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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. From cellular doses to average lung dose

    International Nuclear Information System (INIS)

    Sensitive basal and secretory cells receive a wide range of doses in human bronchial and bronchiolar airways. Variations of cellular doses arise from the location of target cells in the bronchial epithelium of a given airway and the asymmetry and variability of airway dimensions of the lung among airways in a given airway generation and among bronchial and bronchiolar airway generations. To derive a single value for the average lung dose which can be related to epidemiologically observed lung cancer risk, appropriate weighting scenarios have to be applied. Potential biological weighting parameters are the relative frequency of target cells, the number of progenitor cells, the contribution of dose enhancement at airway bifurcations, the promotional effect of cigarette smoking and, finally, the application of appropriate regional apportionment factors. Depending on the choice of weighting parameters, detriment-weighted average lung doses can vary by a factor of up to 4 for given radon progeny exposure conditions. (authors)

  3. 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.

  4. Lung dose depending on exact patient positioning during total body irradiation (TBI) - isoeffective considerations to assess the risk of interstitial pneumonitis after TBI

    International Nuclear Information System (INIS)

    Purpose: In this case report, we studied the effect of patient's movements on total lung dose during total body irradiation (TBI). The dose-effect relationship regarding the development of interstitial pneumonitis and the problem of defining a threshold value are discussed. Based on considerations about the isoeffects we calculated the pneumonitis risk in dependence of increasing lung dose. Patient and Method: We calculated dose-volume histograms of the lung for defined lateral deviations (0-3 cm) from the isocenter. Total dose was 12 Gy, given in six fractions over 3 days. Lung shields were used after a total dose of 9 Gy. Lung shields were transferred into the Helax-TMS trademark planning system to quantify the influence of lateral deviation to lung dose. Results: The child's lateral deviation amounted up to 3 cm. Median dose of the whole lung amounted up to 11.64 Gy depending on lateral deviation. Discussion: In TBI, the lung limits the total dose. To estimate the risk of radiation pneumonitis, we calculated the isoeffective lung dose of our TBI regime for a fractionation scheme of 2 Gy daily using a formalism of van Dyk. The increase of median lung dose from 9.76 to 11.64 Gy would isoeffectively correspond to the increase from 19 Gy (no deviation) to 20.9 Gy (3 cm lateral deviation) with conventional fractionation. According to Burman, a pneumonitis risk of approximately 20% could be expected. Conclusion: With an estimated pneumonitis risk of approximately 20%, an indication for irradiation in general anesthesia seems to be reasonable. This is practicable in cooperation with radiation oncologists, anesthesists and pediatricians and should be included into therapeutic concepts. (orig.)

  5. Enjebi Island dose assessment

    International Nuclear Information System (INIS)

    We have updeated the radiological dose assessment for Enjebi Island at Enewetak Atoll using data derived from analysis of food crops grown on Enjebi. This is a much more precise assessment of potential doses to people resettling Enjebi Island than the 1980 assessment in which there were no data available from food crops on Enjebi. Details of the methods and data used to evaluate each exposure pathway are presented. The terrestrial food chain is the most significant potential exposure pathway and 137Cs is the radionuclide responsible for most of the estimated dose over the next 50 y. The doses are calculated assuming a resettlement date of 1990. The average wholebody maximum annual estimated dose equivalent derived using our diet model is 166 mremy;the effective dose equivalent is 169 mremy. The estimated 30-, 50-, and 70-y integral whole-body dose equivalents are 3.5 rem, 5.1 rem, and 6.2 rem, respectively. Bone-marrow dose equivalents are only slightly higher than the whole-body estimates in each case. The bone-surface cells (endosteal cells) receive the highest dose, but they are a less sensitive cell population and are less sensitive to fatal cancer induction than whole body and bone marrow. The effective dose equivalents for 30, 50, and 70 y are 3.6 rem, 5.3 rem, and 6.6 rem, respectively. 79 refs., 17 figs., 24 tabs

  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. Tissue heterogeneity in IMRT dose calculation for lung cancer.

    Science.gov (United States)

    Pasciuti, Katia; Iaccarino, Giuseppe; Strigari, Lidia; Malatesta, Tiziana; Benassi, Marcello; Di Nallo, Anna Maria; Mirri, Alessandra; Pinzi, Valentina; Landoni, Valeria

    2011-01-01

    The aim of this study was to evaluate the differences in accuracy of dose calculation between 3 commonly used algorithms, the Pencil Beam algorithm (PB), the Anisotropic Analytical Algorithm (AAA), and the Collapsed Cone Convolution Superposition (CCCS) for intensity-modulated radiation therapy (IMRT). The 2D dose distributions obtained with the 3 algorithms were compared on each CT slice pixel by pixel, using the MATLAB code (The MathWorks, Natick, MA) and the agreement was assessed with the γ function. The effect of the differences on dose-volume histograms (DVHs), tumor control, and normal tissue complication probability (TCP and NTCP) were also evaluated, and its significance was quantified by using a nonparametric test. In general PB generates regions of over-dosage both in the lung and in the tumor area. These differences are not always in DVH of the lung, although the Wilcoxon test indicated significant differences in 2 of 4 patients. Disagreement in the lung region was also found when the Γ analysis was performed. The effect on TCP is less important than for NTCP because of the slope of the curve at the level of the dose of interest. The effect of dose calculation inaccuracy is patient-dependent and strongly related to beam geometry and to the localization of the tumor. When multiple intensity-modulated beams are used, the effect of the presence of the heterogeneity on dose distribution may not always be easily predictable. PMID:20970989

  9. SU-E-J-269: Assessing the Precision of Dose Delivery in CBCT-Guided Stereotactic Body Radiation Therapy for Lung and Soft Tissue Metastatic Lesions

    Energy Technology Data Exchange (ETDEWEB)

    Parsai, S; Dalhart, A; Chen, C; Parsai, E; Pearson, D; Sperling, N; Reddy, K [University of Toledo Medical Center, Toledo, OH (United States)

    2014-06-01

    Purpose: Ensuring reproducibility of target localization is critical to accurate stereotactic body radiation treatment (SBRT) for lung and soft tissue metastatic lesions. To characterize interfraction variability in set-up and evaluate PTV margins utilized for SBRT, daily CBCTs were used to calculate delivered target and OAR doses compared to those expected from planning. Methods: CBCT images obtained prior to each fraction of SBRT for a lung and thyroid metastatic lesion were evaluated. The target CTV/ITV and OARs on each of 8 CBCT data sets were contoured. Using MIM fusion software and Pinnacle{sup 3} RTP system, delivered dose distribution was reconstructed on each CBCT, utilizing translational shifts performed prior to treatment. Actual delivered vs. expected doses received by target CTV/ITV and adjacent critical structures were compared to characterize accuracy of pre-treatment translational shifts and PTV margins. Results: The planned CTV/ITV D95% and V100% were 4595cGy and 91.47% for the lung lesion, and 3010cGy and 96.34% for the thyroid lesion. Based on CBCT analysis, actual mean D95% and V100% for lung ITV were 4542±344.4cGy and 91.54±3.45%; actual mean D95% and V100% for thyroid metastasis CTV were 3005±25.98cGy and 95.20±2.522%. For the lung lesion, ipsilateral lung V20, heart V32 (cc) and spinal cord (.03 cc) max were 110.15cc, 3.33cc, and 1680cGy vs. 110.27±14.79cc, 6.74±3.76cc, and 1711±46.56cGy for planned vs. delivered doses, respectively. For the thyroid metastatic lesion, esophagus V18, trachea (.03 cc) max, and spinal cord (.03 cc) max were 0.35cc, 2555cGy, and 850cGy vs. 0.16±0.13cc, 2147±367cGy, and 838±45cGy for planned vs. delivered treatments, respectively. Conclusion: Minimal variability in SBRT target lesion dose delivered based on pre-treatment CBCT-based translational shifts suggests tighter PTV margins may be considered to further decrease dose to surrounding critical structures. Guidelines for optimal target alignment during

  10. 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

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

    International Nuclear Information System (INIS)

    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)

  12. Dose reconstruction in deforming lung anatomy: Dose grid size effects and clinical implications

    International Nuclear Information System (INIS)

    In this study we investigated the accumulation of dose to a deforming anatomy (such as lung) based on voxel tracking and by using time weighting factors derived from a breathing probability distribution function (p.d.f.). A mutual information registration scheme (using thin-plate spline warping) provided a transformation that allows the tracking of points between exhale and inhale treatment planning datasets (and/or intermediate state scans). The dose distributions were computed at the same resolution on each dataset using the Dose Planning Method (DPM) Monte Carlo code. Two accumulation/interpolation approaches were assessed. The first maps exhale dose grid points onto the inhale scan, estimates the doses at the 'tracked' locations by trilinear interpolation and scores the accumulated doses (via the p.d.f.) on the original exhale data set. In the second approach, the 'volume' associated with each exhale dose grid point (exhale dose voxel) is first subdivided into octants, the center of each octant is mapped to locations on the inhale dose grid and doses are estimated by trilinear interpolation. The octant doses are then averaged to form the inhale voxel dose and scored at the original exhale dose grid point location. Differences between the interpolation schemes are voxel size and tissue density dependent, but in general appear primarily only in regions with steep dose gradients (e.g., penumbra). Their magnitude (small regions of few percent differences) is less than the alterations in dose due to positional and shape changes from breathing in the first place. Thus, for sufficiently small dose grid point spacing, and relative to organ motion and deformation, differences due solely to the interpolation are unlikely to result in clinically significant differences to volume-based evaluation metrics such as mean lung dose (MLD) and tumor equivalent uniform dose (gEUD). The overall effects of deformation vary among patients. They depend on the tumor location, field

  13. Lung cancer: assessing resectability

    OpenAIRE

    Quint, Leslie E

    2003-01-01

    Staging classification in patients with non-small cell lung cancer does not always correlate perfectly with surgical resectability. Therefore, it is important to evaluate individual features of a patient’s tumor in order to determine if surgical resection is the optimal method of treatment, regardless of tumor stage. Such features include characteristics of the primary tumor, regional lymph nodes and distant sites.

  14. Multi-component assessment of chronic obstructive pulmonary disease: an evaluation of the ADO and DOSE indices and the global obstructive lung disease categories in international primary care data sets

    Science.gov (United States)

    Jones, Rupert C; Price, David; Chavannes, Niels H; Lee, Amanda J; Hyland, Michael E; Ställberg, Björn; Lisspers, Karin; Sundh, Josefin; van der Molen, Thys; Tsiligianni, Ioanna

    2016-01-01

    Suitable tools for assessing the severity of chronic obstructive pulmonary disease (COPD) include multi-component indices and the global initiative for chronic obstructive lung disease (GOLD) categories. The aim of this study was to evaluate the dyspnoea, obstruction, smoking, exacerbation (DOSE) and the age, dyspnoea, obstruction (ADO) indices and GOLD categories as measures of current health status and future outcomes in COPD patients. This was an observational cohort study comprising 5,114 primary care COPD patients across three databases from UK, Sweden and Holland. The associations of DOSE and ADO indices with (i) health status using the Clinical COPD Questionnaire (CCQ) and St George’s Respiratory Questionnaire (SGRQ) and COPD Assessment test (CAT) and with (ii) current and future exacerbations, admissions and mortality were assessed in GOLD categories and DOSE and ADO indices. DOSE and ADO indices were significant predictors of future exacerbations: incident rate ratio was 1.52 (95% confidence intervals 1.46–1.57) for DOSE, 1.16 (1.12–1.20) for ADO index and 1.50 (1.33–1.68) and 1.23 (1.10–1.39), respectively, for hospitalisations. Negative binomial regression showed that the DOSE index was a better predictor of future admissions than were its component items. The hazard ratios for mortality were generally higher for ADO index groups than for DOSE index groups. The GOLD categories produced widely differing assessments for future exacerbation risk or for hospitalisation depending on the methods used to calculate them. None of the assessment systems were excellent at predicting future risk in COPD; the DOSE index appears better than the ADO index for predicting many outcomes, but not mortality. The GOLD categories predict future risk inconsistently. The DOSE index and the GOLD categories using exacerbation frequency may be used to identify those at high risk for exacerbations and admissions. PMID:27053297

  15. Assessment of low-dose radiotherapy (two 2 Gy sessions) for the cure of MALT lymphoma of the lung; evaluation de la radiotherapie faible (deux seances de 2 Gy) a visee curative dans le lymphome du Malt pulmonaire

    Energy Technology Data Exchange (ETDEWEB)

    Paumier, A.; Ghalibafian, M.; Gilmore, J.; Girinsky, T. [Departement de radiotherapie, institut de cancerologie Gustave-Roussy, Villejuif (France); Hanna, C.; Raphael, J.; Ferme, C.; Ribrag, V. [Departement d' hematologie, institut de cancerologie Gustave-Roussy, Villejuif (France)

    2011-10-15

    The authors report the assessment of low-dose radiotherapy (two sessions of 2 Gy in two days) for the curative treatment of mucosa-associated lymphoid tissue (MALT) lymphoma of the lung. The treatment of this lymphoma is discussed in terms of surgery, chemotherapy, radiotherapy, or even simple monitoring. The authors analyse the results obtained on nine patients who have been treated this way since 2002, straight away for some of them, after surgery or chemotherapy for others. Survival rate, recurrence, evolutions and responses are discussed. Short communication

  16. Relationship between radiation dose and lung function in patients with lung cancer receiving radiotherapy

    International Nuclear Information System (INIS)

    In patients with inoperable non-small cell lung cancer (NSCLC), radical radiotherapy is the treatment of choice. The dose is limited by consequential pneumonitis and lung fibrosis. Hence, a better understanding of the relationship between the dose-volume distributions and normal tissue side effects is needed. CT is a non-invasive method to monitor the development of fibrosis and pneumonitis, and spirometry is an established tool to measure lung function. NSCLC patients were included in a multicenter trial and treated with megavoltage conformal radiotherapy. In a subgroup comprising 16 patients, a total dose of 59-63 Gy with 1.8-1.9 Gy per fraction was given. Dose-volume histograms were calculated and corrected according to the linear-quadratic formula using alpha/beta=3 Gy. The patients underwent repetitive CT examinations (mean follow-up, 133 days) following radiotherapy, and pre and post treatment spirometry (mean follow-up, 240 days). A significant correlation was demonstrated between local lung dose and changes in CT numbers >30 days after treatment (p40 Gy Gy there was a sudden increase in CT numbers at 70-90 days. Somewhat unexpectedly, the highest mean lung doses were found in patients with the least reductions in lung function (peak expiratory flow; p<0.001). The correlation between CT numbers, radiation dose and time after treatment show that CT may be used to monitor development of lung fibrosis/pneumonitis after radiotherapy for lung cancer. Paradoxically, the patients with the highest mean lung doses experienced the minimum deterioration of lung function. This may be explained by reduction in the volume of existing tumour masses obstructing the airways, leading to relief of symptoms. This finding stresses the role of radiotherapy for lung cancer, especially where the treatment aim is palliative

  17. 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.)

  18. 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

    International Nuclear Information System (INIS)

    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 μm, 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 μ 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.)

  19. Dose-response relationship for lung cancer induction at radiotherapy dose

    International Nuclear Information System (INIS)

    Cancer induction after radiation therapy is a severe side effect. It is therefore of interest to predict the probability of second cancer appearance for the treated patient. Currently there is large uncertainty about the shape of the dose-response relationship for carcinogenesis for most cancer types at high dose levels. In this work a dose-response relationship for lung cancer is derived based on (i) the analysis of lung cancer induction after Hodgkin's disease, (ii) a cancer risk model developed for high doses including fractionation based on the linear quadratic model, and (iii) the reconstruction of treatment plans for Hodgkin's patients treated with radiotherapy. The fitted model parameters for an α/β = 3 Gy were α = 0.061Gy-1 and R = 0.84. The value for α is in agreement with analysis of normal tissue complications of the lung after radiation therapy. The repopulation/repair parameter R is large, but seems to be characteristic for lung tissue which is sensitive with regard to fractionation. Lung cancer risk is according to this model for small doses consistent with the finding of the A-bomb survivors, has a maximum at doses of around 15 Gy and drops off only slightly at larger doses. The predicted EAR for lung after radiotherapy of Hodgkin's disease is 18.4/10000PY which can be compared to the findings of several epidemiological studies were EAR for lung varies between 9.7 and 21.5/10000PY. (orig.)

  20. Radiation Dose-Volume Effects in the Lung

    International Nuclear Information System (INIS)

    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.

  1. 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....

  2. Noninvasive assessment of peroxidative lung damage by HIPDM lung scanning

    Energy Technology Data Exchange (ETDEWEB)

    Miniati, M.; Borrelli, E.; Monti, S.; Cocci, F.; Solfanelli, S.; Giani, L.; Pistolesi, M. (Univ. of Pisa (Italy) Univ. of Siena, (Italy))

    1991-03-15

    The basic compound iodobenzyl-propanediamine (HIPDM), when given intravenously, is extracted by the lungs whence it is effluxed at a slow exponential rate. In humans (normal non smokers), the mean residence time ({bar t}) of 123I-HIPDM, assessed by external detection, averages 7.2 {plus minus} 1.1 hrs. Persistence of HIPDM in lungs is significantly increased in asymptomatic smokers and, to a greater extent, in patients with ARDS. Since production of free oxygen radicals reportedly occurs as a consequence of smoke exposure and in the course of acute lung injury, the authors hypothesized that the prolonged persistence of HIPDM in the lungs of smokers and of patients with ARDS might reflect a peroxidative damage of lung tissue. They tested this hypothesis in rabbits since their baseline HIPDM lung clearance is similar to that of nonsmoking humans. In rabbits, acute lung injury was induced by phorbol myristate acetate. Three hrs after PMA administration, the animals received an i.v. bolus of {sup 131}I-HIPDM. Radioactivity over the chest was recorded for 2 hrs by gamma camera and HIPDM mean residence time in the lungs was computed. Thereafter, the animals were sacrificed and their lungs were removed to measure wet/dry weight ratio as index of lung edema and malondialdehyde (MDA) content as index of lipid peroxidation. HIPDM mean residence time was positively correlated with MDA level in lung tissue, but not with wet/dry weight ratio. Noninvasive assessment of HIPDM lung kinetics may then serve as specific in vivo marker of peroxidative lung injury.

  3. Dose distribution and lung cancer incidence in thorotrast patients

    International Nuclear Information System (INIS)

    For German thorotrast patients, the application of lung cancer risk factors derived from radon daughter inhalation in uranium miners would predict the induction of lung tumors in about 10% of the patients surveyed. However, no increase of lung cancer incidence as compared to the control group has been observed by now. In order to refine the currently used dosimetric model, 1st the Landahl morphometry was replaced by Weibel model, and 2nd instead of assuming a homogeneous dose distribution around cylindrical airways with a constant depth, doses were calculated for bronchial stem cells located at generation-specific depths in epithelial tissue. This re-evaluation leads to a significant reduction of radiation doses in upper bronchial air passages, without, however, resolving the apparent discrepancy between observed and predicted lung cancer risk. This suggests that lung doses for radon daughter inhalation may have been underestimated; e.g. taking into account enhanced deposition at bronchial airway bifurcations would increase the radiation dose at such sites for inhalation, but not for exhalation. (orig.)

  4. Assessing resectability of lung cancer

    International Nuclear Information System (INIS)

    In order to assess the value of computed tomography (CT) of the mediastinum, upper abdomen and head in the assessment of resectability of lung cancer, the CT findings of 262 patients, of whom 198 underwent thoracotomy, were anlyzed retrospectively and the stagings obtained at CT and thoracotomy were compared. Mediastinal CT reliably predicted resectability when there was no evidence of mediastinal involvement. However, it was often impossible to determine whether tumour with apparent mediastinal infiltration on CT was resectable or not. The sole finding of lymph node enlargement did not permit differentiation of benign from malignant lymphadenopathy when the lymph node diameter as < 25 mm and the lymphadenopathy was confined to one lymph node station. Upper abdominal metastases were found in 6.1% and brain metastases in 4.6% of patients and neither the histological type nor other features of the tumour were found to be useful predictors of their presence. The large number of non-specific findings decreased the utility of abdominal CT. The appropriate strategy for the pre-operative evaluation of patients with lung cancer is discussed. (author). 29 refs.; 1 fig.; 10 tabs

  5. Dose impact in radiographic lung injury following lung SBRT: Statistical analysis and geometric interpretation

    International Nuclear Information System (INIS)

    Purpose: To demonstrate a new method of evaluating dose response of treatment-induced lung radiographic injury post-SBRT (stereotactic body radiotherapy) treatment and the discovery of bimodal dose behavior within clinically identified injury volumes. Methods: Follow-up CT scans at 3, 6, and 12 months were acquired from 24 patients treated with SBRT for stage-1 primary lung cancers or oligometastic lesions. Injury regions in these scans were propagated to the planning CT coordinates by performing deformable registration of the follow-ups to the planning CTs. A bimodal behavior was repeatedly observed from the probability distribution for dose values within the deformed injury regions. Based on a mixture-Gaussian assumption, an Expectation-Maximization (EM) algorithm was used to obtain characteristic parameters for such distribution. Geometric analysis was performed to interpret such parameters and infer the critical dose level that is potentially inductive of post-SBRT lung injury. Results: The Gaussian mixture obtained from the EM algorithm closely approximates the empirical dose histogram within the injury volume with good consistency. The average Kullback-Leibler divergence values between the empirical differential dose volume histogram and the EM-obtained Gaussian mixture distribution were calculated to be 0.069, 0.063, and 0.092 for the 3, 6, and 12 month follow-up groups, respectively. The lower Gaussian component was located at approximately 70% prescription dose (35 Gy) for all three follow-up time points. The higher Gaussian component, contributed by the dose received by planning target volume, was located at around 107% of the prescription dose. Geometrical analysis suggests the mean of the lower Gaussian component, located at 35 Gy, as a possible indicator for a critical dose that induces lung injury after SBRT. Conclusions: An innovative and improved method for analyzing the correspondence between lung radiographic injury and SBRT treatment dose has

  6. Quantitative detection of drug dose and spatial distribution in the lung revealed by Cryoslicing Imaging.

    Science.gov (United States)

    Barapatre, Nirav; Symvoulidis, Panagiotis; Möller, Winfried; Prade, Friedrich; Deliolanis, Nikolaos C; Hertel, Sebastian; Winter, Gerhard; Yildirim, Ali Ö; Stoeger, Tobias; Eickelberg, Oliver; Ntziachristos, Vasilis; Schmid, Otmar

    2015-01-01

    Administration of drugs via inhalation is an attractive route for pulmonary and systemic drug delivery. The therapeutic outcome of inhalation therapy depends not only on the dose of the lung-delivered drug, but also on its bioactivity and regional distribution. Fluorescence imaging has the potential to monitor these aspects already during preclinical development of inhaled drugs, but quantitative methods of analysis are lacking. In this proof-of-concept study, we demonstrate that Cryoslicing Imaging allows for 3D quantitative fluorescence imaging on ex vivo murine lungs. Known amounts of fluorescent substance (nanoparticles or fluorophore-drug conjugate) were instilled in the lungs of mice. The excised lungs were measured by Cryoslicing Imaging. Herein, white light and fluorescence images are obtained from the face of a gradually sliced frozen organ block. A quantitative representation of the fluorescence intensity throughout the lung was inferred from the images by accounting for instrument noise, tissue autofluorescence and out-of-plane fluorescence. Importantly, the out-of-plane fluorescence correction is based on the experimentally determined effective light attenuation coefficient of frozen murine lung tissue (10.0 ± 0.6 cm(-1) at 716 nm). The linear correlation between pulmonary total fluorescence intensity and pulmonary fluorophore dose indicates the validity of this method and allows direct fluorophore dose assessment. The pulmonary dose of a fluorescence-labeled drug (FcγR-Alexa750) could be assessed with an estimated accuracy of 9% and the limit of detection in ng regime. Hence, Cryoslicing Imaging can be used for quantitative assessment of dose and 3D distribution of fluorescence-labeled drugs or drug carriers in the lungs of mice. PMID:25262414

  7. Using Fluorodeoxyglucose Positron Emission Tomography to Assess Tumor Volume During Radiotherapy for Non-Small-Cell Lung Cancer and Its Potential Impact on Adaptive Dose Escalation and Normal Tissue Sparing

    International Nuclear Information System (INIS)

    Purpose: To quantify changes in fluorodeoxyglucose (FDG)-avid tumor volume on positron emission tomography/computed tomography (PET/CT) during the course of radiation therapy and examine its potential use in adaptive radiotherapy for tumor dose escalation or normal tissue sparing in patients with non-small-cell lung cancer (NSCLC). Methods and Materials: As part of a pilot study, patients with Stage I-III NSCLC underwent FDG-PET/CT before radiotherapy (RT) and in mid-RT (after 40-50 Gy). Gross tumor volumes were contoured on CT and PET scans obtained before and during RT. Three-dimensional conformal RT plans were generated for each patient, first using only pretreatment CT scans. Mid-RT PET volumes were then used to design boost fields. Results: Fourteen patients with FDG-avid tumors were assessed. Two patients had a complete metabolic response, and 2 patients had slightly increased FDG uptake in the adjacent lung tissue. Mid-RT PET scans were useful in the 10 remaining patients. Mean decreases in CT and PET tumor volumes were 26% (range, +15% to -75%) and 44% (range, +10% to -100%), respectively. Designing boosts based on mid-RT PET allowed for a meaningful dose escalation of 30-102 Gy (mean, 58 Gy) or a reduction in normal tissue complication probability (NTCP) of 0.4-3% (mean, 2%) in 5 of 6 patients with smaller yet residual tumor volumes. Conclusions: Tumor metabolic activity and volume can change significantly after 40-50 Gy of RT. Using mid-RT PET volumes, tumor dose can be significantly escalated or NTCP reduced. Clinical studies evaluating patient outcome after PET-based adaptive RT are ongoing

  8. Assessment of Peripheral Lung Mechanics

    OpenAIRE

    Bates, Jason H. T.; Suki, Béla

    2008-01-01

    The mechanical properties of the lung periphery are major determinants of overall lung function, and can change dramatically in disease. In this review we examine the various experimental techniques that have provided data pertaining to the mechanical properties of the lung periphery, together with the mathematical models that have been used to interpret these data. These models seek to make a clear distinction between the central and peripheral compartments of the lung by encapsulating funct...

  9. Early radiation dose-response in lung: an ultrastructural study

    International Nuclear Information System (INIS)

    A systematic fine-structural study of dog lungs was undertaken to ascertain the radiation dose response in the lungs of large animals. The capillary endothelium appeared to be the initial site of the post-irradiation pulmonary damage. This subpheural response included diffuse septal thickening, fibrosis, edema, and reduced alveolar lumina. The deep parenchymal response involved perivascular fibrosis, which was associated with perivascular hyperplasia of Type II pneumocytes, increased number and sizes of lamellar bodies, increased production and release of lamellar surfactant. No changes of alveolar luminar size were noted. The most significant changes were observed in those dose zones exposed to greater than 2400 rad, suggesting the possibility of an identifiable dose-response relationship. Early detection of radiation pneumonitis by electron microscopy is demonstrated, and qualitative and quantitative correlation of injury with both postirradiation time and dose is presented

  10. 222Rn alpha dose to organs other than lung

    International Nuclear Information System (INIS)

    The alpha dose to cells in tissues or organs other theft the lung has been calculated using the solubility coefficients for 222 Rn measured in human tissue. The annual alpha dose equivalent f rom 222 Rn and decay products in most tissues is a maximum of 30% of the annual average natural background dose equivalent (1 mSv) for external and internally deposited nuclides. The dose to the small population of lymphocytes located in or under the bronchial epithelium is a special case and their annual dose equivalent is essentially the same as that to basal cells in bronchial epithelium (200 mSv) for continuous exposure to 200 Bq M-3. The significance of this dose is uncertain because the only excess cancer observed in follow up studies of underground miners with high 222 Rn exposure is bronchogenic carcinoma

  11. 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

  12. 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.

  13. Secondary scattered doses of IMRT for lung cancer cases

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Wook; Chung, Weon Kuu [Dept. of radiation oncology, Kyunghee university hospital at Gangdong, Seoul (Korea, Republic of); Yoon, Myong Geun [Dept. of Radiological Science, College of Health Science, Korea University, Seoul (Korea, Republic of); Park, Sung Ho [ASAN medical center, College of Medicine, University of Ulsan , Ulsan (Korea, Republic of)

    2012-11-15

    To compare the secondary radiation doses following intensity-modulated radiotherapy (IMRT), Rapidarc and Tomotherapy(TOMO) in patients with lung cancer by using a radiophotoluminescence glass dosimeter (RPLGD) which is newly introduced, as a substitution of themoluminescence dosimeter (TLD) or other. In conclusion, the secondary dose from TOMO is less than the secondary dose from conventional IMRT and RapidArc around the target area in spite of that tomotherapy has relatively higher monitor units(mu) than the other modalities. In another hand, it is found that rapidarc has shorter treatment time and MU than IMRT and TOMO.

  14. 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.

  15. Aerosol particle size does not predict pharmacokinetic determined lung dose in children

    DEFF Research Database (Denmark)

    Bønnelykke, Klaus; Chawes, Bo L K; Vindfeld, Signe;

    2013-01-01

    In vitro measures of aerosol particles size, such as the fine particle mass, play a pivotal role for approval of inhaled anti-asthmatic drugs. However, the validity as a measure of dose to the lungs in children lacks evidence. In this study we investigated for the first time the association between...... was assessed after single inhalation. The corresponding emitted mass of drug in segments of aerosol particle size was assessed ex vivo by replicating the inhalation flows recorded by transducers built into the Diskus® inhaler and re-playing them in a breathing simulator. There was no correlation between any...... of drug delivery to the lung....

  16. Dose assessments for SFR 1

    International Nuclear Information System (INIS)

    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

  17. Spinal Cord Doses in Palliative Lung Radiotherapy Schedules

    International Nuclear Information System (INIS)

    Aim: We aim to check the safety of the standard palliative radiotherapy techniques by using the Linear quadratic model for a careful estimation of the doses received by the spinal cord, in all standard palliative lung radiotherapy fields and fractionation. Material and Methods: All patients surveyed at this prospective audit were treated with palliative chest radio-therapy for lung cancer over a period from January to June 2005 by different clinical oncology specialists within the department. Radiotherapy field criteria were recorded and compared with the recommended limits of the MRC trial protocols for the dose and fractionation prescribed. Doses delivered to structures off the field central axis were estimated using a standard CT scan of the chest. Dose estimates were made using an SLPLAN planning system. As unexpected spinal cord toxicity has been reported after hypo fractionated chest radiotherapy, a sagittal view was used to calculate the isodoses along the length of the spinal cord that could lie within the RT field. Equivalent dose estimates are made using the Linear Quadratic Equivalent Dose formula (LQED). The relative radiation sensitivity of spinal cord for myelopathy (the a/b dose) cord has been estimated as a/b = 1 Gy. Results: 17 Gy in 2 fraction and 39 Gy in 13 fraction protocols have spinal cord equivalent doses (using the linear-quadratic model) that lie within the conventional safe limits of 50 Gy in 25 fractions for the 100% isodose. However when the dosimetry is modelled for a 6 MV 100 cm isocentric linac in 3 dimensions, and altered separations and air space inhomogeneity are considered, the D-Max doses consistently fall above this limit on our 3 model patients. Conclusion: The 17 Gy in 2 fraction and 39 Gy in 13 fraction protocol would risk spinal cord damage if the radio therapist was unaware of the potential spinal cord doses. Alterative doses are suggested below 15.5 Gy/ 2 fractions (7 days apart) would be most acceptable

  18. Feasibility of optimizing the dose distribution in lung tumors using fluorine-18-fluorodeoxyglucose positron emission tomography and single photon emission computed tomography guided dose prescriptions

    International Nuclear Information System (INIS)

    The information provided by functional images may be used to guide radiotherapy planning by identifying regions that require higher radiation dose. In this work we investigate the dosimetric feasibility of delivering dose to lung tumors in proportion to the fluorine-18-fluorodeoxyglucose activity distribution from positron emission tomography (FDG-PET). The rationale for delivering dose in proportion to the tumor FDG-PET activity distribution is based on studies showing that FDG uptake is correlated to tumor cell proliferation rate, which is shown to imply that this dose delivery strategy is theoretically capable of providing the same duration of local control at all voxels in tumor. Target dose delivery was constrained by single photon emission computed tomography (SPECT) maps of normal lung perfusion, which restricted irradiation of highly perfused lung and imposed dose-function constraints. Dose-volume constraints were imposed on all other critical structures. All dose-volume/function constraints were considered to be soft, i.e., critical structure doses corresponding to volume/function constraint levels were minimized while satisfying the target prescription, thus permitting critical structure doses to minimally exceed dose constraint levels. An intensity modulation optimization methodology was developed to deliver this radiation, and applied to two lung cancer patients. Dosimetric feasibility was assessed by comparing spatially normalized dose-volume histograms from the nonuniform dose prescription (FDG-PET proportional) to those from a uniform dose prescription with equivalent tumor integral dose. In both patients, the optimization was capable of delivering the nonuniform target prescription with the same ease as the uniform target prescription, despite SPECT restrictions that effectively diverted dose from high to low perfused normal lung. In one patient, both prescriptions incurred similar critical structure dosages, below dose-volume/function limits

  19. Predicting Pneumonitis Risk: A Dosimetric Alternative to Mean Lung Dose

    International Nuclear Information System (INIS)

    Purpose: To determine whether the association between mean lung dose (MLD) and risk of severe (grade ≥3) radiation pneumonitis (RP) depends on the dose distribution pattern to normal lung among patients receiving 3-dimensional conformal radiation therapy for non-small-cell lung cancer. Methods and Materials: Three cohorts treated with different beam arrangements were identified. One cohort (2-field boost [2FB]) received 2 parallel-opposed (anteroposterior-posteroanterior) fields per fraction initially, followed by a sequential boost delivered using 2 oblique beams. The other 2 cohorts received 3 or 4 straight fields (3FS and 4FS, respectively), ie, all fields were irradiated every day. The incidence of severe RP was plotted against MLD in each cohort, and data were analyzed using the Lyman-Kutcher-Burman (LKB) model. Results: The incidence of grade ≥3 RP rose more steeply as a function of MLD in the 2FB cohort (N=120) than in the 4FS cohort (N=138), with an intermediate slope for the 3FS group (N=99). The estimated volume parameter from the LKB model was n=0.41 (95% confidence interval, 0.15-1.0) and led to a significant improvement in fit (P=.05) compared to a fit with volume parameter fixed at n=1 (the MLD model). Unlike the MLD model, the LKB model with n=0.41 provided a consistent description of the risk of severe RP in all three cohorts (2FB, 3FS, 4FS) simultaneously. Conclusions: When predicting risk of grade ≥3 RP, the mean lung dose does not adequately take into account the effects of high doses. Instead, the effective dose, computed from the LKB model using volume parameter n=0.41, may provide a better dosimetric parameter for predicting RP risk. If confirmed, these findings support the conclusion that for the same MLD, high doses to small lung volumes (“a lot to a little”) are worse than low doses to large volumes (“a little to a lot”).

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

    International Nuclear Information System (INIS)

    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

  1. 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.

  2. UAE national occupational and environmental dose assessment

    International Nuclear Information System (INIS)

    Radiation safety guidelines and federal regulations require that radiation workers should be monitored in order to maintain the exposure as low as reasonably achievable. Due to the peaceful applications of ionizing radiation in different fields in UAE, there are certain risks which can be restricted and controlled through successful implementation such as occupational and environmental dose assessment. External and internal dose assessment for radiation workers needs to establish monitoring programmes with appropriate dosimetry to be used for individual, workplace and environmental monitoring. Radiation protection department implement the TLD system for external dose assessment and gamma spectrometer for internal dose assessment. Results of applications of both external and internal dose assessment are present. (author)

  3. Lung doses from radon in dwellings and influencing factors

    International Nuclear Information System (INIS)

    The radon concentration in Norwegian dwellings and the lung doses received by the Norwegian population are reported. The biological effects of these doses are discussed. The mean value of radon-daughters in Norwegian dwellings was found to be about 7x10-3 WL (working levels). This corresponds to an annual exposure of about 0.3 WLM (working level months). From studies of the lung cancer statistics of Norway, this exposure may account for about 10% of the annual lung cancer cases in Norway. The variations in the radon concentration inside dwellings are discussed, and the influence of exhalation, ventilation and meteorological parameters upon the respiratory dosage is studied. From the risk estimates performed, the consequences of an increased indoor radon concentration due to reduced ventilation or introduction of building materials with high radium concentrations are discussed. From comparison of the population doses from different sources of radiation, it is evident that a possible future increase in the radon concentration in dwellings is one of the most serious radiation protection problems of our time. (author)

  4. Reducing the low-dose lung radiation for central lung tumors by restricting the IMRT beams and arc arrangement.

    Science.gov (United States)

    Rosca, Florin; Kirk, Michael; Soto, Daniel; Sall, Walter; McIntyre, James

    2012-01-01

    To compare the extent to which 7 different radiotherapy planning techniques for mediastinal lung targets reduces the lung volume receiving low doses of radiation. Thirteen non-small cell lung cancer patients with targets, including the mediastinal nodes, were identified. Treatment plans were generated to both 60- and 74-Gy prescription doses using 7 different planning techniques: conformal, hybrid conformal/intensity-modulated radiation treatment (IMRT), 7 equidistant IMRT beams, 2 restricted beam IMRT plans, a full (360°) modulated arc, and a restricted modulated arc plan. All plans were optimized to reduce total lung V5, V10, and V20 volumes, while meeting normal tissue and target coverage constraints. The mean values for the 13 patients are calculated for V5, V10, V20, V(ave), V0-20, and mean lung dose (MLD) lung parameters. For the 74-Gy prescription dose, the mean lung V10 was 42.7, 43.6, 48.2, 56.6, 57, 55.8, and 54.1% for the restricted ±36° IMRT, restricted modulated arc, restricted ±45° IMRT, full modulated arc, hybrid conformal/IMRT, equidistant IMRT, and conformal plans, respectively. A similar lung sparing hierarchy was found for the 60-Gy prescription dose. For the treatment of central lung targets, the ±36° restricted IMRT and restricted modulated arc planning techniques are superior in lowering the lung volume treated to low dose, as well as in minimizing MLD, followed by the ±45° restricted IMRT plan. All planning techniques that allow the use of lateral or lateral/oblique beams result in spreading the low dose over a higher lung volume. The area under the lung dose-volume histogram curve below 20 Gy, V0-20, is proposed as an alternative to individual V(dose) parameters, both as a measure of lung sparing and as a parameter to be minimized during IMRT optimization. PMID:22189028

  5. Lung cancer incidence after exposure of rats to low doses of radon: influence of dose rate

    International Nuclear Information System (INIS)

    To study the effect on lung cancer incidence of a long exposure to low levels of radon, 500 male 3-months-old Sprague-Dawley rats, were exposed to a cumulative dose of 25 WLM of radon and its daughters, 6 hours a day, 5 days a week, during 18 months. Exposure conditions were controlled in order to maintain a defined PAEC: 42 x 106 J.m-3 (2 WL), in the range of domestic and environmental exposures. Animals were kept until they died or given euthanasia when moribund. Mean survival times were similar in both irradiated and control groups: 828 days (SD = 169) and 830 days (SD = 137), as well as lung cancer incidence, 0.60% at 25 WLM and 0.63% for controls. The incidence of lung lesions was compared statistically with controls and those previously obtained at cumulative exposures of 25 and 50 WLM delivered over a 4-6 month period, inducing a significant increase of lung cancer, 2.2% and 3.8% respectively. Such a comparison showed a decreased lung cancer incidence related to a decrease in the dose rate for low levels of radon exposure. (author)

  6. Metrics, Dose, and Dose Concept: The Need for a Proper Dose Concept in the Risk Assessment of Nanoparticles

    Directory of Open Access Journals (Sweden)

    Myrtill Simkó

    2014-04-01

    Full Text Available In order to calculate the dose for nanoparticles (NP, (i relevant information about the dose metrics and (ii a proper dose concept are crucial. Since the appropriate metrics for NP toxicity are yet to be elaborated, a general dose calculation model for nanomaterials is not available. Here we propose how to develop a dose assessment model for NP in analogy to the radiation protection dose calculation, introducing the so-called “deposited and the equivalent dose”. As a dose metric we propose the total deposited NP surface area (SA, which has been shown frequently to determine toxicological responses e.g. of lung tissue. The deposited NP dose is proportional to the total surface area of deposited NP per tissue mass, and takes into account primary and agglomerated NP. By using several weighting factors the equivalent dose additionally takes into account various physico-chemical properties of the NP which are influencing the biological responses. These weighting factors consider the specific surface area, the surface textures, the zeta-potential as a measure for surface charge, the particle morphology such as the shape and the length-to-diameter ratio (aspect ratio, the band gap energy levels of metal and metal oxide NP, and the particle dissolution rate. Furthermore, we discuss how these weighting factors influence the equivalent dose of the deposited NP.

  7. Dose evaluation and effective dose estimation from CT fluoroscopy-guided lung biopsy

    International Nuclear Information System (INIS)

    The development of computerized tomography (CT) has made CT fluoroscopy possible with real-time CT images. However examination are expected to have high medical and occupational exposures. Then, exposures to patients and operating and assisting physicians during the CT fluoroscopy-guided lung biopsy were estimated. And changes in the examination conditions to lower the dose were made. Patient exposure was measured using an anthropomorphic phantom by simulation of clinical examination conditions. The surface dose to the physician was measured during actual clinical examinations. The average effective dose for the patient was 34±22 mSv. The highest surface dose amounted to 1.9 Gy, although this was in a very narrow field. Patient doses could be reduced by a factor of 2.5-3 by changing examination methods while still retaining diagnostic quality. The highest dose to the operating physician was 10 mGy which was recorded on the back of the hand and the average effective dose was estimated as 5.99 μSv per 1-minute examination. Doses were reduced by about a factor of 50 by lowering the tube voltage from 120 kV to 80 kV and using a supplementary tool. The doses for assisting physicians were not significant. The exposure for physicians and patients was much affected by lowering the tube voltage used for fluoroscopy. Using a supplementary tool was effective for reducing the dose for physicians. (author)

  8. Irrigation in dose assessments models

    International Nuclear Information System (INIS)

    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

  9. 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

  10. Measurement of the indoor and outdoor 220Rn (thoron) equilibrium factor: Application to lung dose

    International Nuclear Information System (INIS)

    A miniature four-chamber alpha track detector was developed that measures both 222Rn (radon) and 220Rn (thoron), in duplicate. Using this detector and the previous long-term measurements of the 220Rn decay products 212Pb, and 212Bi, an equilibrium factor, Feq, is derived for both outdoor and indoor 220Rn environments (0.004+0.001 outdoors and 0.04+0.01 indoors). The lung airway dose can then be calculated from a dose factor from UNSCEAR that requires the equilibrium equivalent thoron concentration (EEC), i.e. the product of Feq and the 220Rn gas concentration. The lung dose from thoron in domestic or occupational surveys is often overlooked. The values of Feq for thoron in several published studies are in general agreement with the values reported here. Thus, a long-term alpha track measurement of thoron multiplied by an appropriate indoor or outdoor equilibrium factor yields the EEC, which can be used to assess bronchial lung dose. (authors)

  11. Effects of radioactive 125I seeds on A549 cell line and human embryonic lung diploid cell line 2BS cultivated in vitro and assessment of its clinical safety dose

    International Nuclear Information System (INIS)

    Objective: To observe the cell count changes of A549 cell line and human embryonic lung diploid cell line 2BS after irradiated by 125I seeds with different doses, and to study the growth inhibition of 125I on this two kinds of cell lines, and to determine its clinical safety dose in treatment of non-small cell lung. Methods: 125I seeds with different doses (low dose: 0.2 mCi, mediate dose: 0.4 mCi, high dose: 0.8 mCi) were chosen and put into A549 cells and human embryonic lung diploid cell line 2BS in vitro, the cells on the 2nd, 4th, 6th and 8th days after irradiation were collected, the alive cells were counted by cells dyeing experiments, then the growth curves were drawn, and the IC50 of the radioactive 125I seeds to both two cell lines were calculated. Results: Compared with blank and control groups, the cell proliferation trend of A549 cells in low dose group was not significantly influenced (P>0.05), but the growth of A549 cells in mediate and high dose groups were inhibited in a time-dependent manner, there were significant differences (P<0.05), the most obvious change was on the 6th day. The IC50 of the radioactive 125I seeds to A549 cells was about .04 mCi. While the growth inhibition of 125I 2BS had no statistically significant differences between various dose groups (P>0.05), and the IC50 of the radioactive 125I seeds to 2BS cell line was about 1.65 mCi. Conclusion: 0.4 mCi of radioactive 125I seeds has already had the obvious damage effect on A549 cell, 0.8 mCi of radioactive 125I seeds has the stronger effect. The IC50 of the radioactive 125I seeds to 2BS cells is about 1.65 mCi, so the clinical safety dosage is 0.4-0.8 mCi. (authors)

  12. Effects of dose, dose-rate and fraction on radiation-induced breast and lung cancers

    International Nuclear Information System (INIS)

    Recent results from a large Canadian epidemiologic cohort study of low-LET radiation and cancer will be described. This is a study of 64,172 tuberculosis patients first treated in Canada between 1930 and 1952, of whom many received substantial doses to breast and lung tissue from repeated chest fluoroscopies. The mortality of the cohort between 1950 and 1987 has been determined by computerized record linkage to the National Mortality Data Base. There is a strong positive association between radiation and breast cancer risk among the females in the cohort, but in contrast very little evidence of any increased risk in lung cancer. The results of this and other studies suggest that the effect of dose-rate and/or fractionation on cancer risk may will differ depending upon the particular cancer being considered. (author)

  13. Impact of inhomogeneity corrections on dose coverage in the treatment of lung cancer using stereotactic body radiation therapy

    International Nuclear Information System (INIS)

    The purpose of this study is to assess the real target dose coverage when radiation treatments were delivered to lung cancer patients based on treatment planning according to the RTOG-0236 Protocol. We compare calculated dosimetric results between the more accurate anisotropic analytical algorithm (AAA) and the pencil beam algorithm for stereotactic body radiation therapy treatment planning in lung cancer. Ten patients with non-small cell lung cancer were given 60 Gy in three fractions using 6 and 10 MV beams with 8-10 fields. The patients were chosen in accordance with the lung RTOG-0236 protocol. The dose calculations were performed using the pencil beam algorithm with no heterogeneity corrections (PB-NC) and then recalculated with the pencil beam with modified Batho heterogeneity corrections (PB-MB) and the AAA using an identical beam setup and monitor units. The differences in calculated dose to 95% or 99% of the PTV, between using the PB-NC and the AAA, were within 10% of prescribed dose (60 Gy). However, the minimum dose to 95% and 99% of PTV calculated using the PB-MB were consistently overestimated by up to 40% and 36% of the prescribed dose, respectively, compared to that calculated by the AAA. Using the AAA as reference, the calculated maximum doses were underestimated by up to 27% using the PB-NC and overestimated by 19% using the PB-MB. The calculations of dose to lung from PB-NC generally agree with that of AAA except in the small high-dose region where PB-NC underestimates. The calculated dose distributions near the interface using the AAA agree with those from Monte Carlo calculations as well as measured values. This study indicates that the real minimum PTV dose coverage cannot be guaranteed when the PB-NC is used to calculate the monitor unit settings in dose prescriptions

  14. Thoron in the air: assessment of the occupational dose

    International Nuclear Information System (INIS)

    The occupational dose due to inhalation of thoron was assessed through the committed effective dose and the committed equivalent dose received by workers exposed to the radionuclide at the nuclear materials storage site and the thorium purification plant of the Instituto de Pesquisas Energeticas e Nucleares (IPEN-CNEN/SP). The radiation doses were performed by compartmental analysis following the compartmental model of the lung and biokinetic model of the lead, through the thoron equilibrium equivalent concentrations. These values were obtained by gamma ray spectrometry, total alpha count and alpha particle spectrometry of air samples glass fiber filters. The results of the thoron equilibrium equivalent concentration varied from 0.3 to 0,67 Bq/m3 at the nuclear materials storage site and from 0.9 to 249.8 Bq/m3 at the thorium purification plant. The committed effective dose due to thoron inhalation varied from 0.03 mSv/a to 0.67 mSv/a at the nuclear materials storage site and from 0.12 mSv/a to 6.0 mSv/a at the thorium purification plant. The risk assessment of lung cancer and fatal cancers for the workers exposed to thoron at the nuclear materials storage site and the thorium purification plant showed an increment for both risk cancer. (author)

  15. Howard Hughes Medical Institute dose assessment survey

    International Nuclear Information System (INIS)

    Biomedical science researchers often express frustration that health physics practices vary widely between individual institutions. A survey examining both internal and external dose assessment practices was devised and mailed to fifty institutions supporting biomedical science research. The results indicate that health physics dose assessment practices and policies are highly variable. Factors which may contribute to the degree of variation are discussed. 2 tabs

  16. Low-dose CT of the lung: potential value of iterative reconstructions

    Energy Technology Data Exchange (ETDEWEB)

    Baumueller, Stephan; Winklehner, Anna; Karlo, Christoph; Goetti, Robert; Frauenfelder, Thomas; Alkadhi, Hatem [University Hospital Zurich, Institute for Diagnostic and Interventional Radiology, Zurich (Switzerland); Flohr, Thomas [Siemens Healthcare, Computed Tomography Division, Forchheim (Germany); Russi, Erich W. [University Hospital Zurich, Pulmonary Division, Department of Internal Medicine, Zurich (Switzerland)

    2012-12-15

    To prospectively assess the impact of sinogram-affirmed iterative reconstruction (SAFIRE) on image quality of nonenhanced low-dose lung CT as compared to filtered back projection (FBP). Nonenhanced low-dose chest CT (tube current-time product: 30 mAs) was performed on 30 patients at 100 kVp and on 30 patients at 80 kVp. Images were reconstructed with FBP and SAFIRE. Two blinded, independent readers measured image noise; two readers assessed image quality of normal anatomic lung structures on a five-point scale. Radiation dose parameters were recorded. Image noise in datasets reconstructed with FBP (57.4 {+-} 15.9) was significantly higher than with SAFIRE (31.7 {+-} 9.8, P < 0.001). Image quality was significantly superior with SAFIRE than with FBP (P < 0.01), without significant difference between FBP at 100 kVp and SAFIRE at 80 kVp (P = 0.68). Diagnostic image quality was present with FBP in 96% of images at 100 kVp and 88% at 80 kVp, and with SAFIRE in 100% at 100 kVp and 98% at 80 kVp. There were significantly more datasets with diagnostic image quality with SAFIRE than with FBP (P < 0.01). Mean CTDI{sub vol} and effective doses were 1.5 {+-} 0.7 mGy.cm and 0.7 {+-} 0.2 mSv at 100 kVp, and 1.4 {+-} 2.8 mGy.cm and 0.5 {+-} 0.2 mSv at 80 kVp (P < 0.001, both). Use of SAFIRE in low-dose lung CT reduces noise, improves image quality, and renders more studies diagnostic as compared to FBP. (orig.)

