WorldWideScience

Sample records for patient dose assessment

  1. Eye lens exposure to medical staff performing electrophysiology procedures: dose assessment and correlation to patient dose

    International Nuclear Information System (INIS)

    Ciraj-Bjelac, Olivera; Bozovic, Predrag; Arandjic, Danijela; Antic, Vojislav; Selakovic, Jovana; Pavlovic, Sinisa

    2016-01-01

    The purpose of this study was to assess the patient exposure and staff eye dose levels during implantation procedures for all types of pacemaker therapy devices performed under fluoroscopic guidance and to investigate potential correlation between patients and staff dose levels. The mean eye dose during pacemaker/defibrillator implementation was 12 μSv for the first operator, 8.7 μSv for the second operator/nurse and 0.50 μSv for radiographer. Corresponding values for cardiac re-synchronisation therapy procedures were 30, 26 and 2.0 μSv, respectively. Significant (p < 0.01) correlation between the eye dose and the kerma-area product was found for the first operator and radiographers, but not for other staff categories. The study revealed eye dose per procedure and eye dose normalised to patient dose indices for different staff categories and provided an input for radiation protection in electrophysiology procedures. (authors)

  2. Dose assessment in patients undergoing lung examinations by computed tomography

    International Nuclear Information System (INIS)

    Gonzaga, Natalia B.; Silva, Teogenes A. da; Magalhaes, Marcos J.

    2011-01-01

    In the last fifteen years, the use of computed tomography (CT) has increased alongside other radiology technologies technologies. Its contribution has already achieved 34% in terms of doses undergone by patients. Radiation protection of patients submitted to CT examinations is based on the knowledge of internationally defined dosimetric quantities as the CT air kerma-length product (P K,L ) and weighted CT air kerma index (C w ). In Brazil, those dosimetric quantities are not routinely used and the optimization criteria are based only upon the MSAD - the average dose in multislices. In this work, the dosimetric quantities P K,L and C w were assessed by the CT Expo program for seven protocols used daily for lung examinations in adults with the use of Siemens and Philips scanners in Belo Horizonte. Results showed that P K,L values varied from 163 to 558 mGy.cm and the C w from 9.6 to 17.5 mGy. All results were found to be lower than the reference values internationally recommended by ICRP 87 and the European Community 16262 (30 mGy and 650 mGy.cm). The large dose ranges suggest that optimization of patient dose reduction is still possible without losses in the image quality and new reference dose levels could be recommended after a large survey to be carried out in the region. (author)

  3. Rectal dose assessment in patients submitted to high-dose-rate brachytherapy for uterine cervix cancer

    International Nuclear Information System (INIS)

    Oliveira, Jetro Pereira de; Batista, Delano Valdivino Santos; Bardella, Lucia Helena; Carvalho, Arnaldo Rangel

    2009-01-01

    Objective: The present study was aimed at developing a thermoluminescent dosimetric system capable of assessing the doses delivered to the rectum of patients submitted to high-dose-rate brachytherapy for uterine cervix cancer. Materials and methods: LiF:Mg,Ti,Na powder was the thermoluminescent material utilized for evaluating the rectal dose. The powder was divided into small portions (34 mg) which were accommodated in a capillary tube. This tube was placed into a rectal probe that was introduced into the patient's rectum. Results: The doses delivered to the rectum of six patients submitted to high-dose-rate brachytherapy for uterine cervix cancer evaluated by means of thermoluminescent dosimeters presented a good agreement with the planned values based on two orthogonal (anteroposterior and lateral) radiographic images of the patients. Conclusion: The thermoluminescent dosimetric system developed in the present study is simple and easy to be utilized as compared to other rectal dosimetry methods. The system has shown to be effective in the evaluation of rectal doses in patients submitted to high-dose-rate brachytherapy for uterine cervix cancer. (author)

  4. Patient dose assessment in different diagnostic procedures in nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Sena, E de; Bejar, M J; Berenguer, R [Servicio de Radiofisica y Proteccion Radiologica, Salamanca (Spain); Ruano, R; Tamayo, P [Servicio de Medicina Nuclear, Hospital Universitario de Salamanca (Spain)

    2001-03-01

    Effective doses have been estimated for 314 patients under diagnostic procedures in a Nuclear Medicine Department using data reported in ICRP-80 and RIDIC (Radiation Internal Dose Information Center). Data on administered activity, radiopharmaceutical and administration route, age and sex of the patients have been collected. Doses in the most exposed critical organ for every protocol, doses in uterus, doses in fetus versus the stage of pregnancy (in case the female patient was pregnant) and doses for nursing infants have been also estimated. Ga-67 studies give the highest effective doses per protocol followed by cardiac SPECT procedures using Tl-201 chloride. Ga-67 studies also give the highest absorbed doses in uterus. Due to not administering different activities, depending on height and weight of adults, women receive doses about 20% higher than men. This would be a practice to modify in the future in order to optimise doses. (author)

  5. Patient dose assessment in different diagnostic procedures in nuclear medicine

    International Nuclear Information System (INIS)

    Sena, E. de; Bejar, M.J.; Berenguer, R.; Ruano, R.; Tamayo, P.

    2001-01-01

    Effective doses have been estimated for 314 patients under diagnostic procedures in a Nuclear Medicine Department using data reported in ICRP-80 and RIDIC (Radiation Internal Dose Information Center). Data on administered activity, radiopharmaceutical and administration route, age and sex of the patients have been collected. Doses in the most exposed critical organ for every protocol, doses in uterus, doses in fetus versus the stage of pregnancy (in case the female patient was pregnant) and doses for nursing infants have been also estimated. Ga-67 studies give the highest effective doses per protocol followed by cardiac SPECT procedures using Tl-201 chloride. Ga-67 studies also give the highest absorbed doses in uterus. Due to not administering different activities, depending on height and weight of adults, women receive doses about 20% higher than men. This would be a practice to modify in the future in order to optimise doses. (author)

  6. Assessment of patient radiation doses during routine diagnostic radiography examinations

    International Nuclear Information System (INIS)

    Adam, Asim Karam Aldden Adam

    2015-11-01

    Medical applications of radiation represent the largest source of exposure to general population. Accounting for 3.0 mSv against an estimated 2.4 mSv from a natural back ground in United States. The association of ionizing radiation an cancer risk is assumed to be continuos and graded over the entire range of exposure, The objective of this study is to evaluate the patient radiation doses in radiology departments in Khartoum state. A total of 840 patients ? during two in the following hospitals Khartoum Teaching Hospital (260 patients), Fedail specialized hospital ( 261 patients). National Ribat University hospital ( 189 patients) and Engaz hospital (130 patients). Patient doses were measured for 9 procedures. The Entrance surface Air Kerma (ESAK) was quantified using x-ray unit output by Unifiers xi dose rate meter( Un fore inc. Billdal. Sweden) and patient exposure parameters. The mean patient age. Weight and Body Mass index (BMI) were 42.6 year 58/4 kg and 212 kg/m respectively. The mean patient doses, kv and MAS and E.q was 0.35 mGy per procedures 59.9 volt 19.8 Ampere per second 0.32 Sv . Patient doses were comparable with previous studies. Patient radiation doses showed considerable difference between hospitals due to x- ray systems exposure settings and patient weight. Patient are exposed to unnecessary radiation.(Author)

  7. Assessment of patients' skin dose during interventional cardiology procedures

    International Nuclear Information System (INIS)

    Tsapaki, V.; Vardalaki, E.; Kottou, S.; Molfetas, M.; Neofotistou, V.

    2002-01-01

    During the last 30 years the use of Interventional Cardiology (IC) procedures has increased significantly, mainly due to the benefits and advantages of the method that offers more accurate diagnosis and treatment along with less complications and hospitalization. However, IC procedures are based on the use of x-ray radiation, mostly localized at certain areas of patient's body and for extended periods of time. Consequently, patient may receive high radiation dose and deterministic effects, such as erythema, epilation or even dermal necrosis may be observed. Therefore, the need for reducing radiation dose is highly important. In order to achieve this, good knowledge of the dose levels delivered to the patient during IC procedures is essential since radiation effects are known to increase with dose. It is of great interest to know the point where the maximum skin dose (MSD) is noted since individual sensitivity may vary. MSDs greater than 1 Gy should be recorded. Patient dosimetry during IC procedures is a complex task since these type of procedures depend on various factors, such as complexity and severity of case, different specifications of x-ray equipment and patient's physical characteristics. Moreover, cardiologist's experience plays an important role. For these reasons, Food and Drug Administration (FDA), the International Commission on Radiological Protection (ICRP) as well as the World Health Organization (WHO), have published documents on radiation safety and ways to reduce skin injuries during IC procedures. Various methods have been proposed for measuring MSD such as the use of slow radiotherapy films, thermoluminescent detectors (TLD), scintillation detectors, Dose-Area Product (DAP) meter, as well as a combination of DAP and air kerma. A literature review on MSDs measured during IC procedures showed that doses ranged from 300 to 43000 mGy

  8. Assessment of doses due to secondary neutrons received by patient treated by proton therapy

    International Nuclear Information System (INIS)

    Sayah, R.; Martinetti, F.; Donadille, L.; Clairand, I.; Delacroix, S.; De Oliveira, A.; Herault, J.

    2010-01-01

    Proton therapy is a specific technique of radiotherapy which aims at destroying cancerous cells by irradiating them with a proton beam. Nuclear reactions in the device and in the patient himself induce secondary radiations involving mainly neutrons which contribute to an additional dose for the patient. The author reports a study aimed at the assessment of these doses due to secondary neutrons in the case of ophthalmological and intra-cranial treatments. He presents a Monte Carlo simulation of the room and of the apparatus, reports the experimental validation of the model (dose deposited by protons in a water phantom, ambient dose equivalent due to neutrons in the treatment room, absorbed dose due to secondary particles in an anthropomorphic phantom), and the assessment with a mathematical phantom of doses dues to secondary neutrons received by organs during an ophthalmological treatment. He finally evokes current works of calculation of doses due to secondary neutrons in the case of intra-cranial treatments

  9. Evaluation of various approaches for assessing dose indicators and patient organ doses resulting from radiotherapy cone-beam CT

    International Nuclear Information System (INIS)

    Rampado, Osvaldo; Giglioli, Francesca Romana; Rossetti, Veronica; Ropolo, Roberto; Fiandra, Christian; Ragona, Riccardo

    2016-01-01

    Purpose: The aim of this study was to evaluate various approaches for assessing patient organ doses resulting from radiotherapy cone-beam CT (CBCT), by the use of thermoluminescent dosimeter (TLD) measurements in anthropomorphic phantoms, a Monte Carlo based dose calculation software, and different dose indicators as presently defined. Methods: Dose evaluations were performed on a CBCT Elekta XVI (Elekta, Crawley, UK) for different protocols and anatomical regions. The first part of the study focuses on using PCXMC software (PCXMC 2.0, STUK, Helsinki, Finland) for calculating organ doses, adapting the input parameters to simulate the exposure geometry, and beam dose distribution in an appropriate way. The calculated doses were compared to readouts of TLDs placed in an anthropomorphic Rando phantom. After this validation, the software was used for analyzing organ dose variability associated with patients’ differences in size and gender. At the same time, various dose indicators were evaluated: kerma area product (KAP), cumulative air-kerma at the isocenter (K_a_i_r), cone-beam dose index, and central cumulative dose. The latter was evaluated in a single phantom and in a stack of three adjacent computed tomography dose index phantoms. Based on the different dose indicators, a set of coefficients was calculated to estimate organ doses for a range of patient morphologies, using their equivalent diameters. Results: Maximum organ doses were about 1 mGy for head and neck and 25 mGy for chest and pelvis protocols. The differences between PCXMC and TLDs doses were generally below 10% for organs within the field of view and approximately 15% for organs at the boundaries of the radiation beam. When considering patient size and gender variability, differences in organ doses up to 40% were observed especially in the pelvic region; for the organs in the thorax, the maximum differences ranged between 20% and 30%. Phantom dose indexes provided better correlation with organ doses

  10. Development of Computational Procedure for Assessment of Patient Dose in Multi-Detector Computed Tomography

    International Nuclear Information System (INIS)

    Park, Dong Wook

    2007-02-01

    Technological development to improve the quality and speed with which images are obtained have fostered the growth of frequency and collective effective dose of CT examination. Especially, High-dose x-ray technique of CT has increased in the concern of patient dose. However CTDI and DLP in CT dosimetry leaves something to be desired to evaluate patient dose. And even though the evaluation of effective dose in CT practice is required for comparison with other radiography, it's not sufficient to show any estimation because it's not for medical purpose. Therefore the calculation of effective dose in CT procedure is needed for that purpose. However modelling uncertainties will be due to insufficient information from manufacturing tolerances. Therefore the purpose of this work is development of computational procedure for assessment of patient dose through the experiment for getting essential information in MDCT. In order to obtain exact absorbed dose, normalization factors must be created to relate simulated dose values with CTDI air measurement. The normalization factors applied to the calculation of CTDI 100 using axial scanning and organ effective dose using helical scanning. The calculation of helical scanning was compared with the experiment of Groves et al.(2004). The result has a about factor 2 of the experiment. It seems because AEC is not simulated. In several studies, when AEC applied to a CT examination, approximately 20-30% dose reduction was appeared. Therefore the study of AEC simulation should be added and modified

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

    Science.gov (United States)

    Hanlon, Justin Mitchell

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

  12. Assessment of mean glandular dose to patients from digital mammography systems

    International Nuclear Information System (INIS)

    Pwamang, Caroline K.

    2016-07-01

    Mean glandular dose assessment of patients undergoing digital mammography examination has been done. A total of 297 patient data was used for the study. Basic Quality Control tests were done to ascertain the performance of the equipment used. The results of Quality Control tests indicated that the three Mammography units used for this study were functioning within the internationally acceptable performance criteria. Patients with a breast thickness of 30 mm within the two age groups of 40-49 yrs and 50-64 yrs received doses slightly higher than the acceptable dose levels. A patient in the category 40-49 yrs with breast thickness of 30 mm received 1.83 mGy as calculated Mean Glandular Dose, 2.10 mGy was the recorded dose and 1.58 mGy was recorded under the age group 50-64 yrs. These values have deviated by -22%, -40%, and -5.33% respectively from 1.5 mGy which is the recommended dose for a breast thickness of 30 mm. Also patients with breast thickness of 70 mm under the age group 40–49 yrs had a recorded dose of 6.58 mGy, which deviated by -1.21% from the recommended value of 6.5 mGy for that breast thickness. Aside these values, all the other values were within the recommended dose values. The percentage deviation between the recommended values and the calculated values was within ±25% which was a working limit that was set for this work. Doses delivered by the Full-field Digital mammography equipment were higher than doses delivered by the Computered Radiography equipment. The calculated Mean Glandular Doses for the three facilities were within recommended dose values. (author)

  13. Assessment of CT dose to the fetus and pregnant female patient using patient-specific computational models

    DEFF Research Database (Denmark)

    Xie, Tianwu; Poletti, Pierre-Alexandre; Platon, Alexandra

    2018-01-01

    of pregnant patients and the embedded foetus, we developed a methodology for construction of patient-specific voxel-based computational phantoms based on existing standardised hybrid computational pregnant female phantoms. We estimated the maternal absorbed dose and foetal organ dose for 30 pregnant patients...... for assessment of the radiation risks to pregnant patients and the foetus from various CT scanning protocols, thus guiding the decision-making process. KEY POINTS: • In CT examinations, the absorbed dose is non-uniformly distributed within foetal organs. • This work reports, for the first time, estimates...

  14. Assessing patient dose in interventional fluoroscopy using patient-dependent hybrid phantoms

    Science.gov (United States)

    Johnson, Perry Barnett

    Interventional fluoroscopy uses ionizing radiation to guide small instruments through blood vessels or other body pathways to sites of clinical interest. The technique represents a tremendous advantage over invasive surgical procedures, as it requires only a small incision, thus reducing the risk of infection and providing for shorter recovery times. The growing use and increasing complexity of interventional procedures, however, has resulted in public health concerns regarding radiation exposures, particularly with respect to localized skin dose. Tracking and documenting patient-specific skin and internal organ dose has been specifically identified for interventional fluoroscopy where extended irradiation times, multiple projections, and repeat procedures can lead to some of the largest doses encountered in radiology. Furthermore, inprocedure knowledge of localized skin doses can be of significant clinical importance to managing patient risk and in training radiology residents. In this dissertation, a framework is presented for monitoring the radiation dose delivered to patients undergoing interventional procedures. The framework is built around two key points, developing better anthropomorphic models, and designing clinically relevant software systems for dose estimation. To begin, a library of 50 hybrid patient-dependent computational phantoms was developed based on the UF hybrid male and female reference phantoms. These phantoms represent a different type of anthropomorphic model whereby anthropometric parameters from an individual patient are used during phantom selection. The patient-dependent library was first validated and then used in two patient-phantom matching studies focused on cumulative organ and local skin dose. In terms of organ dose, patient-phantom matching was shown most beneficial for estimating the dose to large patients where error associated with soft tissue attenuation differences could be minimized. For small patients, inherent difference

  15. Assessment of CT dose to the fetus and pregnant female patient using patient-specific computational models

    Energy Technology Data Exchange (ETDEWEB)

    Xie, Tianwu; Poletti, Pierre-Alexandre; Platon, Alexandra; Becker, Christoph D. [Geneva University Hospital, Department of Medical Imaging and Information Sciences, Geneva (Switzerland); Zaidi, Habib [Geneva University Hospital, Department of Medical Imaging and Information Sciences, Geneva (Switzerland); Geneva University, Geneva Neuroscience Center, Geneva (Switzerland); University Medical Center Groningen, Department of Nuclear Medicine and Molecular Imaging, University of Groningen, Groningen (Netherlands); University of Southern Denmark, Department of Nuclear Medicine, Odense (Denmark); Geneva University Hospital, Division of Nuclear Medicine and Molecular Imaging, Geneva (Switzerland)

    2018-03-15

    This work provides detailed estimates of the foetal dose from diagnostic CT imaging of pregnant patients to enable the assessment of the diagnostic benefits considering the associated radiation risks. To produce realistic biological and physical representations of pregnant patients and the embedded foetus, we developed a methodology for construction of patient-specific voxel-based computational phantoms based on existing standardised hybrid computational pregnant female phantoms. We estimated the maternal absorbed dose and foetal organ dose for 30 pregnant patients referred to the emergency unit of Geneva University Hospital for abdominal CT scans. The effective dose to the mother varied from 1.1 mSv to 2.0 mSv with an average of 1.6 mSv, while commercial dose-tracking software reported an average effective dose of 1.9 mSv (range 1.7-2.3 mSv). The foetal dose normalised to CTDI{sub vol} varies between 0.85 and 1.63 with an average of 1.17. The methodology for construction of personalised computational models can be exploited to estimate the patient-specific radiation dose from CT imaging procedures. Likewise, the dosimetric data can be used for assessment of the radiation risks to pregnant patients and the foetus from various CT scanning protocols, thus guiding the decision-making process. (orig.)

  16. Assessment of patient doses and image quality in X-ray diagnostics in Norway

    International Nuclear Information System (INIS)

    Olerud, H.M.

    1998-01-01

    Results from other industrialized countries indicate that the annual number of diagnostic procedures approaches one for every member of the population, and in many cases the individual radiation doses are higher than from any other human activity. Furthermore, the doses to patients for the same type of examination differ widely from place to place, suggesting that there is a considerable potential for dose reduction. This motivated an investigation of the diagnostic use of X-rays in Norway. The trends in the number of X-ray examinations performed annually have been studied. The patient doses (all diagnostics) and image quality (mammography and computed tomography) have been assessed for various radiological procedures. This form the basis for the assessment of total collective effective dose (CED) from X-rays in Norway, and further risk estimates. The radiological practice has then been evaluated according to the radiation protection principles of justification and optimisation. Based on the 1993 examination frequency, the total CED was assessed to 3400 manSv (0.78 mSv/inhabitant). It is estimated that this radiation burden may cause about 100 excess cancer deaths annually. The frequency of CT examination has doubled every fifth year, and did in 1993 represent 7% of the total number of examinations and 30% of the total CED. 129 refs

  17. Assessment of patient doses and image quality in X-ray diagnostics in Norway

    Energy Technology Data Exchange (ETDEWEB)

    Olerud, H M

    1998-06-01

    Results from other industrialized countries indicate that the annual number of diagnostic procedures approaches one for every member of the population, and in many cases the individual radiation doses are higher than from any other human activity. Furthermore, the doses to patients for the same type of examination differ widely from place to place, suggesting that there is a considerable potential for dose reduction. This motivated an investigation of the diagnostic use of X-rays in Norway. The trends in the number of X-ray examinations performed annually have been studied. The patient doses (all diagnostics) and image quality (mammography and computed tomography) have been assessed for various radiological procedures. This form the basis for the assessment of total collective effective dose (CED) from X-rays in Norway, and further risk estimates. The radiological practice has then been evaluated according to the radiation protection principles of justification and optimisation. Based on the 1993 examination frequency, the total CED was assessed to 3400 manSv (0.78 mSv/inhabitant). It is estimated that this radiation burden may cause about 100 excess cancer deaths annually. The frequency of CT examination has doubled every fifth year, and did in 1993 represent 7% of the total number of examinations and 30% of the total CED. 129 refs.

  18. Quantification of micronuclei in blood lymphocytes of patients exposed to gamma radiation for dose absorbed assessment

    International Nuclear Information System (INIS)

    Barbosa, Isvania Maria Serafim da Silva

    2003-02-01

    Dose assessment in an important step to evaluate biological effects as a result of individual exposure to ionizing radiation. The use of cytogenetic dosimetry based on the quantification of micronuclei in lymphocytes is very important to complement physical dosimetry, since the measurement of absorbed dose cannot be always performed. In this research, the quantification of micronuclei was carried out in order to evaluate absorbed dose as a result of radiotherapy with 60 Co, using peripheral blood samples from 5 patients with cervical uterine cancer. For this purpose, an aliquot of whole blood from the individual patients was added in culture medium RPMI 1640 supplemented with fetal calf serum and phytohaemagglutinin. The culture was incubated for 44 hours. Henceforth, cytochalasin B was added to block the dividing lymphocytes in cytokinesis. The culture was returned to the incubator for further of 28 hours. Thus, cells were harvested, processed and analyzed. Values obtained considering micronuclei frequency after pelvis irradiation with absorption of 0,08 Gy and 1,8 Gy were, respectively, 0,0021 and 0,052. These results are in agreement with some recent researches that provided some standard values related to micronuclei frequency induced by gamma radiation exposure in different exposed areas for the human body. The results presented in this report emphasizes biological dosimetry as an important tool for dose assessment of either total or partial-body exposure to ionizing radiation, mainly in retrospective dose investigation. (author)

  19. Assessment of radiation doses to adult patients in computed tomography procedures

    International Nuclear Information System (INIS)

    Kabashi, Kabashi Hommeda Yosif

    2015-10-01

    The purpose of this study was to assess radiation dose and estimate the effective dose in three different detectors of CT scanners (64 slices, 16 slices and dual slice) for routine CT investigation. A total of 60 patients were examined in this study. 20 patients for dual slice (10 patient for chest and 10 for abdomen, 20 patient for sixteen slices (10 for chest and 10 for abdomen ) and 20 for sixty four slices (10 for chest and 10 for abdomen). The mean dose values for CT chest for sixteen slices were DLP 152.4±56,76 mGy.cm, CTDIvo1 4.53±1.47 mGy ED 2.13±0.974 mSv, while for dual slice the mean values were DLP is 167±55,51 mGy.cm. CTDIvo1 5.02±1.41 mGy ED 2.3±0.77 mSv, while the mean dose values for sixty four slice were DLP 567±43.63 mGy.cm,CTDIvo1 15.08±0.252 ED 7.9±0.61 mSv and for CT abdomen the mean dose values for sixteen slices were DLP 306.6±43.63 mGy.cm, CTDIvo1 6.45±3.31 mGy ED 4.59±1.83 mSv, while for dual slice the mean dose values were DLP 208±78.46 mGy.cm, CTDIvo1 27±1.46 mGy ED 3.12±1.18 mSv, while for sixty four slices the mean dose values were DLP 694.6±28.44 mGy.cm, CTDIvol 121.56±0.250 mGy ED 10.42±0.43 mSv dual slice delivered the least radiation dose while 16 and 64 slice scanners delivered the highest radiation dose. CT dose optimization protocol is not implemented in all departments. (author)

  20. WAZA-ARI. A dose assessment system for patients in CT scan

    International Nuclear Information System (INIS)

    Sato, Kaoru; Takahashi, Fumiaki; Endo, Akira; Ono, Koji; Ban, Nobuhiko; Hasegawa, Takayuki; Katsunuma, Yasushi; Yoshitake, Takayasu; Kai, Michiaki

    2015-01-01

    The Japan Atomic Energy Agency (JAEA) are now developing WAZA-ARI for improvement of management of exposure doses due to CT examination under the joint research with the Oita University of Nursing and Health Sciences. The trial version of WAZA-ARI has been released on 21 December 2012. In trial version, users can perform dose assessment by using organ dose database based on the average adult Japanese male (JM-103) and female (JF-103) voxel phantoms and a 4 years old female voxel phantom (UFF4). The homepage of WAZA-ARI has been accessed over 1000 times per month and 28421 times by the end of September 2014. We are developing WAZA-ARI version 2 as the extension version of dose calculation functions of WAZA-ARI. WAZA-ARI version 2 will be released by the end of March 2015. In WAZA-ARI version 2. Users can upload dose calculation results to WAZA-ARI version 2 server, and utilize improvement of the dose management of patients and the optimization of CT scan conditions. (author)

  1. Dose assessment of the patient and the helper in emergency head computed tomography

    International Nuclear Information System (INIS)

    Chang, Rong-Chou; Yu, Cheng-Ching; Hsu, Fang-Yuh; Chen, Tou-Rong; Hsu, Shih-Ming; Tyan, Yeu-Sheng

    2011-01-01

    Computed Tomography (CT) becomes more and more important and is frequently used in modern diagnostic techniques. CT offers an effective diagnosis on lesion and pathology; however, it also delivers a radiation dose to patients. Besides, in some special emergency cases, the patient may require someone to help him in the examination room to perform the head CT, due to the patient lost intellectual and operational capacity. This study evaluated the delivered radiation dose and the risk of radiation-induced cancer for the patient and for the helper after carrying out the emergent head CT examination. A Rando phantom with thermoluminescent dosimeter (TLD) chips inside relevant organs was used to simulate the patient during head CT examination. An effective dose of 2.06 ± 0.16 mSv and 1.46 ± 0.07 mSv without and with wearing the lead apron were found respectively, considering ICRP 60 recommendation. ICRP 103 recommendations the readings would have been 1.29 ± 0.15 mSv and 0.71 ± 0.04 mSv. The effective dose determined from the dose-length product (DLP) method (2.19 mSv) was similar to the value (2.06 ± 0.16 mSv) estimated by TLD method considering the ICRP 60 recommendation (without lead apron). Assuming a 5% total risk for fatal cancer per Sv in the general population, risk of radiation-induced cancer for patients were 1.03 × 10 −2 % (without lead apron) and 7.80 × 10 −3 % (with lead apron) for ICRP 60, and were 6.45 × 10 −3 % (without lead apron) and 3.55 × 10 −3 % (with lead apron) for ICRP 103. The dose received by the helper was assessed by wearing a personal badge. The helper during emergent head CT examination may receive a personal dose equivalent (H p (10)) of 19.36 ± 5.89 μSv and 138.81 ± 101.28 μSv with and without lead apron, respectively, at distance of 0.3–1 m from the center of CT scanner. Based on the observed dose reduction of a factor of 7.17 we recommend that helpers wear lead apron in the CT examination room.

  2. Assessment of postoperative changes in antihypertensive drug consumption in patients with primary aldosteronism using the defined daily dose

    Directory of Open Access Journals (Sweden)

    Takanobu Utsumi

    2014-10-01

    Conclusion: The defined daily dose is a useful tool for assessing total changes in the consumption of antihypertensive drugs in patients with primary aldosteronism. Using the defined daily dose, clinicians could explain in detail to patients with primary aldosteronism the predicted postoperative change in antihypertensive drug consumption.

  3. Kodak EDR2 film for patient skin dose assessment in cardiac catheterization procedures.

    Science.gov (United States)

    Morrell, R E; Rogers, A T

    2006-07-01

    Patient skin doses were measured using Kodak EDR2 film for 20 coronary angiography (CA) and 32 percutaneous transluminal coronary angioplasty (PTCA) procedures. For CA, all skin doses were well below 1 Gy. However, 23% of PTCA patients received skin doses of 1 Gy or more. Dose-area product (DAP) was also recorded and was found to be an inadequate indicator of maximum skin dose. Practical compliance with ICRP recommendations requires a robust method for skin dosimetry that is more accurate than DAP and is applicable over a wider dose range than EDR2 film.

  4. Rectal dose assessment in patients submitted to high-dose-rate brachytherapy for uterine cervix cancer; Avaliacao da dose no reto em pacientes submetidas a braquiterapia de alta taxa de dose para o tratamento do cancer do colo uterino

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Jetro Pereira de [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Faculdade de Medicina; Rosa, Luiz Antonio Ribeiro da [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)], e-mail: lrosa@ird.gov.br; Batista, Delano Valdivino Santos; Bardella, Lucia Helena [Instituto Nacional de Cancer (INCA), Rio de Janeiro, RJ (Brazil). Unit of Medical Physics; Carvalho, Arnaldo Rangel [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Lab. of Thermoluminescent Dosimetry

    2009-03-15

    Objective: The present study was aimed at developing a thermoluminescent dosimetric system capable of assessing the doses delivered to the rectum of patients submitted to high-dose-rate brachytherapy for uterine cervix cancer. Materials and methods: LiF:Mg,Ti,Na powder was the thermoluminescent material utilized for evaluating the rectal dose. The powder was divided into small portions (34 mg) which were accommodated in a capillary tube. This tube was placed into a rectal probe that was introduced into the patient's rectum. Results: The doses delivered to the rectum of six patients submitted to high-dose-rate brachytherapy for uterine cervix cancer evaluated by means of thermoluminescent dosimeters presented a good agreement with the planned values based on two orthogonal (anteroposterior and lateral) radiographic images of the patients. Conclusion: The thermoluminescent dosimetric system developed in the present study is simple and easy to be utilized as compared to other rectal dosimetry methods. The system has shown to be effective in the evaluation of rectal doses in patients submitted to high-dose-rate brachytherapy for uterine cervix cancer. (author)

  5. Development of low-dose protocols for thin-section CT assessment of cystic fibrosis in pediatric patients.

    LENUS (Irish Health Repository)

    O'Connor, Owen J

    2010-12-01

    To develop low-dose thin-section computed tomographic (CT) protocols for assessment of cystic fibrosis (CF) in pediatric patients and determine the clinical usefulness thereof compared with chest radiography.

  6. Assessment of mean glandular dose for patients in mammography in some Hospitals in Khartoum state

    International Nuclear Information System (INIS)

    Abu Elmola, Alaa Mahdi

    2016-12-01

    A mammography examination facilitates the early detection of breast cancer. However, the potential risk of radiation- induced carcinogenesis is also increased with such a procedure. Thus assessment of the breast dose is important. The objective of this study was to determine the mean glandular dose (MGD) resulting from cranio caudal(CC) and mediolateral oblique (MLO) views in one breast and the total dose per woman in Sudan, and to identify the factors affecting it. Measurements were performed to estimate mean glandular doses for 60 patients who underwent mammography examination in two clinics in Khartoum, Sudan.Doses were studied in RCH and NDC, centers which were using computed radiography(CR)devices. The piranha system was used for determining the MGD in this work. The characteristics of the radiographic equipment and the exposure data of each patient were recorded using designed format. The MGD was calculated from the measured incident Air kerma using appropriate conversion coefficients. The range of CBT was (1-7)cm for two projections. The respective averages for the CC and MLO projections were (4.55±1.38)mGy and (4.15±1.33) mGy, respectively. The average MGD per image was (4.3±1.35)mGy. The MGD per women was (8.6±1.35)mGy. The mean±SD MGD per image in the present study was lower than most of similar reports. The average MGD values recorded in this study were above the limiting value of the Institute of Physical Sciences in Medicine(2.0 mGy) and American College of Radiology (3.0 mGy recommendation. This suggests that mammography x-ray generators in this case are not capable of achieving acceptable dose levels for patients safety. Therefore, with consideration of all other factors, quality control program tests must be carried out periodically and frequently of the mammography equipment.(Author)

  7. Dose, image quality and spine modeling assessment of biplanar EOS micro-dose radiographs for the follow-up of in-brace adolescent idiopathic scoliosis patients.

    Science.gov (United States)

    Morel, Baptiste; Moueddeb, Sonia; Blondiaux, Eleonore; Richard, Stephen; Bachy, Manon; Vialle, Raphael; Ducou Le Pointe, Hubert

    2018-05-01

    The aim of this study was to compare the radiation dose, image quality and 3D spine parameter measurements of EOS low-dose and micro-dose protocols for in-brace adolescent idiopathic scoliosis (AIS) patients. We prospectively included 25 consecutive patients (20 females, 5 males) followed for AIS and undergoing brace treatment. The mean age was 12 years (SD 2 years, range 8-15 years). For each patient, in-brace biplanar EOS radiographs were acquired in a standing position using both the conventional low-dose and micro-dose protocols. Dose area product (DAP) was systematically recorded. Diagnostic image quality was qualitatively assessed by two radiologists for visibility of anatomical structures. The reliability of 3D spine modeling between two operators was quantitatively evaluated for the most clinically relevant 3D radiological parameters using intraclass correlation coefficient (ICC). The mean DAP for the posteroanterior and lateral acquisitions was 300 ± 134 and 433 ± 181 mGy cm 2 for the low-dose radiographs, and 41 ± 19 and 81 ± 39 mGy cm 2 for micro-dose radiographs. Image quality was lower with the micro-dose protocol. The agreement was "good" to "very good" for all measured clinical parameters when comparing the low-dose and micro-dose protocols (ICC > 0.73). The micro-dose protocol substantially reduced the delivered dose (by a factor of 5-7 compared to the low-dose protocol) in braced children with AIS. Although image quality was reduced, the micro-dose protocol proved to be adapted to radiological follow-up, with adequate image quality and reliable clinical measurements. These slides can be retrieved under Electronic Supplementary Material.

  8. Health risk assessment of doses to patients\\' eyes from dental X-ray ...

    African Journals Online (AJOL)

    The skin entry dose to patients\\' eyes during dental x-ray examination was carried out on one hundred and ten patients comprising infants and adult of both sexes. The dose measurements was performed at Alpha dental centre, Ibadan, using Lithium fluoride thermoluminiscent dosimeters (TLD). The results of the study ...

  9. Development of the voxel computational phantoms of pediatric patients and their application to organ dose assessment

    Science.gov (United States)

    Lee, Choonik

    A series of realistic voxel computational phantoms of pediatric patients were developed and then used for the radiation risk assessment for various exposure scenarios. The high-resolution computed tomographic images of live patients were utilized for the development of the five voxel phantoms of pediatric patients, 9-month male, 4-year female, 8-year female, 11-year male, and 14-year male. The phantoms were first developed as head and torso phantoms and then extended into whole body phantoms by utilizing computed tomographic images of a healthy adult volunteer. The whole body phantom series was modified to have the same anthropometrics with the most recent reference data reported by the international commission on radiological protection. The phantoms, named as the University of Florida series B, are the first complete set of the pediatric voxel phantoms having reference organ masses and total heights. As part of the dosimetry study, the investigation on skeletal tissue dosimetry methods was performed for better understanding of the radiation dose to the active bone marrow and bone endosteum. All of the currently available methodologies were inter-compared and benchmarked with the paired-image radiation transport model. The dosimetric characteristics of the phantoms were investigated by using Monte Carlo simulation of the broad parallel beams of external phantom in anterior-posterior, posterior-anterior, left lateral, right lateral, rotational, and isotropic angles. Organ dose conversion coefficients were calculated for extensive photon energies and compared with the conventional stylized pediatric phantoms of Oak Ridge National Laboratory. The multi-slice helical computed tomography exams were simulated using Monte Carlo simulation code for various exams protocols, head, chest, abdomen, pelvis, and chest-abdomen-pelvis studies. Results have found realistic estimates of the effective doses for frequently used protocols in pediatric radiology. The results were very

  10. Enjebi Island dose assessment

    International Nuclear Information System (INIS)

    Robison, W.L.; Conrado, C.L.; Phillips, W.A.

    1987-07-01

    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 137 Cs 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

  11. Assessment of fetal radiation dose to patients and staff in diagnostic radiology

    International Nuclear Information System (INIS)

    Osei, E.K.

    2000-07-01

    A major source of uncertainty in the estimation of fetal absorbed radiation dose is the influence of fetal size and position as these change with gestational age. Consequently, dose to the fetus is related to gestational age. Most studies of fetal dose estimation during pregnancy assume that the uterus dose is equal to fetal dose. These dose estimates do not take account of gestational age and individual fetal depth, factors which are significant when calculating dose. To establish both positional and size data for estimation of fetal absorbed dose from radiological examinations, the depths from the mother's anterior surface to the mid-line of the fetal head and abdomen were measured from ultrasound scans in 215 pregnant women. Depths were measured along a ray path projected in the anterior-posterior direction from the mother's abdomen. The fetal size was estimated from measurements of the fetal abdominal and head circumference, femur length and the biparietal diameter. The effects of fetal presentation, maternal bladder volume, placenta location, gestational age and maternal AP thickness on fetal depth and size were analysed. A Monte Carlo (MC) model was developed, and used to derive factors for converting dose-area product and free-in-air entrance surface dose from medical exposure of a pregnant patient to absorbed dose to the uterus/embryo, and for converting uterus dose to fetal dose in the later stages of pregnancy. Also presented are factors for converting thermoluminescence dosimeter reading from occupational exposure of a pregnant worker to equivalent dose to the fetus. The MC model was verified experimentally by direct measurement of uterus depth dose in a female Rando phantom, and also by comparison with other experimental work and MC results in the literature. The application of the various conversion factors is demonstrated by a review of the dose estimation process in 50 cases of fetal irradiation from medical exposures. (author)

  12. Assessment of contralateral breast dose reduction in post mastectomy patients using superflab during EBRT

    International Nuclear Information System (INIS)

    Akanksha, S.; Athiyaman, M.; Hemalatha, A.; Kumar, H.S.

    2016-01-01

    Breast cancer (BC) is most common cancer in women worldwide. External beam radiotherapy (EBRT) is used as adjuvant in most post operative BC cases for loco-regional control. Present study is concerned about dose received by contralateral breast (CLB) during EBRT which results due to scatter from treatment head. Dose to CLB in 18 post operative BC patients were evaluated using CaSO_4-Dy thermoluminiscence dosimeters (TLDs) and effect of superflab is also investigated for dose reduction

  13. Assessment of Patients Radiation Dose During Interventional Radiological Procedure in PPUKM

    International Nuclear Information System (INIS)

    Mohd Khalid Matori; Husaini Salleh; Muhammad Jamal Muhammad Isa

    2014-01-01

    Interventional Radiology (IR) is a relatively new subspecialty of radiology. It is subspecialty where minimally invasive procedures are performed under radiological guidance using X-ray. This procedure can deliver high radiation doses compared with other radiological method due to long screening time. Because of these it is important to determine radiation doses received by patients undergoing IR procedures. It is to ensure that the dose is within the range deemed to be saved. A total of 128 patients undergoing IR procedures in PPUKM between 2012 and 2013 were study retrospectively. Dose area product (DAP) meter were used to measure the integral dose for the whole procedures. Mean kerma-area products for abdomen, head, pelvis, and thorax were 243.1, 107.3, 39.05 and 45.7 Gycm 2 , respectively. This study may provide the useful information which can be use to establish baseline patient dose data for dose optimizing study and carried out a recommendation on effective method of patient dose reduction during IR procedures. A more detail results of this study are presented in this paper. (author)

  14. Assessment of patient dose and radiogenic risks during endoscopic retrograde cholangiopancreatography

    Energy Technology Data Exchange (ETDEWEB)

    Sulieman, A.; Elzaki, M. [Sudan University of Science and Technology, College of Medical Radiologic Science, P. O. Box 1908, Khartoum 11111 (Sudan); Alkhorayef, M.; Babikir, E. [King Saud University, College of Applied Sciences, Radiological Sciences Department, P. O. Box 10219, Riyadh 11433 (Saudi Arabia); Abuzaid, M. [University of Sharjah, College of Health Sciences, Medical Diagnostic Imaging Department, Sharjah (United Arab Emirates); Dalton, A.; Bradley, D., E-mail: Abdelmoneim_a@yahoo.com [University of Surrey, Centre for Nuclear and Radiation Physics, Department of Physics, GU2-7XH, Guildford, Surrey (United Kingdom)

    2015-10-15

    Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive technique that has been used for over 30 years in the diagnosis and management of pancreaticobiliary disorders. The objectives of this study were to evaluate the patient entrance surface air kerma doses (ESAK) and estimate the organ and effective doses during ERCP in three hospitals in Khartoum. A total of 55 patients were examined in three hospitals in Khartoum state, Sudan. Calibrated thermoluminescence dosimeters (TLD)-Gr-200-A)) were used to measure patients ESAK. The overall mean of ESAK for all ERCP procedures was 42.4 mGy. The mean patient ESAK in Fedail, Soba and Ibn sena centers were 26.7 mGy, 26.0 mGy, 72.4 mGy, respectively. The effective doses in three centers were 1.6, 1.56 and 2.67 mSv in that order and the overall mean effective dose was 2.01 mSv. Patient radiation doses vary widely among the different hospitals. Patient ESAK is low compared to previous studies in the light of the current practice. Patient dose was decreased significantly in the last two decades. (Author)

  15. Assessment of patient dose and radiogenic risks during endoscopic retrograde cholangiopancreatography

    International Nuclear Information System (INIS)

    Sulieman, A.; Elzaki, M.; Alkhorayef, M.; Babikir, E.; Abuzaid, M.; Dalton, A.; Bradley, D.

    2015-10-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive technique that has been used for over 30 years in the diagnosis and management of pancreaticobiliary disorders. The objectives of this study were to evaluate the patient entrance surface air kerma doses (ESAK) and estimate the organ and effective doses during ERCP in three hospitals in Khartoum. A total of 55 patients were examined in three hospitals in Khartoum state, Sudan. Calibrated thermoluminescence dosimeters (TLD)-Gr-200-A)) were used to measure patients ESAK. The overall mean of ESAK for all ERCP procedures was 42.4 mGy. The mean patient ESAK in Fedail, Soba and Ibn sena centers were 26.7 mGy, 26.0 mGy, 72.4 mGy, respectively. The effective doses in three centers were 1.6, 1.56 and 2.67 mSv in that order and the overall mean effective dose was 2.01 mSv. Patient radiation doses vary widely among the different hospitals. Patient ESAK is low compared to previous studies in the light of the current practice. Patient dose was decreased significantly in the last two decades. (Author)

  16. Determination of dose to patient in different teams of TC and assessment with international reference levels

    International Nuclear Information System (INIS)

    Ruiz Morales, C.; Fernandez lara, A. A.; Buades Forner, M. J.; Tobarra Gonzalez, B. M.

    2013-01-01

    The increase in CT studies and the differences observed between the different equipment used in our hospital prompted us to determine the doses to patients in different studies and check the results obtained with the reference values published internationally. (Author)

  17. Assessment of patient radiation doses in chest X-ray examinations

    International Nuclear Information System (INIS)

    Orsini, S.; Scribano, V.S.; Merluzzi, F.; Tosca, L.

    1987-01-01

    The paper reports the initial results of a radioprotection programme for diagnostic radiology carried out in a major hospital in Milan. The data cover chest X-ray examinations. The dose values were obtained using different techniques, according to the specific diagnostic requirements in each departement. A wide radiation dose range was observed between the different techniques, with a ratio between maximum and minimum dose > 30 for the skin and the spine. The doses were however lower than those capable of inducing non-stochastic effects by about 10000 and were so low that the probability of a stochastics effect is minimal. Nevertheless, because chest X-rays are performed so frequently, it is recommended that radiologists take greater account of patient dose, as far as compatible with diagnostic requirements. Radiology technicians must strictly observe the regulations for radioprotection of the patient

  18. SU-F-I-38: Patient Organ Specific Dose Assessment in Coronary CT Angiograph Using Voxellaized Volume Dose Index in Monte Carlo Simulation

    Energy Technology Data Exchange (ETDEWEB)

    Fallal, Mohammadi Gh.; Riyahi, Alam N.; Graily, Gh. [Tehran University of Medical Scienced(TUMS), School of Medicine, Department of Nedical Physics and Biomedical Engineering, Tehran (Iran, Islamic Republic of); Paydar, R. [Iran University of Medical Sciences(IUMS), Allied Medicine Faculty, Department of radiation Sciences, Tehran (Iran, Islamic Republic of)

    2016-06-15

    Purpose: Clinical use of multi detector computed tomography(MDCT) in diagnosis of diseases due to high speed in data acquisition and high spatial resolution is significantly increased. Regarding to the high radiation dose in CT and necessity of patient specific radiation risk assessment, the adoption of new method in the calculation of organ dose is completely required and necessary. In this study by introducing a conversion factor, patient organ dose in thorax region based on CT image data using MC system was calculated. Methods: The geometry of x-ray tube, inherent filter, bow tie filter and collimator were designed using EGSnrc/BEAMnrc MC-system component modules according to GE-Light-speed 64-slices CT-scanner geometry. CT-scan image of patient thorax as a specific phantom was voxellised with 6.25mm3 in voxel and 64×64×20 matrix size. Dose to thorax organ include esophagus, lung, heart, breast, ribs, muscle, spine, spinal cord with imaging technical condition of prospectively-gated-coronary CT-Angiography(PGT) as a step and shoot method, were calculated. Irradiation of patient specific phantom was performed using a dedicated MC-code as DOSXYZnrc with PGT-irradiation model. The ratio of organ dose value calculated in MC-method to the volume CT dose index(CTDIvol) reported by CT-scanner machine according to PGT radiation technique has been introduced as conversion factor. Results: In PGT method, CTDIvol was 10.6mGy and Organ Dose/CTDIvol conversion factor for esophagus, lung, heart, breast, ribs, muscle, spine and spinal cord were obtained as; 0.96, 1.46, 1.2, 3.28. 6.68. 1.35, 3.41 and 0.93 respectively. Conclusion: The results showed while, underestimation of patient dose was found in dose calculation based on CTDIvol, also dose to breast is higher than the other studies. Therefore, the method in this study can be used to provide the actual patient organ dose in CT imaging based on CTDIvol in order to calculation of real effective dose(ED) based on organ dose

  19. Assessment of leakage dose in vivo in patients undergoing radiotherapy for breast cancer

    Directory of Open Access Journals (Sweden)

    Peta Lonski

    2018-01-01

    Full Text Available Background and purpose: Accurate quantification of the relatively small radiation doses delivered to untargeted regions during breast irradiation in patients with breast cancer is of increasing clinical interest for the purpose of estimating long-term radiation-related risks. Out-of-field dose calculations from commercial planning systems however may be inaccurate which can impact estimates for long-term risks associated with treatment. This work compares calculated and measured dose out-of-field and explores the application of a correction for leakage radiation. Materials and methods: Dose calculations of a Boltzmann transport equation solver, pencil beam-type, and superposition-type algorithms from a commercial treatment planning system (TPS were compared with in vivo thermoluminescent dosimetry (TLD measurements conducted out-of-field on the contralateral chest at points corresponding to the thyroid, axilla and contralateral breast of eleven patients undergoing tangential beam radiotherapy for breast cancer. Results: Overall, the TPS was found to under-estimate doses at points distal to the radiation field edge with a modern linear Boltzmann transport equation solver providing the best estimates. Application of an additive correction for leakage (0.04% of central axis dose improved correlation between the measured and calculated doses at points greater than 15 cm from the field edge. Conclusions: Application of a correction for leakage doses within peripheral regions is feasible and could improve accuracy of TPS in estimating out-of-field doses in breast radiotherapy. Keywords: Breast radiotherapy, TLD, Leakage dose, Dose calculation algorithm

  20. Assessment of absorbed dose to the ovaries of patients undergoing pelvic CT examination

    Energy Technology Data Exchange (ETDEWEB)

    Tavakoli, H.M.B. [Isfahan Univ. of Medical Sciences (Iran, Islamic Republic of)

    2006-07-01

    Full text of publication follows: Introduction: Although Computed Tomography (CT) procedures constitute about 5% of the total diagnostic radiology procedures but are responsible for about 40% of the total ionizing radiation dose to the general population. As the dose is high especially in the CT of female pelvis, genetic radiation risk is also considerable. Materials and Methods: Radiation doses to the ovaries of the patients undergoing CT examination of the pelvis were measured from 9 different CT scanners available in Isfahan city. For each CT scanner 20 patients were selected. Measurement of organ dose was performed using TLD method. Results and Discussions: Mean and S.D. of absorbed dose to the ovaries from Shimadzo 2500 were 56.6 2.8; from GE Max 640 were 36.8 1.7; from GE Sytec 3000 were 36.6 1.8; from GE Sytec 4000 were 36.6 2.6; from Piker were 38.4 2.1; from Shimadzo 4500 were 36.4 1.2 and from Shimadzo 7800TE 28.2 1.5. Associated risks due to the measured dose are discussed. (author)

  1. Patient's dose assessment during sinus X-rays radiography at 'Hopital du Point G'

    International Nuclear Information System (INIS)

    Sidibe, S.; Sacko, B.Y.; Doucoure, M.; Traore, B.; Traore, I.

    2001-01-01

    Objective: To evaluate the patient's X-rays dose during head radiography for sinusitis; To precise the influence of source-image distance on the patient's dose. Material and method: From May 1997 to January 1999, 83 patients with clinical suspicious sinusitis have been included in this study. Skull radiography in 3 positions (posterior, lateral and Blondeau view) have been achieved for each patient on 24x30 centimeters size films. These radiographies were realised on a Diagnost 7 Masio Philip X-rays machine. Three TLD dosimeters were pasted against every patient target organs (thyroid, right and left eyes). The source-image distance (SID) was 100 centimeters for the first group (35 patients) and 125 centimeters for the second group (48 patients). The selected parameters (high voltage and charge) were as follows: Skull postero-anterior view: 65 to 85 kV, 80 mAs; Skull lateral view: 60 to 75 kV, 80 mAs; Blondeau view (paranasal sinuses): 90 to 95 kV, 100 mAs. Results: All the radiographies were analysed by the same radiologist who didn't know the SID. All the films were of good quality. The patient's dose in millisievert for each target organ were: Group I (SID = 100 cm): Left eye 3,2 (+ ou - 0,66); Right eye 3, 0 (+ ou - 0,82); Thyroid 0,62 (+ ou - 0,09). Group II (SID = 125 cm): Left eye 1,9 (+ ou - 0,48); Right eye 1, 86 (+ ou - 0,50); Thyroid 0,39 (+ ou - 0,08). In conclusion, the increase of SID from 100 to 125 centimeters allows patient's dose reduction by a factor of 1.6 without the alteration of the films quality, hence the reliability of the diagnosis. (author)

  2. 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...

  3. SU-E-T-616: Plan Quality Assessment of Both Treatment Planning System Dose and Measurement-Based 3D Reconstructed Dose in the Patient

    International Nuclear Information System (INIS)

    Olch, A

    2015-01-01

    Purpose: Systematic radiotherapy plan quality assessment promotes quality improvement. Software tools can perform this analysis by applying site-specific structure dose metrics. The next step is to similarly evaluate the quality of the dose delivery. This study defines metrics for acceptable doses to targets and normal organs for a particular treatment site and scores each plan accordingly. The input can be the TPS or the measurement-based 3D patient dose. From this analysis, one can determine whether the delivered dose distribution to the patient receives a score which is comparable to the TPS plan score, otherwise replanning may be indicated. Methods: Eleven neuroblastoma patient plans were exported from Eclipse to the Quality Reports program. A scoring algorithm defined a score for each normal and target structure based on dose-volume parameters. Each plan was scored by this algorithm and the percentage of total possible points was obtained. Each plan also underwent IMRT QA measurements with a Mapcheck2 or ArcCheck. These measurements were input into the 3DVH program to compute the patient 3D dose distribution which was analyzed using the same scoring algorithm as the TPS plan. Results: The mean quality score for the TPS plans was 75.37% (std dev=14.15%) compared to 71.95% (std dev=13.45%) for the 3DVH dose distribution. For 3/11 plans, the 3DVH-based quality score was higher than the TPS score, by between 0.5 to 8.4 percentage points. Eight/11 plans scores decreased based on IMRT QA measurements by 1.2 to 18.6 points. Conclusion: Software was used to determine the degree to which the plan quality score differed between the TPS and measurement-based dose. Although the delivery score was generally in good agreement with the planned dose score, there were some that improved while there was one plan whose delivered dose quality was significantly less than planned. This methodology helps evaluate both planned and delivered dose quality. Sun Nuclear Corporation has

  4. SU-E-T-616: Plan Quality Assessment of Both Treatment Planning System Dose and Measurement-Based 3D Reconstructed Dose in the Patient

    Energy Technology Data Exchange (ETDEWEB)

    Olch, A [University of Southern California, Los Angeles, CA (United States)

    2015-06-15

    Purpose: Systematic radiotherapy plan quality assessment promotes quality improvement. Software tools can perform this analysis by applying site-specific structure dose metrics. The next step is to similarly evaluate the quality of the dose delivery. This study defines metrics for acceptable doses to targets and normal organs for a particular treatment site and scores each plan accordingly. The input can be the TPS or the measurement-based 3D patient dose. From this analysis, one can determine whether the delivered dose distribution to the patient receives a score which is comparable to the TPS plan score, otherwise replanning may be indicated. Methods: Eleven neuroblastoma patient plans were exported from Eclipse to the Quality Reports program. A scoring algorithm defined a score for each normal and target structure based on dose-volume parameters. Each plan was scored by this algorithm and the percentage of total possible points was obtained. Each plan also underwent IMRT QA measurements with a Mapcheck2 or ArcCheck. These measurements were input into the 3DVH program to compute the patient 3D dose distribution which was analyzed using the same scoring algorithm as the TPS plan. Results: The mean quality score for the TPS plans was 75.37% (std dev=14.15%) compared to 71.95% (std dev=13.45%) for the 3DVH dose distribution. For 3/11 plans, the 3DVH-based quality score was higher than the TPS score, by between 0.5 to 8.4 percentage points. Eight/11 plans scores decreased based on IMRT QA measurements by 1.2 to 18.6 points. Conclusion: Software was used to determine the degree to which the plan quality score differed between the TPS and measurement-based dose. Although the delivery score was generally in good agreement with the planned dose score, there were some that improved while there was one plan whose delivered dose quality was significantly less than planned. This methodology helps evaluate both planned and delivered dose quality. Sun Nuclear Corporation has

  5. Retrospective Analysis of Dose Titration and Serum Testosterone Level Assessments in Patients Treated With Topical Testosterone.

    Science.gov (United States)

    Muram, David; Kaltenboeck, Anna; Boytsov, Natalie; Hayes-Larson, Eleanor; Ivanova, Jasmina; Birnbaum, Howard G; Swindle, Ralph

    2015-11-01

    Patterns of care following topical testosterone agent (TTA) initiation are poorly understood. This study aimed to characterize care following TTA initiation and compare results between patients with and without a serum testosterone (T) assay within 30 days before and including TTA initiation. Adult men (N=4,146) initiating TTAs from January 1, 2011, to March 31, 2012, were identified from a commercially insured database. Patients were included if they initiated at recommended starting dose (RSD) and had ≥12 and ≥6 months of continuous eligibility preinitiation (baseline) and postinitiation (study period), respectively. Patients were stratified by preinitiation T assay. Maintenance dose attainment month was determined using unadjusted generalized estimating equations regression to compare dose relative to RSD month by month. Outcomes included maintenance dose attainment month, time to stopping of index TTA refills or a claim for nonindex testosterone replacement therapy (TRT), and proportion of patients with study period T assay or diagnosis of hypogonadism (HG) or another low testosterone condition, and were compared using chi-square and Wilcoxon rank-sum tests for categorical and continuous variables, respectively. Maintenance dose was attained in Month 4 postinitiation, at 115.2% of RSD. Approximately 46% of patients had a preinitiation T assay; these men were more likely to receive a diagnosis of HG or another low testosterone condition, to have a follow-up T assay, to continue treatment by filling a nonindex TRT, and less likely to stop refilling treatment with their index TTA. Differences in care following TTA initiation suggest that preinitiation T assays (i.e., guideline-based care) may be helpful in ensuring treatment benefits. © The Author(s) 2014.

  6. Assessment of radiological parameters and patient dose audit using semi-empirical model

    International Nuclear Information System (INIS)

    Olowookere, C.J.; Onabiyi, B.; Ajumobi, S. A.; Obed, R.I.; Babalola, I. A.; Bamidele, L.

    2011-01-01

    Risk is associated with all human activities, medical imaging is no exception. The risk in medical imaging is quantified using effective dose. However, measurement of effective dose is rather difficult and time consuming, therefore, energy imparted and entrance surface dose are obtained and converted into effective dose using the appropriate conversion factors. In this study, data on exposure parameters and patient characteristics were obtained during the routine diagnostic examinations for four common types of X-ray procedures. A semi-empirical model involving computer software Xcomp5 was used to determine energy imparted per unit exposure-area product, entrance skin exposure(ESE) and incident air kerma which are radiation dose indices. The value of energy imparted per unit exposure-area product ranges between 0.60 and 1.21x 10 -3 JR -1 cm -2 and entrance skin exposure range from 5.07±1.25 to 36.62±27.79 mR, while the incident air kerma range between 43.93μGy and 265.5μGy. The filtrations of two of the three machines investigated were lower than the standard requirement of CEC for the machines used in conventional radiography. The values of and ESE obtained in the study were relatively lower compared to the published data, indicating that patients irradiated during the routine examinations in this study are at lower health risk. The energy imparted per unit exposure- area product could be used to determine the energy delivered to the patient during diagnostic examinations, and it is an approximate indicator of patient risk.

  7. Quality assessment of delineation and dose planning of early breast cancer patients included in the randomized Skagen Trial 1

    DEFF Research Database (Denmark)

    Francolini, Giulio; Thomsen, Mette S; Yates, Esben S

    2017-01-01

    , Dmax, D98%, D95% and D2%) from randomly selected dose plans were assessed. Target volume delineation according to ESTRO guidelines was obtained through atlas based automated segmentation and centrally approved as gold standard (GS). Dice similarity scores (DSC) with original delineations were measured....... No deviations in the dosimetric outcome were found in 76% of the patients, 82% and 95% of the patients had successful coverage of breast/chestwall and CTVn_L2-4-interpectoral. Dosimetric outcomes of original delineation and GS were comparable. CONCLUSIONS: QA showed high protocol compliance and adequate dose...... coverage in most patients. Inter-observer variability in contouring was low. Dose parameters were in harmony with protocol regardless original or GS segmentation....

  8. Patient dose assessment from fluoroscopic procedures at Korle-Bu Teaching Hospital

    International Nuclear Information System (INIS)

    Gyekye, P. K.

