SU-E-T-371: Validation of Organ Doses Delivered During Craniospinal Irradiation with Helical Tomotherapy

Energy Technology Data Exchange (ETDEWEB)

Perez-Andujar, A; Chen, J; Garcia, A; Haas-Kogan, D [University of San Francisco, San Francisco, CA (United States)

2014-06-01

Purpose: New techniques have been developed to deliver more conformal treatments to the craniospinal axis. One concern, however, is the widespread low dose delivered and implications for possible late effects. The purpose of this work is for the first time to validate the organ doses calculated by the treatment planning system (TPS), including out-of-field doses for a pediatric craniospinal treatment (CSI). Methods: A CSI plan prescribed to 23.4 Gy and a posterior fossa boost plan to 30.6 Gy (total dose 54.0 Gy) was developed for a pediatric anthropomorphic phantom representing a 13 yearold- child. For the CSI plan, the planning target volumes (PTV) consisted of the brain and spinal cord with 2 mm and 5 mm expansions, respectively. Organs at risk (OAR) were contoured and included in the plan optimization. The plans were delivered on a helical tomotherapy unit. Thermoluminescent dosimeters (TLDs) were used to measure the dose at 54 positions within the PTV and OARs. Results: For the CSI treatment, the mean percent difference between TPS dose calculations and measurements was 5% for the PTV and 10% for the OARs. For the boost, the average was 3% for the PTV. The percent difference for the OARs, which lie outside the field and received a small fraction of the prescription dose, varied from 15% to 200%. However in terms of absolute dose, the average difference between measurement and TPS per treatment Gy was 2 cGy/Gy and 3 mGy/Gy for the CSI and boost plans, respectively. Conclusion: There was good agreement between doses calculated by the TPS and measurements for the CSI treatment. Higher percent differences were observed for out-of-field doses in the boost plan, but absolute dose differences were very small compared to the prescription dose. These findings can help in the estimation of late effects after radiotherapy for pediatric patients.

SU-E-T-357: Electronic Compensation Technique to Deliver Total Body Dose

Energy Technology Data Exchange (ETDEWEB)

Lakeman, T [State University of New York at Buffalo, Buffalo, NY (United States); Wang, I; Podgorsak, M [State University of New York at Buffalo, Buffalo, NY (United States); Roswell Park Cancer Institute, Buffalo, NY (United States)

2015-06-15

Purpose: Total body irradiation (TBI) uses large parallel-opposed radiation fields to suppress the patient’s immune system and eradicate the residual cancer cells in preparation of recipient for bone marrow transplant. The manual placement of lead compensators has conventionally been used to compensate for the varying thickness through the entire body in large-field TBI. The goal of this study is to pursue utilizing the modern electronic compensation technique to more accurately and efficiently deliver dose to patients in need of TBI. Methods: Treatment plans utilizing electronic compensation to deliver a total body dose were created retrospectively for patients for whom CT data had been previously acquired. Each treatment plan includes two, specifically weighted, pair of opposed fields. One pair of open, large fields (collimator=45°), to encompass the patient’s entire anatomy, and one pair of smaller fields (collimator=0°) focused only on the thicker midsection of the patient. The optimal fluence for each one of the smaller fields was calculated at a patient specific penetration depth. Irregular surface compensators provide a more uniform dose distribution within the smaller opposed fields. Results: Dose-volume histograms (DVH) were calculated for the evaluating the electronic compensation technique. In one case, the maximum body doses calculated from the DVH were reduced from the non-compensated 195.8% to 165.3% in the electronically compensated plans, indicating a more uniform dose with the region of electronic compensation. The mean body doses calculated from the DVH were also reduced from the non-compensated 120.6% to 112.7% in the electronically compensated plans, indicating a more accurate delivery of the prescription dose. All calculated monitor units were well within clinically acceptable limits. Conclusion: Electronic compensation technique for TBI will not substantially increase the beam on time while it can significantly reduce the compensator

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

Science.gov (United States)

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

2011-12-01

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

Influence of daily setup measurements and corrections on the estimated delivered dose during IMRT treatment of prostate cancer patients

International Nuclear Information System (INIS)

Haaren, Paul M.A. van; Bel, Arjan; Hofman, Pieter; Vulpen, Marco van; Kotte, Alexis N.T.J.; Heide, Uulke A. van der

2009-01-01

Purpose: To evaluate the impact of marker-based position verification, using daily imaging and an off-line correction protocol, by calculating the delivered dose to prostate, rectum and bladder. Methods: Prostate cancer patients (n = 217) were treated with IMRT, receiving 35 daily fractions. Plans with five beams were optimized taking target coverage (CTV, boost) and organs-at-risk (rectum and bladder) into account. PTV margins were 8 mm. Prostate position was verified daily using implanted fiducial gold markers by imaging the first segment of all the five beams on an EPID. Setup deviations were corrected off-line using an adapted shrinking-action-level protocol. The estimated delivered dose, including daily organ movements, was calculated using a version of PLATO's dose engine, enabling batch processing of large numbers of patients. The dose was calculated ± inclusion of setup corrections, and was evaluated relative to the original static plan. The marker-based measurements were considered representative for all organs. Results: Daily organ movements would result in an underdosage of 2-3 Gy to CTV and boost volume relative to the original plan, which was prevented by daily setup corrections. The dose to rectum and bladder was on average unchanged, but a large spread was introduced by organ movements, which was reduced by including setup corrections. Conclusions: Without position verification and setup corrections, margins of 8mm would be insufficient to account for position uncertainties during IMRT of prostate cancer. With the daily off-line correction protocol, the remaining variations are accommodated adequately

Reduction of patient dose delivered by CHR diagnostic x-ray examinations

International Nuclear Information System (INIS)

Evans, R.D.; Schlenker, R.A.

1978-01-01

Three changes in technique have been made which reduce the x-ray dose delivered by diagnostic examinations of patients of the Center for Human Radiobiology (CHR): Kodak Lanex Regular screens and Kodak Ortho G film have been substituted for DuPont Cronex Parspeed screens and DuPont Cronex 4 film for five projections in the MIT examinations; 3 mm Al added filtration is now used in place of 1 mm Al added filtration in the ANL examination; improvements in collimation for the ANL examination have been made. Use of the new screen-film combination at MIT has reduced the mean dose to the active marrow of the female RANDO phantom from 606 +- 69 mrad to 235 +- 16 mrad; it has reduced the ovary dose from 606 +- 40 mrad to 291 +- 19 mrad and has left the breast dose unchanged at 333 +- 103 mrad. The change from 1 mm Al to 3 mm Al added filtration at ANL, without changes in collimation, would reduce the mean marrow dose in the phantom from 232 +- 14 mrad to 175 +- 26 mrad, reduce the ovary dose from 243 +- 25 mrad to 162 +- 38 mrad and reduce the breast dose from 388 +- 35 mrad to 226 +- 9 mrad. The changes in collimation at ANL should reduce these doses even further but the quantitative effect has not been ascertained

A method for describing the doses delivered by transmission x-ray computed tomography

International Nuclear Information System (INIS)

Shope, T.B.; Gagne, R.M.; Johnson, G.C.

1981-01-01

A method for describing the absorbed dose delivered by x-ray transmission computed tomography (CT) is proposed which provides a means to characterize the dose resulting from CT procedures consisting of a series of adjacent scans. The dose descriptor chosen is the average dose at several locations in the imaged volume of the central scan of the series. It is shown that this average dose, as defined, for locations in the central scan of the series can be obtained from the integral of the dose profile perpendicular to the scan plane at these same locations for a single scan. This method for estimating the average dose from a CT procedure has been evaluated as a function of the number of scans in the multiple scan procedure and location in the dosimetry phantom using single scan dose profiles obtained from five different types of CT systems. For the higher dose regions in the phantoms, the multiple scan dose descriptor derived from the single scan dose profiles overestimates the multiple scan average dose by no more than 10%, provided the procedure consists of at least eight scans

SU-E-T-29: A Web Application for GPU-Based Monte Carlo IMRT/VMAT QA with Delivered Dose Verification

International Nuclear Information System (INIS)

Folkerts, M; Graves, Y; Tian, Z; Gu, X; Jia, X; Jiang, S

2014-01-01

Purpose: To enable an existing web application for GPU-based Monte Carlo (MC) 3D dosimetry quality assurance (QA) to compute “delivered dose” from linac logfile data. Methods: We added significant features to an IMRT/VMAT QA web application which is based on existing technologies (HTML5, Python, and Django). This tool interfaces with python, c-code libraries, and command line-based GPU applications to perform a MC-based IMRT/VMAT QA. The web app automates many complicated aspects of interfacing clinical DICOM and logfile data with cutting-edge GPU software to run a MC dose calculation. The resultant web app is powerful, easy to use, and is able to re-compute both plan dose (from DICOM data) and delivered dose (from logfile data). Both dynalog and trajectorylog file formats are supported. Users upload zipped DICOM RP, CT, and RD data and set the expected statistic uncertainty for the MC dose calculation. A 3D gamma index map, 3D dose distribution, gamma histogram, dosimetric statistics, and DVH curves are displayed to the user. Additional the user may upload the delivery logfile data from the linac to compute a 'delivered dose' calculation and corresponding gamma tests. A comprehensive PDF QA report summarizing the results can also be downloaded. Results: We successfully improved a web app for a GPU-based QA tool that consists of logfile parcing, fluence map generation, CT image processing, GPU based MC dose calculation, gamma index calculation, and DVH calculation. The result is an IMRT and VMAT QA tool that conducts an independent dose calculation for a given treatment plan and delivery log file. The system takes both DICOM data and logfile data to compute plan dose and delivered dose respectively. Conclusion: We sucessfully improved a GPU-based MC QA tool to allow for logfile dose calculation. The high efficiency and accessibility will greatly facilitate IMRT and VMAT QA

SU-E-T-29: A Web Application for GPU-Based Monte Carlo IMRT/VMAT QA with Delivered Dose Verification

Energy Technology Data Exchange (ETDEWEB)

Folkerts, M [The University of Texas Southwestern Medical Ctr, Dallas, TX (United States); University of California, San Diego, La Jolla, CA (United States); Graves, Y [University of California, San Diego, La Jolla, CA (United States); Tian, Z; Gu, X; Jia, X; Jiang, S [The University of Texas Southwestern Medical Ctr, Dallas, TX (United States)

2014-06-01

Purpose: To enable an existing web application for GPU-based Monte Carlo (MC) 3D dosimetry quality assurance (QA) to compute “delivered dose” from linac logfile data. Methods: We added significant features to an IMRT/VMAT QA web application which is based on existing technologies (HTML5, Python, and Django). This tool interfaces with python, c-code libraries, and command line-based GPU applications to perform a MC-based IMRT/VMAT QA. The web app automates many complicated aspects of interfacing clinical DICOM and logfile data with cutting-edge GPU software to run a MC dose calculation. The resultant web app is powerful, easy to use, and is able to re-compute both plan dose (from DICOM data) and delivered dose (from logfile data). Both dynalog and trajectorylog file formats are supported. Users upload zipped DICOM RP, CT, and RD data and set the expected statistic uncertainty for the MC dose calculation. A 3D gamma index map, 3D dose distribution, gamma histogram, dosimetric statistics, and DVH curves are displayed to the user. Additional the user may upload the delivery logfile data from the linac to compute a 'delivered dose' calculation and corresponding gamma tests. A comprehensive PDF QA report summarizing the results can also be downloaded. Results: We successfully improved a web app for a GPU-based QA tool that consists of logfile parcing, fluence map generation, CT image processing, GPU based MC dose calculation, gamma index calculation, and DVH calculation. The result is an IMRT and VMAT QA tool that conducts an independent dose calculation for a given treatment plan and delivery log file. The system takes both DICOM data and logfile data to compute plan dose and delivered dose respectively. Conclusion: We sucessfully improved a GPU-based MC QA tool to allow for logfile dose calculation. The high efficiency and accessibility will greatly facilitate IMRT and VMAT QA.

Daily variations in delivered doses in patients treated with radiotherapy for localized prostate cancer

International Nuclear Information System (INIS)

Kupelian, Patrick A.; Langen, Katja M.; Zeidan, Omar A.; Meeks, Sanford L.; Willoughby, Twyla R.; Wagner, Thomas H.; Jeswani, Sam; Ruchala, Kenneth J.; Haimerl, Jason; Olivera, Gustavo H.

2006-01-01

Purpose: The aim of this work was to study the variations in delivered doses to the prostate, rectum, and bladder during a full course of image-guided external beam radiotherapy. Methods and Materials: Ten patients with localized prostate cancer were treated with helical tomotherapy to 78 Gy at 2 Gy per fraction in 39 fractions. Daily target localization was performed using intraprostatic fiducials and daily megavoltage pelvic computed tomography (CT) scans, resulting in a total of 390 CT scans. The prostate, rectum, and bladder were manually contoured on each CT by a single physician. Daily dosimetric analysis was performed with dose recalculation. The study endpoints were D95 (dose to 95% of the prostate), rV2 (absolute rectal volume receiving 2 Gy), and bV2 (absolute bladder volume receiving 2 Gy). Results: For the entire cohort, the average D95 (±SD) was 2.02 ± 0.04 Gy (range, 1.79-2.20 Gy). The average rV2 (±SD) was 7.0 ± 8.1 cc (range, 0.1-67.3 cc). The average bV2 (±SD) was 8.7 ± 6.8 cc (range, 0.3-36.8 cc). Unlike doses for the prostate, there was significant daily variation in rectal and bladder doses, mostly because of variations in volume and shape of these organs. Conclusion: Large variations in delivered doses to the rectum and bladder can be documented with daily megavoltage CT scans. Image guidance for the targeting of the prostate, even with intraprostatic fiducials, does not take into account the variation in actual rectal and bladder doses. The clinical impact of techniques that take into account such dosimetric parameters in daily patient set-ups should be investigated

Quality assurance of the dose delivered by small radiation segments

International Nuclear Information System (INIS)

Hansen, Vebeke N.; Evans, Philip M.; Budgell, Geoffrey J.; Mott, Judith H.L.; Williams, Peter C.; Brugmans, Marco J.P.; Wittkaemper, Frits W.; Mijnheer, Ben J.; Brown, Kevin

1998-01-01

The use of intensity modulation with multiple static fields has been suggested by many authors as a way to achieve highly conformal fields in radiotherapy. However, quality assurance of linear accelerators is generally done only for beam segments of 100 MU or higher, and by measuring beam profiles once the beam has stabilized. We propose a set of measurements to check the stability of dose delivery in small segments, and present measured data from three radiotherapy centres. The dose delivered per monitor unit, MU, was measured for various numbers of MU segments. The field flatness and symmetry were measured using either photographic films that are subsequently scanned by a densitometer, or by using a diode array. We performed the set of measurements at the three radiotherapy centres on a set of five different Philips SL accelerators with energies of 6 MV, 8 MV, 10 MV and 18 MV. The dose per monitor unit over the range of 1 to 100 MU was found to be accurate to within ±5% of the nominal dose per monitor unit as defined for the delivery of 100 MU for all the energies. For four out of the five accelerators the dose per monitor unit over the same range was even found to be accurate to within ±2%. The flatness and symmetry were in some cases found to be larger for small segments by a maximum of 9% of the flatness/symmetry for large segments. The result of this study provides the dosimetric evidence that the delivery of small segment doses as top-up fields for beam intensity modulation is feasible. However, it should be stressed that linear accelerators have different characteristics for the delivery of small segments, hence this type of measurement should be performed for each machine before the delivery of small dose segments is approved. In some cases it may be advisable to use a low pulse repetition frequency (PRF) to obtain more accurate dose delivery of small segments. (author)

Reduction of Dose Delivered to Organs at Risk in Prostate Cancer Patients via Image-Guided Radiation Therapy

International Nuclear Information System (INIS)

Pawlowski, Jason M.; Yang, Eddy S.; Malcolm, Arnold W.; Coffey, Charles W.; Ding, George X.

2010-01-01

Purpose: To determine whether image guidance can improve the dose delivered to target organs and organs at risk (OARs) for prostate cancer patients treated with intensity-modulated radiotherapy (IMRT). Methods and Materials: Eight prostate cancer patients were treated with IMRT to 76 Gy at 2 Gy per fraction. Daily target localization was performed via alignment of three intraprostatic fiducials and weekly kV-cone beam computed tomography (CBCT) scans. The prostate and OARs were manually contoured on each CBCT by a single physician. Daily patient setup shifts were obtained by comparing alignment of skin tattoos with the treatment position based on fiducials. Treatment fields were retrospectively applied to CBCT scans. The dose distributions were calculated using actual treatment plans (an 8-mm PTV margin everywhere except for 6-mm posteriorly) with and without image guidance shifts. Furthermore, the feasibility of margin reduction was evaluated by reducing planning margins to 4 mm everywhere except for 3 mm posteriorly. Results: For the eight treatment plans on the 56 CBCT scans, the average doses to 98% of the prostate (D98) were 102% (range, 99-104%) and 99% (range, 45-104%) with and without image guidance, respectively. Using margin reduction, the average D98s were 100% (range, 84-104%) and 92% (range, 40-104%) with and without image guidance, respectively. Conclusions: Currently, margins used in IMRT plans are adequate to deliver a dose to the prostate with conventional patient positioning using skin tattoos or bony anatomy. The use of image guidance may facilitate significant reduction of planning margins. Future studies to assess the efficacy of decreasing margins and improvement of treatment-related toxicities are warranted.

SU-C-202-03: A Tool for Automatic Calculation of Delivered Dose Variation for Off-Line Adaptive Therapy Using Cone Beam CT

Energy Technology Data Exchange (ETDEWEB)

Zhang, B; Lee, S; Chen, S; Zhou, J; Prado, K; D’Souza, W; Yi, B [University of Maryland School of Medicine, Baltimore, MD (United States)

2016-06-15

Purpose: Monitoring the delivered dose is an important task for the adaptive radiotherapy (ART) and for determining time to re-plan. A software tool which enables automatic delivered dose calculation using cone-beam CT (CBCT) has been developed and tested. Methods: The tool consists of four components: a CBCT Colleting Module (CCM), a Plan Registration Moduel (PRM), a Dose Calculation Module (DCM), and an Evaluation and Action Module (EAM). The CCM is triggered periodically (e.g. every 1:00 AM) to search for newly acquired CBCTs of patients of interest and then export the DICOM files of the images and related registrations defined in ARIA followed by triggering the PRM. The PRM imports the DICOM images and registrations, links the CBCTs to the related treatment plan of the patient in the planning system (RayStation V4.5, RaySearch, Stockholm, Sweden). A pre-determined CT-to-density table is automatically generated for dose calculation. Current version of the DCM uses a rigid registration which regards the treatment isocenter of the CBCT to be the isocenter of the treatment plan. Then it starts the dose calculation automatically. The AEM evaluates the plan using pre-determined plan evaluation parameters: PTV dose-volume metrics and critical organ doses. The tool has been tested for 10 patients. Results: Automatic plans are generated and saved in the order of the treatment dates of the Adaptive Planning module of the RayStation planning system, without any manual intervention. Once the CTV dose deviates more than 3%, both email and page alerts are sent to the physician and the physicist of the patient so that one can look the case closely. Conclusion: The tool is capable to perform automatic dose tracking and to alert clinicians when an action is needed. It is clinically useful for off-line adaptive therapy to catch any gross error. Practical way of determining alarming level for OAR is under development.

Comparison of radiation delivered by current diagnostic procedures for herniated disc

International Nuclear Information System (INIS)

Gasquet, C.; Drouineau, J.; Goubault, F.; Hurmic, A.; Lavigne, B.; Vandermarcq, P.

1983-01-01

Three methods are currently employed for the diagnosis of sciatica due to disc lesions: radiculography, spinal phlebography, and computed tomography. Though their indications vary according to the author, it seemed worthwhile to compare radiation delivered by each of them, because of the often young age of the patients. Dosimetric studies using a Rando Phantom enabled calculation of doses to the skin, spinal cord, and gonads. Results indicated that low doses were delivered by the scanner, relatively high doses by spinal phlebography, and intermediate doses by radiculography. These findings suggest that the initial examination preoperatively in cases of simple sciatica due to herniated disc should be a CT scan whenever possible. Phlebography, on the contrary, and particularly in young women, should be used only exceptionally, as a result of the high doses delivered to the ovaries even during technically simple explorations [fr

Evaluation of dose delivered to critical organs during pituitary radiation therapy

International Nuclear Information System (INIS)

Awoda, Marwa Elrashied Mohammed

2017-12-01

The selection of an appropriate energy in radiation therapy for tumor and the delivery adequate dose to the tumors to be treated, is very important during the radiation treatment planning. Also the dose received to critical organs surrounding the tumor has be considered. In addition, validation of treatment plan quality is important, so the purpose of this study was to evaluate the effect of teletherapy cobalt and 6MV linac energies on dose distribution for the pituitary gland tumors and dose delivered to critical organs surrounding the tumor. 10 patients with pituitary adenocarcinomas were selected. For treatment plans with three field technique, verdes and two lateral fields, were used. For the therapeutic area, five organs left and right eye lens left and right optic never and chasms and brain stem, were considered as Organ at risk (OARS). Several physical indices for for planning target volume (PTV) and the organs at risk 9 (OARS) as means dose (MD). 95%, dose (D950), 5% dose (D5) and normal tissue dose (NTID), were calculated, and the homogeneity index and conformity index were also two other evaluation parameters have been taken into account. The comparative evaluation was based on dose volume histogram ( DVH) analysis for both energies plans. After performing the treatment planning with two different energies the dose received to critical organs and dose distribution in PTV were studied. Results showed that the difference between the integral dose received to OARs with Co-60 and 6-MV linac respectively, 2.16±1.48, 1.85±1.55 for Lt eye lens. 3.01±2.52, 1.89±2.09 for Rt eye lens, 18.5±10.97, 19.43±10.65 for Lt optic nerve and chasms, 15.86±11.30, 17.44±15.73 for Rt optic nerve and chasms and 24.03±13.68, 23.77±16.64 for Brain stem case showed higher integral dose for linac than Co-60 than due to using the 6-MV energy as an open field with no beam modifiers such MLCs or shielding blocks. Eventually, it found that using of 6-MV linac provides better

Dose delivered from Varian's CBCT to patients receiving IMRT for prostate cancer

International Nuclear Information System (INIS)

Wen Ning; Guan Huaiqun; Hammoud, Rabih; Pradhan, Deepak; Nurushev, T; Li Shidong; Movsas, Benjamin

2007-01-01

With the increased use of cone beam CT (CBCT) for daily patient setup, the accumulated dose from CBCT may be significantly higher than that from simulation CT or portal imaging. The objective of this work is to measure the dose from daily pelvic scans with fixed technical settings and collimations. CBCT scans were acquired in half-fan mode using a half bowtie and x-rays were delivered in pulsed-fluoro mode. The skin doses for seven prostate patients were measured on an IRB-approved protocol. TLD capsules were placed on the patient's skin at the central axis of three beams: AP, left lateral (Lt Lat) and right lateral (Rt Lat). To avoid the ring artefacts centred in the prostate, the treatment couch was dropped 3 cm from the patient's tattoo (central axis). The measured AP skin doses ranged 3-6 cGy for 20-33 cm separation. The larger the patient size the less the AP skin dose. Lateral doses did not change much with patient size. The Lt Lat dose was ∼4.0 cGy, which was ∼40% higher than the Rt Lat dose of ∼2.6 cGy. To verify this dose asymmetry, surface doses on an IMRT QA phantom (oval shaped, 30 cm x 20 cm) were measured at the same three sites using TLD capsules with 3 cm table-drop. The dose asymmetry was due to: (1) kV source rotation which always starts from the patient's Lt Lat and ends at Lt Lat. Gantry rotation gets much slower near the end of rotation but dose rate stays constant and (2) 370 0 scan rotation (10 0 scan overlap on the Lt Lat side). In vivo doses were measured inside a Rando pelvic heterogeneous phantom using TLDs. The left hip (femoral head and neck) received the highest doses of ∼10-11 cGy while the right hip received ∼6-7 cGy. The surface and in vivo doses were also measured for phantoms at the central-axis setup. The difference was less than ∼12% to the table-drop setup

Image guidance doses delivered during radiotherapy: Quantification, management, and reduction: Report of the AAPM Therapy Physics Committee Task Group 180.