  17. Precision therapy for lung cancer : Image processing and dose calculation in stereotactic body radiotherapy

    International Nuclear Information System (INIS)

    Stereotactic body radiotherapy (SBRT) is an effective technique in lung cancer treatment and several prerequisites are essential in order to achieve good local control. These include precise imaging of the lesion before irradiation and accurate dose calculation to account for density heterogeneities in lung tissue. Both aspects were investigated within the framework of the thesis: a new approach in imaging with a conventional electronic portal imaging device (EPID) was investigated and the performance and limits of a new Monte Carlo (MC) calculation algorithm commercially available were studied. More specifically, digitally reconstructed radiographs (DRR) of lung lesions were compared with MV portal images in a feasibility study to assess any displacement of the tumour. The precision of displacement results of three registration algorithms was tested when compared to a projection image of the tumour. The various algorithms were applied to test images, a lung simulation phantom and finally to patient data including 38 tumours and images of 113 fractions. Image guidance results of tested registration algorithms proved the accuracy in the lung phantom study whereas clinical patient data had successful registrations in about 59% of anterior-posterior (AP) and 46% of lateral projections, respectively. Excluding real patient data with a clinical target volume smaller than 10 cm3, successful registrations occurred in 90% of AP and 50% lateral projections. With respect to dose calculation accuracy, experimental verification of a commercial Monte Carlo-based planning system was performed for high-energy photon beams. Several simple and complex treatment cases were calculated and compared with measurements in different phantom types. Besides ion chamber measurements, radiochromic films were irradiated to gain 2D dose distributions which were compared to calculations applying the gamma-index criterion. The dose calculation accuracy of the Monte Carlo algorithm implemented in

  18. Early detection of lung cancer using low-dose CT: an update

    International Nuclear Information System (INIS)

    Lung cancer is the leading cause of death from malignancy. Due to a lack of early symptoms patients usually undergo therapy at advanced tumor stages when prognosis is poor. Feasibility studies of low-dose spiral CT screening of heavy smokers have shown that many small, resectable lung cancers can be diagnosed at early stages using simple diagnostic algorithms based on size and attenuation of detected pulmonary nodules with a small proportion of invasive procedures for benign lesions. Preliminary results of repeat screening confirms small size and favourable stage distribution of detected cancers, using even simpler diagnostic algorithms: additional diagnostic procedures are only required in new or growing nodules whereas follow-up with low-dose CT is sufficient in nodules that appear unchanged to exclude slow growth. However, mortality reduction by lung cancer screening with low-dose CT has yet to be demonstrated. Several randomised controlled trials are under way to assess possible mortality reduction by comparison of mortalities in a screening group and a control group. It is hoped that through international cooperation data from these trials can be pooled to allow for statistically significant conclusions as early as possible. (orig.)

  19. Reducing the low-dose lung radiation for central lung tumors by restricting the IMRT beams and arc arrangement

    Energy Technology Data Exchange (ETDEWEB)

    Rosca, Florin, E-mail: frosca@partners.org [Department of Radiation Oncology, Mass General/North Shore, Danvers, MA (United States); Kirk, Michael; Soto, Daniel; Sall, Walter; McIntyre, James [Department of Radiation Oncology, Mass General/North Shore, Danvers, MA (United States)

    2012-10-01

    To compare the extent to which 7 different radiotherapy planning techniques for mediastinal lung targets reduces the lung volume receiving low doses of radiation. Thirteen non-small cell lung cancer patients with targets, including the mediastinal nodes, were identified. Treatment plans were generated to both 60- and 74-Gy prescription doses using 7 different planning techniques: conformal, hybrid conformal/intensity-modulated radiation treatment (IMRT), 7 equidistant IMRT beams, 2 restricted beam IMRT plans, a full (360 Degree-Sign ) modulated arc, and a restricted modulated arc plan. All plans were optimized to reduce total lung V5, V10, and V20 volumes, while meeting normal tissue and target coverage constraints. The mean values for the 13 patients are calculated for V5, V10, V20, V{sub ave}, V0-20, and mean lung dose (MLD) lung parameters. For the 74-Gy prescription dose, the mean lung V10 was 42.7, 43.6, 48.2, 56.6, 57, 55.8, and 54.1% for the restricted {+-}36 Degree-Sign IMRT, restricted modulated arc, restricted {+-}45 Degree-Sign IMRT, full modulated arc, hybrid conformal/IMRT, equidistant IMRT, and conformal plans, respectively. A similar lung sparing hierarchy was found for the 60-Gy prescription dose. For the treatment of central lung targets, the {+-}36 Degree-Sign restricted IMRT and restricted modulated arc planning techniques are superior in lowering the lung volume treated to low dose, as well as in minimizing MLD, followed by the {+-}45 Degree-Sign restricted IMRT plan. All planning techniques that allow the use of lateral or lateral/oblique beams result in spreading the low dose over a higher lung volume. The area under the lung dose-volume histogram curve below 20 Gy, V0-20, is proposed as an alternative to individual V{sub dose} parameters, both as a measure of lung sparing and as a parameter to be minimized during IMRT optimization.

  20. SU-E-J-87: Ventilation Weighting Effect On Mean Doses of Both Side Lungs for Patients with Advanced Stage Lung Cancer

    International Nuclear Information System (INIS)

    Purpose: To study ventilation weighting effect on radiation doses to both side lungs for patients with advanced stage lung cancer. Methods: Fourteen patients with advanced stage lung cancer were included in this retrospective study. Proprietary software was developed to calculate the lung ventilation map based on 4DCT images acquired for radiation therapy. Two phases of inhale (0%) and exhale (50%) were used for the lung ventilation calculations. For each patient, the CT images were resampled to the same dose calculation resolution of 3mmx3mmx3mm. The ventilation distribution was then normalized by the mean value of the ventilation. The ventilation weighted dose was calculated by applying linearly weighted ventilation to the dose of each pixel. The lung contours were automatically delineated from patient CT image with lung window, excluding the tumor and high density tissues. For contralateral and ipsilateral lungs, the mean lung doses from the original plan and ventilation weighted mean lung doses were compared using two tail t-Test. Results: The average of mean dose was 6.1 ±3.8Gy for the contralateral lungs, and 26.2 ± 14.0Gy for the ipsilateral lungs. The average of ventilation weighted dose was 6.3± 3.8Gy for the contralateral lungs and 24.6 ± 13.1Gy for the ipsilateral lungs. The statistics analysis shows the significance of the mean dose increase (p<0.015) for the contralateral lungs and decrease (p<0.005) for the ipsilateral lungs. Conclusion: Ventilation weighted doses were greater than the un-weighted doses for contralateral lungs and smaller for ipsilateral lungs. This Result may be helpful to understand the radiation dosimetric effect on the lung function and provide planning guidance for patients with advance stage lung cancer

  1. Low-dose CT scan screening for lung cancer: comparison of images and radiation doses between low-dose CT and follow-up standard diagnostic CT

    OpenAIRE

    ONO, KOJI; Hiraoka, Toru; Ono, Asami; Komatsu, Eiji; Shigenaga, Takehiko; Takaki, Hajime; Maeda, Toru; Ogusu, Hiroyuki; Yoshida, Shintaro; Fukushima, Kiyoyasu; Kai, Michiaki

    2013-01-01

    Objectives This study aim to compare image quality and radiation doses between low-dose CT and follow-up standard diagnostic CT for lung cancer screening. Methods In a single medical institution, 19 subjects who had been screened for lung cancer by low-dose CT before going through follow-up standard diagnostic CT were randomly selected. Both CT image sets for all subjects were independently evaluated by five specialized physicians. Results There were no significant differences between low-dos...

  2. 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.

  3. Screening for lung cancer with low-dose computed tomography

    International Nuclear Information System (INIS)

    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.)

  4. Thermoluminescent dosimetry and assessment of personal dose

    International Nuclear Information System (INIS)

    Thermoluminescence is discussed in terms of the energy band structure of a crystalline solid and the trapping of charge carriers by point defects. Some general properties of thermoluminescent materials used for dosimetry are outlined, with thermoluminescence of CaSO4:Dy being described in detail. The energy response function and the modification of the energy response of a dosimeter by shielding are discussed. The final section covers the connection between exposure, as recorded by a TLD badge, and the absorbed dose to various organs from gamma radiation in a uranium mine; the conversion from absorbed dose to dose equivalent; and uncertainties in assessment of dose equivalent

  5. SU-F-BRF-11: Dose Rearrangement in High Dose Locally Advanced Lung Patients Based On Perfusion Imaging

    International Nuclear Information System (INIS)

    Purpose: The use of mean lung dose (MLD) limits allows individualization of lung patient tumor doses at safe levels. However, MLD does not account for local lung function differences between patients, leading to toxicity variability at the same MLD. We investigated dose rearrangement to minimize dose to functional lung, as measured by perfusion SPECT, while maintaining target coverage and conventional MLD limits. Methods: Retrospective plans were optimized for 15 locally advanced NSCLC patients enrolled in a prospective imaging trial. A priority-based optimization system was used. The baseline priorities were (1) meet OAR dose constraints, (2) maximize target gEUD, and (3) minimize physical MLD. As a final step, normal tissue doses were minimized. To determine the benefit of rearranging dose using perfusion SPECT, plans were reoptimized to minimize functional lung gEUD as the 4th priority. Results: When only minimizing physical MLD, the functional lung gEUD was 10.8+/−5.0 Gy (4.3–19.8 Gy). Only 3/15 cases showed a decrease in functional lung gEUD of ≥4% when rearranging dose to minimize functional gEUD in the cost function (10.5+/−5.0 Gy range 4.3−19.7). Although OAR constraints were respected, the dose rearrangement resulted in ≥10% increases in gEUD to an OAR in 4/15 cases. Only slight reductions in functional lung gEUD were noted when omitting the minimization of physical MLD, suggesting that constraining the target gEUD minimizes the potential to redistribute dose. Conclusion: Prioritydriven optimization permits the generation of plans that respect traditional OAR limits and target coverage, but with the ability to rearrange dose based on functional imaging. The latter appears to be limited due to the decreased solution space when constraining target coverage. Since dose rearrangement may increase dose to other OARs, it is also worthwhile to investigate global biomarkers of lung toxicity to further individualize treatment in this population

  6. 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).

  7. Preliminary evaluation of lung doses for dogs exposed to 239PuO2

    International Nuclear Information System (INIS)

    A group of beagle dogs exposed to inhaled 239PuO2 is being followed for life-span effects. This paper reports preliminary lung dose estimates and dose-response relationships for incidence of lung tumors and radiation pneumonitis which have been observed to date. Doses were estimated by using both conventional dose-averaging and microdosimetric techniques. Cascade impactor sampling data were used to reconstruct the original plutonium aerosol size distributions unique to each of about 120 individual dogs exposed to 239PuO2. Data providing the initial plutonium lung burden and lifetime lung retention-clearance functions of plutonium for each dog were used for calculating average dose rates, cumulative absorbed doses, and specific energy distributions. A linear dose-response relationship for lung tumor induction was estimated on the basis of cumulative lung dose. Average time to death was estimated as a function of average dose rate. Conclusions regarding the potential value of microdosimetry in the interpretation of such dose-response relationships are discussed. 8 refs., 5 figs., 1 tab

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

    Science.gov (United States)

    Lowenstein, Lisa M; Richards, Vincent F; Leal, Viola B; Housten, Ashley J; Bevers, Therese B; Cantor, Scott B; Cinciripini, Paul M; Cofta-Woerpel, Ludmila M; Escoto, Kamisha H; Godoy, Myrna C B; Linder, Suzanne K; Munden, Reginald F; Volk, Robert J

    2016-12-01

    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. PMID:27512650

  9. The effects of anatomic resolution, respiratory variations and dose calculation methods on lung dosimetry

    Science.gov (United States)

    Babcock, Kerry Kent Ronald

    2009-04-01

    The goal of this thesis was to explore the effects of dose resolution, respiratory variation and dose calculation method on dose accuracy. To achieve this, two models of lung were created. The first model, called TISSUE, approximated the connective alveolar tissues of the lung. The second model, called BRANCH, approximated the lungs bronchial, arterial and venous branching networks. Both models were varied to represent the full inhalation, full exhalation and midbreath phases of the respiration cycle. To explore the effects of dose resolution and respiratory variation on dose accuracy, each model was converted into a CT dataset and imported into a Monte Carlo simulation. The resulting dose distributions were compared and contrasted against dose distributions from Monte Carlo simulations which included the explicit model geometries. It was concluded that, regardless of respiratory phase, the exclusion of the connective tissue structures in the CT representation did not significantly effect the accuracy of dose calculations. However, the exclusion of the BRANCH structures resulted in dose underestimations as high as 14% local to the branching structures. As lung density decreased, the overall dose accuracy marginally decreased. To explore the effects of dose calculation method on dose accuracy, CT representations of the lung models were imported into the Pinnacle 3 treatment planning system. Dose distributions were calculated using the collapsed cone convolution method and compared to those derived using the Monte Carlo method. For both lung models, it was concluded that the accuracy of the collapsed cone algorithm decreased with decreasing density. At full inhalation lung density, the collapsed cone algorithm underestimated dose by as much as 15%. Also, the accuracy of the CCC method decreased with decreasing field size. Further work is needed to determine the source of the discrepancy.

  10. Ultrasonography for the assessment of lung recruitment maneuvers.

    Science.gov (United States)

    Tusman, Gerardo; Acosta, Cecilia M; Costantini, Mauro

    2016-12-01

    Lung collapse is a known complication that affects most of the patients undergoing positive pressure mechanical ventilation. Such atelectasis and airways closure lead to gas exchange and lung mechanics impairment and has the potential to develop an inflammatory response in the lungs. These negative effects of lung collapse can be reverted by a lung recruitment maneuver (RM) i.e. a ventilatory strategy that resolves lung collapse by a brief and controlled increment in airway pressures. However, an unsolved question is how to assess such RM at the bedside. The aim of this paper is to describe the usefulness of lung sonography (LUS) to conduct and personalize RM in a real-time way at the bedside. LUS has favorable features to assess lung recruitment due to its high specificity and sensitivity to detect lung collapse together with its non-invasiveness, availability and simple use. PMID:27496127

  11. 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

  12. 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

    on assumed homogeneous distribution of clonogenic cells either in the GTV, CTV or PTV showed absolute TCP increases of approximately 15, 10 and 5 percentage points, respectively. This increase in local control was obtained without increasing the mean lung dose. However, small increases in maximum doses...

  13. 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

  14. Spectrum of early lung cancer presentation in low-dose screening CT: a pictorial review.

    Science.gov (United States)

    Rampinelli, Cristiano; Calloni, Sonia Francesca; Minotti, Marta; Bellomi, Massimo

    2016-06-01

    The typical presentation of early stage lung cancers on low-dose CT screening are non-calcified pulmonary nodules. However, there is a wide spectrum of unusual focal abnormalities that can be early presentations of lung cancer. These abnormalities include, for example, cancers associated with 'cystic airspaces' or scar-like cancers. The detection of lung cancer with low-dose CT can be affected by the absence of intravenous contrast medium. As a consequence, endobronchial and central lesions can be difficult to recognize, raising the potential for missed cancers. Focal lesions arising within pre-existing lung disease, such as lung fibrosis or apical scars, can also be early lung cancer manifestations and deserve particular consideration as recognition of these lesions may be hindered by the underlying disease. Furthermore, the unpredictable growth rate of lung cancer, which ranges from indolent to aggressive cancers, necessitates attention to the wide spectrum of progression in lung cancer appearance on serial low-dose CT scans. In this pictorial review we discuss the spectrum of early lung cancer presentation in low-dose CT screening, highlighting typical as well as unusual radiological features and the varied growth rates of early lung cancer. Teaching Points • There is a wide spectrum of early presentations of lung cancer on LDCT. • Low radiation dose and the absence of contrast medium injection can affect lung cancer detection. • Lung cancer growth shows various behaviours, ranging from indolent to aggressive cancers. • Familiarity with LDCT technique can improve CT screening effectiveness and avoid missed diagnosis. PMID:27188380

  15. Longitudinal follow-up study of smoking-induced emphysema progression in low-dose CT screening of lung cancer

    Science.gov (United States)

    Suzuki, H.; Matsuhiro, M.; Kawata, Y.; Niki, N.; Nakano, Y.; Ohmatsu, H.; Kusumoto, M.; Tsuchida, T.; Eguchi, K.; Kaneko, Masahiro; Moriyama, N.

    2014-03-01

    Chronic obstructive pulmonary disease is a major public health problem that is predicted to be third leading cause of death in 2030. Although spirometry is traditionally used to quantify emphysema progression, it is difficult to detect the loss of pulmonary function by emphysema in early stage, and to assess the susceptibility to smoking. This study presents quantification method of smoking-induced emphysema progression based on annual changes of low attenuation volume (LAV) by each lung lobe acquired from low-dose CT images in lung cancer screening. The method consists of three steps. First, lung lobes are segmented using extracted interlobar fissures by enhancement filter based on fourdimensional curvature. Second, LAV of each lung lobe is segmented. Finally, smoking-induced emphysema progression is assessed by statistical analysis of the annual changes represented by linear regression of LAV percentage in each lung lobe. This method was applied to 140 participants in lung cancer CT screening for six years. The results showed that LAV progressions of nonsmokers, past smokers, and current smokers are different in terms of pack-year and smoking cessation duration. This study demonstrates effectiveness in diagnosis and prognosis of early emphysema in lung cancer CT screening.

  16. The influence of biological and aerosol parameters of inhaled short-lived radon decay products on human lung dose

    International Nuclear Information System (INIS)

    The purpose of this article is to assess the influence of biological and aerosol parameters on human lung dose with regard to a comparison with the corresponding recommended dose values of the International Commission on Radiological Protection (ICRP). The dose conversion factor which gives the relationship between effective dose and potential alpha energy concentration of inhaled short-lived radon decay products (218Po, 214Pb, 214Bi/214Po) is calculated with a dosimetric approach. The calculations are based on a lung dose model with a structure that is related to the recently recommended ICRP respiratory tract model. Because of the short half-lives of the investigated nuclides, simplifying modification of the model were possible. Firstly, the underlying assumptions of the model are described. Secondly, important input parameters of the model are varied to assess the uncertainty of the dose conversion factor due to uncertainty of these parameters. The main emphasis is focused on biological and aerosol parameter variability like variation of breathing rate and breathing mode, clearance rates, critical cells for the induction of lung cancer, particle size and dispersion of the activity size distributions. The possible range of dose conversion factors is discussed both for indoor and mine aerosol conditions in the framework of the presented dose model. The investigation shows that the dosimetric approach leads to a dose conversion convention which is a factor of more than two times higher than the recommended epidemiological values of the ICRP of 3.9 mSv.WLM-1 for the public and 5.1 mSv.WLM-1 at working places. The dosimetric results yield both for indoor and mine aerosol conditions dose conversion factors in the range of 10 mSv.WLM-1 to 15 mSv.WLM-1 depending on breathing mode. (author)

  17. Assessing non-resectability of lung cancer

    International Nuclear Information System (INIS)

    To investigate whether the assessment of resectability of lung cancer can be reliably made on the basis of computed tomography (CT), the thoracic CT scans of 96 lung cancer patients who were operated on, and in whom the tumour was classified to be of stage III at preoperative CT or at thoracotomy, were analysed. Of the patients, 58 underwent complete resection of the tumour, whereas thoracotomy resulted in non-complete resection or exploration only in 38 cases. Overlapping of the CT findings in the groups of complete and non-successful resection was observed. The majority of tumours with apparent growth to the carina, trachea, oesophagus or great vessels at CT were completely resected. Tumours that only bordered on the pleura could not be distinguished from those with pleural invasion. Mediastinal lymph node enlargement did not always mean metastatic spread. We conclude that there is no definite sign that identifies non-resectability of lung tumours, and a certain proportion of non-curative thoracotomies must be accepted. (orig.)

  18. Model-based risk assessment for motion effects in 3D radiotherapy of lung tumors

    Science.gov (United States)

    Werner, René; Ehrhardt, Jan; Schmidt-Richberg, Alexander; Handels, Heinz

    2012-02-01

    Although 4D CT imaging becomes available in an increasing number of radiotherapy facilities, 3D imaging and planning is still standard in current clinical practice. In particular for lung tumors, respiratory motion is a known source of uncertainty and should be accounted for during radiotherapy planning - which is difficult by using only a 3D planning CT. In this contribution, we propose applying a statistical lung motion model to predict patients' motion patterns and to estimate dosimetric motion effects in lung tumor radiotherapy if only 3D images are available. Being generated based on 4D CT images of patients with unimpaired lung motion, the model tends to overestimate lung tumor motion. It therefore promises conservative risk assessment regarding tumor dose coverage. This is exemplarily evaluated using treatment plans of lung tumor patients with different tumor motion patterns and for two treatment modalities (conventional 3D conformal radiotherapy and step-&- shoot intensity modulated radiotherapy). For the test cases, 4D CT images are available. Thus, also a standard registration-based 4D dose calculation is performed, which serves as reference to judge plausibility of the modelbased 4D dose calculation. It will be shown that, if combined with an additional simple patient-specific breathing surrogate measurement (here: spirometry), the model-based dose calculation provides reasonable risk assessment of respiratory motion effects.

  19. Assessments for High Dose Radionuclide Therapy Treatment Planning

    International Nuclear Information System (INIS)

    Advances in the biotechnology of cell-specific targeting of cancer, and the increased number of clinical trials involving treatment of cancer patients with radiolabeled antibodies, peptides, and similar delivery vehicles have led to an increase in the number of high-dose radionuclide therapy procedures. Optimized radionuclide therapy for cancer treatment is based on the concept of absorbed dose to the dose-limiting normal organ or tissue. The limiting normal tissue is often the red marrow, but it may sometimes be lungs, liver, intestinal tract, or kidneys. Appropriate treatment planning requires assessment of radiation dose to several internal organs and tissues, and usually involves biodistribution studies in the patient using a tracer amount of radionuclide bound to the targeting agent and imaged at sequential time points using a planar gamma camera. Time-activity curves are developed from the imaging data for the major organs tissues of concern, for the whole body, and sometimes for selected tumors. Patient-specific factors often require that dose estimates be customized for each patient. The Food and Drug Administration regulates the experimental use of investigational new drugs and requires reasonable calculation of radiation absorbed dose to the whole body and to critical organs using methods prescribed by the Medical Internal Radiation Dose (MIRD) Committee of the Society of Nuclear Medicine. Review of high-dose studies in the U.S. and elsewhere shows that (1) some studies are conducted with minimal dosimetry, (2) the marrow dose is difficult to establish and is subject to large uncertainties, and (3) despite the general availability of MIRD software, internal dosimetry methods are often inconsistent from one clinical center to another

  20. Assessments for high dose radionuclide therapy treatment planning

    International Nuclear Information System (INIS)

    Advances in the biotechnology of cell specific targeting of cancer and the increased number of clinical trials involving treatment of cancer patients with radiolabelled antibodies, peptides, and similar delivery vehicles have led to an increase in the number of high dose radionuclide therapy procedures. Optimised radionuclide therapy for cancer treatment is based on the concept of absorbed dose to the dose limiting normal organ or tissue. The limiting normal tissue is often the red marrow, but it may sometimes be the lungs, liver, intestinal tract, or kidneys. Appropriate treatment planning requires assessment of radiation dose to several internal organs and tissues, and usually involves biodistribution studies in the patient using a tracer amount of radionuclide bound to the targeting agent and imaged at sequential timepoints using a planar gamma camera. Time-activity curves are developed from the imaging data for the major organ tissues of concern, for the whole body and sometimes for selected tumours. Patient specific factors often require that dose estimates be customised for each patient. In the United States, the Food and Drug Administration regulates the experimental use of investigational new drugs and requires 'reasonable calculation of radiation absorbed dose to the whole body and to critical organs' using the methods prescribed by the Medical Internal Radiation Dose (MIRD) Committee of the Society of Nuclear Medicine. Review of high dose studies shows that some are conducted with minimal dosimetry, that the marrow dose is difficult to establish and is subject to large uncertainties. Despite the general availability of software, internal dosimetry methods often seem to be inconsistent from one clinical centre to another. (author)

  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. Improved heart, lung and target dose with deep inspiration breath hold in a large clinical series of breast cancer patients

    International Nuclear Information System (INIS)

    Background and purpose: This study aims at evaluating the effect of deep-inspiration breath hold (DIBH) on target coverage and dose to organs at risk in a large series of breast cancer patients. Materials and methods: Clinical dose plans for 319 breast cancer patients were evaluated: 144 left-sided patients treated with DIBH and 175 free-breathing (FB) patients (83 left-sided and 92 right-sided). All patients received whole breast irradiation with tangential fields, based on a forward-planned intensity-modulated radiation therapy (IMRT) technique. Dose to heart, ipsi-lateral lung and ipsi-lateral breast were assessed and median values compared between patient groups. Results: Comparing group median values, DIBH plans show large reductions of dose to the heart compared with left-sided FB plans; V20Gy (relative volume receiving ⩾20 Gy) for the heart is reduced from 7.8% to 2.3% (−70%, p < 0.0001), V40Gy from 3.4% to 0.3% (−91%, p < 0.0001) and mean dose from 5.2 to 2.7 Gy (−48%, p < 0.0001). Lung dose also shows a small reduction in V20Gy (p < 0.04), while median target coverage is slightly improved (p = 0.0002). Conclusions: In a large series of clinical patients we find that implementation of DIBH in daily clinical practice results in reduced irradiation of heart and lung, without compromising target coverage

  3. Inhalation dose assessment for Maralinga and Emu

    International Nuclear Information System (INIS)

    Dose assessments for the inhalation of artificial radionuclides are presented for all types of contaminated areas at Maralinga and Emu. These enable Committed Effective Dose Equivalent (CEDE), to be estimated by scaling at any area of interest where activity concentrations are known. In the case of Aborigines, these dose are estimated assuming respirable dust loadings of 1 mg/m3 for adults and 1.5 mg/m3 for children and infants. Details of the calculations are presented in the appendix. The model of the respiratory system used in this assessment is that described in Interantional Commission on Radiological Protection (ICRP) Publication 30 (ICRP, 1979a). With the exception of Kuli, which is contaminated with uranium, at all other sites it is only the inhalation of plutonium and americium that contributes significantly to the dose, and of these 239Pu is the largest contributor. Therefore, considering the long half lives of the radionuclides concerned, it appears that the inhalation problems highlighted by this dose assessment will not diminish significantly within any reasonable period of time and hence management strategies must be developed to deal with such problems. 32 refs., 5 tabs., 1 fig

  4. Recommendations for dose calculations of lung cancer treatment plans treated with stereotactic ablative body radiotherapy (SABR)

    International Nuclear Information System (INIS)

    The purpose of this study was to systematically evaluate dose distributions computed with 5 different dose algorithms for patients with lung cancers treated using stereotactic ablative body radiotherapy (SABR). Treatment plans for 133 lung cancer patients, initially computed with a 1D-pencil beam (equivalent-path-length, EPL-1D) algorithm, were recalculated with 4 other algorithms commissioned for treatment planning, including 3-D pencil-beam (EPL-3D), anisotropic analytical algorithm (AAA), collapsed cone convolution superposition (CCC), and Monte Carlo (MC). The plan prescription dose was 48 Gy in 4 fractions normalized to the 95% isodose line. Tumors were classified according to location: peripheral tumors surrounded by lung (lung-island, N=39), peripheral tumors attached to the rib-cage or chest wall (lung-wall, N=44), and centrally-located tumors (lung-central, N=50). Relative to the EPL-1D algorithm, PTV D95 and mean dose values computed with the other 4 algorithms were lowest for 'lung-island' tumors with smallest field sizes (3-5 cm). On the other hand, the smallest differences were noted for lung-central tumors treated with largest field widths (7-10 cm). Amongst all locations, dose distribution differences were most strongly correlated with tumor size for lung-island tumors. For most cases, convolution/superposition and MC algorithms were in good agreement. Mean lung dose (MLD) values computed with the EPL-1D algorithm were highly correlated with that of the other algorithms (correlation coefficient =0.99). The MLD values were found to be ∼10% lower for small lung-island tumors with the model-based (conv/superposition and MC) vs. the correction-based (pencil-beam) algorithms with the model-based algorithms predicting greater low dose spread within the lungs. This study suggests that pencil beam algorithms should be avoided for lung SABR planning. For the most challenging cases, small tumors surrounded entirely by lung tissue (lung-island type

  5. Recommendations for dose calculations of lung cancer treatment plans treated with stereotactic ablative body radiotherapy (SABR)

    Science.gov (United States)

    Devpura, S.; Siddiqui, M. S.; Chen, D.; Liu, D.; Li, H.; Kumar, S.; Gordon, J.; Ajlouni, M.; Movsas, B.; Chetty, I. J.

    2014-03-01

    The purpose of this study was to systematically evaluate dose distributions computed with 5 different dose algorithms for patients with lung cancers treated using stereotactic ablative body radiotherapy (SABR). Treatment plans for 133 lung cancer patients, initially computed with a 1D-pencil beam (equivalent-path-length, EPL-1D) algorithm, were recalculated with 4 other algorithms commissioned for treatment planning, including 3-D pencil-beam (EPL-3D), anisotropic analytical algorithm (AAA), collapsed cone convolution superposition (CCC), and Monte Carlo (MC). The plan prescription dose was 48 Gy in 4 fractions normalized to the 95% isodose line. Tumors were classified according to location: peripheral tumors surrounded by lung (lung-island, N=39), peripheral tumors attached to the rib-cage or chest wall (lung-wall, N=44), and centrally-located tumors (lung-central, N=50). Relative to the EPL-1D algorithm, PTV D95 and mean dose values computed with the other 4 algorithms were lowest for "lung-island" tumors with smallest field sizes (3-5 cm). On the other hand, the smallest differences were noted for lung-central tumors treated with largest field widths (7-10 cm). Amongst all locations, dose distribution differences were most strongly correlated with tumor size for lung-island tumors. For most cases, convolution/superposition and MC algorithms were in good agreement. Mean lung dose (MLD) values computed with the EPL-1D algorithm were highly correlated with that of the other algorithms (correlation coefficient =0.99). The MLD values were found to be ~10% lower for small lung-island tumors with the model-based (conv/superposition and MC) vs. the correction-based (pencil-beam) algorithms with the model-based algorithms predicting greater low dose spread within the lungs. This study suggests that pencil beam algorithms should be avoided for lung SABR planning. For the most challenging cases, small tumors surrounded entirely by lung tissue (lung-island type), a Monte

  6. Critical dose and toxicity index of organs at risk in radiotherapy: Analyzing the calculated effects of modified dose fractionation in non–small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pedicini, Piernicola, E-mail: ppiern@libero.it [Service of Medical Physics, I.R.C.C.S. Regional Cancer Hospital C.R.O.B, Rionero in Vulture (Italy); Strigari, Lidia [Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome (Italy); Benassi, Marcello [Service of Medical Physics, Scientific Institute of Tumours of Romagna I.R.S.T., Meldola (Italy); Caivano, Rocchina [Service of Medical Physics, I.R.C.C.S. Regional Cancer Hospital C.R.O.B, Rionero in Vulture (Italy); Fiorentino, Alba [U.O. of Radiotherapy, I.R.C.C.S. Regional Cancer Hospital C.R.O.B., Rionero in Vulture (Italy); Nappi, Antonio [U.O. of Nuclear Medicine, I.R.C.C.S. Regional Cancer Hospital C.R.O.B., Rionero in Vulture (Italy); Salvatore, Marco [U.O. of Nuclear Medicine, I.R.C.C.S. SDN Foundation, Naples (Italy); Storto, Giovanni [U.O. of Nuclear Medicine, I.R.C.C.S. Regional Cancer Hospital C.R.O.B., Rionero in Vulture (Italy)

    2014-04-01

    To increase the efficacy of radiotherapy for non–small cell lung cancer (NSCLC), many schemes of dose fractionation were assessed by a new “toxicity index” (I), which allows one to choose the fractionation schedules that produce less toxic treatments. Thirty-two patients affected by non resectable NSCLC were treated by standard 3-dimensional conformal radiotherapy (3DCRT) with a strategy of limited treated volume. Computed tomography datasets were employed to re plan by simultaneous integrated boost intensity-modulated radiotherapy (IMRT). The dose distributions from plans were used to test various schemes of dose fractionation, in 3DCRT as well as in IMRT, by transforming the dose-volume histogram (DVH) into a biological equivalent DVH (BDVH) and by varying the overall treatment time. The BDVHs were obtained through the toxicity index, which was defined for each of the organs at risk (OAR) by a linear quadratic model keeping an equivalent radiobiological effect on the target volume. The less toxic fractionation consisted in a severe/moderate hyper fractionation for the volume including the primary tumor and lymph nodes, followed by a hypofractionation for the reduced volume of the primary tumor. The 3DCRT and IMRT resulted, respectively, in 4.7% and 4.3% of dose sparing for the spinal cord, without significant changes for the combined-lungs toxicity (p < 0.001). Schedules with reduced overall treatment time (accelerated fractionations) led to a 12.5% dose sparing for the spinal cord (7.5% in IMRT), 8.3% dose sparing for V{sub 20} in the combined lungs (5.5% in IMRT), and also significant dose sparing for all the other OARs (p < 0.001). The toxicity index allows to choose fractionation schedules with reduced toxicity for all the OARs and equivalent radiobiological effect for the tumor in 3DCRT, as well as in IMRT, treatments of NSCLC.

  7. The embryogenesis of dose assessment at Hanford

    International Nuclear Information System (INIS)

    Several significant events occurred between 1955 and 1960 that resulted in major changes in environmental monitoring at Hanford and in the initiation of comprehensive dose assessments. These included: (1) specification of dose limits for nonoccupational exposure (including internal emitters); (2) a national and international awakening to the need for managing the disposal of radioactive wastes; (3) identification of the most important radionuclides and their sources of exposure; (4) data that quantified the transfer coefficients of nuclides along environmental pathways; and (5) development of greatly improved radiation detection instrumentation. In response to a growing need, the Hanford Laboratories formed the Environmental Studies and Evaluation component. This group revamped the monitoring and sampling programs so that analytical results contributed directly to dose estimation. Special studies were conducted to ascertain local dietary and recreational habits that affected dose calculations and to calibrate the models. These studies involved extensive contact with the public and governmental agencies, which elicited a positive reaction

  8. Internal dose assessment in radiation accidents

    International Nuclear Information System (INIS)

    Although numerous models have been developed for occupational and medical internal dosimetry, they may not be applicable to an accident situation. Published dose coefficients relate effective dose to intake, but if acute deterministic effects are possible, effective dose is not a useful parameter. Consequently, dose rates to the organs of interest need to be computed from first principles. Standard bioassay methods may be used to assess body contents, but, again, the standard models for bioassay interpretation may not be applicable because of the circumstances of the accident and the prompt initiation of decorporation therapy. Examples of modifications to the standard methodologies include adjustment of biological half-times under therapy, such as in the Goiania accident, and the same effect, complicated by continued input from contaminated wounds, in the Hanford 241Am accident. (author)

  9. Development and application of a random lung model for dose calculations in radiotherapy

    Science.gov (United States)

    Liang, Liang

    Radiotherapy requires accurate dose calculations in the human body, especially in disease sites with large variations of electron density in neighboring tissues, such as the lung. Currently, the lung is modeled by a voxelized geometry interpolated from computed tomography (CT) scans to various resolutions. The simplest such voxelized lung, the atomic mix model, is a homogenized whole lung with a volume-averaged bulk density. However, according traditional transport theory, even the relatively fine CT voxelization of the lung is not valid, due to the extremely small mean free path (MFP) of the electrons. The purpose of this thesis is to study the impact of the lung's heterogeneities on dose calculations in lung treatment planning. We first extend the traditional atomic mix theory for charged particles by approximating the Boltzmann equation for electrons to its Fokker-Planck (FP) limit, and then applying a formal asymptotic analysis to the BFP equation. This analysis raises the length scale for homogenizing a heterogeneous medium from the electron mean free path (MFP) to the much larger electron transport MFP. Then, using the lung's anatomical data and our new atomic mix theory, we build a realistic 2 1/2-D random lung model. The dose distributions for representative realizations of the random lung model are compared to those from the atomic mix approximation of the random lung model, showing that significant perturbations may occur with small field sizes and large lung structures. We also apply our random lung model to a more realistic lung phantom and investigate the effect of CT resolutions on lung treatment planning. We show that, compared to the reference 1 x 1 mm2 CT resolution, a 2 x 2 mm2 CT resolution is sufficient to voxelize the lung, while significant deviations in dose can be observed with a larger 4 x 4 mm 2 CT resolution. We use the Monte Carlo method extensively in this thesis, to avoid systematic errors caused by inaccurate heterogeneity corrections

  10. Assessment of external dose indoors in Lithuania

    International Nuclear Information System (INIS)

    The aim of this paper was an assessment of external exposure indoors and its dependence on construction materials and indoor radon concentrations in Lithuanian living houses. Relationship of absorbed dose rate in air indoors and activity indexes of the most commonly used construction materials (wood, concrete and bricks) have been studied using results received in measurements done in >4700 rooms in 1995-2005. Possible connections of dose rate indoors with indoor radon concentrations are also discussed. Findings of this study helped to make an assessment of the mean value of effective dose of Lithuanian population due to external exposure indoors which is equal to 0.58 mSv y-1. The received data might also be used in improvement of quality of personal dosimetric measurements done in premises constructed of different construction materials. (authors)

  11. Analysis of the risk factors for exposure of the lung to low irradiation doses

    International Nuclear Information System (INIS)

    In this report a description is presented of the risk factors for induction of lungtumours. The contribution of natural radioactivity from uranium and thorium to the lungs is mainly caused by inhalation of alpha-emitting radon and thorium daughter products. Apart from exposure by inhalation the lungs are also exposed to external radiation. For internal as well as external exposure a value of 10-3 lungcancers per Sv lung dose equivalence is found to be acceptable for the riskfactor. (Auth.)

  12. Human data and internal dose assessment

    International Nuclear Information System (INIS)

    Recent data on physical and anatomical and physiological or metabolic data regarding Japanese Reference Man is briefly reviewed. This includes reference values for masses of all organs and tissues proposed for a Japanese Reference male adult. Part of the data is used to assess alpha doses to bone tissues from naturally occurring 226Ra in bone of Japanese adult. (author)

  13. 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. PMID:17022235

  14. Paradigm shift in LUNG SBRT dose calculation associated with Heterogeneity correction

    International Nuclear Information System (INIS)

    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)

  15. 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.

  16. Mid-ventilation position planning: Optimal model for dose distribution in lung tumour

    International Nuclear Information System (INIS)

    Purpose. - The dose distribution for lung tumour is estimated using a 3D-CT scan, and since a person breathes while the images are captured, the dose distribution doesn't reflect the reality. A 4D-CT scan integrates the motion of the tumour during breathing and, therefore, provides us with important information regarding tumour's motion in all directions, the motion volume (ITV) and the time-weighted average position (MVP). Patient and methods. - Based on these two concepts, we have estimated, for a lung carcinoma case a 3D dose distribution from a 3D-CT scan, and a 4D dose distribution from a 4-D CT scan. To this, we have applied a non-rigid registration to estimate the cumulative dose. Results. - Our study shows that the 4D dose estimation of the GTV is almost the same when made using MVP and ITV concepts, but sparring of the healthy lung is better done using the MPV model (MVP), as compared to the ITV model. This improvement of the therapeutic index allows, from a projection on the theoretical maximal dose to PTV (strictly restricted to doses for the lungs and the spinal cord), for an increase of about 11% on the total dose (maximal dose of 86 Gy for the ITV and 96 Gy for the MVP). Conclusion. - Further studies with more patients are needed to confirm our data. (authors)

  17. Dose assessment in the Marshall Islands

    International Nuclear Information System (INIS)

    Bikini Atoll and Enewetak Atoll in the Marshall Islands were the sites of major U.S. weapons testing from 1948 through 1958. Both the Bikini and Knewetak people have expressed a desire to return to their native Atolls. In 1968 clean-up and resettlement of Bikini was begun. In 1972-73 the initial survey of Enewetak Atoll was conducted and clean-up began in 1977. Surveys have been conducted at both Atolls to establish the concentrations of radionuclides in the biota and to determine the external exposure rates. Subsequent to the surveys dose assessments have been made to determine the potential dose to returning (100) populations at both Atolls. This talk will include discussions of the relative importance of the critical exposure pathways (i.e., external exposure, inhalation, marine, terrestrial and drinking water), the predominant radionuclides contributing to the predicted doses for each pathway, the doses predicted for alternate living patterns, comparison to Federal Guidelines, the comparison between Atolls, some of the social problems created by adherence to Federal Guidelines and the follow-up research identified and initiated to help refine the dose assessments and better predict the long term use of the Atolls (86). (author)

  18. Radiation dose assessment for building material

    International Nuclear Information System (INIS)

    A mathematical model for radiation dose assessment for building materials based on attenuation and build up for gamma rays of the natural emitters was studied in this work. This was done by calculate the air absorbed dose from elemental volume and integrate over the total wall volume, which uniformed density and activity concentration. The used form of the build-up is a mixing of exponential and linear form for Berger model [1]. To convert absorbed dose to effective dose for all natural emitter (include 137Cs in case of fallout), the dose rate conversion factors which were reported in UNSCEAR (1993) Report [2] and U. S. NCRP (1987) [3] was used. These factors are 0.7 Sv/Gy for adult and 0.8 Sv/Gy for children. A computer program for calculating the absorbed and the annual effective dose was prepared in MATLAB language. The program is applicable for wall or room building materials when walls consist of one or two layers. The obtained results were compared with published studies. (author)

  19. Exposure pathways and environmental dose assessment

    International Nuclear Information System (INIS)

    Radionuclides released into the environment from various nuclear facilities during normal operating conditions and under accident conditions eventually reach man through various pathways of exposure. It is required to assess the dose received by members of the public at various stages of nuclear facility. At the design stage of the nuclear facility such assessment is necessary for determining the adequacy of design provisions. During the operational phase, the assessment is needed to establish compliance with the standards and limits laid down for the facility and site

  20. A new approach to radiopharmaceutical dose assessment

    International Nuclear Information System (INIS)

    Dosimetry for bone-seeking radiopharmaceuticals relies on an accurate measurement of the activity administered, a model for uptake of the pharmaceutical, and calculations of the dose to the target organ. The authors report here a new approach to experimental assessment of the radiation dose to bone using electron paramagnetic resonance (EPR) spectrometry. Ionizing radiations interact with mineralized bone tissue (hydroxyapatite) to produce dose-dependent concentrations of long-lived paramagnetic centers. They have successfully applied the EPR technique to bone tissues of an animal treated with a radiopharmaceutical to demonstrate its sensitivity towards radiation-induced centers in the mineralized tissue. Although the EPR bone dosimetry method is invasive, it does offer the first experimental technique for measuring and mapping the tissue response to the administered radioactivity

  1. Deep inspiration breath-hold technique for lung tumors: the potential value of target immobilization and reduced lung density in dose escalation

    International Nuclear Information System (INIS)

    compared to assess the improvement due to target immobilization and reduced lung density. To estimate the role of target immobilization alone, an additional plan is generated using the DIBH PTV, but with the assumption it is surrounded by free-breathing, not deep inspiration, density lung. Results: The results of the study suggest that the DIBH technique can reduce the mass of lung irradiated to high dose, so that the possibility for dose escalation is increased. The relative contribution of reduced lung density and reduced margin for motion vary depending on the tumor size, level of DIBH and extent of tumor motion in free-breathing. An example treatment plan comparison for a typical patient is shown in the figure, which is a cumulative dose mass histogram (DMH) depicting the mass of normal lung tissue receiving at least a certain dose. The lung DMHs shown are for three plans: (A) Free-breathing; (B) Target immobilization only; (C) Target immobilization plus reduced lung density. It is observed that the mass of lung tissue treated to high doses is less for cases B and C. For example, the mass receiving >24.5 Gy is 235 g for free-breathing (A), 180 g for immobilization alone (B) and 150 g for DIBH (C). For this patient, target immobilization alone would allow a dose escalation from 75.6 Gy to 95 Gy for the same level of NTCP as the free-breathing plan, the added effect of reduced density would then enable a further escalation from 95 Gy to 110 Gy. For this study, the measured tumor motions ranged from 5 to 12 mm for free-breathing and 1 to 3 mm for DIBH. For the example shown in the figure the tumor motion was 10 mm and DIBH reproducibility was 3 mm. Additional details on the DIBH technique and results for a group of patients will be presented. Conclusions: Compared to conventional free-breathing treatment the DIBH technique benefits from reduced margins, as a result of the suppressed target motion, as well as a decreased lung density - both contribute to moving normal lung

  2. Bio-indicators for radiation dose assessment

    International Nuclear Information System (INIS)

    In nuclear facilities, such as Chalk River Laboratories, dose to the atomic radiation workers (ARWs) is assessed routinely by using physical dosimeters and bioassay procedures in accordance with regulatory recommendations. However, these procedures may be insufficient in some circumstances, e.g., in cases where the reading of the physical dosimeters is questioned, in cases of radiation accidents where the person(s) in question was not wearing a dosimeter, or in the event of a radiation emergency when an exposure above the dose limits is possible. The desirability of being able to assess radiation dose on the basis of radio-biological effects has prompted the Dosimetric Research Branch to investigate the suitability of biological devices and techniques that could be used for this purpose. Current biological dosimetry concepts suggest that there does not appear to be any bio-indicator that could reliably measure the very low doses that are routinely measured by the physical devices presently in use. Nonetheless, bio-indicators may be useful in providing valuable supplementary information in cases of unusual radiation exposures, such as when the estimated body doses are doubtful because of lack of proper physical measurements, or in cases where available results need to be confirmed for medical treatment plannings. This report evaluates the present state of biological dosimetry and, in particular, assesses the efficiency and limits of individual indicators. This has led to the recommendation of a few promising research areas that may result in the development of appropriate biological dosimeters for operational and emergency needs at Chalk River

  3. A Real Time Dose Assessment System

    International Nuclear Information System (INIS)

    The construction of the second Egyptian Research Reactor ETRR-2 at Anshas area in the same site as the first Egyptian Research Reactor ETRR-1 together with all the other nuclear Laboratories and installations necessitates the presence of a real time dose assessment system (RTDAS). The RTDAS as a part of an overall decision making aid, will help the emergency response manager to consolidate decisions regarding the required management of an off-site emergency. The present work describes a proposed dose assessment system based on a Geographical Information System (GIS). The system consists of Hardware and Software parts. The Hardware includes radiation-monitoring equipment connected to a central computer. The real time model is designed for operational use so it can provide decisions makers with information about the probable future consequences of an accidental release of radioactivity almost immediately of few minutes of receipt of the appropriate information. The output information from the model can be presented in terms of dose estimates for population at risk and can be displayed either as tabulated data or as dose contours superimposed upon a map of the area

  4. Effect of intravenous contrast on treatment planning system dose calculations in the lung

    International Nuclear Information System (INIS)

    Intravenous contrast-enhanced computed tomography is utilised in radiotherapy lung treatment planning to improve the delineation of the tumour volume and nodal areas. In the resultant CT images, the electron density is increased within the vascular structures of the lung and the overall density in the lung volume may also be increased. As yet, it is unclear whether the change in density affects the accuracy of dose calculations based on this CT data. Two investigations were undertaken. Firstly, contrast-enhancement was simulated using an anthropomorphic phantom. In the second investigation, bulk density corrections were performed in an existing patient dataset. In both investigations, treatment plans were generated using both pre- and post-contrast datasets. The numbers of monitor units calculated in each of the plans were compared, as were the resulting isodose curves, dose volume histograms and physical mean lung doses. The numbers of monitor units calculated from the contrast- and non contrast-enhanced datasets agreed within 2%. The isodose curves and dose volume histograms showed very minor differences in size and shape. With the introduction of contrast agent, the physical mean lung doses calculated remained below the limit recommended for an acceptable plan. These results indicate that the introduction of contrast agent has a minimal dosimetric impact upon lung cancer treatment plans

  5. Dose-Guided Radiotherapy: Potential Benefit of Online Dose Recalculation for Stereotactic Lung Irradiation in Patients With Non-Small-Cell Lung Cancer

    International Nuclear Information System (INIS)

    Purpose: To determine whether dose-guided radiotherapy (i.e., online recalculation and evaluation of the actual dose distribution) can improve decision making for lung cancer patients treated with stereotactic body radiotherapy. Methods and Materials: For this study 108 cone-beam computed tomography (CBCT) scans of 10 non-small-cell lung cancer patients treated with stereotactic body radiotherapy were analyzed retrospectively. The treatment plans were recalculated on the CBCT scans. The V100% of the internal target volume (ITV) and Dmax of the organs at risk (OARs) were analyzed. Results from the recalculated data were compared with dose estimates for target and OARs by superposition of the originally planned dose distribution on CBCT geometry (i.e., the original dose distribution was assumed to be spatially invariant). Results: Before position correction was applied the V100% of the ITV was 100% in 65% of the cases when an ITV–PTV margin of 5 mm was used and 52% of the cases when a margin of 3 mm was used. After position correction, the difference of Dmax in the OARs with respect to the treatment plan was within 5% in the majority of the cases. When the dose was not recalculated but estimated assuming an invariant dose distribution, clinically relevant errors occurred in both the ITV and the OARs. Conclusion: Dose-guided radiotherapy can be used to determine the actual dose in OARs when the target has moved with respect to the OARs. When the workflow is optimized for speed, it can be used to prevent unnecessary position corrections. Estimating the dose by assuming an invariant dose instead of recalculation of the dose gives clinically relevant errors.

  6. Dose. Detriment. Limit assessment; Dosis. Schadensmass. Grenzwertsetzung

    Energy Technology Data Exchange (ETDEWEB)

    Breckow, J. [Technische Hochschule Mittelhessen, Giessen (Germany). Inst. fuer Medizinische Physik und Strahlenschutz (IMPS)

    2015-07-01

    One goal of radiation protection is the limitation of stochastic effects due to radiation exposure. The probability of occurrence of a radiation induced stochastic effect, however, is only one of several other parameters which determine the radiation detriment. Though the ICRP-concept of detriment is a quantitative definition, the kind of detriment weighting includes somewhat subjective elements. In this sense, the detriment-concept of ICRP represents already at the stage of effective dose a kind of assessment. Thus, by comparing radiation protection standards and concepts interconvertible or with those of environment or occupational protection one should be aware of the possibly different principles of detriment assessment.

  7. Monte Carlo calculation of synchrotron x-ray beam dose profiles in a lung phantom

    International Nuclear Information System (INIS)

    Full text: Recent advances in synchrotron generated X-ray beams with high fluence rate permit investigation of the application of an array of closely spaced, parallel or converging microplanar beams in radiotherapy. The proposed technique takes advantage of the hypothesized repair mechanism of capillary cells between alternate microbeam zones, which regenerates the lethally irradiated endothelial cells. The lateral and depth doses of 100 keV microplanar beams are investigated for different beam dimensions and spacings in a tissue, lung and tissue/lung/tissue phantom. The EGS4 Monte Carlo code is used to calculate dose profiles at different depth and bundles of beams (up to 20x20 cm square cross section). The maximum dose on the beam axis (peak) and the minimum interbeam dose (valley) are compared at different depths, bundles, heights, widths and beam spacings. Relatively high peak to valley ratios are observed in the lung region, suggesting an ideal environment for microbeam radiotherapy. For a single field, the ratio at the tissue/lung interface will set the maximum dose to the target volume. However, in clinical application, several fields would be involved allowing much greater doses to be applied for the elimination of cancer cells. We conclude therefore that multifield microbeam therapy has the potential to achieve useful therapeutic ratios for the treatment of lung cancer

  8. Geometric dose prediction model for hemithoracic intensity-modulated radiation therapy in mesothelioma patients with two intact lungs.