    2008-06-01

    Organ and effective dose to ninety (90) patients undergoing myelogram, urethrogram, barium swallow, barium meal and barium enema examinations at the KorIe-Bu Teaching Hospital was estimated using the Monte Carlo Code (PCXMC). Free in air measurements were made with a calibrated ionisation chamber to estimate the entrance surface air kerma for each examination. Evaluation of fluoroscopy beam on time and number of radiographs taken per patient was done for all the examinations considered and studies were done on how they affect patient dose. Dose area product (DAP) was calculated from the entrance surface air kerma and the area of the beam on the surface of the patient and compared with internationally accepted reference levels. Excess relative risk of site specific solid cancer and all solid cancers excluding thyroid and Non-melanoma skin cancers incidences were estimated for the various examinations using Biological Effects of Ionising Radiation VII Committee risk model from the knowledge of the mean effective doses for each examination. The mean effective dose was found to be 0.29 :±: 0.07 mSv for urethrogram, 0.84:±: 0.13 mSv for barium swallow, 3.15 :±: 0.44 mSv for barium meal, 6.24 :±: 0.7 mSv for barium enema and 0.38 :I: 0.05 mSv for myelogram examinations. The estimated mean dose area product (DAP) was found to be 3.55 :±: 0.95 Gycm2 for urethrogram, 16.44:1: 2.60 Gycm2 for barium swallow, 50.81 :±: 7.04 Gycm2 for barium meal, 99.69 :±: 10.85 Gycm2 for barium enema and 9.32 :±: 0.99 Gycm2 for myelogram examinations. The estimated excess relative risk for the occurrence of all solid cancer was found to be 9.5700E-S and 1.6530E-4 for males and females respectively undergoing urethrogram examination, 2.7720E-4 and 4.7880E-4 for males and females respectively undergoing barium swallow examination, 1.0395E-3 and 1.7955E-3 for males and females respectively undergoing barium meal examination, 2.0592E-3 and 3.5568E-3 for males and females respectively

  9. Patient dose assessment in various Interventional radiology and cardiology procedures in Algeria (IAEA regional project results)

    International Nuclear Information System (INIS)

    Khelassi-Toutaoui, Nadia; Merad, Ahmed; Toutaoui, A.E.K.; Bairi, Souad

    2008-01-01

    Full text: Purpose: To evaluate patient doses in Interventional Radiology (IR) and Cardiology (IC) procedures in Algeria, within the framework of an International Atomic Energy Agency (IAEA) regional project on radiation protection of patients and medical exposure control (RAF 9033). Materials and Methods: Three public hospitals (CHU Bab el Oued, CHU Parnet and CHU Mustapha) and one specialised Cardiology Service (Clinique Maouche) were chosen for the study. For Maximum Skin Dose (MSD) evaluation, gafchromic films XR type R were used, placed on patient's back before the procedure. The Dose Area Product (DAP) and MSD were measured in 57 IR and IC procedures, either diagnostic or therapeutic. Results: The results revealed large variations in MSD (0.06-3.3 Gy) and DAP (5.5-332 mGycm 2 ). Mean MSD was 0.227 Gy in cerebral angiography, 0.202 Gy in coronary angiography, 1.162 Gy in Percutaneus Transluminal Coronary Angioplasty (PTCA) and 0.128 in abdominal angiography. The correlation of DAP and MSD was significant (r = 0.7). The correlation was DAP and fluoroscopy time was also significant (r = 0.8). Conclusion: The highest MSD values were found in PTCA which is a therapeutic procedure. Two PTCAs out of the 57 procedures measured in total had MSD over the threshold of 2 Gy for deterministic effects (MSD 1 = 3.0 Gy and MSD 2 3.3 Gy). The large variations in MSD reveal the need to continuously monitor patient doses in IR and IC procedures with special emphasis in PTCA procedure. (author)

  10. A collimated detection system for assessing leakage dose from medical linear accelerators at the patient plane.

    Science.gov (United States)

    Lonski, P; Taylor, M L; Franich, R D; Kron, T

    2014-03-01

    Leakage radiation from linear accelerators can make a significant contribution to healthy tissue dose in patients undergoing radiotherapy. In this work thermoluminescent dosimeters (LiF:Mg,Cu,P TLD chips) were used in a focused lead cone loaded with TLD chips for the purpose of evaluating leakage dose at the patient plane. By placing the TLDs at one end of a stereotactic cone, a focused measurement device is created; this was tested both in and out of the primary beam of a Varian 21-iX linac using 6 MV photons. Acrylic build up material of 1.2 cm thickness was used inside the cone and measurements made with either one or three TLD chips at a given distance from the target. Comparing the readings of three dosimeters in one plane inside the cone offered information regarding the orientation of the cone relative to a radiation source. Measurements in the patient plane with the linac gantry at various angles demonstrated that leakage dose was approximately 0.01% of the primary beam out of field when the cone was pointed directly towards the target and 0.0025% elsewhere (due to scatter within the gantry). No specific 'hot spots' (e.g., insufficient shielding or gaps at abutments) were observed. Focused cone measurements facilitate leakage dose measurements from the linac head directly at the patient plane and allow one to infer the fraction of leakage due to 'direct' photons (along the ray-path from the bremsstrahlung target) and that due to scattered photons.

  11. A collimated detection system for assessing leakage dose from medical linear accelerators at the patient plane

    International Nuclear Information System (INIS)

    Lonski, P.; Kron, T.; Taylor, M.L.; Franich, R.D.

    2014-01-01

    Leakage radiation from linear accelerators can make a significant contribution to healthy tissue dose in patients undergoing radiotherapy. In this work thermoluminescent dosimeters (LiF:Mg,Cu,P TLD chips) were used in a focused lead cone loaded with TLD chips for the purpose of evaluating leakage dose at the patient plane. By placing the TLDs at one end of a stereotactic cone, a focused measurement device is created; this was tested both in and out of the primary beam of a Varian 21-iX linac using 6 MV photons. Acrylic build up material of 1.2 cm thickness was used inside the cone and measurements made with either one or three TLD chips at a given distance from the target. Comparing the readings of three dosimeters in one plane inside the cone offered information regarding the orientation of the cone relative to a radiation source. Measurements in the patient plane with the linac gantry at various angles demonstrated that leakage dose was approximately 0.01 % of the primary beam out of field when the cone was pointed directly towards the target and 0.0025 % elsewhere (due to scatter within the gantry). No specific ‘hot spots’ (e.g., insufficient shielding or gaps at abutments) were observed. Focused cone measurements facilitate leakage dose measurements from the linac head directly at the patient plane and allow one to infer the fraction of leakage due to ‘direct’ photons (along the ray-path from the bremsstrahlung target) and that due to scattered photons.

  12. Assessment of medical radiation exposure to patients and ambient doses in several diagnostic radiology departments

    Science.gov (United States)

    Sulieman, A.; Elhadi, T.; Babikir, E.; Alkhorayef, M.; Alnaaimi, M.; Alduaij, M.; Bradley, D. A.

    2017-11-01

    In many countries diagnostic medical exposures typically account for a very large fraction of the collective effective dose that can be assigned to anthropological sources and activities. This in part flags up the question of whether sufficient steps are being taken in regard to potential dose saving from such medical services. As a first step, one needs to survey doses to compare against those of best practice. The present study has sought evaluation of the radiation protection status and patient doses for certain key radiological procedures in four film-based radiology departments within Sudan. The radiation exposure survey, carried out using a survey meter and quality control test tools, involved a total of 299 patients their examinations being carried out at one or other of these four departments. The entrance surface air kerma (ESAK) was determined from exposure settings using DosCal software and an Unfors -Xi-meter. The mean ESAK for x-ray examination of the chest was 0.30±0.1 mGy, for the skull it was 0.96±0.7 mGy, for the abdomen 0.85±0.01 mGy, for spinal procedures 1.30±0.6 mGy and for procedures involving the limbs it was 0.43±0.3 mGy. Ambient dose-rates in the reception area, at the closed door of the x-ray room, recorded instantaneous values of up to 100 μSv/h. In regard to protection, the associated levels were found to be acceptable in three of the four departments, corrective action being required for one department, regular quality control also being recommended.

  13. Dose. Detriment. Limit assessment

    International Nuclear Information System (INIS)

    Breckow, J.

    2015-01-01

    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.

  14. Impact of patient positioning on radiotherapy dose distribution: An assessment in parotid tumor

    Directory of Open Access Journals (Sweden)

    Seema Sharma

    2016-03-01

    Full Text Available Purpose: We intended to study the impact of patient positioning on the dose distribution within target volume and organs at risk in patients with parotid malignancies treated with 3D conformal radiotherapy (3D-CRT with photon wedge pair (WP or intensity modulated radiotherapy (IMRT.Methods: Three patients with a non-Hodgkin’s lymphoma of the right parotid gland were consecutively immobilized using thermoplastic cast in 2 positions: supine with head in neutral position (HN and with head turned 90° to the left side (HT. Images for treatment planning purpose were acquired in both positions. For both positions, photon WP plans and 5 field IMRT plans were generated, after contouring clinical target volume (CTV, planning target volume (PTV= CTV + 5 mm margin and organs at risk (OAR. All plans were evaluated for target coverage and dose to OARs.Results: Both CTV and PTV were apparently larger in HN compared with HT (31.76±8.89 cc, 30.31±7.83 cc and 62.49±19.01 cc, 58.89±15.33 cc respectively. The CI value for PTV was slightly better for HT compared to HN position in both the WP and IMRT plans. The homogeneity was comparable in both the head positions in case of WP plan. The mean HI of PTV was increased in case of IMRT plan at HT versus HN position (1.108 vs. 1.097. A change in head position from HN to HT with wedge pair plan resulted in a reduction of brainstem Dmax and Dmean. Lesser dose was observed in HN position for contralateral parotid. A difference of 0.9 Gy in the average Dmax to spinal cord was seen. The values of Dmean to mandible, oral cavity, ipsilateral and contralateral cochlea were higher in the HT position. A change in head position from HN to HT with IMRT plan resulted in a dose reduction in average Dmax to brainstem. The spinal cord Dmax increased at the HT position by 1.2 Gy. The dose to contralateral parotid and cochlea was comparable in both the positions. However, the Dmean to oral cavity was reduced at HT position. Whereas

  15. Assessment of patient dose reduction when using AEC technique in toshiba 64 MDCT

    International Nuclear Information System (INIS)

    Khojali, Wadah Mohamed Ali.

    2016-03-01

    The aim of research is to evaluate the efficiency of AEC (SUREDOSE) used in Toshiba CT scanner in reducing patient radiation dose. 107 patients were studied from four CT scanners. Scan factors and radiation dose received during abdominal CT scan was registered between the contract phases of abdominal CT scan, where the arterial contrast phases was done with Routine Manual Protocol i.e. fixed mA and kVp regardless patient age, weight and reason of scan, while the vinous phase done using AEC. The mA values were considerably less in vinous phase than in the arterial phase for all hospitals with exceptional to hospital 4 where the mA values had increased. There were no variations between the two phases in the other scan factors (kVp. pitch, slice thickness, scan length), which indicates that the software was mainly changing the mA values. The mA also showed wide variations during venous phase as a result of the varying mA applied by the AEC for the different patient ages and weights. The data collection has showed that, the application of SURDOSE decreases that average mA by 56.6%, 61%6 and 56.6 for hospitals 1, 2, and 3 respectively. The reduction of the average of the CTD1_vol were 54.2%. 64.1% in hospital 1.2. and 3 respectively. The average DLPs were also less by 57.1%. 62.8%. 57.5% in hospital, 2, and 3 respectively between the phases. In hospital 4 one raw of the CT detector was not functioning this has disturbed the SURDOSE software. Leading to increase of the mA values and hence the patient radiation dose mA, CTD1_vol and DLP in this hospital increased by 47.7%, 54.3% and 42.8% respectively. This highlighted the risk of not applying the AEC correctly. The non application of this software was only due to lake of knowledge how to use it and the benefits of dose reduction associated with it. Application of this software is very useful and operator should be trained to use it in all CT exams. (Author)

  16. Personalized Assessment of kV Cone Beam Computed Tomography Doses in Image-guided Radiotherapy of Pediatric Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Yibao [Beijing Key Lab of Medical Physics and Engineering, Peking University, Beijing (China); Yan Yulong [Department of Radiation Oncology, University of Arkansas for Medical Sciences, Little Rock, Arkansas (United States); Nath, Ravinder [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States); Bao Shanglian [Beijing Key Lab of Medical Physics and Engineering, Peking University, Beijing (China); Deng Jun, E-mail: jun.deng@yale.edu [Department of Therapeutic Radiology, Yale University, New Haven, Connecticut (United States)

    2012-08-01

    Purpose: To develop a quantitative method for the estimation of kV cone beam computed tomography (kVCBCT) doses in pediatric patients undergoing image-guided radiotherapy. Methods and Materials: Forty-two children were retrospectively analyzed in subgroups of different scanned regions: one group in the head-and-neck and the other group in the pelvis. Critical structures in planning CT images were delineated on an Eclipse treatment planning system before being converted into CT phantoms for Monte Carlo simulations. A benchmarked EGS4 Monte Carlo code was used to calculate three-dimensional dose distributions of kVCBCT scans with full-fan high-quality head or half-fan pelvis protocols predefined by the manufacturer. Based on planning CT images and structures exported in DICOM RT format, occipital-frontal circumferences (OFC) were calculated for head-and-neck patients using DICOMan software. Similarly, hip circumferences (HIP) were acquired for the pelvic group. Correlations between mean organ doses and age, weight, OFC, and HIP values were analyzed with SigmaPlot software suite, where regression performances were analyzed with relative dose differences (RDD) and coefficients of determination (R{sup 2}). Results: kVCBCT-contributed mean doses to all critical structures decreased monotonically with studied parameters, with a steeper decrease in the pelvis than in the head. Empirical functions have been developed for a dose estimation of the major organs at risk in the head and pelvis, respectively. If evaluated with physical parameters other than age, a mean RDD of up to 7.9% was observed for all the structures in our population of 42 patients. Conclusions: kVCBCT doses are highly correlated with patient size. According to this study, weight can be used as a primary index for dose assessment in both head and pelvis scans, while OFC and HIP may serve as secondary indices for dose estimation in corresponding regions. With the proposed empirical functions, it is possible

  17. Patient dose in neonatal units

    International Nuclear Information System (INIS)

    Smans, K.; Struelens, L.; Smet, M.; Bosmans, H.; Vanhavere, F.

    2008-01-01

    Lung disease represents one of the most life-threatening conditions in prematurely born children. In the evaluation of the neonatal chest, the primary and most important diagnostic study is therefore the chest radiograph. Since prematurely born children are very sensitive to radiation, those radiographs may lead to a significant radiation detriment. Hence, knowledge of the patient dose is necessary to justify the exposures. A study to assess the patient doses was started at the neonatal intensive care unit (NICU) of the Univ. Hospital in Leuven. Between September 2004 and September 2005, prematurely born babies underwent on average 10 X-ray examinations in the NICU. In this sample, the maximum was 78 X-ray examinations. For chest radiographs, the median entrance skin dose was 34 μGy and the median dose area product was 7.1 mGy.cm 2 . By means of conversion coefficients, the measured values were converted to organ doses. Organ doses were calculated for three different weight classes: extremely low birth weight infants ( 2500 g). The doses to the lungs for a single chest radiograph for infants with extremely low birth weights, low birth weights and normal birth weights were 24, 25 and 32 μGy, respectively. (authors)

  18. Assessment of absorbed dose to thyroid, parotid and ovaries in patients undergoing Gamma Knife radiosurgery

    International Nuclear Information System (INIS)

    Hasanzadeh, H; Sharafi, A; Verdi, M Allah; Nikoofar, A

    2006-01-01

    Stereotactic radiosurgery was originally introduced by Lars Leksell in 1951. This treatment refers to the noninvasive destruction of an intracranial target localized stereotactically. The purpose of this study was to identify the dose delivered to the parotid, ovaries, testis and thyroid glands during the Gamma Knife radiosurgery procedure. A three-dimensional, anthropomorphic phantom was developed using natural human bone, paraffin and sodium chloride as the equivalent tissue. The phantom consisted of a thorax, head and neck and hip. In the natural places of the thyroid, parotid (bilateral sides) and ovaries (midline), some cavities were made to place TLDs. Three TLDs were inserted in a batch with 1 cm space between the TLDs and each batch was inserted into a single cavity. The final depth of TLDs was 3 cm from the surface for parotid and thyroid and was 15 cm for the ovaries. Similar batches were placed superficially on the phantom. The phantom was gamma irradiated using a Leksell model C Gamma Knife unit. Subsequently, the same batches were placed superficially over the thyroid, parotid, testis and ovaries in 30 patients (15 men and 15 women) who were undergoing radiosurgery treatment for brain tumours. The mean dosage for treating these patients was 14.48 ± 3.06 Gy (10.5-24 Gy) to a mean tumour volume of 12.30 ± 9.66 cc (0.27-42.4 cc) in the 50% isodose curve. There was no significant difference between the superficial and deep batches in the phantom studies (P-value < 0.05). The mean delivered doses to the parotid, thyroid, ovaries and testis in human subjects were 21.6 ± 15.1 cGy, 9.15 ± 3.89 cGy, 0.47 ± 0.3 cGy and 0.53 ± 0.31 cGy, respectively. The data can be used in making decisions for special clinical situations such as treating pregnant patients or young patients with benign lesions who need radiosurgery for eradication of brain tumours

  19. Assessing patient characteristics and radiation-induced non-targeted effects in vivo for high dose-rate (HDR) brachytherapy.

    Science.gov (United States)

    Pinho, Christine; Timotin, Emilia; Wong, Raimond; Sur, Ranjan K; Hayward, Joseph E; Farrell, Thomas J; Seymour, Colin; Mothersill, Carmel

    2015-01-01

    To test whether blood, urine, and tissue based colony-forming assays are a useful clinical detection tool for assessing fractionated treatment responses and non-targeted radiation effects in bystander cells. To assess patients' responses to radiation treatments, blood serum, urine, and an esophagus explant-based in vivo colony-forming assay were used from oesophageal carcinoma patients. These patients underwent three fractions of high dose rate (HDR) intraluminal brachytherapy (ILBT). Human keratinocyte reporters exposed to blood sera taken after the third fraction of brachytherapy had a significant increase in cloning efficiency compared to baseline samples (p fractions for the blood sera data only. Patient characteristics such as gender had no statistically significant effect (p > 0.05). Large variability was observed among the patients' tissue samples, these colony-forming assays showed no significant changes throughout fractionated brachytherapy (p > 0.05). Large inter-patient variability was found in the urine and tissue based assays, so these techniques were discontinued. However, the simple blood-based assay had much less variability. This technique may have future applications as a biological dosimeter to predict treatment outcome and assess non-targeted radiation effects.

  20. Assessing local patients' knowledge and awareness of radiation dose and risks associated with medical imaging: a questionnaire study

    International Nuclear Information System (INIS)

    Sin, Ho-kwan; Wong, Chun-Sing; Huang, Bingsheng; Yiu, Ka-ling; Wong, Wai-lam; Chu, Yin Ching Tiffany

    2013-01-01

    To assess the awareness of radiation dose and associated risks caused by radiological procedures among local patients. All subjects were recruited by randomly sampling the patients receiving radiological examinations. These subjects were stratified on age, sex and education. The questionnaire was in Chinese and consisted of 28 questions mostly in multiple choice/true-or-false format, divided into three sections examining demographic data, radiation knowledge/awareness and expectations. A total of 173 questionnaires were returned (83 females and 84 females; mean age of 53). Of these, 32.6% had attended college, 32.6% had completed matriculation and 24.4% secondary school. Most subjects underwent CT (75), MRI (70) and PET-CT (18). Education significantly affected the radiation knowledge (P=0.013). 60.7% and 32.7% were not aware of the radiation-free nature of MRI and USG, respectively. Respectively, 45.4% and 43.5% were of the misconception that Barium enema and Barium swallow studies do not involve radiation. Moreover, 77.6% and 87.9% were aware of the radiation-laden nature of CT and plain X-rays, respectively. Furthermore, 34% and 50%, respectively, think that they are not exposed to radiation at home and on a plane. Regarding the fatal cancer risk from CT, 17.8% chose the correct answer and 62% underestimated the risk. 32.2% correctly estimated the equivalent dose of CT in terms of number of conventional X-rays and 43.2% underestimated the dose. Most (98.2%) were told of the indication, and 42.7% were told the associated radiation dose. Patient radiation awareness is unsatisfactory. There is need to increase patient radiation awareness, and to provide them with the necessary information.

  1. Assessment of Absorbed Dose in Persons close to the Patients during 192Ir brachytherapy for Cervical Cancer

    International Nuclear Information System (INIS)

    Jung, Joo Young; Kang, Se Sik

    2010-01-01

    According to the 2007 Annual Report of the National Cancer Registry, cervical cancer showed an occurring frequency of 7th in female cancers and 4rd in females with an age of 35-64 years. Both radiotherapy and chemotherapy are mainly used for the treatment of cervical cancer. In case of radiotherapy, brachytherapy using radioisotopes in conjunction with external-beam radiation therapy (EBRT) using a linear accelerator is used in most cases to improve the outcome of cancer treatment. Brachytherapy, one of the cervical cancer radiotherapies, is a method that can minimize the damage of normal tissues restricting absorbed dose to uterus. It is, however, necessary to conduct a quantitative assessment on brachytherapy because it may cause radiation exposure to medical care providers during the radiotherapy. Therefore, the study provides the basic research data regarding brachytherapy for cervical cancer, estimating the absorbed dose in persons close to the patients using a mathematical phantom during 192Ir brachytherapy for cervical cancer

  2. Use of PET Images in Assessment of Brain Absorbed Dose of Patients Undergoing [C-11] Raclopride Positron Emission Tomography

    International Nuclear Information System (INIS)

    Park, Jong O

    2005-08-01

    The positron emission tomography (PET) in combination with [C-11] raclopride is commonly used for early detection of the Parkinson's disease. Injection of considerable amount of radioactivity, typically 300∼500 MBq of [C-11] at a time, for the examination calls for attention to doses to tissues of the patient, particularly to the brain. Since [C-11] raclopride is not a common radiopharmaceutical, dosimetric data for internal dose evaluation are rare yet. In this study, an attempt was made to determine doses to the brain and the striatum of patients by use of the PET images obtained for the clinical purposes. Four informed patients suffering Parkinson's disease participated in this study. Time series of 18 frames, 35 slices in each frame, of PET images of the head were obtained. By transforming the pixel intensity in the assigned region of interests into radioactivity contents, the retention curves were constructed to evaluate the residence times. Absorbed doses to the target tissues were calculated by applying the S-values given in the MIRDOSE3.1 code. The resulting dose coefficients for the whole brain and the striatum were 0.0110±0.0016 mGy/MBq and 0.0664±0.0238 mGy/MBq, respectively. The brain dose coefficient is considerably higher than the corresponding values in other studies employing healthy subjects. This may be attributed to probable enhanced capture of [C-11] raclopride by the dopamine D 2 receptors in case of subjects with Parkinson's disease. The transcrianial magnetic stimulation (TMS) procedures are often used in treatment of Parkinson's disease. If the procedure stimulates secretion of dopamine, less retention of [C-11] raclopride is expected due to competition. So the similar assessments were made for the same patients after TMS treatments. Disappointingly, the ratios of residence time without TMS to that with TMS were 0.943±0.074 and 0.98±0.14 for the brain and the striatum, respectively. For the striatum, the ratios for three patients were

  3. Calibration of Kodak EDR2 film for patient skin dose assessment in cardiac catheterization procedures.

    Science.gov (United States)

    Morrell, Rachel E; Rogers, Andy

    2004-12-21

    Kodak EDR2 film has been calibrated across the range of exposure conditions encountered in our cardiac catheterization laboratory. Its dose-response function has been successfully modelled, up to the saturation point of 1 Gy. The most important factor affecting film sensitivity is the use of beam filtration. Spectral filtration and kVp together account for a variation in dose per optical density of -10% to +25%, at 160 mGy. The use of a dynamic wedge filter may cause doses to be underestimated by up to 6%. The film is relatively insensitive to variations in batch, field size, exposure rate, time to processing and day-to-day fluctuations in processor performance. Overall uncertainty in the calibration is estimated to be -20% to +40%, at 160 mGy. However, the uncertainty increases at higher doses, as the curve saturates. Artefacts were seen on a number of films, due to faults in the light-proofing of the film packets.

  4. Dose assessment by quantification of chromosome aberrations and micronuclei in peripheral blood lymphocytes from patients exposed to gamma radiation

    Energy Technology Data Exchange (ETDEWEB)

    Silva-Barbosa, Isvania; Pereira-MagnataI, Simey; Amaral, Ademir [Pernambuco Univ., Recife, PE (Brazil). Dept. de Energia Nuclear. Grupo de Estudos em Radioprotecao e Radioecologia - GERAR; Sotero, Graca [Fundacao de Hematologia e Hemoterapia, Recife, PE (Brazil); Melo, Homero Cavalcanti [Hospital do Cancer, Recife, PE (Brazil). Centro de Radioterapia de Pernambuco]. E-mail: isvania@uol.com.br

    2005-07-15

    Scoring of unstable chromosome aberrations (dicentrics, rings and fragments) and micronuclei in circulating lymphocytes are the most extensively studied biological means for estimating individual exposure to ionizing radiation (IR), which can be used as complementary methods to physical dosimetry or when the latter cannot be performed. In this work, the quantification of the frequencies of chromosome aberrations and micronuclei were carried out based on cytogenetic analyses of peripheral blood samples from 5 patients with cervical uterine cancer following radiotherapy in order to evaluate the absorbed dose as a result of partial-body exposure to 60Co source. Blood samples were collected from each patient in three phases of the treatment: before irradiation, 24 h after receiving 0.08 Gy and 1.8 Gy, respectively. The results presented in this report emphasize biological dosimetry, employing the quantification of chromosome aberrations and micronuclei in lymphocytes from peripheral blood, as an important methodology of dose assessment for either whole or partial-body exposure to IR.

  5. Image quality evaluation and patient dose assessment of medical fluoroscopic X-ray systems: A national study

    International Nuclear Information System (INIS)

    Economides, S.; Hourdakis, C. J.; Kalivas, N.; Kalathaki, M.; Simantirakis, G.; Tritakis, P.; Manousaridis, G.; Vogiatzi, S.; Kipouros, P.; Boziari, A.; Kamenopoulou, V.

    2008-01-01

    This study presents the results from a survey conducted by the Greek Atomic Energy Commission (GAEC), during the period 1998-2003, in 530 public and private owned fluoroscopic X-ray systems in Greece. Certain operational parameters for conventional and remote control systems were assessed, according to a quality control protocol developed by GAEC on the basis of the current literature. Public (91.5%) and private (81.5%) owned fluoroscopic units exhibit high-contrast resolution values over 1 lp mm -1 . Moreover, 88.5 and 87.1% of the fluoroscopic units installed in the public and private sector, respectively, present Maximum Patient Entrance Kerma Rate values lower than 100 mGy min -1 . Additionally, 68.3% of the units assessed were found to perform within the acceptance limits. Finally, the third quartile of the Entrance Surface Dose Rate distribution was estimated according to the Dose Reference Level definition and found equal to 35 mGy min -1 . (authors)

  6. Accuracy assessment of pharmacogenetically predictive warfarin dosing algorithms in patients of an academic medical center anticoagulation clinic.

    Science.gov (United States)

    Shaw, Paul B; Donovan, Jennifer L; Tran, Maichi T; Lemon, Stephenie C; Burgwinkle, Pamela; Gore, Joel

    2010-08-01

    The objectives of this retrospective cohort study are to evaluate the accuracy of pharmacogenetic warfarin dosing algorithms in predicting therapeutic dose and to determine if this degree of accuracy warrants the routine use of genotyping to prospectively dose patients newly started on warfarin. Seventy-one patients of an outpatient anticoagulation clinic at an academic medical center who were age 18 years or older on a stable, therapeutic warfarin dose with international normalized ratio (INR) goal between 2.0 and 3.0, and cytochrome P450 isoenzyme 2C9 (CYP2C9) and vitamin K epoxide reductase complex subunit 1 (VKORC1) genotypes available between January 1, 2007 and September 30, 2008 were included. Six pharmacogenetic warfarin dosing algorithms were identified from the medical literature. Additionally, a 5 mg fixed dose approach was evaluated. Three algorithms, Zhu et al. (Clin Chem 53:1199-1205, 2007), Gage et al. (J Clin Ther 84:326-331, 2008), and International Warfarin Pharmacogenetic Consortium (IWPC) (N Engl J Med 360:753-764, 2009) were similar in the primary accuracy endpoints with mean absolute error (MAE) ranging from 1.7 to 1.8 mg/day and coefficient of determination R (2) from 0.61 to 0.66. However, the Zhu et al. algorithm severely over-predicted dose (defined as >or=2x or >or=2 mg/day more than actual dose) in twice as many (14 vs. 7%) patients as Gage et al. 2008 and IWPC 2009. In conclusion, the algorithms published by Gage et al. 2008 and the IWPC 2009 were the two most accurate pharmacogenetically based equations available in the medical literature in predicting therapeutic warfarin dose in our study population. However, the degree of accuracy demonstrated does not support the routine use of genotyping to prospectively dose all patients newly started on warfarin.

  7. Consultative exercise on dose assessments.

    Science.gov (United States)

    Bridges, B A; Parker, T; Simmonds, J R; Sumner, D

    2001-06-01

    A summary is given of a meeting held at Sussex University, UK, in October 2000, which allowed the exchange of ideas on methods of assessment of dose to the public arising from potential authorised radioactive discharges from nuclear sites in the UK. Representatives of groups with an interest in dose assessments were invited, and hence the meeting was called the Consultative Exercise on Dose Assessments (CEDA). Although initiated and funded by the Food Standards Agency, its organisation, and the writing of the report, were overseen by an independent Chairman and Steering Group. The report contains recommendations for improvement in co-ordination between different agencies involved in assessments, on method development and on the presentation of data on assessments. These have been prepared by the Steering Group, and will be taken forward by the Food Standards Agency and other agencies in the UK. The recommendations are included in this memorandum.

  8. Assessment of image quality and patient doses in mammography in Tanzania

    International Nuclear Information System (INIS)

    Muhogora, W.E.; Lema, U.S.; Lyimo, R.; Dharsee, J.D.

    2008-01-01

    Full text: The objective of this work was to investigate on pilot scale the potential for optimization of screen-film based mammography practice in Tanzania. Two hospitals participated in the study and were Samaritan (with Siemens unit, model MAMMOMAT 5427901X059) and AgaKhan Medical Centre (with a Philips unit, model MD 4000). Image quality assessment was done by the radiologist at the hospital in two phases each of 2 weeks by scoring the images with assistance of image quality criteria supplied by IAEA. The causes for poor image quality were also identified. A quality assurance (QA) program was then implemented and corrective actions applied based on image quality assessment and equipment performance. In the second phase, image quality assessment was repeated followed by the estimation of entrance surface air kerma (ESAK) on 4.5 cm PMMA. The results show that the magnitude of poor image quality was up to 50% for Siemens in the first phase and decreased up to 30% after implementation of QA programme. With Philips unit, the magnitude of poor image quality was up to 70% and decreased up to 39% after implementation of QA programme. Generally, the main causes of poor images at all hospitals were over and under exposure, artefacts and breast misplacement. Others were unsharpness of skin structure (rosette from pores) along pectoral muscle, unsharpness of vascular structure (seen through most dense parenchyma), media breast tissue, and vessels and fibrous strands, pectoral muscle margin. Major image quality improvement in terms of percentage points were 10 (over or under exposure), 11 (artefacts) and 9 (skin structure (rosettes from pores-visually not sharp). However, the influence of some causes could not be reduced with QA program, presumably due to skill or equipment related reasons. The ESAK was determined to be 7.1 mGy (30 kVp, Mo/Mo) for Siemens and 3.1 mGy (28 kVp, Mo/Mo) for Philips unit. The ESAK values were well below the recommended diagnostic reference level

  9. Applying the PCXMC software for dose assessment in patients submitted to abdomen and pelvis X-ray examinations

    International Nuclear Information System (INIS)

    Oliveira, V.L.S.; Silva, T.A. da

    2009-01-01

    The PCXMC R computational methodology was applied as a evaluation tool of the organ doses in patients submitted to different X-ray conventional diagnoses examinations. Simulations were made based in x-ray parameters and exposure geometry of three patient of same age group in an Emergency Hospital of the metropolitan area of Belo Horizonte city. Contributions to the effective dose from critical organs were evaluated and analyzed in terms of patient height and weight for the examinations of abdomen and pelvis. (author)

  10. Study on the quality assurance of diagnostic X-ray machines and assessment of the absorbed dose to patients

    Science.gov (United States)

    Hassan, G. M.; Rabie, N.; Mustafa, K. A.; Abdel-Khalik, S. S.

    2012-09-01

    Radiation exposure and image quality in X-ray diagnostic radiology provide a clear understanding of the relationship between the radiation dose delivered to a patient and image quality in optimizing medical diagnostic radiology. Because a certain amount of radiation is unavoidably delivered to patients, this should be as low as reasonably achievable. Several X-ray diagnostic machines were used at different medical diagnostic centers in Egypt for studying the beam quality and the dose delivered to the patient. This article studies the factors affecting the beam quality, such as the kilo-volt peak (kVp), exposure time (mSc), tube current (mAs) and the absorbed dose in (μGy) for different examinations. The maximum absorbed dose measured per mAs was 594±239 and 12.5±3.7 μGy for the abdomen and the chest, respectively, while the absorbed dose at the elbow was 18±6 μGy, which was the minimum dose recorded. The compound and expanded uncertainties accompanying these measurements were 4±0.35% and 8±0.7%, respectively. The measurements were done through quality control tests as acceptance procedures.

  11. Assessment of radiation dose due to fluoroscopic procedures in patients at some selected facilities in the Greater Accra Region, Ghana

    International Nuclear Information System (INIS)

    Gyasi, E.

    2013-07-01

    Radiation doses to 182 adults patients who underwent barium enema, barium meal, barium swallow, myelogram, hysterosalpingography and urethrogram examination collectively at facilities A and B were investigated. Radiation dose was measured using kerma-area-product (KAP) meter. From the KAP readings, patient's data and other relevant information from the control console, effective dose and selective organ doses were estimated using Monte Carlo program software (PCXMC version 1.5). Quality control tests performed on the two fluoroscopy machines were found to be within the acceptance criteria. Mean effective doses were found to be 8.45 ± 0.38mSv, 7.628 ± 0.42 mSv, 1.46 ± 0.13 mSv, 2.02 ± 0.16 mSv, 0.32 ± 0.03 mSv for barium enema, barium meal, barium swallow, myelogram and urethrogram examinations respectively at Facility A. At Facility B the mean effective dose were found to be 4.12 ± 0.15 mSv, 1.83 ± 0.10 mSv, 0.81 ± 0.04 mSv, 0.53 ± 0.036 mSv and 0.27 ± 0.01 mSv for barium enema, barium meal, barium swallow, myelogram, hysterosalpingography and urethrogram examination respectively. Thymus received the highest organ dose of 29.19± 2.07mGy during barium meal studies at Facility A of all the procedures in the two hospitals. Magnitude of organ doses was observed to to be in relation with the closeness to or in the direction of the primary beam of radiation. Organ and effective doses from Facility A were relatively higher than those from Facility B in comparison by a factor of a about 2 with the exception of the barium meal examination at Facility A which was by a factor of about 4. The measured KAP readings fro the two facilities were below the international accepted reference levels with the exception of barium meal examination at Facility A which recorded a higher value of 25.96 ± 1.83 Gy.cm 2 as compared to ICRP (2001) reference value of 25 Gy.cm 2 . Longer radiation beam on time, high number of radiographs taken per patient, wide exposure beam area on

  12. Assessment of physician and patient (child and adult) equivalent doses during renal angiography by Monte Carlo method

    International Nuclear Information System (INIS)

    Karimian, A.; Nikparvar, B.; Jabbari, I.

    2014-01-01

    Renal angiography is one of the medical imaging methods in which patient and physician receive high equivalent doses due to long duration of fluoroscopy. In this research, equivalent doses of some radiosensitive tissues of patient (adult and child) and physician during renal angiography have been calculated by using adult and child Oak Ridge National Laboratory phantoms and Monte Carlo method (MCNPX). The results showed, in angiography of right kidney in a child and adult patient, that gall bladder with the amounts of 2.32 and 0.35 mSv, respectively, has received the most equivalent dose. About the physician, left hand, left eye and thymus absorbed the most amounts of doses, means 0.020 mSv. In addition, equivalent doses of the physician's lens eye, thyroid and knees were 0.023, 0.007 and 7.9 - 4 mSv, respectively. Although these values are less than the reported thresholds by ICRP 103, it should be noted that these amounts are related to one examination. (authors)

  13. Patient and staff dose during hysterosalpinography

    International Nuclear Information System (INIS)

    Buls, N.; Osteaux, M.

    2001-01-01

    Hysterosalpingography (HSG) is a useful and widely employed technique which uses X-ray fluoroscopy to investigate the female genital tract. Fluoroscopy is assessed by a gynaecologist, a physician who is not always trained to work with ionising radiation. Dose-area product measurements in a group of 34 patients allowed an estimation of the median effective dose (0,83 mSv) and the median dose to the ovaries (1,63 mGy) of the patient per procedure. The dose to the staff was estimated using thermoluminescent dosimetry. The following median entrance surface doses were estimated per procedure: 0,22 mGy to the lens of the eye, 0,15 mGy to the neck at thyroid level and 0,19 mGy to the back of the hand. The annual eye dose limit could be exceeded if the gynaecologist is a member of the public. (author)

  14. Assessment of individual dose utilization vs. physician prescribing recommendations for recombinant activated factor VII (rFVIIa) in paediatric and adult patients with congenital haemophilia and alloantibody inhibitors (CHwI): the Dosing Observational Study in Hemophilia (DOSE).

    Science.gov (United States)

    Gruppo, R A; Kessler, C M; Neufeld, E J; Cooper, D L

    2013-07-01

    Recent data from the Dosing Observational Study in Hemophilia diary study has described home treatment with recombinant activated factor VII (rFVIIa) in congenital haemophilia with inhibitors (CHwI). The current analysis compares prescribed and patient/caregiver-reported rFVIIa administration in paediatric and adult CHwI patients in this study. Patients with ≥ 4 bleeding episodes within a 3-month period prescribed rFVIIa as first-line therapy for bleeding episodes were eligible. Patients/caregivers completed a diary for ≥ 90 days or until the patient experienced four bleeds. Initial, total and mean rFVIIa doses reported for each bleeding episode were calculated and compared with the physician-prescribed doses. Of 52 enrolled patients (25 children; 27 adults), 39 (75%) completed the study. Children and adults had similar mean durations of bleeding episodes. Both patient groups were administered higher initial rFVIIa doses for joint bleeds than prescribed: median (range) 215.2 (74.1-400.0) mcg kg(-1) vs. 200.0 (61.0-270.0) mcg kg(-1) for children, and 231.3 (59.3-379.7) mcg kg(-1) vs. 123.0 (81.0-289.0) mcg kg(-1) for adults. The median infused dose for joint bleeds was higher in adults than children (175.2 vs. 148.0 mcg kg(-1) ), but children received significantly more doses per joint bleed than adults (median 6.5 vs. 3.0). The median total dose per joint bleed was higher in children than adults (1248.7 vs. 441.6). For children and adults, both initial and additional doses administered for bleeds were higher than prescribed. Children received higher total doses per bleed due to an increased number of infusions per bleed. © 2013 John Wiley & Sons Ltd.

  15. SU-F-J-62: Assessment of Dose Changes Due to Anterior-Posterior Patient Separation During Daily MVCT Scans

    Energy Technology Data Exchange (ETDEWEB)

    Leney, M [Wayne State University, Detroit, MI (United States); Nalichowski, A; Patel, S [Karmanos Cancer Institute, Detroit, MI (United States)

    2016-06-15

    Purpose: To determine the effects of patient separation on absolute dose and dose distribution in patients undergoing pelvic radiotherapy on TomoTherapy. Methods: An Alderson RANDO phantom with 4cm of bolus was imaged on a CT simulator and the resulting scans were contoured as a whole pelvic case. Using TomoTherapy Planning Station, the plan was designed to give 45 Gy to 95% of the treatment volume in 25 fractions. TomoTherapy MVCT scans were performed on the RANDO phantom with 2cm and 4cm of bolus removed to simulate visible changes in a patient’s anatomy. The MVCT images were rigidly registered with planning CT images on TomoTherapy Planned Adaptive. The original fluence was recalculated on the MVCT images and changes in dose distribution due to patient separation were quantified by the changes in DVHs for the target volume and the organs at risk. Results: Patient separation difference equivalent to 2cm and 4cm in anterior-posterior direction resulted in an increase of the PTV D50 and maximum PTV dose of 5.6%, 6.2% for 2cm and 7.7%, 10.4% for 4cm, respectively. For the 2cm change, D50 and maximum doses to organs at risk increased by 6.5%, 7.1% in the bladder, 4.9%, 4.8% in the rectum, and 5.3%, 6.6% in the bowel. For the 4cm change, D50 and maximum doses increased by 10.7%, 12.2% in the bladder, 5.9%, 6.1% in the rectum, and 7.7%, 10.1% in the bowel. Conclusion: This research indicates that, without any changes to the structures, patient separation in the anterior-posterior direction can affect the dose distribution for the PTV and organs at risk. These results can assist physicians in determining if obtaining a new CT simulation set and replanning is necessary for pelvic patients on TomoTherapy.

  16. Dose study of the multikinase inhibitor, LY2457546, in patients with relapsed acute myeloid leukemia to assess safety, pharmacokinetics, and pharmacodynamics

    International Nuclear Information System (INIS)

    Wacheck, Volker; Lahn, Michael; Dickinson, Gemma; Füreder, Wolfgang; Meyer, Renata; Herndlhofer, Susanne; Füreder, Thorsten; Dorfner, Georg; Pillay, Sada; André, Valérie; Burkholder, Timothy P; Akunda, Jacqueline K; Flye-Blakemore, Leann; Van Bockstaele, Dirk; Schlenk, Richard F; Sperr, Wolfgang R; Valent, Peter

    2011-01-01

    Acute myeloid leukemia (AML) is a life-threatening malignancy with limited treatment options in chemotherapy-refractory patients. A first-in-human dose study was designed to investigate a safe and biologically effective dose range for LY2457546, a novel multikinase inhibitor, in patients with relapsed AML. In this nonrandomized, open-label, dose escalation Phase I study, LY2457546 was administered orally once a day. Safety, pharmacokinetics, changes in phosphorylation of target kinases in AML blasts, and risk of drug–drug interactions (DDI) were assessed. Five patients were treated at the starting and predicted minimal biologically effective dose of 50 mg/day. The most commonly observed adverse events were febrile neutropenia, epistaxis, petechiae, and headache. The majority of adverse events (81%) were Grade 1 or 2. One patient had generalized muscle weakness (Grade 3), which was deemed to be a dose-limiting toxicity. Notably, the pharmacokinetic profile of LY2457546 showed virtually no elimination of LY2457546 within 24 hours, and thus prevented further dose escalation. No significant DDI were observed. Ex vivo flow cytometry studies showed downregulation of the phosphoproteins, pcKIT, pFLT3, and pS6, in AML blasts after LY2457546 administration. No medically relevant responses were observed in the five treated patients. No biologically effective dose could be established for LY2457546 in chemotherapy-resistant AML patients. Lack of drug clearance prevented safe dose escalation, and the study was terminated early. Future efforts should be made to develop derivatives with a more favorable pharmacokinetic profile

  17. Dose assessment in radiological accidents

    International Nuclear Information System (INIS)

    Donkor, S.

    2013-04-01

    The applications of ionizing radiation bring many benefits to humankind, ranging from power generation to uses in medicine, industry and agriculture. Facilities that use radiation source require special care in the design and operation of equipment to prevent radiation injury to workers or to the public. Despite considerable development of radiation safety, radiation accidents do happen. The purpose of this study is therefore to discuss how to assess doses to people who will be exposed to a range of internal and external radiation sources in the event of radiological accidents. This will go a long way to complement their medical assessment thereby helping to plan their treatment. Three radiological accidents were reviewed to learn about the causes of those accidents and the recommendations that were put in place to prevent recurrence of such accidents. Various types of dose assessment methods were discussed.(au)

  18. Phase I dose escalation pharmacokinetic assessment of intravenous humanized anti-MUC1 antibody AS1402 in patients with advanced breast cancer.

    Science.gov (United States)

    Pegram, Mark D; Borges, Virginia F; Ibrahim, Nuhad; Fuloria, Jyotsna; Shapiro, Charles; Perez, Susan; Wang, Karen; Schaedli Stark, Franziska; Courtenay Luck, Nigel

    2009-01-01

    MUC1 is a cell-surface glycoprotein that establishes a molecular barrier at the epithelial surface and engages in morphogenetic signal transduction. Alterations in MUC1 glycosylation accompany the development of cancer and influence cellular growth, differentiation, transformation, adhesion, invasion, and immune surveillance. A 20-amino-acid tandem repeat that forms the core protein of MUC1 is overexpressed and aberrantly glycosylated in the majority of epithelial tumors. AS1402 (formerly R1550) is a humanized IgG1k monoclonal antibody that binds to PDTR sequences within this tandem repeat that are not exposed in normal cells. AS1402 is a potent inducer of antibody-dependent cellular cytotoxicity (ADCC), specifically against MUC1-expressing tumor cells. The objective of this study was to determine the safety, tolerability, and pharmacokinetic (PK) characteristics of AS1402 monotherapy in patients with locally advanced or metastatic MUC1-positive breast cancer that had progressed after anthracyclines- and taxane-based therapy. Patients received AS1402 over a 1- to 3-hour intravenous (i.v.) infusion at doses between 1 and 16 mg/kg, with repeated dosing every 1 to 3 weeks (based on patient-individualized PK assessment) until disease progression. Serum AS1402 levels were measured at multiple times after i.v. administration. Human anti-human antibody (HAHA) responses were measured to determine the immunogenicity of AS1402. Noncompartmental pharmacokinetic parameters were determined and were used to assess dose dependency across the dose range studied. Twenty-six patients were treated. AS1402 was generally well tolerated. Two grade 3/4 drug-related adverse events were reported, both at the 3-mg/kg dose. Neither was observed in expanded or subsequent dosing cohorts. No anti-human antibodies were detected. Plasma concentrations of AS1402 appeared to be proportional to dose within the 1- to 16-mg/kg dose range assessed, with a mean terminal half-life of 115.4 +/- 37.1 hours

  19. Patient doses in interventional cardiology procedures

    International Nuclear Information System (INIS)

    Domienik, J.; Papierz, S.; Jankowski, J.; Peruga, J.Z.

    2008-01-01

    In most countries of European Union legislation requires the determination of the total skin dose to patient resulting from interventional procedures to assess the risk of deterministic effect. To this end, various dose indicators like dose area product (DAP), cumulative dose (CD) and entrance dose at the patient plane (EFD) are used in clinical practice. The study aims at relating those dose indicators with doses ascribe to the most irradiated areas of the patient skin usually expressed in terms of local maximal skin dose (MSD). For the study the local MSD and related to their areas are investigated and compared for coronary angiography CA and intervention (PCI). Two methods implying radiographic films Kodak EDR2 and matrixes of thermoluminescent dosimeters (TLDs) are applied for direct measurements of dose distribution for selected procedures. Both methods are compared. Additionally, for patient dosimetry the following data: MSD, CD, EFD, fluoroscopy time (FT), number of acquired images, total DAP, fluoro-DAP and record-DAP were collected for randomly selected procedure. The statistical quantities like: median, 3 rd quartile, mean and standard deviation for all dosimetric parameters are determined. Preliminary study showed that the values of data collected for coronary procedures are in the ranges 0,7 - 27,3 min for fluoroscopy time, 50 - 350 Gy cm 2 for total DAP, 300 - 2000 mGy for CD, 140 - 2000 mGy for EFD and 100 - 1500 mGy for local maximal skin dose. For interventions the ranges are, accordingly 3,0 - 43,6 min , 25 - 450 Gy cm 2 , 270 - 6600 mGy, 80 - 2600 mGy and 80 - 1500 mGy. As a result of the study the correlations between dose indicators and local MSD are analyzed. The concentration of dose on irradiated films are going to be investigated in some detail as well. (author)

  20. Assessment of dose to patients undergoing computed radiography and film screen x-ray examinations in some Khartoum Hospitals

    International Nuclear Information System (INIS)

    Mohamed Khair, Haiffa Daffa Allah Mustafa

    2015-12-01

    Medical ionizing radiation sources give by far the largest contribution to the population dose from man made sources and most of the contribution comes from diagnostic x-rays. The optimization principle of radiation protection requires the minimization of radiation dose to patients while acquiring diagnostic quality images in radiology. In radiography, the extent of patient dose reduction is limited by the characteristics of the system used and the quality (or penetrating ability) of the x-ray beam. In this study, the entrance surface air kerma doses (ESA Ks) to patients undergoing 7 selected x-ray examinations were estimated. The study was conducted in eight hospitals in Khartoum State, comprising nine x-ray units and a total of 1200 patients were involved. Four of the hospitals involved in this study use computed radiography (CR) technology while the other four use film screen (FS) technology. The selected examinations were, abdomen (AP), chest (PA), pelvis (AP), skull (AP/PA), skull (LAT), thoracic spine (AP) and thoracic spine (LAT). The entrance surface air kerma was calculated by two methods, utilizing software CAL Dose X-3.5 and a mathematical model. Average ESAK values calculated using the two methods for hospitals using (CR) technology in mGy were 2.99 and 2.98, 0.34 and 0.31, 2.79 and 2.58, 0.76 and 0.71, 0.94 and 0.79, 3.4 and 3,2 and 5.9 and 5.03, for the above mentioned selected investigations respectively. And average ESAK values calculated using two methods for hospital using FS technology in mGy were found 4.98 and 4.19, 0.37 and 0.34, 4.15 and 3.95, 2.2 and 2. 1.3 and 1.1, 3.9 and 3.9, 9.4 and 8.3 for the above mentioned selected investigations respectively. Average ESAK values obtained by two methods for FS were higher values than the obtained by CR by 37 and 29%, 50 and 25%, 8%, 32 and 34%, 65 and 64%, 27 and 28%, 12% and 73% and 39% for the above mentioned selected investigations, respectively. This shows that CR technique allows diagnostically

  1. Emergency assessment of patients with acute abdominal pain using low-dose CT with iterative reconstruction: a comparative study

    Energy Technology Data Exchange (ETDEWEB)

    Poletti, Pierre-Alexandre; Becker, Minerva; Becker, Christoph D.; Zaidi, Habib; Platon, Alexandra [University Hospital of Geneva, Department of Radiology, Geneva (Switzerland); Halfon Poletti, Alice; Rutschmann, Olivier T. [University Hospital of Geneva, Department of Community, Primary Care and Emergency Medicine, Geneva (Switzerland); Perneger, Thomas [University Hospital of Geneva, Division of Clinical Epidemiology, Geneva (Switzerland)

    2017-08-15

    To determine if radiation dose delivered by contrast-enhanced CT (CECT) for acute abdominal pain can be reduced to the dose administered in abdominal radiography (<2.5 mSv) using low-dose CT (LDCT) with iterative reconstruction algorithms. One hundred and fifty-one consecutive patients requiring CECT for acute abdominal pain were included, and their body mass index (BMI) was calculated. CECT was immediately followed by LDCT. LDCT series was processed using 1) 40% iterative reconstruction algorithm blended with filtered back projection (LDCT-IR-FBP) and 2) model-based iterative reconstruction algorithm (LDCT-MBIR). LDCT-IR-FBP and LDCT-MBIR images were reviewed independently by two board-certified radiologists (Raters 1 and 2). Abdominal pathology was revealed on CECT in 120 (79%) patients. In those with BMI <30, accuracies for correct diagnosis by Rater 1 with LDCT-IR-FBP and LDCT-MBIR, when compared to CECT, were 95.4% (104/109) and 99% (108/109), respectively, and 92.7% (101/109) and 100% (109/109) for Rater 2. In patients with BMI ≥30, accuracies with LDCT-IR-FBP and LDCT-MBIR were 88.1% (37/42) and 90.5% (38/42) for Rater 1 and 78.6% (33/42) and 92.9% (39/42) for Rater 2. The radiation dose delivered by CT to non-obese patients with acute abdominal pain can be safely reduced to levels close to standard radiography using LDCT-MBIR. (orig.)

  2. Dose assessments for SFR 1

    International Nuclear Information System (INIS)

    Bergstroem, Ulla; Avila, Rodolfo; Ekstroem, Per-Anders; Cruz, Idalmis de la

    2008-05-01

    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

  3. 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

  4. Occupational dose assessment and national dose registry system in Iran

    International Nuclear Information System (INIS)

    Jafari-Zadeh, M.; Nazeri, F.; Hosseini-Pooya, S. M.; Taheri, M.; Gheshlaghi, F.; Kardan, M. R.; Babakhani, A.; Rastkhah, N.; Yousefi-Nejad, F.; Darabi, M.; Oruji, T.; Gholamali-Zadeh, Z.; Karimi-Diba, J.; Kazemi-Movahed, A. A.; Dashti-Pour, M. R.; Enferadi, A.; Jahanbakhshian, M. H.; Sadegh-Khani, M. R.

    2011-01-01

    This report presents status of external and internal dose assessment of workers and introducing the structure of National Dose Registry System of Iran (NDRSI). As well as types of individual dosemeters in use, techniques for internal dose assessment are presented. Results obtained from the International Atomic Energy Agency intercomparison programme on measurement of personal dose equivalent H p (10) and consistency of the measured doses with the delivered doses are shown. Also, implementation of dosimetry standards, establishment of quality management system, authorisation and approval procedure of dosimetry service providers are discussed. (authors)

  5. Assessment of warfarin therapy under full dose using indium-111 platelet scintigraphy in patients with intracardiac thrombi

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Makoto; Onishi, Kenji; Fukunami, Masatake and others

    1988-12-01

    Twenty patients in whom intracardiac thrombi were detected by indium-111 platelet scintigraphy (the first platelet scintigraphy) were prospectively studied to examine the effect of warfarin therapy under full dose on the intracardiac thrombogenecity. Eleven patients (group I) who received 2-6 mg/day of warfarin and 9 patients (group II) who did not received warfarin had the second platelet scintigraphies 14-71 days after the first platelet scintigraphies. In group I, 10 platelet scintigraphies became negative and one remained positive for intracardiac thrombi after administration of warfarin, while in group II 8 platelet scintigraphies remained positive and only one changed to negative. The incidence of negative image at the second platelet scintigraphy was significantly lower in group II than that in group I. In group I, the degree of accumulation of platelets onto the surface of the thrombus (%IE), showed significant reduction (0.69+-0.48 to 0.11+-0.21) after warfarin therapy, while in group II %IE at the second scintigraphy (1.07+-1.03) were not significantly different from those at the first scintigraphy (1.13+-0.79). These results indicated that warfarin therapy under full dose inhibited the deposition of platelets on the intracardiac thrombi and thrombogenecity in the patients with intracardiac thrombi which were detected by indium-111 platelet scintigraphy.

  6. Assessment of warfarin therapy under full dose using indium-111 platelet scintigraphy in patients with intracardiac thrombi

    International Nuclear Information System (INIS)

    Yamada, Makoto; Onishi, Kenji; Fukunami, Masatake

    1988-01-01

    Twenty patients in whom intracardiac thrombi were detected by indium-111 platelet scintigraphy (the first platelet scintigraphy) were prospectively studied to examine the effect of warfarin therapy under full dose on the intracardiac thrombogenecity. Eleven patients (group I) who received 2-6 mg/day of warfarin and 9 patients (group II) who did not received warfarin had the second platelet scintigraphies 14-71 days after the first platelet scintigraphies. In group I, 10 platelet scintigraphies became negative and one remained positive for intracardiac thrombi after administration of warfarin, while in group II 8 platelet scintigraphies remained positive and only one changed to negative. The incidence of negative image at the second platelet scintigraphy was significantly lower in group II than that in group I. In group I, the degree of accumulation of platelets onto the surface of the thrombus (%IE), showed significant reduction (0.69±0.48 to 0.11±0.21) after warfarin therapy, while in group II %IE at the second scintigraphy (1.07±1.03) were not significantly different from those at the first scintigraphy (1.13±0.79). These results indicated that warfarin therapy under full dose inhibited the deposition of platelets on the intracardiac thrombi and thrombogenecity in the patients with intracardiac thrombi which were detected by indium-111 platelet scintigraphy. (author)

  7. Patient surface doses in computerized tomography examinations

    International Nuclear Information System (INIS)

    Vekic, B.; Kovacevic, S.; Ranogajec Komor, M.; Duvnjak, N.; Marusic, P.; Anic, P.; Dolencic, P.

    1996-01-01

    Computed tomography (CT) has become a major source of the population exposure to diagnostic x-rays, and acknowledge of the doses delivered by the CT equipment has become very important. Considerable efforts should be made to keep these doses to a reasonable minimum, without sacrificing the image quality. The conditions of exposure in CT are quite different from dose in conventional x-ray imaging. This has required the development of specific techniques for assessing patient dose from CT. The aims of this work were to determine the dose delivered to various organs of patients undergoing computed tomography of abdomen, thorax, pelvis and kidney as measured on the surface of the body and to estimate the risk to the patients. Dosimetric measurements were performed at two different CT scanners (Siemens SOMATOM DR-H ver. HC-1 and Shimadzu SCT-4500TE). The dose absorbed by different organs (gonads, chest, thyroid and eye lens) and by the examined part of the body of 95 patients of various sex and age were measured with TLD-700. The doses absorbed by different organs during the diagnostic CT examination of the body depend on the technical parameters, such as the number of scan, mAs, the thickness of scans, scanning times, tube voltage and other characteristics, some of each depend on the type and severity of illness. Clinical parameters, such as patient size and composition, and patient cooperation with regard to the control and motion, also influence the dose and the image quality. The highest dose measured in this study (89.19 mGy) was delivered to kidney during CT examination of this organ. (author)

  8. Design of a multicentre randomized controlled trial to assess the safety and efficacy of dose titration by specialized nurses in patients with heart failure. ETIFIC study protocol.

    Science.gov (United States)

    Oyanguren, Juana; García-Garrido, LLuisa; Nebot Margalef, Magdalena; Lekuona, Iñaki; Comin-Colet, Josep; Manito, Nicolás; Roure, Julia; Ruiz Rodriguez, Pilar; Enjuanes, Cristina; Latorre, Pedro; Torcal Laguna, Jesús; García-Gutiérrez, Susana

    2017-11-01

    Heart failure (HF) is associated with many hospital admissions and relatively high mortality, rates decreasing with administration of beta-blockers (BBs), angiotensin-converting-enzyme inhibitors, angiotensin II receptor blockers, and mineralocorticoid receptor antagonists. The effect is dose dependent, suboptimal doses being common in clinical practice. The 2012 European guidelines recommend close monitoring and dose titration by HF nurses. Our main aim is to compare BB doses achieved by patients after 4 months in intervention (HF nurse-managed) and control (cardiologist-managed) groups. Secondary aims include comparing doses of the other aforementioned drugs achieved after 4 months, adverse events, and outcomes at 6 months in the two groups. We have designed a multicentre (20 hospitals) non-inferiority randomized controlled trial, including patients with new-onset HF, left ventricular ejection fraction ≤40%, and New York Heart Association class II-III, with no contraindications to BBs. We will also conduct qualitative analysis to explore potential barriers to and facilitators of dose titration by HF nurses. In the intervention group, HF nurses will implement titration as prescribed by cardiologists, following a protocol. In controls, cardiologists will both prescribe and titrate doses. The study variables are doses of each of the drugs after 4 months relative to the target dose (%), New York Heart Association class, left ventricular ejection fraction, N-terminal pro B-type natriuretic peptide levels, 6 min walk distance, comorbidities, renal function, readmissions, mortality, quality of life, and psychosocial characteristics. The trial seeks to assess whether titration by HF nurses of drugs recommended in practice guidelines is safe and not inferior to direct management by cardiologists. The results could have an impact on clinical practice. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of

  9. Periodical assessment of genitourinary and gastrointestinal toxicity in patients who underwent prostate low-dose-rate brachytherapy

    International Nuclear Information System (INIS)

    Tanaka, Nobumichi; Asakawa, Isao; Anai, Satoshi; Hirayama, Akihide; Hasegawa, Masatoshi; Konishi, Noboru; Fujimoto, Kiyohide

    2013-01-01

    To compare the periodical incidence rates of genitourinary (GU) and gastrointestinal (GI) toxicity in patients who underwent prostate low-dose-rate brachytherapy between the monotherapy group (seed implantation alone) and the boost group (in combination with external beam radiation therapy (EBRT)). A total of 218 patients with a median follow-up of 42.5 months were enrolled. The patients were divided into 2 groups by treatment modality, namely, the monotherapy group (155 patients) and the boost group (63 patients). The periodical incidence rates of GU and GI toxicity were separately evaluated and compared between the monotherapy group and the boost group using the National Cancer Institute - Common Terminology Criteria for Adverse Events, version 3.0. To elucidate an independent factor among clinical and postdosimetric parameters to predict grade 2 or higher GU and GI toxicity in the acute and late phases, univariate and multivariate logistic regression analyses were carried out. Of all patients, 78.0% showed acute GU toxicity, and 7.8% showed acute GI toxicity, while 63.8% showed late GU toxicity, and 21.1% showed late GI toxicity. The incidence rates of late GU and GI toxicity were significantly higher in the boost group. Multivariate analysis showed that the International Prostate Symptom Score (IPSS) before seed implantation was a significant parameter to predict acute GU toxicity, while there were no significant predictive parameters for acute GI toxicity. On the other hand, combination with EBRT was a significant predictive parameter for late GU toxicity, and rectal volume (mL) receiving 100% of the prescribed dose (R100) was a significant predictive parameter for late GI toxicity. The boost group showed higher incidence rates of both GU and GI toxicity. Higher IPSS before seed implantation, combination with EBRT and a higher R100 were significant predictors for acute GU, late GU and late GI toxicity

  10. Quantification of micronuclei in blood lymphocytes of patients exposed to gamma radiation for dose absorbed assessment; Quantificacao de micronucleos em linfocitos de pacientes expostas a radiacao gama para a avaliacao da dose absorvida

    Energy Technology Data Exchange (ETDEWEB)

    Barbosa, Isvania Maria Serafim da Silva

    2003-02-15

    Dose assessment in an important step to evaluate biological effects as a result of individual exposure to ionizing radiation. The use of cytogenetic dosimetry based on the quantification of micronuclei in lymphocytes is very important to complement physical dosimetry, since the measurement of absorbed dose cannot be always performed. In this research, the quantification of micronuclei was carried out in order to evaluate absorbed dose as a result of radiotherapy with {sup 60}Co, using peripheral blood samples from 5 patients with cervical uterine cancer. For this purpose, an aliquot of whole blood from the individual patients was added in culture medium RPMI 1640 supplemented with fetal calf serum and phytohaemagglutinin. The culture was incubated for 44 hours. Henceforth, cytochalasin B was added to block the dividing lymphocytes in cytokinesis. The culture was returned to the incubator for further of 28 hours. Thus, cells were harvested, processed and analyzed. Values obtained considering micronuclei frequency after pelvis irradiation with absorption of 0,08 Gy and 1,8 Gy were, respectively, 0,0021 and 0,052. These results are in agreement with some recent researches that provided some standard values related to micronuclei frequency induced by gamma radiation exposure in different exposed areas for the human body. The results presented in this report emphasizes biological dosimetry as an important tool for dose assessment of either total or partial-body exposure to ionizing radiation, mainly in retrospective dose investigation. (author)

  11. Quality of life assessment in asthmatic patients receiving fluticasone compared with equipotent doses of beclomethasone or budesonide

    Directory of Open Access Journals (Sweden)

    Thomas Sabin

    2005-01-01

    Full Text Available Aims: To assess the quality of life in patients with asthma receiving either fluticasone or other inhaled steroids like beclomethasone or budesonide. To assess the effect of equipotent dosage of inhaled steroids at 3 months duration. Methods: Patients were randomised to receive either fluticasone or beclomethasone/budesonide. After spirometry, St. George′s Respiratory Questionnaire (SGRQ was administered at baseline and at 15 th , 30 th , 45 th , 60 th and 90 th day, to assess improvement in lung function and HRQoL. Results: Out of 96 patients who were enrolled, eighty patients completed three months duration of the study, while sixteen patients dropped out. Forty patients received fluticasone and forty received either beclomethasone or budesonide. No significant difference (p>0.05 was found in the baseline values of St. George′s Respiratory Questionnaire (SGRQ scores and Forced Expiratory Volume at first second (FEV 1 between the two groups. However, significant difference (p< 0.05 was noted between the above two groups, in Quality of Life (QoL but not in pulmonary functions, on 15th day favoring fluticasone. No significant difference (p>0.05 was noted either in QoL or in pulmonary function tests on subsequent follow-ups. Conclusion: Early response in terms of improved QoL was observed in fluticasone treated group in patients with moderate to severe asthma.

