WorldWideScience

Sample records for assess lung dose

  1. 4D cone beam CT-based dose assessment for SBRT lung cancer treatment

    Science.gov (United States)

    Cai, Weixing; Dhou, Salam; Cifter, Fulya; Myronakis, Marios; Hurwitz, Martina H.; Williams, Christopher L.; Berbeco, Ross I.; Seco, Joao; Lewis, John H.

    2016-01-01

    The purpose of this research is to develop a 4DCBCT-based dose assessment method for calculating actual delivered dose for patients with significant respiratory motion or anatomical changes during the course of SBRT. To address the limitation of 4DCT-based dose assessment, we propose to calculate the delivered dose using time-varying (‘fluoroscopic’) 3D patient images generated from a 4DCBCT-based motion model. The method includes four steps: (1) before each treatment, 4DCBCT data is acquired with the patient in treatment position, based on which a patient-specific motion model is created using a principal components analysis algorithm. (2) During treatment, 2D time-varying kV projection images are continuously acquired, from which time-varying ‘fluoroscopic’ 3D images of the patient are reconstructed using the motion model. (3) Lateral truncation artifacts are corrected using planning 4DCT images. (4) The 3D dose distribution is computed for each timepoint in the set of 3D fluoroscopic images, from which the total effective 3D delivered dose is calculated by accumulating deformed dose distributions. This approach is validated using six modified XCAT phantoms with lung tumors and different respiratory motions derived from patient data. The estimated doses are compared to that calculated using ground-truth XCAT phantoms. For each XCAT phantom, the calculated delivered tumor dose values generally follow the same trend as that of the ground truth and at most timepoints the difference is less than 5%. For the overall delivered dose, the normalized error of calculated 3D dose distribution is generally less than 3% and the tumor D95 error is less than 1.5%. XCAT phantom studies indicate the potential of the proposed method to accurately estimate 3D tumor dose distributions for SBRT lung treatment based on 4DCBCT imaging and motion modeling. Further research is necessary to investigate its performance for clinical patient data.

  2. A Histological Assessment of Lung Injury in Rats Exposed to Inhaled Sulfur Mustard across Dose and Time

    Science.gov (United States)

    2015-06-01

    following HD exposure at 7.5 hours (3.0 mg/kg). Histopathology of the BALT and overlying respiratory epithelium in the accessory lung lobe. Note the...USAMRICD‐TR‐15‐02  A Histological Assessment of  Lung  Injury in Rats  Exposed to Inhaled Sulfur Mustard across Dose  and Time    Derron A... Lung Injury in rats Exposed to Inhaled Sulfur Mustard across Dose and Time 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR

  3. Radiation dose response of normal lung assessed by Cone Beam CT - a potential tool for biologically adaptive radiation therapy

    DEFF Research Database (Denmark)

    Bertelsen, Anders; Schytte, Tine; Bentzen, Søren M;

    2011-01-01

    Density changes of healthy lung tissue during radiotherapy as observed by Cone Beam CT (CBCT) might be an early indicator of patient specific lung toxicity. This study investigates the time course of CBCT density changes and tests for a possible correlation with locally delivered dose....

  4. Quantification of Proton Dose Calculation Accuracy in the Lung

    Energy Technology Data Exchange (ETDEWEB)

    Grassberger, Clemens, E-mail: Grassberger.Clemens@mgh.harvard.edu [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Center for Proton Radiotherapy, Paul Scherrer Institute, Villigen (Switzerland); Daartz, Juliane; Dowdell, Stephen; Ruggieri, Thomas; Sharp, Greg; Paganetti, Harald [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States)

    2014-06-01

    Purpose: To quantify the accuracy of a clinical proton treatment planning system (TPS) as well as Monte Carlo (MC)–based dose calculation through measurements and to assess the clinical impact in a cohort of patients with tumors located in the lung. Methods and Materials: A lung phantom and ion chamber array were used to measure the dose to a plane through a tumor embedded in the lung, and to determine the distal fall-off of the proton beam. Results were compared with TPS and MC calculations. Dose distributions in 19 patients (54 fields total) were simulated using MC and compared to the TPS algorithm. Results: MC increased dose calculation accuracy in lung tissue compared with the TPS and reproduced dose measurements in the target to within ±2%. The average difference between measured and predicted dose in a plane through the center of the target was 5.6% for the TPS and 1.6% for MC. MC recalculations in patients showed a mean dose to the clinical target volume on average 3.4% lower than the TPS, exceeding 5% for small fields. For large tumors, MC also predicted consistently higher V5 and V10 to the normal lung, because of a wider lateral penumbra, which was also observed experimentally. Critical structures located distal to the target could show large deviations, although this effect was highly patient specific. Range measurements showed that MC can reduce range uncertainty by a factor of ∼2: the average (maximum) difference to the measured range was 3.9 mm (7.5 mm) for MC and 7 mm (17 mm) for the TPS in lung tissue. Conclusion: Integration of Monte Carlo dose calculation techniques into the clinic would improve treatment quality in proton therapy for lung cancer by avoiding systematic overestimation of target dose and underestimation of dose to normal lung. In addition, the ability to confidently reduce range margins would benefit all patients by potentially lowering toxicity.

  5. Uncertainties on lung doses from inhaled plutonium.

    Science.gov (United States)

    Puncher, Matthew; Birchall, Alan; Bull, Richard K

    2011-10-01

    In a recent epidemiological study, Bayesian uncertainties on lung doses have been calculated to determine lung cancer risk from occupational exposures to plutonium. These calculations used a revised version of the Human Respiratory Tract Model (HRTM) published by the ICRP. In addition to the Bayesian analyses, which give probability distributions of doses, point estimates of doses (single estimates without uncertainty) were also provided for that study using the existing HRTM as it is described in ICRP Publication 66; these are to be used in a preliminary analysis of risk. To infer the differences between the point estimates and Bayesian uncertainty analyses, this paper applies the methodology to former workers of the United Kingdom Atomic Energy Authority (UKAEA), who constituted a subset of the study cohort. The resulting probability distributions of lung doses are compared with the point estimates obtained for each worker. It is shown that mean posterior lung doses are around two- to fourfold higher than point estimates and that uncertainties on doses vary over a wide range, greater than two orders of magnitude for some lung tissues. In addition, we demonstrate that uncertainties on the parameter values, rather than the model structure, are largely responsible for these effects. Of these it appears to be the parameters describing absorption from the lungs to blood that have the greatest impact on estimates of lung doses from urine bioassay. Therefore, accurate determination of the chemical form of inhaled plutonium and the absorption parameter values for these materials is important for obtaining reliable estimates of lung doses and hence risk from occupational exposures to plutonium.

  6. The mean lung dose (MLD). Predictive criterion for lung damage

    Energy Technology Data Exchange (ETDEWEB)

    Geyer, Peter; Appold, Steffen [Dresden University of Technology (TU Dresden), Clinic and Polyclinic for Radiotherapy and Radiation Oncology, Carl Gustav Carus Medical Faculty, Dresden (Germany); Herrmann, Thomas

    2015-07-15

    The purpose of this work was to prove the validity of the mean lung dose (MLD), widely used in clinical practice to estimate the lung toxicity of a treatment plan, by reevaluating experimental data from mini pigs. A total of 43 mini pigs were irradiated in one of four dose groups (25, 29, 33, and 37 Gy). Two regimens were applied: homogeneous irradiation of the right lung or partial irradiation of both lungs - including parts with lower dose - but with similar mean lung doses. The animals were treated with five fractions with a linear accelerator applying a CT-based treatment plan. The clinical lung reaction (breathing frequency) and morphological changes in CT scans were examined frequently during the 48 weeks after irradiation. A clear dose-effect relationship was found for both regimens of the trial. However, a straightforward relationship between the MLD and the relative number of responders with respect to different grades of increased breathing frequency for both regimens was not found. A morphologically based parameter NTCP{sub lung} was found to be more suitable for this purpose. The dependence of this parameter on the MLD is markedly different for the two regimens. In clinical practice, the MLD can be used to predict lung toxicity of a treatment plan, except for dose values that could lead to severe side effects. In the latter mentioned case, limitations to the predictive value of the MLD are possible. Such severe developments of a radiation-induced pneumopathy are better predicted by the NTCP{sub lung} formalism. The predictive advantage of this parameter compared to the MLD seems to remain in the evaluation and comparison of widely differing dose distributions, like in the investigated trial. (orig.) [German] Es soll unter Reevaluation von Tierversuchsdaten am Minischwein geprueft werden, ob die in der klinischen Praxis zur Beurteilung der Lungentoxizitaet eines Bestrahlungsregims regelhaft verwendete mittlere Lungendosis (MLD) eine zuverlaessige

  7. Assessment of internal doses

    CERN Document Server

    Rahola, T; Falk, R; Isaksson, M; Skuterud, L

    2002-01-01

    There is a definite need for training in dose calculation. Our first course was successful and was followed by a second, both courses were fully booked. An example of new tools for software products for bioassay analysis and internal dose assessment is the Integrated Modules for Bioassay Analysis (IMBA) were demonstrated at the second course. This suite of quality assured code modules have been adopted in the UK as the standard for regulatory assessment purposes. The intercomparison measurements are an important part of the Quality Assurance work. In what is known as the sup O utside workers ' directive it is stated that the internal dose measurements shall be included in the European Unions supervision system for radiation protection. The emergency preparedness regarding internal contamination was much improved by the training with and calibration of handheld instruments from participants' laboratories. More improvement will be gained with the handbook giving practical instructions on what to do in case of e...

  8. Utirik Atoll Dose Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Robison, W.L.; Conrado, C.L.; Bogen, K.T

    1999-10-06

    On March 1, 1954, radioactive fallout from the nuclear test at Bikini Atoll code-named BRAVO was deposited on Utirik Atoll which lies about 187 km (300 miles) east of Bikini Atoll. The residents of Utirik were evacuated three days after the fallout started and returned to their atoll in May 1954. In this report we provide a final dose assessment for current conditions at the atoll based on extensive data generated from samples collected in 1993 and 1994. The estimated population average maximum annual effective dose using a diet including imported foods is 0.037 mSv y{sup -1} (3.7 mrem y{sup -1}). The 95% confidence limits are within a factor of three of their population average value. The population average integrated effective dose over 30-, 50-, and 70-y is 0.84 mSv (84, mrem), 1.2 mSv (120 mrem), and 1.4 mSv (140 mrem), respectively. The 95% confidence limits on the population-average value post 1998, i.e., the 30-, 50-, and 70-y integral doses, are within a factor of two of the mean value and are independent of time, t, for t > 5 y. Cesium-137 ({sup 137}Cs) is the radionuclide that contributes most of this dose, mostly through the terrestrial food chain and secondarily from external gamma exposure. The dose from weapons-related radionuclides is very low and of no consequence to the health of the population. The annual background doses in the U. S. and Europe are 3.0 mSv (300 mrem), and 2.4 mSv (240 mrem), respectively. The annual background dose in the Marshall Islands is estimated to be 1.4 mSv (140 mrem). The total estimated combined Marshall Islands background dose plus the weapons-related dose is about 1.5 mSv y{sup -1} (150 mrem y{sup -1}) which can be directly compared to the annual background effective dose of 3.0 mSv y{sup -1} (300 mrem y{sup -1}) for the U. S. and 2.4 mSv y{sup -1} (240 mrem y{sup -1}) for Europe. Moreover, the doses listed in this report are based only on the radiological decay of {sup 137}Cs (30.1 y half-life) and other

  9. Microscopic dose to lung from inhaled alpha emitters in humans

    Energy Technology Data Exchange (ETDEWEB)

    Diel, Joseph; Belosokhov, Maxim; Romanov, Sergey [Southern Urals Biophysics Institute, Ozersk, Chelyabinsk Region (Russian Federation); Guilmette, Raymond [Los Alamos National Laboratory, MS G761, RP-2, Los Alamos, NM 87545 (United States)

    2007-07-01

    Because of the short range of alpha particles in tissue, the degree of uniformity of irradiation of the lung varies greatly depending on the form of the inhaled material. Animal studies have shown that the degree of dose uniformity influences the risk of lung cancer. This study investigates the radiation dose distribution of plutonium in human lung. Numerical maps of tissue configuration and target cell locations are obtained from histological sections of human lung tissue stained to enhance the identification of putative cell types for parenchymal lung cancers, i.e. alveolar type II cells and Clara cells. Monte Carlo simulations are used to obtain dose distribution around individual particles, and these distributions are used to compute dose distribution in volumes of lung tissue. Lung dose is characterised both by the degree of non-uniformity of irradiation and the relative degree of irradiation of all tissue versus the special cells of interest. (authors)

  10. Optimizing dose prescription in stereotactic body radiotherapy for lung tumours using Monte Carlo dose calculation

    NARCIS (Netherlands)

    Widder, Joachim; Hollander, Miranda; Ubbels, Jan F.; Bolt, Rene A.; Langendijk, Johannes A.

    2010-01-01

    Purpose: To define a method of dose prescription employing Monte Carlo (MC) dose calculation in stereotactic body radiotherapy (SBRT) for lung tumours aiming at a dose as low as possible outside of the PTV. Methods and materials: Six typical T1 lung tumours - three small, three large - were construc

  11. Structural and functional changes in the minipig lung following irradiation of different lung volumes at a constant mean lung dose; Strukturelle und funktionelle Veraenderungen an der Lunge von Minischweinen nach Bestrahlung unterschiedlich grosser Lungenvolumina mit gleicher mittlerer Lungendosis

    Energy Technology Data Exchange (ETDEWEB)

    Kusche, S.; Herrmann, T.; Appold, S.; Hoelscher, T.; Bruechner, K.; Geyer, P.; Baumann, M.; Kumpf, R.

    2004-07-01

    Minipigs were subjected to irradiation of different lung volumes at approximately the same mean lung dose (D{sub m}ean) and examined for structural and morphological changes of the lung. The outcome confirmed earlier findings on the pig lung. While no significant differences between irradiation groups was found in terms of functional lung changes, there was a clear correlation between functional changes observed and the mean lung dose. This is in good agreement with data from clinical studies. It follows that the mean lung dose is of predictive value in considering functional lung damage in the assessment of different irradiation regimes. By contrast structural damage was found to correlate with applied dose. [German] Es wurden an Minischweinen unterschiedliche grosse Lungenvolumina mit vergleichbaren mittleren Lungendosen (mean lung dose, D{sub mean}) bestrahlt und die funktionellen und morphologischen Veraenderungen bestimmt. Die Untersuchungen zu funktionellen und morphologischen Veaenderungen bestaetigen fruehere Untersuchungen an der Schweinelunge. Hinsichtlich funktioneller Lungenveraenderungen fand sich kein signifikanter Unterschied zwischen den Bestrahlungsarmen, aber es konnte eine eindeutige Korrelation dieser Veraenderungen mit der mittleren Lungendosis D{sub mean} nachgewiesen werden. Dies steht in gutem Einklang mit Daten aus klinischen Untersuchungen. Somit bestaetigt sich, dass die mean lung dose eine praediktive Bedeutung zur Abschaetzung funktionaler Schaeden der Lunge bei der Beurteilung unterschiedlicher Bestrahlungsplaene hat. Die strukturellen Schaeden korrelieren hingegen mit der applizierten Dosis. (orig.)

  12. Superposition dose calculation in lung for 10MV photons.

    Science.gov (United States)

    Hoban, P W; Murray, D C; Metcalfe, P E; Round, W H

    1990-06-01

    Currently available radiotherapy treatment planning systems employ scatter function models such as ETAR and Batho dSAR for dose calculation. Errors using these models for high energy photon irradiation occur in and beyond lung tissue for small fields. For larger fields, central axis dose is correctly predicted but penumbral broadening in lung is underestimated. The major source of error is the assumption that lateral electronic equilibrium is always established. A superposition algorithm has been developed for 10MV photons which calculates the dose by convolving the TERMA (Total Energy Released per unit MAss by primary photons) with a dose spread array formed using the EGS4 Monte Carlo code. TERMA and dose spread arrays are both generated using a 10 component photon energy spectrum. Dose in inhomogeneous media is calculated using dose spread arrays generated for different density media and by scaling dose spread arrays according to density variations. This method ensures that electronic disequilibrium is modelled in situations where it exists. Superposition results in a lung phantom for a 5 x 5 cm field agree with EGS4 Monte Carlo results to within 2% for p = 0.20 gcm-3 and p = 0.30 gcm-3 lung. Profiles generated by superposition for a 10 x 10 cm field at mid-lung and compared with film measurements show that penumbral broadening in low density material is also correctly predicted.

  13. Lung Cancer Screening with Low Dose CT

    Science.gov (United States)

    Caroline, Chiles

    2014-01-01

    SUMMARY The announcement of the results of the NLST, showing a 20% reduction in lung-cancer specific mortality with LDCT screening in a high risk population, marked a turning point in lung cancer screening. This was the first time that a randomized controlled trial had shown a mortality reduction with an imaging modality aimed at early detection of lung cancer. Current guidelines endorse LDCT screening for smokers and former smokers ages 55 to 74, with at least a 30 pack year smoking history. Adherence to published algorithms for nodule follow-up is strongly encouraged. Future directions for screening research include risk stratification for selection of the screening population, and improvements in the diagnostic follow-up for indeterminate pulmonary nodules. As with screening for other malignancies, screening for lung cancer with LDCT has revealed that there are indolent lung cancers which may not be fatal. More research is necessary if we are to maximize the risk-benefit ratio in lung cancer screening. PMID:24267709

  14. Assessment of the solubility of thorium and uranium from black sand of Camargue in both simulated lung and gut fluids for dose calculation after internal exposure

    Energy Technology Data Exchange (ETDEWEB)

    Frelon, S.; Chazel, V.; Tourlonias, E.; Paquet, F. [IRSN/ DRPH/ SRBE, LRTOX, BP 166, 26702 Pierrelatte Cedex (France); Blanchardon, E. [IRSN/ DRPH/ SDI, LEDI, BP 17, 92262 Fontenay Aux Roses Cedex (France); Bouisset, P. [IRSN/ DEI/ STEME, LMRE, Bois des rames, 91400 Orsay (France); Pourcelot, L. [IRSN/ DEI/ SESURE, LERCM, BP3, 13 115 St Paul lez Durance Cedex (France)

    2006-07-01

    In the south of France, some beaches of Camargue present a high rate of natural radioactivity due to thorium and uranium from zircon and apatite heavy minerals present in the so-called black sand. These radionuclides may lead to internal exposure consecutive to inhalation or ingestion of this sand. The accurate assessment of radiological risk after internal exposure of public frequenting these beaches requires some information on the human bioavailability of U and Th from the sand. Both routes of intake were studied in this work and the consecutive dose delivered was calculated under two different scenarios for each type of exposure. As far as inhalation is concerned, the first important conclusion is that the inhalable fraction, i.e. particles with aerodynamic diameters below 50 {mu}m, was tiny (0.002%) in this sample of sand. Moreover in vitro assays of solubility were performed for this fraction and showed that U and Th as well as their progeny presented moderate solubility. Then effective doses under several scenarios were calculated and seem to demonstrate a very poor risk of exposure after inhalation. Indeed, a dose of 1 mSv would be received by a babies after inhalation of about 40 Kg of sand, that is impossible, whereas a more realistic scenario of chronic exposure only reached 31 {mu} Sv. In case of ingestion, the solubility of Th and U in the gastrointestinal fluids was found to be very low with a maximum solubility of 0.5% of the initial mass of radioelement in the sample of sand. Then the worst hypothesis studied yields an effective dose of 0.018 mSv./(g-swallowed sand) that is roughly 50 times less than the legal annual dose limit for members of the public. as a conclusion, the possible internal dose after exposure by inhalation or ingestion of black sand of Camargue seems to be very low under the conditions of this study. (N.C.)

  15. Radiation dose-volume effects in the lung

    DEFF Research Database (Denmark)

    Marks, Lawrence B; Bentzen, Soren M; Deasy, Joseph O;

    2010-01-01

    The three-dimensional dose, volume, and outcome data for lung are reviewed in detail. The rate of symptomatic pneumonitis is related to many dosimetric parameters, and there are no evident threshold "tolerance dose-volume" levels. There are strong volume and fractionation effects....

  16. Screening for lung cancer with low-dose CT.

    Science.gov (United States)

    Coche, E

    2008-01-01

    Lung cancer represents the leading cause of cancer-related mortality in the world. In the past, many attempts were made to detect the disease at an early stage and subsequently reduce its mortality. Chest X-ray was abandoned for this purpose. For several years low-dose computed tomography has been introduced as a potential tool for early screening in a high-risk population. As demonstrated in several papers, the task is not easy and researchers are faced with many difficulties. This paper reviews mainly the role of low-dose CT for early cancer screening. Results of past and current trials, controversies related to the high rate of lung nodules, cost-effectiveness, and delivered radiation dose to the patient are presented. Finally some limitations of low dose CT for lung cancer detection are explained.

  17. Analytical modelling of regional radiotherapy dose response of lung

    Science.gov (United States)

    Lee, Sangkyu; Stroian, Gabriela; Kopek, Neil; AlBahhar, Mahmood; Seuntjens, Jan; El Naqa, Issam

    2012-06-01

    Knowledge of the dose-response of radiation-induced lung disease (RILD) is necessary for optimization of radiotherapy (RT) treatment plans involving thoracic cavity irradiation. This study models the time-dependent relationship between local radiation dose and post-treatment lung tissue damage measured by computed tomography (CT) imaging. Fifty-eight follow-up diagnostic CT scans from 21 non-small-cell lung cancer patients were examined. The extent of RILD was segmented on the follow-up CT images based on the increase of physical density relative to the pre-treatment CT image. The segmented RILD was locally correlated with dose distribution calculated by analytical anisotropic algorithm and the Monte Carlo method to generate the corresponding dose-response curves. The Lyman-Kutcher-Burman (LKB) model was fit to the dose-response curves at six post-RT time periods, and temporal change in the LKB parameters was recorded. In this study, we observed significant correlation between the probability of lung tissue damage and the local dose for 96% of the follow-up studies. Dose-injury correlation at the first three months after RT was significantly different from later follow-up periods in terms of steepness and threshold dose as estimated from the LKB model. Dependence of dose response on superior-inferior tumour position was also observed. The time-dependent analytical modelling of RILD might provide better understanding of the long-term behaviour of the disease and could potentially be applied to improve inverse treatment planning optimization.

  18. Assessment of lung tumor response by perfusion CT.

    Science.gov (United States)

    Coche, E

    2013-01-01

    Perfusion CT permits evaluation of lung cancer angiogenesis and response to therapy by demonstrating alterations in lung tumor vascularity. It is advocated that perfusion CT performed shortly after initiating therapy may provide a better evaluation of physiological changes rather than the conventional size assessment obtained with RECIST. The radiation dose,the volume of contrast medium delivered to the patient and the reproducibility of blood flow parameters remain an issue for this type of investigation.

  19. Dose assessments for SFR 1

    Energy Technology Data Exchange (ETDEWEB)

    Bergstroem, Ulla (Swedish Nuclear Fuel and Waste Management Co., Stockholm (Sweden)); Avila, Rodolfo; Ekstroem, Per-Anders; Cruz, Idalmis de la (Facilia AB, Bromma (Sweden))

    2008-06-15

    Following a review by the Swedish regulatory authorities of the safety analysis of the SFR 1 disposal facility for low and intermediate level waste, SKB has prepared an updated safety analysis, SAR-08. This report presents estimations of annual doses to the most exposed groups from potential radionuclide releases from the SFR 1 repository for a number of calculation cases, selected using a systematic approach for identifying relevant scenarios for the safety analysis. The dose estimates can be used for demonstrating that the long term safety of the repository is in compliance with the regulatory requirements. In particular, the mean values of the annual doses can be used to estimate the expected risks to the most exposed individuals, which can then be compared with the regulatory risk criteria for human health. The conversion from doses to risks is performed in the main report. For one scenario however, where the effects of an earthquake taking place close to the repository are analysed, risk calculations are presented in this report. In addition, prediction of concentrations of radionuclides in environmental media, such as water and soil, are compared with concentration limits suggested by the Erica-project as a base for estimating potential effects on the environment. The assessment of the impact on non-human biota showed that the potential impact is negligible. Committed collective dose for an integration period of 10,000 years for releases occurring during the first thousand years after closure are also calculated. The collective dose commitment was estimated to be 8 manSv. The dose calculations were carried out for a period of 100,000 years, which was sufficient to observe peak doses in all scenarios considered. Releases to the landscape and to a well were considered. The peaks of the mean annual doses from releases to the landscape are associated with C-14 releases to a future lake around year 5,000 AD. In the case of releases to a well, the peak annual doses

  20. STUDY ON LUNG DOSE FOR DIFFERENT ANIMALS BY INHALATION OF SHORT—LIVED RADON DAUGHTERS

    Institute of Scientific and Technical Information of China (English)

    李素云; 张升慧; 等

    1994-01-01

    The dose distribution in the lung is inhomogeneous.The dose to the basal cell layer of trachea and main bronchi is much higher than the dose to total lung both for rabbits at different ages and for different animals.A maximum value of the dose to lung tissue for rabbits at ages of 20-40d is observed.The dose decreases with increasing body weight.The relationship between the dose and body weight can be descreibed by a power function.The dose to total lung increases exponentially with the minute breathing volume per unit of lung weight.

  1. Dose assessments for SFR 1

    Energy Technology Data Exchange (ETDEWEB)

    Bergstroem, Ulla (Swedish Nuclear Fuel and Waste Management Co., Stockholm (Sweden)); Avila, Rodolfo; Ekstroem, Per-Anders; Cruz, Idalmis de la (Facilia AB, Bromma (Sweden))

    2008-06-15

    Following a review by the Swedish regulatory authorities of the safety analysis of the SFR 1 disposal facility for low and intermediate level waste, SKB has prepared an updated safety analysis, SAR-08. This report presents estimations of annual doses to the most exposed groups from potential radionuclide releases from the SFR 1 repository for a number of calculation cases, selected using a systematic approach for identifying relevant scenarios for the safety analysis. The dose estimates can be used for demonstrating that the long term safety of the repository is in compliance with the regulatory requirements. In particular, the mean values of the annual doses can be used to estimate the expected risks to the most exposed individuals, which can then be compared with the regulatory risk criteria for human health. The conversion from doses to risks is performed in the main report. For one scenario however, where the effects of an earthquake taking place close to the repository are analysed, risk calculations are presented in this report. In addition, prediction of concentrations of radionuclides in environmental media, such as water and soil, are compared with concentration limits suggested by the Erica-project as a base for estimating potential effects on the environment. The assessment of the impact on non-human biota showed that the potential impact is negligible. Committed collective dose for an integration period of 10,000 years for releases occurring during the first thousand years after closure are also calculated. The collective dose commitment was estimated to be 8 manSv. The dose calculations were carried out for a period of 100,000 years, which was sufficient to observe peak doses in all scenarios considered. Releases to the landscape and to a well were considered. The peaks of the mean annual doses from releases to the landscape are associated with C-14 releases to a future lake around year 5,000 AD. In the case of releases to a well, the peak annual doses

  2. Radiological dose assessment for vault storage concepts

    Energy Technology Data Exchange (ETDEWEB)

    Richard, R.F.

    1997-02-25

    This radiological dose assessment presents neutron and photon dose rates in support of project W-460. Dose rates are provided for a single 3013 container, the ``infloor`` storage vault concept, and the ``cubicle`` storage vault concept.

  3. Lung cancer risk at low doses of alpha particles.

    Science.gov (United States)

    Hofmann, W; Katz, R; Zhang, C X

    1986-10-01

    A survey of inhabitant exposures arising from the inhalation of 222Rn and 220Rn progeny, and lung cancer mortality has been carried out in two adjacent areas in Guangdong Province, People's Republic of China, designated as the "high background" and the "control" area. Annual exposure rates are 0.38 working level months (WLM) per year in the high background, and 0.16 WLM/yr in the control area. In 14 yr of continuous study, from 1970 to 1983, age-adjusted mortality rates were found to be 2.7 per 10(5) living persons of all ages in the high background area, and 2.9 per 10(5) living persons in the control area. From this data, we conclude that we are unable to determine excess lung cancers over the normal fluctuations below a cumulative exposure of 15 WLM. This conclusion is supported by lung cancer mortality data from Austrian and Finnish high-background areas. A theoretical analysis of epidemiological data on human lung cancer incidence from inhaled 222Rn and 220Rn progeny, which takes into account cell killing as competitive with malignant transformation, leads to the evaluation of a risk factor which is either a linear-exponential or a quadratic-exponential function of the alpha-particle dose. Animal lung cancer data and theoretical considerations can be supplied to support either hypothesis. Thus we conclude that at our current stage of knowledge both the linear-exponential and the quadratic-exponential extrapolation to low doses seem to be equally acceptable for Rn-induced lung cancer risk, possibly suggesting a linear-quadratic transformation function with an exponential cell-killing term, or the influence of risk-modifying factors such as repair or proliferation stimuli.

  4. SU-E-T-500: Dose Escalation Strategy for Lung Cancer Patients Using a Biologically- Guided Target Definition

    Energy Technology Data Exchange (ETDEWEB)

    Shusharina, N; Khan, F; Choi, N; Sharp, G [Massachusetts General Hospital, Boston, MA (United States)

    2014-06-01

    Purpose: Dose escalation strategy for lung cancer patients can lead to late symptoms such as pneumonitis and cardiac injury. We propose a strategy to increase radiation dose for improving local tumor control while simultaneously striving to minimize the injury of organs at risk (OAR). Our strategy is based on defining a small, biologically-guided target volume for receiving additional radiation dose. Methods: 106 patients with lung cancer treated with radiotherapy were selected for patients diagnosed with stage II and III disease. Previous research has shown that 50% of the maximum SUV threshold in FDG-PET imaging is appropriate for delineation of the most aggressive part of a tumor. After PET- and CT-derived targets were contoured, an IMRT treatment plan was designed to deliver 60 Gy to the GTV as delineated on a 4D CT (Plan 1). A second plan was designed with additional dose of 18 Gy to the PET-derived volume (Plan 2). A composite plan was generated by the addition of Plan 1 and Plan 2. Results: Plan 1 was compared to the composite plan and increases in OAR dose were assessed. For seven patients on average, lung V5 was increased by 1.4% and V20 by 4.2% for ipsilateral lung and by 13.5% and 7% for contralateral lung. For total lung, V5 and V20 were increased by 4.5% and 4.8% respectively. Mean lung dose was increased by 9.7% for the total lung. The maximum dose to the spinal cord increased by 16% on average. For the heart, V20 increased by 4.2% and V40 by 5.2%. Conclusion: It seems feasible that an additional 18 Gy of radiation dose can be delivered to FDG PET-derived subvolume of the CT-based GTV of the primary tumor without significant increase in total dose to the critical organs such as lungs, spinal cord and heart.

  5. Coffee and tea consumption and risk of lung cancer: a dose-response analysis of observational studies.

    Science.gov (United States)

    Wang, Yaopeng; Yu, Xuyi; Wu, Yili; Zhang, Dongfeng

    2012-11-01

    Results from the recent meta-analysis suggested a favorable effect of green tea consumption and risk of lung cancer, while no significant association was found between black tea consumption and risk of lung cancer. Besides, a significantly positive association was found between coffee consumption and risk of lung cancer. However, the relationship of green tea and coffee consumption is unclear. Thus the dose-response relationship was assessed by restricted cubic spline model and multivariate random-effect meta-regression. Results suggested that a linear dose-response relationship exists between coffee consumption and risk of lung cancer, while the dose-response relationship is nonlinear between green tea consumption and risk of lung cancer.

  6. Method for calculating dose when lung tissue lies in the treatment field

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, S.C.; Keller, B.E.; Rubin, P.

    1976-07-01

    The absorbed dose in lung and beyond lung as a result of increased lung transmission of x and ..gamma.. irradiation is described. The correction factor used to calculate the absorbed dose is a function of beam energy, field area, lung density, and lung and soft tissue depth. Agreement between measurements and calculations in the Alderson phantom is within 3%. An example of how this technique can be used is described. (AIP)

  7. Irrigation in dose assessments models

    Energy Technology Data Exchange (ETDEWEB)

    Bergstroem, Ulla; Barkefors, Catarina [Studsvik RadWaste AB, Nykoeping (Sweden)

    2004-05-01

    SKB has carried out several safety analyses for repositories for radioactive waste, one of which was SR 97, a multi-site study concerned with a future deep bedrock repository for high-level waste. In case of future releases due to unforeseen failure of the protective multiple barrier system, radionuclides may be transported with groundwater and may reach the biosphere. Assessments of doses have to be carried out with a long-term perspective. Specific models are therefore employed to estimate consequences to man. It has been determined that the main pathway for nuclides from groundwater or surface water to soil is via irrigation. Irrigation may cause contamination of crops directly by e.g. interception or rain-splash, and indirectly via root-uptake from contaminated soil. The exposed people are in many safety assessments assumed to be self-sufficient, i.e. their food is produced locally where the concentration of radionuclides may be the highest. Irrigation therefore plays an important role when estimating consequences. The present study is therefore concerned with a more extensive analysis of the role of irrigation for possible future doses to people living in the area surrounding a repository. Current irrigation practices in Sweden are summarised, showing that vegetables and potatoes are the most common crops for irrigation. In general, however, irrigation is not so common in Sweden. The irrigation model used in the latest assessments is described. A sensitivity analysis is performed showing that, as expected, interception of irrigation water and retention on vegetation surfaces are important parameters. The parameters used to describe this are discussed. A summary is also given how irrigation is proposed to be handled in the international BIOMASS (BIOsphere Modelling and ASSessment) project and in models like TAME and BIOTRAC. Similarities and differences are pointed out. Some numerical results are presented showing that surface contamination in general gives the

  8. Automated detection and classification of interstitial lung diseases from low-dose CT images

    Science.gov (United States)

    Zheng, Bin; Leader, Joseph K.; Fuhrman, Carl R.; Sciurba, Frank C.; Gur, David

    2004-05-01

    We developed a computer-aided diagnosis (CAD) scheme to detect and quantitatively assess interstitial lung diseases (ILD) depicted on low-dose and multi-slice helical high-resolution computed tomography (CT) examinations. Eighteen CT cases acquired from patients who underwent routine low-dose whole-lung screening examinations for the detection of lung cancer were used to test the scheme. ILD was identified in all of these cases. The CAD scheme involves multiple steps to segment lung areas, identify suspicious ILD regions depicted on each CT slice, and generate volumetric ILD lesions by grouping and matching ILD regions detected on multiple adjacent slices. The scheme computes five "global" features for each identified ILD region, which include size (or volume), contrast, average local pixel value fluctuation, mean of stochastic fractal dimension, and geometric fractal dimension. Two sets of classification rules are applied to remove false-positive detections. The severity of ILD in each case was rated by one experienced chest radiologist into one of the three categories (mild, moderate, and severe). A distance-weighted k-nearest neighbor algorithm and round-robin validation method was applied to classify each testing case into one of the three categories of severity. In this experiment, the CAD scheme classified 78% (14 out of 18) cases into the same categories as rated by the radiologist.

  9. Investigation of optimal beam margins for stereotactic radiotherapy of lung-cancer using Monte Carlo dose calculations

    Energy Technology Data Exchange (ETDEWEB)

    Jin, L; Wang, L; Li, J; Luo, W; Feigenberg, S J; Ma, C-M [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111 (United States)

    2007-07-21

    This work investigated the selection of beam margins in lung-cancer stereotactic body radiotherapy (SBRT) with 6 MV photon beams. Monte Carlo dose calculations were used to systematically and quantitatively study the dosimetric effects of beam margins for different lung densities (0.1, 0.15, 0.25, 0.35 and 0.5 g cm{sup -3}), planning target volumes (PTVs) (14.4, 22.1 and 55.3 cm{sup 3}) and numbers of beam angles (three, six and seven) in lung-cancer SBRT in order to search for optimal beam margins for various clinical situations. First, a large number of treatment plans were generated in a commercial treatment planning system, and then recalculated using Monte Carlo simulations. All the plans were normalized to ensure that 95% of the PTV at least receives the prescription dose and compared quantitatively. Based on these plans, the relationships between the beam margin and quantities such as the lung toxicity (quantified by V{sub 20}, the percentage volume of the two lungs receiving at least 20 Gy) and the maximum target (PTV) dose were established for different PTVs and lung densities. The impact of the number of beam angles on the relationship between V{sub 20} and the beam margin was assessed. Quantitative information about optimal beam margins for lung-cancer SBRT was obtained for clinical applications.

  10. Evaluating proton stereotactic body radiotherapy to reduce chest wall dose in the treatment of lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Welsh, James, E-mail: jwelsh@mdanderson.org [Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX (United States); Amini, Arya [Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX (United States); UC Irvine School of Medicine, Irvine, CA (United States); Ciura, Katherine; Nguyen, Ngoc; Palmer, Matt [Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX (United States); Soh, Hendrick [Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX (United States); Department of Radiation Physics, The University of Texas, MD Anderson Cancer Center, Houston, TX (United States); Allen, Pamela K.; Paolini, Michael; Liao, Zhongxing [Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX (United States); Bluett, Jaques; Mohan, Radhe [Department of Radiation Physics, The University of Texas, MD Anderson Cancer Center, Houston, TX (United States); Gomez, Daniel; Cox, James D.; Komaki, Ritsuko; Chang, Joe Y. [Department of Radiation Oncology, The University of Texas, MD Anderson Cancer Center, Houston, TX (United States)

    2013-01-01

    Stereotactic body radiotherapy (SBRT) can produce excellent local control of several types of solid tumor; however, toxicity to nearby critical structures is a concern. We found previously that in SBRT for lung cancer, the chest wall (CW) volume receiving 20, 30, or 40 Gy (V{sub 20}, V{sub 30}, or V{sub 40}) was linked with the development of neuropathy. Here we sought to determine whether the dosimetric advantages of protons could produce lower CW doses than traditional photon-based SBRT. We searched an institutional database to identify patients treated with photon SBRT for lung cancer with tumors within < 2.5 cm of the CW. We found 260 cases; of these, chronic grade ≥ 2 CW pain was identified in 23 patients. We then selected 10 representative patients from this group and generated proton SBRT treatment plans, using the identical dose of 50 Gy in 4 fractions, and assessed potential differences in CW dose between the 2 plans. The proton SBRT plans reduced the CW doses at all dose levels measured. The median CW V{sub 20} was 364.0 cm{sup 3} and 160.0 cm{sup 3} (p < 0.0001), V{sub 30} was 144.6 cm{sup 3}vs 77.0 cm{sup 3} (p = 0.0012), V{sub 35} was 93.9 cm{sup 3}vs 57.9 cm{sup 3} (p = 0.005), V{sub 40} was 66.5 cm{sup 3}vs 45.4 cm{sup 3} (p = 0.0112), and mean lung dose was 5.9 Gy vs 3.8 Gy (p = 0.0001) for photons and protons, respectively. Coverage of the planning target volume (PTV) was comparable between the 2 sets of plans (96.4% for photons and 97% for protons). From a dosimetric standpoint, proton SBRT can achieve the same coverage of the PTV while significantly reducing the dose to the CW and lung relative to photon SBRT and therefore may be beneficial for the treatment of lesions closer to critical structures.

  11. Loss of lung function after chemo-radiotherapy for NSCLC measured by perfusion SPECT/CT: Correlation with radiation dose and clinical morbidity

    DEFF Research Database (Denmark)

    Farr, Katherina P; Møller, Ditte S; Khalil, Azza A;

    2015-01-01

    BACKGROUND: The purpose of the study was to assess dose and time dependence of radiotherapy (RT)-induced changes in regional lung function measured with single photon emission computed tomography (SPECT) of the lung and relate these changes to the symptomatic endpoint of radiation pneumonitis (RP......) in patients treated for non-small cell lung cancer (NSCLC). MATERIAL AND METHODS: NSCLC patients scheduled to receive curative RT of minimum 60 Gy were included prospectively in the study. Lung perfusion SPECT/CT was performed before and three months after RT. Reconstructed SPECT/CT data were registered...... to treatment planning CT. Dose to the lung was segmented into regions corresponding to 0-5, 6-20, 21-40, 41-60 and > 60 Gy. Changes (%) in regional lung perfusion before and after RT were correlated with regional dose and symptomatic RP (CTC grade 2-5) outcome. RESULTS: A total of 58 patients were included...

  12. Calculational Tool for Skin Contamination Dose Assessment

    CERN Document Server

    Hill, R L

    2002-01-01

    Spreadsheet calculational tool was developed to automate the calculations preformed for dose assessment of skin contamination. This document reports on the design and testing of the spreadsheet calculational tool.

  13. The evidence for low-dose CT screening of lung cancer.

    Science.gov (United States)

    Ruchalski, Kathleen; Gutierrez, Antonio; Genshaft, Scott; Abtin, Fereidoun; Suh, Robert

    2016-01-01

    Lung cancer remains the leading cause of cancer-related death in the United States. An effective screening tool for early lung cancer detection has long been sought. Early chest radiograph and low-dose computed tomography (LDCT) screening trials were promising and demonstrated increased cancer detection. However, these studies were not able to improve lung cancer mortality. The National Lung Screening Trial resulted in decreased lung cancer mortality with LDCT screening in a high-risk population. Similar trials are currently underway in Europe. With LDCT now being widely implemented, it is paramount for radiologists to understand the evidence for lung cancer screening.

  14. Detection of lung cancer through low-dose CT screening (NELSON) : a prespecifi ed analysis of screening test performance and interval cancers

    NARCIS (Netherlands)

    Horeweg, Nanda; Scholten, Ernst Th; de Jong, Pim A.; van der Aalst, Carlijn M.; Weenink, Carla; Lammers, Jan-Willem J.; Nackaerts, Kristiaan; Vliegenthart, Rozemarijn; ten Haaf, Kevin; Yousaf-Khan, Uraujh A.; Heuvelmans, Marjolein A.; Thunnissen, Erik; Oudkerk, Matthijs; Mali, Willem; de Koning, Harry J.

    2014-01-01

    Background Low-dose CT screening is recommended for individuals at high risk of developing lung cancer. However, CT screening does not detect all lung cancers: some might be missed at screening, and others can develop in the interval between screens. The NELSON trial is a randomised trial to assess

  15. An updated dose assessment for Rongelap Island

    Energy Technology Data Exchange (ETDEWEB)

    Robison, W.L.; Conrado, C.L.; Bogen, K.T.

    1994-07-01

    We have updated the radiological dose assessment for Rongelap Island at Rongelap Atoll using data generated from field trips to the atoll during 1986 through 1993. The data base used for this dose assessment is ten fold greater than that available for the 1982 assessment. Details of each data base are presented along with details about the methods used to calculate the dose from each exposure pathway. The doses are calculated for a resettlement date of January 1, 1995. The maximum annual effective dose is 0.26 mSv y{sup {minus}1} (26 mrem y{sup {minus}1}). The estimated 30-, 50-, and 70-y integral effective doses are 0.0059 Sv (0.59 rem), 0.0082 Sv (0.82 rem), and 0.0097 Sv (0.97 rem), respectively. More than 95% of these estimated doses are due to 137-Cesium ({sup 137}Cs). About 1.5% of the estimated dose is contributed by 90-Strontium ({sup 90}Sr), and about the same amount each by 239+240-Plutonium ({sup 239+240}PU), and 241-Americium ({sup 241}Am).

  16. TU-G-BRA-01: Assessing Radiation-Induced Reductions in Regional Lung Perfusion Following Stereotactic Radiotherapy for Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    McGurk, R; Green, R; Lawrence, M [NC Cancer Hospital, Chapel Hill, NC (United States); Schreiber, E; Das, S; Zagar, T; Marks, L [UNC School of Medicine, Chapel Hill, NC (United States); Sheikh, A; McCartney, W; Rivera, P [University of North Carolina at Chapel Hill, Chapel Hill, NC (United States)

    2015-06-15

    Purpose: The dose-dependent nature of radiation therapy (RT)-induced lung injury following hypo-fractionated stereotactic RT is unclear. We herein report preliminary results of a prospective study assessing the magnitude of RT-induced reductions in regional lung perfusion following hypo-fractionated stereotactic RT. Methods: Four patients undergoing hypo-fractionated stereotactic lung RT (SBRT: 12 Gy x 4 fractions or 10 Gy x 5 fractions) had a pre-treatment SPECT (single-photon emission computed tomography) perfusion scan providing a 3D map of regional lung perfusion. Scans were repeated 3–6 months post-treatment. Pre- and post SPECT scans were registered to the planning CT scan (and hence the 3D dose data). Changes in regional perfusion (counts per cc on the pre-post scans) were computed in regions of the lung exposed to different doses of radiation (in 5 Gy intervals), thus defining a dose-response function. SPECT scans were internally normalized to the regions receiving <5 Gy. Results: At 3 months post-RT, the changes in perfusion are highly variable. At 6 months, there is a consistent dose-dependent reduction in regional perfusion. The average percent decline in regional perfusion was 10% at 15–20 Gy, 20% at 20–25 Gy, and 30% at 25–30 Gy representing a relatively linear dose response with an approximate 2% reduction per Gray for doses in excess of 10 Gy. There was a subtle increase in perfusion in the lung receiving <10 Gy. Conclusion: Hypo-fractionated stereotactic RT appears to cause a dose-dependent reduction in regional lung perfusion. There appears to be a threshold effect with no apparent perfusion loss at doses <10 Gy, though this might be in part due to the normalization technique used. Additional data is needed from a larger number of patients to better assess this issue. This sort of data can be used to assist optimizing RT treatment plans that minimize the risk of lung injury. Partly supported by the NIH (CA69579) and the Lance Armstrong

  17. Assessment of the skin dose for aircrew.

    Science.gov (United States)

    Meier, Matthias M; Matthiä, Daniel

    2017-03-02

    Epidemiological studies are a useful instrument for investigating the influence of environmental factors on human health. In this context, the determination and quantification of the corresponding exposure is a demanding challenge. With regard to the investigation of the potential health effects in aircrew due to cosmic radiation, their occupational exposure at aviation altitudes is usually assessed in terms of the radiation protection quantity effective dose, which is stored in and available from official dose registers in many countries. However, when biological effects on a particular organ are investigated, knowledge of the corresponding exposure of that particular organ is necessary. In this study, we investigate the differences between the skin dose and the effective dose for the exposure of aircrew to cosmic radiation using a mathematical model for the radiation field at aviation altitudes. Furthermore, we present a method to deduce skin dose values from the officially registered effective doses.

  18. A brief measure of Smokers' knowledge of lung cancer screening with low-dose computed tomography

    Directory of Open Access Journals (Sweden)

    Lisa M. Lowenstein

    2016-12-01

    Full Text Available We describe the development and psychometric properties of a new, brief measure of smokers' knowledge of lung cancer screening with low-dose computed tomography (LDCT. Content experts identified key facts smokers should know in making an informed decision about lung cancer screening. Sample questions were drafted and iteratively refined based on feedback from content experts and cognitive testing with ten smokers. The resulting 16-item knowledge measure was completed by 108 heavy smokers in Houston, Texas, recruited from 12/2014 to 09/2015. Item difficulty, item discrimination, internal consistency and test-retest reliability were assessed. Group differences based upon education levels and smoking history were explored. Several items were dropped due to ceiling effects or overlapping constructs, resulting in a 12-item knowledge measure. Additional items with high item uncertainty were retained because of their importance in informed decision making about lung cancer screening. Internal consistency reliability of the final scale was acceptable (KR-20 = 0.66 and test-retest reliability of the overall scale was 0.84 (intraclass correlation. Knowledge scores differed across education levels (F = 3.36, p = 0.04, while no differences were observed between current and former smokers (F = 1.43, p = 0.24 or among participants who met or did not meet the 30-pack-year screening eligibility criterion (F = 0.57, p = 0.45. The new measure provides a brief, valid and reliable indicator of smokers' knowledge of key concepts central to making an informed decision about lung cancer screening with LDCT, and can be part of a broader assessment of the quality of smokers' decision making about lung cancer screening.

  19. Lung cancer screening by low-dose spiral computed tomography

    NARCIS (Netherlands)

    van Klaveren, RJ; Habbema, JDF; Pedersen, JH; de Koning, HJ; Oudkerk, M; Hoogsteden, HC

    2001-01-01

    The poor prognosis of lung cancer has barely changed in the last decades, but the prognosis is better when the disease is detected earlier. Lung cancer screening by chest radiography did not lead to a decrease in lung cancer mortality, presumably because the chest radiograph is a poor screening tool

  20. Assessing dose rate distributions in VMAT plans

    Science.gov (United States)

    Mackeprang, P.-H.; Volken, W.; Terribilini, D.; Frauchiger, D.; Zaugg, K.; Aebersold, D. M.; Fix, M. K.; Manser, P.

    2016-04-01

    Dose rate is an essential factor in radiobiology. As modern radiotherapy delivery techniques such as volumetric modulated arc therapy (VMAT) introduce dynamic modulation of the dose rate, it is important to assess the changes in dose rate. Both the rate of monitor units per minute (MU rate) and collimation are varied over the course of a fraction, leading to different dose rates in every voxel of the calculation volume at any point in time during dose delivery. Given the radiotherapy plan and machine specific limitations, a VMAT treatment plan can be split into arc sectors between Digital Imaging and Communications in Medicine control points (CPs) of constant and known MU rate. By calculating dose distributions in each of these arc sectors independently and multiplying them with the MU rate, the dose rate in every single voxel at every time point during the fraction can be calculated. Independently calculated and then summed dose distributions per arc sector were compared to the whole arc dose calculation for validation. Dose measurements and video analysis were performed to validate the calculated datasets. A clinical head and neck, cranial and liver case were analyzed using the tool developed. Measurement validation of synthetic test cases showed linac agreement to precalculated arc sector times within  ±0.4 s and doses  ±0.1 MU (one standard deviation). Two methods for the visualization of dose rate datasets were developed: the first method plots a two-dimensional (2D) histogram of the number of voxels receiving a given dose rate over the course of the arc treatment delivery. In similarity to treatment planning system display of dose, the second method displays the dose rate as color wash on top of the corresponding computed tomography image, allowing the user to scroll through the variation over time. Examining clinical cases showed dose rates spread over a continuous spectrum, with mean dose rates hardly exceeding 100 cGy min-1 for conventional

  1. Experimentally studied dynamic dose interplay does not meaningfully affect target dose in VMAT SBRT lung treatments

    Energy Technology Data Exchange (ETDEWEB)

    Stambaugh, Cassandra [Department of Physics, University of South Florida, Tampa, Florida 33612 (United States); Nelms, Benjamin E. [Canis Lupus LLC, Merrimac, Wisconsin 53561 (United States); Dilling, Thomas; Stevens, Craig; Latifi, Kujtim; Zhang, Geoffrey; Moros, Eduardo; Feygelman, Vladimir [Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida 33612 (United States)

    2013-09-15

    Purpose: The effects of respiratory motion on the tumor dose can be divided into the gradient and interplay effects. While the interplay effect is likely to average out over a large number of fractions, it may play a role in hypofractionated [stereotactic body radiation therapy (SBRT)] treatments. This subject has been extensively studied for intensity modulated radiation therapy but less so for volumetric modulated arc therapy (VMAT), particularly in application to hypofractionated regimens. Also, no experimental study has provided full four-dimensional (4D) dose reconstruction in this scenario. The authors demonstrate how a recently described motion perturbation method, with full 4D dose reconstruction, is applied to describe the gradient and interplay effects during VMAT lung SBRT treatments.Methods: VMAT dose delivered to a moving target in a patient can be reconstructed by applying perturbations to the treatment planning system-calculated static 3D dose. Ten SBRT patients treated with 6 MV VMAT beams in five fractions were selected. The target motion (motion kernel) was approximated by 3D rigid body translation, with the tumor centroids defined on the ten phases of the 4DCT. The motion was assumed to be periodic, with the period T being an average from the empirical 4DCT respiratory trace. The real observed tumor motion (total displacement ≤8 mm) was evaluated first. Then, the motion range was artificially increased to 2 or 3 cm. Finally, T was increased to 60 s. While not realistic, making T comparable to the delivery time elucidates if the interplay effect can be observed. For a single fraction, the authors quantified the interplay effect as the maximum difference in the target dosimetric indices, most importantly the near-minimum dose (D{sub 99%}), between all possible starting phases. For the three- and five-fractions, statistical simulations were performed when substantial interplay was found.Results: For the motion amplitudes and periods obtained from

  2. ESR dose assessment in irradiated chicken legs

    Energy Technology Data Exchange (ETDEWEB)

    Bordi, F. [II Universita, Rome (Italy). Dipartimento di Medicina Interna; Fattibene, P.; Onori, S.; Pantaloni, M. [Istituto Superiore di Santia, Rome (Italy)]|[Istituto Nazionale di Fisica Nucleare, Rome (Italy). Sezione Sanita

    1994-05-01

    The electron spin resonance technique has received a wide consensus for dose assessment in irradiated chicken bone. Nevertheless, some practical problems are still open like the most suitable mathematical expression to be used for dose evaluation with the re-irradiation method. In the present paper the linear and exponential approximations were analyzed using 40 bone chicken samples and a reproducible readout procedure. The results suggested the use of the exponential dose-effect relationship and gave some indications on the procedure to be practically adopted. (author).

  3. Statins dose-dependently exert a chemopreventive effect against lung cancer in COPD patients: a population-based cohort study

    Science.gov (United States)

    Hsu, Yi-Ping; Hao, Wen-Rui; Kao, Pai-Feng; Sung, Li-Chin; Chen, Chun-Chao; Wu, Szu-Yuan

    2016-01-01

    Purpose Chronic obstructive pulmonary disease (COPD) is associated with increased lung cancer risk. We evaluated the association of statin use with lung cancer risk in COPD patients and identified which statins possess the highest chemopreventive potential. Results After adjustment for age, sex, CCI, diabetes, hypertension, dyslipidemia, urbanization level, and monthly income according to propensity scores, lung cancer risk in the statin users was lower than that in the statin nonusers (adjusted hazard ratio [aHR] = 0.37). Of the individual statins, lovastatin and fluvastatin did not reduce lung cancer risk significantly. By contrast, lung cancer risk in patients using rosuvastatin, simvastatin, atorvastatin, and pravastatin was significantly lower than that in statin nonusers (aHRs = 0.41, 0.44, 0.52, and 0.58, respectively). Statins dose-dependently reduced lung cancer risk in all subgroups and the main model with additional covariates (nonstatin drug use). MATERIALS AND METHODS The study cohort comprised all patients diagnosed with COPD at health care facilities in Taiwan (n = 116,017) between January 1, 2001 and December 31, 2012. Our final study cohort comprised 43,802 COPD patients: 10,086 used statins, whereas 33,716 did not. Patients were followed up to assess lung cancer risk or protective factors. In addition, we also considered demographic characteristics, namely age, sex, comorbidities (diabetes, hypertension, dyslipidemia, and Charlson comorbidity index [CCI]), urbanization level, monthly income, and nonstatin drug use. The index date of statin use was the COPD confirmation date. To examine the dose–response relationship, we categorized statin use into four groups in each cohort: 365 cumulative defined daily doses (cDDDs). Patients receiving Statins dose-dependently exert a significant chemopreventive effect against lung cancer in COPD patients. Rosuvastatin, simvastatin, and atorvastatin exhibited the highest chemopreventive potential. PMID:27517752

  4. Novel lung IMRT planning algorithms with nonuniform dose delivery strategy to account for respiratory motion.

    Science.gov (United States)

    Li, Xiang; Zhang, Pengpeng; Mah, Dennis; Gewanter, Richard; Kutcher, Gerald

    2006-09-01

    To effectively deliver radiation dose to lung tumors, respiratory motion has to be considered in treatment planning. In this paper we first present a new lung IMRT planning algorithm, referred as the dose shaping (DS) method, that shapes the dose distribution according to the probability distribution of the tumor over the breathing cycle to account for respiratory motion. In IMRT planning a dose-based convolution method was generally adopted to compensate for random organ motion by performing 4-D dose calculations using a tumor motion probability density function. We modified the CON-DOSE method to a dose volume histogram based convolution method (CON-DVH) that allows nonuniform dose distribution to account for respiratory motion. We implemented the two new planning algorithms on an in-house IMRT planning system that uses the Eclipse (Varian, Palo Alto, CA) planning workstation as the dose calculation engine. The new algorithms were compared with (1) the conventional margin extension approach in which margin is generated based on the extreme positions of the tumor, (2) the dose-based convolution method, and (3) gating with 3 mm residual motion. Dose volume histogram, tumor control probability, normal tissue complication probability, and mean lung dose were calculated and used to evaluate the relative performance of these approaches at the end-exhale phase of the respiratory cycle. We recruited six patients in our treatment planning study. The study demonstrated that the two new methods could significantly reduce the ipsilateral normal lung dose and outperformed the margin extension method and the dose-based convolution method. Compared with the gated approach that has the best performance in the low dose region, the two methods we proposed have similar potential to escalate tumor dose, but could be more efficient because dose is delivered continuously.

  5. Utility of SPECT Lung Perfusion Scans in Assessing the Early Changes in Pulmonary Function after Radiotherapy for Patients with Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    Wenjie Zhang; Rong Zheng; Luiun Zhao; Luhua Wang; Shengzu Chen

    2005-01-01

    OBJECTIVE Radiation-induced lung injury commonly follows radiotherapy (RT) fortumors within and near the thorax. Lung function is usually measured by pulmonary function tests (PFTs). But RT-induced regional changes of pulmonary function cannot be accurately evaluated by PFTs. Lung perfusion scintigraphy compared with other radiographic methods can assess well regional pulmonary physiological function, and a 3-dimensional conformal radiotherapy planning system can quantitatively calculate irradiation dosage. The purpose of this study is to assess, by lung perfusion scintigraphy, early changes in the pulmonary function of patients with lung cancer when receiving thoracic 3-dimensional conformal radiotherapy (3D-CRT).METHODS Nineteen patients receiving thoracic 3D-CRT for lung cancer were studied. A single photon emission computed tomography (SPECT)lung perfusion scan, X-ray or CT scan before RT and after 40~50Gy radiation were performed. Pre-RT SPECT lung perfusion images were classified by comparing lung perfusion defects with radiological abnormalities before RT. Grade 0: There was no lung perfusion defect in the area of radiological abnormality. Grade 1: The size of the radiological abnormality was similar to the area of the lung perfusion defect. Grade 2: The area of the lung perfusion defect was bigger than the size of the radiological abnormality and extended to one lobe of the lung. Grade 3: The area of lung perfusion defect exceeded one lobe of the lung. The radiation field with more than 20 Gy was drawn as a region of interest (ROI). The proportion of radioactive dose within this ROI relative to total lung dose in one slice was calculated.RESULTS All patients had lung perfusion defects, nine patients with grade 1,five patients with grade 2 and five patients with grade 3 damage,respectively. All tumors in the 19 patients were reduced in CT or X-ray images to various degrees after 40~50 Gy radiation. The mean proportion of ROI in 19 patients was 53.7±29

  6. Dose-dependence of the time of appearance of lung damage in mice given thoracic irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Collis, C.H.; Steel, G.G. (Institute of Cancer Research, Sutton (UK). Surrey Branch)

    1982-09-01

    Male CBA mice were given X-radiation to the thorax in the range 7 to 23 Gy and their response was quantified by measuring ventilation rate and carbon monoxide uptake at intervals up to 2 years thereafter; their survival was also documented. The two functional end-points were similarly sensitive indicators of lung damage. Radiation damage was not observed below 10 Gy. As radiation dose was raised above this level there was a rapid shortening of the time to the appearance of damage and subsequent death. At a dose of 15 Gy the median survival time was 14 weeks but raising the dose above this level only slightly reduced the survival time. The way in which the time of survival after lung damage depends on dose is an important characteristic of the development of radiation-induced lung damage which should be considered when examining factors that may influence the development of radiation-induced lung damage.

  7. 20 percent lower lung cancer mortality with low-dose CT vs chest X-ray

    Science.gov (United States)

    Scientists have found a 20 percent reduction in deaths from lung cancer among current or former heavy smokers who were screened with low-dose helical computed tomography (CT) versus those screened by chest X-ray.

  8. HRCT technique with low-dose protocols for interstitial lung diseases; HRCT-Technik mit Low-dose-Protokollen bei interstitiellen Lungenerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Ley-Zaporozhan, J. [Klinikum der Ludwig-Maximilians-Universitaet, Institut fuer Klinische Radiologie, Muenchen (Germany); Ley, S. [Klinikum der Ludwig-Maximilians-Universitaet, Institut fuer Klinische Radiologie, Muenchen (Germany); Chirurgische Klinik Dr. Rinecker, Diagnostische und Interventionelle Radiologie, Muenchen (Germany)

    2014-12-15

    For optimal visualization of the lung parenchyma a dedicated computed tomography (CT) examination protocol has to be selected. High resolution CT (HRCT) is the best technique for non-invasive evaluation of the lung parenchyma. Given the possibility to examine the complete lungs within one breath hold, assessment of disease severity and distribution is easily possible. Various parameters have to be considered to generate optimal image quality and best possible clinical results. This review article discusses the various image acquisition parameters for HRCT as well as the issue of dose reduction. (orig.) [German] Die Wahl des optimalen Untersuchungsprotokolls fuer eine CT der Lunge ist relevant fuer die diagnostische Aussagekraft. Die hochaufloesende Computertomographie (HRCT) der Lunge ist das beste Verfahren zur nichtinvasiven Beurteilung des Lungenparenchyms. Durch die Moeglichkeit der Untersuchung der gesamten Lunge in einer Atemstillstandsphase ist die Abschaetzung der Erkrankungsschwere problemlos moeglich. Verschiedene Aspekte sind zu beachten, um eine optimale Bildqualitaet zu erreichen und eine bestmoegliche Aussagekraft der Untersuchung zu gewaehrleisten. In dieser Uebersicht werden die verschiedenen Aufnahmeparameter erlaeutert sowie das Thema der Dosisreduktion diskutiert. (orig.)

  9. Probabilistic evaluation of target dose deterioration in dose painting by numbers for stage II/III lung cancer

    NARCIS (Netherlands)

    Fontanarosa, Davide; Witte, Marnix; Meijer, Gert; Shakirin, Georgy; Steenhuijsen, Jacco; Schuring, Danny; van Herk, Marcel; Lambin, Philippe

    2015-01-01

    Purpose: Non-small cell lung cancer is typically irradiated with 60-66 Gy in 2-Gy fractions. Local control could be improved by increasing dose to the more radiation-resistant areas (eg, based on the standardized uptake values of a pretreatment [18F]fluoro-deoxyglucose positron emission tomography s

  10. A dose rate model predicting radon-induced lung cancer risk in rats

    Energy Technology Data Exchange (ETDEWEB)

    Hofmann, W.; Lettner, H. (Salzburg Univ. (Austria). Div. of Biophysics); Crawford-Brown, D.J. (North Carolina Univ., Chapel Hill, NC (United States). Dept. of Environmental Sciences and Engineering)

    1992-01-01

    The laboratory rat has been used in inhalation studies as a surrogate to estimate human lung cancer risk following exposure to ambient radon progeny. Deposition, mucociliary clearance and dosimetry for the inhalation of radon progeny in the rat lung have been simulated for a variety of inhalation conditions. A state-vector model for radiation carcinogenesis has then been applied to predict the carcinogenic risk in the rat lung for different doses and dose rates. The model is based on the concepts of initiation and promotion, with the irradiation acting both to damage intercellular structures and to change the state of cells surrounding an initiated cell. Predicted lung cancer incidences show fair agreement with the experimental data. Consistent with the experimental evidence is the inverse dose rate effect observed for intermediate cumulative exposures. (author).

  11. Optimization of extracranial stereotactic radiation therapy of small lung lesions using accurate dose calculation algorithms

    Directory of Open Access Journals (Sweden)

    Polednik Martin

    2006-11-01

    Full Text Available Abstract Background The aim of this study was to compare and to validate different dose calculation algorithms for the use in radiation therapy of small lung lesions and to optimize the treatment planning using accurate dose calculation algorithms. Methods A 9-field conformal treatment plan was generated on an inhomogeneous phantom with lung mimics and a soft tissue equivalent insert, mimicking a lung tumor. The dose distribution was calculated with the Pencil Beam and Collapsed Cone algorithms implemented in Masterplan (Nucletron and the Monte Carlo system XVMC and validated using Gafchromic EBT films. Differences in dose distribution were evaluated. The plans were then optimized by adding segments to the outer shell of the target in order to increase the dose near the interface to the lung. Results The Pencil Beam algorithm overestimated the dose by up to 15% compared to the measurements. Collapsed Cone and Monte Carlo predicted the dose more accurately with a maximum difference of -8% and -3% respectively compared to the film. Plan optimization by adding small segments to the peripheral parts of the target, creating a 2-step fluence modulation, allowed to increase target coverage and homogeneity as compared to the uncorrected 9 field plan. Conclusion The use of forward 2-step fluence modulation in radiotherapy of small lung lesions allows the improvement of tumor coverage and dose homogeneity as compared to non-modulated treatment plans and may thus help to increase the local tumor control probability. While the Collapsed Cone algorithm is closer to measurements than the Pencil Beam algorithm, both algorithms are limited at tissue/lung interfaces, leaving Monte-Carlo the most accurate algorithm for dose prediction.

  12. Coronary artery calcification scoring in low-dose ungated CT screening for lung cancer: interscan agreement.

    NARCIS (Netherlands)

    Jacobs, P.C.; Isgum, I.; Gondrie, M.J.; Mali, W.P.Th.; Ginneken, B. van; Prokop, M.; Graaf, Y. van der

    2010-01-01

    OBJECTIVE: In previous studies detection of coronary artery calcification (CAC) with low-dose ungated MDCT performed for lung cancer screening has been compared with detection with cardiac CT. We evaluated the interscan agreement of CAC scores from two consecutive low-dose ungated MDCT examinations.

  13. Coronary Artery Calcification Scoring in Low-Dose Ungated CT Screening for Lung Cancer : Interscan Agreement

    NARCIS (Netherlands)

    Jacobs, Peter C. A.; Isgum, Ivana; Gondrie, Martijn J. A.; Mali, Willem P. Th. M.; van Ginneken, Bram; Prokop, Mathias; van der Graaf, Yolanda

    2010-01-01

    OBJECTIVE. In previous studies detection of coronary artery calcification (CAC) with low-dose ungated MDCT performed for lung cancer screening has been compared with detection with cardiac CT. We evaluated the interscan agreement of CAC scores from two consecutive low-dose ungated MDCT examinations.

  14. Impact of temporal probability in 4D dose calculation for lung tumors.

    Science.gov (United States)

    Rouabhi, Ouided; Ma, Mingyu; Bayouth, John; Xia, Junyi

    2015-11-08

    The purpose of this study was to evaluate the dosimetric uncertainty in 4D dose calculation using three temporal probability distributions: uniform distribution, sinusoidal distribution, and patient-specific distribution derived from the patient respiratory trace. Temporal probability, defined as the fraction of time a patient spends in each respiratory amplitude, was evaluated in nine lung cancer patients. Four-dimensional computed tomography (4D CT), along with deformable image registration, was used to compute 4D dose incorporating the patient's respiratory motion. First, the dose of each of 10 phase CTs was computed using the same planning parameters as those used in 3D treatment planning based on the breath-hold CT. Next, deformable image registration was used to deform the dose of each phase CT to the breath-hold CT using the deformation map between the phase CT and the breath-hold CT. Finally, the 4D dose was computed by summing the deformed phase doses using their corresponding temporal probabilities. In this study, 4D dose calculated from the patient-specific temporal probability distribution was used as the ground truth. The dosimetric evaluation matrix included: 1) 3D gamma analysis, 2) mean tumor dose (MTD), 3) mean lung dose (MLD), and 4) lung V20. For seven out of nine patients, both uniform and sinusoidal temporal probability dose distributions were found to have an average gamma passing rate > 95% for both the lung and PTV regions. Compared with 4D dose calculated using the patient respiratory trace, doses using uniform and sinusoidal distribution showed a percentage difference on average of -0.1% ± 0.6% and -0.2% ± 0.4% in MTD, -0.2% ± 1.9% and -0.2% ± 1.3% in MLD, 0.09% ± 2.8% and -0.07% ± 1.8% in lung V20, -0.1% ± 2.0% and 0.08% ± 1.34% in lung V10, 0.47% ± 1.8% and 0.19% ± 1.3% in lung V5, respectively. We concluded that four-dimensional dose computed using either a uniform or sinusoidal temporal probability distribution can

  15. Small pulmonary nodules in baseline and incidence screening rounds of low-dose CT lung cancer screening.

    Science.gov (United States)

    Walter, Joan E; Heuvelmans, Marjolein A; Oudkerk, Matthijs

    2017-02-01

    Currently, lung cancer screening by low-dose computed tomography (LDCT) is widely recommended for high-risk individuals by US guidelines, but there still is an ongoing debate concerning respective recommendations for European countries. Nevertheless, the available data regarding pulmonary nodules released by lung cancer screening studies could improve future screening guidelines, as well as the clinical practice of incidentally detected pulmonary nodules on routine CT scans. Most lung cancer screening trials present results for baseline and incidence screening rounds separately, clustering pulmonary nodules initially found at baseline screening and newly detected pulmonary nodules after baseline screening together. This approach does not appreciate possible differences among pulmonary nodules detected at baseline and firstly detected at incidence screening rounds and is heavily influenced by methodological differences of the respective screening trials. This review intends to create a basis for assessing non-calcified pulmonary nodules detected during LDCT lung cancer screening in a more clinical relevant manner. The aim is to present data of non-calcified pulmonary baseline nodules and new non-calcified pulmonary incident nodules without clustering them together, thereby also simplifying translation to the clinical practice of incidentally detected pulmonary nodules. Small pulmonary nodules newly detected at incidence screening rounds of LDCT lung cancer screening may possess a greater lung cancer probability than pulmonary baseline nodules at a smaller size, which is essential for the development of new guidelines.

  16. Uncertainties in electron-absorbed fractions and lung doses from inhaled beta-emitters.

    Science.gov (United States)

    Farfán, Eduardo B; Bolch, Wesley E; Huston, Thomas E; Rajon, Didier A; Huh, Chulhaeng; Bolch, W Emmett

    2005-01-01

    The computer code LUDUC (Lung Dose Uncertainty Code), developed at the University of Florida, was originally used to investigate the range of potential doses from the inhalation of either plutonium or uranium oxides. The code employs the ICRP Publication 66 Human Respiratory Tract model; however, rather than using simple point estimates for each of the model parameters associated with particle deposition, clearance, and lung-tissue dosimetry, probability density functions are ascribed to these parameters based upon detailed literature review. These distributions are subsequently sampled within LUDUC using Latin hypercube sampling techniques to generate multiple (e.g., approximately 1,000) sets of input vectors (i.e., trials), each yielding a unique estimate of lung dose. In the present study, the dosimetry component of the ICRP-66 model within LUDUC has been extended to explicitly consider variations in the beta particle absorbed fraction due to corresponding uncertainties and biological variabilities in both source and target tissue depths and thicknesses within the bronchi and bronchioles of the thoracic airways. Example dose distributions are given for the inhalation of absorption Type S compounds of 90Sr (Tmax = 546 keV) and 90Y (Tmax = 2,284 keV) as a function of particle size. Over the particle size range of 0.001 to 1 microm, estimates of total lung dose vary by a factor of 10 for 90Sr particles and by a factor of 4 to 10 for 90Y particles. As the particle size increases to 10 microm, dose uncertainties reach a factor of 100 for both radionuclides. In comparisons to identical exposures scenarios run by the LUDEP 2.0 code, Reference Man doses for inhaled beta-emitters were shown to provide slightly conservative estimates of lung dose compared to those in this study where uncertainties in lung airway histology are considered.

  17. Evaluation of chronic infectious interstitial pulmonary disease in children by low-dose CT-guided transthoracic lung biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Heyer, Christoph M.; Lemburg, Stefan P.; Kagel, Thomas; Nicolas, Volkmar [Ruhr-University of Bochum, Institute of Diagnostic Radiology, Interventional Radiology and Nuclear Medicine, BG Clinics Bergmannsheil, Bochum (Germany); Mueller, Klaus-Michael [Ruhr-University of Bochum, Institute of Pathology, BG Clinics Bergmannsheil, Bochum (Germany); Nuesslein, Thomas G.; Rieger, Christian H.L. [Ruhr-University of Bochum, Pediatric Hospital, Bochum (Germany)

    2005-07-01

    Children with chronic infectious interstitial lung disease often have to undergo open lung biopsy to establish a final diagnosis. Open lung biopsy is an invasive procedure with major potential complications. Transthoracic lung biopsy (TLB) guided by computed tomography (CT) is a less-invasive well-established procedure in adults. Detailing the role of low-dose CT-guided TLB in the enhanced diagnosis of chronic lung diseases related to infection in children. A group of 11 children (age 8 months to 16 years) underwent CT-guided TLB with a 20-gauge biopsy device. All investigations were done under general anaesthesia on a multidetector CT scanner (SOMATOM Volume Zoom, Siemens, Erlangen, Germany) using a low-dose protocol (single slices, 120 kV, 20 mAs). Specimens were processed by histopathological, bacteriological, and virological techniques. All biopsies were performed without major complications; one child developed a small pneumothorax that resolved spontaneously. A diagnosis could be obtained in 10 of the 11 patients. Biopsy specimens revealed chronic interstitial alveolitis in ten patients. In five patients Chlamydia pneumoniae PCR was positive, in three Mycoplasma pneumoniae PCR was positive, and in two Cytomegalovirus PCR was positive. The average effective dose was 0.83 mSv. Low-dose CT-guided TLB can be a helpful tool in investigating chronic infectious inflammatory processes in children with minimal radiation exposure. It should be considered prior to any open surgical procedure performed for biopsy alone. In our patient group no significant complication occurred. A disadvantage of the method is that it does not allow smaller airways and vessels to be assessed. (orig.)

  18. Dose-to-medium vs. dose-to-water: Dosimetric evaluation of dose reporting modes in Acuros XB for prostate, lung and breast cancer

    Directory of Open Access Journals (Sweden)

    Suresh Rana

    2014-12-01

    Full Text Available Purpose: Acuros XB (AXB dose calculation algorithm is available for external beam photon dose calculations in Eclipse treatment planning system (TPS. The AXB can report the absorbed dose in two modes: dose-to-water (Dw and dose-to-medium (Dm. The main purpose of this study was to compare the dosimetric results of the AXB_Dm with that of AXB_Dw on real patient treatment plans. Methods: Four groups of patients (prostate cancer, stereotactic body radiation therapy (SBRT lung cancer, left breast cancer, and right breast cancer were selected for this study, and each group consisted of 5 cases. The treatment plans of all cases were generated in the Eclipse TPS. For each case, treatment plans were computed using AXB_Dw and AXB_Dm for identical beam arrangements. Dosimetric evaluation was done by comparing various dosimetric parameters in the AXB_Dw plans with that of AXB_Dm plans for the corresponding patient case. Results: For the prostate cancer, the mean planning target volume (PTV dose in the AXB_Dw plans was higher by up to 1.0%, but the mean PTV dose was within ±0.3% for the SBRT lung cancer. The analysis of organs at risk (OAR results in the prostate cancer showed that AXB_Dw plans consistently produced higher values for the bladder and femoral heads but not for the rectum. In the case of SBRT lung cancer, a clear trend was seen for the heart mean dose and spinal cord maximum dose, with AXB_Dw plans producing higher values than the AXB_Dm plans. However, the difference in the lung doses between the AXB_Dm and AXB_Dw plans did not always produce a clear trend, with difference ranged from -1.4% to 2.9%. For both the left and right breast cancer, the AXB_Dm plans produced higher maximum dose to the PTV for all cases. The evaluation of the maximum dose to the skin showed higher values in the AXB_Dm plans for all 5 left breast cancer cases, whereas only 2 cases had higher maximum dose to the skin in the AXB_Dm plans for the right breast cancer

  19. SU-E-J-87: Lung Deformable Image Registration Using Surface Mesh Deformation for Dose Distribution Combination

    Energy Technology Data Exchange (ETDEWEB)

    Labine, A; Carrier, J; Bedwani, S [CHUM - Notre-Dame, Montreal, Quebec (Canada); Chav, R [Laboratoire de recherche en imagerie et orthopedie (LIO), Montreal, Quebec (Canada); Ecole de technologie superieure, Montreal, Quebec (Canada); DeGuise, J [Laboratoire de recherche en imagerie et orthopedie (LIO), Montreal, Quebec (Canada)

    2014-06-01

    Purpose: To allow a reliable deformable image registration (DIR) method for dose calculation in radiation therapy. This work proposes a performance assessment of a morphological segmentation algorithm that generates a deformation field from lung surface displacements with 4DCT datasets. Methods: From the 4DCT scans of 15 selected patients, the deep exhale phase of the breathing cycle is identified as the reference scan. Varian TPS EclipseTM is used to draw lung contours, which are given as input to the morphological segmentation algorithm. Voxelized contours are smoothed by a Gaussian filter and then transformed into a surface mesh representation. Such mesh is adapted by rigid and elastic deformations to match each subsequent lung volumes. The segmentation efficiency is assessed by comparing the segmented lung contour and the TPS contour considering two volume metrics, defined as Volumetric Overlap Error (VOE) [%] and Relative Volume Difference (RVD) [%] and three surface metrics, defined as Average Symmetric Surface Distance (ASSD) [mm], Root Mean Square Symmetric Surface Distance (RMSSD) [mm] and Maximum Symmetric Surface Distance (MSSD) [mm]. Then, the surface deformation between two breathing phases is determined by the displacement of corresponding vertices in each deformed surface. The lung surface deformation is linearly propagated in the lung volume to generate 3D deformation fields for each breathing phase. Results: The metrics were averaged over the 15 patients and calculated with the same segmentation parameters. The volume metrics obtained are a VOE of 5.2% and a RVD of 2.6%. The surface metrics computed are an ASSD of 0.5 mm, a RMSSD of 0.8 mm and a MSSD of 6.9 mm. Conclusion: This study shows that the morphological segmentation algorithm can provide an automatic method to capture an organ motion from 4DCT scans and translate it into a volume deformation grid needed by DIR method for dose distribution combination.