    Science.gov (United States)

    Kuo, LiCheng; Yorke, Ellen D; Dumane, Vishruta A; Foster, Amanda; Zhang, Zhigang; Mechalakos, James G; Wu, Abraham J; Rosenzweig, Kenneth E; Rimner, Andreas

    2016-01-01

    The presence of two intact lungs makes it challenging to reach a tumoricidal dose with hemithoracic pleural intensity-modulated radiation therapy (IMRT) in patients with malignant pleural mesothelioma (MPM) who underwent pleurectomy/decor-tications or have unresectable disease. We developed an anatomy-based model to predict attainable prescription dose before starting optimization. Fifty-six clinically delivered IMRT plans were analyzed regarding correlation of prescription dose and individual and total lung volumes, planning target volume (PTV), ipsilateral normal lung volume and ratios: contralateral/ipsilateral lung (CIVR); contralateral lung/PTV (CPVR); ipsilateral lung /PTV (IPVR); ipsilateral normal lung /total lung (INTLVR); ipsilateral normal lung/PTV (INLPVR). Spearman's rank correlation and Fisher's exact test were used. Correlation between mean ipsilateral lung dose (MILD) and these volume ratios and between prescription dose and single lung mean doses were studied. The prediction models were validated in 23 subsequent MPM patients. CIVR showed the strongest correlation with dose (R = 0.603, p IMRT treatment of MPM patients with two intact lungs. PMID:27167294

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

    International Nuclear Information System (INIS)

    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.)

  10. 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.)

  11. The impact of photon dose calculation algorithms on expected dose distributions in lungs under different respiratory phases

    International Nuclear Information System (INIS)

    A planning study was carried out on a cohort of CT datasets from breast patients scanned during different respiratory phases. The aim of the study was to investigate the influence of different air filling in lungs on the calculation accuracy of photon dose algorithms and to identify potential patterns of failure with clinical implications. Selected respiratory phases were free breathing (FB), representative of typical end expiration, and deep inspiration breath hold (DIBH), a typical condition for clinical treatment with respiratory gating. Algorithms investigated were the pencil beam (PBC), the anisotropic analytical algorithm (AAA) and the collapsed cone (CC) from the Varian Eclipse or Philips Pinnacle planning system. Reference benchmark calculations were performed with the Voxel Monte Carlo (VMC++). An analysis was performed in terms of physical quantities inspecting either dose-volume or dose-mass histograms and in terms of an extension to three dimensions of the γ index of Low. Results were stratified according to a breathing phase and algorithm. Collectives acquired in FB or DIBH showed well-separated average lung density distributions with mean densities of 0.27 ± 0.04 and 0.16 ± 0.02 g cm-3, respectively, and average peak densities of 0.17 ± 0.03 and 0.09 ± 0.02 g cm-3. Analysis of volume-dose or mass-dose histograms proved the expected deviations on PBC results due to the missing lateral transport of electrons with underestimations in the low dose region and overestimations in the high dose region. From the γ analysis, it resulted that PBC is systematically defective compared to VMC++ over the entire range of lung densities and dose levels with severe violations in both respiratory phases. The fraction of lung voxels with γ > 1 for PBC reached 25% in DIBH and about 15% in FB. CC and AAA performed, in contrast, similarly and with fractions of lung voxels with γ > 1 in average inferior to 2% in FB and 4-5% (AAA) or 6-8% (CC) in DIBH. In summary, PBC

  12. The impact of photon dose calculation algorithms on expected dose distributions in lungs under different respiratory phases

    Energy Technology Data Exchange (ETDEWEB)

    Fogliata, Antonella; Nicolini, Giorgia; Vanetti, Eugenio; Clivio, Alessandro; Cozzi, Luca [Oncology Institute of Southern Switzerland, Medical Physics Unit, 6504 Bellinzona (Switzerland); Winkler, Peter [Department of Therapeutic Radiology and Oncology, University Hospital Graz (Austria)], E-mail: lucozzi@iosi.ch

    2008-05-07

    A planning study was carried out on a cohort of CT datasets from breast patients scanned during different respiratory phases. The aim of the study was to investigate the influence of different air filling in lungs on the calculation accuracy of photon dose algorithms and to identify potential patterns of failure with clinical implications. Selected respiratory phases were free breathing (FB), representative of typical end expiration, and deep inspiration breath hold (DIBH), a typical condition for clinical treatment with respiratory gating. Algorithms investigated were the pencil beam (PBC), the anisotropic analytical algorithm (AAA) and the collapsed cone (CC) from the Varian Eclipse or Philips Pinnacle planning system. Reference benchmark calculations were performed with the Voxel Monte Carlo (VMC++). An analysis was performed in terms of physical quantities inspecting either dose-volume or dose-mass histograms and in terms of an extension to three dimensions of the {gamma} index of Low. Results were stratified according to a breathing phase and algorithm. Collectives acquired in FB or DIBH showed well-separated average lung density distributions with mean densities of 0.27 {+-} 0.04 and 0.16 {+-} 0.02 g cm{sup -3}, respectively, and average peak densities of 0.17 {+-} 0.03 and 0.09 {+-} 0.02 g cm{sup -3}. Analysis of volume-dose or mass-dose histograms proved the expected deviations on PBC results due to the missing lateral transport of electrons with underestimations in the low dose region and overestimations in the high dose region. From the {gamma} analysis, it resulted that PBC is systematically defective compared to VMC++ over the entire range of lung densities and dose levels with severe violations in both respiratory phases. The fraction of lung voxels with {gamma} > 1 for PBC reached 25% in DIBH and about 15% in FB. CC and AAA performed, in contrast, similarly and with fractions of lung voxels with {gamma} > 1 in average inferior to 2% in FB and 4

  13. The impact of photon dose calculation algorithms on expected dose distributions in lungs under different respiratory phases

    Science.gov (United States)

    Fogliata, Antonella; Nicolini, Giorgia; Vanetti, Eugenio; Clivio, Alessandro; Winkler, Peter; Cozzi, Luca

    2008-05-01

    A planning study was carried out on a cohort of CT datasets from breast patients scanned during different respiratory phases. The aim of the study was to investigate the influence of different air filling in lungs on the calculation accuracy of photon dose algorithms and to identify potential patterns of failure with clinical implications. Selected respiratory phases were free breathing (FB), representative of typical end expiration, and deep inspiration breath hold (DIBH), a typical condition for clinical treatment with respiratory gating. Algorithms investigated were the pencil beam (PBC), the anisotropic analytical algorithm (AAA) and the collapsed cone (CC) from the Varian Eclipse or Philips Pinnacle planning system. Reference benchmark calculations were performed with the Voxel Monte Carlo (VMC++). An analysis was performed in terms of physical quantities inspecting either dose-volume or dose-mass histograms and in terms of an extension to three dimensions of the γ index of Low. Results were stratified according to a breathing phase and algorithm. Collectives acquired in FB or DIBH showed well-separated average lung density distributions with mean densities of 0.27 ± 0.04 and 0.16 ± 0.02 g cm-3, respectively, and average peak densities of 0.17 ± 0.03 and 0.09 ± 0.02 g cm-3. Analysis of volume-dose or mass-dose histograms proved the expected deviations on PBC results due to the missing lateral transport of electrons with underestimations in the low dose region and overestimations in the high dose region. From the γ analysis, it resulted that PBC is systematically defective compared to VMC++ over the entire range of lung densities and dose levels with severe violations in both respiratory phases. The fraction of lung voxels with γ > 1 for PBC reached 25% in DIBH and about 15% in FB. CC and AAA performed, in contrast, similarly and with fractions of lung voxels with γ > 1 in average inferior to 2% in FB and 4-5% (AAA) or 6-8% (CC) in DIBH. In summary, PBC

  14. 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.

  15. GTV-based prescription in SBRT for lung lesions using advanced dose calculation algorithms

    International Nuclear Information System (INIS)

    The aim of current study was to investigate the way dose is prescribed to lung lesions during SBRT using advanced dose calculation algorithms that take into account electron transport (type B algorithms). As type A algorithms do not take into account secondary electron transport, they overestimate the dose to lung lesions. Type B algorithms are more accurate but still no consensus is reached regarding dose prescription. The positive clinical results obtained using type A algorithms should be used as a starting point. In current work a dose-calculation experiment is performed, presenting different prescription methods. Three cases with three different sizes of peripheral lung lesions were planned using three different treatment platforms. For each individual case 60 Gy to the PTV was prescribed using a type A algorithm and the dose distribution was recalculated using a type B algorithm in order to evaluate the impact of the secondary electron transport. Secondly, for each case a type B algorithm was used to prescribe 48 Gy to the PTV, and the resulting doses to the GTV were analyzed. Finally, prescriptions based on specific GTV dose volumes were evaluated. When using a type A algorithm to prescribe the same dose to the PTV, the differences regarding median GTV doses among platforms and cases were always less than 10% of the prescription dose. The prescription to the PTV based on type B algorithms, leads to a more important variability of the median GTV dose among cases and among platforms, (respectively 24%, and 28%). However, when 54 Gy was prescribed as median GTV dose, using a type B algorithm, the variability observed was minimal. Normalizing the prescription dose to the median GTV dose for lung lesions avoids variability among different cases and treatment platforms of SBRT when type B algorithms are used to calculate the dose. The combination of using a type A algorithm to optimize a homogeneous dose in the PTV and using a type B algorithm to prescribe the

  16. Radiobiological impact of dose calculation algorithms on biologically optimized IMRT lung stereotactic body radiation therapy plans

    OpenAIRE

    Liang, X.; Penagaricano, J.; Zheng, D.; Morrill, S.; Zhang, X; Corry, P.; Griffin, R. J.; Han, E. Y.; Hardee, M.; Ratanatharathom, V.

    2016-01-01

    Background The aim of this study is to evaluate the radiobiological impact of Acuros XB (AXB) vs. Anisotropic Analytic Algorithm (AAA) dose calculation algorithms in combined dose-volume and biological optimized IMRT plans of SBRT treatments for non-small-cell lung cancer (NSCLC) patients. Methods Twenty eight patients with NSCLC previously treated SBRT were re-planned using Varian Eclipse (V11) with combined dose-volume and biological optimization IMRT sliding window technique. The total dos...

  17. Radiobiological impact of dose calculation algorithms on biologically optimized IMRT lung stereotactic body radiation therapy plans

    International Nuclear Information System (INIS)

    The aim of this study is to evaluate the radiobiological impact of Acuros XB (AXB) vs. Anisotropic Analytic Algorithm (AAA) dose calculation algorithms in combined dose-volume and biological optimized IMRT plans of SBRT treatments for non-small-cell lung cancer (NSCLC) patients. Twenty eight patients with NSCLC previously treated SBRT were re-planned using Varian Eclipse (V11) with combined dose-volume and biological optimization IMRT sliding window technique. The total dose prescribed to the PTV was 60 Gy with 12 Gy per fraction. The plans were initially optimized using AAA algorithm, and then were recomputed using AXB using the same MUs and MLC files to compare with the dose distribution of the original plans and assess the radiobiological as well as dosimetric impact of the two different dose algorithms. The Poisson Linear-Quadatric (PLQ) and Lyman-Kutcher-Burman (LKB) models were used for estimating the tumor control probability (TCP) and normal tissue complication probability (NTCP), respectively. The influence of the model parameter uncertainties on the TCP differences and the NTCP differences between AAA and AXB plans were studied by applying different sets of published model parameters. Patients were grouped into peripheral and centrally-located tumors to evaluate the impact of tumor location. PTV dose was lower in the re-calculated AXB plans, as compared to AAA plans. The median differences of PTV(D95%) were 1.7 Gy (range: 0.3, 6.5 Gy) and 1.0 Gy (range: 0.6, 4.4 Gy) for peripheral tumors and centrally-located tumors, respectively. The median differences of PTV(mean) were 0.4 Gy (range: 0.0, 1.9 Gy) and 0.9 Gy (range: 0.0, 4.3 Gy) for peripheral tumors and centrally-located tumors, respectively. TCP was also found lower in AXB-recalculated plans compared with the AAA plans. The median (range) of the TCP differences for 30 month local control were 1.6 % (0.3 %, 5.8 %) for peripheral tumors and 1.3 % (0.5 %, 3.4 %) for centrally located tumors. The lower TCP

  18. Comparison of dose distribution between hypofractionated IMRT and SRT plans in lung tumor

    International Nuclear Information System (INIS)

    Objective: To compare the characteristics of dose distribution between hypofractionated intensity modulated radiotherapy (IMRT) and hypofractionated stereotactic radiotherapy (SRT) plans in lung tumor and to select an optimal clinical approach. Methods: SRT plans were designed for 16 patients with lung tumors who had received IMRT between April 2007 and April 2008. The dose distribution of target volume and normal tissues, conformal index (CI) and heterogenous index (HI) were analyzed using the dose-volume histogram (DVH) for the IMRT and SRT plans. Results: The mean dose and equivalent uni-form dose of planning target volume (PTV) in IMRT were similar to those in SRT. SRT had significantly better CI and HI than IMRT (t = 2.77, P 0.05). The lung V20 of IMRT and SRT was 6.9% ± 2.1% and 4.2%± 1.9%, respectively (t = 3.30, P 3 or the long diameter of tumor is less than 4.7 cm, hypofractionated SRT has similar dose distribution to hypofractionated IMRT, while the lung dose was lower in the former. (authors)

  19. Dose-response in stereotactic irradiation of lung tumors

    International Nuclear Information System (INIS)

    The dose-response for local tumor control after stereotactic radiotherapy of 92 pulmonary tumors (36 NSCLC and 56 metastases) was evaluated. Short course irradiation of 1-8 fractions with different fraction doses was used. After a median follow-up of 14 months (2-85 months) 11 local recurrences were observed with significant advantage for higher doses. When normalization to a biologically effective dose (BED) is used a dose of 94 Gy at the isocenter and 50 Gy at the PTV-margin are demonstrated to give 50% probability of tumor control (TCD50). Multivariate analysis revealed the dose at the PTV-margin as the only significant factor for local control

  20. Quantitative assessment of emphysema from whole lung CT scans: comparison with visual grading

    Science.gov (United States)

    Keller, Brad M.; Reeves, Anthony P.; Apanosovich, Tatiyana V.; Wang, Jianwei; Yankelevitz, David F.; Henschke, Claudia I.

    2009-02-01

    Emphysema is a disease of the lungs that destroys the alveolar air sacs and induces long-term respiratory dysfunction. CT scans allow for imaging of the anatomical basis of emphysema and for visual assessment by radiologists of the extent present in the lungs. Several measures have been introduced for the quantification of the extent of disease directly from CT data in order to add to the qualitative assessments made by radiologists. In this paper we compare emphysema index, mean lung density, histogram percentiles, and the fractal dimension to visual grade in order to evaluate the predictability of radiologist visual scoring of emphysema from low-dose CT scans through quantitative scores, in order to determine which measures can be useful as surrogates for visual assessment. All measures were computed over nine divisions of the lung field (whole lung, individual lungs, and upper/middle/lower thirds of each lung) for each of 148 low-dose, whole lung scans. In addition, a visual grade of each section was also given by an expert radiologist. One-way ANOVA and multinomial logistic regression were used to determine the ability of the measures to predict visual grade from quantitative score. We found that all measures were able to distinguish between normal and severe grades (p<0.01), and between mild/moderate and all other grades (p<0.05). However, no measure was able to distinguish between mild and moderate cases. Approximately 65% prediction accuracy was achieved from using quantitative score to predict visual grade, with 73% if mild and moderate cases are considered as a single class.

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

    International Nuclear Information System (INIS)

    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

  3. 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

  4. [Phantom Study on Dose Reduction Using Iterative Reconstruction in Low-dose Computed Tomography for Lung Cancer Screening].

    Science.gov (United States)

    Minehiro, Kaori; Takata, Tadanori; Hayashi, Hiroyuki; Sakuda, Keita; Nunome, Haruka; Kawashima, Hiroko; Sanada, Shigeru

    2015-12-01

    We investigated dose reduction ability of an iterative reconstruction technology for low-dose computed tomography (CT) for lung cancer screening. The Sinogram Affirmed Iterative Reconstruction (SAFIRE) provided in a multi slice CT system, Somatom Definition Flash (Siemens Healthcare) was used. An anthropomorphic chest phantom (N-1, Kyoto Kagaku) was scanned at volume CT dose index (CTDIvol) of 0.50-11.86 mGy with 120 kV. For noise (standard deviation) and contrast-to-noise ratio (CNR) measurements, CTP486 and CTP515 modules in the Catphan (The Phantom Laboratory) were scanned. Radiological technologists were participated in the perceptual comparison. SAFIRE reduced the SD values by approximately 50% compared with filter back projection (FBP). The estimated dose reduction rates by SAFIRE determined from the perceptual comparison was approximately 23%, while 75% dose reduction rate was expected from the SD value reduction of 50%. PMID:26685831

  5. Lung cancer treatment with high cyclophosphamide doses versus high cyclophosphamide doses plus radiotherapy

    International Nuclear Information System (INIS)

    Sixty-six evaluable male patients with a histologically proved inoperable lung cancer, with a Karnofsky's score greater than or equal to 30, were considered for study. The mean age was 57.2 (range 20 to 74) years. Tumor cell types were of epidermoid carcinoma 50, adenocarcinoma 6, undifferentiated small cell carcinoma 5, and undifferentiated large cell carcinoma 5. Fifty patients had limited disease and 15 had extensive disease. They were treated with combined modality therapy Cyclophosphamide (CY) 50 mg/kg body weight, administered into the tubing of a freely running intravenous infusion of 5% dextrose every 10 to 12 days, followed by radiation therapy with 60Co, 6000 rad and then, with CY 17 mg/kg body weight every 15 days until progression (Ch-R-Ch group). The control group (Ch) of 31 patients was treated with CY 50 mg/kg body every 10/12 days. Complete response was achieved in 3/35 patients and partial response in 15/35 patients of the Ch-R-Ch group. In the control group, 12/31 patients achieved partial response. Total dose of CY was higher in responders achieving a significantly longer survival (median 12+ months) in comparison to non-responders (median 7 months) and the control group (median 6 months). Less toxic reactions were seen in patients responding to Ch-R-Ch regimen. Bone marrow depletion did not affect the patient's survival, but cystitis and alopecia, it appeared, decreased life expectancy. It is concluded that combined modality therapy is better than chemotherapy alone, with less cytotoxicity in responders

  6. Evaluation of parameters of the HDV (V20 and dose average) in radiotherapy of lung cancer with lung volumes design adapted compounds (ITV)

    International Nuclear Information System (INIS)

    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)

  7. Reviewing risks and benefits of low-dose computed tomography screening for lung cancer.

    Science.gov (United States)

    Chopra, Ishveen; Chopra, Avijeet; Bias, Thomas K

    2016-01-01

    Lung cancer is the third most common cancer among men and women and is one of the leading causes of cancer-related mortality. Diagnosis at an early stage has been suggested crucial for improving survival in individuals at high-risk of lung cancer. One potential facilitator to early diagnosis is low-dose computed tomography (LDCT). The United States Preventive Services Task Force guidelines call for annual LDCT screening for individuals at high-risk of lung cancer. This recommendation was based on the effectiveness of LDCT in early diagnosis of lung cancer, as indicated by the findings from the National Lung Screening Trial conducted in 2011. Although lung cancer accounts for more than a quarter of all cancer deaths in the United States and LDCT screening shows promising results regarding early lung cancer diagnosis, screening for lung cancer remains controversial. There is uncertainty about risks, cost-effectiveness, adequacy of evidence, and application of screening in a clinical setting. This narrative review provides an overview of risks and benefits of LDCT screening for lung cancer. Further, this review discusses the potential for implementation of LDCT in clinical setting. PMID:26680693

  8. A clinical study of lung cancer dose calculation accuracy with Monte Carlo simulation

    International Nuclear Information System (INIS)

    The accuracy of dose calculation is crucial to the quality of treatment planning and, consequently, to the dose delivered to patients undergoing radiation therapy. Current general calculation algorithms such as Pencil Beam Convolution (PBC) and Collapsed Cone Convolution (CCC) have shortcomings in regard to severe inhomogeneities, particularly in those regions where charged particle equilibrium does not hold. The aim of this study was to evaluate the accuracy of the PBC and CCC algorithms in lung cancer radiotherapy using Monte Carlo (MC) technology. Four treatment plans were designed using Oncentra Masterplan TPS for each patient. Two intensity-modulated radiation therapy (IMRT) plans were developed using the PBC and CCC algorithms, and two three-dimensional conformal therapy (3DCRT) plans were developed using the PBC and CCC algorithms. The DICOM-RT files of the treatment plans were exported to the Monte Carlo system to recalculate. The dose distributions of GTV, PTV and ipsilateral lung calculated by the TPS and MC were compared. For 3DCRT and IMRT plans, the mean dose differences for GTV between the CCC and MC increased with decreasing of the GTV volume. For IMRT, the mean dose differences were found to be higher than that of 3DCRT. The CCC algorithm overestimated the GTV mean dose by approximately 3% for IMRT. For 3DCRT plans, when the volume of the GTV was greater than 100 cm3, the mean doses calculated by CCC and MC almost have no difference. PBC shows large deviations from the MC algorithm. For the dose to the ipsilateral lung, the CCC algorithm overestimated the dose to the entire lung, and the PBC algorithm overestimated V20 but underestimated V5; the difference in V10 was not statistically significant. PBC substantially overestimates the dose to the tumour, but the CCC is similar to the MC simulation. It is recommended that the treatment plans for lung cancer be developed using an advanced dose calculation algorithm other than PBC. MC can accurately

  9. More than lung cancer: Automated analysis of low-dose screening CT scans

    OpenAIRE

    Mets, O.M.

    2012-01-01

    Smoking is a major health care problem and is projected to cause over 8 million deaths per year worldwide in the coming decades. To reduce lung cancer mortality in heavy smokers, several randomized screening trials were initiated in the past years using screening with low-dose Computed Tomography (CT). Recently, the National Lung Screening Trial (NLST), which was performed in the United States of America and compared about 25,000 participants screened with CT against 25,000 participants scree...

  10. Dose impact of a carbon fiber couch for stereotactic body radiation therapy of lung tumors

    International Nuclear Information System (INIS)

    The aim of this study was to measure the dose attenuation caused by a carbon fiber radiation therapy table (Imaging Couch Top; ICT, BrainLab) and to evaluate the dosimetric impact of ICT during stereotactic body radiation therapy (SBRT) in lung tumors. The dose attenuation of ICT was measured using an ionization chamber and modeled by means of a treatment planning system (TPS). SBRT was planned with and without ICT in a lung tumor phantom and ten cases of clinical lung tumors. The results were analyzed from isocenter doses and a dose-volume histogram (DVH): D95, Dmean, V20, V5, homogeneity index (HI), and conformity index (CI). The dose attenuation of the ICT modeled with TPS agreed to within ±1% of the actually measured values. The isocenter doses, D95 and Dmean with and without ICT showed differences of 4.1-5% for posterior single field and three fields in the phantom study, and differences of 0.6-2.4% for five fields and rotation in the phantom study and six fields in ten clinical cases. The dose impact of ICT was not significant for five or more fields in SBRT. It is thus possible to reduce the dose effect of ICT by modifying the beam angle and beam weight in the treatment plan. (author)

  11. Not traditional regimes of radiotherapeutic dose fractionation as modifier of radiotherapy for carcinoma of lungs

    International Nuclear Information System (INIS)

    The efficiency of applying various of radiotherapeutic dose fractionation was analyzed. The results of the own studies performed at the Scientific and Research Institute of Oncology and Medical Radiology for elaborating not traditional regimes of radiotherapeutic dose fractionation (a dynamic fractionation applying enlarged regimes at the first stage and the classic ones at the second stage) were presented. Appliance of the modified radiotherapy for the epidermoid carcinoma of the lungs allowed to increase the objective response from 45,3+-3% to 80+-5% the tumor disappearing completely in 40+-6% of patients as compared with 10+-2%. Appliance of the intensive not traditional variant of the radiotherapy dynamic fractionation in case of a small cell carcinoma of the lungs resulted in the therapy duration reduction from 6 to 4 weeks. Thus the not traditional dose fractionation might become a mechanism for the improving the radiotherapy of persons suffering from the carcinoma of the lungs. (authors)

  12. Biological indicators for radiation dose assessment

    International Nuclear Information System (INIS)

    After an introductory report on the present level of practical experience in using biological indicator systems to identify and assess doses from radiation exposures, the state of the art in the field of biochemical, cytological and immunological indicators was presented as a basis for discussions in working groups. With reference to the type of radiation - gamma radiation, electrons, neutrons - the question was examined how and to which extent body doses could be evaluated on the basis of results from biological indicator systems. The indicator systems were examined and evaluated in working groups under the aspects of practical use, validity of results and demand of research according to uniform criteria. These were, among others, dose effect relationship, detection limit, reproducibility and specificity, interference factors, stress and reasonable inconvenience of the examined person, earliest possible availability of results and the maximum time needed to identify a biological effect after radiation exposure, as well as the possible maximum number of persons examined from a population group of radiation exposed individuals. The results of the working groups discussions were compiled and summarized in recommendations. (orig./MG)

  13. Assessment of dose during an SGTR

    International Nuclear Information System (INIS)

    The Nuclear Regulatory Commission requires utilities to determine the response of a pressurized water reactor to a steam generator tube rupture (SGTR) as part of the safety analysis for the plant. The SGTR analysis includes assumptions regarding the iodine concentration in the reactor coolant system (RCS) due to iodine spikes, primary flashing and bypass fractions, and iodine partitioning in the secondary coolant system (SCS). Experimental and analytical investigations have recently been completed wherein these assumptions were tested to determine whether and to what degree they were conservative (that is, whether they result in a calculated iodine source term/dose that is at least as large or larger than that expected during an actual event). The current study has the objective to assess the overall effects of the results of these investigations on the calculated iodine dose to the environment during an SGTR. To assist in this study, a computer program, DOSE, was written. This program uses a simple, non-mechanistic model to calculate the iodine source term to the environment during an SGTR as a function of water mass inventories and flow rates and iodine concentrations in the RCS and SCS. The principal conclusion of this study is that the iodine concentration in the RCS is the dominant parameter, due to the dominance of primary flashing on the iodine source term

  14. Dose assessment considering evolution of the biosphere

    International Nuclear Information System (INIS)

    Swedish Nuclear Fuel and Waste Management AB (SKB) is presently updating the safety assessment for SFR (Final repository for radioactive operational waste) in Sweden. The bio-spheric part of the analysis is performed by Studsvik Eco and Safety AB. According to the regulations the safety of the repository has to be accounted for different possible courses of the development of the biosphere. A number of studies have been carried out during the past years to investigate and document the biosphere in the area surrounding the repository. Modelling of shore-level displacement by land uplift, coastal water exchange and sedimentation have provided data for prediction of the evolution of the area. The prediction is done without considering a future change in climatic conditions. The results from this study show that accumulation of radionuclides in sediments is an important process to simulate when performing dose assessments covering biosphere evolution. The dose calculated for the first years of the period with agricultural use of the contaminated sediments may be severely underestimated in a scenario with large accumulation in coastal and lake stages. (LN)

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

    International Nuclear Information System (INIS)

    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

  16. 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.

  17. Association between absolute volumes of lung spared from low-dose irradiation and radiation-induced lung injury after intensity-modulated radiotherapy in lung cancer: a retrospective analysis

    OpenAIRE

    Chen, Jinmei; Hong, Jinsheng; Zou, Xi; Lv, Wenlong; Guo, Feibao; Hong, Hualan; Zhang, Weijian

    2015-01-01

    The aim of this study was to investigate the association between absolute volumes of lung spared from low-dose irradiation and radiation-induced lung injury (RILI) after intensity-modulated radiotherapy (IMRT) for lung cancer. The normal lung relative volumes receiving greater than 5, 10, 20 and 30 Gy (V5–30) mean lung dose (MLD), and absolute volumes spared from greater than 5, 10, 20 and 30 Gy (AVS5–30) for the bilateral and ipsilateral lungs of 83 patients were recorded. Any association of...

  18. Biological dose assessment of 15 victims in Haerbin radiation accident

    International Nuclear Information System (INIS)

    Full text: a) On July 5 and 8, 2005, Two patients with bone marrow suppression were successively hospitalized by the First Affiliated Hospital of Haerbin Medical University. Examination results showed that the patients seemed to get suspicious radiation disease. On July 13, 2005, a radioactive source was found in the patients' dwelling. The radiation source is Iridium-192 with 0.5 Ci(1.85 x 1010Bq) radioactivity. The radiation source is a metal bar which is a kind of radioactive industrial detection source for welding. The source is currently stored in the urban radioactive waste storehouse of Heilongjiang province. After finding the radioactive source on July 13, The Haerbin municipal government initiated an emergency response plan and developed medical rescue, radioactive source examination and case detection through organizing ministries involving health, environmental protection and public security. After receiving a report at 17:00 on July 14, 2005, Chinese Ministry of Health immediately sent experts to the spot for investigation, dose estimation and direction of patients' rescue. Health authority carried out physical examination twice on 113 residents within 30 meters to the source, among which 4 got radiation sickness, 5 showed abnormal hemotogram, and others showed no abnormal response. Of 4 patients with radiation sickness, one 81 year old patient has died of severe bone marrow form of sub acute radiation sickness coupled with lung infection and prostrate apparatus at 13:00 on Oct., 20. Two children have been treated in Beitaiping Road Hospital in Beijing, another patient has been treated in local hospital. b) Biological dosimetry using conventional chromosome aberration analysis in human peripheral blood lymphocytes has been shown as a reliable and useful tool in medical management of radiation accident victims. Peripheral blood lymphocytes of the victims were cultured using conventional culture medium with colchicine added at the beginning. Chromosome

  19. 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.

  20. 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

    International Nuclear Information System (INIS)

    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 V5 and V10 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

  1. Influence of dose calculation algorithms on isotoxic dose-escalation of non-small cell lung cancer radiotherapy

    International Nuclear Information System (INIS)

    Background and purpose: A series of phase I/II clinical trials are being initiated in several UK centres to explore the use of dose-escalated schedules for the treatment of non-small cell lung cancer (NSCLC). Among them the IDEAL-CRT trial (ISRCTN12155469) will investigate the introduction of individualised 'isotoxic' treatment schedules based on the relative mean lung normalised total dose (rNTDmean), an estimator related to lung toxicity. Since treatment planning will be performed using different treatment planning systems (TPSs), for the quality assurance of the trial we have carried out work to quantify the influence of dose calculation algorithms based on the determination of rNTDmean and on the choice of individualised prescription doses. Material and methods: Twenty-five patient plans with stage I, II and III NSCLC were calculated, with the same prescription dose, using the Adaptive Convolve (AC) and Collapsed Cone (CC) algorithms of the Pinnacle TPS, the pencil beam convolution (PBC) and AAA algorithms of Eclipse, and the CC and pencil beam (PB) algorithms of Oncentra Masterplan (OMP). For the paired-lungs-GTV structure, dose-volume histograms were obtained and used to calculate the corresponding rNTDmean values and results obtained with the different algorithms were compared. Results: For most (19 out of 25) of the patients studied, no algorithm-to-algorithm differences were seen in dose prescription based on rNTDmean. For the other 6 patients differences were within 2.3 Gy, except in one case where the difference was 4 Gy. Conclusions: For the IDEAL-CRT trial no corrections need to be applied to the value of rNTDmean calculated using any of the more advanced convolution/superposition algorithms studied in this work. For the two pencil beam algorithms analysed, no correction is necessary for the data obtained with the Eclipse-PBC, while for OMP-PB data a small correction needs to be applied, by using a scaling factor, to make prescription doses consistent

  2. Evaluation of the absorbed dose to the lungs due to Xe133 and Tc99m (MAA)

    International Nuclear Information System (INIS)

    The absorbed dose in lungs of an adult patient has been evaluated using the biokinetics of radiopharmaceuticals containing Xe133 or Tc99m (MAA). The absorbed dose was calculated using the MIRD formalism, and the Cristy-and Eckerman lungs model. The absorbed dose in the lungs due to 133Xe is 0.00104 mGy/MBq. Here, the absorbed dose due to remaining tissue, included in the 133Xe biokinetics is not significant. The absorbed dose in the lungs, due Tc99m (MAA), is 0.065 mGy/MBq. Approximately, 4.6% of the absorbed dose is due to organs like liver, kidneys, bladder, and the rest of tissues, included in the Tc99m biokinetics. Here, the absorbed dose is very significant to be overlooked. The dose contribution is mainly due to photons emitted by the liver. (Author)

  3. A Proposed In Vitro Method to Assess Effects of Inhaled Particles on Lung Surfactant Function.

    Science.gov (United States)

    Sørli, Jorid B; Da Silva, Emilie; Bäckman, Per; Levin, Marcus; Thomsen, Birthe L; Koponen, Ismo K; Larsen, Søren T

    2016-03-01

    The lung surfactant (LS) lining is a thin liquid film covering the air-liquid interface of the respiratory tract. LS reduces surface tension, enabling lung surface expansion and contraction with minimal work during respiration. Disruption of surface tension is believed to play a key role in severe lung conditions. Inhalation of aerosols that interfere with the LS may induce a toxic response and, as a part of the safety assessment of chemicals and inhaled medicines, it may be relevant to study their impact on LS function. Here, we present a novel in vitro method, based on the constrained drop surfactometer, to study LS functionality after aerosol exposure. The applicability of the method was investigated using three inhaled asthma medicines, micronized lactose, a pharmaceutical excipient used in inhaled medication, and micronized albumin, a known inhibitor of surfactant function. The surfactometer was modified to allow particles mixed in air to flow through the chamber holding the surfactant drop. The deposited dose was measured with a custom-built quartz crystal microbalance. The alterations allowed the study of continuously increasing quantified doses of particles, allowing determination of the dose of particles that affects the LS function. The tested pharmaceuticals did not inhibit the function of a model LS even at extreme doses--neither did lactose. Micronized albumin, however, impaired surfactant function. The method can discriminate between safe inhaled aerosols--as exemplified by the approved inhaled medicines and the pharmaceutical excipient lactose--and albumin known to impair lung functionality by inhibiting LS function. PMID:26524226

  4. Wound trauma alters ionizing radiation dose assessment

    Directory of Open Access Journals (Sweden)

    Kiang Juliann G

    2012-06-01

    Full Text Available Abstract Background Wounding following whole-body γ-irradiation (radiation combined injury, RCI increases mortality. Wounding-induced increases in radiation mortality are triggered by sustained activation of inducible nitric oxide synthase pathways, persistent alteration of cytokine homeostasis, and increased susceptibility to bacterial infection. Among these factors, cytokines along with other biomarkers have been adopted for biodosimetric evaluation and assessment of radiation dose and injury. Therefore, wounding could complicate biodosimetric assessments. Results In this report, such confounding effects were addressed. Mice were given 60Co γ-photon radiation followed by skin wounding. Wound trauma exacerbated radiation-induced mortality, body-weight loss, and wound healing. Analyses of DNA damage in bone-marrow cells and peripheral blood mononuclear cells (PBMCs, changes in hematology and cytokine profiles, and fundamental clinical signs were evaluated. Early biomarkers (1 d after RCI vs. irradiation alone included significant decreases in survivin expression in bone marrow cells, enhanced increases in γ-H2AX formation in Lin+ bone marrow cells, enhanced increases in IL-1β, IL-6, IL-8, and G-CSF concentrations in blood, and concomitant decreases in γ-H2AX formation in PBMCs and decreases in numbers of splenocytes, lymphocytes, and neutrophils. Intermediate biomarkers (7 – 10 d after RCI included continuously decreased γ-H2AX formation in PBMC and enhanced increases in IL-1β, IL-6, IL-8, and G-CSF concentrations in blood. The clinical signs evaluated after RCI were increased water consumption, decreased body weight, and decreased wound healing rate and survival rate. Late clinical signs (30 d after RCI included poor survival and wound healing. Conclusion Results suggest that confounding factors such as wounding alters ionizing radiation dose assessment and agents inhibiting these responses may prove therapeutic for radiation combined

  5. Dose assessment from radon in tourist caves

    International Nuclear Information System (INIS)

    Indoor radon measurements in tourist caves have traditionally being used in the studies of conservation of existent prehistoric artistic manifestations inside cavities. This kind of measurements can provide the grade, and partly the dynamics, of ventilation and renovation of the air of the caves. On the other hand, since 2001, Spanish law incorporated EURATOM basic standards for radiological protection, which include a request at the EC Member States to determine the working places on which exposure to natural radiation is significant. On Title VII (BOE 178/2001) radiation coming from natural sources has analogous role than radiation emitted from artificial ones used to. Because of the low ventilation rates existing at tourist caves, indoor radon concentration can be significantly high. In developed caves in which guides provide tours for the general public great care is needed for taking remedial actions concerning radon, because in some circumstances forced ventilation may alter the humidity inside the cave affecting some of the formations or paintings that attract tourists. Tourist guides can work about 1900 hours per year, so the only option to protect them and other cave workers from radon exposure is to apply an appropriate system of radiation protection mainly based on limitation of exposure by restricting the amount of time spent in the cave. From a previous radon measurement campaign carried out in caves at the region of Cantabria (Spain), those with higher concentration values were selected for a new survey. In this study more detailed radon measurements were performed in order to get more detailed information about monthly concentration variations, as well to determine the dose received by people working there. In dose assessment, specific characteristics of the cave concerning the behaviour of radon and its decay products are of main importance. Factors like unattached progeny fraction (fp), equilibrium factor (F) and particle concentration (Z) are

  6. Risk assessment of lung cancer for Brazilian uranium mining workers

    International Nuclear Information System (INIS)

    The fatality risks of lung cancer is estimated for several categories of miners working in the Brazilian uranium mine Osamu Utsumi in Pocos de Caldas, during the period of 03/76 to 07/78. A total of 198 miners were classified conforming the type of work performed and it was considered the lung dose equivalent received due only to the inhalation of the short lived airborne Radon-222 daughters. The average lung dose equivalent values were evaluated from the individual accumulated alpha exposure. These were expressed in unit of WLM derived from the periods of occupancy and working level data obtained by daily air monitoring using the Harley method. (M.A.C.)

  7. Dose-rate effects on lung cancers induced by exposure to radon progeny in rats

    International Nuclear Information System (INIS)

    months period, at a potential alpha energy concentration (PAEC) of 0.042 mJm-3 (2 WL), resulted in fewer lung carcinoma in rats than a similar cumulative exposure protracted over 4 to 6 months at a PAEC of 2.1 mJm-3 (100 WL). Moreover, the lung cancer incidence in rats exposed at low exposure rate (0.60%) was slightly lower than that in control animals (0.63%). The results of a new series of experiments carried out to investigate the influence of exposure-rate on lung cancer induction in rats at relatively low cumulative exposures of 0.36 Jhm-3 (100 WLM), and PAEC varying from 0.22 mJm-3 (13 WL) to 3.15 mJm-3 (150 WL) indicate that at relatively low cumulative exposures comparable to lifetime exposures in high-radon houses or current underground mining exposures, the risk of lung cancer in rats decreases with decreasing PAEC, i.e., exposure rates. These data suggest that in terms of risk of induction of lung cancer, there is a complex interplay between cumulative exposure and exposure rate, resulting in an optimal exposure rate at a given exposure level. The significance of exposure rates in assessing the hazards of domestic radon exposure was addressed on biophysical grounds by Brenner, who concluded that, when cumulative exposures are sufficiently low that multiple traversals of target cells by alpha particles are rare - that is the case for typical domestic radon exposures -, all exposure-rate enhancement effects disappear. The results of recent experiments of the same group showed that traversal of cell nuclei by a single alpha particle induced significantly lower oncogenic transformation in the C3H10T1/2 mouse fibroblast system than does a Poisson-distributed mean of one alpha particle, suggesting that cells traversed by multiple alpha particles contribute most to the risk. In this respect, based on dose-rate effect considerations, extrapolation of lower exposure-rate miner data to residential exposures - where no target cell is traversed by more than a single alpha

  8. Imaging dose assessment for IGRT in particle beam therapy

    International Nuclear Information System (INIS)

    Introduction: Image-guided advanced photon and particle beam treatments are promising options for improving lung treatments. Extensive use of imaging increases the overall patient dose. The aim of this study was to determine the imaging dose for different IGRT solutions used in photon and particle beam therapy. Material and methods: Measurements were performed in an Alderson phantom with TLDs. Clinically applied protocols for orthogonal planar kV imaging, stereoscopic imaging, CT scout views, fluoroscopy, CT, 4D-CT and CBCT were investigated at five ion beam centers and one conventional radiotherapy department. The overall imaging dose was determined for a patient undergoing a lung tumor irradiation with institute specific protocols. Results: OAR doses depended on imaging modality and OAR position. Dose values were in the order of 1 mGy for planar and stereoscopic imaging and 10–50 mGy for volumetric imaging, except for one CBCT device leading to lower doses. The highest dose per exam (up to 150 mGy to the skin) was recorded for a 3-min fluoroscopy. Discussion: Modalities like planar kV or stereoscopic imaging result in very low doses (∼1 mGy) to the patient. Imaging a moving target during irradiation, low-dose protocols and protocol optimization can reduce the imaging dose to the patient substantially

  9. The influence of x-ray energy on lung dose uniformity in total-body irradiation

    International Nuclear Information System (INIS)

    Purpose: In this study we examine the influence of x-ray energy on the uniformity of the dose within the lung in total-body irradiation treatments in which partial transmission blocks are used to control the lung dose. Methods and Materials: A solid water phantom with a cork insert to simulate a lung was irradiated by x-rays with energies of either 6, 10, or 18 MV. The source to phantom distance was 3.9 meters. The cork insert was either 10 cm wide or 6 cm wide. Partial transmission blocks with transmission factors of 50% were placed anterior to the cork insert. The blocks were either 8 or 4 cm in width. Kodak XV-2 film was placed in the midline of the phantom to record the dose. Midplane dose profiles were measured with a densitometer. Results: For the 10 cm wide cork insert the uniformity of the dose over 80% of the block width varied from 6.6% for the 6 MV x-rays to 12.2% for the 18 MV x-rays. For the 6 cm wide cork insert the uniformity was comparable for all three x-ray energies, but for 18 MV the central dose increased by 9.4% compared to the 10 cm wide insert. Conclusion: Many factors must be considered in optimizing the dose for total-body irradiation. This study suggests that for AP/PA techniques lung dose uniformity is superior with 6 MV irradiation. The blanket recommendation that the highest x-ray energy be used in TBI is not valid for all situations

  10. Translating bed total body irradiation lung shielding and dose optimization using asymmetric MLC apertures.

    Science.gov (United States)

    Ahmed, Shahbaz; Brown, Derek; Ahmed, Saad B S; Kakakhel, Muhammad B; Muhammad, Wazir; Hussain, Amjad

    2016-01-01

    A revised translating bed total body irradiation (TBI) technique is developed for shielding organs at risk (lungs) to tolerance dose limits, and optimizing dose distribution in three dimensions (3D) using an asymmetrically-adjusted, dynamic multileaf collimator. We present a dosimetric comparison of this technique with a previously developed symmetric MLC-based TBI technique. An anthropomor-phic RANDO phantom is CT scanned with 3 mm slice thickness. Radiological depths (RD) are calculated on individual CT slices along the divergent ray lines. Asymmetric MLC apertures are defined every 9 mm over the phantom length in the craniocaudal direction. Individual asymmetric MLC leaf positions are optimized based on RD values of all slices for uniform dose distributions. Dose calculations are performed in the Eclipse treatment planning system over these optimized MLC apertures. Dose uniformity along midline of the RANDO phantom is within the confidence limit (CL) of 2.1% (with a confidence probability p = 0.065). The issue of over- and underdose at the interfaces that is observed when symmetric MLC apertures are used is reduced from more than ± 4% to less than ± 1.5% with asymmetric MLC apertures. Lungs are shielded by 20%, 30%, and 40% of the prescribed dose by adjusting the MLC apertures. Dose-volume histogram analysis confirms that the revised technique provides effective lung shielding, as well as a homogeneous dose coverage to the whole body. The asymmetric technique also reduces hot and cold spots at lung-tissue interfaces compared to previous symmetric MLC-based TBI technique. MLC-based shielding of OARs eliminates the need to fabricate and setup cumbersome patient-specific physical blocks. PMID:27074477

  11. Preliminary dose assessment of the Chernobyl accident

    International Nuclear Information System (INIS)

    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 131I was the predominant fission product. The time of arrival of the plume and the maximum concentrations of 131I 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 106 person-rem. From the Soviet report, it appears that a first year population dose of about 2 x 107 person-rem (2 x 105 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

  12. Quantitative assessment of pulmonary function using low dose multi-slice spiral CT in smoker

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical feasibility of low dose MSCT for quantitative assessment of pulmonary function in smokers. Methods: One hundred and forty-six patients with chronic objective pulmonary disease (COPD) including 109 smokers (74.6%) and 37 non-smokers (25.3%) underwent pulmonary function test and low-dose MSCT scan. All data were analyzed using computer-aided lung analysis software. Pulmonary function parameters from low-dose MSCT were compared between smokers and non-smokers and also compared with pulmonary function test in non-smokers (Pearson test). Results: In smokers, the average volume at full inspiratory phase (Vin) was (5125 ± 862 ) ml, mean lung attenuation was (-902 ± 26) HU, mean lung density was (0.0984 ± 0.0260 ) g/cm3, emphysema volume was (2890 ±1370) ml. The average volume at full expiratory phase (Vex) was (2756 ±1027) ml, mean lung attenuation was (-811 ±62) HU, mean lung density was (0.1878 ±0.0631) g/cm3, emphysema volume was (685 ±104) ml. In non-smokers, the average Vin was (3734 ± 759) ml, mean lung attenuation was (-876 ±40) HU,mean lung density was (0.1244 ±0.0401)g/cm3, emphysema volume was ( 1503 ± 1217) ml. The average Vex was (1770 ± 679) ml, mean lung attenuation was (-765 ± 56) HU, mean lung density was (0.2360 ± 0.0563) g/cm3, emphysema volume was (156 ± 45) ml. There were significant differences between smokers and non-smokers (P<0.01). The Vex/Vin was correlated with residual volume/total lung capacity (RV/TLC, r=0.60, P<0.01), and Vin was correlated with TLC (r=0.58, P<0.01), Vex with RV (r=0.59, P<0.01). Pixel index (PI) -950 in was correlated with FEV 1% pre and FEV1/FVC% (r=-0.53, -0.62, respective, P<0.01), Pl-950ex was correlated with FEV1 % pre and FEV1/FVC% (r=-0.71, -0.77, respective, P<0.01). Conclusion: Low-dose MSCT can be a potential imaging tool for quantitative pulmonary function assessment in smokes. (authors)

  13. Feasibility of high-dose three-dimensional radiation therapy in the treatment of localised non-small-cell lung cancer; Irradiation conformationelle de haute dose dans les cancers bronchiques non a petites cellules localement evolues: etude de faisabilite

    Energy Technology Data Exchange (ETDEWEB)

    Belliere, A.; Girard, N.; Chapet, O.; Khodri, M.; Kubas, A.; Mornex, F. [Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Dept. de Radiotherapie-Oncologie, 69 - Pierre-Benite (France); Souquet, P.J. [Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Dept. de Medecine Respiratoire, 69 - Pierre-Benite (France)

    2009-07-15

    Purpose/ Chemoradiotherapy is the standard treatment of inoperable and/or non-resectable IIIA/B non-small-cell lung cancer (N.S.C.L.C.). Aware of the necessity to increase local control in locally advanced N.S.C.L.C., we analyzed the feasibility of high-dose three-dimensional conformal radiation therapy (3D-C.R.T.) in the treatment of localised N.S.C.L.C. Patients and methods: We undertook a retrospective analysis of consecutive patients with non-resectable N.S.C.L.C. treated with high-dose (74 Gy) standard-fractionation 3D-C.R.T., with particular attention to the relationship between lung and heart radiation-induced toxicities. Results: Fifty patients (41 males, 9 females) were included. A total of 35 (70%) patients received the planned total dose of 74 Gy. Patients irradiated to inferior doses interrupted the treatment because of limiting toxicities. Induction and concurrent chemotherapy was delivered to 39 (78%) and 14 (28%) patients, respectively. Eight (16%) patients experienced grade 3-4 acute lung toxicity, all of them having a history of pulmonary disease, a FEV1 below 1.6 L, and a lung V20 of at least 25%. Three (6%) patients were deemed to experience radiation-induced cardiac toxicity. Conclusions: This study assesses the feasibility of delivering a total dose of 74 Gy combined with chemotherapy in locally advanced N.S.C.L.C.. High lung and heart V20 increases the risk of radiation-induced lung and cardiac toxicity, the later being highly difficult to precisely assess, as late deaths are rarely documented, and responsibility of the treatment might be often underestimated. The precise evaluation of cardiac condition may be helpful to spare fragile patients from potentially toxic effects of high-dose radiation, especially in controlled trials. (authors)

  14. 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

  15. Validation of dose painting of lung tumours using alanine/EPR dosimetry.

    Science.gov (United States)

    Knudtsen, Ingerid Skjei; Svestad, Jørund Graadal; Skaug Sande, Erlend Peter; Rekstad, Bernt Louni; Rødal, Jan; van Elmpt, Wouter; Öllers, Michel; Hole, Eli Olaug; Malinen, Eirik

    2016-03-21

    Biologic image guided radiotherapy (RT) with escalated doses to tumour sub volumes challenges today's RT dose planning and delivery systems. In this phantom study, we verify the capability of a clinical dose planning and delivery system to deliver an 18F-FDG-PET based dose painted treatment plan to a lung tumour. Furthermore, we estimate the uncertainties of the dose painted treatment compared to conventional RT plans. An anthropomorphic thorax phantom of polystyrene and polyurethane was constructed based on CT images of a lung cancer patient. 101 EPR/alanine dosimeters were placed in separate cavities within the phantom. IMRT and VMAT plans were generated in Eclipse (version 10.0, Analytical Anisotropic Algorithm version 10.2.28, Varian Medical Systems, Inc.) for 6 and 15 MV photons, based on 18F-FDG-PET/CT images of the patient. A boost dose of 3.8 Gy/fraction was given to the 18F-FDG-avid region (biological planning volume; BTV), whereas 3.1 Gy/fraction was planned to the planning target volume (PTV, excluding the BTV). For the homogenous plans, 3.2 Gy/fraction was given to the PTV. Irradiation of the phantom was carried out at a Varian Trilogy linear accelerator (Varian Medical Systems, Inc.). Uncertainties involved in treatment planning and delivery were estimated from portal dosimetry gamma evaluation. Measured and calculated doses were compared by Bland-Altmann analysis. For all treatment plans, all dose-volume objectives could be achieved in the treatment planning system. The mean absolute differences between calculated and measured doses were small (lung and soft tissue. The estimated uncertainty of the planned doses was less than 3% for all plans, whereas the estimated uncertainty in the measured doses was less 2.3%. Our results show that planning and delivery of dose escalated lung cancer treatment on a clinical dose planning and delivery system has high dosimetric accuracy. The uncertainties associated with the dose escalated treatment plans are

  16. 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

    PURPOSE: To evaluate against Monte-Carlo the performance of various dose calculations algorithms regarding lung tumour coverage in stereotactic body radiotherapy (SBRT) conditions. MATERIALS AND METHODS: Dose distributions in virtual lung phantoms have been calculated using four commercial...... 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 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...

