/ to allow us to keep these figures in their present set up. 27first paragraph and figures 8 and ( &resented results correspond to 9 cm long source. :owever6 conclusions are generali;ed for any source length. 5or e3ample6 for a #cm long source differences < %= between "C and analytical data are e3pected only for radial distances.2 ($reed* Thank you for bringing this point to our attention. ,n this pro>ect we had investigated dosimetric characteristics of sources with active lengths ranging from # cm to 8 cm. 5or the brevity of the manuscript6 we had limited ourselves for presenting the data for #cm6 %cm6 and 9 cm data6 but our conclusion is based on the entire source lengths used in the investigation. The te3t was revised to clarify this point.

4
Figure 1a

%
Page 9

&eviewer 'B) General Comments

Comments * The work reported in this manuscript represents a further installment in the ongoing efforts of the ?niversity of @entucky group to characteri;e the dosimetry for RadioCoil &d-#$% sources6 which unlike most interstitial sources 'apart from ,r-#A4 wires) have a length of more than a few mm. Bew results presented here indicate that 'i) a cylindrical coordinate system appears to be more efficient for T*-+% data parameteri;ation6 and 'ii) the linear segmented source '-..) model6 in con>unction with cylindrical coordinate based parameters for a #.$ cm long source6 can be used to replicate the dose distribution around a RadioCoil source of integral length CDE 8 cm with clinically acceptable accuracy. *enerally speaking the manuscript is well-written and the e3position clear6 however it could benefit from revision as indicated in the detailed comments following. 0 potential concern bearing on publication is the commercial status of the RadioCoil product. "y attempt to obtain further information from the Radio"ed website 'www.radiomed.com) revealed that the site no longer e3ists. ,nstead6 , was re-directed to the ,FT Gosimetry website6 where no mention is made of the RadioCoil product. &esponse* 0uthors thank for Reviews !F/ for the comments that our manuscript is well-written and the e3position is clear. 5urthermore6 authors appreciate reviewers for the agreeing with our conclusion of this pro>ect6 that the linear segmented source '-..) model6 in con>unction with cylindrical coordinate based parameters for a #.$ cm long source6 can be used to replicate the dose distribution around elongated sources with clinically acceptable accuracy. 1e assured to incorporate the reviewers detailed comments in preparation of the revised manuscript.

0uthors agree with the reviewers comment that commercial status of RadioCoil is not very clear at this point. :owever various manufacturers are negotiating on the commercial aspect of this product. Regardless of the commercial aspect of the product6 the content of this manuscript has been prepared to address that polar coordinate system based T*-+%?# parameters are not more appropriate for elongated sources6 whereas cylindrical coordinate system based T*-+%?# parameters reproduce dose distribution more accurately as also commented by the Reviewer himself. ,n this pro>ect data for RadioCoilH#$%&d sources has been presented as sample of one of the elongated source. These formalisms can be e3tended to any elongated source model.

%peci!ic Comments
Comment + #.
[6, 11]

Comments and response '1hat is the basis for modeling &d-#$% activity as being deposited to a 4$ micron depthI ,s this detail importantI 0re the circular tori tally cells of diameter # mm too large to avoid volume averaging effects at distances very close to the sourceI/ &esponse* The depth of distribution of activity in the RadioCoilH
#$%

&d

sources have been e3amined in our previous investigations by comparison of the e3perimental data with the "onte Carlo simulated values. The same depth has been used in this pro>ect. Gistribution of activity in "onte Carlo simulation of a brachytherapy source is vital for its accuracy. 1ith these intentions6 distribution of activity is provided in the manuscript. 1e have e3amined the effect of the selection of dimension of the torus in calculating the dose profile along the longitudinal a3is of the source. Bo significant differences between the results of a $.+ mm diameter tours over $.J mm diameter tours6 if the calculation is performed with J$ million

photons.
4. . [7, 2nd last]

Therefore6 we had used the larger radii tours to reduce the

statistical fluctuation of the "onte Carlo simulations. 'sp. Thermoluminescence/ ($ree Te3t corrected for typographical error.