  20. Low-dose lung cancer screening with photon-counting CT: a feasibility study

    Science.gov (United States)

    Symons, Rolf; Cork, Tyler E.; Sahbaee, Pooyan; Fuld, Matthew K.; Kappler, Steffen; Folio, Les R.; Bluemke, David A.; Pourmorteza, Amir

    2017-01-01

    To evaluate the feasibility of using a whole-body photon-counting detector (PCD) CT scanner for low-dose lung cancer screening compared to a conventional energy integrating detector (EID) system. Radiation dose-matched EID and PCD scans of the COPDGene 2 phantom were acquired at different radiation dose levels (CTDIvol: 3.0, 1.5, and 0.75 mGy) and different tube voltages (120, 100, and 80 kVp). EID and PCD images were compared for quantitative Hounsfield unit (HU) accuracy, noise levels, and contrast-to-noise ratios (CNR) for detection of ground-glass nodules (GGN) and emphysema. The PCD HU accuracy was better than EID for water at all scan parameters. PCD HU stability for lung, GGN and emphysema regions were superior to EID and PCD attenuation values were more reproducible than EID for all scan parameters (all P  lung, GGN and emphysema ROIs changed significantly for EID with decreasing dose (all P  lung, ground-glass, and emphysema-equivalent foams at lower radiation dose settings with better reproducibility than EID. Additionally, PCD showed up to 10% less noise, and 11% higher CNR at 0.75 mGy for both 100 and 80 kVp. PCD technology may help reduce radiation exposure in lung cancer screening while maintaining diagnostic quality.

  1. Lack of a Dose-Effect Relationship for Pulmonary Function Changes After Stereotactic Body Radiation Therapy for Early-Stage Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Guckenberger, Matthias, E-mail: Guckenberger_M@klinik.uni-wuerzburg.de [Department of Radiation Oncology, University Hospital Wuerzburg, Wuerzburg (Germany); Klement, Rainer J. [Department of Radiation Oncology, University Hospital Wuerzburg, Wuerzburg (Germany); Kestin, Larry L. [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Hope, Andrew J. [Princess Margaret Hospital, University of Toronto, Toronto, ON (Canada); Belderbos, Jose [The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Werner-Wasik, Maria [Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (United States); Yan, Di [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Sonke, Jan-Jakob [The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Bissonnette, Jean-Pierre [Princess Margaret Hospital, University of Toronto, Toronto, ON (Canada); Xiao, Ying [Thomas Jefferson University Hospital, Philadelphia, Pennsylvania (United States); Grills, Inga S. [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States)

    2013-03-15

    Purpose: To evaluate the influence of tumor size, prescription dose, and dose to the lungs on posttreatment pulmonary function test (PFT) changes after stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (NSCLC). Methods and Materials: The analysis is based on 191 patients treated at 5 international institutions: inclusion criteria were availability of pre- and post-SBRT PFTs and dose-volume histograms of the lung and planning target volume (PTV); patients treated with more than 1 SBRT course were excluded. Correlation between early (1-6 months, median 3 months) and late (7-24 months, median 12 months) PFT changes and tumor size, planning target volume (PTV) dose, and lung doses was assessed using linear regression analysis, receiver operating characteristics analysis, and Lyman's normal tissue complication probability model. The PTV doses were converted to biologically effective doses and lung doses to 2 Gy equivalent doses before correlation analyses. Results: Up to 6 months after SBRT, forced expiratory volume in 1 second and carbon monoxide diffusion capacity changed by −1.4% (95% confidence interval [CI], −3.4% to 0) and −7.6% (95% CI, −10.2% to −3.4%) compared with pretreatment values, respectively. A modest decrease in PFTs was observed 7-24 months after SBRT, with changes of −8.1% (95% CI, −13.3% to −5.3%) and −12.4% (95% CI, −15.5% to −6.9%), respectively. Using linear regression analysis, receiver operating characteristic analysis, and normal tissue complication probability modeling, all evaluated parameters of tumor size, PTV dose, mean lung dose, and absolute and relative volumes of the lung exposed to minimum doses of 5-70 Gy were not correlated with early and late PFT changes. Subgroup analysis based on pre-SBRT PFTs (greater or equal and less than median) did not identify any dose-effect relationship. Conclusions: This study failed to demonstrate a significant dose-effect relationship for

  2. Dose assessment of aircrew using passive detectors

    Energy Technology Data Exchange (ETDEWEB)

    Hajek, M.; Berge, T.; Schoener, W.; Summerer, L.; Vana, N

    2002-07-01

    Radiation exposure of aircrew is a serious concern which has been given special emphasis in the European Council directive 96/29/Euratom. The cosmic ray induced neutron component can contribute more than 50% to the biologically relevant dose at aviation altitudes. Various computational approaches to route dose assessment, e.g. CARI, are in use nowadays and are compared with experimental data. Measurements of aircrew exposure usually involve extensive instrumentation in order to cover the whole particle spectrum and energy range present inside aircraft. Due to their small size and easy handling, thermoluminescence dosemeters represent an appropriate alternative. Previous measurements onboard aircraft applying the high-temperature ratio method with LiF:Mg,Ti dosemeters for the determination of an 'averaged' linear energy transfer of mixed radiation fields demonstrate the ability of this method to evaluate the dose equivalent, according to the Q(LET{sub (}) relationship proposed by the ICRP. Measurements with CaF{sub 2}:Tm dosemeters are currently in progress and are discussed here. (author)

  3. Comparison of measured and estimated maximum skin doses during CT fluoroscopy lung biopsies

    Energy Technology Data Exchange (ETDEWEB)

    Zanca, F., E-mail: Federica.Zanca@med.kuleuven.be [Department of Radiology, Leuven University Center of Medical Physics in Radiology, UZ Leuven, Herestraat 49, 3000 Leuven, Belgium and Imaging and Pathology Department, UZ Leuven, Herestraat 49, Box 7003 3000 Leuven (Belgium); Jacobs, A. [Department of Radiology, Leuven University Center of Medical Physics in Radiology, UZ Leuven, Herestraat 49, 3000 Leuven (Belgium); Crijns, W. [Department of Radiotherapy, UZ Leuven, Herestraat 49, 3000 Leuven (Belgium); De Wever, W. [Imaging and Pathology Department, UZ Leuven, Herestraat 49, Box 7003 3000 Leuven, Belgium and Department of Radiology, UZ Leuven, Herestraat 49, 3000 Leuven (Belgium)

    2014-07-15

    Purpose: To measure patient-specific maximum skin dose (MSD) associated with CT fluoroscopy (CTF) lung biopsies and to compare measured MSD with the MSD estimated from phantom measurements, as well as with the CTDIvol of patient examinations. Methods: Data from 50 patients with lung lesions who underwent a CT fluoroscopy-guided biopsy were collected. The CT protocol consisted of a low-kilovoltage (80 kV) protocol used in combination with an algorithm for dose reduction to the radiology staff during the interventional procedure, HandCare (HC). MSD was assessed during each intervention using EBT2 gafchromic films positioned on patient skin. Lesion size, position, total fluoroscopy time, and patient-effective diameter were registered for each patient. Dose rates were also estimated at the surface of a normal-size anthropomorphic thorax phantom using a 10 cm pencil ionization chamber placed at every 30°, for a full rotation, with and without HC. Measured MSD was compared with MSD values estimated from the phantom measurements and with the cumulative CTDIvol of the procedure. Results: The median measured MSD was 141 mGy (range 38–410 mGy) while the median cumulative CTDIvol was 72 mGy (range 24–262 mGy). The ratio between the MSD estimated from phantom measurements and the measured MSD was 0.87 (range 0.12–4.1) on average. In 72% of cases the estimated MSD underestimated the measured MSD, while in 28% of the cases it overestimated it. The same trend was observed for the ratio of cumulative CTDIvol and measured MSD. No trend was observed as a function of patient size. Conclusions: On average, estimated MSD from dose rate measurements on phantom as well as from CTDIvol of patient examinations underestimates the measured value of MSD. This can be attributed to deviations of the patient's body habitus from the standard phantom size and to patient positioning in the gantry during the procedure.

  4. Quantitative Risk Assessment for Lung Cancer from Exposure to Metal Ore Dust

    Institute of Scientific and Technical Information of China (English)

    FUHUA; JINGXIPENG; 等

    1992-01-01

    To quantitatively assess risk for lung cancer of metal miners,a historical cohort study was conducted.The cohort consisted of 1113 miners who were employed to underground work for at least 12 months between January 1,1960and December,12,1974,According to the records or dust concentration,a cumulative dust dose of each miner in the cohort was estimated.There wer 162 deaths in total and 45 deaths from lung cancer with a SMR of 2184,The SMR for lung cancer increased from 1019 for those with cumulative dust of less than 500mg-year to 2469 for those with the dose of greater than 4500mg-year.Furthermore,the risk in the highest category of combined cumulative dust dose and cigarette smoking was 46-fold greater than the lowest category of dust dose and smoking.This study showed that there was an exposure-response relationship between metal ore dust and lung cancer,and an interaction of lung cancer between smoking and metal ore dust exposure.

  5. TH-A-19A-03: Impact of Proton Dose Calculation Method On Delivered Dose to Lung Tumors: Experiments in Thorax Phantom and Planning Study in Patient Cohort

    Energy Technology Data Exchange (ETDEWEB)

    Grassberger, C; Daartz, J; Dowdell, S; Ruggieri, T; Sharp, G; Paganetti, H [Massachusetts General Hospital and Harvard Medical School, Boston, MA (United States)

    2014-06-15

    Purpose: Evaluate Monte Carlo (MC) dose calculation and the prediction of the treatment planning system (TPS) in a lung phantom and compare them in a cohort of 20 lung patients treated with protons. Methods: A 2-dimensional array of ionization chambers was used to evaluate the dose across the target in a lung phantom. 20 lung cancer patients on clinical trials were re-simulated using a validated Monte Carlo toolkit (TOPAS) and compared to the TPS. Results: MC increases dose calculation accuracy in lung compared to the clinical TPS significantly and predicts the dose to the target in the phantom within ±2%: the average difference between measured and predicted dose in a plane through the center of the target is 5.6% for the TPS and 1.6% for MC. MC recalculations in patients show a mean dose to the clinical target volume on average 3.4% lower than the TPS, exceeding 5% for small fields. The lower dose correlates significantly with aperture size and the distance of the tumor to the chest wall (Spearman's p=0.0002/0.004). For large tumors MC also predicts consistently higher V{sub 5} and V{sub 10} to the normal lung, due to a wider lateral penumbra, which was also observed experimentally. Critical structures located distal to the target can show large deviations, though this effect is very patient-specific. Conclusion: Advanced dose calculation techniques, such as MC, would improve treatment quality in proton therapy for lung cancer by avoiding systematic overestimation of target dose and underestimation of dose to normal lung. This would increase the accuracy of the relationships between dose and effect, concerning tumor control as well as normal tissue toxicity. As the role of proton therapy in the treatment of lung cancer continues to be evaluated in clinical trials, this is of ever-increasing importance. This work was supported by National Cancer Institute Grant R01CA111590.

  6. Tumor Volume-Adapted Dosing in Stereotactic Ablative Radiotherapy of Lung Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Trakul, Nicholas; Chang, Christine N.; Harris, Jeremy [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States); Chapman, Christopher [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States); University of Michigan School of Medicine, Ann Arbor, MI (United States); Rao, Aarti [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States); University of California, Davis, School of Medicine, Davis, CA (United States); Shen, John [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States); University of California, Irvine, School of Medicine, Irvine, CA (United States); Quinlan-Davidson, Sean [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States); Department of Radiation Oncology, McMaster University, Juravinski Cancer Centre, Hamilton, Ontario (Canada); Filion, Edith J. [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States); Departement de Medecine, Service de Radio-Oncologie, Centre Hospitalier de l' Universite de Montreal, Montreal, Quebec (Canada); Wakelee, Heather A.; Colevas, A. Dimitrios [Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA (United States); Whyte, Richard I. [Department of Cardiothoracic Surgery, Division of General Thoracic Surgery, Stanford University School of Medicine, Stanford, CA (United States); Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA (United States); and others

    2012-09-01

    Purpose: Current stereotactic ablative radiotherapy (SABR) protocols for lung tumors prescribe a uniform dose regimen irrespective of tumor size. We report the outcomes of a lung tumor volume-adapted SABR dosing strategy. Methods and Materials: We retrospectively reviewed the outcomes in 111 patients with a total of 138 primary or metastatic lung tumors treated by SABR, including local control, regional control, distant metastasis, overall survival, and treatment toxicity. We also performed subset analysis on 83 patients with 97 tumors treated with a volume-adapted dosing strategy in which small tumors (gross tumor volume <12 mL) received single-fraction regimens with biologically effective doses (BED) <100 Gy (total dose, 18-25 Gy) (Group 1), and larger tumors (gross tumor volume {>=}12 mL) received multifraction regimens with BED {>=}100 Gy (total dose, 50-60 Gy in three to four fractions) (Group 2). Results: The median follow-up time was 13.5 months. Local control for Groups 1 and 2 was 91.4% and 92.5%, respectively (p = 0.24) at 12 months. For primary lung tumors only (excluding metastases), local control was 92.6% and 91.7%, respectively (p = 0.58). Regional control, freedom from distant metastasis, and overall survival did not differ significantly between Groups 1 and 2. Rates of radiation pneumonitis, chest wall toxicity, and esophagitis were low in both groups, but all Grade 3 toxicities developed in Group 2 (p = 0.02). Conclusion: A volume-adapted dosing approach for SABR of lung tumors seems to provide excellent local control for both small- and large-volume tumors and may reduce toxicity.

  7. Objective and Structured Assessment of Lung Ultrasound Competence

    DEFF Research Database (Denmark)

    Skaarup, Søren Helbo; Laursen, Christian B; Bjerrum, Anne Sofie

    2017-01-01

    RATIONALE: Point-of-care lung ultrasound imaging has substantial diagnostic value and is widely used in respiratory, emergency and critical care medicine. Like other ultrasound examinations, lung ultrasound is operator-dependent. The current recommendations for competence in lung ultrasound sets...... a fixed number of ultrasound procedures to be performed without considering different learning rates. Recommendations do not consider different uses of lung ultrasound across specialties. OBJECTIVE: To create a reliable, valid and feasible instrument to assess lung ultrasound competence that includes...... 23 ultrasound operators of different competence levels. Examination time was measured and skill was rated by experienced observers using the assessment tool. Inter-rater agreement was examined by two observers in 9 lung ultrasound examinations. RESULTS: Consensus was obtained within 3 Delphi rounds...

  8. Lung cancer screening beyond low-dose computed tomography: the role of novel biomarkers.

    Science.gov (United States)

    Hasan, Naveed; Kumar, Rohit; Kavuru, Mani S

    2014-10-01

    Lung cancer is the most common and lethal malignancy in the world. The landmark National lung screening trial (NLST) showed a 20% relative reduction in mortality in high-risk individuals with screening low-dose computed tomography. However, the poor specificity and low prevalence of lung cancer in the NLST provide major limitations to its widespread use. Furthermore, a lung nodule on CT scan requires a nuanced and individualized approach towards management. In this regard, advances in high through-put technology (molecular diagnostics, multi-gene chips, proteomics, and bronchoscopic techniques) have led to discovery of lung cancer biomarkers that have shown potential to complement the current screening standards. Early detection of lung cancer can be achieved by analysis of biomarkers from tissue samples within the respiratory tract such as sputum, saliva, nasal/bronchial airway epithelial cells and exhaled breath condensate or through peripheral biofluids such as blood, serum and urine. Autofluorescence bronchoscopy has been employed in research setting to identify pre-invasive lesions not identified on CT scan. Although these modalities are not yet commercially available in clinic setting, they will be available in the near future and clinicians who care for patients with lung cancer should be aware. In this review, we present up-to-date state of biomarker development, discuss their clinical relevance and predict their future role in lung cancer management.

  9. TBI lung dose comparisons using bilateral and anteroposterior delivery techniques and tissue density corrections.

    Science.gov (United States)

    Bailey, Daniel W; Wang, Iris Z; Lakeman, Tara; Hales, Lee D; Singh, Anurag K; Podgorsak, Matthew B

    2015-03-08

    This study compares lung dose distributions for two common techniques of total body photon irradiation (TBI) at extended source-to-surface distance calculated with, and without, tissue density correction (TDC). Lung dose correction factors as a function of lateral thorax separation are approximated for bilateral opposed TBI (supine), similar to those published for anteroposterior-posteroanterior (AP-PA) techniques in AAPM Report 17 (i.e., Task Group 29). 3D treatment plans were created retrospectively for 24 patients treated with bilateral TBI, and for whom CT data had been acquired from the head to the lower leg. These plans included bilateral opposed and AP-PA techniques- each with and without - TDC, using source-to-axis distance of 377 cm and largest possible field size. On average, bilateral TBI requires 40% more monitor units than AP-PA TBI due to increased separation (26% more for 23 MV). Calculation of midline thorax dose without TDC leads to dose underestimation of 17% on average (standard deviation, 4%) for bilateral 6 MV TBI, and 11% on average (standard deviation, 3%) for 23 MV. Lung dose correction factors (CF) are calculated as the ratio of midlung dose (with TDC) to midline thorax dose (without TDC). Bilateral CF generally increases with patient separation, though with high variability due to individual uniqueness of anatomy. Bilateral CF are 5% (standard deviation, 4%) higher than the same corrections calculated for AP-PA TBI in the 6 MV case, and 4% higher (standard deviation, 2%) for 23 MV. The maximum lung dose is much higher with bilateral TBI (up to 40% higher than prescribed, depending on patient anatomy) due to the absence of arm tissue blocking the anterior chest. Dose calculations for bilateral TBI without TDC are incorrect by up to 24% in the thorax for 6 MV and up to 16% for 23 MV. Bilateral lung CF may be calculated as 1.05 times the values published in Table 6 of AAPM Report 17, though a larger patient pool is necessary to better

  10. Comparative hazard identification by a single dose lung exposure of zinc oxide and silver nanomaterials in mice

    DEFF Research Database (Denmark)

    Gosens, Ilse; Kermanizadeh, Ali; Jacobsen, Nicklas Raun

    2015-01-01

    Comparative hazard identification of nanomaterials (NMs) can aid in the prioritisation for further toxicity testing. Here, we assessed the acute lung, systemic and liver responses in C57BL/6N mice for three NMs to provide a hazard ranking. A silver (Ag), non-functionalised zinc oxide (ZnO) and a ......Comparative hazard identification of nanomaterials (NMs) can aid in the prioritisation for further toxicity testing. Here, we assessed the acute lung, systemic and liver responses in C57BL/6N mice for three NMs to provide a hazard ranking. A silver (Ag), non-functionalised zinc oxide (Zn...... fluid (BALF) after administration of both non-functionalised and functionalised ZnO. The latter also induced systemic inflammation measured as an increase in blood neutrophils and a decrease in blood lymphocytes. Exposure to Ag NM was not accompanied by pulmonary inflammation or cytotoxicity......, or by systemic inflammation. A decrease in glutathione levels was demonstrated in the liver following exposure to high doses of all three nanomaterials irrespective of any noticeable inflammatory or cytotoxic effects in the lung. By applying benchmark dose (BMD) modeling statistics to compare potencies...

  11. Paraquat poisoning: an experimental model of dose-dependent acute lung injury due to surfactant dysfunction

    Directory of Open Access Journals (Sweden)

    M.F.R. Silva

    1998-03-01

    Full Text Available Since the most characteristic feature of paraquat poisoning is lung damage, a prospective controlled study was performed on excised rat lungs in order to estimate the intensity of lesion after different doses. Twenty-five male, 2-3-month-old non-SPF Wistar rats, divided into 5 groups, received paraquat dichloride in a single intraperitoneal injection (0, 1, 5, 25, or 50 mg/kg body weight 24 h before the experiment. Static pressure-volume (PV curves were performed in air- and saline-filled lungs; an estimator of surface tension and tissue works was computed by integrating the area of both curves and reported as work/ml of volume displacement. Paraquat induced a dose-dependent increase of inspiratory surface tension work that reached a significant two-fold order of magnitude for 25 and 50 mg/kg body weight (P<0.05, ANOVA, sparing lung tissue. This kind of lesion was probably due to functional abnormalities of the surfactant system, as was shown by the increase in the hysteresis of the paraquat groups at the highest doses. Hence, paraquat poisoning provides a suitable model of acute lung injury with alveolar instability that can be easily used in experimental protocols of mechanical ventilation

  12. Preliminary dose assessment of the Chernobyl accident

    Energy Technology Data Exchange (ETDEWEB)

    Hull, A.P.

    1987-01-01

    From the major accident at Unit 4 of the Chernobyl nuclear power station, a plume of airborne radioactive fission products was initially carried northwesterly toward Poland, thence toward Scandinavia and into Central Europe. Reports of the levels of radioactivity in a variety of media and of external radiation levels were collected in the Department of Energy's Emergency Operations Center and compiled into a data bank. Portions of these and other data which were obtained directly from published and official reports were utilized to make a preliminary assessment of the extent and magnitude of the external dose to individuals downwind from Chernobyl. Radioactive /sup 131/I was the predominant fission product. The time of arrival of the plume and the maximum concentrations of /sup 131/I in air, vegetation and milk and the maximum reported depositions and external radiation levels have been tabulated country by country. A large amount of the total activity in the release was apparently carried to a significant elevation. The data suggest that in areas where rainfall occurred, deposition levels were from ten to one-hundred times those observed in nearby ''dry'' locations. Sufficient spectral data were obtained to establish average release fractions and to establish a reference spectra of the other nuclides in the release. Preliminary calculations indicated that the collective dose equivalent to the population in Scandinavia and Central Europe during the first year after the Chernobyl accident would be about 8 x 10/sup 6/ person-rem. From the Soviet report, it appears that a first year population dose of about 2 x 10/sup 7/ person-rem (2 x 10/sup 5/ Sv) will be received by the population who were downwind of Chernobyl within the U.S.S.R. during the accident and its subsequent releases over the following week. 32 refs., 14 figs., 20 tabs.

  13. Limits of dose escalation in lung cancer: a dose-volume histogram analysis comparing coplanar and non-coplanar techniques

    Energy Technology Data Exchange (ETDEWEB)

    Derycke, S.; Van Duyse, B.; Schelfhout, J.; De Neve, W.

    1995-12-01

    To evaluate the feasibility of dose escalation in radiotherapy of inoperable lung cancer, a dose-volume histogram analysis was performed comparing standard coplanar (2D) with non-coplanar (3D) beam arrangements on a non-selected group of 20 patients planned by Sherouse`s GRATISTM 3D-planning system. Serial CT-scanning was performed and 2 Target Volumes (Tvs) were defined. Gross Tumor Volume (GTV) defined a high-dose Target Volume (TV-1). GTV plus location of node stations with > 10% probability of invasion (Minet et al.) defined an intermediate-dose Target Volume (TV-2). However, nodal regions which are incompatible with cure were excluded from TV-2. These are ATS-regions 1, 8, 9 and 14 all left and right as well as heterolateral regions. For 3D-planning, Beam`s Eye View selected (by an experienced planner) beam arrangements were optimised using Superdot, a method of target dose-gradient annihilation developed by Sherouse. A second 3D-planning was performed using 4 beam incidences with maximal angular separation. The linac`s isocenter for the optimal arrangement was located at the geometrical center of gravity of a tetraheder, the tetraheder`s comers being the consecutive positions of the virtual source. This ideal beam arrangement was approximated as close as possible, taking into account technical limitations (patient-couch-gantry collisions). Criteria for tolerance were met if no points inside the spinal cord exceeded 50 Gy and if at least 50% of the lung volume received less than 20Gy. If dose regions below 50 Gy were judged acceptable at TV-2, 2D- as well as 3D-plans allow safe escalation to 80 Gy at TV-1. When TV-2 needed to be encompassed by isodose surfaces exceeding 50Gy, 3D-plans were necessary to limit dose at the spinal cord below tolerance. For large TVs dose is limited by lung tolerance for 3D-plans. An analysis (including NTCP-TCP as cost functions) of rival 3D-plans is being performed.

  14. [Breast dose reduction in female CT screening for lung cancer using various metallic shields].

    Science.gov (United States)

    Takada, Kenta; Kaneko, Junichi; Aoki, Kiyoshi

    2009-12-20

    We evaluated the effectiveness of metallic shields that were used for reduction of the breast dose in thoracic computed tomography(CT). For the evaluation, we measured breast surface dose and image standard deviation(SD)in the lung area. The metallic shields were made from bismuth, zinc, copper, and iron. The bismuth shield has been marketed and used for dose reduction. The other three metallic shields were chosen because they have lower atomic numbers and a lower yield of characteristic X-rays. As a result, use of the metallic shields showed a lower breast dose than the decrement of the tube current in the same image SD. The insertion of a thin aluminum sheet between the shield and a phantom was also effective in reducing breast surface dose. We calculated the dose reduction rate to evaluate the effectiveness of these metallic shields. This dose reduction rate was defined as the ratio of the decrease in breast surface dose by metallic shields to the breast surface dose measured with the tube current decrement in the same image SD. The maximum dose reduction rate was 6.4% for the bismuth shield, and 12.0-13.3% for the other shields. These results indicate that the shields made from zinc, copper, and iron are more effective for dose reduction than the shield made form bismuth. The best dose reduction rate, 13.3%, has been achieved when the zinc shield placed 20 mm apart from a phantom with 0.2 mm aluminum was used.

  15. Assessment of internal doses in emergency situations

    Energy Technology Data Exchange (ETDEWEB)

    Rahola, T.; Muikku, M. [Radiation and Nuclear Safety Authority - STUK (Finland); Falk, R.; Johansson, J. [Swedish Radiation Protection Authority - SSI (Sweden); Liland, A.; Thorshaug, S. [NRPA (Norway)

    2006-04-15

    The need for assessing internal radiation doses in emergency situations was demonstrated after accidents in Brazil, Ukraine and other countries. Lately more and more concern has been expressed regarding malevolent use of radiation and radioactive materials. The scenarios for such use are more difficult to predict than for nuclear power plant or weapons accidents. Much of the results of the work done in the IRADES project can be adopted for use in various accidental situations involving radionuclides that are not addressed in this report. If an emergency situation occurs in only one or a few of the Nordic countries, experts from the other countries could be called upon to assist in monitoring. A big advantage is then our common platform. In the Nordic countries much work has been put down on quality assurance of measurements and on training of dose assessment calculations. Attention to this was addressed at the internal dosimetry course in October 2005. Nordic emergency preparedness exercises have so far not included training of direct measurements of people in the early phase of an emergency. The aim of the IRADES project was to improve the preparedness especially for thyroid measurements. The modest financial support did not enable the participants to make big efforts but certainly acted as a much appreciated reminder of the importance of being prepared also to handle situations with malevolent use of radioactive materials. It was left to each country to decide to which extent to improve the practical skills. There is still a need for detailed national implementation plans. Measurement strategies need to be developed in each country separately taking into account national regulations, local circumstances and resources. End users of the IRADES report are the radiation protection authorities. (au)

  16. Lung Dose Calculation With SPECT/CT for {sup 90}Yittrium Radioembolization of Liver Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Naichang, E-mail: yun@ccf.org [Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH (United States); Srinivas, Shaym M.; DiFilippo, Frank P.; Shrikanthan, Sankaran [Department of Nuclear Medicine, Cleveland Clinic, Cleveland, OH (United States); Levitin, Abraham; McLennan, Gordon; Spain, James [Department of Interventional Radiology, Cleveland Clinic, Cleveland, OH (United States); Xia, Ping; Wilkinson, Allan [Department of Radiation Oncology, Cleveland Clinic, Cleveland, OH (United States)

    2013-03-01

    Purpose: To propose a new method to estimate lung mean dose (LMD) using technetium-99m labeled macroaggregated albumin ({sup 99m}Tc-MAA) single photon emission CT (SPECT)/CT for {sup 90}Yttrium radioembolization of liver tumors and to compare the LMD estimated using SPECT/CT with clinical estimates of LMD using planar gamma scintigraphy (PS). Methods and Materials: Images of 71 patients who had SPECT/CT and PS images of {sup 99m}Tc-MAA acquired before TheraSphere radioembolization of liver cancer were analyzed retrospectively. LMD was calculated from the PS-based lung shunt assuming a lung mass of 1 kg and 50 Gy per GBq of injected activity shunted to the lung. For the SPECT/CT-based estimate, the LMD was calculated with the activity concentration and lung volume derived from SPECT/CT. The effect of attenuation correction and the patient's breathing on the calculated LMD was studied with the SPECT/CT. With these effects correctly taken into account in a more rigorous fashion, we compared the LMD calculated with SPECT/CT with the LMD calculated with PS. Results: The mean dose to the central region of the lung leads to a more accurate estimate of LMD. Inclusion of the lung region around the diaphragm in the calculation leads to an overestimate of LMD due to the misregistration of the liver activity to the lung from the patient's breathing. LMD calculated based on PS is a poor predictor of the actual LMD. For the subpopulation with large lung shunt, the mean overestimation from the PS method for the lung shunt was 170%. Conclusions: A new method of calculating the LMD for TheraSphere and SIR-Spheres radioembolization of liver cancer based on {sup 99m}Tc-MAA SPECT/CT is presented. The new method provides a more accurate estimate of radiation risk to the lungs. For patients with a large lung shunt calculated from PS, a recalculation of LMD based on SPECT/CT is recommended.

  17. Relation between intravascular clots of pulmonary artery and lung perfusion defects: assessment with dual source CT low-dose contrast perfusion imaging%双源CT低剂量对比剂肺灌注成像评估肺动脉内血栓与灌注缺损间的关系

    Institute of Scientific and Technical Information of China (English)

    谭四平; 沈比先; 陈丽兴; 薛水培; 楚二伟; 刘康; 汪春荣; 贾飞鸽

    2012-01-01

    Objective: To assess the relation between intravascular clots of pulmonaiy artery and lung perfusion defects with dual source CT low-dose contrast perfusion imaging. Materials and Methods: Image quality of low-dose and conventional dose dual energy lung perfusion imaging (DEP1) in 15 patients without pulmonary embolism (PE) was analyzed. Twenty consecutive patients with suspected PE underwent dual source CT low-dose contrast perfusion imaging. CT pulmonary angiogra-phy (CTPA) and lung perfusion images were analyzed at the same time. Intravascular clots of pulmonary artery were analyzed,including the location,number and morphology by the axial image and three-dimensional reconstruction of CTPA. Lung perfusion defects and its location,extent were evaluated with lung PBV software on the workstation. The relationship between in-trava8Cular clots of pulmonary artery and lung perfusion defects were analyzed statistically. Results: No significant difference was found in the image quality of low-dose and conventional dose DEPI of patients without PE(P>0.05). One hundred and two perfusion defects were found in 13 patients by pulmonary perfusion imaging,including lobular,segmental and BubsegmentaJ perfusion defects. Six perfusion defects in 4 cases had no clear intravascular clots. Images of axial CTPA and three-dimensional reconstruction showed 43 intravascular clots in 11 patients. Two cases with 5 intravascular clots depicted by CTPA showed no perfusion defects. Nine cases showed both intravascular clots and perfusion defects,with 21 perfusion defects unrelated to the blood supply areas of pulmonary artery(8 segmental and 13 subsegmental),and the remaining 75 perfusion defects consistent with the blood supply areas of pulmonary artery. Conclusion: There is unexpected dissociation between the intravascular clots of pulmonary artery and lung perfusion defects. Analysing the perfusion maps and CTPA of dual source CT low-dose contrast perfusion image will improve the accuracy

  18. Evaluation of dose according to the volume and respiratory range during SBRT in lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Deuk Hee [Dept. of Radiation Oncology, Busan Paik Hospital, Inje University, Busan (Korea, Republic of); Park, Eun Tae; Kim, Jung Hoon; Kang, Se Seik [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of)

    2016-09-15

    Stereotactic body radiotherapy is effective technic in radiotherapy for low stage lung cancer. But lung cancer is affected by respiratory so accurately concentrate high dose to the target is very difficult. In this study, evaluated the target volume according to how to take the image. And evaluated the dose by photoluminescence glass dosimeter according to how to contour the volume and respiratory range. As a result, evaluated the 4D CT volume was 10.4 cm{sup 3} which was closest value of real size target. And in dose case is internal target volume dose was 10.82, 16.88, 21.90 Gy when prescribed dose was 10, 15, 20 Gy and it was the highest dose. Respiratory gated radiotherapy dose was more higher than internal target volume. But it made little difference by respiratory range. Therefore, when moving cancer treatment, acquiring image by 4D CT, contouring internal target volume and respiratory gated radiotherapy technic would be the best way.

  19. Difference in performance between 3D and 4D CBCT for lung imaging: a dose and image quality analysis.

    Science.gov (United States)

    Thengumpallil, Sheeba; Smith, Kathleen; Monnin, Pascal; Bourhis, Jean; Bochud, François; Moeckli, Raphaël

    2016-11-08

    The study was to describe and to compare the performance of 3D and 4D CBCT imaging modalities by measuring and analyzing the delivered dose and the image quality. The 3D (Chest) and 4D (Symmetry) CBCT Elekta XVI lung IGRT protocols were analyzed. Dose profiles were measured with TLDs inside a dedicated phantom. The dosimetric indicator cone-beam dose index (CBDI) was evaluated. The image quality analysis was performed by assessing the contrast transfer function (CTF), the noise power spectrum (NPS) and the noise-equivalent quanta (NEQ). Artifacts were also evaluated by simulating irregular breathing variations. The two imaging modalities showed different dose distributions within the phantom. At the center, the 3D CBCT delivered twice the dose of the 4D CBCT. The CTF was strongly reduced by motion compared to static conditions, resulting in a CTF reduction of 85% for the 3D CBCT and 65% for the 4D CBCT. The amplitude of the NPS was two times higher for the 4D CBCT than for the 3D CBCT. In the presence of motion, the NEQ of the 4D CBCT was 50% higher than the 3D CBCT. In the presence of breathing irregularities, the 4D CBCT protocol was mainly affected by view-aliasing artifacts, which were typically cone-beam artifacts, while the 3D CBCT protocol was mainly affected by duplication artifacts. The results showed that the 4D CBCT ensures a reasonable dose and better image quality when mov-ing targets are involved compared to 3D CBCT. Therefore, 4D CBCT is a reliable imaging modality for lung free-breathing radiation therapy.

  20. Dose verification of radiotherapy for lung cancer by using plastic scintillator dosimetry and a heterogeneous phantom

    DEFF Research Database (Denmark)

    Ottosson, Wiviann; Behrens, C. F.; Andersen, Claus E.

    2015-01-01

    Bone, air passages, cavities, and lung are elements present in patients, but challenging to properly correct for in treatment planning dose calculations. Plastic scintillator detectors (PSDs) have proven to be well suited for dosimetry in non-reference conditions such as small fields. The objective...... of this study was to investigate the performance of a commercial treatment planning system (TPS) using a PSD and a specially designed thorax phantom with lung tumor inserts. 10 treatment plans of different complexity and phantom configurations were evaluated. Although the TPS agreed well with the measurements...

  1. Radiation dose is associated with prognosis of small cell lung cancer with superior vena cava syndrome

    Science.gov (United States)

    Wang, Zhen-Bo; Ning, Fang-Ling; Wang, Xiao-Le; Cheng, Yu-Feng; Dong, Xin-Jun; Liu, Chang-Min; Chen, Shao-Shui

    2015-01-01

    Approximately 10% of small cell lung cancer (SCLC) cases develop superior vena cava syndrome (SVCS). Many SCLC patients with SVCS have relatively limited disease, requiring curative rather than palliative treatment. Besides chemotherapy, radiotherapy is important for treating SCLC with SVCS. We retrospectively evaluated the influence of radiotherapy dose on the prognosis of 57 patients with SCLC with SVCS treated with concurrent chemoradiotherapy. The mean biological equivalent radiation dose was 71.5 Gy. We administered etoposide/cisplatin as sequential and concurrent chemotherapy. All patients received at least one cycle of concurrent chemotherapy. All patients had partial or complete response; SVCS-associated symptoms were reduced in 87.7% (50/57) of patients within 3-10 days after treatment. Radiation dose did not affect 2-year local control (74.2% vs. 80.8%). Patients who received high-dose radiation had a lower 2-year overall survival rate than those who received low-dose radiation (11.6 vs. 33%; P = 0.024). The high dose group median survival was 15.0 months (95% confidence interval [CI]: 11.2-19.0) compared with 18.7 months (95% CI: 13.9-23.6) in the low dose group. Grade 3/4 neutropenia occurred in 22/26 high dose patients (84.6%) and 21/31 low dose patients (67.7%). In the high dose group, 30.8% of patients had grade 3/4 esophagitis compared with 19.4% of low dose patients. Only 29.0% of low dose patients received < 4 cycles of chemotherapy in the first 12 weeks after treatment began compared with 46.2% of high dose patients. Concurrent chemoradiotherapy is a tolerable modality for treating stage IIIA/IIIB SCLC with SVCS. Moderate-dose radiotherapy is preferable. PMID:26064339

  2. Relation between intravascular clots of pulmonary artery and lung perfusion defects: assessment with dual source CT low-dose contrast perfusion imaging%低剂量对比剂双能量肺灌注成像评估肺动脉内血栓与灌注缺损间的关系

    Institute of Scientific and Technical Information of China (English)

    沈比先; 谭四平; 彭冬红; 汪春荣; 贾飞鸽; 李元歌; 罗玉娟; 楚二伟

    2012-01-01

    目的:应用双源CT低剂量对比剂双能量肺灌注成像评估急性肺动脉栓塞患者血管内血栓与肺灌注缺损间的关系,以提高对肺动脉栓塞诊断的准确性.方法:随机选择无肺动脉栓塞患者的低剂量与常规剂量双能量肺灌注成像各15例,对比分析其图像质量;收集20例疑肺动脉栓塞患者行低剂量双能量肺灌注成像;同时获得肺动脉CTA及肺灌注图像.分析肺动脉内有无血栓.以及血栓的部位、数量及形态特征.用双能量肺灌注分析软件判断有无灌注缺损及缺损的部位、形态及范围.对比分析并统计肺动脉内血栓与肺灌注缺损间的关系.结果:肺动脉栓塞患者的低剂量与常规剂量双能量肺灌注成像质量无明显差异(P>0.05).20例疑似病例中,15例诊断为肺动脉栓塞,其中13例患者肺灌注图像中出现102个肺叶、肺段、或亚段灌注缺损,4例共6个灌注缺损CTA无明确血栓;11例肺动脉CTA显示43个血栓,其中9例血栓与灌注缺损同时存在,2例CTA共5个血栓肺内无灌注缺损.75个灌注缺损与栓塞肺动脉供血范围一致,21个灌注缺损(8段、13亚段)与肺动脉供血范围无关.结论:综合分析双源CT低剂量双能量肺灌注图与CTPA,可以提高肺动脉栓塞诊断的准确性.%Objective: To assess the relation between intravascular clots of pulmonary artery and lung perfusion defects with dual source CT low-dose contrast perfusion imaging so as to elevate the accuracy of diagnosis of PE. Methods: The image quality of low-dose and conventional dose dual energy lung perfusion imaging (DEPI) of patients without pulmonary embolism (PE). With 15 cases in each sose, were analyzed. Twenty consecutive patients with suspected PE underwent dual source CT low-dose contrast perfusion imaging and CT pulmonary angiography (CTPA) and lung perfusion images were aquired at the same time. The intravascular clots of pulmonary artery if or not, including the

  3. Comparative hazard identification by a single dose lung exposure of zinc oxide and silver nanomaterials in mice.

    Directory of Open Access Journals (Sweden)

    Ilse Gosens

    Full Text Available Comparative hazard identification of nanomaterials (NMs can aid in the prioritisation for further toxicity testing. Here, we assessed the acute lung, systemic and liver responses in C57BL/6N mice for three NMs to provide a hazard ranking. A silver (Ag, non-functionalised zinc oxide (ZnO and a triethoxycaprylylsilane functionalised ZnO NM suspended in water with 2% mouse serum were examined 24 hours following a single intratracheal instillation (I.T.. An acute pulmonary inflammation was noted (marked by a polymorphonuclear neutrophil influx with cell damage (LDH and total protein in broncho-alveolar lavage fluid (BALF after administration of both non-functionalised and functionalised ZnO. The latter also induced systemic inflammation measured as an increase in blood neutrophils and a decrease in blood lymphocytes. Exposure to Ag NM was not accompanied by pulmonary inflammation or cytotoxicity, or by systemic inflammation. A decrease in glutathione levels was demonstrated in the liver following exposure to high doses of all three nanomaterials irrespective of any noticeable inflammatory or cytotoxic effects in the lung. By applying benchmark dose (BMD modeling statistics to compare potencies of the NMs, we rank functionalised ZnO ranked the highest based on the largest number of affected endpoints, as well as the strongest responses observed after 24 hours. The non-functionalised ZnO NM gave an almost similar response, whereas Ag NM did not cause an acute response at similar doses.

  4. 64层螺旋CT低剂量双相扫描肺密度在COPD患者肺功能评价中的应用研究%Sixty-four slice spiral CT low-dose chest two-phase scanning for lung density measurement in assessing the pulmonary function in patients with chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    张利华; 王云华

    2012-01-01

    目的:探讨64层螺旋CT(spiral CT,SCT)低剂量双相扫描肺密度测定在慢性阻塞性肺部疾病(chronic obstructive pulmonary disease,COPD)患者肺功能评价中的应用价值.方法:选择经临床肺功能检查确诊的COPD患者36例(COPD组)和30例无任何心肺疾患且胸部CT检查正常的健康体检者(正常对照组).两组研究对象均采用德国Siemens SOMATOM Sensation 64层SCT机进行深吸气末、深呼气末的全肺低剂量(50 mAs)扫描.按扫描层数将全肺分为上、中、下3个肺区.利用Pulmo软件,分别测量和计算出COPD组与正常对照组深吸气末、深呼气末上、中、下肺区及全肺的各密度指标:深吸气末密度(Din)、深呼气末密度(Dex)、密度差(Dex-Din)、密度比(Dex/Din)、密度变化百分比(Din-Dex)/Din.所有COPD患者均在SCT检查前后3d内完成肺功能检测(pulmonary function tests,PFT),指标为第1秒用力肺活量的实测值与预计值的比值(FEV1%)及第1秒用力肺活量与用力肺活量的比值(FEV1/FVC).比较COPD组与正常对照组之间SCT各密度指标,利用Pearson相关分析来检验各密度指标与肺功能指标FEV1%和FEV1/FVC的相关性.结果:COPD组与正常对照组比较,Din在上、中、下及全肺区的差异有统计学意义(P<0.05);Dex,Dex-Din,Dex/Din,(Din-Dex)/Din在各肺区及全肺区的差异亦有统计学意义(P<0.01).Dex,Dex-Din,Dex/Din,(Din-Dex)/Din均分别与FEV1%,FEV1/FVC有良好的相关性(P<0.01).结论:64层SCT低剂量双相扫描能便捷、准确地获得评价COPD肺功能的密度指标,与FEV1%和FEV1/FVC两项肺功能指标相关性良好,可用于评估COPD患者的肺功能状况,有较高的临床应用价值.%Objective: To explore the value of 64 slice spiral CT (SCT) low-dose chest scanning at full inspiration and full expiration for lung density measurement in assessing the pulmonary function in patients with chronic obstructive pulmonary disease (COPD). Methods

  5. Nutrient intake and nutrient patterns and risk of lung cancer among heavy smokers: results from the COSMOS screening study with annual low-dose CT.

    Science.gov (United States)

    Gnagnarella, Patrizia; Maisonneuve, Patrick; Bellomi, Massimo; Rampinelli, Cristiano; Bertolotti, Raffaella; Spaggiari, Lorenzo; Palli, Domenico; Veronesi, Giulia

    2013-06-01

    The role of nutrients in lung cancer aetiology remains controversial and has never been evaluated in the context of screening. Our aim was to investigate the role of single nutrients and nutrient patterns in the aetiology of lung cancer in heavy smokers. Asymptomatic heavy smokers (≥20 pack-years) were invited to undergo annual low-dose computed tomography. We assessed diet using a self-administered food frequency questionnaire and collected information on multivitamin supplement use. We performed principal component analysis identifying four nutrient patterns and used Cox proportional Hazards regression to assess the association between nutrients and nutrients patterns and lung cancer risk. During a mean follow-up of 5.7 years, 178 of 4,336 participants were diagnosed with lung cancer by screening. We found a significant risk reduction of lung cancer with increasing vegetable fat consumption (HR for highest vs. lowest quartile = 0.50, 95% CI = 0.31-0.80; P-trend = 0.02). Participants classified in the high "vitamins and fiber" pattern score had a significant risk reduction of lung cancer (HR = 0.57; 95% CI = 0.36-0.90, P-trend = 0.01). Among heavy smokers enrolled in a screening trial, high vegetable fat intake and adherence to the "vitamin and fiber" nutrient pattern were associated with reduced lung cancer incidence.

  6. Sci—Thur AM: YIS - 05: 10X-FFF VMAT for Lung SABR: an Investigation of Peripheral Dose

    Energy Technology Data Exchange (ETDEWEB)

    Mader, J [University of Victoria (Australia); Mestrovic, A [University of Victoria (Australia); BC Cancer Agency, Vancouver Island Centre (Canada)

    2014-08-15

    Flattening Filter Free (FFF) beams exhibit high dose rates, reduced head scatter, leaf transmission and leakage radiation. For VMAT lung SABR, treatment time can be significantly reduced using high dose rate FFF beams while maintaining plan quality and accuracy. Another possible advantage offered by FFF beams for VMAT lung SABR is the reduction in peripheral dose. The focus of this study was to investigate and quantify the reduction of peripheral dose offered by FFF beams for VMAT lung SABR. The peripheral doses delivered by VMAT Lung SABR treatments using FFF and flattened beams were investigated for the Varian Truebeam linac. This study was conducted in three stages, (1): ion chamber measurement of peripheral dose for various plans, (2): validation of AAA, Acuros XB and Monte Carlo for peripheral dose using measured data, and (3): using the validated Monte Carlo model to evaluate peripheral doses for 6 VMAT lung SABR treatments. Three energies, 6X, 10X, and 10X-FFF were used for all stages. Measured data indicates that 10X-FFF delivers the lowest peripheral dose of the three energies studied. AAA and Acuros XB dose calculation algorithms were identified as inadequate, and Monte Carlo was validated for accurate peripheral dose prediction. The Monte Carlo-calculated VMAT lung SABR plans show a significant reduction in peripheral dose for 10X-FFF plans compared to the standard 6X plans, while no significant reduction was showed when compared to 10X. This reduction combined with shorter treatment time makes 10X-FFF beams the optimal choice for superior VMAT lung SABR treatments.

  7. Low-dose budesonide treatment improves lung function in patients with infrequent asthma symptoms at baseline

    DEFF Research Database (Denmark)

    Reddel, H. K.; Busse, W. W.; Pedersen, Søren;

    2015-01-01

    in patients with less frequent symptoms at presentation. This was investigated in a post-hoc analysis of the multinational inhaled Steroid Treatment As Regular Therapy in early asthma (START) study.2 METHODS: Patients aged 4-66 years (median 21 years) with a history of recent-onset mild asthma (11 years......RATIONALE: Inhaled corticosteroids (ICS) are highly effective in low doses for improving asthma outcomes, including lung function. In the past, ICS treatment was recommended for patients with 'persistent' asthma, defined by symptoms >2 days/week.1 However, evidence is lacking for the benefit of ICS...... symptom frequency groups (Figure). CONCLUSIONS: Long-term, once-daily, low-dose budesonide treatment plus usual asthma medication improves lung function in patients with mild, recent-onset asthma. These beneficial effects were seen even in patients with the lowest baseline asthma symptom frequency (0...

  8. Individualized dose prescription for hypofractionation in advanced non-small-cell lung cancer radiotherapy: an in silico trial.

    NARCIS (Netherlands)

    Hoffmann, A.L.; Troost, E.G.C.; Huizenga, H.; Kaanders, J.H.A.M.; Bussink, J.

    2012-01-01

    PURPOSE: Local tumor control and outcome remain poor in patients with advanced non-small-cell lung cancer (NSCLC) treated by external beam radiotherapy. We investigated the therapeutic gain of individualized dose prescription with dose escalation based on normal tissue dose constraints for various h

  9. Comparison of the dose to lung volume between supine and prone position during treatment planning

    Institute of Scientific and Technical Information of China (English)

    Yu Li; Huijun Xu ; Sujing Zhang; Xiaoliang Liu

    2015-01-01

    Objective The aim of the study was to compare the dose to lung volume in the supine and prone posi-tion while designing CyberKnife treatment plans to treat metastatic tumors in the spinous processes of the thoracic vertebrae, and of er a reference for reducing damage to normal tissues. Methods Nine cases of metastatic tumors in the spinous processes of the thoracic vertebrae were se-lected, and then we designed treatment plans based on the supine and prone positions and compared the results. Results In contrast with the treatment plan based on the prone position, the one for the supine position required 14862–36337 MU more; the lung D5% was 5.20–7.90 Gy higher; and the lung D20% was 2.61–5.73 Gy higher. The dif erence of dose to spine volume between the two plans was –2.21–2.67 Gy; to the skin volume was –3.93–7.85 Gy; and to the esophagus was 0.28–6.39 Gy. Conclusion The treatment plan based on the prone position of patients can better protect lung tissues than the one based on the supine position, and can also improve the availability of beams.

  10. Effects of CT dose and nodule characteristics on lung-nodule detectability in a cohort of 90 national lung screening trial patients

    Science.gov (United States)

    Young, Stefano; Lo, Pechin; Hoffman, John M.; Kim, H. J. Grace; Brown, Matthew S.; McNitt-Gray, Michael F.

    2016-03-01

    Lung cancer screening CT is already performed at low dose. There are many techniques to reduce the dose even further, but it is not clear how such techniques will affect nodule detectability. In this work, we used an in-house CAD algorithm to evaluate detectability. 90348 patients and their raw CT data files were drawn from the National Lung Screening Trial (NLST) database. All scans were acquired at ~2 mGy CTDIvol with fixed tube current, 1 mm slice thickness, and B50 reconstruction kernel on a Sensation 64 scanner (Siemens Healthcare). We used the raw CT data to simulate two additional reduced-dose scans for each patient corresponding to 1 mGy (50%) and 0.5 mGy (25%). Radiologists' findings on the NLST reader forms indicated 65 nodules in the cohort, which we subdivided based on LungRADS criteria. For larger category 4 nodules, median sensitivities were 100% at all three dose levels, and mean sensitivity decreased with dose. For smaller nodules meeting the category 2 or 3 criteria, the dose dependence was less obvious. Overall, mean patient-level sensitivity varied from 38.5% at 100% dose to 40.4% at 50% dose, a difference of only 1.9%. However, the false-positive rate quadrupled from 1 per case at 100% dose to 4 per case at 25% dose. Dose reduction affected lung-nodule detectability differently depending on the LungRADS category, and the false-positive rate was very sensitive at sub-screening dose levels. Thus, care should be taken to adapt CAD for the very challenging noise characteristics of screening.

  11. CT imaging of congenital lung lesions: effect of iterative reconstruction on diagnostic performance and radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Haggerty, Jay E.; Smith, Ethan A.; Dillman, Jonathan R. [University of Michigan Health System, Section of Pediatric Radiology, Department of Radiology, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Kunisaki, Shaun M. [University of Michigan Health System, Section of Pediatric Surgery, Department of Surgery, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States)

    2015-07-15

    Different iterative reconstruction techniques are available for use in pediatric computed tomography (CT), but these techniques have not been systematically evaluated in infants. To determine the effect of iterative reconstruction on diagnostic performance, image quality and radiation dose in infants undergoing CT evaluation for congenital lung lesions. A retrospective review of contrast-enhanced chest CT in infants (<1 year) with congenital lung lesions was performed. CT examinations were reviewed to document the type of lung lesion, vascular anatomy, image noise measurements and image reconstruction method. CTDI{sub vol} was used to calculate size-specific dose estimates (SSDE). CT findings were correlated with intraoperative and histopathological findings. Analysis of variance and the Student's t-test were used to compare image noise measurements and radiation dose estimates between groups. Fifteen CT examinations used filtered back projection (FBP; mean age: 84 days), 15 used adaptive statistical iterative reconstruction (ASiR; mean age: 93 days), and 11 used model-based iterative reconstruction (MBIR; mean age: 98 days). Compared to operative findings, 13/15 (87%), 14/15 (93%) and 11/11 (100%) lesions were correctly characterized using FBP, ASiR and MBIR, respectively. Arterial anatomy was correctly identified in 12/15 (80%) using FBP, 13/15 (87%) using ASiR and 11/11 (100%) using MBIR. Image noise was less for MBIR vs. ASiR (P < 0.0001). Mean SSDE was different among groups (P = 0.003; FBP = 7.35 mGy, ASiR = 1.89 mGy, MBIR = 1.49 mGy). Congenital lung lesions can be adequately characterized in infants using iterative CT reconstruction techniques while maintaining image quality and lowering radiation dose. (orig.)

  12. Patient dose simulations for scanning-beam digital x-ray tomosynthesis of the lungs

    OpenAIRE

    Nelson, Geoff; Yoon, Sungwon; Krishna, Ganesh; Wilfley, Brian; Fahrig, Rebecca

    2013-01-01

    Purpose: An improved method of image guidance for lung tumor biopsies could help reduce the high rate of false negatives. The aim of this work is to optimize the geometry of the scanning-beam digital tomography system (SBDX) for providing real-time 3D tomographic reconstructions for target verification. The unique geometry of the system requires trade-offs between patient dose, imaging field of view (FOV), and tomographic angle.

  13. Dose Constraints to Prevent Radiation-Induced Brachial Plexopathy in Patients Treated for Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Amini, Arya [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); University of California Irvine School of Medicine, Irvine, California (United States); Yang Jinzhong; Williamson, Ryan [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); McBurney, Michelle L. [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Erasmus, Jeremy [Department of Diagnostic Imaging, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Allen, Pamela K.; Karhade, Mandar; Komaki, Ritsuko; Liao, Zhongxing; Gomez, Daniel; Cox, James [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Dong, Lei [Department of Radiation Physics, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Welsh, James, E-mail: jwelsh@mdanderson.org [Department of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States)

    2012-03-01

    Purpose: As the recommended radiation dose for non-small-cell lung cancer (NSCLC) increases, meeting dose constraints for critical structures like the brachial plexus becomes increasingly challenging, particularly for tumors in the superior sulcus. In this retrospective analysis, we compared dose-volume histogram information with the incidence of plexopathy to establish the maximum dose tolerated by the brachial plexus. Methods and Materials: We identified 90 patients with NSCLC treated with definitive chemoradiation from March 2007 through September 2010, who had received >55 Gy to the brachial plexus. We used a multiatlas segmentation method combined with deformable image registration to delineate the brachial plexus on the original planning CT scans and scored plexopathy according to Common Terminology Criteria for Adverse Events version 4.03. Results: Median radiation dose to the brachial plexus was 70 Gy (range, 56-87.5 Gy; 1.5-2.5 Gy/fraction). At a median follow-up time of 14.0 months, 14 patients (16%) had brachial plexopathy (8 patients [9%] had Grade 1, and 6 patients [7%] had Grade {>=}2); median time to symptom onset was 6.5 months (range, 1.4-37.4 months). On multivariate analysis, receipt of a median brachial plexus dose of >69 Gy (odds ratio [OR] 10.091; 95% confidence interval [CI], 1.512-67.331; p = 0.005), a maximum dose of >75 Gy to 2 cm{sup 3} of the brachial plexus (OR, 4.909; 95% CI, 0.966-24.952; p = 0.038), and the presence of plexopathy before irradiation (OR, 4.722; 95% CI, 1.267-17.606; p = 0.021) were independent predictors of brachial plexopathy. Conclusions: For lung cancers near the apical region, brachial plexopathy is a major concern for high-dose radiation therapy. We developed a computer-assisted image segmentation method that allows us to rapidly and consistently contour the brachial plexus and establish the dose limits to minimize the risk of brachial plexopathy. Our results could be used as a guideline in future prospective

  14. Stereotactic ablative radiotherapy for small lung tumors with a moderate dose. Favorable results and low toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Duncker-Rohr, V.; Nestle, U. [Universitaetsklinikum Freiburg (Germany); Momm, F. [Ortenau Klinikum Offenburg (Germany)] [and others

    2013-01-15

    Background: Stereotactic ablative body radiotherapy (SBRT, SABR) is being increasingly applied because of its high local efficacy, e.g., for small lung tumors. However, the optimum dosage is still under discussion. Here, we report data on 45 lung lesions [non-small cell lung cancer (NSCLC) or metastases] in 39 patients treated between 2009 and 2010 by SABR. Patients and methods: SABR was performed with total doses of 35 Gy (5 fractions) or 37.5 Gy (3 fractions) prescribed to the 60% isodose line encompassing the planning target volume. Three-monthly follow-up CT scans were supplemented by FDG-PET/CT if clinically indicated. Results: The median follow-up was 17 months. Local progression-free survival rates were 90.5% (all patients), 95.0% (NSCLC), and 81.8% (metastases) at 1 year. At 2 years, the respective local progression-free survival rates were 80.5%, 95.0%, and 59.7%. Overall survival rates were 71.1% (all patients), 65.4% (NSCLC), and 83.3% (metastases) at 1 year. Overall survival rates at 2 years were 52.7%, 45.9%, and 66.7%, respectively. Acute side effects were mild. Conclusion: With the moderate dose schedule used, well-tolerated SABR led to favorable local tumor control as in other published series. Standardization in reporting the dose prescription for SABR is needed to allow comparison of different series in order to determine optimum dosage. (orig.)

  15. CANISTER HANDLING FACILITY WORKER DOSE ASSESSMENT

    Energy Technology Data Exchange (ETDEWEB)

    D.T. Dexheimer

    2004-02-27

    The purpose of this calculation is to estimate radiation doses received by personnel working in the Canister Handling Facility (CHF) performing operations to receive transportation casks, transfer wastes, prepare waste packages, perform associated equipment maintenance. The specific scope of work contained in this calculation covers individual worker group doses on an annual basis, and includes the contributions due to external and internal radiation. The results of this calculation will be used to support the design of the CHF and provide occupational dose estimates for the License Application.

  16. Effect of lung and target density on small-field dose coverage and PTV definition

    Energy Technology Data Exchange (ETDEWEB)

    Higgins, Patrick D., E-mail: higgi010@umn.edu; Ehler, Eric D.; Cho, Lawrence C.; Dusenbery, Kathryn E.

    2015-04-01

    We have studied the effect of target and lung density on block margin for small stereotactic body radiotherapy (SBRT) targets. A phantom (50 × 50 × 50 cm{sup 3}) was created in the Pinnacle (V9.2) planning system with a 23-cm diameter lung region of interest insert. Diameter targets of 1.6, 2.0, 3.0, and 4.0 cm were placed in the lung region of interest and centered at a physical depth of 15 cm. Target densities evaluated were 0.1 to 1.0 g/cm{sup 3}, whereas the surrounding lung density was varied between 0.05 and 0.6 g/cm{sup 3}. A dose of 100 cGy was delivered to the isocenter via a single 6-MV field, and the ratio of the average dose to points defining the lateral edges of the target to the isocenter dose was recorded for each combination. Field margins were varied from none to 1.5 cm in 0.25-cm steps. Data obtained in the phantom study were used to predict planning treatment volume (PTV) margins that would match the clinical PTV and isodose prescription for a clinical set of 39 SBRT cases. The average internal target volume (ITV) density was 0.73 ± 0.17, average local lung density was 0.33 ± 0.16, and average ITV diameter was 2.16 ± 0.8 cm. The phantom results initially underpredicted PTV margins by 0.35 cm. With this offset included in the model, the ratio of predicted-to-clinical PTVs was 1.05 ± 0.32. For a given target and lung density, it was found that treatment margin was insensitive to target diameter, except for the smallest (1.6-cm diameter) target, for which the treatment margin was more sensitive to density changes than the larger targets. We have developed a graphical relationship for block margin as a function of target and lung density, which should save time in the planning phase by shortening the design of PTV margins that can satisfy Radiation Therapy Oncology Group mandated treatment volume ratios.

  17. Degradation of proton depth dose distributions attributable to microstructures in lung-equivalent material

    Energy Technology Data Exchange (ETDEWEB)

    Titt, Uwe, E-mail: utitt@mdanderson.org; Mirkovic, Dragan; Mohan, Radhe [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030 (United States); Sell, Martin [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030 and Department of Medical Physics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120 (Germany); Unkelbach, Jan [Department of Radiation Oncology, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts 02114 (United States); Bangert, Mark [Department of Medical Physics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120 (Germany); Oelfke, Uwe [Department of Medical Physics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg 69120, Germany and Department of Physics, The Institute of Cancer Research, 123 Old Brompton Road, London SW7 3RP (United Kingdom)

    2015-11-15

    Purpose: The purpose of the work reported here was to investigate the influence of sub-millimeter size heterogeneities on the degradation of the distal edges of proton beams and to validate Monte Carlo (MC) methods’ ability to correctly predict such degradation. Methods: A custom-designed high-resolution plastic phantom approximating highly heterogeneous, lung-like structures was employed in measurements and in Monte Carlo simulations to evaluate the degradation of proton Bragg curves penetrating heterogeneous media. Results: Significant differences in distal falloff widths and in peak dose values were observed in the measured and the Monte Carlo simulated curves compared to pristine proton Bragg curves. Furthermore, differences between simulations of beams penetrating CT images of the phantom did not agree well with the corresponding experimental differences. The distal falloff widths in CT image-based geometries were underestimated by up to 0.2 cm in water (corresponding to 0.8–1.4 cm in lung tissue), and the peak dose values of pristine proton beams were overestimated by as much as ~35% compared to measured curves or depth-dose curves simulated on the basis of true geometry. The authors demonstrate that these discrepancies were caused by the limited spatial resolution of CT images that served as a basis for dose calculations and lead to underestimation of the impact of the fine structure of tissue heterogeneities. A convolution model was successfully applied to mitigate the underestimation. Conclusions: The results of this study justify further development of models to better represent heterogeneity effects in soft-tissue geometries, such as lung, and to correct systematic underestimation of the degradation of the distal edge of proton doses.

  18. Radiation dose reduction in computed tomography-guided lung interventions using an iterative reconstruction technique

    Energy Technology Data Exchange (ETDEWEB)

    Chang, D.H.; Hiss, S.; Borggrefe, J.; Bunck, A.C.; Maintz, D.; Hackenbroch, M. [Cologne University Hospital (Germany). Dept. of Radiology; Mueller, D. [Clinical Science Philips Healthcare GmbH, Munich (Germany). Clinical Science; Hellmich, M. [Cologne University Hospital (Germany). Inst. of Medical Statistics, Informatics and Epidemiology

    2015-10-15

    To compare the radiation doses and image qualities of computed tomography (CT)-guided interventions using a standard-dose CT (SDCT) protocol with filtered back projection and a low-dose CT (LDCT) protocol with both filtered back projection and iterative reconstruction. Image quality and radiation doses (dose-length product and CT dose index) were retrospectively reviewed for 130 patients who underwent CT-guided lung interventions. SDCT at 120 kVp and automatic mA modulation and LDCT at 100 kVp and a fixed exposure were each performed for 65 patients. Image quality was objectively evaluated as the contrast-to-noise ratio and subjectively by two radiologists for noise impression, sharpness, artifacts and diagnostic acceptability on a four-point scale. The groups did not significantly differ in terms of diagnostic acceptability and complication rate. LDCT yielded a median 68.6 % reduction in the radiation dose relative to SDCT. In the LDCT group, iterative reconstruction was superior to filtered back projection in terms of noise reduction and subjective image quality. The groups did not differ in terms of beam hardening artifacts. LDCT was feasible for all procedures and yielded a more than two-thirds reduction in radiation exposure while maintaining overall diagnostic acceptability, safety and precision. The iterative reconstruction algorithm is preferable according to the objective and subjective image quality analyses.

  19. SU-C-BRB-02: Symmetric and Asymmetric MLC Based Lung Shielding and Dose Optimization During Translating Bed TBI

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, S; Kakakhel, MB [Pakistan Institute of Engineering & Applied Sciences (PIEAS), Islamabad (Pakistan); Ahmed, SBS; Hussain, A [Aga Khan University Hospital (AKUH), Karachi (Pakistan)

    2015-06-15

    Purpose: The primary aim was to introduce a dose optimization method for translating bed total body irradiation technique that ensures lung shielding dynamically. Symmetric and asymmetric dynamic MLC apertures were employed for this purpose. Methods: The MLC aperture sizes were defined based on the radiological depth values along the divergent ray lines passing through the individual CT slices. Based on these RD values, asymmetrically shaped MLC apertures were defined every 9 mm of the phantom in superior-inferior direction. Individual MLC files were created with MATLAB™ and were imported into Eclipse™ treatment planning system for dose calculations. Lungs can be shielded to an optimum level by reducing the MLC aperture width over the lungs. The process was repeated with symmetrically shaped apertures. Results: Dose-volume histogram (DVH) analysis shows that the asymmetric MLC based technique provides better dose coverage to the body and optimum shielding of the lungs compared to symmetrically shaped beam apertures. Midline dose homogeneity is within ±3% with asymmetric MLC apertures whereas it remains within ±4.5% with symmetric ones (except head region where it drops down to −7%). The substantial over and under dosage of ±5% at tissue interfaces has been reduced to ±2% with asymmetric MLC technique. Lungs dose can be reduced to any desired limit. In this experiment lungs dose was reduced to 80% of the prescribed dose, as was desired. Conclusion: The novel asymmetric MLC based technique assures optimum shielding of OARs (e.g. lungs) and better 3-D dose homogeneity and body-dose coverage in comparison with the symmetric MLC aperture optimization. The authors acknowledge the financial and infrastructural support provided by Pakistan Institute of Engineering & Applied Sciences (PIEAS), Islamabad and Aga Khan University Hospital (AKUH), Karachi during the course of this research project. Authors have no conflict of interest with any national / international

  20. Lung cancer incidence and mortality in National Lung Screening Trial participants who underwent low-dose CT prevalence screening: a retrospective cohort analysis of a randomised, multicentre, diagnostic screening trial

    Science.gov (United States)

    Patz, Edward F; Greco, Erin; Gatsonis, Constantine; Pinsky, Paul; Kramer, Barnett S; Aberle, Denise R

    2016-01-01

    Summary Background Annual low-dose CT screening for lung cancer has been recommended for high-risk individuals, but the necessity of yearly low-dose CT in all eligible individuals is uncertain. This study examined rates of lung cancer in National Lung Screening Trial (NLST) participants who had a negative prevalence (initial) low-dose CT screen to explore whether less frequent screening could be justified in some lower-risk subpopulations. Methods We did a retrospective cohort analysis of data from the NLST, a randomised, multicentre screening trial comparing three annual low-dose CT assessments with three annual chest radiographs for the early detection of lung cancer in high-risk, eligible individuals (aged 55–74 years with at least a 30 pack-year history of cigarette smoking, and, if a former smoker, had quit within the past 15 years), recruited from US medical centres between Aug 5, 2002, and April 26, 2004. Participants were followed up for up to 5 years after their last annual screen. For the purposes of this analysis, our cohort consisted of all NLST participants who had received a low-dose CT prevalence (T0) screen. We determined the frequency, stage, histology, study year of diagnosis, and incidence of lung cancer, as well as overall and lung cancer-specific mortality, and whether lung cancers were detected as a result of screening or within 1 year of a negative screen. We also estimated the effect on mortality if the first annual (T1) screen in participants with a negative T0 screen had not been done. The NLST is registered with ClinicalTrials.gov, number NCT00047385. Findings Our cohort consisted of 26 231 participants assigned to the low-dose CT screening group who had undergone their T0 screen. The 19 066 participants with a negative T0 screen had a lower incidence of lung cancer than did all 26 231 T0-screened participants (371·88 [95% CI 337·97–408·26] per 100 000 person-years vs 661·23 [622·07–702·21]) and had lower lung cancer

  1. Optimizing Collimator Margins for Isotoxically Dose-Escalated Conformal Radiation Therapy of Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Warren, Samantha, E-mail: Samantha.warren@oncology.ox.ac.uk [Department of Oncology, Gray Institute of Radiation Oncology and Biology, University of Oxford, Oxford (United Kingdom); Oxford Cancer Centre, Oxford University Hospitals, Oxford (United Kingdom); Panettieri, Vanessa [William Buckland Radiotherapy Centre, Alfred Hospital, Commercial Road, Melbourne (Australia); Panakis, Niki; Bates, Nicholas [Oxford Cancer Centre, Oxford University Hospitals, Oxford (United Kingdom); Lester, Jason F. [Velindre Cancer Centre, Velindre Road, Whitchurch, Cardiff (United Kingdom); Jain, Pooja [Clatterbridge Cancer Centre, Clatterbridge Road, Wirral (United Kingdom); Landau, David B. [Department of Radiotherapy, Guy' s and St. Thomas' NHS Foundation Trust, London (United Kingdom); Nahum, Alan E.; Mayles, W. Philip M. [Clatterbridge Cancer Centre, Clatterbridge Road, Wirral (United Kingdom); Fenwick, John D. [Department of Oncology, Gray Institute of Radiation Oncology and Biology, University of Oxford, Oxford (United Kingdom); Oxford Cancer Centre, Oxford University Hospitals, Oxford (United Kingdom)

    2014-04-01

    Purpose: Isotoxic dose escalation schedules such as IDEAL-CRT [isotoxic dose escalation and acceleration in lung cancer chemoradiation therapy] (ISRCTN12155469) individualize doses prescribed to lung tumors, generating a fixed modeled risk of radiation pneumonitis. Because the beam penumbra is broadened in lung, the choice of collimator margin is an important element of the optimization of isotoxic conformal radiation therapy for lung cancer. Methods and Materials: Twelve patients with stage I-III non-small cell lung cancer (NSCLC) were replanned retrospectively using a range of collimator margins. For each plan, the prescribed dose was calculated according to the IDEAL-CRT isotoxic prescription method, and the absolute dose (D{sub 99}) delivered to 99% of the planning target volume (PTV) was determined. Results: Reducing the multileaf collimator margin from the widely used 7 mm to a value of 2 mm produced gains of 2.1 to 15.6 Gy in absolute PTV D{sub 99}, with a mean gain ± 1 standard error of the mean of 6.2 ± 1.1 Gy (2-sided P<.001). Conclusions: For NSCLC patients treated with conformal radiation therapy and an isotoxic dose prescription, absolute doses in the PTV may be increased by using smaller collimator margins, reductions in relative coverage being offset by increases in prescribed dose.

  2. Quantitative assessment of the risk of lung cancer associated with occupational exposure to refractory ceramic fibers.

    Science.gov (United States)

    Moolgavkar, S H; Luebeck, E G; Turim, J; Hanna, L

    1999-08-01

    We present the results of a quantitative assessment of the lung cancer risk associated with occupational exposure to refractory ceramic fibers (RCF). The primary sources of data for our risk assessment were two long-term oncogenicity studies in male Fischer rats conducted to assess the potential pathogenic effects associated with prolonged inhalation of RCF. An interesting feature of the data was the availability of the temporal profile of fiber burden in the lungs of experimental animals. Because of this information, we were able to conduct both exposure-response and dose-response analyses. Our risk assessment was conducted within the framework of a biologically based model for carcinogenesis, the two-stage clonal expansion model, which allows for the explicit incorporation of the concepts of initiation and promotion in the analyses. We found that a model positing that RCF was an initiator had the highest likelihood. We proposed an approach based on biological considerations for the extrapolation of risk to humans. This approach requires estimation of human lung burdens for specific exposure scenarios, which we did by using an extension of a model due to Yu. Our approach acknowledges that the risk associated with exposure to RCF depends on exposure to other lung carcinogens. We present estimates of risk in two populations: (1) a population of nonsmokers and (2) an occupational cohort of steelworkers not exposed to coke oven emissions, a mixed population that includes both smokers and nonsmokers.

  3. Comparison and Evaluation of the Effects of Rib and Lung Inhomogeneities on Lung Dose in Breast Brachytherapy using a Treatment Planning System and the MCNPX Code

    Directory of Open Access Journals (Sweden)

    Hossein Salehi Yazdi

    2010-09-01

    Full Text Available Introduction: This study investigates to what extent the computed dose received by lung tissue in a commercially available treatment planning system (TPS for 192Ir high-dose-rate breast brachytherapy is accurate in view of tissue inhomogeneities and presence of ribs. Materials and Methods: A CT scan of the breast was used to construct a patient-equivalent phantom in the clinical treatment planning system. An implant involving 13 plastic catheters and 383 programmed source dwell positions were simulated using the MCNPX code. Results: The results were compared with the corresponding commercial TPS in the form of isodoses and cumulative dose–volume histogram in breast, lung and ribs. The comparison of Monte Carlo results and TPS calculation showed that the isodoses greater than 62% in the breast that were located rather close to the implant or away from the breast curvature surface and lung boundary were in good agreement. TPS calculations, however, overestimated dose in the lung for lower isodose contours and points that were lying near the breast-air boundary and relatively away from the implant. Discussion and Conclusions: Taking into account the ribs and entering the actual data for breast, rib and lung, revealed an average overestimation of dose in lung in the TPS calculation.

  4. Evaluation of the systematic error in using 3D dose calculation in scanning beam proton therapy for lung cancer.

    Science.gov (United States)

    Li, Heng; Liu, Wei; Park, Peter; Matney, Jason; Liao, Zhongxing; Chang, Joe; Zhang, Xiaodong; Li, Yupeng; Zhu, Ronald X

    2014-09-08

    The objective of this study was to evaluate and understand the systematic error between the planned three-dimensional (3D) dose and the delivered dose to patient in scanning beam proton therapy for lung tumors. Single-field and multifield optimized scanning beam proton therapy plans were generated for ten patients with stage II-III lung cancer with a mix of tumor motion and size. 3D doses in CT datasets for different respiratory phases and the time-weighted average CT, as well as the four-dimensional (4D) doses were computed for both plans. The 3D and 4D dose differences for the targets and different organs at risk were compared using dose-volume histogram (DVH) and voxel-based techniques, and correlated with the extent of tumor motion. The gross tumor volume (GTV) dose was maintained in all 3D and 4D doses, using the internal GTV override technique. The DVH and voxel-based techniques are highly correlated. The mean dose error and the standard deviation of dose error for all target volumes were both less than 1.5% for all but one patient. However, the point dose difference between the 3D and 4D doses was up to 6% for the GTV and greater than 10% for the clinical and planning target volumes. Changes in the 4D and 3D doses were not correlated with tumor motion. The planning technique (single-field or multifield optimized) did not affect the observed systematic error. In conclusion, the dose error in 3D dose calculation varies from patient to patient and does not correlate with lung tumor motion. Therefore, patient-specific evaluation of the 4D dose is important for scanning beam proton therapy for lung tumors.

  5. Osteoporosis markers on low-dose lung cancer screening chest computed tomography scans predict all-cause mortality

    Energy Technology Data Exchange (ETDEWEB)

    Buckens, C.F. [University Medical Center Utrecht, Radiology Department, Utrecht (Netherlands); University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Graaf, Y. van der [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Verkooijen, H.M.; Mali, W.P.; Jong, P.A. de [University Medical Center Utrecht, Radiology Department, Utrecht (Netherlands); Isgum, I.; Mol, C.P. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Verhaar, H.J. [University Medical Center Utrecht, Department of Geriatric Medicine, Utrecht (Netherlands); Vliegenthart, R.; Oudkerk, M. [Medical Center Groningen, Department of Radiology, Utrecht (Netherlands); Aalst, C.M. van; Koning, H.J. de [Erasmus MC Rotterdam, Department of Public Health, Rotterdam (Netherlands)

    2015-01-15

    Further survival benefits may be gained from low-dose chest computed tomography (CT) by assessing vertebral fractures and bone density. We sought to assess the association between CT-measured vertebral fractures and bone density with all-cause mortality in lung cancer screening participants. Following a case-cohort design, lung cancer screening trial participants (N = 3,673) who died (N = 196) during a median follow-up of 6 years (inter-quartile range: 5.7-6.3) were identified and added to a random sample of N = 383 from the trial. We assessed vertebral fractures using Genant and acute;s semiquantative method on sagittal reconstructions and measured bone density (Hounsfield Units (HU)) in vertebrae. Cox proportional hazards modelling was used to determine if vertebral fractures or bone density were independently predictive of mortality. The prevalence of vertebral fractures was 35 % (95 % confidence interval 30-40 %) among survivors and 51 % (44-58 %) amongst cases. After adjusting for age, gender, smoking status, pack years smoked, coronary and aortic calcium volume and pulmonary emphysema, the adjusted hazard ratio (HR) for vertebral fracture was 2.04 (1.43-2.92). For each 10 HU decline in trabecular bone density, the adjusted HR was 1.08 (1.02-1.15). Vertebral fractures and bone density are independently associated with all-cause mortality. (orig.)