  17. Population dose assessment: characteristics of PC CREAM

    International Nuclear Information System (INIS)

    This paper presents the main features of the PC CREAM, a program for performing radiological impact assessments due to radioactive discharges into the environment during the operation of radioactive and nuclear facilities. PC CREAM is a suite of six programs that can be used to estimate individual and collective radiation doses. The methodology of PC CREAM is based on updated environmental and dosimetric models, including ICRP 60 recommendations. The models include several exposure pathways and the input files are easy to access. The ergonomics of the program improves the user interaction and makes easier the input of local data. This program is useful for performing sensitivity analysis, siting studies and validation of model comparing the activity concentration output data with environmental monitoring data. The methodology of each module is described as well as the output data. (author)

  18. Italian intercomparison exercise on internal dose assessment

    International Nuclear Information System (INIS)

    In 2001, the Radiation Protection Institute of ENEA promoted an Italian intercomparison exercise on internal dose assessment addressed to the qualified experts in radiation protection, following the coming into force in Italian law of the EURATOM 96/29 Directive. Five case studies of occupational exposure related to the Italian situation are used. The considered radioisotopes are: 60Co, 89Sr, 125I, 131I, and 222Rn + NORM (238U-235U-232Th). Data related to WBC, thyroid and urine excretion measurements, as well as radionuclide air concentration in the workplace are provided to the participants. The results related to medical, industrial and Rn occupational exposure are well represented as means of log-normal distributions with values of the geometric standard deviation less than 2. A wider spread of results is present for the evaluation of occupational exposure to NORM. (author)

  19. Verification of lung dose in an anthropomorphic phantom calculated by the collapsed cone convolution method

    International Nuclear Information System (INIS)

    Verification of calculated lung dose in an anthropomorphic phantom is performed using two dosimetry media. Dosimetry is complicated by factors such as variations in density at slice interfaces and appropriate position on CT scanning slice to accommodate these factors. Dose in lung for a 6 MV and 10 MV anterior-posterior field was calculated with a collapsed cone convolution method using an ADAC Pinnacle, 3D planning system. Up to 5% variations between doses calculated at the centre and near the edge of the 2 cm phantom slice positioned at the beam central axis were seen, due to the composition of each phantom slice. Validation of dose was performed with LiF thermoluminescent dosimeters (TLDs) and X-Omat V radiographic film. Both dosimetry media produced dose results which agreed closely with calculated results nearest their physical positioning in the phantom. The collapsed cone convolution method accurately calculates dose within inhomogeneous lung regions at 6 MV and 10 MV x-ray energy. (author)

  20. Analysis of the dose calculation accuracy for IMRT in lung: A 2D approach

    Energy Technology Data Exchange (ETDEWEB)

    Dvorak, Pavel; Stock, Markus; Kroupa, Bernhard; Bogner, Joachim; Georg, Diet mar [Div. of Medical Radiation Physics, Dept. of Radiotherapy and Radiobiology, AKH Vienna, Medical Univ. Vienna, Vienna (Austria)

    2007-10-15

    The purpose of this study was to compare the dosimetric accuracy of IMRT plans for targets in lung with the accuracy of standard uniform-intensity conformal radiotherapy for different dose calculation algorithms. Tests were performed utilizing a special phantom manufactured from cork and polystyrene in order to quantify the uncertainty of two commercial TPS for IMRT in the lung. Ionization and film measurements were performed at various measuring points/planes. Additionally, single-beam and uniform-intensity multiple-beam tests were performed, in order to investigate deviations due to other characteristics of IMRT. Helax-TMS V6.1(A) was tested for 6, 10 and 25 MV and BrainSCAN 5.2 for 6 MV photon beams, respectively. Pencil beam (PB) with simple inhomogeneity correction and 'collapsed cone' (CC) algorithms were applied for dose calculations. However, the latter was not incorporated during optimization hence only post-optimization recalculation was tested. Two-dimensional dose distributions were evaluated applying the b.gamma index concept. Conformal plans showed the same accuracy as IMRT plans. Ionization chamber measurements detected deviations of up to 5% when a PB algorithm was used for IMRT dose calculations. Significant improvement was observed when IMRT plans were recalculated with the CC algorithm, especially for the highest nominal energy. All b.gamma evaluations confirmed substantial improvement with the CC algorithm in 2D. While PB dose distributions showed most discrepancies in lower (<50%) and high (>90%) dose regions, the CC dose distributions deviated mainly in the high dose gradient (20-80%) region. The advantages of IMRT (conformity, intra-target dose control) should be counterbalanced with possible calculation inaccuracies for targets in the lung. Until no superior dose calculation algorithms are involved in the iterative optimization process it should be used with great care. When only PB algorithm with simple inhomogeneity correction is

  1. Analysis of the dose calculation accuracy for IMRT in lung: a 2D approach.

    Science.gov (United States)

    Dvorak, Pavel; Stock, Markus; Kroupa, Bernhard; Bogner, Joachim; Georg, Dietmar

    2007-01-01

    The purpose of this study was to compare the dosimetric accuracy of IMRT plans for targets in lung with the accuracy of standard uniform-intensity conformal radiotherapy for different dose calculation algorithms. Tests were performed utilizing a special phantom manufactured from cork and polystyrene in order to quantify the uncertainty of two commercial TPS for IMRT in the lung. Ionization and film measurements were performed at various measuring points/planes. Additionally, single-beam and uniform-intensity multiple-beam tests were performed, in order to investigate deviations due to other characteristics of IMRT. Helax-TMS V6.1(A) was tested for 6, 10 and 25 MV and BrainSCAN 5.2 for 6 MV photon beams, respectively. Pencil beam (PB) with simple inhomogeneity correction and 'collapsed cone' (CC) algorithms were applied for dose calculations. However, the latter was not incorporated during optimization hence only post-optimization recalculation was tested. Two-dimensional dose distributions were evaluated applying the gamma index concept. Conformal plans showed the same accuracy as IMRT plans. Ionization chamber measurements detected deviations of up to 5% when a PB algorithm was used for IMRT dose calculations. Significant improvement (deviations approximately 2%) was observed when IMRT plans were recalculated with the CC algorithm, especially for the highest nominal energy. All gamma evaluations confirmed substantial improvement with the CC algorithm in 2D. While PB dose distributions showed most discrepancies in lower (90%) dose regions, the CC dose distributions deviated mainly in the high dose gradient (20-80%) region. The advantages of IMRT (conformity, intra-target dose control) should be counterbalanced with possible calculation inaccuracies for targets in the lung. Until no superior dose calculation algorithms are involved in the iterative optimization process it should be used with great care. When only PB algorithm with simple inhomogeneity correction is

  2. Analysis of the dose calculation accuracy for IMRT in lung: A 2D approach

    International Nuclear Information System (INIS)

    The purpose of this study was to compare the dosimetric accuracy of IMRT plans for targets in lung with the accuracy of standard uniform-intensity conformal radiotherapy for different dose calculation algorithms. Tests were performed utilizing a special phantom manufactured from cork and polystyrene in order to quantify the uncertainty of two commercial TPS for IMRT in the lung. Ionization and film measurements were performed at various measuring points/planes. Additionally, single-beam and uniform-intensity multiple-beam tests were performed, in order to investigate deviations due to other characteristics of IMRT. Helax-TMS V6.1(A) was tested for 6, 10 and 25 MV and BrainSCAN 5.2 for 6 MV photon beams, respectively. Pencil beam (PB) with simple inhomogeneity correction and 'collapsed cone' (CC) algorithms were applied for dose calculations. However, the latter was not incorporated during optimization hence only post-optimization recalculation was tested. Two-dimensional dose distributions were evaluated applying the b.gamma index concept. Conformal plans showed the same accuracy as IMRT plans. Ionization chamber measurements detected deviations of up to 5% when a PB algorithm was used for IMRT dose calculations. Significant improvement was observed when IMRT plans were recalculated with the CC algorithm, especially for the highest nominal energy. All b.gamma evaluations confirmed substantial improvement with the CC algorithm in 2D. While PB dose distributions showed most discrepancies in lower (90%) dose regions, the CC dose distributions deviated mainly in the high dose gradient (20-80%) region. The advantages of IMRT (conformity, intra-target dose control) should be counterbalanced with possible calculation inaccuracies for targets in the lung. Until no superior dose calculation algorithms are involved in the iterative optimization process it should be used with great care. When only PB algorithm with simple inhomogeneity correction is used, lower energy photon

  3. Feasibility of high-dose three-dimensional radiation therapy in the treatment of localised non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Purpose/ Chemoradiotherapy is the standard treatment of inoperable and/or non-resectable IIIA/B non-small-cell lung cancer (N.S.C.L.C.). Aware of the necessity to increase local control in locally advanced N.S.C.L.C., we analyzed the feasibility of high-dose three-dimensional conformal radiation therapy (3D-C.R.T.) in the treatment of localised N.S.C.L.C. Patients and methods: We undertook a retrospective analysis of consecutive patients with non-resectable N.S.C.L.C. treated with high-dose (74 Gy) standard-fractionation 3D-C.R.T., with particular attention to the relationship between lung and heart radiation-induced toxicities. Results: Fifty patients (41 males, 9 females) were included. A total of 35 (70%) patients received the planned total dose of 74 Gy. Patients irradiated to inferior doses interrupted the treatment because of limiting toxicities. Induction and concurrent chemotherapy was delivered to 39 (78%) and 14 (28%) patients, respectively. Eight (16%) patients experienced grade 3-4 acute lung toxicity, all of them having a history of pulmonary disease, a FEV1 below 1.6 L, and a lung V20 of at least 25%. Three (6%) patients were deemed to experience radiation-induced cardiac toxicity. Conclusions: This study assesses the feasibility of delivering a total dose of 74 Gy combined with chemotherapy in locally advanced N.S.C.L.C.. High lung and heart V20 increases the risk of radiation-induced lung and cardiac toxicity, the later being highly difficult to precisely assess, as late deaths are rarely documented, and responsibility of the treatment might be often underestimated. The precise evaluation of cardiac condition may be helpful to spare fragile patients from potentially toxic effects of high-dose radiation, especially in controlled trials. (authors)

  4. Assessment of internal doses in emergency situations

    International Nuclear Information System (INIS)

    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)

  5. The estimation of lung dose from mid-perineum ionization chamber measurements in total body irradiations: A quality control check on dose delivery

    International Nuclear Information System (INIS)

    A series of patients (eleven males and eight females) receiving total body irradiation prior to bone marrow transplantation was monitored during treatment by recording the dose from an ionization chamber placed between the thighs in the mid-perineal region. The treatment was delivered by opposed lateral 6 MV photon beams. The patient was encompassed by the radiation field with the maximum collimator opening at a distance of 3.49 m from the X-ray focus to the patient mid-line. An analysis was made of the measured dose and the calculated percentage average lung dose for each patient in the series to seek a correlation between measured doses and patients' anatomical data so that estimates of delivered lung doses could be made. Whilst a global factor can be applied to measured dose to predict lung dose, it is concluded that perineal dose measurements distal to the region where dose is prescribed (mean lung dose) are sub-optimal for checks on target dose delivery. Entrance and exit dose measurements at the level of dose prescription (in the thorax) are preferable for more accurate predictions and quality control checks. 6 refs., 1 tab., 2 figs

  6. The estimation of lung dose from mid-perineum ionization chamber measurements in total body irradiations: A quality control check on dose delivery

    Energy Technology Data Exchange (ETDEWEB)

    Cross, P. [Saint Vincent`s Hospital, Darlinghurst, NSW (Australia)

    1995-11-01

    A series of patients (eleven males and eight females) receiving total body irradiation prior to bone marrow transplantation was monitored during treatment by recording the dose from an ionization chamber placed between the thighs in the mid-perineal region. The treatment was delivered by opposed lateral 6 MV photon beams. The patient was encompassed by the radiation field with the maximum collimator opening at a distance of 3.49 m from the X-ray focus to the patient mid-line. An analysis was made of the measured dose and the calculated percentage average lung dose for each patient in the series to seek a correlation between measured doses and patients` anatomical data so that estimates of delivered lung doses could be made. Whilst a global factor can be applied to measured dose to predict lung dose, it is concluded that perineal dose measurements distal to the region where dose is prescribed (mean lung dose) are sub-optimal for checks on target dose delivery. Entrance and exit dose measurements at the level of dose prescription (in the thorax) are preferable for more accurate predictions and quality control checks. 6 refs., 1 tab., 2 figs.

  7. Lung dose depending on exact patient positioning during total body irradiation (TBI) - isoeffective considerations to assess the risk of interstitial pneumonitis after TBI; Lungendosis in Abhaengigkeit von der Lagerungsgenauigkeit bei Ganzkoerperbestrahlungen (TBI). Isoeffektivitaetsueberlegungen zur Einschaetzung des Risikos einer interstitiellen Pneumonitis nach Ganzkoerperbestrahlung

    Energy Technology Data Exchange (ETDEWEB)

    Piroth, M.D.; Zierhut, D.; Sroka-Perez, G.; Wannenmacher, M. [Radiologische Klinik der Univ. Heidelberg (Germany). Abt. fuer Klinische Radiologie; Kampen, M. van [Krankenhaus Nord-West, Frankfurt am Main (Germany). Radioonkologische Klinik

    2002-01-01

    Purpose: In this case report, we studied the effect of patient's movements on total lung dose during total body irradiation (TBI). The dose-effect relationship regarding the development of interstitial pneumonitis and the problem of defining a threshold value are discussed. Based on considerations about the isoeffects we calculated the pneumonitis risk in dependence of increasing lung dose. Patient and Method: We calculated dose-volume histograms of the lung for defined lateral deviations (0-3 cm) from the isocenter. Total dose was 12 Gy, given in six fractions over 3 days. Lung shields were used after a total dose of 9 Gy. Lung shields were transferred into the Helax-TMS trademark planning system to quantify the influence of lateral deviation to lung dose. Results: The child's lateral deviation amounted up to 3 cm. Median dose of the whole lung amounted up to 11.64 Gy depending on lateral deviation. Discussion: In TBI, the lung limits the total dose. To estimate the risk of radiation pneumonitis, we calculated the isoeffective lung dose of our TBI regime for a fractionation scheme of 2 Gy daily using a formalism of van Dyk. The increase of median lung dose from 9.76 to 11.64 Gy would isoeffectively correspond to the increase from 19 Gy (no deviation) to 20.9 Gy (3 cm lateral deviation) with conventional fractionation. According to Burman, a pneumonitis risk of approximately 20% could be expected. Conclusion: With an estimated pneumonitis risk of approximately 20%, an indication for irradiation in general anesthesia seems to be reasonable. This is practicable in cooperation with radiation oncologists, anesthesists and pediatricians and should be included into therapeutic concepts. (orig.) [German] Hintergrund: An einem Fallbeispiel werden die Auswirkungen von Lagerungsungenauigkeiten auf die Gesamtlungendosis bei Ganzkoerperbestrahlung eines Kindes erlaeutert. Die Dosis-Wirkungs-Beziehung bezueglich der Entstehung einer interstitiellen Pneumonitis nach

  8. Interactive Rapid Dose Assessment Model (IRDAM): scenarios for comparing dose-assessment models. Vol.3

    International Nuclear Information System (INIS)

    The Interactive Rapid Dose Assessment Model (IRDAM) is a micro-computer based program designed to provide rapid assessments of the radiological impact of accidents at nuclear power plants. The main body of this document consists of 28 examples of IRDAM input and output, representing various types of accidents and releases. These examples are intended to provide a basis for comparison with other models or for testing IRDAM itself. Figures are included which show dose rates calculated by IRDAM for each scenario. Figures are also included which show calculations made using the computer codes WRAITH (Scherpelz, Borst and Hoenes, 1980) and RADPUR (Dabbert, et. al., 1982). Two other 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. Reactor Accident Assessment Methods (NUREG/CR-3012, Volume 2) describes the technical bases for IRDAM including methods, models and assumptions used in calculations

  9. Monte Carlo estimation of dose difference in lung from 192Ir brachytherapy due to tissue inhomogeneity

    International Nuclear Information System (INIS)

    Lung brachytherapy using high-dose rate 192Ir technique is a well-established technique of radiation therapy. However, many commercial treatment planning systems do not have the ability to consider the inhomogeneity of lung in relation to normal tissue. Under such circumstances dose calculations for tissues and organs at risk close to the target are inaccurate. The purpose of the current study was to estimate the dose difference due to tissue inhomogeneity using the Monte Carlo simulation code MCNP-5. Results showed that there was a relative sub dosage by treatment planning systems calculations in neighbouring tissues around the radioactive source due to inhomogeneity ignorance. The presence of lung instead of normal tissue resulted in an increase in relative dose, which approached 8 % at 4-cm distance from the source. Additionally, the relative increase was small for the lung (2.1 %) and larger for organs at risk such as the heart (6.8 %) and bone marrow (7.6 %). (authors)

  10. Dosimetric impact of Acuros XB deterministic radiation transport algorithm for heterogeneous dose calculation in lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Han Tao; Followill, David; Repchak, Roman; Molineu, Andrea; Howell, Rebecca; Salehpour, Mohammad [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Mikell, Justin [Department of Radiation Physics, the University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); University of Texas Graduate School of Biomedical Sciences at Houston, Houston, Texas 77030 (United States); Mourtada, Firas [Department of Radiation Physics, the University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Department of Radiation Oncology, Christiana Care Health System, Newark, Delaware 19713 (United States)

    2013-05-15

    Purpose: The novel deterministic radiation transport algorithm, Acuros XB (AXB), has shown great potential for accurate heterogeneous dose calculation. However, the clinical impact between AXB and other currently used algorithms still needs to be elucidated for translation between these algorithms. The purpose of this study was to investigate the impact of AXB for heterogeneous dose calculation in lung cancer for intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT). Methods: The thorax phantom from the Radiological Physics Center (RPC) was used for this study. IMRT and VMAT plans were created for the phantom in the Eclipse 11.0 treatment planning system. Each plan was delivered to the phantom three times using a Varian Clinac iX linear accelerator to ensure reproducibility. Thermoluminescent dosimeters (TLDs) and Gafchromic EBT2 film were placed inside the phantom to measure delivered doses. The measurements were compared with dose calculations from AXB 11.0.21 and the anisotropic analytical algorithm (AAA) 11.0.21. Two dose reporting modes of AXB, dose-to-medium in medium (D{sub m,m}) and dose-to-water in medium (D{sub w,m}), were studied. Point doses, dose profiles, and gamma analysis were used to quantify the agreement between measurements and calculations from both AXB and AAA. The computation times for AAA and AXB were also evaluated. Results: For the RPC lung phantom, AAA and AXB dose predictions were found in good agreement to TLD and film measurements for both IMRT and VMAT plans. TLD dose predictions were within 0.4%-4.4% to AXB doses (both D{sub m,m} and D{sub w,m}); and within 2.5%-6.4% to AAA doses, respectively. For the film comparisons, the gamma indexes ({+-}3%/3 mm criteria) were 94%, 97%, and 98% for AAA, AXB{sub Dm,m}, and AXB{sub Dw,m}, respectively. The differences between AXB and AAA in dose-volume histogram mean doses were within 2% in the planning target volume, lung, heart, and within 5% in the spinal cord

  11. The impact of central lung distance, maximal heart distance, and radiation technique on the volumetric dose of the lung and heart for intact breast radiation

    International Nuclear Information System (INIS)

    Purpose: To investigate the impact of radiographic parameter and radiation technique on the volumetric dose of lung and heart for intact breast radiation. Methods and Materials: Forty patients with both two-dimensional (2D) and computed tomographic (CT) simulations were enrolled in the study. Central lung distance (CLD), maximal heart distance (MHD), and maximal heart length (MHL) were measured under virtual simulation. Four plans were compared for each patient. Plan A used a traditional 2D tangential setup. Plan B used clinical target volume (CTV) based three-dimensional (3D) planning. Both plans C and D used a combination of a medial breast field with shallow tangents. Plan D is a further modification of plan C. Results: Under the traditional tangential setup, the mean ipsilateral lung dose and volume at 20, 30, and 40 Gy correlated linearly with CLD (R = 0.85∼0.91). The mean ipsilateral lung dose (Gy) approximated 4 times the CLD value (cm), whereas the percentage volume (%) of ipsilateral lung at 20, 30, and 40 Gy was about 10 times the CLD (cm). The mean heart dose and percentage volume at 20, 30, and 40 Gy correlated with MHD (R = 0.76∼0.80) and MHL (R 0.65∼0.75). The mean heart dose (Gy) approximated 3 times the MHD value (cm), and the percentage volume (%) of the heart at 10, 20, 30, and 40 Gy was about 6 times MHD (cm). Radiation technique impacted lung and heart dose. The 3D tangential plan (plan B) failed to reduce the volumetric dose of lung and heart from that of the 2D plan (plan A). The medial breast techniques (plans C and D) significantly decreased the volume of lung and heart receiving high doses (30 and 40 Gy). Plan D further decreased the 20 Gy volumes. By use of the medial breast technique, the lung and heart dose were not impacted by original CLD and MHD/MHL. Therefore, the improvement from the tangential technique was more remarkable for patients with CLD ≥ 3.0 cm (p<0.001). Conclusions: The CLD and MHD impact the volumetric dose of

  12. Stereotactic, single-dose irradiation of stage I non-small cell lung cancer and lung metastases

    International Nuclear Information System (INIS)

    We prospectively reviewed response rates, local control, and side effects after non-fractionated stereotactic high single-dose body radiation therapy for lung tumors. Fifty-eight patients underwent radiosurgery involving single-dose irradiation. With 25 patients, 31 metastases in the lungs were irradiated; with each of 33 patients, stage I non-small cell lung cancer (NSCLC) was subject to irradiation. The standard dose prescribed to the isocenter was 30 Gy with an axial safety margin of 10 mm and a longitudinal safety margin of 15 mm. The planning target volume (PTV) was defined using three CT scans with reference to the phases of respiration so that the movement span of the clinical target volume (CTV) was enclosed. The volume of the metastases (CTV) varied from 2.8 to 55.8 cm3 (median: 6.0 cm3) and the PTV varied from 12.2 to 184.0 cm3 (median: 45.0 cm3). The metastases ranged from 0.7 to 4.5 cm in largest diameter. The volume of the bronchial carcinomas varied from 4.2 to 125.4 cm3(median: 17.5 cm3) and the PTV from 15.6 to 387.3 cm3 (median: 99.8 cm3). The bronchial carcinomas ranged from 1.7 to 10 cm in largest diameter. Follow-up periods varied from 6.8 to 63 months (median: 22 months for metastases and 18 months for NSCLC). Local control was achieved with 94% of NSCLC and 87% of metastases. No serious symptomatic side effects were observed. According to the Kaplan-Meier method the overall survival probability rates of patients with lung metastases were as follows: 1 year: 97%, 2 years: 73%, 3 years: 42%, 4 years: 42%, 5 years: 42% (median survival: 26 months); of those with NSCLC: 1 year: 83%, 2 years: 63%, 3 years: 53%, 4 years: 39%: (median survival: 20.4 months). Non-fractionated single-dose irradiation of metastases in the lungs or of small, peripheral bronchial carcinomas is an effective and safe form of local treatment and might become a viable alternative to invasive techniques

  13. CT-based dose calculations and in vivo dosimetry for lung cancer treatment

    International Nuclear Information System (INIS)

    Reliable CT-based dose calculations and dosimetric quality control are essential for the introduction of new conformal techniques for the treatment of lung cancer. The first aim of this study was therefore to check the accuracy of dose calculations based on CT-densities, using a simple inhomogeneity correction model, for lung cancer patients irradiated with an AP-PA treatment technique. Second, the use of diodes for absolute exit dose measurements and an Electronic Portal Imaging Device (EPID) for relative transmission dose verification was investigated for 22 and 12 patients, respectively. The measured dose values were compared with calculations performed using our 3-dimensional treatment planning system, using CT-densities or assuming the patient to be water-equivalent. Using water-equivalent calculations, the actual exit dose value under lung was, on average, underestimated by 30%, with an overall spread of 10% (1 SD). Using inhomogeneity corrections, the exit dose was, on average, overestimated by 4%, with an overall spread of 6% (1 SD). Only 2% of the average deviation was due to the inhomogeneity correction model. An uncertainty in exit dose calculation of 2.5% (1 SD) could be explained by organ motion, resulting from the ventilatory or cardiac cycle. The most important reason for the large overall spread was, however, the uncertainty involved in performing point measurements: about 4% (1 SD). This difference resulted from the systematic and random deviation in patient set-up and therefore in diode position with respect to patient anatomy. Transmission and exit dose values agreed with an average difference of 1.1%. Transmission dose profiles also showed good agreement with calculated exit dose profiles. Our study shows that, for this treatment technique, the dose in the thorax region is quite accurately predicted using CT-based dose calculations, even if a simple inhomogeneity correction model is used. Point detectors such as diodes are not suitable for exit

  14. Dose planning in telecobalt irradiation of lung tumors and its objective evaluation

    International Nuclear Information System (INIS)

    For the high voltage radiotherapy of lung tumors the concentration of the tumor dose to the target and the careful treatment of the healthy environment take an especially important part because the pulmonary tissue has to be regarded as an organ of risk beside the myelon. An evaluation, as objective as possible, of the dose distribution of a planned irradiation in the patient's cross-section at the individual planning of the radiotherapy, basing on the physician's demand of dose for the target and the organs of risk, can be accomplished by means of 'functions to measure'. These equations allow very simply the statement whether the dose distribution and the planned irradiation, belonging to it, can be accepted and which demands of the physician are not fulfilled in the dose plan, respectively. By means of the evaluating model, variants of the dose plan were evaluated and made more precisely in an individual case of irradiation. (author)

  15. Hypersensitive response of normal human lung epithelial cells at low radiation doses

    International Nuclear Information System (INIS)

    The effect of very low single X-ray doses (0.05-4Gy) was investigated in a human lung epithelial cell line (L132). Cell survival measurements were made using a Dynamic Microscopic Imaging Processing Scanner (DMIPS), which allowed single cells to be located accurately, their positions recorded and these positions revisited after an appropriate incubation period at 37oC; surviving cells were identified by their ability to produce a colony ≥50 cells. The survival data at doses ≥2 Gy were well-fitted by a linear-quadratic (LQ) model. For doses <1 Gy, increased X-ray effectiveness was observed with cell survival below the prediction from the fit of the LQ model to the higher dose data, extrapolated into the low dose region. This is the first evidence for the existence of a hypersensitive survival response to very low doses in normal human cells. (Author)

  16. 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.

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

    International Nuclear Information System (INIS)

    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

  18. 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.

  19. Lung Dose Calculation With SPECT/CT for 90Yittrium Radioembolization of Liver Cancer

    International Nuclear Information System (INIS)

    Purpose: To propose a new method to estimate lung mean dose (LMD) using technetium-99m labeled macroaggregated albumin (99mTc-MAA) single photon emission CT (SPECT)/CT for 90Yttrium 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 99mTc-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 99mTc-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

  20. Adaptive statistical iterative reconstruction-applied ultra-low-dose CT with radiography- comparable radiation dose: Usefulness for lung nodule detection

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hyun Jung; Chung, Myung Jin; Hwang, Hye Sun; Lee, Kyung Soo [Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Moon, Jung Won [Dept. of Radiology, Kangbuk Samsung Hospital, Seoul (Korea, Republic of)

    2015-10-15

    To assess the performance of adaptive statistical iterative reconstruction (ASIR)-applied ultra-low-dose CT (ULDCT) in detecting small lung nodules. Thirty patients underwent both ULDCT and standard dose CT (SCT). After determining the reference standard nodules, five observers, blinded to the reference standard reading results, independently evaluated SCT and both subsets of ASIR- and filtered back projection (FBP)-driven ULDCT images. Data assessed by observers were compared statistically. Converted effective doses in SCT and ULDCT were 2.81 ± 0.92 and 0.17 ± 0.02 mSv, respectively. A total of 114 lung nodules were detected on SCT as a standard reference. There was no statistically significant difference in sensitivity between ASIR-driven ULDCT and SCT for three out of the five observers (p = 0.678, 0.735, < 0.01, 0.038, and < 0.868 for observers 1, 2, 3, 4, and 5, respectively). The sensitivity of FBP-driven ULDCT was significantly lower than that of ASIR-driven ULDCT in three out of the five observers (p < 0.01 for three observers, and p = 0.064 and 0.146 for two observers). In jackknife alternative free-response receiver operating characteristic analysis, the mean values of figure-of-merit (FOM) for FBP, ASIR-driven ULDCT, and SCT were 0.682, 0.772, and 0.821, respectively, and there were no significant differences in FOM values between ASIR-driven ULDCT and SCT (p = 0.11), but the FOM value of FBP-driven ULDCT was significantly lower than that of ASIR-driven ULDCT and SCT (p = 0.01 and 0.00). Adaptive statistical iterative reconstruction-driven ULDCT delivering a radiation dose of only 0.17 mSv offers acceptable sensitivity in nodule detection compared with SCT and has better performance than FBP-driven ULDCT.

  1. Adaptive statistical iterative reconstruction-applied ultra-low-dose CT with radiography- comparable radiation dose: Usefulness for lung nodule detection

    International Nuclear Information System (INIS)

    To assess the performance of adaptive statistical iterative reconstruction (ASIR)-applied ultra-low-dose CT (ULDCT) in detecting small lung nodules. Thirty patients underwent both ULDCT and standard dose CT (SCT). After determining the reference standard nodules, five observers, blinded to the reference standard reading results, independently evaluated SCT and both subsets of ASIR- and filtered back projection (FBP)-driven ULDCT images. Data assessed by observers were compared statistically. Converted effective doses in SCT and ULDCT were 2.81 ± 0.92 and 0.17 ± 0.02 mSv, respectively. A total of 114 lung nodules were detected on SCT as a standard reference. There was no statistically significant difference in sensitivity between ASIR-driven ULDCT and SCT for three out of the five observers (p = 0.678, 0.735, < 0.01, 0.038, and < 0.868 for observers 1, 2, 3, 4, and 5, respectively). The sensitivity of FBP-driven ULDCT was significantly lower than that of ASIR-driven ULDCT in three out of the five observers (p < 0.01 for three observers, and p = 0.064 and 0.146 for two observers). In jackknife alternative free-response receiver operating characteristic analysis, the mean values of figure-of-merit (FOM) for FBP, ASIR-driven ULDCT, and SCT were 0.682, 0.772, and 0.821, respectively, and there were no significant differences in FOM values between ASIR-driven ULDCT and SCT (p = 0.11), but the FOM value of FBP-driven ULDCT was significantly lower than that of ASIR-driven ULDCT and SCT (p = 0.01 and 0.00). Adaptive statistical iterative reconstruction-driven ULDCT delivering a radiation dose of only 0.17 mSv offers acceptable sensitivity in nodule detection compared with SCT and has better performance than FBP-driven ULDCT

  2. Dose escalation for non-small cell lung cancer: Analysis and modelling of published literature

    International Nuclear Information System (INIS)

    Purpose: To review the published clinical data on non-small cell lung cancer treated with radical radiotherapy to confirm a dose-response relationship as a basis for further dose-escalation trials. Methods: Twenty-four published clinical trials were identified, 16 of which - with 29 different standard, hyper- and hypofractionated treatment schedules - were analysed. Prescription doses were converted to biologically-equivalent dose (BED), with a correction for repopulation. Disease-free survival data were corrected for the stage profile of each cohort to allow better comparison of results. We also analysed moderate (grade II and III) lung and oesophageal acute toxicity related to the corrected BED delivered to the tumour. Results: The clinical data analysed showed good agreement between the observed and modelled disease-free survival at 2 years when compared to the published models of Fenwick (correlation coefficient 0.525, p = 0.003) and Martel (correlation coefficient 0.492, p = 0.007), indicating a clear tumour dose-response. In the normally fractionated treatments (∼2 Gy per fraction), improved disease-free survival was generally observed in the shorter schedules (maximum around 6 weeks). However, the best outcomes were obtained for the hypofractionated schedules. No systematic relationship was seen between prescribed dose and lung or oesophageal acute toxicity, possibly due to dose selection depending on V20 or MLD in some studies and the diversity of the patients analysed. Conclusions: We have demonstrated a dose-response relationship for NSCLC based on clinical data. The clinical data provide a rational basis for selection of dose escalation schedules to be tested in future randomised trials.

  3. Variations of Dose to the Lung During Computed Tomography (CT) Thorax Examinations: A Monte Carlo Study

    International Nuclear Information System (INIS)

    This study determined the influence of patient individuality on lung organ doses for chest computed tomography (CT) examinations, viewed in the context of the recommendation of the ICRP 103. Within this current recommendation, a more individualized dose estimation is emphasized. The new ICRP 110 voxelized adult phantom was used and compared to calculation of lung doses for chest CT studies with identical scan parameters (120 kV, 135 mAs, 100 mm collimation, 1.5 pitch). For all patient images, the lung was contoured, and the scanning geometry was simulated using the Monte Carlo method. The lungs were completely included in the scan area. A user code was developed for the Monte Carlo package EGSnrc, which enables the simulation of a CT examination procedure and allows an efficient dose scoring within a patient geometry. All simulations were calculated with the same CT source model and calibrated to a realistic CTDIair value. Simulation values were grouped into 1 mSv classes. The organ dose classes fit well to a Gaussian distribution (adjusted correlation coefficient R2 = 0.95). The mean value of the fit was 10 mSv, with a standard deviation of 2 mSv. The variability was about ±30% with a minimum of 8 mSv and maximum of 13 mSv. The calculated lung dose of the ICRP adult female phantom was approximately 11 mSv and thus within the calculated standard deviation of the patient pool. The correlation between lung volume and dose was weak (adjusted correlation coefficient R2 = 0.33). Gender specific differences between the ICRP male and female phantoms were about 17%. In comparison, the differences between the female and a limited set of male patient studies were not statistically significant. Further, the relation between the HU values of CT scans and material/density necessary for the Monte Carlo simulations was investigated. It resulted that the simple but commonly employed relationship leads to significant deviations compared to definite materials in the ICRP phantoms

  4. Assessment of the mode of action for hexavalent chromium-induced lung cancer following inhalation exposures

    International Nuclear Information System (INIS)

    Highlights: • No published or well recognized MOA for Cr(VI)-induced lung tumors exists. • MOA analysis for Cr(VI)-induced lung cancer was conducted to inform risk assessment. • Cr(VI) epidemiologic, toxicokinetic, toxicological, mechanistic data were evaluated. • Weight of evidence does not support a mutagenic MOA for Cr(VI)-induced lung cancer. • Non-linear approaches should be considered for evaluating Cr(VI) lung cancer risk. - Abstract: Inhalation of hexavalent chromium [Cr(VI)] is associated with increased lung cancer risk among workers in several industries, most notably chromate production workers exposed to high concentrations of Cr(VI) (≥100 μg/m3), for which clear exposure–response relationships and respiratory irritation and tissue damage have been reported. Data from this industry are used to assess lung cancer risk associated with environmental and current occupational exposures, occurring at concentrations that are significantly lower. There is considerable uncertainty in the low dose extrapolation of historical occupational epidemiology data to assess risk at current exposures because no published or well recognized mode of action (MOA) for Cr(VI)-induced lung tumors exists. We conducted a MOA analysis for Cr(VI)-induced lung cancer evaluating toxicokinetic and toxicological data in humans and rodents and mechanistic data to assess plausibility, dose–response, and temporal concordance for potential MOAs. Toxicokinetic data support that extracellular reduction of Cr(VI), which limits intracellular absorption of Cr(VI) and Cr(VI)-induced toxicity, can be overwhelmed at high exposure levels. In vivo genotoxicity and mutagenicity data are mostly negative and do not support a mutagenic MOA. Further, both chronic bioassays and the epidemiologic literature support that lung cancer occurs at exposures that cause tissue damage. Based on this MOA analysis, the overall weight of evidence supports a MOA involving deposition and accumulation of

  5. TU-F-17A-08: The Relative Accuracy of 4D Dose Accumulation for Lung Radiotherapy Using Rigid Dose Projection Versus Dose Recalculation On Every Breathing Phase

    International Nuclear Information System (INIS)

    Purpose: To investigate the accuracy of 4D dose accumulation using projection of dose calculated on the end-exhalation, mid-ventilation, or average intensity breathing phase CT scan, versus dose accumulation performed using full Monte Carlo dose recalculation on every breathing phase. Methods: Radiotherapy plans were analyzed for 10 patients with stage I-II lung cancer planned using 4D-CT. SBRT plans were optimized using the dose calculated by a commercially-available Monte Carlo algorithm on the end-exhalation 4D-CT phase. 4D dose accumulations using deformable registration were performed with a commercially available tool that projected the planned dose onto every breathing phase without recalculation, as well as with a Monte Carlo recalculation of the dose on all breathing phases. The 3D planned dose (3D-EX), the 3D dose calculated on the average intensity image (3D-AVE), and the 4D accumulations of the dose calculated on the end-exhalation phase CT (4D-PR-EX), the mid-ventilation phase CT (4D-PR-MID), and the average intensity image (4D-PR-AVE), respectively, were compared against the accumulation of the Monte Carlo dose recalculated on every phase. Plan evaluation metrics relating to target volumes and critical structures relevant for lung SBRT were analyzed. Results: Plan evaluation metrics tabulated using 4D-PR-EX, 4D-PR-MID, and 4D-PR-AVE differed from those tabulated using Monte Carlo recalculation on every phase by an average of 0.14±0.70 Gy, - 0.11±0.51 Gy, and 0.00±0.62 Gy, respectively. Deviations of between 8 and 13 Gy were observed between the 4D-MC calculations and both 3D methods for the proximal bronchial trees of 3 patients. Conclusions: 4D dose accumulation using projection without re-calculation may be sufficiently accurate compared to 4D dose accumulated from Monte Carlo recalculation on every phase, depending on institutional protocols. Use of 4D dose accumulation should be considered when evaluating normal tissue complication

  6. Impact of dose calculation accuracy during optimization on lung IMRT plan quality.

    Science.gov (United States)

    Li, Ying; Rodrigues, Anna; Li, Taoran; Yuan, Lulin; Yin, Fang-Fang; Wu, Q Jackie

    2015-01-01

    The purpose of this study was to evaluate the effect of dose calculation accuracy and the use of an intermediate dose calculation step during the optimization of intensity-modulated radiation therapy (IMRT) planning on the final plan quality for lung cancer patients. This study included replanning for 11 randomly selected free-breathing lung IMRT plans. The original plans were optimized using a fast pencil beam convolution algorithm. After optimization, the final dose calculation was performed using the analytical anisotropic algorithm (AAA). The Varian Treatment Planning System (TPS) Eclipse v11, includes an option to perform intermediate dose calculation during optimization using the AAA. The new plans were created using this intermediate dose calculation during optimization with the same planning objectives and dose constraints as in the original plan. Differences in dosimetric parameters for the planning target volume (PTV) dose coverage, organs-at-risk (OARs) dose sparing, and the number of monitor units (MU) between the original and new plans were analyzed. Statistical significance was determined with a p-value of less than 0.05. All plans were normalized to cover 95% of the PTV with the prescription dose. Compared with the original plans, the PTV in the new plans had on average a lower maximum dose (69.45 vs. 71.96Gy, p = 0.005), a better homogeneity index (HI) (0.08 vs. 0.12, p = 0.002), and a better conformity index (CI) (0.69 vs. 0.59, p = 0.003). In the new plans, lung sparing was increased as the volumes receiving 5, 10, and 30 Gy were reduced when compared to the original plans (40.39% vs. 42.73%, p = 0.005; 28.93% vs. 30.40%, p = 0.001; 14.11%vs. 14.84%, p = 0.031). The volume receiving 20 Gy was not significantly lower (19.60% vs. 20.38%, p = 0.052). Further, the mean dose to the lung was reduced in the new plans (11.55 vs. 12.12 Gy, p = 0.024). For the esophagus, the mean dose, the maximum dose, and the volumes receiving 20 and 60 Gy were lower in

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

    International Nuclear Information System (INIS)

    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 for the least complex tests, deviations of tumor dose > 4% were observed for some cases. This study underpins the dosimetric challenge in TPS calculations for clinically relevant heterogeneous geometries. The scintillator system, together with the special phantom, provides a promising tool for evaluation of complex radiotherapy dose calculations and delivery

  8. The refinement of dose assessment of the THOR BNCT beam

    International Nuclear Information System (INIS)

    A refined dose assessment method has been used now in the THOR BNCT facility, which takes into account more delicate corrections, carefully handled calibration factors, and the spectrum- and kerma-weighted kt value. The refined method solved the previous problem of negative derived neutron dose in phantom at deeper positions. With the improved dose assessment, the calculated and measured gamma-ray dose rates match perfectly in a 15×15×15 cm3 PMMA phantom.

  9. Dosimetric accuracy and clinical quality of Acuros XB and AAA dose calculation algorithm for stereotactic and conventional lung volumetric modulated arc therapy plans

    International Nuclear Information System (INIS)

    The main aim of the current study was to assess the dosimetric accuracy and clinical quality of volumetric modulated arc therapy (VMAT) plans for stereotactic (stage I) and conventional (stage III) lung cancer treatments planned with Eclipse version 10.0 Anisotropic Analytical Algorithm (AAA) and Acuros XB (AXB) algorithm. The dosimetric impact of using AAA instead of AXB, and grid size 2.5 mm instead of 1.0 mm for VMAT treatment plans was evaluated. The clinical plan quality of AXB VMAT was assessed using 45 stage I and 73 stage III patients, and was compared with published results, planned with VMAT and hybrid-VMAT techniques. The dosimetric impact on near-minimum PTV dose (D98%) using AAA instead of AXB was large (underdose up to 12.3%) for stage I and very small (underdose up to 0.8%) for stage III lung treatments. There were no significant differences for dose volume histogram (DVH) values between grid sizes. The calculation time was significantly higher for AXB grid size 1.0 than 2.5 mm (p < 0.01). The clinical quality of the VMAT plans was at least comparable with clinical qualities given in literature of lung treatment plans with VMAT and hybrid-VMAT techniques. The average mean lung dose (MLD), lung V20Gy and V5Gy in this study were respectively 3.6 Gy, 4.1% and 15.7% for 45 stage I patients and 12.4 Gy, 19.3% and 46.6% for 73 stage III lung patients. The average contra-lateral lung dose V5Gy-cont was 35.6% for stage III patients. For stereotactic and conventional lung treatments, VMAT calculated with AXB grid size 2.5 mm resulted in accurate dose calculations. No hybrid technique was needed to obtain the dose constraints. AXB is recommended instead of AAA for avoiding serious overestimation of the minimum target doses compared to the actual delivered dose

  10. Radiation fields and dose assessments in Korean nuclear power plants.

    Science.gov (United States)

    Kim, Hee Geun; Kong, Tae Young; Jeong, Woo Tae; Kim, Seok Tae

    2011-07-01

    In the primary systems of nuclear power plants (NPPs), various radionuclides including fission products and corrosion products are generated due to the complex water chemistry conditions. In particular, (3)H, (14)C, (58)Co, (60)Co, (137)Cs, and (131)I are important or potential radionuclides with respect to dose assessment for workers and the management of radioactive effluents or dose assessment for the public. In this paper, the dominant contributors to the dose for workers and the public were reviewed and the process of dose assessment attributable to those contributors was investigated. Furthermore, an analysis was carried out on some examples of dose to workers during NPP operation. PMID:21498858

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

    International Nuclear Information System (INIS)

    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 (V20, V30, or V40) 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 20 was 364.0 cm3 and 160.0 cm3 (p 30 was 144.6 cm3vs 77.0 cm3 (p = 0.0012), V35 was 93.9 cm3vs 57.9 cm3 (p = 0.005), V40 was 66.5 cm3vs 45.4 cm3 (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

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

    OpenAIRE

    M.F.R. Silva; P.H.N. Saldiva

    1998-01-01

    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 l...

  13. An automated system for lung nodule detection in low-dose computed tomography

    OpenAIRE

    Gori, I.; Fantacci, M. E.; Martinez, A. Preite; Retico, A.

    2007-01-01

    A computer-aided detection (CAD) system for the identification of pulmonary nodules in low-dose multi-detector helical Computed Tomography (CT) images was 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, a dot-enhancement filter for nodule candidate selection and a n...

  14. Indoor radon dose assessment for Osijek

    International Nuclear Information System (INIS)

    After ten years' investigation of radon's seasonal variation at three very different locations, as well as radon concentration measurements in kindergartens, schools, air-raid shelters and cellars, systematic indoor radon measurements were undertaken in dwellings (residential buildings) of Osijek (East Croatia, 130andpuncsp; omitted000 citizens). Indoor radon was measured by means of the LR-115 SSNT detector at 48 town locations that gave an arithmetic mean of 71.6 Bq/m3, standard deviation of 44.0 Bq/m3 and geometric mean of 60.1 Bq/m3, for the radon concentration range from 22.7 to 185.6 Bq/m3. Radon measurements, performed by the silicon Radhome detector, did not differ significantly. The empirical frequency distribution of radon concentrations, with the class width of 20 Bq/m3, was in accordance with the theoretical log-normal distribution which was shown with the χ2-test. The radon map pointed out a region of higher radon concentrations (central part of the town) that was ascribed to the geological soil structure. The average equilibrium factor for radon and its progeny in the mentioned dwellings was 0.44. The effective dose equivalent assessment for a few radon models was near 2 mSv/year. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

  15. Dose assessments in nuclear power plant siting

    International Nuclear Information System (INIS)

    This document is mainly intended to provide information on dose estimations and assessments for the purpose of nuclear power plant (NPP) siting. It is not aimed at giving radiation protection guidance, criteria or procedures to be applied during the process of NPP siting nor even to provide recommendations on this subject matter. The document may however be of help for implementing some of the Nuclear Safety Standards (NUSS) documents on siting. The document was prepared before April 26, 1986, when a severe accident at the Unit 4 of Chernobyl NPP in the USSR had occurred. It should be emphasized that this document does not bridge the gap which exists in the NUSS programme as far as radiation protection guidance for the specific case of siting of NPP is concerned. The Agency will continue to work on this subject with the aim to prepare a safety series document on radiation protection requirements for NPP siting. This document could serve as a working document for this purpose. Refs, figs and tabs

  16. Depth-dose evaluation for lung and pancreas cancer treatment by BNCT using an epithermal neutron beam

    International Nuclear Information System (INIS)

    The depth-dose distributions were evaluated for possible treatment of both lung and pancreas cancers using an epithermal neutron beam. The MCNP calculations showed that physical dose in tumors were 6 and 7 Gy/h, respectively, for lung and pancreas, attaining an epithermal neutron flux of 5x108 ncm-2s-1. The boron concentrations were assumed at 100 ppm and 30 ppm, respectively, for lung and pancreas tumors and normal tissues contains 1/10 tumor concentrations. The dose ratios of tumor to normal tissue were 2.5 and 2.4, respectively, for lung and pancreas. The dose evaluation suggests that BNCT could be applied for both lung and pancreas cancer treatment. (author)

  17. Program for rapid dose assessment in criticality accident, RADAPAS

    International Nuclear Information System (INIS)

    In a criticality accident, a person near fissile material can receive extremely high dose which can cause acute health effect. For such a case, medical treatment should be carried out for the exposed person, according to severity of the exposure. Then, radiation dose should be rapidly assessed soon after an outbreak of an accident. Dose assessment based upon the quantity of induced 24Na in human body through neutron exposure is expected as one of useful dosimetry techniques in a criticality accident. A dose assessment program, called RADAPAS (RApid Dose Assessment Program from Activated Sodium in Criticality Accidents), was therefore developed to assess rapidly radiation dose to exposed persons from activity of induced 24Na. RADAPAS consists of two parts; one is a database part and the other is a part for execution of dose calculation. The database contains data compendiums of energy spectra and dose conversion coefficients from specific activity of 24Na induced in human body, which had been derived in a previous analysis using Monte Carlo calculation code. Information for criticality configuration or characteristics of radiation in the accident field is to be interactively given with interface displays in the dose calculation. RADAPAS can rapidly derive radiation dose to the exposed person from the given information and measured 24Na specific activity by using the conversion coefficient in database. This report describes data for dose conversions and dose calculation in RADAPAS and explains how to use the program. (author)

  18. 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.

  19. 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

  20. Assessment of a new p-Mosfet usable as a dose rate insensitive gamma dose sensor

    International Nuclear Information System (INIS)

    Dosimetric response of unbiased MOS devices has been assessed at dose rates greater than 2000 cGy/h. Application have been made to a personal dosemeter / dose rate meter to measure the absorbed tissue dose received in the case of acute external irradiation. (D.L.)

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

    International Nuclear Information System (INIS)

    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.

  2. Critical Appraisal of Acuros XB and Anisotropic Analytic Algorithm Dose Calculation in Advanced Non-Small-Cell Lung Cancer Treatments

    Energy Technology Data Exchange (ETDEWEB)

    Fogliata, Antonella, E-mail: afc@iosi.ch [Medical Physics Unit, Oncology Institute of Southern Switzerland, Bellinzona (Switzerland); Nicolini, Giorgia; Clivio, Alessandro; Vanetti, Eugenio; Cozzi, Luca [Medical Physics Unit, Oncology Institute of Southern Switzerland, Bellinzona (Switzerland)

    2012-08-01

    Purpose: To assess the clinical impact of the Acuros XB algorithm (implemented in the Varian Eclipse treatment-planning system) in non-small-cell lung cancer (NSCLC) cases. Methods and Materials: A CT dataset of 10 patients presenting with advanced NSCLC was selected and contoured for planning target volume, lungs, heart, and spinal cord. Plans were created for 6-MV and 15-MV beams using three-dimensional conformal therapy, intensity-modulated therapy, and volumetric modulated arc therapy with RapidArc. Calculations were performed with Acuros XB and the Anisotropic Analytical Algorithm. To distinguish between differences coming from the different heterogeneity management and those coming from the algorithm and its implementation, all the plans were recalculated assigning Hounsfield Unit (HU) = 0 (Water) to the CT dataset. Results: Differences in dose distributions between the two algorithms calculated in Water were <0.5%. This suggests that the differences in the real CT dataset can be ascribed mainly to the different heterogeneity management, which is proven to be more accurate in the Acuros XB calculations. The planning target dose difference was stratified between the target in soft tissue, where the mean dose was found to be lower for Acuros XB, with a range of 0.4% {+-} 0.6% (intensity-modulated therapy, 6 MV) to 1.7% {+-} 0.2% (three-dimensional conformal therapy, 6 MV), and the target in lung tissue, where the mean dose was higher for 6 MV (from 0.2% {+-} 0.2% to 1.2% {+-} 0.5%) and lower for 15 MV (from 0.5% {+-} 0.5% to 2.0% {+-} 0.9%). Mean doses to organs at risk presented differences up to 3% of the mean structure dose in the worst case. No particular or systematic differences were found related to the various modalities. Calculation time ratios between calculation time for Acuros XB and the Anisotropic Analytical Algorithm were 7 for three-dimensional conformal therapy, 5 for intensity-modulated therapy, and 0.2 for volumetric modulated arc therapy

  3. Assessing the Clinical Impact of Approximations in Analytical Dose Calculations for Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Schuemann, Jan, E-mail: jschuemann@mgh.harvard.edu; Giantsoudi, Drosoula; Grassberger, Clemens; Moteabbed, Maryam; Min, Chul Hee; Paganetti, Harald

    2015-08-01

    Purpose: To assess the impact of approximations in current analytical dose calculation methods (ADCs) on tumor control probability (TCP) in proton therapy. Methods: Dose distributions planned with ADC were compared with delivered dose distributions as determined by Monte Carlo simulations. A total of 50 patients were investigated in this analysis with 10 patients per site for 5 treatment sites (head and neck, lung, breast, prostate, liver). Differences were evaluated using dosimetric indices based on a dose-volume histogram analysis, a γ-index analysis, and estimations of TCP. Results: We found that ADC overestimated the target doses on average by 1% to 2% for all patients considered. The mean dose, D95, D50, and D02 (the dose value covering 95%, 50% and 2% of the target volume, respectively) were predicted within 5% of the delivered dose. The γ-index passing rate for target volumes was above 96% for a 3%/3 mm criterion. Differences in TCP were up to 2%, 2.5%, 6%, 6.5%, and 11% for liver and breast, prostate, head and neck, and lung patients, respectively. Differences in normal tissue complication probabilities for bladder and anterior rectum of prostate patients were less than 3%. Conclusion: Our results indicate that current dose calculation algorithms lead to underdosage of the target by as much as 5%, resulting in differences in TCP of up to 11%. To ensure full target coverage, advanced dose calculation methods like Monte Carlo simulations may be necessary in proton therapy. Monte Carlo simulations may also be required to avoid biases resulting from systematic discrepancies in calculated dose distributions for clinical trials comparing proton therapy with conventional radiation therapy.

  4. High-dose radiotherapy in inoperable nonsmall cell lung cancer: comparison of volumetric modulated arc therapy, dynamic IMRT and 3D conformal radiotherapy.