%. [8, 4th last]

', donKt understand the singularity issue. ,snKt the only singularity in 5'R6 L) caused by *'R6 L)6 the singularity in the latter having already been worked outI/ &esponse* The te3t is revised to clarify that the singularity of 4G anisotropy functions for points along the longitudinal a3is of the source. 'The superposition principle inherent in the segmentation approach apparently works fairly well for this low-energy source. Fecause it is not immediately obvious6 , would encourage the authors to draw from their earlier work to indicate why this is so 'either here or later in the Giscussion section)./ 0gree* Te3t has been revised to incorporate reviewers comment.

+. [10, 9]

9. [10, 14]

2..."onte Carlo simulation technique.2 2...show that the dose rate constants...2 ($ree* Te3t revised as directed.

8. [1 , 4]

'1hat differences might be e3pected between the -.. model and "onte Carlo6 based purely on physical considerations 'eg. source self-attenuation6 source and medium scatter)I The authors are encouraged to mention these in the te3t./ &esponse* There are no significant differences between "onte Carlo simulation and -.. model calculated dose profiles. "edium scatter is not as significant due of low energy of the &d-#$% source. .elf-attenuation is also negligible due to no capsule and end caps. Therefore6 differences between "onte Carlo simulation and -.. model calculated dose profiles can be

attributed to variations due to self attenuation and statistical fluctuations.

(. [16, 12]

2...facilitates the interpolation and e3trapolation of this parameter for dose calculation purposes.2 ($ree* Te3t is revised as directed. 2The advantages of this formalism...2 ($ree* Te3t is revised as directed. 2...the cylindrical coordinate formalism makes a significant improvement to...2 ($ree* Te3t is revised as directed.

J. [16, 16]

A. [16, !"n 17]

#$.
[16, 18]

'sp. Gescription/ ($ree* Te3t corrected for spelling error.

##. [18, 2nd last]

Comment* Remove leading period and space. &esponse* Te3t is revised as directed. 'sp. 0pproaches/ ($ree* Te3t corrected as directed. 'Goes the seed source contain &d-#$%I ,f so6 suggest 2...of a conventional seed type &d-#$% source '0)...2 ($ree* Te3t revised to mention conventional #$%&d source !1hy is there such a large percentage difference between the -.. model and "onte Carlo for the %.$ cm source in going from LE%.4 cm to LE %.9 cmI 0re there 'unacceptably) large statistical fluctuations in the "onte Carlo data and if so6 whyI/ &esponse* The te3t is revised to clarify this issue.

#4. [20, 7] #%. [21, 2]

#+. '29, #a$le %&

#9 ' 2, 2nd last)

':ow are the definitions of the anisotropy function 2different2I ,snKt it >ust the natural spatial sampling scheme that differ s between polar and cylindrical coordinatesI/

#8. [Fig ']

&esponse* The te3t is revised to remove the ambiguity. 'This figure illustrates very well that there are two spatial domains '#) LC0-D4 where cylindrical coordinates are more appropriate and '4) L<0-D4 where polar coordinates may be more appropriate. ,s it feasible that two parameteri;ations of the source dosimetry might work better than oneI/ "isa$ree* 0ctually6 the ma>or reason for this pro>ect has been introduced due to the fact the polar coordinate based parameteri;ations failed in reproducing the dose distribution of the elongated sources for L < -D4. ,nvestigating the e3act ;one for which polar coordinate based formalism works better is outside of the scope of this pro>ect and needs to be carefully investigated. ',n panel G6 why do the two right-most data points show such large fluctuationsI/ &esponse* 0ctually6 looking at figure J6 one can find the -.. model6 is reproducing the "onte Carlo simulations to within M4.9= for the points with L N -D4O$.9 cm. :owever6 the difference are larger 'within M9=) for the points with L < -D4 O$.9 cm6 where the statistical fluctuation of the "onte Carlo simulation is larger due to the lower dose rate. The te3t is revised to clarify this point. ',n the lower panel6 the reference number for Rivard should be 496 not 4%./ ($ree* The te3t is revised accordingly.

#(. [Fig 8]

#J. [Fig 10]