  6. Patient dose simulations for scanning-beam digital x-ray tomosynthesis of the lungs

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, Geoff; Fahrig, Rebecca [Department of Radiology, Stanford University, Stanford, California 94305 (United States); Yoon, Sungwon [Varian Medical Systems, Palo Alto, California 94304 (United States); Krishna, Ganesh [Palo Alto Medical Foundation, Mountain View, California 94040 (United States); Wilfley, Brian [Triple Ring Technologies, Inc., Newark, California 94560 (United States)

    2013-11-15

    Purpose: An improved method of image guidance for lung tumor biopsies could help reduce the high rate of false negatives. The aim of this work is to optimize the geometry of the scanning-beam digital tomography system (SBDX) for providing real-time 3D tomographic reconstructions for target verification. The unique geometry of the system requires trade-offs between patient dose, imaging field of view (FOV), and tomographic angle.Methods: Tomosynthetic angle as a function of tumor-to-detector distance was calculated. Monte Carlo Software (PCXMC) was used to calculate organ doses and effective dose for source-to-detector distances (SDDs) from 90 to 150 cm, patient locations with the tumor at 20 cm from the source to 20 cm from the detector, and FOVs centered on left lung and right lung as well as medial and distal peripheries of the lungs. These calculations were done for two systems, a SBDX system and a GE OEC-9800 C-arm fluoroscopic unit. To evaluate the dose effect of the system geometry, results from PCXMC were calculated using a scan of 300 mAs for both SBDX and fluoroscopy. The Rose Criterion was used to find the fluence required for a tumor SNR of 5, factoring in scatter, air-gap, system geometry, and patient position for all models generated with PCXMC. Using the calculated fluence for constant tumor SNR, the results from PCXMC were used to compare the patient dose for a given SNR between SBDX and fluoroscopy.Results: Tomographic angle changes with SDD only in the region near the detector. Due to their geometry, the source array and detector have a peak tomographic angle for any given SDD at a source to tumor distance that is 69.7% of the SDD assuming constant source and detector size. Changing the patient location in order to increase tomographic angle has a significant effect on organ dose distribution due to geometrical considerations. With SBDX and fluoroscopy geometries, the dose to organs typically changes in an opposing manner with changing patient

  7. Computer-aided detection of early interstitial lung diseases using low-dose CT images

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sang Cheol; Kim, Soo Hyung [School of Electronics and Computer Engineering, Chonnam National University, Gwangju 500-757 (Korea, Republic of); Tan, Jun; Wang Xingwei; Lederman, Dror; Leader, Joseph K; Zheng Bin, E-mail: zhengb@upmc.edu [Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213 (United States)

    2011-02-21

    This study aims to develop a new computer-aided detection (CAD) scheme to detect early interstitial lung disease (ILD) using low-dose computed tomography (CT) examinations. The CAD scheme classifies each pixel depicted on the segmented lung areas into positive or negative groups for ILD using a mesh-grid-based region growth method and a multi-feature-based artificial neural network (ANN). A genetic algorithm was applied to select optimal image features and the ANN structure. In testing each CT examination, only pixels selected by the mesh-grid region growth method were analyzed and classified by the ANN to improve computational efficiency. All unselected pixels were classified as negative for ILD. After classifying all pixels into the positive and negative groups, CAD computed a detection score based on the ratio of the number of positive pixels to all pixels in the segmented lung areas, which indicates the likelihood of the test case being positive for ILD. When applying to an independent testing dataset of 15 positive and 15 negative cases, the CAD scheme yielded the area under receiver operating characteristic curve (AUC = 0.884 {+-} 0.064) and 80.0% sensitivity at 85.7% specificity. The results demonstrated the feasibility of applying the CAD scheme to automatically detect early ILD using low-dose CT examinations.

  8. Computer-aided detection of early interstitial lung diseases using low-dose CT images

    Science.gov (United States)

    Park, Sang Cheol; Tan, Jun; Wang, Xingwei; Lederman, Dror; Leader, Joseph K.; Kim, Soo Hyung; Zheng, Bin

    2011-02-01

    This study aims to develop a new computer-aided detection (CAD) scheme to detect early interstitial lung disease (ILD) using low-dose computed tomography (CT) examinations. The CAD scheme classifies each pixel depicted on the segmented lung areas into positive or negative groups for ILD using a mesh-grid-based region growth method and a multi-feature-based artificial neural network (ANN). A genetic algorithm was applied to select optimal image features and the ANN structure. In testing each CT examination, only pixels selected by the mesh-grid region growth method were analyzed and classified by the ANN to improve computational efficiency. All unselected pixels were classified as negative for ILD. After classifying all pixels into the positive and negative groups, CAD computed a detection score based on the ratio of the number of positive pixels to all pixels in the segmented lung areas, which indicates the likelihood of the test case being positive for ILD. When applying to an independent testing dataset of 15 positive and 15 negative cases, the CAD scheme yielded the area under receiver operating characteristic curve (AUC = 0.884 ± 0.064) and 80.0% sensitivity at 85.7% specificity. The results demonstrated the feasibility of applying the CAD scheme to automatically detect early ILD using low-dose CT examinations.

  9. An Internal Dose Assessment Associated with Personal Food Intake

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joeun; Jae, Moosung [Hanyang University, Seoul (Korea, Republic of); Hwang, Wontae [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    ICRP (International Commission on Radiological Protection), Therefore, had recommended the concept of 'Critical Group'. Recently the ICRP has recommended the use of 'Representative Person' on the new basic recommendation 103. On the other hand the U.S. NRC (Nuclear Regulatory Commission) has adopted more conservative concept, 'Maximum Exposed Individuals (MEI)' of critical Group. The dose assessment in Korea is based on MEI. Although dose assessment based on MEI is easy to receive the permission of the regulatory authority, it is not efficient. Meanwhile, the internal dose by food consumption takes an important part. Therefore, in this study, the internal dose assessment was performed in accordance with ICRP's new recommendations. The internal dose assessment was performed in accordance with ICRP's new recommendations. It showed 13.2% decreased of the annual internal dose due to gaseous effluents by replacing MEI to the concept of representative person. Also, this calculation based on new ICRP's recommendation has to be extended to all areas of individual dose assessment. Then, more accurate and efficient values might be obtained for dose assessment.

  10. Dose assessment in the criticality accident at Tokai-mura

    Energy Technology Data Exchange (ETDEWEB)

    Endo, Akira, E-mail: endo.akira3@jaea.go.j [Japan Atomic Energy Agency, Tokai-mura, Ibaraki, 319-1195 (Japan)

    2010-12-15

    The present paper reviews a dose assessment carried out after the criticality accident that occurred on September 30, 1999 at JCO in Tokai-mura, Japan. In the accident, almost all doses were caused by external exposure to neutrons and {gamma}-rays emitted upon the fission of uranium. By a joint effort of Japanese experts in radiation dosimetry, a dose assessment was performed for neighboring residents, JCO employees including 3 workers who were at the accident spot, and emergency response personnel. The dose assessment was carried out using records of dosimeters, radiation monitoring data in and around the site, analysis of biological specimens, and computer simulation techniques. It was concluded from the results of the dose assessment that deterministic effects are not expected, except for the 3 heavily exposed workers, and that the probability of stochastic effects is very small and will be undetectable.

  11. Butyrylcholinesterase in guinea pig lung lavage: a novel biomarker to assess lung injury following inhalation exposure to nerve agent VX.

    Science.gov (United States)

    Graham, Jacob R; Wright, Benjamin S; Rezk, Peter E; Gordon, Richard K; Sciuto, Alfred M; Nambiar, Madhusoodana P

    2006-06-01

    Respiratory disturbances play a central role in chemical warfare nerve agent (CWNA) induced toxicity; they are the starting point of mass casualty and the major cause of death. We developed a microinstillation technique of inhalation exposure to nerve agent VX and assessed lung injury by biochemical analysis of the bronchoalveolar lavage fluid (BALF). Here we demonstrate that normal guinea pig BALF has a significant amount of cholinesterase activity. Treatment with Huperzine A, a specific inhibitor of acetylcholinesterase (AChE), showed that a minor fraction of BALF cholinesterase is AChE. Furthermore, treatment with tetraisopropyl pyrophosphoramide (iso-OMPA), a specific inhibitor of butyrylcholinesterase (BChE), inhibited more than 90% of BChE activity, indicating the predominance of BChE in BALF. A predominance of BChE expression in the lung lavage was seen in both genders. Substrate specific inhibition indicated that nearly 30% of the cholinesterase in lung tissue homogenate is AChE. BALF and lung tissue AChE and BChE activities were strongly inhibited in guinea pigs exposed for 5 min to 70.4 and 90.4 microg/m3 VX and allowed to recover for 15 min. In contrast, BALF AChE activity was increased 63% and 128% and BChE activity was increased 77% and 88% after 24 h of recovery following 5 min inhalation exposure to 70.4 microg/m3 and 90.4 mg/m3 VX, respectively. The increase in BALF AChE and BChE activity was dose dependent. Since BChE is synthesized in the liver and present in the plasma, an increase in BALF indicates endothelial barrier injury and leakage of plasma into lung interstitium. Therefore, a measure of increased levels of AChE and BChE in the lung lavage can be used to determine the chronology of barrier damage as well as the extent of lung injury following exposure to chemical warfare nerve agents.

  12. Extracting the normal lung dose-response curve from clinical DVH data: a possible role for low dose hyper-radiosensitivity, increased radioresistance

    Science.gov (United States)

    Gordon, J. J.; Snyder, K.; Zhong, H.; Barton, K.; Sun, Z.; Chetty, I. J.; Matuszak, M.; Ten Haken, R. K.

    2015-09-01

    In conventionally fractionated radiation therapy for lung cancer, radiation pneumonitis’ (RP) dependence on the normal lung dose-volume histogram (DVH) is not well understood. Complication models alternatively make RP a function of a summary statistic, such as mean lung dose (MLD). This work searches over damage profiles, which quantify sub-volume damage as a function of dose. Profiles that achieve best RP predictive accuracy on a clinical dataset are hypothesized to approximate DVH dependence. Step function damage rate profiles R(D) are generated, having discrete steps at several dose points. A range of profiles is sampled by varying the step heights and dose point locations. Normal lung damage is the integral of R(D) with the cumulative DVH. Each profile is used in conjunction with a damage cutoff to predict grade 2 plus (G2+) RP for DVHs from a University of Michigan clinical trial dataset consisting of 89 CFRT patients, of which 17 were diagnosed with G2+ RP. Optimal profiles achieve a modest increase in predictive accuracy—erroneous RP predictions are reduced from 11 (using MLD) to 8. A novel result is that optimal profiles have a similar distinctive shape: enhanced damage contribution from low doses (curves, which can be modeled using Joiner’s induced repair model. A novel search strategy is employed, which has the potential to estimate RP dependence on the normal lung DVH. When applied to a clinical dataset, identified profiles share a characteristic shape, which resembles HRS/IRR. This suggests that normal lung may have enhanced sensitivity to low doses, and that this sensitivity can affect RP risk.

  13. Cyclophosphamide-induced lung damage in mice: protection by a small preliminary dose.

    Science.gov (United States)

    Collis, C. H.; Wilson, C. M.; Jones, J. M.

    1980-01-01

    Cycylphosphamide (Cy) produces an interstitial pneumonitis in CBA mice. The extent of the lung damage has been quantified by measuring the increase in ventilation rate over 6 weeks after an i.p. injection of Cy 200, 250 and 300 mg/kg. A dose-dependent response was found. When a preliminary ("priming") dose of Cy at 50 mg/kg was given 7, 9 or 14 days before a single large dose of 250 mg/kg, lung damage was reduced, as shown by a smaller increase in ventilation rate than in those receiving 250 mg/kg alone, and this difference was significant (P less than 0.01) in the Day-14-and highly significant (P<0.001) in the Day-7-"primed" groups. When primed less than 7 days before, there was a relative increase in ventilation rate, which was statistically significant (P less than 0.01) in the Day-1-primed group. Similar effects were also seen in the survival of the mice. PMID:7426315

  14. Effects on lung stress of position and different doses of perfluorocarbon in a model of ARDS.

    Science.gov (United States)

    López-Aguilar, Josefina; Lucangelo, Umberto; Albaiceta, Guillermo M; Nahum, Avi; Murias, Gastón; Cañizares, Rosario; Oliva, Joan Carles; Romero, Pablo V; Blanch, Lluís

    2015-05-01

    We determined whether the combination of low dose partial liquid ventilation (PLV) with perfluorocarbons (PFC) and prone positioning improved lung function while inducing minimal stress. Eighteen pigs with acute lung injury were assigned to conventional mechanical ventilation (CMV) or PLV (5 or 10 ml/kg of PFC). Positive end-expiratory pressure (PEEP) trials in supine and prone positions were performed. Data were analyzed by a multivariate polynomial regression model. The interplay between PLV and position depended on the PEEP level. In supine PLV dampened the stress induced by increased PEEP during the trial. The PFC dose of 5 ml/kg was more effective than the dose 10 ml/kg. This effect was not observed in prone. Oxygenation was significantly higher in prone than in supine position mainly at lower levels of PEEP. In conclusion, MV settings should take both gas exchange and stress/strain into account. When protective CMV fails, rescue strategies combining prone positioning and PLV with optimal PEEP should improve gas exchange with minimal stress.

  15. A Monte Carlo approach to lung dose calculation in small fields used in intensity modulated radiation therapy and stereotactic body radiation therapy

    Directory of Open Access Journals (Sweden)

    Asghar Mesbahi

    2014-01-01

    Conclusion: Our study showed that the dose reduction with small fields in the lung was very enormous. Thus, inaccurate prediction of absorbed dose inside lung and also lung soft-tissue interfaces with small photon beams may lead to critical consequences for treatment outcome.

  16. Ventilation/Perfusion Positron Emission Tomography—Based Assessment of Radiation Injury to Lung

    Energy Technology Data Exchange (ETDEWEB)

    Siva, Shankar, E-mail: shankar.siva@petermac.org [Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville (Australia); Hardcastle, Nicholas [Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne (Australia); Centre for Medical Radiation Physics, University of Wollongong, Wollongong (Australia); Kron, Tomas [Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne (Australia); Bressel, Mathias [Department of Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, East Melbourne (Australia); Callahan, Jason [Centre for Molecular Imaging, Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia); MacManus, Michael P.; Shaw, Mark; Plumridge, Nikki [Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); Hicks, Rodney J. [Centre for Molecular Imaging, Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia); Department of Medicine, University of Melbourne, Parkville (Australia); Steinfort, Daniel [Department of Medicine, University of Melbourne, Parkville (Australia); Department of Cancer Medicine, Peter MacCallum Cancer Centre, East Melbourne (Australia); Ball, David L. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne (Australia); Hofman, Michael S. [Centre for Molecular Imaging, Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia); Department of Medicine, University of Melbourne, Parkville (Australia)

    2015-10-01

    Purpose: To investigate {sup 68}Ga-ventilation/perfusion (V/Q) positron emission tomography (PET)/computed tomography (CT) as a novel imaging modality for assessment of perfusion, ventilation, and lung density changes in the context of radiation therapy (RT). Methods and Materials: In a prospective clinical trial, 20 patients underwent 4-dimensional (4D)-V/Q PET/CT before, midway through, and 3 months after definitive lung RT. Eligible patients were prescribed 60 Gy in 30 fractions with or without concurrent chemotherapy. Functional images were registered to the RT planning 4D-CT, and isodose volumes were averaged into 10-Gy bins. Within each dose bin, relative loss in standardized uptake value (SUV) was recorded for ventilation and perfusion, and loss in air-filled fraction was recorded to assess RT-induced lung fibrosis. A dose-effect relationship was described using both linear and 2-parameter logistic fit models, and goodness of fit was assessed with Akaike Information Criterion (AIC). Results: A total of 179 imaging datasets were available for analysis (1 scan was unrecoverable). An almost perfectly linear negative dose-response relationship was observed for perfusion and air-filled fraction (r{sup 2}=0.99, P<.01), with ventilation strongly negatively linear (r{sup 2}=0.95, P<.01). Logistic models did not provide a better fit as evaluated by AIC. Perfusion, ventilation, and the air-filled fraction decreased 0.75 ± 0.03%, 0.71 ± 0.06%, and 0.49 ± 0.02%/Gy, respectively. Within high-dose regions, higher baseline perfusion SUV was associated with greater rate of loss. At 50 Gy and 60 Gy, the rate of loss was 1.35% (P=.07) and 1.73% (P=.05) per SUV, respectively. Of 8/20 patients with peritumoral reperfusion/reventilation during treatment, 7/8 did not sustain this effect after treatment. Conclusions: Radiation-induced regional lung functional deficits occur in a dose-dependent manner and can be estimated by simple linear models with 4D-V/Q PET

  17. Red and processed meat consumption and the risk of lung cancer: a dose-response meta-analysis of 33 published studies.

    Science.gov (United States)

    Xue, Xiu-Juan; Gao, Qing; Qiao, Jian-Hong; Zhang, Jie; Xu, Cui-Ping; Liu, Ju

    2014-01-01

    This meta-analysis was to summarize the published studies about the association between red/processed meat consumption and the risk of lung cancer. 5 databases were systematically reviewed, and random-effect model was used to pool the study results and to assess dose-response relationships. Results shown that six cohort studies and twenty eight case-control studies were included in this meat-analysis. The pooled Risk Radios (RR) for total red meat and processed meat were 1.44 (95% CI, 1.29-1.61) and 1.23 (95% CI, 1.10-1.37), respectively. Dose-response analysis revealed that for every increment of 120 grams red meat per day the risk of lung cancer increases 35% and for every increment of 50 grams red meat per day the risk of lung cancer increases 20%. The present dose-response meta-analysis suggested that both red and processed meat consumption showed a positive effect on lung cancer risk.

  18. SU-E-T-633: Dose Differences in Lung Cancer SBRT: The Influences of MLC Width

    Energy Technology Data Exchange (ETDEWEB)

    Chen, J; Yin, Y [Shandong Cancer Hospital, Jinan, Shandong (China)

    2014-06-15

    Purpose: The aim is to compare the plan dose distribution of lung SBRT with MLCs in different width. Methods: Cases with phase INSCLC were enrolled. 9 cases were undergone 4D-CT scanning in the supine position with both arms raised. 3D-CT images without IV contrast were afterwards acquired with 3mm thickness and used for dose calculations. ITV was generated by using the inspiration and expiration images. The ITV can be expanded by geometric set-up uncertainty (5 mm) to generate the PTV. All chest normal tissues including chest wall were contoured by doctors. A total dose of 55 Gy will be given in 5 fractions within 10–14 days with an inter fraction interval of 2–3 days. Guided by the RTOG trial 3502 protocol, 11–13 non-coplanar fields with 6MV photon were arranged. Three types of MLCs with width of 3mm, 5mm and 10mm at isocenter position, were used separately to generate a CRT plan for each case. Monte Carlo algorithm was applied to dose calculation. All plans were adjusted as possible to meet the dose constraints. Dose-volume parameters from plans as followed were compared and analysized: PTV V55Gy, COMPTV D70% (70% of normalization dose), volume A (body minus PTV), and R100% and R50% (the ratio of x% of prescription dose isoline volume to PTV volume). Results: MLCs, 3mm and 5mm wide, played the identical roles on dosimetry of the plans, excluding the parameter volume A (p<0.05). On the contrary, MLC with width of 10mm was significantly inferior to the other two types on most parameters (p<0.05). For R50%, all types contributed equally (p>0.05). Conclusion: For lung cancer SBRT, MLC width had influence to dosimetry, especially in irradiation area. Small size MLC, e.g. 3mm and 5mm, are helpful to generate a high quality treatment plan, which could meet the strict criteria for targets and OAR.

  19. Optimal unified combination rule in application of Dempster-Shafer theory to lung cancer radiotherapy dose response outcome analysis.

    Science.gov (United States)

    He, Yanyan; Hussaini, M Yousuff; Gong, Yutao U T; Xiao, Ying

    2016-01-08

    Our previous study demonstrated the application of the Dempster-Shafer theory of evidence to dose/volume/outcome data analysis. Specifically, it provided Yager's rule to fuse data from different institutions pertaining to radiotherapy pneumonitis versus mean lung dose. The present work is a follow-on study that employs the optimal unified combination rule, which optimizes data similarity among independent sources. Specifically, we construct belief and plausibility functions on the lung cancer radiotherapy dose outcome datasets, and then apply the optimal unified combination rule to obtain combined belief and plausibility, which bound the probabilities of pneumonitis incidence. To estimate the incidence of pneumonitis at any value of mean lung dose, we use the Lyman-Kutcher-Burman (LKB) model to fit the combined belief and plausibility curves. The results show that the optimal unified combination rule yields a narrower uncertainty range (as represented by the belief-plausibility range) than Yager's rule, which is also theoretically proven.

  20. Are mean lung dose and changes in respiration during RT predictive for pulmonary function changes after RT?

    DEFF Research Database (Denmark)

    Jensen, K.; Bernchou, U.; Schytte, T.

    2015-01-01

    Purpose/Objective: Radiotherapy (RT) of lung cancer patients could be improved if patient specific dose tolerances can be estimated during the first weeks of a fractionated treatment course. Such tolerances may be estimated from the delivered dose distribution and changes in ventilation and respi......Purpose/Objective: Radiotherapy (RT) of lung cancer patients could be improved if patient specific dose tolerances can be estimated during the first weeks of a fractionated treatment course. Such tolerances may be estimated from the delivered dose distribution and changes in ventilation...... and respiration patterns extracted from frequently recorded 4DCone Beam CT. Materials and Methods: This is a study of 140 non-small-cell lung cancer (NSCLC) patients, which were treated with 60-66 Gy in 30-33 fractions. Measures of ventilation were generated by the freeware tool elastix (http...

  1. Dose escalation for unresectable locally advanced non-small cell lung cancer: end of the line?

    Science.gov (United States)

    Hong, Julian C; Salama, Joseph K

    2016-02-01

    Radiation Therapy Oncology Group (RTOG) 0617 was a randomized trial that investigated both the impact of radiation dose-escalation and the addition of cetuximab on the treatment of non-small cell lung cancer (NSCLC). The results of RTOG 0617 were surprising, with the dose escalation randomization being closed prematurely due to futility stopping rules, and cetuximab ultimately showing no overall survival benefit. Locally advanced unresectable NSCLC has conventionally been treated with concurrent chemoradiation. Though advances in treatment technology have improved the ability to deliver adequate treatment dose, the foundation for radiotherapy (RT) has remained the same since the 1980s. Since then, progressive studies have sought to establish the safety and efficacy of escalating radiation dose to loco-regional disease. Though RTOG 0617 did not produce the anticipated result, much interest remains in dose escalation and establishing an explanation for the findings of this study. Cetuximab was also not found to provide a survival benefit when applied to an unselected population. However, planned retrospective analysis suggests that those patients with high epidermal growth factor receptor (EGFR) expression may benefit, suggesting that cetuximab should be applied in a targeted fashion. We discuss the results of RTOG 0617 and additional findings from post-hoc analysis that suggest that dose escalation may be limited by normal tissue toxicity. We also present ongoing studies that aim to address potential causes for mortality in the dose escalation arm through adaptive or proton therapy, and are also leveraging additional concurrent systemic agents such as tyrosine kinase inhibitors (TKIs) for EGFR-activating mutations or EML4-ALK rearrangements, and poly (ADP-ribose) polymerase (PARP) inhibitors.

  2. CT patterns of fungal pulmonary infections of the lung: Comparison of standard-dose and simulated low-dose CT

    Energy Technology Data Exchange (ETDEWEB)

    Christe, Andreas, E-mail: andreas.christe@insel.ch [Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305 (United States); University Institute of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Inselspital, Freiburgstrasse 10, 3010 Bern (Switzerland); Lin, Margaret C., E-mail: mc_lin@hotmail.com [Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305 (United States); Yen, Andrew C., E-mail: acyen@ucsd.edu [Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305 (United States); Hallett, Rich L., E-mail: xraydoc97@yahoo.com [Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305 (United States); Roychoudhury, Kingshuk, E-mail: kingshuk@statucc.ie [Statistics Department, University College Cork, Cork (Ireland); Schmitzberger, Florian, E-mail: florians@stanford.edu [Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305 (United States); Fleischmann, Dominik, E-mail: d.fleischmann@stanford.edu [Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305 (United States); Leung, Ann N., E-mail: aleung@stanford.edu [Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305 (United States); Rubin, Geoffry D., E-mail: grubin@stanford.edu [Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305 (United States); Vock, Peter, E-mail: peter.vock@insel.ch [University Institute of Diagnostic, Interventional and Pediatric Radiology, University Hospital Bern, Inselspital, Freiburgstrasse 10, 3010 Bern (Switzerland); Roos, Justus E., E-mail: justus.roos@stanford.edu [Department of Radiology, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305 (United States)

    2012-10-15

    Purpose: To assess the effect of radiation dose reduction on the appearance and visual quantification of specific CT patterns of fungal infection in immuno-compromised patients. Materials and methods: Raw data of thoracic CT scans (64 × 0.75 mm, 120 kVp, 300 reference mAs) from 41 consecutive patients with clinical suspicion of pulmonary fungal infection were collected. In 32 patients fungal infection could be proven (median age of 55.5 years, range 35–83). A total of 267 cuboids showing CT patterns of fungal infection and 27 cubes having no disease were reconstructed at the original and 6 simulated tube currents of 100, 40, 30, 20, 10, and 5 reference mAs. Eight specific fungal CT patterns were analyzed by three radiologists: 76 ground glass opacities, 42 ground glass nodules, 51 mixed, part solid, part ground glass nodules, 36 solid nodules, 5 lobulated nodules, 6 spiculated nodules, 14 cavitary nodules, and 37 foci of air-space disease. The standard of reference was a consensus subjective interpretation by experts whom were not readers in the study. Results: The mean sensitivity and standard deviation for detecting pathological cuboids/disease using standard dose CT was 0.91 ± 0.07. Decreasing dose did not affect sensitivity significantly until the lowest dose level of 5 mAs (0.87 ± 0.10, p = 0.012). Nodular pattern discrimination was impaired below the dose level of 30 reference mAs: specificity for fungal ‘mixed nodules’ decreased significantly at 20, 10 and 5 reference mAs (p < 0.05). At lower dose levels, classification drifted from ‘solid’ to ‘mixed nodule’, although no lesion was missed. Conclusion: Our simulation data suggest that tube current levels can be reduced from 300 to 30 reference mAs without impairing the diagnostic information of specific CT patterns of pulmonary fungal infections.

  3. Cancer-associated fibroblasts from lung tumors maintain their immunosuppressive abilities after high-dose irradiation.

    Science.gov (United States)

    Gorchs, Laia; Hellevik, Turid; Bruun, Jack-Ansgar; Camilio, Ketil-Andre; Al-Saad, Samer; Stuge, Tor-Brynjar; Martinez-Zubiaurre, Inigo

    2015-01-01

    Accumulating evidence supports the notion that high-dose (>5 Gy) radiotherapy (RT) regimens are triggering stronger pro-immunogenic effects than standard low-dose (2 Gy) regimens. However, the effects of RT on certain immunoregulatory elements in tumors remain unexplored. In this study, we have investigated the effects of high-dose radiotherapy (HD-RT) on the immunomodulating functions of cancer-associated fibroblasts (CAFs). Primary CAF cultures were established from lung cancer specimens derived from patients diagnosed for non-small cell lung cancer. Irradiated and non-irradiated CAFs were examined for immunomodulation in experiments with peripheral blood mononuclear cells from random, healthy donors. Regulation of lymphocytes behavior was checked by lymphocyte proliferation assays, lymphocyte migration assays, and T-cell cytokine production. Additionally, CAF-secreted immunoregulatory factors were studied by multiplex protein arrays, ELISAs, and by LC-MS/MS proteomics. In all functional assays, we observed a powerful immunosuppressive effect exerted by CAF-conditioned medium on activated T-cells (p > 0.001), and this effect was sustained after a single radiation dose of 18 Gy. Relevant immunosuppressive molecules such as prostaglandin E2, interleukin-6, and -10, or transforming growth factor-β were found in CAF-conditioned medium, but their secretion was unchanged after irradiation. Finally, immunogenic cell death responses in CAFs were studied by exploring the release of high motility group box-1 and ATP. Both alarmins remained undetectable before and after irradiation. In conclusion, CAFs play a powerful immunosuppressive effect over activated T-cells, and this effect remains unchanged after HD-RT. Importantly, CAFs do not switch on immunogenic cell death responses after exposure to HD-RT.

  4. Dose estimate of inhaled hafnium tritide using the ICRP 66 lung model.

    Science.gov (United States)

    Cheng, Yung-Sung; Zhou, Yue; Wang, Yang-Sheng; Inkret, William C; Wermer, Joseph R

    2002-06-01

    Metal tritide is widely used for research, purification, compression, and storage of tritium. The current understanding of metal tritide and its radiation dosimetry for internal exposure is limited, and ICRP publications do not provide the tritium dosimetry for hafnium tritide. The current radiation protection guidelines for metal tritide particles (including hafnium tritide) are based on the assumption that their biological behavior is similar to tritiated water, which is completely absorbed by the body. However, the solubility of metal tritide particles depends on the chemical form of the material. The biological half-live of hafnium tritide particles and the dosimetry of an inhalation exposure to those particles could be quite different from tritiated water. This paper describes experiments on the dissolution rate of hafnium tritide particles in a simulated lung fluid. The results showed that less than 1% of the tritium was dissolved in the simulated lung fluid for hafnium tritide particles after 215 d. The short-term and long-term dissolution half times were 46 and 4.28 x 10(5) d, respectively. This indicates that hafnium tritide is an extremely insoluble material. Self-absorption of beta rays in the hafnium tritide particles was estimated by a numerical method. The dose coefficients were calculated as a function of particle size using in vitro solubility data and a calculated self-absorption factor. The dose coefficient decreased with aerodynamic diameters in the range of 0.25 to 10 microm, mainly because the self-absorption factor decreased with increasing particle size. For a particle 1 microm in aerodynamic diameter, the dose coefficient of a hafnium tritide particle was about 10 times higher than that of tritiated water but was about 1.4 times lower than that calculated by ICRP Publication 71 for Type S tritiated particles. The ICRP estimate did not include a self-absorption factor and thus might have overestimated the dose. This finding has significant

  5. Low-Dose Radiation Induces Cell Proliferation in Human Embryonic Lung Fibroblasts but not in Lung Cancer Cells

    Directory of Open Access Journals (Sweden)

    Xinyue Liang

    2016-01-01

    Full Text Available Hormesis and adaptive responses are 2 important biological effects of low-dose ionizing radiation (LDR. In normal tissue, LDR induces hormesis as evinced by increased cell proliferation; however, whether LDR also increases tumor cell proliferation needs to be investigated. In this study, cell proliferation was assayed by total cell numbers and the Cell Counting Kit 8 assay. Mitogen-activated protein kinases (MAPK/extracellular signal-regulated kinase (ERK and phosphatidylinositol 3′ -kinase(PI3K-Akt (PI3K/AKT phosphorylation were determined by Western blot analysis. Human embryonic lung fibroblast 2BS and lung cancer NCI-H446 cell lines were irradiated with LDR at different doses (20-100 mGy. In response to 20 to 75 mGy X-rays, cell proliferation was significantly increased in 2BS but not in NCI-H446 cells. In 2BS cells, LDR at 20 to 75 mGy also stimulated phosphorylation of MAPK/ERK pathway proteins including ERK, MEK, and Raf and of the PI3K/AKT pathway protein AKT. To test whether ERK1/2 and AKT pathway activation was involved in the stimulation of cell proliferation in 2BS cells, the MAPK/ERK and PI3K/AKT pathways were inhibited using their specific inhibitors, U0126 and LY294002. U0126 decreased the phosphorylation of ERK1/2, and LY294002 decreased the phosphorylation of AKT; each could significantly inhibit LDR-induced 2BS cell proliferation. However, LDR did not stimulate these kinases, and kinase inhibitors also did not affect cell proliferation in the NCI-H446 cells. These results suggest that LDR stimulates cell proliferation via the activation of both MAPK/ERK and PI3K/AKT signaling pathways in 2BS but not in NCI-H446 cells. This finding implies the potential for applying LDR to protect normal tissues from radiotherapy without diminishing the efficacy of tumor therapy.

  6. Western red cedar dust exposure and lung function: a dose-response relationship.

    Science.gov (United States)

    Noertjojo, H K; Dimich-Ward, H; Peelen, S; Dittrick, M; Kennedy, S M; Chan-Yeung, M

    1996-10-01

    The relationship between levels of cumulative red cedar dust exposure and decline in lung function was explored in an 11-yr follow-up study of 243 sawmill workers who participated in at least two occasions. We also studied 140 office workers in a similar manner as control subjects. Workers with asthma were excluded from the analysis. During the period of the study, 916 personal and 216 area samples of dust were collected from the sawmill. Cumulative wood dust exposure was calculated for each sawmill worker according to the duration and exposure in each job, based on the geometric mean of all dust measurements for that job. Average daily dust exposure was calculated by dividing the total cumulative exposure by the number of days of work. Workers were divided into low-, medium-, and high-exposure groups with mean daily level of exposure of 0.4 mg/m3, respectively. Sawmill workers had significantly greater declines in FEV1 and FVC compared with office workers adjusted for age, smoking, and initial lung function. A dose-response relationship was observed between the level of exposure and the annual decline in FVC. We conclude that exposure to Western red cedar dust is associated with a greater decline in lung function which may lead to development of chronic airflow limitation.

  7. Automated detection of lung nodules in low-dose computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Cascio, D. [Dipt. di Fisica e Tecnologie Relative, Univ. di Palermo (Italy); Cheran, S.C. [Dipt. di Fisica, Univ. di Genova (Italy); Ist. Nazionale di Fisica Nucleare, Sezione di Torino (Italy); Chincarini, A. [Ist. Nazionale di Fisica Nucleare, Sezione di Genova (Italy); De Nunzio, G. [Dipt. di Scienza dei Materiali, Univ. di Lecce (Italy); Delogu, P.; Fantacci, M.E. [Dipt. di Fisica, Univ. di Pisa (Italy); Ist. Nazionale di Fisica Nucleare, Sezione di Pisa (Italy); Gargano, G. [Dipt. Interateneo di Fisica M. Merlin, Univ. di Bari (Italy); Ist. Nazionale di Fisica Nucleare, Sezione di Bari (Italy); Gori, I.; Retico, A. [Ist. Nazionale di Fisica Nucleare, Sezione di Pisa (Italy); Masala, G.L. [Struttura Dipartimentale di Matematica e Fisica, Univ. di Sassari (Italy); Ist. Nazionale di Fisica Nucleare, Sezione di Cagliari (Italy); Preite Martinez, A. [Centro Studi e Ricerche Enrico Fermi, Roma (Italy); Santoro, M. [Dipt. di Scienze Fisiche, Univ. di Napoli (Italy); Spinelli, C. [Unita Operativa Radiodiagnostica 2, Azienda Ospedaliera Universitaria Pisana, Pisa (Italy); Tarantino, T. [Divisione di Radiologia Diagnostica e Interventistica del Dipt. di Oncologia, Trapianti e Nuove Tecnologie in Medicina, Univ. di Pisa (Italy)

    2007-06-15

    A computer-aided detection (CAD) system for the identification of pulmonary nodules in low-dose multi-detector computed-tomography (CT) images has been developed in the framework of the MAGIC-5 Italian project. One of the main goals of this project is to build a distributed database of lung CT scans in order to enable automated image analysis through a data and cpu GRID infrastructure. The basic modules of our lung-CAD system, consisting in a 3D dot-enhancement filter for nodule detection and a neural classifier for false-positive finding reduction, are described. The system was designed and tested for both internal and sub-pleural nodules. The database used in this study consists of 17 low-dose CT scans reconstructed with thin slice thickness ({proportional_to}300 slices/scan). The preliminary results are shown in terms of the FROC analysis reporting a good sensitivity (85% range) for both internal and sub-pleural nodules at an acceptable level of false positive findings (1-9 FP/scan); the sensitivity value remains very high (75% range) even at 1-6 FP/scan. (orig.)

  8. Assessment of the exposure to and dose from radon decay products in normally occupied homes

    Energy Technology Data Exchange (ETDEWEB)

    Hopke, P.K.; Jensen, B.; Li, C.S.; Montassier, N.; Wasiolek, P. [Clarkson Univ., Potsdam, NY (United States); Cavallo, A.J.; Gatsby, K.; Socolow, R.H. [Princeton Univ., NJ (United States); James, A.C. [Pacific Northwest Lab., Richland, WA (United States)

    1995-05-01

    The exposure to radon decay products has been assessed in seven homes in the northeastern United States and southeastern Canada. In two of the houses, there was a single individual who smoked cigarettes. There were a variety of heating and cooking appliances among these homes. These studies have provide 565 measurements of the activity-weighted size distributions in these houses. The median value for the equilibrium factor was 0.408 as compared with the previously employed value of 0.50. Using the recently adopted ICRP lung deposition and dosimetry model, the hourly equivalent lung dose rate per unit, radon exposure was estimated for each measured size distribution. Differences between houses with smokers present and absent were noted in the exposure conditions, but the resulting dose rate per unit of radon gas concentration was essentially the same for the two groups. Expressed in terms of ICRP`s unit of effective dose for members of the public, the mean dose rate conversion coefficient with respect to radon gas concentration found in this study was 3.8 nSv h{sup -} Bq{sup -} m{sup -3}. 26 refs., 8 figs., 3 tabs.

  9. Investigating the low-dose limits of multidetector CT in lung nodule surveillance.

    Science.gov (United States)

    Paul, N S; Siewerdsen, J H; Patsios, D; Chung, T B

    2007-09-01

    The purpose of this study was to evaluate the factors limiting nodule detection in thoracic computed tomography (CT) and to determine whether prior knowledge of nodule size and attenuation, available from a baseline CT study, influences the minimum radiation dose at which nodule surveillance CT scans can be performed while maintaining current levels of nodule detectability. Multiple nodules varying in attenuation (-509 to + 110 HU) and diameter (1.6 to 9.5 mm) were layered in random and ordered sequences within 2 lung cylinders made of Rando lung material and suspended within a custom-built CT phantom. Multiple CT scans were performed at varying kVp (120, 100, and 80), mA (200, 150, 100, 50, 20, and 10), and beam collimation (5, 2.5, and 1.25 mm) on a four-row multidetector scanner (Lightspeed, General Electric, Milwaukee, WI) using 0.8 s gantry rotation. The corresponding range of radiation dose over which images were acquired was 0.3-26.4 mGy. Nine observers independently performed three specific tasks, namely: (1) To detect a 3.2 mm nodule of 23 HU; (2) To detect 3.2 mm nodules of varying attenuation (-509 to -154 HU); and (3) To detect nodules varying in size (1.6-9 mm) and attenuation (-509 to 110 HU). A two-alternative forced-choice test was used in order to determine the limits of nodule detection in terms of the proportion of correct responses (Pcorr, related to the area under the ROC curve) as a summary metric of observer performance. The radiation dose levels for detection of 99% of nodules in each task were as follows: Task 1 (1 mGy); Task 2 (5 mGy); and Task 3 (7 mGy). The corresponding interobserver confidence limits were 1, 5, and 10 mGy for Tasks 1, 2, and 3, respectively. There was a fivefold increase in the radiation dose required for detection of lower-density nodules (Tasks 1 to 2). Absence of prior knowledge of the nodule size and density (Task 3) corresponds to a significant increase in the minimum required radiation dose. Significant image

  10. Erlotinib dosing-to-rash: A phase II intrapatient dose escalation and pharmacologic study of erlotinib in previously treated advanced non-small cell lung cancer

    NARCIS (Netherlands)

    A. mita (Alain); K. Papadopoulos (K.); M.J.A. de Jonge (Maja); G. Schwartz (G.); J. Verweij (Jaap); A. Ricart (A.); Q.S.C. Chu (Q. S C); A.W. Tolcher (A. W.); L. Wood (Lori); S.W. McCarthy (Stanley); M. Hamilton; K.K. Iwata (Kenneth); B. Wacker; K. de Witte (Karel); E.K. Rowinsky (Eric Keith)

    2011-01-01

    textabstractBackground: To evaluate the anticancer activity of erlotinib in patients with previously treated, advanced non-small cell lung cancer (NSCLC) whose dose is increased to that associated with a maximal level of tolerable skin toxicity (i.e., target rash (TR)); to characterise the pharmacok

  11. Estradiol valerate and alcohol intake: dose-response assessments

    Science.gov (United States)

    Quirarte, Gina L; Reid, Larry D; de la Teja, I Sofía Ledesma; Reid, Meta L; Sánchez, Marco A; Díaz-Trujillo, Arnulfo; Aguilar-Vazquez, Azucena; Prado-Alcalá, Roberto A

    2007-01-01

    Background An injection of estradiol valerate (EV) provides estradiol for a prolonged period. Recent research indicates that a single 2.0 mg injection of EV modifies a female rat's appetite for alcoholic beverages. This research extends the initial research by assessing 8 doses of EV (from .001 to 2.0 mg/female rat), as well assessing the effects of 2.0 mg EV in females with ovariectomies. Results With the administration of EV, there was a dose-related loss of bodyweight reaching the maximum loss, when it occurred, at about 4 days after injections. Subsequently, rats returned to gaining weight regularly. Of the doses tested, only the 2.0 mg dose produced a consistent increase in intake of ethanol during the time previous research indicated that the rats would show enhanced intakes. There was, however, a dose-related trend for smaller doses to enhance intakes. Rats with ovariectomies showed a similar pattern of effects, to intact rats, with the 2 mg dose. After extensive histories of intake of alcohol, both placebo and EV-treated females had estradiol levels below the average measured in females without a history of alcohol-intake. Conclusion The data support the conclusion that pharmacological doses of estradiol can produce enduring changes that are manifest as an enhanced appetite for alcoholic beverages. The effect can occur among females without ovaries. PMID:17335585

  12. A Phase I trial of dose escalation of topotecan combined with whole brain radiotherapy for brain metastasis in lung cancer

    Institute of Scientific and Technical Information of China (English)

    Xiaohui Ge; Wenyan Zhao; Xiaocang Ren; Yongqiang Wang; Zhigang Li; Yanqi Li; Yuee Liu; Qiang Lin

    2012-01-01

    Objective: The aim of this study was to define the maximum-tolerated dose (MTD) and observe the toxicity of escalating topotecan combined whole brain radiotherapy for brain metastasis in lung cancer. Methods: Patients with brain metastasis of lung cancer received conventional fractionation radiotherapy, with 5 daily fractions of 2 Gy per week, the total radiation dose was 40 Gy, while the larger lesions were boosted to 50-60 Gy. The initial dose of topotecan was 1.0 mg/m2. Escalation dose was 0.25 mg/m2. Every cohort contained at least 3 patients.If no dose-limiting toxicity (DLT) was observed,the next dose level was opened for entry. These courses were repeated until DLT appeared. MTD was declared as one dose level below which DLT appeared. Results: Eighteen patients were recruited. Two cases of grade 3 leucopenia/neutropenia was observed as DLT at the level of topotecan 2.0 mg/m2. MTD of topotecan was defined as 1.75 mg/m2.The major side effects were leucopenia/neutropenia, nausea and vomiting. Conclusion: Topotecan combined with whole brain radiotherapy for brain metastasis in lung cancer is well tolerated. Maximum-tolerated dose of topotecan is 1.75 mg/m2, once a week of a total of four.

  13. SU-E-J-149: Establishing the Relationship Between Pre-Treatment Lung Ventilation, Dose, and Toxicity Outcome

    Energy Technology Data Exchange (ETDEWEB)

    Mistry, N; D' Souza, W [University of Maryland School of Medicine, Baltimore, MD (United States); Sornsen de Koste, J; Senan, S [VU University Medical Center, Amsterdam, MB (Netherlands)

    2014-06-01

    Purpose: Recently, there has been an interest in incorporating functional information in treatment planning especially in thoracic tumors. The rationale is that healthy lung regions need to be spared from radiation if possible to help achieve better control on toxicity. However, it is still unclear whether high functioning regions need to be spared or have more capacity to deal with the excessive radiation as compared to the compromised regions of the lung. Our goal with this work is to establish the tools by which we can establish a relationship between pre-treatment lung function, dose, and radiographic outcomes of lung toxicity. Methods: Treatment planning was performed using a single phase of a 4DCT scan, and follow-up anatomical CT scans were performed every 3 months for most patients. In this study, we developed the pipeline of tools needed to analyze such a large dataset, while trying to establish a relationship between function, dose, and outcome. Pre-treatment lung function was evaluated using a recently published technique that evaluates Fractional Regional Ventilation (FRV). All images including the FRV map and the individual follow-up anatomical CT images were all spatially matched to the planning CT using a diffusion based Demons image registration algorithm. Change in HU value was used as a metric to capture the effects of lung toxicity. To validate the findings, a radiologist evaluated the follow-up anatomical CT images and scored lung toxicity. Results: Initial experience in 1 patient shows a relationship between the pre-treatment lung function, dose and toxicity outcome. The results are also correlated to the findings by the radiologist who was blinded to the analysis or dose. Conclusion: The pipeline we have established to study this enables future studies in large retrospective studies. However, the tools are dependent on the fidelity of 4DCT reconstruction for accurate evaluation of regional ventilation. Patent Pending for the technique

  14. Effect of inhomogeneous activity distributions and airway geometry on cellular doses in radon lung dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Szoke, Istvan; Balashazy, Imre; Farkas, Arpad [KFKI Atomic Energy Research Institute, PO Box 49, 1525 Budapest (Hungary); Hofmann, Werner [University of Salzburg, Hellbrunner Str. 34, 5020 Salzburg (Austria)

    2007-07-01

    The human tracheobronchial system has a very complex structure including cylindrical airway ducts connected by airway bifurcation units. The deposition of the inhaled aerosols within the airways exhibits a very inhomogeneous pattern. The formation of deposition hot spots near the carinal ridge has been confirmed by experimental and computational fluid and particle dynamics (CFPD) methods. In spite of these observations, current radon lung dosimetry models apply infinitely long cylinders as models of the airway system and assume uniform deposition of the inhaled radon progenies along the airway walls. The aim of this study is to investigate the effect of airway geometry and non-uniform activity distributions within bronchial bifurcations on cellular dose distributions. In order to answer these questions, the nuclear doses of the bronchial epithelium were calculated in three different irradiation situations. (1) First, CFPD methods were applied to calculate the distribution of the deposited alpha-emitting nuclides in a numerically constructed idealized airway bifurcation. (2) Second, the deposited radionuclides were randomly distributed along the surface of the above-mentioned geometry. (3) Finally, calculations were made in cylindrical geometries corresponding to the parent and daughter branches of the bifurcation geometry assuming random nuclide activity distribution. In all three models, the same {sup 218}Po and {sup 214}Po surface activities per tissue volumes were assumed. Two conclusions can be drawn from this analysis: (i) average nuclear doses are very similar in all three cases (minor differences can be attributed to differences in the linear energy transfer (LET) spectra) and (ii) dose distributions are significantly different in all three cases, with the highest doses at the carinal ridge in case 3. (authors)

  15. [Assessment of sociodemographic and nutritional status of lung cancer patients].

    Science.gov (United States)

    Zabłocka, Katarzyna; Krawczyszyn, Monika; Pieczyńska, Joanna; Prescha, Anna; Ilow, Rafał; Porebska, Irena; Gołecki, Marcin; Kosacka, Monika; Jankowska, Renata; Grajeta, Halina; Biernat, Jadwiga

    2011-01-01

    Low sociodemographic status positively correlates with the risk of lung cancer. Nutritional status assessed during diagnosis of cancer may be a useful predictive factor for response to therapy and influences the quality of life and life expectancy after oncological therapy. The aim of this study was to assess the sociodemographic and nutritional status of patients. Lower Silesian Centre of Lung Diseases, diagnosed with lung cancer. 81 cases and 125 subjects formed the control group were included in this study. The questionnaire about sociodemographic status was performed among all respondents as well as MNA questionnaire and anthropometric measurements for evaluating nutritional status. Lower level of education, lower employment status and more frequent tobacco addiction was found in patient group then in control individuals. Nutritional status of patients was worse than the control group, which has been demonstrated mainly through a MNA questionnaire and arm circumference measurements. The risk of malnutrition or diagnosed malnutrition found in most patients assessed by MNA test may increase the likelihood of complications during treatment.

  16. SU-E-T-78: A Study of Dose Falloff Gradient in RapidArc Planning of Lung SBRT

    Energy Technology Data Exchange (ETDEWEB)

    Desai, D; Srinivasan, S; Elasmar, H [Memorial Health Care System, Chattanooga, TN (United States); Johnson, E [Univ Kentucky Medical Ctr, Lexington, KY (United States)

    2015-06-15

    Purpose: Rapid dose falloff beyond PTV is an important criterion for normal tissue sparing in SBRT. RTOG protocols use D2cm and R50% for plan quality evaluation. This study is aimed at analyzing the dose falloff gradient beyond the PTV extending into normal tissue structures and to ascertain the impact of PTV geometry and location on the dose falloff gradient in RapidArc planning of lung SBRT Methods: In this retrospective study, we analyzed 39 clinical RapidArc lung SBRT treatment plans that met RTOG-0915 criteria. Planning was done on Eclipse 8.9 for delivery on either Novalis NTx or TrueBeam STx equipped with HD MLCs. PTV volumes ranged between 5.3 and 113 cc (2.2 to 6 cm sphere equivalent diameter respectively) and their geographic locations were distributed in both lungs. 6X, 6X-FFF, 10X, and 10X-FFF energies were used for planning. All of these SBRT plans were planned using either 2 or 3 full or hemi arcs, with moderate couch kicks. Dose falloff gradients were obtained by generating 7 concentric 5 mm rings beyond PTV surface. Mean dose in each ring is used to evaluate percentage dose falloff gradient as a function of distance from the PTV surface. Results: The mean percentage dose falloff beyond PTV surface in all plans followed an exponential decay and the data was modeled with double exponential decay fit. Photon energy selection in the plan had a minimal impact on the mean percentage dose fall off beyond PTV surface. Conclusion: Dose falloff beyond PTV surface as a function of distance can be ascertained by the use of the double exponential decay fit coefficients in RapidArc planning of lung SBRT. This will help also in plan quality evaluation in addition to D2cm and R50% defined by RTOG.

  17. Peak Dose Assessment for Proposed DOE-PPPO Authorized Limits

    Energy Technology Data Exchange (ETDEWEB)

    Maldonado, Delis [Oak Ridge Institute for Science and Education, Oak Ridge, TN (United States). Independent Environmental Assessment and Verification Program

    2012-06-01

    The Oak Ridge Institute for Science and Education (ORISE), a U.S. Department of Energy (DOE) prime contractor, was contracted by the DOE Portsmouth/Paducah Project Office (DOE-PPPO) to conduct a peak dose assessment in support of the Authorized Limits Request for Solid Waste Disposal at Landfill C-746-U at the Paducah Gaseous Diffusion Plant (DOE-PPPO 2011a). The peak doses were calculated based on the DOE-PPPO Proposed Single Radionuclides Soil Guidelines and the DOE-PPPO Proposed Authorized Limits (AL) Volumetric Concentrations available in DOE-PPPO 2011a. This work is provided as an appendix to the Dose Modeling Evaluations and Technical Support Document for the Authorized Limits Request for the C-746-U Landfill at the Paducah Gaseous Diffusion Plant, Paducah, Kentucky (ORISE 2012). The receptors evaluated in ORISE 2012 were selected by the DOE-PPPO for the additional peak dose evaluations. These receptors included a Landfill Worker, Trespasser, Resident Farmer (onsite), Resident Gardener, Recreational User, Outdoor Worker and an Offsite Resident Farmer. The RESRAD (Version 6.5) and RESRAD-OFFSITE (Version 2.5) computer codes were used for the peak dose assessments. Deterministic peak dose assessments were performed for all the receptors and a probabilistic dose assessment was performed only for the Offsite Resident Farmer at the request of the DOE-PPPO. In a deterministic analysis, a single input value results in a single output value. In other words, a deterministic analysis uses single parameter values for every variable in the code. By contrast, a probabilistic approach assigns parameter ranges to certain variables, and the code randomly selects the values for each variable from the parameter range each time it calculates the dose (NRC 2006). The receptor scenarios, computer codes and parameter input files were previously used in ORISE 2012. A few modifications were made to the parameter input files as appropriate for this effort. Some of these changes

  18. Development of a real-time radiological dose assessment system

    Energy Technology Data Exchange (ETDEWEB)

    Han, Moon Hee; Lee, Young Bok; Kim, Eun Han; Suh, Kyung Suk; Hwang, Won Tae; Choi, Young Gil

    1997-07-01

    A radiological dose assessment system named FADAS has been developed. This system is necessary to estimated the radiological consequences against a nuclear accident. Mass-consistent wind field module was adopted for the generation of wind field over the whole domain using the several measured wind data. Random-walk dispersion module is used for the calculation of the distribution of radionuclides in the atmosphere. And volume-equivalent numerical integration method has been developed for the assessment of external gamma exposure given from a randomly distributed radioactive materials and a dose data library has been made for rapid calculation. Field tracer experiments have been carried out for the purpose of analyzing the site-specific meteorological characteristics and increasing the accuracy of wind field generation and atmospheric dispersion module of FADAS. At first, field tracer experiment was carried out over flat terrain covered with rice fields using the gas samplers which were designed and manufactured by the staffs of KAERI. The sampled gas was analyzed using gas chromatograph. SODAR and airsonde were used to measure the upper wind. Korean emergency preparedness system CARE was integrated at Kori 4 nuclear power plants in 1995. One of the main functions of CARE is to estimate the radiological dose. The developed real-time dose assessment system FADAS was adopted in CARE as a tool for the radiological dose assessment. (author). 79 refs., 52 tabs., 94 figs.

  19. Inhibition of human lung adenocarcinoma growth using survivint34a by low-dose systematic administration

    Indian Academy of Sciences (India)

    Yan Shan; Chunting Wang; Li Yang; Li Juan Chen; Hong Xin Deng; Han Shuo Yang; Zhimian Li; Zhiyong Li; Li Pan; Fei Leng; Yuquan Wei

    2010-06-01

    Anti-apoptosis plays an important role in tumour formation and development. Survivin is a member of the inhibitor of apoptosis (IAP) family, which is a target for anti-cancer drug exploitation was replaced as development. We investigated the role of the homo dominant-negative mutant Survivin-T34A in suppressing human lung adenocarcinomas (A549). The anti-tumour activity of HSurvivinT34A plasmid was evaluated in the A549 cell line and nude mice bearing A549 subcutaneous tumours. Low-dose systemic administration was continuously used. The HSurvivinT34A plasmid (5 g/one) complexed with a cationic liposome (DOTAP/Chol) significantly inhibited tumour growth in our model. We observed microvessel density degradation by CD31 immunohistochemistry and apoptotic cell increase by TUNEL assay, PI staining and flow cytometric analysis in the treated group. The present findings suggest that the HSurvivinT34A plasmid complexed with a cationic liposome may provide an effective approach to inhibit the growth of human lung adenocarcinomas in vitro and in vivo.

  20. SU-E-T-50: A Multi-Institutional Study of Independent Dose Verification Software Program for Lung SBRT

    Energy Technology Data Exchange (ETDEWEB)

    Kawai, D [Kanagawa Cancer Center, Yokohama, Kanagawa-prefecture (Japan); Takahashi, R; Kamima, T [The Cancer Institute Hospital of JFCR, Koutou-ku, Tokyo (Japan); Baba, H [The National Cancer Center Hospital East, Kashiwa-city, Chiba prefecture (Japan); Yamamoto, T; Kubo, Y [Otemae Hospital, Chuou-ku, Osaka-city (Japan); Ishibashi, S; Higuchi, Y [Sasebo City General Hospital, Sasebo, Nagasaki (Japan); Takahashi, H [St Lukes International Hospital, Chuou-ku, Tokyo (Japan); Tachibana, H [National Cancer Center Hospital East, Kashiwa, Chiba (Japan)

    2015-06-15

    Purpose: The accuracy of dose distribution depends on treatment planning system especially in heterogeneity-region. The tolerance level (TL) of the secondary check using the independent dose verification may be variable in lung SBRT plans. We conducted a multi-institutional study to evaluate the tolerance level of lung SBRT plans shown in the AAPM TG114. Methods: Five institutes in Japan participated in this study. All of the institutes used a same independent dose verification software program (Simple MU Analysis: SMU, Triangle Product, Ishikawa, JP), which is Clarkson-based and CT images were used to compute radiological path length. Analytical Anisotropic Algorithm (AAA), Pencil Beam Convolution with modified Batho-method (PBC-B) and Adaptive Convolve (AC) were used for lung SBRT planning. A measurement using an ion-chamber was performed in a heterogeneous phantom to compare doses from the three different algorithms and the SMU to the measured dose. In addition to it, a retrospective analysis using clinical lung SBRT plans (547 beams from 77 patients) was conducted to evaluate the confidence limit (CL, Average±2SD) in dose between the three algorithms and the SMU. Results: Compared to the measurement, the AAA showed the larger systematic dose error of 2.9±3.2% than PBC-B and AC. The Clarkson-based SMU showed larger error of 5.8±3.8%. The CLs for clinical plans were 7.7±6.0 % (AAA), 5.3±3.3 % (AC), 5.7±3.4 % (PBC -B), respectively. Conclusion: The TLs from the CLs were evaluated. A Clarkson-based system shows a large systematic variation because of inhomogeneous correction. The AAA showed a significant variation. Thus, we must consider the difference of inhomogeneous correction as well as the dependence of dose calculation engine.

  1. A decrease in lung cancer mortality following the introduction of low-dose chest CT screening in Hitachi, Japan.

    Science.gov (United States)

    Nawa, Takeshi; Nakagawa, Tohru; Mizoue, Tetsuya; Kusano, Suzushi; Chonan, Tatsuya; Hayashihara, Kenji; Suito, Tetsushi; Endo, Katsuyuki

    2012-12-01

    Recent US clinical trial demonstrated that CT screening prevents lung cancer death among high risk individuals. However, it remains unclear whether wide implementation of low-dose CT screening for lung cancer can decrease mortality in the community. Among residents in Hitachi City (Japan), where nearly 40% of inhabitants aged 50-69 years were estimated to have participated in the screening at least once from 1998 through 2009, the trend of lung cancer mortality was described in relation to the timing of implementation of the CT screening. Cancer mortality data were obtained from regional cancer registry and standardized mortality ratio (SMR) of lung cancer was calculated for each 5-year period during 1995-2009. In both men and women aged 60 years or older, age-specific lung cancer mortality rates were generally lower during 2005-2009 as compared with those during 1995-2004. For combined men and women aged 50-79 years, SMR was nearly unity prior to or during introductory phase of CT screening and during early period of implementation; however, it was significantly decreased during 2005-2009, well after the implementation of CT screening, with SMR (95% confidence interval) being 0.76 (0.67-0.86). Results suggest that wide implementation of low-dose chest CT screening may decrease lung cancer mortality in the community 4-8 years after introduction of the screening.

  2. Automatic lobar segmentation for diseased lungs using an anatomy-based priority knowledge in low-dose CT images

    Science.gov (United States)

    Park, Sang Joon; Kim, Jung Im; Goo, Jin Mo; Lee, Doohee

    2014-03-01

    Lung lobar segmentation in CT images is a challenging tasks because of the limitations in image quality inherent to CT image acquisition, especially low-dose CT for clinical routine environment. Besides, complex anatomy and abnormal lesions in the lung parenchyma makes segmentation difficult because contrast in CT images are determined by the differential absorption of X-rays by neighboring structures, such as tissue, vessel or several pathological conditions. Thus, we attempted to develop a robust segmentation technique for normal and diseased lung parenchyma. The images were obtained with low-dose chest CT using soft reconstruction kernel (Sensation 16, Siemens, Germany). Our PC-based in-house software segmented bronchial trees and lungs with intensity adaptive region-growing technique. Then the horizontal and oblique fissures were detected by using eigenvalues-ratio of the Hessian matrix in the lung regions which were excluded from airways and vessels. To enhance and recover the faithful 3-D fissure plane, our proposed fissure enhancing scheme were applied to the images. After finishing above steps, for careful smoothening of fissure planes, 3-D rolling-ball algorithm in xyz planes were performed. Results show that success rate of our proposed scheme was achieved up to 89.5% in the diseased lung parenchyma.

  3. The effect of different lung densities on the accuracy of various radiotherapy dose calculation methods: implications for tumour coverage

    DEFF Research Database (Denmark)

    Aarup, Lasse Rye; Nahum, Alan E; Zacharatou, Christina

    2009-01-01

    and tumour have unit density). The lung tissue was assigned five densities (rho(lung)): 0.01, 0.1, 0.2, 0.4 and 1g/cm(3). Four-field treatment plans were calculated with 6- and 18 MV narrow beams for each value of rho(lung). We considered the Pencil Beam Convolution (PBC(Ecl)) and the Analytical Anisotropic...... Algorithm (AAA(Ecl)) from Varian Eclipse and the Pencil Beam Convolution (PBC(OMP)) and the Collapsed Cone Convolution (CCC(OMP)) algorithms from Oncentra MasterPlan. RESULTS: When changing rho(lung) from 0.4 to 0.1g/cm(3), the MC median target dose decreased from 89.2% to 74.9% for 6 MV and from 83...... Treatment Planning System (TPS) algorithms and one Monte Carlo (MC) system (EGSnrc). We compared the performance of the algorithms in calculating the target dose for different degrees of lung inflation. The phantoms had a cubic 'body' and 'lung' and a central 2-cm diameter spherical 'tumour' (the body...

  4. Dosimetric Feasibility of Dose Escalation Using SBRT Boost for Stage III Non-Small Cell Lung Cancer

    Science.gov (United States)

    Hepel, Jaroslaw T.; Peter, Justin; Hiatt, Jessica R.; Patel, Salil; Osibanjo, Oluwademilade; Safran, Howard; Curran, Bruce; DiPetrillo, Thomas

    2012-01-01

    Purpose: Standard chemoradiation therapy for stage III non-small cell lung cancer (NSCLCa) results in suboptimal outcomes with a high rate of local failure and poor overall survival. We hypothesize that dose escalation using stereotactic body radiotherapy (SBRT) boost could improve upon these results. We present here a study evaluating the dosimetric feasibility of such an approach. Methods: Anonymized CT data sets from five randomly selected patients with stage III NSCLCa undergoing definitive chemoradiation therapy in our department with disease volumes appropriate for SBRT boost were selected. Three-dimensional conformal radiation therapy (3D-CRT) plans to 50.4 Gy in 28 fractions were generated follow by SBRT plans to two dose levels, 16 Gy in two fractions and 28 Gy in two fractions. SBRT plans and total composite (3D-CRT and SBRT) were optimized and evaluated for target coverage and dose to critical structures; lung, esophagus, cord, and heart. Results: All five plans met predetermined target coverage and normal tissue dose constraints. PTV V95 was equal to or greater than 95% in all cases. The cumulative lung V20 and V5 of the combined 3D-CRT and SBRT plans were less than or equal to 30 and 55%, respectively. The 5 cc esophageal dose was less than 12 Gy for all low and high dose SBRT plans. The cumulative dose to the esophagus was also acceptable with less than 10% of the esophagus receiving doses in excess of 50 Gy. The cumulative spinal cord dose was less than 33 Gy and heart V25 was less than 5%. Conclusion: The combination of chemoradiation to 50.4 Gy followed by SBRT boost to gross disease at the primary tumor and involved regional lymph nodes is feasible with respect to normal tissue dose constraints in this dosimetric pilot study. A phase I/II trial to evaluate the clinical safety and efficacy of this approach is being undertaken. PMID:23057009

  5. Radon dose assessment in underground mines in Brazil.

    Science.gov (United States)

    Santos, T O; Rocha, Z; Cruz, P; Gouvea, V A; Siqueira, J B; Oliveira, A H

    2014-07-01

    Underground miners are internally exposed to radon, thoron and their short-lived decay products during the mineral processing. There is also an external exposure due to the gamma emitters present in the rock and dust of the mine. However, the short-lived radon decay products are recognised as the main radiation health risk. When inhaled, they are deposited in the respiratory system and may cause lung cancer. To address this concern, concentration measurements of radon and its progeny were performed, the equilibrium factor was determined and the effective dose received was estimated in six Brazilian underground mines. The radon concentration was measured by using E-PERM, AlphaGUARD and CR-39 detectors. The radon progeny was determined by using DOSEman. The annual effective dose for the miners was estimated according to United Nations Scientific Committee on the Effects of Atomic Radiation methodologies. The mean value of the equilibrium factor was 0.4. The workers' estimated effective dose ranged from 1 to 21 mSv a(-1) (mean 9 mSv a(-1)).

  6. Assessment of dose measurement uncertainty using RisøScan

    DEFF Research Database (Denmark)

    Helt-Hansen, J.; Miller, A.

    2006-01-01

    The dose measurement uncertainty of the dosimeter system RisoScan, office scanner and Riso B3 dosimeters has been assessed by comparison with spectrophotometer measurements of the same dosimeters. The reproducibility and the combined uncertainty were found to be approximately 2% and 4%, respectiv...

  7. Acute respiratory distress syndrome and lung fibrosis after ingestion of a high dose of ortho-phenylphenol.

    Science.gov (United States)

    Cheng, Shih-Lung; Wang, Hao-Chien; Yang, Pan-Chyr

    2005-08-01

    Ortho-phenylphenol (OPP) and its sodium salt are used as fungicides and antibacterial agents, ingestion of which has been found to cause liver toxicity, renal toxicity and carcinomas in the urinary tract of rats. Lung damage due to OPP ingestion has not been reported in humans. We report a suicidal 39-year-old woman with stage II cervical cancer who drank a potentially lethal dose of OPP in the form of a commercial antiseptic, which led to the complication of liver and renal function impairment, severe lung damage with acute respiratory distress syndrome and subsequent severe lung fibrosis. Open lung biopsy showed diffuse alveolar damage. She was discharged after 34 days of hospitalization with continuing domiciliary oxygen therapy.

  8. Radiological assessment. A textbook on environmental dose analysis

    Energy Technology Data Exchange (ETDEWEB)

    Till, J.E.; Meyer, H.R. (eds.)

    1983-09-01

    Radiological assessment is the quantitative process of estimating the consequences to humans resulting from the release of radionuclides to the biosphere. It is a multidisciplinary subject requiring the expertise of a number of individuals in order to predict source terms, describe environmental transport, calculate internal and external dose, and extrapolate dose to health effects. Up to this time there has been available no comprehensive book describing, on a uniform and comprehensive level, the techniques and models used in radiological assessment. Radiological Assessment is based on material presented at the 1980 Health Physics Society Summer School held in Seattle, Washington. The material has been expanded and edited to make it comprehensive in scope and useful as a text. Topics covered include (1) source terms for nuclear facilities and Medical and Industrial sites; (2) transport of radionuclides in the atmosphere; (3) transport of radionuclides in surface waters; (4) transport of radionuclides in groundwater; (5) terrestrial and aquatic food chain pathways; (6) reference man; a system for internal dose calculations; (7) internal dosimetry; (8) external dosimetry; (9) models for special-case radionuclides; (10) calculation of health effects in irradiated populations; (11) evaluation of uncertainties in environmental radiological assessment models; (12) regulatory standards for environmental releases of radionuclides; (13) development of computer codes for radiological assessment; and (14) assessment of accidental releases of radionuclides.

  9. Urinary tobacco smoke-constituent biomarkers for assessing risk of lung cancer.

    Science.gov (United States)

    Yuan, Jian-Min; Butler, Lesley M; Stepanov, Irina; Hecht, Stephen S

    2014-01-15

    Tobacco-constituent biomarkers are metabolites of specific compounds present in tobacco or tobacco smoke. Highly reliable analytic methods, based mainly on mass spectrometry, have been developed for quantitation of these biomarkers in both urine and blood specimens. There is substantial interindividual variation in smoking-related lung cancer risk that is determined in part by individual variability in the uptake and metabolism of tobacco smoke carcinogens. Thus, by incorporating these biomarkers in epidemiologic studies, we can potentially obtain a more valid and precise measure of in vivo carcinogen dose than by using self-reported smoking history, ultimately improving the estimation of smoking-related lung cancer risk. Indeed, we have demonstrated this by using a prospective study design comparing biomarker levels in urine samples collected from smokers many years before their development of cancer versus those in their smoking counterparts without a cancer diagnosis. The following urinary metabolites were associated with lung cancer risk, independent of smoking intensity and duration: cotinine plus its glucuronide, a biomarker of nicotine uptake; 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol and its glucuronides (total NNAL), a biomarker of the tobacco carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK); and r-1-,t-2,3,c-4-tetrahydroxy-1,2,3,4-tetrahydrophenanthrene (PheT), a biomarker of polycyclic aromatic hydrocarbons (PAH). These results provide several possible new directions for using tobacco smoke-constituent biomarkers in lung cancer prevention, including improved lung cancer risk assessment, intermediate outcome determination in prevention trials, and regulation of tobacco products.

  10. TSD-DOSE: A radiological dose assessment model for treatment, storage, and disposal facilities

    Energy Technology Data Exchange (ETDEWEB)

    Pfingston, M.; Arnish, J.; LePoire, D.; Chen, S.-Y.

    1998-10-14

    Past practices at US Department of Energy (DOE) field facilities resulted in the presence of trace amounts of radioactive materials in some hazardous chemical wastes shipped from these facilities. In May 1991, the DOE Office of Waste Operations issued a nationwide moratorium on shipping all hazardous waste until procedures could be established to ensure that only nonradioactive hazardous waste would be shipped from DOE facilities to commercial treatment, storage, and disposal (TSD) facilities. To aid in assessing the potential impacts of shipments of mixed radioactive and chemically hazardous wastes, a radiological assessment computer model (or code) was developed on the basis of detailed assessments of potential radiological exposures and doses for eight commercial hazardous waste TSD facilities. The model, called TSD-DOSE, is designed to incorporate waste-specific and site-specific data to estimate potential radiological doses to on-site workers and the off-site public from waste-handling operations at a TSD facility. The code is intended to provide both DOE and commercial TSD facilities with a rapid and cost-effective method for assessing potential human radiation exposures from the processing of chemical wastes contaminated with trace amounts of radionuclides.

  11. Dose estimates for the solid waste performance assessment

    Energy Technology Data Exchange (ETDEWEB)

    Rittman, P.D.

    1994-08-30

    The Solid Waste Performance Assessment calculations by PNL in 1990 were redone to incorporate changes in methods and parameters since then. The ten scenarios found in their report were reduced to three, the Post-Drilling Resident, the Post-Excavation Resident, and an All Pathways Irrigator. In addition, estimates of population dose to people along the Columbia River are also included. The attached report describes the methods and parameters used in the calculations, and derives dose factors for each scenario. In addition, waste concentrations, ground water concentrations, and river water concentrations needed to reach the performance objectives of 100 mrem/yr and 500 person-rem/yr are computed. Internal dose factors from DOE-0071 were applied when computing internal dose. External dose rate factors came from the GENII Version 1.485 software package. Dose calculations were carried out on a spreadsheet. The calculations are described in detail in the report for 63 nuclides, including 5 not presently in the GENII libraries. The spreadsheet calculations were checked by comparison with GENII, as described in Appendix D.

  12. 3D delivered dose assessment using a 4DCT-based motion model

    Energy Technology Data Exchange (ETDEWEB)

    Cai, Weixing; Hurwitz, Martina H.; Williams, Christopher L.; Dhou, Salam; Berbeco, Ross I.; Mishra, Pankaj, E-mail: wcai@lroc.harvard.edu, E-mail: jhlewis@lroc.harvard.edu; Lewis, John H., E-mail: wcai@lroc.harvard.edu, E-mail: jhlewis@lroc.harvard.edu [Brigham and Women’s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts 02115 (United States); Seco, Joao [Francis H. Burr Proton Therapy Center, Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02115 (United States)

    2015-06-15

    Purpose: The purpose of this work is to develop a clinically feasible method of calculating actual delivered dose distributions for patients who have significant respiratory motion during the course of stereotactic body radiation therapy (SBRT). Methods: A novel approach was proposed to calculate the actual delivered dose distribution for SBRT lung treatment. This approach can be specified in three steps. (1) At the treatment planning stage, a patient-specific motion model is created from planning 4DCT data. This model assumes that the displacement vector field (DVF) of any respiratory motion deformation can be described as a linear combination of some basis DVFs. (2) During the treatment procedure, 2D time-varying projection images (either kV or MV projections) are acquired, from which time-varying “fluoroscopic” 3D images of the patient are reconstructed using the motion model. The DVF of each timepoint in the time-varying reconstruction is an optimized linear combination of basis DVFs such that the 2D projection of the 3D volume at this timepoint matches the projection image. (3) 3D dose distribution is computed for each timepoint in the set of 3D reconstructed fluoroscopic images, from which the total effective 3D delivered dose is calculated by accumulating deformed dose distributions. This approach was first validated using two modified digital extended cardio-torso (XCAT) phantoms with lung tumors and different respiratory motions. The estimated doses were compared to the dose that would be calculated for routine 4DCT-based planning and to the actual delivered dose that was calculated using “ground truth” XCAT phantoms at all timepoints. The approach was also tested using one set of patient data, which demonstrated the application of our method in a clinical scenario. Results: For the first XCAT phantom that has a mostly regular breathing pattern, the errors in 95% volume dose (D95) are 0.11% and 0.83%, respectively for 3D fluoroscopic images

  13. TU-G-204-09: The Effects of Reduced- Dose Lung Cancer Screening CT On Lung Nodule Detection Using a CAD Algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Young, S; Lo, P; Kim, G; Hsu, W; Hoffman, J; Brown, M; McNitt-Gray, M [UCLA School of Medicine, Los Angeles, CA (United States)

    2015-06-15

    Purpose: While Lung Cancer Screening CT is being performed at low doses, the purpose of this study was to investigate the effects of further reducing dose on the performance of a CAD nodule-detection algorithm. Methods: We selected 50 cases from our local database of National Lung Screening Trial (NLST) patients for which we had both the image series and the raw CT data from the original scans. All scans were acquired with fixed mAs (25 for standard-sized patients, 40 for large patients) on a 64-slice scanner (Sensation 64, Siemens Healthcare). All images were reconstructed with 1-mm slice thickness, B50 kernel. 10 of the cases had at least one nodule reported on the NLST reader forms. Based on a previously-published technique, we added noise to the raw data to simulate reduced-dose versions of each case at 50% and 25% of the original NLST dose (i.e. approximately 1.0 and 0.5 mGy CTDIvol). For each case at each dose level, the CAD detection algorithm was run and nodules greater than 4 mm in diameter were reported. These CAD results were compared to “truth”, defined as the approximate nodule centroids from the NLST reports. Subject-level mean sensitivities and false-positive rates were calculated for each dose level. Results: The mean sensitivities of the CAD algorithm were 35% at the original dose, 20% at 50% dose, and 42.5% at 25% dose. The false-positive rates, in decreasing-dose order, were 3.7, 2.9, and 10 per case. In certain cases, particularly in larger patients, there were severe photon-starvation artifacts, especially in the apical region due to the high-attenuating shoulders. Conclusion: The detection task was challenging for the CAD algorithm at all dose levels, including the original NLST dose. However, the false-positive rate at 25% dose approximately tripled, suggesting a loss of CAD robustness somewhere between 0.5 and 1.0 mGy. NCI grant U01 CA181156 (Quantitative Imaging Network); Tobacco Related Disease Research Project grant 22RT-0131.