    Science.gov (United States)

    Bree, Ingrid de; van Hinsberg, Mariëlle G E; van Veelen, Lieneke R

    2012-01-01

    Conformal 3D radiotherapy (3D-CRT) combined with chemotherapy for inoperable non-small cell lung cancer (NSCLC) to the preferable high dose is often not achievable because of dose-limiting organs. This reduces the probability of regional tumor control. Therefore, the surplus value of using intensity-modulated radiation therapy (IMRT) techniques, specifically volumetric modulated arc therapy (RapidArc [RA]) and dynamic IMRT (d-IMRT) has been investigated. RA and d-IMRT plans were compared with 3D-CRT treatment plans for 20 patients eligible for concurrent high-dose chemoradiotherapy, in whom a dose of 60 Gy was not achievable. Comparison of dose delivery in the target volume and organs at risk was carried out by evaluating 3D dose distributions and dose-volume histograms. Quality of the dose distribution was assessed using the inhomogeneity and conformity index. For most patients, a higher dose to the target volume can be delivered using RA or d-IMRT; in 15% of the patients a dose ≥60 Gy was possible. Both IMRT techniques result in a better conformity of the dose (p < 0.001). There are no significant differences in homogeneity of dose in the target volume. IMRT techniques for NSCLC patients allow higher dose to the target volume, thus improving regional tumor control. PMID:22459649

  5. High-dose radiotherapy in inoperable nonsmall cell lung cancer: Comparison of volumetric modulated arc therapy, dynamic IMRT and 3D conformal radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Bree, Ingrid de, E-mail: i.de.bree@zrti.nl [Zeeuws Radiotherapeutisch Instituut, Vlissingen (Netherlands); Hinsberg, Marieelle G.E. van; Veelen, Lieneke R. van [Zeeuws Radiotherapeutisch Instituut, Vlissingen (Netherlands)

    2012-01-01

    Conformal 3D radiotherapy (3D-CRT) combined with chemotherapy for inoperable non-small cell lung cancer (NSCLC) to the preferable high dose is often not achievable because of dose-limiting organs. This reduces the probability of regional tumor control. Therefore, the surplus value of using intensity-modulated radiation therapy (IMRT) techniques, specifically volumetric modulated arc therapy (RapidArc [RA]) and dynamic IMRT (d-IMRT) has been investigated. RA and d-IMRT plans were compared with 3D-CRT treatment plans for 20 patients eligible for concurrent high-dose chemoradiotherapy, in whom a dose of 60 Gy was not achievable. Comparison of dose delivery in the target volume and organs at risk was carried out by evaluating 3D dose distributions and dose-volume histograms. Quality of the dose distribution was assessed using the inhomogeneity and conformity index. For most patients, a higher dose to the target volume can be delivered using RA or d-IMRT; in 15% of the patients a dose {>=}60 Gy was possible. Both IMRT techniques result in a better conformity of the dose (p < 0.001). There are no significant differences in homogeneity of dose in the target volume. IMRT techniques for NSCLC patients allow higher dose to the target volume, thus improving regional tumor control.

  6. High-dose radiotherapy in inoperable nonsmall cell lung cancer: Comparison of volumetric modulated arc therapy, dynamic IMRT and 3D conformal radiotherapy

    International Nuclear Information System (INIS)

    Conformal 3D radiotherapy (3D-CRT) combined with chemotherapy for inoperable non–small cell lung cancer (NSCLC) to the preferable high dose is often not achievable because of dose-limiting organs. This reduces the probability of regional tumor control. Therefore, the surplus value of using intensity-modulated radiation therapy (IMRT) techniques, specifically volumetric modulated arc therapy (RapidArc [RA]) and dynamic IMRT (d-IMRT) has been investigated. RA and d-IMRT plans were compared with 3D-CRT treatment plans for 20 patients eligible for concurrent high-dose chemoradiotherapy, in whom a dose of 60 Gy was not achievable. Comparison of dose delivery in the target volume and organs at risk was carried out by evaluating 3D dose distributions and dose-volume histograms. Quality of the dose distribution was assessed using the inhomogeneity and conformity index. For most patients, a higher dose to the target volume can be delivered using RA or d-IMRT; in 15% of the patients a dose ≥60 Gy was possible. Both IMRT techniques result in a better conformity of the dose (p < 0.001). There are no significant differences in homogeneity of dose in the target volume. IMRT techniques for NSCLC patients allow higher dose to the target volume, thus improving regional tumor control.

  7. Radiation dose for normal organs by helical tomotherapy for lung cancer

    International Nuclear Information System (INIS)

    This study derived a simple equation of effective dose (E) versus normal organ of patients with varying body weights undergoing lung cancer treatment of helical tomotherapy (TOMO). Five tissue-equivalent and Rando phantoms were used to simulate lung cancer patients. This study then measured E and equivalent dose of organ or tissues (DT) using thermoluminescent dosimetry (TLD-100H). The TLD-100H was calibrated using TOMO 6 MV photons, then inserted into phantom positions that closely corresponded with the position of the represented organs and tissues. Both E and DT were evaluated by ICRP 103. Peripheral doses varied markedly at positions close to the tumor center. The maximum statistical and total errors were 16.7–22.3%. This analytical result indicates that E of Rando and tissue-equivalent phantoms was in the ranged of 9.44±1.70 (10 kg) to 4.58±0.83 (90 kg) mSv/Gy. Notably, E decreased exponentially as phantom weight increased. Peripheral doses were also evaluated by TLD as a function of distance from the tumor center. Finally, experimental results are compared with those in literature. These findings will prove useful to patients, physicians, radiologists, and the public. - Highlights: • Phantoms were used to measure effective dose of helical tomotherapy. • TLDs inserted into five varying body weights phantoms. • Both effective dose and equivalent dose of organ were evaluated by ICRP 103. • Effective dose decreased exponentially as phantom weight increased. • Peripheral doses varied markedly close to the tumor center

  8. SU-E-P-03: Implementing a Low Dose Lung Screening CT Program Meeting Regulatory Requirements

    Energy Technology Data Exchange (ETDEWEB)

    LaFrance, M; Marsh, S; O' Donnell, G [Baystate Health Systems, Inc., Springfield (United States)

    2014-06-01

    Purpose: To provide information pertaining to IROC Houston QA Center's (RPC) credentialing process for institutions participating in NCI-sponsored clinical trials. Purpose: Provide guidance to the Radiology Departments with the intent of implementing a Low Dose CT Screening Program using different CT Scanners with multiple techniques within the framework of the required state regulations. Method: State Requirements for the purpose of implementing a Low Dose CT Lung Protocol required working with the Radiology and Pulmonary Department in setting up a Low Dose Screening Protocol designed to reduce the radiation burden to the patients enrolled. Radiation dose measurements (CTDIvol) for various CT manufacturers (Siemens16, Siemens 64, Philips 64, and Neusoft128) for three different weight based protocols. All scans were reviewed by the Radiologist. Prior to starting a low dose lung screening protocol, information had to be submitted to the state for approval. Performing a Healing Arts protocol requires extensive information. This not only includes name and address of the applicant but a detailed description of the disease, the x-ray examination and the population to be examined. The unit had to be tested by a qualified expert using the technique charts. The credentials of all the operators, the supervisors and the Radiologists had to be submitted to the state. Results: All the appropriate documentation was sent to the state for review. The measured results between the Low Dose Protocol versus the default Adult Chest Protocol showed that there was a dose reduction of 65% for small (100-150 lb.) patient, 75% for the Medium patient (151-250 lbs.), and a 55% reduction for the Large patient ( over 250 lbs.). Conclusion: Measured results indicated that the Low Dose Protocol indeed lowered the screening patient's radiation dose and the institution was able to submit the protocol to the State's regulators.

  9. Collateral Ventilation to Congenital Hyperlucent Lung Lesions Assessed on Xenon-Enhanced Dynamic Dual-Energy CT: an Initial Experience

    International Nuclear Information System (INIS)

    We wanted to evaluate the resistance to collateral ventilation in congenital hyperlucent lung lesions and to correlate that with the anatomic findings on xenon-enhanced dynamic dual-energy CT. Xenon-enhanced dynamic dual-energy CT was successfully and safely performed in eight children (median age: 5.5 years, 4 boys and 4 girls) with congenital hyperlucent lung lesions. Functional assessment of the lung lesions on the xenon map was done, including performing a time-xenon value curve analysis and assessing the amplitude of xenon enhancement (A) value, the rate of xenon enhancement (K) value and the time of arrival value. Based on the A value, the lung lesions were categorized into high or low (A value > 10 Hounsfi eld unit [HU]) resistance to collateral ventilation. In addition, the morphologic CT findings of the lung lesions, including cyst, mucocele and an accessory or incomplete fissure, were assessed on the weighted-average CT images. The xenon-enhanced CT radiation dose was estimated. Five of the eight lung lesions were categorized into the high resistance group and three lesions were categorized into the low resistance group. The A and K values in the normal lung were higher than those in the low resistance group. The time of arrival values were delayed in the low resistance group. Cysts were identified in five lesions, mucocele in four, accessory fissure in three and incomplete fissure in two. Either cyst or an accessory fissure was seen in four of the five lesions showing high resistance to collateral ventilation. The xenon-enhanced CT radiation dose was 2.3 ± 0.6 mSv. Xenon-enhanced dynamic dual-energy CT can help visualize and quantitate various degrees of collateral ventilation to congenital hyperlucent lung lesions in addition to assessing the anatomic details of the lung

  10. Collateral Ventilation to Congenital Hyperlucent Lung Lesions Assessed on Xenon-Enhanced Dynamic Dual-Energy CT: an Initial Experience

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo; Yang, Dong Hyun; Kim, Nam Kug; Park, Seung Il; Kim, Dong Kwan; Kim, Ellen Ai Rhan [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2011-02-15

    We wanted to evaluate the resistance to collateral ventilation in congenital hyperlucent lung lesions and to correlate that with the anatomic findings on xenon-enhanced dynamic dual-energy CT. Xenon-enhanced dynamic dual-energy CT was successfully and safely performed in eight children (median age: 5.5 years, 4 boys and 4 girls) with congenital hyperlucent lung lesions. Functional assessment of the lung lesions on the xenon map was done, including performing a time-xenon value curve analysis and assessing the amplitude of xenon enhancement (A) value, the rate of xenon enhancement (K) value and the time of arrival value. Based on the A value, the lung lesions were categorized into high or low (A value > 10 Hounsfi eld unit [HU]) resistance to collateral ventilation. In addition, the morphologic CT findings of the lung lesions, including cyst, mucocele and an accessory or incomplete fissure, were assessed on the weighted-average CT images. The xenon-enhanced CT radiation dose was estimated. Five of the eight lung lesions were categorized into the high resistance group and three lesions were categorized into the low resistance group. The A and K values in the normal lung were higher than those in the low resistance group. The time of arrival values were delayed in the low resistance group. Cysts were identified in five lesions, mucocele in four, accessory fissure in three and incomplete fissure in two. Either cyst or an accessory fissure was seen in four of the five lesions showing high resistance to collateral ventilation. The xenon-enhanced CT radiation dose was 2.3 {+-} 0.6 mSv. Xenon-enhanced dynamic dual-energy CT can help visualize and quantitate various degrees of collateral ventilation to congenital hyperlucent lung lesions in addition to assessing the anatomic details of the lung

  11. Non-coplanar beam intensity modulation allows large dose escalation in stage III lung cancer

    International Nuclear Information System (INIS)

    Purpose: To evaluate the feasibility of dose escalation in stage III non-small cell lung cancer, we compared standard coplanar (2D) with non-coplanar beam arrangements, without (3D) and with beam intensity modulation (3D-BIM). Materials and methods: This study was a planning effort performed on a non-selected group of 10 patients. Starting from a serial CT scan, treatment planning was performed using Sherouse's GRATISTM 3D planning system. Two target volumes were defined; gross tumor volume (GTV) defined a high-dose target volume that had to receive a dose of at least 80 Gy and GTV plus the lymph node regions with >10% probability of invasion defined an intermediate-dose target volume (GTV+N). It was our intention to irradiate GTV+N up to 56 Gy or more. If the prescribed doses on GTV and GTV+N could not be reached with either the 2D or 3D technique, a 3D-BIM plan was performed. The 3D-BIM plan was a class solution involving identical gantry angles, segment arrangements and relative segment weights for all patients. Dose volume histograms for GTV, GTV+N, lung and spinal cord were calculated. 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 20 Gy. Under these constraints, maximal achievable doses to GTV and GTV+N were calculated. Results: In all 2D plans, spinal cord was the limiting factor and the prescribed doses for GTV and GTV+N could not be reached in any patient. The non-coplanar 3D plan resulted in a satisfying solution in 4 out of 10 patients under the same constraints. In comparison with 2D, the minimum dose in GTV+N was increased. Six patients had to be planned with the 3D-BIM technique. The theoretical minimum dose to GTV+N ranged between 56 and 98 Gy. The delivery of 80 Gy or more to GTV was possible in all patients. For a minimal dose of 80 Gy to GTV, the maximal dose to any point of the spinal cord varied between 27 and 46 Gy. The lung volume receiving more than

  12. Applying the PCXMCR software for dose assessment in patients submitted to chest and skull X-ray examinations

    International Nuclear Information System (INIS)

    The International Commission of radiation and Units (ICRU) has recommended the use of Monte Carlo calculation software to assess the organ doses in patient undergoing x-ray examinations. The PCXMCR is a largely used computational program for assessing organ doses in chest and skull diagnostic radiology. The aim of this work was assess doses in critical and relevant organs of several patients in a hospital in Belo Horizonte, Minas Gerais. The work was done by recording the patient and geometrical data during several exams in the xray sectors of the hospital. Patients were classified according to their biotype as A, B and C and they were chosen for dose assessment s. Patients A, B and C have the smallest, the medium and the largest dimensions, respectively. Simulation was dose using the PCXMCR and organ doses were assessed. Analyses were carried out only for the highest exposed organs in terms of their contribution to the effective dose; doses due to the posteroanterior followed by lateral projections were added. During the chest examinations, the lungs got the highest doses. The lung doses were 23.5, 33.6, 45.4 μSv in patients A, B and C, respectively. During the skull examinations, the thyroid was the critical organ that gave the highest contribution to the effective dose. The thyroid doses were 30.5, 27.6 and 22.3 μSv, in patient A, B and C, respectively. Doses variations suggested that there is space for standardization of the radiological techniques and for optimizing the radiographic procedures to reduce patient doses. (author)

  13. 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......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...... placebo, in all 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...

  14. An automated system for lung nodule detection in low-dose computed tomography

    CERN Document Server

    Gori, I; Martinez, A Preite; Retico, A

    2007-01-01

    A computer-aided detection (CAD) system for the identification of pulmonary nodules in low-dose multi-detector helical Computed Tomography (CT) images was 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, a dot-enhancement filter for nodule candidate selection 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 results obtained on the collected database of low-dose thin-slice CT scans are shown in terms of free response receiver operating characteristic (FROC) curves and discussed.

  15. Analyses of local dose distributions in the lungs for the determination of risk apportionment factors

    International Nuclear Information System (INIS)

    For radiation protection purposes, the relative contributions of bronchial (BB), bronchiolar (bb) and alveolar-interstitial (AI) doses to lung cancer risk are represented by their corresponding apportionment factors. The current assumption of equal apportionment factors can be tested by comparing different radon and thoron progeny exposures, which produce different regional dose distributions, with the pathologically observed regional cancer distributions: (1) radon progeny inhalation, (2) thoron progeny inhalation, (3) thoron and thoron progeny exhalation (Thorotrast patients) and (4) RP inhalation in rats, and cigarette smoke inhalation as smoking is the dominant cause of lung cancer. Comparison with the pathologically observed regional cancer distributions suggests (1) a smaller apportionment factor for the AI region as compared with BB and bb regions and (2) a higher value for the BB region relative to that for the bb region. (authors)

  16. 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.

  17. Metrics, Dose, and Dose Concept: The Need for a Proper Dose Concept in the Risk Assessment of Nanoparticles

    OpenAIRE

    Myrtill Simkó; Dietmar Nosske; Kreyling, Wolfgang G

    2014-01-01

    In: International Journal of Environmental Research and Public Health, Vol. 11 (2014), No. 4, 4026-4048; DOI: 10.3390/ijerph110404026In order to calculate the dose for nanoparticles (NP), (i) relevant information about the dose metrics and (ii) a proper dose concept are crucial. Since the appropriate metrics for NP toxicity are yet to be elaborated, a general dose calculation model for nanomaterials is not available. Here we propose how to develop a dose assessment model for NP in analogy to ...

  18. Dose calculation accuracy of lung planning with a commercial IMRT treatment planning system.

    Science.gov (United States)

    McDermott, Patrick N; He, Tongming; DeYoung, A

    2003-01-01

    The dose calculation accuracy of a commercial pencil beam IMRT planning system is evaluated by comparison with Monte Carlo calculations and measurements in an anthropomorphic phantom. The target volume is in the right lung and mediastinum and thus significant tissue inhomogeneities are present. The Monte Carlo code is an adaptation of the MCNP code and the measurements were made with TLD and film. Both the Monte Carlo code and the measurements show very good agreement with the treatment planning system except in regions where the dose is high and the electron density is low. In these regions the commercial system shows doses up to 10% higher than Monte Carlo and film. The average calculated dose for the CTV is 5% higher with the commercial system as compared to Monte Carlo. PMID:14604424

  19. Dose assessment in pediatric computerized tomography

    International Nuclear Information System (INIS)

    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 CTDIw 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 CTDIw 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 CTDIw . (author)

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

    International Nuclear Information System (INIS)

    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. CTDIvol 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.)

  1. Dose-volume-region effects in partial irradiation of rat lung

    International Nuclear Information System (INIS)

    Full text: To decrease the uncertainty in normal tissue complication probability prediction dose/volume experiments need to be performed. Here we addressed the issue of lung radiosensitivity. Rats were irradiated by graded single doses (16-22 Gy) to 50% of the total lung volume using a collimated X-ray beam. The irradiation was targeted to 6 different regions: right (R), left (L), apical (A), basal (B), mediastinal (M), lateral (LT). Two structural endpoints - histology and CT scans, and a functional endpoint - breathing frequency rates (BFR) were evaluated. Dose-effect curves for the endpoints were constructed for each region to evaluate the regional dependency of the response. Histological signs of pneumonitis (8 weeks) and fibrosis (26 weeks) were dose- but not region- dependent. CT changes at 8 weeks pointed towards hypersensitivity of L and A regions. BFR increases displayed biphasic dynamics with a first peak between 6 -10 weeks and a second increase starting at 16 weeks. Regional differences were detected during the early peak with the BFR increases expressed in the following order of magnitude: A > LT > L > B > R M. The differences were attenuated at the later time points (> week 20). The results indicate biphasic dynamics in expression of functional damage consistent with the onset of pneumonitis and fibrosis in temporal sequence. Regional differences in sensitivity were observed only during the early phase. They could not be explained by structural damage in the lung tissue itself but were likely linked to the varying proportion of sensitive gas-exchange lung structures as well as the involvement of the heart in the irradiation field

  2. 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.)

  3. Radionuclide transport and dose assessment modelling in biosphere assessment 2009

    International Nuclear Information System (INIS)

    Following the guidelines set forth by the Ministry of Trade and Industry (now Ministry of Employment and Economy), Posiva is preparing to submit a construction license application for the final disposal spent nuclear fuel at the Olkiluoto site, Finland, by the end of the year 2012. Disposal will take place in a geological repository implemented according to the KBS-3 method. The long-term safety section supporting the license application will be based on a safety case that, according to the internationally adopted definition, will be a compilation of the evidence, analyses and arguments that quantify and substantiate the safety and the level of expert confidence in the safety of the planned repository. This report documents in detail the conceptual and mathematical models and key data used in the landscape model set-up, radionuclide transport modelling, and radiological consequences analysis applied in the 2009 biosphere assessment. Resulting environmental activity concentrations in landscape model due to constant unit geosphere release rates, and the corresponding annual doses, are also calculated and presented in this report. This provides the basis for understanding the behaviour of the applied landscape model and subsequent dose calculations. (orig.)

  4. 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.

  5. CANISTER HANDLING FACILITY WORKER DOSE ASSESSMENT

    International Nuclear Information System (INIS)

    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

  6. FUEL HANDLING FACILITY WORKER DOSE ASSESSMENT

    International Nuclear Information System (INIS)

    The purpose of this design calculation is to estimate radiation doses received by personnel working in the Fuel Handling Facility (FHF) of the Monitored Geological Repository (MGR). The FHF is a surface facility supporting waste handling operations i.e. receive transportation casks, transfer wastes, prepare waste packages, and ship out loaded waste packages and empty casks. The specific scope of work contained in this calculation covers both collective doses and individual worker group doses on an annual basis, and includes the contributions due to external and internal radiation. The results are also limited to normal operations only. Results of this calculation will be used to support the FHF design and License Application

  7. Cystic Fibrosis: Are Volumetric Ultra-Low-Dose Expiratory CT Scans Sufficient for Monitoring Related Lung Disease?

    DEFF Research Database (Denmark)

    Loeve, Martine; Lequin, Maarten H; Bruijne, Marleen de;

    2009-01-01

    Purpose: To assess whether chest computed tomography (CT) scores from ultra-low-dose end-expiratory scans alone could suffice for assessment of all cystic fibrosis (CF)-related structural lung abnormalities. Materials and Methods: In this institutional review board–approved study, 20 patients with...... CF aged 6–20 years (eight males, 12 females) underwent low-dose end-inspiratory CT and ultra-low-dose end-expiratory CT. Informed consent was obtained. Scans were randomized and scored by using the Brody-II CT scoring system to assess bronchiectasis, airway wall thickening, mucus plugging, and......-inspiratory and end-expiratory CT scores for Brody-II total score (ICC = 0.96), bronchiectasis (ICC = 0.98), airway wall thickening (ICC = 0.94), mucus plugging (ICC = 0.96), and opacities (ICC = 0.90). Intra- and interobserver agreement were good to very good (ICC range, 0.70–0.98). Bland-Altman plots showed...

  8. MESORAD dose assessment of the Chernobyl reactor accident

    International Nuclear Information System (INIS)

    An accident involving Unit 4 of the Chernobylskaya Atomic Energy Station resulted in the release of a large amount of radioactive material to the atmosphere. This report describes the results of an assessment of the doses near the site (within 80 km) made at the Pacific Northwest Laboratory using the MESORAD Dose Assessment model. 6 refs., 10 figs., 5 tabs

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

    International Nuclear Information System (INIS)

    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 cm3 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

  10. 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

  11. 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.)

  12. Eye dose assessment and management: overview.

    Science.gov (United States)

    Rehani, M M

    2015-07-01

    Some publications have shown that Hp(0.07) or even Hp(10) can be used as good operational quantities for X-rays in view of difficulties with Hp(3). With increasing awareness, there is tendency to use whatever dosimeter is available with correction factor to estimate eye lens dose. The best position for an eye lens dosimeter has been reported to be at the side of the head nearest to the radiation source, close to the eye. Recent studies have reported eye doses with cone beam CT (CBCT) both for patients and staff, and there are many papers reporting eye lens doses to staff in nuclear medicine. To minimise the dose to eyes, the user can take advantage of a feature of CBCT of projections acquired over an angular span of 180° plus cone angle of the X-ray tube and with tube under scan arcs. PMID:25813481

  13. Eye dose assessment and management: overview

    International Nuclear Information System (INIS)

    Some publications have shown that Hp(0.07) or even Hp(10) can be used as good operational quantities for X-rays in view of difficulties with Hp(3). With increasing awareness, there is tendency to use whatever dosimeter is available with correction factor to estimate eye lens dose. The best position for an eye lens dosimeter has been reported to be at the side of the head nearest to the radiation source, close to the eye. Recent studies have reported eye doses with cone beam CT (CBCT) both for patients and staff, and there are many papers reporting eye lens doses to staff in nuclear medicine. To minimise the dose to eyes, the user can take advantage of a feature of CBCT of projections acquired over an angular span of 1808 plus cone angle of the X-ray tube and with tube under scan arcs. (authors)

  14. Smoking cessation interventions within the context of Low-Dose Computed Tomography lung cancer screening: A systematic review.

    Science.gov (United States)

    Piñeiro, Bárbara; Simmons, Vani N; Palmer, Amanda M; Correa, John B; Brandon, Thomas H

    2016-08-01

    The integration of smoking cessation interventions (SCIs) within the context of lung cancer screening programs is strongly recommended by screening guidelines, and is a requirement for Medicare coverage of screening in the US. In Europe, there are no lung cancer screening guidelines, however, research trials are ongoing, and prominent professional societies have begun to recommend lung cancer screening. Little is known about the types and efficacy of SCIs among patients receiving low-dose computed tomography (LDCT) screening. This review addresses this gap. Based on a systematic search, we identified six empirical studies published prior to July 1, 2015, that met inclusion criteria for our review: English language, SCI for LDCT patients, and reported smoking-related outcomes. Three randomized studies and three single-arm studies were identified. Two randomized controlled trials (RCTs) evaluated self-help SCIs, whereas one pilot RCT evaluated the timing (before or after the LDCT scan) of a combined (counseling and pharmacotherapy) SCI. Among the single-arm trials, two observational studies evaluated the efficacy of combined SCI, and one retrospectively assessed the efficacy of clinician-delivered smoking assessment, advice, and assistance. Given the limited research to date, and particularly the lack of studies reporting results from RCTs, assumptions that SCIs would be effective among this population should be made with caution. Findings from this review suggest that participation in a lung screening trial promotes smoking cessation and may represent a teachable moment to quit smoking. Findings also suggest that providers can take advantage of this potentially teachable moment, and that SCIs have been successfully implemented in screening settings. Continued systematic and methodologically sound research in this area will help improve the knowledge base and implementation of interventions for this population of smokers at risk for chronic disease. PMID:27393513

  15. Whole-lung densitometry versus visual assessment of emphysema

    International Nuclear Information System (INIS)

    We compared whole-lung densitometry with visual evaluation of pulmonary emphysema. Thirty patients with chronic obstructive pulmonary disease underwent multi-detector CT (150 mAs and 0.75 collimation) with double reconstruction: thick (5-mm) slices with smooth filter for whole-lung densitometry and thin (1 mm) slices with sharp filter for visual assessment (one of every ten slices). Densitometry and visual assessment were performed by three operators each, and the time required for assessment, the inter-observer agreement and the correlation with the results of the diffusion capacity of carbon monoxide (DLCO) in the same patients were computed. The average time for densitometry (8.49 ± 0.13 min) was significantly longer (p CO with relative area at -960 and -970 Hounsfield units (HU) (both r = -0.66) and of the first percentile point of lung density (r = 0.66) were slightly stronger than that of the visual score (r = -0.62). Densitometry should be preferred to visual assessment because it enables a more reproducible evaluation of the extent of pulmonary emphysema, which can be carried out on the entire lung in a reasonable amount of time. (orig.)

  16. Is the dose-response relationship for local control of Hodgkin disease obscured by lung inhomogeneity corrections

    International Nuclear Information System (INIS)

    Absence of dose response has been reported for local control of Hodgkin disease between 30 Gy and 42 Gy delivered to the mantle field in definitive irradiation. These dose ranges were determined at the central ray by using irregular field calculations without benefit of dosimetric correction for lung inhomogeneity. The authors have performed a detailed analysis of dose delivered to the hilar and mediastinal regions with mantle field irradiation incorporating lung inhomogeneity corrections for the dose ranges indicated for both cobalt-60 and 6 MVX linear accelerator. For a prescribed dose of 36 Gy to midline with 6 MVX, the hila and mediastinum would receive 40-42 Gy with irregular field and lung inhomogeneity corrections. Similar increases in hilar and lateral mediastinal doses were observed with cobalt-60

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

    International Nuclear Information System (INIS)

    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 cm3) 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/cm3, whereas the surrounding lung density was varied between 0.05 and 0.6 g/cm3. 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

  18. 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.

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

    International Nuclear Information System (INIS)

    Purpose: To investigate 68Ga-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 (r2=0.99, P<.01), with ventilation strongly negatively linear (r2=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/CT imaging. These

  20. 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

  1. A review of occupational dose assessment uncertainties and approaches

    International Nuclear Information System (INIS)

    The Radiological Protection Practitioner (RPP) will spend a considerable proportion of his time predicting or assessing retrospective radiation exposures to occupational personnel for different purposes. The assessments can be for a variety of purposes, such as to predict doses for occupational dose control, or project design purposes or to make retrospective estimates for the dose record, or account for dosemeters which have been lost or damaged. There are other less frequent occasions when dose assessment will be required such as to support legal cases and compensation claims and to provide the detailed dose information for epidemiological studies. It is important that the level of detail, justification and supporting evidence in the dose assessment is suitable for the requirements. So for instance, day to day operational dose assessments often rely mainly on the knowledge of the RPP in discussion with operators whilst at the other end of the spectrum a historical dose assessment for a legal case will require substantial research and supporting evidence for the estimate to withstand forensic challenge. The robustness of the assessment will depend on many factors including a knowledge of the work activities, the radiation dose uptake and field characteristics; all of which are affected by factors such as the time elapsed, the memory of operators and the dosemeters employed. This paper reviews the various options and uncertainties in dose assessments ranging from use of personal dosimetry results to the development of upper bound assessments. The level of assessment, the extent of research and the evidence adduced should then be appropriate to the end use of the estimate. (Author)

  2. Association between absolute volumes of lung spared from low-dose irradiation and radiation-induced lung injury after intensity-modulated radiotherapy in lung cancer: a retrospective analysis.

    Science.gov (United States)

    Chen, Jinmei; Hong, Jinsheng; Zou, Xi; Lv, Wenlong; Guo, Feibao; Hong, Hualan; Zhang, Weijian

    2015-11-01

    The aim of this study was to investigate the association between absolute volumes of lung spared from low-dose irradiation and radiation-induced lung injury (RILI) after intensity-modulated radiotherapy (IMRT) for lung cancer. The normal lung relative volumes receiving greater than 5, 10, 20 and 30 Gy (V5-30) mean lung dose (MLD), and absolute volumes spared from greater than 5, 10, 20 and 30 Gy (AVS5-30) for the bilateral and ipsilateral lungs of 83 patients were recorded. Any association of clinical factors and dose-volume parameters with Grade ≥2 RILI was analyzed. The median follow-up was 12.3 months; 18 (21.7%) cases of Grade 2 RILI, seven (8.4%) of Grade 3 and two (2.4%) of Grade 4 were observed. Univariate analysis revealed the located lobe of the primary tumor. V5, V10, V20, MLD of the ipsilateral lung, V5, V10, V20, V30 and MLD of the bilateral lung, and AVS5 and AVS10 of the ipsilateral lung were associated with Grade ≥2 RILI (P lung was prognostic for Grade ≥2 RILI (P = 0.010, OR = 0.272, 95% CI: 0.102-0.729). Receiver operating characteristic curves indicated Grade ≥2 RILI could be predicted using AVS5 of the ipsilateral lung (area under curve, 0.668; cutoff value, 564.9 cm(3); sensitivity, 60.7%; specificity, 70.4%). The incidence of Grade ≥2 RILI was significantly lower with AVS5 of the ipsilateral lung ≥564.9 cm(3) than with AVS5 lung were associated with Grade ≥2 RILI, and AVS5 of the ipsilateral lung was prognostic for Grade ≥2 RILI for lung cancer after IMRT. PMID:26454068

  3. Impact of intensity-modulated radiation therapy as a boost treatment on the lung-dose distributions for non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Purpose: To investigate the feasibility of intensity-modulated radiotherapy (IMRT) as a method of boost radiotherapy after the initial irradiation by the conventional anterior/posterior opposed beams for centrally located non-small-cell lung cancer through the evaluation of dose distributions according to the various boost methods. Methods and Materials: Seven patients with T3 or T4 lung cancer and mediastinal node enlargement who previously received radiotherapy were studied. All patients underwent virtual simulation retrospectively with the previous treatment planning computed tomograms. Initial radiotherapy plans were designed to deliver 40 Gy to the primary tumor and involved nodal regions with the conventional anterior/posterior opposed beams. Two radiation dose levels, 24 and 30 Gy, were used for the boost radiotherapy plans, and four different boost methods (a three-dimensional conformal radiotherapy [3DCRT], five-, seven-, and nine-beam IMRT) were applied to each dose level. The goals of the boost plans were to deliver the prescribed radiation dose to 95% of the planning target volume (PTV) and minimize the volumes of the normal lungs and spinal cord irradiated above their tolerance doses. Dose distributions in the PTVs and lungs, according to the four types of boost plans, were compared in the boost and sum plans, respectively. Results: The percentage of lung volumes irradiated >20 Gy (V20) was reduced significantly in the IMRT boost plans compared with the 3DCRT boost plans at the 24- and 30-Gy dose levels (p 0.007 and 0.0315 respectively). Mean lung doses according to the boost methods were not different in the 24- and 30-Gy boost plans. The conformity indexes (CI) of the IMRT boost plans were lower than those of the 3DCRT plans in the 24- and 30-Gy plans (p = 0.001 in both). For the sum plans, there was no difference of the dose distributions in the PTVs and lungs according to the boost methods. Conclusions: In the boost plans the V20s and CIs were

  4. 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.

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

    International Nuclear Information System (INIS)

    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

  6. IAEA/IDEAS intercomparison exercise on internal dose assessment

    International Nuclear Information System (INIS)

    An Internet based intercomparison exercise on assessment of occupational exposure due to intakes of radionuclides has been performed to check the applicability of the 'General Guidelines for the Assessment of Internal Dose from Monitoring Data' developed by the IDEAS group. There were six intake cases presented on the Internet and 81 participants worldwide reported solutions to these cases. Results of the exercise indicate that the guidelines have a positive influence on the methodologies applied for dose assessments and, if correctly applied, improve the harmonisation of assessed doses. (authors)

  7. In vivo assessment of a lung amine endothelial receptor

    International Nuclear Information System (INIS)

    Lung endothelial N-isopropyl-p-iodoamphetamine (IMP) receptors were assessed applying principles of competitive binding assay adapted for in vivo measurements obtained by digital imaging. Data were acquired following a previously published method. I-123=IMP, the test cellular tracer, and Tc-99m-Dexiran, the reference vascular tracer were imaged during their first pass through the SVC, right heart, lungs and left heart in West African dwarf goats. The lung fractional extraction of IMP diminished progressively from 0.96 to 0.20 as the amount of IMP in the test tracer boli was gradually increased from 0.6 to 150 mg. This demonstrated that lung extraction of IMP is via a saturable carrier mediated transport mechanism, receptors. The dissociation constant of IMP-lung binding sites reaction was calculated by Scatchard plot and found to be 11.7 mg. The amount of IMP bound to the receptors at saturation (R), was found to be 30 mg. Assuming that a single molecule of IMP bound a single receptor, the total number of free receptors was computed as the Avogadro's number times R, divided by the IMP molecular weight, and found to be 6.06 x 10E+19. Using a computer model, it was determined that the 12 mg. per bolus isotherm was the most sensitive for measuring the number of total free receptors. It is the first time that noninvasive in vivo assessment of receptors has been accomplished. Basically, the method used can be applied in humans and also to assess receptors in organs other than the lungs

  8. 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

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

    International Nuclear Information System (INIS)

    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

  10. Dose-Volume Metrics Associated With Radiation Pneumonitis After Stereotactic Body Radiation Therapy for Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Matsuo, Yukinori, E-mail: ymatsuo@kuhp.kyoto-u.ac.jp [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan); Shibuya, Keiko; Nakamura, Mitsuhiro; Narabayashi, Masaru; Sakanaka, Katsuyuki; Ueki, Nami; Miyagi, Ken; Norihisa, Yoshiki; Mizowaki, Takashi [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan); Nagata, Yasushi [Division of Radiation Oncology, Hiroshima University Hospital, Hiroshima (Japan); Hiraoka, Masahiro [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto (Japan)

    2012-07-15

    Purpose: To identify dose-volume factors associated with radiation pneumonitis (RP) after stereotactic body radiation therapy (SBRT) for lung cancer. Methods and Materials: This study analyzed 74 patients who underwent SBRT for primary lung cancer. The prescribed dose for SBRT was uniformly 48 Gy in four fractions at the isocenter. RP was graded according to the Common Terminology Criteria for Adverse Events (CTCAE) v.3. Symptomatic RP was defined as grade 2 or worse. Optimal cut-offs dividing the patient population into two subgroups based on the incidence of symptomatic RP were sought using the following dose-volume metrics: PTV volume (ml), mean lung dose (Gy), and V5, V10, V15, V20, V25, V30, V35, and V40 (%) of both lungs excluding the PTV. Results: With a median follow-up duration of 31.4 months, symptomatic RP was observed in 15 patients (20.3%), including 1 patient with grade 3. Optimal cut-offs for pulmonary dose-volume metrics were V25 and V20. These two factors were highly correlated with each other, and V25 was more significant. Symptomatic RP was observed in 14.8% of the patients with V25 <4.2%, and the rate was 46.2% in the remainder (p = 0.019). PTV volume was another significant factor. The symptomatic RP rate was significantly lower in the group with PTV <37.7 ml compared with the larger PTV group (11.1% vs. 34.5%, p = 0.020). The patients were divided into three subgroups (patients with PTV <37.7 ml; patients with, PTV {>=}37.7 ml and V25 <4.2%; and patients with PTV {>=}37.7 ml and V25 {>=}4.2%); the incidence of RP grade 2 or worse was 11.1%, 23.5%, and 50.0%, respectively (p = 0.013). Conclusions: Lung V25 and PTV volume were significant factors associated with RP after SBRT.

  11. DRY TRANSFER FACILITY WORKER DOSE ASSESSMENT

    International Nuclear Information System (INIS)

    The purpose of this calculation is to estimate radiation doses received by personnel working in the Dry Transfer Facility No.1 (DTF-1) performing operations to receive transportation casks, transfer wastes, prepare waste packages, and ship out loaded waste packages and empty casks. Doses received by workers due to maintenance operations are also included in this revision. The specific scope of work contained in this calculation covers both collective doses and individual worker group doses on an annual basis, and includes the contributions due to external and internal radiation from normal operation, excluding the remediation area of the building. The results of this calculation will be used to support the design of the DTF-1 and to provide occupational dose estimates for the License Application. The calculations contained in this document were developed by Environmental and Nuclear Engineering of the Design and Engineering Organization and are intended solely for the use of the Design and Engineering Organization in its work regarding facility operation. Yucca Mountain Project personnel from the Environmental and Nuclear Engineering should be consulted before use of the calculations for purposes other than those stated herein or use by individuals other than authorized personnel in the Environmental and Nuclear Engineering

  12. Assessment of radiation dose awareness among pediatricians

    Energy Technology Data Exchange (ETDEWEB)

    Thomas, Karen E.; Parnell-Parmley, June E.; Charkot, Ellen; BenDavid, Guila; Krajewski, Connie [The Hospital for Sick Children, Department of Diagnostic Imaging, Toronto, Ontario (Canada); Haidar, Salwa [Mubarak Al-Kabeer Hospital, Department of Radiology, Salmiya (Kuwait); Moineddin, Rahim [University of Toronto, Department of Family and Community Medicine, Toronto (Canada)

    2006-08-15

    There is increasing awareness among pediatric radiologists of the potential risks associated with ionizing radiation in medical imaging. However, it is not known whether there has been a corresponding increase in awareness among pediatricians. To establish the level of awareness among pediatricians of the recent publicity on radiation risks in children, knowledge of the relative doses of radiological investigations, current practice regarding parent/patient discussions, and the sources of educational input. Multiple-choice survey. Of 220 respondents, 105 (48%) were aware of the 2001 American Journal of Roentgenology articles on pediatric CT and radiation, though only 6% were correct in their estimate of the quoted lifetime excess cancer risk associated with radiation doses equivalent to pediatric CT. A sustained or transient increase in parent questioning regarding radiation doses had been noticed by 31%. When estimating the effective doses of various pediatric radiological investigations in chest radiograph (CXR) equivalents, 87% of all responses (and 94% of CT estimates) were underestimates. Only 15% of respondents were familiar with the ALARA principle. Only 14% of pediatricians recalled any relevant formal teaching during their specialty training. The survey response rate was 40%. Awareness of radiation protection issues among pediatricians is generally low, with widespread underestimation of relative doses and risks. (orig.)

  13. Assessment of radiation dose awareness among pediatricians

    International Nuclear Information System (INIS)

    There is increasing awareness among pediatric radiologists of the potential risks associated with ionizing radiation in medical imaging. However, it is not known whether there has been a corresponding increase in awareness among pediatricians. To establish the level of awareness among pediatricians of the recent publicity on radiation risks in children, knowledge of the relative doses of radiological investigations, current practice regarding parent/patient discussions, and the sources of educational input. Multiple-choice survey. Of 220 respondents, 105 (48%) were aware of the 2001 American Journal of Roentgenology articles on pediatric CT and radiation, though only 6% were correct in their estimate of the quoted lifetime excess cancer risk associated with radiation doses equivalent to pediatric CT. A sustained or transient increase in parent questioning regarding radiation doses had been noticed by 31%. When estimating the effective doses of various pediatric radiological investigations in chest radiograph (CXR) equivalents, 87% of all responses (and 94% of CT estimates) were underestimates. Only 15% of respondents were familiar with the ALARA principle. Only 14% of pediatricians recalled any relevant formal teaching during their specialty training. The survey response rate was 40%. Awareness of radiation protection issues among pediatricians is generally low, with widespread underestimation of relative doses and risks. (orig.)

  14. 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.)

  15. 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.

  16. Lung cancer risk in relation to traffic-related nano/ultrafine particle-bound PAHs exposure: a preliminary probabilistic assessment.

    Science.gov (United States)

    Liao, Chung-Min; Chio, Chia-Pin; Chen, Wei-Yu; Ju, Yun-Ru; Li, Wen-Hsuan; Cheng, Yi-Hsien; Liao, Vivian Hsiu-Chuan; Chen, Szu-Chieh; Ling, Min-Pei

    2011-06-15

    Exposures to carcinogenic polycyclic aromatic hydrocarbons (PAHs) have been linked to human lung cancer. The purpose of this study was to assess lung cancer risk caused by inhalation exposure to nano/ultrafine particle-bound PAHs at the population level in Taiwan appraised with recent published data. A human respiratory tract model was linked with a physiologically based pharmacokinetic model to estimate deposition fraction and internal organic-specific PAHs doses. A probabilistic risk assessment framework was developed to estimate potential lung cancer risk. We reanalyzed particle size distribution, total-PAHs, particle-bound benzo(a)pyrene (B[a]P) and PM concentrations. A dose-response profile describing the relationships between external B[a]P concentration and lung cancer risk response was constructed based on population attributable fraction (PAF). We found that 90% probability lung cancer risks ranged from 10(-5) to 10(-4) for traffic-related nano and ultrafine particle-bound PAHs, indicating a potential lung cancer risk. The particle size-specific PAF-based excess annual lung cancer incidence rate due to PAHs exposure was estimated to be less than 1 per 100,000 population, indicating a mild risk factor for lung cancer. We concluded that probabilistic risk assessment linked PAF for limiting cumulative PAHs emissions to reduce lung cancer risk plays a prominent role in future government risk assessment program. PMID:21458918

  17. Combination chemotherapy including high dose methotrexate and radiotherapy, in the treatment of small cell carcinoma of the lung

    International Nuclear Information System (INIS)

    Twenty-nine (88%) of thirty-three patients who were treated with multiple drug chemotherapy, including high dose methotrexate, and radiotherapy for small cell carcinoma of the lung showed significant improvement in their clinical condition and quality of life. Treatment was well tolerated and toxicity acceptable. Cerebral metastases were not detected in any patient on presentation and only developed in three patients (9%). Little information exists regarding the use of high dose methotrexate in small cell carcinoma of the lung. There is no evidence, on the data available, that high dose methotrexate is any more effective than conventional doses. (author)

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

    International Nuclear Information System (INIS)

    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 (D99) 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 D99, 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

  19. Randomised crossover trial of salbutamol aerosol delivered by metered dose inhaler, jet nebuliser, and ultrasonic nebuliser in chronic lung disease

    OpenAIRE

    Fok, T; Lam, K.; Ng, P; So, H.; Cheung, K; Wong, Van W.; So, K

    1998-01-01

    AIMS—To compare the efficacy of salbutamol delivered by metered dose inhaler (MDI), jet nebuliser, and ultrasonic nebuliser in ventilated infants with chronic lung disease.
METHODS—Twenty preterm ventilated infants with chronic lung disease were enrolled in two studies. In study 1 (n=10), each infant was given 200 µg of salbutamol at 4 hour intervals and in random sequence from a metered dose inhaler-spacer device, a jet nebuliser, and an ultrasonic nebuliser with a small me...

  20. Lung cancer screening with CT: Evaluation of radiologists and different computer assisted detection software (CAD) as first and second readers for lung nodule detection at different dose levels

    International Nuclear Information System (INIS)

    Objectives: To find the best pairing of first and second reader at highest sensitivity for detecting lung nodules with CT at various dose levels. Materials and methods: An anthropomorphic lung phantom and artificial lung nodules were used to simulate screening CT-examination at standard dose (100 mAs, 120 kVp) and 8 different low dose levels, using 120, 100 and 80 kVp combined with 100, 50 and 25 mAs. At each dose level 40 phantoms were randomly filled with 75 solid and 25 ground glass nodules (5–12 mm). Two radiologists and 3 different computer aided detection softwares (CAD) were paired to find the highest sensitivity. Results: Sensitivities at standard dose were 92%, 90%, 84%, 79% and 73% for reader 1, 2, CAD1, CAD2, CAD3, respectively. Combined sensitivity for human readers 1 and 2 improved to 97%, (p1 = 0.063, p2 = 0.016). Highest sensitivities – between 97% and 99.0% – were achieved by combining any radiologist with any CAD at any dose level. Combining any two CADs, sensitivities between 85% and 88% were significantly lower than for radiologists combined with CAD (p < 0.03). Conclusions: Combination of a human observer with any of the tested CAD systems provide optimal sensitivity for lung nodule detection even at reduced dose at 25 mAs/80 kVp

  1. Personal monitoring and assessment of doses received by radiation workers

    International Nuclear Information System (INIS)

    The Personal Radiation Monitoring Service operated by the Australian Radiation Laboratory is outlined and the types of monitors used for assessment of doses received by radiation workers are described. The distribution of doses received by radiation workers in different occupational categories is determined. From these distributions, the average doses received have been assessed and the maximum likely additional increase in cancer deaths in Australia as a result of occupational exposure estimated. This increase is shown to be very small. There is, however, a considerable spread of doses received by individuals within occupational groups

  2. Intensity-Modulated Radiotherapy for Locally Advanced Non-Small-Cell Lung Cancer: A Dose-Escalation Planning Study

    International Nuclear Information System (INIS)

    Purpose: To evaluate the potential for dose escalation with intensity-modulated radiotherapy (IMRT) in positron emission tomography-based radiotherapy planning for locally advanced non-small-cell lung cancer (LA-NSCLC). Methods and Materials: For 35 LA-NSCLC patients, three-dimensional conformal radiotherapy and IMRT plans were made to a prescription dose (PD) of 66 Gy in 2-Gy fractions. Dose escalation was performed toward the maximal PD using secondary endpoint constraints for the lung, spinal cord, and heart, with de-escalation according to defined esophageal tolerance. Dose calculation was performed using the Eclipse pencil beam algorithm, and all plans were recalculated using a collapsed cone algorithm. The normal tissue complication probabilities were calculated for the lung (Grade 2 pneumonitis) and esophagus (acute toxicity, grade 2 or greater, and late toxicity). Results: IMRT resulted in statistically significant decreases in the mean lung (p <.0001) and maximal spinal cord (p = .002 and 0005) doses, allowing an average increase in the PD of 8.6-14.2 Gy (p ≤.0001). This advantage was lost after de-escalation within the defined esophageal dose limits. The lung normal tissue complication probabilities were significantly lower for IMRT (p <.0001), even after dose escalation. For esophageal toxicity, IMRT significantly decreased the acute NTCP values at the low dose levels (p = .0009 and p <.0001). After maximal dose escalation, late esophageal tolerance became critical (p <.0001), especially when using IMRT, owing to the parallel increases in the esophageal dose and PD. Conclusion: In LA-NSCLC, IMRT offers the potential to significantly escalate the PD, dependent on the lung and spinal cord tolerance. However, parallel increases in the esophageal dose abolished the advantage, even when using collapsed cone algorithms. This is important to consider in the context of concomitant chemoradiotherapy schedules using IMRT.

  3. Dose assessment in panoramic dental radiography

    International Nuclear Information System (INIS)

    In this paper author deals with the problem of dosimetry at panoramic radiography. Panoramic radiography is a rather complex technique, based on the simultaneous movement of an X-ray tube and an image receptor. A panoramic exposure is acquired by rotating the x-ray tube in an arc around the patients jaw. A thin X-ray beam oriented perpendicular to direction of the motion passes through the jaws at a slight upward angulation with respect to the occlusal plane. Due to this geometry of an examination, it is not straightforward, how to express a dose delivered to a patient during the examination. Because of a similarity with CT examinations, a dose descriptor product of kerma and length PKL is used in panoramic radiology also. However, the way of measurement is different. Currently, no dose descriptor in panoramic radiography is measured in the Czech Republic during the quality control measurements. Therefore, it would be appropriate to accept the product of kerma and length as a standard dose descriptor for panoramic radiography. This measurement should be included in QC procedures as well. Methods of dosimetry at panoramic radiography are discussed. (author)

  4. Radiation dose assessment in nuclear medicine

    International Nuclear Information System (INIS)

    Radionuclides are used in nuclear medicine in a variety of diagnostic and therapeutic procedures. Recently, interest has grown in therapeutic agents for a number of applications in nuclear medicine. Internal dose models and methods have been in use for many years, are well established and can give radiation doses to stylized models representing reference individuals. Kinetic analyses need to be carefully planned, and dose conversion factors should be chosen that are most similar to the subject in question and that can then be tailored to be more patient specific. Such calculations, however, are currently not relevant in patient management in internal emitter therapy, as they are not sufficiently accurate or detailed to guide clinical decision making. Great strides are being made at many centres regarding the use of patient image data to construct individualized voxel based models for more detailed and patient specific dose calculations.These recent advances make it likely that the relevance will soon change to be more similar to that of external beam treatment planning. (author)

  5. Dose assessment for decontamination in Goiania

    International Nuclear Information System (INIS)

    Shortly after the accident at Goiania, the need arose to set derived intervention levels for the various exposure pathways to guide and optimise clean up measures. For the members of the critical group an intervention level of 5 mSv for the total effective dose in the first year after the accident was chosen, which then was subdivided into values of 1 mSv due to the contribution of external irradiation indoors, 3 mSv from external irradiation while being outdoors, and 1 mSv due to incorporation of resuspended particles and ingestion of locally produced food. The clean up indoors could be directed such that a pre-described ambient dose rate was no longer exceeded. These exposure levels and effective doses to the critical groups predicted in 1988 are compared to actual measurements made in 1988 to 1993 in a local house near one primary contamination foci, and best estimate. It can be shown that the actual doses received by members of the public living in the affected areas were significantly lower. The various reasons for this overprediction will be discussed. (author)

  6. Assessment of patient dose in diagnostic radiology: A new dose concept for the lymphatic tissue

    International Nuclear Information System (INIS)

    Diagnostic radiography is a leading cause of man-made radiation exposure to the population. Individual risk assessment and analytic epidemiologic studies likewise require retrospective assessment of lifelong exposure from medical sources. Typical schemes attempt to determine accumulated doses of specific 'critical organs'. The organ dose to the red bone marrow is relevant in studies of diseases like leukemias and malignant lymphomas and there are comprehensive data bases to determine the red bone marrow organ dose of typical radiologic examinations. On the other hand a considerable proportion of the non-Hodgkin's lymphomas are assumed to develop outside the bone marrow compartment. For these a new dose concept for the lymphatic tissue was derived. Tables with conversion factors for typical examinations in diagnostic radiology (conventional radiography, functional radiography with contrast media and computed tomography) are provided that allow the calculation of the doses of the lymphatic tissue from doses of the red bone marrow. (author)

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

    International Nuclear Information System (INIS)

    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

  8. 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

  9. Computer-aided detection of nodule in low-dose CT screening for lung cancer

    International Nuclear Information System (INIS)

    Objective: To evaluate the performance of computer-aided detection (CAD) system for detection of pulmonary nodules in 64-slice low-dose CT screening and to investigate whether CAD can improve the performance of radiologists in detecting pulmonary nodules. Methods: One hundred low-dose screening CT examinations were randomly selected from the database containing 578 consecutive cases between Jun 2007 and Jun 2008. All the examinations were performed on a 64-MSCT scanner with the exposure of 120 kVp, 30 or 40 mA, or automatic exposure control. Before the study started, the screening reports had been made with double reading by two radiologists. All the selected images were analyzed with the lung VCAR software from GE Healthcare with a nodule diameter threshold 3.0 mm. All discrepancies between the screening reports and the CAD results were reviewed and the true non-calcified nodules were determined in consensus by two experienced chest radiologists. Detected nodules were classified by density, size and location.The performance of the double reading and the CAD system were compared and analyzed statistically. McNemar-Bowker test was used for the statistical analysis. Results: A total of 257 true noncalcified nodules were determined in all 100 low-dose screening CT examinations. The detection rate of CAD system was 91.1% (234/257), with the missed rate of 8.9% (23/257). Twenty three nodules were missed by CAD, in which 10 were solid with the diameter ranged from 2.4 to 6.0 mm, and 13 were nonsolid with the diameter ranged from 2.1 to 8.6 mm.Of the 23 nodules, 17 were located in the outer zones of lungs and 6 in the inner zones. The double reading showed a detection rate of 59.1% (152/257) and a missed rate of 40.9% (105/257), which was significantly lower than CAD. The diameter of all the 105 missed nodules by radiologists were ranged from 2.4 to 11.8 mm, in which 94 nodules were solid, 10 were partly solid and 1 was nonsolid, with 69 located in outer zones of lungs

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

    International Nuclear Information System (INIS)

    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.