  12. Assessment of maximum tolerated dose of a new herbal drug, Semelil (ANGIPARSTM in patients with diabetic foot ulcer: A Phase I clinical trial

    Directory of Open Access Journals (Sweden)

    Heshmat R

    2008-04-01

    Full Text Available Background and the purpose of the study: In many cases of diabetic foot ulcer (DFU management, wound healing is incomplete, and wound closure and epithelial junctional integrity are rarely achieved. Our aim was to evaluate the maximum tolerated dose (MTD and dose-limiting toxicity (DLT of Semelil (ANGIPARSTM, a new herbal compound for wound treatment in a Phase I clinical trial.Methods: In this open label study, six male diabetic patients with a mean age of 57±7.6 years were treated with escalating intravenous doses of Semelil, which started at 2 cc/day to 13.5 cc/day for 28 days. Patients were assessed with a full physical exam; variables which analyzed included age, past history of diabetes and its duration, blood pressure, body temperature, weight, characteristics of DFU, Na, K, liver function test, Complete Blood Count and Differential(CBC & diff, serum amylase, HbA1c, PT, PTT, proteinuria, hematuria, and side effects were recorded. All the measurements were taken at the beginning of treatment, the end of week 2 and week 4. We also evaluated Semelil's side effects at the end of weeks 4 and 8 after ending therapy.Results and major conclusions: Up to the drug dose of 10 cc/day foot ulcer dramatically improved. We did not observe any clinical or laboratory side effects at this or lower dose levels in diabetic patients. With daily dose of 13.5 cc of Semelil we observed phlebitis at the infusion site, which was the only side effect. Therefore, in this study we determined the MTD of Semelil at 10 cc/day, and the only DLT was phlebitis in injection vein. The recommended dose of Semelil I.V. administration for Phase II studies was 4 cc/day.

  13. Assessing the dose values received by patients during conventional radiography X-ray examinations and the technical condition of the equipment used for this purpose.

    Science.gov (United States)

    Bekas, Marcin; Pachocki, Krzysztof A; Waśniewska, Elżbieta; Bogucka, Dagmara; Magiera, Andrzej

    2014-01-01

    X-ray examination is associated with patient exposure to ionizing radiation. Dose values depend on the type of medical procedure used, the X-ray unit technical condition and exposure conditions selected. The aim of this study was to determine the dose value received by patients during certain conventional radiography X-ray examinations and to assess the technical condition of medical equipment used for this purpose. The study covered the total number of 118 conventional diagnostic X-ray units located in the Masovian Voivodeship. The methodology used to assess the conventional diagnostic X-ray unit technical condition and the measurement of the radiation dose rate received by patients are based on test procedures developed by the Department of Radiation Protection and Radiobiology of the National Institute of Public Health - National Institute of Hygiene (Warszawa, Poland) accredited for compliance with PN-EN 17025 standard by the Polish Centre for Accreditation. It was found that 84.7% of X-ray units fully meet the criteria set out in the Polish legislation regarding the safe use of ionizing radiation in medicine, while 15.3% of the units do not meet some of them. The broadest dose value range was recorded for adult patients. Particularly, during lateral (LATl) lumbar spine radiography the recorded entrance surface dose (ESD) values ranged from 283.5 to 7827 µGy (mean: 2183.3 µGy). It is absolutely necessary to constantly monitor the technical condition of all X-ray units, because it affects population exposure to ionizing radiation. Furthermore, it is essential to raise radiographers' awareness of the effects that ionizing radiation exposure can have on the human body.

  14. Tissue dose in thorotrast patients

    International Nuclear Information System (INIS)

    Kaul, A.; Noffz, W.

    1978-01-01

    Absorbed doses to the liver, spleen, red marrow, lungs, kidneys, and to various parts of bone tissue were calculated for long-term burdens of intravascularly injected Thorotrast. The estimates were performed for typical injection levels of 10, 30, 50 and 100 ml, based upon best estimates of 232 Th tissue distribution, and steady state activity ratios between the subsequent daughters. Correcting for the α-particle self absorption within Thorotrast aggregates, the mean α-dose to a standard 70-kg man at 30 yr after the injection 0f 25 ml of Thorotrast is 750 rad to the liver, 2100 rad to the spleen, 270 rad to the red marrow, 60-620 rad in various parts of the lung, and 13 rad to the kidneys. Dose rates to various parts of bone tissue (bone surface, compact, and cancellous bone) were estimated by applying the ICRP model on alkaline earth metabolism to the continuous translocation of thorium daughters to bone and to the formation of thorium daughters by decay within bone tissue. The average dose to calcified bone from translocated 224 Ra with its daughters is 18 rad at 30 yr after the injection of 25 ml of Thorotrast. Considering the Spiess-Mays risk coefficient of 0.9-1.7% bone sarcoma/ 100 rad of average skeletal dose from 224 Ra and its daughters, the induction of 1.6-3.1 bone sarcomas per 1000 Thorotrast patients is predicted. (author)

  15. Patient Dose Considerations in Interventional Cardiology

    International Nuclear Information System (INIS)

    Ciraj-Bjelac, O.; Rafajlovic, S.; Arandjic, D.; Kosutic, D.

    2011-01-01

    Interventional cardiology procedures are classified as high-dose procedures, owing to increased risk for radiation skin injuries and stochastic effects, such as cancer. European MED Directive 97/43 requires special consideration and dose evaluation for this kind of procedures . Dose received by a patient, in general, depends on the radiological equipment, examination protocol, the way it is implemented, the patient's body weight and nature of disease. Long-term fluoroscopy of certain parts of the body, a significant body mass, high-value dose intensity, continuous rather than pulsed fluoroscopy, small focus-skin distance and repeated procedure on the same patient, are among the factors that can lead to radiation skin injuries. A particular challenge is the fact that the radiation damage of the skin is difficult to detect and connect to the previously conducted cardiologic procedures. The fact that such injuries do not have immediate manifestation is very often reason that many of them remain undetected. The purpose of this work is to assess the level of radiation dose to patients in percutaneous coronary interventions (PCI) and to investigate possibility for setting of a practical trigger value if dose quantities exceed certain levels in terms of dose descriptors available at display of interventional cardiology unit. Two dedicated interventional cardiology units in a large teaching cardiac centre (Clinical Centre of Serbia, Belgrade, Serbia) were included in the survey. Both rooms (D and F) were equipped with X-ray units of the identical model: Siemens Axiom Artis (Siemens, Erlangen, Germany) with the flat panel detector and integrated ionization chamber to measure air kerma-area product (P K A) and air kerma in international reference point (K I RP). Patient doses were assessed in terms of P K A, K I RP and maximum-skin dose (MSD). P K A and K I RP were assessed using a built-in, in situ calibrated dosimeters, while MSD was estimated using radiochromic films

  16. Dose to patient in tomosynthesis

    International Nuclear Information System (INIS)

    Minambres Moro, A.; Fernandez Leton, P.; Garcia Rui-Zorrilla, J.; Perez Moreno, J. M.; Zucca Aparicio, D.

    2013-01-01

    They are beginning to implement digital mammography with the possibility of acquiring in tomosynthesis, whose biggest advantage is to distinguish structures without overlapping through of pseudotridimensionals images. With these modified mammograms can acquire a planar mammography, with fixed x-ray tube, or a tomosynthesis with tube by turning. For acquire tomosynthesis is necessary a detector of high efficiency together with tungsten white tubes. The objective of this study is to know the dose received by the patient with this new imaging. (Author)

  17. Role of renal function in risk assessment of target non-attainment after standard dosing of meropenem in critically ill patients: a prospective observational study.

    Science.gov (United States)

    Ehmann, Lisa; Zoller, Michael; Minichmayr, Iris K; Scharf, Christina; Maier, Barbara; Schmitt, Maximilian V; Hartung, Niklas; Huisinga, Wilhelm; Vogeser, Michael; Frey, Lorenz; Zander, Johannes; Kloft, Charlotte

    2017-10-21

    Severe bacterial infections remain a major challenge in intensive care units because of their high prevalence and mortality. Adequate antibiotic exposure has been associated with clinical success in critically ill patients. The objective of this study was to investigate the target attainment of standard meropenem dosing in a heterogeneous critically ill population, to quantify the impact of the full renal function spectrum on meropenem exposure and target attainment, and ultimately to translate the findings into a tool for practical application. A prospective observational single-centre study was performed with critically ill patients with severe infections receiving standard dosing of meropenem. Serial blood samples were drawn over 4 study days to determine meropenem serum concentrations. Renal function was assessed by creatinine clearance according to the Cockcroft and Gault equation (CLCR CG ). Variability in meropenem serum concentrations was quantified at the middle and end of each monitored dosing interval. The attainment of two pharmacokinetic/pharmacodynamic targets (100%T >MIC , 50%T >4×MIC ) was evaluated for minimum inhibitory concentration (MIC) values of 2 mg/L and 8 mg/L and standard meropenem dosing (1000 mg, 30-minute infusion, every 8 h). Furthermore, we assessed the impact of CLCR CG on meropenem concentrations and target attainment and developed a tool for risk assessment of target non-attainment. Large inter- and intra-patient variability in meropenem concentrations was observed in the critically ill population (n = 48). Attainment of the target 100%T >MIC was merely 48.4% and 20.6%, given MIC values of 2 mg/L and 8 mg/L, respectively, and similar for the target 50%T >4×MIC . A hyperbolic relationship between CLCR CG (25-255 ml/minute) and meropenem serum concentrations at the end of the dosing interval (C 8h ) was derived. For infections with pathogens of MIC 2 mg/L, mild renal impairment up to augmented renal function was

  18. TH-C-18A-06: Combined CT Image Quality and Radiation Dose Monitoring Program Based On Patient Data to Assess Consistency of Clinical Imaging Across Scanner Models

    Energy Technology Data Exchange (ETDEWEB)

    Christianson, O; Winslow, J; Samei, E [Duke University Medical Center, Durham, NC (United States)

    2014-06-15

    Purpose: One of the principal challenges of clinical imaging is to achieve an ideal balance between image quality and radiation dose across multiple CT models. The number of scanners and protocols at large medical centers necessitates an automated quality assurance program to facilitate this objective. Therefore, the goal of this work was to implement an automated CT image quality and radiation dose monitoring program based on actual patient data and to use this program to assess consistency of protocols across CT scanner models. Methods: Patient CT scans are routed to a HIPPA compliant quality assurance server. CTDI, extracted using optical character recognition, and patient size, measured from the localizers, are used to calculate SSDE. A previously validated noise measurement algorithm determines the noise in uniform areas of the image across the scanned anatomy to generate a global noise level (GNL). Using this program, 2358 abdominopelvic scans acquired on three commercial CT scanners were analyzed. Median SSDE and GNL were compared across scanner models and trends in SSDE and GNL with patient size were used to determine the impact of differing automatic exposure control (AEC) algorithms. Results: There was a significant difference in both SSDE and GNL across scanner models (9–33% and 15–35% for SSDE and GNL, respectively). Adjusting all protocols to achieve the same image noise would reduce patient dose by 27–45% depending on scanner model. Additionally, differences in AEC methodologies across vendors resulted in disparate relationships of SSDE and GNL with patient size. Conclusion: The difference in noise across scanner models indicates that protocols are not optimally matched to achieve consistent image quality. Our results indicated substantial possibility for dose reduction while achieving more consistent image appearance. Finally, the difference in AEC methodologies suggests the need for size-specific CT protocols to minimize variability in image

  19. TH-C-18A-06: Combined CT Image Quality and Radiation Dose Monitoring Program Based On Patient Data to Assess Consistency of Clinical Imaging Across Scanner Models

    International Nuclear Information System (INIS)

    Christianson, O; Winslow, J; Samei, E

    2014-01-01

    Purpose: One of the principal challenges of clinical imaging is to achieve an ideal balance between image quality and radiation dose across multiple CT models. The number of scanners and protocols at large medical centers necessitates an automated quality assurance program to facilitate this objective. Therefore, the goal of this work was to implement an automated CT image quality and radiation dose monitoring program based on actual patient data and to use this program to assess consistency of protocols across CT scanner models. Methods: Patient CT scans are routed to a HIPPA compliant quality assurance server. CTDI, extracted using optical character recognition, and patient size, measured from the localizers, are used to calculate SSDE. A previously validated noise measurement algorithm determines the noise in uniform areas of the image across the scanned anatomy to generate a global noise level (GNL). Using this program, 2358 abdominopelvic scans acquired on three commercial CT scanners were analyzed. Median SSDE and GNL were compared across scanner models and trends in SSDE and GNL with patient size were used to determine the impact of differing automatic exposure control (AEC) algorithms. Results: There was a significant difference in both SSDE and GNL across scanner models (9–33% and 15–35% for SSDE and GNL, respectively). Adjusting all protocols to achieve the same image noise would reduce patient dose by 27–45% depending on scanner model. Additionally, differences in AEC methodologies across vendors resulted in disparate relationships of SSDE and GNL with patient size. Conclusion: The difference in noise across scanner models indicates that protocols are not optimally matched to achieve consistent image quality. Our results indicated substantial possibility for dose reduction while achieving more consistent image appearance. Finally, the difference in AEC methodologies suggests the need for size-specific CT protocols to minimize variability in image

  20. Patient doses in interventional cardiology

    International Nuclear Information System (INIS)

    Carrera, F.; Ojeda, C.; Ruiz-Cruces, R.; Francisco Diaz, J.; Sanchez, A.; Tort, I.

    2001-01-01

    Cardiovascular diseases are the first cause of death in Spain. The most usual procedures in interventional cardiology are coronariography and PTCA. The first is a diagnostic technique, and the second one is interventional. Our goal has been to study procedures made during the first six months in the Interventional Cardiology Unit of the Juan Ramon Jimenez Hospital (Huelva-Spain), taking into account radiation protection issues. We have studied 178 patients; 145 of them underwent coronariography, and 33 of the patients had PTCA too. Every case was analyzed taking into account technical and dosimetric parameters. We show parameters values gathered: Diagnostic techniques (valvular and non-valvular patients), and interventional techniques (coronariography and PTCA in different or in the same intervention). Higher doses were obtained with valvular patients, although the number of frames was similar. Attending to therapeutic procedures, the highest values were gotten with the 'double' interventions. Interventional procedures exceed in 60% doses gotten in diagnostic studies: this is because of the number of series and number of frames per series. Similar values obtained by other authors have been gotten. (author)

  1. Patient and staff doses in interventional neuroradiology

    International Nuclear Information System (INIS)

    Bor, D.; Cekirge, S.; Tuerkay, T.; Turan, O.; Guelay, M.; Oenal, E.; Cil, B.

    2005-01-01

    Radiation doses for interventional examinations are generally high and therefore necessitate dose monitoring for patients and staff. Relating the staff dose to a patient dose index, such as dose-area product (DAP), could be quite useful for dose comparisons. In this study, DAP and skin doses of 57 patients, who underwent neuro-interventional examinations, were measured simultaneously with staff doses. Although skin doses were comparable with the literature data, higher DAP values of 215 and 188.6 Gy cm 2 were measured for the therapeutical cerebral and carotid examinations, respectively, owing to the use of biplane system and complexity of the procedure. Mean staff doses for eye, finger and thyroid were measured as 80.6, 77.6 and 28.8 μGy per procedure. The mean effective dose per procedure for the radiologists was 32 μSv. In order to allow better comparisons to be made, DAP normalised doses were also presented. (authors)

  2. 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

  3. Irrigation in dose assessments models

    International Nuclear Information System (INIS)

    Bergstroem, Ulla; Barkefors, Catarina

    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

  4. Exposure dose assessment using bioassay

    International Nuclear Information System (INIS)

    Suga, Shinichi

    1994-01-01

    Bioassay involves following steps: sampling, pre-treatment, chemical separation and counting of radioactivity. As bioassay samples, urines are usually used, although faecal analysis may be required in some occasions for example to assess intake of non-transferable radioactive materials. Nasal smear is a useful indicator of an inhalation case. Exhalation air is used to estimate the intake of tritiated water. Sample pre-treatment includes evaporation for concentration, wet ashing, dry ashing and co-precipitation. After adding small amount of nitric acid, the sample can be concentrated by 1/10 of initial volume, which may be used to identify γ-emitters. As the pre-treatment of urine, wet ashing is used for example for analysis of Pu, and co-precipitation is used for example for analysis of Sr. Dry ashing by electric furnace is usually adopted for faecal samples. Methods of chemical separation depend on the radionuclide(s) to be analysed. The detection limit depends also on radionuclide, and for example typical detection limits are 0.4Bq / l (volume of urine sample) for 89 Sr or 90 Sr, and 0.01 Bq / l with urine and 0.01 Bq per sample with faeces for 238 Pu, 239 Pu or 241 Am. Simpler methods can be used for some radionuclides: For example, radioactivity concentration of tritium can be determined by liquid scintillation counting of urine or condensed water from exhaled air, and natural uranium in urine can be quantified by using fluorometric method. In some circumstances, gross-α or gross-β analyses are useful for quick estimation. To estimate intakes by inhalation or by ingestion from bioassay results and to assess the committed dose equivalent, commonly available bases are the relevant publications by the ICRP and domestic guides and manuals that conform to the radiation protection regulations. (author)

  5. Assessment of the efficacy of a novel tailored vitamin K dosing regimen in lowering the International Normalised Ratio in over-anticoagulated patients: a randomised clinical trial.

    Science.gov (United States)

    Kampouraki, Emmanouela; Avery, Peter J; Wynne, Hilary; Biss, Tina; Hanley, John; Talks, Kate; Kamali, Farhad

    2017-09-01

    Current guidelines advocate using fixed-doses of oral vitamin K to reverse excessive anticoagulation in warfarinised patients who are either asymptomatic or have minor bleeds. Over-anticoagulated patients present with a wide range of International Normalised Ratio (INR) values and response to fixed doses of vitamin K varies. Consequently a significant proportion of patients remain outside their target INR after vitamin K administration, making them prone to either haemorrhage or thromboembolism. We compared the performance of a novel tailored vitamin K dosing regimen to that of a fixed-dose regimen with the primary measure being the proportion of over-anticoagulated patients returning to their target INR within 24 h. One hundred and eighty-one patients with an index INR > 6·0 (asymptomatic or with minor bleeding) were randomly allocated to receive oral administration of either a tailored dose (based upon index INR and body surface area) or a fixed-dose (1 or 2 mg) of vitamin K. A greater proportion of patients treated with the tailored dose returned to within target INR range compared to the fixed-dose regimen (68·9% vs. 52·8%; P = 0·026), whilst a smaller proportion of patients remained above target INR range (12·2% vs. 34·0%; P vitamin K dosing is more accurate than fixed-dose regimen in lowering INR to within target range in excessively anticoagulated patients. © 2017 John Wiley & Sons Ltd.

  6. [Assessment of the use of racemic ketamine and its S(+) isomer, associated or not with low doses of fentanyl, in balneotherapy for major burn patients].

    Science.gov (United States)

    Cantinho, Fernando Antônio de Freitas; Silva, Antonio Carlos Pereira da

    2009-01-01

    The care of the wounds of major burn patients triggers severe painful stimuli. The objective of this study was to assess the safety and efficacy of different drug combinations in anesthesia for balneotherapy. After approval by the Ethics Commission, 200 procedures of balneotherapy in 87 major burn adult patients were evaluated. Midazolam was used in all cases. The vials of ketamine were numbered and, therefore, at the time of the use, one did not know whether racemic or S(+)ketamine was being used. Each morning it was decided by drawing lots whether fentanyl would be used or not in the procedures of that day. Patients were included in one of four groups: ISO/sf (S(+) isomer without fentanyl), ISO/cf (S(+) isomer with fentanyl), RAC/sf (racemic ketamine without fentanyl), and RAC/cf (racemic ketamine with fentanyl). The initial doses proposed were as follows: midazolam, 0.06 mg.kg-1; ketamine, 1.0 to 1.1 mg.kg-1; and fentanyl, 0.8 (1/4)g.kg1-1; additional doses were administered as needed. Only one patient recalled the pain of balneotherapy. In the group that received S(+)ketamine, the use of fentanyl did not bring additional advantages; however, when associated with racemic ketamine, fentanyl reduced the total dose and the number of ketamine boluses. The extension of body surface burned was the main determinant of the severity of post-procedure pain. Reduced pain severity was the main factor considered by patients when grading their satisfaction with the anesthesia. The four different drug combinations proved to be safe and guaranteed the absence of pain during balneotherapy. Characteristics not directly related to the anesthetics proved to be more important in the incidence of post-procedure pain, which was the main factor considered by major burn patient to define their satisfaction with the anesthesia used.

  7. Optimisation of radioprotection of patients in nuclear medicine: assessment of doses for the new ICRP's reference voxelized phantoms

    International Nuclear Information System (INIS)

    Hadid, L.; Blanchardon, E.; Desbree, A.; Makovicka, L.; Zankl, M.

    2010-01-01

    As the ICPR (International Commission on Radiological Protection) decided to adopt voxelized phantoms to emulate a reference adult, the authors report the validation of calculations of the SFAs (specific absorbed fractions) for the new ICPR's reference phantoms. After a presentation of these phantoms, the authors briefly present the OEDIPE software which is used to compute the SAFs and notably the absorbed doses. They discuss the results obtained for the SAFs (for photons and for electrons) and for the doses

  8. Patient dose measurement and dose reduction in East Anglia (UK)

    International Nuclear Information System (INIS)

    Wade, J.P.; Goldstone, K.E.; Dendy, P.P.

    1995-01-01

    At the end of 1990 a programme of patient dose measurements was introduced as part of the quality assurance service already provided for X ray departments throughout the East Anglian Health Region (UK). Thermoluminescence dosemeters (TLDs) were used to measure over 1200 skin entrance surface doses for four common radiographic views in 33 hospitals in both the NHS and private sector. The four views were chosen to cover a wide range of equipment and techniques. The data collected have enabled Regional reference doses to be set which, for all views considered, fall below the National Radiological Protection Board (NRPB) Reference levels. In departments which exceeded reference levels, techniques were reviewed, improvements suggested and doses re-measured, in accordance with the recommended procedure for patient dose audit. A significant finding was that, given appropriate controls, X ray departments in the private sector could achieve the same acceptably low doses as NHS departments. (Author)

  9. Dose assessment at Bikini Atoll

    International Nuclear Information System (INIS)

    Robison, W.L.; Phillips, W.A.; Colsher, C.S.

    1977-01-01

    Bikini Atoll is one of two sites in the northern Marshall Islands that was used by the United States as testing grounds for the nuclear weapons program from 1946 to 1958. In 1969 a general cleanup began at Bikini Atoll. Subsistence crops, coconut and Pandanus fruit, were planted on Bikini and Eneu Islands, and housing was constructed on Bikini Island. A second phase of housing was planned for the interior of Bikini Island. Preliminary data indicated that external gamma doses in the interior of the island might be higher than in other parts of the island. Therefore, to select a second site for housing on the island with minimum external exposure, a survey of Bikini Atoll was conducted in June 1975. External gamma measurements were made on Bikini and Eneu Islands, and soil and vegetations samples collected to evaluate the potential doses via terrestrial food chains and inhalation. Estimates of potential dose via the marine food chain were based upon data collected on previous trips to the atoll. The terrestrial pathway contributes the greater percentage, external gamma exposure contributes the next highest, and inhalation and marine pathways contribute minor fractions of the total whole body and bone marrow doses. The radionuclides contributing the major fraction of the dose are 90 Sr and 137 Cs. All living patterns involving Bikini Island exceed federal guidelines for 30-yr population doses. The Eneu Island living pattern leads to doses that are slightly less than federal guidelines. All patterns evaluated for Bikini Atoll lead to higher doses than those on the southern islands at Enewetak Atoll

  10. Patient dose in digital mammography

    International Nuclear Information System (INIS)

    Chevalier, Margarita; Moran, Pilar; Ten, Jose I.; Fernandez Soto, Jose M.; Cepeda, T.; Vano, Eliseo

    2004-01-01

    In the present investigation, we analyze the dose of 5034 patients (20 137 images) who underwent mammographic examinations with a full-field digital mammography system. Also, we evaluate the system calibration by analyzing the exposure factors as a function of breast thickness. The information relevant to this study has been extracted from the image DICOM header and stored in a database during a 3-year period (March 2001-October 2003). Patient data included age, breast thickness, kVp, mAs, target/filter combination, and nominal dose values. Entrance surface air kerma (ESAK) without backscatter was calculated from the tube output as measured for each voltage used under clinical conditions and from the tube loading (mAs) included in the DICOM header. Mean values for the patient age and compressed breast thickness were 56 years (SD: 11) and 52 mm (SD: 13), respectively. The majority of the images was acquired using the STD (for standard) automatic mode (98%). The most frequent target/filter combination automatically selected for breast smaller than 35 mm was Mo/Mo (75%); for intermediate thicknesses between 35 and 65 mm, the combinations were Mo/Rh (54%) and Rh/Rh (38.5%); Rh/Rh was the combination selected for 91% of the cases for breasts thicker than 65 mm. A wide kVp range was observed for each target/filter combination. The most frequent values were 28 kVp for Mo/Mo, 29 kVp for Mo/Rh, and 29 and 30 kV for Rh/Rh. Exposure times ranged from 0.2 to 4.2 s with a mean value of 1.1 s. Average glandular doses (AGD) per exposure were calculated by multiplying the ESAK values by the conversion factors tabulated by Dance for women in the age groups 50 to 64 and 40 to 49. This approach is based on the dependence of breast glandularity on breast thickness and age. The total mean average glandular dose (AGD T ) was calculated by summing the values associated with the pre-exposure and with the main exposure. Mean AGD T per exposure was 1.88 mGy (CI 0.01) and the mean AGD T per

  11. Dose study of the multikinase inhibitor, LY2457546, in patients with relapsed acute myeloid leukemia to assess safety, pharmacokinetics, and pharmacodynamics

    Directory of Open Access Journals (Sweden)

    Wacheck V

    2011-05-01

    Full Text Available Volker Wacheck1, Michael Lahn2, Gemma Dickinson3, Wolfgang Füreder4, Renata Meyer4, Susanne Herndlhofer4, Thorsten Füreder1, Georg Dorfner5, Sada Pillay2, Valérie André6, Timothy P Burkholder7, Jacqueline K Akunda8, Leann Flye-Blakemore9, Dirk Van Bockstaele9, Richard F Schlenk10, Wolfgang R Sperr4, Peter Valent4,111Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel, Vienna, Austria; 2Early Oncology Clinical Investigation, Eli Lilly and Company, Indianapolis, IN, USA; 3Department of Pharmacokinetics, Eli Lilly and Company, Erl Wood Research Centre, Windlesham, Surrey, UK; 4Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of Vienna, Währinger Gürtel, Vienna, Austria; 5Eli Lilly GesmbH, Medical Department, Vienna, Austria; 6Department of Statistics, Eli Lilly and Company, Erl Wood Research Centre, Surrey, UK; 7Discovery Chemistry Research and Technology, Eli Lilly and Company, Indianapolis, IN, USA; 8Nonclinical Toxicology, Eli Lilly and Company, Indianapolis, IN, USA; 9Flow Cytometry and Cell Analysis, Esoterix Clinical Trials Services, Mechelen, Belgium; 10Universitätsklinikum Ulm, Klinik für Innere Medizin III, Ulm, Germany; 11Ludwig Boltzmann Cluster Oncology, Vienna, AustriaBackground: Acute myeloid leukemia (AML is a life-threatening malignancy with limited treatment options in chemotherapy-refractory patients. A first-in-human dose study was designed to investigate a safe and biologically effective dose range for LY2457546, a novel multikinase inhibitor, in patients with relapsed AML.Methods: In this nonrandomized, open-label, dose escalation Phase I study, LY2457546 was administered orally once a day. Safety, pharmacokinetics, changes in phosphorylation of target kinases in AML blasts, and risk of drug–drug interactions (DDI were assessed.Results: Five patients were treated at the starting and predicted minimal biologically effective dose of 50 mg

  12. AGING FACILITY WORKER DOSE ASSESSMENT

    International Nuclear Information System (INIS)

    R.L. Thacker

    2005-01-01

    The purpose of this calculation is to estimate radiation doses received by personnel working in the Aging Facility performing operations to transfer aging casks to the aging pads for thermal and logistical management, stage empty aging casks, and retrieve aging casks from the aging pads for further processing in other site facilities. Doses received by workers due to aging cask surveillance and maintenance operations are also included. 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. There are no Category 1 event sequences associated with the Aging Facility (BSC 2004 [DIRS 167268], Section 7.2.1). The results of this calculation will be used to support the design of the Aging Facility 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 Environmental and Nuclear Engineering

  13. Practical experience of monitoring patient dose

    Energy Technology Data Exchange (ETDEWEB)

    McDonnell, C.; Shrimpton, P. (National Radiological Protection Board, Chilton (United Kingdom)); O' Mahoney, M. (National Radiological Protection Board, Leeds (United Kingdom)); Foster, J. (Nuffield Hospitals, Surbiton (United Kingdom))

    1994-05-01

    NRPB recommends the use of reference dose levels for diagnostic medical exposures as an aid to patient dose reduction, but is this approach effective This article describes the broadly encouraging experiences of one large group of hospitals in carrying out measurements of entrance surface dose on patients undergoing some common types of x-ray examination. (author).

  14. Howard Hughes Medical Institute dose assessment survey

    International Nuclear Information System (INIS)

    O'Brien, S.L.; McDougall, M.M.; Barkley, W.E.

    1996-01-01

    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

  15. The patient dose survey and dose reduction in diagnostic radiology

    International Nuclear Information System (INIS)

    Dang Thanh Luong; Duong Van Vinh; Ha Ngoc Thach

    2000-01-01

    This paper presented the results of the patient dose survey in some hospitals in Hanoi from 1995 to 1997. The main investigated types of the X-ray examination were: Chest PA, LAT; Skull PA/AP, LAT; Lumbar spine AP, LAT; and Pelvis AP. The fluctuation of the entrance surface doses (ESD) was too large, even in the same type of X-ray examination and X-ray facility. It was found that the ratio of maximum and minimum ESD were ranged from 1.5 to 18. The mean values of ESD for chest and skull were higher than CEC recommended values, while the mean values of lumbar spine and pelvis were smaller than that of CEC recommended values. The result of dose intercomparison was also reported. Some methods of dose reduction were applied for improving the patient dose in X-ray departments such as a high kV technique, high sensitive screen-film combination. (author)

  16. Patient dose measurement and dose reduction in chest radiography

    Directory of Open Access Journals (Sweden)

    Milatović Aleksandra A.

    2014-01-01

    Full Text Available Investigations presented in this paper represent the first estimation of patient doses in chest radiography in Montenegro. In the initial stage of our study, we measured the entrance surface air kerma and kerma area product for chest radiography in five major health institutions in the country. A total of 214 patients were observed. We reported the mean value, minimum and third quartile values, as well as maximum values of surface air kerma and kerma area product of patient doses. In the second stage, the possibilities for dose reduction were investigated. Mean kerma area product values were 0.8 ± 0.5 Gycm2 for the posterior-anterior projection and 1.6 ± 0.9 Gycm2 for the lateral projection. The max/min ratio for the entrance surface air kerma was found to be 53 for the posterior-anterior projection and 88 for the lateral projection. Comparing the results obtained in Montenegro with results from other countries, we concluded that patient doses in our medical centres are significantly higher. Changes in exposure parameters and increased filtration contributed to a dose reduction of up to 36% for posterior-anterior chest examinations. The variability of the estimated dose values points to a significant space for dose reduction throughout the process of radiological practice optimisation.

  17. Dose assessment models. Annex A

    International Nuclear Information System (INIS)

    1982-01-01

    The models presented in this chapter have been separated into 2 general categories: environmental transport models which describe the movement of radioactive materials through all sectors of the environment after their release, and dosimetric models to calculate the absorbed dose following an intake of radioactive materials or exposure to external irradiation. Various sections of this chapter also deal with atmospheric transport models, terrestrial models, and aquatic models.

  18. Iterative reconstruction technique vs filter back projection: utility for quantitative bronchial assessment on low-dose thin-section MDCT in patients with/without chronic obstructive pulmonary disease

    Energy Technology Data Exchange (ETDEWEB)

    Koyama, Hisanobu; Seki, Shinichiro; Sugimura, Kazuro [Kobe University Graduate School of Medicine, Division of Radiology, Department of Radiology, Kobe, Hyogo (Japan); Ohno, Yoshiharu; Nishio, Mizuho; Matsumoto, Sumiaki; Yoshikawa, Takeshi [Kobe University Graduate School of Medicine, Advanced Biomedical Imaging Research Centre, Kobe (Japan); Kobe University Graduate School of Medicine, Division of Functional and Diagnostic Imaging Research, Department of Radiology, Kobe (Japan); Sugihara, Naoki [Toshiba Medical Systems Corporation, Ohtawara, Tochigi (Japan)

    2014-08-15

    The aim of this study was to evaluate the utility of the iterative reconstruction (IR) technique for quantitative bronchial assessment during low-dose computed tomography (CT) as a substitute for standard-dose CT in patients with/without chronic obstructive pulmonary disease. Fifty patients (mean age, 69.2; mean % predicted FEV1, 79.4) underwent standard-dose CT (150mAs) and low-dose CT (25mAs). Except for tube current, the imaging parameters were identical for both protocols. Standard-dose CT was reconstructed using filtered back-projection (FBP), and low-dose CT was reconstructed using IR and FBP. For quantitative bronchial assessment, the wall area percentage (WA%) of the sub-segmental bronchi and the airway luminal volume percentage (LV%) from the main bronchus to the peripheral bronchi were acquired in each dataset. The correlation and agreement of WA% and LV% between standard-dose CT and both low-dose CTs were statistically evaluated. WA% and LV% between standard-dose CT and both low-dose CTs were significant correlated (r > 0.77, p < 0.00001); however, only the LV% agreement between SD-CT and low-dose CT reconstructed with IR was moderate (concordance correlation coefficient = 0.93); the other agreement was poor (concordance correlation coefficient <0.90). Quantitative bronchial assessment via low-dose CT has potential as a substitute for standard-dose CT by using IR and airway luminal volumetry techniques. circle Quantitative bronchial assessment of COPD using low-dose CT is possible. (orig.)

  19. Carboplatin dosing for adult Japanese patients.

    Science.gov (United States)

    Ando, Yuichi; Shimokata, Tomoya; Yasuda, Yoshinari; Hasegawa, Yoshinori

    2014-02-01

    Carboplatin is a platinum-based anticancer drug that has been long used to treat many types of solid cancer. Because the clearance of carboplatin strongly correlates with the glomerular filtration rate (GFR), its dosage is calculated with the Calvert formula on the basis of the patient's GFR to achieve the target area under the plasma drug concentration-time curve (AUC) for each patient. However, many lines of evidence from previous clinical studies should be interpreted with caution because different methods were used to estimate drug clearance and derive the dosage of carboplatin. There is a particularly high risk of carboplatin overdosing when the dosage is determined on the basis of standardized serum creatinine values. When deciding the dose of carboplatin for adult Japanese patients, preferred methods to assess renal function instead of directly measuring GFR include (1) 24-h urinary collection-based creatinine clearance adjusted by adding 0.2 mg/dl to the serum creatinine concentration measured by standardized methods, and (2) equation-based GFR (eGFR) with a back calculation to units of ml/min per subject. Given the limitations of serum creatinine-based GFR estimations, the GFR or creatinine clearance should be directly measured in each patient whenever possible. To ensure patient safety and facilitate a medical-team approach, the single most appropriate method available at each institute or medical team should be consistently used to calculate the dose of carboplatin with the Calvert formula.

  20. Patient radiation doses from enteroclysis examinations

    International Nuclear Information System (INIS)

    Hart, D.; Wall, B.F.; Haggett, P.J.; Boardman, P.; Nolan, D.J.

    1994-01-01

    Data relating to patient dose have been acquired for enteroclysis examinations (small bowel enemas) performed at the John Radcliffe Hospital, Oxford, on 23 adult patients. Dose-area products, fluoroscopy times and the number of radiographs taken are used to compare the examination procedure at the Hospital with enteroclysis and barium follow-throughs performed elsewhere. The mean dose-area product for the 23 examinations was 6.8 Gy cm 2 and the mean effective dose was estimated to be 1.5 mSv. These doses are intermediate between those arising from barium meals and barium enemas performed in the same room. (author)

  1. Influence of high-dose lipid lowering treatment compared to low-dose lipid lowering treatment on plaque composition assessed by intravascular ultrasound virtual histology in patients with ST-segment elevation acute myocardial infarction

    DEFF Research Database (Denmark)

    Egede, Rasmus; Jensen, Lisette Okkels; Hansen, Henrik Steen

    2013-01-01

    Aims: The aim of this study was to evaluate the effect of low-dose versus high-dose rosuvastatin therapy on the necrotic core content in coronary plaques of angiographic non-significant lesions as assessed by intravascular ultrasound - virtual histology. Methods and results: Eighty-seven statin...

  2. Research and assessment of national population dose

    International Nuclear Information System (INIS)

    Pan Ziqiang

    1984-01-01

    This article describes the necessity and probability of making researches on assessment of national population dose, and discusses some problems which might be noticeable in the research work. (author)

  3. 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.

  4. Thermoluminescent dosimetry and assessment of personal dose

    International Nuclear Information System (INIS)

    Boas, J.F.; Martin, L.J.; Young, J.G.

    1982-01-01

    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 CaSO 4 :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. Assessment of entrance skin doses for patients undergoing diagnostic X-ray examinations in some major hospitals of Uttarakhand, India

    International Nuclear Information System (INIS)

    Uniyal, S.C.; Prasad, V.; Chaturvedi, V.; Raghuvanshi, S.; Sharma, S.D.

    2016-01-01

    Entrance skin dose (ESD) was calculated based on the X-ray beam output, the exposure parameters used for the actual examination and the standard value of backscatter factor. Descriptive statistics were generated from the data by using Microsoft Excel 2010. The third quartile values of ESDs obtained in this study for different X-ray projections of chest anterior-posterior (AP), chest posterior-anterior (PA), cervical spine, thoracic spine, lumber spine AP, lumber spine lateral, abdomen, KUB, pelvis, skull and knee joint were 0.79, 0.28, 1.20, 2.80, 4.26, 9.82, 2.68, 3.21, 2.69, 2.21 and 0.55 mGy respectively. The ratio of maximum to minimum ESD values ranges from 5.2 for thoracic spine to 19.76 for chest AP X-ray examinations. In general, the obtained ESD values were found to be either lower than or in agreement with the reported national/international values

  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. Prognostic value of high-dose dobutamine stress magnetic resonance imaging in 1,493 consecutive patients: assessment of myocardial wall motion and perfusion.

    Science.gov (United States)

    Korosoglou, Grigorios; Elhmidi, Yacine; Steen, Henning; Schellberg, Dieter; Riedle, Nina; Ahrens, Johannes; Lehrke, Stephanie; Merten, Constanze; Lossnitzer, Dirk; Radeleff, Jannis; Zugck, Christian; Giannitsis, Evangelos; Katus, Hugo A

    2010-10-05

    This study sought to determine the prognostic value of wall motion and perfusion assessment during high-dose dobutamine stress (DS) cardiac magnetic resonance imaging (MRI) in a large patient cohort. DS-MRI offers the possibility to integrate myocardial perfusion and wall motion analysis in a single examination for the detection of coronary artery disease (CAD). A total of 1,493 consecutive patients with suspected or known CAD underwent DS-MRI, using a standard protocol in a 1.5-T magnetic resonance scanner. Wall motion and perfusion were assessed at baseline and during stress, and outcome data including cardiac death, nonfatal myocardial infarction ("hard events"), and "late" revascularization performed >90 days after the MR scans were collected during a 2 ± 1 year follow-up period. Fifty-three hard events, including 14 cardiac deaths and 39 nonfatal infarctions, occurred during the follow-up period, whereas 85 patients underwent "late" revascularization. Using multivariable regression analysis, an abnormal result for wall motion or perfusion during stress yielded the strongest independent prognostic value for both hard events and late revascularization, clearly surpassing that of clinical and baseline magnetic resonance parameters (for wall motion: adjusted hazard ratio [HR] of 5.9 [95% confidence interval (CI): 2.5 to 13.6] for hard events and of 3.1 [95% CI: 1.7 to 5.6] for late revascularization, and for perfusion: adjusted HR of 5.4 [95% CI: 2.3 to 12.9] for hard events and of 6.2 [95% CI: 3.3 to 11.3] for late revascularization, p < 0.001 for all). DS-MRI can accurately identify patients who are at increased risk for cardiac death and myocardial infarction, separating them from those with normal findings, who have very low risk for future cardiac events. (Prognostic Value of High Dose Dobutamine Stress Magnetic Resonance Imaging; NCT00837005). Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  8. Patient Dose From Megavoltage Computed Tomography Imaging

    International Nuclear Information System (INIS)

    Shah, Amish P.; Langen, Katja M.; Ruchala, Kenneth J.; Cox, Andrea; Kupelian, Patrick A.; Meeks, Sanford L.

    2008-01-01

    Purpose: Megavoltage computed tomography (MVCT) can be used daily for imaging with a helical tomotherapy unit for patient alignment before treatment delivery. The purpose of this investigation was to show that the MVCT dose can be computed in phantoms, and further, that the dose can be reported for actual patients from MVCT on a helical tomotherapy unit. Methods and Materials: An MVCT beam model was commissioned and verified through a series of absorbed dose measurements in phantoms. This model was then used to retrospectively calculate the imaging doses to the patients. The MVCT dose was computed for five clinical cases: prostate, breast, head/neck, lung, and craniospinal axis. Results: Validation measurements in phantoms verified that the computed dose can be reported to within 5% of the measured dose delivered at the helical tomotherapy unit. The imaging dose scaled inversely with changes to the CT pitch. Relative to a normal pitch of 2.0, the organ dose can be scaled by 0.67 and 2.0 for scans done with a pitch of 3.0 and 1.0, respectively. Typical doses were in the range of 1.0-2.0 cGy, if imaged with a normal pitch. The maximal organ dose calculated was 3.6 cGy in the neck region of the craniospinal patient, if imaged with a pitch of 1.0. Conclusion: Calculation of the MVCT dose has shown that the typical imaging dose is approximately 1.5 cGy per image. The uniform MVCT dose delivered using helical tomotherapy is greatest when the anatomic thickness is the smallest and the pitch is set to the lowest value

  9. Patient doses in digital cardiac imaging

    International Nuclear Information System (INIS)

    Huda, W.; Ogden, K.M.; Roskopf, M.L.; Phadke, K.

    2001-01-01

    In this pilot study, we obtained estimates of entrance skin doses and the corresponding effective doses to patients undergoing digital cardiac imaging procedures on a GE Advantx LC/LP Plus system. Data were obtained for six patients undergoing diagnostic examinations and six patients who had interventional procedures. For each patient examination, radiographic techniques for fluoroscopic and digital cine imaging were recorded, together with the irradiation geometry. The projection with the highest exposure resulted in an average skin dose of 0.64 ± 0.41 Gy (maximum of 1.6 Gy). The average patient skin doses taking into account overlapping projections was 1.1 ± 0.8 Gy (maximum of 3.0 Gy). The exposure area product (EAP) incident on the patient was converted into the energy imparted to the patient and the corresponding effective dose. The average patient effective dose was 28 ± 14 mSv (maximum 62 mSv), with the resultant average fatal cancer risk estimated to be of the order of 8x10 -3 . Average doses for interventional procedures in cardiac imaging are higher than those associated with diagnostic examinations by approximately 50%. (author)

  10. Radiation dose assessment in nuclear medicine

    International Nuclear Information System (INIS)

    Stabin, M.G.

    2002-01-01

    In any application involving the use of ionizing radiation in humans, risks and benefits must be properly evaluated and balanced. 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, particularly in the treatment of hematologic and non-hematologic malignancies. This has heightened interest in the need for radiation dose calculations and challenged the scientific community to develop more patient-specific and relevant dose models. Consideration of radiation dose in such studies is central to efforts to maximize dose to tumor while sparing normal tissues. In many applications, a significant absorbed dose may be received by some radiosensitive organs, particularly the active marrow. This talk will review the methods and models used in internal dosimetry in nuclear medicine, and discuss some current trends and challenges in this field

  11. Dose assessment for brachytherapy with Henschke applicator

    International Nuclear Information System (INIS)

    Yu, Pei-Chieh; Chao, Tsi-Chian; Tung, Chuan-Jong; Wu, Ching-Jung; Lee, Chung-Chi

    2011-01-01

    Dose perturbation caused by the Henschke applicator is a major concern for the brachytherapy planning system (BPS) in recent years. To investigate dose impact owing to neglect of the metal shielding effect, Monte Carlo (MC) simulation, BPS calculation, and film measurement have been performed for dose assessment in a water phantom. Additionally, a cylindrical air cavity representing the rectum was added into the MC simulation to study its effect on dose distribution. Monte Carlo N-Particle Transport Code (MCNP) was used in this study to simulate the dose distribution using a mesh tally. This Monte Carlo simulation has been validated using the TG-43 data in a previous report. For the measurement, the Henschke applicator was placed in a specially-designed phantom, and Gafchromic films were inserted in the center plane for 2D dose assessment. Isodose distributions with and without the Henschke applicator by the MC simulation show significant deviation from those by the BPS. For MC simulation, the isodose curves shrank more significantly when the metal applicator was applied. For the impact of the added air cavity, the results indicate that it is hard to distinguish between with and without the cavity. Thus, the rectum cavity has little impact on the dose distribution around the Henschke applicator.

  12. Patient-specific dose estimation for pediatric chest CT

    Energy Technology Data Exchange (ETDEWEB)

    Li Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Frush, Donald P. [Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 and Department of Radiology, Duke Advanced Imaging Laboratories, Duke University Medical Center, Durham, North Carolina 27705 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 (United States); Department of Radiology, Duke Advanced Imaging Laboratories, Duke University Medical Center, 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); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 and Department of Radiology, Duke Advanced Imaging Laboratories, Duke University Medical Center, Durham, North Carolina 27705 (United States); Department of Radiology, Duke Advanced Imaging Laboratories, Duke University Medical Center, Durham, North Carolina 27705 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 and Global Applied Science Laboratory, GE Healthcare, Waukesha, Wisconsin 53188 (United States); Medical Physics Graduate Program, Duke University, Durham, North Carolina 27705 and Department of Radiology, Division of Pediatric Radiology, Duke University Medical Center, Durham North Carolina 27710 (United States)

    2008-12-15

    dose for any other patient in the same size/protocol group who undergoes the chest scan. In summary, this work reported the first assessment of dose variations across pediatric CT patients in the same size/protocol group due to the variability of patient anatomy and body habitus and provided a previously unavailable method for patient-specific organ dose estimation, which will help in assessing patient risk and optimizing dose reduction strategies, including the development of scan protocols.

  13. Radiation doses to patients in haemodynamic procedures

    Energy Technology Data Exchange (ETDEWEB)

    Canadillas-Perdomo, B; Catalan-Acosta, A; Hernandez-Armas, J [Servicio de Fisica Medica, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain); Perez-Martin, C [Servicio de Ingenieria Biomedica, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain); Armas-Trujillo, D de [Servicio de Cardiologia, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain)

    2001-03-01

    Interventional radio-cardiology gives high doses to patients due to high values of fluoroscopy times and large series of radiographic images. The main objective of the present work is the determination of de dose-area product (DAP) in patients of three different types of cardiology procedures with X-rays. The effective doses were estimated trough the organ doses values measured with thermoluminescent dosimeters (TLDs-100), suitable calibrated, placed in a phantom type Rando which was submitted to the same radiological conditions corresponding to the procedures made on patients. The values for the effective doses in the procedures CAD Seldinger was 6.20 mSv on average and 1.85mSv for pacemaker implants. (author)

  14. Radiation doses to patients in haemodynamic procedures

    International Nuclear Information System (INIS)

    Canadillas-Perdomo, B.; Catalan-Acosta, A.; Hernandez-Armas, J.; Perez-Martin, C.; Armas-Trujillo, D. de

    2001-01-01

    Interventional radio-cardiology gives high doses to patients due to high values of fluoroscopy times and large series of radiographic images. The main objective of the present work is the determination of de dose-area product (DAP) in patients of three different types of cardiology procedures with X-rays. The effective doses were estimated trough the organ doses values measured with thermoluminescent dosimeters (TLDs-100), suitable calibrated, placed in a phantom type Rando which was submitted to the same radiological conditions corresponding to the procedures made on patients. The values for the effective doses in the procedures CAD Seldinger was 6.20 mSv on average and 1.85mSv for pacemaker implants. (author)

  15. Local dose assessment for a contaminated wound

    International Nuclear Information System (INIS)

    Piechowski, J.; Chaptinel, Y.

    2004-01-01

    Contaminated wounds present a great variability concerning the type of lesion. Assessment of the local dose is one amongst other factors for a decision as to the surgical operation. A simple model has been used to calculate the doses in a representative volume, that of a phalanx for instance. The dose rates are given for current radionuclides. The method of calculation is enough simple in order to allow the practitioners to use it in situations involving other radionuclides. Committed dose depends on the biological half-life which can be estimated from the local measurements. Some examples of calculation of committed dose are given considering half-lives characteristic of the compound. Transposition of the dose to the local risk is easy for the non-stochastic risk. Conversely, this is not the case for the risk of chronic inflammation or cancer. The latter question could only be solved by a feedback based on the analysis of real till now observed cases, nevertheless taking into account the fact that the available data are generally not so easy to make use for establishing an unquestionable dose - effect relation. A critical issue remains open as to the use of these doses for their comparison to the regulatory limits and for the subsequent decisions in case of exceeding the limits. The actual impact of an irradiation, especially by alpha particles, is not linked to the calculated dose in a simple and direct way. This question needs further consideration and perhaps a practical guide concerning this topic would be useful. The anatomical (surgical side effects), psychological and professional consequences should have a large weight relatively to the doses, obviously except for the cases, involving actually large contamination. (authors)

  16. Factors affecting patient dose in diagnostic radiology

    International Nuclear Information System (INIS)

    Poletti, J.L.

    1994-03-01

    The report, Factors Affecting Patient Dose in Diagnostic Radiology is divided into three main sections. Part one is introductory and covers the basic principles of x-ray production and image formation. It includes discussion of x-ray generators and x-ray tubes, radiation properties and units, specification and measurement of x-ray beams, methods of patient dose measurement, radiation effects, radiation protection philosophy and finally the essentials of imaging systems. Part two examines factors affecting the x-ray output of x-ray machines and the characteristics of x-ray beams. These include the influence of heat ratings, kVp, waveform, exposure timer, filtration, focus-film distance, beam intensity distribution, x-ray tube age and focal spot size. Part three examines x-ray machine, equipment and patient factors which affect the dose received by individual patients. The factors considered include justification of examinations, choice of examination method, film/screen combinations, kVp, mAs, focus-film distance, collimation and field size, exposure time, projection, scatter, generator calibration errors, waveform, filtration, film processing and patient size. The patient dose implications of fluoroscopy systems, CT scanners, special procedures and mammography are also discussed. The report concludes with a brief discussion of patient dose levels in New Zealand and dose optimisation. 104 refs., 32 figs., 27 tabs

  17. Eye dose assessment and management: overview

    International Nuclear Information System (INIS)

    Rehani, M.M.

    2015-01-01

    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 1808 plus cone angle of the X-ray tube and with tube under scan arcs. (authors)

  18. Patient Assessment File (PAF)

    Data.gov (United States)

    Department of Veterans Affairs — The Patient Assessment File (PAF) database compiles the results of the Patient Assessment Instrument (PAI) questionnaire filled out for intermediate care Veterans...

  19. Internal dose assessment in radiation accidents

    International Nuclear Information System (INIS)

    Toohey, R.E.

    2003-01-01

    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 241 Am accident. (author)

  20. The embryogenesis of dose assessment at Hanford

    International Nuclear Information System (INIS)

    Foster, R.F.

    1990-01-01

    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

  1. Radiation dose to the patient in radionuclide studies

    International Nuclear Information System (INIS)

    Roedler, H.D.

    1981-01-01

    In medical radionuclide studies, the radiation risk has to be considered in addition to the general risk of administering a pharmaceutical. As radiation exposure is an essential factor in radiation risk estimation, some aspects of internal dose calculation, including radiation risk assessments, are treated. The formalism of current internal dose calculation is presented. The input data, especially the residence time and the absorbed dose per transformation, their origin and accuracy are discussed. Results of internal dose calculations for the ten most frequently used radionuclide studies are presented as somatically effective dose equivalents. The accuracy of internal dose calculation is treated in detail by considering the biokinetics of the radiopharmaceutical, the phantoms used for dose calculations, the absorbed dose per transformation, the administered activity, and the transfer of the dose, calculated for a phantom, to the patient. The internal dose calculated for a reference phantom may be assumed to be in accordance with the actual patient dose within a range described by a factor of about two to three. Finally, risk estimates for nuclear medicine procedures are quantified, being generally of sixth order. The radiation risk from the radioiodine test is comparably higher, but probably lower than calculated according to the UNSCEAR risk coefficients. However, further studies are needed to confirm these preliminary results and to improve the quantification of the radiation risk from the medical use of radionuclides. (author)

  2. Inhalation dose assessment for Maralinga and Emu

    International Nuclear Information System (INIS)

    Johnston, P.N.; Lokan, K.H.; Williams, G.A.

    1990-01-01

    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/m 3 for adults and 1.5 mg/m 3 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 239 Pu 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

  3. Dose assessment for Greifswald and Cadarache

    International Nuclear Information System (INIS)

    Raskob, W.

    1996-07-01

    Probabilistic dose assessments for accidental atmospheric releases of tritium and activation products as well as releases under normal operation conditions were performed for the sites of Greifswald, Germany, and Cadarache, France. Additionally, aquatic releases were considered for both sites. No country specific rules were applied and the input parameters were adapted as far as possible to those used within former ITER studies to have a better comparison to site independent dose assessments performed in the frame of ITER. The main goal was to complete the generic data base with site specific values. The agreement between the results from the ITER study on atmospheric releases and the two sites are rather good for tritium, whereas the ITER reference dose values for the activation product releases are often lower, than the maximum doses for Greifswald and Cadarache. However, the percentile values fit better to the deterministic approach of ITER. Within all scenarios, the consequences of aquatic releases are in nearly all cases smaller than those from comparable releases to the atmosphere (HTO and steel). This rule is only broken once in case of accidental releases of activated steel from Cadarache. However, the uncertainties associated with the aquatic assessments are rather high and a better data base is needed to obtain more realistic and thus more reliable dose values. (orig.) [de

  4. Radiation doses of patients and urologists during percutaneous nephrolithotomy

    Energy Technology Data Exchange (ETDEWEB)

    Safak, M; Gogus, C [Faculty of Medicine, Ibni Sina Hospital, Department of Urology, Ankara University, 06450 Samanpazari, Ankara (Turkey); Olgar, T; Bor, D; Berkmen, G [Faculty of Engineering, Department of Physics Engineering, Ankara University, 06100, Tandogan, Ankara (Turkey)], E-mail: olgar@eng.ankara.edu.tr

    2009-09-01

    Renal stones can be treated either by extracorporeal shock wave lithotripsy (ESWL) or percutaneous nephrolithotomy (PCNL). Increasing use of fluoroscopic exposure for access and to detect stone location during PCNL make the measurement of patient and staff doses important. The main objective of this work was to assess patient and urologist doses for the PCNL examination. We used the tube output technique for determination of patient doses (n = 20) and lithium fluoride thermoluminescent dosimeter (TLD) chips for urologist dose measurements. The TLD technique was also used for some patient dose measurements (n = 7) for comparison with the tube output technique. Mean entrance skin doses of 191 and 117 mGy were measured by the tube output technique for anterior-posterior (AP) and right anterior oblique (RAO) 30 deg./left anterior oblique (LAO) 30 deg. projections, respectively. The mean urologist doses for eye, finger and collar were measured as 26, 33.5 and 48 {mu}Gy per procedure, respectively. The mean effective dose per procedure for the urologist was 12.7 {mu}Sv. None of the individual skin dose results approach deterministic levels.

  5. Radiation doses of patients and urologists during percutaneous nephrolithotomy

    International Nuclear Information System (INIS)

    Safak, M; Gogus, C; Olgar, T; Bor, D; Berkmen, G

    2009-01-01

    Renal stones can be treated either by extracorporeal shock wave lithotripsy (ESWL) or percutaneous nephrolithotomy (PCNL). Increasing use of fluoroscopic exposure for access and to detect stone location during PCNL make the measurement of patient and staff doses important. The main objective of this work was to assess patient and urologist doses for the PCNL examination. We used the tube output technique for determination of patient doses (n = 20) and lithium fluoride thermoluminescent dosimeter (TLD) chips for urologist dose measurements. The TLD technique was also used for some patient dose measurements (n = 7) for comparison with the tube output technique. Mean entrance skin doses of 191 and 117 mGy were measured by the tube output technique for anterior-posterior (AP) and right anterior oblique (RAO) 30 deg./left anterior oblique (LAO) 30 deg. projections, respectively. The mean urologist doses for eye, finger and collar were measured as 26, 33.5 and 48 μGy per procedure, respectively. The mean effective dose per procedure for the urologist was 12.7 μSv. None of the individual skin dose results approach deterministic levels.

  6. Patient radiation doses from neuroradiology procedures

    Energy Technology Data Exchange (ETDEWEB)

    Garcia-Roman, M J; Abreu-Luis, J; Hernandez-Armas, J [Servicio de Fisica Medica, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain); Prada-Martinez, E [Servicio de Radiodiagnostico, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain)

    2001-03-01

    Following the presentation of radiation-induced deterministic effects by some patients undergoing neuroradiological procedures during successive sessions, such as temporary epilation, in the 'Hospital Universitario de Canarias', measurements were made of dose to patients. The maximum dose-area product measured by ionization chamber during these procedures was 39617 cGy.cm{sup 2} in a diagnostic of aneurysm and the maximum dose to the skin measured by thermoluminescent dosemeters (TLDs) was 462.53 mGy. This can justify certain deterministic effects but it is unlikely that the patients will suffer serious effects from this skin dose. Also, measurements were made of effective dose about two usual procedures, embolisation of tumour und embolisation of aneurysm. These procedures were reproduced with an anthropomorphic phantom Rando and doses were measured with TLDs. Effective doses obtained were 3.79 mSv and 4.11 mSv, respectively. The effective dose valued by the program EFFDOSE was less than values measured with TLDs. (author)

  7. Patient radiation doses from neuroradiology procedures

    International Nuclear Information System (INIS)

    Garcia-Roman, M.J.; Abreu-Luis, J.; Hernandez-Armas, J.; Prada-Martinez, E.