  14. Quantitative assessment of global lung inflammation following radiation therapy using FDG PET/CT: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Abdulla, Sarah; Salavati, Ali; Saboury, Babak; Torigian, Drew A. [University of Pennsylvania, and Hospital of the University of Pennsylvania, Department of Radiology, Perelman School of Medicine, Philadelphia, PA (United States); Basu, Sandip [Bhabha Atomic Research Center, Tata Memorial Center Annexe, Radiation Medicine Center, Bombay (India); Alavi, Abass [University of Pennsylvania, and Hospital of the University of Pennsylvania, Department of Radiology, Perelman School of Medicine, Philadelphia, PA (United States); Hospital of the University of Pennsylvania, Department of Radiology, Division of Nuclear Medicine, Philadelphia, PA (United States)

    2014-02-15

    Radiation pneumonitis is the most severe dose-limiting complication in patients receiving thoracic radiation therapy. The aim of this study was to quantify global lung inflammation following radiation therapy using FDG PET/CT. We studied 20 subjects with stage III non-small-cell lung carcinoma who had undergone FDG PET/CT imaging before and after radiation therapy. On all PET/CT studies, the sectional lung volume (sLV) of each lung was calculated from each slice by multiplying the lung area by slice thickness. The sectional lung glycolysis (sLG) was calculated by multiplying the sLV and the lung sectional mean standardized uptake value (sSUVmean) on each slice passing through the lung. The lung volume (LV) was calculated by adding all sLVs from the lung, and the global lung glycolysis (GLG) was calculated by adding all sLGs from the lung. Finally, the lung SUVmean was calculated by dividing the GLG by the LV. The amount of inflammation in the lung parenchyma directly receiving radiation therapy was calculated by subtracting tumor measurements from GLG. In the lung directly receiving radiation therapy, the lung parenchyma SUVmean and global lung parenchymal glycolysis were significantly increased following therapy. In the contralateral lung (internal control), no significant changes were observed in lung SUVmean or GLG following radiation therapy. Global lung parenchymal glycolysis and lung parenchymal SUVmean may serve as potentially useful biomarkers to quantify lung inflammation on FDG PET/CT following thoracic radiation therapy. (orig.)

  15. {sup 99m}Tc-MAA overestimates the absorbed dose to the lungs in radioembolization: a quantitative evaluation in patients treated with {sup 166}Ho-microspheres

    Energy Technology Data Exchange (ETDEWEB)

    Elschot, Mattijs; Nijsen, Johannes F.W.; Lam, Marnix G.E.H.; Smits, Maarten L.J.; Prince, Jip F.; Bosch, Maurice A.A.J. van den; Zonnenberg, Bernard A.; Jong, Hugo W.A.M. de [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); Viergever, Max A. [University Medical Center Utrecht, Department of Radiology and Nuclear Medicine, Utrecht (Netherlands); University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands)

    2014-10-15

    Radiation pneumonitis is a rare but serious complication of radioembolic therapy of liver tumours. Estimation of the mean absorbed dose to the lungs based on pretreatment diagnostic {sup 99m}Tc-macroaggregated albumin ({sup 99m}Tc-MAA) imaging should prevent this, with administered activities adjusted accordingly. The accuracy of {sup 99m}Tc-MAA-based lung absorbed dose estimates was evaluated and compared to absorbed dose estimates based on pretreatment diagnostic {sup 166}Ho-microsphere imaging and to the actual lung absorbed doses after {sup 166}Ho radioembolization. This prospective clinical study included 14 patients with chemorefractory, unresectable liver metastases treated with {sup 166}Ho radioembolization. {sup 99m}Tc-MAA-based and {sup 166}Ho-microsphere-based estimation of lung absorbed doses was performed on pretreatment diagnostic planar scintigraphic and SPECT/CT images. The clinical analysis was preceded by an anthropomorphic torso phantom study with simulated lung shunt fractions of 0 to 30 % to determine the accuracy of the image-based lung absorbed dose estimates after {sup 166}Ho radioembolization. In the phantom study, {sup 166}Ho SPECT/CT-based lung absorbed dose estimates were more accurate (absolute error range 0.1 to -4.4 Gy) than {sup 166}Ho planar scintigraphy-based lung absorbed dose estimates (absolute error range 9.5 to 12.1 Gy). Clinically, the actual median lung absorbed dose was 0.02 Gy (range 0.0 to 0.7 Gy) based on posttreatment {sup 166}Ho-microsphere SPECT/CT imaging. Lung absorbed doses estimated on the basis of pretreatment diagnostic {sup 166}Ho-microsphere SPECT/CT imaging (median 0.02 Gy, range 0.0 to 0.4 Gy) were significantly better predictors of the actual lung absorbed doses than doses estimated on the basis of {sup 166}Ho-microsphere planar scintigraphy (median 10.4 Gy, range 4.0 to 17.3 Gy; p < 0.001), {sup 99m}Tc-MAA SPECT/CT imaging (median 2.5 Gy, range 1.2 to 12.3 Gy; p < 0.001), and {sup 99m}Tc-MAA planar

  16. Emphysema quantification on low-dose CT using percentage of low-attenuation volume and size distribution of low-attenuation lung regions: Effects of adaptive iterative dose reduction using 3D processing

    Energy Technology Data Exchange (ETDEWEB)

    Nishio, Mizuho, E-mail: nmizuho@med.kobe-u.ac.jp [Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Matsumoto, Sumiaki, E-mail: sumatsu@med.kobe-u.ac.jp [Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Seki, Shinichiro, E-mail: sshin@med.kobe-u.ac.jp [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Koyama, Hisanobu, E-mail: hkoyama@med.kobe-u.ac.jp [Division of Radiology, Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Ohno, Yoshiharu, E-mail: yosirad@kobe-u.ac.jp [Advanced Biomedical Imaging Research Center, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017 (Japan); Fujisawa, Yasuko, E-mail: yasuko1.fujisawa@toshiba.co.jp [Toshiba Medical Systems Corporation, 1385 Shimoishigami, Otawara, Tochigi 324-8550 (Japan); Sugihara, Naoki, E-mail: naoki.sugihara@toshiba.co.jp [Toshiba Medical Systems Corporation, 1385 Shimoishigami, Otawara, Tochigi 324-8550 (Japan); and others

    2014-12-15

    Highlights: • Emphysema quantification (LAV% and D) was affected by image noise on low-dose CT. • For LAV% and D, AIDR 3D improved agreement of quantification on low-dose CT. • AIDR 3D has the potential to quantify emphysema accurately on low-dose CT. - Abstract: Purpose: To evaluate the effects of adaptive iterative dose reduction using 3D processing (AIDR 3D) for quantification of two measures of emphysema: percentage of low-attenuation volume (LAV%) and size distribution of low-attenuation lung regions. Method and materials: : Fifty-two patients who underwent standard-dose (SDCT) and low-dose CT (LDCT) were included. SDCT without AIDR 3D, LDCT without AIDR 3D, and LDCT with AIDR 3D were used for emphysema quantification. First, LAV% was computed at 10 thresholds from −990 to −900 HU. Next, at the same thresholds, linear regression on a log–log plot was used to compute the power law exponent (D) for the cumulative frequency-size distribution of low-attenuation lung regions. Bland–Altman analysis was used to assess whether AIDR 3D improved agreement between LDCT and SDCT for emphysema quantification of LAV% and D. Results: The mean relative differences in LAV% between LDCT without AIDR 3D and SDCT were 3.73%–88.18% and between LDCT with AIDR 3D and SDCT were −6.61% to 0.406%. The mean relative differences in D between LDCT without AIDR 3D and SDCT were 8.22%–19.11% and between LDCT with AIDR 3D and SDCT were 1.82%–4.79%. AIDR 3D improved agreement between LDCT and SDCT at thresholds from −930 to −990 HU for LAV% and at all thresholds for D. Conclusion: AIDR 3D improved the consistency between LDCT and SDCT for emphysema quantification of LAV% and D.

  17. SU-E-T-573: Normal Tissue Dose Effect of Prescription Isodose Level Selection in Lung Stereotactic Body Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Q; Lei, Y; Zheng, D; Zhu, X; Wahl, A; Lin, C; Zhou, S; Zhen, W [University of Nebraska Medical Center, Omaha, NE (United States)

    2015-06-15

    Purpose: To evaluate dose fall-off in normal tissue for lung stereotactic body radiation therapy (SBRT) cases planned with different prescription isodose levels (IDLs), by calculating the dose dropping speed (DDS) in normal tissue on plans computed with both Pencil Beam (PB) and Monte-Carlo (MC) algorithms. Methods: The DDS was calculated on 32 plans for 8 lung SBRT patients. For each patient, 4 dynamic conformal arc plans were individually optimized for prescription isodose levels (IDL) ranging from 60% to 90% of the maximum dose with 10% increments to conformally cover the PTV. Eighty non-overlapping rind structures each of 1mm thickness were created layer by layer from each PTV surface. The average dose in each rind was calculated and fitted with a double exponential function (DEF) of the distance from the PTV surface, which models the steep- and moderate-slope portions of the average dose curve in normal tissue. The parameter characterizing the steep portion of the average dose curve in the DEF quantifies the DDS in the immediate normal tissue receiving high dose. Provided that the prescription dose covers the whole PTV, a greater DDS indicates better normal tissue sparing. The DDS were compared among plans with different prescription IDLs, for plans computed with both PB and MC algorithms. Results: For all patients, the DDS was found to be the lowest for 90% prescription IDL and reached a highest plateau region for 60% or 70% prescription. The trend was the same for both PB and MC plans. Conclusion: Among the range of prescription IDLs accepted by lung SBRT RTOG protocols, prescriptions to 60% and 70% IDLs were found to provide best normal tissue sparing.

  18. Assessing nodule detection on lung cancer screening CT: the effects of tube current modulation and model observer selection on detectability maps

    Science.gov (United States)

    Hoffman, J. M.; Noo, F.; McMillan, K.; Young, S.; McNitt-Gray, M.

    2016-03-01

    Lung cancer screening using low dose CT has been shown to reduce lung cancer related mortality and been approved for widespread use in the US. These scans keep radiation doses low while maximizing the detection of suspicious lung lesions. Tube current modulation (TCM) is one technique used to optimize dose, however limited work has been done to assess TCM's effect on detection tasks. In this work the effect of TCM on detection is investigated throughout the lung utilizing several different model observers (MO). 131 lung nodules were simulated at 1mm intervals in each lung of the XCAT phantom. A Sensation 64 TCM profile was generated for the XCAT phantom and 2500 noise realizations were created using both TCM and a fixed TC. All nodules and noise realizations were reconstructed for a total of 262 (left and right lungs) nodule reconstructions and 10 000 XCAT lung reconstructions. Single-slice Hotelling (HO) and channelized Hotelling (CHO) observers, as well as a multislice CHO were used to assess area-under-the-curve (AUC) as a function of nodule location in both the fixed TC and TCM cases. As expected with fixed TC, nodule detectability was lowest through the shoulders and leveled off below mid-lung; with TCM, detectability was unexpectedly highest through the shoulders, dropping sharply near the mid-lung and then increasing into the abdomen. Trends were the same for all model observers. These results suggest that TCM could be further optimized for detection and that detectability maps present exciting new opportunities for TCM optimization on a patient-specific level.

  19. Improvement of the following accident dose assessment system

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Enn Han; Han, Moon Hee; Suh, Kyung Suk; Hwang, Won Tae; Choi, Young Gil [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

    1999-12-15

    The FADAS has been updates for calculating the real-time wind fields continuously at the nuclear sites in Korea. The system has been constructed to compute the wind fields using its own process for the dummy meteorological data, and dose not effect on the overall wind field module. If the radioactive materials are released into the atmosphere in real situation, the calculations of wind fields and exposure dose in the previous FADAS are performed in the case of the recognition of the above situation in the source term evaluation module. The current version of FADAS includes the program for evaluating the effect of the predicted accident and the assumed scenario together. The dose assessment module is separated into the real-time and the supposed accident respectively.

  20. ASSESSMENT OF COLLECTIVE DOSE FOR TRAVELLERS BY WATERS

    Institute of Scientific and Technical Information of China (English)

    岳清宇; 姜萍; 等

    1995-01-01

    People travelling by air will receive more exposure dose and by water will receive less one.According to statistic data from the Ministry of Communications in 1988,the turnover in that year was about 2×1010 man.km.The total number of fishermen for inshore fishing was nearly two million reported by Ministry of Agriculture,Animal Husbandry and Fishery.Based on measured data on 212 points in six typical shipping lines of inshore lines and inland rivers,and the total voyage is 5625km,the average natural radiation dose rate received by travellers was calculated.From that assessment of collective effective dose for passengers by water and fishermen was derived.The value is 32.7man.Sv for passengers and 265.3man.Sv for fishermen.

  1. SU-E-T-289: Dose-Volume-Effect Relationships for Lung Cancer Patients Treated with SBRT On a Prospective Protocol

    Energy Technology Data Exchange (ETDEWEB)

    Mayyas, E; Brown, S; Liu, J; Kim, J; Sun, Z; Devpura, S; Ajlouni, M; Siddiqui, F; Movsas, B; Chetty, I [Henry Ford Hospital, Detroit, MI (United States)

    2015-06-15

    Purpose: Stereotactic body radiotherapy (SBRT) is commonly used to treat early stage lung tumors. This study was designed to evaluate associations between dose, volume and clinical outcomes including analysis of both clinical toxicity scores and quality of life (QOL) data for non-small cell lung cancer patients treated with SBRT. Preliminary results are presented. Methods: Sixty-seven NSCLC patients, 46 primarily with early stage, and 21 with recurrent disease were treated with dose regimens consisting mainly of 12 Gy x 4 fractions, and 3 or 5 fractions at lower dose, for patients with recurrent disease (Table 1). Follow-up data is being collected at baseline, after treatment and at 3, 6, 12, 18 and 24 months post-treatment. Clinical follow-up data acquired to date was assessed using the Charlson Comorbidity Clinical and Toxicity Scoring forms. QOL data was evaluated using the EQ-5D, and FACT-TOI validated surveys. All outcomes surveys are collected within an “in-house” developed outcomes database. Results: The median follow-up was 3.5±0.8 months. Mean lung doses (MLD) were converted to BED-2 Gy using the linear-quadratic model with an alpha/beta=3.0. Average MLD was 3.7+3.1 Gy (range: 0.4–20.9 Gy). The percentages of patients with > grade 2 cough, dyspnea and fatigue were 13.3, 17.0, 6.3%, respectively. Preliminary analyses (at 3 months after SBRT) show a mild correlation between MLD > 2 Gy and > grade 2 cough (borderline significant) and dyspnea (significant, p<0.05). One patient was observed with a grade 3 cough. Given the short follow-up, tumor control is not yet assessable. Conclusion: The SBRT dose fractionation regimen of 12 Gy x 4 was well tolerated at early time points. Additional follow-up is required to assess the long-term clinical outcome efficacy and toxicity profiles of the dose regimen.

  2. SU-E-T-92: Achieving Desirable Lung Doses in Total Body Irradiation Based On in Vivo Dosimetry and Custom Tissue Compensation

    Energy Technology Data Exchange (ETDEWEB)

    Cui, G; Shiu, A; Zhou, S; Cui, J; Ballas, L [Univ Southern California, Los Angeles, CA (United States)

    2015-06-15

    Purpose: To achieve desirable lung doses in total body irradiation (TBI) based on in vivo dosimetry and custom tissue compensation. Methods: The 15 MV photon beam of a Varian TrueBeam STx linac was used for TBI. Patients were positioned in the lateral decubitus position for AP/PA treatment delivery. Dose was calculated using the midpoint of the separation distance across the patient’s umbilicus. Patients received 200 cGy twice daily for 3 days. The dose rate at the patient’s midplane was approximately 10 cGy/min. Cerrobend blocks with a 5-HVL thickness were used for the primary lung shielding. A custom styrofoam holder for rice-flour filled bags was created based on the lung block cutouts. This was used to provide further lung shielding based on in vivo dose measurements. Lucite plates and rice-flour bags were placed in the head, neck, chest, and lower extremity regions during the treatment to compensate for the beam off-axis output variations. Two patients were included in the study. Patients 1 and 2 received a craniospinal treatment (1080 cGy) and a mediastinum treatment (2520 cGy), respectively, before the TBI. During the TBI nanoDot dosimeters were placed on the patient skin in the forehead, neck, umbilicus, and lung regions for dose monitoring. The doses were readout immediately after the treatment. Based on the readings, fine tuning of the thickness of the rice-flour filled bags was exploited to achieve the desirable lung doses. Results: For both patients the mean lung doses, which took into consideration all treatments, were controlled within 900 +/−10% cGy, as desired. Doses to the forehead, neck, and umbilicus were achieved within +/−10% of the prescribed dose (1200 cGy). Conclusion: A reliable and robust method was developed to achieve desirable lung doses and uniform body dose in TBI based on in vivo dosimetry and custom tissue compensator.

  3. Lung cancer screening with low-dose helical CT in Korea: experiences at the Samsung Medical Center.

    Science.gov (United States)

    Chong, Semin; Lee, Kyung Soo; Chung, Myung Jin; Kim, Tae Sung; Kim, Hojoong; Kwon, O Jung; Choi, Yoon-Ho; Rhee, Chong H

    2005-06-01

    To determine overall detection rates of lung cancer by low-dose CT (LDCT) screening and to compare histopathologic and imaging differences of detected cancers between high- and low-risk groups, this study included 6,406 asymptomatic Korean adults with >or=45 yr of age who underwent LDCT for lung cancer screening. All were classified into high- (>or=20 pack-year smoking; 3,353) and low-risk (3,053; <20 pack-yr smoking and non-smokers) groups. We compared CT findings of detected cancers and detection rates between high- and low-risk. At initial CT, 35% (2,255 of 6,406) had at least one or more non-calcified nodule. Lung cancer detection rates were 0.36% (23 of 6,406). Twenty-one non-small cell lung cancers appeared as solid (n=14) or ground-glass opacity (GGO) (n=7) nodules. Cancer likelihood was higher in GGO nodules than in solid nodules (p<0.01). Fifteen of 23 cancers occurred in high-risk group and 8 in low-risk group (p=0.215). Therefore, LDCT screening help detect early stage of lung cancer in asymptomatic Korean population with detection rate of 0.36% on a population basis and may be useful for discovering early lung cancer in low-risk group as well as in high-risk group.

  4. SU-E-I-34: Evaluating Use of AEC to Lower Dose for Lung Cancer Screening CT Protocols

    Energy Technology Data Exchange (ETDEWEB)

    Arbique, G; Anderson, J [UT Southwestern Medical Ctr at Dallas, Dallas, TX (United States); Guild, J; Duan, X [UT Southwestern Medical Center, Dallas, TX (United States); Malguria, N; Omar, H; Brewington, C [Ut Southwestern, Dallas, TX (United States); Zhang, D [Toshiba America Medical Systems, Tustin, CA (United States)

    2015-06-15

    Purpose: The National Lung Screening Trial mandated manual low dose CT technique factors, where up to a doubling of radiation output could be used over a regular to large patient size range. Recent guidance from the AAPM and ACR for lung cancer CT screening recommends radiation output adjustment for patient size either through AEC or a manual technique chart. This study evaluated the use of AEC for output control and dose reduction. Methods: The study was performed on a multidetector helical CT scanner (Aquillion ONE, Toshiba Medical) equipped with iterative reconstruction (ADIR-3D), AEC was adjusted with a standard deviation (SD) image quality noise index. The protocol SD parameter was incrementally increased to reduce patient population dose while image quality was evaluated by radiologist readers scoring the clinical utility of images on a Likert scale. Results: Plots of effective dose vs. body size (water cylinder diameter reported by the scanner) demonstrate monotonic increase in patient dose with increasing patient size. At the initial SD setting of 19 the average CTDIvol for a standard size patient was ∼ 2.0 mGy (1.2 mSv effective dose). This was reduced to ∼1.0 mGy (0.5 mSv) at an SD of 25 with no noticeable reduction in clinical utility of images as demonstrated by Likert scoring. Plots of effective patient diameter and BMI vs body size indicate that these metrics could also be used for manual technique charts. Conclusion: AEC offered consistent and reliable control of radiation output in this study. Dose for a standard size patient was reduced to one-third of the 3 mGy CTDIvol limit required for ACR accreditation of lung cancer CT screening. Gary Arbique: Research Grant, Toshiba America Medical Systems; Cecelia Brewington: Research Grant, Toshiba America Medical Systems; Di Zhang: Employee, Toshiba America Medical Systems.

  5. Assessment of patient dose in medical processes by in-vivo dose measuring devices: A review

    Science.gov (United States)

    Tuncel, Nina

    2016-11-01

    In-vivo dosimetry (IVD) in medicine especially in radiation therapy is a well-established and recommended procedure for the estimation of the dose delivered to a patient during the radiation treatment. It became even more important with the emerging use of new and more complex radiotherapy techniques such as intensity-modulated or image-guided radiation therapy. While IVD has been used in brachytherapy for decades and the initial motivation for performing was mainly to assess doses to organs at risk by direct measurements, it is now possible to calculate 3D for detection of deviations or errors. In-vivo dosimeters can be divided into real-time and passive detectors that need some finite time following irradiation for their analysis. They require a calibration against a calibrated ionization chamber in a known radiation field. Most of these detectors have a response that is energy and/or dose rate dependent and consequently require adjustments of the response to account for changes in the actual radiation conditions compared to the calibration situation. Correction factors are therefore necessary to take. Today, the most common dosimeters for patients' dose verification through in-vivo measurements are semiconductor diodes, thermo-luminescent dosimeters, optically stimulated luminescence dosimeters, metal-oxide-semiconductor field-effect transistors and plastic scintillator detectors with small outer diameters.

  6. Percentage depth dose distributions in inhomogeneous phantoms with lung and bone equivalent media for small fields of CyberKnife

    CERN Document Server

    Lee, Chung Il; Yoon, Sei-Chul; Suh, Tae Suk; Hong, Seung-Woo; Min, Kyung Joo; Lee, Sang Deok; Chung, Su Mi; Jung, Jae-Yong

    2014-01-01

    The percentage depth dose distributions in inhomogeneous phantoms with lung and bone equivalent media are studied. For lung equivalent media a Balsa wood is used, and for a soft bone equivalent media a compound material with epoxy resin, hardener and calcium carbonate is used. Polystyrene slabs put together with these materials are used as an inhomogeneous phantom. Dose measurements are performed with Gafchromic EBT film by using photon beams from 6MV CyberKnife at the Seoul Uridul Hospital. The cone sizes of the photon beams are varied from 5, 10 to 30 mm. As a simulation tool GEANT4 Monte Carlo code v9.4.p02 is used. When the Balsa wood is inserted in the phantom, the dose measured with EBT film is found to be significantly different from the dose without the EBT film in and beyond the Balsa wood region, particularly for small field sizes. On the other hand, when the soft bone equivalent material is inserted in the phantom, discrepancy between the dose measured with EBT film and the dose without EBT film ca...

  7. Radiological environmental dose assessment methods and compliance dose results for 2015 operations at the Savannah River Site

    Energy Technology Data Exchange (ETDEWEB)

    Jannik, G. T. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Dixon, K. L. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2016-09-01

    This report presents the environmental dose assessment methods and the estimated potential doses to the offsite public from 2015 Savannah River Site (SRS) atmospheric and liquid radioactive releases. Also documented are potential doses from special-case exposure scenarios - such as the consumption of deer meat, fish, and goat milk.

  8. Radiological environmental dose assessment methods and compliance dose results for 2015 operations at the savannah river site

    Energy Technology Data Exchange (ETDEWEB)

    Jannik, G. T. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Dixon, K. L. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2016-09-01

    This report presents the environmental dose assessment methods and the estimated potential doses to the offsite public from 2015 Savannah River Site (SRS) atmospheric and liquid radioactive releases. Also documented are potential doses from special-case exposure scenarios - such as the consumption of deer meat, fish, and goat milk.

  9. Spiritual Assessment in a Patient With Lung Cancer.

    Science.gov (United States)

    Borneman, Tami

    2014-01-01

    CASE STUDY  Mr. G., an 82-year-old retired European man, was diagnosed with stage 4 non-small cell lung cancer (NSCLC) and recently enrolled on a phase II clinical trial. He is married and has two adult children, who are very supportive. He and his wife described themselves as nonpracticing Catholics. He had never smoked, and there was no personal or family history of cancer. Fatigue was the main side effect from the clinical trial drugs, necessitating frequent periods of rest throughout the day and ultimately requiring dose reduction. His left leg was edematous and painful, and he was diagnosed with and treated for deep-vein thrombosis. Over time, these symptoms resolved, and Mr. G. enjoyed a fairly normal quality of life (QOL). He continued to do well for almost a year, but then his cancer progressed and his performance status began to decline. When offered treatment options, he elected to discontinue the clinical trial, take a break, and then initiate single-agent chemotherapy. Mr. G. was enrolled in a palliative care research study that provided patient-tailored education by an advanced practitioner (AP). The education addressed each QOL domain: physical, psychological, social, and spiritual. When the AP connected with Mr. G. during one of his clinic appointments, he appeared very concerned. He shared that he previously had lived in a communist country and now that he was in the United States, he was afraid of losing his insurance and having to stop treatment. The conversation was interrupted as he was called in for his appointment, yet he consented to talk about the matter further by telephone. The AP contacted Mr. G. the next day. He shared a glimpse of his childhood and experience in his homeland to try to explain his current fears. After reassuring him that his insurance would not be withdrawn, the AP asked whether he would be willing to talk about his life before coming to the United States more than 50 years ago. She wanted to assess where he was

  10. Cone beam computed tomography radiation dose and image quality assessments.

    Science.gov (United States)

    Lofthag-Hansen, Sara

    2010-01-01

    Diagnostic radiology has undergone profound changes in the last 30 years. New technologies are available to the dental field, cone beam computed tomography (CBCT) as one of the most important. CBCT is a catch-all term for a technology comprising a variety of machines differing in many respects: patient positioning, volume size (FOV), radiation quality, image capturing and reconstruction, image resolution and radiation dose. When new technology is introduced one must make sure that diagnostic accuracy is better or at least as good as the one it can be expected to replace. The CBCT brand tested was two versions of Accuitomo (Morita, Japan): 3D Accuitomo with an image intensifier as detector, FOV 3 cm x 4 cm and 3D Accuitomo FPD with a flat panel detector, FOVs 4 cm x 4 cm and 6 cm x 6 cm. The 3D Accuitomo was compared with intra-oral radiography for endodontic diagnosis in 35 patients with 46 teeth analyzed, of which 41 were endodontically treated. Three observers assessed the images by consensus. The result showed that CBCT imaging was superior with a higher number of teeth diagnosed with periapical lesions (42 vs 32 teeth). When evaluating 3D Accuitomo examinations in the posterior mandible in 30 patients, visibility of marginal bone crest and mandibular canal, important anatomic structures for implant planning, was high with good observer agreement among seven observers. Radiographic techniques have to be evaluated concerning radiation dose, which requires well-defined and easy-to-use methods. Two methods: CT dose index (CTDI), prevailing method for CT units, and dose-area product (DAP) were evaluated for calculating effective dose (E) for both units. An asymmetric dose distribution was revealed when a clinical situation was simulated. Hence, the CTDI method was not applicable for these units with small FOVs. Based on DAP values from 90 patient examinations effective dose was estimated for three diagnostic tasks: implant planning in posterior mandible and

  11. Effect of high dose steroids on oleic acid-induced lung injury in rabbits: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hwa Yeon; Yoo, Seung Min [Chung-Ang University Hospital, Seoul (Korea, Republic of)

    2006-02-15

    The purpose of this study is to evaluate the therapeutic efficacy, on the basis of CT findings, of high dose methyl prednisolone for treating acute lung injury that was induced by oleic acid injection. A total of 30 healthy rabbits (1.8-2.2 kg) were included in this study. Group I included 10 rabbits in which 0.2 mL oleic acid was injected through their ear veins. Group IIa included 10 rabbits in which 30 mg/kg methyl prednisolone and 0.2 mL oleic acid were intravenously injected at the same time. Group IIb included 5 rabbits in which 30 mg/kg methyl prednisolone was injected 6 hours prior to the 0.2 mL oleic acid intravenous injection. The other 5 rabbits (Group III) were injected intravenously with 30 mg/kg methyl prednisolone without the oleic acid. After that, 30 mg/kg methyl prednisolone per every 12 hours was injected in the non-sacrificed rabbits of Group II and Group III. Nonenhanced Chest CT scans were performed prior to the 30 minutes, 4 hours, 24 hours, 48 hours, and 72 hours after the intravenous injection of oleic acid or methyl prednisolone. We randomly sacrificed one rabbit of groups I, II and III 30 minutes, 4 hours, 24 hours, 48 hours and 72 hours after CT scanning. The distribution, extent, and pattern of the lesions on the CT scan were analyzed. The analyzed pattern of the lesions was ground glass attenuation, consolidation and interstitial thickening. Pathologic correlation was then done. The main CT findings of Group I were peripheral, wedge shaped, ill-defined ground glass attenuations and /or consolidations. The pathologic findings of Group I were interstitial or intraalveolar edema, intraalveolar hemorrhage and coagulation necrosis. Diffuse ground glass opacities with interstitial thickening were noted in 20% (n=2/10) of Group I and in 60% (n=9/15) of Group II at the 30 minute CT; however, there was no statistical difference between the two groups ({rho} = 0.09). Consolidations with air bronchogram were noted in 22.2% (2/9) of Group I and in

  12. Surgical treatment of patients with lung cancer and limited lung function: Preoperative assessment, operative mortality and morbidity

    Directory of Open Access Journals (Sweden)

    Subotić Dragan

    2007-01-01

    additional lung function assessment. .

  13. Inhomogeneous dose escalation increases expected local control for NSCLC patients with lymph node involvement without increased mean lung dose

    DEFF Research Database (Denmark)

    Nielsen, Tine B; Hansen, Olfred; Schytte, Tine;

    2014-01-01

    in mediastinum, and the thorax wall. The dose was escalated using a TCP model implemented into the planning system. The difference in TCP values between the homogeneous and inhomogeneous plans were evaluated using two different TCP models. RESULTS: Dose escalation was possible for all patients. TCP values based...

  14. MR ASSESSMENT OF LUNG DEVELOPMENT IN FETAL ANOMALIES USING RATIO OF LUNG TO LIVER SIGNAL INTENSITIES

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To evaluate the monitoring and diagnostic potential of MR in fetal lung development using lung signal intensity changes in the fetus. Methods The lung-to-liver intensity ratio was calculated by means of region-of-interest analysis in all 35 fetuses including 7 bilateral urinary anomalies, 9 unilateral urinary anomalies, 5 pulmonary anomalies, and 14 others. Results All fetuses with urinary anomalies and pulmonary anomalies showed low ratio of lung-to-liver signal intensity. Conclusion Low ratio of lung-to-liver signal intensity on MR imaging indicates pulmonary hypoplasia after 22 weeks' gestation.

  15. Phase 1 Study of Dose Escalation in Hypofractionated Proton Beam Therapy for Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gomez, Daniel R., E-mail: dgomez@mdanderson.org [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gillin, Michael [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Liao, Zhongxing [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Wei, Caimiao [Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Lin, Steven H.; Swanick, Cameron; Alvarado, Tina; Komaki, Ritsuko; Cox, James D.; Chang, Joe Y. [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2013-07-15

    Background: Many patients with locally advanced non-small cell lung cancer (NSCLC) cannot undergo concurrent chemotherapy because of comorbidities or poor performance status. Hypofractionated radiation regimens, if tolerable, may provide an option to these patients for effective local control. Methods and Materials: Twenty-five patients were enrolled in a phase 1 dose-escalation trial of proton beam therapy (PBT) from September 2010 through July 2012. Eligible patients had histologically documented lung cancer, thymic tumors, carcinoid tumors, or metastatic thyroid tumors. Concurrent chemotherapy was not allowed, but concurrent treatment with biologic agents was. The dose-escalation schema comprised 15 fractions of 3 Gy(relative biological effectiveness [RBE])/fraction, 3.5 Gy(RBE)/fraction, or 4 Gy(RBE)/fraction. Dose constraints were derived from biologically equivalent doses of standard fractionated treatment. Results: The median follow-up time for patients alive at the time of analysis was 13 months (range, 8-28 months). Fifteen patients received treatment to hilar or mediastinal lymph nodes. Two patients experienced dose-limiting toxicity possibly related to treatment; 1 received 3.5-Gy(RBE) fractions and experienced an in-field tracheoesophageal fistula 9 months after PBT and 1 month after bevacizumab. The other patient received 4-Gy(RBE) fractions and was hospitalized for bacterial pneumonia/radiation pneumonitis 4 months after PBT. Conclusion: Hypofractionated PBT to the thorax delivered over 3 weeks was well tolerated even with significant doses to the lungs and mediastinal structures. Phase 2/3 trials are needed to compare the efficacy of this technique with standard treatment for locally advanced NSCLC.

  16. Dose assessment associated with granite use in residential property

    Energy Technology Data Exchange (ETDEWEB)

    Leal, Andre Luiz do Carmo, E-mail: andre.leal@ifrj.edu.br [Instituto Federal do Rio de Janeiro (IFRJ), Sao Goncalo, RJ (Brazil); Lauria, Dejanira da Costa, E-mail: dejanira@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2015-07-01

    The radioactivity levels in materials used as building materials have been reported in many countries and relatively high levels of radioactivity have been identified in some materials build (Beretka and Mathew, 1985; Pavlidou et al., 2006; Tzortzis et al., 2003 ; Al-Selah and Al-Berzan, 2007; Kitto et al.,2009 ; Myatt et al., 2010 ). Although is reported in the literature some studies on the levels of radionuclides in granites and the associated doses (Salas, 2003; Ahmed et al., 2006; Bonotto et al, 2009 ; Turhan, 2012; Anjos et al., 2005, 2012), most of assessed dose are related with external exposure data (Anjos et al., 2011, Llope, 2011 ). From the radionuclide concentrations in 10 samples of granite rock, this study evaluated the dose by inhalation of radon from the use of national granites as floor covering, according to the refresh rate of air, porosity, and radon emanation rate of diffusion coefficient by sensitivity analyzes, using the RESRAD-BUILD 3.5 code. As a result, it was found that the higher dose by radon inhalation was 0.058 mSv / year and the Rn-220 isotope is the largest contributor to this route of exposure. (author)

  17. Effect of deformable registration on the dose calculated in radiation therapy planning CT scans of lung cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Cunliffe, Alexandra R.; Armato, Samuel G.; White, Bradley; Justusson, Julia [Department of Radiology, The University of Chicago, 5841 South Maryland Avenue, Chicago, Illinois 60637 (United States); Contee, Clay; Malik, Renuka; Al-Hallaq, Hania A., E-mail: hal-hallaq@radonc.uchicago.edu [Department of Radiation and Cellular Oncology, The University of Chicago, 5841 South Maryland Avenue, Chicago, Illinois 60637 (United States)

    2015-01-15

    Purpose: To characterize the effects of deformable image registration of serial computed tomography (CT) scans on the radiation dose calculated from a treatment planning scan. Methods: Eighteen patients who received curative doses (≥60 Gy, 2 Gy/fraction) of photon radiation therapy for lung cancer treatment were retrospectively identified. For each patient, a diagnostic-quality pretherapy (4–75 days) CT scan and a treatment planning scan with an associated dose map were collected. To establish correspondence between scan pairs, a researcher manually identified anatomically corresponding landmark point pairs between the two scans. Pretherapy scans then were coregistered with planning scans (and associated dose maps) using the demons deformable registration algorithm and two variants of the Fraunhofer MEVIS algorithm (“Fast” and “EMPIRE10”). Landmark points in each pretherapy scan were automatically mapped to the planning scan using the displacement vector field output from each of the three algorithms. The Euclidean distance between manually and automatically mapped landmark points (d{sub E}) and the absolute difference in planned dose (|ΔD|) were calculated. Using regression modeling, |ΔD| was modeled as a function of d{sub E}, dose (D), dose standard deviation (SD{sub dose}) in an eight-pixel neighborhood, and the registration algorithm used. Results: Over 1400 landmark point pairs were identified, with 58–93 (median: 84) points identified per patient. Average |ΔD| across patients was 3.5 Gy (range: 0.9–10.6 Gy). Registration accuracy was highest using the Fraunhofer MEVIS EMPIRE10 algorithm, with an average d{sub E} across patients of 5.2 mm (compared with >7 mm for the other two algorithms). Consequently, average |ΔD| was also lowest using the Fraunhofer MEVIS EMPIRE10 algorithm. |ΔD| increased significantly as a function of d{sub E} (0.42 Gy/mm), D (0.05 Gy/Gy), SD{sub dose} (1.4 Gy/Gy), and the algorithm used (≤1 Gy). Conclusions: An

  18. Evaluation of dose-volume histogram parameters (V20 and mean dose) in lung cancer adaptive radiotherapy with design of composite lung volumes (ITV; Evaluacion de parametros del histograma dosis-volumen (V20 y dosis media) en radioterapia adaptada de cancer de pulmon con diseno de volumenes pulmonares compuestos (Internal Target Volume, ITV)

    Energy Technology Data Exchange (ETDEWEB)

    Monroy Anton, J. L.; Solar Tortosa, M.; Lopez Munoz, M.; Navarro Bergada, A.; Estornell gualde, M. A.; Melchor Iniguez, M.

    2013-07-01

    Physiological respiratory motion is a challenge in external radiotherapy for lung tumors. In adaptive radiotherapy, changing position of the target volume should be reflected in the simulation procedure and taken into account in the design of volumes for CTV/PTV proper coverage. This may be achieved through the design of an Internal Target Volume (ITV) as indicated in ICRU-62. However, the Dose-Volume Histogram (DVH) evaluation of the doses received by the healthy lung may vary in the case of designing a single lung volume, compared to the composite lung volume obtained with the fusion of normal breathing, inspiration and expiration (ITV{sub l}ung). (Author)

  19. Improvement of the following accident dose assessment system (II)

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Enn Han; Han, Moon Hee; Suh, Kyung Suk; Hwang, Won Tae; Choi, Young Gil [Korea Atomic Energy Research Institute, Taejeon (Korea)

    2000-12-01

    The FADAS and its database have been updates for calculating the real-time wind fields continuously at the nuclear sites in Korea. The system has been constructed to compute the wind fields using its own process for the dummy meteorological data, and does not effect on the overall wind field module. If the radioactive materials are released into the atmosphere in real situation, the calculations of wind fields and exposure dose in the previous FADAS are performed in the case of the recognition of the above situation in the source term evaluation module. The current version of FADAS includes the program for evaluating the effect of the predicted accident and the assumed scenario together. The dose assessment module is separated into the real-time and the supposed accident respectively. 7 refs., 8 figs., 6 tabs. (Author)

  20. Long-term prognosis of patients with lung cancer detected on low-dose chest computed tomography screening.

    Science.gov (United States)

    Nawa, Takeshi; Nakagawa, Tohru; Mizoue, Tetsuya; Kusano, Suzushi; Chonan, Tatsuya; Fukai, Shimao; Endo, Katsuyuki

    2012-02-01

    The effectiveness of lung cancer screening using low-dose chest computed tomography (CT) remains elusive. The present study examined the prognosis of patients with lung cancer detected on CT screening in Japanese men and women. Subjects were 210 patients with primary lung cancer identified on CT screening at two medical facilities in Hitachi, Japan, where a total of 61,914 CT screenings were performed among 25,385 screenees between 1998 and 2006. Prognostic status of these patients was sought by examining medical records at local hospitals, supplemented by vital status information from local government. The 5-year survival rate was estimated according to the characteristics of patients and lung nodule. A total of 203 (97%) patients underwent surgery. During a 5.7-year mean follow-up period, 19 patients died from lung cancer and 6 died from other causes. The estimated 5-year survival rate for all patients and for those on stage IA was 90% and 97%, respectively. Besides cancer stage, smoking and nodule appearance were independent predictors of a poor survival; multivariable-adjusted hazard ratio (95% confidence interval) was 4.7 (1.3, 16.5) for current and past smokers versus nonsmokers and 4.6 (1.6, 13.9) for solid nodule versus others. Even patients with solid shadow had a 5-year survival of 82% if the lesion was 20mm or less in size. Results suggest that lung cancers detected on CT screening are mostly curative. The impact of CT screening on mortality at community level needs to be clarified by monitoring lung cancer deaths.

  1. MR assessment of fetal lung development using lung volumes and signal intensities

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Thomas M.; Michel, Sven C.A.; Marincek, Borut [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich (Switzerland); Rake, Annett; Wisser, Josef [Department of Obstetrics, University Hospital Zurich, Raemistrasse 100, 8091, Zurich (Switzerland); Seifert, Burkhardt [Department of Biostatistics, University of Zurich, Sumatrastrasse 30, 8006, Zurich (Switzerland); Kubik-Huch, Rahel A. [Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich (Switzerland); Institute of Radiology, Kantonsspital Baden, 5404, Baden (Switzerland)

    2004-06-01

    The purpose of this study was to evaluate the monitoring and diagnostic potential of MRI in fetal lung development and disease using lung volume and signal intensity changes through gestation. Thirty-five healthy fetuses (22-42 weeks) were examined on a 1.5- T MR system using sagittal T2w single-shot fast spin-echo imaging (TR indefinite, TE 90 ms, slice thickness/gap 3-5/0 mm, FOV 26-40 cm, NEX 0.5). Fetal body and lung were segmented manually and volumes calculated. Signal intensities (SI) of fetal lung and three reference values were measured on the section best displaying the lung. Regions of interests were defined by including the maximal organ area possible. The following SI ratios were generated: lung/liver, lung/amniotic fluid, lung/muscle, liver/fluid and liver/muscle. Volumes and ratios were correlated with gestational age. Data from seven fetuses with pulmonary pathology were compared with these normative values. Absolute lung volume varied from 12.3 to 143.5 cm{sup 3} in correlation with gestational age (P<0.001); lung volume relative to total body volume ranged from 1.6 to 5.0%, decreasing with gestational age (P=0.001). (orig.)

  2. Four-dimensional layer-stacking carbon-ion beam dose distribution by use of a lung numeric phantom.

    Science.gov (United States)

    Mori, Shinichiro; Kumagai, Motoki; Miki, Kentaro

    2015-07-01

    To extend layer-stacking irradiation to accommodate intrafractional organ motion, we evaluated the carbon-ion layer-stacking dose distribution using a numeric lung phantom. We designed several types of range compensators. The planning target volume was calculated from the respective respiratory phases for consideration of intrafractional beam range variation. The accumulated dose distribution was calculated by registering of the dose distributions at respective phases to that at the reference phase. We evaluated the dose distribution based on the following six parameters: motion displacement, direction, gating window, respiratory cycle, range-shifter change time, and prescribed dose. All parameters affected the dose conformation to the moving target. By shortening of the gating window, dose metrics for superior-inferior (SI) and anterior-posterior (AP) motions were decreased from a D95 of 94 %, Dmax of 108 %, and homogeneity index (HI) of 23 % at T00-T90, to a D95 of 93 %, Dmax of 102 %, and HI of 20 % at T40-T60. In contrast, all dose metrics except the HI were independent of respiratory cycle. All dose metrics in SI motion were almost the same in respective motion displacement, with a D95 of 94 %, Dmax of 108 %, Dmin of 89 %, and HI of 23 % for the ungated phase, and D95 of 93 %, Dmax of 102 %, Dmin of 85 %, and HI of 20 % for the gated phase. The dose conformation to a moving target was improved by the gating strategy and by an increase in the prescribed dose. A combination of these approaches is a practical means of adding them to existing treatment protocols without modifications.

  3. Terminate lung cancer (TLC) study-A mixed-methods population approach to increase lung cancer screening awareness and low-dose computed tomography in Eastern Kentucky.

    Science.gov (United States)

    Cardarelli, Roberto; Reese, David; Roper, Karen L; Cardarelli, Kathryn; Feltner, Frances J; Studts, Jamie L; Knight, Jennifer R; Armstrong, Debra; Weaver, Anthony; Shaffer, Dana

    2017-02-01

    For low dose CT lung cancer screening to be effective in curbing disease mortality, efforts are needed to overcome barriers to awareness and facilitate uptake of the current evidence-based screening guidelines. A sequential mixed-methods approach was employed to design a screening campaign utilizing messages developed from community focus groups, followed by implementation of the outreach campaign intervention in two high-risk Kentucky regions. This study reports on rates of awareness and screening in intervention regions, as compared to a control region.

  4. Development of Landscape Dose Factors for dose assessments in SR-Can

    Energy Technology Data Exchange (ETDEWEB)

    Avila, Rodolfo; Ekstroem, Per-Anders [Facilia AB, Bromma (Sweden); Kautsky, Ulrik [Swedish Nuclear Fuel and Waste Management Co., Stockholm (Sweden)

    2006-08-15

    In previous safety assessments Ecosystem Dose Factors (EDFs), were derived from estimates of doses to the most exposed group resulting from constant unit radionuclide release rates over 10,000 years to various ecosystem types, e.g. mires, agricultural lands, lakes and marine ecosystems. A number of limitations of the EDF approach have been identified. The objectives of this report is to further develop the EDF approach, in order to resolve the identified limitations, and to use the improved approach for deriving Dose Conversion Factors for use in the SR-Can risk assessments. The Dose Conversion Factors derived in this report are named Landscape Dose Factors (LDFs). It involves modelling the fate of the radionuclides in the whole landscape, which develops from a sea to a inland situation during 20,000 years. Both candidate sites studies in SR-Can, Forsmark and Laxemar, are included in the study. As a basis for the modelling, the period starting at the beginning of the last interglacial (8,000 BC) is used, over which releases from a hypothetical repository were assumed to take place. For the present temperate period, the overall development of the biosphere at each site is outlined in a 1,000 year perspective and beyond, essentially based on the ongoing shoreline displacement and the understanding on the impact this has on the biosphere. The past development, i.e. from deglaciation to the present time, is inferred from geological records and associated reconstructions of the shore-line. For each time step of 1,000 years, the landscape at the site is described as a number of interconnected biosphere objects constituting an integrated landscape model of each site. The water fluxes through the objects were estimated from the average run-off at the site, the areas of the objects and their associated catchment areas. Radionuclides in both dissolved and particulate forms were considered in the transport calculations. The transformation between ecosystems was modelled as

  5. Low-Dose Acetylsalicylic Acid in Treating Patients With Stage I-III Non-Small Cell Lung Cancer

    Science.gov (United States)

    2016-06-28

    Adenocarcinoma of the Lung; Recurrent Non-small Cell Lung Cancer; Stage IA Non-small Cell Lung Cancer; Stage IB Non-small Cell Lung Cancer; Stage IIA Non-small Cell Lung Cancer; Stage IIB Non-small Cell Lung Cancer; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Non-small Cell Lung Cancer

  6. Paradigm shift in LUNG SBRT dose calculation associated with Heterogeneity correction; Cambio de paradigma en SBRT pulmonar asociada al calculo de dosis con correccion de heterogeneidad

    Energy Technology Data Exchange (ETDEWEB)

    Zucca Aparicio, D.; Perez Moreno, J. M.; Fernandez Leton, P.; Garcia Ruiz-Zorrilla, J.; Pinto Monedero, M.; Marti Asensjo, J.; Alonso Iracheta, L.

    2015-07-01

    Treatment of lung injury SBRT requires great dosimetric accuracy, the increasing clinical importance of dose calculation heterogeneities introducing algorithms that adequately model the transport of particles narrow beams in media of low density, as with Monte Carlo calculation. (Author)

  7. Assessment of Patient Dose from CT Examinations in Khorasan, Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Taghi Bahreyni Toossi

    2013-03-01

    Full Text Available Introduction Computed Tomography scans are a very important tool for diagnosis and assessment of response to treatment in the practice of medicine. Ionizing radiation in medical imaging is undoubtedly one of the most powerful diagnostic tools in medicine. Yet, as with all medical interventions, there are potential risks in addition to the clear potential benefits. Materials and Methods Two reference dose quantities have been defined in order to promote the use of good technique in CT. These are weighted CT dose index (CTDIw in (mGy for a single slice in serial scanning or per rotation in helical scanning, and dose–length product (DLP per complete examination (mGy.cm, All measurements were performed using a pencil shaped ionization chamber introduced into polymethyl methacrylate cylindrical brain and body phantoms. This survey was performed on 7 CT scanners in Khorasan Province-Iran. Results DLP for brain, chest, abdomen and pelvic examinations had a range of 255 - 1026, 76-1277, 48-737, 69-854 mGy.cm, respectively. Conclusion The results obtained in this study show that the DLP values obtained in this province are lower than European Commission reference dose levels (EC RDL, in other words performance of all the scanners were satisfactory.

  8. Assessment of Monte Carlo algorithm for compliance with RTOG 0915 dosimetric criteria in peripheral lung cancer patients treated with stereotactic body radiotherapy.

    Science.gov (United States)

    Pokhrel, Damodar; Sood, Sumit; Badkul, Rajeev; Jiang, Hongyu; McClinton, Christopher; Lominska, Christopher; Kumar, Parvesh; Wang, Fen

    2016-05-08

    The purpose of the study was to evaluate Monte Carlo-generated dose distributions with the X-ray Voxel Monte Carlo (XVMC) algorithm in the treatment of peripheral lung cancer patients using stereotactic body radiotherapy (SBRT) with non-protocol dose-volume normalization and to assess plan outcomes utilizing RTOG 0915 dosimetric compliance criteria. The Radiation Therapy Oncology Group (RTOG) protocols for non-small cell lung cancer (NSCLC) currently require radiation dose to be calculated using tissue density heterogeneity corrections. Dosimetric criteria of RTOG 0915 were established based on superposition/convolution or heterogeneities corrected pencil beam (PB-hete) algorithms for dose calculations. Clinically, more accurate Monte Carlo (MC)-based algorithms are now routinely used for lung stereotactic body radiotherapy (SBRT) dose calculations. Hence, it is important to determine whether MC calculations in the delivery of lung SBRT can achieve RTOG standards. In this report, we evaluate iPlan generated MC plans for peripheral lung cancer patients treated with SBRT using dose-volume histogram (DVH) normalization to determine if the RTOG 0915 compliance criteria can be met. This study evaluated 20 Stage I-II NSCLC patients with peripherally located lung tumors, who underwent MC-based SBRT with heterogeneity correction using X-ray Voxel Monte Carlo (XVMC) algorithm (Brainlab iPlan version 4.1.2). Total dose of 50 to 54 Gy in 3 to 5 fractions was delivered to the planning target vol-ume (PTV) with at least 95% of the PTV receiving 100% of the prescription dose (V100% ≥ 95%). The internal target volume (ITV) was delineated on maximum intensity projection (MIP) images of 4D CT scans. The PTV included the ITV plus 5 mm uniform margin applied to the ITV. The PTV ranged from 11.1 to 163.0 cc (mean = 46.1 ± 38.7 cc). Organs at risk (OARs) including ribs were delineated on mean intensity projection (MeanIP) images of 4D CT scans. Optimal clinical MC SBRT plans were

  9. The UK Lung Cancer Screening Trial: a pilot randomised controlled trial of low-dose computed tomography screening for the early detection of lung cancer.

    Science.gov (United States)

    Field, John K; Duffy, Stephen W; Baldwin, David R; Brain, Kate E; Devaraj, Anand; Eisen, Tim; Green, Beverley A; Holemans, John A; Kavanagh, Terry; Kerr, Keith M; Ledson, Martin; Lifford, Kate J; McRonald, Fiona E; Nair, Arjun; Page, Richard D; Parmar, Mahesh Kb; Rintoul, Robert C; Screaton, Nicholas; Wald, Nicholas J; Weller, David; Whynes, David K; Williamson, Paula R; Yadegarfar, Ghasem; Hansell, David M

    2016-01-01

    BACKGROUND Lung cancer kills more people than any other cancer in the UK (5-year survival Nederlands Leuvens Longkanker Screenings Onderzoek: Dutch-Belgian Randomised Lung Cancer Screening Trial) and other European Union trials in 2017 which will provide European mortality and cost-effectiveness data. For now, there is a clear need for mortality results from other trials and further research to identify optimal methods of implementation and delivery. Strategies for increasing uptake and providing support for underserved groups will be key to implementation. TRIAL REGISTRATION Current Controlled Trials ISRCTN78513845. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 20, No. 40. See the NIHR Journals Library website for further project information. PMID:27224642

  10. Assessment of Pulmonary Fibrogenic Potential of Multiwalled Carbon Nanotubes in Human Lung Cells

    Directory of Open Access Journals (Sweden)

    Anurag Mishra

    2012-01-01

    Full Text Available Multiwalled carbon nanotubes have been shown to possess unusual fibrogenic activity in vivo and are currently the focus of intense toxicological investigations. This study further determines the fibrogenic potential of well-dispersed MWCNT in human lung cell culture models and to develop a novel platform for understanding the cellular mechanisms of MWCNT-induced lung fibrosis. Survanta, a natural lung surfactant, showed effectiveness in dispersing agglomerates of MWCNT to fine structures similar in size to aerosolized one. At relevant low doses (0.002–0.2 μg/cm2, MWCNT exhibited a dose-dependent bio-effect on the human lung epithelial cells which is more pronounced in dispersed-MWCNT compared to non-dispersed form. Significantly elevated levels of fibrogenic mediators, such as transforming growth factor-β1 and matrix metalloprotienases-9 were observed in the dispersed-MWCNT treated lung epithelial cells. Based on previous in vivo studies showing that dispersed-MWCNT penetrated the interstitium and caused rapid interstitial fibrosis, we evaluated the potential direct interaction between lung fibroblasts and MWCNT. Direct stimulation of human lung fibroblast cell proliferation, collagen expression and fibroblast growth factor-2 were observed which suggests novel mechanisms of MWCNT-induced lung fibrosis. Our results indicate that the dispersion status of MWCNT determines their fibrogenic activity which is consistent with in vivo findings.

  11. Comparative hazard identification by a single dose lung exposure of zinc oxide and silver nanomaterials in mice

    NARCIS (Netherlands)

    Gosens, Ilse; Kermanizadeh, Ali; Jacobsen, Nicklas Raun; Lenz, Anke-Gabriele; Bokkers, Bas; de Jong, Wim H; Krystek, Petra; Tran, Lang; Stone, Vicki; Wallin, Håkan; Stoeger, Tobias; Cassee, Flemming R

    2015-01-01

    Comparative hazard identification of nanomaterials (NMs) can aid in the prioritisation for further toxicity testing. Here, we assessed the acute lung, systemic and liver responses in C57BL/6N mice for three NMs to provide a hazard ranking. A silver (Ag), non-functionalised zinc oxide (ZnO) and a tri

  12. Assessing medical students’ competence in calculating drug doses

    Directory of Open Access Journals (Sweden)

    Catherine Harries

    2013-09-01

    Full Text Available Evidence suggests that healthcare professionals are not optimally able to calculate medicine doses and various strategies have been employed to improve these skills. In this study, the performance of third and fourth year medical students was assessed and the success of various educational interventions investigated. Students were given four types of dosing calculations typical of those required in an emergency setting. Full competence (at the 100% level was defined as correctly answering all four categories of calculation at any one time. Three categories correct meant competence at the 75% level. Interventions comprised an assignment with a model answer for self-assessment in the third year and a small group tutorial in the fourth year. The small groups provided opportunities for peer-assisted learning. A subgroup of 23 students received individual tuition from the lecturer prior to the start of the fourth year. Amongst the 364 eligible students, full competence rose from 23% at the beginning of the third year to 66% by the end of the fourth year. More students succeeded during the fourth than the third year of study. Success of small group tuition was assessed in a sample of 200 students who had formal assessments both before and after the fourth year tuition. Competence at the 75% level improved by 10% in attendees and decreased by 3% in non-attendees, providing evidence of the value of students receiving assistance from more able same-language peers. Good results were achieved with one-on-one tuition where individualised assistance allowed even struggling students to improve.

  13. Quantitative assessment of irradiated lung volume and lung mass in breast cancer patients treated with tangential fields in combination with deep inspiration breath hold (DIBH)

    Energy Technology Data Exchange (ETDEWEB)

    Kapp, Karin Sigrid [Univ. Clinic of Therapeutic Radiology and Oncology, Medical Univ. of Graz (Austria); Zurl, Brigitte; Stranzl, Heidi; Winkler, Peter

    2010-03-15

    Purpose: Comparison of the amount of irradiated lung tissue volume and mass in patients with breast cancer treated with an optimized tangential-field technique with and without a deep inspiration breath-hold (DIBH) technique and its impact on the normal-tissue complication probability (NTCP). Material and Methods: Computed tomography datasets of 60 patients in normal breathing (NB) and subsequently in DIBH were compared. With a Real-Time Position Management Respiratory Gating System (RPM), anteroposterior movement of the chest wall was monitored and a lower and upper threshold were defined. Ipsilateral lung and a restricted tangential region of the lung were delineated and the mean and maximum doses calculated. Irradiated lung tissue mass was computed based on density values. NTCP for lung was calculated using a modified Lyman-Kutcher-Burman (LKB) model. Results: Mean dose to the ipsilateral lung in DIBH versus NB was significantly reduced by 15%. Mean lung mass calculation in the restricted area receiving {<=} 20 Gy (M{sub 20}) was reduced by 17% in DIBH but associated with an increase in volume. NTCP showed an improvement in DIBH of 20%. The correlation of individual breathing amplitude with NTCP proved to be independent. Conclusion: The delineation of a restricted area provides the lung mass calculation in patients treated with tangential fields. DIBH reduces ipsilateral lung dose by inflation so that less tissue remains in the irradiated region and its efficiency is supported by a decrease of NTCP. (orig.)

  14. Lung Texture in Serial Thoracic Computed Tomography Scans: Correlation of Radiomics-based Features With Radiation Therapy Dose and Radiation Pneumonitis Development

    Energy Technology Data Exchange (ETDEWEB)

    Cunliffe, Alexandra; Armato, Samuel G. [Department of Radiology, The University of Chicago, Chicago, Illinois (United States); Castillo, Richard [Department of Radiation Oncology, The University of Texas Medical Branch, Galveston, Texas (United States); Pham, Ngoc [Baylor College of Medicine, Houston, Texas (United States); Guerrero, Thomas [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Al-Hallaq, Hania A., E-mail: hal-hallaq@radonc.uchicago.edu [Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois (United States)

    2015-04-01

    Purpose: To assess the relationship between radiation dose and change in a set of mathematical intensity- and texture-based features and to determine the ability of texture analysis to identify patients who develop radiation pneumonitis (RP). Methods and Materials: A total of 106 patients who received radiation therapy (RT) for esophageal cancer were retrospectively identified under institutional review board approval. For each patient, diagnostic computed tomography (CT) scans were acquired before (0-168 days) and after (5-120 days) RT, and a treatment planning CT scan with an associated dose map was obtained. 32- × 32-pixel regions of interest (ROIs) were randomly identified in the lungs of each pre-RT scan. ROIs were subsequently mapped to the post-RT scan and the planning scan dose map by using deformable image registration. The changes in 20 feature values (ΔFV) between pre- and post-RT scan ROIs were calculated. Regression modeling and analysis of variance were used to test the relationships between ΔFV, mean ROI dose, and development of grade ≥2 RP. Area under the receiver operating characteristic curve (AUC) was calculated to determine each feature's ability to distinguish between patients with and those without RP. A classifier was constructed to determine whether 2- or 3-feature combinations could improve RP distinction. Results: For all 20 features, a significant ΔFV was observed with increasing radiation dose. Twelve features changed significantly for patients with RP. Individual texture features could discriminate between patients with and those without RP with moderate performance (AUCs from 0.49 to 0.78). Using multiple features in a classifier, AUC increased significantly (0.59-0.84). Conclusions: A relationship between dose and change in a set of image-based features was observed. For 12 features, ΔFV was significantly related to RP development. This study demonstrated the ability of radiomics to provide a quantitative, individualized

  15. Gefitinib: new preparation. Non small-cell lung cancer: stricter assessment needed.

    Science.gov (United States)

    2004-10-01

    (1) Platinum-based chemotherapy is generally used to treat advanced-stage non small-cell lung cancer (stages III and IV), but has only a modest impact on survival. There is no reference treatment. (2) Gefitinib inhibits the tyrosine kinase activity of the receptor for EGF (epidermal growth factor), which is thought to be involved in tumour growth. It has a temporary licence in France and is used on a named-patient basis, but full marketing authorisation has already been granted in Japan, the United States, and elsewhere. (3) Two double-blind dose-finding studies compared two doses of oral gefitinib monotherapy (250 mg/day and 500 mg/day) in patients in whom at least two lines of chemotherapy had failed. The results were favourable, with a median survival of 6 months and a symptomatic improvement in some patients, but they are undermined by the absence of a placebo group and by major protocol violations. (4) Two double-blind trials, each in more than 1000 patients, showed that gefitinib does not increase the efficacy of first-line platinum combinations. (5) About 15% of patients receiving gefitinib monotherapy in clinical trials stopped taking the treatment because of adverse events. The most frequent were gastrointestinal (diarrhea, nausea, vomiting) and cutaneous (rash, acne, dry skin, pruritus). (6) Interstitial pneumonitis occurred in about 1% of patients, and was fatal in about one-third of cases. (7) Gefitinib is metabolised by the cytochrome P450 isoenzyme CYP3A4, so carries a potentially high risk of interactions. (8) In practice, more thorough assessment of gefitinib is needed to determine whether this new drug is beneficial for patients with non small-cell lung cancer. Marketing authorisation is not currently justified.

  16. Exposure to low doses of formaldehyde during pregnancy suppresses the development of allergic lung inflammation in offspring

    Energy Technology Data Exchange (ETDEWEB)

    Maiellaro, Marília [Department of Clinical and Toxicological Analyses, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo (Brazil); Correa-Costa, Matheus [Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo (Brazil); Vitoretti, Luana Beatriz; Gimenes Júnior, João Antônio [Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo (Brazil); Câmara, Niels Olsen Saraiva [Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo (Brazil); Tavares-de-Lima, Wothan [Department of Pharmacology, Institute of Biomedical Sciences, University of São Paulo, São Paulo (Brazil); Farsky, Sandra Helena Poliselli [Department of Clinical and Toxicological Analyses, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo (Brazil); Lino-dos-Santos-Franco, Adriana, E-mail: adrilino@usp.br [Department of Clinical and Toxicological Analyses, Faculty of Pharmaceutical Sciences, University of São Paulo, São Paulo (Brazil)

    2014-08-01

    Formaldehyde (FA) is an environmental and occupational pollutant, and its toxic effects on the immune system have been shown. Nevertheless, no data are available regarding the programming mechanisms after FA exposure and its repercussions for the immune systems of offspring. In this study, our objective was to investigate the effects of low-dose exposure of FA on pregnant rats and its repercussion for the development of allergic lung inflammation in offspring. Pregnant Wistar rats were assigned in 3 groups: P (rats exposed to FA (0.75 ppm, 1 h/day, 5 days/week, for 21 days)), C (rats exposed to vehicle of FA (distillated water)) and B (rats non-manipulated). After 30 days of age, the offspring was sensitised with ovalbumin (OVA)-alum and challenged with aerosolized OVA (1%, 15 min, 3 days). After 24 h the OVA challenge the parameters were evaluated. Our data showed that low-dose exposure to FA during pregnancy induced low birth weight and suppressed the development of allergic lung inflammation and tracheal hyperresponsiveness in offspring by mechanisms mediated by reduced anaphylactic antibodies synthesis, IL-6 and TNF-alpha secretion. Elevated levels of IL-10 were found. Any systemic alteration was detected in the exposed pregnant rats, although oxidative stress in the uterine environment was evident at the moment of the delivery based on elevated COX-1 expression and reduced cNOS and SOD-2 in the uterus. Therefore, we show the putative programming mechanisms induced by FA on the immune system for the first time and the mechanisms involved may be related to oxidative stress in the foetal microenvironment. - Highlights: • Formaldehyde exposure does not cause lung inflammation in pregnant rats. • Formaldehyde exposure suppresses allergic lung inflammation in the offspring. • Formaldehyde exposure induces oxidative stress in uterine environment.

  17. Proton magnetic resonance imaging for assessment of lung function and respiratory dynamics

    Energy Technology Data Exchange (ETDEWEB)

    Eichinger, Monika [Deutsches Krebsforschungszentrum (DKFZ), Department of Radiology (E010), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)], E-mail: m.eichinger@dkfz.de; Tetzlaff, Ralf; Puderbach, Michael [Deutsches Krebsforschungszentrum (DKFZ), Department of Radiology (E010), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Woodhouse, Neil [Unit of Academic Radiology, University of Sheffield (United Kingdom); Kauczor, H.-U. [Deutsches Krebsforschungszentrum (DKFZ), Department of Radiology (E010), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)

    2007-12-15

    Since many pulmonary diseases present with a variable regional involvement, modalities for assessment of regional lung function gained increasing attention over the last years. Together with lung perfusion and gas exchange, ventilation, as a result of the interaction of the respiratory pump and the lungs, is an indispensable component of lung function. So far, this complex mechanism is still mainly assessed indirectly and globally. A differentiation between the individual determining factors of ventilation would be crucial for precise diagnostics and adequate treatment. By dynamic imaging of the respiratory pump, the mechanical components of ventilation can be assessed regionally. Amongst imaging modalities applicable to this topic, magnetic resonance imaging (MRI), as a tool not relying on ionising radiation, is the most attractive. Recent advances in MRI technology have made it possible to assess diaphragmatic and chest wall motion, static and dynamic lung volumes, as well as regional lung function. Even though existing studies show large heterogeneity in design and applied methods, it becomes evident that MRI is capable to visualise pulmonary function as well as diaphragmatic and thoracic wall movement, providing new insights into lung physiology. Partly contradictory results and conclusions are most likely caused by technical limitations, limited number of studies and small sample size. Existing studies mainly evaluate possible imaging techniques and concentrate on normal physiology. The few studies in patients with lung cancer and emphysema already give a promising outlook for these techniques from which an increasing impact on improved and quantitative disease characterization as well as better patient management can be expected.

  18. Interactive Rapid Dose Assessment Model (IRDAM): reactor-accident assessment methods. Vol. 2

    Energy Technology Data Exchange (ETDEWEB)

    Poeton, R.W.; Moeller, M.P.; Laughlin, G.J.; Desrosiers, A.E.

    1983-05-01

    As part of the continuing emphasis on emergency preparedness, the US Nuclear Regulatory Commission (NRC) sponsored the development of a rapid dose assessment system by Pacific Northwest Laboratory (PNL). This system, the Interactive Rapid Dose Assessment Model (IRDAM) is a micro-computer based program for rapidly assessing the radiological impact of accidents at nuclear power plants. This document describes the technical bases for IRDAM including methods, models and assumptions used in calculations. IRDAM calculates whole body (5-cm depth) and infant thyroid doses at six fixed downwind distances between 500 and 20,000 meters. Radionuclides considered primarily consist of noble gases and radioiodines. In order to provide a rapid assessment capability consistent with the capacity of the Osborne-1 computer, certain simplifying approximations and assumptions are made. These are described, along with default values (assumptions used in the absence of specific input) in the text of this document. Two companion volumes to this one provide additional information on IRDAM. The user's Guide (NUREG/CR-3012, Volume 1) describes the setup and operation of equipment necessary to run IRDAM. Scenarios for Comparing Dose Assessment Models (NUREG/CR-3012, Volume 3) provides the results of calculations made by IRDAM and other models for specific accident scenarios.

  19. Assessment of population external irradiation doses with consideration of Rospotrebnadzor bodies equipment for monitoring of photon radiation dose

    Directory of Open Access Journals (Sweden)

    I. P. Stamat

    2016-01-01

    Full Text Available This paper provides review of equipment and methodology for measurement of photon radiation dose; analysis of possible reasons for considerable deviation between the Russian Federation population annual effective external irradiation doses and the relevant average global value. Data on Rospotrebnadzor bodies dosimetry equipment used for measurement of gamma radiation dose are collected and systematized. Over 60 kinds of dosimeters are used for monitoring of population external irradiation doses. Most of dosimeters used in the country have gas-discharge detectors (Geiger-Mueller counters, minor biochemical annunciators, etc. which have higher total values of own background level and of space radiation response than the modern dosimeters with scintillation detectors. This feature of dosimeters is apparently one of most plausible reasons of a bit overstating assessment of population external irradiation doses. The options for specification of population external irradiation doses assessment are: correction of gamma radiation dose measurement results with consideration of dosimeters own background level and space radiation response, introduction of more up-to-date dosimeters with scintillation detectors, etc. The most promising direction of research in verification of population external irradiation doses assessment is account of dosimetry equipment.

  20. Prophylactic G-CSF and antibiotics enable a significant dose-escalation of triplet-chemotherapy in non-small cell lung cancer.

    NARCIS (Netherlands)

    Timmer-Bonte, J.N.H.; Punt, C.J.A.; Heijden, H.F.M. van der; Die, C.E. van; Bussink, J.; Beijnen, J.H.; Huitema, A.D.; Tjan-Heijnen, V.C.

    2008-01-01

    In advanced non-small cell lung cancer (NSCLC) the clinical benefit of a platinum-based doublet is only modest, therefore, attenuated dosed three-drug combinations are investigated. We hypothesized that with adequate support a full dosed chemotherapy triplet is feasible. The study was designed as a

  1. SU-E-T-87: Comparison Study of Dose Reconstruction From Cylindrical Diode Array Measurements, with TLD Measurements and Treatment Planning System Calculations in Anthropomorphic Head and Neck and Lung Phantoms

    Energy Technology Data Exchange (ETDEWEB)

    Benhabib, S; Cardan, R; Huang, M; Brezovich, I; Popple, R [University of Alabama at Birmingham, Birmingham, AL (United States); Faught, A; Followill, D [UT MD Anderson Cancer Center, Houston, TX (United States)

    2014-06-01

    Purpose: To assess dose calculated by the 3DVH software (Sun Nuclear Systems, Melbourne, FL) against TLD measurements and treatment planning system calculations in anthropomorphic phantoms. Methods: The IROC Houston (RPC) head and neck (HN) and lung phantoms were scanned and plans were generated using Eclipse (Varian Medical Systems, Milpitas, CA) following IROC Houston procedures. For the H and N phantom, 6 MV VMAT and 9-field dynamic MLC (DMLC) plans were created. For the lung phantom 6 MV VMAT and 15 MV 9-field dynamic MLC (DMLC) plans were created. The plans were delivered to the phantoms and to an ArcCHECK (Sun Nuclear Systems, Melbourne, FL). The head and neck phantom contained 8 TLDs located at PTV1 (4), PTV2 (2), and OAR Cord (2). The lung phantom contained 4 TLDs, 2 in the PTV, 1 in the cord, and 1 in the heart. Daily outputs were recorded before each measurement for correction. 3DVH dose reconstruction software was used to project the calculated dose to patient anatomy. Results: For the HN phantom, the maximum difference between 3DVH and TLDs was -3.4% and between 3DVH and Eclipse was 1.2%. For the lung plan the maximum difference between 3DVH and TLDs was 4.3%, except for the spinal cord for which 3DVH overestimated the TLD dose by 12%. The maximum difference between 3DVH and Eclipse was 0.3%. 3DVH agreed well with Eclipse because the dose reconstruction algorithm uses the diode measurements to perturb the dose calculated by the treatment planning system; therefore, if there is a problem in the modeling or heterogeneity correction, it will be carried through to 3DVH. Conclusion: 3DVH agreed well with Eclipse and TLD measurements. Comparison of 3DVH with film measurements is ongoing. Work supported by PHS grant CA10953 and CA81647 (NCI, DHHS)

  2. Inclusion of functional information from perfusion SPECT improves predictive value of dose-volume parameters in lung toxicity outcome after radiotherapy for non-small cell lung cancer: A prospective study

    DEFF Research Database (Denmark)

    Farr, Katherina P; Kallehauge, Jesper F; Møller, Ditte S;

    2015-01-01

    BACKGROUND AND PURPOSE: To compare functional and standard dose-volume parameters as predictors of postradiation pulmonary toxicity in lung cancer patients undergoing curative chemo-radiotherapy (RT) studied prospectively. MATERIAL AND METHODS: A total of 58 patients treated with Intensity...... pneumonitis (RP) grade 2-5. RESULTS: Functional mean lung dose (MLD) and lung volumes receiving 5, 10, 20 and 30Gy (V5-V30, respectively) revealed high correlation with corresponding standard parameters (r>0.8). Standard MLD, V20 and V30 were significantly higher in patients with RP (p=0.01). All functional...... Modulated RT (60-66Gy) were analysed. Standard dose-volume parameters were extracted from treatment planning computed tomography (CT) scans. Corresponding functional dose-volume parameters were calculated from perfusion single-photon emission computed tomography (SPECT). Primary end-point was radiation...

  3. Relationship between dose-volume parameters and pulmonary complications after neoadjuvant chemoradiotherapy followed by surgery for lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Shigeo; Shibata, Toru [Kagawa University Hospital, Department of Radiation Oncology, Kagawa (Japan); Go, Tetsuhiko; Kasai, Yoshitaka; Yokomise, Hiroyasu [Kagawa University, Department of General Thoracic, Breast and Endocrine Surgery, Faculty of Medicine, Kagawa (Japan)

    2016-09-15

    This study evaluated the relationship between dose-volume histogram (DVH) parameters and pulmonary complications after neoadjuvant chemoradiotherapy (NACRT) followed by surgery for lung cancer. We also examined a new DVH parameter, because the unresected lung should be more spared than the later resected lung. Data from 43 non-small cell lung cancer patients were retrospectively analyzed. The DVH parameters of the lung were calculated from the total bilateral lung volume minus (1) the gross tumor volume (DVHg) or (2) the later resected lung volume (DVHr). Radiation pneumonitis (RP) and fistula, including bronchopleural and pulmonary fistula, were graded as the pulmonary complications. Factors affecting the incidences of grade 2 or higher RP (≥G2 RP) and fistula were analyzed. Sixteen patients (37 %) experienced ≥G2 RP and a V20 value of the total lung minus the later resected lung (V20r) ≥ 12 % was a significant factor affecting the incidence of ≥G2 RP (p = 0.032). Six patients (14 %) developed a fistula and a V35 value of the total lung minus the gross tumor (V35g) ≥ 19 % and a V40g ≥ 16 % were significant factors affecting the incidence of fistula (p = 0.002 and 0.009, respectively). These DVH parameters may be related to the incidences of ≥G2 RP and fistula. (orig.) [German] In dieser Studie wurde die Beziehung zwischen Dosis-Volumen-Histogramm-(DVH-)Parametern und pulmonalen Komplikationen nach neoadjuvanter Radiochemotherapie (NARCT) und nachfolgender Operation beim Lungenkarzinom untersucht. Zudem wurde ein neuer DVH-Parameter untersucht, da das nichtresezierte Lungengewebe mehr geschont werden sollte als reseziertes Gewebe. Daten von 43 Patienten mit nicht-kleinzelligem Bronchialkarzinom wurden retrospektiv analysiert. Die DVH-Parameter der Lunge wurden aus dem gesamten beidseitigen Lungenvolumen minus (1) das makroskopische Tumorvolumen (DVHg) oder (2) das resezierte Lungenvolumen (DVHr) ermittelt. Strahlenpneumonitis (RP) und Fisteln

  4. Performance of ultralow-dose CT with iterative reconstruction in lung cancer screening: limiting radiation exposure to the equivalent of conventional chest X-ray imaging

    Energy Technology Data Exchange (ETDEWEB)

    Huber, Adrian [University Hospital Inselspital Bern, Department of Diagnostic, Interventional and Paediatric Radiology, Bern (Switzerland); University Hospital Pitie-Salpetriere, Department of Polyvalent and Oncological Radiology, Paris (France); Landau, Julia; Buetikofer, Yanik; Leidolt, Lars; Brela, Barbara; May, Michelle; Heverhagen, Johannes; Christe, Andreas [University Hospital Inselspital Bern, Department of Diagnostic, Interventional and Paediatric Radiology, Bern (Switzerland); Ebner, Lukas [University Hospital Inselspital Bern, Department of Diagnostic, Interventional and Paediatric Radiology, Bern (Switzerland); Duke University Medical Center, Department of Radiology, Durham, NC (United States)

    2016-10-15

    To investigate the detection rate of pulmonary nodules in ultralow-dose CT acquisitions. In this lung phantom study, 232 nodules (115 solid, 117 ground-glass) of different sizes were randomly distributed in a lung phantom in 60 different arrangements. Every arrangement was acquired once with standard radiation dose (100 kVp, 100 references mAs) and once with ultralow radiation dose (80 kVp, 6 mAs). Iterative reconstruction was used with optimized kernels: I30 for ultralow-dose, I70 for standard dose and I50 for CAD. Six radiologists examined the axial 1-mm stack for solid and ground-glass nodules. During a second and third step, three radiologists used maximum intensity projection (MIPs), finally checking with computer-assisted detection (CAD), while the others first used CAD, finally checking with the MIPs. The detection rate was 95.5 % with standard dose (DLP 126 mGy*cm) and 93.3 % with ultralow-dose (DLP: 9 mGy*cm). The additional use of either MIP reconstructions or CAD software could compensate for this difference. A combination of both MIP reconstructions and CAD software resulted in a maximum detection rate of 97.5 % with ultralow-dose. Lung cancer screening with ultralow-dose CT using the same radiation dose as a conventional chest X-ray is feasible. (orig.)