  11. Effect of a single injection of high-dose FK506 on lung transplantation in rats.

    Science.gov (United States)

    Sano, Y; Maruyama, S; Aoe, M; Date, H; Shimizu, N

    1996-01-01

    Orthotopic left lung grafts from Brown Norway (BN) donors were transplanted to Lewis (LEW) rat recipients which had been treated with a single dose of FK506 10mg/kg body weight intramuscularly on postoperative day 3. Although the lungs were rejected with a median survival time of 7 days, with a range of 6-8 days in the untreated controls, maximum survival was prolonged to 60 days. The major adverse effects of this therapy were reduction of feeding, loss of body weight, and diarrhea. One of the 7 rats died on the 21st postoperative day due to anorexia. The effects of this therapy were investigated by histopathological examination and flow cytometric analysis using monoclonal antibodies against rat lymphocytes: OX-39 (anti-interleukin 2 receptor (IL-2R)) and OX-6 (anti-class II MHC). Histopathologically, the lung allografts showed mild perivascular and peribronchiolar cuffs of mononuclear cells, while marked reduction of the thymic medulla with FK506 treatment was also observed. Flow cytometric analysis of the transplanted lung showed no significant changes. Regarding the thymus, the percentages of positive cells labeled with OX-39 and OX-6 were significantly suppressed after this treatment. In the spleen, the number of OX-6-positive cells significantly decreased. The results using this therapy thus suggest that the suppression of IL-2R and MHC class II expression was systemically maintained for a long time. PMID:9017963

  12. Design of spray dried insulin microparticles to bypass deposition in the extrathoracic region and maximize total lung dose.

    Science.gov (United States)

    Ung, Keith T; Rao, Nagaraja; Weers, Jeffry G; Huang, Daniel; Chan, Hak-Kim

    2016-09-25

    Inhaled drugs all too often deliver only a fraction of the emitted dose to the target lung site due to deposition in the extrathoracic region (i.e., mouth and throat), which can lead to increased variation in lung exposure, and in some instances increases in local and systemic side effects. For aerosol medications, improved targeting to the lungs may be achieved by tailoring the micromeritic properties of the particles (e.g., size, density, rugosity) to minimize deposition in the mouth-throat and maximize the total lung dose. This study evaluated a co-solvent spray drying approach to modulate particle morphology and dose delivery characteristics of engineered powder formulations of insulin microparticles. The binary co-solvent system studied included water as the primary solvent mixed with an organic co-solvent, e.g., ethanol. Factors such as the relative rate of evaporation of each component of a binary co-solvent mixture, and insulin solubility in each component were considered in selecting feedstock compositions. A water-ethanol co-solvent mixture with a composition range considered suitable for modulating particle shell formation during drying was selected for experimental investigation. An Alberta Idealized Throat model was used to evaluate the in vitro total lung dose of a series of spray dried insulin formulations engineered with different bulk powder properties and delivered with two prototype inhalers that fluidize and disperse powder using different principles. The in vitro total lung dose of insulin microparticles was improved and favored for powders with low bulk density and small primary particle size, with reduction of deposition in the extrathoracic region. The results demonstrated that a total lung dose >95% of the delivered dose can be achieved with engineered particles, indicating a high degree of lung targeting, almost completely bypassing deposition in the mouth-throat. PMID:27480399

  13. Prediction of radiation-induced lung toxicity in locally advanced non-small cell lung cancer treated with chemoradiotherapy by functional lung dose-volume histogram

    International Nuclear Information System (INIS)

    Objective: To investigate the correlation between functional lung dose-volume histogram (f-DVH) parameters and radiation-induced lung toxicity (RILT) in patients of locally advanced non-small cell lung cancer (NSCLC) treated with late-course accelerated hyperfractionated radiotherapy and chemotherapy, and to identify the excellent predictors of f-DVH and their reference thresholds. Methods: A total of 51 patients of NSCLC at stage Ⅲ underwent PET/CT/SPECT coregistered image guided radiotherapy. Philips Pinnacle3 planning system was used for delineation of the target volume and organs at risk so as to establish the three dimensional conformal radiotherapy or intensity-modulated radiotherapy treatment plans. The version 3.0 of the NCI Common Terminology Criteria for Adverse Events was used to evaluate the grade of RILT, and analyze the correlation of the DVH parameters of the total lung (TL), ipsilateral lung (IL), and functional lung (FL) and RILT, and to identify the excellent predictors. The median follow-up was 15 months. Results: During the follow-up, 10 cases of RILT (19.6%) ≥grade 2 were observed. Single factor analysis showed that the V5-V40 of TL, V5-V20 of IL, and V5-V50 of FL were all related to the occurrence of RILT, and multiple factor analysis showed that TL-V15 and FL-V20 remained associated with RILT (P=0.005 and P=0.016). According to ROC analysis, the V10 (45.38%) of FL was the most sensitive predictor with a sensitivity rate of 90.0% and 1/25 (27.78%) of FL was the most specific predictor with a specificity rate of 90.24%. The sensitivity, specificity and accuracy of V20 of FL were 70.00%, 73.17%, and 74.90%, respectively. Conclusions: The occurrence of RILT is closely associated with multiple f-DVH parameters of FL, and f-DVH has good sensitivity and specificity for prediction. (authors)

  14. Variations of dose to the lung during computed tomography (CT) thorax examinations: A Monte Carlo study

    International Nuclear Information System (INIS)

    This study determined the influence of patient individuality on lung organ doses for chest CT examinations. The aim was a statistical statement on the variability as well as the uncertainty caused by the patient individuality. Furthermore, the reproducibility of the mean organ dose value of the lung using the new ICRP 110 voxelized adult female phantom was determined. Calculation of lung doses for 61 female chest CT studies with identical scan parameters (120 kV, 135 mAs, 100 mm collimation, 1.5 pitch) were done. For all patients, the lung was contoured and the geometry was simulated using the Monte Carlo method without patient table and with its original voxel size. The lungs were completely included in the scan area. A so-called user code CTDOSPP was developed which extends the Monte Carlo package EGSnrc and enables rotational simulation of CT X-ray sources. A developed graphical user interface GMctdospp allows easy handling of simulation parameters and CT studies, which are loaded in the DicomRT struct format. The transformation of CT values to material and density values is carried out with a standard relationship. The ICRP adult female material composition of all organs were directly taken from the publication. The patient table and bed and pillow were assumed to be air in order to be similar to patient pool. All simulations were calibrated for better handling and visualisation to a CTDIair value of 22.9 mGy. Simulation values were grouped into 1 mSv classes. The organ dose classes fit well to a Gaussian distribution (correlation coefficient R2 = 0.97). The fit's mean value is 10 mSv with a standard deviation of 2 mSv. The variability is about ± 30 % with minimum at 8 mSv and maximum at 13 mSv. The calculated organ dose to the lungs of the ICRP adult female phantom is about 11 mSv and thus within the calculated standard deviation of the patient pool. For all simulations the statistical uncertainty was between 2 and 3.5 %. This present study shows good

  15. Functional and histological assessment of the radiobiology of normal rat lung in BNCT

    International Nuclear Information System (INIS)

    This study investigated the radiobiology and sensitivity of the normal rat lung to Boron Neutron Capture Therapy (BNCT) radiation. Rat thorax irradiations were carried out with x-rays or with neutrons in the presence or absence of p-boronophenylalanine (BPA). Lung damage were assessed functionally with breathing rate measurement up to 180 days after irradiation and then histologically. Breathing rates 20% (∼3 σ) above the control group (sham-irradiated rats) mean were considered as positive responses to lung radiation damage. Though most responding animals demonstrated radiation induced pneumonitis (≤110 days) as well as pulmonary fibrosis (>110 days), some animals receiving neutrons plus BPA showed only the latter. The breathing rate dose response data were fit using probit analysis. The ED50 values measured for x-rays, neutron beam only, and neutrons plus BPA were 11.5±0.4 Gy, 9.2±0.5 Gy, and 6.7±0.4 Gy, respectively. The biological weighting factors for the neutron beam (n+γ), the thermal neutron dose component, and the 10B dose component were determined to be 1.2±0.1, 2.2±0.4, and 2.3±0.3, respectively. The histological dose response curves were linear. Consistent with the functional assay, the weighting factors measured histologically were 1.2±0.1 for the thermal neutron beam and 1.9±0.2 for the 10B dose component. (author)

  16. Application of biota dose assessment tools for Japan environment

    International Nuclear Information System (INIS)

    We examined applicability of two biota assessment tools RESRAD-BIOTA and ERICA assessment tool, to Japanese environment. We considered paddy field as the typical Japan environment and used maximum of global fallout nuclide concentrations. The case studies showed that graded approaches used in RESRAD-BIOTA and ERICA assessment tool are effective to apply Japanese environment. In addition, we concluded that it is important to clarify the suitability of some parameter values used in biota dose assessment. Further study is necessary on the recommendation of environmental parameter values for biota dose assessment for Japan environment. (author)

  17. 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.

  18. Improved dosimetry and risk assessment for plutonium-induced lung disease using a microdosimetric approach

    International Nuclear Information System (INIS)

    The risk of developing radiation-induced lung cancer is currently estimated using models based on epidemiological data from populations exposed either to relatively uniform, low-LET radiation, or from uranium miners exposed to radon and its progeny. Because inhaled alpha-emitting radionuclides (e.g., Pu, Am) produce nonuniform, chronic irradiation of the parenchymal region of the lung, a better scientific basis is needed for assessing the risk of developing radiation-induced disease from these radionuclides. Scientists at FIB-1 and LRRI are using a unique resource at the FIB-1, i.e., a set of about 600 lung specimens fixed in 10% formalin, and obtained from a population of workers at the Mayak Production Association, many of whom inhaled significant quantities of Pu and other alpha-emitting radionuclides during their careers. The objectives of this research are to measure the microscopic distribution of Pu by quantitative autoradiography, to determine the spatial distribution of Pu in human lung tissue with respect to specific lung structures and to determine the effect of chronic tobacco-smoke exposure on the distribution of local Pu radiation dose. The approach to analyzing these lung samples is to utilize contemporary stereological sampling and analysis techniques together with quantitative alpha-particle autoradiography. Our initial results have validated the usefulness of these lung specimens for determining Pu particle distribution with respect to anatomic location, as well as identifying normal and diseased compartments in the lung. In brief, particles were most often found associated with parenchymal and nonparenchymal scars, with other particles in organized lymphoid tissue or the interstitium of the pulmonary parenchyma (respiratory bronchioles and alveolar region). Based on comparison of one lung from a smoker and one from a nonsmoker, there was an increased fraction of Pu particles associated with tissue scars in the smoker vs the nonsmoker, and this

  19. Radiation dose assessments for materials with elevated natural radioactivity

    International Nuclear Information System (INIS)

    The report provides practical information needed for evaluating the radiation dose to the general public and workers caused by materials containing elevated levels of natural radionuclides. The report presents criteria, exposure scenarios and calculations used to assess dose with respect to the safety requirements set for construction materials in accordance with the Finnish Radiation Act. A method for calculating external gamma exposure from building materials is presented in detail. The results for most typical cases are given as specific dose rates in table form to enable doses to be assessed without computer calculation. A number of such dose assessments is presented, as is the corresponding computer code. Practical investigation levels for the radioactivity of materials are defined. (23 refs.)

  20. A methodology for using SPECT to reduce intensity-modulated radiation therapy (IMRT) dose to functioning lung

    International Nuclear Information System (INIS)

    Purpose: Single photon emission computed tomography (SPECT) provides a map of the spatial distribution of lung perfusion. Thus, SPECT guidance can be used to divert dose away from higher-functioning lung, potentially reducing lung toxicity. We present a methodology for achieving this aim and test it in intensity-modulated radiotherapy (IMRT) treatment-planning. Methods and Materials: IMRT treatment plans were generated with and without SPECT guidance and compared for 5 patients. Healthy lung was segmented into four regions on the basis of SPECT intensity in the SPECT plan. Dose was sequentially allowed to the target via regions of increasing SPECT intensity. This process results in reduction of dose to functional lung, reflected in the dose-function histogram (DFH). The plans were compared using DFHs and F2/F3 values (Fx is the functional lung receiving dose above x Gy). Results: In all cases, the SPECT-guided plan produced a more favorable DFH compared with the non-SPECT-guided plan. Additionally, the F2 and F3 values were reduced for all patients by an average of 13.6% ± 5.2% and 10.5% ± 5.8%, respectively. In all patients, DFHs of the two highest-functioning SPECT regions were reduced, whereas DFHs of the two lower-functioning regions were increased, illustrating the dose 'give-take' between SPECT regions during redistribution. Conclusions: SPECT-guided IMRT shows potential for reducing the dose delivered to highly functional lung regions. This dose reduction could reduce the number of high-grade pneumonitis cases that develop after radiation treatment and improve patient quality of life

  1. In vitro assessment of Macleaya cordata crude extract bioactivity and anticancer properties in normal and cancerous human lung cells.

    Science.gov (United States)

    Liu, Min; Lin, Yu-ling; Chen, Xuan-Ren; Liao, Chi-Cheng; Poo, Wak-Kim

    2013-09-01

    The purpose of this study is to assess the bioactivity and anticancer properties of Macleaya cordata crude extract in vitro using normal fetal lung fibroblast MRC5 and adenocarcinomic epithelial cell A549 as model systems,. Treatment of extract induced cell detachment, rounding, and irregularity in shape, in both normal and adenocarcinomic human lung cells, in accompanied of significant reduction in cell proliferation. The data indicated that necrosis appeared to be involved in compromising cell growth in both types of lung cells since membrane permeability and cell granularity were elevated. Although apoptosis was evident, the responses were differential in normal and diseased lung cells. Viability of treated MRC5 cells was reduced in a dose-dependent manner, demonstrating that the normal lung cells are sensitive to the extract. Surprisingly, A549 viability was slightly elevated in response to extract exposure at low concentration, implying that cells survived were metabolically active; the viability was reduced accordingly to treatment at higher concentrations. The present findings demonstrate that the crude extract of M. cordata contains agents affecting the functioning of normal and diseased lung cells in vitro. The observed cytotoxic effects against adenocarcinomic lung cells validate the potential of using M. cordata as herbal intervention in combined with conventional chemotherapy for lung cancer treatment. PMID:23238228

  2. TH-A-19A-10: Fast Four Dimensional Monte Carlo Dose Computations for Proton Therapy of Lung Cancer

    International Nuclear Information System (INIS)

    Purpose: To develop and validate a fast and accurate four dimensional (4D) Monte Carlo (MC) dose computation system for proton therapy of lung cancer and other thoracic and abdominal malignancies in which the delivered dose distributions can be affected by respiratory motion of the patient. Methods: A 4D computer tomography (CT) scan for a lung cancer patient treated with protons in our clinic was used to create a time dependent patient model using our in-house, MCNPX-based Monte Carlo system (“MC2”). The beam line configurations for two passively scattered proton beams used in the actual treatment were extracted from the clinical treatment plan and a set of input files was created automatically using MC2. A full MC simulation of the beam line was computed using MCNPX and a set of phase space files for each beam was collected at the distal surface of the range compensator. The particles from these phase space files were transported through the 10 voxelized patient models corresponding to the 10 phases of the breathing cycle in the 4DCT, using MCNPX and an accelerated (fast) MC code called “FDC”, developed by us and which is based on the track repeating algorithm. The accuracy of the fast algorithm was assessed by comparing the two time dependent dose distributions. Results: The error of less than 1% in 100% of the voxels in all phases of the breathing cycle was achieved using this method with a speedup of more than 1000 times. Conclusion: The proposed method, which uses full MC to simulate the beam line and the accelerated MC code FDC for the time consuming particle transport inside the complex, time dependent, geometry of the patient shows excellent accuracy together with an extraordinary speed

  3. TH-A-19A-10: Fast Four Dimensional Monte Carlo Dose Computations for Proton Therapy of Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mirkovic, D; Titt, U; Mohan, R [U.T M.D. Anderson Cancer Center, Houston, TX (United States); Yepes, P [Rice University, Houston, TX (United States)

    2014-06-15

    Purpose: To develop and validate a fast and accurate four dimensional (4D) Monte Carlo (MC) dose computation system for proton therapy of lung cancer and other thoracic and abdominal malignancies in which the delivered dose distributions can be affected by respiratory motion of the patient. Methods: A 4D computer tomography (CT) scan for a lung cancer patient treated with protons in our clinic was used to create a time dependent patient model using our in-house, MCNPX-based Monte Carlo system (“MC{sup 2}”). The beam line configurations for two passively scattered proton beams used in the actual treatment were extracted from the clinical treatment plan and a set of input files was created automatically using MC{sup 2}. A full MC simulation of the beam line was computed using MCNPX and a set of phase space files for each beam was collected at the distal surface of the range compensator. The particles from these phase space files were transported through the 10 voxelized patient models corresponding to the 10 phases of the breathing cycle in the 4DCT, using MCNPX and an accelerated (fast) MC code called “FDC”, developed by us and which is based on the track repeating algorithm. The accuracy of the fast algorithm was assessed by comparing the two time dependent dose distributions. Results: The error of less than 1% in 100% of the voxels in all phases of the breathing cycle was achieved using this method with a speedup of more than 1000 times. Conclusion: The proposed method, which uses full MC to simulate the beam line and the accelerated MC code FDC for the time consuming particle transport inside the complex, time dependent, geometry of the patient shows excellent accuracy together with an extraordinary speed.

  4. Study of the heterogeneity effects of lung in the evaluation of absorbed dose in radiotherapy

    International Nuclear Information System (INIS)

    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 EclipseR 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 EclipseR 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 cm2 treatment field is considered. These differences can cause a considerable subdosage in the lung tissue, reducing the possibility of the patient cure. (author)

  5. 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

    When implementing new technology into clinical practice, there will always be a need for large knowledge gain. The aim of this study was twofold, (I) audit the treatment planning and dose delivery of Flattening Filter Free (FFF) beam technology for Stereotactic Body Radiation Therapy (SBRT) of lung...... tumours across a range of treatment planning systems compared to the conventional Flatting Filter (FF) beams, (II) investigate how sharing knowledge between centres of different experience can improve plan quality. All vendor/treatment planning system (TPS) combinations investigated were able to produce...

  6. MOSFET assessment of radiation dose delivered to mice using the Small Animal Radiation Research Platform (SARRP).

    Science.gov (United States)

    Ngwa, Wilfred; Korideck, Houari; Chin, Lee M; Makrigiorgos, G Mike; Berbeco, Ross I

    2011-12-01

    The Small Animal Radiation Research Platform (SARRP) is a novel isocentric irradiation system that enables state-of-the-art image-guided radiotherapy research to be performed with animal models. This paper reports the results obtained from investigations assessing the radiation dose delivered by the SARRP to different anatomical target volumes in mice. Surgically implanted metal oxide semiconductor field effect transistors (MOSFET) dosimeters were employed for the dose assessment. The results reveal differences between the calculated and measured dose of -3.5 to 0.5%, -5.2 to -0.7%, -3.9 to 0.5%, -5.9 to 2.5%, -5.5 to 0.5%, and -4.3 to 0% for the left kidney, liver, pancreas, prostate, left lung, and brain, respectively. Overall, the findings show less than 6% difference between the delivered and calculated dose, without tissue heterogeneity corrections. These results provide a useful assessment of the need for tissue heterogeneity corrections in SARRP dose calculations for clinically relevant tumor model sites. PMID:21962005

  7. A Novel Method to Incorporate the Spatial Location of the Lung Dose Distribution into Predictive Radiation Pneumonitis Modeling

    International Nuclear Information System (INIS)

    Purpose: Studies have proposed that patients who receive radiation therapy to the base of the lung are more susceptible to radiation pneumonitis than patients who receive therapy to the apex of the lung. The primary purpose of the present study was to develop a novel method to incorporate the lung dose spatial information into a predictive radiation pneumonitis model. A secondary goal was to apply the method to a 547 lung cancer patient database to determine whether including the spatial information could improve the fit of our model. Methods and Materials: The three-dimensional dose distribution of each patient was mapped onto one common coordinate system. The boundaries of the coordinate system were defined by the extreme points of each individual patient lung. Once all dose distributions were mapped onto the common coordinate system, the spatial information was incorporated into a Lyman-Kutcher-Burman predictive radiation pneumonitis model. Specifically, the lung dose voxels were weighted using a user-defined spatial weighting matrix. We investigated spatial weighting matrices that linearly scaled each dose voxel according to the following orientations: superior-inferior, anterior-posterior, medial–lateral, left–right, and radial. The model parameters were fit to our patient cohort with the endpoint of severe radiation pneumonitis. The spatial dose model was compared against a conventional dose–volume model to determine whether adding a spatial component improved the fit of the model. Results: Of the 547 patients analyzed, 111 (20.3%) experienced severe radiation pneumonitis. Adding in a spatial parameter did not significantly increase the accuracy of the model for any of the weighting schemes. Conclusions: A novel method was developed to investigate the relationship between the location of the deposited lung dose and pneumonitis rate. The method was applied to a patient database, and we found that for our patient cohort, the spatial location does not

  8. 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.

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

    International Nuclear Information System (INIS)

    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

  10. The dose-area product and assessment of the occupational dose in interventional radiology

    International Nuclear Information System (INIS)

    This study used dose-area product (DAP) data to determine the relationship between the dose received by radiologists and the DAP. The working conditions were simulated by phantom measurements. The doses of scattered radiation were measured using various scattering angles, distances and tube voltages. The calculated doses of scattered radiation were compared with the measured doses of scattered radiation. To test the validity of using such data for assessing occupational doses, the scatter dose on the radiologist or cardiologist was calculated from the DAP using the measured scatter factors. The dose to the lenses of the eyes may exceed the annual limit, and may therefore restrict the number of interventional procedures. A relation between the DAP and the occupational dose is difficult to establish, especially because staff doses are associated with the use of protective devices, positions of projections with respect to the patient, and working methods. However, the DAP may provide a good reference value for the dosimetric monitoring of staff. (author)

  11. Asbestos Surveillance Program Aachen (ASPA): initial results from baseline screening for lung cancer in asbestos-exposed high-risk individuals using low-dose multidetector-row CT

    International Nuclear Information System (INIS)

    The purpose of this study was to assess the prevalence of lung cancer in a high-risk asbestos-exposed cohort using low-dose MDCT. Of a population of 5,389 former power-plant workers, 316 were characterized as individuals at highest risk for lung cancer according to a lung-cancer risk model including age, asbestos exposure and smoking habits. Of these 316, 187 (mean age: 66.6 years) individuals were included in a prospective trial. Mean asbestos exposure time was 29.65 years and 89% were smokers. Screening was performed on a 16-slice MDCT (Siemens) with low-dose technique (10/20 mAseff.; 1 mm/0.5 mm increment). In addition to soft copy PACS reading analysis on a workstation with a dedicated lung analysis software (LungCARE; Siemens) was performed. One strongly suspicious mass and eight cases of histologically proven lung cancer were found plus 491 additional pulmonary nodules (average volume: 40.72 ml, average diameter 4.62 mm). Asbestos-related changes (pleural plaques, fibrosis) were visible in 80 individuals. Lung cancer screening in this high-risk cohort showed a prevalence of lung cancer of 4.28% (8/187) at baseline screening with an additional large number of indeterminate pulmonary nodules. Low-dose MDCT proved to be feasible in this highly selected population. (orig.)

  12. Role of lung scanning in assessing the resectability of bronchial carcinoma.

    OpenAIRE

    Ellis, D A; Hawkins, T.; Gibson, G. J.; Nariman, S

    1983-01-01

    Ventilation and perfusion lung scans were performed in 58 patients before operation for bronchial carcinoma to determine in which patients the lung scan was most useful for assessing mediastinal spread and resectability of the tumour. Perfusion of the affected lung was less with larger and more centrally situated tumours. Perfusion was also less for left-sided than for right-sided tumours but this is explained by the normal differential perfusion of the right and left lungs. The lung scan was...

  13. Assessment of doses to game animals in Finland

    International Nuclear Information System (INIS)

    A study was carried out to assess the dose rates to game animals in Finland affected by the radioactive caesium deposition that occurred after the accident at the Chernobyl nuclear power plant in Ukraine in 1986. The aim of this assessment was to obtain new information on the dose rates to mammals and birds under Finnish conditions. Dose rates were calculated using the ERICA Assessment Tool developed within the EC 6th Framework Programme. The input data consisted of measured activity concentrations of 137Cs and 134Cs in soil and lake water samples and in flesh samples of selected animal species obtained for environmental monitoring. The study sites were located in the municipality of Lammi, Southern Finland, where the average 137Cs deposition was 46.5 kBq m−2 (1 October 1987). The study sites represented the areas receiving the highest deposition in Finland after the Chernobyl accident. The selected species included moose (Alces alces), arctic hare (Lepus timidus) and several bird species: black grouse (Tetrao tetrix), hazel hen (Bonasia bonasia), mallard (Anas platurhynchos), goldeneye (Bucephala clangula) and teal (Anas crecca). For moose, dose rates were calculated for the years 1986–1990 and for the 2000s. For all other species, maximal measured activity concentrations were used. The results showed that the dose rates to these species did not exceed the default screening level of 10 μGy h−1 used as a protection criterion. The highest total dose rate (internal and external summed), 3.7 μGy h−1, was observed for the arctic hare in 1986. Although the dose rate of 3.7 μGy h−1 cannot be considered negligible given the uncertainties involved in predicting the dose rates, the possible harmful effects related to this dose rate are too small to be assessed based on current knowledge on the biological effects of low doses in mammals

  14. Quantitative Features of Liver Lesions, Lung Nodules, and Renal Stones at Multi-Detector Row CT Examinations: Dependency on Radiation Dose and Reconstruction Algorithm.

    Science.gov (United States)

    Solomon, Justin; Mileto, Achille; Nelson, Rendon C; Roy Choudhury, Kingshuk; Samei, Ehsan

    2016-04-01

    Purpose To determine if radiation dose and reconstruction algorithm affect the computer-based extraction and analysis of quantitative imaging features in lung nodules, liver lesions, and renal stones at multi-detector row computed tomography (CT). Materials and Methods Retrospective analysis of data from a prospective, multicenter, HIPAA-compliant, institutional review board-approved clinical trial was performed by extracting 23 quantitative imaging features (size, shape, attenuation, edge sharpness, pixel value distribution, and texture) of lesions on multi-detector row CT images of 20 adult patients (14 men, six women; mean age, 63 years; range, 38-72 years) referred for known or suspected focal liver lesions, lung nodules, or kidney stones. Data were acquired between September 2011 and April 2012. All multi-detector row CT scans were performed at two different radiation dose levels; images were reconstructed with filtered back projection, adaptive statistical iterative reconstruction, and model-based iterative reconstruction (MBIR) algorithms. A linear mixed-effects model was used to assess the effect of radiation dose and reconstruction algorithm on extracted features. Results Among the 23 imaging features assessed, radiation dose had a significant effect on five, three, and four of the features for liver lesions, lung nodules, and renal stones, respectively (P stones, respectively (P stones, respectively (P stones with MBIR was significantly different than those for the other two algorithms (P < .002 for all comparisons). Although lesion texture was significantly affected by the reconstruction algorithm used (average of 3.33 features affected by MBIR throughout lesion types; P < .002, for all comparisons), no significant effect of the radiation dose setting was observed for all but one of the texture features (P = .002-.998). Conclusion Radiation dose settings and reconstruction algorithms affect the extraction and analysis of quantitative imaging features in

  15. Dose, volume, and tumor control prediction in primary radiotherapy of non-small-cell lung cancer

    International Nuclear Information System (INIS)

    Background: To evaluate the influence of total dose and tumor volume on local control and survival in primary radiotherapy of non-small-cell lung cancer (NSCLC). Methods and Materials: We retrospectively analyzed the clinical course and CT-derived pre- and post-therapeutic tumor volume data of 135 patients with NSCLC undergoing primary radiotherapy at our department between 1989 and 1996. Among these, a total of 192 spatially separated tumor volumes (135 primary tumors, 1 additional intrapulmonary tumor, and 56 involved lymph nodes) were available for analysis. In all patients, treatment was planned using CT-based three-dimensional treatment planning. The dose to each tumor volume was derived from the individual dose plans. Mean total dose was 59.9 Gy (range: 30-80 Gy). All but 3 patients were followed until death. For local control analysis, each tumor was analyzed separately, and its remission status was determined in serial follow-up CT scans. A total of 784 CT scans were analyzed. Actuarial local control analysis was performed for the 192 separated tumor volumes, and survival analysis was performed for the 135 patients. Tumor control probability was calculated using a Poisson statistical model. Results: Overall 1- and 2-year local control rate was 50% and 37%, respectively. The 2-year local control rate for tumors 200 ccm was 51%, 22%, and 10%, respectively (p=0.02). The 2-year local control rate for dose levels ≤60 Gy and >60 Gy was 28% and 43% (p100 ccm were controlled more than 2 years. Multivariate analysis revealed tumor volume, total dose, histopathologic type, and grading as significant and independent prognostic factors for local control. The number of delay days by split course (if used) and application of chemotherapy was not found to influence local control. Overall 1- and 2-year survival rate was 42% and 13%. Total radiation dose, chemotherapy, and T and N stage--but not tumor volume--were found to be independent and significant prognostic factors

  16. PCDOSE-ESTSC, Radioactive Dose Assessment and NRC Verification

    International Nuclear Information System (INIS)

    1 - Description of program or function: PCDOSE was developed for the Nuclear Regulatory Commission (NRC) to perform calculations to determine radioactive dose due to the annual averaged offsite release of liquid and gaseous effluent by U.S. commercial nuclear power facilities. Using NRC approved dose assessment methodologies, it acts as an inspector's tool for verifying the compliance of the facility's dose assessment software. PCDOSE duplicates the calculations of the GASPAR II mainframe code as well as calculations using the methodologies of Reg. Guide 1.109 Rev. 1 and NUREG-0133 by optional choice. 2 - Method of solution: PCDOSE uses spread-sheet models of the dose assessment mathematical equations. The results appear in table format. 3 - Restrictions on the complexity of the problem: PCDOSE requires Lotus 1-2-3 software

  17. Moving tumour influence in dose distribution for stereotactic lung radiotherapy; Influencia do movimento tumoral na distribuicao de dose em radioterapia estereotaxica de pulmao

    Energy Technology Data Exchange (ETDEWEB)

    Moura, D.E.E.S.; Lopes, C.P.; Ferrigno, R.; Goncalves, V.D.; Sakuraba, R.K.; Cruz, J.C. [Hospital Israelita Albert Einstein, Sao Paulo, SP (Brazil). Servico de Radioterapia; Cesar, D.L. [Hospital de Cancer de Barretos, SP (Brazil). Servico de Radioterapia

    2010-07-01

    The stereotactic body radiation treatment for lung tumours in inoperable patients was possible due to the safety margin reduction from the advances in the simulation process and treatment setup. The IMRT treatment planning promoted reduction in the side effects for hypofractionated techniques. However, the intrafraction moving target combined with the field variation can result in interplay of the dose distribution at the target. The dose deviation was analysed for moving ionization chambers measurements relative to static for Rapidarc, IMRT SW, IMRT SS and conformational planning with 150 cGy to 1800 cGy doses per fraction. The maximum relative deviation between the fields was 14,9% for IMRT SS planning with lower dose. The average total dose deviation showed a higher value for IMRT SS with lower dose, with global mean 0,7%{+-}0,7%. Although, high variations has occurred between fields, there was no significant influence to total dose. (author)

  18. Dose distribution measurements by MRI of a phantom containing lung tissue equivalent compartments made of ferrous sulphate gel

    International Nuclear Information System (INIS)

    Gel dosimetry based on magnetic resonance imaging (MRI) has previously been shown to provide verification of calculated dose distributions in soft tissue equivalent homogeneous phantoms. This study demonstrates how measurements of dose distribution can also be achieved in a phantom containing porous, lung-equivalent, Fricke gel. A phantom was made of Fe2+-infused low-density gel and conventional ferrous sulphate gel, filled in separate compartments in a Perspex container. Absorbed dose measurements were accomplished by MR imaging and by calibrating the proton spin-lattice relaxation rate (R1) versus absorbed dose by means of TLD measurements. This study shows that the production of lung-equivalent low-density (LD) dosimeter gel (mean CT number of -610 HU) is feasible. The MR signal detected in the LD gel dosimeter was substantially more noisy (i.e. displayed larger random fluctuations) than the signal from conventional gel, as expected. A deviation between calculated (TPS) and measured dose of about 3% (6 MV) and 4-7% (15 MV) was found in the LD region of the phantom. These results correspond well with data from other studies of dose distribution in lung-equivalent phantoms. The Fe2+-infused LD gel therefore seems suitable for measurement of absorbed dose distribution in phantoms that contain lung tissue compartments. (author)

  19. The MAGIC-5 CAD for nodule detection in low dose and thin slice lung CTs

    International Nuclear Information System (INIS)

    Lung cancer is the leading cause of cancer-related mortality in developed countries. Only 10-15% of all men and women diagnosed with lung cancer live 5 years after the diagnosis. However, the 5-year survival rate for patients diagnosed in the early asymptomatic stage of the disease can reach 70%. Early-stage lung cancers can be diagnosed by detecting non-calcified small pulmonary nodules with computed tomography (CT). Computer-aided detection (CAD) could support radiologists in the analysis of the large amount of noisy images generated in screening programs, where low-dose and thin-slice settings are used. The MAGIC-5 project, funded by the Istituto Nazionale di Fisica Nucleare (INFN, Italy) and Ministero dell'Universita e della Ricerca (MUR, Italy), developed a multi-method approach based on three CAD algorithms to be used in parallel with a merging of their results: the Channeler Ant Model (CAM), based on Virtual Ant Colonies, the Dot-Enhancement/Pleura Surface Normals/VBNA (DE-PSN-VBNA), and the Region Growing Volume Plateau (RGVP). Preliminary results show quite good performances, to be improved with the refining of the single algorithm and the added value of the results merging.

  20. Clinical outcome of stereotactic body radiotherapy for primary and oligometastatic lung tumors: a single institutional study with almost uniform dose with different five treatment schedules

    International Nuclear Information System (INIS)

    To evaluate clinical outcomes of stereotactic body radiotherapy (SBRT) for localized primary and oligometastatic lung tumors by assessing efficacy and safety of 5 regimens of varying fraction size and number. One-hundred patients with primary lung cancer (n = 69) or oligometastatic lung tumors (n = 31), who underwent SBRT between May 2003 and August 2010, were included. The median age was 75 years (range, 45–88). Of them, 98 were judged to have medically inoperable disease, predominantly due to chronic illness or advanced age. SBRT was performed using 3 coplanar and 3 non-coplanar fixed beams with a standard linear accelerator. Fraction sizes were escalated by 1 Gy, and number of fractions given was decreased by 1 for every 20 included patients. Total target doses were between 50 and 56 Gy, administered as 5–9 fractions. The prescribed dose was defined at the isocenter, and median overall treatment duration was 10 days (range, 5–22). The median follow-up was 51.1 months for survivors. The 3-year local recurrence rates for primary lung cancer and oligometastasis was 6 % and 3 %, respectively. The 3-year local recurrence rates for tumor sizes ≤3 cm and >3 cm were 3 % and 14 %, respectively (p = 0.124). Additionally, other factors (fraction size, total target dose, and BED10) were not significant predictors of local control. Radiation pneumonia (≥ grade 2) was observed in 2 patients. Radiation-induced rib fractures were observed in 22 patients. Other late adverse events of greater than grade 2 were not observed. Within this dataset, we did not observe a dose response in BED10 values between 86.4 and 102.6 Gy. SBRT with doses between 50 and 56 Gy, administered over 5–9 fractions achieved acceptable tumor control without severe complications

  1. 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.

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

    International Nuclear Information System (INIS)

    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. Individualized Dose Prescription for Hypofractionation in Advanced Non-Small-Cell Lung Cancer Radiotherapy: An in silico Trial

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, Aswin L.; Troost, Esther G.C.; Huizenga, Henk; Kaanders, Johannes H.A.M. [Radboud University Nijmegen Medical Centre, Department of Radiation Oncology, Nijmegen (Netherlands); Bussink, Johan, E-mail: j.bussink@rther.umcn.nl [Radboud University Nijmegen Medical Centre, Department of Radiation Oncology, Nijmegen (Netherlands)

    2012-08-01

    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 hypofractionation schemes delivered with intensity-modulated radiation therapy. Methods and Materials: For 38 Stage III NSCLC patients, the dose level of an existing curative treatment plan with standard fractionation (66 Gy) was rescaled based on dose constraints for the lung, spinal cord, esophagus, brachial plexus, and heart. The effect on tumor total dose (TTD) and biologic tumor effective dose in 2-Gy fractions (TED) corrected for overall treatment time (OTT) was compared for isotoxic and maximally tolerable schemes given in 15, 20, and 33 fractions. Rescaling was accomplished by altering the dose per fraction and/or the number of fractions while keeping the relative dose distribution of the original treatment plan. Results: For 30 of the 38 patients, dose escalation by individualized hypofractionation yielded therapeutic gain. For the maximally tolerable dose scheme in 33 fractions (MTD{sub 33}), individualized dose escalation resulted in a 2.5-21% gain in TTD. In the isotoxic schemes, the number of fractions could be reduced with a marginal increase in TED. For the maximally tolerable dose schemes, the TED could be escalated up to 36.6%, and for all patients beyond the level of the isotoxic and the MTD{sub 33} schemes (range, 3.3-36.6%). Reduction of the OTT contributed to the therapeutic gain of the shortened schemes. For the maximally tolerable schemes, the maximum esophageal dose was the dominant dose-limiting constraint in most patients. Conclusions: This modeling study showed that individualized dose prescription for hypofractionation in NSCLC radiotherapy, based on scaling of existing treatment plans up to normal tissue dose constraints, enables dose

  4. The utility of SPECT lung perfusion cans in assessing the changes in pulmonary function after radiotherapy for patients with lung cancer

    International Nuclear Information System (INIS)

    Objective: To assess the pulmonary function by lung perfusion scintigraphy in lung cancer patients treated with thoracic conform.al radiotherapy. Materials: Between June and December 2003, 21 lung cancer patients treated with thoracic radiotherapy (RT) performed Single photon emission computed tomography (SPECT) lung perfusion scans before RT and after 40 Gy-50 Gy radiation. Seventeen of these patients receiving thoracic 3-dimension conformal radiotherapy were included in this study. Severn patients had small cell lung carcinoma, 8 squamous cell carcinoma, and 2 no classification. There are 15 male and 2 female. The median age was 56 years, with a range of 46-78 years. SPECT lung perfusion scans were obtained following the intravenous administration of 185 MBq (5 mCi) of technetium-99m-labeled macroaggregated albumin (MAA). Images of static (ANT, POST, RAO, RPO, LAO, LPO, RLAT, LLAT) and tomography (transverse, sagittal, coronal) were acquired after injection using a dual-head SPECT (GE MillenniumTM VGV, Hawkeye) with low energy high resolution collimator, All patients were in supine with their arms above their head. Every attempt was made to have all of the scans and the radiation treatment delivered with the patient in a similar position. At the same time X-ray or CT scan were performed. The pre-RT CT or X-ray of the thorax and SPECT images were visually reviewed to assess the presence of hypoperfusion. Each of post-RT SPECT scan was also visually compared with the pre-RT SPECT image to detect whether or not reperfusion of previously under perfused areas. Furthermore, each pre-RT and post-RT SPECT image set was visually registered with the pre-RT planning CT images; the 3-D dose distribution was thus registered with the lung perfusion scan. The radiotherapy field (>20 Gy) was drawn as a region of interest (ROI) in the SPECT transversal images. The proportion of radioactive count within this ROI relative to total lung count in one slice was determined. Student's t

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

    CERN Document Server

    Cascio, D; Chincarini, A; De Nunzio, G; Delogu, P; Fantacci, M E; Gargano, G; Gori, I; Masala, G L; Martinez, A Preite; Retico, A; Santoro, M; Spinelli, C; Tarantino, T

    2007-01-01

    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 (~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 hig...

  6. Emitted dose and lung deposition of inhaled terbutaline from Turbuhaler at different conditions.

    Science.gov (United States)

    Abdelrahim, Mohamed E

    2010-05-01

    Turbuhaler has a very high resistance hence patient inhalation flow when using it would be low. The total emitted dose (TED) of 500microg terbutaline sulphate from a Bricanyl Turbuhaler was determined using a range of inhalation flows (10-60L min(-1)) with inhalation volume of 2 and 4L using a DPI sampling apparatus after one and two inhalations. The relative lung and systemic bioavailability of terbutaline from Bricanyl Turbuhaler when used by healthy subjects and COPD patients were determined after one and two inhalations at slow and fast inhalation flows using a novel urinary terbutaline pharmacokinetic method. The TED resulted from the one and two inhalations increased significantly (p<0.05) with the increase of the inhalation flow at both 2 and 4L inhalation volumes. The relative lung and systemic bioavailability after one inhalation at fast inhalation flow were significantly higher (p<0.01) than at slow inhalation flow in both healthy subjects and patients. Also the healthy subjects results were significantly higher (p<0.05) than the COPD patients after one inhalation. However after two inhalations there was no significant difference between slow and fast inhalation flow or healthy subjects and COPD patients. Hence it is essential to inhale twice and as deep and hard as possible from each dose of Turbuhaler for patients with low inspiratory flow and limited inhalation volume as they may not receive much benefit from one inhalation. PMID:20004090

  7. Radiation doses to lungs and whole body from use of tritium in luminous paint industry

    Energy Technology Data Exchange (ETDEWEB)

    Rudran, K.

    1988-01-01

    The radiation dose to persons exposed to tritium in the luminous paint industry is reported. The biological half-life of labile tritium is observed to be 7 to 10 days. There is evidence of exposure of lung tissue from tritium labelled polystyrene deposited in the pulmonary region and of soft tissue from organically bound tritium. Delayed excretion of labile tritium in urine following removal of the individuals from tritium handling, presence of tritium in organic constituents of blood and urine, and presence of non-volatile tritium in faecal excretion have been verified. From in vitro studies using fresh bovine serum, solubilisation half-life of tritium from the labelled paint is estimated to be 35 to 70 days after the initial fast clearance. Probable annual doses to the whole body, soft tissue and lungs under the prevailing working conditions have been estimated from the urinary and faecal excretion data. It is revealed that the actual values thus estimated are likely to exceed the values estimated by the conventional technique based on urine analysis for tritiated water.

  8. Thoron-in-breath as a method of internal dose assessment

    International Nuclear Information System (INIS)

    The most promising bioassay methodology for measuring the internal exposure from the chronic inhalation of thorium ore dusts is thoron-in-breath. The current detection limits are of the order 2.5 to 3 Bq of thorium lung burden and it is predicted that this can be readily reduced to better than 1 Bq. An extensive field study of the technique has been undertaken involving tests at six monthly intervals over a twelve, or in one case, eighteen month period. In excess of 350 tests on 115 workers have been made. Thorium lung burdens have been detected over the range -1 over 5 years. The technique is under review as an approved method for assessing the internal dose arising from the chronic inhalation of thorium ore dusts

  9. How extensive of a 4D dataset is needed to estimate cumulative dose distribution plan evaluation metrics in conformal lung therapy?

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the number of intermediate states required to adequately approximate the clinically relevant cumulative dose to deforming/moving thoracic anatomy in four-dimensional (4D) conformal radiotherapy that uses 6 MV photons to target tumors. Four patients were involved in this study. For the first three patients, computed tomography images acquired at exhale and inhale were available; they were registered using B-spline deformation model and the computed transformation was further used to simulate intermediate states between exhale and inhale. For the fourth patient, 4D-acquired, phase-sorted datasets were available and each dataset was registered with the exhale dataset. The exhale-inhale transformation was also used to simulate intermediate states in order to compare the cumulative doses computed using the actual and the simulated datasets. Doses to each state were calculated using the Dose Planning Method (DPM) Monte Carlo code and dose was accumulated for scoring on the exhale anatomy via the transformation matrices for each state and time weighting factors. Cumulative doses were estimated using increasing numbers of intermediate states and compared to simpler scenarios such as a '2-state' model which used only the exhale and inhale datasets or the dose received during the average phase of the breathing cycle. Dose distributions for each modeled state as well as the cumulative doses were assessed using dose volume histograms and several treatment evaluation metrics such as mean lung dose, normal tissue complication probability, and generalized uniform dose. Although significant 'point dose' differences can exist between each breathing state, the differences decrease when cumulative doses are considered, and can become less significant yet in terms of evaluation metrics depending upon the clinical end point. This study suggests that for certain ''clinical'' end points of importance for lung cancer, satisfactory predictions

  10. Application of a simple phantom in assessing the effects of dose reduction on image quality in chest radiography

    International Nuclear Information System (INIS)

    Purpose: Firstly, to evaluate a commercial chest phantom incorporating a quasi anthropomorphic insert by comparing exposure measurements on the phantom with those of actual patients and, secondly, to assess the value of the phantom for image quality and dose optimisation. Methods: In the first part of the study entrance surface doses (ESD), Beam transmission (BT), and optical density (OD) were obtained for 77 chest radiography patients and compared with measurements made from exposures of the phantom using the respective patient exposure factors from chest examination. Differences were assessed with a student t-test, while the Pearson's linear correlation coefficient was used to test for any linear relationship. The second part assessed the applicability of the phantom to image quality studies by investigating the effect, on the clarity and detectability of lung lesions made from gelatine, of reducing patient dose below current dose levels. Clarity of linear objects of different dimensions was also studied. Lesion detectability and clarity was assessed by four observers. The possibility of extending dose reduction below current dose levels (Dref) was assessed from comparison of doses that produced statistically significant differences in image quality from Dref. Results: Results show that, with the exception of entrance doses and beam transmission through the diaphragm (P > 0.05), differences in OD and beam transmission between patients and phantom were statistically significant (P ref produced significant changes in both clarity and detectability. Conclusion: Within limits posed by the observed differences, the phantom can be applied to image quality studies in diagnostic radiology.

  11. The relevance of the rat lung response to particle overload for human risk assessment: a workshop consensus report.

    Science.gov (United States)

    2000-01-01

    On 23-24 March 1998, the International Life Sciences Institute (ILSI) Risk Science Institute convened a workshop entitled "Relevance of the Rat Lung Response to Particle Overload for Human Risk Assessment." The workshop addressed the numerous study reports of lung tumors in rats resulting from chronic inhalation exposures to poorly soluble, nonfibrous particles of low acute toxicity and not directly genotoxic. These poorly soluble particles, indicated by the acronym PSPs (e.g., carbon black, coal dust, diesel soot, nonasbestiform talc, and titanium dioxide), elicit tumors in rats when deposition overwhelms the clearance mechanisms of the lung resulting in a condition referred to as "overload." These PSPs have been shown not to induce tumors in mice and hamsters, and the available data in humans are consistently negative. The objectives were twofold: (1) to provide guidance for risk assessment on the interpretation of neoplastic and nonneoplastic responses of the rat lung to PSPs; and (2) to identify important data gaps in our understanding of the lung responses of rats and other species to PSPs. Utilizing the five critical reviews of relevant literature that follow herein and the combined expertise and experience of the 30 workshop participants, a number of questions were addressed. The consensus views of the workshop participants are presented in this report. Because it is still not known with certainty whether high lung burdens of PSPs can lead to lung cancer in humans via mechanisms similar to those of the rat, in the absence of mechanistic data to the contrary it must be assumed that the rat model can identify potential carcinogenic hazards to humans. Since the apparent responsiveness of the rat model at overload is dependent on coexistent chronic active inflammation and cell proliferation, at lower lung doses where chronic active inflammation and cell proliferation are not present, no lung cancer hazard is anticipated. PMID:10715616

  12. 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...... 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......) within the healthy lung region was used as a measure of the overall lung ventilation during the treatment course. Amsterdam Shrouds of the 4D-CBCT projections were generated by RTK-software, and the respiratory period (ReP) was estimated from the extracted respiratory signal. For each patient the slope...

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

    International Nuclear Information System (INIS)

    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. Reduced lung dose during radiotherapy for thoracic esophageal carcinoma: VMAT combined with active breathing control for moderate DIBH

    OpenAIRE

    Gong, GuanZhong; Wang, Ruozheng; Guo, Yujie; Zhai, Deyin; Liu, Tonghai; Lu, Jie; Chen, Jinhu; Liu, Chengxin; Yin, Yong

    2013-01-01

    Background Lung radiation injury is a critical complication of radiotherapy (RT) for thoracic esophageal carcinoma (EC). Therefore, the goal of this study was to investigate the feasibility and dosimetric effects of reducing the lung tissue irradiation dose during RT for thoracic EC by applying volumetric modulated arc radiotherapy (VMAT) combined with active breathing control (ABC) for moderate deep inspiration breath-hold (mDIBH). Methods Fifteen patients with thoracic EC were randomly sele...