    2001-01-01

    Following the presentation of radiation-induced deterministic effects by some patients undergoing neuroradiological procedures during successive sessions, such as temporary epilation, in the 'Hospital Universitario de Canarias', measurements were made of dose to patients. The maximum dose-area product measured by ionization chamber during these procedures was 39617 cGy.cm 2 in a diagnostic of aneurysm and the maximum dose to the skin measured by thermoluminescent dosemeters (TLDs) was 462.53 mGy. This can justify certain deterministic effects but it is unlikely that the patients will suffer serious effects from this skin dose. Also, measurements were made of effective dose about two usual procedures, embolisation of tumour und embolisation of aneurysm. These procedures were reproduced with an anthropomorphic phantom Rando and doses were measured with TLDs. Effective doses obtained were 3.79 mSv and 4.11 mSv, respectively. The effective dose valued by the program EFFDOSE was less than values measured with TLDs. (author)

  8. Dose assessment in pediatric computerized tomography

    International Nuclear Information System (INIS)

    Vilarinho, Luisa Maria Auredine Lima

    2004-01-01

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

  9. SU-E-P-57: Radiation Doses Assessment to Paediatric Patients for Some Digital Diagnostic Radiology Examination in Emergency Department in Qatar

    Energy Technology Data Exchange (ETDEWEB)

    Abdallah, I; Aly, A; Al Naemi, H [Hamad Medical Corporation, Doha (Qatar)

    2015-06-15

    Purpose: The aim of this study was to evaluate radiation doses to pediatric patients undergoing standard radiographic examinations using Direct Digital Radiography (DDR) in Paediatric emergency center of Hamad General Hospital (HGH) in state of Qatar and compared with regional and international Dose Reference Levels (DRLs). Methods: Entrance Skin Dose (ESD) was measured for 2739 patients for two common X-ray examinations namely: Chest AP/PA, Abdomen. Exposure factors such as kV, mAs and Focal to Skin Distance (FSD) were recorded for each patient. Tube Output was measured for a range of selected kV values. ESD for each individual patient was calculated using the tube output and the technical exposure factors for each examination. The ESD values were compared with the some international Dose Reference Levels (DRL) for all types of examinations. Results: The most performed procedure during the time of this study was chest PA/PA (85%). The mean ESD values obtained from AP chest, PA chest and AP abdomen ranged 91–120, 80–84 and 209 – 659 µGy per radiograph for different age’s groups respectively. Two protocols have been used for chest AP and PA using different radiological parameters, and the different of ESD values for chest PA and were 41% for 1 years old child, 57% for 5 years old for chest AP. Conclusion: The mean ESD were compared with those found in literature and were found to be comparable. The radiation dose can be reduced more for Chest AP and PA examination by optimization of each investigation and hence more studies are required for this task. The results presented will serve as a baseline data needed for deriving local reference doses for pediatric X-ray examinations in this local department and hence it can be applied in the whole Qatar.

  10. The MESORAD dose assessment model: Computer code

    International Nuclear Information System (INIS)

    Ramsdell, J.V.; Athey, G.F.; Bander, T.J.; Scherpelz, R.I.

    1988-10-01

    MESORAD is a dose equivalent model for emergency response applications that is designed to be run on minicomputers. It has been developed by the Pacific Northwest Laboratory for use as part of the Intermediate Dose Assessment System in the US Nuclear Regulatory Commission Operations Center in Washington, DC, and the Emergency Management System in the US Department of Energy Unified Dose Assessment Center in Richland, Washington. This volume describes the MESORAD computer code and contains a listing of the code. The technical basis for MESORAD is described in the first volume of this report (Scherpelz et al. 1986). A third volume of the documentation planned. That volume will contain utility programs and input and output files that can be used to check the implementation of MESORAD. 18 figs., 4 tabs

  11. Assessment of external dose indoors in Lithuania

    International Nuclear Information System (INIS)

    Pilkyte, L.; Butkus, D.; Morkunas, G.

    2006-01-01

    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)

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

    International Nuclear Information System (INIS)

    Christianson, Olav; Li Xiang; Frush, Donald; Samei, Ehsan

    2012-01-01

    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 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 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 adj that differed by up to 44% from effective dose estimates that were not

  13. 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

  14. Human data and internal dose assessment

    International Nuclear Information System (INIS)

    Kawamura, H.; Tanaka, G.; Shiraishi, K.; Yamamoto, M.

    1992-01-01

    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 226 Ra in bone of Japanese adult. (author)

  15. Scatter Dose in Patients in Radiation Therapy

    International Nuclear Information System (INIS)

    Schmidt, W. F. O.

    2003-01-01

    Patients undergoing radiation therapy are often treated with high energy radiation (bremsstrahlung) which causes scatter doses in the patients from various sources as photon scatter coming from collimator, gantry, patient, patient table or room (walls, floor, air) or particle doses resulting from gamma-particle reactions in the atomic nucleus if the photon energies are above 8 MeV. In the last years new treatment techniques like IMRT (esp the step-and-shoot- or the MIMIC-techniques) have increased interest in these topics again. In the lecture an overview about recent measurements on scatter doses resulting from gantry, table and room shall be given. Scatter doses resulting from the volume treated in the patient to other critical parts of the body like eyes, ovarii etc. have been measured in two diploma works in our institute and are compared with a program (PERIDOSE; van der Giessen, Netherlands) to estimate them. In some cases these scatter doses have led to changes of treatment modalities. Also an overview and estimation of doses resulting from photon-particle interactions is given according to a publication from Gudowska et al.(Gudowska I, Brahme A, Andreo P, Gudowski W, Kierkegaard J. Calculation of absorbed dose and biological effectiveness from photonuclear reactions in a bremsstrahlung beam of end point 50 MeV. Phys Med Biol 1999; 44(9):2099-2125.). Energy dose has been calculated with Monte Carlo-methods and is compared with analytical methods for 50 MV bremsstrahlung. From these data biologically effective doses from particles in different depths of the body can be estimated also for energies used in normal radiotherapy. (author)

  16. The development, validation and application of a multi-detector CT (MDCT) scanner model for assessing organ doses to the pregnant patient and the fetus using Monte Carlo simulations

    Science.gov (United States)

    Gu, J.; Bednarz, B.; Caracappa, P. F.; Xu, X. G.

    2009-05-01

    The latest multiple-detector technologies have further increased the popularity of x-ray CT as a diagnostic imaging modality. There is a continuing need to assess the potential radiation risk associated with such rapidly evolving multi-detector CT (MDCT) modalities and scanning protocols. This need can be met by the use of CT source models that are integrated with patient computational phantoms for organ dose calculations. Based on this purpose, this work developed and validated an MDCT scanner using the Monte Carlo method, and meanwhile the pregnant patient phantoms were integrated into the MDCT scanner model for assessment of the dose to the fetus as well as doses to the organs or tissues of the pregnant patient phantom. A Monte Carlo code, MCNPX, was used to simulate the x-ray source including the energy spectrum, filter and scan trajectory. Detailed CT scanner components were specified using an iterative trial-and-error procedure for a GE LightSpeed CT scanner. The scanner model was validated by comparing simulated results against measured CTDI values and dose profiles reported in the literature. The source movement along the helical trajectory was simulated using the pitch of 0.9375 and 1.375, respectively. The validated scanner model was then integrated with phantoms of a pregnant patient in three different gestational periods to calculate organ doses. It was found that the dose to the fetus of the 3 month pregnant patient phantom was 0.13 mGy/100 mAs and 0.57 mGy/100 mAs from the chest and kidney scan, respectively. For the chest scan of the 6 month patient phantom and the 9 month patient phantom, the fetal doses were 0.21 mGy/100 mAs and 0.26 mGy/100 mAs, respectively. The paper also discusses how these fetal dose values can be used to evaluate imaging procedures and to assess risk using recommendations of the report from AAPM Task Group 36. This work demonstrates the ability of modeling and validating an MDCT scanner by the Monte Carlo method, as well as

  17. The development, validation and application of a multi-detector CT (MDCT) scanner model for assessing organ doses to the pregnant patient and the fetus using Monte Carlo simulations

    International Nuclear Information System (INIS)

    Gu, J; Bednarz, B; Caracappa, P F; Xu, X G

    2009-01-01

    The latest multiple-detector technologies have further increased the popularity of x-ray CT as a diagnostic imaging modality. There is a continuing need to assess the potential radiation risk associated with such rapidly evolving multi-detector CT (MDCT) modalities and scanning protocols. This need can be met by the use of CT source models that are integrated with patient computational phantoms for organ dose calculations. Based on this purpose, this work developed and validated an MDCT scanner using the Monte Carlo method, and meanwhile the pregnant patient phantoms were integrated into the MDCT scanner model for assessment of the dose to the fetus as well as doses to the organs or tissues of the pregnant patient phantom. A Monte Carlo code, MCNPX, was used to simulate the x-ray source including the energy spectrum, filter and scan trajectory. Detailed CT scanner components were specified using an iterative trial-and-error procedure for a GE LightSpeed CT scanner. The scanner model was validated by comparing simulated results against measured CTDI values and dose profiles reported in the literature. The source movement along the helical trajectory was simulated using the pitch of 0.9375 and 1.375, respectively. The validated scanner model was then integrated with phantoms of a pregnant patient in three different gestational periods to calculate organ doses. It was found that the dose to the fetus of the 3 month pregnant patient phantom was 0.13 mGy/100 mAs and 0.57 mGy/100 mAs from the chest and kidney scan, respectively. For the chest scan of the 6 month patient phantom and the 9 month patient phantom, the fetal doses were 0.21 mGy/100 mAs and 0.26 mGy/100 mAs, respectively. The paper also discusses how these fetal dose values can be used to evaluate imaging procedures and to assess risk using recommendations of the report from AAPM Task Group 36. This work demonstrates the ability of modeling and validating an MDCT scanner by the Monte Carlo method, as well as

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

    International Nuclear Information System (INIS)

    Park, Sang Hyun

    2003-02-01

    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

  19. Determination of environmental radioactivity for dose assessment

    International Nuclear Information System (INIS)

    Nakoaka, A.; Fukushima, M.; Takagi, S.

    1980-01-01

    A method was devised to determine detection limits for radioactivity in environmental samples. The method is based on the 5 mrem/yr whole-body dose objective established by the Japan Atomic Enerty Commission and is valid for assessing the internal dose from radionuclides in the environment around a nuclear facility. Eleven samples and 15 radionuclides were considered. Internal dose was assumed to be one-half of the total dose (5 mrem/yr) and was assessed using the critical pathway method. Needed detection limits (NDLs) were established to confirm the dose of 5 mrem/yr when there was more than one radionuclide per sample. The NDLs for γ-emitters were 10 -5 pCi/l. for air; 10 -3 pCi/l. for seawater; 10 -1 pCi/l. for drinking water; 10 0 pCi/kg for vegetables and fish; 10 0 pCi/l. for milk; and 10 1 pCi/kg for molluscs, crustaceans, seaweeds, soil and submarine sediments. The NDLs for β-emitters were 1-1/100 of those for γ-emitters. (author)

  20. Real time source term and dose assessment

    International Nuclear Information System (INIS)

    Breznik, B.; Kovac, A.; Mlakar, P.

    2001-01-01

    The Dose Projection Programme is a tool for decision making in case of nuclear emergency. The essential input data for quick emergency evaluation in the case of hypothetical pressurised water reactor accident are following: source term, core damage assessment, fission product radioactivity, release source term and critical exposure pathways for an early phase of the release. A reduced number of radio-nuclides and simplified calculations can be used in dose calculation algorithm. Simple expert system personal computer programme has been developed for the Krsko Nuclear Power Plant for dose projection within the radius of few kilometers from the pressurised water reactor in early phase of an accident. The input data are instantaneous data of core activity, core damage indicators, release fractions, reduction factor of the release pathways, spray operation, release timing, and dispersion coefficient. Main dose projection steps are: accurate in-core radioactivity determination using reactor power input; core damage and in-containment source term assessment based on quick indications of instrumentation or on activity analysis data; user defines release pathway for typical PWR accident scenarius; dose calculation is performed only for exposure pathway critical for decision about evacuation or sheltering in early phase of an accident.(author)

  1. Dose assessment in the Marshall Islands

    International Nuclear Information System (INIS)

    Robison, William L.

    1978-01-01

    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)

  2. Assessment of dose received by organ in lumbosacral examination

    International Nuclear Information System (INIS)

    Eltyeib, Nashwa Kheirallah

    2014-11-01

    The biological damage produced by radiation is closely related to the amount of energy absorbed in the case x- rays. Measurement of produced ionizing provides a useful assessment of the total energy absorbed. This study was performed in Khartoum Teaching Hospital in period of January to June 2014. This study was performed to assess the effective dose (ED) received in lumbosacral radiography examination and to analyze effective dose distributions among radiological department under study. The study was performed in Khartoum Teaching Hospital, covering two x-ray units and a sample of 50 patients. The following parameters were recorded: age weight, height, body mass index (BMI) derived from mass (kg) and (height. (m)) and exposure factors. The dose was measured for lumbosacral x- rays examination. For effective dose calculation, the entrance surface dose (ESD) values were estimated from the x-ray tube output parameters for lumbosacral spine A P and lateral examinations. The ED values were then calculated from the obtained ESD values using IAEA calculation methods. Effective doses were than calculated from energy imported using ED conversion factors by IAEA. The results of ED values calculated showed that patient exposures were within the normal range of exposure. The mean ED values calculated were (2.49 ±0.03) mGy and (5.5.60 ± 0.0.22) mGy for Lumbosacral spine A P and lateral examinations, respectively. Further studies are recommended with more number of patients and using more modalities for comparison.(Author)

  3. SU-F-J-203: Retrospective Assessment of Delivered Proton Dose in Prostate Cancer Patients Based On Daily In-Room CT Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Stuetzer, K; Paessler, T [OncoRay - National Center for Radiation Research in Oncology, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); Valentini, C; Thiele, J; Hoelscher, T [Department of Radiation Oncology, University Hospital Carl Gustav Carus, Techenische Universitaet Dresden (Germany); Exner, F [OncoRay - National Center for Radiation Research in Oncology, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); now with: University of Wuerzburg, Department of Radiation Oncology, Wuerzburg (Germany); Krause, M; Richter, C [OncoRay - National Center for Radiation Research in Oncology, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); Department of Radiation Oncology, University Hospital Carl Gustav Carus, Techenische Universitaet Dresden (Germany); Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiooncology, Dresden (Germany); German Cancer Consortium (DKTK), Dresden, Germany and German Cancer Research Center (DKFZ), Heidelberg (Germany)

    2016-06-15

    Purpose: Retrospective calculation of the delivered proton dose in prostate cancer patients based on a unique dataset of daily CT images. Methods: Inter-fractional motion in prostate cancer patients treated at our proton facility is counteracted by water-filled endorectal ballon and bladder filling protocol. Typical plans (XiO, Elekta Instruments AB, Stockholm) for 74 Gy(RBE) sequential boost treatment in 37 fractions include two series of opposing lateral double-scattered proton beams covering the respective iCTV. Stability of fiducial markers and anatomy were checked in 12 patients by daily scheduled in-room control CT (cCT) after immobilization and positioning according to bony anatomy utilizing orthogonal X-ray. In RayStation 4.6 (RaySearch Laboritories AB, Stockholm), all cCTs are delineated retrospectively and the treatment plans were recalculated on the planning CT and the registered cCTs. All fraction doses were accumulated on the planning CT after deformable registration. Parameters of delivered dose to iCTV (D98%>95%, D2%<107%), bladder (V75Gy<15%, V70Gy<25%, V65Gy<30%), rectum (V70Gy<10%, V50Gy<40%) and femoral heads (V50Gy<5%) are compared to those in the treatment plan. Intra-therapy variation is represented in DVH bands. Results: No alarming differences were observed between planned and retrospectively accumulated dose: iCTV constraints were met, except for one patient (D98%=94.6% in non-boosted iCTV). Considered bladder and femoral head values were below the limits. Rectum V70Gy was slightly exceeded (<11.3%) in two patients. First intra-therapy variability analysis in 4 patients showed no timedependent parameter drift, revealed strongest variability for bladder dose. In some fractions, iCTV coverage (D98%) and rectum V70Gy was missed. Conclusion: Double scattered proton plans are accurately delivered to prostate cancer patients due to fractionation effects and the applied precise positioning and immobilization protocols. As a result of rare

  4. Assessments of conversion coefficients between equivalent dose and accumulated activity using pre-dose scanning images of patients subjected to radioiodine treatment and the Fax/Egs4 computational model

    International Nuclear Information System (INIS)

    Lopes Filho, Ferdinand de J.; Vieira, Jose W.; Andrade Lima, Fernando R. de

    2008-01-01

    The radioiodine is a technique for treatment of thyroid cancer. In this technique, the patients are submitted to the incorporation of the radioactive substance sodium iodide (Na 131 I), which reacts with physiologically metastasis, thyroid tissue remains of and other organs and tissues of the human body. The locations of these reactions are known as areas of highest concentration, hipercaptured areas, hiperconcentrator areas, 'hot areas' or organ-sources and are viewed through images of nuclear medicine scan known as pre-dose (front and rear). To obtain these images, the patient receives, orally, a quantity of 131 I with low activity (± 74 MBq) and is positioned in the chamber of flicker. According to the attendance of hot areas shown in the images, the doctor determines the nuclear activity to be administered in treatment. This analysis is purely qualitative. In this study, the scanning images of pre-dose were adjusted to the dimensions of FAX voxel phantom, and the hot areas correspond to internal sources of the proposed model. Algorithms were developed to generate particles (photons and electrons) in these regions of the FAX. To estimate the coefficients of conversions between equivalent dose and accumulated activity in major radiosensitive organs, FAX and algorithms source were coupled to the Monte Carlo EGS4 code (Electron Gamma Shower, version 4). With these factors is possible to estimate the equivalent doses in the radiosensitive organs and tissues of patients as long as is know the activity administered and the half-life of organic sources. (author)

  5. Managing patient dose in digital radiology

    International Nuclear Information System (INIS)

    2014-01-01

    Digital techniques have the potential to improve the practice of radiology but they also risk the overuse of radiation. The main advantages of digital imaging, i.e. wide dynamic range, post processing, multiple viewing options, and electronic transfer and archiving possibilities, are clear but overexposures can occur without an adverse impact on image quality. In conventional radiography, excessive exposure produces a black film. In digital systems, good images are obtained for a large range of doses. It is very easy to obtain (and delete) images with digital fluoroscopy systems, and there may be a tendency to obtain more images than necessary. In digital radiology, higher patient dose usually means improved image quality, so a tendency to use higher patient doses than necessary could occur. Different medical imaging tasks require different levels of image quality, and doses that have no additional benefit for the clinical purpose should be avoided. Image quality can be compromised by inappropriate levels of data compression and/or post processing techniques. All these new challenges should be part of the optimisation process and should be included in clinical and technical protocols. Local diagnostic reference levels should be re-evaluated for digital imaging, and patient dose parameters should be displayed at the operator console. Frequent patient dose audits should occur when digital techniques are introduced. Training in the management of image quality and patient dose in digital radiology is necessary. Digital radiology will involve new regulations and invoke new challenges for practitioners. As digital images are easier to obtain and transmit, the justification criteria should be reinforced. Commissioning of digital systems should involve clinical specialists, medical physicists, and radiographers to ensure that imaging capability and radiation dose management are integrated. Quality control requires new procedures and protocols (visualisation, transmission

  6. Patient surface doses in computerized tomography examinations

    International Nuclear Information System (INIS)

    Vekic, B; Kovacevic, S.; Ranogajec-Komor, M.; Duvnjak, N.; Marusic, P.; Anic, P.; Dolencic, P.

    1996-01-01

    The diagnostic value of computerized tomography has increased due to very rapid technical advances in both equipment and techniques. When the CT scanners were introduced, a significant problem for the specification of the radiation dose imparted to the patient undergoing CT examination has been created. In CT, the conditions of exposure are quite different from those in conventional X-ray imaging. CT procedure involves the continuous tomography of thin layers. Some of these layers touch each other while others overlap. The radiation doses received by patients can vary considerably. In addition to the radiation from the collimated primary beam, patients are exposed to significant scattered doses in unpredictable amounts. Every effort should be made to keep these doses to a reasonable minimum, without sacrificing the image quality. The aims of this work were to determine the surface doses delivered to various organs of patients during various computerized tomography examinations (head, thorax, kidney, abdomen and pelvis). Particular attention was directed to the precise determination of doses received by the eyes (during CT of head) and gonads (during CT of pelvis and lower abdomen) since these organs can be near or even in the primary X-ray beam

  7. Factors affecting patient dose in diagnostic radiology

    International Nuclear Information System (INIS)

    Poletti, J.L.

    1985-01-01

    There are two stages in the X-ray image forming process; first the irradiation of the patient to produce the X-ray pattern in space, known as the primary radiological image, and second, the conversion of this pattern into a visible form. This report discusses the first stage and its interrelation with image quality and patient dose

  8. Assessments for high dose radionuclide therapy treatment planning

    International Nuclear Information System (INIS)

    Fisher, D.R.

    2003-01-01

    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)

  9. Assessment of radiation dose awareness among pediatricians

    International Nuclear Information System (INIS)

    Thomas, Karen E.; Parnell-Parmley, June E.; Charkot, Ellen; BenDavid, Guila; Krajewski, Connie; Haidar, Salwa; Moineddin, Rahim

    2006-01-01

    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.)

  10. Patient dose in image guided radiotherapy: Monte Carlo study of the CBCT dose contribution

    OpenAIRE

    Leotta, Salvatore; Amato, Ernesto; Settineri, Nicola; Basile, Emilia; Italiano, Antonio; Auditore, Lucrezia; Santacaterina, Anna; Pergolizzi, Stefano

    2018-01-01

    Image Guided RadioTherapy (IGRT) is a technique whose diffusion is growing thanks to the well-recognized gain in accuracy of dose delivery. However, multiple Cone Beam Computed Tomography (CBCT) scans add dose to patients, and its contribution has to be assessed and minimized. Aim of our work was to evaluate, through Monte Carlo simulations, organ doses in IGRT due to CBCT and therapeutic MV irradiation in head-neck, thorax and pelvis districts. We developed a Monte Carlo simulation in GAMOS ...

  11. Bio-indicators for radiation dose assessment

    International Nuclear Information System (INIS)

    Trivedi, A.

    1990-12-01

    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

  12. Excipient Usage Technical Risk Assessment for Generic Solid Dose Products

    Directory of Open Access Journals (Sweden)

    Ajay Babu Pazhayattil

    2017-09-01

    Full Text Available This paper proposes an assessment methodology for solid dose generic small molecule drug products. It addresses the ‘usage of the excipient’ portion of the trinomial by utilizing the systematic approach of Risk Identification, Risk Analysis and Risk Evaluation as per ICH Q9 Quality Risk Management outlined for developing risk control strategies. The assessment and maintenance of excipient risk profile is essential to minimize any potential risk associated to excipients impacting patients.

  13. Uncertainty on faecal analysis on dose assessment

    Energy Technology Data Exchange (ETDEWEB)

    Juliao, Ligia M.Q.C.; Melo, Dunstana R.; Sousa, Wanderson de O.; Santos, Maristela S.; Fernandes, Paulo Cesar P. [Instituto de Radioprotecao e Dosimetria, Comissao Nacional de Energia Nuclear, Av. Salvador Allende s/n. Via 9, Recreio, CEP 22780-160, Rio de Janeiro, RJ (Brazil)

    2007-07-01

    Monitoring programmes for internal dose assessment may need to have a combination of bioassay techniques, e.g. urine and faecal analysis, especially in workplaces where compounds of different solubilities are handled and also in cases of accidental intakes. Faecal analysis may be an important data for assessment of committed effective dose due to exposure to insoluble compounds, since the activity excreted by urine may not be detectable, unless a very sensitive measurement system is available. This paper discusses the variability of the daily faecal excretion based on data from just one daily collection; collection during three consecutive days: samples analysed individually and samples analysed as a pool. The results suggest that just 1 d collection is not appropriate for dose assessment, since the 24 h uranium excretion may vary by a factor of 40. On the basis of this analysis, the recommendation should be faecal collection during three consecutive days, and samples analysed as a pool, it is more economic and faster. (authors)

  14. 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.

  15. Patient dose and risk in mammography

    International Nuclear Information System (INIS)

    Law, J.

    1991-01-01

    Patient dose in mammography is estimated by two methods compared and giving agreement. A mean tissue dose of about 1 mGy per film is found for a breast of 4.5 cm compressed thickness. Variables affecting dose are then considered quantitatively, including compressed breast thickness, tube potential, grids, magnification and beam collimation. The variables having the greatest effect are breast thickness and magnification. The dose estimates are combined with existing data on breast cancer induction to predict the risk of carcinogenesis in a breast screening programme. For example, in a screening centre performing 15 000 examinations per year, only one induced cancer is predicted in about 7 years of screening under average UK conditions of age and breast thickness. (author)

  16. Absorbed doses to patients from angioradiology

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez-Romero, R; Hernandez-Armas, J [Servicio de Fisica Medica, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain); Diaz-Romero, F [Servicio de Radiodiagnostico, Hospital Universitario de Canarias, La Laguna, Tenerife (Spain)

    2001-03-01

    The aim of study was to know patients doses exposes when three different procedures of angioradiology were carried out. The explorations considered were drainage biliary, varicocele embolization and dacriocistography made in the Radiodiagnostic Service at the University Hospital of Canary Islands, Tenerife (Spain). In total 14 patients were studied. The measurements were made using large area transmission ionisation chamber which gives the values of Dose Area Product (DAP). In addition, thermoluminescent dosimeters type TLD-100 were used in anthropomorphic phantom in order to obtain values of organ doses when the phantom was submitted to the same procedures rather than the actual patients. Furthermore, the Effdose program was used to estimate the effective doses in the procedures conditions. The values for DAP were in the range of 70-300 for drainage biliary, 43-180 for varicocele embolization and 1.4-9 for dacriocistography. The organ doses measured with TLD-100 were higher than the corresponding values estimated by Effdose program. The results for varicocele embolization were higher than other published data. In the case of drainage biliary procedure, the values were closed to other published results. It was not possible to find data for dacriocistography from other authors. (author)

  17. Absorbed doses to patients from angioradiology

    International Nuclear Information System (INIS)

    Rodriguez-Romero, R.; Hernandez-Armas, J.; Diaz-Romero, F.

    2001-01-01

    The aim of study was to know patients doses exposes when three different procedures of angioradiology were carried out. The explorations considered were drainage biliary, varicocele embolization and dacriocistography made in the Radiodiagnostic Service at the University Hospital of Canary Islands, Tenerife (Spain). In total 14 patients were studied. The measurements were made using large area transmission ionisation chamber which gives the values of Dose Area Product (DAP). In addition, thermoluminescent dosimeters type TLD-100 were used in anthropomorphic phantom in order to obtain values of organ doses when the phantom was submitted to the same procedures rather than the actual patients. Furthermore, the Effdose program was used to estimate the effective doses in the procedures conditions. The values for DAP were in the range of 70-300 for drainage biliary, 43-180 for varicocele embolization and 1.4-9 for dacriocistography. The organ doses measured with TLD-100 were higher than the corresponding values estimated by Effdose program. The results for varicocele embolization were higher than other published data. In the case of drainage biliary procedure, the values were closed to other published results. It was not possible to find data for dacriocistography from other authors. (author)

  18. Eye lens dosimetry in interventional cardiology: Results of staff dose measurements and link to patient dose levels

    International Nuclear Information System (INIS)

    Antic, V.; Ciraj-Bjelac, O.; Rehani, M.; Aleksandric, S.; Arandjic, D.; Ostojic, M.

    2013-01-01

    Workers involved in interventional cardiology procedures receive high eye lens dose if protection is not used. Currently, there is no suitable method for routine use for the measurement of eye dose. Since most angiography machines are equipped with suitable patient dosemeters, deriving factors linking staff eye doses to the patient doses can be helpful. In this study the patient kerma-area product, cumulative dose at an interventional reference point and eye dose in terms of Hp(3) of the cardiologists, nurses and radiographers for interventional cardiology procedures have been measured. Correlations between the patient dose and the staff eye dose were obtained. The mean eye dose was 121 mSv for the first operator, 33 mSv for the second operator/nurse and 12 mSv for radiographer. Normalised eye lens doses per unit kerma-area product were 0.94 mSv Gy -1 cm -2 for the first operator, 0.33 mSv Gy -1 cm -2 for the second operator/nurse and 0.16 mSv Gy -1 cm -2 for radiographers. Statistical analysis indicated that there is a weak but significant (p < 0.01) correlation between the eye dose and the kerma-area product for all three staff categories. These values are based on a local practice and may provide useful reference for other studies for validation and for wider utilisation in assessing the eye dose using patient dose values. (authors)

  19. Dose assessment under incidental and accidental conditions

    International Nuclear Information System (INIS)

    Huebschmann, W.G.

    1988-01-01

    Dose assessment for the licesing process of a nuclear power plant covers the routine release of radioactive substances into the atmosphere as well as releases due to incidents. Source terms for these incidents are evaluated by the detailed incident analysis of the plant. The types of incidents to be covered are determined in the FRG by the ''Stoerfall-Leitlinien'' of the Ministry of the Interior. The calculation of dose equivalents in the environment of the plant differs from the calculation of doses due to routine releases, as incidents are single events occuring at undeterminate time, and the results must be conservative. Some details are being described. During the operation of the plant it is essential to measure not only the radioactivity release rates but also the necessary meteorological parameters for the instantaneous determination of the atmospheric dispersion in case of incidental or accidental releases of radioactivity. This instantaneous assessment assists in taking measurements of ground contamination and in deciding about countermeasures for the protection of plant personnell and population. (author) [pt

  20. Technical Note: SCUDA: A software platform for cumulative dose assessment

    Energy Technology Data Exchange (ETDEWEB)

    Park, Seyoun; McNutt, Todd; Quon, Harry; Wong, John; Lee, Junghoon, E-mail: rshekhar@childrensnational.org, E-mail: junghoon@jhu.edu [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University, Baltimore, Maryland 21231 (United States); Plishker, William [IGI Technologies, Inc., College Park, Maryland 20742 (United States); Shekhar, Raj, E-mail: rshekhar@childrensnational.org, E-mail: junghoon@jhu.edu [IGI Technologies, Inc., College Park, Maryland 20742 and Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Health System, Washington, DC 20010 (United States)

    2016-10-15

    Purpose: Accurate tracking of anatomical changes and computation of actually delivered dose to the patient are critical for successful adaptive radiation therapy (ART). Additionally, efficient data management and fast processing are practically important for the adoption in clinic as ART involves a large amount of image and treatment data. The purpose of this study was to develop an accurate and efficient Software platform for CUmulative Dose Assessment (SCUDA) that can be seamlessly integrated into the clinical workflow. Methods: SCUDA consists of deformable image registration (DIR), segmentation, dose computation modules, and a graphical user interface. It is connected to our image PACS and radiotherapy informatics databases from which it automatically queries/retrieves patient images, radiotherapy plan, beam data, and daily treatment information, thus providing an efficient and unified workflow. For accurate registration of the planning CT and daily CBCTs, the authors iteratively correct CBCT intensities by matching local intensity histograms during the DIR process. Contours of the target tumor and critical structures are then propagated from the planning CT to daily CBCTs using the computed deformations. The actual delivered daily dose is computed using the registered CT and patient setup information by a superposition/convolution algorithm, and accumulated using the computed deformation fields. Both DIR and dose computation modules are accelerated by a graphics processing unit. Results: The cumulative dose computation process has been validated on 30 head and neck (HN) cancer cases, showing 3.5 ± 5.0 Gy (mean±STD) absolute mean dose differences between the planned and the actually delivered doses in the parotid glands. On average, DIR, dose computation, and segmentation take 20 s/fraction and 17 min for a 35-fraction treatment including additional computation for dose accumulation. Conclusions: The authors developed a unified software platform that provides

  1. Thermoluminescence dosemeter for personal dose equivalent assessment

    International Nuclear Information System (INIS)

    Silva, T.A. da; Rosa, L.A.R. da; Campos, L.L.

    1995-01-01

    The possibility was investigated of utilising a Brazilian thermoluminescence individual dosemeter, usually calibrated in terms of photon dose equivalent, for the assessment of the personal dose equivalent, H p (d), at depths of 0.07 and 10 mm. The dosemeter uses four CaSO 4 :Dy thermoluminescent detectors, between different filters, as the sensitive materials. It was calibrated in gamma and X radiation fields in the energy range from 17 to 1250 keV. Linear combinations of the responses of three detectors, in this energy range, allow the evaluation of H p (0.07) and H p (10), for radiation incidence angles varying from 0 to 60 degrees, with an accuracy better than 35%. The method is not applicable to mixed photon-beta fields. (author)

  2. Combination TLD/TED dose assessment

    International Nuclear Information System (INIS)

    Parkhurst, M.A.

    1992-11-01

    During the early 1980s, an appraisal of dosimetry programs at US Department of Energy (DOE) facilities identified a significant weakness in dose assessment in fast neutron environments. Basing neutron dose equivalent on thermoluminescence dosimeters (TLDS) was not entirely satisfactory for environments that had not been well characterized. In most operational situations, the dosimeters overrespond to neutrons, and this overresponse could be further exaggerated with changes in the neutron quality factor (Q). Because TLDs are energy dependent with an excellent response to thermal and low-energy neutrons but a weak response to fast neutrons, calibrating the dosimetry system to account for mixed and moderated neutron energy fields is a difficult and seldom satisfactory exercise. To increase the detection of fast neutrons and help improve the accuracy of dose equivalent determinations, a combination dosimeter was developed using TLDs to detect thermal and low-energy neutrons and a track-etch detector (TED) to detect fast neutrons. By combining the albedo energy response function of the TLDs with the track detector elements, the dosimeter can nearly match the fluence-to-dose equivalent conversion curve. The polymer CR-39 has neutron detection characteristics superior to other materials tested. The CR-39 track detector is beta and gamma insensitive and does not require backscatter (albedo) from the body to detect the exposure. As part of DOE's Personnel Neutron and Upgrade Program, we have been developing a R-39 track detector over the past decade to address detection and measurement of fast neutrons. Using CR-39 TEDs in combination with TLDs will now allow us to detect the wide spectrum of occupational neutron energies and assign dose equivalents much more confidently

  3. A systematic study on factors affecting patient dose, (1)

    International Nuclear Information System (INIS)

    Otsuka, Akiyoshi; Higashida, Yoshiharu; Utsumi, Hiromoto; Ota, Masaji; Nakanishi, Takashi

    1979-01-01

    In the study of possible reduction in irradiation dose to patients during medical treatments, the following two methods can be considered: (1) To obtain absorbed doses for each part of a body in diagnostic X-ray examinations. (2) To obtain data on factors such as the tube voltage which may affect patient dose. There are a number of reports both at home and abroad concerning the above (1), but very few reports are available concerning the above (2). Moreover, most of them are on fragmentary aspects of each factor and no systematic reports have been made. For this reason, we have taken up, as factors affecting the patient dose, the field size, the tube voltage, and by checking them again, we wanted to obtain some systematic data. Our aim has been fully attained by conducting an experiment. In the ICRP's Publ. 26 issued last year, the idea of the critical organ which had not been fully elucidated in the Publ. 9 was abandoned. As a result, assessment of the irradiation doses has become more rational and the total risk for an individual was obtained. In Japan, the idea proposed in the Publ. 9 is adopted. Therefore, in this paper, we will raise some questions regarding the assessment of the irradiation doses, pointing out at the same time the rationality of the idea put forward in Publ. 26. (author)

  4. The assessment of the carcinogenic effects of low dose radiation

    International Nuclear Information System (INIS)

    Tubiana, M.; Lafuma, J.; Masse, R.; Latarjet, R.

    1991-01-01

    It is concluded that the exclusion of patients for the purposes of risk estimation, the choice of a particular relative risk projection model and of a dose reduction factor equal to 2 are all decisions which result in an overestimation of the actual risk. These choices can be understood when the aim is radiation protection and when it is safer to overestimate the risk; however, they are open to criticism if the aim is a realistic assessment of the risk. For low doses, below 50 mSv/year, and when all causes of uncertainty are added, the actual risk might be markedly lower than the risk estimated with the ICRP (1991) carcinogenic risk coefficient and the DRF estimated by ICRP. Future studies should aim at providing direct and more precise assessments of risk coefficients in the low dose region. (Author)

  5. Receptor dose and patient dose in radiographic exposures: a 15 year review

    International Nuclear Information System (INIS)

    Peet, D.J.; Tyler, N.; Pryor, M.; Hollaway, P.; Strudley, C.; Leavesley, L.

    2008-01-01

    A patient dose programme has been established locally for the last 15 years across 109 hospitals and 250 X-ray rooms in line with the National Protocol, in conjunction with a programme to look at routine performance of these rooms. Routine performance checks initially looked primarily at film density and AEC performance but with the introduction of Computerised Radiography (CR) across UK hospitals and a revision of recommended procedures in the UK, the emphasis has shifted to assessing receptor dose under AEC control. Results show a wide variation in film density in the early years indicating sub optimal performance and dose. The spread was reduced over later years. The introduction of CR has led to a variety of approaches by the CR companies, X-ray companies and local sites. Receptor doses vary widely as a result. Large variations within hospitals were also observed. The doses over the last 15 years are reviewed and compared against diagnostic reference levels and with the performance of the imaging chain. Results show that patient dose programmes and optimisation strategies were having an impact, but the introduction of CR requires renewed efforts to ensure images and doses are optimised. (author)

  6. [Evaluation of patient doses in interventional radiology].

    Science.gov (United States)

    Ropolo, R; Rampado, O; Isoardi, P; Gandini, G; Rabbia, C; Righi, D

    2001-01-01

    To verify the suitability of indicative quantities to evaluate the risk related to patient exposure, in abdominal and vascular interventional radiology, by the study of correlations between dosimetric quantities and other indicators. We performed in vivo measurements of entrance skin dose (ESD) and dose area product (DAP) during 48 procedures to evaluate the correlation among dosimetric quantities, and an estimation of spatial distribution of exposure and effective dose (E). To measure DAP we used a transmission ionization chamber and to evaluate ESD and its spatial distribution we used radiographic film packed in a single envelope and placed near the patient's skin. E was estimated by a calculation software using data from film digitalisation. From the data derived for measurements in 27 interventional procedures on 48 patients we obtained a DAP to E conversion factor of 0.15 mSv / Gy cm2, with an excellent correlation (r=.99). We also found a good correlation between DAP and exposure parameters such as fluoroscopy time and number of images. The greatest effective dose was evaluated for a multiple procedure in the hepatic region, with a DAP value of 425 Gy cm2. The greatest ESD was about 550 mGy. For groups of patients undergoing similar interventional procedures the correlation between ESD and DAP had conversion factors from 6 to 12 mGy Gy-1 cm-2. The evaluation of ESD and E by slow films represents a valid method for patient dosimetry in interventional radiology. The good correlation between DAP and fluoroscopy time and number of images confirm the suitability of these indicators as basic dosimetric information. All the ESD values found are lower than threshold doses for deterministic effects.

  7. Patient radiation dose during mammography procedures

    International Nuclear Information System (INIS)

    Mohamed, Swsan Awd Elkriem

    2015-11-01

    The objectives of this study were to estimate the patient dose in term of mean glandular dose and assist in optimization of radiation protection in mammographic procedures in Sudan. A total number of 107 patients were included. Four mammographic units were participated. Only one center was using automatic exposure control (AEC). The mean doses in (mGy) for the CC projection were 3.13, 1.24, 2.45 and 0.98 and for the MLO projection was 2.13, 1.26, 1.99 and 1.02 for centers A, B, C, and D, respectively. The total mean dose per breast from both projections was 5.26, 2.50, 4.44 and 1.99 mGy for centers A, B, C and D, respectively. The minimum mean glandular dose was found between the digital system which was operated under AEC and one of the manual selected exposure factors systems, this highlight possible optimization of radiation protection in the other manual selected systems. The kilo volt and the tube current time products should be selected correctly according to the breast thickness in both centers A and C. (author)

  8. Computed radiography dose optimization in pediatric patients

    International Nuclear Information System (INIS)

    Juste, B.; Verdu, G.; Tortosa, R.; Villaescusa, J.I.

    2008-01-01

    Radiation dose reduction in pediatric X-ray imaging is especially important because of children radiation sensitivity. For any radiographic examination performed at a fixed radiographic tube potential, the patient absorbed dose is directly proportional to the value of milliampere-seconds (mAs) selected by the operator. Nevertheless, reducing X-ray exposure has the unavoidable disadvantage of increasing the quantum noise in the resultant image. The objective of this work is to identify the minimum tube current setting required for maintaining accurate examinations, to modify, if required, the daily protocols applied at La Fe de Valencia Universitary Hospital. To accomplish this goal, a noise addition software has been developed in order to study the diagnostic accuracy as a function of reducing dose by artificially increasing the image noise. The noise addition tool has been applied to several thorax images acquired from pediatric unit to simulate new lower dose radiographies and allow medical researchers to study how lower dose affects the patient pneumonia diagnosis. (author)

  9. Assessment of dose during an SGTR

    International Nuclear Information System (INIS)

    Adams, J.P.

    1993-01-01

    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

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

    International Nuclear Information System (INIS)

    Liu, Jian-xiang; Huang, Min-yan; Ruan, Jian-lei; Bai, Yu-shu; Xu, Su

    2008-01-01

    unstable aberrations were analyzed and biological dose was assessed according to the dose-effect curves built by our lab member. For micronucleus analysis, blood were added cytochalasin-B after culturing 40 hours. The doses were assessed according to the dose-effect curves built by our lab member. According to a human lymphocyte chromosome aberration and micronucleus analysis, the estimated maximum irradiation dose of 3 exposed patients is lower than 2 Gy, equal to the dose of once uneven total-body irradiation. In vitro dose-response calibration curves for (60)Co gamma rays have been established for unstable chromosome aberrations in human peripheral blood lymphocytes. The observed dose-response data were fitted to a linear quadratic model. The calibration curve parameters were used to estimate the equivalent whole-body dose and dose to the irradiated region in partial body irradiation of cancer patients. The derived partial body doses and fractions of lymphocytes irradiated were in agreement with those estimated from the radiotherapy regimes. (author)

  11. Fixed dose 131-I treatment in Basedow patients

    International Nuclear Information System (INIS)

    Klisarova, A; Bochev, P.; Hristosov, K.

    2003-01-01

    The choice of a treatment for Basedow patients is still unsolved problem. The treatment with 131-I has certain advantages but the determination of the individual therapeutic dose is impossible. The aim of the study is to assess the efficiency of the treatment with a fixed dose. 23 patient have been treated, 30 women and 3 men, age between 48 and 78. All patients are with chronic disease with relapses (1 to 4 relapses). 5 of the patients are with a thyrotoxic heart, 3 - with ophtalmopatia, 2 - with toxic medicamentous hepatitis and 2 with allergies to thyreostatics. Before the treatment with 131-I all patients have been in euthyroid state with normal levels of the peripheral hormones. All patients have received initial doses of 5 mCi 131-I. The hormone levels have been followed on 3rd, 6th, 12th and 24th month after the uptake. From a total of 23 patients, in 3 cases a transitional hypothyroidism has been found between 3th and 6th month, in 3 patients - permanent hypothyroidism. In 5 patients after the 6th month an additional dose of 5 mCi 131-I is given (in one woman a permanent hypothyroidism is reached). Four of the patients have been with a significant thyroid hyperplasia with volume above 60 ml. In three patients in the period between 6th and 12th month a slight hyperthyroidism is registered, which have been suppressed by a low dose thyreostatic. A year after the treatment they have been found euthyroid. The decision for giving a second dose have been based on the evident heptahydrate symptomatic s and the persisting increased thyroid volume. In one case it is observed an acute thyrotoxicosis for 3-5 days after the 131 I uptake. No cases of worsening of the eye symptoms are observed. In conclusion, the treatment with 131 I is a appropriate method for patients with cardiovascular complications, contraindication for surgery or side effects of the thyreostatic treatment. the dose od 5 mCi is sufficient for patients with mild to medium form of Basedow disease and a

  12. Dose assessment considering evolution of the biosphere

    International Nuclear Information System (INIS)

    Karlsson, Sara; Bergstroem, Ulla

    2002-01-01

    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)

  13. Blood phenylalanine concentrations in patients with PAH-deficient hyperphenylalaninaemia off diet without and with three different single oral doses of tetrahydrobiopterin: assessing responsiveness in a model of statistical process control.

    Science.gov (United States)

    Lindner, M; Gramer, G; Garbade, S F; Burgard, P

    2009-08-01

    Tetrahydrobiopterin (BH(4)) cofactor loading is a standard procedure to differentiate defects of BH(4) metabolism from phenylalanine hydroxylase (PAH) deficiency. BH(4) responsiveness also exists in PAH-deficient patients with high residual PAH activity. Unexpectedly, single cases with presumed nil residual PAH activity have been reported to be BH(4) responsive, too. BH(4) responsiveness has been defined either by a >or=30% reduction of blood Phe concentration after a single BH(4) dose or by a decline greater than the individual circadian Phe level variation. Since both methods have methodological disadvantages, we present a model of statistical process control (SPC) to assess BH(4) responsiveness. Phe levels in 17 adult PKU patients of three phenotypic groups off diet were compared without and with three different single oral dosages of BH(4) applied in a double-blind randomized cross-over design. Results are compared for >or=30% reduction and SPC. The effect of BH(4) by >or=30% reduction was significant for groups (p < 0.01) but not for dose (p = 0.064), with no interaction of group with dose (p = 0.24). SPC revealed significant effects for group (p < 0.01) and the interaction for group with dose (p < 0.05) but not for dose alone (p = 0.87). After one or more loadings, seven patients would be judged to be BH(4) responsive either by the 30% criterion or by the SPC model, but only three by both. Results for patients with identical PAH genotype were not very consistent within (for different BH(4) doses) and between the two models. We conclude that a comparison of protein loadings without and with BH(4) combined with a standardized procedure for data analysis and decision would increase the reliability of diagnostic results.

  14. 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

  15. Radiotherapy dose compensation for lung patients

    International Nuclear Information System (INIS)

    Piyaratna, N.; Arnold, A.; Metcalfe, P.

    1999-01-01

    The purpose of the present paper is to provide a more homogeneous dose distribution in the target volume from compensated anterior and posterior fields while the healthy lung is spared by de-weighting the lateral fields. A compensation computation which used linear iterations to compute the most homogeneous dose distribution across the target volume was applied to produce optimum compensator designs. The equivalent tissue-air ratio (E-TAR) inhomogeneity correction was applied for the computations using a GE target series 11 planning computer. The compensators designed were tested for accuracy in a modified water/lung phantom using a scanning diode and an anthropomorphic phantom using thermoluminescent dosimeters. A comparison has been made between the compensated and uncompensated plans for the first nine patients who we have treated with this technique. The dose profiles produced by the computation agreed with the prediction of the computed isodose plans to within ± 2% at the target depth. The thermoluminescent dosimeter (TLD)-measured results in the anthropomorphic phantom agreed with the planning computer within ± 3%. A comparison of nine compensated plans of radiotherapy patients for large-volume targets in the lung region showed a maximum variation in the target to be 19% uncompensated versus 10% compensated. By providing compensated treatment fields from anterior and posterior treatment portals, a homogeneous dose that conforms well to the target volume is provided. As an added bonus, this enables the lateral lung fields to be significantly de-weighted and the healthy lung is spared considerable dose. Copyright (1999) Blackwell Science Pty Ltd

  16. Preliminary dose assessment of the Chernobyl accident

    International Nuclear Information System (INIS)

    Hull, A.P.

    1987-01-01

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

  17. Exercise and rest Tl-201 myocardial SPECT, and low dose dobutamine echocardiography to assess myocardial viability in patients with myocardial infarction

    International Nuclear Information System (INIS)

    Toyama, Takuji; Ishida, Yoshio; Shimonagata, Tsuyoshi; Kawano, Shigeo; Beppu, Shintaro; Nishimura, Tsunehiko.

    1994-01-01

    To evaluate viability of infarcted myocardium, findings of Tl-201 myocardial SPECT were compared with those of low-dose dobutamine (DOB) echocardiography. The subjects were 19 patients with myocardial infarction (23 infarcted zones), consisting of 16 men and 3 women. Findings on myocardial SPECT were classified as evidence of myocardial viability (14 zones, Group A) and no evidence of myocardial viability (9 zones, Group B). For both groups, wall motion and regional % uptake (%UP) were obtained. DOB echocardiography revealed an improvement in 5 of 8 akinesis zones in Group A. In addition, one other zone was found improved by follow-up examination. Six hypokinesis zones were all found improved on DOB echocardiography. Out of a total of 14 akinesis or hypokinesis zones, 11 (79%) showed improvement on DOB echocardiography in Group A. In Group B, all akinesis zones remained unchanged on DOB echocardiography, although one zone was improved by follow-up examination. In 11 zones in which wall motion was improved on DOB echocardiography, %UT was increased by an average of 58% on 4 hr-delayed images and 70% on resting images. The corresponding figures for 12 zones which did not improve on DOB echocardiography were 49% and 50% on the average, respectively. In conclusion, low-dose DOB echocardiography appeared to reflect viability of severely infarcted myocardium, although it had a slightly lower sensitivity than convensional Tl-201 myocardial SPECT in its ability to detect. (N.K.)

  18. Experimental evaluation of neutron dose in radiotherapy patients: Which dose?

    Energy Technology Data Exchange (ETDEWEB)

    Romero-Expósito, M., E-mail: mariateresa.romero@uab.cat; Domingo, C.; Ortega-Gelabert, O.; Gallego, S. [Grup de Recerca en Radiacions Ionizants (GRRI), Departament de Física, Universitat Autònoma de Barcelona, Bellaterra 08193 (Spain); Sánchez-Doblado, F. [Departamento de Fisiología Médica y Biofísica, Universidad de Sevilla, Sevilla 41009 (Spain); Servicio de Radiofísica, Hospital Universitario Virgen Macarena, Sevilla 41009 (Spain)

    2016-01-15

    Purpose: The evaluation of peripheral dose has become a relevant issue recently, in particular, the contribution of secondary neutrons. However, after the revision of the Recommendations of the International Commission on Radiological Protection, there has been a lack of experimental procedure for its evaluation. Specifically, the problem comes from the replacement of organ dose equivalent by the organ-equivalent dose, being the latter “immeasurable” by definition. Therefore, dose equivalent has to be still used although it needs the calculation of the radiation quality factor Q, which depends on the unrestricted linear energy transfer, for the specific neutron irradiation conditions. On the other hand, equivalent dose is computed through the radiation weighting factor w{sub R}, which can be easily calculated using the continuous function provided by the recommendations. The aim of the paper is to compare the dose equivalent evaluated following the definition, that is, using Q, with the values obtained by replacing the quality factor with w{sub R}. Methods: Dose equivalents were estimated in selected points inside a phantom. Two types of medical environments were chosen for the irradiations: a photon- and a proton-therapy facility. For the estimation of dose equivalent, a poly-allyl-diglicol-carbonate-based neutron dosimeter was used for neutron fluence measurements and, additionally, Monte Carlo simulations were performed to obtain the energy spectrum of the fluence in each point. Results: The main contribution to dose equivalent comes from neutrons with energy higher than 0.1 MeV, even when they represent the smallest contribution in fluence. For this range of energy, the radiation quality factor and the radiation weighting factor are approximately equal. Then, dose equivalents evaluated using both factors are compatible, with differences below 12%. Conclusions: Quality factor can be replaced by the radiation weighting factor in the evaluation of dose

  19. Population dose assessment: characteristics of PC CREAM

    International Nuclear Information System (INIS)

    Alonso, Maria T.; Curti, Adriana R.

    2000-01-01

    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)

  20. Assessment of dose in cervical vertebrae radiographic examinations

    International Nuclear Information System (INIS)

    Owrnasir, Wafa Fadol Orsud

    2014-12-01

    Reference dose levels provide a framework to reduce doses variability and aid in the optimization of radiation protection.This study was performed in Khartoum Teaching Hospital in period of January to June 2014. This study performed to assess the entrance surface dose ( ESD) received in Cervical Vertebrae radiographic examination and to analyze effective dose distributions among radiological departments under study. The study was performed in Khartoum Teaching Hospital, covering two x-ray units and a sample of 64 patients. The following parameter were recorded; age, weight, height, body mass index (BMI) derived from weight (kg) and height (m) and exposure factors. The dose was measured for Cervical Vertebrae x-ray examinations, the entrance surface dose (ESD) values were estimated from the x-ray tube output parameters for Cervical Vertebrae AP and lateral examinations. The ESD values were then calculated using IAEA calculation methods. The results of ESD values calculated showed than patient exposure were within the normal range of exposure. The mean ED values calculated were ( 3.85 ±0.04) and (4.02 ±0.05) mGy for Cervical Vertebrae AP and lateral examinations, respectively in department Na1 and (3.99± 0.15) and (4.23± 0.34) mGy, for Cervical Vertebrae Ap and lateral examinations respectively in department Na2, the IAEA standard value of ESD for cervical equal (7), (20) mGy AP and LAT, Further studies are recommended with more number of patients and using more than two modalities for comparison. (Author)

  1. Assessment of internal doses in emergency situations

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-04-15

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

  2. Assessment of internal doses in emergency situations

    International Nuclear Information System (INIS)

    Rahola, T.; Muikku, M.; Falk, R.; Johansson, J.; Liland, A.; Thorshaug, S.

    2006-04-01

    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)

  3. Estimation of patient dose in mammography screening examinations

    International Nuclear Information System (INIS)

    Suzuki, S.; Fujii, S.; Orito, T.; Asada, Y.; Koga, S.; Horita, K.; Kido, C.

    1996-01-01

    Mammography is one of the most effective examinations for detecting breast carcinoma. Although the dose is usually much higher than that in other types of X-ray examination, that is accepted by the patient because for fears of suffering cancer. Benefit of relatively high doses derived from mammographic examinations is considered to well exceed the risk of cancer induction by radiation exposure. The purpose of this study is to investigate patient dose of mammography in Japan by questionnaire sent to 531 institutions selected from whole Japan and direct measurements carried out in 28 hospitals in Aichi Prefecture. The user's guide in mammography published by NCRP and Quality Assurance Program of American College of Radiology were used to assess the exposure and image quality of mammogram. (author)

  4. Optimizing CT radiation dose based on patient size and image quality: the size-specific dose estimate method

    Energy Technology Data Exchange (ETDEWEB)

    Larson, David B. [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States)

    2014-10-15

    The principle of ALARA (dose as low as reasonably achievable) calls for dose optimization rather than dose reduction, per se. Optimization of CT radiation dose is accomplished by producing images of acceptable diagnostic image quality using the lowest dose method available. Because it is image quality that constrains the dose, CT dose optimization is primarily a problem of image quality rather than radiation dose. Therefore, the primary focus in CT radiation dose optimization should be on image quality. However, no reliable direct measure of image quality has been developed for routine clinical practice. Until such measures become available, size-specific dose estimates (SSDE) can be used as a reasonable image-quality estimate. The SSDE method of radiation dose optimization for CT abdomen and pelvis consists of plotting SSDE for a sample of examinations as a function of patient size, establishing an SSDE threshold curve based on radiologists' assessment of image quality, and modifying protocols to consistently produce doses that are slightly above the threshold SSDE curve. Challenges in operationalizing CT radiation dose optimization include data gathering and monitoring, managing the complexities of the numerous protocols, scanners and operators, and understanding the relationship of the automated tube current modulation (ATCM) parameters to image quality. Because CT manufacturers currently maintain their ATCM algorithms as secret for proprietary reasons, prospective modeling of SSDE for patient populations is not possible without reverse engineering the ATCM algorithm and, hence, optimization by this method requires a trial-and-error approach. (orig.)

  5. 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

  6. Radiation dose reduction in paediatric coronary computed tomography: assessment of effective dose and image quality

    International Nuclear Information System (INIS)

    Habib Geryes, Bouchra; Calmon, Raphael; Boddaert, Nathalie; Khraiche, Diala; Bonnet, Damien; Raimondi, Francesca

    2016-01-01

    To assess the impact of different protocols on radiation dose and image quality for paediatric coronary computed tomography (cCT). From January-2012 to June-2014, 140 children who underwent cCT on a 64-slice scanner were included. Two consecutive changes in imaging protocols were performed: 1) the use of adaptive statistical iterative reconstruction (ASIR); 2) the optimization of acquisition parameters. Effective dose (ED) was calculated by conversion of the dose-length product. Image quality was assessed as excellent, good or with significant artefacts. Patients were divided in three age groups: 0-4, 5-7 and 8-18 years. The use of ASIR combined to the adjustment of scan settings allowed a reduction in the median ED of 58 %, 82 % and 85 % in 0-4, 5-7 and 8-18 years group, respectively (7.3 ± 1.4 vs 3.1 ± 0.7 mSv, 5.5 ± 1.6 vs 1 ± 1.9 mSv and 5.3 ± 5.0 vs 0.8 ± 2.0 mSv, all p < 0,05). Prospective protocol was used in 51 % of children. The reduction in radiation dose was not associated with reduction in diagnostic image quality as assessed by the frequency of coronary segments with excellent or good image quality (88 %). cCT can be obtained at very low radiation doses in children using ASIR, and prospective acquisition with optimized imaging parameters. (orig.)

  7. Relationship between dose and risk, and assessment of carcinogenic risks associated with low doses of ionizing radiation

    International Nuclear Information System (INIS)

    Tubiana, M.; Aurengo, A.

    2005-01-01

    This report raises doubts on the validity of using LNT (linear no-threshold) relationship for evaluating the carcinogenic risk of low doses (< 100 mSv) and even more for very low doses (< 10 mSv). The LNT concept can be a useful pragmatic tool for assessing rules in radioprotection for doses above 10 mSv; however since it is not based on biological concepts of our current knowledge, it should not be used without precaution for assessing by extrapolation the risks associated with low and even more so, with very low doses (< 10 mSv), especially for benefit-risk assessments imposed on radiologists by the European directive 97-43. The biological mechanisms are different for doses lower than a few dozen mSv and for higher doses. The eventual risks in the dose range of radiological examinations (0.1 to 5 mSv, up to 20 mSv for some examinations) must be estimated taking into account radiobiological and experimental data. An empirical relationship which has been just validated for doses higher than 200 mSv may lead to an overestimation of risks (associated with doses one hundred fold lower), and this overestimation could discourage patients from undergoing useful examinations and introduce a bias in radioprotection measures against very low doses (< 10 mSv). Decision makers confronted with problems of radioactive waste or risk of contamination, should re-examine the methodology used for the evaluation of risks associated with very low doses and with doses delivered at a very low dose rate. This report confirms the inappropriateness of the collective dose concept to evaluate population irradiation risks

  8. Audit of radiation dose to patients during coronary angiography

    International Nuclear Information System (INIS)

    Livingstone, Roshan S.; Chandy, Sunil; Peace, Timothy B.S.; George, Paul V.; John, Bobby; Pati, Purendra

    2007-01-01

    There is a widespread concern about radiation doses imparted to patients during cardiology procedures in the medical community. The current study intends to audit and optimize radiation dose to patients undergoing coronary angiography performed using two dedicated cardiovascular machines

  9. Pediatric patient doses in interventional cardiology procedures

    International Nuclear Information System (INIS)

    Medeiros, R.B.; Murata, C.H.; Moreira, A.C.

    2014-01-01

    The radiation doses from interventional procedures is relevant when treating children because of their greater radiosensitivity compared with adults. The purposes of this paper were to estimate the dose received by 18 pediatric patients who underwent cardiac interventional procedures and to correlate the maximum entrance surface air kerma (Ke,max), estimated with radiochromic films, with the cumulative air kerma values displayed at the end of procedures. This study was performed in children up to 6 years. The study was performed in two hospitals, one located in Recife and the other one in São Paulo. The x-ray imaging systems used were Phillips Allura 12 model with image intensifier system and a Phillips Allura FD10 flat panel system. To estimate the Ke,max on the patient’s skin radiochromic films(Gafchromic XR-RV2) were used. These values were estimated from the maximum optical density measured on film using a calibration curve. The results showed cumulative air kerma values ranging from 78.3- 500.0mGy, with a mean value of 242,3 mGy. The resulting Ke,max values ranged from 20.0-461.8 mGy, with a mean value of 208,8 mGy. The Ke,max values were correlated with the displayed cumulative air kerma values. The correlation factor R² was 0.78, meaning that the value displayed in the equipment’s console can be useful for monitoring the skin absorbed dose throughout the procedure. The routine fluoroscopy time records is not able by itself alert the physician about the risk of dose exceeding the threshold of adverse reactions, which can vary from an early erythema to serious harmful skin damage. (author)

  10. A radiological dose assessment for the Port Hope conversion facility

    International Nuclear Information System (INIS)

    Garisto, N.C.; Cooper, F.; Janes, A.; Stager, R.; Peters, R.