Science.gov (United States)

Ding, George X; Alaei, Parham; Curran, Bruce; Flynn, Ryan; Gossman, Michael; Mackie, T Rock; Miften, Moyed; Morin, Richard; Xu, X George; Zhu, Timothy C

2018-05-01

With radiotherapy having entered the era of image guidance, or image-guided radiation therapy (IGRT), imaging procedures are routinely performed for patient positioning and target localization. The imaging dose delivered may result in excessive dose to sensitive organs and potentially increase the chance of secondary cancers and, therefore, needs to be managed. This task group was charged with: a) providing an overview on imaging dose, including megavoltage electronic portal imaging (MV EPI), kilovoltage digital radiography (kV DR), Tomotherapy MV-CT, megavoltage cone-beam CT (MV-CBCT) and kilovoltage cone-beam CT (kV-CBCT), and b) providing general guidelines for commissioning dose calculation methods and managing imaging dose to patients. We briefly review the dose to radiotherapy (RT) patients resulting from different image guidance procedures and list typical organ doses resulting from MV and kV image acquisition procedures. We provide recommendations for managing the imaging dose, including different methods for its calculation, and techniques for reducing it. The recommended threshold beyond which imaging dose should be considered in the treatment planning process is 5% of the therapeutic target dose. Although the imaging dose resulting from current kV acquisition procedures is generally below this threshold, the ALARA principle should always be applied in practice. Medical physicists should make radiation oncologists aware of the imaging doses delivered to patients under their care. Balancing ALARA with the requirement for effective target localization requires that imaging dose be managed based on the consideration of weighing risks and benefits to the patient. © 2018 American Association of Physicists in Medicine.

Four-dimensional dose distributions of step-and-shoot IMRT delivered with real-time tumor tracking for patients with irregular breathing: Constant dose rate vs dose rate regulation

International Nuclear Information System (INIS)

Yang Xiaocheng; Han-Oh, Sarah; Gui Minzhi; Niu Ying; Yu, Cedric X.; Yi Byongyong

2012-01-01

Purpose: Dose-rate-regulated tracking (DRRT) is a tumor tracking strategy that programs the MLC to track the tumor under regular breathing and adapts to breathing irregularities during delivery using dose rate regulation. Constant-dose-rate tracking (CDRT) is a strategy that dynamically repositions the beam to account for intrafractional 3D target motion according to real-time information of target location obtained from an independent position monitoring system. The purpose of this study is to illustrate the differences in the effectiveness and delivery accuracy between these two tracking methods in the presence of breathing irregularities. Methods: Step-and-shoot IMRT plans optimized at a reference phase were extended to remaining phases to generate 10-phased 4D-IMRT plans using segment aperture morphing (SAM) algorithm, where both tumor displacement and deformation were considered. A SAM-based 4D plan has been demonstrated to provide better plan quality than plans not considering target deformation. However, delivering such a plan requires preprogramming of the MLC aperture sequence. Deliveries of the 4D plans using DRRT and CDRT tracking approaches were simulated assuming the breathing period is either shorter or longer than the planning day, for 4 IMRT cases: two lung and two pancreatic cases with maximum GTV centroid motion greater than 1 cm were selected. In DRRT, dose rate was regulated to speed up or slow down delivery as needed such that each planned segment is delivered at the planned breathing phase. In CDRT, MLC is separately controlled to follow the tumor motion, but dose rate was kept constant. In addition to breathing period change, effect of breathing amplitude variation on target and critical tissue dose distribution is also evaluated. Results: Delivery of preprogrammed 4D plans by the CDRT method resulted in an average of 5% increase in target dose and noticeable increase in organs at risk (OAR) dose when patient breathing is either 10% faster or

Modelling simple helically delivered dose distributions

International Nuclear Information System (INIS)

Fenwick, John D; Tome, Wolfgang A; Kissick, Michael W; Mackie, T Rock

2005-01-01

In a previous paper, we described quality assurance procedures for Hi-Art helical tomotherapy machines. Here, we develop further some ideas discussed briefly in that paper. Simple helically generated dose distributions are modelled, and relationships between these dose distributions and underlying characteristics of Hi-Art treatment systems are elucidated. In particular, we describe the dependence of dose levels along the central axis of a cylinder aligned coaxially with a Hi-Art machine on fan beam width, couch velocity and helical delivery lengths. The impact on these dose levels of angular variations in gantry speed or output per linear accelerator pulse is also explored

Evaluation of delivered dose for a clinical daily adaptive plan selection strategy for bladder cancer radiotherapy

International Nuclear Information System (INIS)

Lutkenhaus, Lotte J.; Visser, Jorrit; Jong, Rianne de; Hulshof, Maarten C.C.M.; Bel, Arjan

2015-01-01

Purpose: To account for variable bladder size during bladder cancer radiotherapy, a daily plan selection strategy was implemented. The aim of this study was to calculate the actually delivered dose using an adaptive strategy, compared to a non-adaptive approach. Material and methods: Ten patients were treated to the bladder and lymph nodes with an adaptive full bladder strategy. Interpolated delineations of bladder and tumor on a full and empty bladder CT scan resulted in five PTVs for which VMAT plans were created. Daily cone beam CT (CBCT) scans were used for plan selection. Bowel, rectum and target volumes were delineated on these CBCTs, and delivered dose for these was calculated using both the adaptive plan, and a non-adaptive plan. Results: Target coverage for lymph nodes improved using an adaptive strategy. The full bladder strategy spared the healthy part of the bladder from a high dose. Average bowel cavity V30Gy and V40Gy significantly reduced with 60 and 69 ml, respectively (p < 0.01). Other parameters for bowel and rectum remained unchanged. Conclusions: Daily plan selection compared to a non-adaptive strategy yielded similar bladder coverage and improved coverage for lymph nodes, with a significant reduction in bowel cavity V30Gy and V40Gy only, while other sparing was limited

Estimation of Electron Dose Delivered by a 0.4 MeV Accelerator from Bremsstrahlung Dose Measurements

DEFF Research Database (Denmark)

Karadjov, A. G.; Hansen, Jørgen-Walther

1980-01-01

Determination of a 0.4 MeV electron dose from a bremsstrahlung dose measurement using a converter-detector system is considered. The detector used is a Frickle dosimeter, and the converters are aluminum, copper and lead foils. Optimal converter thickness is ascertained experimentally for each mat...... materials within a Z-range of 13–82. A linear relation is found between bremsstrahlung dose and electron dose ranging from 2 to 20 Mrad. Finally the effect of converter area on detector response is studied....

SU-E-T-86: Comparison of Two Commercially Available Programs for the Evaluation of Delivered Daily Dose Using Cone Beam CT (CBCT)

International Nuclear Information System (INIS)

Tuohy, R; Bosse, C; Mavroidis, P; Shi, Z; Crownover, R; Papanikolaou, N; Stathakis, S

2014-01-01

Purpose: In this study, two commercially available programs were compared for the evaluation of delivered daily dose using cone beam CT (CBCT). Methods: Thirty (n=30) patients previously treated in our clinic (10 prostate, 10 SBRT lung and 10 abdomen) were used in this study. The patients' plans were optimized and calculated using the Pinnacle treatment planning system. The daily CBCT scans were imported into Velocity and RayStation along with the corresponding planning CTs, structure sets and 3D dose distributions for each patient. The organs at risk (OAR) were contoured on each CBCT by the prescribing physician and were included in the evaluation of the daily delivered dose. Each CBCT was registered to the planning CT, once with rigid registration and then again, separately, with deformable registration. After registering each CBCT, the dose distribution from the planning CT was overlaid and the dose volume histograms (DVH) for the OAR and the planning target volumes (PTV) were calculated. Results: For prostate patients, we observed daily volume changes for the OARs. The DVH analysis for those patients showed variation in the sparing of the OARs while PTV coverage remained virtually unchanged using both Velocity and RayStation systems. Similar results were observed for abdominal patients. In contrast, for SBRT lung patients, the DVH for the OARs and target were comparable to those from the initial treatment plan. Differences in organ volume and organ doses were also observed when comparing the daily fractions using deformable and rigid registrations. Conclusion: By using daily CBCT dose reconstruction, we proved PTV coverage for prostate and abdominal targets is adequate. However, there is significant dosimetric change for the OARs. For lung SBRT patients, the delivered daily dose for both PTV and OAR is comparable to the planned dose with no significant differences

RadNuc: a graphical user interface to deliver dose rate patterns encountered in nuclear medicine with a 137Cs irradiator.

Science.gov (United States)

Pasternack, Jordan B; Howell, Roger W

2013-02-01

The temporal variations in absorbed dose rates to organs and tissues in the body are very large in diagnostic and therapeutic nuclear medicine. The response of biological endpoints of relevance to radiation safety and therapeutic efficacy is generally modulated by dose rate. Therefore, it is important to understand how the complex dose rate patterns encountered in nuclear medicine impact relevant biological responses. Accordingly, a graphical user interface (GUI) was created to control a cesium-137 irradiator to deliver such dose rate patterns. Visual Basic 6.0 was used to create a user-friendly GUI to control the dose rate by varying the thickness of a mercury attenuator. The GUI facilitates the delivery of a number of dose rate patterns including constant, exponential increase or decrease, and multi-component exponential. Extensive visual feedback is provided by the GUI during both the planning and delivery stages. The GUI controlled irradiator can achieve a maximum dose rate of 40 cGy/h and a minimum dose rate of 0.01 cGy/h. Addition of machined lead blocks can be used to further reduce the minimum dose rate to 0.0001 cGy/h. Measured dose rate patterns differed from programmed dose rate patterns in total dose by 3.2% to 8.4%. The GUI controlled irradiator is able to accurately create dose rate patterns encountered in nuclear medicine and other related fields. This makes it an invaluable tool for studying the effects of chronic constant and variable low dose rates on biological tissues in the contexts of both radiation protection and clinical administration of internal radionuclides. Copyright © 2013 Elsevier Inc. All rights reserved.

Low-dose oxytocin delivered intranasally with Breath Powered device affects social-cognitive behavior: a randomized four-way crossover trial with nasal cavity dimension assessment.

Science.gov (United States)

Quintana, D S; Westlye, L T; Rustan, Ø G; Tesli, N; Poppy, C L; Smevik, H; Tesli, M; Røine, M; Mahmoud, R A; Smerud, K T; Djupesland, P G; Andreassen, O A

2015-07-14

Despite the promise of intranasal oxytocin (OT) for modulating social behavior, recent work has provided mixed results. This may relate to suboptimal drug deposition achieved with conventional nasal sprays, inter-individual differences in nasal physiology and a poor understanding of how intranasal OT is delivered to the brain in humans. Delivering OT using a novel 'Breath Powered' nasal device previously shown to enhance deposition in intranasal sites targeted for nose-to-brain transport, we evaluated dose-dependent effects on social cognition, compared response with intravenous (IV) administration of OT, and assessed nasal cavity dimensions using acoustic rhinometry. We adopted a randomized, double-blind, double-dummy, crossover design, with 16 healthy male adults completing four single-dose treatments (intranasal 8 IU (international units) or 24 IU OT, 1 IU OT IV and placebo). The primary outcome was social cognition measured by emotional ratings of facial images. Secondary outcomes included the pharmacokinetics of OT, vasopressin and cortisol in blood and the association between nasal cavity dimensions and emotional ratings. Despite the fact that all the treatments produced similar plasma OT increases compared with placebo, there was a main effect of treatment on anger ratings of emotionally ambiguous faces. Pairwise comparisons revealed decreased ratings after 8 IU OT in comparison to both placebo and 24 IU OT. In addition, there was an inverse relationship between nasal valve dimensions and anger ratings of ambiguous faces after 8-IU OT treatment. These findings provide support for a direct nose-to-brain effect, independent of blood absorption, of low-dose OT delivered from a Breath Powered device.

SU-F-T-516: Effects of Inter-Fraction Organ Displacement/deformation On the Delivered Doses to the Heart, Esophagus, and Lungs in Patients Receiving Thoracic Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Hammers, J; Matney, J; Kaidar-Person, O; Zagar, T; Marks, L; Das, S; Mavroidis, P [University North Carolina, Chapel Hill, NC (United States)

2016-06-15

Purpose: To quantitatively assess the effects of inter-fraction changes in organ shape and location on the delivered dose distribution to the organs at risk (OAR) in lung cancer patients. Methods: This study analyzes treatment data of 10 patients, who were treated to 60Gy in 30 fractions. In each fraction a cone beam CT (CBCT) was acquired. Each CBCT was registered with the planning CT using deformable registration tools within MIM Software. The daily setup shifts were used to translate the planned dose distribution on the deformed planning CT. The structures of lungs, esophagus and heart were re-delineated by a physician on each CBCT. The doses delivered to each OAR, reflecting changes in the position and shape variations, were recomputed. Resultant daily dose volume histograms (DVHs) for OARs were computed and compared to those from the planning CT. Results: Based on the findings of two patients and 24 CBCTs analyzed so far, higher doses are delivered to the lungs and esophagus compared to the treatment plan. The dose differences per fraction between the delivered doses and those in the treatment plan are: for patient 1, lung mean dose = 5.3±1.3cGy and esophagus mean dose = 3.4±3.5cGy. For patient 2, lung mean dose = 12.0±3.9cGy and esophagus mean dose = 34.2±7.5cGy. Regarding the maximum dose to heart, the results varied (−18.9±22.0cGy for patient1 and 53.0±62.2cGy for patient2). Conclusion: The dosimetric effects of inter-fractional anatomical variations could be estimated using deformable image registration and manual organ segmentation for each CBCT. A considerable dose distribution variation between fractions was observed for the OARs. These changes are currently not taken into account while treating the patients and these may explain cases with severe side effects even when the treatment plan looks satisfactory. These results suggest the need for automated daily dose tracking and accumulation.

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

Dose-response relations for stricture in the proximal oesophagus from head and neck radiotherapy

International Nuclear Information System (INIS)

Alevronta, Eleftheria; Ahlberg, Alexander; Mavroidis, Panayiotis; Al-Abany, Massoud; Friesland, Signe; Tilikidis, Aris; Laurell, Goeran; Lind, Bengt K.

2010-01-01

Background and purpose: Determination of the dose-response relations for oesophageal stricture after radiotherapy of the head and neck. Material and methods: In this study 33 patients who developed oesophageal stricture and 39 patients as controls are included. The patients received radiation therapy for head and neck cancer at Karolinska University Hospital, Stockholm, Sweden. For each patient the 3D dose distribution delivered to the upper 5 cm of the oesophagus was analysed. The analysis was conducted for two periods, 1992-2000 and 2001-2005, due to the different irradiation techniques used. The fitting has been done using the relative seriality model. Results: For the treatment period 1992-2005, the mean doses were 49.8 and 33.4 Gy, respectively, for the cases and the controls. For the period 1992-2000, the mean doses for the cases and the controls were 49.9 and 45.9 Gy and for the period 2001-2005 were 49.8 and 21.4 Gy. For the period 2001-2005 the best estimates of the dose-response parameters are D 50 = 61.5 Gy (52.9-84.9 Gy), γ = 1.4 (0.8-2.6) and s = 0.1 (0.01-0.3). Conclusions: Radiation-induced strictures were found to have a dose response relation and volume dependence (low relative seriality) for the treatment period 2001-2005. However, no dose response relation was found for the complete material.

Magnetic Resonance Image Guided Radiation Therapy for External Beam Accelerated Partial-Breast Irradiation: Evaluation of Delivered Dose and Intrafractional Cavity Motion

Energy Technology Data Exchange (ETDEWEB)

Acharya, Sahaja; Fischer-Valuck, Benjamin W.; Mazur, Thomas R.; Curcuru, Austen; Sona, Karl; Kashani, Rojano; Green, Olga; Ochoa, Laura; Mutic, Sasa; Zoberi, Imran; Li, H. Harold; Thomas, Maria A., E-mail: mthomas@radonc.wustl.edu

2016-11-15

Purpose: To use magnetic resonance image guided radiation therapy (MR-IGRT) for accelerated partial-breast irradiation (APBI) to (1) determine intrafractional motion of the breast surgical cavity; and (2) assess delivered dose versus planned dose. Methods and Materials: Thirty women with breast cancer (stages 0-I) who underwent breast-conserving surgery were enrolled in a prospective registry evaluating APBI using a 0.35-T MR-IGRT system. Clinical target volume was defined as the surgical cavity plus a 1-cm margin (excluding chest wall, pectoral muscles, and 5 mm from skin). No additional margin was added for the planning target volume (PTV). A volumetric MR image was acquired before each fraction, and patients were set up to the surgical cavity as visualized on MR imaging. To determine the delivered dose for each fraction, the electron density map and contours from the computed tomography simulation were transferred to the pretreatment MR image via rigid registration. Intrafractional motion of the surgical cavity was determined by applying a tracking algorithm to the cavity contour as visualized on cine MR. Results: Median PTV volume was reduced by 52% when using no PTV margin compared with a 1-cm PTV margin used conventionally. The mean (± standard deviation) difference between planned and delivered dose to the PTV (V95) was 0.6% ± 0.1%. The mean cavity displacement in the anterior–posterior and superior–inferior directions was 0.6 ± 0.4 mm and 0.6 ± 0.3 mm, respectively. The mean margin required for at least 90% of the cavity to be contained by the margin for 90% of the time was 0.7 mm (5th-95th percentile: 0-2.7 mm). Conclusion: Minimal intrafractional motion was observed, and the mean difference between planned and delivered dose was less than 1%. Assessment of efficacy and cosmesis of this MR-guided APBI approach is under way.

Dose delivered from Varian's CBCT to patients receiving IMRT for prostate cancer

Energy Technology Data Exchange (ETDEWEB)

Wen Ning; Guan Huaiqun; Hammoud, Rabih; Pradhan, Deepak; Nurushev, T; Li Shidong; Movsas, Benjamin [Henry Ford Health System, Detroit, MI (United States)

2007-04-21

With the increased use of cone beam CT (CBCT) for daily patient setup, the accumulated dose from CBCT may be significantly higher than that from simulation CT or portal imaging. The objective of this work is to measure the dose from daily pelvic scans with fixed technical settings and collimations. CBCT scans were acquired in half-fan mode using a half bowtie and x-rays were delivered in pulsed-fluoro mode. The skin doses for seven prostate patients were measured on an IRB-approved protocol. TLD capsules were placed on the patient's skin at the central axis of three beams: AP, left lateral (Lt Lat) and right lateral (Rt Lat). To avoid the ring artefacts centred in the prostate, the treatment couch was dropped 3 cm from the patient's tattoo (central axis). The measured AP skin doses ranged 3-6 cGy for 20-33 cm separation. The larger the patient size the less the AP skin dose. Lateral doses did not change much with patient size. The Lt Lat dose was {approx}4.0 cGy, which was {approx}40% higher than the Rt Lat dose of {approx}2.6 cGy. To verify this dose asymmetry, surface doses on an IMRT QA phantom (oval shaped, 30 cm x 20 cm) were measured at the same three sites using TLD capsules with 3 cm table-drop. The dose asymmetry was due to: (1) kV source rotation which always starts from the patient's Lt Lat and ends at Lt Lat. Gantry rotation gets much slower near the end of rotation but dose rate stays constant and (2) 370{sup 0} scan rotation (10{sup 0} scan overlap on the Lt Lat side). In vivo doses were measured inside a Rando pelvic heterogeneous phantom using TLDs. The left hip (femoral head and neck) received the highest doses of {approx}10-11 cGy while the right hip received {approx}6-7 cGy. The surface and in vivo doses were also measured for phantoms at the central-axis setup. The difference was less than {approx}12% to the table-drop setup.

Effect of patient size, anatomical location and modulation strength on dose delivered and image-quality on CT examination

International Nuclear Information System (INIS)

Greffier, Joel; Larbi, Ahmed; Macri, Francesco; Beregi, Jean-Paul; Pereira, Fabricio

2017-01-01

To study the effect of patient size, anatomical location and modulation strength (MS) on image-quality and delivered dose of CT scans acquired with automatic-exposure control system (AEC). Four anthropomorphic phantoms (three paediatric and one thin adult) were studied, and normal and obese adults were simulated by placing bolus plates around the adult phantom. Thorax and abdomen pelvis CT were performed using an AEC system equipped with five possible MS. Modulated tube current (mAs mod ) was compared to Reference mAs and image-noise was assessed. Effective-mAs were lower than Reference-mAs for all but the obese phantom. However, reversal points were estimated for an effective diameter of 27.8 cm in thorax and 26.9 cm in abdomen pelvis scans, beyond which the patterns of MS were inverted. mAs mod were dependent on attenuation differences among distinct anatomical location. Finally, dose delivered was associated to the mAs mod and patient s size, with both affecting image-quality. (authors)

Interest of pelvimetry by multi detectors computed tomography (M.D.C.T.) 40 pins, reduction of the delivered dose

International Nuclear Information System (INIS)

Thibaut, C.; Marie-Anne, O.; Douws, C.; Grenier, N.; Chateil, J.F.

2006-01-01

This new procedure has allowed to improve the quality of measurement accuracy, annuls the difficulties of realizations of the conventional pictures and reduces in a considerable way the dose delivered to the patient and to the baby. (N.C.)

Out-of-Field Dose Equivalents Delivered by Passively Scattered Therapeutic Proton Beams for Clinically Relevant Field Configurations

International Nuclear Information System (INIS)

Wroe, Andrew; Clasie, Ben; Kooy, Hanne; Flanz, Jay; Schulte, Reinhard; Rosenfeld, Anatoly

2009-01-01

Purpose: Microdosimetric measurements were performed at Massachusetts General Hospital, Boston, MA, to assess the dose equivalent external to passively delivered proton fields for various clinical treatment scenarios. Methods and Materials: Treatment fields evaluated included a prostate cancer field, cranial and spinal medulloblastoma fields, ocular melanoma field, and a field for an intracranial stereotactic treatment. Measurements were completed with patient-specific configurations of clinically relevant treatment settings using a silicon-on-insulator microdosimeter placed on the surface of and at various depths within a homogeneous Lucite phantom. The dose equivalent and average quality factor were assessed as a function of both lateral displacement from the treatment field edge and distance downstream of the beam's distal edge. Results: Dose-equivalent value range was 8.3-0.3 mSv/Gy (2.5-60-cm lateral displacement) for a typical prostate cancer field, 10.8-0.58 mSv/Gy (2.5-40-cm lateral displacement) for the cranial medulloblastoma field, 2.5-0.58 mSv/Gy (5-20-cm lateral displacement) for the spinal medulloblastoma field, and 0.5-0.08 mSv/Gy (2.5-10-cm lateral displacement) for the ocular melanoma field. Measurements of external field dose equivalent for the stereotactic field case showed differences as high as 50% depending on the modality of beam collimation. Average quality factors derived from this work ranged from 2-7, with the value dependent on the position within the phantom in relation to the primary beam. Conclusions: This work provides a valuable and clinically relevant comparison of the external field dose equivalents for various passively scattered proton treatment fields

A method to study the characteristics of 3D dose distributions created by superposition of many intensity-modulated beams delivered via a slit aperture with multiple absorbing vanes

International Nuclear Information System (INIS)

Webb, S.; Oldham, M.