  5. Dose-responsiveness and persistence of microRNA expression alterations induced by cigarette smoke in mouse lung

    Energy Technology Data Exchange (ETDEWEB)

    Izzotti, Alberto; Larghero, Patrizia; Longobardi, Mariagrazia; Cartiglia, Cristina; Camoirano, Anna [Department of Health Sciences, University of Genoa, Genoa (Italy); Steele, Vernon E. [National Cancer Institute (NCI), Rockville, MD (United States); De Flora, Silvio, E-mail: sdf@unige.it [Department of Health Sciences, University of Genoa, Genoa (Italy)

    2011-12-01

    Our previous studies demonstrated that exposure to cigarette smoke (CS), either mainstream or environmental, results in a remarkable downregulation of microRNA expression in the lung of both mice and rats. The goals of the present study were to evaluate the dose responsiveness to CS and the persistence of microRNA alterations after smoking cessation. ICR (CD-1) neonatal mice were exposed whole-body to mainstream CS, at the doses of 119, 292, 438, and 631 mg/m{sup 3} of total particulate matter. Exposure started within 12 h after birth and continued daily for 4 weeks. The levels of bulky DNA adducts and 8-oxo-7,8-dihydro-2 Prime -deoxyguanosine (8-oxodGuo) were measured by {sup 32}P postlabeling procedures, and the expression of 697 mouse microRNAs was analyzed by microarray. The highest CS dose was lethal. Exposure to CS caused a dose-dependent increase of DNA alterations. DNA adducts and, even more sharply, 8-oxodGuo were reverted 1 and 4 weeks after smoking cessation. Exposure to CS resulted in an evident dysregulation of microRNA expression profiles, mainly in the sense of downregulation. The two lowest doses were not particularly effective, while the highest nonlethal dose produced extensive microRNA alterations. The expression of most downregulated microRNAs, including among others 7 members of the let-7 family, was restored one week after smoking cessation. However, the recovery was incomplete for a limited array of microRNAs, including mir-34b, mir-345, mir-421, mir-450b, mir-466, and mir-469. Thus, it appears that microRNAs mainly behave as biomarkers of effect and that exposure to high-dose, lasting for an adequate period of time, is needed to trigger the CS-related carcinogenesis process in the experimental animal model used.

  6. Diffuse and fugitive emission dose assessment on the Hanford Site

    Energy Technology Data Exchange (ETDEWEB)

    Davis, W.E.; Schmidt, J.W.; Gleckler, B.P. [Westinghouse Hanford Co., Richland, WA (United States); Rhoads, K. [Pacific Northwest Lab., Richland, WA (United States)

    1995-01-01

    On February 3, 1993, the US Department of Energy, Richland Operations Office (RL), received a Compliance Order and Information Request from the Director of the Air and Toxics Division of the US Environmental Protection Agency (EPA), Region 10. The Compliance Order requires RL to (1) evaluate all radionuclide emission points at the Hanford Site to determine which are subject to continuous emission measurement requirements in 40 Code of Federal Regulations (CFR) 61, Subpart H, and (2) continuously measure radionuclide emissions in accordance with 40 CFR 61.93. The Information Request requires RL to provide a written Compliance Plan to meet the requirements of the Compliance Order. The RL Compliance Plan included as one of its milestones the requirement to develop a Federal Facility Compliance Agreement (FFCA). An FFCA was negotiated between RL and the EPA, Region 10, and was entered into on February 7, 1994. One of the milestones was to provide EPA, Region 10, with a copy of the Federal Clean Air Act Title V operating air permit application and Air Emission Inventory (AEI) concurrent with its submission to the Washington State Department of Ecology. The AEI will include an assessment of the diffuse and fugitive emissions from the Hanford Site. This assessment does not identify any diffuse or fugitive emission source that would cause an effective dose equivalent greater than 0.1 mrem/yr.

  7. Cancer-Associated Fibroblasts from lung tumors maintain their immuno-suppressive abilities after high-dose irradiation

    Directory of Open Access Journals (Sweden)

    Laia eGorchs

    2015-05-01

    Full Text Available Accumulating evidence supports the notion that high-dose (>5 Gy radiotherapy (RT regimens are triggering stronger pro-immunogenic effects than standard low-dose (2 Gy regimens. However, the effects of RT on certain immunoregulatory elements in tumors remain unexplored. In this study we have investigated the effects of high-dose irradiation (HD-RT on the immunomodulating functions of cancer-associated fibroblasts (CAFs. Primary CAF cultures were established from lung cancer specimens derived from patients diagnosed for non-small cell lung cancer. Irradiated and non-irradiated CAFs were examined for immunomodulation in experiments with peripheral blood mononuclear cells from random, healthy donors. Regulation of lymphocytes behavior was checked by lymphocyte proliferation assays, lymphocyte migration assays and T-cell cytokine production. Additionally, CAF-secreted immuno-regulatory factors were studied by multiplex protein arrays, ELISAs and by LC-MS/MS proteomics. In all functional assays we observed a powerful immuno-suppressive effect exerted by CAF-conditioned medium on activated T-cells (p>0,001, and this effect was sustained after a single radiation dose of 18 Gy. Relevant immuno-suppressive molecules such as prostaglandin E2, interleukin-6 and -10, or transforming growth factor-β were found in CAF conditioned medium, but their secretion was unchanged after irradiation. Finally, immunogenic cell death responses in CAFs were studied by exploring the release of high motility group box-1 and ATP. Both alarmins remained undetectable before and after irradiation. In conclusion, CAFs play a powerful immuno-suppressive effect over activated T-cells, and this effect remains unchanged after HD-RT. Importantly, CAFs do not switch on immunogenic cell death responses after exposure to HD-RT.

  8. Technology Assessment and Roadmap for the Emergency Radiation Dose Assessment Program

    Energy Technology Data Exchange (ETDEWEB)

    Turteltaub, K W; Hartman-Siantar, C; Easterly, C; Blakely, W

    2005-10-03

    A Joint Interagency Working Group (JIWG) under the auspices of the Department of Homeland Security Office of Research and Development conducted a technology assessment of emergency radiological dose assessment capabilities as part of the overall need for rapid emergency medical response in the event of a radiological terrorist event in the United States. The goal of the evaluation is to identify gaps and recommend general research and development needs to better prepare the Country for mitigating the effects of such an event. Given the capabilities and roles for responding to a radiological event extend across many agencies, a consensus of gaps and suggested development plans was a major goal of this evaluation and road-mapping effort. The working group consisted of experts representing the Departments of Homeland Security, Health and Human Services (Centers for Disease Control and the National Institutes of Health), Food and Drug Administration, Department of Defense and the Department of Energy's National Laboratories (see appendix A for participants). The specific goals of this Technology Assessment and Roadmap were to: (1) Describe the general context for deployment of emergency radiation dose assessment tools following terrorist use of a radiological or nuclear device; (2) Assess current and emerging dose assessment technologies; and (3) Put forward a consensus high-level technology roadmap for interagency research and development in this area. This report provides a summary of the consensus of needs, gaps and recommendations for a research program in the area of radiation dosimetry for early response, followed by a summary of the technologies available and on the near-term horizon. We then present a roadmap for a research program to bring present and emerging near-term technologies to bear on the gaps in radiation dose assessment and triage. Finally we present detailed supporting discussion on the nature of the threats we considered, the status of

  9. Lung cancer symptoms and pulse oximetry in the prognostic assessment of patients with lung cancer

    Directory of Open Access Journals (Sweden)

    Harada Cecilia M

    2005-07-01

    Full Text Available Abstract Background Medical oncologists continue to use performance status as a proxy for quality of life (QOL measures, as completion of QOL instruments is perceived as time consuming, may measure aspects of QOL not affected by cancer therapy, and interpretation may be unclear. The pulse oximeter is widely used in clinical practice to predict cardiopulmonary morbidity after lung resection in cancer patients, but little is known on its role outside the surgical setting. We evaluated whether the Lung Cancer Symptom Scale and pulse oximetry may contribute to the evaluation of lung cancer patients who received standard anticancer therapy. Methods We enrolled forty-one consecutive, newly diagnosed, patients with locally advanced or metastatic lung cancer in this study. We developed a survival model with the variables gender, age, histology, clinical stage, Karnofsky performance status, wasting, LCSS symptom scores, average symptom burden index, and pulse oximetry (SpO2. Results Patient and observer-rated scores were correlated, except for the fatigue subscale. The median SpO2 was 95% (range: 86 to 98, was unrelated to symptom scores, and was weakly correlated with observer cough scores. In a multivariate survival model, SpO2 > 90% and patient scores on the LCSS appetite and fatigue subscales were independent predictors of survival. Conclusion LCSS fatigue and appetite rating, and pulse oximetry should be studied further as prognostic factors in lung cancer patients.

  10. Low-dose CT screening in an Asian population with diverse risk for lung cancer: A retrospective cohort study

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Chin A. [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Lee, Kyung Soo [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Sungkyunkwan University School of Medicine, Department of Radiology, Samsung Medical Center, Seoul (Korea, Republic of); Shin, Myung-Hee; Cho, Yun Yung [Sungkyunkwan University School of Medicine, Department of Social and Preventive Medicine, Seoul (Korea, Republic of); Choi, Yoon-Ho [Sungkyunkwan University School of Medicine, Center for Health Promotion, Seoul (Korea, Republic of); Kwon, O. Jung [Sungkyunkwan University School of Medicine, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Seoul (Korea, Republic of); Shin, Kyung Eun [Sungkyunkwan University School of Medicine, Department of Radiology and Center for Imaging Science, Seoul (Korea, Republic of); Kyung Hee University Hospital, Department of Diagnostic Radiology, Seoul (Korea, Republic of)

    2015-08-15

    To evaluate the performance of low-dose CT (LDCT) screening for lung cancer (LCA) detection in an Asian population with diverse risks for LCA. LCA screening was performed in 12,427 symptomless Asian subjects using either LDCT (5,771) or chest radiography (CXR) (6,656) in a non-trial setting. Subjects were divided into high-risk and non-high-risk groups. Data were collected on the number of patients with screening-detected LCAs and their survival in order to compare outcomes between LDCT and CXR screening with the stratification of risks considering age, sex and smoking status. In the non-high-risk group, a significant difference was observed for the detection of lung cancer (adjusted OR, 5.07; 95 % CI, 2.72-9.45) and survival (adjusted HR of LCA survival between LDCT vs. CXR group, 0.08; 95 % CI, 0.01-0.62). No difference in detection or survival of LCA was noticed in the high-risk group. LCAs in the non-high-risk group were predominantly adenocarcinomas (96 %), and more likely to be part-solid or non-solid compared with those in the high-risk group (p = 0.023). In the non-high-risk group, LDCT helps detect more LCAs and offers better survival than CXR screening, due to better detection of part solid or non-solid lung adenocarcinomas. (orig.)

  11. The value of nitrogen washout/washin method in assessing alveolar recruitment volume in acute lung injury patients

    Institute of Scientific and Technical Information of China (English)

    李洋

    2013-01-01

    Objective To evaluate the precision and feasibility of nitrogen washout/washin method in assessing lung recruitment of acute lung injury(ALI)patients.Methods Fifteen ALI patients underwent mechanical ventilation

  12. Strategies of dose escalation in the treatment of locally advanced non-small cell lung cancer: image guidance and beyond

    Directory of Open Access Journals (Sweden)

    Alexander eChi

    2014-06-01

    Full Text Available Radiation dose in the setting of chemo-radiation for locally advanced non-small cell lung cancer (NSCLC has been historically limited by the risk of normal tissue toxicity and this has been hypothesized to correlate with the poor results in regard to local tumor recurrences. Dose escalation, as a means to improve local control, with concurrent chemotherapy has been shown to be feasible with three-dimensional conformal radiotherapy in early phase studies with good clinical outcome. However, the potential superiority of moderate dose escalation to 74 Gy has not been shown in phase III randomized studies. In this review, the limitations in target volume definition in previous studies; and the factors that may be critical to safe dose escalation in the treatment of locally advanced NSCLC, such as respiratory motion management, image guidance, intensity modulation, FDG-PET incorporation in the treatment planning process, and adaptive radiotherapy, are discussed. These factors, along with novel treatment approaches that have emerged in recent years, are proposed to warrant further investigation in future trials in a more comprehensive and integrated fashion.

  13. Models for dose assessments. Modules for various biosphere types

    Energy Technology Data Exchange (ETDEWEB)

    Bergstroem, U.; Nordlinder, S.; Aggeryd, I. [Studsvik Eco and Safety AB, Nykoeping (Sweden)

    1999-12-01

    The main objective of this study was to provide a basis for illustrations of yearly dose rates to the most exposed individual from hypothetical leakages of radionuclides from a deep bedrock repository for spent nuclear fuel and other radioactive waste. The results of this study will be used in the safety assessment SR 97 and in a study on the design and long-term safety for a repository planned to contain long-lived low and intermediate level waste. The repositories will be designed to isolate the radionuclides for several hundred thousands of years. In the SR 97 study, however, hypothetical scenarios for leakage are postulated. Radionuclides are hence assumed to be transported in the geosphere by groundwater, and probably discharge into the biosphere. This may occur in several types of ecosystems. A number of categories of such ecosystems were identified, and turnover of radionuclides was modelled separately for each ecosystem. Previous studies had focused on generic models for wells, lakes and coastal areas. These models were, in this study, developed further to use site-specific data. In addition, flows of groundwater, containing radionuclides, to agricultural land and peat bogs were considered. All these categories are referred to as modules in this report. The forest ecosystems were not included, due to a general lack of knowledge of biospheric processes in connection with discharge of groundwater in forested areas. Examples of each type of module were run with the assumption of a continuous annual release into the biosphere of 1 Bq for each radionuclide during 10 000 years. The results are presented as ecosystem specific dose conversion factors (EDFs) for each nuclide at the year 10 000, assuming stationary ecosystems and prevailing living conditions and habits. All calculations were performed with uncertainty analyses included. Simplifications and assumptions in the modelling of biospheric processes are discussed. The use of modules may be seen as a step

  14. Magnetic resonance lung function – a breakthrough for lung imaging and functional assessment? A phantom study and clinical trial

    Directory of Open Access Journals (Sweden)

    Rauh Manfred

    2006-08-01

    Full Text Available Abstract Background Chronic lung diseases are a major issue in public health. A serial pulmonary assessment using imaging techniques free of ionizing radiation and which provides early information on local function impairment would therefore be a considerably important development. Magnetic resonance imaging (MRI is a powerful tool for the static and dynamic imaging of many organs. Its application in lung imaging however, has been limited due to the low water content of the lung and the artefacts evident at air-tissue interfaces. Many attempts have been made to visualize local ventilation using the inhalation of hyperpolarized gases or gadolinium aerosol responding to MRI. None of these methods are applicable for broad clinical use as they require specific equipment. Methods We have shown previously that low-field MRI can be used for static imaging of the lung. Here we show that mathematical processing of data derived from serial MRI scans during the respiratory cycle produces good quality images of local ventilation without any contrast agent. A phantom study and investigations in 85 patients were performed. Results The phantom study proved our theoretical considerations. In 99 patient investigations good correlation (r = 0.8; p ≤ 0.001 was seen for pulmonary function tests and MR ventilation measurements. Small ventilation defects were visualized. Conclusion With this method, ventilation defects can be diagnosed long before any imaging or pulmonary function test will indicate disease. This surprisingly simple approach could easily be incorporated in clinical routine and may be a breakthrough for lung imaging and functional assessment.

  15. Precision Hypofractionated Radiation Therapy in Poor Performing Patients With Non-Small Cell Lung Cancer: Phase 1 Dose Escalation Trial

    Energy Technology Data Exchange (ETDEWEB)

    Westover, Kenneth D. [Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas (United States); Loo, Billy W. [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Gerber, David E. [Division of Hematology-Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas (United States); Iyengar, Puneeth; Choy, Hak [Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas (United States); Diehn, Maximilian [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Hughes, Randy; Schiller, Joan; Dowell, Jonathan [Division of Hematology-Oncology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas (United States); Wardak, Zabi [Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas (United States); Sher, David [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); Christie, Alana; Xie, Xian-Jin [Department of Clinical Science, Southwestern Medical Center, Dallas, Texas (United States); Corona, Irma [Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas (United States); Sharma, Akanksha [School of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas (United States); Wadsworth, Margaret E. [Radiation Oncology of Mississippi, Jackson, Mississippi (United States); Timmerman, Robert, E-mail: Robert.Timmerman@utsouthwestern.edu [Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas (United States)

    2015-09-01

    Purpose: Treatment regimens for locally advanced non-small cell lung cancer (NSCLC) give suboptimal clinical outcomes. Technological advancements such as radiation therapy, the backbone of most treatment regimens, may enable more potent and effective therapies. The objective of this study was to escalate radiation therapy to a tumoricidal hypofractionated dose without exceeding the maximally tolerated dose (MTD) in patients with locally advanced NSCLC. Methods and Materials: Patients with stage II to IV or recurrent NSCLC and Eastern Cooperative Oncology Group performance status of 2 or greater and not candidates for surgical resection, stereotactic radiation, or concurrent chemoradiation were eligible. Highly conformal radiation therapy was given to treat intrathoracic disease in 15 fractions to a total of 50, 55, or 60 Gy. Results: Fifty-five patients were enrolled: 15 at the 50-Gy, 21 at the 55-Gy, and 19 at the 60-Gy dose levels. A 90-day follow-up was completed in each group without exceeding the MTD. With a median follow-up of 12.5 months, there were 93 grade ≥3 adverse events (AEs), including 39 deaths, although most AEs were considered related to factors other than radiation therapy. One patient from the 55- and 60-Gy dose groups developed grade ≥3 esophagitis, and 5, 4, and 4 patients in the respective dose groups experienced grade ≥3 dyspnea, but only 2 of these AEs were considered likely related to therapy. There was no association between fraction size and toxicity (P=.24). The median overall survival was 6 months with no significant differences between dose levels (P=.59). Conclusions: Precision hypofractionated radiation therapy consisting of 60 Gy in 15 fractions for locally advanced NSCLC is generally well tolerated. This treatment regimen could provide patients with poor performance status a potent alternative to chemoradiation. This study has implications for the cost effectiveness of lung cancer therapy. Additional studies of long

  16. The Comparison 2D and 3D Treatment Planning in Breast Cancer Radiotherapy with Emphasis on Dose Homogeneity and Lung Dose

    Directory of Open Access Journals (Sweden)

    Zahra Falahatpour

    2010-09-01

    Full Text Available Introduction: Breast conserving radiotherapy is one of the most common procedures performed in any radiation oncology department. A tangential parallel-opposed pair is usually used for this purpose. This technique is performed using 2D or 3D treatment planning systems. The aim of this study was to compare 2D treatment planning with 3D treatment planning in tangential irradiation in breast conserving radiotherapy. In this comparison, homogeneity of isodoses in the breast volume and lung dose were considered. Material and Methods: Twenty patients with breast cancer treated with conservative surgery were included in this study. The patients were CT scanned. Two-dimensional treatment planning with the Alfard 2D TPS was performed for each patient using a single central CT slice. The data used on the Alfard 2D TPS was imported into the Eclipse 3D TPS, on which 3D treatment planning was performed. Cobalt-60 beams were used in all plans. Results: Comparing 2D and 3D treatment planning, homogeneity of isodoses was improved in 3D treatment planning (p30Gy was increased in 3D treatment planning (p< 0.01. Discussion and Conclusion: 3D treatment planning is a more suitable option for patients with breast cancer treated with conservative surgery because of improved dose homogeneity in 3D treatment planning. The results of the treatment can be improved with reduced recurrence probability and skin problems.

  17. Mechanisms, assessment and therapeutic implications of lung hyperinflation in COPD.

    Science.gov (United States)

    Rossi, Andrea; Aisanov, Zaurbek; Avdeev, Sergey; Di Maria, Giuseppe; Donner, Claudio F; Izquierdo, José Luis; Roche, Nicolas; Similowski, Thomas; Watz, Henrik; Worth, Heinrich; Miravitlles, Marc

    2015-07-01

    The main complaint of patients with chronic obstructive pulmonary disease (COPD) is shortness of breath with exercise, that is usually progressive. The principal mechanism that explains this symptom is the development of lung hyperinflation (LH) which is defined by an increase of functional residual capacity (FRC) above predicted values. Patients with COPD may develop static LH (sLH) because of destruction of pulmonary parenchyma and loss of elastic recoil. In addition, dynamic LH (dLH) develops when patients with COPD breathe in before achieving a full exhalation and, as a consequence, air is trapped within the lungs with each further breath. Dynamic LH may also occur at rest but it becomes clinically relevant during exercise and exacerbation. Lung hyperinflation may have an impact beyond the lungs and the effects of LH on cardiovascular function have been extensively analysed. The importance of LH makes its identification and measurement crucial. The demonstration of LH in COPD leads to the adoption of strategies to minimise its impact on the daily activities of patients. Several strategies reduce the impact of LH; the use of long-acting bronchodilators has been shown to reduce LH and improve exercise capacity. Non pharmacologic interventions have also been demonstrated to be useful. This article describes the pathophysiology of LH, its impact on the lungs and beyond and reviews the strategies that improve LH in COPD.

  18. Local Tumor Control and Normal Tissue Toxicity of Pulsed Low-Dose Rate Radiotherapy for Recurrent Lung Cancer

    Directory of Open Access Journals (Sweden)

    Peng Zhang

    2015-05-01

    Full Text Available Objectives: This study investigates (1 local tumor control and (2 normal tissue toxicity of pulsed low-dose rate radiotherapy (PLDR for recurrent lung cancer. Methods: For study 1, nude mice were implanted with A549 tumors and divided into the following 3 groups: (1 control (n = 10, (2 conventional radiotherapy (RT; n = 10, and (3 PLDR (n = 10. Tumor-bearing mice received 2 Gy daily dose for 2 consecutive days. Weekly magnetic resonance imaging was used for tumor growth monitoring. For study 2, 20 mice received 8 Gy total body irradiation either continuously (n = 10 or 40 × 0.2 Gy pulses with 3-minute intervals (n = 10. Results: For study 1, both conventional RT and PLDR significantly inhibited the growth of A549 xenografts compared with the control group (>35% difference in the mean tumor volume; P .05. For study 2, the average weight was 20.94 ± 1.68 g and 25.69 ± 1.27 g and the survival time was 8 days and 12 days for mice treated with conventional RT and PLDR (P < .05, respectively. Conclusion: This study showed that PLDR could control A549 tumors as effectively as conventional RT, and PLDR induced much less normal tissue toxicity than conventional RT. Thus, PLDR would be a good modality for recurrent lung cancers. Advances in Knowledge: This article reports our results of an in vivo animal investigation of PLDR for the treatment of recurrent cancers, which may not be eligible for treatment because of the dose limitations on nearby healthy organs that have been irradiated in previous treatments. This was the first in vivo study to quantify the tumor control and normal tissue toxicities of PLDR using mice with implanted tumors, and our findings provided evidence to support the clinical trials that employ PLDR treatment techniques.

  19. Effect of intensiti modulated radiation therapy according to equivalent uniform dose optimization method on patients with lung cancer

    Institute of Scientific and Technical Information of China (English)

    Yu-Fu Zhou; Qian Sun; Ya-Jun Zhang; Geng-Ming Wang; Bin He; Tao Qi; An Zhou

    2016-01-01

    Objective:To analyze the effect of the intensity modulated radiation therapy according to equivalent uniform dose optimization method on patients with lung cancer.Methods:A total of 82 cases of non-small cell lung cancer were divided into observation group and control group according to the random number table method. Patients in the control group received conventional radiotherapy while observation group received intensity modulated radiotherapy based on equivalent uniform dose optimization method. The treatment effects, survival times, blood vessel-related factors, blood coagulation function and the levels of inflammatory factors and so on were compared between the two groups of patients.Results:The effective rate of the observation group after treatment was higher than that of the control group. Progression free survival and median overall survival times were longer than those of patients in the control group (P<0.05). The serum VEGF and HIF-αα levels as well as D-D, TT, PT, APTT and FIB levels were lower in observation group patients after treatment than those in the control group(P<0.05). At the same time point, serum TNF-αα, CRP and PCT levels in the observation group after treatment were lower than those in the control group (P<0.05). Serum M2-PK, CA125, CEA and SCC values of patients in the observation group after treatment were all significantly lower than those in the control group (P< 0.05).Conclusions:Intensity modulated radiation therapy based on equivalent uniform dose optimized method can improve the treatment effect, prolong the survival time, optimize micro inflammatory environment and inhibit tumor biological behavior at the same time.

  20. Residential radon-222 exposure and lung cancer: exposure assessment methodology.

    Science.gov (United States)

    Field, R W; Steck, D J; Lynch, C F; Brus, C P; Neuberger, J S; Kross, B C

    1996-01-01

    Although occupational epidemiological studies and animal experimentation provide strong evidence that radon-222 (222Rn) progeny exposure causes lung cancer, residential epidemiological studies have not confirmed this association. Past residential epidemiological studies have yielded contradictory findings. Exposure misclassification has seriously compromised the ability of these studies to detect whether an association exists between 222Rn exposure and lung cancer. Misclassification of 222Rn exposure has arisen primarily from: 1) detector measurement error; 2) failure to consider temporal and spatial 222Rn variations within a home; 3) missing data from previously occupied homes that currently are inaccessible; 4) failure to link 222Rn concentrations with subject mobility; and 5) measuring 222Rn gas concentration as a surrogate for 222Rn progeny exposure. This paper examines these methodological dosimetry problems and addresses how we are accounting for them in an ongoing, population-based, case-control study of 222Rn and lung cancer in Iowa.

  1. Dose assessment intercomparisons within the RENEB network using G0-lymphocyte prematurely condensed chromosomes (PCC assay)

    OpenAIRE

    Terzoudi, Georgia I; Pantelias, Gabriel; Darroudi, Firouz; Barszczewska, Katarzyna; Buraczewska, Iwona; Depuydt, Julie; Georgieva, Dimka; Hadjidekova, Valeria; Hatzi, Vasiliki I.; Karachristou, Ioanna; Karakosta, Maria; Meschini, Roberta; M’kacher, Radhia; Montoro, Alegria; Palitti, Fabrizio

    2017-01-01

    Purpose: Dose assessment intercomparisons within the RENEB network were performed for triage biodosimetry analyzing G0-lymphocyte PCC for harmonization, standardization and optimization of the PCC assay. Materials and methods: Comparative analysis among different partners for dose assessment included shipment of PCC-slides and captured images to construct dose-response curves for up to 6 Gy c-rays. Accident simulation exercises were performed to assess the suitability of the PCC assay by d...

  2. Comparison of pencil beam–based homogeneous vs inhomogeneous target dose planning for stereotactic body radiotherapy of peripheral lung tumors through Monte Carlo–based recalculation

    Energy Technology Data Exchange (ETDEWEB)

    Ohtakara, Kazuhiro, E-mail: ohtakara@murakami.asahi-u.ac.jp [Department of Radiation Oncology, Murakami Memorial Hospital, Asahi University, Gifu (Japan); Hoshi, Hiroaki [Department of Radiology, Gifu University Graduate School of Medicine, Gifu (Japan)

    2015-10-01

    This study was conducted to ascertain whether homogeneous target dose planning is suitable for stereotactic body radiotherapy (SBRT) of peripheral lung cancer under appropriate breath-holding. For 20 peripheral lung tumors, paired dynamic conformal arc plans were generated by only adjusting the leaf margin to the planning target volume (PTV) edge for fulfilling the conditions such that the prescription isodose surface (IDS) encompassing exactly 95% of the PTV (PTV D{sub 95}) corresponds to 95% and 80% IDS, normalized to 100% at the PTV isocenter under a pencil beam (PB) algorithm with radiologic path length correction. These plans were recalculated using the x-ray voxel Monte Carlo (XVMC) algorithm under otherwise identical conditions, and then compared. Lesions abutting the parietal pleura or not were defined as edge or island tumors, respectively, and the influences of the target volume and its location relative to the chest wall on the target dose were examined. The median (range) leaf margin required for the 95% and 80% plans was 3.9 mm (1.3 to 5.0) and −1.2 mm (−1.8 to 0.1), respectively. Notably, the latter was significantly correlated negatively with PTV. In the 80% plans, the PTV D{sub 95} was slightly higher under XVMC, whereas the PTV D{sub 98} was significantly lower, irrespective of the dose calculation algorithm used. Other PTV and all gross tumor volume doses were significantly higher, while the lung doses outside the PTV were slightly lower. The target doses increased as a function of PTV and were significantly lower for island tumors than for edge tumors. In conclusion, inhomogeneous target dose planning using smaller leaf margin for a larger tumor volume was deemed suitable in ensuring more sufficient target dose while slightly reducing lung dose. In addition, more inhomogeneous target dose planning using <80% IDS (e.g., 70%) for PTV covering would be preferable for island tumors.

  3. Dose assessment in pediatric computerized tomography; Avaliacao de doses em tomografia computadorizada pediatrica

    Energy Technology Data Exchange (ETDEWEB)

    Vilarinho, Luisa Maria Auredine Lima

    2004-07-01

    The objective of this work was the evaluation of radiation doses in paediatric computed tomography scans, considering the high doses usually involved and the absence of any previous evaluation in Brazil. Dose values were determined for skull and abdomen examinations, for different age ranges, by using the radiographic techniques routinely used in the clinical centers investigated. Measurements were done using pencil shape ionization chambers inserted in polymethylmethacrylate (PMMA) phantoms. These were compact phantoms of different diameters were specially designed and constructed for this work, which simulate different age ranges. Comparison of results with published values showed that doses were lower than the diagnostic reference levels established to adults exams by the European Commission. Nevertheless, doses in paediatric phantoms were higher than those obtained in adult phantoms. The paediatric dose values obtained in Hospitals A and B were lower than the reference level (DRL) adopted by SHIMPTON for different age ranges. In the range 0 - 0.5 year (neonatal), the values of DLP in Hospital B were 94 por cent superior to the DRL For the 10 years old children the values of CTDI{sub w} obtained were inferior in 89 por cent for skull and 83 por cent for abdomen examinations, compared to the values published by SHRIMPTON and WALL. Our measured CTDI{sub w} values were inferior to the values presented for SHRIMPTON and HUDA, for all the age ranges and types of examinations. It was observed that the normalized dose descriptors values in children in the neonatal range were always superior to the values of doses for the adult patient. In abdomen examinations, the difference was approximately 90% for the effective dose (E) and of 57%.for CTDI{sub w} . (author)

  4. Optimization of dose and fractionation of endobronchial brachytherapy with or without external radiation in the palliative management of non-small cell lung cancer: A prospective randomized study

    Directory of Open Access Journals (Sweden)

    Mallick I

    2006-01-01

    Full Text Available Aims: Endobronchial brachytherapy (EBBT is an established modality for the palliation in advanced non-small cell lung cancer. We compared three different schedules using EBBT with or without external radiation (XRT in this setting. Materials and Methods: Forty-five patients were randomized to three treatment arms. Arm A received XRT to a dose of 30 Gy/ 10 fr/ 2 weeks and two sessions of EBBT 8 Gy each. Arm B received the same XRT and a single session of EBBT 10 Gy at 1 cm. Arm C received only a single fraction of brachytherapy to a dose of 15 Gy at 1 cm without XRT. Symptomatic response rates, duration of symptom palliation, obstruction scores, quality of life outcomes and complications were assessed and compared. Results: The overall symptomatic response rates were 91% for dyspnea, 84% for cough, 94% for hemoptysis and 83% for obstructive pneumonia. There was no significant difference between the arms. The median time to symptom relapse was 4-8 months for all symptoms and the median time to symptom progression was 6-11 months. The results were comparable between groups except for hemoptysis, where a shorter palliation was seen in Arm C that achieved statistical significance ( P < 0.01. Quality of life showed significant improvement, with maximum benefit in Arm A. Complication rates were low. Only one patient died of fatal hemoptysis. Conclusion: EBBT is thus a safe and effective palliative tool in advanced non-small cell lung cancer, either alone or in conjunction with XRT. The difference between the treatment arms were not statistically significant in most categories, but patients treated with XRT and two endobronchial sessions of 8 Gy had the most consistent benefit in terms of all the parameters studied.

  5. Cystic fibrosis in adults. Short-term and long-term reproducibility of the Brody score for lung morphology in low-dose MDCT scans

    Energy Technology Data Exchange (ETDEWEB)

    Weber, K.; Paolini, M.; Schmitz, M.; Coppenrath, E.; Reiser, M.; Mueller-Lisse, U.G. [Ludwig-Maximilians-Univ. Muenchen (Germany). Inst. fuer Klinische Radiologie; Fischer, R.; Huber, R. [Ludwig-Maximilians-Univ. Muenchen (Germany). Medical Hospital V

    2014-01-15

    Purpose: The semi-quantitative Brody score measures the severity of cystic fibrosis (CF)-related lung disease. We investigated the short-term (28 - 60 days) and long-term (2 - 7 years) intra- and inter-observer reproducibility of the Brody score in low-dose multidetector row computed tomography examinations performed in inspiration (LDCTs) of adult CF patients. Materials and Methods: Composite Brody scores and respective underlying bronchiectasis, mucus plugging, peribronchial thickening, parenchymal opacity, and hyperinflation subscores were evaluated twice (time interval, 1 - 84 months) by each of 3 independent radiologists (1 - 20 years of professional diagnostic radiology experience) in LDCTs (4 - 64 rows, 120 KVp, 10 - 15 mAs/slice, CTDIw approx. 1.0 mGy, effective dose approx. 0.5 mSv) of 15 adult patients with CF-related lung disease (8 female, 7 male, age, 18 - 50 years, mean, 33 years). Results: The average reproducibility of the Brody score was within +/-7 % (range, 2 - 30 %) between radiologists, and +/-6 % (3 - 12 %) within radiologists (short-term, 28 - 60 days, 4 %, 0 - 12 %, long-term, 2 - 7 years, 12 %, 1 - 36 %). For the different subscores, the reproducibility was within +/-25 % (15 - 41 %) between radiologists and +/-23 % (12 - 46 %) within radiologists. Conclusion: The Brody score shows high average inter-observer reproducibility in LDCTs of adult CF patients. The Brody score also demonstrates high average intra-observer reproducibility if subsequent assessments are made within 28 - 61 days. With time intervals of 2 - 7 years between subsequent evaluations, however, intra-observer reproducibility decreases. Respective subscores each demonstrate lower intra- and inter-observer reproducibility than does the composite Brody score. (orig.)

  6. Technology Assessment and Roadmap for the Emergency Radiation Dose Assessment Program (ERDAP)

    Science.gov (United States)

    2005-06-01

    chromosomal aberrations in the exposed individual’s peripheral blood lymphocytes. The presence of dicentrics , a chromosomal aberration, in an individual’s... dicentric and premature chromosome condensation (PCC) assays were used to assess the dose for three severely exposed workers (Hayata 2001; Kanda 2002...lymphocyte chromosome damage in 10 of the 13 severely irradiated Chernobyl victims, suggested that the frequency of metaphase spreads without dicentric

  7. Cardiac toxicity and radiation dose to the heart in definitive treated non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Schytte, Tine; Hansen, Olfred (Dept. of Oncology, Odense Univ. Hospital, 5000 Odense C (Denmark)), E-mail: tine.schytte@dadlnet.dk; Stolberg-Rohr, Thomine; Brink, Carsten (Radiophysic Laboratory, Odense Univ. Hospital, 5000 Odense C (Denmark))

    2010-10-15

    In this retrospective analysis of a consecutive series of NSCLC patients treated with definitive radiotherapy, we did not find a correlation between high mean-dose to three different volumes of the heart (left ventricle, both ventricles or whole heart) and cardiac toxicity defined as having an cardiac event after radiotherapy start. This is not as shown in studies with other diseases treated with radiotherapy. Darby et al. recently published a review concerning radiation related heart disease. They reported a significantly worse survival beyond ten years for breast cancer patients receiving radiotherapy. Some studies reported mortality from heart disease increased by 27%. In Hodgkin lymphoma patients an increased risk value of three to five for cardiac morbidity in general compared to general population and relative risk of death from myocardial infarction compared with general population in range 2 to 4. There may be several possible reasons why we did not experience a significant toxicity despite the high doses we delivered to the heart compared with patients receiving RT for breast cancer and lymphoma. Only relative few NSCLC patients live long enough to experience cardiac disease either due to lung cancer itself or comorbidity as a competitive risk factor. In our study the five year survival was 15% leaving very few patients at risk for developing cardiac disease. Without long-term survivors cardiac toxicity does not seem to be a problem, and this suggests that we should aim to increase tumour control by administrating larger doses of radiotherapy to the tumour and/or by adding concurrent chemotherapy. However, the latter may increase the risk of cardiac toxicity by itself, and the results given in present study, may not be extrapolated to this situation. Another reason might be that if NSCLC patients develop dyspnoea, chest pain, etc. it is interpreted as being due to a relapse of lung cancer and not cardiac disease. There are several studies indicating that

  8. Specific gamma-ray dose constants for nuclides important to dosimetry and radiological assessment

    Energy Technology Data Exchange (ETDEWEB)

    Unger, L.M.; Trubey, D.K.

    1982-05-01

    Tables of specific gamma-ray dose constants (the unshielded gamma-ray dose equivalent rate at 1 m from a point source) have been computed for approximately 500 nuclides important to dosimetry and radiological assessment. The half life, the mean attenuation coefficient, and thickness for a lead shield providing 95% dose equivalent attenuation are also listed.

  9. Specific gamma-ray dose constants for nuclides important to dosimetry and radiological assessment

    Energy Technology Data Exchange (ETDEWEB)

    Unger, L.M.; Trubey, D.K.

    1981-09-01

    Tables of specific gamma-ray dose constants (the unshielded gamma-ray dose equivalent rate at 1 m from a point source) have been computed for approximately 500 nuclides important to dosimetry and radiological assessment. The half life, the mean attenuation coefficient, and thickness for a lead shield providing 95% dose equivalent attenuation are also listed.

  10. KREAM: Korean Radiation Exposure Assessment Model for Aviation Route Dose

    Science.gov (United States)

    Hwang, J.; Dokgo, K.; Choi, E. J.; Kim, K. C.; Kim, H. P.; Cho, K. S. F.

    2014-12-01

    Since Korean Air has begun to use the polar route from Seoul/ICN airport to New York/JFK airport on August 2006, there are explosive needs for the estimation and prediction against cosmic radiation exposure for Korean aircrew and passengers in South Korea from public. To keep pace with those needs of public, Korean government made the law on safety standards and managements of cosmic radiation for the flight attendants and the pilots in 2013. And we have begun to develop our own Korean Radiation Exposure Assessment Model (KREAM) for aviation route dose since last year funded by Korea Meteorological Administration (KMA). GEANT4 model and NRLMSIS 00 model are used for calculation of the energetic particles' transport in the atmosphere and for obtaining the background atmospheric neutral densities depending on altitude. For prediction the radiation exposure in many routes depending on the various space weather effects, we constructed a database from pre-arranged simulations using all possible combinations of R, S, and G, which are the space weather effect scales provided by the National Oceanic and Atmospheric Administration (NOAA). To get the solar energetic particles' spectrum at the 100 km altitude which we set as a top of the atmospheric layers in the KREAM, we use ACE and GOES satellites' proton flux observations. We compare the results between KREAM and the other cosmic radiation estimation programs such as CARI-6M which is provided by the Federal Aviation Agency (FAA). We also validate KREAM's results by comparison with the measurement from Liulin-6K LET spectrometer onboard Korean commercial flights and Korean Air Force reconnaissance flights.

  11. Visual assessment of early emphysema and interstitial abnormalities on CT is useful in lung cancer risk analysis

    DEFF Research Database (Denmark)

    Wille, Mathilde M W; Thomsen, Laura H.; Petersen, Jens;

    2016-01-01

    Objectives: Screening for lung cancer should be limited to a high-risk-population, and abnormalities in low-dose computed tomography (CT) screening images may be relevant for predicting the risk of lung cancer. Our aims were to compare the occurrence of visually detected emphysema and interstitial...... abnormalities in subjects with and without lung cancer in a screening population of smokers. Methods: Low-dose chest CT examinations (baseline and latest possible) of 1990 participants from The Danish Lung Cancer Screening Trial were independently evaluated by two observers who scored emphysema and interstitial.......499). Conclusions: Even early signs of emphysema and interstitial abnormalities are associated with lung cancer. Quantitative measurements of emphysema—regardless of type—do not show the same association. Key Points: • Visually detected emphysema on CT is more frequent in individuals who develop lung cancer...

  12. Toxicity from repeated doses of acetaminophen in children: assessment of causality and dose in reported cases.

    Science.gov (United States)

    Heard, Kennon; Bui, Alison; Mlynarchek, Sara L; Green, Jody L; Bond, G Randall; Clark, Richard F; Kozer, Eran; Koff, Raymond S; Dart, Richard C

    2014-01-01

    Liver injury has been reported in children treated with repeated doses of acetaminophen. The objective of this study was to identify and validate reports of liver injury or death in children younger than 6 years who were administered repeated therapeutic doses of acetaminophen. We reviewed US Poison Center data, peer-reviewed literature, US Food and Drug Administration Adverse Event Reports, and US Manufacturer Safety Reports describing adverse effects after acetaminophen administration. Reports that described hepatic abnormalities (description of liver injury or abnormal laboratory testing) or death after acetaminophen administration to children younger than 6 years were included. The identified reports were double abstracted and then reviewed by an expert panel to determine if the hepatic injury was related to acetaminophen and whether the dose of acetaminophen was therapeutic (≤75 mg/kg) or supratherapeutic. Our search yielded 2531 reports of adverse events associated with acetaminophen use. From these cases, we identified 76 cases of hepatic injury and 26 deaths associated with repeated acetaminophen administration. There were 6 cases of hepatic abnormalities and no deaths associated with what our panel determined to be therapeutic doses. A large proportion of cases could not be fully evaluated due to incomplete case reporting. Although we identified numerous examples of liver injury and death after repeated doses of acetaminophen, all the deaths and all but 6 cases of hepatic abnormalities involved doses more than 75 mg/kg per day. This study suggests that the doses of less than 75 mg/kg per day of acetaminophen are safe for children younger than 6 years.

  13. Quality of Life (QOL) Analysis of a Randomized Radiation Dose Escalation Non-Small Cell Lung Cancer (NSCLC) Study: Radiation Therapy Oncology Group (RTOG) Trial 0617

    Science.gov (United States)

    Movsas, Benjamin; Hu, Chen; Sloan, Jeffrey; Bradley, Jeffrey; Komaki, Ritsuko; Masters, Gregory; Kavadi, Vivek; Narayan, Samir; Michalski, Jeff; Johnson, Douglas W.; Koprowski, Christopher; Curran, Walter J.; Garces, Yolanda I.; Gaur, Rakesh; Wynn, Raymond B.; Schallenkamp, John; Gelblum, Daphna Y.; MacRae, Robert M; Paulus, Rebecca; Choy, Hak

    2015-01-01

    Importance A recent randomized radiation dose escalation trial in unresectable stage III NSCLC showed a lower survival in the high-dose arm (74Gy vs. 60Gy) with concurrent chemotherapy. Quality of life (QOL), an important secondary endpoint, is presented here. Objective The primary QOL hypothesis predicted a clinically meaningful decline (CMD) in QOL via the Functional Assessment of Cancer Therapy-Lung Cancer Subscale (FACT-LCS) in the high-dose RT-arm at 3 months. Design RTOG 0617 was a randomized phase III study (conducted from Nov 2007 to Nov 2011) in stage III NSCLC using a 2×2 factorial design and stratified by histology, PET staging, performance status and radiation technique (3D-conformal RT [3DCRT] vs. intensity-modulated radiation [IMRT]). Setting 185 institutions in the USA and Canada. Participants Of 424 eligible stage III NSCLC patients randomized, 360 (85%) consented to QOL, of whom 313 (88%) completed baseline QOL assessments. Intervention for Clinical Trials 74Gy vs. 60Gy with concurrent and consolidation carboplatin/paclitaxel +/− cetuximab. Main Outcomes and Measures QOL was collected prospectively via FACT-Trial Outcome Index (FACT-TOI), equaling Physical-Well-Being (PWB) + Functional-Well-Being (FWB) + Lung Cancer Subscale (LCS). Data are presented at baseline & 3 and 12 months via minimal clinically meaningful changes of >=2 points for PWB, FWB or LCS or >=5 points for TOI. Results Patient demographics and baseline QOL scores were comparable between the 74Gy and 60Gy arms. Two-hundred-nineteen (72%) of living patients who completed QOL at baseline did so at 3 months and 137 (57%) of living patients did so at 12 months. Significantly more patients on 74Gy arm had clinically meaningful decline in FACT-LCS at 3 months than on the 60Gy arm (45% vs. 30%, p=0.02). At 12 months, fewer patients who received IMRT (vs 3DCRT) had clinically meaningful decline in FACT-LCS (21% vs 46%, p=0.003). Baseline FACT-TOI was associated with overall survival in

  14. Using Generalized Equivalent Uniform Dose Atlases to Combine and Analyze Prospective Dosimetric and Radiation Pneumonitis Data From 2 Non-Small Cell Lung Cancer Dose Escalation Protocols

    Energy Technology Data Exchange (ETDEWEB)

    Liu Fan; Yorke, Ellen D. [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Belderbos, Jose S.A.; Borst, Gerben R. [The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam (Netherlands); Rosenzweig, Kenneth E. [Mount Sinai School of Medicine, New York, New York (United States); Lebesque, Joos V. [The Netherlands Cancer Institute, Antoni Van Leeuwenhoek Hospital, Amsterdam (Netherlands); Jackson, Andrew, E-mail: jacksona@mskcc.org [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States)

    2013-01-01

    Purpose: To demonstrate the use of generalized equivalent uniform dose (gEUD) atlas for data pooling in radiation pneumonitis (RP) modeling, to determine the dependence of RP on gEUD, to study the consistency between data sets, and to verify the increased statistical power of the combination. Methods and Materials: Patients enrolled in prospective phase I/II dose escalation studies of radiation therapy of non-small cell lung cancer at Memorial Sloan-Kettering Cancer Center (MSKCC) (78 pts) and the Netherlands Cancer Institute (NKI) (86 pts) were included; 10 (13%) and 14 (17%) experienced RP requiring steroids (RPS) within 6 months after treatment. gEUD was calculated from dose-volume histograms. Atlases for each data set were created using 1-Gy steps from exact gEUDs and RPS data. The Lyman-Kutcher-Burman model was fit to the atlas and exact gEUD data. Heterogeneity and inconsistency statistics for the fitted parameters were computed. gEUD maps of the probability of RPS rate {>=}20% were plotted. Results: The 2 data sets were homogeneous and consistent. The best fit values of the volume effect parameter a were small, with upper 95% confidence limit around 1.0 in the joint data. The likelihood profiles around the best fit a values were flat in all cases, making determination of the best fit a weak. All confidence intervals (CIs) were narrower in the joint than in the individual data sets. The minimum P value for correlations of gEUD with RPS in the joint data was .002, compared with P=.01 and .05 for MSKCC and NKI data sets, respectively. gEUD maps showed that at small a, RPS risk increases with gEUD. Conclusions: The atlas can be used to combine gEUD and RPS information from different institutions and model gEUD dependence of RPS. RPS has a large volume effect with the mean dose model barely included in the 95% CI. Data pooling increased statistical power.

  15. Blood compounds irradiation process: assessment of absorbed dose using Fricke and Thermoluminescent dosimetric systems

    Energy Technology Data Exchange (ETDEWEB)

    Soares, Gabriela de Amorim; Squair, Peterson Lima; Pinto, Fausto Carvalho; Belo, Luiz Claudio Meira; Grossi, Pablo Andrade [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN-CNEN/MG), Belo Horizonte, MG (Brazil)], e-mail: gas@cdtn.br, e-mail: pls@cdtn.br, e-mail: fcp@cdtn.br, e-mail: lcmb@cdtn.br, e-mail: pabloag@cdtn.br

    2009-07-01

    The assessment of gamma absorbed doses in irradiation facilities allows the quality assurance and control of the irradiation process. The liability of dose measurements is assign to the metrological procedures adopted including the uncertainty evaluation. Fricke and TLD 800 dosimetric systems were used to measure absorbed dose in the blood compounds using the methodology presented in this paper. The measured absorbed doses were used for evaluating the effectiveness of the irradiation procedure and the gamma dose absorption inside the irradiation room of a gamma irradiation facility. The radiation eliminates the functional and proliferative capacities of donor T-lymphocytes, preventing Transfusion associated graft-versus-host disease (TA-GVHD), a possible complication of blood transfusions. The results show the applicability of such dosimetric systems in quality assurance programs, assessment of absorbed doses in blood compounds and dose uniformity assign to the blood compounds irradiation process by dose measurements in a range between 25 Gy and 100 Gy. (author)

  16. Assessing Tumor Response to Treatment in Patients with Lung Cancer Using Dynamic Contrast-Enhanced CT

    DEFF Research Database (Denmark)

    Strauch, Louise S; Eriksen, Rie Ø; Sandgaard, Michael

    2016-01-01

    after treatment. Four out of five studies that measured blood flow post anti-angiogenic treatments found that blood flow was significantly decreased. DCE-CT may be a useful tool in assessing treatment response in patients with lung cancer. It seems that particularly permeability and blood flow......The aim of this study was to provide an overview of the literature available on dynamic contrast-enhanced computed tomography (DCE-CT) as a tool to evaluate treatment response in patients with lung cancer. This systematic review was compiled according to Preferred Reporting Items for Systematic...... Reviews and Meta-Analyses (PRISMA) guidelines. Only original research articles concerning treatment response in patients with lung cancer assessed with DCE-CT were included. To assess the validity of each study we implemented Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). The initial search...

  17. Radiation dose assessment of ACP hot cell in accident

    Energy Technology Data Exchange (ETDEWEB)

    Kook, D. H.; Jeong, W. M.; Koo, J. H.; Jeo, I. J.; Lee, E. P.; Ryu, K. S. [KAERI, Taejon (Korea, Republic of)

    2003-10-01

    The Advanced spent fuel Condition in Process(ACP) is under development for the effective management of spent fuel which had been generated in nuclear plants. The ACP needs a hot cell where most operations will be performed. To give priority to the environments safety, radiation doses evaluations for the radioactive nuclides in accident cases were preliminarily performed with the meteorological data around facility site. Fire accident prevails over several accidnets. Internal Dose and External Dose evaluation according to short dispersion data for that case show a safe margin for regulation limits and SAR limit of IMEF where this facility will be constructed.

  18. Phase I Study of Concurrent High-Dose Three-Dimensional Conformal Radiotherapy With Chemotherapy Using Cisplatin and Vinorelbine for Unresectable Stage III Non-Small-Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sekine, Ikuo, E-mail: isekine@ncc.go.jp [Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Tokyo (Japan); Sumi, Minako; Ito, Yoshinori [Division of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Horinouchi, Hidehito; Nokihara, Hiroshi; Yamamoto, Noboru; Kunitoh, Hideo; Ohe, Yuichiro; Kubota, Kaoru; Tamura, Tomohide [Division of Internal Medicine and Thoracic Oncology, National Cancer Center Hospital, Tokyo (Japan)

    2012-02-01

    Purpose: To determine the maximum tolerated dose in concurrent three-dimensional conformal radiotherapy (3D-CRT) with chemotherapy for unresectable Stage III non-small-cell lung cancer (NSCLC). Patients and Methods: Eligible patients with unresectable Stage III NSCLC, age {>=}20 years, performance status 0-1, percent of volume of normal lung receiving 20 GY or more (V{sub 20}) {<=}30% received three to four cycles of cisplatin (80 mg/m{sup 2} Day 1) and vinorelbine (20 mg/m{sup 2} Days 1 and 8) repeated every 4 weeks. The doses of 3D-CRT were 66 Gy, 72 Gy, and 78 Gy at dose levels 1 to 3, respectively. Results: Of the 17, 16, and 24 patients assessed for eligibility, 13 (76%), 12 (75%), and 6 (25%) were enrolled at dose levels 1 to 3, respectively. The main reasons for exclusion were V{sub 20} >30% (n = 10) and overdose to the esophagus (n = 8) and brachial plexus (n = 2). There were 26 men and 5 women, with a median age of 60 years (range, 41-75). The full planned dose of radiotherapy could be administered to all the patients. Grade 3-4 neutropenia and febrile neutropenia were noted in 24 (77%) and 5 (16%) of the 31 patients, respectively. Grade 4 infection, Grade 3 esophagitis, and Grade 3 pulmonary toxicity were noted in 1 patient, 2 patients, and 1 patient, respectively. The dose-limiting toxicity was noted in 17% of the patients at each dose level. The median survival and 3-year and 4-year survival rates were 41.9 months, 72.3%, and 49.2%, respectively. Conclusions: 72 Gy was the maximum dose that could be achieved in most patients, given the predetermined normal tissue constraints.

  19. Multicentre knowledge sharing and planning/dose audit on flattening filter free beams for SBRT lung

    DEFF Research Database (Denmark)

    Hansen, C. R.; Sykes, J. R.; Barber, J.;

    2015-01-01

    . In particular, for the centres with less SBRT and/or volumetric- modulated arc therapy (VMAT) experience the MPV average per plan improved. All vendor/TPS combinations were also able to successfully deliver the FF and FFF SBRT VMAT plans. The plan quality and dose accuracy were found to be clinically acceptable....

  20. Smoking habits in the randomised Danish Lung Cancer Screening Trial with low-dose CT

    DEFF Research Database (Denmark)

    Ashraf, Haseem; Saghir, Zaigham; Dirksen, Asger

    2014-01-01

    to annual low-dose CT (CT group) and 2052 received no intervention (control group). Participants were current and ex-smokers (≥4 weeks abstinence from smoking) with a tobacco consumption of ≥20 pack years. Smoking habits were determined annually. Missing values for smoking status at the final screening...

  1. Linking Different Exposure Patterns to Internal Lung Dose for Heterogeneous Ambient Aerosols

    Science.gov (United States)

    Particulate matter (PM) in the ambient air is a complex mixture of particles with different sizes and chemical compositions. Because potential health effects are known to be different for different size particles, specific dose of size-fractionated PM under realistic exposure con...

  2. To Screen or not to Screen: Low Dose Computed Tomography in Comparison to Chest Radiography or Usual Care in Reducing Morbidity and Mortality from Lung Cancer

    Science.gov (United States)

    Kamdar, Jay; Moats, Austin; Nguyen, Brenda

    2016-01-01

    Lung cancer has the highest mortality rate of all cancers. This paper seeks to address the question: Can the mortality of lung cancer be decreased by screening with low-dose computerized tomography (LDCT) in higher risk patients compared to chest X-rays (CXR) or regular patient care? Currently, CXR screening is recommended for certain high-risk patients. Several recent trials have examined the effectiveness of LDCT versus chest radiography or usual care as a control. These trials include National Lung Screening Trial (NLST), Detection And screening of early lung cancer with Novel imaging TEchnology (DANTE), Lung Screening Study (LSS), Depiscan, Italian Lung (ITALUNG), and Dutch-Belgian Randomized Lung Cancer Screening Trial (Dutch acronym: NELSON study). NLST, the largest trial (n=53, 454), demonstrated a decrease in mortality from lung cancer in the LDCT group (RRR=20%, P=0.004). LSS demonstrated a greater sensitivity in detecting both early stage and any stage of lung cancer in comparison to traditional CXR. Although the DANTE trial yielded data consistent with findings in LSS, it also showed that via LDCT screening a greater proportion of patients were placed under unnecessary surgical procedures. The Depiscan trial yielded a high nodule detection rate at the cost of a high false-positive rate compared to CXR screening. The ITALUNG and NELSON trials demonstrated the early detection capabilities of LDCT for lung cancers compared to usual care without surveillance imaging. False-positive findings with unnecessary workup, intervention, and radiation exposure remain significant concerns for routine LDCT screening. However, current data suggests LDCT may provide a highly sensitive and specific means for detecting lung cancers and reducing mortality. PMID:27375974

  3. Pulmonary Artery Invasion, High-Dose Radiation, and Overall Survival in Patients With Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Han, Cheng-Bo [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Department of Oncology, Shengjing Hospital of China Medical University, Shenyang (China); Wang, Wei-Li [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Department of Radiation Oncology, Fourth Hospital of China Medical University, Shenyang (China); Quint, Leslie [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Xue, Jian-Xin [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Department of Thoracic Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu (China); Matuszak, Martha; Ten Haken, Randall [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Kong, Feng-Ming, E-mail: fkong@gru.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

    2014-06-01

    Purpose: To investigate whether high-dose radiation to the pulmonary artery (PA) affects overall survival (OS) in patients with non-small cell lung cancer (NSCLC). Methods and Materials: Patients with medically inoperable/unresectable NSCLC treated with definitive radiation therapy in prospective studies were eligible for this study. Pulmonary artery involvement was defined on the basis of pretreatment chest CT and positron emission tomography/CT fusion. Pulmonary artery was contoured according to the Radiation Therapy Oncology Group protocol 1106 atlas, and dose-volume histograms were generated. Results: A total of 100 patients with a minimum follow-up of 1 year for surviving patients were enrolled: 82.0% underwent concurrent chemoradiation therapy. Radiation dose ranged from 60 to 85.5 Gy in 30-37 fractions. Patients with PA invasion of grade ≤2, 3, 4, and 5 had 1-year OS and median survival of 67% and 25.4 months (95% confidence interval [CI] 15.7-35.1), 62% and 22.2 months (95% CI 5.8-38.6), 90% and 35.8 months (95% CI 28.4-43.2), and 50% and 7.0 months, respectively (P=.601). Two of the 4 patients with grade 5 PA invasion died suddenly from massive hemorrhage at 3 and 4.5 months after completion of radiation therapy. Maximum and mean doses to PA were not significantly associated with OS. The V45, V50, V55, and V60 of PA were correlated significantly with a worse OS (P<.05). Patients with V45 >70% or V60 >37% had significantly worse OS (13.3 vs 37.9 months, P<.001, and 13.8 vs 37.9 months, P=.04, respectively). Conclusions: Grade 5 PA invasion and PA volume receiving more than 45-60 Gy may be associated with inferior OS in patients with advanced NSCLC treated with concurrent chemoradiation.

  4. Dose assessment of an accidental exposure at the IPNS

    Energy Technology Data Exchange (ETDEWEB)

    Campos Torres, M.M.

    1995-02-01

    Seven different methods were used to estimate the dose rate to a female worker who was accidentally exposed in the neutron PHOENIX beamline at the IPNS. Theoretical and measured entrance dose ranged from 550 mrem/min to 2850 mrem/min. Theoretical estimates were based on a Monte Carlo simulation of a spectrum provided by IPNS (Crawford Spectrum). Dose measurements were made with TLDs on phantoms and with ionization chambers in a water phantom. Estimates of the whole body total effective dose equivalent (TEDE) rate ranged from 5.2 mrem/min to 840 mrem/min. Assumed and measured quality factors ranged from 2.6 to 11.8. Cytogenetic analyses of blood samples detected no positive exposure. The recommended TEDE rate was 158 mrem/min. The TEDE was 750 mrem.

  5. Dose assessment of an accidental exposure at IPNS

    Energy Technology Data Exchange (ETDEWEB)

    Torres, M.M.C.

    1996-05-01

    Seven different methods were used to estimate the dose rate to a female worker who was accidentally exposed in the neutron PHOENIX beamline at the IPNS. Theoretical and measured entrance dose rates ranged from 550 mrem/min to 2,850 mrem/min. Theoretical estimates were based on a Monte Carlo simulation of a spectrum provided by IPNS (Crawford Spectrum). Dose measurements were made with TLDs on phantoms and with ionization chambers in a water phantom. Estimates of the whole body total effective dose equivalent (TEDE) rate ranged from 5.2 mrem/min to 840 mrem/min. Assumed and measured quality factors ranged from 2.6 to 11.8. Cytogenic analyses of blood samples detected no positive exposure. The recommended TEDE rate was 158 mrem/min. The TEDE was 750 mrem.

  6. Fetal and maternal dose assessment for diagnostic scans during pregnancy

    Science.gov (United States)

    Rafat Motavalli, Laleh; Miri Hakimabad, Hashem; Hoseinian Azghadi, Elie

    2016-05-01

    Despite the concerns about prenatal exposure to ionizing radiation, the number of nuclear medicine examinations performed for pregnant women increased in the past decade. This study attempts to better quantify radiation doses due to diagnostic nuclear medicine procedures during pregnancy with the help of our recently developed 3, 6, and 9 month pregnant hybrid phantoms. The reference pregnant models represent the adult female international commission on radiological protection (ICRP) reference phantom as a base template with a fetus in her gravid uterus. Six diagnostic scintigraphy scans using different radiopharmaceuticals were selected as typical diagnostic nuclear medicine procedures. Furthermore, the biokinetic data of radioiodine was updated in this study. A compartment representing iodide in fetal thyroid was addressed explicitly in the biokinetic model. Calculations were performed using the Monte Carlo transport method. Tabulated dose coefficients for both maternal and fetal organs are provided. The comparison was made with the previously published fetal doses calculated for stylized pregnant female phantoms. In general, the fetal dose in previous studies suffers from an underestimation of up to 100% compared to fetal dose at organ level in this study. A maximum of difference in dose was observed for the fetal thyroid compared to the previous studies, in which the traditional models did not contain the fetal thyroid. Cumulated activities of major source organs are primarily responsible for the discrepancies in the organ doses. The differences in fetal dose depend on several other factors including chord length distribution between fetal organs and maternal major source organs, and anatomical differences according to gestation periods. Finally, considering the results of this study, which was based on the realistic pregnant female phantoms, a more informed evaluation of the risks and benefits of the different procedures could be made.

  7. Dose assessment in accordance with the measured position of size specific dose estimates

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Su [Dept. of Radio-technology, Health Welfare, Wonkwang Health Science University, Iksan (Korea, Republic of); Hong, Sung Wan [Dept. of Radiology, Inje University Ilsan Paik Hospital, Iksan (Korea, Republic of); Kim, Jung Min [Dept. of Radiological Science, Korea University, Seoul (Korea, Republic of)

    2015-12-15

    This study investigated the size specific dose estimates of difference localizer on pediatric CT image. Seventy one cases of pediatric abdomen-pelvic CT (M:F=36:35) were included in this study. Anterior-posterior and lateral diameters were measured in axial CT images. Conversion factors from American Association of Physicists in Medicine (AAPM) report 204 were obtained for effective diameter to determine size specific dose estimate (SSDE) from the CT dose index volume (CTDIvol) recorded from the dose reports. For the localizer of mid-slice SSDE was 107.63% higher than CTDIvol and that of xiphoid-process slices SSDE was higher than 92.91%. The maximum error of iliac crest slices, xiphoid process slices and femur head slices between mid-slices were 7.48%, 17.81% and 14.04%. In conclusion, despite the SSDE of difference localizer has large number of errors, SSDE should be regarded as the primary evaluation tool of the patient radiation in pediatric CT for evaluation.

  8. Differences in dose-volumetric data between the analytical anisotropic algorithm and the x-ray voxel Monte Carlo algorithm in stereotactic body radiation therapy for lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mampuya, Wambaka Ange [Department of Radiation Oncology and Image–Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto (Japan); Matsuo, Yukinori, E-mail: ymatsuo@kuhp.kyoto-u.ac.jp [Department of Radiation Oncology and Image–Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto (Japan); Nakamura, Akira; Nakamura, Mitsuhiro; Mukumoto, Nobutaka; Miyabe, Yuki; Narabayashi, Masaru; Sakanaka, Katsuyuki; Mizowaki, Takashi; Hiraoka, Masahiro [Department of Radiation Oncology and Image–Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto (Japan)

    2013-04-01

    The objective of this study was to evaluate the differences in dose-volumetric data obtained using the analytical anisotropic algorithm (AAA) vs the x-ray voxel Monte Carlo (XVMC) algorithm for stereotactic body radiation therapy (SBRT) for lung cancer. Dose-volumetric data from 20 patients treated with SBRT for solitary lung cancer generated using the iPlan XVMC for the Novalis system consisting of a 6-MV linear accelerator and micro-multileaf collimators were recalculated with the AAA in Eclipse using the same monitor units and identical beam setup. The mean isocenter dose was 100.2% and 98.7% of the prescribed dose according to XVMC and AAA, respectively. Mean values of the maximal dose (D{sub max}), the minimal dose (D{sub min}), and dose received by 95% volume (D{sub 95}) for the planning target volume (PTV) with XVMC were 104.3%, 75.1%, and 86.2%, respectively. When recalculated with the AAA, those values were 100.8%, 77.1%, and 85.4%, respectively. Mean dose parameter values considered for the normal lung, namely the mean lung dose, V{sub 5}, and V{sub 20}, were 3.7 Gy, 19.4%, and 5.0% for XVMC and 3.6 Gy, 18.3%, and 4.7% for the AAA, respectively. All of these dose-volumetric differences between the 2 algorithms were within 5% of the prescribed dose. The effect of PTV size and tumor location, respectively, on the differences in dose parameters for the PTV between the AAA and XVMC was evaluated. A significant effect of the PTV on the difference in D{sub 95} between the AAA and XVMC was observed (p = 0.03). Differences in the marginal doses, namely D{sub min} and D{sub 95}, were statistically significant between peripherally and centrally located tumors (p = 0.04 and p = 0.02, respectively). Tumor location and volume might have an effect on the differences in dose-volumetric parameters. The differences between AAA and XVMC were considered to be within an acceptable range (<5 percentage points)

  9. Low-Dose Chest Computed Tomography for Lung Cancer Screening Among Hodgkin Lymphoma Survivors: A Cost-Effectiveness Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wattson, Daniel A., E-mail: dwattson@partners.org [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Hunink, M.G. Myriam [Departments of Radiology and Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands and Center for Health Decision Science, Harvard School of Public Health, Boston, Massachusetts (United States); DiPiro, Pamela J. [Department of Imaging, Dana-Farber Cancer Institute, Boston, Massachusetts (United States); Das, Prajnan [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Hodgson, David C. [Department of Radiation Oncology, University of Toronto, Toronto, Ontario (Canada); Mauch, Peter M.; Ng, Andrea K. [Department of Radiation Oncology, Brigham and Women' s Hospital and Dana-Farber Cancer Institute, Boston, Massachusetts (United States)

    2014-10-01

    Purpose: Hodgkin lymphoma (HL) survivors face an increased risk of treatment-related lung cancer. Screening with low-dose computed tomography (LDCT) may allow detection of early stage, resectable cancers. We developed a Markov decision-analytic and cost-effectiveness model to estimate the merits of annual LDCT screening among HL survivors. Methods and Materials: Population databases and HL-specific literature informed key model parameters, including lung cancer rates and stage distribution, cause-specific survival estimates, and utilities. Relative risks accounted for radiation therapy (RT) technique, smoking status (>10 pack-years or current smokers vs not), age at HL diagnosis, time from HL treatment, and excess radiation from LDCTs. LDCT assumptions, including expected stage-shift, false-positive rates, and likely additional workup were derived from the National Lung Screening Trial and preliminary results from an internal phase 2 protocol that performed annual LDCTs in 53 HL survivors. We assumed a 3% discount rate and a willingness-to-pay (WTP) threshold of $50,000 per quality-adjusted life year (QALY). Results: Annual LDCT screening was cost effective for all smokers. A male smoker treated with mantle RT at age 25 achieved maximum QALYs by initiating screening 12 years post-HL, with a life expectancy benefit of 2.1 months and an incremental cost of $34,841/QALY. Among nonsmokers, annual screening produced a QALY benefit in some cases, but the incremental cost was not below the WTP threshold for any patient subsets. As age at HL diagnosis increased, earlier initiation of screening improved outcomes. Sensitivity analyses revealed that the model was most sensitive to the lung cancer incidence and mortality rates and expected stage-shift from screening. Conclusions: HL survivors are an important high-risk population that may benefit from screening, especially those treated in the past with large radiation fields including mantle or involved-field RT. Screening

  10. Computational assessment of effective dose and patient specific doses for kilovoltage stereotactic radiosurgery of wet age-related macular degeneration

    Science.gov (United States)

    Hanlon, Justin Mitchell

    Age-related macular degeneration (AMD) is a leading cause of vision loss and a major health problem for people over the age of 50 in industrialized nations. The current standard of care, ranibizumab, is used to help slow and in some cases stabilize the process of AMD, but requires frequent invasive injections into the eye. Interest continues for stereotactic radiosurgery (SRS), an option that provides a non-invasive treatment for the wet form of AMD, through the development of the IRay(TM) (Oraya Therapeutics, Inc., Newark, CA). The goal of this modality is to destroy choroidal neovascularization beneath the pigment epithelium via delivery of three 100 kVp photon beams entering through the sclera and overlapping on the macula delivering up to 24 Gy of therapeutic dose over a span of approximately 5 minutes. The divergent x-ray beams targeting the fovea are robotically positioned and the eye is gently immobilized by a suction-enabled contact lens. Device development requires assessment of patient effective dose, reference patient mean absorbed doses to radiosensitive tissues, and patient specific doses to the lens and optic nerve. A series of head phantoms, including both reference and patient specific, was derived from CT data and employed in conjunction with the MCNPX 2.5.0 radiation transport code to simulate treatment and evaluate absorbed doses to potential tissues-at-risk. The reference phantoms were used to evaluate effective dose and mean absorbed doses to several radiosensitive tissues. The optic nerve was modeled with changeable positions based on individual patient variability seen in a review of head CT scans gathered. Patient specific phantoms were used to determine the effect of varying anatomy and gaze. The results showed that absorbed doses to the non-targeted tissues were below the threshold levels for serious complications; specifically the development of radiogenic cataracts and radiation induced optic neuropathy (RON). The effective dose

  11. A dosimetric phantom study of dose accuracy and build-up effects using IMRT and RapidArc in stereotactic irradiation of lung tumours

    Directory of Open Access Journals (Sweden)

    Seppala Jan

    2012-05-01

    Full Text Available Abstract Background and purpose Stereotactic lung radiotherapy (SLRT has emerged as a curative treatment for medically inoperable patients with early-stage non-small cell lung cancer (NSCLC and the use of intensity-modulated radiotherapy (IMRT and volumetric modulated arc treatments (VMAT have been proposed as the best practical approaches for the delivery of SLRT. However, a large number of narrow field shapes are needed in the dose delivery of intensity-modulated techniques and the probability of underdosing the tumour periphery increases as the effective field size is decreased. The purpose of this study was to evaluate small lung tumour doses irradiated by intensity-modulated techniques to understand the risk for dose calculation errors in precision radiotherapy such as SLRT. Materials and methods The study was executed with two heterogeneous phantoms with targets of Ø1.5 and Ø4.0 cm. Dose distributions in the simulated tumours delivered by small sliding window apertures (SWAs, IMRT and RapidArc treatment plans were measured with radiochromic film. Calculation algorithms of pencil beam convolution (PBC and anisotropic analytic algorithm (AAA were used to calculate the corresponding dose distributions. Results Peripheral doses of the tumours were decreased as SWA decreased, which was not modelled by the calculation algorithms. The smallest SWA studied was 2 mm, which reduced the 90% isodose line width by 4.2 mm with the Ø4.0 cm tumour as compared to open field irradiation. PBC was not able to predict the dose accurately as the gamma evaluation failed to meet the criteria of ±3%/±1 mm on average in 61% of the defined volume with the smaller tumour. With AAA the corresponding value was 16%. The dosimetric inaccuracy of AAA was within ±3% with the optimized treatment plans of IMRT and RapidArc. The exception was the clinical RapidArc plan with dose overestimation of 4%. Conclusions Overall, the peripheral doses of the simulated

  12. Adaptation requirements due to anatomical changes in free-breathing and deep-inspiration breath-hold for standard and dose-escalated radiotherapy of lung cancer patients

    DEFF Research Database (Denmark)

    Sibolt, Patrik; Ottosson, Wiviann; Sjöström, David;

    2015-01-01

    Background. Radiotherapy of lung cancer patients is subject to uncertainties related to heterogeneities, anatomical changes and breathing motion. Use of deep-inspiration breath-hold (DIBH) can reduce the treated volume, potentially enabling dose-escalated (DE) treatments. This study was designed...

  13. Occurrence and lung cancer probability of new solid nodules at incidence screening with low-dose CT : analysis of data from the randomised, controlled NELSON trial

    NARCIS (Netherlands)

    Walter, Joan E.; Heuvelmans, Marjolein A.; de Jong, Pim A.; Vliegenthart, Rozemarijn; van Ooijen, Peter M. A.; Peters, Robin B.; ten Haaf, Kevin; Yousaf-Khan, Uraujh; van der Aalst, Carlijn M.; de Bock, Geertruida H.; Mali, Willem; Groen, Harry J. M.; de Koning, Harry J.; Oudkerk, Matthijs

    2016-01-01

    Background US guidelines now recommend lung cancer screening with low-dose CT for high-risk individuals. Reports of new nodules after baseline screening have been scarce and are inconsistent because of differences in definitions used. We aimed to identify the occurrence of new solid nodules and thei

  14. Occurrence and lung cancer probability of new solid nodules at incidence screening with low-dose CT : analysis of data from the randomised, controlled NELSON trial

    NARCIS (Netherlands)

    Walter, Joan E.; Heuvelmans, Marjolein A.; de Jong, Pim A.; Vliegenthart, Rozemarijn; van Ooijen, Peter M. A.; Peters, Robin B.; ten Haaf, Kevin; Yousaf-Khan, Uraujh; van der Aalst, Carlijn M.; de Bock, Geertruida H.; Mali, Willem; Groen, Harry J. M.; de Koning, Harry J.; Oudkerk, Matthijs

    2016-01-01

    BACKGROUND: US guidelines now recommend lung cancer screening with low-dose CT for high-risk individuals. Reports of new nodules after baseline screening have been scarce and are inconsistent because of differences in definitions used. We aimed to identify the occurrence of new solid nodules and the

  15. Clinical value of a one-stop-shop low-dose lung screening combined with {sup 18}F-FDG PET/CT for the detection of metastatic lung nodules from colorectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Han, Yeon Hee; Lim, Seok Tae; Jeong, Hwan Jeong; Sohn, Myung Hee [Dept. of Nuclear Medicine, Research Institute of Clinical Medicine, Chonbuk National University-Biomedical Research Institute, Chonbuk National University Hospital, Cyclotron Research Center, Molecular Imaging and Therapeutic Medicine Research Center, Chonbuk National University Medical School and Hospital, Jeonju (Korea, Republic of)

    2016-06-15

    The aim of this study was to evaluate the clinical usefulness of additional low-dose high-resolution lung computed tomography (LD-HRCT) combined with 18F-fluoro-2-deoxyglucose positron emission tomography with CT (18F-FDG PET/CT) compared with conventional lung setting image of 18F-FDG PET/CT for the detection of metastatic lung nodules from colorectal cancer. From January 2011 to September 2011, 649 patients with colorectal cancer underwent additional LD-HRCT at maximum inspiration combined with 18F-FDG PET/CT. Forty-five patients were finally diagnosed to have lung metastasis based on histopathologic study or clinical follow-up. Twenty-five of the 45 patients had ≤5 metastatic lung nodules and the other 20 patients had  >5 metastatic nodules. One hundred and twenty nodules in the 25 patients with ≤5 nodules were evaluated by conventional lung setting image of 18F-FDG PET/CT and by additional LD-HRCT respectively. Sensitivities, specificities, diagnostic accuracies, positive predictive values (PPVs), and negative predictive values (NPVs) of conventional lung setting image of 18F-FDG PET/CT and additional LD-HRCT were calculated using standard formulae. The McNemar test and receiver-operating characteristic (ROC) analysis were performed. Of the 120 nodules in the 25 patients with ≤5 metastatic lung nodules, 66 nodules were diagnosed as metastatic. Eleven of the 66 nodules were confirmed histopathologically and the others were diagnosed by clinical follow-up. Conventional lung setting image of 18F-FDG PET/CT detected 40 of the 66 nodules and additional LD-HRCT detected 55 nodules. All 15 nodules missed by conventional lung setting imaging but detected by additional LD-HRCT were <1 cm in size. The sensitivity, specificity, and diagnostic accuracy of the modalities were 60.6 %, 85.2 %, and 71.1 % for conventional lung setting image and 83.3 %, 88.9 %, and 85.8 % for additional LD-HRCT. By ROC analysis, the area under the ROC curve (AUC) of conventional

  16. Screening for early lung cancer with low-dose spiral computed tomography: results of annual follow-up examinations in asymptomatic smokers

    Energy Technology Data Exchange (ETDEWEB)

    Diederich, Stefan [Department of Clinical Radiology, University of Muenster, Albert-Schweitzer-Strasse 33, 48129, Muenster (Germany); Department of Diagnostic and Interventional Radiology, Marien Hospital, Academic Teaching Hospital, Rochusstrasse 2, 40479, Duesseldorf (Germany); Thomas, Michael [Department of Haematology/Oncology and Respiratory Medicine, University of Muenster, Albert-Schweitzer-Strasse 33, 48129, Muenster (Germany); Semik, Michael [Department of Thoracic and Cardiovascular Surgery, University of Muenster, Albert-Schweitzer-Strasse 33, 48129, Muenster (Germany); Lenzen, Horst; Roos, Nikolaus; Weber, Anushe; Heindel, Walter; Wormanns, Dag [Department of Clinical Radiology, University of Muenster, Albert-Schweitzer-Strasse 33, 48129, Muenster (Germany)

    2004-04-01

    The aim of this study was analysis of incidence results in a prospective one-arm feasibility study of lung cancer screening with low-radiation-dose spiral computed tomography in heavy smokers. Eight hundred seventeen smokers ({>=}40 years, {>=}20 pack years of smoking history) underwent baseline low-dose CT. Biopsy was recommended in nodules >10 mm with CT morphology suggesting malignancy. In all other lesions follow-up with low-dose CT was recommended. Annual repeat CT was offered to all study participants. Six hundred sixty-eight (81.8%) of the 817 subjects underwent annual repeat CT with a total of 1735 follow-up years. Follow-up of non-calcified nodules present at baseline CT demonstrated growth in 11 of 792 subjects. Biopsy was performed in 8 of 11 growing nodules 7 of which represented lung cancer. Of 174 new nodules, 3 represented lung cancer. The 10 screen-detected lung cancers were all non-small cell cancer (6 stage IA, 1 stage IB, 1 stage IIIA, 2 stage IV). Five symptom-diagnosed cancers (2 small cell lung cancer: 1 limited disease, 1 extensive disease, 3 central/endobronchial non-small cell lung cancer, 2 stage IIIA, 1 stage IIIB) were diagnosed because of symptoms in the 12-month interval between two annual CT scans. Incidence of lung cancer was lower than prevalence, screen-detected cancers were smaller, and stage I was found in 70% (7 of 10) of screen-detected tumors. Only 27% (4 of 15) of invasive procedures was performed for benign lesions; however, 33% (5 of 15) of all cancers diagnosed in the population were symptom-diagnosed cancers (3 central NSCLC, all stage III, 2 SCLC) demonstrating the limitations of CT screening. (orig.)