    2011-01-01

    The Port Hope Conversion Facility (PHCF) receives uranium trioxide for conversion to uranium hexafluoride (UF 6 ) or uranium dioxide (UO 2 ). The PHCF Site has a long history of industrial use. A Radiological Dose Assessment was undertaken as part of a Site Wide Risk Assessment. This assessment took into account all possible human receptors, both workers and members of the public. This paper focuses on a radiological assessment of dose to members of the public. The doses to members of the public from terrestrial pathways were added to the doses from aquatic pathways to obtain overall dose to receptors. The benchmark used in the assessment is 1 mSv/y. The estimated doses related to PHCF operations are much lower than the dose limit. (author)

  11. High-dose chemotherapy for patients with high-risk breast cancer: a clinical and economic assessment using a quality-adjusted survival analysis.

    Science.gov (United States)

    Marino, Patricia; Roché, Henri; Moatti, Jean-Paul

    2008-04-01

    The benefit of high-dose chemotherapy (HDC) has not been clearly demonstrated. It may offer disease-free survival improvement at the expense of major toxicity and increasing cost. We evaluated the trade-offs between toxicity, relapse, and costs using a quality-adjusted time without symptoms or toxicity (Q-TWiST) analysis. The analysis was conducted in the context of a randomized trial (PEGASE 01) evaluating the benefit of HDC for 314 patients with high-risk breast cancer. A Q-TWiST analysis was first performed to compare HDC with standard chemotherapy. We then used the results of this Q-TWiST analysis to inform a cost per quality-adjusted life-year (QALY) comparison between treatments. Q-TWiST durations were in favor of HDC, whatever the weighting coefficients used for the analysis. This benefit was significant when the weighting coefficient related to the time spent after relapse was low (0.78), HDC offered no benefit. For intermediate values, the results depended on the weighting coefficient attributed to the toxicity period. The incremental cost per QALY ranged from 12,691euro/QALY to 26,439euro/QALY, according to the coefficients used to weight toxicity and relapse. The benefits of HDC outweigh the burdens of treatment for a wide range of utility coefficients. Economic impact is not a barrier to HDC diffusion in this situation. Nevertheless, no significant benefit was demonstrated for a certain range of utility values.

  12. Smartphone apps for calculating insulin dose: a systematic assessment.

    Science.gov (United States)

    Huckvale, Kit; Adomaviciute, Samanta; Prieto, José Tomás; Leow, Melvin Khee-Shing; Car, Josip

    2015-05-06

    Medical apps are widely available, increasingly used by patients and clinicians, and are being actively promoted for use in routine care. However, there is little systematic evidence exploring possible risks associated with apps intended for patient use. Because self-medication errors are a recognized source of avoidable harm, apps that affect medication use, such as dose calculators, deserve particular scrutiny. We explored the accuracy and clinical suitability of apps for calculating medication doses, focusing on insulin calculators for patients with diabetes as a representative use for a prevalent long-term condition. We performed a systematic assessment of all English-language rapid/short-acting insulin dose calculators available for iOS and Android. Searches identified 46 calculators that performed simple mathematical operations using planned carbohydrate intake and measured blood glucose. While 59% (n = 27/46) of apps included a clinical disclaimer, only 30% (n = 14/46) documented the calculation formula. 91% (n = 42/46) lacked numeric input validation, 59% (n = 27/46) allowed calculation when one or more values were missing, 48% (n = 22/46) used ambiguous terminology, 9% (n = 4/46) did not use adequate numeric precision and 4% (n = 2/46) did not store parameters faithfully. 67% (n = 31/46) of apps carried a risk of inappropriate output dose recommendation that either violated basic clinical assumptions (48%, n = 22/46) or did not match a stated formula (14%, n = 3/21) or correctly update in response to changing user inputs (37%, n = 17/46). Only one app, for iOS, was issue-free according to our criteria. No significant differences were observed in issue prevalence by payment model or platform. The majority of insulin dose calculator apps provide no protection against, and may actively contribute to, incorrect or inappropriate dose recommendations that put current users at risk of both catastrophic overdose and more

  13. Dosing algorithm to target a predefined AUC in patients with primary central nervous system lymphoma receiving high dose methotrexate.

    Science.gov (United States)

    Joerger, Markus; Ferreri, Andrés J M; Krähenbühl, Stephan; Schellens, Jan H M; Cerny, Thomas; Zucca, Emanuele; Huitema, Alwin D R

    2012-02-01

    There is no consensus regarding optimal dosing of high dose methotrexate (HDMTX) in patients with primary CNS lymphoma. Our aim was to develop a convenient dosing algorithm to target AUC(MTX) in the range between 1000 and 1100 µmol l(-1) h. A population covariate model from a pooled dataset of 131 patients receiving HDMTX was used to simulate concentration-time curves of 10,000 patients and test the efficacy of a dosing algorithm based on 24 h MTX plasma concentrations to target the prespecified AUC(MTX) . These data simulations included interindividual, interoccasion and residual unidentified variability. Patients received a total of four simulated cycles of HDMTX and adjusted MTX dosages were given for cycles two to four. The dosing algorithm proposes MTX dose adaptations ranging from +75% in patients with MTX C(24) 12 µmol l(-1). The proposed dosing algorithm resulted in a marked improvement of the proportion of patients within the AUC(MTX) target between 1000 and 1100 µmol l(-1) h (11% with standard MTX dose, 35% with the adjusted dose) and a marked reduction of the interindividual variability of MTX exposure. A simple and practical dosing algorithm for HDMTX has been developed based on MTX 24 h plasma concentrations, and its potential efficacy in improving the proportion of patients within a prespecified target AUC(MTX) and reducing the interindividual variability of MTX exposure has been shown by data simulations. The clinical benefit of this dosing algorithm should be assessed in patients with primary central nervous system lymphoma (PCNSL). © 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.

  14. Doses mammography: from phantom to the patient

    Energy Technology Data Exchange (ETDEWEB)

    Cross, P [Gammasonic Radiological Services, Pty., Ltd., Five Dock, NSW (Australia)

    1994-02-01

    While the use of a reference phantom is essential for dosimetry in acceptance testing and in regular quality control checks of a mammographic X-ray unit, it is also of importance to be able to estimate the patient dose in each individual investigation. Radiographic and physical data were analysed for a total of 212 women who were screened at three locations participating in a breast screening programme. The radiologists made estimates of the individual breast composition (%glandular/adipose ratio) at the film reporting sessions, and then the glandular doses were calculated by the auditor according to the NCRP 85 methodology. Arising from the data analysis of this dosimetry survey, a method is proposed to determine objectively patient breast composition from the photo-timed mAs for a given film optical density setting. This permits the NCRP calculations to be extended from breasts of 'average' (50/50) composition to breasts of individually determined composition. The diversity of the results between the three locations emphasises the need for regular audits of a mammographic X-ray unit's performance by an experienced radiological physicists, at least annually or after any major interventional service on the unit. 11 refs., 6 tabs., 4 figs.

  15. Dose assessments in nuclear power plant siting

    International Nuclear Information System (INIS)

    1988-03-01

    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. Effective dose to patient during cardiac interventional procedures (Prague workplaces)

    International Nuclear Information System (INIS)

    Stisova, V.

    2004-01-01

    The aim of this study was to assess effective dose to a patient during cardiac procedures, such as coronary angiography (CA) and percutaneous transluminal angioplasty (PTCA). Measurements were performed on 185 patients in four catheterisation laboratories in three hospitals in Prague using the dose area product (DAP) meter. Calculations of surface and effective dose were performed with Monte-Carlo-based program PCXMC. The mean DAP value per procedure determined in all workplaces ranged between 25.0 and 54.5 Gy cm 2 for CA and 43.0-104.5 Gy cm 2 for PTCA. In three cases, the surface dose exceeded the 2 Gy level for occurrence of transient erythema. The mean effective dose per procedure in an workplaces was determined to be in the range of 2.7-8.8 mSv for CA and 5.7-15.3 mSv for CA + PTCA combined. The results presented are comparable with those published by other authors. (authors)

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

    International Nuclear Information System (INIS)

    Vettese, F.; Donichak, C.; Bourgeault, P.

    1995-01-01

    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.)

  18. When it comes to securing patient health information from breaches, your best medicine is a dose of prevention: A cybersecurity risk assessment checklist.

    Science.gov (United States)

    Blanke, Sandra J; McGrady, Elizabeth

    2016-07-01

    Health care stakeholders are concerned about the growing risk of protecting sensitive patient health information from breaches. The Federal Emergency Management Agency (FEMA) has identified cyber attacks as an emerging concern, and regulations such as the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH) have increased security requirements and are enforcing compliance through stiff financial penalties. The purpose of this study is to describe health care breaches of protected information, analyze the hazards and vulnerabilities of reported breach cases, and prescribe best practices of managing risk through security controls and countermeasures. Prescriptive findings were used to construct a checklist tool to assess and monitor common risks. This research uses a case methodology to describe specific examples of the 3 major types of cyber breach hazards: portable device, insider, and physical breaches. We utilize a risk management framework to prescribe preventative actions that organizations can take to assess, analyze, and mitigate these risks. The health care sector has the largest number of reported breaches, with 3 major types: portable device, insider, and physical breaches. Analysis of actual cases indicates security gaps requiring prescriptive fixes based on "best practices." Our research culminates in a 25-item checklist that organizations can use to assess existing practices and identify security gaps requiring improvement. © 2016 American Society for Healthcare Risk Management of the American Hospital Association.

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

    International Nuclear Information System (INIS)

    Takahashi, Fumiaki

    2006-09-01

    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 24 Na 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 24 Na. 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 24 Na 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 24 Na 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)

  20. Population dose assessment from radiodiagnosis in Portugal

    International Nuclear Information System (INIS)

    Serro, R.; Carreiro, J.V.; Galvao, J.P.; Reis, R.

    1992-01-01

    A survey of radiodiagnostic installations was carried out in Portugal covering 75 premises including public hospitals, local and regional public health centres. A total of 175 X ray tubes was surveyed using the new NEXT methodology covering data on premises, tube and operator, and projection. Average value of voltage, current-time product, HVL, ratio of beam area to film area and source to film distance for the eleven most frequent projections are reported as well as the skin entrance exposure and the doses to some organs. The weighted average dose values per projection and for the different organs allowed an estimate of the whole-body dose per caput. From the gonadal doses the genetic significant dose was also estimated

  1. Measurement of Patient Dose from Computed Tomography Using Physical Anthropomorphic Phantom

    International Nuclear Information System (INIS)

    Jang, Ki Won; Lee, Jae Ki; Kim, Jong Kyung

    2005-01-01

    The computed tomography (CT) provides a high quality in images of human body but contributes relatively high patient dose compared with the conventional X-ray examination. Furthermore, the frequency of CT examination has been increasing in Korea for the last decade owing to the national health insurance benefits. Increasing concerns about high patient dose from CT have stimulated a great deal of researches on dose assessment, which many of these are based on the Monte Carlo simulation. But in this study, absorbed doses and effective dose of patient undergoing CT examination were determined experimentally using anthropomorphic physical phantom and the measured results are compared with those from Monte Carlo calculation

  2. Quality control procedure of the BNCT patient dose determination

    International Nuclear Information System (INIS)

    Bjugg, H.; Kortesniemi, M.; Seppaelae, T.; Karila, J.; Perkioe, J.; Ryynaenen, P.; Savolainen, S.; Auterinen, I.; Kotiluoto, P.; Seren, T.

    2000-01-01

    The concepts used at the Finnish BNCT facility for the patient dose quality assurance are introduced here. Dose planning images are obtained using a MR scanner with MRI sensitive markers. The dose distribution is computed with BNCT Rtpe. The program and the beam (DORT) model used have been verified with measurements and validated with MCNP calculations in phantoms. Dosimetric intercomparison has been done between FiR 1 and BMRR BNCT beams. The FiR 1 beam has been characterised also by visiting teams. Before every patient irradiation the relationship between beam monitor pulse rate and neutron fluence rate in the beam is checked by activation measurements. Cross-hair lasers used in the patient positioning are checked for spatial drift prior to each treatment. Kinetic models used to estimate the time-behaviour of blood boron concentration have been verified using independent patient sample data to assess and verify the performance of the applications. Quality control guides have been developed for each step in the patient irradiation. (author)

  3. Single patient doses of {sup 99m}Tc-HDP: Assessment of radiochemical purity, sterility and extractables from a polypropylene syringe over six hours

    Energy Technology Data Exchange (ETDEWEB)

    Parkes, S.L.; Varelis, P. [St George Hospital, Kogarah, NSW (Australia). Department of Nuclear Medicine

    1997-12-01

    Full text: The purpose of this investigation was to determine the radiochemical purity (RCP), sterility and extractables for {sup 99m}Tc oxidronate ({sup 99m}Tc-HDP) stored in polypropylene syringes over < six-hour period. The radiochemical purity was determined using a two-strip ITLC procedure, performed at time 0, 1, 2, 4, 6 hours. The sterility and endotoxin levels were tested by a NATA accredited laboratory, after allowing the radiopharmaceutical to stand at room temperature for six hours in the syringes. Plasticisers and other likely compounds that could be extracted from the syringes into the aqueous solution were determined by high pressure liquid chromatography (HPLC) diode array detection. This analysis involved shaking normal saline in a syringe over night and then injecting an aliquot of this solution onto a C18 analytical column and monitoring the effluent at 200 and 253 nm. The radiochemical purity of {sup 99m}Tc-HDP did not significantly change over the course of the study and remained above the recommended RCP for this radiopharmaceutical. Furthermore, at six hours the RCP of {sup 99m}Tc-HDP stored in both the manufacturer`s vial and a syringe were identical. Sterility testing of {sup 99m}Tc-HDP stored in syringes showed no microbial growth and less than 10 endotoxin units/mL (pass). The HPLC analysis did not show the presence of any extraneous compounds in the aqueous solution. Single patient doses of {sup 99m}Tc-HDP stored in polypropylene syringes over a six-hour period fulfill all the quality control requirements for administration to humans.

  4. Radiation dose evaluation in patients submitted to conventional radiological examinations

    International Nuclear Information System (INIS)

    Tilly Junior, Joao G.

    1997-01-01

    This work presents the results of the evaluation of radiation dose delivered to the patients undergoing conventional radiological procedures. Based in the realized measurement some indicators are settled to quantitative appraisal of the radiological protection conditions offered to the population. Data assessment was done in the county of Curitiba, in Parana State, Brazil, from 12/95 to 04/96, in ten rooms of three different institutions, under 101 patients, adults with 70 ± 10 kg, during real examinations of chest PA, chest LAT and abdomen AP. (author)

  5. Patient and personnel dose measurements at selective coronarangiography

    International Nuclear Information System (INIS)

    Maripuu, E.

    1977-01-01

    During 1975 dose measurements were performed on patients and doctors at the thoraxradiologic department of the Caroline Hospital in Stockholm, Sweden. The doses were measured during angiography. Skin doses are listed in tables. Also the doses to the bone marrow was estimated. LiF-dosemeters were used for the measurements. Calibration of the dosemeters and errors in the measurements are discussed

  6. Occupational dose assessment in interventional cardiology in Serbia

    International Nuclear Information System (INIS)

    Kaljevic, J.; Ciraj-Bjelac, O.; Stankovic, J.; Arandjic, D.; Bozovic, P.; Antic, V.

    2016-01-01

    The objective of this work is to assess the occupational dose in interventional cardiology in a large hospital in Belgrade, Serbia. A double-dosimetry method was applied for the estimation of whole-body dose, using thermoluminescent dosemeters, calibrated in terms of the personal dose equivalent H p (10). Besides the double-dosimetry method, eye dose was also estimated by means of measuring ambient dose equivalent, H*(10), and doses per procedure were reported. Doses were assessed for 13 physicians, 6 nurses and 10 radiographers, for 2 consequent years. The maximum annual effective dose assessed was 4.3, 2.1 and 1.3 mSv for physicians, nurses and radiographers, respectively. The maximum doses recorded by the dosemeter worn at the collar level (over the apron) were 16.8, 11.9 and 4.5 mSv, respectively. This value was used for the eye lens dose assessment. Estimated doses are in accordance with or higher than annual dose limits for the occupational exposure. (authors)

  7. Patient effective dose from endovascular brachytherapy with 192Ir Sources

    International Nuclear Information System (INIS)

    Perna, L.; Bianchi, C.; Novario, R.; Nicolini, G.; Tanzi, F.; Conte, L.

    2002-01-01

    The growing use of endovascular brachytherapy has been accompanied by the publication of a large number of studies in several fields, but few studies on patient dose have been found in the literature. Moreover, these studies were carried out on the basis of Monte Carlo simulation. The aim of the present study was to estimate the effective dose to the patient undergoing endovascular brachytherapy treatment with 192 Ir sources, by means of experimental measurements. Two standard treatments were taken into account: an endovascular brachytherapy of the coronary artery corresponding to the activity x time product of 184 GBq.min and an endovascular brachytherapy of the renal artery (898 GBq.min). Experimental assessment was accomplished by thermoluminescence dosemeters positioned in more than 300 measurement points in a properly adapted Rando phantom. A method has been developed to estimate the mean organ doses for all tissues and organs concerned in order to calculate the effective dose associated with intravascular brachytherapy. The normalised organ doses resulting from coronary treatment were 2.4x10 -2 mSv.GBq -1 .min -1 for lung, 0.9x10 -2 mSv.GBq -1 .min -1 for oesophagus and 0.48x10 -2 mSv.GBq -1 .min -1 for bone marrow. During brachytherapy of the renal artery, the corresponding normalised doses were 4.2x10 -2 mSv.GBq -1 .min -1 for colon, 7.8x10 -2 mSv.GBq -1 .min -1 for stomach and 1.7x10 -2 mSv.GBq -1 .min -1 for liver. Coronary treatment involved an effective dose of 0.046 mSv.GBq -1 .min -1 , whereas the treatment of the renal artery resulted in an effective dose of 0.15 mSv.GBq -1 .min -1 ; there were many similarities with data from former studies. Based on these results it can be concluded that the dose level of patients exposed during brachytherapy treatment is low. (author)

  8. Patient radiation dose during fluoroscopy testes with contrast medium

    International Nuclear Information System (INIS)

    Darsalih, Abir Abdelrady El noor

    2016-09-01

    The purpose of this study was to assess the patient radiation dose received in fluoroscopy examinations during contrast medium. The cumulative air kerma (Ck), kerma area product (KAP) and fluoroscopy time were measured for sixty ( male and female ) patients undergoing five fluoroscopy examinations KAP metre which was installed for the purpose of this study. The mean kerma area product were found to be 2.681, 5.1561, 9.85529. 5.7974 and 13.09 Gy.cm"2 for HSG, A.S and D.S, GI Track and sonogram tests, respectively. The obtained mean cumulative dose was were 6.31, 13.88, 24.61, 22.56 and 32.14 mGy for HSG, A.S, A.S and D.S , GI Track, respectively, the mean fluoroscopy time were. 0.18, 0.51,0.89,1.57 and 1.75 min, for HSG, A.S, A.S, and D.S, G1 Track and sonogram test respectively. Patient dose is mainly dependent on the patient size, procedure, equipment used exposure factor and user experience. As KV and mA were controlled by the AEC and it was found to be well calibrated, possible optimization could be achieved by radiologist by decreasing the exposure time if possible. (Author)

  9. Radiation dose exposure in patients affected by lymphoma undergoing repeat CT examinations: how to manage the radiation dose variability.

    Science.gov (United States)

    Paolicchi, Fabio; Bastiani, Luca; Guido, Davide; Dore, Antonio; Aringhieri, Giacomo; Caramella, Davide

    2018-03-01

    To assess the variability of radiation dose exposure in patients affected by lymphoma undergoing repeat CT (computed tomography) examinations and to evaluate the influence of different scan parameters on the overall radiation dose. A series of 34 patients (12 men and 22 women with a median age of 34.4 years) with lymphoma, after the initial staging CT underwent repeat follow-up CT examinations. For each patient and each repeat examination, age, sex, use of AEC system (Automated Exposure Control, i.e. current modulation), scan length, kV value, number of acquired scans (i.e. number of phases), abdominal size diameter and dose length product (DLP) were recorded. The radiation dose of just one venous phase was singled out from the DLP of the entire examination. All scan data were retrieved by our PACS (Picture Archiving and Communication System) by means of a dose monitoring software. Among the variables we considered, no significant difference of radiation dose was observed among patients of different ages nor concerning tube voltage. On the contrary the dose delivered to the patients varied depending on sex, scan length and usage of AEC. No significant difference was observed depending on the behaviour of technologists, while radiologists' choices had indirectly an impact on the radiation dose due to the different number of scans requested by each of them. Our results demonstrate that patients affected by lymphoma who undergo repeat whole body CT scanning may receive unnecessary overexposure. We quantified and analyzed the most relevant variables in order to provide a useful tool to manage properly CT dose variability, estimating the amount of additional radiation dose for every single significant variable. Additional scans, incorrect scan length and incorrect usage of AEC system are the most relevant cause of patient radiation exposure.

  10. Four-Dimensional Patient Dose Reconstruction for Scanned Ion Beam Therapy of Moving Liver Tumors

    International Nuclear Information System (INIS)

    Richter, Daniel; Saito, Nami; Chaudhri, Naved; Härtig, Martin; Ellerbrock, Malte; Jäkel, Oliver; Combs, Stephanie E.; Habermehl, Daniel; Herfarth, Klaus; Durante, Marco; Bert, Christoph

    2014-01-01

    Purpose: Estimation of the actual delivered 4-dimensional (4D) dose in treatments of patients with mobile hepatocellular cancer with scanned carbon ion beam therapy. Methods and Materials: Six patients were treated with 4 fractions to a total relative biological effectiveness (RBE)–weighted dose of 40 Gy (RBE) using a single field. Respiratory motion was addressed by dedicated margins and abdominal compression (5 patients) or gating (1 patient). 4D treatment dose reconstructions based on the treatment records and the measured motion monitoring data were performed for the single-fraction dose and a total of 17 fractions. To assess the impact of uncertainties in the temporal correlation between motion trajectory and beam delivery sequence, 3 dose distributions for varying temporal correlation were calculated per fraction. For 3 patients, the total treatment dose was formed from the fractional distributions using all possible combinations. Clinical target volume (CTV) coverage was analyzed using the volumes receiving at least 95% (V 95 ) and 107% (V 107 ) of the planned doses. Results: 4D dose reconstruction based on daily measured data is possible in a clinical setting. V 95 and V 107 values for the single fractions ranged between 72% and 100%, and 0% and 32%, respectively. The estimated total treatment dose to the CTV exhibited improved and more robust dose coverage (mean V 95 > 87%, SD < 3%) and overdose (mean V 107 < 4%, SD < 3%) with respect to the single-fraction dose for all analyzed patients. Conclusions: A considerable impact of interplay effects on the single-fraction CTV dose was found for most of the analyzed patients. However, due to the fractionated treatment, dose heterogeneities were substantially reduced for the total treatment dose. 4D treatment dose reconstruction for scanned ion beam therapy is technically feasible and may evolve into a valuable tool for dose assessment

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

    International Nuclear Information System (INIS)

    Hjerpe, T.; Broed, R.

    2010-11-01

    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.)

  12. Patient doses from CT examinations in the United Arab Emirates

    International Nuclear Information System (INIS)

    Janeczek, J.

    2006-01-01

    Full text of publication follows: The main goal of the study was to estimate effective patient doses from the 6 most common CT examinations for different types of CT scanners within the United Arab Emirates. The results were used to assess future trends in patient CT doses following rapid replacement of axial and single-slice spiral scanners by multi-slice scanners. At present all three types of scanner technology exist: axial, spiral and multi-slice with axial scanners being gradually replaced by multi-slice scanners as the medical infrastructure of the country is modernized. Altogether there are more than 30 CT scanners in the country with a population of 4 million. Out of these 11 scanners are 16-slice models with tube-current modulation system. The majority of larger United Arab Emirates hospitals have at least two CT scanners: a single slice and 4 or 16-slice scanner. The survey was carried out with data collection forms distributed to the majority of CT scanner users in the United Arab Emirates hospitals, both private and government. Effective doses for different examinations were calculated from T.L.D. measurements using an Alderson Rando phantom simulating an average size patient. Our results show that effective doses to patients initially increased with the introduction of 4-slice scanners. Multi-slice scanners with 16 and more slices have tube-current modulation system as a standard. It is routinely used by radiographers in almost all examinations resulting in patient dose reduction up to 40 % in certain examinations. Another factor affecting population dose is the increased number of patients examined using multi-slice scanners. In the United Arab Emirates there was an increase of more than 30 % in the annual number of patients examined using multi-slice scanners in comparison to single-slice scanners. This fact is attributed to the ease and speed of operation of multi-slice scanners. Rapid increase in number of CT examinations is of concern. Medical

  13. Microdosimetric approach for lung dose assessments

    International Nuclear Information System (INIS)

    Hofmann, W.; Steinhausler, F.; Pohl, E.; Bernroider, G.

    1980-01-01

    In the macroscopic region the term ''organ dose'' is related to an uniform energy deposition within a homogeneous biological target. Considering the lung, inhaled radioactive nuclides, however, show a significant non-uniform distribution pattern throughout the respiratory tract. For the calculation of deposition and clearance of inhaled alpha-emitting radionuclides within different regions of this organ, a detailed compartment model, based on the Weibel model A was developed. Since biological effects (e.g. lung cancer initiation) are primarily caused at the cellular level, the interaction of alpha particles with different types of cells of the lung tissue was studied. The basic approach is to superimpose alpha particle tracks on magnified images of randomly selected tissue slices, simulating alpha emitting sources. Particle tracks are generated by means of a specially developed computer program and used as input data for an on-line electronic image analyzer (Quantimet-720). Using adaptive pattern recognition methods the different cells in the lung tissue can be identified and their distribution within the whole organ determined. This microdosimetric method is applied to soluble radon decay products as well as to insoluble, highly localized, plutonium particles. For a defined microdistribution of alpha emitters, the resulting dose, integrated over all cellular dose values, is compared to the compartmental doses of the ICRP lung model. Furthermore this methodology is also applicable to other organs and tissues of the human body for dose calculations in practical health physics. (author)

  14. Effective dose in abdominal digital radiography: Patient factor

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Ji Sung; Koo, Hyun Jung; Park, Jung Hoon; Cho, Young Chul; Do, Kyung Hyun [Dept. of Radiology, and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul(Korea, Republic of); Yang, Hyung Jin [Dept. of Medical Physics, Korea University, Seoul (Korea, Republic of)

    2017-08-15

    To identify independent patient factors associated with an increased radiation dose, and to evaluate the effect of patient position on the effective dose in abdominal digital radiography. We retrospectively evaluated the effective dose for abdominal digital radiography in 222 patients. The patients were divided into two groups based on the cut-off dose value of 0.311 mSv (the upper third quartile of dose distribution): group A (n = 166) and group B (n = 56). Through logistic regression, independent factors associated with a larger effective dose were identified. The effect of patient position on the effective dose was evaluated using a paired t-test. High body mass index (BMI) (≥ 23 kg/m2), presence of ascites, and spinal metallic instrumentation were significantly associated with a larger effective dose. Multivariate logistic regression analysis revealed that high BMI [odds ratio (OR), 25.201; p < 0.001] and ascites (OR, 25.132; p < 0.001) were significantly associated with a larger effective dose. The effective dose was significantly lesser (22.6%) in the supine position than in the standing position (p < 0.001). High BMI and ascites were independent factors associated with a larger effective dose in abdominal digital radiography. Significant dose reduction in patients with these factors may be achieved by placing the patient in the supine position during abdominal digital radiography.

  15. Patient dose in image guided radiotherapy: Monte Carlo study of the CBCT dose contribution

    Directory of Open Access Journals (Sweden)

    Salvatore Leotta

    2018-02-01

    Full Text Available Image Guided RadioTherapy (IGRT is a technique whose diffusion is growing thanks to the well-recognized gain in accuracy of dose delivery. However, multiple Cone Beam Computed Tomography (CBCT scans add dose to patients, and its contribution has to be assessed and minimized. Aim of our work was to evaluate, through Monte Carlo simulations, organ doses in IGRT due to CBCT and therapeutic MV irradiation in head-neck, thorax and pelvis districts. We developed a Monte Carlo simulation in GAMOS (Geant4-based Architecture for Medicine-Oriented Simulations, reproducing an Elekta Synergy medical linac operating at 6 and 10 MV photon energy, and we set up a scalable anthropomorphic model. After a validation by comparison with the experimental quality indexes, we evaluated the average doses to all organs and tissues belonging to the model for the three cases of irradiated district. Scattered radiation in therapy is larger than that diffused by CBCT by one to two orders of magnitude.

  16. Assessment of low absorbed dose with a MOSFET detector

    International Nuclear Information System (INIS)

    Butson, M.J.; Cancer Services, Wollongong, NSW; Cheung, T.; Yu, P.K.N.

    2004-01-01

    Full text: The ability of a MOSFET dosimetry system to measure low therapeutic doses has been evaluated for accuracy for high energy x-ray radiotherapy applications. The MOSFET system in high sensitivity mode produces a dose measurement reproducibility of within 10%, 4% and 2.5% for 2 cGy, 5 cGy and 10cGy dose assessment respectively. This is compared to 7%, 4% and 2% for an Attix parallel plate ionisation chamber and 20%, 7% and 3.5% for a Wellhofer IC4 small volume ionisation chamber. Results for our dose standard thimble ionisation chamber and low noise farmer dosemeter were 2%, 0.5% and 0.25% respectively for these measurements. The quoted accuracy of the MOSFET dosimetry system is partially due to the slight non linear dose response (reduced response) with age of the detector but mainly due to the intrinsic variations in measured voltage differential per applied dose. Results have shown that the MOSFET dosimetry system provides an adequate measure of dose at low dose levels and is comparable in accuracy to the Attix parallel plate ionisation chambers for relative dose assessment at levels of 2cGy to 10cGy. The use of the MOSFET dosimeter at low doses can extend the life expectancy of the device and may provide useful information for areas where low dose assessment is required. Copyright (2004) Australasian College of Physical Scientists and Engineers in Medicine

  17. Dose assessment for decontamination in Goiania

    International Nuclear Information System (INIS)

    Amaral, E.C.S.

    2000-01-01

    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)

  18. Study of Optimal Replacement of Thyroxine in the ElDerly (SORTED): protocol for a mixed methods feasibility study to assess the clinical utility of lower dose thyroxine in elderly hypothyroid patients: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Wilkes, Scott; Pearce, Simon; Ryan, Vicky; Rapley, Tim; Ingoe, Lorna; Razvi, Salman

    2013-03-22

    The population of the UK is ageing. There is compelling evidence that thyroid stimulating hormone distribution levels increase with age. Currently, in UK clinical practice elderly hypothyroid patients are treated with levothyroxine to lower their thyroid stimulating hormone levels to a standard non-age-related range. Evidence suggests that mortality is negatively associated with thyroid stimulating hormone levels. We report the protocol of a feasibility study working towards a full-scale randomized controlled trial to test whether lower dose levothyroxine has beneficial cardiovascular outcomes in the oldest old. SORTED is a mixed methods study with three components: SORTED A: A feasibility study of a dual-center single-blinded randomized controlled trial of elderly hypothyroid patients currently treated with levothyroxine. Patients will be recruited from 20 general practices and two hospital trust endocrine units in Northumberland, Tyne and Wear. Target recruitment of 50 elderly hypothyroid patients currently treated with levothyroxine, identified in both primary and secondary care settings. Reduced dose of levothyroxine to achieve an elevated serum thyroid stimulating hormone (target range 4.1 to 8.0 mU/L) versus standard levothyroxine replacement (target range 0.4 to 4.0 mU/L). Using random permuted blocks, in a ratio of 1:1, randomization will be carried out by Newcastle Clinical Trials Unit. Study feasibility (recruitment and retention rates and medication compliance), acceptability of the trial design, assessment of mobility and falls risk, and change in cardiovascular risk factors. Qualitative study using in-depth interviews to understand patients' willingness to take part in a randomized controlled trial and participants' experience of the intervention. Retrospective cohort study of 400 treated hypothyroid patients aged 80 years or over registered in 2008 in primary care practices, studying their 4-year cardiovascular outcomes to inform the power of SORTED

  19. Going beyond the most exposed people in a dose assessment

    Energy Technology Data Exchange (ETDEWEB)

    Hjerpe, Thomas; Broed, Robert [Facilia AB, Gustavslundsvaegen 151C, SE-167 51 Bromma (Sweden); Ikonen, Ari T.K. [Environmental Research and Assessment, EnviroCase, Ltd., Hallituskatu 1 D 4, FI-28 100 Pori (Finland)

    2014-07-01

    The dose assessment in a long-term radiation safety assessment often focus on assessing dose of a representative person to be used for determining compliance with a radiation dose constraint. This representative person is often assumed to receive a dose that is representative of the most exposed people, i.e., the more highly exposed individuals in the population. This is not always sufficient, the Finnish regulations for disposal of nuclear waste has radiation dose constraint to the most exposed people as well as for larger groups of exposed people. This work presents the methodology to assessing dose of a representative person for a larger group of exposed people as applied by Posiva in the TURVA-2012 safety case for the spent nuclear fuel disposal at Olkiluoto. In addition, annual doses from the set of biosphere calculation cases analysed in TURVA-2012 are presented and discussed. Special focus is given on explaining the differences in exposure levels and exposure routes between the estimated annual doses to representative persons for most exposed people and a larger exposed group. The results show that the annual doses to a larger group of people ranges from one to three orders of magnitude below the annual doses to the most exposed people. Furthermore, the exposure route related to food ingestion is less significant for the larger group of people compared to the most exposed people and that the exposure route related to water ingestion shows the opposite behaviour. (authors)

  20. A review of occupational dose assessment uncertainties and approaches

    International Nuclear Information System (INIS)

    Anderson, R. W.

    2004-01-01

    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)

  1. Evaluation of occupational and patient radiation doses in orthopedic surgery

    International Nuclear Information System (INIS)

    Sulieman, A.; Alzimami, K.; Habeeballa, B.; Osman, H.; Abdelaziz, I.; Sassi, S.A.; Sam, A.K.

    2015-01-01

    This study intends to measure the radiation dose to patients and staff during (i) Dynamic Hip Screw (DHS) and (ii) Dynamic Cannula Screw (DCS) and to evaluate entrance surface Air kerma (ESAK) dose and organ doses and effective doses. Calibrated Thermoluminescence dosimeters (TLD-GR200A) were used. The mean patients’ doses were 0.46 mGy and 0.07 mGy for DHS and DCS procedures, respectively. The mean staff doses at the thyroid and chest were 4.69 mGy and 1.21 mGy per procedure. The mean organ and effective dose for patients and staff were higher in DHS compared to DCS. Orthopedic surgeons were exposed to unnecessary radiation doses due to the lack of protection measures. The radiation dose per hip procedure is within the safety limit and less than the previous studies

  2. Evaluation of patient dose during computed tomography angiography

    International Nuclear Information System (INIS)

    Dafalla, Elamam Yagoob Taha

    2015-10-01

    Computed tomography (CT), is an x-ray procedure that generates high quality cross sectional images of the body, and by comparison to other radiological diagnosis, CT is responsible for higher doses to patients. The evaluation of patient dose from computed tomography for pulmonary examinations the CT is responsible for higher doses to patients. The radiation dose was measured in three hospitals in Khartoum State during March 2015-October 2015 using different CT modalities. The radiation dose was higher at Alzytouna hospital than Daralelaj hospital and Alatebaa hospital was lowest. In this study, the mean effective dose for first hospital was 23.83±3.93 mSv and the mean effective dose for second hospital was 8.94±1.64 mSv and the mean effective dose for third hospital was 2.96±0.79. (author)

  3. IAEA/IDEAS intercomparison exercise on internal dose assessment

    International Nuclear Information System (INIS)

    Doerfel, H.; Andrasi, A.; Cruz-Suarez, R.; Castellani, C. M.; Hurtgen, C.; Marsh, J.; Zeger, J.

    2007-01-01

    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)

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

    International Nuclear Information System (INIS)

    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. (paper)

  5. Post-treatment visual acuity in patients treated with episcleral plaque therapy for choroidal melanoma: Dose and dose rate effects

    International Nuclear Information System (INIS)

    Jones, Robert; Gore, Elizabeth; Mieler, William; Gillin, Michael; Albano, Katherine; Erickson, Beth

    1996-01-01

    Purpose: To determine the relationship between the long-term visual function and the dose and dose rates delivered to critical ocular structures in patients with choroidal melanoma treated with 125 I episcleral plaque radiotherapy. Methods and Materials: From 1987 to 1993, 63 patients underwent 125 I episcleral plaque application for the treatment of choroidal melanoma. Mean tumor height was 4.6 mm (range 1.7-8.3 mm). Plaques utilized were of COMS design. Doses and dose rates at the tumor apex, macula, and optic disc were obtained. Visual acuity data prior to and after plaque application was available for 52 patients. 9 patients were excluded from analysis secondary to co-morbidities or disease progression. 43 records were scored to assess if a decrease in visual acuity of ≥ 2 lines on a standard Snellen eye chart had occurred. Statistical analysis was performed using chi-square tests of significance. Results: Of the 63 total patients, 59 (93.7%) were alive at a median follow-up of 36 months. Local progression occurred in (7(63)) (11.1%). Median dose and dose rate to the tumor apex were 90 Gy and 97.2 cGy/hr, respectively. Of the 43 patients with post-treatment visual acuity analysis, 28 (65.1%) experienced visual loss of ≥ 2 lines on a standard eye chart. Median time to altered visual acuity was 20 months. Median dose and dose rates to the macula in patients with a significant visual loss were 123.3 Gy and 122.5 cGy/hr, respectively, compared with 38 Gy and 51.9 cGy/hr in those without notable visual change. These differences reached statistical significance at a dose and dose rate to the macula of 82.0 Gy (p 125 I plaque brachytherapy for choroidal melanoma experienced favorable tumor control, but with a measurable incidence of decreased visual acuity. Both total dose and dose rates to the macula and optic disc correlated strongly with post-treatment visual outcome. This information may be valuable in decisions about the dose and dose rates used to treat

  6. Post-treatment visual acuity in patients treated with episcleral plaque therapy for choroidal melanoma: dose and dose rate effects

    International Nuclear Information System (INIS)

    Jones, Robert; Gore, Elizabeth; Mieler, William; Murray, Kevin; Gillin, Michael; Albano, Katherine; Erickson, Beth

    1996-01-01

    Purpose: To determine the relationship between the long-term visual function and the dose and dose rates delivered to critical ocular structures in patients with choroidal melanoma treated with 125 I episcleral plaque radiotherapy. Methods and Materials: From 1987 to 1994, 63 patients underwent 125 I episcleral plaque application for the treatment of choroidal melanoma. Mean tumor height was 4.6 mm (range 1.7-8.3 mm). Plaques utilized were of COMS design. Doses and dose rates at the tumor apex, macula, and optic disc were obtained. Visual acuity data prior to and after plaque application was available for 52 patients. Nine patients were excluded from analysis secondary to co-morbidities or disease progression. Forty-three records were scored to assess if a decrease in visual acuity of ≥ 2 lines on a standard Snellen eye chart had occurred. Statistical analysis was performed using chi-square tests of significance. Results: Of the 63 total patients, 59 (93.7%) were alive at a median follow-up of 36 months. Local progression occurred in 7/63 (11.1%). Median dose and dose rate to the tumor apex were 90 Gy and 97.2 cGy/hr, respectively. Of the 43 patients with post-treatment visual acuity analysis, 28 (65.1%) experienced visual loss of ≥ 2 lines on a standard eye chart. Median time to altered visual acuity was 20 months. Median dose and dose rates to the macula in patients with a significant visual loss were 123.3 Gy and 122.5 cGy/hr, respectively, compared with 38 Gy and 51.9 cGy/hr in those without notable visual change. These differences reached statistical significance at a dose and dose rate to the macula of 82.0 Gy (p 125 I plaque brachytherapy for choroidal melanoma experienced favorable tumor control, but with a measurable incidence of decreased visual acuity. Both total dose and dose rates to the macula and optic disc correlated strongly with post-treatment visual outcome. This information may be valuable in decisions about the dose and dose rates used to

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

    International Nuclear Information System (INIS)

    Swindon, T.N.; Morris, N.D.

    1981-12-01

    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

  8. Iodine-129 Dose in LLW Disposal Facility Performance Assessments

    International Nuclear Information System (INIS)

    Wilhite, E.L.

    1999-01-01

    Iodine-129 has the lowest Performance Assessment derived inventory limit in SRS disposal facilities. Because iodine is concentrated in the body to one organ, the thyroid, it has been thought that dilution with stable iodine would reduce the dose effects of 129I.Examination of the dose model used to establish the Dose conversion factor for 129I shows that, at the levels considered in performance assessments of low-level waste disposal facilities, the calculated 129I dose already accounts for ingestion of stable iodine. At higher than normal iodine ingestion rates, the uptake of iodine by the thyroid itself decrease, which effectively cancels out the isotopic dilution effect

  9. Cumulative radiation dose of multiple trauma patients during their hospitalization

    International Nuclear Information System (INIS)

    Wang Zhikang; Sun Jianzhong; Zhao Zudan

    2012-01-01

    Objective: To study the cumulative radiation dose of multiple trauma patients during their hospitalization and to analyze the dose influence factors. Methods: The DLP for CT and DR were retrospectively collected from the patients during June, 2009 and April, 2011 at a university affiliated hospital. The cumulative radiation doses were calculated by summing typical effective doses of the anatomic regions scanned. Results: The cumulative radiation doses of 113 patients were collected. The maximum,minimum and the mean values of cumulative effective doses were 153.3, 16.48 mSv and (52.3 ± 26.6) mSv. Conclusions: Multiple trauma patients have high cumulative radiation exposure. Therefore, the management of cumulative radiation doses should be enhanced. To establish the individualized radiation exposure archives will be helpful for the clinicians and technicians to make decision whether to image again and how to select the imaging parameters. (authors)

  10. WHO and rational reduction of patient dose

    International Nuclear Information System (INIS)

    Hanson, G.

    1995-01-01

    WHO activities aimed at reducing patient dose, while maintaining satisfactory image quality, include rational use of diagnostic imaging, effective choices for examination, equipment design and specification, quality assurance, and guidance for regulatory authorities and radiological personnel. To assist its Member States in developing a rational policy concerning imaging services WHO provides guidance through publications, its network of Collaborating Centres, and its expert advisers. Because approximately 2/3 of the world's population lacked diagnostic imaging services, early in the 1960s WHO became concerned with basic radiology. After several unsuccessful approaches WHO concentrated on development of the Basic Radiological System (WHO-BRS). Following a workshop held in Neuherberg, Germany, a guide for Quality Assurance in Diagnostic Radiology was published by WHO in 1982. A similar guide for Quality Assurance in Nuclear Medicine was also published in 1982. In collaboration with other international organisations WHO is preparing revised editions of both the Basic Safety Standards for Radiation Protection, and the five-volume Manual on Radiation Protection in Hospitals and General Practice. Regarding future needs, within any health care system there is a spectrum of imaging requirements ranging from the most essential to the most complex. Issues to be resolved involve the clinical decision-making process through which diagnostic imaging examinations are produced and the optimum mixture of imaging modalities. (Author)

  11. An Internal Dose Assessment Associated with Personal Food Intake

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-10-15

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

  12. Characteristics of environmental gamma-rays and dose assessment

    International Nuclear Information System (INIS)

    Saito, Kimiaki; Moriuchi, Shigeru

    1986-01-01

    Environmental radioactivity has attracted much attention in terms of exposure to the population, although its exposure doses are minimal. This paper presents problems encountered in the assessment of exposure doses using model and monitoring systems, focusing on the characteristics, such as energy distribution, direction distribution, and site, of environmental gamma-rays. The assessment of outdoor and indoor exposure doses of natural gamma-rays is discussed in relation to the shielding effect of the human body. In the assessment of artificial gamma-rays, calculation of exposure doses using build-up factor, the shielding effect of the human body, and energy dependency of the measuring instrument are covered. A continuing elucidation about uncertainties in dose assessment is emphasized. (Namekawa, K.)

  13. Method of estimating patient skin dose from dose displayed on medical X-ray equipment with flat panel detector

    International Nuclear Information System (INIS)

    Fukuda, Atsushi; Koshida, Kichiro; Togashi, Atsuhiko; Matsubara, Kousuke

    2004-01-01

    The International Electrotechnical Commission (IEC) has stipulated that medical X-ray equipment for interventional procedures must display radiation doses such as air kerma in free air at the interventional reference point and dose area product to establish radiation safety for patients (IEC 60601-2-43). However, it is necessary to estimate entrance skin dose for the patient from air kerma for an accurate risk assessment of radiation skin injury. To estimate entrance skin dose from displayed air kerma in free air at the interventional reference point, it is necessary to consider effective energy, the ratio of the mass-energy absorption coefficient for skin and air, and the backscatter factor. In addition, since automatic exposure control is installed in medical X-ray equipment with flat panel detectors, it is necessary to know the characteristics of control to estimate exposure dose. In order to calculate entrance skin dose under various conditions, we investigated clinical parameters such as tube voltage, tube current, pulse width, additional filter, and focal spot size, as functions of patient body size. We also measured the effective energy of X-ray exposure for the patient as a function of clinical parameter settings. We found that the conversion factor from air kerma in free air to entrance skin dose is about 1.4 for protection. (author)

  14. Monitoring requirements for assessment of internal dose

    International Nuclear Information System (INIS)

    Eckerman, K.F.

    1985-01-01

    Data obtained by routine personnel monitoring is usually not a sufficient basis for estimation of dose. Collected data must be interpreted carefully and supplemented with appropriate information before reasonably accurate estimates of dose (i.e., accurate enough to indicate whether or nor personnel are exposed in excess of recommended limits) can be developed. When the exposure is of sufficient magnitude that a rather precise estimate of dose is needed, the health physicist will bring to bear on the problem other, more refined, methods of dosimetry. These might include a reconstruction of the incident and, for internal emitters, an extensive series of in vivo measurements or analyses of excreta. Thus, cases of special significance must often be evaluated using techniques and resources beyond those routinely employed. This is not a criticism of most routine monitoring programs. These programs are usually carefully designed in a manner commensurate with the degree of exposure routinely encountered and the requirement of a practical program of radiation protection. 10 refs

  15. Balancing patient dose and image quality

    International Nuclear Information System (INIS)

    Martin, C.J.; Sutton, D.G.; Sharp, P.F.

    1999-01-01

    The formation of images in diagnostic radiology involves a complex interdependence of many factors. The ideal balance is to obtain an image which is adequate for the clinical purpose with the minimum radiation dose. Factors which affect radiation dose and image quality can be grouped under three headings; radiation quality, photon fluence and removal of scattered radiation. If optimal performance is to be achieved, it is necessary to understand how these factors influence image formation and affect radiation dose, and apply methodology for image quality and dose analysis at each stage in the development and use of X-ray equipment

  16. Vancomycin Dosing in Obese Patients: Special Considerations and Novel Dosing Strategies.

    Science.gov (United States)

    Durand, Cheryl; Bylo, Mary; Howard, Brian; Belliveau, Paul

    2018-06-01

    To review the literature regarding vancomycin pharmacokinetics in obese patients and strategies used to improve dosing in this population. PubMed, EMBASE (1974 to November 2017), and Google Scholar searches were conducted using the search terms vancomycin, obese, obesity, pharmacokinetics, strategy, and dosing. Additional articles were selected from reference lists of selected studies. Included articles were those published in English with a primary focus on vancomycin pharmacokinetic parameters in obese patients and practical vancomycin dosing strategies, clinical experiences, or challenges of dosing vancomycin in this population. Volume of distribution and clearance are the pharmacokinetic parameters that most often affect vancomycin dosing in obese patients; both are increased in this population. Challenges with dosing in obese patients include inconsistent and inadequate dosing, observations that the obese population may not be homogeneous, and reports of an increased likelihood of supratherapeutic trough concentrations. Investigators have revised and developed dosing and monitoring protocols to address these challenges. These approaches improved target trough attainment to varying degrees. Some of the vancomycin dosing approaches provided promising results in obese patients, but there were notable differences in methods used to develop these approaches, and sample sizes were small. Although some approaches can be considered for validation in individual institutions, further research is warranted. This may include validating approaches in larger populations with narrower obesity severity ranges, investigating target attainment in indication-specific target ranges, and evaluating the impact of different dosing weights and methods of creatinine clearance calculation.

  17. Switching From Age-Based Stimulus Dosing to Dose Titration Protocols in Electroconvulsive Therapy: Empirical Evidence for Better Patient Outcomes With Lower Peak and Cumulative Energy Doses.

    Science.gov (United States)

    O'Neill-Kerr, Alex; Yassin, Anhar; Rogers, Stephen; Cornish, Janie

    2017-09-01

    The aim of this study was to test the proposition that adoption of a dose titration protocol may be associated with better patient outcomes, at lower treatment dose, and with comparable cumulative dose to that in patients treated using an age-based stimulus dosing protocol. This was an analysis of data assembled from archived records and based on cohorts of patients treated respectively on an age-based stimulus dosing protocol and on a dose titration protocol in the National Health Service in England. We demonstrated a significantly better response in the patient cohort treated with dose titration than with age-based stimulus dosing. Peak doses were less and the total cumulative dose was less in the dose titration group than in the age-based stimulus dosing group. Our findings are consistent with superior outcomes in patients treated using a dose titration protocol when compared with age-based stimulus dosing in a similar cohort of patients.

  18. Dose-volume complication analysis for visual pathway structures of patients with advanced paranasal sinus tumors

    International Nuclear Information System (INIS)

    Martel, Mary Kaye; Sandler, Howard M.; Cornblath, Wayne T.; Marsh, Lon H.; Hazuka, Mark B.; Roa, Wilson H.; Fraass, Benedict A.; Lichter, Allen S.

    1997-01-01

    Purpose: The purpose of the present work was to relate dose and volume information to complication data for visual pathway structures in patients with advanced paranasal sinus tumors. Methods and Materials: Three-dimensional (3D) dose distributions for chiasm, optic nerve, and retina were calculated and analyzed for 20 patients with advanced paranasal sinus malignant tumors. 3D treatment planning with beam's eye view capability was used to design beam and block arrangements, striving to spare the contralateral orbit (to lessen the chance of unilateral blindness) and frequently the ipsilateral orbit (to help prevent bilateral blindness). Point doses, dose-volume histogram analysis, and normal tissue complication probability (NTCP) calculations were performed. Published tolerance doses that indicate significant risk of complications were used as guidelines for analysis of the 3D dose distributions. Results: Point doses, percent volume exceeding a specified published tolerance dose, and NTCP calculations are given in detail for patients with complications versus patients without complications. Two optic nerves receiving maximum doses below the published tolerance dose sustained damage (mild vision loss). Three patients (of 13) without optic nerve sparing and/or chiasm sparing had moderate or severe vision loss. Complication data, including individual patient analysis to estimate overall risk for loss of vision, are given. Conclusion: 3D treatment planning techniques were used successfully to provide bilateral sparing of the globe for most patients. It was more difficult to spare the optic nerves, especially on the ipsilateral side, when prescription dose exceeded the normal tissue tolerance doses. NTCP calculations may be useful in assessing complication risk better than point dose tolerance criteria for the chiasm, optic nerve, and retina. It is important to assess the overall risk of blindness for the patient in addition to the risk for individual visual pathway

  19. Patients exposure assessment for radiographic procedures in diagnostic radiology

    International Nuclear Information System (INIS)

    Arandjic, D.; Ciraj-Bjelac, O.; Stankovic, K.; Lazarevic, Dj.; Ciraj-Bjelac, O.)

    2007-01-01

    In this work the results of dose assessment for the most frequent radiographic procedures in diagnostic radiology are shown. Entrance surface doses were assessed for 7 radiographic procedures. Three hospitals, six x-ray units in total, were enrolled in investigation. Patient doses were estimated based on results of x-ray tube output measurements. Finally, doses were compared with Diagnostic reference level. Higher dose values were observed for chest examinations. In comparison with results from other countries, doses from this procedure in Serbia are significantly higher. Estimated doses for other procedures were well below Diagnostic reference levels [sr

  20. Evaluation of Patient Radiation Dose during Orthopedic Surgery

    International Nuclear Information System (INIS)

    Osman, H; Elzaki, A.; Sam, A.K.; Sulieman, A.

    2013-01-01

    The number of orthopedic procedures requiring the use of the fluoroscopic guidance has increased over the recent years. Consequently the patient exposed to un avoidable radiation doses. The aim of the current study was to evaluate patient radiation dose during these procedures.37 patients under went dynamic hip screw (DHS) and dynamic cannulated screw (DCS) were evaluated using calibrated Thermolumincent Dosimeters (TLDs), under carm fluoroscopic machines ,in three centers in Khartoum-Sudan. The mean Entrance Skin Dose (ESD) was 7.9 m Gy per procedure. The bone marrow and gonad organ exposed to significant doses. No correlation was found between ESD and Body Mass Index (BMI), or patient weight. Well correlation was found between kilo voltage applied and ESD. Orthopedic surgeries delivered lower radiation dose to patients than cardiac catheterization or hysterosalpingraphy (HSG) procedures. More study should be implemented to follow radiation dose before surgery and after surgery

  1. Patient radiation dose in conventional and xerographic cephalography

    International Nuclear Information System (INIS)

    Copley, R.L.; Glaze, S.A.; Bushong, S.C.; West, D.C.

    1979-01-01

    A comparison of the radiation doses for xeroradiographic and conventional film screen cephalography was made. Alderson tissue-equivalent phantoms were used for patient simulation. An optimum technique in terms of patient dose and image quality indicated that the dose for the Xerox process ranged from five to eleven times greater than that for the conventional process for entrance and exit exposures, respectively. This dose, however, falls within an acceptable range for other dental and medical radiation doses. It is recommended that conventional cephalography be used for routine purposes and that xeroradiography be reserved for situations requiring the increased image quality that the process affords

  2. Warfarin maintenance dose in older patients: higher average dose and wider dose frequency distribution in patients of African ancestry than those of European ancestry.

    Science.gov (United States)

    Garwood, Candice L; Clemente, Jennifer L; Ibe, George N; Kandula, Vijay A; Curtis, Kristy D; Whittaker, Peter

    2010-06-15

    Studies report that warfarin doses required to maintain therapeutic anticoagulation decrease with age; however, these studies almost exclusively enrolled patients of European ancestry. Consequently, universal application of dosing paradigms based on such evidence may be confounded because ethnicity also influences dose. Therefore, we determined if warfarin dose decreased with age in Americans of African ancestry, if older African and European ancestry patients required different doses, and if their daily dose frequency distributions differed. Our chart review examined 170 patients of African ancestry and 49 patients of European ancestry cared for in our anticoagulation clinic. We calculated the average weekly dose required for each stable, anticoagulated patient to maintain an international normalized ratio of 2.0 to 3.0, determined dose averages for groups 80 years of age and plotted dose as a function of age. The maintenance dose in patients of African ancestry decreased with age (PAfrican ancestry required higher average weekly doses than patients of European ancestry: 33% higher in the 70- to 79-year-old group (38.2+/-1.9 vs. 28.8+/-1.7 mg; P=0.006) and 52% in the >80-year-old group (33.2+/-1.7 vs. 21.8+/-3.8 mg; P=0.011). Therefore, 43% of older patients of African ancestry required daily doses >5mg and hence would have been under-dosed using current starting-dose guidelines. The dose frequency distribution was wider for older patients of African ancestry compared to those of European ancestry (PAfrican ancestry indicate that strategies for initiating warfarin therapy based on studies of patients of European ancestry could result in insufficient anticoagulation and thereby potentially increase their thromboembolism risk. Copyright 2010 Elsevier Inc. All rights reserved.

  3. A Cohort Study of Preoperative Single Dose Versus Four Doses of Antibiotics for Patients With Non-Complicated Acute Appendicitis

    Directory of Open Access Journals (Sweden)

    Salah H. Al Janaby

    2017-02-01

    Full Text Available Objective: To Test the efficacy of single preoperative dose of Cefotaxime 1gm and Metronidazole 500mg in reducing the surgical site infections (SSIs after open appendectomy in patients with non-complicated appendicitis (NCA Place and Duration of Study: Al Hilla General Teaching Hospital, Babel Governorate-Iraq, from January 2013 to January 2014. Patients & Methods: 100 patients, who underwent appendectomy for NCA and fulfilled the selection criteria, were randomized into two groups. The patients in group A received a single dose of pre-operative antibiotics (Cefotaxime sodium and metronidazole, while the group B patients received three more dose of the same antibiotics postoperatively. Patients of both groups were followed-up for 30 days to assess the postoperative infective complications. Results: Group A had 48, while group B comprised of 52 patients. The groups were comparable in the baseline characteristics. Statistically, P value in rates of SSIs between both the groups was 0.9182. None of the patients developed intra-abdominal collection. Conclusion: Single dose of pre-operative antibiotics (Cefotaxime and metronidazole was sufficient in reducing the SSIs after appendectomy for NPA. Postoperative antibiotics did not add an appreciable clinical benefit in these patients. Key words: Preoperative antibiotics, Appendectomy, Surgical site infection, Non-complicated appendicitis Abbreviations: SSI: Surgical Site Infection, NCA: non-complicated appendicitis CDC Center of Disease Control.

  4. Patient dose in CT fluoroscopy examinations

    International Nuclear Information System (INIS)

    Ito, Yusuke; Kobayashi, Masanao; Kataoka, Yumi; Ida, Yoshihiro; Kato, Ryoichi; Katada, Kazuhiro; Asada, Yasuki; Suzuki, Shoichi

    2008-01-01

    CT fluoroscopy(CTF) results in a high dose for the area under investigation in comparison with other types of examination. On the basis of data from April 2005 to March 2008, we measured the X-ray doses at the target site in CTF of the lungs, lumbar vertebrae, and pelvis as well as the X-ray dose to the female reproductive organs, and calculated the effective dose. The CT equipment used was an Aquilion 16. TLDs were inserted into an anthropomorphic phantom in positions corresponding to the target sites and the reproductive organs. Standard tube voltage and tube current were used as measurement conditions, and the scanning time used was the average value for each type of examination during the two years. Dose measurements were taken in the following order: scanography, helical scan, CTF, helical scan. X-ray element calibration was carried out through reciprocal comparison made between an ionization chamber dosimeter corrected according to government standards and the TLD for each tube voltage used for measurement. Dose estimation software was used to calculate the effective doses. During the two years there were 136 CTF examinations. These included 43 scans of the lungs, 13 of lumbar vertebrae, and 18 of the pelvis. The X-ray doses were 0.1 mGy at both the ovaries and the uterus for lung scans, 2 mGy at the ovaries and 1 mGy at the uterus for lumbar vertebrae scans, and 40 mGy at the ovaries and 20 mGy at the uterus for pelvic scans. The effective dose was highest for the lumbar vertebrae, followed by the lungs and finally the pelvis. (author)

  5. Patient and staff doses from digital Bi-plane coronary angiography

    International Nuclear Information System (INIS)

    Janeczek, J.; James, D.; Beal, A.

    2000-01-01

    Coronary angiography is the standard technique for imaging the left ventricle and coronary arteries and is a high radiation dose procedure. The number of these procedures has significantly increased in recent years with a resultant increase in radiation dose to staff and patients. When the new Philips Bi-plane BV-5000 digital angiography unit was installed in Tawam Hospital the assessment of staff and patient doses was undertaken as a part of ongoing program of quality assurance. In this study we examine the technique at Tawam Hospital to determine current practice and measure radiation dose to patient and staff resulting from coronary angiography examinations. Two sets of measurements were conducted: scattered radiation distribution around the unit and patient equivalent dose with additional entrance dose from LAT and AP fields. Prior to the measurements analysis of 10 cardiac procedures involving patients of average size (70-80 kg) was performed and their radiographic parameters recorded and averaged. Dose area product DAP were recorded during these procedures and were used as a reference in both measurements. TLD-100 and TLD-MCP were used for scatter radiation measurements. The former were positioned close to the patient and the latter (due to their higher sensitivity) further away. For patient entrance dose assessment TLD-100 were used. TLD chips were arranged in a 3-D structure positioned close to the patient to measure the scattered dose distribution at the place where the cardiologist, assistant cardiologist and nurse would stand. The other TLDs were placed on thin plastic poles 100 cm from the floor in the areas of interest. Dosimeters were calibrated in terms of absorbed dose to air and soft tissue. TLDs were placed positions and the cardiac procedure was recreated using a Rando Alderson phantom to simulate patient of average size. The mean total DAP calculated from the measurements recorded during 10 patient examinations was 11.8 Gy cm 2 . Using a

  6. Doses to patients from diagnostic radiology in Romania

    International Nuclear Information System (INIS)

    Iacob, O.; Diaconescu, C.