1996-01-01

Highly conformal dose distributions can be created by the superposition of many radiation fields from different directions, each with its intensity spatially modulated by the method known as tomotherapy. At the planning stage, the intensity of radiation of each beam element (or bixel) is determined by working out the effect of superposing the radiation through all bixels with the elemental dose distribution specified as that from a single bixel with all its neighbours closed (the 'independent-vane' (IV) model). However, at treatment-delivery stage, neighbouring bixels may not be closed. Instead the slit beam is delivered with parts of the beam closed for different periods of time to create the intensity modulation. As a result, the 3D dose distribution actually delivered will differ from that determined at the planning stage if the elemental beams do not obey the superposition principle. The purpose of this paper is to present a method to investigate and quantify the relation between planned and delivered 3D dose distributions. Two modes of inverse planning have been performed: (i) with a fit to the measured elemental dose distribution and (ii) with a 'stretched fit' obeying the superposition principle as in the PEACOCK 3D planning system. The actual delivery has been modelled as a series of component deliveries (CDs). The algorithm for determining the component intensities and the appropriate collimation conditions is specified. The elemental beam from the NOMOS MIMiC collimator is too narrow to obey the superposition principle although it can be 'stretched' and fitted to a superposition function. Hence there are differences between the IV plans made using modes (i) and (ii) and the raw and the stretched elemental beam, and also differences with CD delivery. This study shows that the differences between IV and CD dose distributions are smaller for mode (ii) inverse planning than for mode (i), somewhat justifying the way planning is done within PEACOCK. Using a

Conformal intensity-modulated radiotherapy (IMRT) delivered by robotic linac-conformality versus efficiency of dose delivery

International Nuclear Information System (INIS)

Webb, Steve

2000-01-01

Intensity-modulated radiotherapy (IMRT) may be delivered with a high-energy-photon linac mounted on a robotic gantry and executing a complex trajectory. In a previous paper an inverse-planning technique was developed for such an application. Here the work is extended to demonstrate the dependence of conformality on the size of the elemental pencil beam, on the complexity of the trajectory and on the sampling of azimuth and elevation of the collimated source. The improved conformality of complex trajectories is demonstrated and benchmarked relative to simpler trajectories, more representative of existing non-robotic IMRT techniques. Specifically, by choosing a very fine pencil beam, exquisitely conformal dose distributions have been obtained. Important sampling considerations have been determined. Expressions have been derived for the dosimetry and monitor-unit efficiency of robotic IMRT. Equivalent trajectories were computed for executing the complex robotic trajectories instead by using a conventional linac. The work benchmarks an ideal in IMRT against which more practical and more common techniques may be measured. (author)

SU-F-J-89: Assessment of Delivered Dose in Understanding HCC Tumor Progression Following SBRT

Energy Technology Data Exchange (ETDEWEB)

McCulloch, M; Cazoulat, G; Polan, D; Schipper, M; Lawrence, T; Feng, M; Brock, K [University of Michigan, Ann Arbor, MI (United States)

2016-06-15

Purpose: It is well documented that the delivered dose to patients undergoing radiotherapy (RT) is often different from the planned dose due to geometric variability and uncertainties in patient positioning. Recent work suggests that accumulated dose to the GTV is a better predictor of progression compared to the minimum planned dose to the PTV. The purpose of this study is to evaluate if deviations from the planned dose can contributed to tumor progression. Methods: From 2010 to 2014 an in-house Phase II clinical trial of adaptive stereotactic body RT was completed. Of the 90 patients enrolled, 7 patients had a local recurrence defined on contrast enhanced CT or MR imaging 3–21 months after completion of RT. Retrospective dose accumulation was performed using a biomechanical model-based deformable image registration algorithm (DIR) to accumulate the dose based on the kV CBCT acquired prior to each fraction for soft tissue alignment of the patient. The DIR algorithm was previously validated for geometric accuracy in the liver (target registration error = 2.0 mm) and dose accumulation in a homogeneous image, similar to a liver CBCT (gamma index = 91%). Following dose accumulation, the minimum dose to 0.5 cc of the GTV was compared between the planned and accumulated dose. Work is ongoing to evaluate the tumor control probability based on the planned and accumulated dose. Results: DIR and dose accumulation was performed on all fractions for 6 patients with local recurrence. The difference in minimum dose to 0.5 cc of the GTV ranged from −0.3–2.3 Gy over 3–5 fractions. One patient had a potentially significant difference in minimum dose of 2.3 Gy. Conclusion: Dose accumulation can reveal tumor underdosage, improving our ability to understand recurrence and tumor progression patterns, and could aid in adaptive re-planning during therapy to correct for this. This work was supported in part by NIH P01CA059827.

Delivering the right dose

International Nuclear Information System (INIS)

Shaw, A

2004-01-01

For treatment with high intensity focused ultrasound (HIFU), delivering the correct amount of energy to the patient is critical. This paper describes a novel design of sensor based on the pyroelectric principle for monitoring the output power from HIFU transducers of the type used for tissue ablation. The sensor is intended to be minimally perturbing to the ultrasound field, so that it can remain in the ultrasound field throughout treatment and provide a constant monitor of ultrasound power. The main advantages of the technique are: power can be measured or monitored without dismantling the HIFU system, thus reducing equipment downtime; power can be measured immediately before or during every patient treatment, thus ensuring accurate dosimetry; power can be measured at the output levels used for treatment (whereas a radiation force balance may be damaged by overheating); the method uses components which are robust and simple to use compared to radiation force balances or hydrophone scanning systems

SU-E-J-176: Characterization of Inter-Fraction Breast Variability and the Implications On Delivered Dose

Energy Technology Data Exchange (ETDEWEB)

Sudhoff, M; Lamba, M; Kumar, N; Ward, A; Elson, H [University of Cincinnati, Cincinnati, OH (United States)

2015-06-15

Purpose: To systematically characterize inter-fraction breast variability and determine implications on delivered dose. Methods: Weekly port films were used to characterize breast setup variability. Five evenly spaced representative positions across the contour of each breast were chosen on the electronic port film in reference to graticule, and window and level was set such that the skin surface of the breast was visible. Measurements from the skin surface to treatment field edge were taken on each port film at each position and compared to the planning DRR, quantifying the variability. The systematic measurement technique was repeated for all port films for 20 recently treated breast cancer patients. Measured setup variability for each patient was modeled as a normal distribution. The distribution was randomly sampled from the model and applied as isocentric shifts in the treatment planning computer, representing setup variability for each fraction. Dose was calculated for each shifted fraction and summed to obtain DVHs and BEDs that modeled the dose with daily setup variability. Patients were categorized in to relevant groupings that were chosen to investigate the rigorousness of immobilization types, treatment techniques, and inherent anatomical difficulties. Mean position differences and dosimetric differences were evaluated between planned and delivered doses. Results: The setup variability was found to follow a normal distribution with mean position differences between the DRR and port film between − 8.6–3.5 mm with sigma range of 5.3–9.8 mm. Setup position was not found to be significantly different than zero. The mean seroma or whole breast PTV dosimetric difference, calculated as BED, ranged from a −0.23 to +1.13Gy. Conclusion: A systematic technique to quantify and model setup variability was used to calculate the dose in 20 breast cancer patients including variable setup. No statistically significant PTV or OAR BED differences were found between

Influence of a Commercial Lead Apron on Patient Skin Dose Delivered During Oral and Maxillofacial Examinations under Cone Beam Computed Tomography (CBCT).

Science.gov (United States)

Schulze, Ralf Kurt Willy; Sazgar, Mahssa; Karle, Heiko; de Las Heras Gala, Hugo

2017-08-01

The purpose of this paper is to investigate the impact of a commercial lead apron on patient skin dose delivered during maxillofacial CBCT in five critical regions by means of solid-state-dosimetry. Five anatomical regions (thyroid gland, left and right breast, gonads, back of the phantom torso) in an adult female anthropomorphic phantom were selected for dose measurement by means of the highly sensitive solid-state dosimeter QUART didoSVM. Ten repeated single exposures were assessed for each patient body region for a total of five commercial CBCT devices with and without a lead apron present. Shielded and non-shielded exposures were compared under the paired Wilcoxon test, with absolute and relative differences computed. Reproducibility was expressed as the coefficient of variation (CV) between the 10 repeated assessments. The highest doses observed at skin level were found at the thyroid (mean shielded ± SD: 450.5 ± 346.7 μGy; non-shielded: 339.2 ± 348.8 μGy, p = 0.4922). Shielding resulted in a highly significant (p < 0.001) 93% dose reduction in skin dose in the female breast region with a mean non-shielded dose of approximately 35 μGy. Dose reduction was also significantly lower for the back-region (mean: -65%, p < 0.0001) as well as for the gonad-region (mean: -98%, p < 0.0001) in the shielded situation. Reproducibility was inversely correlated to skin dose (Rspearman = -0.748, p < 0.0001) with a mean CV of 10.45% (SD: 24.53 %). Skin dose in the thyroid region of the simulated patient was relatively high and not influenced by the lead apron, which did not shield this region. Dose reduction by means of a commercial lead apron was significant in all other regions, particularly in the region of the female breast.

SU-E-CAMPUS-T-01: Analysis of the Precision of Patient Set-Up, and Fidelity of the Delivered Dose Distribution in Proton Therapy of Ocular Tumors

International Nuclear Information System (INIS)

Trofimov, A; Carpenter, K; Shih, HA

2014-01-01

Purpose: To quantify daily set-up variations in fractionated proton therapy of ocular melanomas, and to assess the effect on the fidelity of delivered distribution to the plan. Methods: In a typical five-fraction course, daily set-up is achieved by matching the position of fiducial markers in orthogonal radiographs to the images generated by treatment planning program. A patient maintains the required gaze direction voluntarily, without the aid of fixation devices. Confirmation radiographs are acquired to assess intrafractional changes. For this study, daily radiographs were analyzed to determine the daily iso-center position and apparent gaze direction, which were then transferred to the planning system to calculate the dose delivered in individual fractions, and accumulated dose for the entire course. Dose-volume metrics were compared between the planned and accumulated distributions for the tumor and organs at risk, for representative cases that varied by location within the ocular globe. Results: The analysis of the first set of cases (3 posterior, 3 transequatorial and 4 anterior tumors) revealed varying dose deviation patterns, depending on the tumor location. For anterior and posterior tumors, the largest dose increases were observed in the lens and ciliary body, while for the equatorial tumors, macula, optic nerve and disk, were most often affected. The iso-center position error was below 1.3 mm (95%-confidence interval), and the standard deviation of daily polar and azimuthal gaze set-up were 1.5 and 3 degrees, respectively. Conclusion: We quantified interfractional and intrafractional set-up variation, and estimated their effect on the delivered dose for representative cases. Current safety margins are sufficient to maintain the target coverage, however, the dose delivered to critical structures often deviates from the plan. The ongoing analysis will further explore the patterns of dose deviation, and may help to identify particular treatment scenarios

SU-E-CAMPUS-T-01: Analysis of the Precision of Patient Set-Up, and Fidelity of the Delivered Dose Distribution in Proton Therapy of Ocular Tumors

Energy Technology Data Exchange (ETDEWEB)

Trofimov, A; Carpenter, K; Shih, HA [Massachusetts General Hospital, Boston, MA (United States)

2014-06-15

Purpose: To quantify daily set-up variations in fractionated proton therapy of ocular melanomas, and to assess the effect on the fidelity of delivered distribution to the plan. Methods: In a typical five-fraction course, daily set-up is achieved by matching the position of fiducial markers in orthogonal radiographs to the images generated by treatment planning program. A patient maintains the required gaze direction voluntarily, without the aid of fixation devices. Confirmation radiographs are acquired to assess intrafractional changes. For this study, daily radiographs were analyzed to determine the daily iso-center position and apparent gaze direction, which were then transferred to the planning system to calculate the dose delivered in individual fractions, and accumulated dose for the entire course. Dose-volume metrics were compared between the planned and accumulated distributions for the tumor and organs at risk, for representative cases that varied by location within the ocular globe. Results: The analysis of the first set of cases (3 posterior, 3 transequatorial and 4 anterior tumors) revealed varying dose deviation patterns, depending on the tumor location. For anterior and posterior tumors, the largest dose increases were observed in the lens and ciliary body, while for the equatorial tumors, macula, optic nerve and disk, were most often affected. The iso-center position error was below 1.3 mm (95%-confidence interval), and the standard deviation of daily polar and azimuthal gaze set-up were 1.5 and 3 degrees, respectively. Conclusion: We quantified interfractional and intrafractional set-up variation, and estimated their effect on the delivered dose for representative cases. Current safety margins are sufficient to maintain the target coverage, however, the dose delivered to critical structures often deviates from the plan. The ongoing analysis will further explore the patterns of dose deviation, and may help to identify particular treatment scenarios

Comparison of film measurements and Monte Carlo simulations of dose delivered with very high-energy electron beams in a polystyrene phantom.

Science.gov (United States)

Bazalova-Carter, Magdalena; Liu, Michael; Palma, Bianey; Dunning, Michael; McCormick, Doug; Hemsing, Erik; Nelson, Janice; Jobe, Keith; Colby, Eric; Koong, Albert C; Tantawi, Sami; Dolgashev, Valery; Maxim, Peter G; Loo, Billy W

2015-04-01

To measure radiation dose in a water-equivalent medium from very high-energy electron (VHEE) beams and make comparisons to Monte Carlo (MC) simulation results. Dose in a polystyrene phantom delivered by an experimental VHEE beam line was measured with Gafchromic films for three 50 MeV and two 70 MeV Gaussian beams of 4.0-6.9 mm FWHM and compared to corresponding MC-simulated dose distributions. MC dose in the polystyrene phantom was calculated with the EGSnrc/BEAMnrc and DOSXYZnrc codes based on the experimental setup. Additionally, the effect of 2% beam energy measurement uncertainty and possible non-zero beam angular spread on MC dose distributions was evaluated. MC simulated percentage depth dose (PDD) curves agreed with measurements within 4% for all beam sizes at both 50 and 70 MeV VHEE beams. Central axis PDD at 8 cm depth ranged from 14% to 19% for the 5.4-6.9 mm 50 MeV beams and it ranged from 14% to 18% for the 4.0-4.5 mm 70 MeV beams. MC simulated relative beam profiles of regularly shaped Gaussian beams evaluated at depths of 0.64 to 7.46 cm agreed with measurements to within 5%. A 2% beam energy uncertainty and 0.286° beam angular spread corresponded to a maximum 3.0% and 3.8% difference in depth dose curves of the 50 and 70 MeV electron beams, respectively. Absolute dose differences between MC simulations and film measurements of regularly shaped Gaussian beams were between 10% and 42%. The authors demonstrate that relative dose distributions for VHEE beams of 50-70 MeV can be measured with Gafchromic films and modeled with Monte Carlo simulations to an accuracy of 5%. The reported absolute dose differences likely caused by imperfect beam steering and subsequent charge loss revealed the importance of accurate VHEE beam control and diagnostics.

Comparison of film measurements and Monte Carlo simulations of dose delivered with very high-energy electron beams in a polystyrene phantom

Energy Technology Data Exchange (ETDEWEB)

Bazalova-Carter, Magdalena; Liu, Michael; Palma, Bianey; Koong, Albert C.; Maxim, Peter G., E-mail: Peter.Maxim@Stanford.edu, E-mail: BWLoo@Stanford.edu; Loo, Billy W., E-mail: Peter.Maxim@Stanford.edu, E-mail: BWLoo@Stanford.edu [Department of Radiation Oncology, Stanford University, Stanford, California 94305-5847 (United States); Dunning, Michael; McCormick, Doug; Hemsing, Erik; Nelson, Janice; Jobe, Keith; Colby, Eric; Tantawi, Sami; Dolgashev, Valery [SLAC National Accelerator Laboratory, Menlo Park, California 94025 (United States)

2015-04-15

Purpose: To measure radiation dose in a water-equivalent medium from very high-energy electron (VHEE) beams and make comparisons to Monte Carlo (MC) simulation results. Methods: Dose in a polystyrene phantom delivered by an experimental VHEE beam line was measured with Gafchromic films for three 50 MeV and two 70 MeV Gaussian beams of 4.0–6.9 mm FWHM and compared to corresponding MC-simulated dose distributions. MC dose in the polystyrene phantom was calculated with the EGSnrc/BEAMnrc and DOSXYZnrc codes based on the experimental setup. Additionally, the effect of 2% beam energy measurement uncertainty and possible non-zero beam angular spread on MC dose distributions was evaluated. Results: MC simulated percentage depth dose (PDD) curves agreed with measurements within 4% for all beam sizes at both 50 and 70 MeV VHEE beams. Central axis PDD at 8 cm depth ranged from 14% to 19% for the 5.4–6.9 mm 50 MeV beams and it ranged from 14% to 18% for the 4.0–4.5 mm 70 MeV beams. MC simulated relative beam profiles of regularly shaped Gaussian beams evaluated at depths of 0.64 to 7.46 cm agreed with measurements to within 5%. A 2% beam energy uncertainty and 0.286° beam angular spread corresponded to a maximum 3.0% and 3.8% difference in depth dose curves of the 50 and 70 MeV electron beams, respectively. Absolute dose differences between MC simulations and film measurements of regularly shaped Gaussian beams were between 10% and 42%. Conclusions: The authors demonstrate that relative dose distributions for VHEE beams of 50–70 MeV can be measured with Gafchromic films and modeled with Monte Carlo simulations to an accuracy of 5%. The reported absolute dose differences likely caused by imperfect beam steering and subsequent charge loss revealed the importance of accurate VHEE beam control and diagnostics.

Design and implementation of a film dosimetry audit tool for comparison of planned and delivered dose distributions in high dose rate (HDR) brachytherapy

Science.gov (United States)

Palmer, Antony L.; Lee, Chris; Ratcliffe, Ailsa J.; Bradley, David; Nisbet, Andrew

2013-10-01

A novel phantom is presented for ‘full system’ dosimetric audit comparing planned and delivered dose distributions in HDR gynaecological brachytherapy, using clinical treatment applicators. The brachytherapy applicator dosimetry test object consists of a near full-scatter water tank with applicator and film supports constructed of Solid Water, accommodating any typical cervix applicator. Film dosimeters are precisely held in four orthogonal planes bisecting the intrauterine tube, sampling dose distributions in the high risk clinical target volume, points A and B, bladder, rectum and sigmoid. The applicator position is fixed prior to CT scanning and through treatment planning and irradiation. The CT data is acquired with the applicator in a near clinical orientation to include applicator reconstruction in the system test. Gamma analysis is used to compare treatment planning system exported RTDose grid with measured multi-channel film dose maps. Results from two pilot audits are presented, using Ir-192 and Co-60 HDR sources, with a mean gamma passing rate of 98.6% using criteria of 3% local normalization and 3 mm distance to agreement (DTA). The mean DTA between prescribed dose and measured film dose at point A was 1.2 mm. The phantom was funded by IPEM and will be used for a UK national brachytherapy dosimetry audit.

Design and implementation of a film dosimetry audit tool for comparison of planned and delivered dose distributions in high dose rate (HDR) brachytherapy

International Nuclear Information System (INIS)

Palmer, Antony L; Bradley, David; Nisbet, Andrew; Lee, Chris; Ratcliffe, Ailsa J

2013-01-01

A novel phantom is presented for ‘full system’ dosimetric audit comparing planned and delivered dose distributions in HDR gynaecological brachytherapy, using clinical treatment applicators. The brachytherapy applicator dosimetry test object consists of a near full-scatter water tank with applicator and film supports constructed of Solid Water, accommodating any typical cervix applicator. Film dosimeters are precisely held in four orthogonal planes bisecting the intrauterine tube, sampling dose distributions in the high risk clinical target volume, points A and B, bladder, rectum and sigmoid. The applicator position is fixed prior to CT scanning and through treatment planning and irradiation. The CT data is acquired with the applicator in a near clinical orientation to include applicator reconstruction in the system test. Gamma analysis is used to compare treatment planning system exported RTDose grid with measured multi-channel film dose maps. Results from two pilot audits are presented, using Ir-192 and Co-60 HDR sources, with a mean gamma passing rate of 98.6% using criteria of 3% local normalization and 3 mm distance to agreement (DTA). The mean DTA between prescribed dose and measured film dose at point A was 1.2 mm. The phantom was funded by IPEM and will be used for a UK national brachytherapy dosimetry audit. (paper)

Assessment of radiation doses to the para-aortic, pelvic, and inguinal lymph nodes delivered by image-guided adaptive brachytherapy in locally advanced cervical cancer

DEFF Research Database (Denmark)

Mohamed, Sandy M I; Aagaard, Torben; Fokdal, Lars U

2015-01-01

PURPOSE: This study evaluated the dose delivered to lymph nodes (LNs) by brachytherapy (BT) and the effect of BT image-guided optimization on the LN dose. METHODS AND MATERIALS: Twenty-five patients with locally advanced cervical cancer were retrospectively analyzed, 16 patients of them had LN...

Effects of low doses; Effet des faibles doses

Energy Technology Data Exchange (ETDEWEB)

Le Guen, B. [Electricite de France (EDF-LAM-SCAST), 93 - Saint-Denis (France)

2001-07-01

Actually, even though it is comfortable for the risk management, the hypothesis of the dose-effect relationship linearity is not confirmed for any model. In particular, in the area of low dose rate delivered by low let emitters. this hypothesis is debated at the light of recent observations, notably these ones relative to the mechanisms leading to genetic instability and induction eventuality of DNA repair. The problem of strong let emitters is still to solve. (N.C.)

Male gonadal dose of ionizing radiation delivered during X-ray examinations and monthly probability of pregnancy: a population-based retrospective study

Directory of Open Access Journals (Sweden)

Slama Remy

2006-03-01

Full Text Available Abstract Background Male gonadal exposure to ionizing radiation may disrupt spermatogenesis, but its influence on the fecundity of couples has been rarely studied. We aimed to characterize the influence of male gonadal dose of ionizing radiation delivered during radiodiagnostic on the monthly probability of pregnancy. Methods We recruited a random sample of women who retrospectively described 1110 periods of unprotected intercourse beginning between 1985 and 1999 and leading either to a live birth or to no pregnancy; their duration was censored after 13 months. The male partner answered a telephone questionnaire on radiodiagnostic examinations. We assigned a mean gonadal dose to each type of radiodiagnostic examination. We defined male dose for each period of unprotected intercourse as the sum of the gonadal doses of the X-ray examinations experienced between 18 years of age and the date of discontinuation of contraception. Time to pregnancy was analysed using a discrete Cox model with random effect allowing to estimate hazard ratios of pregnancy. Results After adjustment for female factors likely to influence fecundity, there was no evidence of an association between male dose and the probability of pregnancy (test of homogeneity, p = 0.55. When compared to couples with a male gonadal dose between 0.01 and 0.20 milligrays (n = 321 periods of unprotected intercourse, couples with a gonadal dose above 10 milligrays had a hazard ratio of pregnancy of 1.44 (95% confidence interval, 0.73–2.86, n = 31. Conclusion Our study provides no evidence of a long-term detrimental effect of male gonadal dose of ionizing radiation delivered during radiodiagnostic on the monthly probability of pregnancy during the year following discontinuation of contraceptive use. Classification errors due to the retrospective assessment of male gonadal exposure may have limited the statistical power of our study.

Audit of radiation dose delivered in time-resolved four-dimensional computed tomography in a radiotherapy department

International Nuclear Information System (INIS)

Hubbard, Patricia; Calllahan, Jason; Cramb, Jim; Budd, Ray

2015-01-01

To review the dose delivered to patients in time-resolved computed tomography (4D CT) used for radiotherapy treatment planning. 4D CT is used at Peter MacCallum Cancer Centre since July 2007 for radiotherapy treatment planning using a Philips Brilliance Wide Bore CT scanner (16 slice, helical 4D CT acquisition). All scans are performed at 140 kVp and reconstructed in 10 datasets for different phases of the breathing cycle. Dose records were analysed retrospectively for 387 patients who underwent 4D CT procedures between 2007 and 2013. A total of 444 4D CT scans were acquired with the majority of them (342) being for lung cancer radiotherapy. Volume CT dose index (CTDIvol) as recorded over this period was fairly constant at approximately 20 mGy for adults. The CTDI for 4D CT for lung cancers of 19.6 ± 9.3 mGy (n = 168, mean ± 1SD) was found to be 63% higher than CTDIs for conventional CT scans for lung patients that were acquired in the same period (CTDIvol 12 ± 4 mGy, sample of n = 25). CTDI and dose length product (DLP) increased with increasing field of view; however, no significant difference between DLPs for different indications (breast, kidney, liver and lung) could be found. Breathing parameters such as breathing rate or pattern did not affect dose. 4D CT scans can be acquired for radiotherapy treatment planning with a dose less than twice the one required for conventional CT scanning.

Comparison of two methods for minimizing the effect of delayed charge on the dose delivered with a synchrotron based discrete spot scanning proton beam.