  17. Lung cancer trends: smoking, obesity, and sex assessed in the Staten Island University’s lung cancer patients

    Directory of Open Access Journals (Sweden)

    Gupta S

    2014-07-01

    Full Text Available Shilpi Gupta,1 Samer Hassan,1 Vijaya R Bhatt,2 Houssein Abdul Sater,1 Asma Dilawari31Hematology-Oncology, Staten Island University Hospital, Staten Island, NY, USA; 2Hematology-Oncology, Nebraska Medical Ctr, Omaha, NE, USA; 3Hematology-Oncology, MedStar Georgetown University Hospital, Olney, Maryland, USAIntroduction: The incidence of lung cancer in the United States decreased by 1.8% from 1991 to 2005 while it increased by 0.5% in females. We assessed whether nonsmokers afflicted with lung cancer at Staten Island University Hospital are disproportionately female in comparison to national averages. We also evaluated different factors including race, histology, and body mass index (BMI in correlation with smoking history.Methods: A retrospective chart review was conducted from 2005 to 2011 on 857 patients. Patients were divided into two groups according to their smoking status: current or ever-smokers, and former or never-smokers. A chi-square test for categorical data and multivariate logistic regression analyses was used to study the relation between BMI and the other clinical and demographic data.Results: Forty-nine percent of patients were men and 51% were women with a mean age at diagnosis of 67.8 years. Current smokers were most common (50.2% followed by ever-smokers (18.2%, former smokers (15.8% and never-smokers (15.6%. Forty eight percent had stage IV lung cancer upon presentation. Never-smokers with lung cancer were 24 times more likely to be females. However, the proportion of female former smokers (31.6% was lower than the proportion of male former smokers (68.4% (P=0.001. There was no significant association between American Joint Committee on Cancer (AJCC stage, sex, race, and histological type in the two smoking groups. Current/ever-smokers tended to be younger at age of diagnosis (P=0.0003. BMI was lower in the current/ever-smokers (26.8 kg/m2 versus former/never-smokers (28.8 in males (P=0.0005. BMI was significantly higher in

  18. Dose-response modeling : Evaluation, application, and development of procedures for benchmark dose analysis in health risk assessment of chemical substances

    OpenAIRE

    Sand, Salomon

    2005-01-01

    In this thesis, dose-response modeling and procedures for benchmark dose (BMD) analysis in health risk assessment of chemical substances have been investigated. The BMD method has been proposed as an alternative to the NOAEL (no-observedadverse- effect-level) approach in health risk assessment of non-genotoxic agents. According to the BMD concept, a dose-response model is fitted to data and the BMD is defined as the dose causing a predetermined change in response. A lowe...

  19. Revised series of stylized anthropometric phantoms for internal and external radiation dose assessment

    Science.gov (United States)

    Han, Eunyoung

    At present, the dosimetry systems of both the International Commission on Radiological Protection, and the Society of Nuclear Medicine's Medical Internal Radiation Dose Committee utilize a series of stylized or mathematical anthropometric models of patient anatomy developed in 1987 at the Oak Ridge National Laboratory (ORNL). In this study, substantial revisions to the ORNL phantom series are reported with tissue compositions, tissue densities, and organ masses adjusted to match their most recent values in the literature. In addition, both the ICRP and MIRD systems of internal dosimetry implicitly consider that electron and beta-particle energy emitted within the source organs of the patient are fully deposited within these organs. With the development of the revised ORNL phantom series, three additional applications were explored as part of this dissertation research. First, the phantoms were used in combination to assess external radiation exposures to family members caring or interacting with patients released from the hospital following radionuclide therapy with I-131. Values of family member effective dose are then compared to values obtained using NRC guidance and based on a simple point-source methodology which ignores the effects of photon attenuation and scatter within both the source individual (patient) and the target individual (family member). Second, the anatomical structures of the extrathoracic airways and thoracic airways (exclusive of the lungs themselves) have been included in the entire revised ORNL phantom series of pediatric individuals. Values of cross-region photon dose are explored for use in radioactive aerosol inhalation exposures to members of the general public, and comparisons are made to values given by the ICRP in which surrogate organ assignments were made in the absence of explicit models of these airways. Finally, the revised ORNL phantoms of the adult male and adult female are used to determine internal photon exposures to

  20. Effect of the normalized prescription isodose line on the magnitude of Monte Carlo vs. pencil beam target dose differences for lung stereotactic body radiotherapy.

    Science.gov (United States)

    Zheng, Dandan; Zhang, Qinghui; Liang, Xiaoying; Zhu, Xiaofeng; Verma, Vivek; Wang, Shuo; Zhou, Sumin

    2016-07-08

    In lung stereotactic body radiotherapy (SBRT) cases, the pencil beam (PB) dose calculation algorithm is known to overestimate target dose as compared to the more accurate Monte Carlo (MC) algorithm. We investigated whether changing the normalized prescription isodose line affected the magnitude of MC vs. PB target dose differences. Forty-eight patient plans and twenty virtual-tumor phantom plans were studied. For patient plans, four alternative plans prescribed to 60%, 70%, 80%, and 90% isodose lines were each created for 12 patients who previously received lung SBRT treatments. Using 6 MV dynamic conformal arcs, the plans were individually optimized to achieve similar dose coverage and conformity for all plans of the same patient, albeit at the different prescription levels. These plans, having used a PB algorithm, were all recalculated with MC to compare the target dose differences. The relative MC vs. PB target dose variations were investigated by comparing PTV D95, Dmean, and D5 loss at the four prescription levels. The MC-to-PB ratio of the plan heterogeneity index (HI) was also evaluated and compared among different isodose levels. To definitively demonstrate the cause of the isodose line dependence, a simulated phantom study was conducted using simple, spherical virtual tumors planned with uniform block margins. The tumor size and beam energy were also altered in the phantom study to investigate the interplay between these confounding factors and the isodose line effect. The magnitude of the target dose overestimation by PB was greater for higher prescription isodose levels. The MC vs. PB reduction in the target dose coverage indices, D95 and V100 of PTV, were found to monotonically increase with increasing isodose lines from 60% to 90%, resulting in more pronounced target dose coverage deficiency at higher isodose prescription levels. No isodose level-dependent trend was observed for the dose errors in the target mean or high dose indices, Dmean or D5. The

  1. Retrospective study on the dose assessment in Algeria over a period 1998-2002

    Energy Technology Data Exchange (ETDEWEB)

    Boudena, B.; Chalal, M.; Bellal, A.; Imatoukene, D. [Nuclear Research Center of Algiers (Algeria)

    2006-07-01

    Full text: In Algeria, the assessment of individual doses of workers occupationally exposed to external radiations is made by the national individual monitoring service at the Nuclear Research Center of Algiers (N.R.C.A.) with photographic dosimeter. In this paper, we have undertaken a retrospective study on dose assessment of workers exposed to external radiations involved in medical and industrial activities according to the new occupational dose limits over a period of five consecutive years (1998 2002). This survey has permitted to observe the impact that would have new dose limits once adopted by our legislation. (author)

  2. Rapid Response to High-Dose, Pulsatile Erlotinib in Afatinib-Refractory Leptomeningeal Carcinomatosis from Adenocarcinoma of the Lung: A Case Report

    Directory of Open Access Journals (Sweden)

    Frank S. Fan

    2016-09-01

    Full Text Available Leptomeningeal carcinomatosis occurred in an old female patient who was on a standard dose of afatinib for the treatment of her non-small cell lung cancer harboring an epidermal growth factor receptor gene mutation sensitive to tyrosine kinase inhibitors when extracranial lesions were still under control. Shifting to high-dose, pulsatile erlotinib dramatically saved her from the devastating condition in a very short period of time. Inadequate afatinib concentration in cerebrospinal fluid is reasonably suspected, and there is a call for clinical trials testing high-dose afatinib in leptomeningeal carcinomatosis.

  3. Quantitative assessment of selective in-plane shielding of tissues in computed tomography through evaluation of absorbed dose and image quality

    Energy Technology Data Exchange (ETDEWEB)

    Geleijns, J.; Veldkamp, W.J.H. [Leiden University Medical Center, Radiology Department, ZA Leiden (Netherlands); Salvado Artells, M.; Lopez Tortosa, M. [Universitat Rovira i Virgili, Facultat de Medicina i Ciencies de la Salut, Departament de Ciencies Mediques Basiques, Reus, Tarragona (Spain); Calzado Cantera, A. [Universidad Complutense de Madrid, Departamento de Radiologia, Madrid (Spain)

    2006-10-15

    This study aimed at assessment of efficacy of selective in-plane shielding in adults by quantitative evaluation of the achieved dose reduction and image quality. Commercially available accessories for in-plane shielding of the eye lens, thyroid and breast, and an anthropomorphic phantom were used for the evaluation of absorbed dose and image quality. Organ dose and total energy imparted were assessed by means of a Monte Carlo technique taking into account tube voltage, tube current, and scanner type. Image quality was quantified as noise in soft tissue. Application of the lens shield reduced dose to the lens by 27% and to the brain by 1%. The thyroid shield reduced thyroid dose by 26%; the breast shield reduced dose to the breasts by 30% and to the lungs by 15%. Total energy imparted (unshielded/shielded) was 88/86 mJ for computed tomography (CT) brain, 64/60 mJ for CT cervical spine, and 289/260 mJ for CT chest scanning. An increase in image noise could be observed in the ranges were bismuth shielding was applied. The observed reduction of organ dose and total energy imparted could be achieved more efficiently by a reduction of tube current. The application of in-plane selective shielding is therefore discouraged. (orig.)

  4. Measurement and evaluation of internal dose

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Tae-Young; Chang, S.Y.; Lee, J.I.; Song, M.Y. [Korea Atomic Energy Research Institute, Taejeon (Korea)

    1999-12-01

    This report describes the contents and results for implementation of internal radiation monitoring programme, measurement of uranium lung deposition by lung counter and assessment of committed effective dose for radiation workers of KNFC. The aim of radiation protection was achieved by implementing this activity. 3 refs., 6 tabs. (Author)

  5. Measurement and evaluation of internal dose

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Tae Young; Chang, S. Y.; Lee, J. I.; Song, M. Y. [Korea Atomic Energy Research Institute, Taejeon (Korea)

    2002-01-01

    This report describes the contents and results for implementation of internal radiating monitoring programme, measurement of uranium present in lung by lung counter and assessment of committed effective dose for radiation workers of KNFC. The aim of radiation protection was achieved by implementing this activity. 8 refs., 14 tabs. (Author)

  6. Measurement and evaluation of internal dose

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Tae Young; Chang, S.Y.; Lee, J.I.; Song, M.Y. [Korea Atomic Energy Research Institute, Taejeon (Korea)

    2001-01-01

    This report describes the contents and results for implementation of internal radiation monitoring programme, measurement of uranium present in lung by lung counter and assessment of committed effective dose for radiation workers of KNFC. The aim of radiation protection was achieved by implementing this activity. 4 refs., 12 tabs. (Author)

  7. Study of limiting dosimetric parameters on lung pathology. Differences in the use of the lung-gtv and lung-ptv volumes; Estudio de los parametros dosimetricos limitantes en la patologia de pulmon diferencias en ul uso de los volumenes pulmon-gtv y pulmo-ptv

    Energy Technology Data Exchange (ETDEWEB)

    Granero Cabanero, D.; Almendros Blanco, P.; Garcia Hernanez, T.; Vicedo gonzalez, A.; Brualla, L.; Hernandez, A.; Solera, C.; Serrano, A.; Rosello, J.

    2013-07-01

    The objective of this work is to study the differences between the use of the volume of lung-GTV and lung-PTV to assess pulmonary toxicity and also to study the relationships between parameters V13, V20, V30, and mean dose of volumes lung, lung-PTV and lung-GTV. It was studied also the possible relationship between volumes of GTV, PTV and volume of lung with the dosimetric parameters described above. (Author)

  8. Standards for Quantitative Assessment of Lung Structure: The Dawn of Stereopneumology

    Directory of Open Access Journals (Sweden)

    Georgios T. Stathopoulos

    2010-01-01

    Full Text Available SUMMARY. The lungs are complex 3D structuresstudied in the clinic and the laboratory using histologic or imaging sections. Although such 2D analyses of lung structure are considered “gold standards”, the information conveyed is often insufficient and does not represent the whole organ. Stereology, the mathematical approach to the analysis of 3D structures via 2D sampling and morphometry, the practical application of stereology, provide solutions to this problem, but had until recently not been systematically adoptedin pneumology. In an effort of minimizing the above-mentioned methodological problems and of standardizing the quantitative assessment of lung structure, the American Thoracic Society and European Respiratory Society formed a task force, which recently published its findings. The task force aimed at comprehensively reviewing current stereologic methods for lung morphometry, formulating practical guidelines for using unbiased methods for basic and translational research of lung structure, and examining the extensions of stereologic methods on non-invasive imaging of lung architecture. In the statement of the task force are included useful directives with important application in the laboratory and the clinic, the most pertinent of which are discussed in the present mini-review. Pneumon 2010, 23(2:141-152.

  9. Assessment and interpretation of internal doses: uncertainty and variability.

    Science.gov (United States)

    Paquet, F; Bailey, M R; Leggett, R W; Harrison, J D

    2016-06-01

    Internal doses are calculated on the basis of knowledge of intakes and/or measurements of activity in bioassay samples, typically using reference biokinetic and dosimetric models recommended by the International Commission on Radiological Protection (ICRP). These models describe the behaviour of the radionuclides after ingestion, inhalation, and absorption to the blood, and the absorption of the energy resulting from their nuclear transformations. They are intended to be used mainly for the purpose of radiological protection: that is, optimisation and demonstration of compliance with dose limits. These models and parameter values are fixed by convention and are not subject to uncertainty. Over the past few years, ICRP has devoted a considerable amount of effort to the revision and improvement of models to make them more physiologically realistic. ICRP models are now sufficiently sophisticated for calculating organ and tissue absorbed doses for scientific purposes, and in many other areas, including toxicology, pharmacology and medicine. In these specific cases, uncertainties in parameters and variability between individuals need to be taken into account.

  10. Methanolic extract of Moringa oleifera leaf and low doses of gamma radiation alleviated amiodarone-induced lung toxicity in albino rats

    Directory of Open Access Journals (Sweden)

    Hasan Hesham F.

    2016-01-01

    Full Text Available This study aimed to evaluate the effects of methanolic extract of Moringa oleifera (MO and/or low doses of gamma radiation (LDR on amiodarone (AMD-induced lung toxicity in rats. AMD administered to female albino rats (100 mg/kg body weight for 10 consecutive days. Rats received methanolic extract of MO (250 mg/kg bwt for 15 successive days and/or were exposed to whole body LDR (0.25Gy on the 1st and 10th days, up to a total dose of 0.5Gy. MO administration induced a significant decrease in serum tumor necrosis factor-alpha (TNF-α and transforming growth factor-beta (TGF-β levels as well as lactate dehydrogenase (LDH activity. Also, the content of malondialdehyde (MDA and hydroxyproline (HYP was significantly decreased in lung tissue. Furthermore, MO significantly increased reduced glutathione (GSH content in lung tissue as compared with AMD. The histopathological investigation of lung tissue revealed the appearance of interstitial pneumonia in rats treated with AMD. The oral administration of MO and/or exposure to LDR reversed the biochemical and histopathological alterations induced by AMD. It can be posited that MO and LDR might have a considerable role in the prevention of lung toxicity induced by AMD.

  11. Low Dose Hyper-radiosensitivity in Human Lung Cancer Cell Line A549 and Its Possible Mechanisms

    Institute of Scientific and Technical Information of China (English)

    Xiaofang DAI; Dan TAO; Hongge WU; Jing CHENG

    2009-01-01

    The low dose hyper-radiosensitivity (HRS) in human lung cancer cell line A549 was in-vestigated,the changes of ATM kinase,cell cycle and apoptosis of cells at different doses of radiation were observed,and the possible mechanisms were discussed.A549 cells in logarithmic growth phase were irradiated with 60Co γ-rays at doses of 0-2 Gy.Together with flow cytometry for precise cell sorting,cell survival fraction was measured by means of conventional colony-formation assay.The expression of ATM1981Ser-P protein was examined by Western blot 1 h after radiation.Apoptosis was detected by Hoechst 33258 fluorescent staining,and Annexin V-FITC/PI staining flow cytometry 24 h after radiation.Cell cycle distribution was observed by flow cytometly 6,12 and 24 h after ra-diation.The results showed that the expression of ATM1981Ser-P protein was observed at 0.2 Gy,followed by an increase at >0.2 Gy,and reached the peak at 0.5 Gy,with little further increase as the dose exceeded 0.5 Gy.Twenty-four h after radiation,partial cells presented the characteristic mor-phological changes of apoptosis,and the cell apoptosis curve was coincident with the survival curve.As compared with control group,the cell cycle almost had no changes after exposure to 0.1 and 0.2 Gy radiation (P>0.05).After exposure to 0.3,0.4 and 0.5 Cry radiation,G2/M phase arrest occurred 6 and 12 h after radiation (P<0.05),and the ratio of G2/M phase cells was decreased 24 h after radiation (P<0.05).It was concluded that A549 cells displayed the phenomenon of HRS/IRR.The mode of cell death was mainly apoptosis.The activity of ATM and cell cycle change may take an important role in HRS/IRR.

  12. Using the Monte Carlo method for assessing the tissue and organ doses of patients in dental radiography

    Science.gov (United States)

    Makarevich, K. O.; Minenko, V. F.; Verenich, K. A.; Kuten, S. A.

    2016-05-01

    This work is dedicated to modeling dental radiographic examinations to assess the absorbed doses of patients and effective doses. For simulating X-ray spectra, the TASMIP empirical model is used. Doses are assessed on the basis of the Monte Carlo method by using MCNP code for voxel phantoms of ICRP. The results of the assessment of doses to individual organs and effective doses for different types of dental examinations and features of X-ray tube are presented.

  13. Longitudinal micro-CT provides biomarkers of lung disease that can be used to assess the effect of therapy in preclinical mouse models, and reveal compensatory changes in lung volume.

    Science.gov (United States)

    Vande Velde, Greetje; Poelmans, Jennifer; De Langhe, Ellen; Hillen, Amy; Vanoirbeek, Jeroen; Himmelreich, Uwe; Lories, Rik J

    2016-01-01

    In vivo lung micro-computed tomography (micro-CT) is being increasingly embraced in pulmonary research because it provides longitudinal information on dynamic disease processes in a field in which ex vivo assessment of experimental disease models is still the gold standard. To optimize the quantitative monitoring of progression and therapy of lung diseases, we evaluated longitudinal changes in four different micro-CT-derived biomarkers [aerated lung volume, lung tissue (including lesions) volume, total lung volume and mean lung density], describing normal development, lung infections, inflammation, fibrosis and therapy. Free-breathing mice underwent micro-CT before and repeatedly after induction of lung disease (bleomycin-induced fibrosis, invasive pulmonary aspergillosis, pulmonary cryptococcosis) and therapy (imatinib). The four lung biomarkers were quantified. After the last time point, we performed pulmonary function tests and isolated the lungs for histology. None of the biomarkers remained stable during longitudinal follow-up of adult healthy mouse lungs, implying that biomarkers should be compared with age-matched controls upon intervention. Early inflammation and progressive fibrosis led to a substantial increase in total lung volume, which affects the interpretation of aerated lung volume, tissue volume and mean lung density measures. Upon treatment of fibrotic lung disease, the improvement in aerated lung volume and function was not accompanied by a normalization of the increased total lung volume. Significantly enlarged lungs were also present in models of rapidly and slowly progressing lung infections. The data suggest that total lung volume changes could partly reflect a compensatory mechanism that occurs during disease progression in mice. Our findings underscore the importance of quantifying total lung volume in addition to aerated lung or lesion volumes to accurately document growth and potential compensatory mechanisms in mouse models of lung

  14. A planning study of radiotherapy dose escalation of PET-active tumour volumes in non-small cell lung cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Sloth Moeller, Ditte; Hoffmann, Lone (Dept. of Medical Physics, Aarhus Univ. Hospital, Aarhus (Denmark)), e-mail: dittmoel@rm.dk; Khalil, Azza Ahmed; Marquard Knap, Marianne (Dept. of Oncology, Aarhus Univ. Hospital, Aarhus (Denmark)); Muren, Ludvig Paul (Dept. of Medical Physics, Aarhus Univ. Hospital, Aarhus (Denmark); Dept. of Oncology, Aarhus Univ. Hospital, Aarhus (Denmark))

    2011-08-15

    Background. Patients with non-small cell lung cancer (NSCLC) have poor prognosis partly because of high local failure rates. Escalating the dose to the tumour may decrease the local failure rates and thereby, improve overall survival, but the risk of complications will limit the possibility to dose-escalate a broad range of patients. Escalating only PET-active areas of the tumour may increase the potential for reaching high doses for a variety of tumour sizes and locations. Material and methods. Ten patients were randomly chosen for a dose escalation planning study. A planning target volume (PTV) was defined on the mid-ventilation scan of a four-dimensional computed tomography (4D-CT) scan and a boost planning target volume (PTV-boost) was defined based on a positron emission tomography computed tomography (PET-CT) scan. Treatment plans were created aiming to reach the highest achievable of 74 Gy, 78 Gy or 82 Gy in 2 Gy per fraction prescribed to the PTV-boost without compromising normal tissue constraints and with the PTV prescribed in all cases a biological equivalent dose in 2 Gy fractions of 66 Gy. Results. Nine of ten patients could be escalated to the highest dose level (82 Gy), while one patient was limited by the oesophagus dose constraint and could only reach 74 Gy. Four patients could be dose-escalated above 82 Gy without compromising normal tissue constraints. Conclusion. Dose-escalating only the PET-active areas of lung tumours to doses of 82 Gy while respecting normal tissue constraints is feasible, also in a series of unselected patients including cases with relatively large tumours

  15. Screening for lung cancer with low-dose computed tomography; Bronchialkarzinom-Screening mit Niedrigdosis-CT. Aktueller Stand

    Energy Technology Data Exchange (ETDEWEB)

    Diederich, S.; Wormanns, D.; Heindel, W. [Muenster Univ. (Germany). Inst. fuer Klinische Radiologie

    2001-03-01

    Lung cancer is the most common cause of death from malignancy. It is characterized by a favourable prognosis when treated in early stages and a poor prognosis in advanced stages. Populations at risk are relatively well defined, i.e. heavy smokers and workers exposed to asbestos and radon. Therefore, early detection using diagnostic techniques promises reduction of mortality from this tumor. Previous studies using chest radiography and sputum cytology were, however, disappointing due to poor sensitivity of these tests for early tumor stages. The new technique of low-dose computed tomography provides both high sensitivity for small tumors and a comfortable examination. As small benign pulmonary nodules are common reliable non-invasive diagnostic algorithms are required for classification of nodules. Preliminary studies using low-dose CT screening in smokers have provided promising results. Prior to a wide application of the technique in clinical routine more data are required as to inclusion criteria, examination intervals and the effect of screening on mortality reduction. (orig.) [German] Das Bronchialkarzinom ist der am haeufigsten zum Tode fuehrende maligne Tumor. Seine Prognose ist bei einer Therapie in fruehen Stadien relativ gut, in fortgeschrittenen Erkrankungsstadien dagegen ausgesprochen schlecht. Die Risikopopulationen sind gut charakterisiert, v.a. starke Raucher und Personen mit einer beruflichen Asbest- bzw. Radonexposition. Vor diesem Hintergrund erscheinen Frueherkennungsuntersuchungen mittels diagnostischer Verfahren sinnvoll, um die Sterblichkeit an diesem Tumor zu senken. Bisherige Erfahrungen mit Thoraxroentgenaufnahmen und Sputumuntersuchungen waren aufgrund der geringen Sensitivitaet der Verfahren fuer fruehe Tumorstadien jedoch enttaeuschend. Das relativ neue Verfahren der Niedrigdosis-Computertomographie des Thorax verbindet eine hohe Sensitivitaet fuer kleine Tumoren mit einer geringen Belastung der untersuchten Person. Wegen der Haeufigkeit

  16. Treatment of small cell carcinoma of lung with combined high dose mediastinal irradiation, whole brain prophylaxis and chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Shank, B.; Natale, R.B.; Hilaris, B.S.; Wittes, R.E.

    1981-04-01

    Survival of patients with small cell carcinoma of lung, treated on a new combined radiotherapy-chemotherapy protocol, compares favorably with other regimens in the literature and our own previous combined approaches. Radiation, given after induction chemotherapy, consisted of whole brain prophylaxis in all 44 evaluable patients. Patients with limited disease were also treated to the primary and mediastinum to a high dose (5000 rad equivalent) using multiple fields. The new chemotherapy regimen consisted of induction with cyclophosphamide, doxorubicin, and vincristine alternated with cis-platinum and VP-16 (an epipodophyllotoxin) for two cycles, followed by consolidation with low dose cyclophosphamide and vincristine concurrent with irradiation. Patients with limited disease who achieved less than complete response, and all patients with extensive disease were not continued on maintenance chemotherapy. Out of 24 evaluable patients with limited disease, there was 73% survival at 1 year by life-table analysis, measured from treatment initiation. After induction, 16/24 of these limited disease patients were CR (complete responders): 20/24 were CR at completion of their irradiation. Out of 20 evaluable patients with extensive disease, there was 59% survival at 1 year by life-table analysis. Only 4/44 (9%) brain parenchymal relapses occurred, one at 3 months and one at 6 months after local failure and two in patients who did not become CRs, implicating a possible re-seeding mechanism. Five patients had central nervous system relapses outside of brain parenchyma (spinal epidural and leptomeningeal); in three patients this was the initial site of failure. Significant complications included leukopenia (50%) and thrombocytopenia (24%) primarily during induction, and chronic pulmonary fibrosis (25%), possibly contributing to two deaths.

  17. EMP Attachment 3 DOE-SC PNNL Site Dose Assessment Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Snyder, Sandra F.

    2011-12-21

    This Dose Assessment Guidance (DAG) describes methods to use to determine the Maximally-Exposed Individual (MEI) location and to estimate dose impact to that individual under the U.S. Department of Energy Office of Science (DOE-SC) Pacific Northwest National Laboratory (PNNL) Site Environmental Monitoring Plan (EMP). This guidance applies to public dose from radioactive material releases to the air from PNNL Site operations. This document is an attachment to the Pacific Northwest National Laboratory (PNNL) Environmental Monitoring Plan (EMP) and describes dose assessment guidance for radiological air emissions. The impact of radiological air emissions from the U.S. Department of Energy Office of Science (DOE-SC) PNNL Site is indicated by dose estimates to a maximally exposed member of the public, referred to as the maximally exposed individual (MEI). Reporting requirements associated with dose to members of the public from radiological air emissions are in 40 CFR Part 61.94, WAC 246-247-080, and DOE Order 458.1. The DOE Order and state standards for dose from radioactive air emissions are consistent with U.S. Environmental Protection Agency (EPA) dose standards in 40 CFR 61.92 (i.e., 10 mrem/yr to a MEI). Despite the fact that the current Contract Requirements Document (CRD) for the DOE-SC PNNL Site operations does not include the requirement to meet DOE CRD 458.1, paragraph 2.b, public dose limits, the DOE dose limits would be met when EPA limits are met.

  18. Ablative dose proton beam therapy for stage I and recurrent non-small cell lung carcinomas. Ablative dose PBT for NSCLC

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sung Uk; Cho, Kwan Ho; Kim, Joo Young; Kim, Dae Yong; Kim, Tae Hyun; Suh, Yang-Gun; Kim, Yeon-Joo [Research Institute and Hospital, National Cancer Center, Proton Therapy Center, Goyang (Korea, Republic of); Moon, Sung Ho [Research Institute and Hospital, National Cancer Center, Proton Therapy Center, Goyang (Korea, Republic of); Research Institute and Hospital, National Cancer Center, Center for Lung Cancer, Goyang (Korea, Republic of); Research Institute and Hospital, National Cancer Center, Proton Therapy Center, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769 (Korea, Republic of); Pyo, Hong Ryull [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiation Oncology, Seoul (Korea, Republic of)

    2016-09-15

    To evaluate the efficacy and safety of ablative dose hypofractionated proton beam therapy (PBT) for patients with stage I and recurrent non-small cell lung carcinoma (NSCLC). A total of 55 patients with stage I (n = 42) and recurrent (n = 13) NSCLC underwent hypofractionated PBT and were retrospectively reviewed. A total dose of 50-72 CGE (cobalt gray equivalent) in 5-12 fractions was delivered. The median follow-up duration was 29 months (range 4-95 months). There were 24 deaths (43.6%) during the follow-up period: 11 died of disease progression and 13 from other causes. Kaplan-Meier overall survival rate (OS) at 3 years was 54.9% and the median OS was 48.6 months (range 4-95 months). Local progression was observed in 7 patients and the median time to local progression was 9.3 months (range 5-14 months). Cumulative actuarial local control rate (LCR), lymph node metastasis-free survival, and distant metastasis-free survival rates at 3 years were 85.4, 78.4, and 76.5%, respectively. Larger tumor diameter was significantly associated with poorer LCR (3-year: 94% for ≤3 cm vs. 65% for >3 cm, p = 0.006) on univariate analysis and also an independent prognostic factor for LCR (HR 6.9, 95% CI = 1.3-37.8, p = 0.026) on multivariate analysis. No grade 3 or 4 treatment-related toxicities developed. One grade 5 treatment-related adverse event occurred in a patient with symptomatic idiopathic pulmonary fibrosis. Ablative dose hypofractionated PBT was safe and promising for stage I and recurrent NSCLC. (orig.) [German] Beurteilung von Wirksamkeit und Sicherheit hypofraktionierter Protonentherapie (PBT) mit ablativen Dosen fuer nichtkleinzellige Lungenkarzinome (NSCLC) im Stadium I und rekurrierende NSCLC. Retrospektiv wurden insgesamt 55 NSCLC-Patienten (Stadium I: n = 42; rekurrierender Tumor: n = 13), analysiert. Sie waren mit einer Gesamtdosis von 50-72 CGE (''cobalt gray equivalent'') in 5-12 Fraktionen behandelt worden. Der Median der Follow

  19. Accelerated high-dose radiotherapy alone or combined with either concomitant or sequential chemotherapy; treatments of choice in patients with Non-Small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Pieters Bradley R

    2007-07-01

    Full Text Available Abstract Background Results of high-dose chemo-radiotherapy (CRT, using the treatment schedules of EORTC study 08972/22973 or radiotherapy (RT alone were analyzed among all patients (pts with Non Small Cell Lung Cancer (NSCLC treated with curative intent in our department from 1995–2004. Material Included are 131 pts with medically inoperable or with irresectable NSCLC (TNM stage I:15 pts, IIB:15 pts, IIIA:57 pts, IIIB:43 pts, X:1 pt. Treatment Group I: Concomitant CRT: 66 Gy/2.75 Gy/24 fractions (fx/33 days combined with daily administration of cisplatin 6 mg/m2: 56 pts (standard. Group II: Sequential CRT: two courses of a 21-day schedule of chemotherapy (gemcitabin 1250 mg/m2 d1, cisplatin 75 mg/m2 d2 followed by 66 Gy/2.75 Gy/24 fx/33 days without daily cisplatin: 26 pts. Group III: RT: 66 Gy/2.75 Gy/24 fx/33 days or 60 Gy/3 Gy/20 fx/26 days: 49 pts. Results The 1, 2, and 5 year actuarial overall survival (OS were 46%, 24%, and 15%, respectively. At multivariate analysis the only factor with a significantly positive influence on OS was treatment with chemo-radiation (P = 0.024 (1-, 2-, and 5-yr OS 56%, 30% and 22% respectively. The incidence of local recurrence was 36%, the incidence of distant metastases 46%. Late complications grade 3 were seen in 21 pts and grade 4 in 4 patients. One patient had a lethal complication (oesophageal. For 32 patients insufficient data were available to assess late complications. Conclusion In this study we were able to reproduce the results of EORTC trial 08972/22973 in a non-selected patient population outside of the setting of a randomised trial. Radiotherapy (66 Gy/24 fx/33 days combined with either concomitant daily low dose cisplatin or with two neo-adjuvant courses of gemcitabin and cisplatin are effective treatments for patients with locally advanced Non-Small Cell Lung Cancer. The concomitant schedule is also suitable for elderly people with co-morbidity.

  20. Facial exposure dose assessment during intraoral radiography by radiological technologists

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Hwan; Yang, Han Joon [Dept. of International Radiological Science, Hallym University of Graduate Studies, Chuncheon (Korea, Republic of)

    2014-09-15

    The study examined the changes in the decreased facial exposure dose for radiological technologists depending on increased distance between the workers and the X-ray tube head during intraoral radiography. First, the facial phantom similar to the human tissues was manufactured. The shooting examination was configured to the maxillary molars for adults (60 kVp, 10 mA, 50 msec) and for children (60 kVp, 10 mA, 20 msec), and the chamber was fixed where the facial part of the radiation worker would be placed using the intraoral radiography equipment. The distances between the X-ray tube head and the phantom were set to 10 cm, 15 cm, 20 cm, 25 cm, 30 cm, 35 cm, and 40 cm. The phantom was radiated 20 times with each examination condition and the average scattered doses were examined. The rate at the distance of 40 cm decreased by about 92.6% to 7.43% based on the scattered rays radiated at the distance of 10 cm under the adult conditions. The rate at the distance of 40 cm decreased by about 97.6% to 2.58% based on the scattered rays radiated at the distance of 10 cm under the children conditions. Protection from the radiation exposure was required during the dental radiographic examination.

  1. TRANSPORTATION CASK RECEIPT AND RETURN FACILITY WORKER DOSE ASSESSMENT

    Energy Technology Data Exchange (ETDEWEB)

    V. Arakali

    2005-02-24

    The purpose of this design calculation is to estimate radiation doses received by personnel working in the Transportation Cask Receipt and Return Facility (TCRRF) of the repository including the personnel at the security gate and cask staging areas. This calculation is required to support the preclosure safety analysis (PCSA) to ensure that the predicted doses are within the regulatory limits prescribed by the U.S. Nuclear Regulatory Commission (NRC). The Cask Receipt and Return Facility receives NRC licensed transportation casks loaded with spent nuclear fuel (SNF) and high-level radioactive waste (HLW). The TCRRF operation starts with the receipt, inspection, and survey of the casks at the security gate and the staging areas, and proceeds to the process facilities. The transportation casks arrive at the site via rail cars or trucks under the guidance of the national transportation system. This calculation was developed by the Environmental and Nuclear Engineering organization and is intended solely for the use of Design and Engineering in work regarding facility design. Environmental and Nuclear Engineering personnel should be consulted before using this calculation for purposes other than those stated herein or for use by individuals other than authorized personnel in the Environmental and Nuclear Engineering organization.

  2. Quality assurance of the EORTC trial 22881/10882 : 'assessment of the role of the booster dose in breast conserving therapy'; The Dummy Run

    Energy Technology Data Exchange (ETDEWEB)

    Tienhoven, G. van; Bree, N.A.M. van; Mijnheer, B.J.; Bartelink, H. (Nederlands Kanker Inst. ' Antoni van Leeuwenhoekhuis' , Amsterdam (Netherlands) the EORTC Radiotherapy Group)

    1991-12-01

    The EORTC trial 22881/10882 is a randomised trial with the aim to assess the role of the boost dose in breast conserving therapy in stage I and II breast cancer.In order to detect potential protocol deviations concerning irradiation technique and in dose specification procedure of participating institutions before actual patient accrual, a Dummy Run was performed. Three transverse sections of a patient were sent to 16 institutions with a request to make a 3-plane treatment plan according to protocol prescriptions. A treatment chart and beam data were also requested for recalculation of the dose. Additional information was asked in a questionnaire. On evaluation, the techniques differed considerably with respect to photon beam energy, varying between {sup 60}Co gamma-rays and 8MV X-rays, and use of wedge filters. Two institutions did not apply wedges, whereas wedge angles in the other institutions varied between 6deg and 45 deg. Twelve institutions used collimator rotation and/or a table wedge to diminish the amount of irradiated lung volume. The dose was specified in a point according to the protocol prescription in 11 institutions and to the 90, 95 or 100% isodose curve in four. Twelve institutions applied lung density corrections during treatment planning, while nine reported problems with their planning system in off-axis dose distribution calculation and/or the stimulation of collimator rotation. Recalculation of dose at the isocentre showed agreement within 2% compared with stated dose. Dose reported in the tumor excision area varied between 93 and 100%. It can be concluded that good accordance and high quality breast irradiation can be achieved by all institutions participating in the trial, provided a few recommendations are followed. The results of this analysis show the necessity and usefulness of a quality assurance programme at the initial phase of a clinical trial. (author). 27 refs.; 3 figs.; 4 tabs.

  3. Accuracy and Utility of Deformable Image Registration in {sup 68}Ga 4D PET/CT Assessment of Pulmonary Perfusion Changes During and After Lung Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hardcastle, Nicholas, E-mail: nick.hardcastle@gmail.com [Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne (Australia); Centre for Medical Radiation Physics, University of Wollongong, Wollongong (Australia); Hofman, Michael S. [Molecular Imaging, Centre for Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne (Australia); Hicks, Rodney J. [Molecular Imaging, Centre for Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne (Australia); Department of Medicine, University of Melbourne, Melbourne (Australia); Callahan, Jason [Molecular Imaging, Centre for Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne (Australia); Kron, Tomas [Department of Medical Imaging and Radiation Sciences, Monash University, Clayton (Australia); The Sir Peter MacCallum Department of Oncology, Melbourne University, Victoria (Australia); MacManus, Michael P.; Ball, David L. [Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia); The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne (Australia); Jackson, Price [Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne (Australia); Siva, Shankar [Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia)

    2015-09-01

    Purpose: Measuring changes in lung perfusion resulting from radiation therapy dose requires registration of the functional imaging to the radiation therapy treatment planning scan. This study investigates registration accuracy and utility for positron emission tomography (PET)/computed tomography (CT) perfusion imaging in radiation therapy for non–small cell lung cancer. Methods: {sup 68}Ga 4-dimensional PET/CT ventilation-perfusion imaging was performed before, during, and after radiation therapy for 5 patients. Rigid registration and deformable image registration (DIR) using B-splines and Demons algorithms was performed with the CT data to obtain a deformation map between the functional images and planning CT. Contour propagation accuracy and correspondence of anatomic features were used to assess registration accuracy. Wilcoxon signed-rank test was used to determine statistical significance. Changes in lung perfusion resulting from radiation therapy dose were calculated for each registration method for each patient and averaged over all patients. Results: With B-splines/Demons DIR, median distance to agreement between lung contours reduced modestly by 0.9/1.1 mm, 1.3/1.6 mm, and 1.3/1.6 mm for pretreatment, midtreatment, and posttreatment (P<.01 for all), and median Dice score between lung contours improved by 0.04/0.04, 0.05/0.05, and 0.05/0.05 for pretreatment, midtreatment, and posttreatment (P<.001 for all). Distance between anatomic features reduced with DIR by median 2.5 mm and 2.8 for pretreatment and midtreatment time points, respectively (P=.001) and 1.4 mm for posttreatment (P>.2). Poorer posttreatment results were likely caused by posttreatment pneumonitis and tumor regression. Up to 80% standardized uptake value loss in perfusion scans was observed. There was limited change in the loss in lung perfusion between registration methods; however, Demons resulted in larger interpatient variation compared with rigid and B-splines registration

  4. Low-dose computed tomography for lung cancer screening: comparison of performance between annual and biennial screen

    Energy Technology Data Exchange (ETDEWEB)

    Sverzellati, Nicola; Silva, M. [University of Parma, Radiology, Department of Surgical Sciences, Parma (Italy); Calareso, G.; Marchiano, A. [Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Radiology, Milan (Italy); Galeone, C. [University of Milano-Bicocca, Department of Statistics and Quantitative Methods, Division of Biostatistics, Epidemiology and Public Health, Laboratory of Healthcare Research and Pharmacoepidemiology, Milan (Italy); Sestini, S.; Pastorino, U. [Fondazione IRCCS Istituto Nazionale dei Tumori, Department of Surgery, Section of Thoracic Surgery, Milan (Italy); Sozzi, G. [Fondazione IRCCS Istituto Nazionale dei Tumori, Tumor Genomics Unit, Department of Experimental Oncology and Molecular Medicine, Milan (Italy)

    2016-11-15

    To compare the performance metrics of two different strategies of lung cancer screening by low-dose computed tomography (LDCT), namely, annual (LDCT1) or biennial (LDCT2) screen. Recall rate, detection rate, interval cancers, sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively) were compared between LDCT1 and LDCT2 arms of the MILD trial over the first seven (T0-T6; median follow-up 7.3 years) and four rounds (T0-T3; median follow-up 7.3 years), respectively. 1152 LDCT1 and 1151 LDCT2 participants underwent a total of 6893 and 4715 LDCT scans, respectively. The overall recall rate was higher in LDCT2 arm (6.97 %) than in LDCT1 arm (5.81 %) (p = 0.01), which was counterbalanced by the overall lower number of LDCT scans. No difference was observed for the overall detection rate (0.56 % in both arms). The two LDCT arms had similar specificity (99.2 % in both arms), sensitivity (73.5 %, in LDCT2 vs. 68.5 % in LDCT1, p = 0.62), PPV (42.4 %, in LDCT2, vs. 40.6 %, in LDCT1, p = 0.83) and NPV (99.8 %, in LDCT2 vs. 99.7 %, in LDCT1, p = 0.71). Biennial screen may save about one third of LDCT scans with similar performance indicators as compared to annual screening. (orig.)

  5. Which Is the Optimal Biologically Effective Dose of Stereotactic Body Radiotherapy for Stage I Non-Small-Cell Lung Cancer? A Meta-Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Jian; Yang Fujun [Department of Radiation Oncology, Cancer Hospital, Tianjin Medical University, Tianjin (China); Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan (China); Shandong' s Key Laboratory of Radiation Oncology, Jinan (China); Li Baosheng, E-mail: baoshli@yahoo.com [Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan (China); Shandong' s Key Laboratory of Radiation Oncology, Jinan (China); Li Hongsheng [Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan (China); Shandong' s Key Laboratory of Radiation Oncology, Jinan (China); Liu Jing [School of Public Health, Shandong University, Jinan (China); Huang Wei; Wang Dongqing; Yi Yan; Wang Juan [Department of Radiation Oncology, Shandong Cancer Hospital, Shandong Academy of Medical Sciences, Jinan (China); Shandong' s Key Laboratory of Radiation Oncology, Jinan (China)

    2011-11-15

    Purpose: To assess the relationship between biologically effective dose (BED) and efficacy of stereotactic body radiation therapy (SBRT) and to explore the optimal BED range for Stage I non-small-cell lung cancer (NSCLC). Methods and Materials: Eligible studies were identified on Medline, Embase, the Cochrane Library, and the proceedings of annual meetings through June 2010. According to the quartile of included studies, BED was divided into four dose groups: low (<83.2 Gy), medium (83.2-106 Gy), medium to high (106-146 Gy), high (>146 Gy). To obtain pooled estimates of overall survival (OS), cancer-specific survival (CSS), and local control rate (LCR), data were combined in a random effect model. Pooled estimates were corrected for the percentage of small tumors (<3 cm). Results: Thirty-four observational studies with a total of 2,587 patients were included in the meta-analysis. Corrected pooled estimates of 2- or 3-year OS in the medium BED (76.1%, 63.5%) or the medium to high BED (68.3%, 63.2%) groups were higher than in the low (62.3%, 51.9%) or high groups (55.9%, 49.5%), respectively (p {<=} 0.004). Corrected 3-year CSS in the medium (79.5%), medium to high (80.6%), and high groups (90.0%) were higher than in the low group (70.1%, p = 0.016, 0.018, 0.001, respectively). Conclusion: The OS for the medium or medium to high BED groups were higher than those for the low or high BED group for SBRT in Stage I NSCLC. The medium or medium to high BED (range, 83.2-146 Gy) for SBRT may currently be more beneficial and reasonable in Stage I NSCLC.

  6. Visual assessment of early emphysema and interstitial abnormalities on CT is useful in lung cancer risk analysis

    Energy Technology Data Exchange (ETDEWEB)

    Wille, Mathilde M.W.; Dirksen, Asger; Shaker, Saher B. [Gentofte Hospital, Department of Respiratory Medicine, Hellerup (Denmark); Thomsen, Laura H. [Hvidovre Hospital, Department of Respiratory Medicine, Hvidovre (Denmark); Petersen, Jens [University of Copenhagen, Department of Computer Science, DIKU, Koebenhavn Oe (Denmark); Bruijne, Marleen de [University of Copenhagen, Department of Computer Science, DIKU, Koebenhavn Oe (Denmark); Erasmus MC -University Medical Center Rotterdam, Biomedical Imaging Group Rotterdam, Departments of Radiology and Medical Informatics, Rotterdam (Netherlands); Pedersen, Jesper H. [Copenhagen University Hospital, Department of Thoracic Surgery, Rigshospitalet, Koebenhavn Oe (Denmark)

    2016-02-15

    Screening for lung cancer should be limited to a high-risk-population, and abnormalities in low-dose computed tomography (CT) screening images may be relevant for predicting the risk of lung cancer. Our aims were to compare the occurrence of visually detected emphysema and interstitial abnormalities in subjects with and without lung cancer in a screening population of smokers. Low-dose chest CT examinations (baseline and latest possible) of 1990 participants from The Danish Lung Cancer Screening Trial were independently evaluated by two observers who scored emphysema and interstitial abnormalities. Emphysema (lung density) was also measured quantitatively. Emphysema was seen more frequently and its extent was greater among participants with lung cancer on baseline (odds ratio (OR), 1.8, p = 0.017 and p = 0.002) and late examinations (OR 2.6, p < 0.001 and p < 0.001). No significant difference was found using quantitative measurements. Interstitial abnormalities were more common findings among participants with lung cancer (OR 5.1, p < 0.001 and OR 4.5, p < 0.001).There was no association between presence of emphysema and presence of interstitial abnormalities (OR 0.75, p = 0.499). Even early signs of emphysema and interstitial abnormalities are associated with lung cancer. Quantitative measurements of emphysema - regardless of type - do not show the same association. (orig.)

  7. Evaluation of parameters of the HDV (V20 and dose average) in radiotherapy of lung cancer with lung volumes design adapted compounds (ITV); Evaluacion de parametros del HDV (V20 Y Dmed) en radioterapia adaptada de cancer de pulmon con diseno de volumenes pulmonares compuestos (ITV)

    Energy Technology Data Exchange (ETDEWEB)

    Monroy Anton, J. L.; Solar Tortosa, M.; Lopez Munoz, M.; Navarro Bergada, A.; Estornell Gualde, M. A.; Melchor Iniguez, M.

    2013-07-01

    Our objective was to evaluate the V20 parameters and dose average compared to a single lung volume designed with a CT study in normal breathing of the patient and the corresponding to a lung volume composed, designed from three studies of CT in different phases of the respiratory cycle. Check if there are important differences in these cases that determine the necessity of creating a composite lung volume to evaluate dose volume histogram. (Author)

  8. Boron Diffused Thermoluminescent Surface Layer in LiF TLDs for Skin Dose Assessments

    DEFF Research Database (Denmark)

    Christensen, Poul; Majborn, Benny

    1980-01-01

    A new high-temperature glow peak produced in a thin surface layer of LiF TLDs by diffusion of boron into the LiF material has been studied for skin dose assessments in personnel dosimetry.......A new high-temperature glow peak produced in a thin surface layer of LiF TLDs by diffusion of boron into the LiF material has been studied for skin dose assessments in personnel dosimetry....

  9. Assessment of CF lung disease using motion corrected PROPELLER MRI: a comparison with CT

    Energy Technology Data Exchange (ETDEWEB)

    Ciet, Pierluigi [General Hospital Ca' Foncello, Radiology Department, Treviso (Italy); Sophia Children' s Hospital, Pediatric Pulmonology Erasmus MC, Rotterdam (Netherlands); Erasmus MC, Radiology, Rotterdam (Netherlands); Serra, Goffredo; Catalano, Carlo [University of Rome ' ' Sapienza' ' , Radiology, Rome (Italy); Bertolo, Silvia; Morana, Giovanni [General Hospital Ca' Foncello, Radiology Department, Treviso (Italy); Spronk, Sandra [Erasmus MC, Radiology, Rotterdam (Netherlands); Erasmus MC, Epidemiology, Rotterdam (Netherlands); Ros, Mirco [Ca' Foncello Hospital, Pediatrics, Treviso (Italy); Fraioli, Francesco [University College London (UCL), Institute of Nuclear Medicine, London (United Kingdom); Quattrucci, Serena [University of Rome Sapienza, Pediatrics, Rome (Italy); Assael, M.B. [Azienda Ospedaliera di Verona, Verona CF Center, Verona (Italy); Pomerri, Fabio [University of Padova, Department of Medicine-DIMED, Padova (Italy); Tiddens, Harm A.W.M. [Sophia Children' s Hospital, Pediatric Pulmonology Erasmus MC, Rotterdam (Netherlands); Erasmus MC, Radiology, Rotterdam (Netherlands)

    2016-03-15

    To date, PROPELLER MRI, a breathing-motion-insensitive technique, has not been assessed for cystic fibrosis (CF) lung disease. We compared this technique to CT for assessing CF lung disease in children and adults. Thirty-eight stable CF patients (median 21 years, range 6-51 years, 22 female) underwent MRI and CT on the same day. Study protocol included respiratory-triggered PROPELLER MRI and volumetric CT end-inspiratory and -expiratory acquisitions. Two observers scored the images using the CF-MRI and CF-CT systems. Scores were compared with intra-class correlation coefficient (ICC) and Bland-Altman plots. The sensitivity and specificity of MRI versus CT were calculated. MRI sensitivity for detecting severe CF bronchiectasis was 0.33 (CI 0.09-0.57), while specificity was 100 % (CI 0.88-1). ICCs for bronchiectasis and trapped air were as follows: MRI-bronchiectasis (0.79); CT-bronchiectasis (0.85); MRI-trapped air (0.51); CT-trapped air (0.87). Bland-Altman plots showed an MRI tendency to overestimate the severity of bronchiectasis in mild CF disease and underestimate bronchiectasis in severe disease. Motion correction in PROPELLER MRI does not improve assessment of CF lung disease compared to CT. However, the good inter- and intra-observer agreement and the high specificity suggest that MRI might play a role in the short-term follow-up of CF lung disease (i.e. pulmonary exacerbations). (orig.)

  10. Slope of the dose-response curve: usefulness in assessing bronchial responses to inhaled histamine.

    OpenAIRE

    Cockcroft, D. W.; Berscheid, B A

    1983-01-01

    The value of determining the slope of the histamine dose-response curve, in addition to the histamine provocation concentration producing a 20% reduction in FEV1 (PC20-FEV1), was assessed by analysis of histamine dose-response curves in 40 patients selected as having a wide range of increased non-specific bronchial responsiveness to inhaled histamine. The histamine dose-response curves were found to be fit the linear curve (dose v response, mean r2 = 0.97) better than the logarithmic curve (l...

  11. Dosimetry experiences and lessons learned for radiation dose assessment in Korean nuclear power plants.

    Science.gov (United States)

    Choi, Jong Rak; Kim, Hee Geun; Kong, Tae Young; Son, Jung Kwon

    2013-07-01

    Since the first Korean nuclear power plant (NPP), Kori 1, commenced operation in 1978, a total of 21 NPPs had been put into operation in Korea by the end of 2011. Radiation doses of NPP workers have been periodically evaluated and controlled within the prescribed dose limit. Radiation dose assessment is carried out monthly by reading personal dosemeters for external radiation exposure, which have traceability in compliance with strict technical guidelines. In the case of the internal radiation exposure, workers who have access to the possible area of polluted air are also evaluated for their internal dose after maintenance task. In this article, the overall situation and experience for the assessment and distribution of radiation doses in Korean NPPs is described.

  12. Influence of radiation dose and reconstruction algorithm in MDCT assessment of airway wall thickness: A phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Gomez-Cardona, Daniel [Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, 1111 Highland Avenue, Madison, Wisconsin 53705 (United States); Nagle, Scott K. [Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, 1111 Highland Avenue, Madison, Wisconsin 53705 (United States); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, Wisconsin 53792 (United States); Department of Pediatrics, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, Wisconsin 53792 (United States); Li, Ke; Chen, Guang-Hong, E-mail: gchen7@wisc.edu [Department of Medical Physics, University of Wisconsin-Madison School of Medicine and Public Health, 1111 Highland Avenue, Madison, Wisconsin 53705 (United States); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, 600 Highland Avenue, Madison, Wisconsin 53792 (United States); Robinson, Terry E. [Department of Pediatrics, Stanford School of Medicine, 770 Welch Road, Palo Alto, California 94304 (United States)

    2015-10-15

    Purpose: Wall thickness (WT) is an airway feature of great interest for the assessment of morphological changes in the lung parenchyma. Multidetector computed tomography (MDCT) has recently been used to evaluate airway WT, but the potential risk of radiation-induced carcinogenesis—particularly in younger patients—might limit a wider use of this imaging method in clinical practice. The recent commercial implementation of the statistical model-based iterative reconstruction (MBIR) algorithm, instead of the conventional filtered back projection (FBP) algorithm, has enabled considerable radiation dose reduction in many other clinical applications of MDCT. The purpose of this work was to study the impact of radiation dose and MBIR in the MDCT assessment of airway WT. Methods: An airway phantom was scanned using a clinical MDCT system (Discovery CT750 HD, GE Healthcare) at 4 kV levels and 5 mAs levels. Both FBP and a commercial implementation of MBIR (Veo{sup TM}, GE Healthcare) were used to reconstruct CT images of the airways. For each kV–mAs combination and each reconstruction algorithm, the contrast-to-noise ratio (CNR) of the airways was measured, and the WT of each airway was measured and compared with the nominal value; the relative bias and the angular standard deviation in the measured WT were calculated. For each airway and reconstruction algorithm, the overall performance of WT quantification across all of the 20 kV–mAs combinations was quantified by the sum of squares (SSQs) of the difference between the measured and nominal WT values. Finally, the particular kV–mAs combination and reconstruction algorithm that minimized radiation dose while still achieving a reference WT quantification accuracy level was chosen as the optimal acquisition and reconstruction settings. Results: The wall thicknesses of seven airways of different sizes were analyzed in the study. Compared with FBP, MBIR improved the CNR of the airways, particularly at low radiation dose

  13. Reduced-dose CT protocol for the assessment of cerebral vasospasm

    Energy Technology Data Exchange (ETDEWEB)

    Bricout, N.; Estrade, L.; Boustia, F.; Kalsoum, E.; Pruvo, J.P.; Leclerc, X. [Hopital Roger Salengro, CHRU de Lille, Department of Neuroradiology, Universite Lille Nord de France, Lille cedex (France)

    2015-12-15

    Despite the increased radiation dose, multimodal CT including noncontrast CT (NCT), CT angiography (CTA), and perfusion CT (PCT) remains a useful tool for the diagnosis of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH). The aim of this study was to assess the radiation dose and the image quality between a standard-dose and a reduced-dose multimodal CT protocol. The study group consisted of 26 aSAH patients with a suspicion of DCI on clinical examination and transcranial doppler. Two different CT protocols were used: a standard-dose protocol (NCT 120 kV, 350 mAs; CTA 100 kV, 250 mAs; PCT 80 kV, 200 mAs) from August 2011 to October 2013 (n = 13) and a reduced-dose protocol (NCT 100 kV, 400 mAs; CTA 100 kV, 220 mAs; PCT 80 kV, 180 mAs) from November 2013 to May 2014 (n = 13). Dose-length product (DLP), effective dose, volume CT dose index (CTDI), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and overall image quality were determined for each examination. The overall image quality was judged as good or excellent in all cases. The reduced-dose protocol allowed a 15 % decrease in both the median total DLP (2438 vs 2898 mGy cm, p < 0.0001) and the effective dose as well as a significant decrease in median CTDI of 23, 31, and 10 % for NCT, CTA, and CTP, respectively. This dose reduction did not result in significant alteration of SNR (except for NCT) or CNR between groups. The present study showed that the reduced-dose multimodal CT protocol enabled a significant reduction of radiation dose without image quality impairment. (orig.)

  14. Establishment of a radiological dose assessment system for HANARO emergency preparedness

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Han; Han, Moon Hee; Suh, Kyung Suk; Hwang, Won Tae; Choi, Young Gil

    1999-12-01

    A radiological dose assessment system has been established to calculate the three-dimensional wind field based on the observed data at meteorological towers, and to calculate the exposure dose in the radiological accidents or for emergency training. The wind fields program has been constructed to calculate the real-time wind field using the atmospheric stability and the diffusion parameters based on the meteorological data sets measured from two meteorological towers. The result is separated into the effective dose and thyroid dose with 4 age groups such as infant, children, teenage and adult. Dose rate and cumulated dose for above each termare calculated and repeated for the prediction and modification according to the elapsed time. The evaluated data sets are displayed on the map around KAERI site with social and environmental information which is made with GIS. (author)

  15. Dose to level I and II axillary lymph nodes and lung by tangential field radiation in patients undergoing postmastectomy radiation with tissue expander reconstruction

    Directory of Open Access Journals (Sweden)

    Russo James K

    2011-12-01

    Full Text Available Abstract Background To define the dosimetric coverage of level I/II axillary volumes and the lung volume irradiated in postmastectomy radiotherapy (PMRT following tissue expander placement. Methods and Materials Twenty-three patients were identified who had undergone postmastectomy radiotherapy with tangent only fields. All patients had pre-radiation tissue expander placement and expansion. Thirteen patients had bilateral expander reconstruction. The level I/II axillary volumes were contoured using the RTOG contouring atlas. The patient-specific variables of expander volume, superior-to-inferior location of expander, distance between expanders, expander angle and axillary volume were analyzed to determine their relationship to the axillary volume and lung volume dose. Results The mean coverage of the level I/II axillary volume by the 95% isodose line (VD95% was 23.9% (range 0.3 - 65.4%. The mean Ipsilateral Lung VD50% was 8.8% (2.2-20.9. Ipsilateral and contralateral expander volume correlated to Axillary VD95% in patients with bilateral reconstruction (p = 0.01 and 0.006, respectively but not those with ipsilateral only reconstruction (p = 0.60. Ipsilateral Lung VD50% correlated with angle of the expander from midline (p = 0.05. Conclusions In patients undergoing PMRT with tissue expanders, incidental doses delivered by tangents to the axilla, as defined by the RTOG contouring atlas, do not provide adequate coverage. The posterior-superior region of level I and II is the region most commonly underdosed. Axillary volume coverage increased with increasing expander volumes in patients with bilateral reconstruction. Lung dose increased with increasing expander angle from midline. This information should be considered both when placing expanders and when designing PMRT tangent only treatment plans by contouring and targeting the axilla volume when axillary treatment is indicated.

  16. Dose to level I and II axillary lymph nodes and lung by tangential field radiation in patients undergoing postmastectomy radiation with tissue expander reconstruction

    Science.gov (United States)

    2011-01-01

    Background To define the dosimetric coverage of level I/II axillary volumes and the lung volume irradiated in postmastectomy radiotherapy (PMRT) following tissue expander placement. Methods and Materials Twenty-three patients were identified who had undergone postmastectomy radiotherapy with tangent only fields. All patients had pre-radiation tissue expander placement and expansion. Thirteen patients had bilateral expander reconstruction. The level I/II axillary volumes were contoured using the RTOG contouring atlas. The patient-specific variables of expander volume, superior-to-inferior location of expander, distance between expanders, expander angle and axillary volume were analyzed to determine their relationship to the axillary volume and lung volume dose. Results The mean coverage of the level I/II axillary volume by the 95% isodose line (VD95%) was 23.9% (range 0.3 - 65.4%). The mean Ipsilateral Lung VD50% was 8.8% (2.2-20.9). Ipsilateral and contralateral expander volume correlated to Axillary VD95% in patients with bilateral reconstruction (p = 0.01 and 0.006, respectively) but not those with ipsilateral only reconstruction (p = 0.60). Ipsilateral Lung VD50% correlated with angle of the expander from midline (p = 0.05). Conclusions In patients undergoing PMRT with tissue expanders, incidental doses delivered by tangents to the axilla, as defined by the RTOG contouring atlas, do not provide adequate coverage. The posterior-superior region of level I and II is the region most commonly underdosed. Axillary volume coverage increased with increasing expander volumes in patients with bilateral reconstruction. Lung dose increased with increasing expander angle from midline. This information should be considered both when placing expanders and when designing PMRT tangent only treatment plans by contouring and targeting the axilla volume when axillary treatment is indicated. PMID:22204504

  17. Radiation-induced changes in breathing frequency and lung histology of C57BL/6J mice are time- and dose-dependent

    Energy Technology Data Exchange (ETDEWEB)

    Eldh, T.; Heinzelmann, F.; Velalakan, A. [Univ. Hospital of Tuebingen (Germany). Dept. of Radiation Oncology; Budach, W. [Duesseldorf Univ. (Germany). Dept. of Radiation Oncology; Belka, C. [Univ. Hospital of Tuebingen (Germany). Dept. of Radiation Oncology; Muenchen Univ. (Germany). Dept. of Radiation Oncology; Jendrossek, V. [Univ. Hospital of Tuebingen (Germany). Dept. of Radiation Oncology; Duisburg-Essen Univ., Essen (DE). Inst. of Cell Biology (Cancer Research)

    2012-03-15

    Pneumonitis and fibrosis constitute serious adverse effects of radiotherapy in the thoracic region. In this study, time-course and dose-dependence of clinically relevant parameters of radiation-induced lung injury in C57BL/6J mice were analyzed. A well-characterized disease model is necessary for the analysis of the cellular and molecular mechanisms using genetically modified mice. C57BL/6J mice received single dose right hemithorax irradiation with 12.5 or 22.5 Gy. Body weight and breathing frequency were recorded as parameters for health impairment. Lung tissue was collected over 24 weeks for histological analysis. Hemithorax irradiation with 12.5 or 22.5 Gy induced biphasic breathing impairment with the first increase between days 7 and 70. Although breathing impairment was more pronounced in the 22.5 Gy group, it was accompanied in both dose groups by pneumonitis-associated histological changes. A second rise in breathing frequency ratios became visible starting on day 70 with a steady increase until day 210. Again, breathing was more strongly affected in the 22.5 Gy group. However, breathing impairment coincided only in the 22.5 Gy group with a significant increase in collagen deposition in the lung tissue by day 210. Tissue inflammation and fibrosis were observed in the irradiated and the shielded lungs, pointing toward involvement of systemic effects. Hemithorax irradiation induces time-dependent pneumonitis and fibrosis in C57BL/6J mice. While hemithorax irradiation with 12.5 Gy is sufficient to induce lung inflammation, it is below the threshold for collagen deposition and fibrosis development by day 210.

  18. Development of environmental dose assessment system (EDAS) code of PC version

    CERN Document Server

    Taki, M; Kobayashi, H; Yamaguchi, T

    2003-01-01

    A computer code (EDAS) was developed to assess the public dose for the safety assessment to get the license of nuclear reactor operation. This code system is used for the safety analysis of public around the nuclear reactor in normal operation and severe accident. This code was revised and composed for personal computer user according to the Nuclear Safety Guidelines reflected the ICRP1990 recommendation. These guidelines are revised by Nuclear Safety Commission on March, 2001, which are 'Weather analysis guideline for the safety assessment of nuclear power reactor', 'Public dose around the facility assessment guideline corresponding to the objective value for nuclear power light water reactor' and 'Public dose assessment guideline for safety review of nuclear power light water reactor'. This code has been already opened for public user by JAERI, and English version code and user manual are also prepared. This English version code is helpful for international cooperation concerning the nuclear safety assessme...

  19. Assessing the nutritional status of elderly Chinese lung cancer patients using the Mini-Nutritional Assessment (MNA® tool

    Directory of Open Access Journals (Sweden)

    Zhang L

    2013-03-01

    Full Text Available Lei Zhang,1,* Yanjun Su,1,* Chen Wang,2 Yongsheng Sha,1 Hong Zhu,3 Shumin Xie,4 Sabrina Kwauk,5 Jing Zhang,2 Yunshou Lin,2 Changli Wang1,*1Department of Thoracic Surgery, Key Laboratory of Cancer Prevention and Therapy, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, Tianjin, 2Tianjin Medical University, Tianjin, 3Department of Public Health, Tianjin Medical University, Tianjin, 4Xiangya Medical School of Central-South University, Changsha, People's Republic of China; 5School of Public Health, Harvard University, Boston, Cambridge, MA, USA*These authors contributed equally to this workPurpose: This study assessed the nutritional status of elderly Chinese lung cancer inpatients using a revised version of the Mini-Nutritional Assessment (MNA® tool.Patients and methods: The revised version of the MNA tool was used to assess the nutritional status of 180 elderly Chinese lung cancer inpatients prior to their scheduled surgery between June 2010 and July 2011. Patients' demographic data, anthropometric parameters, and biochemical markers were collected and analyzed.Results: Among the 180 inpatients who underwent the MNA, 9% were malnourished (MNA score < 19, 33% were at risk of malnutrition (MNA score 19–23, and 58% were well nourished (MNA score ≥ 24. There was significant correlation between the MNA scores of patients who were malnourished, at risk of malnutrition, and well nourished (P < 0.001, as well as between total MNA score and most MNA questions. The three patient groups with different nutritional statuses differed significantly in their responses to anthropometrics and global, diet, and subjective assessments.Conclusion: Incidence rates of malnutrition prior to surgery are high among elderly Chinese lung cancer inpatients. The revised MNA is a valid and reliable tool that can be used to assess and prevent malnutrition among these inpatients.Keywords: malnutrition, MNA-SF, nutrition, inpatients, diet

  20. Assessment of inhalation dose sensitivity by physicochemical properties of airborne particulates containing naturally occurring radioactive materials

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Si Young; Choi, Cheol Kyu; Kim, Yong Geon; Choi, Won Chul; Kim, Kwang Pyo [Kyung Hee University, Seoul (Korea, Republic of)

    2015-12-15

    Facilities processing raw materials containing naturally occurring radioactive materials (NORM) may give rise to enhanced radiation dose to workers due to chronic inhalation of airborne particulates. Internal radiation dose due to particulate inhalation varies depending on particulate properties, including size, shape, density, and absorption type. The objective of the present study was to assess inhalation dose sensitivity to physicochemical properties of airborne particulates. Committed effective doses to workers resulting from inhalation of airborne particulates were calculated based on International Commission on Radiological Protection 66 human respiratory tract model. Inhalation dose generally increased with decreasing particulate size. Committed effective doses due to inhalation of 0.01μm sized particulates were higher than doses due to 100μm sized particulates by factors of about 100 and 50 for {sup 238}U and {sup 230}Th, respectively. Inhalation dose increased with decreasing shape factor. Shape factors of 1 and 2 resulted in dose difference by about 18 %. Inhalation dose increased with particulate mass density. Particulate mass densities of 11 g·cm{sup -3} and 0.7 g·cm{sup -3} resulted in dose difference by about 60 %. For {sup 238}U, inhalation doses were higher for absorption type of S, M, and F in that sequence. Committed effective dose for absorption type S of {sup 238}U was about 9 times higher than dose for absorption F. For {sup 230}Th, inhalation doses were higher for absorption type of F, M, and S in that sequence. Committed effective dose for absorption type F of {sup 230}Th was about 16 times higher than dose for absorption S. Consequently, use of default values for particulate properties without consideration of site specific physiochemical properties may potentially skew radiation dose estimates to unrealistic values up to 1-2 orders of magnitude. For this reason, it is highly recommended to consider site specific working materials and

  1. Isotoxic dose escalation in the treatment of lung cancer by means of heterogeneous dose distributions in the presence of respiratory motion

    DEFF Research Database (Denmark)

    Baker, Mariwan; Nielsen, Morten; Hansen, Olfred;

    2011-01-01

    To test, in the presence of intrafractional respiration movement, a margin recipe valid for a homogeneous and conformal dose distribution and to test whether the use of smaller margins combined with heterogeneous dose distributions allows an isotoxic dose escalation when respiratory motion is con...

  2. Tumor control probability and the utility of 4D vs 3D dose calculations for stereotactic body radiotherapy for lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Valdes, Gilmer, E-mail: gilmer.valdes@uphs.upenn.edu [Department of Radiation Oncology, Perelman Center for Advanced Medicine, University of Pennsylvania, Philadelphia, PA (United States); Robinson, Clifford [Department of Radiation Oncology, Siteman Cancer Center, Washington University in St. Louis, St. Louis, MO (United States); Lee, Percy [Department of Radiation Oncology, David Geffen School of Medicine, UCLA, Los Angeles, CA (United States); Morel, Delphine [Department of Biomedical Engineering, AIX Marseille 2 University, Marseille (France); Department of Medical Physics, Joseph Fourier University, Grenoble (France); Low, Daniel; Iwamoto, Keisuke S.; Lamb, James M. [Department of Radiation Oncology, David Geffen School of Medicine, UCLA, Los Angeles, CA (United States)

    2015-04-01

    Four-dimensional (4D) dose calculations for lung cancer radiotherapy have been technically feasible for a number of years but have not become standard clinical practice. The purpose of this study was to determine if clinically significant differences in tumor control probability (TCP) exist between 3D and 4D dose calculations so as to inform the decision whether 4D dose calculations should be used routinely for treatment planning. Radiotherapy plans for Stage I-II lung cancer were created for 8 patients. Clinically acceptable treatment plans were created with dose calculated on the end-exhale 4D computed tomography (CT) phase using a Monte Carlo algorithm. Dose was then projected onto the remaining 9 phases of 4D-CT using the Monte Carlo algorithm and accumulated onto the end-exhale phase using commercially available deformable registration software. The resulting dose-volume histograms (DVH) of the gross tumor volume (GTV), planning tumor volume (PTV), and PTV{sub setup} were compared according to target coverage and dose. The PTV{sub setup} was defined as a volume including the GTV and a margin for setup uncertainties but not for respiratory motion. TCPs resulting from these DVHs were estimated using a wide range of alphas, betas, and tumor cell densities. Differences of up to 5 Gy were observed between 3D and 4D calculations for a PTV with highly irregular shape. When the TCP was calculated using the resulting DVHs for fractionation schedules typically used in stereotactic body radiation therapy (SBRT), the TCP differed at most by 5% between 4D and 3D cases, and in most cases, it was by less than 1%. We conclude that 4D dose calculations are not necessary for most cases treated with SBRT, but they might be valuable for irregularly shaped target volumes. If 4D calculations are used, 4D DVHs should be evaluated on volumes that include margin for setup uncertainty but not respiratory motion.

  3. The Assessment of Health-Related Quality of Life in Scleroderma-Interstitial Lung Disease

    Directory of Open Access Journals (Sweden)

    Shahrzad M Lari

    2014-05-01

    Full Text Available Introduction: Pulmonary involvement is the most common cause of mortality and disability in patients with systemic sclerosis and it significantly affects the quality of life in these patients. Therefore, early diagnosis and treatment of pulmonary involvement seems necessary in patients with SSc. In this study, we aimed to assess the health-related quality of life (HRQoL in patients with Scleroderma-Interstitial Lung Disease (SSc-ILD and its relationship with pulmonary function parameters. Materials and Methods: Considering the inclusion and exclusion criteria, 25 patients with SSc-ILD were enrolled in this cross-sectional study from April 2012 to June 2013. Full tests of lung function, including body plethysmography and diffusing capacity of the lungs for carbon monoxide (DLCO, 6-minute walk distance (6MWD, and pulse oximetry were performed. The HRQoL was assessed using St. George’s and CAT questionnaires; also, dyspnea was evaluated for all the patients, using modified medical research council (MMRC scale. Afterwards, the relationship between the total scores of HRQoL questionnaires and the severity of lung disease was analyzed, based on the recorded variables. Results: The mean age of the patients was 40.36±9.50 years and the mean duration of the disease was 7.16±4.50 years. A statistically significant inverse correlation was observed between 6MWD (r=-0.50, P=0.01, DLCO (r=-0.67, P

  4. Assessment of adequacy of hemodialysis dose at a Palestinian hospital

    Directory of Open Access Journals (Sweden)

    Heba Adas

    2014-01-01

    Full Text Available Adequacy of hemodialysis improves patient survival, quality of life and biochemical outcomes and minimizes disease complications and hospitalizations. This study was an observational cross-sectional study that was conducted in July 2012. Blood tests, weight and blood pressure were measured before and after hemodialysis. Single-pool Kt/V and urea reduction ratio (URR were calculated. The targets based on the National Kidney Foundation Disease Outcomes Quality Initiative (KDOQI Clinical Practice Guidelines were Kt/V ≥ 1.2 and URR ≥ 65%. Of the 64 patients, 41 (64.1% were males. The mean age of the patients was 58.13 ± 17.2 years. The mean body mass index (BMI was 25.04 ± 5.01 kg/m 2 . The mean Kt/V and URR were 1.06 ± 0.05 and 54.4 ± 19.3, respectively. There was no significant difference between men and women (1.06 ± 0.47 versus 1.04 ± 0.55, P = 0.863 and (54.7 ± 19.59 versus 53.81 ± 19.17, P = 0.296. Only 25 (39.1% patients achieved the Kt/V goal and only 22 (34.4% had target URR, and there was no significant association between hemodialysis adequacy and any of the variables such as sex, age, presence of chronic diseases or BMI. Serum potassium levels post-dialysis were significantly lower in patients who reached the target Kt/V (mean = 3.44 ± 0.48 versus 3.88 ± 0.48, P = 0.001. Most patients were inadequately dialyzed and a large percentage of the patients did not attain the targets. Attempts to achieve the desired goals are necessary. It is important to calculate Kt/V or URR and individualize the dialysis doses for each patient.

  5. Development of a real-time radiological dose assessment system

    Energy Technology Data Exchange (ETDEWEB)

    Han, Moon Hee; Lee, Young Bok; Kim, Eun Han; Suh, Kyung Suk; Hwang, Won Tae

    1997-01-01

    Inspection and repair of tower structure and lift, instrument calibration have been done. Wireless data transmission to MIPS (Meteorological Information Processing System) has been done after collection in the DAS where environmental assessment can be done by the developed simulation programs in both cases of normal operation and emergency. Wind direction, wind speed, temperature, humidity at 67m, 27m, and 10m height and temperature, humidity, atmospheric pressure, solar radiation, precipitation, and visibility at surface have been measured analyzed with statistical methods. At the site, the prevailing wind directions were SW in spring and summer, NNW in winter season. (author). 6 refs., 9 tabs., 4 figs.