    2001-01-01

    Effective doses to over 2400 patients undergoing 20 of the most important types of X-ray examinations have been estimated from entrance surface doses or dose-area products, measured in 27 X-ray departments, and the appropriate conversion coefficients calculated by the NRPB for six mathematical phantoms representing 0, 1, 5, 10, 15 year old children and the adult. The patient-weighted mean effective dose from X-ray examinations performed annually in Romania is 1.32 mSv, with 1.40 mSv for the average adult patient and 0,59 mSv for the average paediatric patient. The corresponding annual collective effective dose is about 13,430 man Sv, with the main contribution belonging to adult patients (95%), the remainder of 5 percent - to paediatric patients. (author)

  7. Assessing the effect of electron density in photon dose calculations

    International Nuclear Information System (INIS)

    Seco, J.; Evans, P. M.

    2006-01-01

    Photon dose calculation algorithms (such as the pencil beam and collapsed cone, CC) model the attenuation of a primary photon beam in media other than water, by using pathlength scaling based on the relative mass density of the media to water. In this study, we assess if differences in the electron density between the water and media, with different atomic composition, can influence the accuracy of conventional photon dose calculations algorithms. A comparison is performed between an electron-density scaling method and the standard mass-density scaling method for (i) tissues present in the human body (such as bone, muscle, etc.), and for (ii) water-equivalent plastics, used in radiotherapy dosimetry and quality assurance. We demonstrate that the important material property that should be taken into account by photon dose algorithms is the electron density, and not the mass density. The mass-density scaling method is shown to overestimate, relative to electron-density predictions, the primary photon fluence for tissues in the human body and water-equivalent plastics, where 6%-7% and 10% differences were observed respectively for bone and air. However, in the case of patients, differences are expected to be smaller due to the large complexity of a treatment plan and of the patient anatomy and atomic composition and of the smaller thickness of bone/air that incident photon beams of a treatment plan may have to traverse. Differences have also been observed for conventional dose algorithms, such as CC, where an overestimate of the lung dose occurs, when irradiating lung tumors. The incorrect lung dose can be attributed to the incorrect modeling of the photon beam attenuation through the rib cage (thickness of 2-3 cm in bone upstream of the lung tumor) and through the lung and the oversimplified modeling of electron transport in convolution algorithms. In the present study, the overestimation of the primary photon fluence, using the mass-density scaling method, was shown

  8. Determination of dose to patient in different teams of TC and assessment with international reference levels; Determinacion de dosis a pacientes en diferentes equipos de TC y evaluacion con niveles de referencia internacionales

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz Morales, C.; Fernandez lara, A. A.; Buades Forner, M. J.; Tobarra Gonzalez, B. M.

    2013-07-01

    The increase in CT studies and the differences observed between the different equipment used in our hospital prompted us to determine the doses to patients in different studies and check the results obtained with the reference values published internationally. (Author)

  9. The impact of diagnostic reference levels on patient doses from X-ray examinations

    International Nuclear Information System (INIS)

    Leitz, W.; Almen, A.

    2008-01-01

    The aim of this study was to evaluate the effect of diagnostic reference levels (DRL). For this study patient doses for the years 1999 and 2006 were available. Patient doses on a national level for eleven specified X-ray examinations were assessed. For the conventional examinations DRL have been used after the first survey in 1999, for computed tomography no DRL were used and for mammography DRL have been used for more than 20 years. Whereas the patient doses for conventional examinations were 30% lower in 2006 compared to 1999 the doses remained essentially the same for computed tomography and mammography. The widths of the dose distributions had only slightly decreased for conventional examinations and remained the same for computed tomography and mammography. This study has shown that after implementation of DRL a considerable dose reduction can be expected. Practices exceeding DRL will perform remedial actions with the aim to reduce dose, as demonstrated for the conventional examinations. Despite the fact that practices for computed tomography could compare doses with others practices, in the absence of DRL no actions to reduce doses were performed. The margin for further dose reductions in mammography is small due to the long term use of DRL. The impact of DRL on patient doses is changing with time. When introduced large dose reductions can be expected. After long term use DRL will counteract the introduction of new technique with unjustified high patient doses. Despite the merits in terms of dose saving it must be recognized that DRL has its limits - it has to be amended with other radiological protection activities. Other means and measures have to be developed, for example by the authorities, in order to ensure that optimisation is continued even when the patient doses are below the DRL. (author)

  10. Posttreatment visual acuity in patients treated with episcleral plaque therapy for choroidal melanomas: dose and dose rate effects

    International Nuclear Information System (INIS)

    Jones, Robert; Gore, Elizabeth; Mieler, William; Murray, Kevin; Gillin, Michael; Albano, Katherine; Erickson, Beth

    2002-01-01

    Purpose: To determine the relationship between the long-term visual function and the dose and dose rates delivered to critical ocular structures in patients with choroidal melanoma treated with 125 I episcleral plaque radiotherapy. Methods and Materials: From 1987 to 1994, 63 patients underwent 125 I episcleral plaque (Collaborative Ocular Melanoma Study [COMS] design) application for the treatment of choroidal melanoma. The mean tumor height was 4.5 mm (range 1.7-8.3). Doses and dose rates at the tumor apex, macula, and optic disc were calculated. Forty-three records were scored to assess whether a decrease in visual acuity of >2 lines on a standard Snellen eye chart had occurred. Patient age and the presence of hypertension or diabetes were noted. Statistical analysis was performed to assess both the rate at which visual decline had occurred and the presence of significant factors that had contributed to this decline. Results: With a median follow-up of 36 months, the 3-year actuarial survival rate was 93.6%. The 3-year actuarial local control rate was 86.9%. The median time to visual loss after therapy was 18.7 months. The 3-year actuarial rate of visual preservation was 40.5%. Multivariate analysis demonstrated higher macula dose rates (p=0.003) to forecast visual decline. Macula dose rates of 111±11.1 cGy/h were associated with a 50% risk of significant visual loss. Conclusion: Patients in our series treated with 125 I plaque brachytherapy for choroidal melanoma experienced favorable tumor control, but with a measurable incidence of visual decline. Higher dose rates to the macula correlated strongly with poorer posttreatment visual outcome. This information may be valuable in selecting the optimal dose rates to treat choroidal melanomas and to predict the risk of visual decline

  11. Correlation of patient maximum skin doses in cardiac procedures with various dose indicators

    International Nuclear Information System (INIS)

    Domienik, J.; Papierz, S.; Jankowski, J.; Peruga, J.Z.; Werduch, A.; Religa, W.

    2008-01-01

    In most countries of European Union, legislation requires the determination of the total skin dose received by patients during interventional procedures in order to prevent deterministic damages. Various dose indicators like dose-area product (DAP), cumulative dose (CD) and entrance dose at the patient plane (EFD) are used for patient dosimetry purposes in clinical practice. This study aimed at relating those dose indicators with doses ascribed to the most irradiated areas of the patient skin usually expressed in terms of local maximal skin dose (MSD). The study was performed in two different facilities for two most common cardiac procedures coronary angiography (CA) and percutaneous coronary interventions (PCI). For CA procedures, the registered values of fluoroscopy time, total DAP and MSD were in the range (0.7-27.3) min, (16-317) Gy cm 2 and (43-1507) mGy, respectively, and for interventions, accordingly (2.1-43.6) min, (17-425) Gy cm 2 , (71-1555) mGy. Moreover, for CA procedures, CD and EFD were in the ranges (295-4689) mGy and (121-1768) mGy and for PCI (267-6524) mGy and (68-2279) mGy, respectively. No general and satisfactory correlation was found for safe estimation of MSD. However, results show that the best dose indicator which might serve for rough, preliminary estimation is DAP value. In the study, the appropriate trigger levels were proposed for both facilities. (authors)

  12. Iodine 131 therapy patients: radiation dose to staff

    International Nuclear Information System (INIS)

    Castronovo, F.P. Jr.; Beh, R.A.; Veilleux, N.M.

    1986-01-01

    Metastasis to the skeletal system from follicular thyroid carcinoma may be treated with an oral dose of 131 I-NaI. Radiation exposures to hospital personnel attending these patients were calculated as a function of administered dose, distance from the patient and time after administration. Routine or emergency patient handling tasks would not exceed occupational radiation protection guidelines for up to 30 min immediately after administration. The emergency handling of several patients presents the potential for exceeding these guidelines. (author)

  13. Analysis of Dose and Dose Distribution for Patients Undergoing Selected X-Ray Diagnostic Procedures in Ghana

    Energy Technology Data Exchange (ETDEWEB)

    Schandorf, C.; Tetteh, G.K

    1998-07-01

    The levels of dose and dose distributions for adult patients undergoing five selected common types of X ray examination in Ghana were determined using thermoluminescence dosemeters (TLD) attached to the skin where the beam enters the patient. To assess the performance of each X ray room surveyed, the mean of the entrance surface dose for patients whose statistics were close to a standard patient (70 kg weight and 20 cm AP trunk thickness) were compared to the Commission of the European Communities guideline values for chest PA, lumbar spine AP, pelvis/abdomen AP and skull AP examinations. The third quartiles dose values were 1.3 mGy, 14.5 mGy, 12.0 mGy and 7.9 mGy for chest PA, lumbar spine AP, pelvis/abdomen AP and skull AP respectively. Analysis of the data show that 86%, 58%, 37.5% and 50% of radiographic rooms delivered a mean dose greater than the CEC guideline values for chest PA, lumbar spine AP, pelvis/abdomen and skull AP respectively. This suggests that radiographic departments should undertake a review of their radiographic practice in order to bring their doses to optimum levels. (author)

  14. Analysis of Dose and Dose Distribution for Patients Undergoing Selected X-Ray Diagnostic Procedures in Ghana

    International Nuclear Information System (INIS)

    Schandorf, C.; Tetteh, G.K.

    1998-01-01

    The levels of dose and dose distributions for adult patients undergoing five selected common types of X ray examination in Ghana were determined using thermoluminescence dosemeters (TLD) attached to the skin where the beam enters the patient. To assess the performance of each X ray room surveyed, the mean of the entrance surface dose for patients whose statistics were close to a standard patient (70 kg weight and 20 cm AP trunk thickness) were compared to the Commission of the European Communities guideline values for chest PA, lumbar spine AP, pelvis/abdomen AP and skull AP examinations. The third quartiles dose values were 1.3 mGy, 14.5 mGy, 12.0 mGy and 7.9 mGy for chest PA, lumbar spine AP, pelvis/abdomen AP and skull AP respectively. Analysis of the data show that 86%, 58%, 37.5% and 50% of radiographic rooms delivered a mean dose greater than the CEC guideline values for chest PA, lumbar spine AP, pelvis/abdomen and skull AP respectively. This suggests that radiographic departments should undertake a review of their radiographic practice in order to bring their doses to optimum levels. (author)

  15. Risk and dose assessment methods in gamma knife QA

    International Nuclear Information System (INIS)

    Banks, W.W.; Jones, E.D.; Rathbun, P.

    1992-10-01

    Traditional methods used in assessing risk in nuclear power plants may be inappropriate to use in assessing medical radiation risks. The typical philosophy used in assessing nuclear reactor risks is machine dominated with only secondary attention paid to the human component, and only after critical machine failure events have been identified. In assessing the risk of a misadministrative radiation dose to patients, the primary source of failures seems to stem overwhelmingly, from the actions of people and only secondarily from machine mode failures. In essence, certain medical misadministrations are dominated by human events not machine failures. Radiological medical devices such as the Leksell Gamma Knife are very simple in design, have few moving parts, and are relatively free from the risks of wear when compared with a nuclear power plant. Since there are major technical differences between a gamma knife and a nuclear power plant, one must select a particular risk assessment method which is sensitive to these system differences and tailored to the unique medical aspects of the phenomena under study. These differences also generate major shifts in the philosophy and assumptions which drive the risk assessment (Machine-centered vs Person-centered) method. We were prompted by these basic differences to develop a person-centered approach to risk assessment which would reflect these basic philosophical and technological differences, have the necessary resolution in its metrics, and be highly reliable (repeatable). The risk approach chosen by the Livermore investigative team has been called the ''Relative Risk Profile Method'' and has been described in detail by Banks and Paramore, (1983)

  16. Measuring radiation dose to patients undergoing fluoroscopically-guided interventions

    International Nuclear Information System (INIS)

    Lubis, L E; Badawy, M K

    2016-01-01

    The increasing prevalence and complexity of fluoroscopically guided interventions (FGI) raises concern regarding radiation dose to patients subjected to the procedure. Despite current evidence showing the risk to patients from the deterministic effects of radiation (e.g. skin burns), radiation induced injuries remain commonplace. This review aims to increase the awareness surrounding radiation dose measurement for patients undergoing FGI. A review of the literature was conducted alongside previous researches from the authors’ department. Studies pertaining to patient dose measurement, its formalism along with current advances and present challenges were reviewed. Current patient monitoring techniques (using available radiation dosimeters), as well as the inadequacy of accepting displayed dose as patient radiation dose is discussed. Furthermore, advances in real-time patient radiation dose estimation during FGI are considered. Patient dosimetry in FGI, particularly in real time, remains an ongoing challenge. The increasing occurrence and sophistication of these procedures calls for further advances in the field of patient radiation dose monitoring. Improved measuring techniques will aid clinicians in better predicting and managing radiation induced injury following FGI, thus improving patient care. (paper)

  17. A real-time internal dose assessment exercise

    International Nuclear Information System (INIS)

    Bingham, D.; Bull, R. K.

    2013-01-01

    A real-time internal dose assessment exercise has been conducted in which participants were required to make decisions about sampling requirements, seek relevant information about the 'incident' and make various interim dose assessments. At the end of the exercise, each participant was requested to make a formal assessment, providing statements of the methods, models and assumptions used in that assessment. In this paper we describe how the hypothetical assessment case was set up and the exercise was conducted, the responses of the participants and the assessments of dose that they made. Finally we discuss the lessons learnt from the exercise and suggest how the exercise may be adapted to a wider range of participants. (authors)

  18. Objective and Longitudinal Assessment of Dermatitis After Postoperative Accelerated Partial Breast Irradiation Using High-Dose-Rate Interstitial Brachytherapy in Patients With Breast Cancer Treated With Breast Conserving Therapy: Reduction of Moisture Deterioration by APBI

    International Nuclear Information System (INIS)

    Tanaka, Eiichi; Yamazaki, Hideya; Yoshida, Ken; Takenaka, Tadashi; Masuda, Norikazu; Kotsuma, Tadayuki; Yoshioka, Yasuo; Inoue, Takehiro

    2011-01-01

    Purpose: To objectively evaluate the radiation dermatitis caused by accelerated partial breast irradiation (APBI) using high-dose-rate interstitial brachytherapy. Patients and Methods: The skin color and moisture changes were examined using a newly installed spectrophotometer and corneometer in 22 patients who had undergone APBI using open cavity implant high-dose-rate interstitial brachytherapy (36 Gy in six fractions) and compared with the corresponding values for 44 patients in an external beam radiotherapy (EBRT) control group (50–60 Gy in 25–30 fractions within 5–6 weeks) after breast conserving surgery. Results: All values changed significantly as a result of APBI. The extent of elevation in a∗ (reddish) and reduction in L∗ (black) values caused by APBI were similar to those for EBRT, with slightly delayed recovery for 6–12 months after treatment owing to the surgical procedure. In contrast, only APBI caused a change in the b∗ values, and EBRT did not, demonstrating that the reduction in b∗ values (yellowish) depends largely on the surgical procedure. The changes in moisture were less severe after APBI than after EBRT, and the recovery was more rapid. The toxicity assessment using the Common Toxicity Criteria, version 3, showed that all dermatitis caused by APBI was Grade 2 or less. Conclusion: An objective analysis can quantify the effects of APBI procedures on color and moisture cosmesis. The radiation dermatitis caused by APBI using the present schedule showed an equivalent effect on skin color and a less severe effect on moisture than the effects caused by standard EBRT.

  19. Skin Entrance dose to patients from routine P-A chest X-ray ...

    African Journals Online (AJOL)

    Background: Radiation of any amount is potentially hazardous and it should be minimized as much as possible during health care delivery. Objective: To determine and assess the variation of the dose received by patients undergoing chest x-ray examination, and to provide a useful baseline data to evaluate the dose to the ...

  20. Nonparametric estimation of benchmark doses in environmental risk assessment

    Science.gov (United States)

    Piegorsch, Walter W.; Xiong, Hui; Bhattacharya, Rabi N.; Lin, Lizhen

    2013-01-01

    Summary An important statistical objective in environmental risk analysis is estimation of minimum exposure levels, called benchmark doses (BMDs), that induce a pre-specified benchmark response in a dose-response experiment. In such settings, representations of the risk are traditionally based on a parametric dose-response model. It is a well-known concern, however, that if the chosen parametric form is misspecified, inaccurate and possibly unsafe low-dose inferences can result. We apply a nonparametric approach for calculating benchmark doses, based on an isotonic regression method for dose-response estimation with quantal-response data (Bhattacharya and Kong, 2007). We determine the large-sample properties of the estimator, develop bootstrap-based confidence limits on the BMDs, and explore the confidence limits’ small-sample properties via a short simulation study. An example from cancer risk assessment illustrates the calculations. PMID:23914133

  1. A systematic study on factors affecting patient dose, 2

    International Nuclear Information System (INIS)

    Otsuka, Akiyoshi; Higashida, Yoshiharu; Utsumi, Hiromoto; Ota, Masaji; Nakanishi, Takashi

    1979-01-01

    In the preceding report, we dealt with the field size and the tube voltage. This paper covers the differences in patient dose due to the focus to film distance (FFD), the patient thickness and whether the grid is used or not. Regarding the FFD, 100 cm is most commonly employed except in X-ray examinations of the chest, but from the viewpoint of the patient dose, this requires special consideration as to whether there is any theoretical basis for it. The patient thickness has a great bearing on the patient dose, but there is an individual difference, and it is almost impossible to change it artificially. However, there has been no detailed report on the relation between the patient thickness and the patient dose, therefore, this report treats of such relationship as well. Concerning the grid, consideration is given to the exposure times (Bucky factor). (author)

  2. A phantom based method for deriving typical patient doses from measurements of dose-area product on populations of patients

    International Nuclear Information System (INIS)

    Chapple, C.-L.; Broadhead, D.A.

    1995-01-01

    One of the chief sources of uncertainty in the comparison of patient dosimetry data is the influence of patient size on dose. Dose has been shown to relate closely to the equivalent diameter of the patient. This concept has been used to derive a prospective, phantom based method for determining size correction factors for measurements of dose-area product. The derivation of the size correction factor has been demonstrated mathematically, and the appropriate factor determined for a number of different X-ray sets. The use of phantom measurements enables the effect of patient size to be isolated from other factors influencing patient dose. The derived factors agree well with those determined retrospectively from patient dose survey data. Size correction factors have been applied to the results of a large scale patient dose survey, and this approach has been compared with the method of selecting patients according to their weight. For large samples of data, mean dose-area product values are independent of the analysis method used. The chief advantage of using size correction factors is that it allows all patient data to be included in a survey, whereas patient selection has been shown to exclude approximately half of all patients. (author)

  3. Impact of ibrutinib dose adherence on therapeutic efficacy in patients with previously treated CLL/SLL.

    Science.gov (United States)

    Barr, Paul M; Brown, Jennifer R; Hillmen, Peter; O'Brien, Susan; Barrientos, Jacqueline C; Reddy, Nishitha M; Coutre, Steven; Mulligan, Stephen P; Jaeger, Ulrich; Furman, Richard R; Cymbalista, Florence; Montillo, Marco; Dearden, Claire; Robak, Tadeusz; Moreno, Carol; Pagel, John M; Burger, Jan A; Suzuki, Samuel; Sukbuntherng, Juthamas; Cole, George; James, Danelle F; Byrd, John C

    2017-05-11

    Ibrutinib, an oral inhibitor of Bruton's tyrosine kinase (BTK), at a once-daily dose of 420 mg achieved BTK active-site occupancy in patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) that was maintained at 24 hours. It is unknown if intermittent interruption of ibrutinib therapy contributes to altered clinical outcomes. We therefore evaluated the effect of ibrutinib dose adherence on patient outcomes in the phase 3 RESONATE trial. The overall mean dose intensity (DI) was 95% with median treatment duration of ∼9 months. Pharmacokinetic assessment of ibrutinib exposure at 420-mg dose suggested similar exposure regardless of patient weight or age. As assessed by independent review committee, patients with higher DI experienced longer median progression-free survival (PFS) compared with those with lower DI regardless of del17p and/or TP53 status. Of 79 patients requiring a drug hold, treatment was restarted at the original dose in 73 (92%) patients. Mean duration of a missed-dose event was 18.7 days (range, 8-56). Patients missing ≥8 consecutive days of ibrutinib had a shorter median PFS vs those missing ibrutinib dosing at 420 mg as clinically feasible to achieve optimal outcomes in patients with previously treated CLL. The trial was registered at www.clinicaltrials.gov as #NCT01578707. © 2017 by The American Society of Hematology.

  4. Evaluation of absorbed doses during irradiation of patients

    International Nuclear Information System (INIS)

    Denisenko, O.N.; Kozlov, V.A.

    1981-01-01

    Provided is an analysis of a general scheme for the method of control over the dose field realization in the patient's body using direct dose measurements in patients. On the basis of data from literature presented are error limits in the stages of preradiation preparation and irradiation of patients, and in the stage of dose measurement for different irradiation techniques and radiation types. The authors also provide scientific data of their own. It has been concluded that the main emphasis should be placed on the improvement of topometry facilities, field calculation, patients posture and visual control methods of the radiation beam position [ru

  5. Assessment of dose inhomogeneity at target level by in vivo dosimetry

    International Nuclear Information System (INIS)

    Leunens, G.; Verstraete, J.; Dutreix, A.; Schueren, E. van der

    1992-01-01

    Inhomogeneity of dose delivered to the target volume due to irregular body surface and tissue densities remains in many cases unknown, since dose distribution is calculated for most radiation treatments in only one transverse section and assuming the patient to be water equivalent. In this study transmission and target absorbed dose homogeneity is assessed for 11 head-and-neck cancer treatments by in vivo measurements with silicon diodes. Besides the dose to specification point, the dose delivered to 2-4 off-axis points in midline sagittal plane is estimated from entrance and exit dose measurements. Simultaneously made portal films allow to identify anatomical structures passed by the beam before reaching exit diode. Mean deviation from expected transmission is -6.8% for bone, +6% for air cavities and -2.5% for soft tissue. At midplane, mean deviations from expected target dose are respectively -3.5%, +2.3% and -1.9%. Deviations from prescribed dose are larger than 5% in 12/39 target points. Accuracy requirements in target dose delivery of plus or minus 5%, as proposed by ICRU, cannot be fulfilled in 7/11 patients and is mostly due to irregular body contour and tissue densities. as only a limited number of points are considered, inhomogeneity in dose delivered throughout whole irradiated volume is underestimated, as is illustrated from exit dose profiles obtained from portal image. Besides its tremendous value as a quality assurance procedure, in vivo dose measurements are shown to be a valid method for assessing dose delivered to irradiated tissues when dose computations are assumed to be inaccurate or even impossible in current practice. (author). 21 refs., 8 figs., 1 tab

  6. Assessment of Organ Radiation Dose Associated with Uterine Artery Embolization

    International Nuclear Information System (INIS)

    Glomset, O.; Hellesnes, J.; Heimland, N.; Hafsahl, G.; Smith, H.J.

    2006-01-01

    Purpose: To evaluate the radiation dose to the skin, uterus, and ovaries during uterine artery embolization. Material and Methods: Guided uterine artery embolization for leiomyomata and two types of X-ray equipment with different dose levels were utilized during fluoroscopy in 20 women (ages ranging from 32 to 52 years, body weights from 55 to 68 kg). The first 13 women were treated using a non-pulsed system A, with 3.3 mm Al filtering and, for simplicity, a fixed peak voltage 80 kV. During treatment of the other 7 women, a pulsed system B with 5.4 mm Al filtering and an identical fixed voltage was used. The dose area product (DAP) was recorded. The vaginal dose of the first 13 patients and the peak skin dose of all patients were measured with thermoluminescent dosimeters (TLDs). TLDs were placed in the posterior vaginal fornix and on the skin at the beam entrance site. The uterine and ovarian doses were estimated based on the measured skin doses, normalized depth dose, and organ depth values. The effective dose (D eff ) was estimated based on the observed DAP values. The measured vaginal doses and the corresponding estimated uterine doses were compared statistically, as were the DAP values from systems A and B. Results: For system A, the mean fluoroscopic time was 20.9 min (range 12.7-31.1), and for system B 35.9 min (range 16.4-55.4). The mean numbers of angiographic exposures for systems A and B were 82 (range 30-164) and 37 (range 20-72), respectively. The mean peak skin dose for system A was 601.5 mGy (range 279-1030) and for system B 453 mGy (range 257-875). The mean DAP for system A was 88.6 Gy cm 2 (range 41.4-161.0) and for system B 52.5 Gy cm 2 (range 20.1-107.9). Statistical analysis showed a significant difference between the DAP values, the DAP for system B being the lower one. The mean estimated effective doses from systems A and B were 32 mSv (range 15.1-58.4) and 22 mSv (range 9-46), respectively. The mean estimated maximum uterine and ovarian doses

  7. The system of radiation dose assessment and dose conversion coefficients in the ICRP and FGR

    Energy Technology Data Exchange (ETDEWEB)

    Kim, So Ra; Min, Byung Il; Park, Kihyun; Yang, Byung Mo; Suh, Kyung Suk [Nuclear Environmental Safety Research Division, Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2016-12-15

    The International Commission on Radiological Protection (ICRP) recommendations and the Federal Guidance Report (FGR) published by the U.S. Environmental Protection Agency (EPA) have been widely applied worldwide in the fields of radiation protection and dose assessment. The dose conversion coefficients of the ICRP and FGR are widely used for assessing exposure doses. However, before the coefficients are used, the user must thoroughly understand the derivation process of the coefficients to ensure that they are used appropriately in the evaluation. The ICRP provides recommendations to regulatory and advisory agencies, mainly in the form of guidance on the fundamental principles on which appropriate radiological protection can be based. The FGR provides federal and state agencies with technical information to assist their implementation of radiation protection programs for the U.S. population. The system of radiation dose assessment and dose conversion coefficients in the ICRP and FGR is reviewed in this study. A thorough understanding of their background is essential for the proper use of dose conversion coefficients. The FGR dose assessment system was strongly influenced by the ICRP and the U.S. National Council on Radiation Protection and Measurements (NCRP), and is hence consistent with those recommendations. Moreover, the ICRP and FGR both used the scientific data reported by Biological Effects of Ionizing Radiation (BEIR) and United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) as their primary source of information. The difference between the ICRP and FGR lies in the fact that the ICRP utilized information regarding a population of diverse races, whereas the FGR utilized data on the American population, as its goal was to provide guidelines for radiological protection in the US. The contents of this study are expected to be utilized as basic research material in the areas of radiation protection and dose assessment.

  8. The system of radiation dose assessment and dose conversion coefficients in the ICRP and FGR

    International Nuclear Information System (INIS)

    Kim, So Ra; Min, Byung Il; Park, Kihyun; Yang, Byung Mo; Suh, Kyung Suk

    2016-01-01

    The International Commission on Radiological Protection (ICRP) recommendations and the Federal Guidance Report (FGR) published by the U.S. Environmental Protection Agency (EPA) have been widely applied worldwide in the fields of radiation protection and dose assessment. The dose conversion coefficients of the ICRP and FGR are widely used for assessing exposure doses. However, before the coefficients are used, the user must thoroughly understand the derivation process of the coefficients to ensure that they are used appropriately in the evaluation. The ICRP provides recommendations to regulatory and advisory agencies, mainly in the form of guidance on the fundamental principles on which appropriate radiological protection can be based. The FGR provides federal and state agencies with technical information to assist their implementation of radiation protection programs for the U.S. population. The system of radiation dose assessment and dose conversion coefficients in the ICRP and FGR is reviewed in this study. A thorough understanding of their background is essential for the proper use of dose conversion coefficients. The FGR dose assessment system was strongly influenced by the ICRP and the U.S. National Council on Radiation Protection and Measurements (NCRP), and is hence consistent with those recommendations. Moreover, the ICRP and FGR both used the scientific data reported by Biological Effects of Ionizing Radiation (BEIR) and United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) as their primary source of information. The difference between the ICRP and FGR lies in the fact that the ICRP utilized information regarding a population of diverse races, whereas the FGR utilized data on the American population, as its goal was to provide guidelines for radiological protection in the US. The contents of this study are expected to be utilized as basic research material in the areas of radiation protection and dose assessment

  9. Interactive Rapid Dose Assessment Model (IRDAM): user's guide

    International Nuclear Information System (INIS)

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

    1983-05-01

    As part of the continuing emphasis on emergency preparedness the US Nuclear Regulatory Commission (NRC) sponsored the development of a rapid dose assessment system by Pacific Northwest Laboratory (PNL). This system, the Interactive Rapid Dose Assessment Model (IRDAM) is a micro-computer based program for rapidly assessing the radiological impact of accidents at nuclear power plants. This User's Guide provides instruction in the setup and operation of the equipment necessary to run IRDAM. Instructions are also given on how to load the magnetic disks and access the interactive part of the program. Two other companion volumes to this one provide additional information on IRDAM. Reactor Accident Assessment Methods (NUREG/CR-3012, Volume 2) describes the technical bases for IRDAM including methods, models and assumptions used in calculations. Scenarios for Comparing Dose Assessment Models (NUREG/CR-3012, Volume 3) provides the results of calculations made by IRDAM and other models for specific accident scenarios

  10. Dose assessment activities in the Republic of the Marshall Islands

    International Nuclear Information System (INIS)

    Simon, S.L.; Graham, J.C.

    1996-01-01

    Dose assessments, both retrospective and prospective, comprise one important function of a radiological study commissioned by the Republic of the Marshall Islands (RMI) government in late 1989. Estimating past or future exposure requires the synthesis of information from historical data, results from a recently completed field monitoring program, laboratory measurements, and some experimental studies. Most of the activities in the RMI to date have emphasized a pragmatic rather than theoretical approach. In particular, most of the recent effort has been expended on conducting an independent radiological monitoring program to determine the degree of deposition and the geographical extent of weapons test fallout over the nation. Contamination levels on 70% of the land mass of the Marshall Islands were unknown prior to 1994. The environmental radioactivity data play an integral role in both retrospective and prospective assessments. One recent use of dose assessment has been to interpret environmental measurements of radioactivity into annual doses that might be expected at every atoll. A second use for dose assessment has been to determine compliance with dose action level for the rehabitation of Rongelap Island. Careful examination of exposure pathways relevant to the island lifestyle has been necessary to accommodate these purposes. Finally, an examination is underway of gummed film, fixed-instrument, and aerial survey data accumulated during the 1950's by the Health and Safety Laboratory of the U.S. AEC. This article gives an overview of these many different activities and a summary of recent dose assessments

  11. The measurement of patient doses from diagnostic x-rays

    International Nuclear Information System (INIS)

    Morris, N.D.; Solomon, S.B.

    1980-06-01

    As part of the National Health and Medical Research Council survey to determine the genetic and mean bone-marrow doses to the Australian population from the medical, dental and chiropractic uses of radiation sources, doses to patients undergoing X-ray diagnostic procedures were evaluated. The doses were measured using capsules of LiF or CaF 2 :Dy thermoluminescent dosemeters (TLD). The evaluation of the TLD measurements is described and the mean values of the skin doses for patients undergoing various radiographic examinations in Australia in 1970 are presented

  12. Effective dose estimation to patients and staff during urethrography procedures

    International Nuclear Information System (INIS)

    Sulieman, A.; Barakat, H.; Alkhorayef, M.; Babikir, E.; Dalton, A.; Bradley, D.

    2015-10-01

    Medical-related radiation is the largest source of controllable radiation exposure to humans and it accounts for more than 95% of radiation exposure from man-made sources. Few data were available worldwide regarding patient and staff dose during urological ascending urethrography (ASU) procedure. The purposes of this study are to measure patient and staff entrance surface air kerma dose (ESAK) during ASU procedure and evaluate the effective doses. A total of 243 patients and 145 staff (Urologist) were examined in three Hospitals in Khartoum state. ESAKs were measured for patient and staff using thermoluminescent detectors (TLDs). Effective doses (E) were calculated using published conversion factors and methods recommended by the national Radiological Protection Board (NRPB). The mean ESAK dose for patients and staff dose were 7.79±6.7 mGy and 0.161±0.30 mGy per procedures respectively. The mean and range of the effective dose was 1.21 mSv per procedure. The radiation dose in this study is comparable with previous studies except Hospital C. It is obvious that high patient and staff exposure is due to the lack of experience and protective equipment s. Interventional procedures remain operator dependent; therefore continuous training is crucial. (Author)

  13. Effective dose estimation to patients and staff during urethrography procedures

    Energy Technology Data Exchange (ETDEWEB)

    Sulieman, A. [Prince Sattam bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, P. O- Box 422, Alkharj 11942 (Saudi Arabia); Barakat, H. [Neelain University, College of Science and Technology, Medical Physics Department, Khartoum (Sudan); Alkhorayef, M.; Babikir, E. [King Saud University, College of Applied Sciences, Radiological Sciences Department, P. O. Box 10219, Riyadh 11433 (Saudi Arabia); Dalton, A.; Bradley, D. [University of Surrey, Centre for Nuclear and Radiation Physics, Department of Physics, Surrey, GU2 7XH Guildford (United Kingdom)

    2015-10-15

    Medical-related radiation is the largest source of controllable radiation exposure to humans and it accounts for more than 95% of radiation exposure from man-made sources. Few data were available worldwide regarding patient and staff dose during urological ascending urethrography (ASU) procedure. The purposes of this study are to measure patient and staff entrance surface air kerma dose (ESAK) during ASU procedure and evaluate the effective doses. A total of 243 patients and 145 staff (Urologist) were examined in three Hospitals in Khartoum state. ESAKs were measured for patient and staff using thermoluminescent detectors (TLDs). Effective doses (E) were calculated using published conversion factors and methods recommended by the national Radiological Protection Board (NRPB). The mean ESAK dose for patients and staff dose were 7.79±6.7 mGy and 0.161±0.30 mGy per procedures respectively. The mean and range of the effective dose was 1.21 mSv per procedure. The radiation dose in this study is comparable with previous studies except Hospital C. It is obvious that high patient and staff exposure is due to the lack of experience and protective equipment s. Interventional procedures remain operator dependent; therefore continuous training is crucial. (Author)

  14. Variations of Patient Doses in Interventional Examinations at Different Angiographic Units

    International Nuclear Information System (INIS)

    Bor, Dogan; Toklu, Tuerkay; Olgar, Turan; Sancak, Tanzer; Cekirge, Saruhan; Onal, Baran; Bilgic, Sadik

    2006-01-01

    Purpose. We analyzed doses for various angiographic procedures using different X-ray systems in order to assess dose variations. Methods. Dose-area product (DAP), skin doses from thermoluminescent dosimeters and air kerma measurements of 308 patients (239 diagnostic and 69 interventional) were assessed for five different angiographic units. All fluoroscopic and radiographic exposure parameters were recorded online for single and multiprojection studies. Radiation outputs of each X-ray system were also measured for all the modes of exposure using standard protocols for such measurements. Results. In general, the complexity of the angiographic procedure was found to be the most important reason for high radiation doses. Skill of the radiologist, management of the exposure parameters and calibration of the system are the other factors to be considered. Lateral cerebral interventional studies carry the highest risk for deterministic effects on the lens of the eye. Effective doses were calculated from DAP measurements and maximum fatal cancer risk factors were found for carotid studies. Conclusions. Interventional radiologists should measure patient doses for their examinations. If there is a lack of necessary instrumentation for this purpose, then published dose reports should be used in order to predict the dose levels from some of the exposure parameters. Patient dose information should include not only the measured quantity but also the measured radiation output of the X-ray unit and exposure parameters used during radiographic and fluoroscopic exposures

  15. Epidemiological methods for assessing dose-response and dose-effect relationships

    DEFF Research Database (Denmark)

    Kjellström, Tord; Grandjean, Philippe

    2007-01-01

    Selected Molecular Mechanisms of Metal Toxicity and Carcinogenicity General Considerations of Dose-Effect and Dose-Response Relationships Interactions in Metal Toxicology Epidemiological Methods for Assessing Dose-Response and Dose-Effect Relationships Essential Metals: Assessing Risks from Deficiency......Description Handbook of the Toxicology of Metals is the standard reference work for physicians, toxicologists and engineers in the field of environmental and occupational health. This new edition is a comprehensive review of the effects on biological systems from metallic elements...... access to a broad range of basic toxicological data and also gives a general introduction to the toxicology of metallic compounds. Audience Toxicologists, physicians, and engineers in the fields of environmental and occupational health as well as libraries in these disciplines. Will also be a useful...

  16. Re-assessment of dose from the Vinten extremity dosemeter

    International Nuclear Information System (INIS)

    O'Hagan, J.B.; Pearson, A.J.; Dutt, J.C.

    1989-01-01

    A procedure is described for re-assessing the dose from the Vinten extremity dosemeter using phototransferred thermoluminescence. The technique produces a linear response up to 50 Sv. The re-assessment efficiency is approximately 10% for the first re-assessment and 3-5% for the second re-assessment. The detection threshold values (at the 95% confidence level) are 3 mSv and 9 mSv respectively. (author)

  17. Assessment of concomitant testicular dose with radiochromic film

    International Nuclear Information System (INIS)

    Fricker, Katherine; Thompson, Christine; Meyer, Juergen

    2013-01-01

    To assess the suitability of EBT2 and XRQA2 Gafchromic film for measuring low doses in the periphery of treatment fields, and to measure the accumulative concomitant dose to the contralateral testis resulting from CT imaging, pre-treatment imaging (CBCT) and seminoma radiotherapy with and without gonadal shielding. Superficial peripheral dose measurements made using EBT2 Gafchromic film on the surface of water equivalent material were compared to measurements made with an ionisation chamber in a water phantom to evaluate the suitability and accuracy of the film dosimeter for such measurements. Similarly, XRQA2 was used to measure surface doses within a kilovoltage beam and compared with ionisation chamber measurements. Gafchromic film was used to measure CT, CBCT and seminoma treatment related testicular doses on an anthropomorphic phantom. Doses were assessed for two clinical plans, both with and without gonadal shielding. Testicular doses resulting from the treatment of up to 0.83 ± 0.17 Gy were measured per treatment. Additional doses of up to 0.49 ± 0.01 and 2.35 ± 0.05 cGy were measured per CBCT and CT image, respectively. Reductions in the testicular dose in the order of 10, 36 and 78 % were observed when gonadal shielding was fitted for treatment, CT and CBCT imaging, respectively. Gafchromic film was found to be suitable for measuring dose in the periphery of treatment fields. The dose to the testis should be limited to minimise the risk of radiation related side effects. This can be achieved by using appropriate gonadal shielding, irrespective of the treatment fields employed.

  18. Trend of patient radiation doses in medical examination in Japan

    International Nuclear Information System (INIS)

    Suzuki, Shoichi

    2013-01-01

    We have investigated radiation doses to patients in selected types of examinations in Japan since 1974 and have analyzed the trend of patient radiation doses during a period of 37 years. This study covered regular plain X-ray scanning (including mammography) and computed tomography (CT) scanning. Dose evaluation was performed in terms of entrance skin dose (ESD) for regular plain X-ray scanning, average glandular dose (AGD) for mammography, and volume CT dose index (CTDIvol) for CT scanning. Evaluation was performed in 26 orientations at 21 sites for regular plain X-rays, and for cranial, thoracic, and abdominal scans of children and adults for CT scanning. With the exception of chest X-rays, the dose during regular plain X-ray scanning had decreased by approximately 50% compared with scans performed in 1974. The dose during mammography had decreased to less than 10% of its former level. In scans performed in 2011, dose at all sites were within International Atomic Energy Authority (IAEA) guidance levels. The increasing use of multiple detectors in CT scanning devices was evident in CT scanning. A comparison of doses from cranial non-helical scans performed in 2007 and 2011 found that the latter were higher. An examination of changes in doses between 1997 and 2011 revealed that doses had tended to increase in cranial scans of adults, but had hardly changed at all in abdominal scans. Doses during CT scanning of children were around half those for adults in cranial, thoracic, and abdominal scans. We have ascertained changes in the doses to which patients have been exposed during X-ray scanning in Japan. (author)

  19. MR enterography with oral contrast agent composed of methylcellulose, low-dose barium sulfate, sorbitol, and lactulose: assessment of diagnostic performance, reliability, image quality, and patient tolerance.

    Science.gov (United States)

    Evrimler, Sehnaz; Algin, Oktay

    2016-01-01

    The objective was to show efficiency of magnetic resonance enterography (MRE) with our previously assessed new oral contrast agent. Each bowel segments was evaluated for luminal distension, wall conspicuity, wall thickening, and hyperintensity on fat-saturated (FS) T2-weighted and contrast enhancement on postcontrast FS T1-weighted images. Also, consensus scoring results of MRE exams were compared with the gold standard tests in terms of active inflammatory bowel disease detection. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of MRE for active inflammatory bowel disease detection were 62%, 98%, 80%, 96%, and 71.4%, respectively. MRE obtained with the new mixture has a high reliability and shows good correlation with endoscopic examination±biopsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. TU-H-CAMPUS-JeP3-02: Automated Dose Accumulation and Dose Accuracy Assessment for Online Or Offline Adaptive Replanning

    International Nuclear Information System (INIS)

    Chen, G; Ahunbay, E; Li, X

    2016-01-01

    Purpose: With introduction of high-quality treatment imaging during radiation therapy (RT) delivery, e.g., MR-Linac, adaptive replanning of either online or offline becomes appealing. Dose accumulation of delivered fractions, a prerequisite for the adaptive replanning, can be cumbersome and inaccurate. The purpose of this work is to develop an automated process to accumulate daily doses and to assess the dose accumulation accuracy voxel-by-voxel for adaptive replanning. Methods: The process includes the following main steps: 1) reconstructing daily dose for each delivered fraction with a treatment planning system (Monaco, Elekta) based on the daily images using machine delivery log file and considering patient repositioning if applicable, 2) overlaying the daily dose to the planning image based on deformable image registering (DIR) (ADMIRE, Elekta), 3) assessing voxel dose deformation accuracy based on deformation field using predetermined criteria, and 4) outputting accumulated dose and dose-accuracy volume histograms and parameters. Daily CTs acquired using a CT-on-rails during routine CT-guided RT for sample patients with head and neck and prostate cancers were used to test the process. Results: Daily and accumulated doses (dose-volume histograms, etc) along with their accuracies (dose-accuracy volume histogram) can be robustly generated using the proposed process. The test data for a head and neck cancer case shows that the gross tumor volume decreased by 20% towards the end of treatment course, and the parotid gland mean dose increased by 10%. Such information would trigger adaptive replanning for the subsequent fractions. The voxel-based accuracy in the accumulated dose showed that errors in accumulated dose near rigid structures were small. Conclusion: A procedure as well as necessary tools to automatically accumulate daily dose and assess dose accumulation accuracy is developed and is useful for adaptive replanning. Partially supported by Elekta, Inc.

  1. Effective doses to patients undergoing thoracic computed tomography examinations.

    Science.gov (United States)

    Huda, W; Scalzetti, E M; Roskopf, M

    2000-05-01

    The purpose of this study was to investigate how x-ray technique factors and effective doses vary with patient size in chest CT examinations. Technique factors (kVp, mAs, section thickness, and number of sections) were recorded for 44 patients who underwent a routine chest CT examination. Patient weights were recorded together with dimensions and mean Hounsfield unit values obtained from representative axial CT images. The total mass of directly irradiated patient was modeled as a cylinder of water to permit the computation of the mean patient dose and total energy imparted for each chest CT examination. Computed values of energy imparted during the chest CT examination were converted into effective doses taking into account the patient weight. Patient weights ranged from 4.5 to 127 kg, and half the patients in this study were children under 18 years of age. All scans were performed at 120 kVp with a 1 s scan time. The selected tube current showed no correlation with patient weight (r2=0.06), indicating that chest CT examination protocols do not take into account for the size of the patient. Energy imparted increased with increasing patient weight, with values of energy imparted for 10 and 70 kg patients being 85 and 310 mJ, respectively. The effective dose showed an inverse correlation with increasing patient weight, however, with values of effective dose for 10 and 70 kg patients being 9.6 and 5.4 mSv, respectively. Current CT technique factors (kVp/mAs) used to perform chest CT examinations result in relatively high patient doses, which could be reduced by adjusting technique factors based on patient size.

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

    International Nuclear Information System (INIS)

    Scherpelz, R.I.; Bander, T.J.; Athey, G.F.; Ramsdell, J.V.

    1986-03-01

    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

  3. MO-E-17A-05: Individualized Patient Dosimetry in CT Using the Patient Dose (PATDOSE) Algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez, A; Boone, J [UC Davis Medical Center, Sacramento, CA (United States)

    2014-06-15

    Purpose: Radiation dose to the patient undergoing a CT examination has been the focus of many recent studies. While CTDIvol and SSDE-based methods are important tools for patient dose management, the CT image data provides important information with respect to CT dose and its distribution. Coupled with the known geometry and output factors (kV, mAs, pitch, etc.) of the CT scanner, the CT dataset can be used directly for computing absorbed dose. Methods: The HU numbers in a patient's CT data set can be converted to linear attenuation coefficients (LACs) with some assumptions. With this (PAT-DOSE) method, which is not Monte Carlo-based, the primary and scatter dose are computed separately. The primary dose is computed directly from the geometry of the scanner, x-ray spectrum, and the known patient LACs. Once the primary dose has been computed to all voxels in the patient, the scatter dose algorithm redistributes a fraction of the absorbed primary dose (based on the HU number of each source voxel), and the methods here invoke both tissue attenuation and absorption and solid angle geometry. The scatter dose algorithm can be run N times to include Nth-scatter redistribution. PAT-DOSE was deployed using simple PMMA phantoms, to validate its performance against Monte Carlo-derived dose distributions. Results: Comparison between PAT-DOSE and MCNPX primary dose distributions showed excellent agreement for several scan lengths. The 1st-scatter dose distributions showed relatively higher-amplitude, long-range scatter tails for the PAT-DOSE algorithm then for MCNPX simulations. Conclusion: The PAT-DOSE algorithm provides a fast, deterministic assessment of the 3-D dose distribution in CT, making use of scanner geometry and the patient image data set. The preliminary implementation of the algorithm produces accurate primary dose distributions however achieving scatter distribution agreement is more challenging. Addressing the polyenergetic x-ray spectrum and spatially

  4. Systems automated reporting of patient dose in digital radiology

    International Nuclear Information System (INIS)

    Collado Chamorro, P.; Sanz Freire, C. J.; Martinez Mirallas, O.; Tejada San Juan, S.; Lopez de Gammarra, M. S.

    2013-01-01

    It has developed a procedure automated reporting of doses to patients in Radiology. This procedure allows to save the time required of the data used to calculate the dose to patients by yields. Also saves the time spent in the transcription of these data for the realization of the necessary calculations. This system has been developed using open source software. The characteristics of the systems of digital radiography for the automation of procedures, in particular the registration of dose should benefit from patient. This procedure is validated and currently in use at our institution. (Author)

  5. Patient Doses and Risk Evaluation in Bone Mineral Densitometry

    International Nuclear Information System (INIS)

    Angelucci, M.; Borio, R.; Chiocchini, S.; Degli Esposti, P.; Dipilato, A.C.; Policani, G.

    1999-01-01

    The aim of this work was to evaluate the equipment dose to the organs and tissues and the effective dose of patients undergoing the most frequent examinations carried out in bone mineral densitometry (BMD): lumbar spine and femur. Experimental measurements of absorbed doses on a Rando phantom, allow comparison of the performances of three different photon emitter facilities. The comparison of the entrance and exit doses measured on a Rando phantom and on 50 female non-obese patients show that entrance doses on Rando can be used as 'diagnostic reference levels' for patients. A quantitative estimate of the stochastic risk due to BMD procedures was made: the results obtained show that the stochastic risk is very low and that the BMD is, at present, the most confirmed procedure for osteoporosis diagnosis and management. (author)

  6. Patient doses from diagnostic radiographic examinations in Syria

    International Nuclear Information System (INIS)

    Kharita, M.H.; Khedr, M.; Wannus, K.

    2009-05-01

    The aim of this study is to evaluate radiation doses received by adult patients undergoing 9 routine common types of x-ray examination in Syria covering (chest PA, lumbar spine PA, lumbar spine LAT, Urography, abdomen, pelvis and hip, head, shoulder and extremities). The study consisted of measurements for 1308 x-ray examination for patients in 26 public hospitals. The average effective dose imparted to each patient per examination was computed from measurement of dose area product for the examination and using the X-dose software, the result of the effective dose except for extremities are gradually (0.125, 1.67, 1.23, 2.7, 1.07, 0.85, 0.05 and 0.025) and the average of the DAP for extremities was 0.095 Gy.cm 2 . (author)

  7. Quality Control in Mammography: Image Quality and Patient Doses

    International Nuclear Information System (INIS)

    Ciraj Bjelac, O.; Arandjic, D.; Boris Loncar, B.; Kosutic, D.

    2008-01-01

    Mammography is method of choice for early detection of breast cancer. The purpose of this paper is preliminary evaluation the mammography practice in Serbia, in terms of both quality control indicators, i.e. image quality and patient doses. The survey demonstrated considerable variations in technical parameters that affect image quality and patients doses. Mean glandular doses ranged from 0.12 to 2.8 mGy, while reference optical density ranged from 1.2 to 2.8. Correlation between image contrast and mean glandular doses was demonstrated. Systematic implementation of quality control protocol should provide satisfactory performance of mammography units and maintain satisfactory image quality and keep patient doses as low as reasonably practicable. (author)

  8. Assessment of exposure dose to workers in virtual decommissioning environments

    International Nuclear Information System (INIS)

    Jeong, KwanSeong; Moon, JeiKwon; Choi, ByungSeon; Hyun, Dongjun; Lee, Jonghwan; Kim, Ikjune; Kim, GeunHo; Seo, JaeSeok

    2014-01-01

    This paper is intended to suggest the method analyze and assess the exposure dose to workers in virtual decommissioning environments. To simulate a lot of decommissioning scenarios, decommissioning environments were designed in virtual reality. To simulate and assess the exposure dose to workers, human model also was designed in virtual environments. These virtual decommissioning environments made it possible to real-time simulate and assess the exposure dose to workers. This work was to be able to simulate scenarios of decommissioning so that exposure dose to workers could be measured and assessed. To establish the plan of exposure dose to workers during decommissioning of nuclear facilities before decommissioning activities are accomplished, the method of simulation assessment was developed in virtual radiological environments. But this work was developed as a tool of simulation for single subject mode. Afterwards, the simulation environment for multi-subjects mode will be upgraded by simultaneous modules with networking environments. Then the much more practical method will be developed by changing number of workers and duration of time under any circumstances of decommissioning

  9. Assessment of exposure dose to workers in virtual decommissioning environments

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, KwanSeong; Moon, JeiKwon; Choi, ByungSeon; Hyun, Dongjun; Lee, Jonghwan; Kim, Ikjune; Kim, GeunHo; Seo, JaeSeok [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2014-10-15

    This paper is intended to suggest the method analyze and assess the exposure dose to workers in virtual decommissioning environments. To simulate a lot of decommissioning scenarios, decommissioning environments were designed in virtual reality. To simulate and assess the exposure dose to workers, human model also was designed in virtual environments. These virtual decommissioning environments made it possible to real-time simulate and assess the exposure dose to workers. This work was to be able to simulate scenarios of decommissioning so that exposure dose to workers could be measured and assessed. To establish the plan of exposure dose to workers during decommissioning of nuclear facilities before decommissioning activities are accomplished, the method of simulation assessment was developed in virtual radiological environments. But this work was developed as a tool of simulation for single subject mode. Afterwards, the simulation environment for multi-subjects mode will be upgraded by simultaneous modules with networking environments. Then the much more practical method will be developed by changing number of workers and duration of time under any circumstances of decommissioning.

  10. The assessment of personal dose due to external radiation

    International Nuclear Information System (INIS)

    Boas, J.F.; Young, J.G.

    1990-01-01

    The fundamental basis of thermoluminescent dosimetry (TLD) is discussed and a number of considerations in the measurement of thermoluminescence described, with particular reference to CaSO 4 :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

  11. Assessment of skin dose modification caused by application of immobilizing cast in head and neck radiotherapy

    International Nuclear Information System (INIS)

    Soleymanifard, Shokouhozaman; Toossi, Mohammad T.B.; Khosroabadi, Mohsen; Noghreiyan, Atefeh Vejdani; Shahidsales, Soodabeh; Tabrizi, Fatemeh Varshoee

    2014-01-01

    Skin dose assessment for radiotherapy patients is important to ensure that the dose received by skin is not excessive and does not cause skin reactions. Immobilizing casts may have a buildup effect, and can enhance the skin dose. This study has quantified changes to the surface dose as a result of head and neck immobilizing casts. Medtech and Renfu casts were stretched on the head of an Alderson Rando-Phantom. Irradiation was performed using 6 and 15 MV X-rays, and surface dose was measured by thermoluminescence dosimeters. In the case of 15MV photons, immobilizing casts had no effect on the surface dose. However, the mean surface dose increase reached up to 20 % when 6MV X-rays were applied. Radiation incidence angle, thickness, and meshed pattern of the casts affected the quantity of dose enhancement. For vertical beams, the surface dose increase was more than tangential beams, and when doses of the points under different areas of the casts were analysed separately, results showed that only doses of the points under the thick area had been changed. Doses of the points under the thin area and those within the holes were identical to the same points without immobilizing casts. Higher dose which was incurred due to application of immobilizing casts (20 %) would not affect the quality of life and treatment of patients whose head and neck are treated. Therefore, the benefits of head and neck thermoplastic casts are more than their detriments. However, producing thinner casts with larger holes may reduce the dose enhancement effect.

  12. 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

  13. Carboplatin Dosing for Adult Japanese Patients

    OpenAIRE

    ANDO, YUICHI; SHIMOKATA, TOMOYA; YASUDA, YOSHINARI; HASEGAWA, YOSHINORI

    2014-01-01

    ABSTRACT Carboplatin is a platinum-based anticancer drug that has been long used to treat many types of solid cancer. Because the clearance of carboplatin strongly correlates with the glomerular filtration rate (GFR), its dosage is calculated with the Calvert formula on the basis of the patient?s GFR to achieve the target area under the plasma drug concentration-time curve (AUC) for each patient. However, many lines of evidence from previous clinical studies should be interpreted with caution...

  14. Radiation doses to patients at dental radiography

    Energy Technology Data Exchange (ETDEWEB)

    Paulusson-Odenhagen, M

    1975-11-01

    An investigation about the technique and the equipment at x-ray investigations and the distribution of the radiation doses to the thyroid and the gonads has been made in the dental policlinics belonging to the county council of the province of Stockholm. This investigation, which was suggested by the National Institute of Radiation Protection and the faculty of odontology in Stockholm, consisted of on one hand a distributed questionnaire and on the other visits. The questionnaire was distributed to all dentists (altogether 343) belonging to the dental policlinics of the county council of the province of Stockholm. 22 dentists of these were visited.

  15. Patient dose reduction during voiding cystourethrography

    International Nuclear Information System (INIS)

    Ward, Valerie L.

    2006-01-01

    Voiding cystourethrography (VCUG) is a commonly performed examination in a pediatric uroradiology practice. This article contains suggestions on how the radiation dose to a child from VCUG can be made ''as low as reasonably achievable'' (ALARA). The pediatric radiologist should consider the appropriateness of the clinical indication before performing VCUG and utilize radiation exposure techniques and parameters during VCUG to reduce radiation exposure to a child. The medical physicist and fluoroscope manufacturer can also work together to optimize a pulsed-fluoroscopy unit and further reduce the radiation exposure. Laboratory and clinical research is necessary to investigate methods that reduce radiation exposures during VCUG, and current research is presented here. (orig.)

  16. Evaluation of occupational and patient radiation doses in orthopedic surgery

    International Nuclear Information System (INIS)

    Sulieman, A.; Habiballah, B.; Abdelaziz, I.; Alzimami, K.; Osman, H.; Omer, H.; Sassi, S. A.

    2014-08-01

    Orthopedists are exposed to considerable radiation dose during orthopedic surgeries procedures. The staff is not well trained in radiation protection aspects and its related risks. In Sudan, regular monitoring services are not provided for all staff in radiology or interventional personnel. It is mandatory to measure staff and patient exposure in order to radiology departments. The main objectives of this study are: to measure the radiation dose to patients and staff during (i) Dynamic Hip Screw (Dhs) and (i i) Dynamic Cannula Screw (Dcs); to estimate the risk of the aforementioned procedures and to evaluate entrance surface dose (ESD) and organ dose to specific radiosensitive patients organs. The measurements were performed in Medical Corps Hospital, Sudan. The dose was measured for unprotected organs of staff and patient as well as scattering radiation. Calibrated Thermoluminescence dosimeters (TLD-Gr-200) of lithium fluoride (LiF:Mg, Cu,P) were used for ESD measurements. TLD signal are obtained using automatic TLD Reader model (Plc-3). The mean patients doses were 0.46 mGy and 0.07 for Dhs and Dcs procedures, respectively. The mean staff doses at the thyroid and chest were 4.69 mGy and 1.21 mGy per procedure. The mean radiation dose for staff was higher in Dhs compared to Dcs. This can be attributed to the long fluoroscopic exposures due to the complication of the procedures. Efforts should be made to reduce radiation exposure to orthopedic patients, and operating surgeons especially those with high work load. Staff training and regular monitoring will reduce the radiation dose for both patients and staff. (Author)

  17. Evaluation of occupational and patient radiation doses in orthopedic surgery

    Energy Technology Data Exchange (ETDEWEB)

    Sulieman, A. [Salman bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, P.O. Box 422, Alkharj (Saudi Arabia); Habiballah, B.; Abdelaziz, I. [Sudan Univesity of Science and Technology, College of Medical Radiologic Sciences, P.O. Box 1908, Khartoum (Sudan); Alzimami, K. [King Saud University, College of Applied Medical Sciences, Radiological Sciences Department, P.O. Box 10219, 11433 Riyadh (Saudi Arabia); Osman, H. [Taif University, College of Applied Medical Science, Radiology Department, Taif (Saudi Arabia); Omer, H. [University of Dammam, Faculty of Medicine, Dammam (Saudi Arabia); Sassi, S. A., E-mail: Abdelmoneim_a@yahoo.com [Prince Sultan Medical City, Department of Medical Physics, Riyadh (Saudi Arabia)

    2014-08-15

    Orthopedists are exposed to considerable radiation dose during orthopedic surgeries procedures. The staff is not well trained in radiation protection aspects and its related risks. In Sudan, regular monitoring services are not provided for all staff in radiology or interventional personnel. It is mandatory to measure staff and patient exposure in order to radiology departments. The main objectives of this study are: to measure the radiation dose to patients and staff during (i) Dynamic Hip Screw (Dhs) and (i i) Dynamic Cannula Screw (Dcs); to estimate the risk of the aforementioned procedures and to evaluate entrance surface dose (ESD) and organ dose to specific radiosensitive patients organs. The measurements were performed in Medical Corps Hospital, Sudan. The dose was measured for unprotected organs of staff and patient as well as scattering radiation. Calibrated Thermoluminescence dosimeters (TLD-Gr-200) of lithium fluoride (LiF:Mg, Cu,P) were used for ESD measurements. TLD signal are obtained using automatic TLD Reader model (Plc-3). The mean patients doses were 0.46 mGy and 0.07 for Dhs and Dcs procedures, respectively. The mean staff doses at the thyroid and chest were 4.69 mGy and 1.21 mGy per procedure. The mean radiation dose for staff was higher in Dhs compared to Dcs. This can be attributed to the long fluoroscopic exposures due to the complication of the procedures. Efforts should be made to reduce radiation exposure to orthopedic patients, and operating surgeons especially those with high work load. Staff training and regular monitoring will reduce the radiation dose for both patients and staff. (Author)

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

    International Nuclear Information System (INIS)

    Maldonado, Delis

    2012-01-01

    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

  19. Techniques and radiation dose in CT examinations of adult patients

    International Nuclear Information System (INIS)

    Elameen, S. E. A.