Science.gov (United States)

Whitaker, Thomas J; Beltran, Chris; Tryggestad, Erik; Bues, Martin; Kruse, Jon J; Remmes, Nicholas B; Tasson, Alexandria; Herman, Michael G

2014-08-01

Delayed charge is a small amount of charge that is delivered to the patient after the planned irradiation is halted, which may degrade the quality of the treatment by delivering unwarranted dose to the patient. This study compares two methods for minimizing the effect of delayed charge on the dose delivered with a synchrotron based discrete spot scanning proton beam. The delivery of several treatment plans was simulated by applying a normally distributed value of delayed charge, with a mean of 0.001(SD 0.00025) MU, to each spot. Two correction methods were used to account for the delayed charge. Method one (CM1), which is in active clinical use, accounts for the delayed charge by adjusting the MU of the current spot based on the cumulative MU. Method two (CM2) in addition reduces the planned MU by a predicted value. Every fraction of a treatment was simulated using each method and then recomputed in the treatment planning system. The dose difference between the original plan and the sum of the simulated fractions was evaluated. Both methods were tested in a water phantom with a single beam and simple target geometry. Two separate phantom tests were performed. In one test the dose per fraction was varied from 0.5 to 2 Gy using 25 fractions per plan. In the other test the number fractions were varied from 1 to 25, using 2 Gy per fraction. Three patient plans were used to determine the effect of delayed charge on the delivered dose under realistic clinical conditions. The order of spot delivery using CM1 was investigated by randomly selecting the starting spot for each layer, and by alternating per layer the starting spot from first to last. Only discrete spot scanning was considered in this study. Using the phantom setup and varying the dose per fraction, the maximum dose difference for each plan of 25 fractions was 0.37-0.39 Gy and 0.03-0.05 Gy for CM1 and CM2, respectively. While varying the total number of fractions, the maximum dose difference increased at a rate

Comparison of two methods for minimizing the effect of delayed charge on the dose delivered with a synchrotron based discrete spot scanning proton beam

International Nuclear Information System (INIS)

Whitaker, Thomas J.; Beltran, Chris; Tryggestad, Erik; Kruse, Jon J.; Remmes, Nicholas B.; Tasson, Alexandria; Herman, Michael G.; Bues, Martin

2014-01-01

Purpose: Delayed charge is a small amount of charge that is delivered to the patient after the planned irradiation is halted, which may degrade the quality of the treatment by delivering unwarranted dose to the patient. This study compares two methods for minimizing the effect of delayed charge on the dose delivered with a synchrotron based discrete spot scanning proton beam. Methods: The delivery of several treatment plans was simulated by applying a normally distributed value of delayed charge, with a mean of 0.001(SD 0.00025) MU, to each spot. Two correction methods were used to account for the delayed charge. Method one (CM1), which is in active clinical use, accounts for the delayed charge by adjusting the MU of the current spot based on the cumulative MU. Method two (CM2) in addition reduces the planned MU by a predicted value. Every fraction of a treatment was simulated using each method and then recomputed in the treatment planning system. The dose difference between the original plan and the sum of the simulated fractions was evaluated. Both methods were tested in a water phantom with a single beam and simple target geometry. Two separate phantom tests were performed. In one test the dose per fraction was varied from 0.5 to 2 Gy using 25 fractions per plan. In the other test the number fractions were varied from 1 to 25, using 2 Gy per fraction. Three patient plans were used to determine the effect of delayed charge on the delivered dose under realistic clinical conditions. The order of spot delivery using CM1 was investigated by randomly selecting the starting spot for each layer, and by alternating per layer the starting spot from first to last. Only discrete spot scanning was considered in this study. Results: Using the phantom setup and varying the dose per fraction, the maximum dose difference for each plan of 25 fractions was 0.37–0.39 Gy and 0.03–0.05 Gy for CM1 and CM2, respectively. While varying the total number of fractions, the maximum dose

Prescribing and evaluating target dose in dose-painting treatment plans

DEFF Research Database (Denmark)

Håkansson, Katrin; Specht, Lena; Aznar, Marianne C

2014-01-01

BACKGROUND: Assessment of target dose conformity in multi-dose-level treatment plans is challenging due to inevitable over/underdosage at the border zone between dose levels. Here, we evaluate different target dose prescription planning aims and approaches to evaluate the relative merit of such p......-painting and multi-dose-level plans. The tool can be useful for quality assurance of multi-center trials, and for visualizing the development of treatment planning in routine clinical practice....... of such plans. A quality volume histogram (QVH) tool for history-based evaluation is proposed. MATERIAL AND METHODS: Twenty head and neck cancer dose-painting plans with five prescription levels were evaluated, as well as clinically delivered simultaneous integrated boost (SIB) plans from 2010 and 2012. The QVH...

A comparison of skin and chest wall dose delivered with multicatheter, Contura multilumen balloon, and MammoSite breast brachytherapy.

Science.gov (United States)

Cuttino, Laurie W; Todor, Dorin; Rosu, Mihaela; Arthur, Douglas W

2011-01-01

Skin and chest wall doses have been correlated with toxicity in patients treated with breast brachytherapy . This investigation compared the ability to control skin and chest wall doses between patients treated with multicatheter (MC), Contura multilumen balloon (CMLB), and MammoSite (MS) brachytherapy. 43 patients treated with the MC technique, 45 patients treated with the CMLB, and 83 patients treated with the MS were reviewed. The maximum doses delivered to the skin and chest wall were calculated for all patients. The mean maximum skin doses for the MC, CMLB, and MS were 2.3 Gy (67% of prescription dose), 2.8 Gy (82% of prescription dose), and 3.2 Gy per fraction (94% of prescription dose), respectively. Although the skin distances were similar (p = 0.23) for the two balloon techniques, the mean skin dose with the CMLB was significantly lower than with the MS (p = 0.05). The mean maximum rib doses for the MC, CMLB, and MS were 2.3 Gy (67% of prescription dose), 2.8 Gy (82% of prescription dose), and 3.6 Gy per fraction (105% of prescription dose), respectively. Again, the mean rib dose with the CMLB was significantly lower than with the MS (p = 0.002). The MC and CMLB techniques are associated with significantly lower mean skin and rib doses than is the MS. Treatment with the MS was associated with significantly more patients receiving doses to the skin or rib in excess of 125% of the prescription. Treatment with the CMLB may prove to yield less normal tissue toxicity than treatment with the MS. Copyright © 2011 Elsevier Inc. All rights reserved.

A Comparison of Skin and Chest Wall Dose Delivered With Multicatheter, Contura Multilumen Balloon, and MammoSite Breast Brachytherapy

International Nuclear Information System (INIS)

Cuttino, Laurie W.; Todor, Dorin; Rosu, Mihaela; Arthur, Douglas W.

2011-01-01

Purpose: Skin and chest wall doses have been correlated with toxicity in patients treated with breast brachytherapy . This investigation compared the ability to control skin and chest wall doses between patients treated with multicatheter (MC), Contura multilumen balloon (CMLB), and MammoSite (MS) brachytherapy. Methods and Materials: 43 patients treated with the MC technique, 45 patients treated with the CMLB, and 83 patients treated with the MS were reviewed. The maximum doses delivered to the skin and chest wall were calculated for all patients. Results: The mean maximum skin doses for the MC, CMLB, and MS were 2.3 Gy (67% of prescription dose), 2.8 Gy (82% of prescription dose), and 3.2 Gy per fraction (94% of prescription dose), respectively. Although the skin distances were similar (p = 0.23) for the two balloon techniques, the mean skin dose with the CMLB was significantly lower than with the MS (p = 0.05). The mean maximum rib doses for the MC, CMLB, and MS were 2.3 Gy (67% of prescription dose), 2.8 Gy (82% of prescription dose), and 3.6 Gy per fraction (105% of prescription dose), respectively. Again, the mean rib dose with the CMLB was significantly lower than with the MS (p = 0.002). Conclusion: The MC and CMLB techniques are associated with significantly lower mean skin and rib doses than is the MS. Treatment with the MS was associated with significantly more patients receiving doses to the skin or rib in excess of 125% of the prescription. Treatment with the CMLB may prove to yield less normal tissue toxicity than treatment with the MS.

Considering job-related doses in Europe

International Nuclear Information System (INIS)

Anon.

1990-01-01

As part of its role of safeguarding nuclear workers the Commission of the European Community has created a European data bank on job-related doses. The data bank is intended to correlate jobs and workers doses and is a useful instrument to observe the collected doses of workers in nuclear power plants. Set up in 1980, the database covers doses in PWRs and BWRs. To create it a questionnaire is distributed to plant operators. The database responses provide information on (i) Trends in total collective doses, including those for some ancillary jobs. It is possible to see trends by calendar year and by fuel cycle number. (ii) Other trends such as dose in terms of installed power or dose in terms of power station design. (iii) Dose differences between power stations, normalized against the differences in dose rates. This is only possible for PWRs that monitor dose rates using the EPRI standard monitoring programme. (vi) The relative dose rate in each plant for a defined job. The questionnaire is not perfectly adapted to all the working criteria in nuclear power stations but it is an effective tool for implementing radiation protection. (author)

Examining the cost of delivering routine immunization in Honduras.

Science.gov (United States)

Janusz, Cara Bess; Castañeda-Orjuela, Carlos; Molina Aguilera, Ida Berenice; Felix Garcia, Ana Gabriela; Mendoza, Lourdes; Díaz, Iris Yolanda; Resch, Stephen C

2015-05-07

Many countries have introduced new vaccines and expanded their immunization programs to protect additional risk groups, thus raising the cost of routine immunization delivery. Honduras recently adopted two new vaccines, and the country continues to broaden the reach of its program to adolescents and adults. In this article, we estimate and examine the economic cost of the Honduran routine immunization program for the year 2011. The data were gathered from a probability sample of 71 health facilities delivering routine immunization, as well as 8 regional and 1 central office of the national immunization program. Data were collected on vaccinations delivered, staff time dedicated to the program, cold chain equipment and upkeep, vehicle use, infrastructure, and other recurrent and capital costs at each health facility and administrative office. Annualized economic costs were estimated from a modified societal perspective and reported in 2011 US dollars. With the addition of rotavirus and pneumococcal conjugate vaccines, the total cost for routine immunization delivery in Honduras for 2011 was US$ 32.5 million. Vaccines and related supplies accounted for 23% of the costs. Labor, cold chain, and vehicles represented 54%, 4%, and 1%, respectively. At the facility level, the non-vaccine system costs per dose ranged widely, from US$ 25.55 in facilities delivering fewer than 500 doses per year to US$ 2.84 in facilities with volume exceeding 10,000 doses per year. Cost per dose was higher in rural facilities despite somewhat lower wage rates for health workers in these settings; this appears to be driven by lower demand for services per health worker in sparsely populated areas, rather than increased cost of outreach. These more-precise estimates of the operational costs to deliver routine immunizations provide program managers with important information for mobilizing resources to help sustain the program and for improving annual planning and budgeting as well as longer

SU-E-T-515: Field-In-Field Compensation Technique Using Multi-Leaf Collimator to Deliver Total Body Irradiation (TBI) Dose

Energy Technology Data Exchange (ETDEWEB)

Lakeman, T [The State University of New York at Buffalo (United States); Wang, IZ [The State University of New York at Buffalo (United States); Roswell Park Cancer Institute, Buffalo, NY (United States)

2014-06-01

Purpose: Total body irradiation (TBI) uses large parallel-opposed radiation fields to suppress the patient's immune system and eradicate the residual cancer cells in preparation of recipient for bone marrow transplant. The manual placement of lead compensators has been used conventionally to compensate for the varying thickness through the entire body in large-field TBI. The goal of this study is to pursue utilizing the modern field-in-field (FIF) technique with the multi-leaf collimator (MLC) to more accurately and efficiently deliver dose to patients in need of TBI. Method: Treatment plans utilizing the FIF technique to deliver a total body dose were created retrospectively for patients for whom CT data had been previously acquired. Treatment fields include one pair of opposed open large fields (collimator=45°) with a specific weighting and a succession of smaller fields (collimator=90°) each with their own weighting. The smaller fields are shaped by moving MLC to block the sections of the patient which have already received close to 100% of the prescribed dose. The weighting factors for each of these fields were calculated using the attenuation coefficient of the initial lead compensators and the separation of the patient in different positions in the axial plane. Results: Dose-volume histograms (DVH) were calculated for evaluating the FIF compensation technique. The maximum body doses calculated from the DVH were reduced from the non-compensated 179.3% to 148.2% in the FIF plans, indicating a more uniform dose with the FIF compensation. All calculated monitor units were well within clinically acceptable limits and exceeded those of the original lead compensation plan by less than 50 MU (only ~1.1% increase). Conclusion: MLC FIF technique for TBI will not significantly increase the beam on time while it can substantially reduce the compensator setup time and the potential risk of errors in manually placing lead compensators.

Technical Evaluation of Radiation Dose Delivered in Prostate Cancer Patients as Measured by an Implantable MOSFET Dosimeter

International Nuclear Information System (INIS)

Beyer, Gloria P.; Scarantino, Charles W.; Prestidge, Bradley R.; Sadeghi, Amir G.; Anscher, Mitchell S.; Miften, Moyed; Carrea, Tammy B.; Sims, Marianne C.; Black, Robert D.

2007-01-01

Purpose: To perform a comparison of the daily measured dose at depth in tissue with the predicted dose values from treatment plans for 29 prostate cancer patients involved in a clinical trial. Methods and Materials: Patients from three clinical sites were implanted with one or two dosimeters in or near the prostatic capsule. The implantable device, known as the DVS, is based on a metal-oxide-semiconductor field effect transistor (MOSFET) detector. A portable telemetric readout system couples to the dosimeter antenna (visible on kilovoltage, computed tomography, and ultrasonography) for data transfer. The predicted dose values were determined by the location of the MOSFET on the treatment planning computed tomography scan. Serial computed tomography images were taken every 2 weeks to evaluate any migration of the device. The clinical protocol did not permit alteration of the treatment parameters using the dosimeter readings. For some patients, one of several image-guided radiotherapy (RT) modalities was used for target localization. Results: The evaluation of dose discrepancy showed that in many patients the standard deviation exceeded the previous values obtained for the dosimeter in a phantom. In some patients, the cumulative dose disagreed with the planned dose by ≥5%. The data presented suggest that an implantable dosimeter can help identify dose discrepancies (random or systematic) for patients treated with external beam RT and could be used as a daily treatment verification tool for image-guided RT and adaptive RT. Conclusion: The results of our study have shown that knowledge of the dose delivered per fraction can potentially prevent over- or under-dosage to the treatment area and increase the accuracy of RT. The implantable dosimeter could also be used as a localizer for image-guided RT

Estimation of the total effective dose from low-dose CT scans and radiopharmaceutical administrations delivered to patients undergoing SPECT/CT explorations

International Nuclear Information System (INIS)

Montes, C.; Hernandez, J.; Gomez-Caminero, F.; Garcia, S.; Martin, C.; Rosero, A.; Tamayo, P.

2013-01-01

Hybrid imaging, such as single photon emission computed tomography (SPECT)/CT, is used in routine clinical practice, allowing coregistered images of the functional and structural information provided by the two imaging modalities. However, this multimodality imaging may mean that patients are exposed to a higher radiation dose than those receiving SPECT alone. The study aimed to determine the radiation exposure of patients who had undergone SPECT/CT examinations and to relate this to the Background Equivalent Radiation Time (BERT). 145 SPECT/CT studies were used to estimate the total effective dose to patients due to both radiopharmaceutical administrations and low-dose CT scans. The CT contribution was estimated by the Dose-Length Product method. Specific conversion coefficients were calculated for SPECT explorations. The radiation dose from low-dose CTs ranged between 0.6 mSv for head and neck CT and 2.6 mSv for whole body CT scan, representing a maximum of 1 year of background radiation exposure. These values represent a decrease of 80-85% with respect to the radiation dose from diagnostic CT. The radiation exposure from radiopharmaceutical administration varied from 2.1 mSv for stress myocardial perfusion SPECT to 26 mSv for gallium SPECT in patients with lymphoma. The BERT ranged from 1 to 11 years. The contribution of low-dose CT scans to the total radiation dose to patients undergoing SPECT/CT examinations is relatively low compared with the effective dose from radiopharmaceutical administration. When a CT scan is only acquired for anatomical localization and attenuation correction, low-dose CT scan is justified on the basis of its lower dose. (author)

Development of an Exergame to Deliver a Sustained Dose of High-Intensity Training: Formative Pilot Randomized Trial.

Science.gov (United States)

McBain, Thomas; Weston, Matthew; Crawshaw, Paul; Haighton, Catherine; Spears, Iain

2018-03-27

Sport science can play a critical role in reducing health inequalities. The inverse relationship between life expectancy, cardiorespiratory fitness, and socioeconomic status could be addressed by performing high-intensity training (HIT), delivered in a class salient and accessible approach. Commercially available exergames have shown encouraging compliance rates but are primarily designed for entertainment purposes rather than focusing on health-related outcomes. A serious game tailored toward delivering an exercise stimulus, while reducing the aversive protocols associated with HIT, could be beneficial to engage and improve health outcomes in socially deprived males. The aims of this study were to develop an exergame capable of delivering HIT and evaluate the effect on selected health outcomes in men recruited in regions of socioeconomic deprivation. We conducted an exploratory trial in our target population, and participants were allocated to intervention (n=14) or control groups (n=10) by third-party minimization. The intervention was a 6-week training program consisting of three sessions of exergaming per week. The sessions involved a structured warm-up, then brief intermittent repetitions in the form of boxing rounds (10 s, 20 s, and 30 s) against their peers with a work/rest ratio of 0.25. Retention to the intervention was 87.5% (21/24). Over the duration of the intervention, session attendance was 67.5% (170/252); repetition mean and peak heart rates (% of maximal) and session ratings of perceived exertion (AU, arbitrary units) were 86.3 (5.4%), 89.9 (6.1%), and 7.5 (2.2 AU), respectively. The effect of the intervention, when compared with the control, was a likely small beneficial improvement in predicted maximum oxygen consumption (VO 2 max, 3.0; 90% confidence limits ±2.6%). Effects on body mass, waist circumference, and blood pressure were either trivial or unclear. Over the 6-week intervention, the exergame delivered a consistent and sustained dose of

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

Radiation Doses to Structures Within and Adjacent to the Larynx are Correlated With Long-Term Diet- and Speech-Related Quality of Life

International Nuclear Information System (INIS)

Dornfeld, Ken; Simmons, Joel R.; Karnell, Lucy; Karnell, Michael; Funk, Gerry; Yao Min; Wacha, Judith; Zimmerman, Bridget; Buatti, John M.

2007-01-01

Purpose: To test the hypothesis that radiation dose to key sites in the upper aerodigestive tract is associated with long-term functional outcome after (chemo)radiotherapy for head-and-neck cancers. Methods and Materials: This study examined the outcome for 27 patients treated with intensity-modulated radiotherapy for definitive management of their head-and-neck cancer who were disease free for at least 1 year after treatment. Head-and-neck cancer-specific quality of life (QoL) was assessed before treatment and at 1 year after treatment. Type of diet tolerated, presence of a feeding tube, and degree of weight loss 1 year after treatment were also used as outcome measures. Radiation doses delivered to various points along the upper aerodigestive tract, including base of tongue, lateral pharyngeal walls, and laryngeal structures, were determined from each treatment plan. Radiation doses for each of these points were tested for correlation with outcome measures. Results: Higher doses delivered to the aryepiglottic folds, false vocal cords, and lateral pharyngeal walls near the false cords correlated with a more restrictive diet, and higher doses to the aryepiglottic folds correlated with greater weight loss (p < 0.05) 1 year after therapy. Better posttreatment speech QoL scores were associated with lower doses delivered to structures within and surrounding the larynx. Conclusion: Our data show an inverse relationship between radiation dose delivered to laryngeal structures and speech and diet and QoL outcomes after definitive (chemo)radiation treatment. These findings suggest that efforts to deliver lower doses to laryngeal structures may improve outcomes after definitive (chemo)radiation therapy

Surface applicators for high dose rate brachytherapy in AIDS-related kaposi's sarcoma

International Nuclear Information System (INIS)

Evans, Michael D.C.; Yassa, Mariam; Podgorsak, Ervin B.; Roman, Ted N.; Schreiner, L. John; Souhami, Luis

1997-01-01

Purpose: The development of commercially available surface applicators using high dose rate remote afterloading devices has enabled radiotherapy centers to treat selected superficial lesions using a remote afterloading brachytherapy unit. The dosimetric parameters of these applicators, the clinical implementation of this technique, and a review of the initial patient treatment regimes are presented. Methods and Materials: A set of six fixed-diameter (1, 2, and 3 cm), tungsten/steel surface applicators is available for use with a single stepping-source (Ir-192, 370 GBq) high dose rate afterloader. The source can be positioned either in a parallel or perpendicular orientation to the treatment plane at the center of a conical aperture that sits at an SSD of approximately 15 mm and is used with a 1-mm thick removable plastic cap. The surface dose rates, percent depth dose, and off-axis ratios were measured. A custom-built, ceiling-mounted immobilization device secures the applicator on the surface of the patient's lesion during treatment. Results: Between November 1994, and September 1996, 16 AIDS-related Kaposi's sarcoma patients having a total of 120 lesions have been treated with palliative intent. Treatment sites were distributed between the head and neck, extremity, and torso. Doses ranged from 8 to 20 Gy, with a median dose of 10 Gy delivered in a single fraction. Treatments were well tolerated with minimal skin reaction, except for patients with lesions treated to 20 Gy who developed moderate/severe desquamation. Conclusion: Radiotherapy centers equipped with a high dose rate remote afterloading unit may treat small selected surface lesions with commercially available surface applicators. These surface applicators must be used with a protective cap to eliminate electron contamination. The optimal surface dose appears to be either 10 or 15 Gy depending upon the height of the lesion

In situ biological dose mapping estimates the radiation burden delivered to 'spared' tissue between synchrotron X-ray microbeam radiotherapy tracks.

Directory of Open Access Journals (Sweden)

Kai Rothkamm

Full Text Available Microbeam radiation therapy (MRT using high doses of synchrotron X-rays can destroy tumours in animal models whilst causing little damage to normal tissues. Determining the spatial distribution of radiation doses delivered during MRT at a microscopic scale is a major challenge. Film and semiconductor dosimetry as well as Monte Carlo methods struggle to provide accurate estimates of dose profiles and peak-to-valley dose ratios at the position of the targeted and traversed tissues whose biological responses determine treatment outcome. The purpose of this study was to utilise γ-H2AX immunostaining as a biodosimetric tool that enables in situ biological dose mapping within an irradiated tissue to provide direct biological evidence for the scale of the radiation burden to 'spared' tissue regions between MRT tracks. Γ-H2AX analysis allowed microbeams to be traced and DNA damage foci to be quantified in valleys between beams following MRT treatment of fibroblast cultures and murine skin where foci yields per unit dose were approximately five-fold lower than in fibroblast cultures. Foci levels in cells located in valleys were compared with calibration curves using known broadbeam synchrotron X-ray doses to generate spatial dose profiles and calculate peak-to-valley dose ratios of 30-40 for cell cultures and approximately 60 for murine skin, consistent with the range obtained with conventional dosimetry methods. This biological dose mapping approach could find several applications both in optimising MRT or other radiotherapeutic treatments and in estimating localised doses following accidental radiation exposure using skin punch biopsies.

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

Purpose: High geometrical and dosimetrical accuracies are required for radiotherapy treatments where IMRT is applied in combination with narrow treatment margins in order to minimize dose delivery to normal tissues. As an overall check, we implemented a method for reconstruction of the actually delivered 3D dose distribution to the patient during a treatment fraction, i.e., the 'dose of the day'. In this article results on the clinical evaluation of this concept for a group of IMRT prostate cancer patients are presented. Materials and methods: The actual IMRT fluence maps delivered to a patient were derived from measured EPID-images acquired during treatment using a previously described iterative method. In addition, the patient geometry was obtained from in-room acquired cone-beam CT images. For dose calculation, a mapping of the Hounsfield Units from the planning CT was applied. With the fluence maps and the modified cone-beam CT the 'dose of the day' was calculated. The method was validated using phantom measurements and evaluated clinically for 10 prostate cancer patients in 4 or 5 fractions. Results: The phantom measurements showed that the delivered dose could be reconstructed within 3%/3 mm accuracy. For prostate cancer patients, the isocenter dose agreed within -0.4 ± 1.0% (1 SD) with the planned value, while for on average 98.1% of the pixels within the 50% isodose surface the actually delivered dose agreed within 3% or 3 mm with the planned dose. For most fractions, the dose coverage of the prostate volume was slightly deteriorated which was caused by small prostate rotations and small inaccuracies in fluence delivery. The dose that was delivered to the rectum remained within the constraints used during planning. However, for two patients a large degrading of the dose delivery was observed in two fractions. For one patient this was related to changes in rectum filling with respect to the planning CT and for the other to large intra-fraction motion during

Effects of low doses

International Nuclear Information System (INIS)

Le Guen, B.