  6. 30 Gy or 34 Gy? Comparing 2 Single-Fraction SBRT Dose Schedules for Stage I Medically Inoperable Non-Small Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Videtic, Gregory M.M., E-mail: videtig@ccf.org; Stephans, Kevin L.; Woody, Neil M.; Reddy, Chandana A.; Zhuang, Tingliang; Magnelli, Anthony; Djemil, Toufik

    2014-09-01

    Purpose: To review outcomes of 2 single-fraction lung stereotactic body radiation therapy (SBRT) schedules used for medically inoperable early stage lung cancer. Methods and Materials: Patients in our institution have been treated on and off protocols using single-fraction SBRT (30 Gy and 34 Gy, respectively). All patients had node-negative lung cancer measuring ≤5 cm and lying ≥2 cm beyond the trachea-bronchial tree and were treated on a Novalis/BrainLAB system with the ExactTrac positioning system for daily image guidance. Results: For the interval from 2009 to 2012, 80 patients with 82 lesions were treated with single-fraction lung SBRT. Fifty-five patients (69%) and 25 patients (31%) received 30 Gy and 34 Gy, respectively. In a comparison of 30 Gy and 34 Gy cohorts, patient and tumor characteristics were balanced and median follow-up in months was 18.7 and 17.8, respectively. The average heterogeneity-corrected mean doses to the target were 33.75 Gy and 37.94 Gy for the 30-Gy and 34-Gy prescriptions, respectively. Comparing 30-Gy and 34-Gy cohorts, 92.7% and 84.0% of patients, respectively, experienced no toxicity (P was not significant), and had neither grade 3 nor higher toxicities. For the 30-Gy and 34-Gy patients, rates of 1-year local failure, overall survival, and lung cancer-specific mortality were 2.0% versus 13.8%, 75.0% versus 64.0%, and 2. 1% versus 16.0%, respectively (P values for differences were not significant). Conclusions: This is the largest single-fraction lung SBRT series yet reported. and it confirms the safety, efficacy, and minimal toxicity of this schedule for inoperable early stage lung cancer.

  7. Dose-response assessment using the benchmark dose approach of changes in hepatic EROD activity for individual polychlorinated biphenyl congeners

    Energy Technology Data Exchange (ETDEWEB)

    Fattore, E.; Fanelli, R. [' ' Mario Negri' ' Institute for Pharmacological Research, Milan (Italy); Chu, I. [Safe Environments Programme, Healthy Environments and Consumer Safety Branch, Tunney' s Pasture, Ottawa, ON (Canada); Sand, S.; Haakansson, H. [Institute of Environmental Medicine, Karolinska Institutet, Stockholm (Sweden); Falk-Filippson, A. [Swedish Chemicals Inspectorate, Sundbyberg (Sweden)

    2004-09-15

    The benchmark dose (BMD) approach was proposed as an alternative to the no-observedadverse- effect-level (NOAEL) or the lowest-observed-adverse-effect-level (LOAEL) as point of departure (POD) for extrapolation of data from animal studies to the low dose human exposure situation. In the risk assessment process using the NOAEL/LOAEL parameter, the reference dose (RfD) or the admissible daily intake (ADI) is obtained by dividing the NOAEL/LOAEL value by uncertainty factors. The uncertainty factors are incorporated in order to take into account variability in the sensitivity of different species, inter-individual differences in sensitivity within the human population, and variability in experimental data. In the BMD approach a dose-response curve is fitted to experimental data (Figure 1) and the BMD is calculated from the equation of the curve as the dose corresponding to a predetermined change in the response defined as the benchmark response (BMR). The 95% lower confidence bound of the BMD, usually referred to as BMDL, can be used as the POD in the extrapolation process to get a RfD or an ADI. The advantages of using the BMD approach are many. First, all the experimental data are utilized to construct the doseresponse curve; second, the variability and uncertainty are taken into account by incorporating standard deviations of means; and third, it represents a single methodology for cancer and noncancer endpoints. In this study the BMD methodology was applied to evaluate dose-response data of seven chlorinated biphenyl (CB) congeners (Table 1), some of which are dioxin-like while others are not. The data were obtained from subchronic dietary exposure studies in male and female Sprague Dawley rats. Elevation in ethoxyresorufin-O-deethylase (EROD) activity was selected as biological response because it is known to be an endpoint sensitive to the exposure of dioxin-like PCBs. Since this response is not an adverse effect per se, in this paper we will refer to the no

  8. Assessing Tumor Response to Treatment in Patients with Lung Cancer Using Dynamic Contrast-Enhanced CT

    Directory of Open Access Journals (Sweden)

    Louise S. Strauch

    2016-07-01

    Full Text Available The aim of this study was to provide an overview of the literature available on dynamic contrast-enhanced computed tomography (DCE-CT as a tool to evaluate treatment response in patients with lung cancer. This systematic review was compiled according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines. Only original research articles concerning treatment response in patients with lung cancer assessed with DCE-CT were included. To assess the validity of each study we implemented Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2. The initial search yielded 651 publications, and 16 articles were included in this study. The articles were divided into groups of treatment. In studies where patients were treated with systemic chemotherapy with or without anti-angiogenic drugs, four out of the seven studies found a significant decrease in permeability after treatment. Four out of five studies that measured blood flow post anti-angiogenic treatments found that blood flow was significantly decreased. DCE-CT may be a useful tool in assessing treatment response in patients with lung cancer. It seems that particularly permeability and blood flow are important perfusion values for predicting treatment outcome. However, the heterogeneity in scan protocols, scan parameters, and time between scans makes it difficult to compare the included studies.

  9. Non-contrast-enhanced preoperative assessment of lung perfusion in patients with non-small-cell lung cancer using Fourier decomposition magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, Gregor, E-mail: gregor.sommer@usb.ch [Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg (Germany); Clinic of Radiology and Nuclear Medicine, University of Basel Hospital, Petersgraben 4, 4031 Basel (Switzerland); Bauman, Grzegorz, E-mail: gbauman@wisc.edu [Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg (Germany); Department of Medical Physics in Radiology (E020), German Cancer Research Center (DKFZ), Heidelberg (Germany); Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Avenue, Madison, 53705 WI (United States); Koenigkam-Santos, Marcel, E-mail: marcelk46@yahoo.com.br [Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg (Germany); Department of Radiology, University Hospital of the School of Medicine of Ribeirao Preto – University of Sao Paulo, Ribeirao Preto (Brazil); Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik Heidelberg gGmbH, Amalienstr. 5, 69126 Heidelberg (Germany); Draenkow, Christopher, E-mail: c.draenkow@thoraxklinik-heidelberg.de [Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg (Germany); Department of Surgery, Thoraxklinik Heidelberg gGmbH, Amalienstr. 5, 69126 Heidelberg (Germany); Heussel, Claus Peter, E-mail: heussel@uni-heidelberg.de [Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research, Heidelberg (Germany); Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik Heidelberg gGmbH, Amalienstr. 5, 69126 Heidelberg (Germany); and others

    2013-12-01

    Objective: To investigate non-contrast-enhanced Fourier decomposition MRI (FD MRI) for assessment of regional lung perfusion in patients with Non-Small-Cell Lung Cancer (NSCLC) in comparison to dynamic contrast-enhanced MRI (DCE MRI). Methods: Time-resolved non-contrast-enhanced images of the lungs were acquired prospectively in 15 patients using a 2D balanced steady-state free precession (b-SSFP) sequence. After non-rigid registration of the native image data, perfusion-weighted images were calculated by separating periodic changes of lung proton density at the cardiac frequency using FD. DCE MRI subtraction datasets were acquired as standard of reference. Both datasets were analyzed visually for perfusion defects. Then segmentation analyses were performed to describe perfusion of pulmonary lobes semi-quantitatively as percentages of total lung perfusion. Overall FD MRI perfusion signal was compared to velocity-encoded flow measurements in the pulmonary trunk as an additional fully quantitative reference. Results: Image quality ratings of FD MRI were significantly inferior to those of DCE MRI (P < 0.0001). Sensitivity, specificity, and accuracy of FD MRI for visual detection of perfusion defects were 84%, 92%, and 91%. Semi-quantitative evaluation of lobar perfusion provided high agreement between FD MRI and DCE MRI for both entire lungs and upper lobes, but less agreement in the lower parts of both lungs. FD perfusion signal showed high linear correlation with pulmonary arterial blood flow. Conclusion: FD MRI is a promising technique that allows for assessing regional lung perfusion in NSCLC patients without contrast media or ionizing radiation. However, for being applied in clinical routine, image quality and robustness of the technique need to be further improved.

  10. Quantitative evaluation of correlation of dose and FDG-PET uptake value with clinical chest wall complications in patients with lung cancer treated with stereotactic body radiation therapy.

    Science.gov (United States)

    Algan, O; Confer, M; Algan, S; Matthiesen, C; Herman, T; Ahmad, S; Ali, I

    2015-01-01

    The aim of this study was to investigate quantitatively the dosimetric factors that increase the risk of clinical complications of rib fractures or chest wall pain after stereotactic body radiation therapy (SBRT) to the lung. The correlations of clinical complications with standard-uptake values (SUV) and FDG-PET activity distributions from post-treatment PET-imaging were studied. Mean and maximum doses from treatment plans, FDG-PET activity values on post-SBRT PET scans and the presence of clinical complications were determined in fifteen patients undergoing 16 SBRT treatments for lung cancer. SBRT treatments were delivered in 3 to 5 fractions using 5 to 7 fields to prescription doses in the range from 39.0 to 60.0 Gy. The dose and FDG-PET activity values were extracted from regions of interest in the chest wall that matched anatomically. Quantitative evaluation of the correlation between dose deposition and FDG-PET activity was performed by calculating the Pearson correlation coefficient using pixel-by-pixel analysis of dose and FDG-PET activity maps in selected regions of interest associated with clinical complications. Overall, three of fifteen patients developed rib fractures with chest wall pain, and two patients developed pain symptoms without fracture. The mean dose to the rib cage in patients with fractures was 37.53 Gy compared to 33.35 Gy in patients without fractures. Increased chest wall activity as determined by FDG-uptake was noted in patients who developed rib fractures. Enhanced activity from PET-images correlated strongly with high doses deposited to the chest wall which could be predicted by a linear relationship. The local enhanced activity was associated with the development of clinical complications such as chest wall inflammation and rib fracture. This study demonstrates that rib fractures and chest wall pain can occur after SBRT treatments to the lung and is associated with increased activity on subsequent PET scans. The FDG-PET activity

  11. Characteristics of the graded wildlife dose assessment code K-BIOTA and its application

    Energy Technology Data Exchange (ETDEWEB)

    Keum, Dong Kwon; Jun, In; Lim, Kwang Muk; Kim, Byeong Ho; Choi, Yong Ho [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-12-15

    This paper describes the technical background for the Korean wildlife radiation dose assessment code, K-BIOTA, and the summary of its application. The K-BIOTA applies the graded approaches of 3 levels including the screening assessment (Level 1 and 2), and the detailed assessment based on the site specific data (Level 3). The screening level assessment is a preliminary step to determine whether the detailed assessment is needed, and calculates the dose rate for the grouped organisms, rather than an individual biota. In the Level 1 assessment, the risk quotient (RQ) is calculated by comparing the actual media concentration with the environmental media concentration limit (EMCL) derived from a bench-mark screening reference dose rate. If RQ for the Level 1 assessment is less than 1, it can be determined that the ecosystem would maintain its integrity, and the assessment is terminated. If the RQ is greater than 1, the Level 2 assessment, which calculates RQ using the average value of the concentration ratio (CR) and equilibrium distribution coefficient (Kd) for the grouped organisms, is carried out for the more realistic assessment. Thus, the Level 2 assessment is less conservative than the Level 1 assessment. If RQ for the Level 2 assessment is less than 1, it can be determined that the ecosystem would maintain its integrity, and the assessment is terminated. If the RQ is greater than 1, the Level 3 assessment is performed for the detailed assessment. In the Level 3 assessment, the radiation dose for the representative organism of a site is calculated by using the site specific data of occupancy factor, CR and Kd. In addition, the K-BIOTA allows the uncertainty analysis of the dose rate on CR, Kd and environmental medium concentration among input parameters optionally in the Level 3 assessment. The four probability density functions of normal, lognormal, uniform and exponential distribution can be applied. The applicability of the code was tested through the

  12. Combined photon-electron beams in the treatment of the supraclavicular lymph nodes in breast cancer: A novel technique that achieves adequate coverage while reducing lung dose

    Energy Technology Data Exchange (ETDEWEB)

    Salem, Ahmed, E-mail: ahmed.salem@doctors.org.uk [Department of Radiation Oncology, King Hussein Cancer Center, Amman (Jordan); Mohamad, Issa; Dayyat, Abdulmajeed [Department of Radiation Oncology, King Hussein Cancer Center, Amman (Jordan); Kanaa’n, Haitham [Section of Medical Physics, Department of Radiation Oncology, King Hussein Cancer Center, Amman (Jordan); Sarhan, Nasim [Department of Radiation Oncology, King Hussein Cancer Center, Amman (Jordan); Roujob, Ibrahim [Section of Medical Physics, Department of Radiation Oncology, King Hussein Cancer Center, Amman (Jordan); Salem, Abdel-Fattah [Department of Obstetrics and Gynecology, Hashemite University, Zarqa (Jordan); Afifi, Shatha [Section of Medical Physics, Department of Radiation Oncology, King Hussein Cancer Center, Amman (Jordan); Jaradat, Imad; Mubiden, Rasmi; Almousa, Abdelateif [Department of Radiation Oncology, King Hussein Cancer Center, Amman (Jordan)

    2015-10-01

    Radiation pneumonitis is a well-documented side effect of radiation therapy for breast cancer. The purpose of this study was to compare combined photon-electron, photon-only, and electron-only plans in the radiation treatment of the supraclavicular lymph nodes. In total, 13 patients requiring chest wall and supraclavicular nodal irradiation were planned retrospectively using combined photon-electron, photon-only, and electron-only supraclavicular beams. A dose of 50 Gy over 25 fractions was prescribed. Chest wall irradiation parameters were fixed for all plans. The goal of this planning effort was to cover 95% of the supraclavicular clinical target volume (CTV) with 95% of the prescribed dose and to minimize the volume receiving ≥ 105% of the dose. Comparative end points were supraclavicular CTV coverage (volume covered by the 95% isodose line), hotspot volume, maximum radiation dose, contralateral breast dose, mean total lung dose, total lung volume percentage receiving at least 20 Gy (V{sub 20} {sub Gy}), heart volume percentage receiving at least 25 Gy (V{sub 25} {sub Gy}). Electron and photon energies ranged from 8 to 18 MeV and 4 to 6 MV, respectively. The ratio of photon-to-electron fractions in combined beams ranged from 5:20 to 15:10. Supraclavicular nodal coverage was highest in photon-only (mean = 96.2 ± 3.5%) followed closely by combined photon-electron (mean = 94.2 ± 2.5%) and lowest in electron-only plans (mean = 81.7 ± 14.8%, p < 0.001). The volume of tissue receiving ≥ 105% of the prescription dose was higher in the electron-only (mean = 69.7 ± 56.1 cm{sup 3}) as opposed to combined photon-electron (mean = 50.8 ± 40.9 cm{sup 3}) and photon-only beams (mean = 32.2 ± 28.1 cm{sup 3}, p = 0.114). Heart V{sub 25} {sub Gy} was not statistically different among the plans (p = 0.999). Total lung V{sub 20} {sub Gy} was lowest in electron-only (mean = 10.9 ± 2.3%) followed by combined photon-electron (mean = 13.8 ± 2.3%) and highest in photon

  13. Assessment of the dose from radon and its decay products in the Bozkov dolomite cave.

    Science.gov (United States)

    Rovenská, K; Thinová, L; Zdímal, V

    2008-01-01

    The dose from radon and its progeny remains a frequently discussed problem. ICRP 65 provides a commonly used methodology to calculate the dose from radon. Our work focuses on a cave environment and on assessing the doses in public open caves. The differences in conditions (aerosol size distribution, humidity, radon and its progeny ratio, etc.) are described by the so-called cave factor j. The cave factor is used to correct the dose for workers which is calculated using the ICRP 65 recommendation. In this work, the authors have brought together measured data of aerosol size distribution, unattached and attached fraction activity, and have calculated the so-called cave factor for the Bozkov dolomite cave environment. The dose conversion factors based on measured data and used for evaluating the cave factor were calculated by LUDEP software, which implements HRTM ICRP66.

  14. The Inflammatory-Nutritional Index: assessing nutritional status and prognosis in gastrointestinal and lung cancer patients

    OpenAIRE

    Carla Alberici Pastore; Silvana Paiva Orlandi; Maria Cristina Gonzalez

    2014-01-01

    Objective: To evaluate the prognostic capacity of the Inflammatory-Nutritional Index (INI) in gastrointestinal and lung cancer patients. Methods: Longitudinal study, including patients from a chemotherapy service in Brazil, between July 2008 and May 2010. INI (Albumin/CRP) and nutritional status (by Subjective Global Assessment - SGA) were evaluated. Risk INI was defined as lower than 0.35. The mean follow-up of survival was 1.6 year. Statistical analyses were performed using Stata 11.1™. Res...

  15. Identification and dose assessment of irradiated cardamom and cloves by EPR spectrometry

    Science.gov (United States)

    Beshir, W. B.

    2014-03-01

    The use of electron paramagnetic resonance spectroscopy to accurately distinguish irradiated from unirradiated cardamom and cloves and assesses the absorbed dose to radiation processed cardamom and cloves are examined. The results were successful for identifying both irradiated and unirradiated cardamom and cloves. Additive reirradiation of cardamom and cloves produces reproducible dose-response functions, which can be used to assess the initial dose by back-extrapolation. Third degree polynomial function was used to fit the EPR signal/dose curves. It was found that this 3rd degree polynomial function provides satisfactory results without correction of decay for free radicals. The stability of the radiation induced EPR signal of irradiated cardamom and cloves were studied over a storage period of almost 8 months.

  16. Radiological dose assessment related to management of naturally occurring radioactive materials generated by the petroleum industry

    Energy Technology Data Exchange (ETDEWEB)

    Smith, K.P.; Blunt, D.L.; Williams, G.P. [Argonne National Lab., IL (United States). Environmental Assessment Div.; Tebes, C.L. [Univ. of Illinois, Urbana, IL (United States)

    1996-09-01

    A preliminary radiological dose assessment of equipment decontamination, subsurface disposal, landspreading, equipment smelting, and equipment burial was conducted to address concerns regarding the presence of naturally occurring radioactive materials (NORM) in production waste streams. The assessment estimated maximum individual dose equivalents for workers and the general public. Sensitivity analyses of certain input parameters also were conducted. On the basis of this assessment, it is concluded that (1) regulations requiring workers to wear respiratory protection during equipment cleaning operations are likely to result in lower worker doses, (2) underground injection and downhole encapsulation of NORM wastes present a negligible risk to the general public, and (3) potential doses to workers and the general public related to smelting NORM-contaminated equipment can be controlled by limiting the contamination level of the initial feed. It is recommended that (1) NORM wastes be further characterized to improve studies of potential radiological doses; (2) states be encouraged to permit subsurface disposal of NORM more readily, provided further assessments support this study; results; (3) further assessment of landspreading NORM wastes be conducted; and (4) the political, economic, sociological, and nonradiological issues related to smelting NORM-contaminated equipment be studied to fully examine the feasibility of this disposal option.

  17. Qualitative and quantitative approaches in the dose-response assessment of genotoxic carcinogens.

    Science.gov (United States)

    Fukushima, Shoji; Gi, Min; Kakehashi, Anna; Wanibuchi, Hideki; Matsumoto, Michiharu

    2016-05-01

    Qualitative and quantitative approaches are important issues in field of carcinogenic risk assessment of the genotoxic carcinogens. Herein, we provide quantitative data on low-dose hepatocarcinogenicity studies for three genotoxic hepatocarcinogens: 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx), 2-amino-3-methylimidazo[4,5-f]quinoline (IQ) and N-nitrosodiethylamine (DEN). Hepatocarcinogenicity was examined by quantitative analysis of glutathione S-transferase placental form (GST-P) positive foci, which are the preneoplastic lesions in rat hepatocarcinogenesis and the endpoint carcinogenic marker in the rat liver medium-term carcinogenicity bioassay. We also examined DNA damage and gene mutations which occurred through the initiation stage of carcinogenesis. For the establishment of points of departure (PoD) from which the cancer-related risk can be estimated, we analyzed the above events by quantitative no-observed-effect level and benchmark dose approaches. MeIQx at low doses induced formation of DNA-MeIQx adducts; somewhat higher doses caused elevation of 8-hydroxy-2'-deoxyquanosine levels; at still higher doses gene mutations occurred; and the highest dose induced formation of GST-P positive foci. These data indicate that early genotoxic events in the pathway to carcinogenesis showed the expected trend of lower PoDs for earlier events in the carcinogenic process. Similarly, only the highest dose of IQ caused an increase in the number of GST-P positive foci in the liver, while IQ-DNA adduct formation was observed with low doses. Moreover, treatment with DEN at low doses had no effect on development of GST-P positive foci in the liver. These data on PoDs for the markers contribute to understand whether genotoxic carcinogens have a threshold for their carcinogenicity. The most appropriate approach to use in low dose-response assessment must be approved on the basis of scientific judgment.

  18. Realistic retrospective dose assessments to members of the public around Spanish nuclear facilities

    Energy Technology Data Exchange (ETDEWEB)

    Jimenez, M.A., E-mail: majg@csn.es [Consejo de Seguridad Nuclear (CSN), Pedro Justo Dorado Dellmans 11, E-28040 Madrid (Spain); Martin-Valdepenas, J.M.; Garcia-Talavera, M.; Martin-Matarranz, J.L.; Salas, M.R.; Serrano, J.I.; Ramos, L.M. [Consejo de Seguridad Nuclear (CSN), Pedro Justo Dorado Dellmans 11, E-28040 Madrid (Spain)

    2011-11-15

    In the frame of an epidemiological study carried out in the influence areas around the Spanish nuclear facilities (ISCIII-CSN, 2009. Epidemiological Study of The Possible Effect of Ionizing Radiations Deriving from The Operation of Spanish Nuclear Fuel Cycle Facilities on The Health of The Population Living in Their Vicinity. Final report December 2009. Ministerio de Ciencia e Innovacion, Instituto de Salud Carlos III, Consejo de Seguridad Nuclear. Madrid. Available from: (http://www.csn.es/images/stories/actualidad{sub d}atos/especiales/epidemiologico/epidemiological{sub s}tudy.pdf)), annual effective doses to public have been assessed by the Spanish Nuclear Safety Council (CSN) for over 45 years using a retrospective realistic-dose methodology. These values are compared with data from natural radiation exposure. For the affected population, natural radiation effective doses are in average 2300 times higher than effective doses due to the operation of nuclear installations (nuclear power stations and fuel cycle facilities). When considering the impact on the whole Spanish population, effective doses attributable to nuclear facilities represent in average 3.5 x 10{sup -5} mSv/y, in contrast to 1.6 mSv/y from natural radiation or 1.3 mSv/y from medical exposures. - Highlights: > Most comprehensive dose assessment to public by nuclear facilities ever done in Spain. > Dose to public is dominated by liquid effluent pathways for the power stations. > Dose to public is dominated by Rn inhalation for milling and mining facilities. > Average annual doses to public in influence areas are negligible (10 {mu}Sv/y or less). > Doses from facilities average 3.5 x 10{sup -2} {mu}Sv/y per person onto whole Spanish population.

  19. Dosimetric characterization and organ dose assessment in digital breast tomosynthesis: Measurements and Monte Carlo simulations using voxel phantoms

    Energy Technology Data Exchange (ETDEWEB)

    Baptista, Mariana, E-mail: marianabaptista@ctn.ist.utl.pt; Di Maria, Salvatore; Barros, Sílvia; Vaz, Pedro [Centro de Ciências e Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Estrada Nacional 10, km 139,7, Bobadela LRS 2695-066 (Portugal); Figueira, Catarina [Centre for Plasma Physics, School of Mathematics and Physics, Queen’s University, Belfast BT7 1NN (United Kingdom); Sarmento, Marta; Orvalho, Lurdes [Serviço de Imagiologia, Hospital da Luz, Avenida Lusíada, 100, Lisboa 1500-650 (Portugal)

    2015-07-15

    . Regarding the BSF, the results achieved may lead to a MGD correction of about 6%, contributing to the improvement of the current guidelines used in these applications. Finally, considering the MC results obtained for the organ dose study, the radiation doses found for the tissues of the body other than the breast were in the range of tens of μSv, and are in part comparable to the ones obtained in standard DM. Nevertheless, in a single DBT examination, some organs (such as lung and thyroid) receive higher doses (of about 9% and 21%, respectively) with respect to the CC DM acquisition. Conclusions: Taking into account an average breast with a thickness of 4.5 cm, the MGDs for DM and DBT acquisitions were below the achievable value (2.0 mGy) defined by the European protocol. Additionally, in the case of a fusion imaging study (DM + DBT), the MGD for a 4.5 cm thick breast is of the order of 1.88 ± 0.36 mGy. Finally, organ dose evaluations underline the need to improve awareness concerning dose estimation of DBT exams for some organs, especially when radiation risk is assessed by using the effective dose.

  20. Validity of lamellar body count as a fetal lung maturity assessment in twin pregnancy.

    Science.gov (United States)

    Tsuda, Hiroyuki; Kotani, Tomomi; Sumigama, Seiji; Kawabata, Ichiro; Takahashi, Yuichiro; Iwagaki, Shigenori; Kigoshi, Kaori; Kikkawa, Fumitaka

    2012-08-01

    Fetal lung maturity assessment in twin pregnancy has been discussed, but is still controversial. The purpose of this study is to predict the occurrence of respiratory distress syndrome (RDS) using lamellar body count (LBC) and analyze the validity of LBC for fetal lung maturity assessment in twin pregnancy. Three-hundred two amniotic fluid samples were obtained at cesarean section from 29 to 38 weeks of gestation. Samples were analyzed immediately with no centrifugation and the number of lamellar bodies was counted using a platelet channel on the Sysmex SF-3000. There were 18 neonates (6.0%) suffering from RDS. An LBC cut-off value of 2.95×10⁴/μL resulted in 91.5% sensitivity and 83.3% specificity for predicting RDS. This cut-off value for predicting RDS was the same as that in singleton pregnancy. Moreover, the median LBC value in RDS cases was significantly lower than in non-RDS cases (1.50±1.1×10⁴/μL vs. 10.6±7.5×10⁴/μL; ptwin pregnancy and also the largest study on fetal lung maturity assessment in twin pregnancy. An LBC value of >2.95×10⁴/μL means reassuring findings for RDS even in twin pregnancy. We believe the data in this study provide valuable, new information for the management of twin pregnancies.

  1. Influence of dose distribution on risk of lung cancer occurrence after actinide oxide inhalation; Influence de la distribution de dose sur le risque d'apparition de cancers pulmonaires apres inhalation d'oxydes d'actinides

    Energy Technology Data Exchange (ETDEWEB)

    Fritsch, P.; Dudoignon, N.; Guillet, K.; Rateau, G.; Delforge, J. [Lab. de Radiotoxicologie, CEA/DSV/DRR/SRCA, Bruyeres le Chatel (France)

    2002-07-01

    The aim of this work was to estimate risk of lung tumour occurrence after inhalation of actinide oxides from published studies and rat studies in progress. For the same delivered dose, the risk increases when homogeneity of irradiation increases, i.e., the number of particles deposited after inhalation increases (small particles and (or) low specific alpha activity). The dose-effect relationships reported appear linear up to a few gray, depending on the aerosol considered, and then the slope decreases. This slope, which corresponds with the risk, can vary over one order of magnitude de ending on the aerosol used. An effective threshold at about 1 Gy was not observed for the most homogeneous dose distributions. A dosimetric and biological approach is proposed to provide a more realistic risk estimate. (author)

  2. Development of internal dose assessment procedure for workers in industries using raw materials containing naturally occurring radioactive materials

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Cheol Kyu; KIm, Yong Geon; Ji, Seung Woo; Kim, Kwang Pyo [College of Engineering, Kyung Hee University, Yongin (Korea, Republic of); Koo, Bon Cheol; Chang, Byung Uck [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2016-09-15

    It is necessary to assess radiation dose to workers due to inhalation of airborne particulates containing naturally occurring radioactive materials (NORM) to ensure radiological safety required by the Natural Radiation Safety Management Act. The objective of this study is to develop an internal dose assessment procedure for workers at industries using raw materials containing natural radionuclides. The dose assessment procedure was developed based on harmonization, accuracy, and proportionality. The procedure includes determination of dose assessment necessity, preliminary dose estimation, airborne particulate sampling and characterization, and detailed assessment of radiation dose. The developed dose assessment procedure is as follows. Radioactivity concentration criteria to determine dose assessment necessity are 10 Bq·g-1 for 40K and 1 Bq·g-1 for the other natural radionuclides. The preliminary dose estimation is performed using annual limit on intake (ALI). The estimated doses are classified into 3 groups (<0.1 mSv, 0.1-0.3 mSv, and >0.3 mSv). Air sampling methods are determined based on the dose estimates. Detailed dose assessment is performed using air sampling and particulate characterization. The final dose results are classified into 4 different levels (<0.1 mSv, 0.1-0.3 mSv, 0.3-1 mSv, and >1 mSv). Proper radiation protection measures are suggested according to the dose level. The developed dose assessment procedure was applied for NORM industries in Korea, including coal combustion, phosphate processing, and monazite handing facilities. The developed procedure provides consistent dose assessment results and contributes to the establishment of optimization of radiological protection in NORM industries.

  3. Evaluation of the neutron spectrum and dose assessment around the venus reactor.

    Science.gov (United States)

    Coeck, Michèle; Vermeersch, Fernand; Vanhavere, Filip

    2005-01-01

    An assessment of the neutron field near the VENUS reactor is made in order to evaluate the neutron dose to the operators, particularly in an area near the reactor shielding and in the control room. Therefore, a full MCNPX model of the shielding geometry was developed. The source term used in the simulation is derived from a criticality calculation done beforehand. Calculations are compared to routine neutron dose rate measurements and show good agreement. The MCNPX model developed easily allows core adaptations in order to evaluate the effect of future core configuration on the neutron dose to the operators.

  4. The debate on the use of linear no threshold for assessing the effects of low doses

    Energy Technology Data Exchange (ETDEWEB)

    Tubiana, M; Aurengo, A; Averbeck, D; Masse, R [Centre Antoine Beclere, 45 rue des Saints-Peres, 75006 Paris (France)

    2006-09-15

    From December 2004 to July 2005, three reports on the effects of low doses of ionising radiation were released: ICRP (2004), the joint report of the French Academies of Science and Medicine (Tubiana et al 2005), and a report from the American Academy of Sciences (BEIR VII 2005). These reports quote the same recent articles on the biological effects of low doses, yet their conclusions diverge. The French report concludes that recent biological data show that the efficacy of defense mechanisms is modulated by dose and dose rate and that linear no threshold (LNT) is no longer plausible. The ICRP and the BEIR VII reports recognise that there are biologic arguments against LNT but feel that there are not sufficient biological proofs against it to change risk assessment methodology and subsequent regulatory policy based on LNT. They point out the remaining uncertainties and the lack of mechanistic explanations of phenomena such as low dose hyperlethality or the adaptive response. In this context, a critical analysis of the available data is necessary. The epidemiological data and the experimental data challenge the validity of the LNT hypothesis for assessing the carcinogenic effect of low doses, but do not allow its exclusion. Therefore, the main criteria for selecting the most reliable dose-effect relationship from a scientific point of view should be based on biological data. Their analysis should help one to understand the current controversy. (opinion)

  5. The debate on the use of linear no threshold for assessing the effects of low doses.

    Science.gov (United States)

    Tubiana, M; Aurengo, A; Averbeck, D; Masse, R

    2006-09-01

    From December 2004 to July 2005, three reports on the effects of low doses of ionising radiation were released: ICRP (2004), the joint report of the French Academies of Science and Medicine (Tubiana et al 2005), and a report from the American Academy of Sciences (BEIR VII 2005). These reports quote the same recent articles on the biological effects of low doses, yet their conclusions diverge. The French report concludes that recent biological data show that the efficacy of defense mechanisms is modulated by dose and dose rate and that linear no threshold (LNT) is no longer plausible. The ICRP and the BEIR VII reports recognise that there are biologic arguments against LNT but feel that there are not sufficient biological proofs against it to change risk assessment methodology and subsequent regulatory policy based on LNT. They point out the remaining uncertainties and the lack of mechanistic explanations of phenomena such as low dose hyperlethality or the adaptive response. In this context, a critical analysis of the available data is necessary. The epidemiological data and the experimental data challenge the validity of the LNT hypothesis for assessing the carcinogenic effect of low doses, but do not allow its exclusion. Therefore, the main criteria for selecting the most reliable dose-effect relationship from a scientific point of view should be based on biological data. Their analysis should help one to understand the current controversy.

  6. Effects of long-term low-dose oxygen supplementation on the epithelial function, collagen metabolism and interstitial fibrogenesis in the guinea pig lung

    Directory of Open Access Journals (Sweden)

    Ishizaka Akitoshi

    2008-04-01

    Full Text Available Abstract Background The patient population receiving long-term oxygen therapy has increased with the rising morbidity of COPD. Although high-dose oxygen induces pulmonary edema and interstitial fibrosis, potential lung injury caused by long-term exposure to low-dose oxygen has not been fully analyzed. This study was designed to clarify the effects of long-term low-dose oxygen inhalation on pulmonary epithelial function, edema formation, collagen metabolism, and alveolar fibrosis. Methods Guinea pigs (n = 159 were exposed to either 21% or 40% oxygen for a maximum of 16 weeks, and to 90% oxygen for a maximum of 120 hours. Clearance of inhaled technetium-labeled diethylene triamine pentaacetate (Tc-DTPA and bronchoalveolar lavage fluid-to-serum ratio (BAL/Serum of albumin (ALB were used as markers of epithelial permeability. Lung wet-to-dry weight ratio (W/D was measured to evaluate pulmonary edema, and types I and III collagenolytic activities and hydroxyproline content in the lung were analyzed as indices of collagen metabolism. Pulmonary fibrotic state was evaluated by histological quantification of fibrous tissue area stained with aniline blue. Results The clearance of Tc-DTPA was higher with 2 week exposure to 40% oxygen, while BAL/Serum Alb and W/D did not differ between the 40% and 21% groups. In the 40% oxygen group, type I collagenolytic activities at 2 and 4 weeks and type III collagenolytic activity at 2 weeks were increased. Hydroxyproline and fibrous tissue area were also increased at 2 weeks. No discernible injury was histologically observed in the 40% group, while progressive alveolar damage was observed in the 90% group. Conclusion These results indicate that epithelial function is damaged, collagen metabolism is affected, and both breakdown of collagen fibrils and fibrogenesis are transiently induced even with low-dose 40% oxygen exposure. However, these changes are successfully compensated even with continuous exposure to low-dose

  7. Prognostic impact of average iodine density assessed by dual-energy spectral imaging for predicting lung tumor recurrence after stereotactic body radiotherapy.

    Science.gov (United States)

    Aoki, Masahiko; Hirose, Katsumi; Sato, Mariko; Akimoto, Hiroyoshi; Kawaguchi, Hideo; Hatayama, Yoshiomi; Fujioka, Ichitaro; Tanaka, Mitsuki; Ono, Shuichi; Takai, Yoshihiro

    2016-07-01

    The purpose of this study was to investigate the prognostic significance of average iodine density as assessed by dual-energy computed tomography (DE-CT) for lung tumors treated with stereotactic body radiotherapy (SBRT). From March 2011 to August 2014, 93 medically inoperable patients with 74 primary lung cancers and 19 lung metastases underwent DE-CT prior to SBRT of a total dose of 45-60 Gy in 5-10 fractions. Of these 93 patients, nine patients had two lung tumors. Thus, 102 lung tumors were included in this study. DE-CT was performed for pretreatment evaluation. Regions of interest were set for the entire tumor, and average iodine density was obtained using a dedicated imaging software and evaluated with regard to local control. The median follow-up period was 23.4 months (range, 1.5-54.5 months). The median value of the average iodine density was 1.86 mg/cm(3) (range, 0.40-9.27 mg/cm(3)). Two-year local control rates for the high and low average iodine density groups divided by the median value of the average iodine density were 96.9% and 75.7% (P = 0.006), respectively. Tumors with lower average iodine density showed a worse prognosis, possibly reflecting a hypoxic cell population in the tumor. The average iodine density exhibited a significant impact on local control. Our preliminary results indicate that iodine density evaluated using dual-energy spectral CT may be a useful, noninvasive and quantitative assessment of radio-resistance caused by presumably hypoxic cell populations in tumors.

  8. Computed Tomography–Guided Interstitial High-Dose-Rate Brachytherapy in Combination With Regional Positive Lymph Node Intensity-Modulated Radiation Therapy in Locally Advanced Peripheral Non–Small Cell Lung Cancer: A Phase 1 Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Xiang, Li; Zhang, Jian-wen; Lin, Sheng; Luo, Hui-Qun; Wen, Qing-Lian; He, Li-Jia; Shang, Chang-Ling; Ren, Pei-Rong; Yang, Hong-Ru; Pang, Hao-Wen; Yang, Bo; He, Huai-Lin [Department of Oncology, Affiliated Hospital of Luzhou Medical College, Luzhou (China); Chen, Yue, E-mail: chenyue5523@126.com [Department of Nuclear Medicine, Affiliated Hospital of Luzhou Medical College, Luzhou (China); Wu, Jing-Bo, E-mail: wjb6147@163.com [Department of Oncology, Affiliated Hospital of Luzhou Medical College, Luzhou (China)

    2015-08-01

    Purpose: To assess the technical safety, adverse events, and efficacy of computed tomography (CT)-guided interstitial high-dose-rate (HDR) brachytherapy in combination with regional positive lymph node intensity modulated radiation therapy in patients with locally advanced peripheral non–small cell lung cancer (NSCLC). Methods and Materials: Twenty-six patients with histologically confirmed NSCLC were enrolled in a prospective, officially approved phase 1 trial. Primary tumors were treated with HDR brachytherapy. A single 30-Gy dose was delivered to the 90% isodose line of the gross lung tumor volume. A total dose of at least 70 Gy was administered to the 95% isodose line of the planning target volume of malignant lymph nodes using 6-MV X-rays. The patients received concurrent or sequential chemotherapy. We assessed treatment efficacy, adverse events, and radiation toxicity. Results: The median follow-up time was 28 months (range, 7-44 months). There were 3 cases of mild pneumothorax but no cases of hemothorax, dyspnea, or pyothorax after the procedure. Grade 3 or 4 acute hematologic toxicity was observed in 5 patients. During follow-up, mild fibrosis around the puncture point was observed on the CT scans of 2 patients, but both patients were asymptomatic. The overall response rates (complete and partial) for the primary mass and positive lymph nodes were 100% and 92.3%, respectively. The 1-year and 2-year overall survival (OS) rates were 90.9% and 67%, respectively, with a median OS of 22.5 months. Conclusion: Our findings suggest that HDR brachytherapy is safe and feasible for peripheral locally advanced NSCLC, justifying a phase 2 clinical trial.

  9. A functional assessment of patients two years after lung transplantation in Poland

    Science.gov (United States)

    Gumola, Anna; Wojarski, Jacek; Żegleń, Sławomir; Ochman, Marek; Czyżewski, Damian; Ziora, Dariusz; Zembala, Marian; Kozielski, Jerzy

    2014-01-01

    The aim of the study The aim of the study was to assess the long-term results of lung transplantation (LT) in Poland two years after the procedure. Material and methods The study included patients who underwent LT between December 2004 and December 2009 in the Silesian Center for Heart Diseases in Zabrze. Various lung functions (forced vital capacity – FVC; forced expiratory volume in 1 second – FEV1), the quality of life (SF-36 questionnaire), the level of perceived dyspnea (Medical Research Council – MRC; basic dyspnea index – BDI), and the patient's mobility (the 6-minute walking test – 6MWT) were assessed before and approximately 24 months after LT. Among 35 patients who underwent LT, 20 patients were referred to our study (mean age: 46.6 ± 9.03 years). Results After LT, a statistically significant increase was observed in the distance achieved in the 6MWT (323.8 vs. 505.8 m), FVC (1.64 vs. 2.88 L), and FEV1 (1.37 vs. 2.09 L). An improvement in perceived dyspnea in MRC and BDI questionnaires was observed in patients with chronic obstructive pulmonary disease (COPD) after LT. The assessment of the quality of life, excluding perceived pain, showed the most significant improvement in the physical cumulative score (PCS; 25 vs. 45 points), especially in patients with idiopathic pulmonary fibrosis. Conclusions Lung transplantation in Poland, in patients who live longer than 2 years after the procedure, significantly improves the mobility, lung function, perceived dyspnea, and the quality of life. PMID:26336415

  10. One-year treatment with different dosing schedules of fluticasone propionate in childhood asthma - Effects on hyperresponsiveness, lung function, and height

    NARCIS (Netherlands)

    Visser, MJ; Postma, DS; Arends, LR; De Vries, TW; Duiverman, EJ; Brand, PLP

    2001-01-01

    Dose-dependent effects of inhaled corticosteroids have been described. Although it has been advised to start treatment with inhaled corticosteroids with a high dose tapering off subsequently (stepdown approach), no clinical studies have assessed this strategy. We compared two different dosage schedu

  11. Expression of genes involved in mouse lung cell differentiation/regulation after acute exposure to photons and protons with or without low-dose preirradiation.

    Science.gov (United States)

    Tian, Jian; Zhao, WeiLing; Tian, Sisi; Slater, James M; Deng, Zhiyong; Gridley, Daila S

    2011-11-01

    The goal of this study was to compare the effects of acute 2 Gy irradiation with photons (0.8 Gy/min) or protons (0.9 Gy/min), both with and without pre-exposure to low-dose/low-dose-rate γ rays (0.01 Gy at 0.03 cGy/h), on 84 genes involved in stem cell differentiation or regulation in mouse lungs on days 21 and 56. Genes with a ≥1.5-fold difference in expression and P photons in modulating the genes. More genes were affected by protons than by photons (22 compared to 2 and 6 compared to 2 on day 21 and day 56, respectively) compared to 0 Gy. Preirradiation with low-dose-rate γ rays enhanced the acute photon-induced gene modulation on day 21 (11 compared to 2), and all 11 genes were significantly downregulated on day 56. On day 21, seven genes (aldh2, bmp2, cdc2a, col1a1, dll1, foxa2 and notch1) were upregulated in response to most of the radiation regimens. Immunoreactivity of Clara cell secretory protein was enhanced by all radiation regimens. The number of alveolar type 2 cells positive for prosurfactant protein C in irradiated groups was higher on day 56 (12.4-14.6 cells/100) than on day 21 (8.5-11.2 cells/100) (P photons and protons induced different gene expression profiles in the lungs and that pre-exposure to low-dose-rate γ rays sometimes had modulatory effects. In addition, proteins associated with lung-specific stem cells/progenitors were highly sensitive to radiation.

  12. Flattening filter free beams in SBRT and IMRT. Dosimetric assessment of peripheral doses

    Energy Technology Data Exchange (ETDEWEB)

    Kragl, Gabriele; Baier, Franziska; Albrich, David; Kroupa, Bernhard; Georg, Dietmar [Medical Univ. of Vienna/AKH Vienna (Austria). Dept. of Radiotherapy; Lutz, Steffen; Wiezorek, Tilo [University Hospital Jena (Germany). Dept. of Radiotherapy; Dalaryd, Maarten; Knoeoes, Tommy [Lund Univ. (Sweden). Radiation Physics; Skaane Univ. Hospital (Sweden). Radiation Physics

    2011-07-01

    Purpose: Recently, there has been a growing interest in operating medical linear accelerators without a flattening filter. Due to reduced scatter, leaf transmission and radiation head leakage a reduction of out-of-field dose is expected for flattening filter free beams. The aim of the present study was to determine the impact of unflattened beams on peripheral dose for advanced treatment techniques with a large number of MUs. Material and methods: An Elekta Precise linac was modified to provide 6 and 10 MV photon beams without a flattening filter. Basic beam data were collected and implemented into the TPS Oncentra Masterplan (Nucletron). Leakage radiation, which predominantly contributes to peripheral dose at larger distances from the field edge, was measured using a Farmer type ionisation chamber. SBRT (lung) and IMRT (prostate, head and neck) treatment plans were generated for 6 and 10 MV for both flattened and unflattened beams. All treatment plans were delivered to the relevant anatomic region of an anthropomorphic phantom which was extended by a solid water slab phantom. Dosimetric measurements were performed with TLD-700 rods, radiochromic films and a Farmer type ionisation chamber. The detectors were placed within the slab phantom and positioned along the isocentric longitudinal axis. Results: Using unflattened beams results in a reduction of treatment head leakage by 52% for 6 and 65% for 10 MV. Thus, peripheral doses were in general smaller for treatment plans calculated with unflattened beams. At about 20 cm distance from the field edge the dose was on average reduced by 23 and 31% for the 6 and 10 MV SBRT plans. For the IMRT plans (10 MV) the average reduction was 16% for the prostate and 18% for the head and neck case, respectively. For all examined cases, the relative deviation between peripheral doses of flattened and unflattened beams was found to increase with increasing distance from the field. Conclusions: Removing the flattening filter lead to

  13. Environmental dose rate assessment of ITER using the Monte Carlo method

    Directory of Open Access Journals (Sweden)

    Karimian Alireza

    2014-01-01

    Full Text Available Exposure to radiation is one of the main sources of risk to staff employed in reactor facilities. The staff of a tokamak is exposed to a wide range of neutrons and photons around the tokamak hall. The International Thermonuclear Experimental Reactor (ITER is a nuclear fusion engineering project and the most advanced experimental tokamak in the world. From the radiobiological point of view, ITER dose rates assessment is particularly important. The aim of this study is the assessment of the amount of radiation in ITER during its normal operation in a radial direction from the plasma chamber to the tokamak hall. To achieve this goal, the ITER system and its components were simulated by the Monte Carlo method using the MCNPX 2.6.0 code. Furthermore, the equivalent dose rates of some radiosensitive organs of the human body were calculated by using the medical internal radiation dose phantom. Our study is based on the deuterium-tritium plasma burning by 14.1 MeV neutron production and also photon radiation due to neutron activation. As our results show, the total equivalent dose rate on the outside of the bioshield wall of the tokamak hall is about 1 mSv per year, which is less than the annual occupational dose rate limit during the normal operation of ITER. Also, equivalent dose rates of radiosensitive organs have shown that the maximum dose rate belongs to the kidney. The data may help calculate how long the staff can stay in such an environment, before the equivalent dose rates reach the whole-body dose limits.

  14. Lung nodule detection performance in five observers on computed tomography (CT) with adaptive iterative dose reduction using three-dimensional processing (AIDR 3D) in a Japanese multicenter study: Comparison between ultra-low-dose CT and low-dose CT by receiver-operating characteristic analysis

    Energy Technology Data Exchange (ETDEWEB)

    Nagatani, Yukihiro, E-mail: yatsushi@belle.shiga-med.ac.jp [Department of Radiology, Shiga University of Medical Science, Otsu 520-2192, Shiga (Japan); Takahashi, Masashi; Murata, Kiyoshi [Department of Radiology, Shiga University of Medical Science, Otsu 520-2192, Shiga (Japan); Ikeda, Mitsuru [Department of Radiological and Medical Laboratory Science, Nagoya University Graduate School of Medicine, Nagoya 461-8673, Aichi (Japan); Yamashiro, Tsuneo [Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara 903-0215, Okinawa (Japan); Miyara, Tetsuhiro [Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara 903-0215, Okinawa (Japan); Department of Radiology, Okinawa Prefectural Yaeyama Hospital, Ishigaki 907-0022, Okinawa (Japan); Koyama, Hisanobu [Department of Radiology, Kobe University Graduate School of Medicine, Kobe 650-0017, Hyogo (Japan); Koyama, Mitsuhiro [Department of Radiology, Osaka Medical College, Takatsuki 569-8686, Osaka (Japan); Sato, Yukihisa [Department of Radiology, Osaka University Graduate School of Medicine, Suita 565-0871, Osaka (Japan); Department of Radiology, Osaka Medical Center of Cancer and Cardiovascular Diseases, Osaka 537-8511, Osaka (Japan); Moriya, Hiroshi [Department of Radiology, Ohara General Hospital, Fukushima 960-8611 (Japan); Noma, Satoshi [Department of Radiology, Tenri Hospital, Tenri 632-8552, Nara (Japan); Tomiyama, Noriyuki [Department of Radiology, Osaka University Graduate School of Medicine, Suita 565-0871, Osaka (Japan); Ohno, Yoshiharu [Department of Radiology, Kobe University Graduate School of Medicine, Kobe 650-0017, Hyogo (Japan); Murayama, Sadayuki [Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Nishihara 903-0215, Okinawa (Japan)

    2015-07-15

    Highlights: • Using AIDR 3D, ULDCT showed comparable LND of solid nodules to LDCT. • Using AIDR 3D, LND of smaller GGN in ULDCT was inferior to that in LDCT. • Effective dose in ULDCT was about only twice of that in chest X-ray. • BMI values in study population were mostly in the normal range body habitus. - Abstract: Purpose: To compare lung nodule detection performance (LNDP) in computed tomography (CT) with adaptive iterative dose reduction using three dimensional processing (AIDR3D) between ultra-low dose CT (ULDCT) and low dose CT (LDCT). Materials and methods: This was part of the Area-detector Computed Tomography for the Investigation of Thoracic Diseases (ACTIve) Study, a multicenter research project being conducted in Japan. Institutional Review Board approved this study and informed consent was obtained. Eighty-three subjects (body mass index, 23.3 ± 3.2) underwent chest CT at 6 institutions using identical scanners and protocols. In a single visit, each subject was scanned using different tube currents: 240, 120 and 20 mA (3.52, 1.74 and 0.29 mSv, respectively). Axial CT images with 2-mm thickness/increment were reconstructed using AIDR3D. Standard of reference (SOR) was determined based on CT images at 240 mA by consensus reading of 2 board-certificated radiologists as to the presence of lung nodules with the longest diameter (LD) of more than 3 mm. Another 5 radiologists independently assessed and recorded presence/absence of lung nodules and their locations by continuously-distributed rating in CT images at 20 mA (ULDCT) and 120 mA (LDCT). Receiver-operating characteristic (ROC) analysis was used to evaluate LNDP of both methods in total and also in subgroups classified by LD (>4, 6 and 8 mm) and nodular characteristics (solid and ground glass nodules). Results: For SOR, 161 solid and 60 ground glass nodules were identified. No significant difference in LNDP for entire solid nodules was demonstrated between both methods, as area under ROC

  15. Increasing Radiation Therapy Dose Is Associated With Improved Survival in Patients Undergoing Stereotactic Body Radiation Therapy for Stage I Non–Small-Cell Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Koshy, Matthew, E-mail: mkoshy@radonc.uchicago.edu [Department of Radiation Oncology, University of Illinois at Chicago, Chicago, Illinois (United States); Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois (United States); Malik, Renuka [Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois (United States); Weichselbaum, Ralph R. [Department of Radiation Oncology, University of Illinois at Chicago, Chicago, Illinois (United States); Department of Radiation and Cellular Oncology, The University of Chicago, Chicago, Illinois (United States); Sher, David J. [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States)

    2015-02-01

    Purpose: To determine the comparative effectiveness of different stereotactic body radiation therapy (SBRT) dosing regimens for early-stage non–small-cell lung cancer, using a large national database, focusing on the relative impact of dose as a function of tumor stage. Methods and Materials: The study included patients in the National Cancer Database from 2003 to 2006 with T1-T2N0M0 inoperable lung cancer (n=498). The biologically effective dose (BED) was calculated according to the linear quadratic formula using an α/β ratio of 10. High versus lower-dose (HD vs LD) SBRT was defined as a calculated BED above or below 150 Gy. Overall survival was estimated using Kaplan-Meier methods and Cox proportional hazard regression. Results: The 5 most common dose fractionation schemes (percentage of cohort) used were 20 Gy × 3 (34%), 12 Gy × 4 (16%), 18 Gy × 3 (10%), 15 Gy × 3 (10%), and 16 Gy × 3 (4%). The median calculated BED was 150 Gy (interquartile range 106-166 Gy). The 3-year overall survival (OS) for patients who received HD versus LD was 55% versus 46% (log–rank P=.03). On subset analysis of the T1 cohort there was no association between calculated BED and 3-year OS (61% vs 60% with HD vs LD, P=.9). Among the T2 cohort, patients receiving HD experienced superior 3-year OS (37% vs 24%, P=.01). On multivariable analysis, factors independently prognostic for mortality were female gender (hazard ratio [HR] 0.76, P=.01), T2 tumor (HR 1.99, P=.0001), and HD (HR 0.68, P=.001). Conclusions: This comparative effectiveness analysis of SBRT dose for patients with stage I non–small-cell lung cancer suggests that higher doses (>150 Gy BED) are associated with a significant survival benefit in patients with T2 tumors.

  16. Poster — Thur Eve — 70: Automatic lung bronchial and vessel bifurcations detection algorithm for deformable image registration assessment

    Energy Technology Data Exchange (ETDEWEB)

    Labine, Alexandre; Carrier, Jean-François; Bedwani, Stéphane [Centre hospitalier de l' Université de Montréal (Canada); Chav, Ramnada; De Guise, Jacques [Laboratoire de recherche en imagerie et d' orthopédie-CRCHUM, École de technologie supérieure (Canada)

    2014-08-15

    Purpose: To investigate an automatic bronchial and vessel bifurcations detection algorithm for deformable image registration (DIR) assessment to improve lung cancer radiation treatment. Methods: 4DCT datasets were acquired and exported to Varian treatment planning system (TPS) EclipseTM for contouring. The lungs TPS contour was used as the prior shape for a segmentation algorithm based on hierarchical surface deformation that identifies the deformed lungs volumes of the 10 breathing phases. Hounsfield unit (HU) threshold filter was applied within the segmented lung volumes to identify blood vessels and airways. Segmented blood vessels and airways were skeletonised using a hierarchical curve-skeleton algorithm based on a generalized potential field approach. A graph representation of the computed skeleton was generated to assign one of three labels to each node: the termination node, the continuation node or the branching node. Results: 320 ± 51 bifurcations were detected in the right lung of a patient for the 10 breathing phases. The bifurcations were visually analyzed. 92 ± 10 bifurcations were found in the upper half of the lung and 228 ± 45 bifurcations were found in the lower half of the lung. Discrepancies between ten vessel trees were mainly ascribed to large deformation and in regions where the HU varies. Conclusions: We established an automatic method for DIR assessment using the morphological information of the patient anatomy. This approach allows a description of the lung's internal structure movement, which is needed to validate the DIR deformation fields for accurate 4D cancer treatment planning.

  17. RADIATION HYGIENIC MONITORING AND ASSESSMENT OF POPULATION DOSES IN RADIOACTIVELY CONTAMINATED AREAS OF TULA REGION

    Directory of Open Access Journals (Sweden)

    T. M. Chichura

    2016-01-01

    Full Text Available The goal. The analyses of radiation hygienic monitoring conducted in Tula region territories affected by the Chernobyl NPP accident regarding cesium-137 and strontium- 90 in the local foodstuffs and the analyses of populational annual effective dose. The materials and methods. The survey was conducted in Tula Region since 1997 to 2015. Over that period, more than fifty thousand samples of the main foodstuffs from the post-Chernobyl contaminated area were analyzed. Simultaneously with that, the external gamma - radiation dose rate was measured in the fixed control points. The dynamics of cesium -137 and strontium-90 content in foodstuffs were assessed along with the maximum values of the mean annual effective doses to the population and the contribution of the collective dose from medical exposures into the structure of the annual effective collective dose to the population. The results. The amount of cesium-137 and strontium -90 in the local foodstuffs was identified. The external gamma- radiation dose rate values were found to be stable and not exceeding the natural fluctuations range typical for the middle latitudes of Russia’s European territory. The maximum mean annual effective dose to the population reflects the stable radiation situation and does not exceed the permissible value of 1 mSv. The contribution of the collective dose from medical exposures of the population has been continuously reducing as well as the average individual dose to the population per one medical treatment under the annual increase of the medical treatments quantities. The conclusion. There is no exceedance of the admissible levels of cesium-137 and strontium- 90 content in the local foodstuffs. The mean annual effective dose to the population has decreased which makes it possible to transfer the settlements affected by the Chernobyl NPP accident to normal life style. This is covered by the draft concept of the settlements’ transfer to normal life style.

  18. Lifetime Effective Dose Assessment Based on Background Outdoor Gamma Exposure in Chihuahua City, Mexico.

    Science.gov (United States)

    Luevano-Gurrola, Sergio; Perez-Tapia, Angelica; Pinedo-Alvarez, Carmelo; Carrillo-Flores, Jorge; Montero-Cabrera, Maria Elena; Renteria-Villalobos, Marusia

    2015-09-30

    Determining ionizing radiation in a geographic area serves to assess its effects on a population's health. The aim of this study was to evaluate the spatial distribution of the background environmental outdoor gamma dose rates in Chihuahua City. This study also estimated the annual effective dose and the lifetime cancer risks of the population of this city. To determine the outdoor gamma dose rate in air, the annual effective dose and the lifetime cancer risk, 48 sampling points were randomly selected in Chihuahua City. Outdoor gamma dose rate measurements were carried out by using a Geiger-Müller counter. Outdoor gamma dose rates ranged from 113 to 310 nGy·h(-1). At the same sites, 48 soil samples were taken to obtain the activity concentrations of (226)Ra, (232)Th and (40)K and to calculate their terrestrial gamma dose rates. Radioisotope activity concentrations were determined by gamma spectrometry. Calculated gamma dose rates ranged from 56 to 193 nGy·h(-1). Results indicated that the lifetime effective dose of the inhabitants of Chihuahua City is on average 19.8 mSv, resulting in a lifetime cancer risk of 0.001. In addition, the mean of the activity concentrations in soil were 52, 73 and 1097 Bq·kg(-1), for (226)Ra, (232)Th and (40)K, respectively. From the analysis, the spatial distribution of (232)Th, (226)Ra and (40)K is to the north, to the north-center and to the south of city, respectively. In conclusion, the natural background gamma dose received by the inhabitants of Chihuahua City is high and mainly due to the geological characteristics of the zone. From the radiological point of view, this kind of study allows us to identify the importance of manmade environments, which are often highly variable and difficult to characterize.

  19. Lifetime Effective Dose Assessment Based on Background Outdoor Gamma Exposure in Chihuahua City, Mexico

    Directory of Open Access Journals (Sweden)

    Sergio Luevano-Gurrola

    2015-09-01

    Full Text Available Determining ionizing radiation in a geographic area serves to assess its effects on a population’s health. The aim of this study was to evaluate the spatial distribution of the background environmental outdoor gamma dose rates in Chihuahua City. This study also estimated the annual effective dose and the lifetime cancer risks of the population of this city. To determine the outdoor gamma dose rate in air, the annual effective dose and the lifetime cancer risk, 48 sampling points were randomly selected in Chihuahua City. Outdoor gamma dose rate measurements were carried out by using a Geiger-Müller counter. Outdoor gamma dose rates ranged from 113 to 310 nGy·h−1. At the same sites, 48 soil samples were taken to obtain the activity concentrations of 226Ra, 232Th and 40K and to calculate their terrestrial gamma dose rates. Radioisotope activity concentrations were determined by gamma spectrometry. Calculated gamma dose rates ranged from 56 to 193 nGy·h−1. Results indicated that the lifetime effective dose of the inhabitants of Chihuahua City is on average 19.8 mSv, resulting in a lifetime cancer risk of 0.001. In addition, the mean of the activity concentrations in soil were 52, 73 and 1097 Bq·kg−1, for 226Ra, 232Th and 40K, respectively. From the analysis, the spatial distribution of 232Th, 226Ra and 40K is to the north, to the north-center and to the south of city, respectively. In conclusion, the natural background gamma dose received by the inhabitants of Chihuahua City is high and mainly due to the geological characteristics of the zone. From the radiological point of view, this kind of study allows us to identify the importance of manmade environments, which are often highly variable and difficult to characterize.

  20. Detailed diesel exhaust characteristics including particle surface area and lung deposited dose for better understanding of health effects in human chamber exposure studies

    Science.gov (United States)

    Wierzbicka, Aneta; Nilsson, Patrik T.; Rissler, Jenny; Sallsten, Gerd; Xu, Yiyi; Pagels, Joakim H.; Albin, Maria; Österberg, Kai; Strandberg, Bo; Eriksson, Axel; Bohgard, Mats; Bergemalm-Rynell, Kerstin; Gudmundsson, Anders

    2014-04-01

    Several diesel exhaust (DE) characteristics, comprising both particle and gas phase, recognized as important when linking with health effects, are not reported in human chamber exposure studies. In order to understand effects of DE on humans there is a need for better characterization of DE when performing exposure studies. The aim of this study was to determine and quantify detailed DE characteristics during human chamber exposure. Additionally to compare to reported DE properties in conducted human exposures. A wide battery of particle and gas phase measurement techniques have been used to provide detailed DE characteristics including the DE particles (DEP) surface area, fraction and dose deposited in the lungs, chemical composition of both particle and gas phase such as NO, NO2, CO, CO2, volatile organic compounds (including aldehydes, benzene, toluene) and polycyclic aromatic hydrocarbons (PAHs). Eyes, nose and throat irritation effects were determined. Exposure conditions with PM1 (<1 μm) mass concentration 280 μg m-3, number concentration 4 × 105 cm-3 and elemental to total carbon fraction of 82% were generated from a diesel vehicle at idling. When estimating the lung deposited dose it was found that using the size dependent effective density (in contrast to assuming unity density) reduced the estimated respiratory dose by 132% by mass. Accounting for agglomerated structure of DEP prevented underestimation of lung deposited dose by surface area by 37% in comparison to assuming spherical particles. Comparison of DE characteristics reported in conducted chamber exposures showed that DE properties vary to a great extent under the same DEP mass concentration and engine load. This highlights the need for detailed and standardized approach for measuring and reporting of DE properties. Eyes irritation effects, most probably caused by aldehydes in the gas phase, as well as nose irritation were observed at exposure levels below current occupational exposure limit

  1. Effect of low-dose CT and iterative reconstruction on trabecular bone microstructure assessment

    Science.gov (United States)

    Kopp, Felix K.; Baum, Thomas; Nasirudin, Radin A.; Mei, Kai; Garcia, Eduardo G.; Burgkart, Rainer; Rummeny, Ernst J.; Bauer, Jan S.; Noël, Peter B.

    2016-03-01

    The trabecular bone microstructure is an important factor in the development of osteoporosis. It is well known that its deterioration is one effect when osteoporosis occurs. Previous research showed that the analysis of trabecular bone microstructure enables more precise diagnoses of osteoporosis compared to a sole measurement of the mineral density. Microstructure parameters are assessed on volumetric images of the bone acquired either with high-resolution magnetic resonance imaging, high-resolution peripheral quantitative computed tomography or high-resolution computed tomography (CT), with only CT being applicable to the spine, which is one of clinically most relevant fracture sites. However, due to the high radiation exposure for imaging the whole spine these measurements are not applicable in current clinical routine. In this work, twelve vertebrae from three different donors were scanned with standard and low radiation dose. Trabecular bone microstructure parameters were assessed for CT images reconstructed with statistical iterative reconstruction (SIR) and analytical filtered backprojection (FBP). The resulting structure parameters were correlated to the biomechanically determined fracture load of each vertebra. Microstructure parameters assessed for low-dose data reconstructed with SIR significantly correlated with fracture loads as well as parameters assessed for standard-dose data reconstructed with FBP. Ideal results were achieved with low to zero regularization strength yielding microstructure parameters not significantly different from those assessed for standard-dose FPB data. Moreover, in comparison to other approaches, superior noise-resolution trade-offs can be found with the proposed methods.

  2. Combined use of positron emission tomography and volume doubling time in lung cancer screening with low-dose CT scanning

    DEFF Research Database (Denmark)

    Ashraf, H; Dirksen, A; Jakobsen, Annika Loft

    2011-01-01

    In lung cancer screening the ability to distinguish malignant from benign nodules is a key issue. This study evaluates the ability of positron emission tomography (PET) and volume doubling time (VDT) to discriminate between benign and malignant nodules.......In lung cancer screening the ability to distinguish malignant from benign nodules is a key issue. This study evaluates the ability of positron emission tomography (PET) and volume doubling time (VDT) to discriminate between benign and malignant nodules....

  3. The Thule accident: Assessment of radiation doses from terrestrial radioactive contamination

    Energy Technology Data Exchange (ETDEWEB)

    Ulbak, K. (National Institute of Radiation Protection, Herlev (Denmark))

    2011-12-15

    Risoe DTU has carried out research on the terrestrial contamination in the Thule area after the radioactive contents of four nuclear weapons were dispersed following the crash of an American B-52 bomber in 1968. The results of Risoe DTU's studies are described in the report Thule-2007 - Investigation of radioactive pollution on land, which covers all measurements that were carried out on land in Thule in the years 2003, 2006, 2007 and 2008. The present report uses Risoe DTU's report as a basis for assessing radiation doses and consequently the risk for individuals as a result of terrestrial radioactive contamination in the Thule area. The assessment of radiation doses involves a number of conservative assumptions, estimates, and measurements, all of which are subject to considerable uncertainty. In some cases, models have been used based on experiences from other contaminated areas elsewhere in the world, which are subject to climatic and other conditions that diverge from those in the Thule area. The calculated doses are thus associated with considerable uncertainty, which must be taken into account when the results are used for comparison and when the risks of staying in the Thule area are assessed. It has therefore been chosen to provide the assessed radiation doses in the form of indicative orders of magnitude, which are applicable to everyone who might stay in the area, across various age groups. If the estimated doses in this report are combined with the National Institute of Radiation Protection's recommended reference level for contamination as a result of the Thule Accident of 1 mSv/year, the assessed magnitudes of radiation doses for inhalation and ingestion as exposure pathways are many orders of magnitude below the reference level (10,000-10 million times smaller). The wound contamination exposure pathway has a magnitude of radiation dose that is smaller than the reference level by a factor of 10-1000, and it should be recalled that the

  4. Assessment of indoor radon doses received by the students in the Azad Kashmir schools, Pakistan.

    Science.gov (United States)

    Rafique, Muhammad; Rahman, S U; Rahman, Said; Matiullah; Shahzad, M Ikram; Ahmed, Navid; Iqbal, Javid; Ahmed, Basharat; Ahmed, Tanveer; Akhtar, Nadeem

    2010-12-01

    Several epidemiological studies conducted on thousands of underground miners suggest that long- term exposure to high radon concentration can increase the risk of lung cancer. Keeping in view the importance of the subject, numerous studies throughout the world have been carried out to measure indoor radon concentration and its resulting doses at occupational and non-occupational sites. The purpose of the current study was to measure indoor radon concentration and its resulting doses received by the students of Azad Kashmir government schools. For this purpose, CR-39 radon detectors were installed in 80 carefully selected schools. The detectors were placed at a height of 3-5 ft. (depending upon average height of students in particular class) from the ground. After exposure of 90 d detectors were etched for 9 h in 6 M NaOH at 70°C and the observed track densities were related to radon concentrations. The measured indoor radon concentration ranged from 22 ± 9 to 228 ± 3 Bq m(-3) with a mean value of 78 ± 5 Bq m(-3). Based on the measured indoor radon data, the annual effective doses were found to vary from 0.55 ± 0.04 to 0.71 ± 0.03 mSv y(-1). The overall mean effective dose for the studied area was found to be 0.63 ± 0.04 mSv y(-1). Reported values for radon concentrations and corresponding doses are lower than ICRP recommended limits for workplaces.

  5. Cyclophosphamide-refractory scleroderma-associated interstitial lung disease: remarkable clinical and radiological response to a single course of rituximab combined with high-dose corticosteroids.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2011-10-01

    We would like to report our experience of using rituximab in cyclophosphamide refractory, rapidly progressive interstitial lung disease (ILD) in a patient with limited scleroderma. A 40-year-old man presented with 10-week history of inflammatory polyarthritis, which responded to a short course of oral corticosteroids. However, 3 weeks later, he developed new onset of exertional dyspnoea. High-resolution CT of the thorax was suggestive of early ILD. Surgical lung biopsy showed features of fibrotic non-specific interstitial pneumonia. He was diagnosed with scleroderma on the basis of: presence of anticentromere antibodies, Raynaud\\'s phenomenon, pulmonary fibrosis, digital oedema and hypomotility along with a dilated oesophagus. He was treated aggressively with pulse doses of corticosteroids and cyclophosphamide; however, his ILD continued to deteriorate. At this stage, he received rituximab (two pulses of 1 g each), which led to a gradual clinical improvement. Now, 12 months since his rituximab infusion, he walks 2 miles daily without any exertional dyspnoea.

  6. Assessment of patient doses and image quality in X-ray diagnostics in Norway

    Energy Technology Data Exchange (ETDEWEB)

    Olerud, H.M.

    1998-06-01

    Results from other industrialized countries indicate that the annual number of diagnostic procedures approaches one for every member of the population, and in many cases the individual radiation doses are higher than from any other human activity. Furthermore, the doses to patients for the same type of examination differ widely from place to place, suggesting that there is a considerable potential for dose reduction. This motivated an investigation of the diagnostic use of X-rays in Norway. The trends in the number of X-ray examinations performed annually have been studied. The patient doses (all diagnostics) and image quality (mammography and computed tomography) have been assessed for various radiological procedures. This form the basis for the assessment of total collective effective dose (CED) from X-rays in Norway, and further risk estimates. The radiological practice has then been evaluated according to the radiation protection principles of justification and optimisation. Based on the 1993 examination frequency, the total CED was assessed to 3400 manSv (0.78 mSv/inhabitant). It is estimated that this radiation burden may cause about 100 excess cancer deaths annually. The frequency of CT examination has doubled every fifth year, and did in 1993 represent 7% of the total number of examinations and 30% of the total CED. 129 refs.

  7. Additional dose assessment from the activation of high-energy linear accelerators used in radiation therapy

    Directory of Open Access Journals (Sweden)

    Ateia Embarka

    2008-01-01

    Full Text Available It is well known that medical linear accelerators generate activation products when operated above certain electron (photon energies. The aim of the present work is to assess the activation behavior of a medium-energy radiotherapy linear accelerator by applying in situ gamma-ray spectrometry and dose measurements, and to estimate the additional dose to radiotherapy staff on the basis of these results. Spectral analysis was performed parallel to dose rate measurements in the isocenter of the linear accelerator, immediately after the termination of irradiation. The following radioisotopes were detected by spectral analysis: 28Al, 62Cu, 56Mn, 64Cu, 187W, and 57Ni. The short-lived isotopes such as 28Al and 62Cu are the most important factors of the clinical routine, while the contribution to the radiation dose of medium-lived isotopes such as 56Mn, 57Ni, 64Cu, and 187W increases during the working day. Measured dose rates at the isocenter ranged from 2.2 µSv/h to 10 µSv/h in various measuring points of interest for the members of the radiotherapy staff. Within the period of 10 minutes, the dose rate decreased to values of 0.8 µSv/h. According to actual workloads in radiotherapy departments, a realistic exposure scenario was set, resulting in a maximal additional annual whole body dose to the radiotherapy staff of about 3.5 mSv.

  8. Preclinical assessment of HIV vaccines and microbicides by repeated low-dose virus challenges.

    Directory of Open Access Journals (Sweden)

    Roland R Regoes

    2005-08-01

    Full Text Available BACKGROUND: Trials in macaque models play an essential role in the evaluation of biomedical interventions that aim to prevent HIV infection, such as vaccines, microbicides, and systemic chemoprophylaxis. These trials are usually conducted with very high virus challenge doses that result in infection with certainty. However, these high challenge doses do not realistically reflect the low probability of HIV transmission in humans, and thus may rule out preventive interventions that could protect against "real life" exposures. The belief that experiments involving realistically low challenge doses require large numbers of animals has so far prevented the development of alternatives to using high challenge doses. METHODS AND FINDINGS: Using statistical power analysis, we investigate how many animals would be needed to conduct preclinical trials using low virus challenge doses. We show that experimental designs in which animals are repeatedly challenged with low doses do not require unfeasibly large numbers of animals to assess vaccine or microbicide success. CONCLUSION: Preclinical trials using repeated low-dose challenges represent a promising alternative approach to identify potential preventive interventions.

  9. Landscape dose conversion factors used in the safety assessment SR-Site

    Energy Technology Data Exchange (ETDEWEB)

    Avila, Rodolfo; Ekstroem, Per-Anders; Aastrand, Per-Gustav (Facilia AB (Sweden))

    2010-12-15

    In this report two types of Dose Conversion Factors have been derived: i) a Landscape Dose Conversion Factor (LDF) that is applicable to continuous long-term releases to the biosphere at a constant rate, and ii) a Landscape Dose Conversion Factor for pulse releases (LDF pulse) that is applicable to a radionuclide release that reaches the biosphere in a pulse within years to hundreds of years. In SR-Site these Dose Factors are multiplied with modelled release rates or pulse releases from the geosphere to obtain dose estimates used in assessment of compliance with the regulatory risk criterion. The LDFs were calculated for three different periods of the reference glacial cycle; a period of submerged conditions following the deglaciation, the temperate period, and a prolonged period of periglacial conditions. Additionally, LDFs were calculated for the global warming climate case. The LDF pulse was calculated only for temperate climate conditions. The LDF and LDF pulse can be considered as Best Estimate values, which can be used in calculations of Best Estimate values of doses to a representative individual of the most exposed group from potential releases from a future repository. A systematic analysis of the effects of system, model and parameter uncertainties on the LDFs has been carried out. This analysis has shown that the use of the derived LDF would lead to cautious or realistic dose estimates. The models and methods that were used for derivation of the LDFs and LDF pulse are also described in this report

  10. A A field test for extremity dose assessment during outages at Korean nuclear power plants.

    Science.gov (United States)

    Kim, Hee Geun; Kong, Tae Young

    2013-05-01

    During maintenance on the water chamber of a steam generator, the pressuriser heater and the pressure tube feeder in nuclear power plants, workers are likely to receive high radiation doses due to the severe workplace conditions. In particular, it is expected that workers' hands would receive the highest radiation doses because of their contact with the radioactive materials. In this study, field tests for extremity dose assessments in radiation workers undertaking contact tasks with high radiation doses were conducted during outages at pressurised water reactors and pressurised heavy water reactors in Korea. In the test, the radiation workers were required to wear additional thermoluminescent dosemeters (TLDs) on their backs and wrists and an extremity dosemeter on the finger, as well as a main TLD on the chest while performing the maintenance tasks.

  11. Study of the heterogeneity effects of lung in the evaluation of absorbed dose in radiotherapy; Estudo dos efeitos da heterogeneidade de pulmao na avaliacao da dose absorvida em radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Campos, Luciana Tourinho

    2006-02-15

    The main objective of radiotherapy is to deliver the highest possible dose to the tumour, in order to destroy it, reducing as much as possible the doses to healthy tissues adjacent to the target volume. Therefore, it is necessary to do a planning of the treatment. The more complex is the treatment, the more difficult the planning will be, demanding computation sophisticated methods in its execution, in order to consider the heterogeneities present in the human body. Additionally, with the appearing of new radiotherapeutic techniques, that used irradiation fields of small area, for instance, the intensity modulated radiotherapy, the difficulties for the execution of a reliable treatment planning, became still larger. In this work it was studied the influence of the lung heterogeneity in the planning of the curves of percentage depth dose, PDP, obtained with the Eclipse{sup R} planning system for different sizes of irradiation fields, using the correction algorithms for heterogeneities available in the planning system: modified Batho, general Batho and equivalent tissue-air ratio. A thorax phantom, manufactured in acrylic, containing a region made of cork to simulate the lung tissue, was used. The PDP curves generated by the planning system were compared to those obtained by Monte Carlo simulation and with the use of thermoluminescent, TL, dosimetry. It was verified that the algorithms used by the Eclipse{sup R} system for the correction of heterogeneity effects are not able to generate correct results for PDP curves in the case of small fields, occurring differences of up to 100%, when the 1x1 cm{sup 2} treatment field is considered. These differences can cause a considerable subdosage in the lung tissue, reducing the possibility of the patient cure. (author)

  12. Monte Carlo estimation of radiation dose in organs of female and male adult phantoms due to FDG-F18 absorbed in the lungs

    Science.gov (United States)

    Belinato, Walmir; Santos, William S.; Silva, Rogério M. V.; Souza, Divanizia N.

    2014-03-01

    The determination of dose conversion factors (S values) for the radionuclide fluorodeoxyglucose (18F-FDG) absorbed in the lungs during a positron emission tomography (PET) procedure was calculated using the Monte Carlo method (MCNPX version 2.7.0). For the obtained dose conversion factors of interest, it was considered a uniform absorption of radiopharmaceutical by the lung of a healthy adult human. The spectrum of fluorine was introduced in the input data file for the simulation. The simulation took place in two adult phantoms of both sexes, based on polygon mesh surfaces called FASH and MASH with anatomy and posture according to ICRP 89. The S values for the 22 internal organs/tissues, chosen from ICRP No. 110, for the FASH and MASH phantoms were compared with the results obtained from a MIRD V phantoms called ADAM and EVA used by the Committee on Medical Internal Radiation Dose (MIRD). We observed variation of more than 100% in S values due to structural anatomical differences in the internal organs of the MASH and FASH phantoms compared to the mathematical phantom.