    2010-06-01

    The use of CT in medical diagnosis delivers radiation dose to patients that are higher than those from other radiological procedures. Lake of optimized protocols could be an additional source of increased dose. The aim of this study was to measure radiation doses in CT examination of the adults in three Sudanese hospitals. Details were obtained from approximately 160 CT examination carried out in 3 hospitals (3 CT scanners). Effective dose was calculated for each examination using CT dose indices. exposure related parameters and CT D1- to- effective dose conversion factors. CT air kerma index (CT D1) and dose length products (DLP) determined were below the established international reference dose levels. The mean effective doses in this study for the head, chest, and abdomen are 0.82, 3.7 and 5.4 mGy respectively. These values were observed that the effective dose per examination was lower in Sudan than in other countries. The report of a CT survey done in these centers indicates that the mean DLP values for adult patients were ranged from 272-460 mGy cm (head) 195-995 mGy cm (chest), 270-459 mGy cm (abdomen). There are a number of observed parameters that greatly need optimization, such as minimize the scan length, without missing any vital anatomical regions, modulation of exposure parameters (kV, mA, exposure time, and slice thickness) based on patient size and age. Another possible method is through use of contrast media only to optimize diagnostic yield. The last possible method is the use of radio protective materials for protection however, in order to achieve the above optimization strategies: there is great demand to educate CT personnel on the effects of scan parameter settings on radiation dose to patients and image quality required for accurate diagnosis. (Author)

  20. patient entrance skin doses at minna and ibadan for common

    African Journals Online (AJOL)

    DR. AMINU

    Entrance surface dose from two diagnostic x-ray centers in Nigeria for three common radiological examinations is .... typical ESD values for adult patients for three different ... TTX located in the region of Nigeria where regulatory activities have ...

  1. VirtualDose: a software for reporting organ doses from CT for adult and pediatric patients

    Science.gov (United States)

    Ding, Aiping; Gao, Yiming; Liu, Haikuan; Caracappa, Peter F.; Long, Daniel J.; Bolch, Wesley E.; Liu, Bob; Xu, X. George

    2015-07-01

    This paper describes the development and testing of VirtualDose—a software for reporting organ doses for adult and pediatric patients who undergo x-ray computed tomography (CT) examinations. The software is based on a comprehensive database of organ doses derived from Monte Carlo (MC) simulations involving a library of 25 anatomically realistic phantoms that represent patients of different ages, body sizes, body masses, and pregnant stages. Models of GE Lightspeed Pro 16 and Siemens SOMATOM Sensation 16 scanners were carefully validated for use in MC dose calculations. The software framework is designed with the ‘software as a service (SaaS)’ delivery concept under which multiple clients can access the web-based interface simultaneously from any computer without having to install software locally. The RESTful web service API also allows a third-party picture archiving and communication system software package to seamlessly integrate with VirtualDose’s functions. Software testing showed that VirtualDose was compatible with numerous operating systems including Windows, Linux, Apple OS X, and mobile and portable devices. The organ doses from VirtualDose were compared against those reported by CT-Expo and ImPACT—two dosimetry tools that were based on the stylized pediatric and adult patient models that were known to be anatomically simple. The organ doses reported by VirtualDose differed from those reported by CT-Expo and ImPACT by as much as 300% in some of the patient models. These results confirm the conclusion from past studies that differences in anatomical realism offered by stylized and voxel phantoms have caused significant discrepancies in CT dose estimations.

  2. VirtualDose: a software for reporting organ doses from CT for adult and pediatric patients

    International Nuclear Information System (INIS)

    Ding, Aiping; Gao, Yiming; Liu, Haikuan; Caracappa, Peter F; Xu, X George; Long, Daniel J; Bolch, Wesley E; Liu, Bob

    2015-01-01

    This paper describes the development and testing of VirtualDose—a software for reporting organ doses for adult and pediatric patients who undergo x-ray computed tomography (CT) examinations. The software is based on a comprehensive database of organ doses derived from Monte Carlo (MC) simulations involving a library of 25 anatomically realistic phantoms that represent patients of different ages, body sizes, body masses, and pregnant stages. Models of GE Lightspeed Pro 16 and Siemens SOMATOM Sensation 16 scanners were carefully validated for use in MC dose calculations. The software framework is designed with the ‘software as a service (SaaS)’ delivery concept under which multiple clients can access the web-based interface simultaneously from any computer without having to install software locally. The RESTful web service API also allows a third-party picture archiving and communication system software package to seamlessly integrate with VirtualDose’s functions. Software testing showed that VirtualDose was compatible with numerous operating systems including Windows, Linux, Apple OS X, and mobile and portable devices. The organ doses from VirtualDose were compared against those reported by CT-Expo and ImPACT—two dosimetry tools that were based on the stylized pediatric and adult patient models that were known to be anatomically simple. The organ doses reported by VirtualDose differed from those reported by CT-Expo and ImPACT by as much as 300% in some of the patient models. These results confirm the conclusion from past studies that differences in anatomical realism offered by stylized and voxel phantoms have caused significant discrepancies in CT dose estimations. (paper)

  3. 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.

  4. Skin dose assessment in routine personnel beta/gamma dosimetry

    International Nuclear Information System (INIS)

    Christensen, P.

    1980-01-01

    The International Commission on Radiological Protection (Publication 26) has recommended a tissue depth of 5 to 10 mg.cm -2 for skin dose assessments. This requirement is generally not fulfilled by routine monitoring procedures because of practical difficulties in using very thin dosemeters with low sensitivity and therefore a high minimum detectable dose. Especially for low-energy beta-ray exposures underestimations of the skin dose by a factor of more than ten may occur. Low-transparent graphite-mixed sintered LiF and Li 2 B 4 0 7 : Mn dosemeters were produced which show a skin-equivalent response to beta and gamma exposures over a wide range of energies. These have found wide-spread application for extremity dosimetry but have not yet been generally introduced in routine personnel beta/gamma monitoring. The following adaptations of existing routine monitoring systems for improved skin dose assessments have been investigated: 1) Placement of a supplementary, thin, skin-dose equivalent dosemeter in the TLD badge to give additional information on low-energy exposures. 2) Introduction of a second photomultiplier in the read-out chamber which enables a simultaneous determination of emitted TL from both sides of the dosemeter separately. This method makes use of the selfshielding of the dosemeter to give information on the low-energy dose contribution. 3) By diffusion of Li 2 B 4 0 7 into solid LiF-dosemeters it was possible to produce a surface layer with a new distinct glow-peak at about 340 deg C which is not present in the undiffused part of the LiF chip, and which can be utilized for the assessment of the skin-dose. Data on energy response and accuracy of dose measurement for beta/gamma exposures are given for the three methods and advantages and disadvantages are discussed (H.K.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Vilarinho, Luisa Maria Auredine Lima

    2004-07-01

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

  6. Dose area product measurement for diagnostic reference levels and analysis of patient dose in dental radiography

    International Nuclear Information System (INIS)

    Han, S.; Lee, B.; Shin, G.; Choi, J.; Kim, J.; Park, C.; Park, H.; Lee, K.; Kim, Y.

    2008-01-01

    In this study, diagnostic reference levels (DRLs) were suggested and patient doses were analysed through the dose-area product value in dental radiography. In intraoral radiography, at three sites, i.e. molar, premolar and incisor on the maxilla and acquired third quartile values: 55.5, 46 and 36.5 mGy cm 2 , respectively, were measured. In panoramic, cephalo-metric and cone beam computed tomography, the values were 120.3, 146 and 3203 mGy cm 2 (16 x 18 cm), respectively. It has been shown that, in intraoral radiography, the patient dose changes proportionally to the value of mA s, but the change in extra-oral radiography in response to mA s could not be confirmed. The authors could confirm, however, the difference in dose according to the manufacturer in all dental radiography examinations, except for panoramic radiography. Depending on the size of hospital, there were some differences in patient dose in intraoral radiography, but no difference in patient dose in extra-oral radiography. (authors)

  7. Public Dose Assessment Modeling from Skyshine by Proton Accelerator

    Energy Technology Data Exchange (ETDEWEB)

    Mwambinga, S. A. [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Yoo, S. J. [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2013-10-15

    In this paper, the skyshine dose by proton accelerator (230 MeV) has been evaluated. The amount of dose by skyshine is related to some influence factors which are emission angle (Height wall), the thickness of ceiling and distance from source to receptor (Human body). Empirical formula is made by using MCNPX code results. It can easily calculate and assess dose from skyshine by proton accelerator. The skyshine doses are calculated with MCNPX code and DCFs in ICRP 116. Thereafter, we made empirical formula which can calculate dose easily and be compared with the results of MCNPX. The maximum exposure point by skyshine is about 5 ∼ 10 m from source. Therefore, the licensee who wants to operate the proton accelerator must keep the appropriate distance from accelerator and set the fence to restrict the approach by the public. And, exposure doses by accelerator depend on operating time and proton beam intensities. Eq. (6) suggested in this study is just considered for mono energy proton accelerator. Therefore, it is necessary to expand the dose calculation to diverse proton energies. Radiations like neutron and photon generated by high energy proton accelerators over 10 MeV, are important exposure sources to be monitored to radiation workers and the public members near the facility. At that case, one of the exposure pathways to the public who are located in near the facility is skyshine. Neutrons and photons can be scattered by the atmosphere near the facility and exposed to public as scattered dose. All of the facilities using high energy radiation and NDI (Non-Destructive Inspection) which is tested at open field, skyshine dose must be taken into consideration. Skyshine dose is not related to the wall thickness of radiation shielding directly.

  8. Radiological dose assessment from the operation of Daeduk nuclear facilities

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Won Tae; Kim, Eun Han; Suh, Kyung Suk; Choi, Young Gil [Korea Atomic Energy Research Institute, Taejon (Korea)

    2000-02-01

    The objective of this project is to assure the public acceptance for nuclear facilities, and the environmental safety from the operation of Daeduk nuclear facilities, such as HANARO research reactor, nuclear fuel processing facilities and others. For identifying the integrity of their facilities, the maximum individual doses at the site boundary and on the areas with high population density were assessed. Also, the collective doses within radius 80 km from the site were assessed. The radiation impacts for residents around the site from the operation of Daeduk nuclear facilities in 1999 were neglectable. 8 refs., 10 figs., 27 tabs. (Author)

  9. Effective dose to patients from thoracic spine examinations with tomosynthesis

    International Nuclear Information System (INIS)

    Svalkvist, Angelica; Baath, Magnus; Soederman, Christina

    2016-01-01

    The purposes of the present work were to calculate the average effective dose to patients from lateral tomosynthesis examinations of the thoracic spine, compare the results with the corresponding conventional examination and to determine a conversion factor between dose-area product (DAP) and effective dose for the tomosynthesis examination. Thoracic spine examinations from 17 patients were included in the study. The registered DAP and information about the field size for each projection radiograph were, together with patient height and mass, used to calculate the effective dose for each projection radiograph. The total effective doses for the tomosynthesis examinations were obtained by adding the effective doses from the 60 projection radiographs included in the examination. The mean effective dose was 0.47 mSv (range 0.24-0.81 mSv) for the tomosynthesis examinations and 0.20 mSv (range 0.07-0.29 mSv) for the corresponding conventional examinations (anteroposterior + left lateral projection). For the tomosynthesis examinations, a conversion factor between total DAP and effective dose of 0.092 mSv Gycm -2 was obtained. (authors)

  10. EFFECTIVE DOSE TO PATIENTS FROM THORACIC SPINE EXAMINATIONS WITH TOMOSYNTHESIS.

    Science.gov (United States)

    Svalkvist, Angelica; Söderman, Christina; Båth, Magnus

    2016-06-01

    The purposes of the present work were to calculate the average effective dose to patients from lateral tomosynthesis examinations of the thoracic spine, compare the results with the corresponding conventional examination and to determine a conversion factor between dose-area product (DAP) and effective dose for the tomosynthesis examination. Thoracic spine examinations from 17 patients were included in the study. The registered DAP and information about the field size for each projection radiograph were, together with patient height and mass, used to calculate the effective dose for each projection radiograph. The total effective doses for the tomosynthesis examinations were obtained by adding the effective doses from the 60 projection radiographs included in the examination. The mean effective dose was 0.47 mSv (range 0.24-0.81 mSv) for the tomosynthesis examinations and 0.20 mSv (range 0.07-0.29 mSv) for the corresponding conventional examinations (anteroposterior + left lateral projection). For the tomosynthesis examinations, a conversion factor between total DAP and effective dose of 0.092 mSv Gycm(-2) was obtained. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Optimal initial dose adjustment of warfarin in orthopedic patients.

    Science.gov (United States)

    Lenzini, Petra A; Grice, Gloria R; Milligan, Paul E; Gatchel, Susan K; Deych, Elena; Eby, Charles S; Burnett, R Stephen J; Clohisy, John C; Barrack, Robert L; Gage, Brian F

    2007-11-01

    Warfarin sodium is commonly prescribed for the prophylaxis and treatment of venous thromboembolism. Dosing algorithms have not been widely adopted because they require a fixed initial warfarin dose (eg, 5 mg) and are not tailored to other factors that may affect the international normalized ratio (INR). To develop an algorithm that could predict a therapeutic warfarin dose based on drug interactions, INR response after the initial warfarin doses, and other clinical factors. We used stepwise regression to quantify the relationship between these factors in patients beginning prophylactic warfarin therapy immediately prior to joint replacement. In the derivation cohort (n = 271), we separately modeled the therapeutic dose after 2 and 3 initial doses. We prospectively validated these 2 models in an independent cohort (n = 105). About half of the therapeutic dose variability was predictable after 3 days of therapy: R2 was 53% in the derivation cohort and 42% in the validation cohort. INR response after 3 warfarin doses (INR3) inversely correlated with therapeutic dose (p < 0.001). Intraoperative blood loss transiently, but significantly, elevated the postoperative INR values. Other significant (p < 0.03) predictors were the first and second warfarin doses (+7% and +6%, respectively, per 1 mg), and statin use (-15.0%). The model derived after 2 warfarin doses explained 32% of the variability in therapeutic dose. We developed and validated algorithms that estimate therapeutic warfarin doses based on clinical factors and INR response available after 2-3 days of warfarin therapy. The algorithms are implemented online at www.WarfarinDosing.org.

  12. Survey of patient dose in computed tomography in Syria 2009.

    Science.gov (United States)

    Kharita, M H; Khazzam, S

    2010-09-01

    The radiation doses to patient in computed tomography (CT) in Syria have been investigated and compared with similar studies in different countries. This work surveyed 30 CT scanners from six different manufacturers distributed all over Syria. Some of the results in this paper were part of a project launched by the International Atomic Energy Agency in different regions of the world covering Asia, Africa and Eastern Europe. The dose quantities covered are CT dose index (CTDI(w)), dose-length product (DLP), effective dose (E) and collective dose. It was found that most CTDI(w) and DLP values were similar to the European reference levels and in line with the results of similar surveys in the world. The results were in good agreement with the UNSCEAR Report 2007. This study concluded a recommendation for national diagnostic reference level for the most common CT protocols in Syria. The results can be used as a base for future optimisation studies in the country.

  13. Nordic Guidance Levels for Patient Doses in Diagnostic Radiology

    International Nuclear Information System (INIS)

    Saxebol, G.; Olerud, H.M.; Hjardemaal, O.; Leitz, W.; Servomaa, A.; Walderhaug, T.

    1998-01-01

    Within the framework of Nordic authoritative cooperation in radiation protection and nuclear safety, recommendations have been prepared dealing with dose constraints in diagnostic radiology. A working group with participants from all the Nordic countries has met and discussed possible implementations of the ICRP dose constraint for medical radiology. Dose constraints, expressed as guidance levels, were specified for six different radiological examinations, i.e. chest, pelvis, lumbar spine, urography, barium meal and enema in units of kerma-area product and entrance surface dose. The recommendations are described in report No 5 in the series 'Report on Nordic Radiation Protection Cooperation'. Examples of dose distributions and factors affecting the patient dose are described in the report. (author)

  14. Doubling the infliximab dose versus halving the infusion intervals in Crohn's disease patients with loss of response

    DEFF Research Database (Denmark)

    Katz, Lior; Gisbert, Javier P; Manoogian, Beth

    2012-01-01

    Intensifying infliximab therapy is often practiced in Crohn's disease (CD) patients losing response to the drug but there are no data if halving the interval is superior to doubling the dose. We aimed to assess the efficacy of infliximab dose intensification by interval-halving compared with dose...

  15. Estimation of organ doses of patient undergoing hepatic chemoembolization procedures

    International Nuclear Information System (INIS)

    Jaramillo, G.W.; Kramer, R.; Khoury, H.J.; Barros, V.S.M.; Andrade, G.

    2015-01-01

    The aim of this study is to evaluate the organ doses of patients undergoing hepatic chemoembolization procedures performed in two hospitals in the city of Recife-Brazil. Forty eight patients undergoing fifty hepatic chemoembolization procedures were investigated. For the 20 cases with PA projection only, organ and tissue absorbed doses as well as radiation risks were calculated. For this purpose organs and tissues dose to KAP conversion coefficients were calculated using the mesh-based phantom series FASH and MASH coupled to the EGSnrc Monte Carlo code. Clinical, dosimetric and irradiations parameters were registered for all patients. The maximum organ doses found were 1.72 Gy, 0.65Gy, 0.56 Gy and 0.33 Gy for skin, kidneys, adrenals and liver, respectively. (authors)

  16. Assessment of female breast dose for thoracic cone-beam CT using MOSFET dosimeters.

    Science.gov (United States)

    Sun, Wenzhao; Wang, Bin; Qiu, Bo; Liang, Jian; Xie, Weihao; Deng, Xiaowu; Qi, Zhenyu

    2017-03-21

    To assess the breast dose during a routine thoracic cone-beam CT (CBCT) check with the efforts to explore the possible dose reduction strategy. Metal oxide semiconductor field-effect transistor (MOSFET) dosimeters were used to measure breast surface doses during a thorax kV CBCT scan in an anthropomorphic phantom. Breast doses for different scanning protocols and breast sizes were compared. Dose reduction was attempted by using partial arc CBCT scan with bowtie filter. The impact of this dose reduction strategy on image registration accuracy was investigated. The average breast surface doses were 20.02 mGy and 11.65 mGy for thoracic CBCT without filtration and with filtration, respectively. This indicates a dose reduction of 41.8% by use of bowtie filter. It was found 220° partial arc scanning significantly reduced the dose to contralateral breast (44.4% lower than ipsilateral breast), while the image registration accuracy was not compromised. Breast dose reduction can be achieved by using ipsilateral 220° partial arc scan with bowtie filter. This strategy also provides sufficient image quality for thorax image registration in daily patient positioning verification.

  17. Measurement of patient radiation doses in certain urography procedures

    International Nuclear Information System (INIS)

    Sulieman, A.; Barakat, H.; Zailae, A.; Abuderman, A.; Theodorou, K.

    2015-01-01

    Patients are exposed to significant radiation doses during diagnostic and interventional urological procedures. This study aimed to measure patient entrance surface air kerma (ESAK) and to estimate the effective dose during intravenous urography (IVU), extracorporeal shock-wave lithotripsy (ESWL), and ascending urethrogram (ASU) procedures. ESAK was measured in patients using calibrated thermo luminance dosimeters, GR200A). Effective doses (E) were calculated using the National Radiological Protection Board (NRPB) software. A total of 179 procedures were investigated. 27.9 % of the patients underwent IVU procedures, 27.9 % underwent ESWL procedures and 44.2 % underwent ASU procedures. The mean ESAK was 2.1, 4.18 and 4.9 mGy for IVU, ESWL, and ASU procedures, respectively. Differences in patient ESAK for the same procedure were observed. The mean ESAK values were comparable with those in previous studies. (authors)

  18. Patient absorbed radiation doses estimation related to irradiation anatomy

    International Nuclear Information System (INIS)

    Soares, Flavio Augusto Penna; Soares, Amanda Anastacio; Kahl, Gabrielly Gomes

    2014-01-01

    Developed a direct equation to estimate the absorbed dose to the patient in x-ray examinations, using electric, geometric parameters and filtering combined with data from irradiated anatomy. To determine the absorbed dose for each examination, the entrance skin dose (ESD) is adjusted to the thickness of the patient's specific anatomy. ESD is calculated from the estimated KERMA greatness in the air. Beer-Lambert equations derived from power data mass absorption coefficients obtained from the NIST / USA, were developed for each tissue: bone, muscle, fat and skin. Skin thickness was set at 2 mm and the bone was estimated in the central ray of the site, in the anteroposterior view. Because they are similar in density and attenuation coefficients, muscle and fat are treated as a single tissue. For evaluation of the full equations, we chose three different anatomies: chest, hand and thigh. Although complex in its shape, the equations simplify direct determination of absorbed dose from the characteristics of the equipment and patient. The input data is inserted at a single time and total absorbed dose (mGy) is calculated instantly. The average error, when compared with available data, is less than 5% in any combination of device data and exams. In calculating the dose for an exam and patient, the operator can choose the variables that will deposit less radiation to the patient through the prior analysis of each combination of variables, using the ALARA principle in routine diagnostic radiology sector

  19. A CONCEPTUAL FRAMEWORK FOR MANAGING RADIATION DOSE TO PATIENTS IN DIAGNOSTIC RADIOLOGY USING REFERENCE DOSE LEVELS.

    Science.gov (United States)

    Almén, Anja; Båth, Magnus

    2016-06-01

    The overall aim of the present work was to develop a conceptual framework for managing radiation dose in diagnostic radiology with the intention to support optimisation. An optimisation process was first derived. The framework for managing radiation dose, based on the derived optimisation process, was then outlined. The outset of the optimisation process is four stages: providing equipment, establishing methodology, performing examinations and ensuring quality. The optimisation process comprises a series of activities and actions at these stages. The current system of diagnostic reference levels is an activity in the last stage, ensuring quality. The system becomes a reactive activity only to a certain extent engaging the core activity in the radiology department, performing examinations. Three reference dose levels-possible, expected and established-were assigned to the three stages in the optimisation process, excluding ensuring quality. A reasonably achievable dose range is also derived, indicating an acceptable deviation from the established dose level. A reasonable radiation dose for a single patient is within this range. The suggested framework for managing radiation dose should be regarded as one part of the optimisation process. The optimisation process constitutes a variety of complementary activities, where managing radiation dose is only one part. This emphasises the need to take a holistic approach integrating the optimisation process in different clinical activities. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. A conceptual framework for managing radiation dose to patients in diagnostic radiology using reference dose levels

    International Nuclear Information System (INIS)

    Almen, Anja; Baath, Magnus

    2016-01-01

    The overall aim of the present work was to develop a conceptual framework for managing radiation dose in diagnostic radiology with the intention to support optimisation. An optimisation process was first derived. The framework for managing radiation dose, based on the derived optimisation process, was then outlined. The outset of the optimisation process is four stages: providing equipment, establishing methodology, performing examinations and ensuring quality. The optimisation process comprises a series of activities and actions at these stages. The current system of diagnostic reference levels is an activity in the last stage, ensuring quality. The system becomes a reactive activity only to a certain extent engaging the core activity in the radiology department, performing examinations. Three reference dose levels-possible, expected and established-were assigned to the three stages in the optimisation process, excluding ensuring quality. A reasonably achievable dose range is also derived, indicating an acceptable deviation from the established dose level. A reasonable radiation dose for a single patient is within this range. The suggested framework for managing radiation dose should be regarded as one part of the optimisation process. The optimisation process constitutes a variety of complementary activities, where managing radiation dose is only one part. This emphasises the need to take a holistic approach integrating the optimisation process in different clinical activities. (authors)

  1. Radiation dose to relations of patients treated with 131I

    International Nuclear Information System (INIS)

    Pant, G.S.; Sharma, S.K.; Bal, C.S.; Rakesh Kumar; Rath, G.K.

    2003-01-01

    Due to its efficacy and simplicity, radioiodine treatment of thyrotoxicosis and differentiated thyroid cancer (DTC) has become extremely popular. A large number of such patients are getting benefit with this treatment modality. Though the radiation dose to the relations of these patients, who may be in close proximity for some time after treatment have been mentioned as within safe limits but we do have sufficient data of our own in India. The life style and social conditions in India are very different than in the developed world. We have been measuring external dose in relations/attendants of these patients who have enough chance to come in close contacts with patients during and after their radioiodine treatment. The TL discs of CaSO 4 (Renentech Laboratories) were exposed to graded doses of gamma photons from 131 I for establishing a dose response relationship. The annealed discs from a given lot were measured for background counts and issued to the relations of patients who have maximum chance of being in proximity with the patient for 2 weeks. The TLDs were collected after a use of 2 weeks for dose estimation. We have so far studied 60 families with a total of 71 attendants. The external doses in all the persons attending the patients at home are well within safe prescribed limits. However, due to varied social and practical circumstances 5 persons exceeded 1 mSv dose. This is possibly due to travelling long distance by train immediately after discharge from the hospital when the accompanying person remains in close proximity throughout the journey. There are situations for non-ambulatory patients, when the attendants have to attend them for relatively longer period. (author)

  2. Patient doses and radiation risks in film-screen mammography in Finland

    International Nuclear Information System (INIS)

    Servomaa, A.; Parviainen, T.; Komppa, T.

    1995-01-01

    Screen-film mamography is the most sensitive method for the early detection of breast cancer. Breast doses in mamography should be measured for several reasons, especially for the evaluation of patient risk in a screening programme, but also for the assessment and comparison of imaging techniques and equipment performance. In this study, the factors affecting patient doses were assessed by making performance and patient dose measurements; about 50 mammographic units used for screening were included in the study. The lifetime risk as a function of age at exposure was calculated using the average glandular dose, the relative risk model shown in the BEIR V report, and the breast cancer mortality in Finland. The mean surface dose of a 4.5 cm thick phantom was 6.3 mGy, and the mean glandular dose 1.0 mGy. Analysis of the surface dose with respect to film optical density, relative speed of film processing, sensitivity of image receptors, and antiscatter grid showed that the mean surface dose could be decreased by more than 50%. For the screened age group of 50 to 59 years, the risk of exposure-induced death (REID) of breast cancer is about 1.4 x 10 -6 mSv -1 , and the average loss of life expectancy due to the radiation-induced breast cancer deaths (LLE/REID) is about 9.5 years. (Author)

  3. Proposed Rectal Dose Constraints for Patients Undergoing Definitive Whole Pelvic Radiotherapy for Clinically Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Chan, Linda W.; Xia Ping; Gottschalk, Alexander R.; Akazawa, Michelle; Scala, Matthew; Pickett, Barby M.S.; Hsu, I-C.; Speight, Joycelyn; Roach, Mack

    2008-01-01

    Purpose: Although several institutions have reported rectal dose constraints according to threshold toxicity, the plethora of trials has resulted in multiple, confusing dose-volume histogram recommendations. A set of standardized, literature-based constraints for patients undergoing whole pelvic radiotherapy (RT) for prostate cancer would help guide the practice of prostate RT. The purpose of this study was to develop these constraints, demonstrate that they are achievable, and assess the corresponding rectal toxicity. Methods and Materials: An extensive literature search identified eight key studies relating dose-volume histogram data to rectal toxicity. A correction factor was developed to address differences in the anatomic definition of the rectum across studies. The dose-volume histogram constraints recommended by each study were combined to generate the constraints. The data from all patients treated with definitive intensity-modulated RT were then compared against these constraints. Acute rectal toxicity was assessed. Results: A continuous, proposed rectal dose-constraint curve was generated. Intensity-modulated RT not only met this constraint curve, but also was able to achieve at least 30-40% lower dose to the rectum. The preliminary clinical results were also positive: 50% of patients reported no acute bowel toxicity, 33% reported Grade 1 toxicity, and 17% reported Grade 2 toxicity. No patients reported Grade 3-4 acute rectal toxicity. Conclusions: In this study, we developed a set of proposed rectal dose constraints. This allowed for volumetric assessment of the dose-volume relationship compared with single dose-volume histogram points. Additional research will be performed to validate this threshold as a class solution for rectal dose constraints

  4. Management of patient dose in radiology in the UK

    International Nuclear Information System (INIS)

    Martin, C. J.

    2011-01-01

    Programmes to manage patient dose in radiology are becoming a higher priority as the number of imaging examinations and the proportion of higher dose computed tomography (CT) and complex interventional procedures all continue to rise. Such programmes have a number of components and their implementation in UK hospitals, which have been developing such programmes over two decades, is described. As part of any programme to manage patient doses, elements should be in place for both justification and optimisation. The system for justification needs to be robust in order to minimise the number of unnecessary procedures and requires the provision of training in radiation protection for medical and other staff to ensure that they understand the risks. Optimisation of X-ray techniques requires performance tests on equipment at installation and regularly thereafter, linked to surveys of patient doses. Confirming the performance of the available options on fluoroscopy and CT equipment is essential and the information obtained should be available to radiographers and radiologists, so they can make informed choices in developing imaging protocols. Patient doses should be compared with diagnostic reference levels set in terms of measured dose quantities to allow the identification of equipment that is giving higher doses. Taking the next step of analysing results to determine the reasons for high doses is crucial and requires a link with the equipment performance tests and an understanding of the underlying physics. Medical physics services play an important role at the hub of the dose management programme for carrying out tests, organising surveys, making recommendations on optimisation strategies and training other staff in radiation protection, performance testing and dose reduction. Programmes for management of patient doses in UK hospitals were first set up in the late 1980's by medical physicists and have been developed since that time to keep pace with the developments in

  5. Integrated Worker Radiation Dose Assessment for the K Basins

    International Nuclear Information System (INIS)

    NELSON, J.V.

    1999-01-01

    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

  6. Actual trends in patients dose reduction in radiodiagnostic

    International Nuclear Information System (INIS)

    Nikodemova, D.; Gomola, I.; Horvathova, M.

    2001-01-01

    In our contribution we tried to survey the entrance surface doses, as well as dose area product measurements by studying 3 types of radiodiagnostic examinations (mammography, chest examination of children and fluoroscopy). The analysis of the obtained data and their comparison with reference values of European Union has demonstrated the significant role of radiation protection dosimetry as an integral part of quality assurance strategy in radiology. Optimisation in radiodiagnostic requires fulfilling the following criteria: - patient doses to be in accordance with accepted diagnostic practice; - patient doses to be as low as reasonably practicable in order to achieve the required diagnostic results; - professionals clinically and physically directing medical exposures to be familiar with typical doses, methods of measurements and means of dose reduction. One of the basic requirements for continuous quality improvement is the repeating cycle of patient dose measurements for determining the level of risk associated with particular radiological examination at given radiodiagnostic department. Beside the undeniable positive influence of Quality Assurance (QA) procedures possible negative effects should be avoided. The danger exist that the development of new techniques is slowed down by standardising all procedures and wide agreement in implementing of required modifications. Reaching of a consensus of a certain procedure became therefore a labour intensive and time-consuming process. (authors)

  7. Patient dose surveys for radiological examinations in Dutch hospitals between 1993 and 2000

    International Nuclear Information System (INIS)

    Spoelstra, F.M.; Geleijns, J.; Broerse, J.J.; Teeuwisse, W.M.; Zweers, D.

    2001-01-01

    Our inventory studies on radiation dose to patients in Dutch hospitals are reviewed and compared with current European guidelines on patient dose and reference dose values of the NRPB. Between the years 1993 and 2000 doses were measured and effective dose was assessed at 14 hospitals for paediatric radiography, at 18 hospitals for PA chest radiography, at 10 respectively 9 hospitals for barium meal and barium enema examinations and at 18 hospitals for CT scans of the brain, chest (including high resolution CT of the chest), abdomen and lumbar spine in The Netherlands. Effective doses varied from 1 μSv (AP chest radiograph premature) to 26 mSv (CT abdomen scan). Doses were in general well below the reference dose values, with the exception of CT where the dose length product often exceeded reference levels. Interhospital variations were considerable, the largest range was observed for PA chest examinations, i.e.a ratio of 27 between maximum and minimum effective dose. (author)

  8. Radiological assessment. A textbook on environmental dose analysis

    International Nuclear Information System (INIS)

    Till, J.E.; Meyer, H.R.

    1983-09-01

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

  9. 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.

  10. Dose assessment according to changes in algorithm in cardiac CT

    Science.gov (United States)

    Jang, H. C.; Cho, J. H.; Lee, H. K.; Hong, I. S.; Cho, M. S.; Park, C. S.; Lee, S. Y.; Dong, K. R.; Goo, E. H.; Chung, W. K.; Ryu, Y. H.; Lim, C. S.

    2012-06-01

    The principal objective of this study was to determine the effects of the application of the adaptive statistical iterative reconstruction (ASIR) technique in combination with another two factors (body mass index (BMI) and tube potential) on radiation dose in cardiac computed tomography (CT). For quantitative analysis, regions of interest were positioned on the central region of the great coronary artery, the right coronary artery, and the left anterior descending artery, after which the means and standard deviations of measured CT numbers were obtained. For qualitative analysis, images taken from the major coronary arteries (right coronary, left anterior descending, and left circumflex) were graded on a scale of 1-5, with 5 indicating the best image quality. Effective dose, which was calculated by multiplying the value of the dose length product by a standard conversion factor of 0.017 for the chest, was employed as a measure of radiation exposure dose. In cardiac CT in patients with BMI of less than 25 kg/m2, the use of 40% ASIR in combination with a low tube potential of 100 kVp resulted in a significant reduction in the radiation dose without compromising diagnostic quality. Additionally, the combination of the 120 kVp protocol and the application of 40% ASIR application for patients with BMI higher than 25 kg/m2 yielded similar results.

  11. Biosphere model for assessing doses from nuclear waste disposal

    International Nuclear Information System (INIS)

    Zach, R.; Amiro, B.D.; Davis, P.A.; Sheppard, S.C.; Szekeley, J.G.

    1994-01-01

    The biosphere model, BIOTRAC, for predicting long term nuclide concentrations and radiological doses from Canada's nuclear fuel waste disposal concept of a vault deep in plutonic rock of the Canadian Shield is presented. This generic, boreal zone biosphere model is based on scenario analysis and systems variability analysis using Monte Carlo simulation techniques. Conservatism is used to bridge uncertainties, even though this creates a small amount of extra nuclide mass. Environmental change over the very long assessment period is mainly handled through distributed parameter values. The dose receptors are a critical group of humans and four generic non-human target organisms. BIOTRAC includes six integrated submodels and it interfaces smoothly with a geosphere model. This interface includes a bedrock well. The geosphere model defines the discharge zones of deep groundwater where nuclides released from the vault enter the biosphere occupied by the dose receptors. The size of one of these zones is reduced when water is withdrawn from the bedrock well. Sensitivity analysis indicates 129 I is by far the most important radionuclide. Results also show bedrock-well water leads to higher doses to man than lake water, but the former doses decrease with the size of the critical group. Under comparable circumstances, doses to the non-human biota are greater than those for man

  12. Dose Assessment Model for Chronic Atmospheric Releases of Tritium

    International Nuclear Information System (INIS)

    Shen Huifang; Yao Rentai

    2010-01-01

    An improved dose assessment model for chronic atmospheric releases of tritium was proposed. The proposed model explicitly considered two chemical forms of tritium.It was based on conservative assumption of transfer of tritiated water (HTO) from air to concentration of HTO and organic beam tritium (OBT) in vegetable and animal products.The concentration of tritium in plant products was calculated based on considering dividedly leafy plant and not leafy plant, meanwhile the concentration contribution of tritium in the different plants from the tritium in soil was taken into account.Calculating the concentration of HTO in animal products, average water fraction of animal products and the average weighted tritium concentration of ingested water based on the fraction of water supplied by each source were considered,including skin absorption, inhalation, drinking water and food.Calculating the annual doses, the ingestion doses were considered, at the same time the contribution of inhalation and skin absorption to the dose was considered. Concentrations in foodstuffs and dose of annual adult calculated with the specific activity model, NEWTRI model and the model proposed by the paper were compared. The results indicate that the model proposed by the paper can predict accurately tritium doses through the food chain from chronic atmospheric releases. (authors)

  13. A model for radiological dose assessment in an urban environment

    International Nuclear Information System (INIS)

    Hwang, Won Tae; Kim, Eun Han; Jeong, Hyo Joon; Suh, Kyung Suk; Han, Moon Hee

    2007-01-01

    A model for radiological dose assessment in an urban environment, METRO-K has been developed. Characteristics of the model are as follows ; 1) mathematical structures are simple (i.e. simplified input parameters) and easy to understand due to get the results by analytical methods using experimental and empirical data, 2) complex urban environment can easily be made up using only 5 types of basic surfaces, 3) various remediation measures can be applied to different surfaces by evaluating the exposure doses contributing from each contamination surface. Exposure doses contributing from each contamination surface at a particular location of a receptor were evaluated using the data library of kerma values as a function of gamma energy and contamination surface. A kerma data library was prepared for 7 representative types of Korean urban building by extending those data given for 4 representative types of European urban buildings. Initial input data are daily radionuclide concentration in air and precipitation, and fraction of chemical type. Final outputs are absorbed dose rate in air contributing from the basic surfaces as a function of time following a radionuclide deposition, and exposure dose rate contributing from various surfaces constituting the urban environment at a particular location of a receptor. As the result of a contaminative scenario for an apartment built-up area, exposure dose rates show a distinct difference for surrounding environment as well as locations of a receptor

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

    International Nuclear Information System (INIS)

    Campos, Marcia Pires de

    1999-01-01

    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/m 3 at the nuclear materials storage site and from 0.9 to 249.8 Bq/m 3 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. Patient dose management practice in computed tomography with special emphasis to pediatric patients

    International Nuclear Information System (INIS)

    Kharita, M. H.; Wali, Kh.

    2010-12-01

    As per UNSCEAR 2000, CT contributes over 34% of collective dose from diagnostic X-Ray examinations in the world. The radiation dose in CT particular importance for children, it is very well known that children are more sensitive and likely to get radiation induced cancer than adults. This paper discusses the radiation dose of patients (adults and children) in Computed Tomography in syria ( 30 CT units form 6 different manufacturers). The radiation dose measurements has covered computed tomography dose index, dose length product and effective dose. The result of this study indicating, that most computed tomography dose index and dose length product values recorded were below dose reference levels, only for high resolution chest protocol, the dose length product results were higher than that of the International Commission on Radiological Protection (author)

  16. SU-F-J-52: A Novel Approach to X-Ray Tube Quality Assurance for CBCT Systems in Order to Better Assess the Patient Imaging Dose in a Large, Multi-Unit Treatment Facility

    International Nuclear Information System (INIS)

    Buckley, L; Lambert, C; Nyiri, B; Gerig, L; Webb, R

    2016-01-01

    Purpose: To standardize the tube calibration for Elekta XVI cone beam CT (CBCT) systems in order to provide a meaningful estimate of the daily imaging dose and reduce the variation between units in a large centre with multiple treatment units. Methods: Initial measurements of the output from the CBCT systems were made using a Farmer chamber and standard CTDI phantom. The correlation between the measured CTDI and the tube current was confirmed using an Unfors Xi detector which was then used to perform a tube current calibration on each unit. Results: Initial measurements showed measured tube current variations of up to 25% between units for scans with the same image settings. In order to reasonably estimate the imaging dose, a systematic approach to x-ray generator calibration was adopted to ensure that the imaging dose was consistent across all units at the centre and was adopted as part of the routine quality assurance program. Subsequent measurements show that the variation in measured dose across nine units is on the order of 5%. Conclusion: Increasingly, patients receiving radiation therapy have extended life expectancies and therefore the cumulative dose from daily imaging should not be ignored. In theory, an estimate of imaging dose can be made from the imaging parameters. However, measurements have shown that there are large differences in the x-ray generator calibration as installed at the clinic. Current protocols recommend routine checks of dose to ensure constancy. The present study suggests that in addition to constancy checks on a single machine, a tube current calibration should be performed on every unit to ensure agreement across multiple machines. This is crucial at a large centre with multiple units in order to provide physicians with a meaningful estimate of the daily imaging dose.

  17. SU-F-J-52: A Novel Approach to X-Ray Tube Quality Assurance for CBCT Systems in Order to Better Assess the Patient Imaging Dose in a Large, Multi-Unit Treatment Facility

    Energy Technology Data Exchange (ETDEWEB)

    Buckley, L; Lambert, C; Nyiri, B; Gerig, L [The Ottawa Hospital Cancer Ctr., Ottawa, ON (Canada); Webb, R [Elekta, Montreal, Quebec (Canada)

    2016-06-15

    Purpose: To standardize the tube calibration for Elekta XVI cone beam CT (CBCT) systems in order to provide a meaningful estimate of the daily imaging dose and reduce the variation between units in a large centre with multiple treatment units. Methods: Initial measurements of the output from the CBCT systems were made using a Farmer chamber and standard CTDI phantom. The correlation between the measured CTDI and the tube current was confirmed using an Unfors Xi detector which was then used to perform a tube current calibration on each unit. Results: Initial measurements showed measured tube current variations of up to 25% between units for scans with the same image settings. In order to reasonably estimate the imaging dose, a systematic approach to x-ray generator calibration was adopted to ensure that the imaging dose was consistent across all units at the centre and was adopted as part of the routine quality assurance program. Subsequent measurements show that the variation in measured dose across nine units is on the order of 5%. Conclusion: Increasingly, patients receiving radiation therapy have extended life expectancies and therefore the cumulative dose from daily imaging should not be ignored. In theory, an estimate of imaging dose can be made from the imaging parameters. However, measurements have shown that there are large differences in the x-ray generator calibration as installed at the clinic. Current protocols recommend routine checks of dose to ensure constancy. The present study suggests that in addition to constancy checks on a single machine, a tube current calibration should be performed on every unit to ensure agreement across multiple machines. This is crucial at a large centre with multiple units in order to provide physicians with a meaningful estimate of the daily imaging dose.

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

    International Nuclear Information System (INIS)

    Sato, Kaoru; Takahashi, Fumiaki; Satoh, Daiki; Endo, Akira

    2011-12-01

    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)

  19. Reduction of radiation doses on patients. Practice cases

    International Nuclear Information System (INIS)

    Ruiz Perez de Villar, M.J.; Llorca Diaz, A.L.; Vano Carruana, E.

    1993-01-01

    The percentages of patient dose reduction achieved in chest, abdomen, lumbar spine and pelvis imaging as a result of the quality controls applied to X-ray generators and tubes are presented. Dosimetry was done with lithium fluoride thermoluminescent crystals. The absorbed doses were measured before and after the quality controls and were compared with reference doses provided by the European Community and by the Medical Physics department of the Universidad Complutense in Madrid. The procedures applied in the quality controls of generators and tubes were noninvasive. In chest studies, the reductions in dose ranged between 60 and 80%. In studies of abdomen, lumbar column and pelvis, it was possible to reduce the absorbed dose by 35%. (Author)

  20. Prospective electrocardiogram-gated axial 64-detector computed tomographic angiography vs retrospective gated helical technique to assess coronary artery bypass graft anastomosis. Comparison of image quality and patient radiation dose

    International Nuclear Information System (INIS)

    Machida, Haruhiko; Masukawa, Ai; Tanaka, Isao; Fukui, Rika; Suzuki, Kazufumi; Ueno, Eiko; Kodera, Kojiro; Nakano, Kiyoharu; Shen, Y.

    2010-01-01

    In the present study the effective dose and image quality at distal anastomoses were retrospectively compared between prospective electrocardiogram (ECG)-gated axial and retrospective ECG-gated helical techniques on 64-detector computed tomographic (CT) angiography following coronary artery bypass graft surgery. Following bypass surgery, 52 patients with a heart rate <65 beats/min underwent CT angiography: 26 patients each with prospective and retrospective ECG gating techniques. The effective dose was compared between the 2 groups using a 4-point scale (4, excellent; 1, poor) to grade the quality of curved multiplanar reformation images at distal anastomoses. Patient characteristics of the 2 groups were well matched, and the same CT scan parameters were used for both, except for the interval between surgery and CT examination, tube current, and image noise index. Image quality scores did not differ significantly (3.26±0.95 vs 3.35±0.87; P=0.63), but the effective dose was significantly lower in the prospective (7.3±1.8 mSv) than in the retrospective gating group (23.6±4.5 mSv) (P<0.0001). Following bypass surgery, 64-detector CT angiography using prospective ECG gating is superior to retrospective gating in limiting the radiation dose and maintaining the image quality of distal anastomoses. (author)

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

    International Nuclear Information System (INIS)

    Egbe, N.O.; Heaton, B.; Sharp, P.F.

    2010-01-01

    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 (D ref ) was assessed from comparison of doses that produced statistically significant differences in image quality from D ref . 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.

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

    International Nuclear Information System (INIS)

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

    1998-01-01

    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

  3. Radiation dose rates from adult patients undergoing nuclear medicine investigations

    International Nuclear Information System (INIS)

    Mountford, P.J.; O'Doherty, M.J.; Forge, N.I.; Jeffries, A.; Coakley, A.J.

    1991-01-01

    Adult patients undergoing nuclear medicine investigations may subsequently come into close contact with members of the public and hospital staff. In order to expand the available dosimetry and derive appropriate recommendations, dose rates were measured at 0.1, 0.5 and 1.0 m from 80 adult patients just before they left the nuclear medicine department after undergoing one of eight 99 Tc m studies, an 123 I thyroid, an 111 In leucocyte or a 201 Tl cardiac scan. The maximum departure dose rates at these distances of 150, 30 and 7.3 μSv h -1 were greater than those found in similar published studies of adult and paediatric patients. To limit the dose to an infant to less than 1 mSv, an 111 In leucocyte scan is the only investigation for which it may be necessary to restrict close contact between the infant and a radioactive parent, depending on the dose rate near the surface of the patient, the parent's habits and how fretful is the infant. It is unlikely that a ward nurse will receive a dose of 60 μSv in a working day if caring for just one radioactive adult patient, unless the patient is classified as totally helpless and had undergone a 99 Tc m marrow, bone or brain scan. The data and revised calculations of effective exposure times based on a total close contact time of 9 h in every 24 h period should allow worst case estimates of radiation dose to be made and recommendations to be formulated for other circumstances, including any future legislative changes in dose limits or derived levels. (author)

  4. Assessment of regional pediatric computed tomography dose indices in Tamil Nadu

    OpenAIRE

    A Saravanakumar; K Vaideki; K N Govindarajan; S Jayakumar; B Devanand

    2017-01-01

    The aim of this article is to assess Tamil Nadu pediatric computed tomography (CT) diagnostic reference levels (DRLs) by collecting radiation dose data for the most commonly performed CT examinations. This work was performed for thirty CT scanners installed in various parts of the Tamil Nadu region. The patient cohort was divided into two age groups:

  5. The relative importance of ingestion for multiple pathway dose assessments

    International Nuclear Information System (INIS)

    Wicker, W.; Grogan, H.; Bergstroem, U.; Hoffman, O.

    1991-01-01

    The general purpose of this report is to examine the relative importance of ingestion pathways, and particularly food chain transport in overall dose assessment. The importance of ingestion pathways is examined for various release scenarios and radionuclides because the findings are expected to differ with circumstances. The degree to which contaminated food products contribute to the total dose will affect the importance of accuracy and uncertainty of food chain model predictions, which is the main thrust of the Biospheric Model Validation Study (BIOMOVS). This analysis requires that all modes of radiation exposure be examined, including inhalation, external exposure, and the various ingestion pathways. (2 figs., 2 tabs.)

  6. Summary of the dose assessment tool for diagnostic X-ray CT, WAZA-ARIv2

    International Nuclear Information System (INIS)

    Koba, Yosuke

    2016-01-01

    WAZA-ARIv2 is the web-based open system for the dose assessment for diagnostic X-ray CT. Amid growing interest about the dose assessment for medical exposure, WAZA-ARIv2 is opened to the public from January 2015 and attracts rising attention. Using WAZA-ARIv2 system, users can calculate exposure dose to consider patient's age and body shape, and can register the calculation results on WAZA-ARIv2 server for checking as histogram statistics. This paper reviews the background of development of WAZA-ARI system, the comparison of characteristics between WAZA-ARIv2 and other tools, and the calculation method of organ dose in WAZA-ARIv2. (author)

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

    International Nuclear Information System (INIS)

    Pfingston, M.

    1998-01-01

    In May 1991, the U.S. Department of Energy (DOE), Office of Waste Operations, issued a nationwide moratorium on shipping slightly radioactive mixed waste from DOE facilities to commercial treatment, storage, and disposal (TSD) facilities. Studies were subsequently conducted to evaluate the radiological impacts associated with DOE's prior shipments through DOE's authorized release process under DOE Order 5400.5. To support this endeavor, a radiological assessment computer code--TSD-DOSE (Version 1.1)--was developed and issued by DOE in 1997. The code was developed on the basis of detailed radiological assessments performed for eight commercial hazardous waste TSD facilities. It was designed to utilize 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 has since been released for use by DOE field offices and was recently used by DOE to evaluate the release of septic waste containing residual radioactive material to a TSD facility licensed under the Resource Conservation and Recovery Act. Revisions to the code were initiated in 1997 to incorporate comments received from users and to increase TSD-DOSE's capability, accuracy, and flexibility. These updates included incorporation of the method used to estimate external radiation doses from DOE's RESRAD model and expansion of the source term to include 85 radionuclides. In addition, a detailed verification and benchmarking analysis was performed

  8. KERMA-based radiation dose management system for real-time patient dose measurement

    Science.gov (United States)

    Kim, Kyo-Tae; Heo, Ye-Ji; Oh, Kyung-Min; Nam, Sang-Hee; Kang, Sang-Sik; Park, Ji-Koon; Song, Yong-Keun; Park, Sung-Kwang

    2016-07-01

    Because systems that reduce radiation exposure during diagnostic procedures must be developed, significant time and financial resources have been invested in constructing radiation dose management systems. In the present study, the characteristics of an existing ionization-based system were compared to those of a system based on the kinetic energy released per unit mass (KERMA). Furthermore, the feasibility of using the KERMA-based system for patient radiation dose management was verified. The ionization-based system corrected the effects resulting from radiation parameter perturbations in general radiography whereas the KERMA-based system did not. Because of this difference, the KERMA-based radiation dose management system might overestimate the patient's radiation dose due to changes in the radiation conditions. Therefore, if a correction factor describing the correlation between the systems is applied to resolve this issue, then a radiation dose management system can be developed that will enable real-time measurement of the patient's radiation exposure and acquisition of diagnostic images.

  9. Quality-controlled dose reduction of full-leg radiography in patients with knee malalignment

    Energy Technology Data Exchange (ETDEWEB)

    Kloth, Jost Karsten; Neumann, Regina; Stiller, Wolfram; Kauczor, Hans-Ulrich; Weber, Marc-Andre [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Stillfried, Eva von; Ewerbeck, Volker [University Hospital Heidelberg, Department of Orthopedic and Trauma Surgery, Heidelberg (Germany)

    2014-12-05

    Digital plain radiographs of the full leg are frequently performed examinations of children and young adults. Thus, the objective of this work was to reduce the radiation exposure dependent on specific indications, and to determine objective quality-control criteria to ensure accurate assessment. Institutional review board approval and informed consent of all participants were obtained. In this prospective, randomized controlled, blinded, two-armed single-center study, 288 evaluable patients underwent plain radiography of the full leg with standard and reduced doses. The evaluation of the plain radiographs was conducted using the following criteria: mechanical axis, leg length, and maturation of the epiphyseal plate. Two blinded radiologists evaluated these criteria using a score ranging from 1 (definitely assessable) to 4 (not assessable). If a single criterion had been evaluated with a score of 3 or more points or all criteria with 2 points, the radiograph was scored as ''not assessable''. The study was designed as a non-inferiority trial. Eleven (3.8 %) examined X-rays were scored as not assessable. The rate of non-assessable radiographs with 33 % reduced dose was significantly not inferior to the rate of non-assessable radiographs with standard dose. The evaluation of the quality criteria was dose independent. Full-leg plain radiography in patients with knee malalignment can be performed at 33 % reduced dose without loss of relevant diagnostic information. (orig.)

  10. Analysis of patient CT dose data using virtualdose

    Science.gov (United States)

    Bennett, Richard

    X-ray computer tomography has many benefits to medical and research applications. Recently, over the last decade CT has had a large increase in usage in hospitals and medical diagnosis. In pediatric care, from 2000 to 2006, abdominal CT scans increased by 49 % and chest CT by 425 % in the emergency room (Broder 2007). Enormous amounts of effort have been performed across multiple academic and government groups to determine an accurate measure of organ dose to patients who undergo a CT scan due to the inherent risks with ionizing radiation. Considering these intrinsic risks, CT dose estimating software becomes a necessary tool that health care providers and radiologist must use to determine many metrics to base the risks versus rewards of having an x-ray CT scan. This thesis models the resultant organ dose as body mass increases for patients with all other related scan parameters fixed. In addition to this,this thesis compares a modern dose estimating software, VirtualDose CT to two other programs, CT-Expo and ImPACT CT. The comparison shows how the software's theoretical basis and the phantom they use to represent the human body affect the range of results in organ dose. CT-Expo and ImPACT CT dose estimating software uses a different model for anatomical representation of the organs in the human body and the results show how that approach dramatically changes the outcome. The results categorizes four datasets as compared to the three software types where the appropriate phantom was available. Modeling was done to simulate chest abdominal pelvis scans and whole body scans. Organ dose difference versus body mass index shows as body mass index (BMI) ranges from 23.5 kg/m 2 to 45 kg/m2 the amount of organ dose also trends a percent change from -4.58 to -176.19 %. Comparing organ dose difference with increasing x-ray tube potential from 120 kVp to 140 kVp the percent change in organ dose increases from 55 % to 65 % across all phantoms. In comparing VirtualDose to CT

  11. Staff and patient absorbed doses due to diagnostic nuclear medicine procedures

    International Nuclear Information System (INIS)

    Tabei, F.; Neshandar Asli, I.; Aghamiri, S.M.; Arbabi, K.

    2004-01-01

    Background: annual patient effective dose equivalent can be considered as a quantitative physical parameter describing the activities performed in each nuclear medicine department. annual staff dose equivalent could be also considered as a parameter describing the amount of radiation risk for performing the activities. We calculated the staff to patient dose equivalent ratio to be used as a physical parameter for quantification of ALARA law in nuclear medicine department. Materials and methods: as a part of nationwide study, this paper reports the staff and patient absorbed dose equivalents from diagnostic nuclear medicine examinations performed in four nuclear medicine department during 1999-2002. The type and frequency of examinations in each department were determined directly from hospital medical reports. Staff absorbed doses equivalents were calculated from regular personal dosimeter reports. Results: the total number of examinations increased by 16.7 % during these years. Annual patient collective dose equivalent increased about 13.0 % and the mean effective dose equivalent per exam was 3.61 ± 0.07 mSv. Annual total staff absorbed dose equivalent (total of 24 radiation workers) in four departments increased from 40.45 mSv to 47.81 mSv during four years that indicates an increase of about 20.6 %. The average of annual ratios of staff to patient effective dose equivalents in four departments were 1.83 x 10 -3 , 1.04 x 10 -3 , 3.28 x 10 -3 and 3.24 x 10 -3 , respectively, within a range of 0.9 x 10 -3 - 4.17 x 10 -3 . The mean value of ratios in four years was about 2.24 x 10 -3 ± 1.09 x 10 -3 that indicates the staff dose of about two 1000 th of patient dose. Conclusion: The mean value of ratios in four years was about 1.89 x 10 -3 ± 0.95 x 10 -3 indicating the staff dose of about one 1000 th of the patient dose. The staff to patient absorbed dose equivalent ratio could be used as a quantitative parameter for describing ALARA law in radiation protection and

  12. Investigation on radiation doses to patients in digital radiography

    International Nuclear Information System (INIS)

    Qiu Zhengshuai; Deng Daping; Li Quantai; Song Gang; Su Xu

    2014-01-01

    Objective: To investigate the patients' radiation dose received in digital radiography(DR) and provide basic data for developing diagnostic reference levels. Methods: The patient's ESD was estimated using the TLDs and DAP was measured by the dose-area product meter. The E values were then calculated by the DAP using Monte Carlo data and RefDose software. Measurements were made for twelve types of examination: skull PA, skull LAT, chest PA, chest LAT, abdomen AP, pelvis AP, cervix spine PA, cervix spine LAT, thoracic spine PA, thoracic spine LAT, lumber spine PA and lumber spine LAT. Results: Both kV and mAs varied in the same type of examination for ESD, DAP and E(F = 33.47, 24.68, 43.19, P < 0.05). The dose each time for lumber spine LAT was the highest, reached 4.62 mGy in ESD and 2.26 Gy·cm 2 in DAP, respectively. The E of abdomen AP averaged as 0.59 mSv, higher than that of lumber spine LAT. Even for the same type of examination, the dose from each equipment was different. Conclusions: DR has the potential to reduce the patients' radiation doses. The guidance levels suitable for Chinese population should be established as soon as possible. (authors)

  13. Dose survey of pediatric and adult patients in Sudan

    International Nuclear Information System (INIS)

    Mohamadain, K.E.M.; Azevedo, A.C.P.; And others

    2006-01-01

    A survey of radiation doses to children and adults from diagnostic radiography has been carried out in seven hospitals in Sudan. In four hospitals only pediatric examinations were died. In two hospitals only adult patients were recorded and in one hospital both kinds of patients (pediatric and adults) were evaluated. For pediatric patients only chest x-ray examination was evaluated and children were divided according to age ranges: from (0-1) and 5) years for chest AP only and from (5-10) and (10-15) for chest PA. For adult patients the examinations were chest AP and PA, abdomen AP and skull AP and PA. Entrance Surface Dose SD) and the Effective Dose (E) were calculated using the Dose Cal software. The mean ESD r children, measured in p.Gy, ranged from (45-53) and (53-56) for (0-1) and (1-5) years, respectively and from (55-71) and (68-85) for (5-10) and (10-15) years, respectively. In two of le pediatric hospitals the mean ESD values were greater than the CEC Reference Dose Levels. In El bulk and Si nar hospitals the values ranged from 167-261 and 186-308 μGy for the age ranges (0-1) and (1-5) respectively and 167-194 and 279-312 μGy for the age ranges of (5-10) and (10-15) respectively. For adult patients the ESD and E dose values evaluated in Alfisal hospital presented values comparable with the CEC Reference Dose Level. However for Alshorta hospital the values were higher for the chest AP and PA with results for ESD 0.446 and 0.551 mGy respectively

  14. Post-closure radiation dose assessment for Yucca Mountain repository

    International Nuclear Information System (INIS)

    Jia Mingyan; Zhang Xiabin; Yang Chuncai

    2006-01-01

    A brief introduction of post-closure long-term radiation safety assessment results was represented for the yucca mountain high-level waste geographic disposal repository. In 1 million years after repository closure, for the higher temperature repository operating mode, the peak annual dose would be 150 millirem (120 millirem under the lower-temperature operating mode) to a reasonably maximally exposed individual approximately 18 kilometers (11 miles) from the repository. The analysis of a drilling intrusion event occurring at 30,000 years indicated a peak of the mean annual dose to the reasonably maximally exposed individual approximately 18 kilometers (11 miles) downstream of the repository would be 0.002 millirem. The analysis of an igneous activity scenario, including a volcanic eruption event and igneous intrusion event indicated a peak of the mean annual dose to the reasonably maximally exposed individual approximately 18 kilometers downstream of the repository would be 0.1 millirem. (authors)

  15. Assessment of cosmic radiation doses received by air crew

    International Nuclear Information System (INIS)

    McAulay, I.R.

    1998-01-01

    Cosmic radiation in the atmosphere is such a complex mixture of radiation type that it is difficult to get a single instrument which is suitable for such measurements. Passive devices such as film badges and track etch detectors have also been used, but again present difficulties of interpretation and requirements of multiple devices to accommodate the different types of radiation encountered. In summary, air crew are the occupational group most highly exposed to radiation. The radiation doses experienced by them are sufficiently high as to require assessment on a regular basis and possible control by appropriate rostering. There appears little possibility of the dose limit for workers being exceeded, except possibly in the case of pregnant female crew. This category of air crew should be the subject of special controls aimed at ensuring that the dose limits for the foetus should not be exceeded

  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. Radioiodine (I-131) treatment for uncomplicated hyperthyroidism: An assessment of optimal dose and cost-effectiveness

    International Nuclear Information System (INIS)

    Paul, A.K.; Rahman, H.A.; Jahan, N.