  15. Automated size-specific CT dose monitoring program: Assessing variability in CT dose

    Energy Technology Data Exchange (ETDEWEB)

    Christianson, Olav; Li Xiang; Frush, Donald; Samei, Ehsan [Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 and Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States) and Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Clinical Imaging Physics Group, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Carl E. Ravin Advanced Imaging Laboratories, Department of Radiology, Duke University Medical Center, Durham, North Carolina 27705 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 (United States); Department of Physics, Duke University, Durham, North Carolina 27710 (United States); and Department of Biomedical Engineering, Duke University, Durham, North Carolina 27708 (United States)

    2012-11-15

    Purpose: The potential health risks associated with low levels of ionizing radiation have created a movement in the radiology community to optimize computed tomography (CT) imaging protocols to use the lowest radiation dose possible without compromising the diagnostic usefulness of the images. Despite efforts to use appropriate and consistent radiation doses, studies suggest that a great deal of variability in radiation dose exists both within and between institutions for CT imaging. In this context, the authors have developed an automated size-specific radiation dose monitoring program for CT and used this program to assess variability in size-adjusted effective dose from CT imaging. Methods: The authors radiation dose monitoring program operates on an independent health insurance portability and accountability act compliant dosimetry server. Digital imaging and communication in medicine routing software is used to isolate dose report screen captures and scout images for all incoming CT studies. Effective dose conversion factors (k-factors) are determined based on the protocol and optical character recognition is used to extract the CT dose index and dose-length product. The patient's thickness is obtained by applying an adaptive thresholding algorithm to the scout images and is used to calculate the size-adjusted effective dose (ED{sub adj}). The radiation dose monitoring program was used to collect data on 6351 CT studies from three scanner models (GE Lightspeed Pro 16, GE Lightspeed VCT, and GE Definition CT750 HD) and two institutions over a one-month period and to analyze the variability in ED{sub adj} between scanner models and across institutions. Results: No significant difference was found between computer measurements of patient thickness and observer measurements (p= 0.17), and the average difference between the two methods was less than 4%. Applying the size correction resulted in ED{sub adj} that differed by up to 44% from effective dose

  16. 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.

  17. Mesorad dose assessment model. Volume 1. Technical basis

    International Nuclear Information System (INIS)

    MESORAD is a dose assessment model for emergency response applications. Using release data for as many as 50 radionuclides, the model calculates: (1) external doses resulting from exposure to radiation emitted by radionuclides contained in elevated or deposited material; (2) internal dose commitment resulting from inhalation; and (3) total whole-body doses. External doses from airborne material are calculated using semi-infinite and finite cloud approximations. At each stage in model execution, the appropriate approximation is selected after considering the cloud dimensions. Atmospheric processes are represented in MESORAD by a combination of Lagrangian puff and Gaussian plume dispersion models, a source depletion (deposition velocity) dry deposition model, and a wet deposition model using washout coefficients based on precipitation rates

  18. Lung

    International Nuclear Information System (INIS)

    At present no simple statement can be made relative to the role of radionuclidic lung studies in the pediatric population. It is safe to assume that they will be used with increasing frequency for research and clinical applications because of their sensitivity and ready applicability to the pediatric patient. Methods comparable to those used in adults can be used in children older than 4 years. In younger children, however, a single injection of 133Xe in solution provides an index of both regional perfusion and ventilation which is easier to accomplish. This method is particularly valuable in infants and neonates because it is rapid, requires no patient cooperation, results in a very low radiation dose, and can be repeated in serial studies. Radionuclidic studies of ventilation and perfusion can be performed in almost all children if the pediatrician and the nuclear medicine specialist have motivation and ingenuity. S

  19. Individualized Radical Radiotherapy of Non-Small-Cell Lung Cancer Based on Normal Tissue Dose Constraints: A Feasibility Study

    International Nuclear Information System (INIS)

    Purpose: Local recurrence is a major problem after (chemo-)radiation for non-small-cell lung cancer. We hypothesized that for each individual patient, the highest therapeutic ratio could be achieved by increasing total tumor dose (TTD) to the limits of normal tissues, delivered within 5 weeks. We report first results of a prospective feasibility trial. Methods and Materials: Twenty-eight patients with medically inoperable or locally advanced non-small-cell lung cancer, World Health Organization performance score of 0-1, and reasonable lung function (forced expiratory volume in 1 second > 50%) were analyzed. All patients underwent irradiation using an individualized prescribed TTD based on normal tissue dose constraints (mean lung dose, 19 Gy; maximal spinal cord dose, 54 Gy) up to a maximal TTD of 79.2 Gy in 1.8-Gy fractions twice daily. No concurrent chemoradiation was administered. Toxicity was scored using the Common Terminology Criteria for Adverse Events criteria. An 18F-fluoro-2-deoxy-glucose-positron emission tomography-computed tomography scan was performed to evaluate (metabolic) response 3 months after treatment. Results: Mean delivered dose was 63.0 ± 9.8 Gy. The TTD was most often limited by the mean lung dose (32.1%) or spinal cord (28.6%). Acute toxicity generally was mild; only 1 patient experienced Grade 3 cough and 1 patient experienced Grade 3 dysphagia. One patient (3.6%) died of pneumonitis. For late toxicity, 2 patients (7.7%) had Grade 3 cough or dyspnea; none had severe dysphagia. Complete metabolic response was obtained in 44% (11 of 26 patients). With a median follow-up of 13 months, median overall survival was 19.6 months, with a 1-year survival rate of 57.1%. Conclusions: Individualized maximal tolerable dose irradiation based on normal tissue dose constraints is feasible, and initial results are promising

  20. Combined chemoradiotherapy with daily low-dose cisplatin in stage III non-small cell lung cancer. An interim report

    International Nuclear Information System (INIS)

    To improve the local control of stage III non-small cell lung cancer, we tried concurrent chemoradiotherapy with daily low-dose cisplatin during the first 5 weeks conventional radiotherapy. Ten consecutive patients with stage III non-small cell lung cancer were treated with chemoradiotherapy with 66 Gy in conventional fractionation and concurrent daily low-dose cisplatin (4 mg/m2), which was given 5 days per week (from Monday to Friday) for the first 5 weeks. There was no case with ≥grade 3 toxicity. The median survival was 14.6 months, and the 2-year local progression-free survival rate was 35%. Daily low-dose cisplatin combined with conventional radiotherapy was considered to be feasible and to have the possibility to offer better local control than radiotherapy alone in the treatment of stage III non-small cell lung cancer. (author)

  1. Methemoglobin-Based Biological Dose Assessment for Human Blood.

    Science.gov (United States)

    Zhang, Xiao-Hong; Hu, Xiao-Dan; Zhao, Su-Ying; Xie, Li-Hua; Miao, Yu-Ji; Li, Qun; Min, Rui; Liu, Pei-Dang; Zhang, Hai-Qian

    2016-07-01

    Methemoglobin is an oxidative form of hemoglobin in erythrocytes. The authors' aim was to develop a new biological dosimeter based on a methemoglobin assay. Methemoglobin in peripheral blood (of females or males) that was exposed to a Co source (0.20 Gy min) was quantified using an enzyme-linked immunosorbent assay. The dose range was 0.5-8.0 Gy. In a time-course experiment, the time points 0, 0.02, 1, 2, 3, 7, 15, 21, and 30 d after 4-Gy irradiation of heparinized peripheral blood were used. Methemoglobin levels in a lysed erythrocyte pellet from the irradiated blood of females and males increased with the increasing dose. Methemoglobin levels in female blood irradiated with γ-doses more than 4 Gy were significantly higher than those in male samples at the same doses. Two dose-response relations were fitted to the straight line: one is with the correlation coefficient of 0.98 for females, and the other is with the correlation coefficient of 0.99 for males. The lower limit of dose assessment based on methemoglobin is about 1 Gy. Methemoglobin levels in blood as a result of auto-oxidation increase after 7-d storage at -20 °C. The upregulation of methemoglobin induced by γ-radiation persists for ∼3 d. The absorbed doses that were estimated using the two dose-response relations were close to the actual doses. The results suggest that methemoglobin can be used as a rapid and accurate biological dosimeter for early assessment of absorbed γ-dose in human blood. PMID:27218292

  2. Assessing exposure risk for dust storm events-associated lung function decrement in asthmatics and implications for control

    Science.gov (United States)

    Hsieh, Nan-Hung; Liao, Chung-Min

    2013-04-01

    Asian dust storms (ADS) events are seasonally-based meteorological phenomena that exacerbate chronic respiratory diseases. The purpose of this study was to assess human health risk from airborne dust exposure during ADS events in Taiwan. A probabilistic risk assessment framework was developed based on exposure and experimental data to quantify ADS events induced lung function decrement. The study reanalyzed experimental data from aerosol challenge in asthmatic individuals to construct the dose-response relationship between inhaled dust aerosol dose and decreasing percentage of forced expiratory volume in 1 s (%FEV1). An empirical lung deposition model was used to predict deposition fraction for size specific dust aerosols in pulmonary regions. The toxicokinetic and toxicodynamic models were used to simulate dust aerosols binding kinetics in lung airway in that %FEV1 change was also predicted. The mask respirators were applied to control the inhaled dose under dust aerosols exposure. Our results found that only 2% probability the mild ADS events were likely to cause %FEV1 decrement higher than 5%. There were 50% probability of decreasing %FEV1 exceeding 16.9, 18.9, and 7.1% in north, center, and south Taiwan under severe ADS events, respectively. Our result implicates that the use of activated carbon of mask respirators has the best efficacy for reducing inhaled dust aerosol dose, by which the %FEV1 decrement can be reduced up to less than 1%.

  3. The assessment of personal dose due to external radiation

    International Nuclear Information System (INIS)

    The fundamental basis of thermoluminescent dosimetry (TLD) is discussed and a number of considerations in the measurement of thermoluminescence described, with particular reference to CaSO4:Dy. The steps taken to convert a thermoluminescence measurement to an exposure and then an absorbed dose are outlined. The calculation of effective dose equivalents due to external exposure to γ-radiation in a number of situations commonly encountered in a uranium mine is discussed. Factors which may affect the accuracy of external dose assessments are described

  4. Updated radiological dose assessment of Bikini and Eneu Islands at Bikini Atoll

    International Nuclear Information System (INIS)

    This report is part of a continuing effort to refine dose assessments for resettlement options at Bikini Atoll. Radionuclide concentration data developed at Bikini Atoll since 1977 have been used in conjunction with recent dietary information and current dose models to develop the annual dose rate and 30- and 50-y integral doses presented here for Bikini and Eneu Island living patterns. The terrestrial food chain is the most significant exposure pathway--it contributes more than 50% of the total dose--and external gamma exposure is the second most significant pathway. Other pathways evaluated are the marine food chain, drinking water, and inhalation. Cesium-137 produces more than 85% of the predicted dose; 90Sr is the second most significant radionuclide; 60Co contributes to the external gamma exposure in varying degrees, but is a small part of the total predicted dose; the transuranic radionuclides contribute a small portion of the total predicted lung and bone doses but do present a long-term source of exposure. Maximum annual dose rates for Bikini Island are about 1 rem/y for the whole body and bone marrow when imported foods are available and about 1.9 rem/y when imports are unavailable. Maximum annual dose rates for Eneu Island when imports are available are 130 mrem/y for the whole body and 136 mrem/y for bone marrow. Similar doses when imported foods are unavailable are 245 and 263 mrem/y, respectively. The 30-y integral doses for Bikini Island are about 23 rem for whole body and bone marrow when imported foods are available and more than 40 rem when imports are unavailable. The Eneu Island 30-y integral doses for whole body and bone marrow are about 3 rem when imports are available and 5.5 and 6.1 rem, respectively, when imports are unavailable. Doses from living patterns involving some combination of Bikini and Eneu Islands fall between the doses listed above for each island separately

  5. Lung cancer screening with low-dose computed tomography: Canadian experience

    International Nuclear Information System (INIS)

    In 2003, the department of medical imaging at the University Health Network in Toronto, Ontario, became the first Canadian site of the International Early Lung Cancer Action Program (I-ELCAP). We report the results from the first 1000 baseline studies. Between June 2003 and December 2005, we enrolled 1000 high-risk smokers (that is, smokers with a history of a least 10 pack years, or the equivalent of one pack daily for 10 years), aged 55 years or older. A low-dose helical computed tomography (CT) (40 to 60 mA, 120 kV) was performed with 1.0mm to 1.25 collimation. Nodules found at baseline were followed according to the I-ELCAP protocol: 1) no noncalcified nodules (NCNs) or NCNs ≤ 4 mm or nonsolid nodules < 8 mm, annual repeat: 2) NCNs ≥ 5mm or nonsolid nodules ≥ 8 mm, 3-month follow up: or 3) nonsolid nodules ≥ 15 mm, antibiotics and 1-month follow-up. The first 100 study participants were aged 63 years, standard deviation (SD) 6 years, with a smoking history of 38 pack years, SD 22 pack years; 662 (66%) were former smokers, and 338 (34%) were current smokers; 453 (45%) were men, and 547 (55%) were women. Of the participants, 256 (26%) had a positive baseline low-dose computed tomography (LCDT) scan; 227 (23%) were followed after 3 months and 15 (1.6%) after 1 month; 7 (0.7%) received a contrast-enhanced CT and 6 (0.6%) an immediate CT-guided biopsy. Twenty-six invasive procedures were performed: 22 CT-guided biopsies, 1 ultrasound-guided lymph node metastasis biopsy, 1 bronchoscopic biopsy and 2 surgeries. The malignancy rate of the invasive procedures was 85%. Overall, the malignancy prevalence is 2.2%. Of the malignancies, 20 are lung carcinomas: 19 non-small-cell lung carcinomas (NSCLCs) (14 adenocarcinoma or bronchioalveolar carcinoma [BAC], 4 squamous carcinoma, and 1 large-cell carcinoma) and 1 small-cell carcinoma; 15 (78%) of the NSCLCs are Stage 1. Fourteen patients underwent surgery (1 pneumonectomy, 9 lobectomies, and 4 segmentectomies). Our

  6. External dose assessment in the Ukraine following the Chernobyl accident

    Science.gov (United States)

    Frazier, Remi Jordan Lesartre

    While the physiological effects of radiation exposure have been well characterized in general, it remains unclear what the relationship is between large-scale radiological events and psychosocial behavior outcomes in individuals or populations. To investigate this, the National Science Foundation funded a research project in 2008 at the University of Colorado in collaboration with Colorado State University to expand the knowledge of complex interactions between radiation exposure, perception of risk, and psychosocial behavior outcomes by modeling outcomes for a representative sample of the population of the Ukraine which had been exposed to radiocontaminant materials released by the reactor accident at Chernobyl on 26 April 1986. In service of this project, a methodology (based substantially on previously published models specific to the Chernobyl disaster and the Ukrainian population) was developed for daily cumulative effective external dose and dose rate assessment for individuals in the Ukraine for as a result of the Chernobyl disaster. A software platform was designed and produced to estimate effective external dose and dose rate for individuals based on their age, occupation, and location of residence on each day between 26 April 1986 and 31 December 2009. A methodology was developed to transform published 137Cs soil deposition contour maps from the Comprehensive Atlas of Caesium Deposition on Europe after the Chernobyl Accident into a geospatial database to access these data as a radiological source term. Cumulative effective external dose and dose rate were computed for each individual in a 703-member cohort of Ukrainians randomly selected to be representative of the population of the country as a whole. Error was estimated for the resulting individual dose and dose rate values with Monte Carlo simulations. Distributions of input parameters for the dose assessment methodology were compared to computed dose and dose rate estimates to determine which

  7. Dose measurements and calculations for tumors within lung: a comparative 3D study for 6 and 18 MV photons

    International Nuclear Information System (INIS)

    Purpose/Objective: For treatment of lung cancer, dose heterogeneity corrections and subsequent prescription alteration remain controversial. Previous dosimetry studies based on slab geometry and single beam geometry may not adequately represent the clinical situation of a circumscribed tumor within lung. Energy choice also remains a controversy. The objective of this study was to perform dose measurements for a tumor in lung in an anthropomorphic phantom using a clinically relevant beam arrangement for both 6 and 18 MV photons. Measured and calculated dose distributions were compared, using several different dose calculation algorithms. Methods and Materials: An anthropomorphic phantom was modified by replacing lung cylinders (2.5 and 5.0 cm diameter) with muscle-equivalent cylinders. The phantom was scanned on a CT simulator. Gross, clinical, and planning target volumes (GTV, CTV, PTV1 - tumor and regional nodes plus one cm margin, PTV2 - tumor only plus one cm margin) were delineated slice-by-slice. 3D planning was performed with large fields (AP/PA/RPO) covering PTV1 and boost fields optimized for each PTV2 for 6 and 18 MV photons. Ratio-TAR (RTAR) both with and without heterogeneity corrections, convolution adapted RTAR (CARTAR), and superposition convolution dose calculation algorithms were tested. Film was placed in between phantom slices at the 'tumor' levels. The phantom was irradiated using homogeneous monitor unit calculations. Measured and calculated dose distributions were compared by isodoses and dose volume histograms. One test case (2.5 cm. cylinder) compared film and TLD dose measurements with similar results. Lung-tissue ratio (LTR) measurements with an ion chamber imbedded in a 3 x 3 cm2 muscle-equivalent rectangular solid, surrounded by either lung or muscle-equivalent material, were also performed. Results: The three heterogeneity correction algorithms, compared with the measured isodoses, overpredicted the minimum dose to PTV2 by 11-18% for the

  8. 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.

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

    International Nuclear Information System (INIS)

    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

  10. 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

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

    International Nuclear Information System (INIS)

    When implementing new technology into clinical practice, there will always be a need for large knowledge gain. The aim of this study was twofold, (I) audit the treatment planning and dose delivery of Flattening Filter Free (FFF) beam technology for Stereotactic Body Radiation Therapy (SBRT) of lung tumours across a range of treatment planning systems compared to the conventional Flatting Filter (FF) beams, (II) investigate how sharing knowledge between centres of different experience can improve plan quality. All vendor/treatment planning system (TPS) combinations investigated were able to produce acceptable treatment plans and the dose accuracy was clinically acceptable for all plans. By sharing knowledge between the different centres, the minor protocol violations (MPV) could be significantly reduced, from an average of 1.9 MPV per plan to 0.6 after such sharing of treatment planning knowledge. 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

  12. Low dose elective brain irradiation in small cell carcinoma of the lung

    International Nuclear Information System (INIS)

    Elective brain irradiation (EBI) in a dosage of 3000 rad (midplane) in 2 weeks (nominal standard dose (NSD) = 1314 ret) has proven highly effective in preventing initial brain relapse in small cell lung carcinoma. However, the optimal radiation dose for EBI is unknown. 55 patients (31 with regional disease, 24 with extensive disease) without brain metastases were treated with a 4 drug chemotherapy program, (lomustine (CCNU), methotrexate, cyclophosphamide, vincristine) plus radiotherapy (R.T.), 3000 rad in 2 weeks to the primary chest lesion and were randomized to EBI or a control group. The EBI consisted of 2400 rad whole brain, midplane, in 8 fractions, 10 days (NSD = 1130 ret) given at the same time as the R.T. to the primary (3 weeks post-initial chemotherapy). Though all 54 evaluable patients received CCNU 50 mg/M2q. 6 weeks, there were 5 initial brain relapses among 31 control patients (16%) vs none in the 23 EBI patients. The time at risk for recurrence was similar in the two groups, i.e. 31 weeks median in the EBI and 32 weeks in the no-EBI patients. Brain relapses occurred in 2/17 with limited disease and 3/14 with extensive disease. It appears that 2400 rad in 8 fractions is as effective for EBI as larger doses. Toxicity was limited to alopecia. Survival was not significantly affected by EBI, though there is a suggestion of improvement in the regional group

  13. The impact of the dose time ratio on the outcomes in postoperative radiation therapy for non small cell lung cancer

    International Nuclear Information System (INIS)

    The aim of the study was to analyse the results of irradiation and the prognostic factors related to clinical, pathological and therapeutic characteristics observed in patients with non-small cell lung cancer. We analysed the cases of 64 patients with primary non-small cell lung cancer treated between the years 1994-2000, who were operated on in the Lower Silesian Lung Disease Center and underwent postoperative irradiation at the Lower Silesian Oncology Center. Dose fractionation was 2 Gy or 2.66 Gy per day, with five fractions per week; total dose was 39.9 to 64 Gy. The results were analysed statistically. We examined the correlations between the following parameters and their influence on survival and disease-free survival - gender, age, type of operation, radicality of operation, pTNM, histologic subtype, grade of histologic malignancy, number of chemotherapy cycles, total dose of radiotherapy, dose intensity, fractionation dilution and the dose time ratio. Only the grade of histologic malignancy and parameters connected with the intensity of radiotherapy influenced patient survival. Local Disease Free Survival (LDFS) and Disease Free Survival (DFS) were statistically significantly shorter among patients with Dose Intensity (DI) 1.47. The Dose Time Ratio (DTR) on Local Disease Free Survival (LDFS) and Disease Free Survival (DFS) exhibited the strongest statistical power, but there was no influence on Overall Survival (OS). Interruptions during postoperative radiotherapy are detrimental for disease-free survival and survival free of locoregional relapse in patients with NSCLC. (author)

  14. Optimization strategies for pulsed low-dose-rate IMRT of recurrent lung and head and neck cancers.

    Science.gov (United States)

    Kang, Shengwei; Lang, Jinyi; Wang, Pei; Li, Jie; Lin, Muhan; Chen, Xiaoming; Guo, Ming; Chen, Fu; Chen, Lili; Ma, Charlie Ming

    2014-01-01

    Pulsed low-dose-rate radiotherapy (PLDR) has been proven to be a valid method of reirradiation. Previous studies of recurrent cancer radiotherapy were mainly based on conventional 3D CRT and VMAT delivery techniques. There are difficulties in IMRT planning using existing commercial treatment planning systems (TPS) to meet the PLDR protocol. This work focuses on PLDR using ten-field IMRT and a commercial TPS for two specific sites: recurrent lung cancers and head and neck cancers. Our PLDR protocol requires that the maximum dose to the PTV be less than 0.4 Gy and the mean dose to be 0.2 Gy per field. We investigated various planning strategies to meet the PLDR requirements for 20 lung and head and neck patients. The PTV volume for lung cases ranged from 101.7 to 919.4 cm3 and the maximum dose to the PTV ranged from 0.22 to 0.39 Gy. The PTV volume for head and neck cases ranged from 66.2 to 282.1 cm3 and the maximum dose to the PTV ranged from 0.21 to 0.39 Gy. With special beam arrangements and dosimetry parameters, it is feasible to use a commercial TPS to generate quality PLDR IMRT plans for lung and head and neck reirradiation. PMID:24892337

  15. Is a reduction in radiation lung volume and dose necessary with paclitaxel chemotherapy for node-positive breast cancer?

    International Nuclear Information System (INIS)

    Purpose: To evaluate and quantify the effect of irradiated lung volume, radiation dose, and paclitaxel chemotherapy on the development of radiation pneumonitis (RP) in breast cancer patients with positive lymph nodes. Methods and Materials: We previously reported the incidence of RP among 41 patients with breast cancer treated with radiotherapy (RT) and adjuvant paclitaxel-containing chemotherapy. We recorded the central lung distance, a measure of the extent of lung included in the RT volume, in these patients. We used this measure and the historical and observed rates of RP in our series to model the lung tolerance to RT in patients receiving chemotherapy (CHT) both with and without paclitaxel. To evaluate the risk factors for the development of RP, we performed a case-control study comparing paclitaxel-treated patients who developed RP with those who did not, and a second case-control study comparing patients receiving paclitaxel in addition to standard CHT/RT (n = 41) and controls receiving standard CHT/RT alone (n 192). Results: The actuarial rate of RP in the paclitaxel-treated group was 15.4% compared with 0.9% among breast cancer patients treated with RT and non-paclitaxel-containing CHT. Our mathematical model found that the effective lung tolerance for patients treated with paclitaxel was reduced by approximately 24%. No statistically significant difference was found with regard to the dose delivered to specific radiation fields, dose per fraction, central lung distance, or percentage of lung irradiated in the case-control study of paclitaxel-treated patients who developed RP compared with those who did not. In the comparison of 41 patients receiving RT and CHT with paclitaxel and 192 matched controls receiving RT and CHT without paclitaxel, the only significant differences identified were the more frequent use of a supraclavicular radiation field and a decrease in the RT lung dose among the paclitaxel-treated patients. This finding indicates that the

  16. 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.)

  17. Assessment of X-ray output dose in the dose calculation of linear accelerators

    International Nuclear Information System (INIS)

    Many structural types of MLC (multiple-leaf collimator) are now introduced for linear accelerators and are important factors influencing the exposure dose to patients. In other words, the formula for dose calculation would differ depending on the type which, however, does not always require the different method of dose assessment for different MLC type. Rather, the assessment can be generalized and be applicable in any case of irradiation conditions when the concept of output factors is used. This article described the concept now recognized globally: The output factors consists from field factors and scatter factors, which are further divided in some factors attributable to the apparatus with MLC and irradiation object. The review also demonstrated the effectiveness of the concept by experiments using phantoms under various irradiation conditions. (K.H.)

  18. Assessment of the expected harm from prenatal irradiation with low doses and low dose rates

    International Nuclear Information System (INIS)

    The validity of the coefficients, suggested by ICRP (Publication 45) for assessment of the risk from prenatal irradiation with low doses and low dose rates is discussed. This includes: development of lethal and curable cancer, severe genetic defects, death before implantation and retarded mental development. Summarizing the individual assessment, the total harm from prenatal irradiation with 1 mvSv have been estimated at 4,9.104 lost years. The expected harm from the additional irradiation of the Bulgarian population during the first year after the Chernobyl accident is evaluated on that basis, taking into account the number of expected pregnancies among Bulgarian women in reproductive age and the individual effective equivalent doses. 15 refs

  19. Internal dose assessment of 99mTc-HTOC

    International Nuclear Information System (INIS)

    Full text: Octreotide is a synthetic octapeptide analog of somatostatin. Its major effects inhibit the release of pituitary growth hormone and the endocrine secretions of the pancreas, stomach, and intestine. So it is recommended to control symptoms associated with neuroendocrine tumours. In therapy, it is necessary to estimate patient-specific absorbed dose, especially to dose-limiting risk organs and to the tumour tissue. Kinetic analyses need to be carefully planned, meanwhile absorbed fraction are most similar to the subject in question should be chosen. However, the result of dose assessment is not sufficiently accurate or detailed to guide clinical decision-making, and not well correlated with observed effects on patient's organs and tumours. In this study, 99mTc-HTOC is an excellent indicator that displays the distribution of 188Re- HTOC in patient's body. The kinetic information of 99mTc -HTOC in patient's body can be obtained by SPECT in 1,4 h after injection. The activity in patient's tumours and organs can be calculated by lined the time-activity curve. In the study, the data of 86 cases can be collected. Although the basic formula of dose assessment is based on that of the medical internal radiation dose committee (MIRD), the absorbed fractions have been adjusted to be more patient-specific by patient's CT image and other data. It make internal dose of patients more accurate by the method. (author)

  20. 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.

  1. Whole body exposure of mice to secondhand smoke induces dose-dependent and persistent promutagenic DNA adducts in the lung

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sang-In [Department of Cancer Biology, Beckman Research Institute of the City of Hope, 1500 East Duarte Road, Duarte, CA 91010 (United States); Arlt, Volker M. [Section of Molecular Carcinogenesis, Institute of Cancer Research, Brookes Lawley Building, Sutton, Surrey SM2 5NG (United Kingdom); Yoon, Jae-In [Department of Cancer Biology, Beckman Research Institute of the City of Hope, 1500 East Duarte Road, Duarte, CA 91010 (United States); Cole, Kathleen J. [Section of Molecular Carcinogenesis, Institute of Cancer Research, Brookes Lawley Building, Sutton, Surrey SM2 5NG (United Kingdom); Pfeifer, Gerd P. [Department of Cancer Biology, Beckman Research Institute of the City of Hope, 1500 East Duarte Road, Duarte, CA 91010 (United States); Phillips, David H. [Section of Molecular Carcinogenesis, Institute of Cancer Research, Brookes Lawley Building, Sutton, Surrey SM2 5NG (United Kingdom); Besaratinia, Ahmad, E-mail: ania@coh.org [Department of Cancer Biology, Beckman Research Institute of the City of Hope, 1500 East Duarte Road, Duarte, CA 91010 (United States)

    2011-11-01

    Secondhand smoke (SHS) exposure is a known risk factor for lung cancer in lifelong nonsmokers. However, the underlying mechanism of action of SHS in lung carcinogenesis remains elusive. We have investigated, using the {sup 32}P-postlabeling assay, the genotoxic potential of SHS in vivo by determining the formation and kinetics of repair of DNA adducts in the lungs of mice exposed whole body to SHS for 2 or 4 months (5 h/day, 5 days/week), and an ensuing one-month recovery period. We demonstrate that exposure of mice to SHS elicits a significant genotoxic response as reflected by the elevation of DNA adduct levels in the lungs of SHS-exposed animals. The increases in DNA adduct levels in the lungs of SHS-exposed mice are dose-dependent as they are related to the intensity and duration of SHS exposure. After one month of recovery in clean air, the levels of lung DNA adducts in the mice exposed for 4 months remain significantly higher than those in the mice exposed for 2 months (P < 0.0005), levels in both groups being significantly elevated relative to controls (P < 0.00001). Our experimental findings accord with the epidemiological data showing that exposure to smoke-derived carcinogens is a risk factor for lung cancer; not only does the magnitude of risk depend upon carcinogen dose, but it also becomes more irreversible with prolonged exposure. The confirmation of epidemiologic data by our experimental findings is of significance because it strengthens the case for the etiologic involvement of SHS in nonsmokers' lung cancer. Identifying the etiologic factors involved in the pathogenesis of lung cancer can help define future strategies for prevention, early detection, and treatment of this highly lethal malignancy.

  2. Whole body exposure of mice to secondhand smoke induces dose-dependent and persistent promutagenic DNA adducts in the lung

    International Nuclear Information System (INIS)

    Secondhand smoke (SHS) exposure is a known risk factor for lung cancer in lifelong nonsmokers. However, the underlying mechanism of action of SHS in lung carcinogenesis remains elusive. We have investigated, using the 32P-postlabeling assay, the genotoxic potential of SHS in vivo by determining the formation and kinetics of repair of DNA adducts in the lungs of mice exposed whole body to SHS for 2 or 4 months (5 h/day, 5 days/week), and an ensuing one-month recovery period. We demonstrate that exposure of mice to SHS elicits a significant genotoxic response as reflected by the elevation of DNA adduct levels in the lungs of SHS-exposed animals. The increases in DNA adduct levels in the lungs of SHS-exposed mice are dose-dependent as they are related to the intensity and duration of SHS exposure. After one month of recovery in clean air, the levels of lung DNA adducts in the mice exposed for 4 months remain significantly higher than those in the mice exposed for 2 months (P < 0.0005), levels in both groups being significantly elevated relative to controls (P < 0.00001). Our experimental findings accord with the epidemiological data showing that exposure to smoke-derived carcinogens is a risk factor for lung cancer; not only does the magnitude of risk depend upon carcinogen dose, but it also becomes more irreversible with prolonged exposure. The confirmation of epidemiologic data by our experimental findings is of significance because it strengthens the case for the etiologic involvement of SHS in nonsmokers' lung cancer. Identifying the etiologic factors involved in the pathogenesis of lung cancer can help define future strategies for prevention, early detection, and treatment of this highly lethal malignancy.

  3. Dose differences in intensity-modulated radiotherapy plans calculated with pencil beam and Monte Carlo for lung SBRT.

    Science.gov (United States)

    Liu, Han; Zhuang, Tingliang; Stephans, Kevin; Videtic, Gregory; Raithel, Stephen; Djemil, Toufik; Xia, Ping

    2015-01-01

    For patients with medically inoperable early-stage non-small cell lung cancer (NSCLC) treated with stereotactic body radiation therapy, early treatment plans were based on a simpler dose calculation algorithm, the pencil beam (PB) calculation. Because these patients had the longest treatment follow-up, identifying dose differences between the PB calculated dose and Monte Carlo calculated dose is clinically important for understanding of treatment outcomes. Previous studies found significant dose differences between the PB dose calculation and more accurate dose calculation algorithms, such as convolution-based or Monte Carlo (MC), mostly for three-dimensional conformal radiotherapy (3D CRT) plans. The aim of this study is to investigate whether these observed dose differences also exist for intensity-modulated radiotherapy (IMRT) plans for both centrally and peripherally located tumors. Seventy patients (35 central and 35 peripheral) were retrospectively selected for this study. The clinical IMRT plans that were initially calculated with the PB algorithm were recalculated with the MC algorithm. Among these paired plans, dosimetric parameters were compared for the targets and critical organs. When compared to MC calculation, PB calculation overestimated doses to the planning target volumes (PTVs) of central and peripheral tumors with different magnitudes. The doses to 95% of the central and peripheral PTVs were overestimated by 9.7% ± 5.6% and 12.0% ± 7.3%, respectively. This dose overestimation did not affect doses to the critical organs, such as the spinal cord and lung. In conclusion, for NSCLC treated with IMRT, dose differences between the PB and MC calculations were different from that of 3D CRT. No significant dose differences in critical organs were observed between the two calculations. PMID:26699560

  4. 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.

  5. Assessment of doses to biota in the river system

    International Nuclear Information System (INIS)

    Doses to aquatic biota in the hydrological system Techa - Ob are estimated.The following water bodies with different levels of radioactive contamination are considered: industrial reservoirs, Techa, Iset, Tobol and Irtysh Rivers. Doses to biota are calculated using the observed data on the content of radionuclides in various environmental components, with consideration for geometric characteristics of the organisms and the exposure sources. The following groups of the river biota are considered: aquatic plants, mollusks and fish. Simplified geometric models (ellipsoids) are used in the internal dose calculations for fish and mollusks. Aquatic plants are approximated either with spheres or with a layer of finite depth. For the external doses assessment the water was considered as an infinite source with the uniform distribution of radionuclides. Sediments were represented as a source with the uniformly distributed activity. Concentration factor of scattered radiation was taken into account for gamma emitters. Sources and levels of radioactive contamination of the Techa - Ob system are analyzed. Data on the activity concentration of radionuclides in water, bottom sediments and aquatic biota are used for the dose assessment. Assessment of doses to biota in the Techa -Ob river system in the period from 1949 to the present time are performed.The highest doses (over 0.01 Gy/day) were received by aquatic organisms in the upper reaches of the Techa River in the period of maximum discharges of radionuclides (1950-1951). In that period, a major contribution to the dose to aquatic organisms was due to the incorporated radionuclides: 89 Sr, 90 Sr, 106 Ru,137 Cs, 144 Ce and others. During 1950-1951, the doses to aquatic organisms were estimated, on average, at 0.003-0.1 Gy/day. After the cessation of intensive radioactive discharges and the construction of a system of protective water bodies, the doses to aquatic biota noticeably decreased. Current levels of exposure to fish in

  6. Initial assessment of image quality for low-dose PET: evaluation of lesion detectability

    Science.gov (United States)

    Schaefferkoetter, Joshua D.; Yan, Jianhua; Townsend, David W.; Conti, Maurizio

    2015-07-01

    In the context of investigating the potential of low-dose PET imaging for screening applications, we developed methods to assess small lesion detectability as a function of the number of counts in the scan. We present here our methods and preliminary validation using tuberculosis cases. FDG-PET data from seventeen patients presenting diffuse hyper-metabolic lung lesions were selected for the study, to include a wide range of lesion sizes and contrasts. Reduced doses were simulated by randomly discarding events in the PET list mode, and ten realizations at each simulated dose were generated and reconstructed. The data were grouped into 9 categories determined by the number of included true events, from  >40 M to  <250 k counts. The images reconstructed from the original full statistical set were used to identify lung lesions, and each was, at every simulated dose, quantified by 6 parameters: lesion metabolic volume, lesion-to-background contrast, mean lesion tracer uptake, standard deviation of activity measurements (across realizations), lesion signal-to-noise ratio (SNR), and Hotelling observer SNR. Additionally, a lesion-detection task including 550 images was presented to several experienced image readers for qualitative assessment. Human observer performances were ranked using receiver operating characteristic analysis. The observer results were correlated with the lesion image measurements and used to train mathematical observer models. Absolute sensitivities and specificities of the human observers, as well as the area under the ROC curve, showed clustering and performance similarities among images produced from 5 million or greater counts. The results presented here are from a clinically realistic but highly constrained experiment, and more work is needed to validate these findings with a larger patient population.

  7. Initial assessment of image quality for low-dose PET: evaluation of lesion detectability

    International Nuclear Information System (INIS)

    In the context of investigating the potential of low-dose PET imaging for screening applications, we developed methods to assess small lesion detectability as a function of the number of counts in the scan. We present here our methods and preliminary validation using tuberculosis cases. FDG-PET data from seventeen patients presenting diffuse hyper-metabolic lung lesions were selected for the study, to include a wide range of lesion sizes and contrasts. Reduced doses were simulated by randomly discarding events in the PET list mode, and ten realizations at each simulated dose were generated and reconstructed. The data were grouped into 9 categories determined by the number of included true events, from  >40 M to  <250 k counts. The images reconstructed from the original full statistical set were used to identify lung lesions, and each was, at every simulated dose, quantified by 6 parameters: lesion metabolic volume, lesion-to-background contrast, mean lesion tracer uptake, standard deviation of activity measurements (across realizations), lesion signal-to-noise ratio (SNR), and Hotelling observer SNR. Additionally, a lesion-detection task including 550 images was presented to several experienced image readers for qualitative assessment. Human observer performances were ranked using receiver operating characteristic analysis. The observer results were correlated with the lesion image measurements and used to train mathematical observer models. Absolute sensitivities and specificities of the human observers, as well as the area under the ROC curve, showed clustering and performance similarities among images produced from 5 million or greater counts. The results presented here are from a clinically realistic but highly constrained experiment, and more work is needed to validate these findings with a larger patient population. (paper)

  8. The validity of risk assessments for lung cancer induced by radon daughters

    International Nuclear Information System (INIS)

    Available input data for the risk assessment from low level radon daughter (Rn-d) exposure are mostly either of low quality, partially contradicting or simply ''guesstimates''. Therefore at present only the upper limit of this risk can be estimated. Results of epidemiological studies amongst miners are associated with large uncertainties with regard to the assessment of past radiation exposure, lung cancer diagnostic and/or classification and synergistic effects due to smoking and dust exposure. An alternative approach uses dosimetric modelling for Rn-d inhalation to obtain Rn-d exposure-dose conversion factors. Large uncertainty is caused by individual variability due the influence of life style, physical and biological parameters. It is concluded that for ''normal'' indoor Rn-d exposure the resulting risk is neglegible compared to other risks ''accepted'' by society

  9. Coronary artery disease in lung transplant candidates: role of routine invasive assessment

    OpenAIRE

    Wild, Johannes; Arrigo, Mattia; Isenring, Bruno Dieter; Buergi, Urs; Kurowski, Thomas; Schuurmans, Macé M.; Huber, Lars C; Benden, Christian

    2015-01-01

    BACKGROUND: An atherosclerotic disease burden sufficient to put lung transplant candidates at risk for end-organ disease after transplantation is considered to be a relative contraindication for lung transplantation. OBJECTIVES: The aim of this study was to assess our current practice of cardiac workup by coronary angiography in lung transplant candidates ≥50 years of age. METHODS: We retrospectively analyzed 50 consecutive lung transplant candidates ≥50 years of age in which coronary a...

  10. Impact of geometrical uncertainties on 3D CRT and IMRT dose distributions for lung cancer treatment

    International Nuclear Information System (INIS)

    Purpose: To quantify the effect of set-up errors and respiratory motion on dose distributions for non-small cell lung cancer (NSCLC) treatment. Methods and Materials: Irradiations of 5 NSCLC patients were planned with 3 techniques, two (conformal radiation therapy (CRT) and intensity modulated radiation therapy (IMRT1)) with a homogeneous dose in the planning target volume (PTV) and a third (IMRT2) with dose heterogeneity. Set-up errors were simulated for gross target volume (GTV) and organs at risk (OARs). For the GTV, the respiration was also simulated with a periodical motion around a varying average. Two configurations were studied for the breathing motion, to describe the situations of free-breathing (FB) and respiration-correlated (RC) CT scans, each with 2 amplitudes (5 and 10 mm), thus resulting in 4 scenarios (FB5, FB10, RC5 and RC10). Five thousand treatment courses were simulated, producing probability distributions for the dosimetric parameters. Results: For CRT and IMRT1, RC5, RC10 and FB5 were associated with a small degradation of the GTV coverage. IMRT2 with FB10 showed the largest deterioration of the GTV dosimetric indices, reaching 7% for Dmin at the 95% probability level. Removing the systematic error due to the periodic breathing motion was advantageous for a 10 mm respiration amplitude. The estimated probability of radiation pneumonitis and acute complication for the esophagus showed limited sensitivity to geometrical uncertainties. Dmax in the spinal cord and the parameters predicting the risk of late esophageal toxicity were associated to a probability up to 50% of violating the dose tolerances. Conclusions: Simulating the effect of geometrical uncertainties on the individual patient plan should become part of the standard pre-treatment verification procedure

  11. Dose escalation with stereotactic body radiation therapy boost for locally advanced non small cell lung cancer

    International Nuclear Information System (INIS)

    Low survival outcomes have been reported for the treatment of locally advanced non small cell lung cancer (LA-NSCLC) with the standard of care treatment of concurrent chemoradiation (cCRT). We present our experience of dose escalation using stereotactic body radiosurgery (SBRT) following conventional cCRT for patients with LA-NSCLC. Sixteen patients with a median age of 67.5 treated with fractionated SBRT from 2010 to 2012 were retrospectively analyzed. Nine (56%) of the patients had stage IIIB, 6 (38%) has stage IIIA, and 1 (6%) had recurrent disease. Majority of the patients (63%) presented with N2 disease. All patients had a PET CT for treatment planning. Patients received conventional cCRT to a median dose of 50.40 Gy (range 45–60) followed by an SBRT boost with an average dose of 25 Gy (range 20–30) given over 5 fractions. With a median follow-up of 14 months (range, 1–14 months), 1-year overall survival (OS), progression free survival (PFS), local control (LC), regional control (RC), and distant control (DC) rates were, 78%, 42%, 76%, 79%, and 71%, respectively. Median times to disease progression and regional failure were 10 months and 18 months, respectively. On univariate analysis, advanced age and nodal status were worse prognostic factors of PFS (p < 0.05). Four patients developed radiation pneumonitis and one developed hemoptysis. Treatment was interrupted in one patient who required hospitalization due to arrhythmias and pneumonia. Risk adaptive dose escalation with SBRT following external beam radiotherapy is possible and generally tolerated treatment option for patients with LA-NSCLC

  12. Dose-Volume Comparison of Proton Radiotherapy and Stereotactic Body Radiotherapy for Non-Small-Cell Lung Cancer

    International Nuclear Information System (INIS)

    Purpose: This study designed photon and proton treatment plans for patients treated with hypofractionated proton radiotherapy (PT) at the Southern Tohoku Proton Therapy Center (STPTC). We then calculated dosimetric parameters and compared results with simulated treatment plans for stereotactic body radiotherapy (SBRT), using dose--volume histograms to clearly explain differences in dose distributions between PT and SBRT. Methods and Materials: Twenty-one patients with stage I non-small-cell lung cancer (stage IA, n = 15 patients; stage IB, n = 6 patients) were studied. All tumors were located in the peripheral lung, and total dose was 66 Gray equivalents (GyE) (6.6 GyE/fraction). For treatment planning, beam incidence for proton beam technique was restricted to two to three directions for PT, and seven or eight noncoplanar beams were manually selected for SBRT to achieve optimal planning target volume (PTV) coverage and minimal dose to organs at risk. Results: Regarding lung tissues, mean dose, V5, V10, V13, V15, and V20 values were 4.6 Gy, 13.2%, 11.4%, 10.6%, 10.1%, and 9.1%, respectively, for PT, whereas those values were 7.8 Gy, 32.0%, 21.8%, 17.4%, 15.3%, and 11.4%, respectively, for SBRT with a prescribed dose of 66 Gy. Pearson product moment correlation coefficients between PTV and dose--volume parameters of V5, V10, V15, and V20 were 0.45, 0.52, 0.58, and 0.63, respectively, for PT, compared to 0.52, 0.45, 0.71, and 0.74, respectively, for SBRT. Conclusions: Correlations between dose--volume parameters of the lung and PTV were observed and may indicate that PT is more advantageous than SBRT when treating a tumor with a relatively large PTV or several tumors.

  13. Proton MRI as a noninvasive tool to assess elastase-induced lung damage in spontaneously breathing rats.

    Science.gov (United States)

    Quintana, Harry Karmouty; Cannet, Catherine; Zurbruegg, Stefan; Blé, François-Xavier; Fozard, John R; Page, Clive P; Beckmann, Nicolau

    2006-12-01

    Elastase-induced changes in lung morphology and function were detected in spontaneously breathing rats using conventional proton MRI at 4.7 T. A single dose of porcine pancreatic elastase (75 U/100 g body weight) or vehicle (saline) was administered intratracheally (i.t.) to male Brown Norway (BN) rats. MRI fluid signals were detected in the lungs 24 hr after administration of elastase and resolved within 2 weeks. These results correlated with perivascular edema and cellular infiltration observed histologically. Reductions in MRI signal intensity of the lung parenchyma, and increases in lung volume were detected as early as 2 weeks following elastase administration and remained uniform throughout the study, which lasted 8 weeks. Observations were consistent with air trapping resulting from emphysema detected histologically. In a separate experiment, animals were treated daily intraperitoneally (i.p.) with all-trans-retinoic acid (ATRA; 500 microg/kg body weight) or its vehicle (triglyceride oil) starting on day 21 after elastase administration and continuing for 12 days. Under these conditions, ATRA did not elicit a reversal of elastase-induced lung damage as measured by MRI and histology. The present approach complements other validated applications of proton MRI in experimental lung research as a method for assessing drugs in rat models of respiratory diseases. PMID:17029230

  14. Integrated Worker Radiation Dose Assessment for the K Basins

    International Nuclear Information System (INIS)

    This report documents an assessment of the radiation dose workers at the K Basins are expected to receive in the process of removing spent nuclear fuel from the storage basins. The K Basins (K East and K West) are located in the Hanford 100K Area

  15. Radiological assessment. A textbook on environmental dose analysis

    International Nuclear Information System (INIS)

    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

  16. 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.

  17. SU-E-J-200: A Dosimetric Analysis of 3D Versus 4D Image-Based Dose Calculation for Stereotactic Body Radiation Therapy in Lung Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Ma, M; Rouabhi, O; Flynn, R; Xia, J [University of Iowa Hospitals and Clinics, Iowa City, IA (United States); Bayouth, J [University of Wisconsin, Madison, WI (United States)

    2014-06-01

    Purpose: To evaluate the dosimetric difference between 3D and 4Dweighted dose calculation using patient specific respiratory trace and deformable image registration for stereotactic body radiation therapy in lung tumors. Methods: Two dose calculation techniques, 3D and 4D-weighed dose calculation, were used for dosimetric comparison for 9 lung cancer patients. The magnitude of the tumor motion varied from 3 mm to 23 mm. Breath-hold exhale CT was used for 3D dose calculation with ITV generated from the motion observed from 4D-CT. For 4D-weighted calculation, dose of each binned CT image from the ten breathing amplitudes was first recomputed using the same planning parameters as those used in the 3D calculation. The dose distribution of each binned CT was mapped to the breath-hold CT using deformable image registration. The 4D-weighted dose was computed by summing the deformed doses with the temporal probabilities calculated from their corresponding respiratory traces. Dosimetric evaluation criteria includes lung V20, mean lung dose, and mean tumor dose. Results: Comparing with 3D calculation, lung V20, mean lung dose, and mean tumor dose using 4D-weighted dose calculation were changed by −0.67% ± 2.13%, −4.11% ± 6.94% (−0.36 Gy ± 0.87 Gy), −1.16% ± 1.36%(−0.73 Gy ± 0.85 Gy) accordingly. Conclusion: This work demonstrates that conventional 3D dose calculation method may overestimate the lung V20, MLD, and MTD. The absolute difference between 3D and 4D-weighted dose calculation in lung tumor may not be clinically significant. This research is supported by Siemens Medical Solutions USA, Inc and Iowa Center for Research By Undergraduates.

  18. Radiotherapy dose calculation on KV cone-beam CT image for lung tumor using the CIRS calibration.

    Science.gov (United States)

    Ma, Changsheng; Cao, Jianping; Yin, Yong; Zhu, Jian

    2014-01-01

    On-board kilovoltage (KV) cone-beam computed tomography (CBCT) images are used predominantly for the setup of patients' positioning. The image data can also potentially be used for dose calculation with the precise calibration of Hounsfield units (HU) to electron density (HU-density). CBCT calibration was analyzed in this study. A clinical treatment planning system was employed for CT and KV CBCT image to dose calculations and subsequent comparisons. Two HU-density tables were generated using the Computerized Imaging Reference Systems (CIRS) phantom. The results showed that a maximum ∼4% dose discrepancy was observed for inserts. The single field isodose curves were very close. The lung clinical patient study indicated that the volume of lung tumor that achieved the prescribed dose in CBCT was lower than in the CT plan. Our study showed that the dosimetric accuracy of CBCT-based dose calculation for lung tumor is acceptable only for the purpose of dosimetric checks with calibration applied. KV CBCT images cannot replace traditional CT images for dose calculation accuracy. PMID:26766975

  19. The effect of breathing and set-up errors on the cumulative dose to a lung tumor

    International Nuclear Information System (INIS)

    Background and purpose: To assess the impact of both set-up errors and respiration-induced tumor motion on the cumulative dose delivered to a clinical target volume (CTV) in lung, for an irradiation based on current clinically applied field sizes. Materials and methods: A cork phantom, having a 50 mm spherically shaped polystyrene insertion to simulate a gross tumor volume (GTV) located centrally in a lung was irradiated with two parallel opposed beams. The planned 95% isodose surface was conformed to the planning target volume (PTV) using a multi leaf collimator. The resulting margin between the CTV and the field edge was 16 mm in beam's eye view. A dose of 70 Gy was prescribed. Dose area histograms (DAHs) of the central plane of the CTV (GTV+5 mm) were determined using radiographic film for different combinations of set-up errors and respiration-induced tumor motion. The DAHs were evaluated using the population averaged tumor control probability (TCPpop) and the equivalent uniform dose (EUD) model. Results: Compared with dose volume histograms of the entire CTV, DAHs overestimate the impact of tumor motion on tumor control. Due to the choice of field sizes a large part of the PTV will receive a too low dose resulting in an EUD of the central plane of the CTV of 68.9 Gy for the static case. The EUD drops to 68.2, 66.1 and 51.1 Gy for systematic set-up errors of 5, 10 and 15 mm, respectively. For random set-up errors of 5, 10 and 15 mm (1 SD), the EUD decreases to 68.7, 67.4 and 64.9 Gy, respectively. For similar amplitudes of respiration-induced motion, the EUD decreases to 68.8, 68.5 and 67.7 Gy, respectively. For a clinically relevant scenario of 7.5 mm systematic set-up error, 3 mm random set-up error and 5 mm amplitude of breathing motion, the EUD is 66.7 Gy. This corresponds with a tumor control probability TCPpop of 41.7%, compared with 50.0% for homogeneous irradiation of the CTV to 70 Gy. Conclusion: Systematic set-up errors have a dominant effect on the

  20. Assessment of organ equivalent doses and effective doses from diagnostic X-ray examinations

    International Nuclear Information System (INIS)

    The MIRD-type adult male, female and age 10 phantoms were constructed to evaluate organ equivalent dose and effective dose of patient due to typical diagnostic X-ray examination. These phantoms were constructed with external and internal dimensions of Korean. The X-ray energy spectra were generated with SPEC78. MCNP4B ,the general-purposed Monte Carlo code, was used. Information of chest PA , chest LAT, and abdomen AP diagnostic X-ray procedures was collected on the protocol of domestic hospitals. The results showed that patients pick up approximate 0.02 to 0.18 mSv of effective dose from a single chest PA examination, and 0.01 to 0.19 mSv from a chest LAT examination depending on the ages. From an abdomen AP examination, patients pick up 0.17 to 1.40 mSv of effective dose. Exposure time, organ depth from the entrance surface and X-ray beam field coverage considerably affect the resulting doses. Deviation among medical institutions is somewhat high, and this indicated that medical institutions should interchange their information and the need of education for medical staff. The methodology and the established system can be applied, with some expansion, to dose assessment for other medical procedures accompanying radiation exposure of patients like nuclear medicine or therapeutic radiology

  1. 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; Kramer, Stine; Morsing, Anni; Grau, Cai

    2015-01-01

    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...