2001-01-01

Actually, even though it is comfortable for the risk management, the hypothesis of the dose-effect relationship linearity is not confirmed for any model. In particular, in the area of low dose rate delivered by low let emitters. this hypothesis is debated at the light of recent observations, notably these ones relative to the mechanisms leading to genetic instability and induction eventuality of DNA repair. The problem of strong let emitters is still to solve. (N.C.)

Circulating miR-29a and miR-150 correlate with delivered dose during thoracic radiation therapy for non-small cell lung cancer

International Nuclear Information System (INIS)

Dinh, Tru-Khang T.; Fendler, Wojciech; Chałubińska-Fendler, Justyna; Acharya, Sanket S.; O’Leary, Colin; Deraska, Peter V.; D’Andrea, Alan D.; Chowdhury, Dipanjan; Kozono, David

2016-01-01

Risk of normal tissue toxicity limits the amount of thoracic radiation therapy (RT) that can be routinely prescribed to treat non-small cell lung cancer (NSCLC). An early biomarker of response to thoracic RT may provide a way to predict eventual toxicities—such as radiation pneumonitis—during treatment, thereby enabling dose adjustment before the symptomatic onset of late effects. MicroRNAs (miRNAs) were studied as potential serological biomarkers for thoracic RT. As a first step, we sought to identify miRNAs that correlate with delivered dose and standard dosimetric factors. We performed miRNA profiling of plasma samples obtained from five patients with Stage IIIA NSCLC at five dose-points each during radical thoracic RT. Candidate miRNAs were then assessed in samples from a separate cohort of 21 NSCLC patients receiving radical thoracic RT. To identify a cellular source of circulating miRNAs, we quantified in vitro miRNA expression intracellularly and within secreted exosomes in five NSCLC and stromal cell lines. miRNA profiling of the discovery cohort identified ten circulating miRNAs that correlated with delivered RT dose as well as other dosimetric parameters such as lung V20. In the validation cohort, miR-29a-3p and miR-150-5p were reproducibly shown to decrease with increasing radiation dose. Expression of miR-29a-3p and miR-150-5p in secreted exosomes decreased with radiation. This was concomitant with an increase in intracellular levels, suggesting that exosomal export of these miRNAs may be downregulated in both NSCLC and stromal cells in response to radiation. miR-29a-3p and miR-150-5p were identified as circulating biomarkers that correlated with delivered RT dose. miR-150 has been reported to decrease in the circulation of mammals exposed to radiation while miR-29a has been associated with fibrosis in the human heart, lungs, and kidneys. One may therefore hypothesize that outlier levels of circulating miR-29a-3p and miR-150-5p may eventually help

Independent verification of the delivered dose in High-Dose Rate (HDR) brachytherapy

International Nuclear Information System (INIS)

Portillo, P.; Feld, D.; Kessler, J.

2009-01-01

An important aspect of a Quality Assurance program in Clinical Dosimetry is an independent verification of the dosimetric calculation done by the Treatment Planning System for each radiation treatment. The present paper is aimed at creating a spreadsheet for the verification of the dose recorded at a point of an implant with radioactive sources and HDR in gynecological injuries. An 192 Ir source automatic differed loading equipment, GammaMedplus model, Varian Medical System with HDR installed at the Angel H. Roffo Oncology Institute has been used. The planning system implemented for getting the dose distribution is the BraquiVision. The sources coordinates as well as those of the calculation point (Rectum) are entered into the Excel-devised verification program by assuming the existence of a point source in each one of the applicators' positions. Such calculation point has been selected as the rectum is an organ at risk, therefore determining the treatment planning. The dose verification is performed at points standing at a sources distance having at least twice the active length of such sources, so they may be regarded as point sources. Most of the sources used in HDR brachytherapy with 192 Ir have a 5 mm active length for all equipment brands. Consequently, the dose verification distance must be at least of 10 mm. (author)

Beam intensity scanner system for three dimensional dose verification of IMRT

International Nuclear Information System (INIS)

Vahc, Young W.; Kwon, Ohyun; Park, Kwangyl; Park, Kyung R.; Yi, Byung Y.; Kim, Keun M.

2003-01-01

Patient dose verification is clinically one of the most important parts in the treatment delivery of radiation therapy. The three dimensional (3D) reconstruction of dose distribution delivered to target volume helps to verify patient dose and determine the physical characteristics of beams used in IMRT. Here we present beam intensity scanner (BInS) system for the pre-treatment dosimetric verification of two dimensional photon intensity. The BInS is a radiation detector with a custom-made software for dose conversion of fluorescence signals from scintillator. The scintillator is used to produce fluorescence from the irradiation of 6 MV photons on a Varian Clinac 21EX. The digitized fluoroscopic signals obtained by digital video camera-based scintillator (DVCS) will be processed by our custom made software to reproduce 3D- relative dose distribution. For the intensity modulated beam (IMB), the BInS calculates absorbed dose in absolute beam fluence which is used for the patient dose distribution. Using BInS, we performed various measurements related to IMRT and found the following: (1) The 3D-dose profiles of the IMBs measured by the BInS demonstrate good agreement with radiographic film, pin type ionization chamber and Monte Carlo simulation. (2) The delivered beam intensity is altered by the mechanical and dosimetric properties of the collimation of dynamic and/or step MLC system. This is mostly due to leaf transmission, leaf penumbra scattered photons from the round edges of leaves, and geometry of leaf. (3) The delivered dose depends on the operational detail of how to make multi leaf opening. These phenomena result in a fluence distribution that can be substantially different from the initial and calculated intensity modulation and therefore, should be taken into account by the treatment planning for accurate dose calculations delivered to the target volume in IMRT. (author)

Delivered dose uncertainty analysis at the tumor apex for ocular brachytherapy

Energy Technology Data Exchange (ETDEWEB)

Morrison, Hali, E-mail: hamorris@ualberta.ca; Menon, Geetha; Larocque, Matthew P.; Jans, Hans-Sonke; Sloboda, Ron S. [Department of Medical Physics, Cross Cancer Institute, Edmonton, Alberta T6G 1Z2, Canada and Department of Oncology, University of Alberta, Edmonton, Alberta T6G 2R3 (Canada); Weis, Ezekiel [Department of Ophthalmology, University of Alberta, Edmonton, Alberta T6G 2R3 (Canada)

2016-08-15

Purpose: To estimate the total dosimetric uncertainty at the tumor apex for ocular brachytherapy treatments delivered using 16 mm Collaborative Ocular Melanoma Study (COMS) and Super9 plaques loaded with {sup 125}I seeds in order to determine the size of the apex margin that would be required to ensure adequate dosimetric coverage of the tumor. Methods: The total dosimetric uncertainty was assessed for three reference tumor heights: 3, 5, and 10 mm, using the Guide to the expression of Uncertainty in Measurement/National Institute of Standards and Technology approach. Uncertainties pertaining to seed construction, source strength, plaque assembly, treatment planning calculations, tumor height measurement, plaque placement, and plaque tilt for a simple dome-shaped tumor were investigated and quantified to estimate the total dosimetric uncertainty at the tumor apex. Uncertainties in seed construction were determined using EBT3 Gafchromic film measurements around single seeds, plaque assembly uncertainties were determined using high resolution microCT scanning of loaded plaques to measure seed positions in the plaques, and all other uncertainties were determined from the previously published studies and recommended values. All dose calculations were performed using PLAQUESIMULATOR v5.7.6 ophthalmic treatment planning system with the inclusion of plaque heterogeneity corrections. Results: The total dosimetric uncertainties at 3, 5, and 10 mm tumor heights for the 16 mm COMS plaque were 17.3%, 16.1%, and 14.2%, respectively, and for the Super9 plaque were 18.2%, 14.4%, and 13.1%, respectively (all values with coverage factor k = 2). The apex margins at 3, 5, and 10 mm tumor heights required to adequately account for these uncertainties were 1.3, 1.3, and 1.4 mm, respectively, for the 16 mm COMS plaque, and 1.8, 1.4, and 1.2 mm, respectively, for the Super9 plaque. These uncertainties and associated margins are dependent on the dose gradient at the given prescription

Eye lens dosimetry for interventional procedures – Relation between the absorbed dose to the lens and dose at measurement positions

International Nuclear Information System (INIS)

Geber, Therese; Gunnarsson, Mikael; Mattsson, Sören

2011-01-01

This study investigated the relationship between the absorbed dose to the lens of the eye and the absorbed dose at different measurement positions near the eye of interventional radiologists. It also visualised the dose distribution inside the head, both when protective eyewear were used and without such protection. The best position for an eye lens dosimeter was found to be at the side of the head nearest to the radiation source, close to the eye. Positioning the dosimeter at the eyebrow could lead to an underestimation of the lens dose of as much as 45%. The measured dose distribution showed that the absorbed dose to the eye lenses was high compared to the other parts of the head, which stresses the importance of wearing protective eyewear. However, many models of eyewear were found to be deficient as the radiation could slip through at several places, e.g. at the cheek. The relationship between the absorbed dose to the lens and the kerma-area-product (P KA ) delivered to the patient was also studied.

Costs of delivering human papillomavirus vaccination to schoolgirls in Mwanza Region, Tanzania

Science.gov (United States)

2012-01-01

Background Cervical cancer is the leading cause of female cancer-related deaths in Tanzania. Vaccination against human papillomavirus (HPV) offers a new opportunity to control this disease. This study aimed to estimate the costs of a school-based HPV vaccination project in three districts in Mwanza Region (NCT ID: NCT01173900), Tanzania and to model incremental scaled-up costs of a regional vaccination program. Methods We first conducted a top-down cost analysis of the vaccination project, comparing observed costs of age-based (girls born in 1998) and class-based (class 6) vaccine delivery in a total of 134 primary schools. Based on the observed project costs, we then modeled incremental costs of a scaled-up vaccination program for Mwanza Region from the perspective of the Tanzanian government, assuming that HPV vaccines would be delivered through the Expanded Programme on Immunization (EPI). Results Total economic project costs for delivering 3 doses of HPV vaccine to 4,211 girls were estimated at about US$349,400 (including a vaccine price of US$5 per dose). Costs per fully-immunized girl were lower for class-based delivery than for age-based delivery. Incremental economic scaled-up costs for class-based vaccination of 50,290 girls in Mwanza Region were estimated at US$1.3 million. Economic scaled-up costs per fully-immunized girl were US$26.41, including HPV vaccine at US$5 per dose. Excluding vaccine costs, vaccine could be delivered at an incremental economic cost of US$3.09 per dose and US$9.76 per fully-immunized girl. Financial scaled-up costs, excluding costs of the vaccine and salaries of existing staff were estimated at US$1.73 per dose. Conclusions Project costs of class-based vaccination were found to be below those of age-based vaccination because of more eligible girls being identified and higher vaccine uptake. We estimate that vaccine can be delivered at costs that would make HPV vaccination a very cost-effective intervention. Potentially

Comparison of testicular dose delivered by intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) in patients with prostate cancer

International Nuclear Information System (INIS)

Martin, Jeffrey M.; Handorf, Elizabeth A.; Price, Robert A.; Cherian, George; Buyyounouski, Mark K.; Chen, David Y.; Kutikov, Alexander; Johnson, Matthew E.; Ma, Chung-Ming Charlie; Horwitz, Eric M.

2015-01-01

A small decrease in testosterone level has been documented after prostate irradiation, possibly owing to the incidental dose to the testes. Testicular doses from prostate external beam radiation plans with either intensity-modulated radiation therapy (IMRT) or volumetric-modulated arc therapy (VMAT) were calculated to investigate any difference. Testicles were contoured for 16 patients being treated for localized prostate cancer. For each patient, 2 plans were created: 1 with IMRT and 1 with VMAT. No specific attempt was made to reduce testicular dose. Minimum, maximum, and mean doses to the testicles were recorded for each plan. Of the 16 patients, 4 received a total dose of 7800 cGy to the prostate alone, 7 received 8000 cGy to the prostate alone, and 5 received 8000 cGy to the prostate and pelvic lymph nodes. The mean (range) of testicular dose with an IMRT plan was 54.7 cGy (21.1 to 91.9) and 59.0 cGy (25.1 to 93.4) with a VMAT plan. In 12 cases, the mean VMAT dose was higher than the mean IMRT dose, with a mean difference of 4.3 cGy (p = 0.019). There was a small but statistically significant increase in mean testicular dose delivered by VMAT compared with IMRT. Despite this, it unlikely that there is a clinically meaningful difference in testicular doses from either modality

Comparison of testicular dose delivered by intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) in patients with prostate cancer

Energy Technology Data Exchange (ETDEWEB)

Martin, Jeffrey M. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Handorf, Elizabeth A. [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, PA (United States); Price, Robert A.; Cherian, George [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Buyyounouski, Mark K. [Department of Radiation Oncology, Stanford University, Stanford, CA (United States); Chen, David Y.; Kutikov, Alexander [Department of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Johnson, Matthew E.; Ma, Chung-Ming Charlie [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States); Horwitz, Eric M., E-mail: eric.horwitz@fccc.edu [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)

2015-10-01

A small decrease in testosterone level has been documented after prostate irradiation, possibly owing to the incidental dose to the testes. Testicular doses from prostate external beam radiation plans with either intensity-modulated radiation therapy (IMRT) or volumetric-modulated arc therapy (VMAT) were calculated to investigate any difference. Testicles were contoured for 16 patients being treated for localized prostate cancer. For each patient, 2 plans were created: 1 with IMRT and 1 with VMAT. No specific attempt was made to reduce testicular dose. Minimum, maximum, and mean doses to the testicles were recorded for each plan. Of the 16 patients, 4 received a total dose of 7800 cGy to the prostate alone, 7 received 8000 cGy to the prostate alone, and 5 received 8000 cGy to the prostate and pelvic lymph nodes. The mean (range) of testicular dose with an IMRT plan was 54.7 cGy (21.1 to 91.9) and 59.0 cGy (25.1 to 93.4) with a VMAT plan. In 12 cases, the mean VMAT dose was higher than the mean IMRT dose, with a mean difference of 4.3 cGy (p = 0.019). There was a small but statistically significant increase in mean testicular dose delivered by VMAT compared with IMRT. Despite this, it unlikely that there is a clinically meaningful difference in testicular doses from either modality.

Synchronized dynamic dose reconstruction

International Nuclear Information System (INIS)

Litzenberg, Dale W.; Hadley, Scott W.; Tyagi, Neelam; Balter, James M.; Ten Haken, Randall K.; Chetty, Indrin J.

2007-01-01

Variations in target volume position between and during treatment fractions can lead to measurable differences in the dose distribution delivered to each patient. Current methods to estimate the ongoing cumulative delivered dose distribution make idealized assumptions about individual patient motion based on average motions observed in a population of patients. In the delivery of intensity modulated radiation therapy (IMRT) with a multi-leaf collimator (MLC), errors are introduced in both the implementation and delivery processes. In addition, target motion and MLC motion can lead to dosimetric errors from interplay effects. All of these effects may be of clinical importance. Here we present a method to compute delivered dose distributions for each treatment beam and fraction, which explicitly incorporates synchronized real-time patient motion data and real-time fluence and machine configuration data. This synchronized dynamic dose reconstruction method properly accounts for the two primary classes of errors that arise from delivering IMRT with an MLC: (a) Interplay errors between target volume motion and MLC motion, and (b) Implementation errors, such as dropped segments, dose over/under shoot, faulty leaf motors, tongue-and-groove effect, rounded leaf ends, and communications delays. These reconstructed dose fractions can then be combined to produce high-quality determinations of the dose distribution actually received to date, from which individualized adaptive treatment strategies can be determined

WE-EF-BRA-03: Catheter- Free Ablation with External Photon Radiation: Treatment Planning, Delivery Considerations, and Correlation of Effects with Delivered Dose

International Nuclear Information System (INIS)

Deisher, A; Anderson, S; Cusma, J; Herman, M; Johnson, S; Lehmann, H; Packer, D; Parker, K; Song, L; Takami, M; Kruse, J

2015-01-01

Purpose: To plan, target, and calculate delivered dose in atrioventricular node (AVN) ablation with volume-modulated arc therapy (VMAT) in an intact porcine model. Methods: Seven pigs underwent AVN irradiation, with prescription doses ranging between 25 and 55Gy in a single fraction. Cardiac CT scans were acquired at expiration. Two physicians contoured AVN targets on 10 phases, providing estimates of target motion and inter-physician variability. Treatment planning was conducted on a static phase-averaged CT. The volume designated to receive prescription dose covered the full extent of AVN cardiac motion, expanded by 4mm for setup uncertainty. Optimization limited doses to risk structures according to single-fraction tumor treatment protocols. Orthogonal kV images were used to align bony anatomy at time of treatment. Localization was further refined with respiratory-gated cone-beam CT, and range of cardiac motion was verified under fluoroscopy. Beam delivery was respiratory-gated for expiration with a mean efficiency of 60%. Deformable registration of the 10 cardiac CT phases was used to calculate actual delivered dose for comparison to electro-anatomical and visually evident lesions. Results: The mean [minimum,maximum] amplitude of AVN cardiac motion was LR 2.9 [1.7,3.9]mm, AP 6.6 [4.4,10.4]mm, and SI 5.6 [2.0,9.9]mm. Incorporating cardiac motion into the dose calculation showed the volume receiving full dose was 40–80% of the volume indicated on the static planning image, although the contoured AVN target received full dose in all animals. Initial results suggest the dimensions of the electro-anatomical lesion are correlated with the 40Gy isodose volume. Conclusion: Image-guidance techniques allow for accurate and precise delivery of VMAT for catheter-free arrhythmia ablation. An arsenal of advanced radiation planning, dose optimization, and image-guided delivery techniques was employed to assess and mitigate effects of cardiac and respiratory motion

WE-EF-BRA-03: Catheter- Free Ablation with External Photon Radiation: Treatment Planning, Delivery Considerations, and Correlation of Effects with Delivered Dose

Energy Technology Data Exchange (ETDEWEB)

Deisher, A; Anderson, S; Cusma, J; Herman, M; Johnson, S; Lehmann, H; Packer, D; Parker, K; Song, L; Takami, M; Kruse, J [Mayo Clinic, Rochester, MN (United States)

2015-06-15

Purpose: To plan, target, and calculate delivered dose in atrioventricular node (AVN) ablation with volume-modulated arc therapy (VMAT) in an intact porcine model. Methods: Seven pigs underwent AVN irradiation, with prescription doses ranging between 25 and 55Gy in a single fraction. Cardiac CT scans were acquired at expiration. Two physicians contoured AVN targets on 10 phases, providing estimates of target motion and inter-physician variability. Treatment planning was conducted on a static phase-averaged CT. The volume designated to receive prescription dose covered the full extent of AVN cardiac motion, expanded by 4mm for setup uncertainty. Optimization limited doses to risk structures according to single-fraction tumor treatment protocols. Orthogonal kV images were used to align bony anatomy at time of treatment. Localization was further refined with respiratory-gated cone-beam CT, and range of cardiac motion was verified under fluoroscopy. Beam delivery was respiratory-gated for expiration with a mean efficiency of 60%. Deformable registration of the 10 cardiac CT phases was used to calculate actual delivered dose for comparison to electro-anatomical and visually evident lesions. Results: The mean [minimum,maximum] amplitude of AVN cardiac motion was LR 2.9 [1.7,3.9]mm, AP 6.6 [4.4,10.4]mm, and SI 5.6 [2.0,9.9]mm. Incorporating cardiac motion into the dose calculation showed the volume receiving full dose was 40–80% of the volume indicated on the static planning image, although the contoured AVN target received full dose in all animals. Initial results suggest the dimensions of the electro-anatomical lesion are correlated with the 40Gy isodose volume. Conclusion: Image-guidance techniques allow for accurate and precise delivery of VMAT for catheter-free arrhythmia ablation. An arsenal of advanced radiation planning, dose optimization, and image-guided delivery techniques was employed to assess and mitigate effects of cardiac and respiratory motion

Agriculture-related radiation dose calculations

International Nuclear Information System (INIS)

Furr, J.M.; Mayberry, J.J.; Waite, D.A.

1987-10-01

Estimates of radiation dose to the public must be made at each stage in the identification and qualification process leading to siting a high-level nuclear waste repository. Specifically considering the ingestion pathway, this paper examines questions of reliability and adequacy of dose calculations in relation to five stages of data availability (geologic province, region, area, location, and mass balance) and three methods of calculation (population, population/food production, and food production driven). Calculations were done using the model PABLM with data for the Permian and Palo Duro Basins and the Deaf Smith County area. Extra effort expended in gathering agricultural data at succeeding environmental characterization levels does not appear justified, since dose estimates do not differ greatly; that effort would be better spent determining usage of food types that contribute most to the total dose; and that consumption rate and the air dispersion factor are critical to assessment of radiation dose via the ingestion pathway. 17 refs., 9 figs., 32 tabs

Stereotactic targeting and dose verification for age-related macular degeneration

Energy Technology Data Exchange (ETDEWEB)

Gertner, Michael; Chell, Erik; Pan, Kuang-Hung; Hansen, Steve; Kaiser, Peter K.; Moshfeghi, Darius M. [Oraya Therapeutics, Inc., Newark, California 94560 (United States); Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44915 (United States); Department of Ophthalmology, Stanford University, Stanford, California 94305 (United States)

2010-02-15

Purpose: Validation of the targeting and dose delivery of the IRay low voltage age-related macular degeneration treatment system. Methods: Ten human cadaver eyes were obtained for this study and mounted in the IRay system. Using gel and vacuum, an I-Guide immobilization device was coupled to the eyes and radiochromic film was affixed to the posterior aspect of the globes. Three narrow x-ray beams were delivered through the pars plana to overlap on the predicted nominal fovea. A needle was placed through the center of the film's beam spot and into the eye to register the film and the inner retina. The process was performed three times for each of the ten eyes (30 simulated treatments; 90 individual beams). The globes were dissected to assess the targeting accuracy by measuring the distances from the needles to the fovea. The dose to the fovea was calculated from the radiochromic film. Results: X-ray targeting on the retina averaged 0.6{+-}0.4 mm from the fovea. Repeated treatments on the same eye showed a reproducibility of 0.4{+-}0.4 mm. The optic nerve was safely avoided, with the 90% isodose edge of the beam spot between 0.4 and 2.6 mm from the edge of the optic disk. Measured dose matched that prescribed. Conclusions: This study provides confidence that the IRay, with an average accuracy of 0.6 mm and a precision of 0.4 mm, can reliably treat most AMD lesions centered on the fovea. With the exception of motion, all sources of error are included.

Implications of free breathing motion assessed by 4D-computed tomography on the delivered dose in radiotherapy for esophageal cancer

Energy Technology Data Exchange (ETDEWEB)

Duma, Marciana Nona, E-mail: Marciana.Duma@mri.tum.de [Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, München (Germany); Berndt, Johannes [Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, München (Germany); Rondak, Ina-Christine [Institute of Medical Statistics and Epidemiology, Klinikum rechts der Isar, Technische Universität München, München (Germany); Devecka, Michal; Wilkens, Jan J. [Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, München (Germany); Geinitz, Hans [Department of Radiation Oncology, Krankenhaus Barmherzige Schwestern Linz (Austria); Combs, Stephanie Elisabeth; Oechsner, Markus [Department of Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, München (Germany)

2015-01-01

The aim of this study was to assess the effect of breathing motion on the delivered dose in esophageal cancer 3-dimensional (3D)-conformal radiotherapy (3D-CRT), intensity-modulated radiotherapy (IMRT), and volumetric modulated arc therapy (VMAT). We assessed 16 patients with esophageal cancer. All patients underwent 4D-computed tomography (4D-CT) for treatment planning. For each of the analyzed patients, 1 3D-CRT, 1 IMRT, and 1 VMAT (RapidArc—RA) plan were calculated. Each of the 3 initial plans was recalculated on the 4D-CT (for the maximum free inspiration and maximum free expiration) to assess the effect of breathing motion. We assessed the minimum dose (D{sub min}) and mean dose (D{sub mean}) to the esophagus within the planning target volume, the volume changes of the lungs, the D{sub mean} and the total lung volume receiving at least 40 Gy (V{sub 40}), and the V{sub 30}, V{sub 20}, V{sub 10}, and V{sub 5}. For the heart we assessed the D{sub mean} and the V{sub 25}. Over all techniques and all patients the change in D{sub mean} as compared with the planned D{sub mean} (planning CT [PCT]) to the esophagus was 0.48% in maximum free inspiration (CT-insp) and 0.55% in maximum free expiration (CT-exp). The D{sub min} CT-insp change was 0.86% and CT-exp change was 0.89%. The D{sub mean} change of the lungs (heart) was in CT-insp 1.95% (2.89%) and 3.88% (2.38%) in CT-exp. In all, 4 patients had a clinically relevant change of the dose (≥ 5% D{sub mean} to the heart and the lungs) between inspiration and expiration. These patients had a very cranially or caudally situated tumor. There are no relevant differences in the delivered dose to the regions of interest among the 3 techniques. Breathing motion management could be considered to achieve a better sparing of the lungs or heart in patients with cranially or caudally situated tumors.