    2002-01-01

    Aim: Radioiodine (I-131) is increasingly being considered for the treatment of hyperthyroidism but there is no general agreement for the initial dose. To determine the cost-effectiveness and optimal dose of I-131 to cure disease, we prospectively studied the outcome of radioiodine therapy of 423 patients. Material and Methods: Any of the fixed doses of 6, 8, 10, 12 or 15 mCi of I-131 was administered to the patients relating to thyroid gland size. The individual was excluded from this study who had multinodular goitre and autonomous toxic nodule. Patients were classified as cured if the clinical and biochemical status was either euthyroid or hypothyroid at one year without further treatment by antithyroid drugs or radioiodine. The costs were assessed by analyzing the total cost of care including office visit, laboratory testing, radioiodine treatment, average conveyance and income loss of patient and attendant and thyroxine replacement for a period of 2 years from the day of I-131 administration. Results: The results showed a progressive increase of cure rate from the doses of 6, 8 and 10 mCi by 67%, 76.5% and 85.7% respectively but the cure rate for the doses of 12 and 15 mCi was 87.9% and 88.8% respectively. Cure was directly related to the dose between 6 and 10 mCi but at higher doses the cure rate was increased marginally at the expense of increased total body radiation. There was little variation in total costs, but was higher for low dose-therapy and the cost proportion between the 6 mCi regimen and 10 mCi regimen was 1.04:1. Conclusion: We could conclude that an initial 10 mCi of I-131 may be the optimal dose for curing hyperthyroidism and will also limit the total costs

  18. Pan-oral dose assessment: a comparative report of methodologies

    International Nuclear Information System (INIS)

    Shafford, J.; Pryor, M.; Hollaway, P.; Peet, D.; Oduko, J.

    2015-01-01

    National guidance from the Institute of Physics and Engineering in Medicine (IPEM Report 91) currently recommends that the patient dose for a pan-oral X-ray unit is measured as dose area product (DAP) replacing dose width product described in earlier guidance. An investigation identifying different methods available to carry out this measurement has been undertaken and errors in the methodologies analysed. It has been shown that there may be up to a 30 % variation in DAP measurement between methods. This paper recommends that where possible a DAP meter is used to measure the dose-area product from a pan-oral X-ray unit to give a direct DAP measurement. However, by using a solid-state dose measurement and film/ruler to calculate DAP the authors have established a conversion factor of 1.4. It is strongly recommended that wherever a DAP value is quoted the methodology used to obtain that value is also reported. (authors)

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

    International Nuclear Information System (INIS)

    Takahashi, Fumiaki; Shigemori, Yuji; Seki, Akiyuki

    2009-07-01

    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

  20. Evaluation of patient dose in some mammography centres in Iran

    International Nuclear Information System (INIS)

    Paknyat, A.; Samarin, E. R. P.; Jeshvaghane, N. A.; Paydar, R.; Fasaei, B.; Karamloo, A.; Khosravi, H. R.; Deevband, M. R.

    2011-01-01

    High diagnostic sensitivity and specificity while maintaining the least dose to the patient is the ideal mammography. The objective of this work was to evaluate patient dose and image quality of mammograms to propose corrective actions. The image quality for 1242 patient in 7 mammography facilities in Tehran city was evaluated based on selected image quality criteria using a three-point scale. Clinical image quality, the entrance surface air kerma, the average glandular dose and optical density of films for standard PMMA phantom of 4.5 cm thickness were evaluated. The results showed that up to 72 % of mammograms were in good condition to be diagnosed, and only about 3.4 % of the images were unacceptable or with suboptimal quality. The entrance surface air kerma values were in the range of 3.8-10.5 mGy, average glandular dose 0.5-1.8 mGy and optical density of films 0.74-2.03. The image quality evaluation after correction actions, periodic image quality evaluation and using the correct equipment certainly will improve patient dose. (authors)

  1. Dose-area product measurement for patients in diagnostic radiography

    International Nuclear Information System (INIS)

    Alkhawad, Safaa Ibrahim Awad Elkarim

    2001-09-01

    There is a wide spread of the utilization of medical diagnostic x-ray in Sudan upon the last years, in private clinics as well as in public hospitals. The aim of this study was to measure the doses to patients from x-ray in radiography departments in Khartoum State. Use was made of ionization chamber that measures the product of dose times the exposed area of the patient in units of Gy cm 2 . The work was performed in 7 hospitals over 250 patients. 71.2% of the patients were males and 28.8% females. From this work, it appears that the chest radiography represent 42% of the total exposure of human body organs to radiography, there was also a clear variation in doses resulting from this exposure for different x-ray machines. The results of this study were compared with similar from Germany, Finland, New Zealand and Norway; which are recently available studies. The comparison showed those investigation of abdomen, spine and pelvis result in higher radiation doses. No data for limb exposure were obtained from these countries, in Sudan exposure of the limb carry radiation doses compared to the rest of the human body.(Author)

  2. Radiation dose to procedural personnel and patients from an X-ray volume imaging system

    International Nuclear Information System (INIS)

    Paul, Jijo; Mbalisike, Emmanuel C.; Vogl, Thomas J.

    2013-01-01

    To evaluate the radiation dose received by procedural personnel and patients from an X-ray volume imaging (XVI) system during interventional procedures. Forty patients were examined using catheter angiography (group A), digital subtraction angiography (group B) and cone-beam CT (CBCT, group C). Doses to procedural personnel (using thermo-luminescent dosimeters, TLDs) and patients were estimated. Image quality and lesion delineation were assessed using objective and subjective methods. Shapiro-Wilk, two-sided Student's t and Wilcoxon matched-pairs tests were used to test statistical significance. Doses (milligrays) measured in the hands and left knee of the interventionist were higher than those in an assistant physician (P < 0.05). Doses (dose-area product and skin entry dose) were lower in group A and higher in C compared with other groups; moreover, comparison among the groups were significant (all P = 0.0001). Subjective and objective lesion delineation showed significant results (all P < 0.05) among the tumour types considered. Image quality estimation showed the opposite results for objective and subjective analysis. More doses were obtained for hands of the procedural personnel compared to other anatomical regions measured. Catheter angiography showed lower dose compared with other imaging groups examined. Lesion delineation was clearly possible using CBCT. Objective and subjective analysis showed the opposite results regarding image quality because of higher noise levels and artefacts. (orig.)

  3. Inter-patient image registration algorithms to disentangle regional dose bioeffects.

    Science.gov (United States)

    Monti, Serena; Pacelli, Roberto; Cella, Laura; Palma, Giuseppe

    2018-03-20

    Radiation therapy (RT) technological advances call for a comprehensive reconsideration of the definition of dose features leading to radiation induced morbidity (RIM). In this context, the voxel-based approach (VBA) to dose distribution analysis in RT offers a radically new philosophy to evaluate local dose response patterns, as an alternative to dose-volume-histograms for identifying dose sensitive regions of normal tissue. The VBA relies on mapping patient dose distributions into a single reference case anatomy which serves as anchor for local dosimetric evaluations. The inter-patient elastic image registrations (EIRs) of the planning CTs provide the deformation fields necessary for the actual warp of dose distributions. In this study we assessed the impact of EIR on the VBA results in thoracic patients by identifying two state-of-the-art EIR algorithms (Demons and B-Spline). Our analysis demonstrated that both the EIR algorithms may be successfully used to highlight subregions with dose differences associated with RIM that substantially overlap. Furthermore, the inclusion for the first time of covariates within a dosimetric statistical model that faces the multiple comparison problem expands the potential of VBA, thus paving the way to a reliable voxel-based analysis of RIM in datasets with strong correlation of the outcome with non-dosimetric variables.

  4. Methods of assessing total doses integrated across pathways

    International Nuclear Information System (INIS)

    Grzechnik, M.; Camplin, W.; Clyne, F.; Allott, R.; Webbe-Wood, D.

    2006-01-01

    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

  5. Reference doses and patient size in paediatric radiology

    International Nuclear Information System (INIS)

    Hart, D.; Wall, B.; Shrimpton, P.

    2000-01-01

    There is a wide range in patient size from a newborn baby to a 15 year old adolescent. Reference doses for paediatric radiology can sensibly be established only for specific sizes of children. Here five standard sizes have been chosen, representing 0 (newborn), 1, 5, 10 and 15 year old patients. This selection of standard ages has the advantage of matching the paediatric mathematical phantoms which are often used in Monte Carlo organ dose calculations. A method has been developed for calculating factors for normalising doses measured on individual children to those for the nearest standard-sized 'child'. These normalisation factors for entrance surface dose (ESD) and dose-area product (DAP) measurements depend on the thickness of the real child, the thickness of the nearest standard 'child', and an effective linear attenuation coefficient (μ) which is itself a function of the x-ray spectrum, the field size, and whether or not an antiscatter grid is used. Entrance and exit dose measurements were made with phantom material representing soft tissue to establish μ values for abdominal and head examinations, and with phantom material representing lung for chest examinations. These measurements of μ were confirmed and extended to other x-ray spectra and field sizes by Monte Carlo calculations. The normalisation factors are tabulated for ESD measurements for specific radiographic projections through the head and trunk, and for DAP measurements for complete multiprojection examinations in the trunk. The normalisation factors were applied to European survey data for entrance surface dose and dose-area product measurements to derive provisional reference doses for common radiographic projections and for micturating cystourethrography (MCU) examinations - the most frequent fluoroscopic examination on children. (author)

  6. SU-E-T-04: 3D Dose Based Patient Compensator QA Procedure for Proton Radiotherapy

    International Nuclear Information System (INIS)

    Zou, W; Reyhan, M; Zhang, M; Davis, R; Jabbour, S; Khan, A; Yue, N

    2015-01-01

    Purpose: In proton double-scattering radiotherapy, compensators are the essential patient specific devices to contour the distal dose distribution to the tumor target. Traditional compensator QA is limited to checking the drilled surface profiles against the plan. In our work, a compensator QA process was established that assess the entire compensator including its internal structure for patient 3D dose verification. Methods: The fabricated patient compensators were CT scanned. Through mathematical image processing and geometric transformations, the CT images of the proton compensator were combined with the patient simulation CT images into a new series of CT images, in which the imaged compensator is placed at the planned location along the corresponding beam line. The new CT images were input into the Eclipse treatment planning system. The original plan was calculated to the combined CT image series without the plan compensator. The newly computed patient 3D dose from the combined patientcompensator images was verified against the original plan dose. Test plans include the compensators with defects intentionally created inside the fabricated compensators. Results: The calculated 3D dose with the combined compensator and patient CT images reflects the impact of the fabricated compensator to the patient. For the test cases in which no defects were created, the dose distributions were in agreement between our method and the corresponding original plans. For the compensator with the defects, the purposely changed material and a purposely created internal defect were successfully detected while not possible with just the traditional compensator profiles detection methods. Conclusion: We present here a 3D dose verification process to qualify the fabricated proton double-scattering compensator. Such compensator detection process assesses the patient 3D impact of the fabricated compensator surface profile as well as the compensator internal material and structure changes

  7. [Efficacy of low-dose tadalafil on ED assessed by Self-Esteem and Relationship Questionnaire].

    Science.gov (United States)

    Li, Jing-Ping; Li, Fei; Guo, Wen-Bin; Zhou, Qi-Zhao; Liu, Cun-Dong; Mao, Xiang-Ming; Tan, Wan-Long; Zheng, Shao-Bin

    2010-12-01

    To explore the effects of low-dose oral tadalafil on self-esteem, confidence and sexual relationship in ED patients. We treated 17 ED patients with oral tadalafil at the low dose of 5 mg once daily for 12 weeks, and used the paired t test to compare their scores on The Self-Esteem and Relationship Questionnaire (SEAR) and IIEF-5 and the results of nocturnal penile tumescence (NPT) obtained by nocturnal electrobioimpedance volumetric assessment (NEVA) before and after the medication. The scores on SEAR and IIEF-5 were significantly increased (P P Low-dose oral tadalafil once daily can significantly improve the self-esteem, confidence, sexual relationship satisfaction and NPT of ED patients.

  8. Sub-dissociative-dose intranasal ketamine for moderate to severe pain in adult emergency department patients.

    Science.gov (United States)

    Yeaman, Fiona; Meek, Robert; Egerton-Warburton, Diana; Rosengarten, Pamela; Graudins, Andis

    2014-06-01

    There are currently no studies assessing effectiveness of sub-dissociative intranasal (IN) ketamine as the initial analgesic for adult patients in the ED. The study aims to examine the effectiveness of sub-dissociative IN ketamine as a primary analgesic agent for adult patients in the ED. This is a prospective, observational study of adult ED patients presenting with severe pain (≥6 on 11-point scale at triage). IN ketamine dose was 0.7 mg/kg, with secondary dose of 0.5 mg/kg at 15 min if pain did not improve. After 6 months, initial dose was increased to 1.0 mg/kg with the same optional secondary dose. The primary outcomes are change in VAS rating at 30 min; percentage of patients reporting clinically significant reduction in VAS (≥20 mm) at 30 min; dose resulting in clinically significant pain reduction. Of the 72 patients available for analysis, median age was 34.5 years and 64% were men. Median initial VAS rating was 76 mm (interquartile range [IQR]: 65-82). Median total dose of IN ketamine for all patients was 0.98 mg/kg (IQR: 0.75-1.15, range: 0.59-1.57). Median reduction in VAS rating at 30 min was 24 mm (IQR: 2-45). Forty (56%, 95% CI: 44.0-66.7) reported VAS reduction ≥20 mm, these patients having had a total median ketamine dose of 0.94 mg/kg (IQR: 0.72-1.04). IN ketamine, at a dose of about 1 mg/kg, was an effective analgesic agent in 56% of study patients. The place of IN ketamine in analgesic guidelines for adults requires further investigation. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  9. Dose assessment activities in the Republic of the Marshall Islands.

    Science.gov (United States)

    Simon, S L; Graham, J C

    1996-10-01

    Dose assessments, both retrospective and prospective, comprise one important function of a radiological study commissioned by the Republic of the Marshall Islands (RMI) government in late 1989. Estimating past or future exposure requires the synthesis of information from historical data, results from a recently completed field monitoring program, laboratory measurements, and some experimental studies. Most of the activities in the RMI to date have emphasized a pragmatic rather than theoretical approach. In particular, most of the recent effort has been expended on conducting an independent radiological monitoring program to determine the degree of deposition and the geographical extent of weapons test fallout over the nation. Contamination levels on 70% of the land mass of the Marshall Islands were unknown prior to 1994. The environmental radioactivity data play an integral role in both retrospective and prospective assessments. One recent use of dose assessment has been to interpret environmental measurements of radioactivity into annual doses that might be expected at every atoll. A second use for dose assessment has been to determine compliance with a dose action level for the rehabilitation of Rongelap Island. Careful examination of exposure pathways relevant to the island lifestyle has been necessary to accommodate these purposes. Examples of specific issues studied include defining traditional island diets as well as current day variations, sources of drinking water, uses of tropical plants including those consumed for food and for medicinal purposes, the nature and microvariability of plutonium particles in the soil and unusual pathways of exposure, e.g., that which might be associated with cooking and washing outdoors and inadvertent soil ingestion. A study on the prevalence of thyroid disease is also being conducted and the geographic pattern of disease may be useful as a bioindicator of the geographic pattern of exposure to radioiodine. Finally, an

  10. Dose-stress synergism in cancer risk assessment

    International Nuclear Information System (INIS)

    Pop-Jordanova, N.; Pop-Jordanov, J.

    2001-01-01

    Our hypothesis is that the relatively low risk of cancer or leukaemia from depleted uranium, as predicted by the World Health Organization and the International Atomic Energy Agency, is a result of neglecting the synergism between physico-chemical agents and psychological stress agents (here shortly denoted as dose-stress synergism). We use the modified risk assessment model that comprises a psycho-somatic extension, originally developed by us for assessing the risks of energy sources. Our preliminary meta-analysis of animal and human studies on cancers confirmed the existence of stress effects, including the amplifying synergism. Consequently, the psychological stress can increase the probability of even small toxic chemical or ionizing radiation exposure to produce malignancy. Such dose-stress synergism might influence the health risks among military personnel and the residents in the highly stressful environment in the Balkans. Further investigation is needed to estimate the order of magnitude of these combined effects in particular circumstances. (Original)

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

    International Nuclear Information System (INIS)

    Clairand, I.; Bottollier, J.F.; Trompier, F.

    2003-01-01

    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)

  12. Biological dosimetry: chromosomal aberration analysis for dose assessment

    International Nuclear Information System (INIS)

    1986-01-01

    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

  13. Skin dose assessment in routine personnel beta/gamma dosimetry

    International Nuclear Information System (INIS)

    Christensen, P.

    1980-01-01

    Three alternative methods are outlined by which substantial improvements of the capabilities of existing routine monitoring systems for skin dose assessment can be obtained. The introduction of a supplementary skin dosemeter may be an attractive method for systems with badges that have a capability for an additional dosemeter already built-in. The two-side reading method has limited possibilities because of reduced accuracy for mixed radiation and technical difficulties in using it for TLD systems with planchet heating. The use of a boron diffused LiF layer for skin dose assessment seems to be most attractive method since the only modification needed here is replacement of a dosemeter. However the study of this method is so far only in a preliminary stage and further investigations are needed. (U.K.)

  14. Patient radiation doses in the most common interventional cardiology procedures in croatia: First results

    International Nuclear Information System (INIS)

    Brnic, Z.; Krpan, T.; Faj, D.; Kubelka, D.; Ramac, J. P.; Posedel, D.; Steiner, R.; Vidjak, V.; Brnic, V.; Viskovic, K.; Baraban, V.

    2010-01-01

    Apart from its benefits, the interventional cardiology (IC) is known to generate high radiation doses to patients and medical staff involved. The European Union Medical Exposures Directive 97/43/EURATOM strongly recommend patient dosimetry in interventional radiology, including IC. IC patient radiation doses in four representative IC rooms in Croatia were investigated. Setting reference levels for these procedures have difficulties due to the large difference in procedure complexity. Nevertheless, it is important that some guideline values are available as a benchmark to guide the operators during these potentially high-dose procedures. Local and national diagnostic reference levels (DRLs) were proposed as a guidance. A total of 138 diagnostic (coronary angiography, CA) and 151 therapeutic (PTCA, stenting) procedures were included. Patient irradiation was measured in terms of kerma-area product (KAP), fluoroscopy time (FT) and number of cine-frames (F). KAP was recorded using calibrated KAP-meters. DRLs of KAP, FT and F were calculated as third quartile values rounded up to the integer. Skin doses were assessed on a selected sample of high skin dose procedures, using radiochromic films, and peak skin doses (PSD) were presented. A relative large range of doses in IC was detected. National DRLs were proposed as follows: 32 Gy cm 2 , 6.6 min and 610 frames for CA and 72 Gy cm 2 , 19 min and 1270 frames for PTCA. PSD 2 Gy in 8% of selected patients. Measuring the patient doses in radiological procedures is required by law, but rarely implemented in Croatia. The doses recorded in the study are acceptable when compared with the literature, but optimisation is possible. The preliminary DRL values proposed may be used as a guideline for local departments, and should be a basis for radiation reduction measures and quality assurance programmes in IC in Croatia. (authors)

  15. Monitoring of doses to patients in interventional cardiology: first results from three Serbian hospitals

    International Nuclear Information System (INIS)

    Ciraj-Bjelac, Olivera; Arandjic, Danijela; Kosutic, Dushko

    2010-01-01

    The aim of this work is to assess level of radiation dose to patients in interventional cardiology procedures in three large Serbian hospitals and to investigate possibility for setting of trigger levels if dose quantities exceed certain levels. Three dedicated interventional cardiology laboratories were included in the survey. Information on annual workload was estimated based on number of coronary angiography (CA) procedures and percutaneous coronary interventions (PCI). Patients doses were assessed in terms of air kerma area product (PKA) and air kerma in international reference point (KIRP). Results were compared with internationally proposed Diagnostic Reference Levels (DRL) and similar surveys results. Average total annual number of procedures was 820, 1100 and 2500 in three hospitals, respectively, while total number of dose measurements was 337. All three centers reported PKA values higher than 100 Gy·cm 2 and even values above 200 Gy·cm 2 , corresponding to 42% and 16% of all measurements. Measured KIRP value higher than 5 Gy was reported in one center, indicating that skin doses associated possibility of skin injuries were observed. PKA mean hospital values for CA ranged from 33 to 78 Gy·cm 2 and for PCI from 73 to 113 Gy·cm 2 , while associated vales for KIRP were: 0.45-1.2 Gy and 1.1-1.8 Gy, respectively. Comparison of obtained results with international DRL indicated that significant number of procedures is not optimally performed as in some centers more than a half of patients receive doses above DRL. The presented results are valuable input for dose optimization strategies and increased awareness related to importance of dose management. With respect to high dose values, risk for stochastic effects and tissue reactions, dose management methods were proposed. (Author)

  16. Nurse dose: linking staffing variables to adverse patient outcomes.

    Science.gov (United States)

    Manojlovich, Milisa; Sidani, Souraya; Covell, Christine L; Antonakos, Cathy L

    2011-01-01

    Inconsistent findings in more than 100 studies have made it difficult to explain how variation in nurse staffing affects patient outcomes. Nurse dose, defined as the level of nurses required to provide patient care in hospital settings, draws on variables used in staffing studies to describe the influence of many staffing variables on outcomes. The aim of this study was to examine the construct validity of nurse dose by determining its association with methicillin-resistant Staphylococcus aureus (MRSA) infections and reported patient falls on a sample of inpatient adult acute care units. Staffing data came from 26 units in Ontario, Canada, and Michigan. Financial and human resource data were data sources for staffing variables. Sources of data for MRSA came from infection control departments. Incident reports were the data source for patient falls. Data analysis consisted of bivariate correlations and Poisson regression. Bivariate correlations revealed that nurse dose attributes (active ingredient and intensity) were associated significantly with both outcomes. Active ingredient (education, experience, skill mix) and intensity (full-time employees, registered nurse [RN]:patient ratio, RN hours per patient day) were significant predictors of MRSA. Coefficients for both attributes were negative and almost identical. Both attributes were significant predictors of reported patient falls, and coefficients were again negative, but coefficient sizes differed. By conceptualizing nurse and staffing variables (education, experience, skill mix, full-time employees, RN:patient ratio, RN hours per patient day) as attributes of nurse dose and by including these in the same analysis, it is possible to determine their relative influence on MRSA infections and reported patient falls.

  17. Doses to patients from dental radiology in France

    International Nuclear Information System (INIS)

    Benedittini, M.; Maccia, C.; Lefaure, C.; Fagnani, F.

    1989-01-01

    In France, a national study was undertaken to estimate both dental radiology practices (equipment and activity) and the associated population collective dose. This study was done in two steps: A nationwide survey was conducted on the practitioner categories involved in dental radiology, and dosimetric measurements were performed on patients and on an anthropomorphic phantom by using conventional dental x-ray machines and pantomographic units. A total of 27.5 x 10(6) films were estimated to have been performed in 1984; 6% of them were pantomographic and 94% were conventional. Most of the organ doses measured for one intra-oral film were lower than 1 mGy (100 mrad); pantomogram dose values were generally higher than intra-oral ones. The collective effective dose equivalent figure was 2,000 person-Sv (2 x 10(5) person rem) leading to a per head dose equivalent of 0.037 mSv (3.7 mrem). The study allowed authors to identify ways to reduce the patient dose in France (e.g., implementing the use of long cone devices and controlling darkroom practices)

  18. Assessment of dose measurement uncertainty using RisoScan

    International Nuclear Information System (INIS)

    Helt-Hansen, Jakob; Miller, Arne

    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%, 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

  19. 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......%, 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....

  20. Effective dose for patient in multimode panoramic radiography

    International Nuclear Information System (INIS)

    Yasaki, Shiro; Daibo, Motoji

    1999-01-01

    In recent years, multimode panoramic radiography has had various functions, such as the auto exposure function, auto focus function (auto function), TMJ radiography and tomogram radiography functions. The purpose of this study was to estimate the effective dose for patients in each mode of the new multimode panoramic radiography (J. MORITA MFG. CORP. Dental Panorama X-ray Apparatus: Veraview Scope X 600). The absorbed doses in important organs involved in the causation of stochastic effects were measured by a thermoluminescent dosimeter using RANDO phantom. The effective doses were calculated using modified tissue weighting factors recommended by the International Commission on Radiological Protection (ICRP) in 1999. The mean field size over skin in typical panoramic and tomographic examinations was about 3% and 0.4% of the total body surface area of 15000 cm 2 . Assuming that the incidence of skin cancer is proportional to the area of skin exposed to ionizing radiation, the tissue weighting factor of skin can be estimated to be about 0.0003 and 0.00004. The estimate in effective dose was lower (5.3 μSv) in the panoramic auto function mode (an average exposure condition of 69 kV 7 mA) than that (6.5-13.8 μSv) in the linear tomogram modes. Since the linear tomogram mode requires a scout view, such as standard panoramic radiography, the dose in the linear tomogram mode becomes higher than other modes. A percentage of gonad doses in effective doses was negligible. (author)

  1. Kilovoltage Imaging Doses in the Radiotherapy of Pediatric Cancer Patients

    Energy Technology Data Exchange (ETDEWEB)

    Deng Jun, E-mail: jun.deng@yale.edu [Department of Therapeutic Radiology, Yale University, New Haven, CT (United States); Chen Zhe; Roberts, Kenneth B.; Nath, Ravinder [Department of Therapeutic Radiology, Yale University, New Haven, CT (United States)

    2012-04-01

    Purpose: To investigate doses induced by kilovoltage cone-beam computed tomography (kVCBCT) to pediatric cancer patients undergoing radiotherapy, as well as strategies for dose reduction. Methods and Materials: An EGS4 Monte Carlo code was used to calculate three-dimensional dose deposition due to kVCBCT on 4 pediatric cancer patients. Absorbed doses to various organs were analyzed for both half-fan and full-fan modes. Clinical conditions, such as distance from organ at risk (OAR) to CBCT field border, kV peak energy, and testicular shielding, were studied. Results: The mean doses induced by one CBCT scan operated at 125 kV in half-fan mode to testes, liver, kidneys, femoral heads, spinal cord, brain, eyes, lens, and optical nerves were 2.9, 4.7, 7.7, 10.5, 8.8, 7.6, 7.7, 7.8, and 7.2 cGy, respectively. Increasing the distances from OARs to CBCT field border greatly reduced the doses to OARs, ranging from 33% reduction for spinal cord to 2300% reduction for testes. As photon beam energy increased from 60 to 125 kV, the dose increase due to kVCBCT ranged from 170% for lens to 460% for brain and spinal cord. A testicular shielding made of 1-cm cerrobend could reduce CBCT doses down to 31%, 51%, 68%, and 82%, respectively, for 60, 80, 100, and 125 kV when the testes lay within the CBCT field. Conclusions: Generally speaking, kVCBCT deposits much larger doses to critical structures in children than in adults, usually by a factor of 2 to 3. Increasing the distances from OARs to CBCT field border greatly reduces doses to OARs. Depending on OARs, kVCBCT-induced doses increase linearly or exponentially with photon beam energy. Testicular shielding works more efficiently at lower kV energies. On the basis of our study, it is essential to choose an appropriate scanning protocol when kVCBCT is applied to pediatric cancer patients routinely.

  2. Radiation doses to patients in computed tomography including a ready reckoner for dose estimation

    International Nuclear Information System (INIS)

    Szendroe, G.; Axelsson, B.; Leitz, W.

    1995-11-01

    The radiation burden from CT-examinations is still growing in most countries and has reached a considerable part of the total from medical diagnostic x-ray procedures. Efforts for avoiding excess radiation doses are therefore especially well motivated within this field. A survey of CT-examination techniques practised in Sweden showed that standard settings for the exposure variables are used for the vast majority of examinations. Virtually no adjustments to the patient's differences in anatomy have been performed - even for infants and children on average the same settings have been used. The adjustment of the exposure variables to the individual anatomy offers a large potential of dose savings. Amongst the imaging parameters, a change of the radiation dose will primarily influence the noise. As a starting point it is assumed that, irrespective of the patient's anatomy, the same level of noise can be accepted for a certain diagnostic task. To a large extent the noise level is determined by the number of photons that are registered in the detector. Hence, for different patient size and anatomy, the exposure should be adjusted so that the same transmitted photon fluence is achieved. An appendix with a ready reckoner for dose estimation for CT-scanners used in Sweden is attached. 7 refs, 5 figs, 8 tabs

  3. Low-dose multislice CT in febrile neutropenic patients

    International Nuclear Information System (INIS)

    Wendel, F.; Jenett, M.; Hahn, D.; Sandstede, J.; Geib, A.

    2005-01-01

    Purpose: to define the value of low-dose multislice CT in a clinical setting for early detection of pneumonia in neutropenic patients with fever of unknown origin. Materials and methods: thirty-five neutropenic patients suffering from fever of unknown origin with normal chest X-ray underwent unenhanced low-dose CT of the chest (120 kV, 10 eff. mAs, collimation 4 x 1 mm) using a multislice CT scanner. Axial und frontal slices with a thickness of 5 mm were calculated. If no pneumonia was found, standard antibiotics were given and a repeated examination was performed if fever continued. In case of pneumonia, antimycotic therapy was added and a follow-up CT was performed within one week. Regression or progression of pneumonia at follow-up served as evidence of pneumonia; lowering of fever within 48 h or inconspicuous follow-up CT was regarded as absence of pneumonia. Results: ten of 35 patients had pneumonic infiltration, which decreased or increased on follow-up CT in 3 and 6 patients, respectively. One patient revealed leucemic infiltration by bronchoalveolar lavage. Twenty-five of 35 patients had no evidence of pneumonia. Twenty of these patients were free of fever within 48 h under antibiotics; one patient died due to his basic illness. Out of 4 patients with persisting fever, 3 patients had no pneumonia on repeated examination; one patient showed disseminated micronodular infiltration. Frontal reconstructions helped to differentiate infiltration from atelectasis in 4 patients. Sensitivity and specificity for the detection of pneumonia at the first examination were 90% and 96%, negative predictive value was 96%. Conclusion: low-dose multislice CT should be performed in neutropenic patients having a fever of unknown origin and normal chest X-ray. (orig.)

  4. Optimization of Patient Doses in Interventional Radiology and Cardiology

    International Nuclear Information System (INIS)

    Nikodemova, D.; Boehm, K.

    2011-01-01

    Interventional radiology and cardiology belongs to the imaging modalities connected with significantly higher radiation exposure of patients and medical staff, compared to the exposure during other diagnostic procedures. The objective of this presentation is to promote typical technical parameters and parameters related to the radiation policy, used during the most frequent endovascular and cardiology procedures, as well as the monitoring of the exposure of patients. The presented study reports the results of collecting the data of monitoring doses received by 318 patients undergoing interventional examinations in 3 various departments of the Slovak National Institute of Cardiology and Vascular Diseases. There were 9 different endovascular and cardiology procedures reviewed. The reported patient's radiation exposures were established by using the KAP values, directly shown on the display of the X-ray equipment. From the measured KAP values the entrance surface doses were calculated. Equivalent doses have been measured on hands, legs and other parts of medical staff body, by using electronic dosimeters or thermoluminescent dosimeters. The presented results have covered a wide range of the measured fluoroscopy time values, different number of acquisitions used in various interventional procedures, various cumulated KAP values and also a wide range of the cumulated entrance surface doses. The occupational doses of the operators, followed during dose measurements on their left hands, covered the range from 0.1 μSv to 1513 μSv for one examination performed. The important contribution of the presented results to the radiation protection policy in the Slovak Republic is the mapping of the current situation of the radiation exposure of patients undergoing the chosen interventional examinations and the professional radiation exposure level of interventional operators, providing the most significant interventional procedures in the Slovak interventional hospitals. The

  5. An engagement factor for caregiver radiation dose assessment with radioiodine treatment

    International Nuclear Information System (INIS)

    Lee, Hyun Kuk; Hong, Seong Jong; Jeong, Kyu Hwan; Jung, Jae Won; Kim, Seong Min; Kang, Yun-Hee; Han, Man Seok

    2015-01-01

    This study aims to suggest ways to better manage thyroid cancer patients treated with high- and low-activity radioiodine ( 131 I) by assessing external radiation doses to family members and caregivers and the level of radiation in the surrounding environment. The radiation doses to caregivers of 33 inpatients (who were quarantined in the hospital for 2-3 d after treatment) and 31 outpatients who received radioiodine treatment after thyroidectomy were measured using passive thermoluminescence dosemeters. In this study, 33 inpatients were administered high-activity (100-200 mCi) 131 I, and 31 outpatients were administered low-activity (30 mCi) 131 I. The average doses to caregivers were measured at 0.61 mSv for outpatients and 0.16 mSv for inpatients. The total integrated dose of the recovery (recuperation) rooms where the patients stayed after release from hospital was measured to be 0.83 mSv for outpatients and 0.23 mSv for inpatients. To reflect the degree of engagement between the caregiver and the patient, considering the duration and distance between two during exposure, the authors used the engagement factor introduced by Jeong et al. (Estimation of external radiation dose to caregivers of patients treated with radioiodine after thyroidectomy. Health Phys 2014;106:466-474.). This study presents a new engagement factor (K-value) of 0.82 obtained from the radiation doses to caregivers of both in- and out-patients treated with high- and low-activity radioiodine, and based on this new value, this study presented a new predicted dose for caregivers. A patient treated with high-activity radioiodine can be released after 24 h of isolation, whereas outpatients treated with low-activity radioiodine should be isolated for at least 12 h. (authors)

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

    International Nuclear Information System (INIS)

    Jannik, G. T.; Dixon, K. L.

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-09-01

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

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

    International Nuclear Information System (INIS)

    Scott, C.K.; Kennedy, E.R.; Hughs, R.

    1991-05-01

    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

  9. Assessment and recording of radiation doses to workers

    International Nuclear Information System (INIS)

    1986-01-01

    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

  10. Patient radiation exposure and dose tracking: a perspective.

    Science.gov (United States)

    Rehani, Madan M

    2017-07-01

    Much of the emphasis on radiation protection about 2 decades ago accrued from the need for protection of radiation workers and collective doses to populations from medical exposures. With the realization that individual patient doses were rising and becoming an issue, the author had propagated the concept of a smart card for radiation exposure history of individual patients. During the last 7 years, much has happened wherein radiation exposure and the dose history of individual patients has become a reality in many countries. In addition to dealing with overarching questions, such as "Why track, what to track, and how to track?," this review elaborates on a number of points such as attitudes toward tracking, review of practices in large parts of the world, description of various elements for exposure and dose tracking, how to use the information available from tracking, achievements and stumbling blocks in implementation to date, templates for implementation of tracking at different levels of health care, the role of picture archiving and communication systems and eHealth, the role of tracking in justification and optimization of protection, comments on cumulative dose, how referrers can use this information, current provisions in international standards, and future actions.

  11. Survey on patient doses in cardiology in Latin America. Criteria for high skin doses follow up

    International Nuclear Information System (INIS)

    Duran, Ariel; Duro, Ivanna; Lopez, Leonardo; Ramirez, Alfredo; Herrera, Carlos; Navarro, Joaquin; Rivarola, Carlos; Lopez, Jose A.

    2008-01-01

    Full text: As part of the International Action Plan for Protection of Patients and supporting by the IAEA, a survey on patient doses in fluoroscopy guided procedures in cardiology in Latin America has been conducted since 2006. One of the objectives of the survey was to set criteria for the identification and evaluation of high skin doses in a certain number of patients to recommend a clinical follow up for potential radiation injuries (more than 3 Gy at the skin). The used methodology for the survey was initiated with two dedicated workshops held in Santiago de Chile (2005) and San Jose de Costa Rica (2007) involving relevant cardiologists from 15 different Latin American Countries. Some sessions were also attended by experts from the Regulatory and Health Authorities. Standardized forms to collect demographic and patient dosimetric data were agreed. Considering that most of the involved centres had still not dosimeters installed in the cardiology x-ray systems, it was agreed to collect data on fluoroscopy time and total number of cine frames per procedure. Relevant factors influencing radio sensitivity of the skin were also collected. Data from 10 countries representing a sample of 709 patients were received during the first year. Procedures included were diagnostic (DG) (coronary angiography and electrophysiology studies), therapeutic (TH) (percutaneous transluminal coronary angioplasties, cardiac ablations and valvuloplasties) or including both DG and TH. A total of 26 patients (3.7%) were selected for potential high skin doses. Initial considered criteria for selection were more than 30 minutes of fluoroscopy, more than 3,000 cine frames per procedure or patients with more than 100 kg of weight. Maximum reported values were 72 minutes and 8,100 frames. In addition, 5 of these patients were diabetic, 6 have previous fluoroscopy procedures and 5 were over 95 kg. The percentage of selected cases for clinical follow up derived from potential skin injuries seem

  12. Radiation Dose Estimation for Pediatric Patients Undergoing Cardiac Catheterization

    Science.gov (United States)

    Wang, Chu

    Patients undergoing cardiac catheterization are potentially at risk of radiation-induced health effects from the interventional fluoroscopic X-ray imaging used throughout the clinical procedure. The amount of radiation exposure is highly dependent on the complexity of the procedure and the level of optimization in imaging parameters applied by the clinician. For cardiac catheterization, patient radiation dosimetry, for key organs as well as whole-body effective, is challenging due to the lack of fixed imaging protocols, unlike other common X-ray based imaging modalities. Pediatric patients are at a greater risk compared to adults due to their greater cellular radio-sensitivities as well as longer remaining life-expectancy following the radiation exposure. In terms of radiation dosimetry, they are often more challenging due to greater variation in body size, which often triggers a wider range of imaging parameters in modern imaging systems with automatic dose rate modulation. The overall objective of this dissertation was to develop a comprehensive method of radiation dose estimation for pediatric patients undergoing cardiac catheterization. In this dissertation, the research is divided into two main parts: the Physics Component and the Clinical Component. A proof-of-principle study focused on two patient age groups (Newborn and Five-year-old), one popular biplane imaging system, and the clinical practice of two pediatric cardiologists at one large academic medical center. The Physics Component includes experiments relevant to the physical measurement of patient organ dose using high-sensitivity MOSFET dosimeters placed in anthropomorphic pediatric phantoms. First, the three-dimensional angular dependence of MOSFET detectors in scatter medium under fluoroscopic irradiation was characterized. A custom-made spherical scatter phantom was used to measure response variations in three-dimensional angular orientations. The results were to be used as angular dependence

  13. Evaluation of patient radiation doses using DAP meter in interventional radiology procedures

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Byung Sam [Dept. of Radiological Technology. Shingu University, Sungnam (Korea, Republic of); Yoon, Yong Su [Dept. of Health Sciences, Graduate School of Medical Sciences, Kyushu Univeristy, Kyushu (Japan)

    2017-03-15

    The author investigated interventional radiology patient doses in several other countries, assessed accuracy of DAP meters embedded in intervention equipment in domestic country, conducted measurement of patient doses for 13 major interventional procedures with use of Dose Area Product(DAP) meters from 23 hospitals in Korea, and referred to 8,415 cases of domestic data related to interventional procedures by radiation exposure after evaluation the actual effective of dose reduction variables through phantom test. Finally, dose reference level for major interventional procedures was suggested. In this study, guidelines for patient doses were 237.7 Gy·cm{sup 2} in TACE, 17.3 Gy·cm{sup 2} in AVF, 114.1 Gy·cm{sup 2} in LE PTA and STENT, 188.5 Gy·cm{sup 2} in TFCA, 383.5 Gy·cm{sup 2} in Aneurysm Coil, 64.6 Gy·cm{sup 2} in PTBD, 64.6 Gy·cm{sup 2} in Biliary Stent, 22.4 Gy·cm{sup 2} in PCN, 4.3 Gy·cm{sup 2} in Hickman, 2.8 Gy·cm{sup 2} in Chemo-port, 4.4 Gy·cm{sup 2} in Perm-Cather, 17.1 Gy·cm{sup 2} in PCD, and 357.9 Gy·cm{sup 2} in Vis, EMB. Dose reference level acquired in this study is considered to be able to use as minimal guidelines for reducing patient dose in the interventional radiology procedures. For the changes and advances of materials and development of equipment and procedures in the interventional radiology procedures, further studies and monitoring are needed on dose reference level Korean DAP dose conversion factor for the domestic procedures.

  14. Trends in x-ray photography and patient exposure dose

    International Nuclear Information System (INIS)

    Orito, Takeo; Sanada, Shigeru; Maekawa, Ryuichi; Koshida, Kichiro; Hiraki, Tatsunosuke

    1980-01-01

    The exposure doses of patients in X-ray photography are influenced by such technological factors as X-ray tube voltage, filter, sensitizing screen, film and grid. Survey by questionnnaire was made previously in 1973 on the above factors. The trends five years after were surveyed similarly, in connection with the exposure doses of patients. Questionnaires were sent to 200 radiation technicians, and 121 (60.5%) answered the survey in March, 1979. The results in the cases of simple X-ray photography and obstetric, infant and breast X-ray photographings are described. X-ray tube voltage is generally on the increase. In the sensitizing screens, exposure doses are fairly decreased due to the use of improved intensifying screen (LT-II). In the grid, the ratio 8 : 1 is used more than 5 : 1. In the usage of additional filters and in the distance of photography, improvements are desired. (J.P.N.)

  15. Vitamin D supplementation in nursing home patients: randomized controlled trial of standard daily dose versus individualized loading dose regimen.

    Science.gov (United States)

    Wijnen, Hugo; Salemink, Dayenne; Roovers, Lian; Taekema, Diana; de Boer, Hans

    2015-05-01

    Supplementation of cholecalciferol 800 IU daily appears to be insufficient to raise vitamin D levels to >75 nmol/l in nursing home (NH) patients. Our objective was to compare the efficacy of an individualized cholecalciferol loading dose (LD) regimen and a daily dose (DD) regimen of cholecalciferol 800 IU in reaching 25-OH vitamin D (25OHD) levels >75 nmol/l. A total of 30 NH patients with 25OHD levels 50 nmol/l were included. Patients were randomized using the minimization method in the LD or DD group. The cholecalciferol LD, calculated with an algorithm based on serum 25OHD level and body weight, was administered in divided doses of 50,000 IU twice a week, followed by a monthly maintenance dose of either 50,000 or 25,000 IU. The DD regimen consisted of cholecalciferol 800 IU daily for 26 weeks. Serum 25OHD, calcium, creatinine, phosphate, and parathyroid hormone were measured, and 2-minute walking test, handgrip strength, and timed get up and go test were assessed at baseline (T 0), after 5 weeks (T 5), 12 weeks (T 12), and 26 weeks (T 26). The primary endpoint was the percentage of patients with 25OHD levels >75 nmol/l at T 5. Secondary endpoints were the proportion of patients with 25OHD levels >75 nmol/l at T 26, safety of LD regimen, and improvement of performance tests with normalization of vitamin D levels. Median baseline 25OHD levels (interquartile range) were comparable between the 14 DD and 16 LD patients: 20.9 (15.9-29.6) and 21.7 (16.4-32.8) nmol/l, respectively. Levels of 25OHD >75 nmol/l at T 5 were reached in 79 % of the 14 LD patients, but in none of the 13 DD patients (p 75 nmol/l were reached in 83 % of the 12 LD patients and in 30 % of the ten DD patients (p tests was observed. In NH patients with severe 25OHD deficiency, an individualized calculated cholecalciferol LD is likely to be superior to a DD of cholecalciferol 800 IU in terms of the ability to rapidly normalize vitamin D levels.

  16. A real time dose monitoring and dose reconstruction tool for patient specific VMAT QA and delivery

    International Nuclear Information System (INIS)

    Tyagi, Neelam; Yang Kai; Gersten, David; Yan Di

    2012-01-01

    Purpose: To develop a real time dose monitoring and dose reconstruction tool to identify and quantify sources of errors during patient specific volumetric modulated arc therapy (VMAT) delivery and quality assurance. Methods: The authors develop a VMAT delivery monitor tool called linac data monitor that connects to the linac in clinical mode and records, displays, and compares real time machine parameters with the planned parameters. A new measure, called integral error, keeps a running total of leaf overshoot and undershoot errors in each leaf pair, multiplied by leaf width, and the amount of time during which the error exists in monitor unit delivery. Another tool reconstructs Pinnacle 3 ™ format delivered plan based on the saved machine logfile and recalculates actual delivered dose in patient anatomy. Delivery characteristics of various standard fractionation and stereotactic body radiation therapy (SBRT) VMAT plans delivered on Elekta Axesse and Synergy linacs were quantified. Results: The MLC and gantry errors for all the treatment sites were 0.00 ± 0.59 mm and 0.05 ± 0.31°, indicating a good MLC gain calibration. Standard fractionation plans had a larger gantry error than SBRT plans due to frequent dose rate changes. On average, the MLC errors were negligible but larger errors of up to 6 mm and 2.5° were seen when dose rate varied frequently. Large gantry errors occurred during the acceleration and deceleration process, and correlated well with MLC errors (r= 0.858, p= 0.0004). PTV mean, minimum, and maximum dose discrepancies were 0.87 ± 0.21%, 0.99 ± 0.59%, and 1.18 ± 0.52%, respectively. The organs at risk (OAR) doses were within 2.5%, except some OARs that showed up to 5.6% discrepancy in maximum dose. Real time displayed normalized total positive integral error (normalized to the total monitor units) correlated linearly with MLC (r= 0.9279, p < 0.001) and gantry errors (r= 0.742, p= 0.005). There is a strong correlation between total integral

  17. Average glandular dose in patients submitted to mammographic examinations

    International Nuclear Information System (INIS)

    Nogueira, M.S.; Silva, T.A. da; Oliveira, M. de; Joana, G.S.; Oliveira, A.L.K.

    2008-01-01

    Doses in mammography should be maintained as low as possible without reducing the high image quality needed to the early detection of the breast cancer. As the breast is composed of tissues with very soft composition and densities, it increases the difficulty to detect small changes in the normal anatomical structures that may be associated with breast cancer. To achieve the standards of resolution and contrast for mammography, the quality and intensity of the X-ray beam, the breast positioning and compression, the film screen system, and the film processing must be in optimal operational conditions. This study intended to evaluate the mean glandular dose of patients undergoing routine exams in one mammography unit. Patient image analyses were done by a radiologist doctor who took into account 10 evaluation criteria for each CC and MLO incidences. For estimating each patient glandular dose the radiographic technique parameters (kV and mAs) and the thickness of the compressed breast were recorded. European image quality criteria were adopted by the radiologist doctor to accept the image for diagnostic purpose. For breast densities of 50% adipose and 50% glandular tissues the incident air-kerma was measured and the glandular dose calculated considering the x-ray output during the exam. In the study of 50 patients the mean glandular dose varied from 0.90 to 3.27 mGy with a mean value of 1.98 mGy for CC incidences. For MLO incidences the mean glandular doses ranged from 0.97 to 3.98 mGy and a mean value of 2.60 mGy. (author)

  18. Patient caries risk assessment

    DEFF Research Database (Denmark)

    Twetman, Svante; Fontana, Margherita

    2009-01-01

    Risk assessment is an essential component in the decision-making process for the correct prevention and management of dental caries. Multiple risk factors and indicators have been proposed as targets in the assessment of risk of future disease, varying sometimes based on the age group at which...... they are targeted. Multiple reviews and systematic reviews are available in the literature on this topic. This chapter focusses primarily on results of reviews based on longitudinal studies required to establish the accuracy of caries risk assessment. These findings demonstrate that there is a strong body...... of evidence to support that caries experience is still, unfortunately, the single best predictor for future caries development. In young children, prediction models which include a variety of risk factors seem to increase the accuracy of the prediction, while the usefulness of additional risk factors...

  19. Dental radiographic units - radiation safety and patient doses

    International Nuclear Information System (INIS)

    Nagpal, J.S.; Varadharajan, Geetha

    2001-01-01

    Three models of dental radiographic machines have been examined for radiation safety. Using TL dosemeters, doses received by the patients at chest level and the gonads have been estimated. Care should be taken to shield gonads during dental radiographic examinations. (author)

  20. Proposal of a dosemeter for skin beta radiation dose assessment

    International Nuclear Information System (INIS)

    Rosa, L.A.R. da; Caldas, L.V.E.

    1987-08-01

    Beta radiation is, undoubtedly, less penetrating than X or gamma radiation. Thus, beta radiation sources external to the human body do not cause a significant irradiation of its deeper tissues. However, in some cases, they may contribute in a very important way to the irradiation of the lens of the eyes and, mainly, of the skin. Specially, the hands and finger tips may receive a high dose. In this work some relevant aspects of the individual monitoring in beta radiation fields are discussed and the importance of monitoring this kind of radiation in some activities where the skin absorbed dose may be a limiting factor is evidenced. The main characteristics of the thermoluminescent (TL) response of ultra-thin CaSO 4 : Dy detectors (UT-CaSO 4 : Dy) in the detection of this kind of radiation are also studied. The irradiation are performed with 90 Sr 90 Y, 204 TI and 147 Pm sources. The reproducibility, linearity, dependence on the absorbed dose rate, optical fading, energy and angular dependences of the detector TL responce are investigated. Transmission factors for different thicknesses of tissue equivalent material are obtained for the TL detectors using the three available beta sources. Based on the results obtained, a dosemeter for skin beta radiation absorbed dose assessment with an energy dependence better than 12% is proposed. (Author) [pt

  1. Patient dose with quality image under diagnostic reference levels

    International Nuclear Information System (INIS)

    Akula, Suresh Kumar; Singh, Gurvinder; Chougule, Arun

    2016-01-01

    Need to set Diagnostic Reference Level (DRL) for locations for all diagnostic procedures in local as compared to National. The review of DRL's should compare local with national or referenced averages and a note made of any significant variances to these averages and the justification for it. To survey and asses radiation doses to patient and reduce the redundancy in patient imaging to maintain DRLs

  2. Optimization of image quality and patient dose in mammography

    International Nuclear Information System (INIS)

    Shafqat Faaruq; Jaferi, R.A.; Nafeesa Nazlee

    2007-01-01

    Complete test of publication follows. Optimization of patient dose and image quality can be defined as to get the best image quality with minimum possible radiation dose to the patient by setting various parameters and modes of operation available in mammography machines. The optimization procedures were performed on two mammography units from M/S GE and Metaltronica, available at NORI, using standard mammographic accreditation phantom (Model: BR-156) and acrylic sheets of variable thicknesses. Quality assurance and quality control (QC) tests being the essential part of optimization. The QC tests as recommended by American College of Radiology, were first performed on both machines as well as X-ray film processor. In the second step, different affecting the image quality and radiation dose to patient, like film screen combination (FSC), phantom optical density (PD), kVp, mAs etc, were adjusted for various phantom thicknesses ranging from 3 cm to 6.5 cm in various modes of operation in the machines (semi-auto- and manual in GE, Auto-, semi-auto- and manual mode in Metaltronica). The image quality was studied for these optimized parameters on the basis of the number of test objects of the phantom visible in these images. Finally the linear relationship between mAs and skin entrance dose (mGy) was verified using ionization chamber with the phantom and the actual patients. Despite some practical limitations, the results of the quality assurance tests were within acceptable limits defined by ACR. The dose factor for GE was 68.0 y/mAs, while 76.0 mGy/mAs for Metaltronica at 25 kVp. Before the start of this study the only one mammography unit GE, was routinely used at NORI and normal mode of operation of this unit was semi-auto mode with fixed kVp independent of compressed breast thickness, but in this study it was concluded that selecting kVp according to beast thickness result in an appreciable dose reduction (4-5 times less) without any compromise in image quality. The

  3. Application of 80-kVp scan and raw data-based iterative reconstruction for reduced iodine load abdominal-pelvic CT in patients at risk of contrast-induced nephropathy referred for oncological assessment: effects on radiation dose, image quality and renal function.

    Science.gov (United States)

    Nagayama, Yasunori; Tanoue, Shota; Tsuji, Akinori; Urata, Joji; Furusawa, Mitsuhiro; Oda, Seitaro; Nakaura, Takeshi; Utsunomiya, Daisuke; Yoshida, Eri; Yoshida, Morikatsu; Kidoh, Masafumi; Tateishi, Machiko; Yamashita, Yasuyuki

    2018-05-01

    To evaluate the image quality, radiation dose, and renal safety of contrast medium (CM)-reduced abdominal-pelvic CT combining 80-kVp and sinogram-affirmed iterative reconstruction (SAFIRE) in patients with renal dysfunction for oncological assessment. We included 45 patients with renal dysfunction (estimated glomerular filtration rate  60 ml per lmin per 1.73 m 2 ) who underwent standard oncological abdominal-pelvic CT (600 mgI kg -1 , 120-kVp, filtered-back projection) were included as controls. CT attenuation, image noise, and contrast-to-noise ratio (CNR) were compared. Two observers performed subjective image analysis on a 4-point scale. Size-specific dose estimate and renal function 1-3 months after CT were measured. The size-specific dose estimate and iodine load of 80-kVp protocol were 32 and 41%,, respectively, lower than of 120-kVp protocol (p 0.05). No significant kidney injury associated with CM administration was observed. 80-kVp abdominal-pelvic CT with SAFIRE yields diagnostic image quality in oncology patients with renal dysfunction under substantially reduced iodine and radiation dose without renal safety concerns. Advances in knowledge: Using 80-kVp and SAFIRE allows for 40% iodine load and 32% radiation dose reduction for abdominal-pelvic CT without compromising image quality and renal function in oncology patients at risk of contrast-induced nephropathy.

  4. Patient dose, gray level and exposure index with a computed radiography system

    Science.gov (United States)

    Silva, T. R.; Yoshimura, E. M.

    2014-02-01

    Computed radiography (CR) is gradually replacing conventional screen-film system in Brazil. To assess image quality, manufactures provide the calculation of an exposure index through the acquisition software of the CR system. The objective of this study is to verify if the CR image can be used as an evaluator of patient absorbed dose too, through a relationship between the entrance skin dose and the exposure index or the gray level values obtained in the image. The CR system used for this study (Agfa model 30-X with NX acquisition software) calculates an exposure index called Log of the Median (lgM), related to the absorbed dose to the IP. The lgM value depends on the average gray level (called Scan Average Level (SAL)) of the segmented pixel value histogram of the whole image. A Rando male phantom was used to simulate a human body (chest and head), and was irradiated with an X-ray equipment, using usual radiologic techniques for chest exams. Thermoluminescent dosimeters (LiF, TLD100) were used to evaluate entrance skin dose and exit dose. The results showed a logarithm relation between entrance dose and SAL in the image center, regardless of the beam filtration. The exposure index varies linearly with the entrance dose, but the angular coefficient is beam quality dependent. We conclude that, with an adequate calibration, the CR system can be used to evaluate the patient absorbed dose.

  5. Does IGRT ensure target dose coverage of head and neck IMRT patients?

    International Nuclear Information System (INIS)

    Graff, Pierre; Hu Weigang; Yom, Sue S.; Pouliot, Jean

    2012-01-01

    Purpose: To determine if image-guided radiotherapy (IGRT) ensures dose coverage to the target, and to assess the dosimetric impact of anatomic changes using megavoltage cone-beam CT (MVCBCT) for patient positioning during head and neck IMRT. Methods and materials: Forty-eight MVCBCT from 10 head and neck IMRT/IGRT patients were analyzed off-line. Target volumes and organs at risk (OARs) contours delineated on CT were transferred and adjusted on MVCBCT images. Each MVCBCT was processed to allow dose recalculation, resulting in 469 dose–volume histograms (DVHs). The concept of dosimetric latitude was introduced to provide a clinical perspective. Results: MVCBCT target DVHs showed a moderate level of difference in D95 (dose to ⩾95% of volume), generally less than a 5% difference from the planned dose. Delivered-dose increases to the spinal cord and brainstem showed no apparent time trend. The 4 mm margin around OARs was a useful precaution to prevent exceeding critical dose thresholds. The parotid glands showed progressive increases in mean dose related to shrinkage of the external contours. Conclusion: IGRT repositioning ensured target volume coverage, but significant dose variations were observed for OARs. The dosimetric impact of anatomic changes during radiotherapy was of lesser importance than the effects of IGRT repositioning.

  6. Evaluation of the 'dose of the day' for IMRT prostate cancer patients derived from portal dose measurements and cone-beam CT

    International Nuclear Information System (INIS)

    Zijtveld, Mathilda van; Dirkx, Maarten; Breuers, Marcel; Kuipers, Ruud; Heijmen, Ben

    2010-01-01

    treatment delivery, resulting in mean underdosages of 16% in the prostate volume. Conclusions: A method to accurately assess the 'dose of the day' was evaluated for prostate cancer patients treated with IMRT. To correct for observed dose deviations off-line dose-adaptive strategies will be developed.

  7. Oral sodium phenylbutyrate in patients with recurrent malignant gliomas: a dose escalation and pharmacologic study.

    Science.gov (United States)

    Phuphanich, Surasak; Baker, Sharyn D; Grossman, Stuart A; Carson, Kathryn A; Gilbert, Mark R; Fisher, Joy D; Carducci, Michael A

    2005-04-01

    We determined the maximum tolerated dose (MTD), toxicity profile, pharmacokinetic parameters, and preliminary efficacy data of oral sodium phenylbutyrate (PB) in patients with recurrent malignant gliomas. Twenty-three patients with supratentorial recurrent malignant gliomas were enrolled on this dose escalation trial. Four dose levels of PB were studied: 9, 18, 27, and 36 g/day. Data were collected to assess toxicity, response, survival, and pharmacokinetics. All PB doses of 9, 18, and 27 g/day were well tolerated. At 36 g/day, two of four patients developed dose-limiting grade 3 fatigue and somnolence. At the MTD of 27 g/day, one of seven patients developed reversible grade 3 somnolence. Median survival from time of study entry was 5.4 months. One patient had a complete response for five years, and no partial responses were noted, which yielded an overall response rate of 5%. Plasma concentrations of 706, 818, 1225, and 1605 muM were achieved with doses of 9, 18, 27, and 36 g/day, respectively. The mean value for PB clearance in this patient population was 22 liters/h, which is significantly higher than the 16 liters/h reported in patients with other malignancies who were not receiving P450 enzyme-inducing anticonvulsant drugs (P = 0.038). This study defines the MTD and recommended phase 2 dose of PB at 27 g/day for heavily pretreated patients with recurrent gliomas. The pharmacology of PB appears to be affected by concomitant administration of P450-inducing anticonvulsants.

  8. Oral sodium phenylbutyrate in patients with recurrent malignant gliomas: A dose escalation and pharmacologic study1

    Science.gov (United States)

    Phuphanich, Surasak; Baker, Sharyn D.; Grossman, Stuart A.; Carson, Kathryn A.; Gilbert, Mark R.; Fisher, Joy D.; Carducci, Michael A.

    2005-01-01

    We determined the maximum tolerated dose (MTD), toxicity profile, pharmacokinetic parameters, and preliminary efficacy data of oral sodium phenylbutyrate (PB) in patients with recurrent malignant gliomas. Twenty-three patients with supratentorial recurrent malignant gliomas were enrolled on this dose escalation trial. Four dose levels of PB were studied: 9, 18, 27, and 36 g/day. Data were collected to assess toxicity, response, survival, and pharmacokinetics. All PB doses of 9, 18, and 27 g/day were well tolerated. At 36 g/day, two of four patients developed dose-limiting grade 3 fatigue and somnolence. At the MTD of 27 g/day, one of seven patients developed reversible grade 3 somnolence. Median survival from time of study entry was 5.4 months. One patient had a complete response for five years, and no partial responses were noted, which yielded an overall response rate of 5%. Plasma concentrations of 706, 818, 1225, and 1605 μM were achieved with doses of 9, 18, 27, and 36 g/day, respectively. The mean value for PB clearance in this patient population was 22 liters/h, which is significantly higher than the 16 liters/h reported in patients with other malignancies who were not receiving P450 enzyme–inducing anticonvulsant drugs (P = 0.038). This study defines the MTD and recommended phase 2 dose of PB at 27 g/day for heavily pretreated patients with recurrent gliomas. The pharmacology of PB appears to be affected by concomitant administration of P450-inducing anticonvulsants. PMID:15831235

  9. VMAT QA: Measurement-guided 4D dose reconstruction on a patient

    Energy Technology Data Exchange (ETDEWEB)

    Nelms, Benjamin E.; Opp, Daniel; Robinson, Joshua; Wolf, Theresa K.; Zhang, Geoffrey; Moros, Eduardo; Feygelman, Vladimir [Canis Lupus LLC, Merrimac, Wisconsin 53561 (United States); Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida 33612 (United States); Department of Physics, University of South Florida, Tampa, Florida 33612 (United States); Live Oak Technologies LLC, Kirkwood, Missouri 63122 (United States); Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida 33612 (United States)

    2012-07-15

    Purpose: To develop and validate a volume-modulated arc therapy (VMAT) quality assurance (QA) tool that takes as input a time-resolved, low-density ({approx}10 mm) cylindrical surface dose map from a commercial helical diode array, and outputs a high density, volumetric, time-resolved dose matrix on an arbitrary patient dataset. This first validation study is limited to a homogeneous 'patient.'Methods: A VMAT treatment is delivered to a diode array phantom (ARCCHECK, Sun Nuclear Corp., Melbourne, FL). 3DVH software (Sun Nuclear) derives the high-density volumetric dose using measurement-guided dose reconstruction (MGDR). MGDR cylindrical phantom results are then used to perturb the three-dimensional (3D) treatment planning dose on the patient dataset, producing a semiempirical volumetric dose grid. Four-dimensional (4D) dose reconstruction on the patient is also possible by morphing individual sub-beam doses instead of the composite. For co