  2. Toxicology study assessing efficacy and safety of repeated administration of lipid/DNA complexes to mouse lung.

    Science.gov (United States)

    Alton, E W F W; Boyd, A C; Cheng, S H; Davies, J C; Davies, L A; Dayan, A; Gill, D R; Griesenbach, U; Higgins, T; Hyde, S C; Innes, J A; McLachlan, G; Porteous, D; Pringle, I; Scheule, R K; Sumner-Jones, S

    2014-01-01

    For gene therapy to improve lung function in cystic fibrosis (CF) subjects, repeated administration of the gene transfer agent over the lifetime of patients is likely to be necessary. This requirement limits the utility of adenoviral and adeno-associated viral vectors (both previously evaluated in CF gene therapy trials) because of induced adaptive immune responses that render repeated dosing ineffective. For CF gene therapy trials, non-viral vectors are currently the only viable option. We previously showed that the cationic lipid formulation GL67A is the most efficient of several non-viral vectors analysed for airway gene transfer. Here, we assessed the efficacy and safety of administering 12 inhaled doses of GL67A complexed with pGM169, a CpG-free plasmid encoding human CFTR complementary DNA, into mice. We show that repeated administration of pGM169/GL67A to murine lungs is feasible, safe and achieves reproducible, dose-related and persistent gene expression (>140 days after each dose) using an aerosol generated by a clinically relevant nebuliser. This study supports progression into the first non-viral multidose lung trial in CF patients. PMID:24196086

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

    OpenAIRE

    Gupta, Shilpi; Hassan, Samer; Bhatt, Vijaya R.; Abdul Sater, Houssein; Dilawari, Asma

    2014-01-01

    Introduction 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 ...

  4. 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

  5. 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

  6. Dose estimates for the solid waste performance assessment

    International Nuclear Information System (INIS)

    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

  7. 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.

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

    OpenAIRE

    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....

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

    International Nuclear Information System (INIS)

    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

  10. Deep inspiration breath-hold technique for lung tumors: the potential value of target immobilization and reduced lung density in dose escalation

    International Nuclear Information System (INIS)

    Purpose/Objective: This study evaluates the dosimetric benefits and feasibility of a deep inspiration breath-hold (DIBH) technique in the treatment of lung tumors. The technique has two distinct features--deep inspiration, which reduces lung density, and breath-hold, which immobilizes lung tumors, thereby allowing for reduced margins. Both of these properties can potentially reduce the amount of normal lung tissue in the high-dose region, thus reducing morbidity and improving the possibility of dose escalation. Methods and Materials: Five patients treated for non-small cell lung carcinoma (Stage IIA-IIIB) received computed tomography (CT) scans under 4 respiration conditions: free-breathing, DIBH, shallow inspiration breath-hold, and shallow expiration breath-hold. The free-breathing and DIBH scans were used to generate 3-dimensional conformal treatment plans for comparison, while the shallow inspiration and expiration scans determined the extent of tumor motion under free-breathing conditions. To acquire the breath-hold scans, the patients are brought to reproducible respiration levels using spirometry, and for DIBH, modified slow vital capacity maneuvers. Planning target volumes (PTVs) for free-breathing plans included a margin for setup error (0.75 cm) plus a margin equal to the extent of tumor motion due to respiration (1-2 cm). Planning target volumes for DIBH plans included the same margin for setup error, with a reduced margin for residual uncertainty in tumor position (0.2-0.5 cm) as determined from repeat fluoroscopic movies. To simulate the effects of respiration-gated treatments and estimate the role of target immobilization alone (i.e., without the benefit of reduced lung density), a third plan is generated from the free-breathing scan using a PTV with the same margins as for DIBH plans. Results: The treatment plan comparison suggests that, on average, the DIBH technique can reduce the volume of lung receiving more than 25 Gy by 30% compared to free

  11. Construction of average adult Japanese voxel phantoms for dose assessment

    International Nuclear Information System (INIS)

    The International Commission on Radiological Protection (ICRP) adopted the adult reference voxel phantoms based on the physiological and anatomical reference data of Caucasian on October, 2007. The organs and tissues of these phantoms were segmented on the basis of ICRP Publication 103. In future, the dose coefficients for internal dose and dose conversion coefficients for external dose calculated using the adult reference voxel phantoms will be widely used for the radiation protection fields. On the other hand, the body sizes and organ masses of adult Japanese are generally smaller than those of adult Caucasian. In addition, there are some cases that the anatomical characteristics such as body sizes, organ masses and postures of subjects influence the organ doses in dose assessment for medical treatments and radiation accident. Therefore, it was needed to use human phantoms with average anatomical characteristics of Japanese. The authors constructed the averaged adult Japanese male and female voxel phantoms by modifying the previously developed high-resolution adult male (JM) and female (JF) voxel phantoms. It has been modified in the following three aspects: (1) The heights and weights were agreed with the Japanese averages; (2) The masses of organs and tissues were adjusted to the Japanese averages within 10%; (3) The organs and tissues, which were newly added for evaluation of the effective dose in ICRP Publication 103, were modeled. In this study, the organ masses, distances between organs, specific absorbed fractions (SAFs) and dose conversion coefficients of these phantoms were compared with those evaluated using the ICRP adult reference voxel phantoms. This report provides valuable information on the anatomical and dosimetric characteristics of the averaged adult Japanese male and female voxel phantoms developed as reference phantoms of adult Japanese. (author)

  12. Patient-specific quantification of respiratory motion-induced dose uncertainty for step-and-shoot IMRT of lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Li, Heng; Park, Peter; Liu, Wei; Matney, Jason; Balter, Peter; Zhang, Xiaodong; Li, Xiaoqiang; Zhu, X. Ronald [Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Liao, Zhongxing [Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Li, Yupeng [Applied Research, Varian Medical Systems, Palo Alto, California 94304 (United States)

    2013-12-15

    Purpose: The objective of this study was to quantify respiratory motion-induced dose uncertainty at the planning stage for step-and-shoot intensity-modulated radiation therapy (IMRT) using an analytical technique.Methods: Ten patients with stage II/III lung cancer who had undergone a planning four-dimensional (4D) computed tomographic scan and step-and-shoot IMRT planning were selected with a mix of motion and tumor size for this retrospective study. A step-and-shoot IMRT plan was generated for each patient. The maximum and minimum doses with respiratory motion were calculated for each plan, and the mean deviation from the 4D dose was calculated, taking delivery time, fractionation, and patient breathing cycle into consideration.Results: For all patients evaluated in this study, the mean deviation from the 4D dose in the planning target volume (PTV) was <2.5%, with a standard deviation <1.2%, and maximum point dose variation from the 4D dose was <6.2% in the PTV assuming delivery dose rate of 200 MU/min and patient breathing cycle of 8 s. The motion-induced dose uncertainty is a function of motion, fractionation, MU (plan modulation), dose rate, and patient breathing cycle.Conclusions: Respiratory motion-induced dose uncertainty varies from patient to patient. Therefore, it is important to evaluate the dose uncertainty on a patient-specific basis, which could be useful for plan evaluation and treatment strategy determination for selected patients.

  13. Patient-specific quantification of respiratory motion-induced dose uncertainty for step-and-shoot IMRT of lung cancer

    International Nuclear Information System (INIS)

    Purpose: The objective of this study was to quantify respiratory motion-induced dose uncertainty at the planning stage for step-and-shoot intensity-modulated radiation therapy (IMRT) using an analytical technique.Methods: Ten patients with stage II/III lung cancer who had undergone a planning four-dimensional (4D) computed tomographic scan and step-and-shoot IMRT planning were selected with a mix of motion and tumor size for this retrospective study. A step-and-shoot IMRT plan was generated for each patient. The maximum and minimum doses with respiratory motion were calculated for each plan, and the mean deviation from the 4D dose was calculated, taking delivery time, fractionation, and patient breathing cycle into consideration.Results: For all patients evaluated in this study, the mean deviation from the 4D dose in the planning target volume (PTV) was <2.5%, with a standard deviation <1.2%, and maximum point dose variation from the 4D dose was <6.2% in the PTV assuming delivery dose rate of 200 MU/min and patient breathing cycle of 8 s. The motion-induced dose uncertainty is a function of motion, fractionation, MU (plan modulation), dose rate, and patient breathing cycle.Conclusions: Respiratory motion-induced dose uncertainty varies from patient to patient. Therefore, it is important to evaluate the dose uncertainty on a patient-specific basis, which could be useful for plan evaluation and treatment strategy determination for selected patients

  14. {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

  15. Methodology for assessing doses and radiation impact on marine organisms

    International Nuclear Information System (INIS)

    Environmental protection is one of the key issues in the prospective policy and strategy of radiation protection. In this context, numerous efforts have been made for developing the framework for the protection of non-human species from ionizing radiation, especially in European countries and Unite States. The present report summarizes knowledge so far attained on the assessment of doses and radiation impact on marine organisms. Special attention was directed to the methodology for calculating absorbed doses of marine organisms, based on which a case study was also carried out for estimating absorbed dose rate of several species of marine organisms inhabiting in the coastal sea off Rokkasho-Mura, Aomori Prefecture where a spent nuclear fuel reprocessing plant came into operation. (author)

  16. 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.

  17. 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.

  18. Improvement of the following accident dose assessment system

    International Nuclear Information System (INIS)

    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

  19. 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.

  20. 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

    International Nuclear Information System (INIS)

    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

  1. Assessment of out-of-field absorbed dose and equivalent dose in proton fields

    Energy Technology Data Exchange (ETDEWEB)

    Clasie, Ben; Wroe, Andrew; Kooy, Hanne; Depauw, Nicolas; Flanz, Jay; Paganetti, Harald; Rosenfeld, Anatoly [Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114 (United States); Department of Radiation Medicine, Loma Linda University Medical Center, Loma Linda, California 92354 (United States) and Centre for Medical Radiation Physics, University of Wollongong, Wollongong, New South Wales, 2522 (Australia); Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114 (United States); Centre for Medical Radiation Physics, University of Wollongong, Wollongong, New South Wales, 2522 (Australia)

    2010-01-15

    . Conclusions: The dose deposited immediately downstream of the primary field, in these cases, is dominated by internally produced neutrons; therefore, scattered and scanned fields may have similar risk of second cancer in this region. The authors confirm that there is a reduction in the out-of-field dose in active scanning but the effect decreases with depth. GEANT4 is suitable for simulating the dose deposited outside the primary field. The agreement with measurements is comparable to or better than the agreement reported for other implementations of Monte Carlo models. Depending on the position, the absorbed dose outside the primary field is dominated by contributions from primary protons that may or may not have scattered in the brass collimating devices. This is noteworthy as the quality factor of the low LET protons is well known and the relative dose risk in this region can thus be assessed accurately.

  2. Epidemiology and diagnostic assessment of interstitial lung diseases

    OpenAIRE

    Thomeer, Michael

    2010-01-01

    The interstitial lung diseases affect the parenchyma of the lung including the pulmonary alveolar epithelium, the capillary endothelium and the spaces between these structures, together with the tissues within the septa including the perivascular and perilymphatic tissues. Although the different interstitial lung diseases have rather similar clinical presentations with increasing shortness of breath, a restrictive lung function and a widespread shadowing on the chest radiograph, they comprise...

  3. [Early lung cancer detection in an occupational asbestos exposed population: clinical impact of low-dose computed tomography screening].

    Science.gov (United States)

    Pira, E; Coggiola, M; Bosio, D

    2010-01-01

    Lung cancer is the primary cause of cancer mortality in developed countries. Early detection and surgical resection is essential for the treatment of lung cancer. The introduction of low-dose spiral computed tomography (LDCT) is considered one of the most promising clinical research developments in early diagnosis of lung cancer. Our study is aimed at the evaluation of spiral CT in a cohort of subjects with a past occupational exposure to asbestos at high risk of developing lung cancer. 149 subjects were enrolled between 2007 and 2009 (the criteria for enrollment were date of birth between 1930-1961, no previous cancer and general good health, latency from the beginning of exposure > 10 years, exposure duration > 1 year, possibility to undergo to surgery). A helical low-dose CT (LDCT) of the chest was performed yearly and an evaluation protocol derived from IEO with a morphological analysis of nodules have been adopted. 13 nodules were diagnosed in the first CT, 7 in the second and 3 in the third but no invasive procedures have been taken and no lung cancer have been detected. Our early follow-up data aren't able yet to evaluate the effect of screening with LDCT on mortality but have do not confirm some of the literature initial results such as the Increase in cases of overdiagnosis (false positive) due to the high prevalence of benign lesions. PMID:21438306

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

    International Nuclear Information System (INIS)

    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

  5. 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.

  6. Even low doses of radiation lead to DNA damage accumulation in lung tissue according to the genetically-defined DNA repair capacity

    International Nuclear Information System (INIS)

    Background and purpose: Intensity-modulated radiation therapy for thoracic malignancies increases the exposure of healthy lung tissue to low-dose radiation. The biological impact of repetitive low-dose radiation on the radiosensitive lung is unclear. Materials and methods: In the present study, using mouse strains with different genetic DNA repair capacities, we monitored the extent of DNA damage in lung parenchyma after 2, 4, 6, 8, and 10 weeks of daily low-dose 100-mGy radiation. Results: Using 53BP1 as a marker for double-strand breaks, we observed DNA damage accumulation during fractionated low-dose radiation with increasing cumulative doses. The amount of radiation-induced 53BP1 varied significantly between bronchiolar and alveolar epithelial cells, suggesting that different cell populations in the lung parenchyma had varying vulnerabilities to ionizing radiation. The genetic background of DNA repair determined the extent of cumulative low-dose radiation damage. Moreover, increased DNA damage during fractionated low-dose radiation affected replication, and apoptosis in the lung parenchyma, which may influence overall lung function. Conclusion: Collectively, our results suggest that low, yet damaging, doses of radiation increase the risk of toxicity to normal lung tissue and the probability of developing secondary malignancies

  7. Daily low-dose cisplatin and concurrent thoracic irradiation for poor-risk patients with unresectable non-small-cell lung cancer.

    Directory of Open Access Journals (Sweden)

    Takata I

    2002-10-01

    Full Text Available A pilot study was conducted to assess the efficacy and feasibility of daily low-dose cisplatin with concurrent thoracic irradiation for clinically unresectable non-small-cell lung cancer (NSCLC. Patients with inoperable NSCLC who had poor risk factors such as advanced age, poor performance status, poor lung function, or concomitant active malignancy were entered into the study. Low-dose cisplatin (6 mg/m2 was administered daily before concurrent thoracic irradiation (2 Gy/day; total dose of 60 Gy was given. Twenty-five patients were registered. The majority of the patients had either stage IIIA (24.0% or stage IIIB (60.0% disease. Fifteen patients (60.0% completed the planned treatment. Both chemotherapy and radiotherapy were stopped in 3 patients (12.0% due to poor response, and 7 patients (28.0% partly received radiotherapy alone as a result of their toxicity response. The proportion of total administered dose to planned dose was 90.9% for chemotherapy and 99.3% for radiotherapy, which were comparable to those in previous studies for LA-NSCLC patients without poor risk factors. Grade 3 leukopenia and neutropenia developed in 14 patients (56.0% and 10 patients (40.0%, respectively, but grade 4 toxicity was not encountered. Grade 3 pneumonitis and esophagitis were observed in 4 patients (16.0% and 2 patients (8.0%, respectively. The overall response rate was 60.0%. The median survival time was 22 months, and the 2-year survival rate was 50.3%. Daily low-dose cisplatin and concurrent thoracic irradiation were well tolerated even by poor-risk patients with NSCLC, and showed a therapeutic efficacy similar to that for good-risk patients.

  8. 4D dose-position verification in radiation therapy using the RADPOS system in a deformable lung phantom

    International Nuclear Information System (INIS)

    Purpose: A novel 4D in vivo dosimetry system (RADPOS), in conjunction with a deformable lung phantom, has been evaluated as a potential quality assurance tool for 4D radiotherapy. Methods: RADPOS detectors, which consist of a MOSFET dosimeter combined with an electromagnetic positioning probe, were placed inside the deformable lung phantom. One detector was positioned directly inside a tumor embedded in the lung phantom and another was positioned inside the lung portion of the phantom, outside the tumor. CT scans were taken with the phantom at three breathing phases, and for each phase, the detector position inside the phantom was read with the RADPOS software and compared to the position as determined from the CT data. These values were also compared to RADPOS measurements taken with the phantom on the couch of a Varian Clinac 6EX linac. The deformable phantom and the RADPOS system were also used in two radiation delivery scenarios: (1) A simulation of a free-breathing delivery and (2) a simulation of an adaptive treatment. Results: Compared to CT imaging, the RADPOS positional accuracy was found to be better than 2.5 mm. The radial displacement measurements taken in the CT and linac rooms agreed to within an average of (0.7±0.3) mm. Hence, the system can provide relative displacement measurements in the treatment room, consistent with measurements made in the CT room. For the free-breathing delivery, the total dose reported by RADPOS agreed to within 4% and 5% of the treatment planning doses in the tumor and the lung portion of the phantom, respectively. The RADPOS-measured dose values for the adaptive delivery were within 1.5% of the treatment plan values, which was well within the estimated experimental uncertainties. Conclusions: This work has shown that the deformable lung phantom-RADPOS system can be an efficient quality assurance tool for 4D radiation therapy.

  9. 4D dose-position verification in radiation therapy using the RADPOS system in a deformable lung phantom

    Energy Technology Data Exchange (ETDEWEB)

    Cherpak, Amanda; Serban, Monica; Seuntjens, Jan; Cygler, Joanna E. [Medical Physics, Ottawa Hospital Cancer Centre, Ottawa, Ontario K1H 8L6 (Canada) and Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6 (Canada); Hopital Maisonneuve-Rosemont Hospital, Service de radiophysique, Montreal, Quebec H1T 2M4 (Canada); Medical Physics Unit, McGill University, Montreal, Quebec H3G 1A4 (Canada); Medical Physics, Ottawa Hospital Cancer Centre, Ottawa, Ontario K1H 8L6 (Canada) and Department of Physics, Carleton University, Ottawa, Ontario K1S 5B6 (Canada)

    2011-01-15

    Purpose: A novel 4D in vivo dosimetry system (RADPOS), in conjunction with a deformable lung phantom, has been evaluated as a potential quality assurance tool for 4D radiotherapy. Methods: RADPOS detectors, which consist of a MOSFET dosimeter combined with an electromagnetic positioning probe, were placed inside the deformable lung phantom. One detector was positioned directly inside a tumor embedded in the lung phantom and another was positioned inside the lung portion of the phantom, outside the tumor. CT scans were taken with the phantom at three breathing phases, and for each phase, the detector position inside the phantom was read with the RADPOS software and compared to the position as determined from the CT data. These values were also compared to RADPOS measurements taken with the phantom on the couch of a Varian Clinac 6EX linac. The deformable phantom and the RADPOS system were also used in two radiation delivery scenarios: (1) A simulation of a free-breathing delivery and (2) a simulation of an adaptive treatment. Results: Compared to CT imaging, the RADPOS positional accuracy was found to be better than 2.5 mm. The radial displacement measurements taken in the CT and linac rooms agreed to within an average of (0.7{+-}0.3) mm. Hence, the system can provide relative displacement measurements in the treatment room, consistent with measurements made in the CT room. For the free-breathing delivery, the total dose reported by RADPOS agreed to within 4% and 5% of the treatment planning doses in the tumor and the lung portion of the phantom, respectively. The RADPOS-measured dose values for the adaptive delivery were within 1.5% of the treatment plan values, which was well within the estimated experimental uncertainties. Conclusions: This work has shown that the deformable lung phantom-RADPOS system can be an efficient quality assurance tool for 4D radiation therapy.

  10. Biokinetics and dose assessment of radionuclides in juveniles

    International Nuclear Information System (INIS)

    In the aftermath of the Chernobyl accident, it becomes evident that dose coefficients for members of the public are necessary. International Commission on Radiological Protection (ICRP) established a task group of Committee 2 charged with the assessment of dose coefficients as a function of an individual's age. However, little data is available on the biokinetics of radionuclides in juvenile and there is a need to develop age-dependent biokinetic models, such as for the gastrointestinal tract. The present paper reviewed an outline on characteristics of biokinetics of radionuclides in juvenile animals focusing on the previous experimental data. The following radionuclides are discussed: 54Mn, 60Co, 65Zn, 75Se, 106Ru, 110mAg, 115mCd, 125Sb, 137Cs, 141Ce, 203Hg and 3H. Generally, intestinal absorption and whole-body retention of radionuclides in juveniles were higher than that of adult. In the case of sucklings, it is very important to study how radionuclides are transferred through the placenta and milk. The transfer rate of radionuclides through the placenta and milk is dependent on the period of gestation at the time of dosing. The IDES(Internal Dose Estimation System) which is based on the ICRP model was used for dose calculation. We modified the IDES using the biokinetic data which was gained animal experiment. The IDES is flexible because the absorbed dose can be calculated by substituting arbitrary physical and physiological parameters and also substituting ingested dose coefficients not only for the ICRP Reference Man, but also for Japanese of 1 year old, 5 years old, 10 years old, 15 years old and the adult, respectively. (author)

  11. Assessment of patient dose in mammography using Monte Carlo simulation

    International Nuclear Information System (INIS)

    Breast doses due to mammographic examinations were assessed using a MIRD-type female phantom and Monte Carlo simulations. Clinical mammographic data, which vary according to the age group of the subject undergoing the examinations, were obtained from the Korea Cancer Center Hospital in Seoul. The tube potential was fixed to 26 kVp, most commonly used in the mammographic examination, and the source-film distance was kept constant at 65 cm. The breast tissue was assumed to have an even composition between glandular tissue and adipose tissue. The nominal breast equivalent doses were in the range from 0.6 to 1.8 mSv and the resulting effective doses ranged from 0.06 to 0.19 mSv depending on the age group and the projection modes. Lower doses were resulted at older ages. Contributions of organs other than the breast to the effective doses were negligible as long as the X-ray beam was adequately collimated and aligned to avoid exposure of other part of the body than the breast. This means that a simple breast-only phantom can be used in dosimetric calculations for mammography. (author)

  12. Development of radiation dose assessment system for radiation accident (RADARAC)

    International Nuclear Information System (INIS)

    The possibility of radiation accident is very rare, but cannot be regarded as zero. Medical treatments are quite essential for a heavily exposed person in an occurrence of a radiation accident. Radiation dose distribution in a human body is useful information to carry out effectively the medical treatments. A radiation transport calculation utilizing the Monte Carlo method has an advantageous in the analysis of radiation dose inside of the body, which cannot be measured. An input file, which describes models for the accident condition and quantities of interest, should be prepared to execute the radiation transport calculation. Since the accident situation, however, cannot be prospected, many complicated procedures are needed to make effectively the input file soon after the occurrence of the accident. In addition, the calculated doses are to be given in output files, which usually include much information concerning the radiation transport calculation. Thus, Radiation Dose Assessment system for Radiation Accident (RADARAC) was developed to derive effectively radiation dose by using the MCNPX or MCNP code. RADARAC mainly consists of two parts. One part is RADARAC-INPUT, which involves three programs. A user can interactively set up necessary resources to make input files for the codes, with graphical user interfaces in a personnel computer. The input file includes information concerning the geometric structure of the radiation source and the exposed person, emission of radiations during the accident, physical quantities of interest and so on. The other part is RADARAC-DOSE, which has one program. The results of radiation doses can be effectively indicated with numerical tables, graphs and color figures visibly depicting dose distribution by using this program. These results are obtained from the outputs of the radiation transport calculations. It is confirmed that the system can effectively make input files with a few thousand lines and indicate more than 20

  13. Biological dosimetry: chromosomal aberration analysis for dose assessment

    International Nuclear Information System (INIS)

    In view of the growing importance of chromosomal aberration analysis as a biological dosimeter, the present report provides a concise summary of the scientific background of the subject and a comprehensive source of information at the technical level. After a review of the basic principles of radiation dosimetry and radiation biology basic information on the biology of lymphocytes, the structure of chromosomes and the classification of chromosomal aberrations are presented. This is followed by a presentation of techniques for collecting blood, storing, transporting, culturing, making chromosomal preparations and scaring of aberrations. The physical and statistical parameters involved in dose assessment are discussed and examples of actual dose assessments taken from the scientific literature are given

  14. 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......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......%, respectively, at one standard deviation. The subroutine in RisoScan for electron energy measurement is shown to give results that are equivalent to the measurements with a scanning spectrophotometer. (c) 2006 Elsevier Ltd. All rights reserved....

  15. Equine scintigraphy: assessment of the dose received by the personnel

    International Nuclear Information System (INIS)

    Following a request from the Permanent Secretary of the French Commission for Artificial Radioelements (CIREA) engaged to investigate a request for a licence related to a new scintigraphy unit dedicated to equidae, a dosimetric assessment concerning the personnel attending the examination was carried out. This scintigraphy unit depends on the Goustranville Centre for Imaging and Research on the Locomotive Diseases of Equidae (CIRALE) in the Calvados region. The dosimetric assessment was carried out for the different operators during the successive stages of the scintigraphic examination. Assuming 150 examinations per year, the annual equivalent dose to the fingers skin is 150 mSv maximum for the technologist and 2 mSv for the veterinary surgeon; the annual effective dose ranges from 0.15 to 0.45 mSv, depending on the operators. (authors)

  16. Dose imaging in a thorax phantom with lung-equivalent volume at the epithermal neutron beam of LVR-15 reactor

    Energy Technology Data Exchange (ETDEWEB)

    Gambarini, G. [Department of Physics, University of Milan (Italy); INFN-National Institute of Nuclear Physics, Division of Milan (Italy)], E-mail: grazia.gambarini@mi.infn.it; Vanossi, E. [Department of Energy, Polytechnic of Milan (Italy); INFN-National Institute of Nuclear Physics, Division of Milan (Italy); Bartesaghi, G. [Department of Physics, University of Milan (Italy); INFN-National Institute of Nuclear Physics, Division of Milan (Italy); Carrara, M. [Fondazione IRCCS ' Istituto Nazionale Tumori' , Milan (Italy); Mariani, M. [Department of Energy, Polytechnic of Milan (Italy); Negri, A. [Department of Physics, University of Milan (Italy); INFN-National Institute of Nuclear Physics, Division of Milan (Italy); Burian, J.; Viererbl, L.; Klupak, V.; Rejchrt, J. [Department of Reactor Physics, NRI Rez, plc (Czech Republic)

    2009-07-15

    A thorax phantom has been designed, consisting of PMMA and PE plates containing a cavity filled with a laboratory-made lung-substitute. Fricke-gel dosimeters have been placed in the lung-substitute volume, and the phantom has been irradiated at the epithermal column of LVR-15 reactor. Absorbed dose images have been obtained for both gamma radiation and charged particles emitted in the {sup 10}B reactions with thermal neutrons. Measurements with thermoluminescence dosimeters (TLDs) and Monte Carlo (MC) calculations have been performed too, in order to attain inter-comparison of results.

  17. Methods of assessing total doses integrated across pathways

    International Nuclear Information System (INIS)

    Calculated doses for comparison with limits resulting from discharges into the environment should be summed across all relevant pathways and food groups to ensure adequate protection. Current methodology for assessments used in the radioactivity in Food and the Environment (R.I.F.E.) reports separate doses from pathways related to liquid discharges of radioactivity to the environment from those due to gaseous releases. Surveys of local inhabitant food consumption and occupancy rates are conducted in the vicinity of nuclear sites. Information has been recorded in an integrated way, such that the data for each individual is recorded for all pathways of interest. These can include consumption of foods, such as fish, crustaceans, molluscs, fruit and vegetables, milk and meats. Occupancy times over beach sediments and time spent in close proximity to the site is also recorded for inclusion of external and inhalation radiation dose pathways. The integrated habits survey data may be combined with monitored environmental radionuclide concentrations to calculate total dose. The criteria for successful adoption of a method for this calculation were: Reproducibility can others easily use the approach and reassess doses? Rigour and realism how good is the match with reality?Transparency a measure of the ease with which others can understand how the calculations are performed and what they mean. Homogeneity is the group receiving the dose relatively homogeneous with respect to age, diet and those aspects that affect the dose received? Five methods of total dose calculation were compared and ranked according to their suitability. Each method was labelled (A to E) and given a short, relevant name for identification. The methods are described below; A) Individual doses to individuals are calculated and critical group selection is dependent on dose received. B) Individual Plus As in A, but consumption and occupancy rates for high dose is used to derive rates for application in

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

    International Nuclear Information System (INIS)

    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 cm3 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.)

  19. Influence of lung parameter values for the Brazilian population on inhalation dose

    International Nuclear Information System (INIS)

    The Human Respiratory Tract Model (HRTM) proposed by the ICRP Publication 66 accounts for the morphology and physiology of the respiratory tract. The ICRP 66 presents deposition fraction in the respiratory tract regions considering reference values from Caucasian man. However, in order to obtain a more accurate assessment of intake and dose the ICRP recommends the use of specific information when they are available. The main objective of this study is to evaluate the influence in dose calculation to each region of the respiratory tract when physiological parameters from samples of Brazilian population, in different levels of exercise, are applied in the deposition model.The dosimetric model of HRTM was implemented in the software EXCEL for Windows and committed equivalent dose was determined for each respiratory tract region. First it was calculated the total number of nuclear transformations considering the fractional deposition of activity in each source tissue obtained by application of physiological and morphological Brazilian parameters in the deposition model and then it was calculated the total energy absorbed per unit mass in the target tissue.The variation in the fractional deposition in the compartments of the respiratory tract in changing the physiological parameters from Caucasian to Brazilian adult man causes variation in the number of total transformations and also in the equivalent dose in each region of the respiratory tract. The variations are not the same for all regions of the respiratory tract and depend on levels of exercise. (author)

  20. Accuracy of patient dose calculation for lung IMRT: A comparison of Monte Carlo, convolution/superposition, and pencil beam computations.

    Science.gov (United States)

    Vanderstraeten, Barbara; Reynaert, Nick; Paelinck, Leen; Madani, Indira; De Wagter, Carlos; De Gersem, Werner; De Neve, Wilfried; Thierens, Hubert

    2006-09-01

    The accuracy of dose computation within the lungs depends strongly on the performance of the calculation algorithm in regions of electronic disequilibrium that arise near tissue inhomogeneities with large density variations. There is a lack of data evaluating the performance of highly developed analytical dose calculation algorithms compared to Monte Carlo computations in a clinical setting. We compared full Monte Carlo calculations (performed by our Monte Carlo dose engine MCDE) with two different commercial convolution/superposition (CS) implementations (Pinnacle-CS and Helax-TMS's collapsed cone model Helax-CC) and one pencil beam algorithm (Helax-TMS's pencil beam model Helax-PB) for 10 intensity modulated radiation therapy (IMRT) lung cancer patients. Treatment plans were created for two photon beam qualities (6 and 18 MV). For each dose calculation algorithm, patient, and beam quality, the following set of clinically relevant dose-volume values was reported: (i) minimal, median, and maximal dose (Dmin, D50, and Dmax) for the gross tumor and planning target volumes (GTV and PTV); (ii) the volume of the lungs (excluding the GTV) receiving at least 20 and 30 Gy (V20 and V30) and the mean lung dose; (iii) the 33rd percentile dose (D33) and Dmax delivered to the heart and the expanded esophagus; and (iv) Dmax for the expanded spinal cord. Statistical analysis was performed by means of one-way analysis of variance for repeated measurements and Tukey pairwise comparison of means. Pinnacle-CS showed an excellent agreement with MCDE within the target structures, whereas the best correspondence for the organs at risk (OARs) was found between Helax-CC and MCDE. Results from Helax-PB were unsatisfying for both targets and OARs. Additionally, individual patient results were analyzed. Within the target structures, deviations above 5% were found in one patient for the comparison of MCDE and Helax-CC, while all differences between MCDE and Pinnacle-CS were below 5%. For both

  1. Accuracy of patient dose calculation for lung IMRT: A comparison of Monte Carlo, convolution/superposition, and pencil beam computations

    International Nuclear Information System (INIS)

    The accuracy of dose computation within the lungs depends strongly on the performance of the calculation algorithm in regions of electronic disequilibrium that arise near tissue inhomogeneities with large density variations. There is a lack of data evaluating the performance of highly developed analytical dose calculation algorithms compared to Monte Carlo computations in a clinical setting. We compared full Monte Carlo calculations (performed by our Monte Carlo dose engine MCDE) with two different commercial convolution/superposition (CS) implementations (Pinnacle-CS and Helax-TMS's collapsed cone model Helax-CC) and one pencil beam algorithm (Helax-TMS's pencil beam model Helax-PB) for 10 intensity modulated radiation therapy (IMRT) lung cancer patients. Treatment plans were created for two photon beam qualities (6 and 18 MV). For each dose calculation algorithm, patient, and beam quality, the following set of clinically relevant dose-volume values was reported: (i) minimal, median, and maximal dose (Dmin, D50, and Dmax) for the gross tumor and planning target volumes (GTV and PTV); (ii) the volume of the lungs (excluding the GTV) receiving at least 20 and 30 Gy (V20 and V30) and the mean lung dose; (iii) the 33rd percentile dose (D33) and Dmax delivered to the heart and the expanded esophagus; and (iv) Dmax for the expanded spinal cord. Statistical analysis was performed by means of one-way analysis of variance for repeated measurements and Tukey pairwise comparison of means. Pinnacle-CS showed an excellent agreement with MCDE within the target structures, whereas the best correspondence for the organs at risk (OARs) was found between Helax-CC and MCDE. Results from Helax-PB were unsatisfying for both targets and OARs. Additionally, individual patient results were analyzed. Within the target structures, deviations above 5% were found in one patient for the comparison of MCDE and Helax-CC, while all differences between MCDE and Pinnacle-CS were below 5%. For both

  2. An airborne dispersion/dose assessment computer program. Phase 1

    International Nuclear Information System (INIS)

    The Atomic Energy Control Board (AECB) staff have a need for an airborne dispersion-dose assessment computer programme for a microcomputer. The programme must be capable of analyzing the dispersion of both radioactive and non-radioactive materials. A further requirement of the programme is that it be implemented on the AECB complex of microcomputers and that it have an advanced graphical user interface. A survey of computer programs was conducted to determine which, if any, could meet the AECB's requirements in whole or in part. Ten programmes were selected for detailed review including programs for nuclear and non-radiological emergencies. None of the available programmes for radiation dose assessment meets all the requirements for reasons of user interaction, method of source term estimation or site specificity. It is concluded that the best option for meeting the AECB requirements is to adopt the CAMEO programme (specifically the ALOHA portion) which has a superior graphical user interface and add the necessary models for radiation dose assessment

  3. Assessment and recording of radiation doses to workers

    International Nuclear Information System (INIS)

    The assessment and recording of the radiation exposure of workers in activities involving radiation risks are required for demonstrating compliance with institutional dose limitations and for a number of other complementary purposes. A significant proportion of the labor force involved in radiation work is currently represented by those specialised workers who operate as itinerant contractors for different nuclear installations and in different countries. In order to ensure that the exposure of these workers is adequately and consistently controlled and kept within acceptable limits, there is a need for the criteria and methods for dose assessment and recording to be harmonised throughout the different countries. An attempt in that direction has been made in this report, which has been prepared by a group of experts convened by the Committee on Radiation Protection and Public Health of the OECD Nuclear Energy Agency. Its primary purpose is to describe recommended technical procedures for an unified approach to the assessment and recording of worker doses. The report is published under the responsibility of the Secretary-General of the OECD, and does not commit Member governments

  4. Assessment of internal dose from radionuclides - dosimetric and biokinetic models

    International Nuclear Information System (INIS)

    For the assessment of annual limits on intakes of radionuclides by workers, and of dose coefficients for intakes of radionuclides by members of the public and patients, the ICRP has developed biokinetic models for the uptake of radionuclides by the gastrointestinal and the respiratory tract as well as for the systemic behaviour of radionuclides and their elimination from the body. The dosimetric and biokinetic models and data used for the assessments are described in detail. Present results and future activities of the ICRP on secondary limits for internal exposure are briefly mentioned. (orig./HP)

  5. 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

    2016-01-01

     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 inde-pendent sources. Specifically, we construct belief and plausibility functions on the lung cancer radiotherapy dose outcome datasets, and then apply the optimal uni-fied 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. PMID:26894343

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

    International Nuclear Information System (INIS)

    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

  7. 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.

  8. 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...

  9. 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

  10. Research on pharmacokinetics of high-dose tamoxifen in non-small cell lung cancer patients

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To study the pharmacokinetics of tamoxifen at a high dosage, which will offer a theoretical support for an appropriate clinical use of the medicine in non-small cell lung cancer (NSCLC) patients. Methods Three qualified NSCLC patients are selected and given tamoxifen (TAM) 160 mg per Os. Blood samples were collected at different times and then analyzed by high-performance liguid chromatography. The PK-GRAPH program was used to obtain the parameters. Results The concentration-time courses of the TAM 160 mg were fitted to one-compartment model. The pharmacokinetic parameters were estimated as follows: Tmax (6.35±1.24)h, Cmax (217.39±7.71)ng/Ml, AUC (12 127.39±636.16)ng·h/Ml and T1/2ke (34.13±2.97)h. Conclusion TAM 160mg one day per Os cannot reach the effective maintenance concentration in vivo required for reversing MDR in vitro. Loading-maintenance dose strategy is recommended to study the pharmacodynamics of tamoxifen at a high dosage in NSCLC patients.

  11. Non-human biota dose assessment. Sensitivity analysis and knowledge quality assessment

    International Nuclear Information System (INIS)

    This report provides a summary of a programme of work, commissioned within the BIOPROTA collaborative forum, to assess the quantitative and qualitative elements of uncertainty associated with biota dose assessment of potential impacts of long-term releases from geological disposal facilities (GDF). Quantitative and qualitative aspects of uncertainty were determined through sensitivity and knowledge quality assessments, respectively. Both assessments focused on default assessment parameters within the ERICA assessment approach. The sensitivity analysis was conducted within the EIKOS sensitivity analysis software tool and was run in both generic and test case modes. The knowledge quality assessment involved development of a questionnaire around the ERICA assessment approach, which was distributed to a range of experts in the fields of non-human biota dose assessment and radioactive waste disposal assessments. Combined, these assessments enabled critical model features and parameters that are both sensitive (i.e. have a large influence on model output) and of low knowledge quality to be identified for each of the three test cases. The output of this project is intended to provide information on those parameters that may need to be considered in more detail for prospective site-specific biota dose assessments for GDFs. Such information should help users to enhance the quality of their assessments and build greater confidence in the results. (orig.)

  12. Assessment of tumors of the lung apex by imaging techniques

    International Nuclear Information System (INIS)

    The purpose of this study was to analyze the value of MR in the preoperative staging of tumors of the lung apex and detection of local invasion of adjacent structures to determine its influence on the therapeutic approach. We obtained plain X-ray images in two planes, as well as CT and Mr images, in 12 patients with Pan coast tumor in whom there was surgical (n=8) or clinical (n=4) evidence of invasion. The objective was to assess local infiltration of brain stem and chest wall soft tissue, enveloping of the subclavian artery, substantial involvement of the brachial plexus and destruction of the vertebral body. In our series, MR was superior to the other imaging techniques in predicting the involvement of the structures surrounding the tumor. In conclusion, MR should be performed in a patient diagnosed by plain radiography as having an apical tumors to assess local tumor extension, while CT should be done to detect mediastinal lymph node involvement and distant metastases. 19 refs

  13. Approach to derive doses for case-control studies of lung cancer and leukaemia among workers internally exposed to uranium and plutonium

    International Nuclear Information System (INIS)

    Case-control studies are currently conducted in 3 European countries (Belgium, France and the United Kingdom) to estimate the risk of lung cancer and leukaemia in relation to internal exposure to uranium and plutonium amongst workers in the nuclear industry. The project requires calculating doses absorbed by the lung and the bone marrow for many hundreds of cases and controls internally exposed. In order to establish a common approach to dose reconstruction, a detailed dosimetry protocol and a database of individual exposure were set up and will be presented. The dose reconstruction relies heavily on bioassay data, which are usually urine analysis, extending back over 50 years in some cases. Inevitably, data obtained over such a time span are of variable quality. It is important to review the monitoring practices at the various laboratories and to assess the reliability of these data in order to estimate possible biases as well as random uncertainties. Another key step in the reconstruction process is to decide upon the likely intake regimes consistent with the data. Generally, chronic intakes will be assumed and acute intakes will be added only when their existence is supported by operational data. Biokinetic models are used both to calculate intakes from bioassay data and to convert intakes to doses. The ICRP publication 66 respiratory tract model will be used along with the latest systemic models described by ICRP. These will be supplemented by the Leggett 2005 model for plutonium. These various models will be implemented by the code IMBA-Expert. Since it is essential to obtain central estimates for the doses, a particular problem is encountered with datasets consisting only of values below the limit of detection. For these cases Bayesian statistics will be employed using a non-informative prior probability distribution. (author)

  14. Use of FDG-PET to guide dose prescription heterogeneity in stereotactic body radiation therapy for lung cancers with volumetric modulated arc therapy: a feasibility study

    International Nuclear Information System (INIS)

    The aim of this study was to assess if FDG-PET could guide dose prescription heterogeneity and decrease arbitrary location of hotspots in SBRT. For three patients with stage I lung cancer, a CT-simulation and a FDG-PET were registered to define respectively the PTVCT and the biological target volume (BTV). Two plans involving volumetric modulated arc therapy (VMAT) and simultaneous integrated boost (SIB) were calculated. The first plan delivered 4 × 12 Gy within the PTVCT and the second plan, with SIB, 4 × 12 Gy and 13.8 Gy (115% of the prescribed dose) within the PTVCT and the BTV respectively. The Dmax-PTVCT had to be inferior to 60 Gy (125% of the prescribed dose). Plans were evaluated through the D95%, D99% and Dmax-PTVCT, the D2 cm, the R50% and R100% and the dice similarity coefficient (DSC) between the isodose 115% and BTV. DSC allows verifying the location of the 115% isodose (ideal value = 1). The mean PTVCT and BTV were 36.7 (±12.5) and 6.5 (±2.2) cm3 respectively. Both plans led to similar target coverage, same doses to the OARs and equivalent fall-off of the dose outside the PTVCT. On the other hand, the location of hotspots, evaluated through the DSC, was improved for the SIB plans with a mean DSC of 0.31 and 0.45 for the first and the second plans respectively. Use of PET to decrease arbitrary location of hotspots is feasible with VMAT and SIB for lung cancer

  15. 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

  16. CAP-88, Dose Risk Assessment from Air Emissions of Radionuclides

    International Nuclear Information System (INIS)

    1 - Description of program or function: The Clean Air Act Assessment Package-1988 (CAP-88) is designed for assessment of dose and risk from radionuclide emissions to air in compliance with National Emission Standards for Hazardous Air Pollutants (NESHAPs) for Radionuclides. CAP-88 estimates health impacts from the inhalation, ingestion, air immersion and ground surface irradiation pathways, and tabulates results for maximally exposed individuals and regional populations out to 80 kilometers. The system provides risk information in a concise, easy-to-read format and prints an echo of the input. CAP-88 consists of updated versions of the mainframe codes AIRDOS-EPA and DARTAB. Atmospheric dispersion and deposition are calculated by AIRDOS2. Dose and risk assessment tables are calculated by DARTAB2 from the binary output file produced by AIRDOS2 and a file of dose and risk factors calculated by RADRISK. Pre-processors (PREPAR2 and PREDA) for AIRDOS2 and DARTAB2 access data bases of element and nuclide dependent data to simplify the execution of the principal programs. 2 - Method of solution: AIRDOS-EPA implements a long term average Gaussian Plume model. The associated terrestrial model for deposition is based on NRC Regulatory Guide 1.109. The 50-year effective dose equivalent factors for DARTAB2 are calculated by RADRISK and use weighting factors from ICRP-26. Risks are calculated using a linear Life Table model consistent with BEIR-3. The resultant risk factors are 4.0E-4 cancer deaths per rem and 3.6E-4 cancer deaths per person working-level-month exposure to radon decay products. CAP88-PC (CCC-0542/02) is able to use population data and weather data downloaded from mainframe versions of CAP-88. CAP88-PC also comes with sample population arrays from some DOE facilities, and includes weather data from many DOE sites and major U.S. cities. 3 - Restrictions on the complexity of the problem: Programs are limited to 36 radionuclides and to 20 downwind distances for each

  17. Radiation-induced rib fractures after hypofractionated stereotactic body radiation therapy of non-small cell lung cancer: A dose- and volume-response analysis

    International Nuclear Information System (INIS)

    Background and purpose: The aim of this study is to analyse the dose-response and the volume-response of radiation-induced rib fractures after hypofractionated stereotactic body radiation therapy (SBRT). Materials and methods: During the period 1998-2005, 68 patients with medically inoperable stage I non-small cell lung cancer (NSCLC) were treated with hypofractionated SBRT to 45 Gy in 3 fractions. Among the 33 patients with complete treatment records and radiographic follow-up exceeding 15 months (median: 29 months), 13 fractures were found in seven patients. Identifying all ribs receiving at least 21 Gy, 81 ribs (13 with and 68 without fracture) in 26 patients were separately contoured and their dose-volume histograms (DVHs) were obtained. The DVHs were assessed with the mean dose and cut-off models. Maximum likelihood estimation was used to fit dose-response and volume-response curves to each model. Results: It was possible to quantify the risk of radiation-induced rib fracture using response curves and information contained in the DVHs. Absolute volumes provided better fits than relative volumes and dose-response curves were more suitable than volume-response curves. For the dose given by the 2 cm3 cut-off volume, D2cm3, the logistic dose-response curve for three fractions was parameterised by D50 = 49.8 Gy and γ50 = 2.05. Consequently, for a median follow-up of 29 months, if D2cm3 2cm3 = 3 x 9.1 Gy and 3 x 16.6 Gy, respectively. Conclusions: In this group of patients, the risk for radiation-induced rib fracture following hypofractionated SBRT was related to the dose to 2 cm3 of the rib.

  18. 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.

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

    International Nuclear Information System (INIS)

    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

  20. Application Monte Carlo code calculates dose distribution of the emitted photon beams from linear accelerator in case radiotherapy lung cancer

    International Nuclear Information System (INIS)

    The dose distribution calculation is one of major steps in cancer radiotherapy. This paper applies Monte Carlo code, MCNP5, in simulation 15 MV photon beams from linear accelerator of General Hospital of Kien Giang in a case treatment of lung cancer. The settings for beam direction, field size and isocenter position used in MCNP5 must be the same as in treatment plan at hospital to ensure the results from MCNP5 are accurate. We also built a program CODIM by using MATLAB® programming software. This program is used to construct digital voxel phantoms from lung CT images obtained from cancer treatment cases at Kien Giang hospital and then simulate the delivered dose of linac in these phantoms by using MCNP5 simulation code. The results show that there is a difference of 5% in comparison to Prowess Panther program - a semi-empirical simulation program which is being used for treatment planning in Kien Giang hospital. (author)

  1. Dose painting by contours versus dose painting by numbers for stage II/III lung cancer: Practical implications of using a broad or sharp brush

    International Nuclear Information System (INIS)

    Purpose: Local recurrence rates are high in patients with locally advanced NSCLC treated with 60 to 66 Gy in 2 Gy fractions. It is hypothesised that boosting volumes with high SUV on the pre-treatment FDG-PET scan potentially increases local control while maintaining acceptable toxicity levels. We compared two approaches: threshold-based dose painting by contours (DPBC) with voxel-based dose painting by numbers (DPBN). Materials and methods: Two dose painted plans were generated for 10 stage II/III NSCLC patients with 66 Gy at 2-Gy fractions to the entire PTV and a boost dose to the high SUV areas within the primary GTV. DPBC aims for a uniform boost dose at the volume encompassing the SUV 50%-region (GTVboost). DPBN aims for a linear relationship between the boost dose to a voxel and the underlying SUV. For both approaches the boost dose was escalated up to 130 Gy (in 33 fractions) or until the dose limiting constraint of an organ at risk was met. Results: For three patients (with relatively small peripheral tumours) the dose within the GTV could be boosted to 130 Gy using both strategies. For the remaining patients the boost dose was confined by a critical structure (mediastinal structures in six patients, lungs in one patient). In general the amount of large brush DPBC boosting is limited whenever the GTVboost is close to any serial risk organ. In contrast, small brush DPBN inherently boosts at a voxel-by-voxel basis allowing significant higher dose values to high SUV voxels more distant from the organs at risk. We found that the biological SUV gradients are reasonably congruent with the dose gradients that standard linear accelerators can deliver. Conclusions: Both large brush DPBC and sharp brush DPBN techniques can be used to considerably boost the dose to the FDG avid regions. However, significantly higher boost levels can be obtained using sharp brush DPBN although sometimes at the cost of a less increased dose to the low SUV regions.

  2. ARAC: a flexible real-time dose consequence assessment system

    International Nuclear Information System (INIS)

    ARAC (the Atmospheric Release Advisory Capability), an emergency radiological dose assessment capability of the U.S. Government, has been called on to do consequence assessments for releases into the atmosphere of radionuclides and a variety of other substances. Because of the variety of requirements of each unique assessment, ARAC has developed and maintains a flexible system of people, computer software and hardware. A new version of ADPIC that can simulate the transport of any number of radionuclide particulates and gases and all of the decay products that are generated during transport and after deposition. This code will be most suitable for application to nuclear reactor accidents. ARAC has personal computer and advanced computer workstations at approximately 50 remote sites that communicate central system and which can initiate an ARAC response by transmitting time, location and source information about an accident to the central system

  3. 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)

  4. Source term calculations for assessing radiation dose to equipment

    International Nuclear Information System (INIS)

    This study examines results of analyses performed with the Source Term Code Package to develop updated source terms using NUREG-0956 methods. The updated source terms are to be used to assess the adequacy of current regulatory source terms used as the basis for equipment qualification. Time-dependent locational distributions of radionuclides within a containment following a severe accident have been developed. The Surry reactor has been selected in this study as representative of PWR containment designs. Similarly, the Peach Bottom reactor has been used to examine radionuclide distributions in boiling water reactors. The time-dependent inventory of each key radionuclide is provided in terms of its activity in curies. The data are to be used by Sandia National Laboratories to perform shielding analyses to estimate radiation dose to equipment in each containment design. See NUREG/CR-5175, ''Beta and Gamma Dose Calculations for PWR and BWR Containments.'' 6 refs., 11 tabs

  5. 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; 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

    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...... 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...

  6. Successful treatment of EGFR-mutated non-small cell lung cancer with reduced-dose gefitinib: A case report

    OpenAIRE

    Watanabe, Hiroko; TAMURA, TOMOHIRO; KAGOHASHI, KATSUNORI; TAKAYASHIKI, NORIO; KURISHIMA, KOICHI; Satoh, Hiroaki; HIZAWA, NOBUYUKI

    2015-01-01

    Epidermal growth factor receptor (EGFR) mutation is a favorable prognostic factor of non-small cell lung cancer (NSCLC). In the majority of patients with EGFR mutations, clinical benefits of EGFR-tyrosine kinase inhibitors (TKIs) have been reported. One of the TKIs, gefitinib, appears to be less toxic to the skin than other TKIs. The present study reports a case of NSCLC with EGFR mutation (exon 19 deletion) in which dose-reduced gefitinib was effective against recurrence. Due to development ...

  7. 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.)

  8. 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. PMID:21813201

  9. 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 treatmen