  13. Monte Carlo estimation of radiation dose in organs of female and male adult phantoms due to FDG-F18 absorbed in the lungs

    Directory of Open Access Journals (Sweden)

    Belinato Walmir

    2014-03-01

    Full Text Available The determination of dose conversion factors (S values for the radionuclide fluorodeoxyglucose (18F-FDG absorbed in the lungs during a positron emission tomography (PET procedure was calculated using the Monte Carlo method (MCNPX version 2.7.0. For the obtained dose conversion factors of interest, it was considered a uniform absorption of radiopharmaceutical by the lung of a healthy adult human. The spectrum of fluorine was introduced in the input data file for the simulation. The simulation took place in two adult phantoms of both sexes, based on polygon mesh surfaces called FASH and MASH with anatomy and posture according to ICRP 89. The S values for the 22 internal organs/tissues, chosen from ICRP No. 110, for the FASH and MASH phantoms were compared with the results obtained from a MIRD V phantoms called ADAM and EVA used by the Committee on Medical Internal Radiation Dose (MIRD. We observed variation of more than 100% in S values due to structural anatomical differences in the internal organs of the MASH and FASH phantoms compared to the mathematical phantom.

  14. The influence of different contrast medium concentrations and injection protocols on quantitative and clinical assessment of FDG–PET/CT in lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Verburg, Frederik A., E-mail: fverburg@ukaachen.de [RWTH Aachen University Hospital, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen (Germany); Maastricht University Medical Center, Department of Nuclear Medicine, P. Debyelaan 25, 6229 HX Maastricht (Netherlands); Kuhl, Christiane K. [RWTH Aachen University Hospital, Department of Diagnostic and Interventional Radiology, Pauwelsstraße 30, 52074 Aachen (Germany); Pietsch, Hubertus [Bayer Pharma AG, Berlin, Müllerstrasse 178, 13353 Berlin (Germany); Palmowski, Moritz [RWTH Aachen University Hospital, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen (Germany); Mottaghy, Felix M. [RWTH Aachen University Hospital, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen (Germany); Maastricht University Medical Center, Department of Nuclear Medicine, P. Debyelaan 25, 6229 HX Maastricht (Netherlands); Behrendt, Florian F. [RWTH Aachen University Hospital, Department of Nuclear Medicine, Pauwelsstraße 30, 52074 Aachen (Germany)

    2013-10-01

    Objectives: To compare the effects of two different contrast medium concentrations for use in computed X-ray tomography (CT) employing two different injection protocols on positron emission tomography (PET) reconstruction in combined 2-{sup 18}F-desoxyglucose (FDG) PET/CT in patients with a suspicion of lung cancer. Methods: 120 patients with a suspicion of lung cancer were enrolled prospectively. PET images were reconstructed with the non-enhanced and venous phase contrast CT obtained after injection of iopromide 300 mg/ml or 370 mg/ml using either a fixed-dose or a body surface area adapted injection protocol. Maximum and mean standardized uptake values (SUVmax and SUVmean) and contrast enhancement (HU) were determined in the subclavian vein, ascending aorta, abdominal aorta, inferior vena cava, portal vein, liver and kidney and in the suspicious lung lesion. PET data were evaluated visually for the presence of malignancy and image quality. Results: At none of the sites a significant difference in the extent of the contrast enhancement between the four different protocols was found. However, the variability of the contrast enhancement at several anatomical sites was significantly greater in the fixed dose groups than in the BSA groups for both contrast medium concentrations. At none of the sites a significant difference was found in the extent of the SUVmax and SUVmean increase as a result of the use of the venous phase contrast enhanced CT for attenuation. Visual clinical evaluation of lesions showed no differences between contrast and non-contrast PET/CT (P = 0.32). Conclusions: Contrast enhanced CT for attenuation correction in combined PET/CT in lung cancer affects neither the clinical assessment nor image quality of the PET-images. A body surface adapted contrast medium protocol reduces the interpatient variability in contrast enhancement.

  15. Benchmark dose profiles for joint-action continuous data in quantitative risk assessment.

    Science.gov (United States)

    Deutsch, Roland C; Piegorsch, Walter W

    2013-09-01

    Benchmark analysis is a widely used tool in biomedical and environmental risk assessment. Therein, estimation of minimum exposure levels, called benchmark doses (BMDs), that induce a prespecified benchmark response (BMR) is well understood for the case of an adverse response to a single stimulus. For cases where two agents are studied in tandem, however, the benchmark approach is far less developed. This paper demonstrates how the benchmark modeling paradigm can be expanded from the single-agent setting to joint-action, two-agent studies. Focus is on continuous response outcomes. Extending the single-exposure setting, representations of risk are based on a joint-action dose-response model involving both agents. Based on such a model, the concept of a benchmark profile-a two-dimensional analog of the single-dose BMD at which both agents achieve the specified BMR-is defined for use in quantitative risk characterization and assessment.

  16. ACUTRI a computer code for assessing doses to the general public due to acute tritium releases

    CERN Document Server

    Yokoyama, S; Noguchi, H; Ryufuku, S; Sasaki, T

    2002-01-01

    Tritium, which is used as a fuel of a D-T burning fusion reactor, is the most important radionuclide for the safety assessment of a nuclear fusion experimental reactor such as ITER. Thus, a computer code, ACUTRI, which calculates the radiological impact of tritium released accidentally to the atmosphere, has been developed, aiming to be of use in a discussion of licensing of a fusion experimental reactor and an environmental safety evaluation method in Japan. ACUTRI calculates an individual tritium dose based on transfer models specific to tritium in the environment and ICRP dose models. In this calculation it is also possible to analyze statistically on meteorology in the same way as a conventional dose assessment method according to the meteorological guide of the Nuclear Safety Commission of Japan. A Gaussian plume model is used for calculating the atmospheric dispersion of tritium gas (HT) and/or tritiated water (HTO). The environmental pathway model in ACUTRI considers the following internal exposures: i...

  17. LOW DOSE PIRFENIDONE SUPPRESSES TRANSFORMING GROWTH FACTOR BETA-1 AND TISSUE INHIBITOR OF METALLOPROTEINASE-1,AND PROTECTS RATS FROM LUNG FIBROSIS INDUCED BY BLEOMYCIN

    Institute of Scientific and Technical Information of China (English)

    Xin-lun Tian; Wei Yao; Zi-jian Guo; Li Gu; Yuan-jue Zhu

    2006-01-01

    Objective To investigate the optimal dosage of pirfenidone for the treatment of pulmonary fibrosis induced by bleomycin in Wistar rats, and the alteration of expressions of transforming growth factor beta-1 (TGF-β1), tissue inhibitor of metalloproteinase-1 (TIMP-1), and matrix metalloproteinase-13 (MMP-13) in lung tissue.Methods Male Wistar rats were endotracheally instilled with bleomycin or normal saline. Pirfenidone (25-800 mg·kg-1·d-1), dexamethasone (3 mg/kg), or 1% carboxymethylcellulose sodium were given daily by feed 2 days before instillation of bleomycin. Groups T7 and T14 were fed pirfenidone 50 mg·kg -1·d-1 at 7 days or 14 days after bleomycin instillation. Lungs were harvested at 28 days after bleomycin instillation. Patholological changes in lung tissues were evaluated with HE staining. Lung collagen was stained by sirius red and measured by content of hydroxyproline. Expression of proteins of TGF-β, TIMP-1, and MMP-13 were detected by Western blotting.Results At doses of 25, 50, and 100 mg·kg-1·d-1, pirfenidone had significant anti-fibrofic effects for bleomycin-induced rat pulmonary fibrosis, and these effects were most significantly attenuated at the dosage of 50mg·kg-1 1d-1 (HE: P<0.01, P<0.01, and P =0.064; sirius red: P<0.05, P<0.01, and P<0. 05; hydroxyproline: P=0.595, P<0.01, and P=0.976). Pirfenidone at a dosage of 50 mg·kg -1·d-1 inhibited protein expression of TGF-β1 and TIMP-1 in lung tissue in the early phase (0.79 and 0.75 times of control group), but had no effect on expression of MMP-13.Conclusion Low dose pirfenidone, especially at dosage of 50 mg·kg-1·d-1, has significant anti-fibrotic effects on bleomycin-induced rat pulmonary fibrosis. Pirfenidone partially inhibits the enhancement of the expression of TGF-β1 and TIMP-1 in lung tissue.

  18. Skin Dose Assessment Methodology for Military Personnel at McMurdo Station, Antarctica (1962-1979)

    Science.gov (United States)

    2014-06-01

    Military Personnel at McMurdo Station, Antarctica (1962-1979) Approved for public release: distribution is unlimited. June 2014 Prepared by...From - To) 4. TITLE AND SUBTITLE Skin Dose Assessment Methodology for Military Personnel at McMurdo Station, Antarctica (1962-1979) 5a. CONTRACT... Antarctica (1962-1979) Table of Contents List of Tables

  19. Committed dose assessment based on background outdoor gamma exposure in Chihuahua City, Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Luevano G, S.; Perez T, A.; Pinedo A, C.; Renteria V, M. [Universidad Autonoma de Chihuahua, Facultad de Zootecnia y Ecologia, Perif. Francisco R. Almada Km 1, 31415 Chihuahua, Chih. (Mexico); Carrillo F, J.; Montero C, M. E., E-mail: mrenteria@uach.mx [Centro de Investigacion en Materiales Avanzados, Miguel de Cervantes 120, 31136 Chihuahua, Chih. (Mexico)

    2015-10-15

    Full text: Determining ionizing radiation in a geographic area serves to assess its effects on populations health. The aim of this study was to evaluate the spatial distribution of the background environmental outdoor gamma dose rates in Chihuahua City. This study also estimated the committed dose and the lifetime cancer risks of the population of this city. To determine the outdoor gamma dose rate in air, annual effective dose, and the lifetime cancer risk, 48 sampling points were randomly selected along the Chihuahua City. Outdoor gamma dose rate measurements were carried out by using a Geiger-Muller counter. At the same sites, 48 soil samples were taken to obtain the activity concentrations of {sup 226}Ra, {sup 232}Th, {sup 40}K and their terrestrial gamma dose rates. Radioisotope activity concentrations were determined by gamma spectrometry. Outdoor gamma dose rates ranged from 56 to 193 n Gy h{sup -1}. Results indicated that lifetime effective dose to inhabitants of Chihuahua City is in average of 19.8 mSv, resulting in a lifetime cancer risk of 0.001. In addition, the mean of activity concentrations in soil were 51.8, 73.1, and 1096.5 Bq kg{sup -1}, of {sup 226}Ra, {sup 232}Th and {sup 40}K, respectively. From the analysis of the spatial distribution of {sup 232}Th, {sup 226}Ra, and {sup 40}K is to north, to north-center, and to south of city, respectively. In conclusion, natural background gamma dose received by inhabitants of Chihuahua City is high and mainly due to geological characteristics of the zone. (Author)

  20. Development of environmental dose assessment system (EDAS) code of PC version

    Energy Technology Data Exchange (ETDEWEB)

    Taki, Mitsumasa; Kikuchi, Masamitsu; Kobayashi, Hideo; Yamaguchi, Takenori [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment

    2003-05-01

    A computer code (EDAS) was developed to assess the public dose for the safety assessment to get the license of nuclear reactor operation. This code system is used for the safety analysis of public around the nuclear reactor in normal operation and severe accident. This code was revised and composed for personal computer user according to the Nuclear Safety Guidelines reflected the ICRP1990 recommendation. These guidelines are revised by Nuclear Safety Commission on March, 2001, which are 'Weather analysis guideline for the safety assessment of nuclear power reactor', 'Public dose around the facility assessment guideline corresponding to the objective value for nuclear power light water reactor' and 'Public dose assessment guideline for safety review of nuclear power light water reactor'. This code has been already opened for public user by JAERI, and English version code and user manual are also prepared. This English version code is helpful for international cooperation concerning the nuclear safety assessment with JAERI. (author)

  1. Accuracy and precision of perfusion lung scintigraphy versus {sup 133}Xe-radiospirometry for preoperative pulmonary functional assessment of patients with lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mariano-Goulart, Denis [Montpellier University Hospital, Department of Nuclear Medicine, Montpellier (France); Service Central de Medecine Nucleaire, CHU Lapeyronie, Montpellier Cedex 5 (France); Barbotte, Eric; Basurko, Celia [Montpellier University Hospital, Department of Statistics and Epidemiology, Montpellier (France); Comte, F.; Rossi, Michel [Montpellier University Hospital, Department of Nuclear Medicine, Montpellier (France)

    2006-09-15

    Purpose: This study sought to determine whether {sup 133}Xe-radiospirometry (XRS) successfully selects patients able to undergo lung resection without postoperative respiratory complications and whether perfusion lung scintigraphy (PLS) is likely to provide a similar selection of patients for certain tumour stages. Methods: Two hundred and eighty-four patients with resectable lung cancer underwent preoperative assessment of postoperative forced expiratory volume in 1 s (FEV{sub 1}) by XRS and PLS. Correlations, Bland and Altman analysis and contingency tables were used to analyse the difference between the two predictive techniques. One hundred and sixty patients underwent lung resection on the basis of XRS preoperative testing only. None of them developed respiratory insufficiency. Despite a close correlation, the limits of agreement between predicted FEV{sub 1} by XRS and PLS exceeded {+-}0.3 l/s. For tumour stages T1Nx and T2N0, PLS underestimated postoperative FEV{sub 1} whereas it overestimated this parameter for stage III. XRS accurately selects patients able to undergo lung resection without postoperative pulmonary insufficiency. The agreement between XRS and PLS is unacceptable. When only PLS is available, higher thresholds for patients with stage III cancers and lower thresholds for those with stage I cancers should be used to decide on operability. (orig.)

  2. SU-E-T-322: Dosimetric Evaluation of Rib Dose in Peripheral Lung Tumors Treated with X-Ray Voxel Monte Carlo (XVMC) Based Lung Stereotactic Body Radiotherapy (SBRT) Following RTOG 0915 Guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Pokhrel, D; Sood, S; Badkul, R; Jiang, H; Kumar, P; Wang, F [University of Kansas Hospital, Kansas City, KS (United States)

    2015-06-15

    Purpose: To evaluate XVMC computed rib doses for peripherally located non-small-cell-lung tumors treated with SBRT following RTOG-0915 guidelines. Methods: Twenty patients with solitary peripherally located non-small-cell-lung tumors were treated using XVMC-based SBRT to 50–54Gy in 5−3 fractions, respectively, for PTV(V100%)=95%. Based on 4D-CT, ITV was delineated on MaximumIP images and organs-at-risk(OARs) including ribs were contoured on MeanIP images. Mean PTV(ITV+5mm uniform margin) was 46.1±38.7cc (range, 11.1–163.0cc). XVMC SBRT treatment plans were generated with a combination of non-coplanar 3D-conformal arcs/beams, and were delivered by Novalis-TX consisting of HD-MLCs and a 6MV-SRS(1000MU/min) beam, following RTOG-0915 criteria. XVMC rib maximum dose and dose to <1cc, <5cc, <10cc were evaluated as a function of PTV, prescription dose and 3D-distance from tumor isocenter to the most proximal rib contour. Plans were re-computed using heterogeneity-corrected pencil-beam (PB-hete) algorithm utilizing identical beam geometry/MLC positions and MUs and subsequently compared to XVMC. Results: XVMC average maximum rib dose was 50.9±6.4Gy (range, 35.1–59.3Gy). XVMC mean rib dose to <1cc was 41.6±5.6Gy (range, 27.9–47.9Gy), <5cc was 31.2±7.3Gy (range, 10.6–43.1Gy), and <10cc was 21.2±8.7Gy (range, 1.1–36Gy), respectively. For the given prescription, correlation between PTV and rib doses to <5cc (p=0.005) and <10cc (p=0.018) was observed. 3D-distance from the tumor isocenter to the proximal rib contour strongly correlated with maximum rib dose (p=0.0001). PB-hete algorithm overestimated maximum rib dose and dose to <1cc, <5cc, and <10cc of ribs by 5%, 3%, 3%, and 3%, respectively. Conclusion: PB-hete overestimates ribs dose relative to XVMC. Since all the clinical XVMC plans were generated without compromising the target coverage (per RTOG-0915), almost all patient’s ribs doses were higher than the protocol guidelines. As expected, larger tumor

  3. Clinical evaluation of a dose monitoring software tool based on Monte Carlo Simulation in assessment of eye lens doses for cranial CT scans

    Energy Technology Data Exchange (ETDEWEB)

    Guberina, Nika; Suntharalingam, Saravanabavaan; Nassenstein, Kai; Forsting, Michael; Theysohn, Jens; Wetter, Axel; Ringelstein, Adrian [University Hospital Essen, Institute of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany)

    2016-10-15

    The aim of this study was to verify the results of a dose monitoring software tool based on Monte Carlo Simulation (MCS) in assessment of eye lens doses for cranial CT scans. In cooperation with the Federal Office for Radiation Protection (Neuherberg, Germany), phantom measurements were performed with thermoluminescence dosimeters (TLD LiF:Mg,Ti) using cranial CT protocols: (I) CT angiography; (II) unenhanced, cranial CT scans with gantry angulation at a single and (III) without gantry angulation at a dual source CT scanner. Eye lens doses calculated by the dose monitoring tool based on MCS and assessed with TLDs were compared. Eye lens doses are summarized as follows: (I) CT angiography (a) MCS 7 mSv, (b) TLD 5 mSv; (II) unenhanced, cranial CT scan with gantry angulation, (c) MCS 45 mSv, (d) TLD 5 mSv; (III) unenhanced, cranial CT scan without gantry angulation (e) MCS 38 mSv, (f) TLD 35 mSv. Intermodality comparison shows an inaccurate calculation of eye lens doses in unenhanced cranial CT protocols at the single source CT scanner due to the disregard of gantry angulation. On the contrary, the dose monitoring tool showed an accurate calculation of eye lens doses at the dual source CT scanner without gantry angulation and for CT angiography examinations. The dose monitoring software tool based on MCS gave accurate estimates of eye lens doses in cranial CT protocols. However, knowledge of protocol and software specific influences is crucial for correct assessment of eye lens doses in routine clinical use. (orig.)

  4. Assessment of lung function using a non-invasive oscillating gas-forcing technique.

    Science.gov (United States)

    Clifton, Lei; Clifton, David A; Hahn, Clive E W; Farmery, Andrew D

    2013-10-01

    Conventional methods for monitoring lung function can require complex, or special, gas analysers, and may therefore not be practical in clinical areas such as the intensive care unit (ICU) or operating theatre. The system proposed in this article is a compact and non-invasive system for the measurement and monitoring of lung variables, such as alveolar volume, airway dead space, and pulmonary blood flow. In contrast with conventional methods, the compact apparatus and non-invasive nature of the proposed method could eventually allow it to be used in the ICU, as well as in general clinical settings. We also propose a novel tidal ventilation model using a non-invasive oscillating gas-forcing technique, where both nitrous oxide and oxygen are used as indicator gases. Experimental results are obtained from healthy volunteers, and are compared with those obtained using a conventional continuous ventilation model. Our findings show that the proposed technique can be used to assess lung function, and has several advantages over conventional methods such as compact and portable apparatus, easy usage, and quick estimation of cardiopulmonary variables.

  5. Assessment of a new e-learning system on thorax, trachea, and lung ultrasound.

    Science.gov (United States)

    Cuca, Colleen; Scheiermann, Patrick; Hempel, Dorothea; Via, Gabriele; Seibel, Armin; Barth, Magnus; Hirche, Tim O; Walcher, Felix; Breitkreutz, Raoul

    2013-01-01

    Background. Lung ultrasound has become an emerging tool in acute and critical care medicine. Combined theoretical and hands-on training has been required to teach ultrasound diagnostics. Current computer technology allows for display, explanation, and animation of information in a remote-learning environment. Objective. Development and assessment of an e-learning program for lung ultrasound. Methods. An interactive online tutorial was created. A prospective learning success study was conducted with medical students using a multiple-choice test (Trial A). This e-learning program was used as preparation for a certified course followed by an evaluation of trained doctors (Trial B) by linear analogue scales. Pretests were compared with postcourse tests and sustainability tests as well as a posttest of a one-day custom classroom training. Results. In Trial A, during the learning success study (n = 29), the increase of correct answers was 11.7 to 17/20 in the post-test and to 16.6/20 in the sustainability test (relative change 45.1%, P < 0.0001). E-learning almost equalled scores of classroom-based training regarding gain and retention of factual knowledge. In Trial B, nineteen participating doctors found a 79.5% increase of knowledge (median, 95% CI: 69%; 88%). Conclusion. The basics of lung ultrasound can be taught in a highly effective manner using e-learning.

  6. Assessment of a New E-Learning System on Thorax, Trachea, and Lung Ultrasound

    Directory of Open Access Journals (Sweden)

    Colleen Cuca

    2013-01-01

    Full Text Available Background. Lung ultrasound has become an emerging tool in acute and critical care medicine. Combined theoretical and hands-on training has been required to teach ultrasound diagnostics. Current computer technology allows for display, explanation, and animation of information in a remote-learning environment. Objective. Development and assessment of an e-learning program for lung ultrasound. Methods. An interactive online tutorial was created. A prospective learning success study was conducted with medical students using a multiple-choice test (Trial A. This e-learning program was used as preparation for a certified course followed by an evaluation of trained doctors (Trial B by linear analogue scales. Pretests were compared with postcourse tests and sustainability tests as well as a posttest of a one-day custom classroom training. Results. In Trial A, during the learning success study (n=29, the increase of correct answers was 11.7 to 17/20 in the post-test and to 16.6/20 in the sustainability test (relative change 45.1%, P<0.0001. E-learning almost equalled scores of classroom-based training regarding gain and retention of factual knowledge. In Trial B, nineteen participating doctors found a 79.5% increase of knowledge (median, 95% CI: 69%; 88%. Conclusion. The basics of lung ultrasound can be taught in a highly effective manner using e-learning.

  7. Cystic fibrosis lung disease: genetic influences, microbial interactions, and radiological assessment

    Energy Technology Data Exchange (ETDEWEB)

    Moskowitz, Samuel M.; Gibson, Ronald L. [University of Washington, Department of Pediatrics, Seattle, WA (United States); Effmann, Eric L. [University of Washington School of Medicine, Children' s Hospital and Regional Medical Center, Department of Radiology, Seattle, WA (United States)

    2005-08-01

    Cystic fibrosis (CF) is a multiorgan disease caused by mutation of the CF transmembrane conductance regulator (CFTR) gene. Obstructive lung disease is the predominant cause of morbidity and mortality; thus, most efforts to improve outcomes are directed toward slowing or halting lung-disease progression. Current therapies, such as mucolytics, airway clearance techniques, bronchodilators, and antibiotics, aim to suppress airway inflammation and the processes that stimulate it, namely, retention and infection of mucus plaques at the airway surface. New approaches to therapy that aim to ameliorate specific CFTR mutations or mutational classes by restoring normal expression or function are being investigated. Because of its sensitivity in detecting changes associated with early airway obstruction and regional lung disease, high-resolution CT (HRCT) complements pulmonary function testing in defining disease natural history and measuring response to both conventional and experimental therapies. In this review, perspectives on the genetics and microbiology of CF provide a context for understanding the increasing importance of HRCT and other imaging techniques in assessing CF therapies. (orig.)

  8. Radioactivity in food and the environment: calculations of UK radiation doses using integrated assessment methods

    Energy Technology Data Exchange (ETDEWEB)

    Camplin, W C; Brownless, G P; Round, G D; Winpenny, K; Hunt, G J [Centre for Environment, Fisheries and Aquaculture Science, CEFAS Laboratory, Lowestoft (United Kingdom)

    2002-12-01

    A new method for estimating radiation doses to UK critical groups is proposed for discussion. Amongst others, the Food Standards Agency (FSA) and the Scottish Environment Protection Agency (SEPA) undertake surveillance of UK food and the environment as a check on the effect of discharges of radioactive wastes. Discharges in gaseous and liquid form are made under authorisation by the Environment Agency and SEPA under powers in the Radioactive Substance Act. Results of surveillance by the FSA and SEPA are published in the Radioactivity in Food and the Environment (RIFE) report series. In these reports, doses to critical groups are normally estimated separately for gaseous and liquid discharge pathways. Simple summation of these doses would tend to overestimate doses actually received. Three different methods of combining the effects of both types of discharge in an integrated assessment are considered and ranked according to their ease of application, transparency, scientific rigour and presentational issues. A single integrated assessment method is then chosen for further study. Doses are calculated for surveillance data for the calendar year 2000 and compared with those from the existing RIFE method.

  9. Assessment of Concentration and the Annual Effective Dose of Radon Gas in Imam Hospital Indoor Air

    Directory of Open Access Journals (Sweden)

    Kobra Verijkazemi

    2016-09-01

    Full Text Available Introduction and purpose: Exposure to natural sources of radiation, especially radon and its short-term products, is an important issue around the world. Radon exposure causes lung cancer in humans. Therefore, the aim of this study was to measure the concentration of radon gas and its annual effective dose in Imam Hospital of Tehran, Iran and to compare its concentrations with the recommended standards. Methods: Radon levels and meteorological parameters (temperature, pressure, and moisture were measured in different levels and in four seasons, using Radstar and Lutron Electronic devices, respectively, during June 2014-June 2015. The collected data were analyzed through SPSS 18. Annual effective dose was calculated, using the equation for annual effective dose introduced by Scientific Committee of the United Nations. Results: The highest concentration of radon and annual effective dose were observed in the winter, which were 82/15 Bq/m3 and0/48 ms/y, respectively. Furthermore, concerning the various levels, the highest concentration was observed in the lowest level (56/1 Bq/m3.Conclusion: The results of the current study demonstrated that radon concentration was lower than the standards set by Environmental Protection Agency and World Health Organization. Regarding this, there are not concerns about the possible dangers of radon gas activities for the personnel and patients of the hospital. 

  10. Mimicking lung dose by wire-mesh-capped deposition sensors: a new dosimetric strategy of radon (thoron) decay products.

    Science.gov (United States)

    Mishra, Rosaline; Mayya, Y S; Tommasino, L

    2012-06-01

    The dose conversion factor (DCF) of radon decay products may vary by a factor of ∼40 within the particle size range from ∼0.5 nm to tens of micrometres. An ideal detector should have a response, which closely mimics the strong dependence of the DCF on the particle size. This dependence is essentially determined by the different deposition rates of the particles with different sizes on the trachea-bronchial tree and alveoli. These deposition rates versus the particle sizes are similar to those of the decay products onto indoor surfaces. These conclusions are conducive to a new strategy for the dosimetry of radon (thoron) decay products, which is simply based on the detection of decay products deposited on flat surfaces. The dependence of the deposition rate of radon decay products onto flat surfaces versus the particle size is necessarily different from that of the deposition rate on the trachea-bronchial region, especially for particle sizes smaller than a few nanometres and larger than a few micrometres. In the present work, in order to obtain a better mimic between the measurement of flat-surface-deposited radon (thoron) decay products and the DCF at any given particle size, a suitable screen is placed against the surrogate surface, used for the assessment of the radon (thoron) decay products deposition.

  11. Assessment of radiation dose in nuclear cardiovascular imaging using realistic computational models

    Energy Technology Data Exchange (ETDEWEB)

    Xie, Tianwu [Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva 4 CH-1211 (Switzerland); Lee, Choonsik [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institute of Health, Bethesda, Maryland 20852 (United States); Bolch, Wesley E. [Departments of Nuclear and Radiological and Biomedical Engineering, University of Florida, Gainesville, Florida 32611 (United States); Zaidi, Habib, E-mail: habib.zaidi@hcuge.ch [Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospital, Geneva 4 CH-1211 (Switzerland); Geneva Neuroscience Center, Geneva University, Geneva CH-1205 (Switzerland); Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen 9700 RB (Netherlands)

    2015-06-15

    Purpose: Nuclear cardiology plays an important role in clinical assessment and has enormous impact on the management of a variety of cardiovascular diseases. Pediatric patients at different age groups are exposed to a spectrum of radiation dose levels and associated cancer risks different from those of adults in diagnostic nuclear medicine procedures. Therefore, comprehensive radiation dosimetry evaluations for commonly used myocardial perfusion imaging (MPI) and viability radiotracers in target population (children and adults) at different age groups are highly desired. Methods: Using Monte Carlo calculations and biological effects of ionizing radiation VII model, we calculate the S-values for a number of radionuclides (Tl-201, Tc-99m, I-123, C-11, N-13, O-15, F-18, and Rb-82) and estimate the absorbed dose and effective dose for 12 MPI radiotracers in computational models including the newborn, 1-, 5-, 10-, 15-yr-old, and adult male and female computational phantoms. Results: For most organs, {sup 201}Tl produces the highest absorbed dose whereas {sup 82}Rb and {sup 15}O-water produce the lowest absorbed dose. For the newborn baby and adult patient, the effective dose of {sup 82}Rb is 48% and 77% lower than that of {sup 99m}Tc-tetrofosmin (rest), respectively. Conclusions: {sup 82}Rb results in lower effective dose in adults compared to {sup 99m}Tc-labeled tracers. However, this advantage is less apparent in children. The produced dosimetric databases for various radiotracers used in cardiovascular imaging, using new generation of computational models, can be used for risk-benefit assessment of a spectrum of patient population in clinical nuclear cardiology practice.

  12. Assessment of the effectiveness of radon screening programs in reducing lung cancer mortality.

    Science.gov (United States)

    Gagnon, Fabien; Courchesne, Mathieu; Lévesque, Benoît; Ayotte, Pierre; Leclerc, Jean-Marc; Belles-Isles, Jean-Claude; Prévost, Claude; Dessau, Jean-Claude

    2008-10-01

    The present study was aimed at assessing the health consequences of the presence of radon in Quebec homes and the possible impact of various screening programs on lung cancer mortality. Lung cancer risk due to this radioactive gas was estimated according to the cancer risk model developed by the Sixth Committee on Biological Effects of Ionizing Radiations. Objective data on residential radon exposure, population mobility, and tobacco use in the study population were integrated into a Monte-Carlo-type model. Participation rates to radon screening programs were estimated from published data. According to the model used, approximately 10% of deaths due to lung cancer are attributable to residential radon exposure on a yearly basis in Quebec. In the long term, the promotion of a universal screening program would prevent less than one death/year on a province-wide scale (0.8 case; IC 99%: -3.6 to 5.2 cases/year), for an overall reduction of 0.19% in radon-related mortality. Reductions in mortality due to radon by (1) the implementation of a targeted screening program in the region with the highest concentrations, (2) the promotion of screening on a local basis with financial support, or (3) the realization of systematic investigations in primary and secondary schools would increase to 1%, 14%, and 16.4%, respectively, in the each of the populations targeted by these scenarios. Other than the battle against tobacco use, radon screening in public buildings thus currently appears as the most promising screening policy for reducing radon-related lung cancer.

  13. Radiation dose assessment in a 320-detector-row CT scanner used in cardiac imaging

    Energy Technology Data Exchange (ETDEWEB)

    Goma, Carles; Ruiz, Agustin; Jornet, Nuria; Latorre, Artur; Pallerol, Rosa M.; Carrasco, Pablo; Eudaldo, Teresa; Ribas, Montserrat [Servei de Radiofisica i Radioproteccio, Hospital de la Santa Creu i Sant Pau, Sant Antoni Maria Claret 167, 08025 Barcelona (Spain)

    2011-03-15

    Purpose: In the present era of cone-beam CT scanners, the use of the standardized CTDI{sub 100} as a surrogate of the idealized CTDI is strongly discouraged and, consequently, so should be the use of the dose-length product (DLP) as an estimate of the total energy imparted to the patient. However, the DLP is still widely used as a reference quantity to normalize the effective dose for a given scan protocol mainly because the CTDI{sub 100} is an easy-to-measure quantity. The aim of this article is therefore to describe a method for radiation dose assessment in large cone-beam single axial scans, which leads to a straightforward estimation of the total energy imparted to the patient. The authors developed a method accessible to all medical physicists and easy to implement in clinical practice in an attempt to update the bridge between CT dosimetry and the estimation of the effective dose. Methods: The authors used commercially available material and a simple mathematical model. The method described herein is based on the dosimetry paradigm introduced by the AAPM Task Group 111. It consists of measuring the dose profiles at the center and the periphery of a long body phantom with a commercial solid-state detector. A weighted dose profile is then calculated from these measurements. To calculate the CT dosimetric quantities analytically, a Gaussian function was fitted to the dose profile data. Furthermore, the Gaussian model has the power to condense the z-axis information of the dose profile in two parameters: The single-scan central dose, f(0), and the width of the profile, {sigma}. To check the energy dependence of the solid-state detector, the authors compared the dose profiles to measurements made with a small volume ion chamber. To validate the overall method, the authors compared the CTDI{sub 100} calculated analytically to the measurement made with a 100 mm pencil ion chamber. Results: For the central and weighted dose profiles, the authors found a good

  14. Effect of dose rate and multiple fractions per day on radiation-induced lung damage in mice

    Energy Technology Data Exchange (ETDEWEB)

    Collis, C.H.; Down, J.D. (Institute of Cancer Research, Sutton (UK). Surrey Branch)

    1984-11-01

    Acute single and fractionated exposures were carried out at a fixed dose rate, 1 Gy min/sup -1/, and exposure times therefore ranged from 10 to 28 min. For low dose-rate continuous irradiation, the overall treatment time (2, 4 or 8 h) was kept constant and the various test doses obtained by varying the dose rate. Rates ranged from 11.7 to 18.3 cGy min/sup -1/ for the 2-h exposure, from 6.7 to 11.7 cGy min/sup -1/ for the 4-h exposure, and from 3.7 to 6.7 cGy min/sup -1/ for the 8-h exposure. Results confirmed (a) the marked dose-sparing effect of fractionation even over short time intervals, and (b) that still greater sparing is obtained by low dose-rate irradiation.

  15. Relevance of a Geriatric Assessment for Elderly Patients With Lung Cancer-A Systematic Review.

    Science.gov (United States)

    Schulkes, Karlijn J G; Hamaker, Marije E; van den Bos, Frederiek; van Elden, Leontine J R

    2016-09-01

    Lung cancer is predominantly a disease of the elderly: one half of all newly diagnosed patients will be > 70 years old. In the Netherlands, > 12,000 new cases are diagnosed annually. We sought to assemble all available evidence on the relevance of a geriatric assessment for lung cancer patients. A systematic Medline and Embase search was performed for studies in which a geriatric assessment was used to detect health issues or that had addressed the association between a baseline geriatric assessment (composed of ≥ 2 of the following domains: cognitive function, mood/depression, nutritional status, activities of daily living, instrumental activities of daily living, polypharmacy, objectively measured physical capacity, social support and frailty) and outcome. A total of 23 publications from 18 studies were included. The median age of patients was 76 years (range, 73-81 years). Despite generally good Eastern Cooperative Oncology Group performance status, the prevalence of geriatric impairments was high, with the median ranging from 29% for cognitive impairment to 70% for instrumental activities of daily living impairment. Objective physical capacity and nutritional status, as items of the geriatric assessment, had a consistent association with mortality. The information revealed by a geriatric assessment led to changes in oncologic treatment and nononcologic interventions. The present review has demonstrated that a geriatric assessment can detect multiple health issues not reflected in the Eastern Cooperative Oncology Group performance status. Impairments in geriatric domains have predictive value for mortality and appear to be associated with treatment completion. It would be useful to develop and validate an individualized treatment algorithm that includes these geriatric domains.

  16. Assessment of the occupational eye lens dose for clinical staff in interventional radiology, cardiology and neuroradiology.

    Science.gov (United States)

    Omar, Artur; Kadesjö, Nils; Palmgren, Charlotta; Marteinsdottir, Maria; Segerdahl, Tony; Fransson, Annette

    2017-03-20

    In accordance with recommendations by the International Commission on Radiological Protection, the current European Basic Safety Standards has adopted a reduced occupational eye lens dose limit of 20 mSv yr(-1). The radiation safety implications of this dose limit is of concern for clinical staff that work with relatively high dose x-ray angiography and interventional radiology. Presented in this work is a thorough assessment of the occupational eye lens dose based on clinical measurements with active personal dosimeters worn by staff during various types of procedures in interventional radiology, cardiology and neuroradiology. Results are presented in terms of the estimated equivalent eye lens dose for various medical professions. In order to compare the risk of exceeding the regulatory annual eye lens dose limit for the widely different clinical situations investigated in this work, the different medical professions were separated into categories based on their distinct work pattern: staff that work (a) regularly beside the patient, (b) in proximity to the patient and (c) typically at a distance from the patient. The results demonstrate that the risk of exceeding the annual eye lens dose limit is of concern for staff category (a), i.e. mainly the primary radiologist/cardiologist. However, the results also demonstrate that the risk can be greatly mitigated if radiation protection shields are used in the clinical routine. The results presented in this work cover a wide range of clinical situations, and can be used as a first indication of the risk of exceeding the annual eye lens dose limit for staff at other medical centres.

  17. Internal dose assessment due to large area contamination: Main lessons drawn from the Chernobyl accident

    Energy Technology Data Exchange (ETDEWEB)

    Andrasi, A. [KFKI Atomic Energy Research Inst., Budapest (Hungary)

    1997-03-01

    The reactor accident at Chernobyl in 1986 beside its serious and tragic consequences provided also an excellent opportunity to check, test and validate all kind of environmental models and calculation tools which were available in the emergency preparedness systems of different countries. Assessment of internal and external doses due to the accident has been carried out for the population all over Europe using different methods. Dose predictions based on environmental model calculation considering various pathways have been compared with those obtained by more direct monitoring methods. One study from Hungary and one from the TAEA is presented shortly. (orig./DG)

  18. Combination chemotherapy with intermittent erlotinib and pemetrexed for pretreated patients with advanced non-small cell lung cancer: a phase I dose-finding study

    Directory of Open Access Journals (Sweden)

    Minami Seigo

    2012-07-01

    Full Text Available Abstract Background Erlotinib and pemetrexed have been approved for the second-line treatment of non-small cell lung cancer (NSCLC. These two agents have different mechanisms of action. Combined treatment with erlotinib and pemetrexed could potentially augment the antitumor activity of either agent alone. In the present study, we investigated the safety profile of combined administration of the two agents in pretreated NSCLC patients. Methods A phase I dose-finding study (Trial registration: UMIN000002900 was performed in patients with stage III/IV nonsquamous NSCLC whose disease had progressed on or after receiving first-line chemotherapy. Patients received 500 mg/m2 of pemetrexed intravenously every 21 days and erlotinib (100 mg at Level 1 and 150 mg at Level 2 orally on days 2–16. Results Twelve patients, nine males and three females, were recruited. Patient characteristics included a median age of 66 years (range, 48–78 years, stage IV disease (nine cases, adenocarcinoma (seven cases and activating mutation-positives in the epidermal growth factor receptor gene (two cases. Treatment was well-tolerated, and the recommended dose of erlotinib was fixed at 150 mg. Dose-limiting toxicities were experienced in three patients and included: grade 3 elevation of serum alanine aminotransferase, repetitive grade 4 neutropenia that required reduction of the second dose of pemetrexed and grade 3 diarrhea. No patient experienced drug-induced interstitial lung disease. Three patients achieved a partial response and stable disease was maintained in five patients. Conclusions Combination chemotherapy of intermittent erlotinib with pemetrexed was well-tolerated, with promising efficacy against pretreated advanced nonsquamous NSCLC.

  19. Hazard identification and characterisation, and dose response assessment of spore forming pathogens in cooked chilled food containing vegetables

    NARCIS (Netherlands)

    Leusden FM van; MGB

    2001-01-01

    A hazard identification and characterisation, including a preliminary dose response assessment, of sporeforming pathogens in cooked chilled food containing vegetables was performed according to the structure and principles for a quantitative microbiological risk assessment as described by the Codex

  20. Assessment of DNA damage of Lewis lung carcinoma cells irradiated by carbon ions and X-rays using alkaline comet assay

    Science.gov (United States)

    Li, Ping; Zhou, Li-Bin; Jin, Xiao-Dong; He, Jing; Dai, Zhong-Ying; Zhou, Guang-Ming; Gao, Qing-Xiang; Li, Sha; Li, Qiang

    2008-01-01

    DNA damage and cell reproductive death determined by alkaline comet and clonogenic survival assays were examined in Lewis lung carcinoma cells after exposure to 89.63 MeV/u carbon ion and 6 MV X-ray irradiations, respectively. Based on the survival data, Lewis lung carcinoma cells were verified to be more radiosensitive to the carbon ion beam than to the X-ray irradiation. The relative biological effectiveness (RBE) value, which was up to 1.77 at 10% survival level, showed that the DNA damage induced by the high-LET carbon ion beam was more remarkable than that induced by the low-LET X-ray irradiation. The dose response curves of “Tail DNA (%)” (TD) and “Olive tail moment” (OTM) for the carbon ion irradiation showed saturation beyond about 8 Gy. This behavior was not found in the X-ray curves. Additionally, the carbon ion beam produced a lower survival fraction at 2 Gy (SF2) value and a higher initial Olive tail moment 2 Gy (OTM2) than those for the X-ray irradiation. These results suggest that carbon ion beams having high-LET values produced more severe cell reproductive death and DNA damage in Lewis lung carcinoma cells in comparison with X-rays and comet assay might be an effective predictive test even combining with clonogenic assay to assess cellular radiosensitivity.

  1. Stereological assessment of mouse lung parenchyma via nondestructive, multiscale micro-CT imaging validated by light microscopic histology.

    Science.gov (United States)

    Vasilescu, Dragos M; Klinge, Christine; Knudsen, Lars; Yin, Leilei; Wang, Ge; Weibel, Ewald R; Ochs, Matthias; Hoffman, Eric A

    2013-03-15

    Quantitative assessment of the lung microstructure using standard stereological methods such as volume fractions of tissue, alveolar surface area, or number of alveoli, are essential for understanding the state of normal and diseased lung. These measures are traditionally obtained from histological sections of the lung tissue, a process that ultimately destroys the three-dimensional (3-D) anatomy of the tissue. In comparison, a novel X-ray-based imaging method that allows nondestructive sectioning and imaging of fixed lungs at multiple resolutions can overcome this limitation. Scanning of the whole lung at high resolution and subsequent regional sampling at ultrahigh resolution without physically dissecting the organ allows the application of design-based stereology for assessment of the whole lung structure. Here we validate multiple stereological estimates performed on micro-computed tomography (μCT) images by comparing them with those obtained via conventional histology on the same mouse lungs. We explore and discuss the potentials and limitations of the two approaches. Histological examination offers higher resolution and the qualitative differentiation of tissues by staining, but ultimately loses 3-D tissue relationships, whereas μCT allows for the integration of morphometric data with the spatial complexity of lung structure. However, μCT has limited resolution satisfactory for the sterological estimates presented in this study but not for differentiation of tissues. We conclude that introducing stereological methods in μCT studies adds value by providing quantitative information on internal structures while not curtailing more complex approaches to the study of lung architecture in the context of physiological or pathological studies.

  2. Spontaneous and Dosing Route-related Lung Lesions in Beagle Dogs from Oral Gavage and Inhalation Toxicity Studies: Differentiation from Compound-induced Lesions.

    Science.gov (United States)

    Mukaratirwa, Sydney; Garcia, Begonya; Isobe, Kaori; Petterino, Claudio; Bradley, Alys

    2016-10-01

    This study was conducted to characterize lung microscopic lesions in control beagle dogs from inhalation and oral gavage toxicity studies, to determine differences associated with the route of administration, and to discuss distinguishing features from compound-induced lung lesions. Samples from 138 control dogs from oral gavage studies and 124 control dogs from inhalation (vehicle control) studies were evaluated microscopically. There was no significant sex-related difference in the incidence of all lesions. Perivascular mononuclear cell infiltration, centriacinar mixed cell infiltration, bronchopneumonia, subpleural septal fibrosis, and alveolar macrophage accumulation were the most common lesions. Aspiration pneumonia was more common in dogs from gavage studies, suggesting reflux after gavage dosing or accidental administration of test formulation as possible causes. Centriacinar mixed cell infiltration was more common in dogs from inhalation studies, suggesting mild irritation by the vehicles used. Vascular lesions, which included pulmonary arteriopathy and smooth muscle mineralization, were observed in a few animals. Some of the spontaneous lesions are similar to lesions induced by test compounds. Compared to spontaneous lesions, compound-induced lesions tend to be multifocal or diffuse, follow a pattern of distribution (e.g., centriacinar, perivascular, and interstitial), show a dose response in the incidence and severity, and may show cell-specific toxicity.

  3. Bridging the etiologic and prognostic outlooks in individualized assessment of absolute risk of an illness: application in lung cancer.

    Science.gov (United States)

    Karp, Igor; Sylvestre, Marie-Pierre; Abrahamowicz, Michal; Leffondré, Karen; Siemiatycki, Jack

    2016-11-01

    Assessment of individual risk of illness is an important activity in preventive medicine. Development of risk-assessment models has heretofore relied predominantly on studies involving follow-up of cohort-type populations, while case-control studies have generally been considered unfit for this purpose. To present a method for individualized assessment of absolute risk of an illness (as illustrated by lung cancer) based on data from a 'non-nested' case-control study. We used data from a case-control study conducted in Montreal, Canada in 1996-2001. Individuals diagnosed with lung cancer (n = 920) and age- and sex-matched lung-cancer-free subjects (n = 1288) completed questionnaires documenting life-time cigarette-smoking history and occupational, medical, and family history. Unweighted and weighted logistic models were fitted. Model overfitting was assessed using bootstrap-based cross-validation and 'shrinkage.' The discriminating ability was assessed by the c-statistic, and the risk-stratifying performance was assessed by examination of the variability in risk estimates over hypothetical risk-profiles. In the logistic models, the logarithm of incidence-density of lung cancer was expressed as a function of age, sex, cigarette-smoking history, history of respiratory conditions and exposure to occupational carcinogens, and family history of lung cancer. The models entailed a minimal degree of overfitting ('shrinkage' factor: 0.97 for both unweighted and weighted models) and moderately high discriminating ability (c-statistic: 0.82 for the unweighted model and 0.66 for the weighted model). The method's risk-stratifying performance was quite high. The presented method allows for individualized assessment of risk of lung cancer and can be used for development of risk-assessment models for other illnesses.

  4. Dose assessment for ingestion of a 330 kilo-becquerel {sup 60}Co hot particle

    Energy Technology Data Exchange (ETDEWEB)

    Whillans, D.W.; Chase, W.J.; Wolodarsky, W.H. [Health Physics Department, Ontario Power Generation, Whitby, Ontario, L1 N 9E3 (Canada)

    2007-07-01

    On leaving the irradiated fuel bay at Pickering A nuclear power station, a worker triggered a whole body monitor alarm with activity in or on his head, and despite careful decontamination techniques he subsequently swallowed a hot particle. Over the next 3 d, the radioactivity was tracked through the body. It was then excreted in a single faecal sample and recovered for physical and radiochemical analysis. This analysis demonstrated that the particle contained 330 kBq of {sup 60}Co and only traces of other radioactivity. Its dimensions were {approx}50-130 {mu}m and its composition was consistent with that of Stellite 6. A dose assessment was carried out taking into account the residence time of the particle in the mouth and its transit through the body. The estimated committed effective dose was 1.4 mSv, and the equivalent dose to the maximally exposed 1 cm{sup 2} of skin, 81 mSv. (authors)

  5. A preliminary assessment of potential doses to man from radioactive waste dumped in the Arctic sea

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, S.P. [Risoe National Lab., Roskilde (Denmark); Iosjpe, M.; Strand, P. [Statens Straalevern, Oesteraas (Norway)

    1995-11-01

    This report describes a preliminary radiological assessment of collective doses to the world population from radioactive material dumped in the Kara and Barents Seas in the period 1961-1991. Information on the dumped waste and the rates of release of radionuclides have been available from Russian sources and from the International Atomic Energy Agency. A box model has been used to simulate the dispersion of radionuclides in the marine environment and to calculate the contamination of seafood and the subsequent radiation doses to man. Two release scenarios have been adopted. The worst-case release scenario, which ignores the presence of barriers between spent nuclear fuel and seawater, is estimated to give rise to about 10 mansievert calculated to 1000 years from the time of release. A more realistic release scenario is estimated to cause about 3 mansieverts. In both cases exposure from the radionuclide {sup 137}Cs is found to dominate the doses. 19 refs., 56 figs., 8 tabs.

  6. A preliminary assessment of potential doses to man from radioactive waste dumped in the Arctic Sea

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, S.P. [Forskningscente Risoe, Roskilde (Denmark); Iosjpe, M.; Strand, P. [Norwegian Radiation Protection Authority, Oesteraas (Norway)

    1995-09-01

    This report describes a preliminary radiological assessment of collective doses to the world population from radioactive material dumped in the Barents and Kara Seas in the period 1961-1991. Information on the dumped waste and the rates of release of radionuclides have been available from Russian sources and from the International Atomic Energy Agency. A box model has been used to simulate the dispersion of radionuclides in the marine environment and to calculate the contamination of seafood and the subsequent radiation doses to man. Two release scenarios have been adopted. The worst-case release scenario which ignores the presence of barriers between spent nuclear fuel and seawater is estimated to give rise to about 10 mansieverts calculated to 1000 years from the time of release. A more realistic release scenario is estimated to cause about 3 mansieverts. In both cases exposure from the radionuclide {sup 137}Cs is found to dominate the doses. (au) 8 tabs., 56 ills., 19 refs.

  7. Shutdown dose rate assessment with the Advanced D1S method: Development, applications and validation

    Energy Technology Data Exchange (ETDEWEB)

    Villari, R., E-mail: rosaria.villari@enea.it [Associazione EURATOM-ENEA sulla Fusione, Via Enrico Fermi 45, 00044 Frascati, Rome (Italy); Fischer, U. [Karlsruhe Institute of Technology KIT, Institute for Neutron Physics and Reactor Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen (Germany); Moro, F. [Associazione EURATOM-ENEA sulla Fusione, Via Enrico Fermi 45, 00044 Frascati, Rome (Italy); Pereslavtsev, P. [Karlsruhe Institute of Technology KIT, Institute for Neutron Physics and Reactor Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen (Germany); Petrizzi, L. [European Commission, DG Research and Innovation K5, CDMA 00/030, B-1049 Brussels (Belgium); Podda, S. [Associazione EURATOM-ENEA sulla Fusione, Via Enrico Fermi 45, 00044 Frascati, Rome (Italy); Serikov, A. [Karlsruhe Institute of Technology KIT, Institute for Neutron Physics and Reactor Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen (Germany)

    2014-10-15

    Highlights: Development of Advanced-D1S for shutdown dose rate calculations; Recent applications of the tool to tokamaks; Summary of the results of benchmarking with measurements and R2S calculations; Limitations and further development. Abstract: The present paper addresses the recent developments and applications of Advanced-D1S to the calculations of shutdown dose rate in tokamak devices. Results of benchmarking with measurements and Rigorous 2-Step (R2S) calculations are summarized and discussed as well as limitations and further developments. The outcomes confirm the essential role of the Advanced-D1S methodology and the evidence for its complementary use with the R2Smesh approach for the reliable assessment of shutdown dose rates and related statistical uncertainties in present and future fusion devices.

  8. Lack-of-fit tests for assessing mean structures for continuous dose-response data

    DEFF Research Database (Denmark)

    Martinussen, Torben

    2011-01-01

    We review a range of lack-of-fit tests suitable for assessing the appropriateness of the mean function in dose-response models. The review encompasses both well-known tests and new tests based on recent developments in statistics, which we have extended to the dose-response case. We argue...... that the classical methods are inadequate in certain situations, where the new tests may be applied. Power comparisons are carried out by means of extensive simulation studies, covering both designs with and without replicates at small and large sample sizes. Three datasets from dose-response applications illustrate...... differences and similarities between the tests. The results suggest that the new tests perform better and exhibit a wider applicability....

  9. Dual energy CT for the assessment of lung perfusion-Correlation to scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Thieme, Sven F.; Becker, Christoph R. [Department of Clinical Radiology, Ludwig-Maximilians-University of Munich (Germany); Hacker, Marcus [Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich (Germany); Nikolaou, Konstantin; Reiser, Maximilian F. [Department of Clinical Radiology, Ludwig-Maximilians-University of Munich (Germany); Johnson, Thorsten R.C. [Department of Clinical Radiology, Ludwig-Maximilians-University of Munich (Germany)], E-mail: thorsten.johnson@med.uni-muenchen.de

    2008-12-15

    Purpose of this study was to determine the diagnostic value of dual energy CT in the assessment of pulmonary perfusion with reference to pulmonary perfusion scintigraphy. Thirteen patients received both dual energy CT (DECT) angiography (Somatom Definition, Siemens) and ventilation/perfusion scintigraphy. Median time between scans was 3 days (range, 0-90). DECT perfusion maps were generated based on the spectral properties of iodine. Two blinded observes assessed DECT angiograms, perfusion maps and scintigrams for presence and location of perfusion defects. The results were compared by patient and by segment, and diagnostic accuracy of DECT perfusion imaging was calculated regarding scintigraphy as standard of reference. Diagnostic accuracy per patient showed 75% sensitivity, 80% specificity and a negative predictive value of 66%. Sensitivity per segment amounted to 83% with 99% specificity, with 93% negative predictive value. Peripheral parts of the lungs were not completely covered by the 80 kVp detector in 85% of patients. CTA identified corresponding emboli in 66% of patients with concordant perfusion defects in DECT and scintigraphy. Dual energy CT perfusion imaging is able to display pulmonary perfusion defects with good agreement to scintigraphic findings. DECT can provide a pulmonary CT angiogram, high-resolution morphology of the lung parenchyma and perfusion information in one single exam.

  10. Biological Bases for Radiation Adaptive Responses in the Lung

    Energy Technology Data Exchange (ETDEWEB)

    Scott, Bobby R. [Lovelace Biomedical and Environmental Research Inst., Albuquerque, NM (United States); Lin, Yong [Lovelace Biomedical and Environmental Research Inst., Albuquerque, NM (United States); Wilder, Julie [Lovelace Biomedical and Environmental Research Inst., Albuquerque, NM (United States); Belinsky, Steven [Lovelace Biomedical and Environmental Research Inst., Albuquerque, NM (United States)

    2015-03-01

    Our main research objective was to determine the biological bases for low-dose, radiation-induced adaptive responses in the lung and use the knowledge gained to produce an improved risk model for radiation-induced lung cancer that accounts for activated natural protection, genetic influences, and the role of epigenetic regulation (epiregulation). Currently, low-dose radiation risk assessment is based on the linear-no-threshold hypothesis which now is known to be unsupported by a large volume of data.

  11. Benchmark dose profiles for joint-action quantal data in quantitative risk assessment.

    Science.gov (United States)

    Deutsch, Roland C; Piegorsch, Walter W

    2012-12-01

    Benchmark analysis is a widely used tool in public health risk analysis. Therein, estimation of minimum exposure levels, called Benchmark Doses (BMDs), that induce a prespecified Benchmark Response (BMR) is well understood for the case of an adverse response to a single stimulus. For cases where two agents are studied in tandem, however, the benchmark approach is far less developed. This article demonstrates how the benchmark modeling paradigm can be expanded from the single-dose setting to joint-action, two-agent studies. Focus is on response outcomes expressed as proportions. Extending the single-exposure setting, representations of risk are based on a joint-action dose-response model involving both agents. Based on such a model, the concept of a benchmark profile (BMP) - a two-dimensional analog of the single-dose BMD at which both agents achieve the specified BMR - is defined for use in quantitative risk characterization and assessment. The resulting, joint, low-dose guidelines can improve public health planning and risk regulation when dealing with low-level exposures to combinations of hazardous agents.

  12. Biosphere Modeling for the Dose Assessment of a HLW Repository: Development of ACBIO

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Youn Myoung; Hwang, Yong Soo; Kang, Chul Hyung

    2006-01-15

    For the purpose of evaluating a dose rate to an individual due to a long-term release of nuclides from a HLW repository, a biosphere assessment model and an implemented code, ACBIO, based on the BIOMASS methodology have been developed by utilizing AMBER, a general compartment modeling tool. To demonstrate its practicability and usability as well as to observe the sensitivity of the compartment scheme, the concentration, the activity in the compartments as well as the annual flux between the compartments at their peak values, were calculated and investigated. For each case when changing the structure of the compartments and GBIs as well as varying selected input Kd values, all of which seem very important among the others, the dose rate per nuclide release rate is calculated separately and analyzed. From the maximum dose rates, the flux to dose conversion factors for each nuclide were derived, which are used for converting the nuclide release rate appearing from the geosphere through various GBIs to dose rates (Sv/y) for an individual in a critical group. It has also been observed that the compartment scheme, the identification of a possible exposure group and the GBIs could all be highly sensitive to the final consequences in a biosphere modeling.

  13. Realistic retrospective dose assessments to members of the public around Spanish nuclear facilities.

    Science.gov (United States)

    Jiménez, M A; Martín-Valdepeñas, J M; García-Talavera, M; Martín-Matarranz, J L; Salas, M R; Serrano, J I; Ramos, L M

    2011-11-01

    In the frame of an epidemiological study carried out in the influence areas around the Spanish nuclear facilities (ISCIII-CSN, 2009. Epidemiological Study of The Possible Effect of Ionizing Radiations Deriving from The Operation of Spanish Nuclear Fuel Cycle Facilities on The Health of The Population Living in Their Vicinity. Final report December 2009. Ministerio de Ciencia e Innovación, Instituto de Salud Carlos III, Consejo de Seguridad Nuclear. Madrid. Available from: http://www.csn.es/images/stories/actualidad_datos/especiales/epidemiologico/epidemiological_study.pdf), annual effective doses to public have been assessed by the Spanish Nuclear Safety Council (CSN) for over 45 years using a retrospective realistic-dose methodology. These values are compared with data from natural radiation exposure. For the affected population, natural radiation effective doses are in average 2300 times higher than effective doses due to the operation of nuclear installations (nuclear power stations and fuel cycle facilities). When considering the impact on the whole Spanish population, effective doses attributable to nuclear facilities represent in average 3.5×10(-5)mSv/y, in contrast to 1.6mSv/y from natural radiation or 1.3mSv/y from medical exposures.

  14. Concurrent chemoradiotherapy with low-dose weekly docetaxel followed by consolidation chemotherapy with docetaxel and cisplatin in the treatment of stage III non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Tianlin XIAO

    2008-02-01

    Full Text Available Background and objective Concurrent chemoradiotherapy is regarded as the standard care for locally advanced non-small cell lung cancer at present. This paper is designed to evaluate the efficacy and toxicity of low-dose weekly docetaxel (DTX with concurrent chemoradiotherapy followed by consolidation chemotherapy with DTX and cisplatin for unresectable stage III non-small cell lung cancer(NSCLC. Methods 44 previously untreated patients with stage III NSCLC were randomized into low-dose weekly DTX group and control group concomitant with radiotherapy. Both groups were treated by the standard fractionation schedule with three-dimensional conformal radiotherapy. An involved-field irradiation technique was performed. Gross tumor and metastatic lymph nodes were irradiated to a total dose of 66 Gy~70 Gy. Patients in the former group received chemotherapy with DTX 20mg. m-2.w-1,and the other group patients received DTX 60 mg/m2 on day 1 and DDP 30 mg/m2 on day 1~3 every 21 days. All patients received consolidation chemotherapy with DP regime after chemoradiotherapy for no more than 4 cycles. Results The overall response rates of patients in the low-dose weekly DTX group and control group were 81.8% with 27.3% CR(complete response and 86.4% with 27.3% CR respectively (Chisquare=0.120, P=0.942. After a median follow-up of 20months, the median survival time was 20 months and 17 months respectively. The 1-, 2- year survival rates of patients in low-dose weekly DTX group and control group were 69.8%, 48.1% versus 66.5%, 40.2% respectively;there was no difference between two groups. Grade 3 or 4 neutropenia and esophagitis occurred in 26.3%, 14.3% and 15.8%, 28.6% respectively (Chiquare=0.765,P =0.382(Chiquare=1.108,P =0.292.Grade 3 and 4 pulmonary toxicity was unusual.Conclusion Concurrent chemoradiotherapy with low-dose weekly docetaxel followed by consolidation chemotherapy with docetaxel and cisplatin is highly active with manageable toxicity in patients

  15. SU-E-T-620: Planning and Dosimetry for Pulsed Low Dose Rate RT for Recurrent Lung, Spine, GYN and Head and Neck Cancers

    Energy Technology Data Exchange (ETDEWEB)

    Tong, X; Luo, F; Liu, Y; Zhang, W; Xu, Q; Zhang, T; Li, J [3rd Affiliated Hospital of Qiqihar Medical University, Qiqihar (China); Chen, L; Ma, C [Fox Chase Cancer Center, Philadelphia, PA (United States)

    2015-06-15

    Purpose: Extensive in vitro and in vivo studies have shown that pulsed low dose rate (PLDR) radiotherapy has potential to provide significant local tumor control and to reduce normal tissue toxicities. This work investigated the planning and dosimetry of PLDR re-irradiation for recurrent cancers. Methods: We analyzed the treatment plans and dosimetry for 13 recurrent patients who were treated with the PLDR technique in this study. All cases were planned with the 3DCRT technique with optimal beam angle selection. The treatment was performed on a Siemens accelerator using 6MV beams. The target volume ranged between 161 and 703cc. The previous RT dose was 40–60Gy while the re-irradiation dose was 16–60Gy. The interval between previous RT and re-irradiation was 13–336 months, and the follow-up time was up to 27months. The total prescription dose was administered in 2Gy/day fractions with the daily dose delivered in 10 sub-fractions (pulses) of 20cGy with a 3min interval between the pulses to achieve an effective dose rate of 6.7cGy/min. Results: The clinical outcome was analyzed based on the treatment plans. All pulses were kept with Dmax<40cGy. The PLDR treatments were effective (CR: 3 patients, PR: 10 patients). The acute and late toxicities were all acceptable (generally grade II or under). Two patients died three months after the PLDR re-irradiation, one due to massive cerebral infarction and the other due to acute cardiac failure. All others survived more than 8 months. Five patients showed good conditions at the last follow-up. Among them two recurrent lung cancer patients had survived 23 months and one nasopharyngeal cancer patient had survived 27 months. Conclusion: The PLDR technique was effective for the palliative treatment of head and neck, lung, spine and GYN cancers. Further phase II and III studies are warranted to quantify the efficacy of PLDR for recurrent cancers.

  16. Dose assessment for inhalation intakes in complex, energetic environments: experience from the US Capstone study.

    Science.gov (United States)

    Guilmette, Raymond A; Parkhurst, Mary Ann

    2007-01-01

    Because of the lack of existing information needed to evaluate the risks from inhalation exposures to depleted uranium (DU) aerosols of US soldiers during the 1991 Persian Gulf War, the US Department of Defense funded an experimental study to measure the characteristics of DU aerosols created when Abrams tanks and Bradley fighting vehicles are struck with large-caliber DU penetrators, and a dose and risk assessment for individuals present in such vehicles. This paper describes some of the difficulties experienced in dose assessment modelling of the very complex DU aerosols created in the Capstone studies, e.g. high concentrations, heterogeneous aerosol properties, non-lognormal particle size distributions, triphasic in vitro dissolution and rapid time-varying functions of both DU air concentration and particle size. The approaches used to solve these problems along with example results are presented.

  17. An evaluation of the feasibility of assessment of volume perfusion for the whole lung by 128-slice spiral CT

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Haitao [Imaging Center of Taian Central Hospital, Taian, Shandong (China); Gao, Fei; Li, Ning; Liu, Cheng [Shandong Univ., Shandong Medical Imaging Research Inst., CT Room, Shandong (China)], e-mail: liucheng491025@sina.com

    2013-10-15

    Background: Lung perfusion based on dynamic scanning cannot provide a quantitative assessment of the whole lung because of the limited coverage of the current computed tomography (CT) detector designs. Purpose: To evaluate the feasibility of dynamic volume perfusion CT (VPCT) of the whole lung using a 128-slice CT for the quantitative assessment and visualization of pulmonary perfusion. Material and Methods: Imaging was performed in a control group of 17 subjects who had no signs of disturbance of pulmonary function or diffuse lung disease, and 15 patients (five patients with acute pulmonary embolism and 10 with emphysema) who constituted the abnormal lung group. Dynamic VPCT was performed in all subjects, and pulmonary blood flow (PBF), pulmonary blood volume (PBV), and mean transit time (MTT) were calculated from dynamic contrast images with a coverage of 20.7 cm. Regional and volumetric PBF, PBV, and MTT were statistically evaluated and comparisons were made between the normal and abnormal lung groups. Results: Regional PBF (94.2{+-}36.5, 161.8 {+-}29.6, 185.7 {+-}38.1 and 125.5 {+-}46.1, 161.9 {+-}31.4, 169.3 {+-}51.7), PBV (6.7 {+-}2.8, 10.9 {+-}3.0, 12.9 {+-}4.5 and 9.9 {+-}4.6, 10.3 {+-}2.9, 11.9 {+-}4.5), and MTT (5.8 {+-}2.4, 4.5 {+-}1.3, 4.7 {+-}2.1 and 5.6 {+-}2.3, 4.3 {+-}1.5, 4.9 {+-}1.5) demonstrated significant differences in the gravitational and isogravitational directions in the normal lung group (P < 0.05). The PBF (154.2 {+-}30.6 vs. 94.9 {+-}15.9) and PBV (11.1 {+-}4.0 vs. 6.6 {+-}1.7) by dynamic VPCT showed significant differences between normal and abnormal lungs (P < 0.05), notwithstanding the four large lungs that had coverage > 20.7 cm. Conclusion: Dynamic VPCT of the whole lung is feasible for the quantitative assessment of pulmonary perfusion by 128-slice CT, and may in future permit the evaluation of both morphological and functional features of the whole lung in a single examination.

  18. Mayak Worker Dosimetry System 2008 (MWDS-2008): assessment of internal dose from measurement results of plutonium activity in urine.

    Science.gov (United States)

    Khokhryakov, Victor V; Khokhryakov, Valentin F; Suslova, Klara G; Vostrotin, Vadim V; Vvedensky, Vladimir E; Sokolova, Alexandra B; Krahenbuhl, Melinda P; Birchall, Alan; Miller, Scott C; Schadilov, Anatoly E; Ephimov, Alexander V

    2013-04-01

    A new modification of the prior human lung compartment plutonium model, Doses-2005, has been described. The modified model was named "Mayak Worker Dosimetry System-2008" (MWDS-2008). In contrast to earlier models developed for workers at the Mayak Production Association (Mayak PA), the new model more correctly describes plutonium biokinetics and metabolism in pulmonary lymph nodes. The MWDS-2008 also provides two sets of doses estimates: one based on bioassay data and the other based on autopsy data, where available. The algorithm of internal dose calculation from autopsy data will be described in a separate paper. Results of comparative analyses of Doses-2005 and MWDS-2008 are provided. Perspectives on the further development of plutonium dosimetry are discussed.

  19. An assessment of bias and uncertainty in recorded dose from external sources of radiation for workers at the Hanford Site

    Energy Technology Data Exchange (ETDEWEB)

    Fix, J.J.; Gilbert, E.S.; Baumgartner, W.V.

    1994-08-01

    Worker dose estimates are used in epidemiologic studies of nuclear workers. A major objective of these studies is to provide a direct assessment of the carcinogenic risk of exposure to ionizing radiation at low doses and dose rates. If dose estimates used in analyses of worker data are biased, then risk estimates expressed per unit of dose will also be biased. In addition, random error in dose estimates may lead to underestimation of risk coefficients and can also distort dose-response analyses. Analyses of data from nuclear worker studies, including Hanford, have typically not been adjusted for biases and uncertainties in dose estimates in part because of the lack of adequate information on the nature and magnitude of these biases and uncertainties. This report describes an approach used to assess bias and uncertainty in radiation dose for Hanford dosimetry systems. The approach can be considered as an elaboration of work conducted by a technical committee appointed by the National Academy of Sciences (NAS) used to quantify the bias and uncertainty in estimated doses for personnel exposed to radiation as a result of atmospheric testing of nuclear weapons between 1945 and 1962. In addition, laboratory studies were conducted to measure bias for selected sources of photon radiation resulting from angular response characteristics of Hanford dosimeter systems. An overall assessment is presented of bias and uncertainty for photon radiation greater than 100 keV. This radiation is expected to have caused the vast majority of recorded dose for Hanford workers.

  20. Pilot website to support international collaboration for dose assessments in a radiation emergency

    Energy Technology Data Exchange (ETDEWEB)

    Livingston, G.K., E-mail: Gordon.Livingston@orise.orau.gov [Oak Ridge Associated Universities, REAC/TS, Radiation Emergency Medicine (REM), P.O. Box 117, Oak Ridge, TN 37831 (United States); Wilkins, R.C., E-mail: Ruth.Wilkins@hc-sc.gc.ca [Health Canada, Consumer and Clinical Radiation Protection Bureau, Ottawa, ON K1A 1C1 (Canada); Ainsbury, E.A., E-mail: liz.ainsbury@hpa.org.uk [Health Protection Agency, Radiation Protection Division, Chilton, Didcot, Oxfordshire OX11 0RQ (United Kingdom)

    2011-09-15

    Nuclear terrorism has emerged as a significant threat which could require timely medical interventions to reduce potential radiation casualties. Early dose assessments are critical since optimal care depends on knowing a victim's radiation dose. The dicentric chromosome aberration assay is considered the 'gold standard' to estimate the radiation dose because the yield of dicentrics correlates positively with the absorbed dose. Dicentrics have a low background frequency, are independent of age and gender and are relatively easy to identify. This diagnostic test for radiation exposure, however, is labor intensive and any single or small group of laboratories could easily be overwhelmed by a mass casualty event. One solution to this potential problem is to link the global WHO BioDoseNet members via the Internet so multiple laboratories could work cooperatively to screen specimens for dicentric chromosomes and generate timely dose estimates. Inter-laboratory comparison studies have shown that analysis of electronic chromosome images viewed on the computer monitor produces scoring accuracy equivalent to viewing live images in the microscope. This functional equivalence was demonstrated during a comparative study involving five laboratories constructing {sup 60}Co gamma ray calibration curves and was further confirmed when comparing results of blind dose estimates submitted by each laboratory. It has been further validated in two recent WHO BioDoseNet trial exercises where 20 metaphase images were shared by e-mail and 50 images were shared on a test website created for this purpose. The Internet-based exercise demonstrated a high level of concordance among 20 expert scorers who evaluated the same 50 metaphase spreads selected to exhibit no, low, moderate and severe radiation damage. Nineteen of 20 scorers produced dicentric equivalent counts within the 95% confidence limits of the mean. The Chi-squared test showed strong evidence of homogeneity in the data

  1. SU-E-T-57: A Novel Method to Improve Dose Heterogeneity of Target and Organs at Risk Sparing in the Intensity-Modulated Radiotherapy for Stage III Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Huang, B-T; Lu, J-Y [Cancer Hospital of Shantou University Medical College, Shantou (China)

    2015-06-15

    Purpose: Intensity-modulated radiotherapy (IMRT) treatment for lung cancer is difficult due to the heterogeneous dose distribution and excessive dose to the organs at risk (OARs). We introduce a simple method based on the base dose function (BDF) in Eclipse treatment planning system to overcome the difficulties. Methods: Thirteen patients suffered from stage III non-small cell lung cancer (NSCLC) were enrolled in the study. Three kinds of approaches were applied to obtain clinically acceptable treatment plans: 1) conventionally optimizing method with hot and cold spots re-optimization (CO); 2) target-divided optimizing method (TDO) in which the optimization objective in the lung density of planning target volume (PTV) was set to 2 to 4 Gy higher than in the soft tissue density; 3) base dose function (BDF) in which the treatment plan was produced based on the original plan for re-optimization. CO, TDO and BDF methods were then compared in terms of conformity index (CI), homogeneity index (HI), OARs sparing and monitor units (MUs). Additionally, delta4, portal dosimetry and IMSure were used to measure the dose delivering accuracy. Results: The BDF technique provided more superior CI and HI than the other two methods. Moreover, the new method also reduced the lung, esophagus, heart and spinal cord dose. However, the BDF plans needed extra 15% and 10% MUs than the CO and TDO methods. Dose verification results demonstrated good and comparable γ pass rates among the three methods. Conclusion: The proposed BDF method greatly improves the dose homogeneity and OARs sparing in the IMRT treatment for lung cancer.

  2. Toxicity-adjusted dose (TAD) administration of chemotherapy: Effect of baseline and nadir neutrophil count in patients with breast, ovarian, and lung cancer?

    DEFF Research Database (Denmark)

    Carus, Andreas; Donskov, Frede; Gebski, Val;

    2011-01-01

    Background: In some solid cancers a survival benefit has been observed for patients who had chemotherapy-induced neutropenia. The prognostic impact of baseline and nadir blood neutrophils was assessed in the present study. Methods: Data on patients with breast cancer st.I-IV, ovarian cancer st.......I-IV, non-small cell lung cancer (NSCLC) st.II-IV, and small-cell lung cancer (SCLC) treated from 1997 to 2005 at Westmead Hospital, Sydney, with complete medical records of the first 3 cycles of chemotherapy and a full set of baseline and nadir laboratory data were collected from patient medical files...... elevated neutrophil count was associated with short survival (p

  3. Probabilistic assessment of the influence of lake properties in long-term radiation doses to humans.

    Science.gov (United States)

    Pohjola, Jari; Turunen, Jari; Lipping, Tarmo; Ikonen, Ari T K

    2016-11-01

    The assessment processes concerning the safety of nuclear waste repositories include the modelling of radionuclide transport in biosphere and the evaluation of the doses to the most affected humans. In this paper, a scenario, in which a contaminated lake is the water source for drinking water, irrigation water and watering of livestock, is presented. The objective of the paper is to probabilistically study the influence of lake properties as parameters in the assessment scenario. The properties of the lake are a result of previously conducted probabilistic studies, where the land uplift of the terrain surrounding the repositories and the formation of water bodies were studied in a 10,000-year time span using Monte Carlo simulation. The lake is formed at 3000 years from present day and the changing properties of the lake have been used in the study. The studied radionuclides (36)Cl, (135)Cs, (129)I, (237)Np, (90)Sr, (99)Tc and (238)U enter the lake with a rate of 1 Bq/year. The transport process from the lake water to humans is described and the doses (dose conversion factors) to adult humans are evaluated based on a study on average food consumption. Sensitivity analysis is used for identifying the parameters having the most influence on the outcome of the dose. Based on the results from the sensitivity analysis, the volumetric outflow rate of the lake and the volume of the lake were taken into closer consideration. The results show the influence of probabilistically derived geomorphic lake input parameters on the dose.

  4. A novel approach to pharmacodynamic assessment of antimicrobial agents: new insights to dosing regimen design.

    Directory of Open Access Journals (Sweden)

    Vincent H Tam

    Full Text Available Pharmacodynamic modeling has been increasingly used as a decision support tool to guide dosing regimen selection, both in the drug development and clinical settings. Killing by antimicrobial agents has been traditionally classified categorically as concentration-dependent (which would favor less fractionating regimens or time-dependent (for which more frequent dosing is preferred. While intuitive and useful to explain empiric data, a more informative approach is necessary to provide a robust assessment of pharmacodynamic profiles in situations other than the extremes of the spectrum (e.g., agents which exhibit partial concentration-dependent killing. A quantitative approach to describe the interaction of an antimicrobial agent and a pathogen is proposed to fill this unmet need. A hypothetic antimicrobial agent with linear pharmacokinetics is used for illustrative purposes. A non-linear functional form (sigmoid Emax of killing consisted of 3 parameters is used. Using different parameter values in conjunction with the relative growth rate of the pathogen and antimicrobial agent concentration ranges, various conventional pharmacodynamic surrogate indices (e.g., AUC/MIC, Cmax/MIC, %T>MIC could be satisfactorily linked to outcomes. In addition, the dosing intensity represented by the average kill rate of a dosing regimen can be derived, which could be used for quantitative comparison. The relevance of our approach is further supported by experimental data from our previous investigations using a variety of gram-negative bacteria and antimicrobial agents (moxifloxacin, levofloxacin, gentamicin, amikacin and meropenem. The pharmacodynamic profiles of a wide range of antimicrobial agents can be assessed by a more flexible computational tool to support dosing selection.

  5. Is Intermediate Radiation Dose Escalation With Concurrent Chemotherapy for Stage III Non–Small-Cell Lung Cancer Beneficial? A Multi-Institutional Propensity Score Matched Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues, George, E-mail: george.rodrigues@lhsc.on.ca [London Health Sciences Centre, London, Ontario (Canada); Oberije, Cary [MAASTRO Clinic, Maastricht (Netherlands); Senan, Suresh [VU University Medical Center, Amsterdam (Netherlands); Tsujino, Kayoko [Hyogo Cancer Center, Akashi (Japan); Wiersma, Terry [MAASTRO Clinic, Maastricht (Netherlands); Moreno-Jimenez, Marta [Universidad de Navarra, Pamplona (Spain); Kim, Tae Hyun [National Cancer Center, Goyang-si, Gy eonggi (Korea, Republic of); Marks, Lawrence B. [University of North Carolina, Chapel Hill, North Carolina (United States); Rengan, Ramesh [University of Washington, Seattle, Washington (United States); De Petris, Luigi [Karolinska University Hospital, Stockholm (Sweden); Ramella, Sara [Campus Bio-M