SIFT: A method to verify the IMRT fluence delivered during patient treatment using an electronic portal imaging device

International Nuclear Information System (INIS)

Vieira, Sandra C.; Dirkx, Maarten L.P.; Heijmen, Ben J.M.; Boer, Hans C.J. de

2004-01-01

Purpose: Radiotherapy patients are increasingly treated with intensity-modulated radiotherapy (IMRT) and high tumor doses. As part of our quality control program to ensure accurate dose delivery, a new method was investigated that enables the verification of the IMRT fluence delivered during patient treatment using an electronic portal imaging device (EPID), irrespective of changes in patient geometry. Methods and materials: Each IMRT treatment field is split into a static field and a modulated field, which are delivered in sequence. Images are acquired for both fields using an EPID. The portal dose image obtained for the static field is used to determine changes in patient geometry between the planning CT scan and the time of treatment delivery. With knowledge of these changes, the delivered IMRT fluence can be verified using the portal dose image of the modulated field. This method, called split IMRT field technique (SIFT), was validated first for several phantom geometries, followed by clinical implementation for a number of patients treated with IMRT. Results: The split IMRT field technique allows for an accurate verification of the delivered IMRT fluence (generally within 1% [standard deviation]), even if large interfraction changes in patient geometry occur. For interfraction radiological path length changes of 10 cm, deliberately introduced errors in the delivered fluence could still be detected to within 1% accuracy. Application of SIFT requires only a minor increase in treatment time relative to the standard IMRT delivery. Conclusions: A new technique to verify the delivered IMRT fluence from EPID images, which is independent of changes in the patient geometry, has been developed. SIFT has been clinically implemented for daily verification of IMRT treatment delivery

WE-AB-207B-09: Margin Reduction for Planning Target Volume (PTV) in Patients with Localized Prostate Cancer: Impact On Delivered Dose and Quality of Life

Energy Technology Data Exchange (ETDEWEB)

Kumarasiri, A; Liu, C; Brown, S; Glide-Hurst, C; Elshaikh, M; Chetty, I; Movsas, B [Henry Ford Health System, Detroit, MI (United States)

2016-06-15

Purpose: To estimate the delivered (cumulative) dose to targets and organs at risk for localized prostate cancer patients treated with reduced PTV margins and to evaluate preliminary patient reported quality-of-life (QOL). Methods: Under an IRB-approved protocol, 20 prostate cancer patients (including 11 control patients) were treated with reduced planning margins (5 mm uniform with 4 mm at prostate/rectum interface). Control patients had standard margin (10/6 mm)-based treatments. A parameter-optimized Elastix algorithm along with energy-mass mapping was used to deform and resample dose of the day onto the planning CT for each fraction to estimate the delivered dose over all fractions. QOL data were collected via Expanded Prostate cancer Index Composite (EPIC-26) questionnaires at time points pre-treatment, post-treatment, and at 2, 6, 12, 18 month follow-ups. Standardized QOL scores [range: 0–100] were determined and baseline-corrected by subtracting pre-treatment QOL data. Mean QOL differences between the margin reduced group and control group (QOLmr-QOLcontrol) were calculated for first 18 months. Results: The difference between the cumulative mean dose (Dmean) and the planned mean dose (±SD) for PTV, prostate, bladder, and rectum were −2.2±1.0, 0.3±0.5, −0.7±2.6, and −2.1±1.3 Gy respectively for the margin-reduced group, and −0.8±2.0, 0.9±1.4, - 0.7±3.1 and −1.0±2.4 Gy for the control group. Difference between the two groups was statistically insignificant (p=0.1). Standardized and baseline corrected QOLmr-QOLcontrol for EPIC domains categorized as “Urinary Incontinence”, “Urinary Irritative/Obstructive”, “Bowel”, “Sexual”, and “Hormonal” were 0.6, 12.1, 9.1, 13.3, and −0.9 for the 18 months following radiation therapy (higher values better). Delivered dose to rectum showed a weak correlation to “Bowel” domain (Pearson’s coefficient −0.24, p<0.001), while bladder dose did not correlate to Urinary Incontinence

WE-AB-207B-09: Margin Reduction for Planning Target Volume (PTV) in Patients with Localized Prostate Cancer: Impact On Delivered Dose and Quality of Life

International Nuclear Information System (INIS)

Kumarasiri, A; Liu, C; Brown, S; Glide-Hurst, C; Elshaikh, M; Chetty, I; Movsas, B

2016-01-01

Purpose: To estimate the delivered (cumulative) dose to targets and organs at risk for localized prostate cancer patients treated with reduced PTV margins and to evaluate preliminary patient reported quality-of-life (QOL). Methods: Under an IRB-approved protocol, 20 prostate cancer patients (including 11 control patients) were treated with reduced planning margins (5 mm uniform with 4 mm at prostate/rectum interface). Control patients had standard margin (10/6 mm)-based treatments. A parameter-optimized Elastix algorithm along with energy-mass mapping was used to deform and resample dose of the day onto the planning CT for each fraction to estimate the delivered dose over all fractions. QOL data were collected via Expanded Prostate cancer Index Composite (EPIC-26) questionnaires at time points pre-treatment, post-treatment, and at 2, 6, 12, 18 month follow-ups. Standardized QOL scores [range: 0–100] were determined and baseline-corrected by subtracting pre-treatment QOL data. Mean QOL differences between the margin reduced group and control group (QOLmr-QOLcontrol) were calculated for first 18 months. Results: The difference between the cumulative mean dose (Dmean) and the planned mean dose (±SD) for PTV, prostate, bladder, and rectum were −2.2±1.0, 0.3±0.5, −0.7±2.6, and −2.1±1.3 Gy respectively for the margin-reduced group, and −0.8±2.0, 0.9±1.4, - 0.7±3.1 and −1.0±2.4 Gy for the control group. Difference between the two groups was statistically insignificant (p=0.1). Standardized and baseline corrected QOLmr-QOLcontrol for EPIC domains categorized as “Urinary Incontinence”, “Urinary Irritative/Obstructive”, “Bowel”, “Sexual”, and “Hormonal” were 0.6, 12.1, 9.1, 13.3, and −0.9 for the 18 months following radiation therapy (higher values better). Delivered dose to rectum showed a weak correlation to “Bowel” domain (Pearson’s coefficient −0.24, p<0.001), while bladder dose did not correlate to Urinary Incontinence

TU-H-BRC-06: Temperature Simulation of Tungsten and W25Re Targets to Deliver High Dose Rate 10 MV Photons

Energy Technology Data Exchange (ETDEWEB)

Wang, J; Trovati, S; Loo, B; Maxim, P; Fahrig, R [Stanford University School of Medicine, Stanford, California (United States); Borchard, P [Tibaray Inc, San Francisco, CA (United States)

2016-06-15

Purpose: To study the impact of electron beam size, target thickness, and target temperature on the ability of the flattening filter-free mode (FFF) treatment head to deliver high-dose-rate irradiations. Methods: The dose distribution and transient temperature of the X-ray target under 10 MeV electron beam with pulse length of 5 microseconds, and repetition rate of 1000 Hz was studied. A MCNP model was built to calculate the percentage depth dose (PPD) distribution in a water phantom at a distance of 100 cm. ANSYS software was used to run heat transfer simulations. The PPD and temperature for both tungsten and W25Re targets for different electron beam sizes (FHWM 0.2, 0.5, 1 and 2 mm) and target thickness (0.2 to 2 mm) were studied. Results: Decreasing the target thickness from 1 mm to 0.5 mm, caused a surface dose increase about 10 percent. For both target materials, the peak temperature was about 1.6 times higher for 0.5 mm electron beam compared to the 1 mm beam after reaching their equilibrium. For increasing target thicknesses, the temperature rise caused by the first pulse is similar for all thicknesses, however the temperature difference for subsequent pulses becomes larger until a constant ratio is reached. The target peak temperature after reaching equilibrium can be calculated by adding the steady state temperature and the amplitude of the temperature oscillation. Conclusion: This work indicates the potential to obtain high dose rate irradiation by selecting target material, geometry and electron beam parameters. W25Re may not outperformed tungsten when the target is thick due to its relatively low thermal conductivity. The electron beam size only affects the target temperature but not the PPD. Thin target is preferred to obtain high dose rate and low target temperature, however, the resulting high surface dose is a major concern. NIH funding:R21 EB015957-01; DOD funding:W81XWH-13-1-0165 BL, PM, PB, and RF are founders of TibaRay, Inc. BL is also a borad

TU-H-BRC-06: Temperature Simulation of Tungsten and W25Re Targets to Deliver High Dose Rate 10 MV Photons

International Nuclear Information System (INIS)

Wang, J; Trovati, S; Loo, B; Maxim, P; Fahrig, R; Borchard, P

2016-01-01

Purpose: To study the impact of electron beam size, target thickness, and target temperature on the ability of the flattening filter-free mode (FFF) treatment head to deliver high-dose-rate irradiations. Methods: The dose distribution and transient temperature of the X-ray target under 10 MeV electron beam with pulse length of 5 microseconds, and repetition rate of 1000 Hz was studied. A MCNP model was built to calculate the percentage depth dose (PPD) distribution in a water phantom at a distance of 100 cm. ANSYS software was used to run heat transfer simulations. The PPD and temperature for both tungsten and W25Re targets for different electron beam sizes (FHWM 0.2, 0.5, 1 and 2 mm) and target thickness (0.2 to 2 mm) were studied. Results: Decreasing the target thickness from 1 mm to 0.5 mm, caused a surface dose increase about 10 percent. For both target materials, the peak temperature was about 1.6 times higher for 0.5 mm electron beam compared to the 1 mm beam after reaching their equilibrium. For increasing target thicknesses, the temperature rise caused by the first pulse is similar for all thicknesses, however the temperature difference for subsequent pulses becomes larger until a constant ratio is reached. The target peak temperature after reaching equilibrium can be calculated by adding the steady state temperature and the amplitude of the temperature oscillation. Conclusion: This work indicates the potential to obtain high dose rate irradiation by selecting target material, geometry and electron beam parameters. W25Re may not outperformed tungsten when the target is thick due to its relatively low thermal conductivity. The electron beam size only affects the target temperature but not the PPD. Thin target is preferred to obtain high dose rate and low target temperature, however, the resulting high surface dose is a major concern. NIH funding:R21 EB015957-01; DOD funding:W81XWH-13-1-0165 BL, PM, PB, and RF are founders of TibaRay, Inc. BL is also a borad

Use of a concise prescription for specifying absolute dose distribution in external beam radiation therapy

International Nuclear Information System (INIS)

Viggers, D.A.; Shalev, S.

1989-01-01

Radiation therapy dose distributions are usually calculated relative to some normalization point to which a prescribed dose in grays is to be delivered. Often the radiation therapist requests that the prescribed dose be delivered to some other point(s), such as the 90% isodose. Therefore the prescribed dose is not well defined. Furthermore, this procedure leaves the shape of the dose distribution unspecified. The authors have used a dose prescription specifying the volumes of target and nontarget tissue that must lie within dose limits stated in grays. These dose-volume limits determine the magnitude and shape of the dose distribution. The prescription is well defined while allowing the absolute dose at a chosen point to be adjusted so that the dose distribution satisfies the prescription

Cone Beam CT vs. Fan Beam CT: A Comparison of Image Quality and Dose Delivered Between Two Differing CT Imaging Modalities.

Science.gov (United States)

Lechuga, Lawrence; Weidlich, Georg A

2016-09-12

A comparison of image quality and dose delivered between two differing computed tomography (CT) imaging modalities-fan beam and cone beam-was performed. A literature review of quantitative analyses for various image quality aspects such as uniformity, signal-to-noise ratio, artifact presence, spatial resolution, modulation transfer function (MTF), and low contrast resolution was generated. With these aspects quantified, cone beam computed tomography (CBCT) shows a superior spatial resolution to that of fan beam, while fan beam shows a greater ability to produce clear and anatomically correct images with better soft tissue differentiation. The results indicate that fan beam CT produces superior images to that of on-board imaging (OBI) cone beam CT systems, while providing a considerably less dose to the patient.

Collective dose commitments from nuclear power programmes

International Nuclear Information System (INIS)

Beninson, D.

1977-01-01

The concepts of collective dose and collective dose commitment are discussed, particularly regarding their use to compare the relative importance of the exposure from several radiation sources and to predict future annual doses from a continuing practice. The collective dose commitment contributions from occupational exposure and population exposure due to the different components of the nuclear power fuel cycle are evaluated. A special discussion is devoted to exposures delivered over a very long time by released radionuclides of long half-lives and to the use of the incomplete collective dose commitment. The maximum future annual ''per caput'' doses from present and projected nuclear power programmes are estimated

Comments on 'Reconsidering the definition of a dose-volume histogram'-dose-mass histogram (DMH) versus dose-volume histogram (DVH) for predicting radiation-induced pneumonitis

International Nuclear Information System (INIS)

Mavroidis, Panayiotis; Plataniotis, Georgios A; Gorka, Magdalena Adamus; Lind, Bengt K

2006-01-01

In a recently published paper (Nioutsikou et al 2005 Phys. Med. Biol. 50 L17) the authors showed that the use of the dose-mass histogram (DMH) concept is a more accurate descriptor of the dose delivered to lung than the traditionally used dose-volume histogram (DVH) concept. Furthermore, they state that if a functional imaging modality could also be registered to the anatomical imaging modality providing a functional weighting across the organ (functional mass) then the more general and realistic concept of the dose-functioning mass histogram (D[F]MH) could be an even more appropriate descriptor. The comments of the present letter to the editor are in line with the basic arguments of that work since their general conclusions appear to be supported by the comparison of the DMH and DVH concepts using radiobiological measures. In this study, it is examined whether the dose-mass histogram (DMH) concept deviated significantly from the widely used dose-volume histogram (DVH) concept regarding the expected lung complications and if there are clinical indications supporting these results. The problem was investigated theoretically by applying two hypothetical dose distributions (Gaussian and semi-Gaussian shaped) on two lungs of uniform and varying densities. The influence of the deviation between DVHs and DMHs on the treatment outcome was estimated by using the relative seriality and LKB models using the Gagliardi et al (2000 Int. J. Radiat. Oncol. Biol. Phys. 46 373) and Seppenwoolde et al (2003 Int. J. Radiat. Oncol. Biol. Phys. 55 724) parameter sets for radiation pneumonitis, respectively. Furthermore, the biological equivalent of their difference was estimated by the biologically effective uniform dose (D-bar) and equivalent uniform dose (EUD) concepts, respectively. It is shown that the relation between the DVHs and DMHs varies depending on the underlying cell density distribution and the applied dose distribution. However, the range of their deviation in terms of

Comparison of proton and photon dose distributions

International Nuclear Information System (INIS)

Goitein, Michael

1995-01-01

Recently, there has been considerable work, as yet largely theoretical, in developing ways to improve the dose distributions which can be achieved with x-rays. Foremost among these developments are the use of non-coplanar beam directions, the use of intensity-modulated beams, and the implementation of computer-controlled delivery of complex plans using new beam modifiers such as multi-leaf collimators and beam scanners. One way of improving the dose distributions which have been achieved with conventional radiations is to use protons, with their quite different physical characteristics but very similar radiobiological properties as compared with supervoltage x-rays. Some substantial experience has been gained in the use of protons which has confirmed clinically that better results have been obtained as a result of their better dose distributions. Indeed, it is fair to say that the advantages which protons have demonstrated are, in large part, responsible for the renewed interest in improving the dose distributions from all radiation modalities. So much better are the dose distributions which the new techniques, mentioned above, offer that there is the impression that, with their use, photons can deliver dose distributions as good as can be obtained with protons. In this paper, the extent of the possible improvement will be discussed. It will be suggested that the integral dose is relatively little affected by the treatment technique - so that the lower normal tissue doses which the new approaches offer is almost always at the price of delivering dose to a larger volume. Protons can be matched pencil beam for pencil beam with photons - and then almost always deliver substantially less dose outside the target volume. Ultimately, the clinical importance of the differences will have to decided by clinical trial

Comparison of C-reactive protein levels with delivered dose of Kt/V in patients with end-stage renal disease on maintenance hemodialysis

Directory of Open Access Journals (Sweden)

Humayun Rashid

2015-01-01

Full Text Available The objective of our study is to compare the C-reactive protein (CRP levels with the delivered dose of dialysis in terms of Kt/V in patients undergoing maintenance hemodialysis (HD. This is a comparative, cross-sectional survey. The study was conducted at the HD unit of the Shaikh Zayed Hospital, Lahore, Pakistan. Patients who fulfilled the inclusion and exclusion criteria were enrolled in this study. The delivered dose of HD (Kt/V was assessed by an online clearance module (OCM in Fresenius machines at the end of every dialysis session and the weekly Kt/V was determined by adding all three Kt/V values. The serum CRP sample was taken after each session of HD and the mean CRP was calculated and considered elevated if it was >6 mg/dL. Both weekly Kt/V and CRP values were entered in a pre-designed proforma. Data were analyzed by using statistical software SPSS and P-value £0.05 was considered significant. Of 100 patients on maintenance HD, high serum CRP level (>6 mg/dL was found in 38 patients. When the Kt/V was compared with the CRP level, there was a negative correlation between the two parameters (r = 0.212, P = 0.032. Low Kt/V means dialysis inadequacy, which is associated with chronic inflammatory state, resulting in high CRP levels. We suggest that the quality of life of dialysis patients can be improved by offering an adequate dose of HD reflected by Kt/V ≥3.6/week.

Monitor units are not predictive of neutron dose for high-energy IMRT

Directory of Open Access Journals (Sweden)

Hälg Roger A

2012-08-01

Full Text Available Abstract Background Due to the substantial increase in beam-on time of high energy intensity-modulated radiotherapy (>10 MV techniques to deliver the same target dose compared to conventional treatment techniques, an increased dose of scatter radiation, including neutrons, is delivered to the patient. As a consequence, an increase in second malignancies may be expected in the future with the application of intensity-modulated radiotherapy. It is commonly assumed that the neutron dose equivalent scales with the number of monitor units. Methods Measurements of neutron dose equivalent were performed for an open and an intensity-modulated field at four positions: inside and outside of the treatment field at 0.2 cm and 15 cm depth, respectively. Results It was shown that the neutron dose equivalent, which a patient receives during an intensity-modulated radiotherapy treatment, does not scale with the ratio of applied monitor units relative to an open field irradiation. Outside the treatment volume at larger depth 35% less neutron dose equivalent is delivered than expected. Conclusions The predicted increase of second cancer induction rates from intensity-modulated treatment techniques can be overestimated when the neutron dose is simply scaled with monitor units.

An environmental dose experiment

Science.gov (United States)

Peralta, Luis

2017-11-01

Several radiation sources worldwide contribute to the delivered dose to the human population. This radiation also acts as a natural background when detecting radiation, for instance from radioactive sources. In this work a medium-sized plastic scintillation detector is used to evaluate the dose delivered by natural radiation sources. Calibration of the detector involved the use of radioactive sources and Monte Carlo simulation of the energy deposition per disintegration. A measurement of the annual dose due to background radiation to the body was then estimated. A dose value compatible with the value reported by the United Nations Scientific Committee on the Effects of Atomic Radiation was obtained.

An environmental dose experiment

International Nuclear Information System (INIS)

Peralta, Luis

2017-01-01

Several radiation sources worldwide contribute to the delivered dose to the human population. This radiation also acts as a natural background when detecting radiation, for instance from radioactive sources. In this work a medium-sized plastic scintillation detector is used to evaluate the dose delivered by natural radiation sources. Calibration of the detector involved the use of radioactive sources and Monte Carlo simulation of the energy deposition per disintegration. A measurement of the annual dose due to background radiation to the body was then estimated. A dose value compatible with the value reported by the United Nations Scientific Committee on the Effects of Atomic Radiation was obtained. (paper)

Equivalent dose, effective dose and risk assessment from cephalometric radiography to critical organs

International Nuclear Information System (INIS)

Kang, Seong Sook; Cho, Bon Hae; Kim, Hyun Ja

1995-01-01

In head and neck region, the critical organ and tissue doses were determined, and the risks were estimated from lateral, posteroanterial and basilar cephalometric radiography. For each cephalometric radiography, 31 TLDs were placed in selected sites (18 internal and 13 external sites) in a tissue-equivalent phantom and exposed, then read-out in the TLD reader. The following results were obtained; 1. From lateral cephalometric radiography, the highest effective dose recorded was that delivered to the salivary gland (3.6 μSv) and the next highest dose was that received by the bone marrow (3 μSv). 2. From posteroanterial cephalometric radiography, the highest effective dose recorded was that delivered to the salivary gland (2 μSv) and the next highest dose was that received by the bone marrow (1.8 μSv). 3. From basilar cephalometric radiography, the highest effective dose recorded was that delivered to the thyroid gland (31.4 μSv) and the next highest dose was that received by the salivary gland (13.3 μSv). 4. The probabilities of stochastic effect from lateral, posteroanterial and basilar cephalometric radiography were 0.72 X 10 -6 , 0.49 X 10 -6 and 3.51 X 10 -6 , respectively.

Dynamically accumulated dose and 4D accumulated dose for moving tumors

International Nuclear Information System (INIS)

Li Heng; Li Yupeng; Zhang Xiaodong; Li Xiaoqiang; Liu Wei; Gillin, Michael T.; Zhu, X. Ronald

2012-01-01

Purpose: The purpose of this work was to investigate the relationship between dynamically accumulated dose (dynamic dose) and 4D accumulated dose (4D dose) for irradiation of moving tumors, and to quantify the dose uncertainty induced by tumor motion. Methods: The authors established that regardless of treatment modality and delivery properties, the dynamic dose will converge to the 4D dose, instead of the 3D static dose, after multiple deliveries. The bounds of dynamic dose, or the maximum estimation error using 4D or static dose, were established for the 4D and static doses, respectively. Numerical simulations were performed (1) to prove the principle that for each phase, after multiple deliveries, the average number of deliveries for any given time converges to the total number of fractions (K) over the number of phases (N); (2) to investigate the dose difference between the 4D and dynamic doses as a function of the number of deliveries for deliveries of a “pulsed beam”; and (3) to investigate the dose difference between 4D dose and dynamic doses as a function of delivery time for deliveries of a “continuous beam.” A Poisson model was developed to estimate the mean dose error as a function of number of deliveries or delivered time for both pulsed beam and continuous beam. Results: The numerical simulations confirmed that the number of deliveries for each phase converges to K/N, assuming a random starting phase. Simulations for the pulsed beam and continuous beam also suggested that the dose error is a strong function of the number of deliveries and/or total deliver time and could be a function of the breathing cycle, depending on the mode of delivery. The Poisson model agrees well with the simulation. Conclusions: Dynamically accumulated dose will converge to the 4D accumulated dose after multiple deliveries, regardless of treatment modality. Bounds of the dynamic dose could be determined using quantities derived from 4D doses, and the mean dose

Dose-dependent social-cognitive effects of intranasal oxytocin delivered with novel Breath Powered device in adults with autism spectrum disorder: a randomized placebo-controlled double-blind crossover trial

OpenAIRE

Quintana, D S; Westlye, L T; Hope, S; N?rland, T; Elvs?shagen, T; D?rum, E; Rustan, ?; Valstad, M; Rezvaya, L; Lishaugen, H; Stens?nes, E; Yaqub, S; Smerud, K T; Mahmoud, R A; Djupesland, P G

2017-01-01

The neuropeptide oxytocin has shown promise as a treatment for symptoms of autism spectrum disorders (ASD). However, clinical research progress has been hampered by a poor understanding of oxytocin?s dose?response and sub-optimal intranasal delivery methods. We examined two doses of oxytocin delivered using a novel Breath Powered intranasal delivery device designed to improve direct nose-to-brain activity in a double-blind, crossover, randomized, placebo-controlled trial. In a randomized sequ...

High-dose-rate brachytherapy as monotherapy delivered in two fractions within one day for favorable/intermediate-risk prostate cancer: preliminary toxicity data.

Science.gov (United States)

Ghilezan, Michel; Martinez, Alvaro; Gustason, Gary; Krauss, Daniel; Antonucci, J Vito; Chen, Peter; Fontanesi, James; Wallace, Michelle; Ye, Hong; Casey, Alyse; Sebastian, Evelyn; Kim, Leonard; Limbacher, Amy

2012-07-01

To report the toxicity profile of high-dose-rate (HDR)-brachytherapy (BT) as monotherapy in a Human Investigation Committee-approved study consisting of a single implant and two fractions (12 Gy × 2) for a total dose of 24 Gy, delivered within 1 day. The dose was subsequently increased to 27 Gy (13.5 Gy × 2) delivered in 1 day. We report the acute and early chronic genitourinary and gastrointestinal toxicity. A total of 173 patients were treated between December 2005 and July 2010. However, only the first 100 were part of the IRB-approved study and out of these, only 94 had a minimal follow-up of 6 months, representing the study population for this preliminary report. All patients had clinical Stage T2b or less (American Joint Committee on Cancer, 5th edition), Gleason score 6-7 (3+4), and prostate-specific antigen level of ≤12 ng/mL. Ultrasound-guided HDR-BT with real-time dosimetry was used. The prescription dose was 24 Gy for the first 50 patients and 27 Gy thereafter. The dosimetric goals and constraints were the same for the two dose groups. Toxicity was scored using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3. The highest toxicity scores encountered at any point during follow-up are reported. The median follow-up was 17 months (range, 6-40.5). Most patients had Grade 0-1 acute toxicity. The Grade 2 acute genitourinary toxicity was mainly frequency/urgency (13%), dysuria (5%), hematuria, and dribbling/hesitancy (2%). None of the patients required a Foley catheter at any time; however, 8% of the patients experienced transient Grade 1 diarrhea. No other acute gastrointestinal toxicities were found. The most common chronic toxicity was Grade 2 urinary frequency/urgency in 16% of patients followed by dysuria in 4% of patients; 2 patients had Grade 2 rectal bleeding and 1 had Grade 4, requiring laser treatment. Favorable-risk prostate cancer patients treated with a single implant HDR-BT to 24-27 Gy in two fractions

High-Dose-Rate Brachytherapy as Monotherapy Delivered in Two Fractions Within One Day for Favorable/Intermediate-Risk Prostate Cancer: Preliminary Toxicity Data

Energy Technology Data Exchange (ETDEWEB)

Ghilezan, Michel, E-mail: mghilezan@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital and Rose Cancer Institute, Royal Oak, Michigan (United States); Martinez, Alvaro; Gustason, Gary; Krauss, Daniel; Antonucci, J. Vito; Chen, Peter; Fontanesi, James; Wallace, Michelle; Ye Hong; Casey, Alyse; Sebastian, Evelyn; Kim, Leonard; Limbacher, Amy [Department of Radiation Oncology, William Beaumont Hospital and Rose Cancer Institute, Royal Oak, Michigan (United States)

2012-07-01

Purpose: To report the toxicity profile of high-dose-rate (HDR)-brachytherapy (BT) as monotherapy in a Human Investigation Committee-approved study consisting of a single implant and two fractions (12 Gy Multiplication-Sign 2) for a total dose of 24 Gy, delivered within 1 day. The dose was subsequently increased to 27 Gy (13.5 Gy Multiplication-Sign 2) delivered in 1 day. We report the acute and early chronic genitourinary and gastrointestinal toxicity. Methods and Materials: A total of 173 patients were treated between December 2005 and July 2010. However, only the first 100 were part of the IRB-approved study and out of these, only 94 had a minimal follow-up of 6 months, representing the study population for this preliminary report. All patients had clinical Stage T2b or less (American Joint Committee on Cancer, 5th edition), Gleason score 6-7 (3+4), and prostate-specific antigen level of {<=}12 ng/mL. Ultrasound-guided HDR-BT with real-time dosimetry was used. The prescription dose was 24 Gy for the first 50 patients and 27 Gy thereafter. The dosimetric goals and constraints were the same for the two dose groups. Toxicity was scored using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3. The highest toxicity scores encountered at any point during follow-up are reported. Results: The median follow-up was 17 months (range, 6-40.5). Most patients had Grade 0-1 acute toxicity. The Grade 2 acute genitourinary toxicity was mainly frequency/urgency (13%), dysuria (5%), hematuria, and dribbling/hesitancy (2%). None of the patients required a Foley catheter at any time; however, 8% of the patients experienced transient Grade 1 diarrhea. No other acute gastrointestinal toxicities were found. The most common chronic toxicity was Grade 2 urinary frequency/urgency in 16% of patients followed by dysuria in 4% of patients; 2 patients had Grade 2 rectal bleeding and 1 had Grade 4, requiring laser treatment. Conclusions: Favorable

High-Dose-Rate Brachytherapy as Monotherapy Delivered in Two Fractions Within One Day for Favorable/Intermediate-Risk Prostate Cancer: Preliminary Toxicity Data

International Nuclear Information System (INIS)

Ghilezan, Michel; Martinez, Alvaro; Gustason, Gary; Krauss, Daniel; Antonucci, J. Vito; Chen, Peter; Fontanesi, James; Wallace, Michelle; Ye Hong; Casey, Alyse; Sebastian, Evelyn; Kim, Leonard; Limbacher, Amy

2012-01-01

Purpose: To report the toxicity profile of high-dose-rate (HDR)-brachytherapy (BT) as monotherapy in a Human Investigation Committee-approved study consisting of a single implant and two fractions (12 Gy × 2) for a total dose of 24 Gy, delivered within 1 day. The dose was subsequently increased to 27 Gy (13.5 Gy × 2) delivered in 1 day. We report the acute and early chronic genitourinary and gastrointestinal toxicity. Methods and Materials: A total of 173 patients were treated between December 2005 and July 2010. However, only the first 100 were part of the IRB-approved study and out of these, only 94 had a minimal follow-up of 6 months, representing the study population for this preliminary report. All patients had clinical Stage T2b or less (American Joint Committee on Cancer, 5th edition), Gleason score 6-7 (3+4), and prostate-specific antigen level of ≤12 ng/mL. Ultrasound-guided HDR-BT with real-time dosimetry was used. The prescription dose was 24 Gy for the first 50 patients and 27 Gy thereafter. The dosimetric goals and constraints were the same for the two dose groups. Toxicity was scored using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3. The highest toxicity scores encountered at any point during follow-up are reported. Results: The median follow-up was 17 months (range, 6–40.5). Most patients had Grade 0-1 acute toxicity. The Grade 2 acute genitourinary toxicity was mainly frequency/urgency (13%), dysuria (5%), hematuria, and dribbling/hesitancy (2%). None of the patients required a Foley catheter at any time; however, 8% of the patients experienced transient Grade 1 diarrhea. No other acute gastrointestinal toxicities were found. The most common chronic toxicity was Grade 2 urinary frequency/urgency in 16% of patients followed by dysuria in 4% of patients; 2 patients had Grade 2 rectal bleeding and 1 had Grade 4, requiring laser treatment. Conclusions: Favorable-risk prostate cancer patients treated with

Increase of doses delivered to patients during medical imagery examinations. Conclusions of 16 September 2010 seminar organized by the ASN

International Nuclear Information System (INIS)

2011-01-01

This document reports the contributions of the participants to the seminar which aimed at discussing the increase of doses delivered in medical imagery, and the actions to undertake to limit this increase. The authors recall the regulatory and legal context regarding the optimization of medical procedures and the organisation of radiation protection for medical exposures, comment the assessment of exposures by medical imagery in 2007, comment the CE marking of medical devices, the recent evolutions in dose optimization of radiology and scanography devices. Other sets of interventions address the application of the justification and optimization principle by professionals (in new scanography practices, in radio-paediatrics), the professional training issue (radiologist continuous training, electro-radiology operator training), the comparison between scanner and RMI (new fields for RMI, imagery benchmark), the assessment of professional practices (tools for continuous professional development of health professionals, medical imagery initiatives in Belgium), and international recommendations (by the IAEA, the WHO, the European Union)

On-line estimations of delivered radiation doses in three-dimensional conformal radiotherapy treatments of carcinoma uterine cervix patients in linear accelerator.

Science.gov (United States)

Putha, Suman Kumar; Saxena, P U; Banerjee, S; Srinivas, Challapalli; Vadhiraja, B M; Ravichandran, Ramamoorthy; Joan, Mary; Pai, K Dinesh

2016-01-01

Transmission of radiation fluence through patient's body has a correlation to the planned target dose. A method to estimate the delivered dose to target volumes was standardized using a beam level 0.6 cc ionization chamber (IC) positioned at electronic portal imaging device (EPID) plane from the measured transit signal (S t ) in patients with cancer of uterine cervix treated with three-dimensional conformal radiotherapy (3DCRT). The IC with buildup cap was mounted on linear accelerator EPID frame with fixed source to chamber distance of 146.3 cm, using a locally fabricated mount. S t s were obtained for different water phantom thicknesses and radiation field sizes which were then used to generate a calibration table against calculated midplane doses at isocenter (D iso,TPS ), derived from the treatment planning system. A code was developed using MATLAB software which was used to estimate the in vivo dose at isocenter (D iso,Transit ) from the measured S t s. A locally fabricated pelvic phantom validated the estimations of D iso,Transit before implementing this method on actual patients. On-line dose estimations were made (3 times during treatment for each patient) in 24 patients. The D iso,Transit agreement with D iso,TPS in phantom was within 1.7% and the mean percentage deviation with standard deviation is -1.37% ±2.03% ( n = 72) observed in patients. Estimated in vivo dose at isocenter with this method provides a good agreement with planned ones which can be implemented as part of quality assurance in pelvic sites treated with simple techniques, for example, 3DCRT where there is a need for documentation of planned dose delivery.

Evaluation of Kodak EDR2 film for dose verification of intensity modulated radiation therapy delivered by a static multileaf collimator.

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Zhu, X R; Jursinic, P A; Grimm, D F; Lopez, F; Rownd, J J; Gillin, M T

2002-08-01

A new type of radiographic film, Kodak EDR2 film, was evaluated for dose verification of intensity modulated radiation therapy (IMRT) delivered by a static multileaf collimator (SMLC). A sensitometric curve of EDR2 film irradiated by a 6 MV x-ray beam was compared with that of Kodak X-OMAT V (XV) film. The effects of field size, depth and dose rate on the sensitometric curve were also studied. It is found that EDR2 film is much less sensitive than XV film. In high-energy x-ray beams, the double hit process is the dominant mechanism that renders the grains on EDR2 films developable. As a result, in the dose range that is commonly used for film dosimetry for IMRT and conventional external beam therapy, the sensitometric curves of EDR2 films cannot be approximated as a linear function, OD = c * D. Within experimental uncertainty, the film sensitivity does not depend on the dose rate (50 vs 300 MU/min) or dose per pulse (from 1.0 x 10(-4) to 4.21 x 10(-4) Gy/pulse). Field sizes and depths (up to field size of 10 x 10 cm2 and depth = 10 cm) have little effect on the sensitometric curves. Percent depth doses (PDDs) for both 6 and 23 MV x rays were measured with both EDR2 and XV films and compared with ion chamber data. Film data are within 2.5% of the ion chamber results. Dose profiles measured with EDR2 film are consistent with those measured with an ion chamber. Examples of measured IMRT isodose distributions versus calculated isodoses are presented. We have used EDR2 films for verification of all IMRT patients treated by SMLC in our clinic. In most cases, with EDR2 film, actual clinical daily fraction doses can be used for verification of composite isodose distributions of SMLC-based IMRT.

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

A comparison of entrance skin dose delivered by clinical angiographic c-arms using the real-time dosimeter: the MOSkin

International Nuclear Information System (INIS)

Thorpe, Nathan K.; Cutajar, Dean; Lian, Cheryl; Rosenfeld, Anatoly; Pitney, Mark; Friedman, Daniel; Perevertaylo, Vladimir

2016-01-01

Coronary angiography is a procedure used in the diagnosis and intervention of coronary heart disease. The procedure is often considered one of the highest dose diagnostic procedures in clinical use. Despite this, there is minimal use of dosimeters within angiographic catheterisation laboratories due to challenges resulting from their implementation. The aim of this study was to compare entrance dose delivery across locally commissioned c-arms to assess the need for real-time dosimetry solutions during angiographic procedures. The secondary aim of this study was to establish a calibration method for the MOSkin dosimeter that accurately produces entrance dose values from the clinically sampled beam qualities and energies. The MOSkin is a real-time dosimeter used to measure the skin dose delivered by external radiation beams. The suitability of the MOSkin for measurements in the angiographic catheterisation laboratory was assessed. Measurements were performed using a 30 × 30 × 30cm 3 PMMA phantom positioned at the rotational isocenter of the c-arm gantry. The MOSkin calibration factor was established through comparison of the MOSkin response to EBT2 film response. Irradiation of the dosimeters was performed using several clinical beam qualities ranging in energy from 70 to 105 kVp. A total of four different interventional c-arm machines were surveyed and compared using the MOSkin dosimeter. The phantom was irradiated from a normal angle of incidence using clinically relevant protocols, field sizes and source to image detector distance values. The MOSkin was observed to be radiotranslucent to the c-arm beam in all clinical environments. The MOSkin response was reproducible to within 2 % of the average value across repeated measurements for each beam setting. There were large variations in entrance dose delivery to the phantom between the different c-arm machines with the highest observed cine-acquisition entrance dose rate measuring 326 % higher than the lowest

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)

Dose indices: everybody wants a number

International Nuclear Information System (INIS)

Strauss, Keith J.

2014-01-01

This paper discusses the merits and weaknesses of the standard terms that have been developed to quantify CT dose: CT dose indices (CTDI), dose length product (DLP) and effective dose. The difference between the measured CTDI vol and the CTDI vol displayed on the CT scanner illustrates a clinical dilemma. Displayed CTDI vol represents the radiation dose delivered to a plastic phantom, which is significantly different from the dose delivered to the patient, depending on the size of the patient. Although effective dose is simple to calculate for an individual patient, it was never intended for this purpose. The need for a simple, appropriate method to estimate pediatric patient doses led to the development of the size-specific dose estimate (SSDE), the newest CT dose index. Here I compare SSDE and its merits to the use of effective dose to estimate patient dose. The discussion concludes with a few sample calculations and basic clinical applications of SSDE to better quantify pediatric patient dose from CT scans. (orig.)

Automatic contour propagation using deformable image registration to determine delivered dose to spinal cord in head-and-neck cancer radiotherapy

Science.gov (United States)

Yeap, P. L.; Noble, D. J.; Harrison, K.; Bates, A. M.; Burnet, N. G.; Jena, R.; Romanchikova, M.; Sutcliffe, M. P. F.; Thomas, S. J.; Barnett, G. C.; Benson, R. J.; Jefferies, S. J.; Parker, M. A.

2017-08-01

To determine delivered dose to the spinal cord, a technique has been developed to propagate manual contours from kilovoltage computed-tomography (kVCT) scans for treatment planning to megavoltage computed-tomography (MVCT) guidance scans. The technique uses the Elastix software to perform intensity-based deformable image registration of each kVCT scan to the associated MVCT scans. The registration transform is then applied to contours of the spinal cord drawn manually on the kVCT scan, to obtain contour positions on the MVCT scans. Different registration strategies have been investigated, with performance evaluated by comparing the resulting auto-contours with manual contours, drawn by oncologists. The comparison metrics include the conformity index (CI), and the distance between centres (DBC). With optimised registration, auto-contours generally agree well with manual contours. Considering all 30 MVCT scans for each of three patients, the median CI is 0.759 +/- 0.003 , and the median DBC is (0.87 +/- 0.01 ) mm. An intra-observer comparison for the same scans gives a median CI of 0.820 +/- 0.002 and a DBC of (0.64 +/- 0.01 ) mm. Good levels of conformity are also obtained when auto-contours are compared with manual contours from one observer for a single MVCT scan for each of 30 patients, and when they are compared with manual contours from six observers for two MVCT scans for each of three patients. Using the auto-contours to estimate organ position at treatment time, a preliminary study of 33 patients who underwent radiotherapy for head-and-neck cancers indicates good agreement between planned and delivered dose to the spinal cord.

Automatic contour propagation using deformable image registration to determine delivered dose to spinal cord in head-and-neck cancer radiotherapy.

Science.gov (United States)

Yeap, P L; Noble, D J; Harrison, K; Bates, A M; Burnet, N G; Jena, R; Romanchikova, M; Sutcliffe, M P F; Thomas, S J; Barnett, G C; Benson, R J; Jefferies, S J; Parker, M A

2017-07-12

To determine delivered dose to the spinal cord, a technique has been developed to propagate manual contours from kilovoltage computed-tomography (kVCT) scans for treatment planning to megavoltage computed-tomography (MVCT) guidance scans. The technique uses the Elastix software to perform intensity-based deformable image registration of each kVCT scan to the associated MVCT scans. The registration transform is then applied to contours of the spinal cord drawn manually on the kVCT scan, to obtain contour positions on the MVCT scans. Different registration strategies have been investigated, with performance evaluated by comparing the resulting auto-contours with manual contours, drawn by oncologists. The comparison metrics include the conformity index (CI), and the distance between centres (DBC). With optimised registration, auto-contours generally agree well with manual contours. Considering all 30 MVCT scans for each of three patients, the median CI is [Formula: see text], and the median DBC is ([Formula: see text]) mm. An intra-observer comparison for the same scans gives a median CI of [Formula: see text] and a DBC of ([Formula: see text]) mm. Good levels of conformity are also obtained when auto-contours are compared with manual contours from one observer for a single MVCT scan for each of 30 patients, and when they are compared with manual contours from six observers for two MVCT scans for each of three patients. Using the auto-contours to estimate organ position at treatment time, a preliminary study of 33 patients who underwent radiotherapy for head-and-neck cancers indicates good agreement between planned and delivered dose to the spinal cord.

Evaluation of doses delivered during CT examination by different scanners for purposes of intercomparison and dose optimization

International Nuclear Information System (INIS)

Bashiru, Adam

2017-07-01

This research study was aimed at performing dosimetry intercomparison on different CT scanners in the diagnostic radiology departments of Korle-Bu Teaching Hospital (KBTH), Sweden Ghana Medical Center (SGMC) and Global Medical and Imaging Center (GMIC). Using the standard body phantom and integrated ion chamber technique volume computed tomography dose index (CTDIvol) and Dose-Length Product (DLPs) within the phantom were evaluated. The ion chamber technique was applied to two 16 slice Siemens and one Toshiba Aquilion one CT scanners. CTDIvol and DLP values for the standard body polymethyl methacrylate (PMMA) phantom were estimated and comparison made with corresponding console displayed values for accuracy and also to deduce a suitable method for optimization of patients and occupationally exposed worker doses. Effective doses were also calculated. An intra and inter institutional comparison of measured doses and console displayed doses were performed. Chest protocol at Automatic Exposure Control (AEC) was applied during the scanning of the phantom. Estimated CTDIvol values (mGy) were 17mGy, 24mGy and 13.1mGy for SGMC, GMIC and KBTH respectively. These values deviated from the console displayed values by 24.1%, 22.9% and 31.3% respectively. Similarly, estimated DLP values (mGy.cm) were 675mGy.cm,944mGy.cm and 419mGy.cm for SGMC, GMIC and KBTH respectively deviating from the console displayed values by 24.1%, 24.2% and 29% respectively. In terms of effective doses (E), the calculated E (mSv) values were 9.45mSv, 13.2mSv and 5.87mSv estimated from the DLPs from SGMC, GMIC and KBTH respectively using K, the anatomy-specific dose coefficient expressing effective dose normalized to DLP in a standard CT dosimetry phantom of 0.014 mSv mGy-1 cm-1. The estimated doses were compared to other selected international Dose Reference Levels (DRLs) and were within range. (au)

Measurement of radiation dose to ovaries from CT of the head and trunk

Energy Technology Data Exchange (ETDEWEB)

Al-Habdhan, M.A.M.; Kinsara, A.R. [King Abdul Aziz Univ., Nuclear Engineering Dept., Jeddah (Saudi Arabia)

2001-07-01

With the rise in concern about doses received by patients over recent years, there has been a growing requirement for information on typical doses and the range of dose received during Computerized Tomography (CT). This study was performed for the assessment of radiation dose to the ovaries from various CT protocols for head and trunk imaging. Thermo luminescent dosimeters (TLD) were used for the dosimetry measurement in an anthropomorphic Rando Alderson phantom. The wanted (obligatory) and unwanted (non-useful) radiation doses delivered to the ovaries during CT examinations of head, facial bone, orbits, abdomen, chest, pelvis, neck, nasopharynx, cervical spine, lumber spine and sacroiliac joint were assessed. The results are compared with the corresponding values published in the literature. A comparison of the received dose from CT examinations and general radiography examinations by the ovaries was made. It is found that relatively high doses of unwanted radiation are delivered with computerized tomography. (author)

Pelvic Radiotherapy for Cancer of the Cervix: Is What You Plan Actually What You Deliver?

International Nuclear Information System (INIS)

Lim, Karen; Kelly, Valerie; Stewart, James; Xie, Jason; Cho, Young-Bin; Moseley, Joanne B.; Brock, Kristy; Fyles, Anthony; Lundin, Anna; Rehbinder, Henrik; Milosevic, Michael

2009-01-01

Purpose: Whole pelvic intensity-modulated radiotherapy (IMRT) is increasingly being used to treat cervix cancer and other gynecologic tumors. However, tumor and normal organ movement during treatment can substantially detract from the benefits of this approach. This study explored the effect of internal anatomic changes on the dose delivered to the tumor and organs at risk using a strategy integrating deformable soft-tissue modeling with simulated dose accumulation. Methods and Materials: Twenty patients with cervix cancer underwent baseline and weekly pelvic magnetic resonance imaging during treatment. Interfraction organ motion and delivered (accumulated) dose was modeled for three treatment scenarios: four-field box, large-margin whole pelvic IMRT (20-mm planning target volume, but 10 mm inferiorly) and small-margin IMRT (5-mm planning target volume). Results: Individually, the planned dose was not the same as the simulated delivered dose; however, when taken as a group, this was not statistically significant for the four-field box and large-margin IMRT plans. The small-margin IMRT plans yielded adequate target coverage in most patients; however, significant target underdosing occurred in 1 patient who displayed excessive, unpredictable internal target movement. The delivered doses to the organs at risk were significantly reduced with the small-margin plan, although substantial variability was present among the patients. Conclusion: Simulated dose accumulation might provide a more accurate depiction of the target and organ at risk coverage during fractionated whole pelvic IMRT for cervical cancer. The adequacy of primary tumor coverage using 5-mm planning target volume margins is contingent on the use of daily image-guided setup.

Bayesian estimation of dose rate effectiveness

International Nuclear Information System (INIS)

Arnish, J.J.; Groer, P.G.

2000-01-01

A Bayesian statistical method was used to quantify the effectiveness of high dose rate 137 Cs gamma radiation at inducing fatal mammary tumours and increasing the overall mortality rate in BALB/c female mice. The Bayesian approach considers both the temporal and dose dependence of radiation carcinogenesis and total mortality. This paper provides the first direct estimation of dose rate effectiveness using Bayesian statistics. This statistical approach provides a quantitative description of the uncertainty of the factor characterising the dose rate in terms of a probability density function. The results show that a fixed dose from 137 Cs gamma radiation delivered at a high dose rate is more effective at inducing fatal mammary tumours and increasing the overall mortality rate in BALB/c female mice than the same dose delivered at a low dose rate. (author)

Dose rate-dependent marrow toxicity of TBI in dogs and marrow sparing effect at high dose rate by dose fractionation.

Science.gov (United States)

Storb, R; Raff, R F; Graham, T; Appelbaum, F R; Deeg, H J; Schuening, F G; Sale, G; Seidel, K

1999-01-01

We evaluated the marrow toxicity of 200 and 300 cGy total-body irradiation (TBI) delivered at 10 and 60 cGy/min, respectively, in dogs not rescued by marrow transplant. Additionally, we compared toxicities after 300 cGy fractionated TBI (100 cGy fractions) to that after single-dose TBI at 10 and 60 cGy/min. Marrow toxicities were assessed on the basis of peripheral blood cell count changes and mortality from radiation-induced pancytopenia. TBI doses studied were just below the dose at which all dogs die despite optimal support. Specifically, 18 dogs were given single doses of 200 cGy TBI, delivered at either 10 (n=13) or 60 (n=5) cGy/min. Thirty-one dogs received 300 cGy TBI at 10 cGy/min, delivered as either single doses (n=21) or three fractions of 100 cGy each (n=10). Seventeen dogs were given 300 cGy TBI at 60 cGy/min, administered either as single doses (n=5) or three fractions of 100 cGy each (n=10). Within the limitations of the experimental design, three conclusions were drawn: 1) with 200 and 300 cGy single-dose TBI, an increase of dose rate from 10 to 60 cGy/min, respectively, caused significant increases in marrow toxicity; 2) at 60 cGy/min, dose fractionation resulted in a significant decrease in marrow toxicities, whereas such a protective effect was not seen at 10 cGy/min; and 3) with fractionated TBI, no significant differences in marrow toxicity were seen between dogs irradiated at 60 and 10 cGy/min. The reduced effectiveness of TBI when a dose of 300 cGy was divided into three fractions of 100 cGy or when dose rate was reduced from 60 cGy/min to 10 cGy/min was consistent with models of radiation toxicity that allow for repair of sublethal injury in DNA.

SU-F-J-105: Towards a Novel Treatment Planning Pipeline Delivering Pareto- Optimal Plans While Enabling Inter- and Intrafraction Plan Adaptation

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Kontaxis, C; Bol, G; Lagendijk, J; Raaymakers, B [University Medical Center Utrecht, Utrecht (Netherlands); Breedveld, S; Sharfo, A; Heijmen, B [Erasmus University Medical Center Rotterdam, Rotterdam (Netherlands)

2016-06-15

Purpose: To develop a new IMRT treatment planning methodology suitable for the new generation of MR-linear accelerator machines. The pipeline is able to deliver Pareto-optimal plans and can be utilized for conventional treatments as well as for inter- and intrafraction plan adaptation based on real-time MR-data. Methods: A Pareto-optimal plan is generated using the automated multicriterial optimization approach Erasmus-iCycle. The resulting dose distribution is used as input to the second part of the pipeline, an iterative process which generates deliverable segments that target the latest anatomical state and gradually converges to the prescribed dose. This process continues until a certain percentage of the dose has been delivered. Under a conventional treatment, a Segment Weight Optimization (SWO) is then performed to ensure convergence to the prescribed dose. In the case of inter- and intrafraction adaptation, post-processing steps like SWO cannot be employed due to the changing anatomy. This is instead addressed by transferring the missing/excess dose to the input of the subsequent fraction. In this work, the resulting plans were delivered on a Delta4 phantom as a final Quality Assurance test. Results: A conventional static SWO IMRT plan was generated for two prostate cases. The sequencer faithfully reproduced the input dose for all volumes of interest. For the two cases the mean relative dose difference of the PTV between the ideal input and sequenced dose was 0.1% and −0.02% respectively. Both plans were delivered on a Delta4 phantom and passed the clinical Quality Assurance procedures by achieving 100% pass rate at a 3%/3mm gamma analysis. Conclusion: We have developed a new sequencing methodology capable of online plan adaptation. In this work, we extended the pipeline to support Pareto-optimal input and clinically validated that it can accurately achieve these ideal distributions, while its flexible design enables inter- and intrafraction plan

SU-F-J-105: Towards a Novel Treatment Planning Pipeline Delivering Pareto- Optimal Plans While Enabling Inter- and Intrafraction Plan Adaptation

International Nuclear Information System (INIS)

Kontaxis, C; Bol, G; Lagendijk, J; Raaymakers, B; Breedveld, S; Sharfo, A; Heijmen, B

2016-01-01

Purpose: To develop a new IMRT treatment planning methodology suitable for the new generation of MR-linear accelerator machines. The pipeline is able to deliver Pareto-optimal plans and can be utilized for conventional treatments as well as for inter- and intrafraction plan adaptation based on real-time MR-data. Methods: A Pareto-optimal plan is generated using the automated multicriterial optimization approach Erasmus-iCycle. The resulting dose distribution is used as input to the second part of the pipeline, an iterative process which generates deliverable segments that target the latest anatomical state and gradually converges to the prescribed dose. This process continues until a certain percentage of the dose has been delivered. Under a conventional treatment, a Segment Weight Optimization (SWO) is then performed to ensure convergence to the prescribed dose. In the case of inter- and intrafraction adaptation, post-processing steps like SWO cannot be employed due to the changing anatomy. This is instead addressed by transferring the missing/excess dose to the input of the subsequent fraction. In this work, the resulting plans were delivered on a Delta4 phantom as a final Quality Assurance test. Results: A conventional static SWO IMRT plan was generated for two prostate cases. The sequencer faithfully reproduced the input dose for all volumes of interest. For the two cases the mean relative dose difference of the PTV between the ideal input and sequenced dose was 0.1% and −0.02% respectively. Both plans were delivered on a Delta4 phantom and passed the clinical Quality Assurance procedures by achieving 100% pass rate at a 3%/3mm gamma analysis. Conclusion: We have developed a new sequencing methodology capable of online plan adaptation. In this work, we extended the pipeline to support Pareto-optimal input and clinically validated that it can accurately achieve these ideal distributions, while its flexible design enables inter- and intrafraction plan

Impact of respiratory motion on variable relative biological effectiveness in 4D-dose distributions of proton therapy.

Science.gov (United States)

Ulrich, Silke; Wieser, Hans-Peter; Cao, Wenhua; Mohan, Radhe; Bangert, Mark

2017-11-01

Organ motion during radiation therapy with scanned protons leads to deviations between the planned and the delivered physical dose. Using a constant relative biological effectiveness (RBE) of 1.1 linearly maps these deviations into RBE-weighted dose. However, a constant value cannot account for potential nonlinear variations in RBE suggested by variable RBE models. Here, we study the impact of motion on recalculations of RBE-weighted dose distributions using a phenomenological variable RBE model. 4D-dose calculation including variable RBE was implemented in the open source treatment planning toolkit matRad. Four scenarios were compared for one field and two field proton treatments for a liver cancer patient assuming (α∕β) x  = 2 Gy and (α∕β) x  = 10 Gy: (A) the optimized static dose distribution with constant RBE, (B) a static recalculation with variable RBE, (C) a 4D-dose recalculation with constant RBE and (D) a 4D-dose recalculation with variable RBE. For (B) and (D), the variable RBE was calculated by the model proposed by McNamara. For (C), the physical dose was accumulated with direct dose mapping; for (D), dose-weighted radio-sensitivity parameters of the linear quadratic model were accumulated to model synergistic irradiation effects on RBE. Dose recalculation with variable RBE led to an elevated biological dose at the end of the proton field, while 4D-dose recalculation exhibited random deviations everywhere in the radiation field depending on the interplay of beam delivery and organ motion. For a single beam treatment assuming (α∕β) x  = 2 Gy, D 95 % was 1.98 Gy (RBE) (A), 2.15 Gy (RBE) (B), 1.81 Gy (RBE) (C) and 1.98 Gy (RBE) (D). The homogeneity index was 1.04 (A), 1.08 (B), 1.23 (C) and 1.25 (D). For the studied liver case, intrafractional motion did not reduce the modulation of the RBE-weighted dose postulated by variable RBE models for proton treatments.

Skin dose variation: influence of energy

International Nuclear Information System (INIS)

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

2004-01-01

Full text: This research aimed to quantitatively evaluate the differences in percentage dose of maximum for 6MV and 18MV x-ray beams within the first lcm of interactions. Thus provide quantitative information regarding the basal, dermal and subcutaneous dose differences achievable with these two types of high-energy x-ray beams. Percentage dose of maximum build up curves are measured for most clinical field sizes using 6MV and 18MV x-ray beams. Calculations are performed to produce quantitative results highlighting the percentage dose of maximum differences delivered to various depths within the skin and subcutaneous tissue region by these two beams Results have shown that basal cell layer doses are not significantly different for 6MV and 18Mv x-ray beams At depths beyond the surface and basal cell layer there is a measurable and significant difference in delivered dose. This variation increases to 20% of maximum and 22% of maximum at Imm and 1cm depths respectively. The percentage variations are larger for smaller field sizes where the photon in phantom component of the delivered dose is the most significant contributor to dose By producing graphs or tables of % dose differences in the build up region we can provide quantitative information to the oncologist for consideration (if skin and subcutaneous tissue doses are of importance) during the beam energy selection process for treatment. Copyright (2004) Australasian College of Physical Scientists and Engineers in Medicine

SU-G-BRB-14: Uncertainty of Radiochromic Film Based Relative Dose Measurements

Energy Technology Data Exchange (ETDEWEB)

Devic, S; Tomic, N; DeBlois, F; Seuntjens, J [McGill University, Montreal, QC (Canada); Lewis, D [RCF Consulting, LLC, Monroe, CT (United States); Aldelaijan, S [King Faisal Specialist Hospital & Research Center, Riyadh (Saudi Arabia)

2016-06-15

Purpose: Due to inherently non-linear dose response, measurement of relative dose distribution with radiochromic film requires measurement of absolute dose using a calibration curve following previously established reference dosimetry protocol. On the other hand, a functional form that converts the inherently non-linear dose response curve of the radiochromic film dosimetry system into linear one has been proposed recently [Devic et al, Med. Phys. 39 4850–4857 (2012)]. However, there is a question what would be the uncertainty of such measured relative dose. Methods: If the relative dose distribution is determined going through the reference dosimetry system (conversion of the response by using calibration curve into absolute dose) the total uncertainty of such determined relative dose will be calculated by summing in quadrature total uncertainties of doses measured at a given and at the reference point. On the other hand, if the relative dose is determined using linearization method, the new response variable is calculated as ζ=a(netOD)n/ln(netOD). In this case, the total uncertainty in relative dose will be calculated by summing in quadrature uncertainties for a new response function (σζ) for a given and the reference point. Results: Except at very low doses, where the measurement uncertainty dominates, the total relative dose uncertainty is less than 1% for the linear response method as compared to almost 2% uncertainty level for the reference dosimetry method. The result is not surprising having in mind that the total uncertainty of the reference dose method is dominated by the fitting uncertainty, which is mitigated in the case of linearization method. Conclusion: Linearization of the radiochromic film dose response provides a convenient and a more precise method for relative dose measurements as it does not require reference dosimetry and creation of calibration curve. However, the linearity of the newly introduced function must be verified. Dave Lewis

Main clinical, therapeutic and technical factors related to patient's maximum skin dose in interventional cardiology procedures

Science.gov (United States)

Journy, N; Sinno-Tellier, S; Maccia, C; Le Tertre, A; Pirard, P; Pagès, P; Eilstein, D; Donadieu, J; Bar, O

2012-01-01

Objective The study aimed to characterise the factors related to the X-ray dose delivered to the patient's skin during interventional cardiology procedures. Methods We studied 177 coronary angiographies (CAs) and/or percutaneous transluminal coronary angioplasties (PTCAs) carried out in a French clinic on the same radiography table. The clinical and therapeutic characteristics, and the technical parameters of the procedures, were collected. The dose area product (DAP) and the maximum skin dose (MSD) were measured by an ionisation chamber (Diamentor; Philips, Amsterdam, The Netherlands) and radiosensitive film (Gafchromic; International Specialty Products Advanced Materials Group, Wayne, NJ). Multivariate analyses were used to assess the effects of the factors of interest on dose. Results The mean MSD and DAP were respectively 389 mGy and 65 Gy cm−2 for CAs, and 916 mGy and 69 Gy cm−2 for PTCAs. For 8% of the procedures, the MSD exceeded 2 Gy. Although a linear relationship between the MSD and the DAP was observed for CAs (r=0.93), a simple extrapolation of such a model to PTCAs would lead to an inadequate assessment of the risk, especially for the highest dose values. For PTCAs, the body mass index, the therapeutic complexity, the fluoroscopy time and the number of cine frames were independent explanatory factors of the MSD, whoever the practitioner was. Moreover, the effect of technical factors such as collimation, cinematography settings and X-ray tube orientations on the DAP was shown. Conclusion Optimising the technical options for interventional procedures and training staff on radiation protection might notably reduce the dose and ultimately avoid patient skin lesions. PMID:22457404

Alternatives to dose, quality factor and dose equivalent for low level irradiation

International Nuclear Information System (INIS)

Sondhaus, C.A.; Bond, V.P.; Feinendegen, L.E.

1988-01-01

Randomly occurring energy deposition events produced by low levels of ionizing radiation interacting with tissue deliver variable amounts of energy to the sensitive target volumes within a small fraction of the cell population. A model is described in which an experimentally derived function relating event size to cell response probability operates mathematically on the microdosimetric event size distribution characterizing a given irradiation and thus determines the total fractional number of responding cells; this fraction measures the effectiveness of the given radiation. Normalizing to equal numbers of events produced by different radiations and applying this cell response or hit size effectiveness function (HSEF) should define radiation quality, or relative effectiveness, on a more nearly absolute basis than do the absorbed dose and dose evaluation, which are confounded when applied to low level irradiations. Examples using both calculation and experimental data are presented. 15 refs., 18 figs

Absorbed dose/melting heat dependence studies for the PVDF homopolymer

International Nuclear Information System (INIS)

Batista, Adriana S.M.; Gual, Maritza R.; Pereira, Claubia

2013-01-01

Differential Scanning Calorimetry (DSC) of gamma irradiated Poly (vinylidene Fluoride) [PVDF] homopolymer has been studied in connection with the use of material in industrial high gamma dose measurement. Interaction between gamma radiation and PVDF leads to the radio-induction of C=O and conjugated C=C bonds, as it can be inferred from previous infrared (FTIR) and ultraviolet-visible (UV-Vis) spectrometric data. These induced defects result in a decrease of the polymer crystallinity that can be followed with DSC scans, by measuring the latent heat during the melting transition (Hmelt). After a systematic investigation, we have found that Hmelt is unambiguously related to the delivered doses ranging from 100 to 2,000 kGy of gamma radiation. One the other hand, further fading investigation analysis has proved that the Hmelt x Dose relationship can be fitted by an exponential function that remains constant for several months. Both the very large range of dose measurement and also the possibility of evaluating high gamma doses until five months after irradiation make PVDF homopolymers very good candidates to be investigated as commercial high gamma dose dosimeters. The high gamma dose irradiation facilities in Brazil used to develop high dose dosimeters are all devoted to industrial and medical purposes. Therefore, in view of the uncertainties involved in the dose measurements related to the electronic equilibrium correction factors and backscattering in the isodose curves used at the irradiation setup, a validation process is required to correctly evaluate the delivered absorbed doses. The sample irradiations were performed with a Co-60 source, at 12kGy/h and 2,592 kGy/h, in the high gamma dose facilities at Centro de Desenvolvimento da Tecnologia Nuclear CDTN/CNEN, Belo Horizonte, Brazil. The comparison of the curve of the Hmelt vs Dose is presented in this paper. (author)

Out-of-field dose measurements in radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Kaderka, Robert

2011-07-13

This thesis describes the results from measurements of the out-of-field dose in radiotherapy. The dose outside the treatment volume has been determined in a water phantom and an anthropomorphic phantom. Measurements were performed with linac photons, passively delivered protons, scanned protons, passively delivered carbon ions as well as scanned carbon ions. It was found that the use of charged particles for radiotherapy reduces the out-of-field dose by up to three orders of magnitude compared to conventional radiotherapy with photons.

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

International Nuclear Information System (INIS)

Bertelsen, Anders; Schytte, Tine; Bentzen, Soren M.; Hansen, Olfred; Nielsen, Morten; Brink, Carsten

2011-01-01

Background: Density changes of healthy lung tissue during radiotherapy as observed by Cone Beam CT (CBCT) might be an early indicator of patient specific lung toxicity. This study investigates the time course of CBCT density changes and tests for a possible correlation with locally delivered dose. Methods: A total of 665 CBCTs in 65 lung cancer patients treated with IMRT/VMAT to 60 or 66 Gy in 2 Gy fractions were analyzed. For each patient, CBCT lung density changes during the treatment course were related to the locally delivered dose. Results: A dose response is observed for the patient population at the end of the treatment course. However, the observed dose response is highly variable among patients. Density changes at 10th and 20th fraction are clearly correlated to those observed at the end of the treatment course. Conclusions: CBCT density changes in healthy lung tissue during radiotherapy correlate with the locally delivered dose and can be detected relatively early during the treatment. If these density changes are correlated to subsequent clinical toxicity this assay could form the basis for biological adaptive radiotherapy.

Relative safety profiles of high dose statin regimens

Directory of Open Access Journals (Sweden)

Carlos Escobar

2008-06-01

Full Text Available Carlos Escobar, Rocio Echarri, Vivencio BarriosDepartment of Cardiology, Hospital Ramón y Cajal, Madrid, SpainAbstract: Recent clinical trials recommend achieving a low-density lipoprotein cholesterol level of <100 mg/dl in high-risk and <70 mg/dl in very high risk patients. To attain these goals, however, many patients will need statins at high doses. The most frequent side effects related to the use of statins, myopathy, rhabdomyolysis, and increased levels of transaminases, are unusual. Although low and moderate doses show a favourable profile, there is concern about the tolerability of higher doses. During recent years, numerous trials to analyze the efficacy and tolerability of high doses of statins have been published. This paper updates the published data on the safety of statins at high doses.Keywords: statins, high doses, tolerability, liver, muscle

Radon-222 related influence on ambient gamma dose.

Science.gov (United States)

Melintescu, A; Chambers, S D; Crawford, J; Williams, A G; Zorila, B; Galeriu, D

2018-04-03

Ambient gamma dose, radon, and rainfall have been monitored in southern Bucharest, Romania, from 2010 to 2016. The seasonal cycle of background ambient gamma dose peaked between July and October (100-105 nSv h -1 ), with minimum values in February (75-80 nSv h -1 ), the time of maximum snow cover. Based on 10 m a.g.l. radon concentrations, the ambient gamma dose increased by around 1 nSv h -1 for every 5 Bq m -3 increase in radon. Radon variability attributable to diurnal changes in atmospheric mixing contributed less than 15 nSv h -1 to the overall variability in ambient gamma dose, a factor of 4 more than synoptic timescale changes in air mass fetch. By contrast, precipitation-related enhancements of the ambient gamma dose were 15-80 nSv h -1 . To facilitate routine analysis, and account in part for occasional equipment failure, an automated method for identifying precipitation spikes in the ambient gamma dose was developed. Lastly, a simple model for predicting rainfall-related enhancement of the ambient gamma dose is tested against rainfall observations from events of contrasting duration and intensity. Results are also compared with those from previously published models of simple and complex formulation. Generally, the model performed very well. When simulations underestimated observations the absolute difference was typically less than the natural variability in ambient gamma dose arising from atmospheric mixing influences. Consequently, combined use of the automated event detection method and the simple model of this study could enable the ambient gamma dose "attention limit" (which indicates a potential radiological emergency) to be reduced from 200 to 400% above background to 25-50%. Copyright © 2018 Elsevier Ltd. All rights reserved.

Low Dose Suppression of Neoplastic Transformation in Vitro

Energy Technology Data Exchange (ETDEWEB)

John Leslie Redpath

2012-05-01

This grant was to study the low dose suppression of neoplastic transformation in vitro and the shape of the dose-response curve at low doses and dose-rates of ionizing radiation. Previous findings had indicated a suppression of transformation at dose <10cGy of low-LET radiation when delivered at high dose-rate. The present study indicates that such suppression extends out to doses in excess of 100cGy when the dose (from I-125 photons) is delivered at dose-rates as low as 0.2 mGy/min and out to in excess of {approx}25cGy the highest dose studied at the very low dose-rate of 0.5 mGy/day. We also examined dose-rate effects for high energy protons (which are a low-LET radiation) and suppression was evident below {approx}10cGy for high dose-rate delivery and at least out to 50cGy for low dose-rate (20cGy/h) delivery. Finally, we also examined the effect of low doses of 1 GeV/n iron ions (a high-LET radiation) delivered at high dose-rate on transformation at low doses and found a suppression below {approx}10cGy that could be attributable to an adaptive response in bystander cells induced by the associated low-LET delta rays. These results have implications for cancer risk assessment at low doses.

Operation of the radiation dose registration system for decontamination and related works

International Nuclear Information System (INIS)

Ogawa, Tsubasa; Yasutake, Tsuneo; Itoh, Atsuo; Miyabe, Kenjiro

2017-01-01

The radiation dose registration system for decontamination and related works was established on 15 November 2013. Radiation dose registration center and primary contractors of decontamination and related works manage decontamination registration and management system. As of 31 March 2017, 384 primary contractors joined in the radiation dose registration system for decontamination and related works. 383,087 quarterly exposure dose records for decontamination and related works were registered. Based on the registered data provided by the primary contractors, radiation dose registration center has released the statistical data that represent the radiation control status for workers engaged in radiation work at the work areas of decontamination and related works, etc. The statistical data shows that there were 40,377 workers engaged in decontamination and related works in 2015. The average exposure dose for workers was 0.6 mSv in 2015. The maximum exposure dose for workers was 7.8 mSv in 2015. Dose distribution by age of workers shows the range of 60 to 64 years old were most engaged in decontamination and related works in 2015. Dose distribution by gender of workers shows 97% of workers were male in 2015. From 2012 to 2015, about 95% of workers were exposed to radiation less than 3 mSv. And about 80% of workers were exposed to radiation less than 1 mSv. The average exposure dose per year was ranged from 0.5 to 0.7 mSv. (author)

The relative biological effectiveness of out-of-field dose

International Nuclear Information System (INIS)

Balderson, Michael; Koger, Brandon; Kirkby, Charles

2016-01-01

Purpose: using simulations and models derived from existing literature, this work investigates relative biological effectiveness (RBE) for out-of-field radiation and attempts to quantify the relative magnitudes of different contributing phenomena (spectral, bystander, and low dose hypersensitivity effects). Specific attention is paid to external beam radiotherapy treatments for prostate cancer. Materials and methods: using different biological models that account for spectral, bystander, and low dose hypersensitivity effects, the RBE was calculated for different points moving radially out from isocentre for a typical single arc VMAT prostate case. The RBE was found by taking the ratio of the equivalent dose with the physical dose. Equivalent doses were calculated by determining what physical dose would be necessary to produce the same overall biological effect as that predicted using the different biological models. Results: spectral effects changed the RBE out-of-field less than 2%, whereas response models incorporating low dose hypersensitivity and bystander effects resulted in a much more profound change of the RBE for out-of-field doses. The bystander effect had the largest RBE for points located just outside the edge of the primary radiation beam in the cranial caudal (z-direction) compared to low dose hypersensitivity and spectral effects. In the coplanar direction, bystander effect played the largest role in enhancing the RBE for points up to 8.75 cm from isocentre. Conclusions: spectral, bystander, and low dose hypersensitivity effects can all increase the RBE for out-of-field radiation doses. In most cases, bystander effects seem to play the largest role followed by low dose hypersensitivity. Spectral effects were unlikely to be of any clinical significance. Bystander, low dose hypersensitivity, and spectral effect increased the RBE much more in the cranial caudal direction (z-direction) compared with the coplanar directions. (paper)

Comparison of the efficacy of intensity modulated radiotherapy delivered by competing technologies

International Nuclear Information System (INIS)

Seco, Joao Carlos

2003-01-01

The project involved the study and comparison of the various intensity-modulated radiation therapy (IMRT) delivery techniques. IMRT can be delivered via (i) the NOMOS MIMiC tomotherapy device, (ii) the dynamic multileaf collimator (DMLC), and (iii) the technique of multiple-static fields (MSF) using a multileaf collimator (MLC). To evaluate the relative benefits and limitations of the different methods of delivering IMRT an inverse-planning simulation code was developed. The simulation uses two distinct beam models: (a) the PEACOCK pencil-beam model based on the double Gaussian convolution for the MIMiC, and (b) the macropencil beam model (with the extended source model included to correct for the output factor) which is used for the DMLC and MSF-MLC delivery techniques. The process of delivering an IMRT treatment may involve various beam-modifying techniques such as multileaf collimators, the NOMOS MIMiC, blocks, wedges, etc. The constraints associated with the IMRT delivery technique are usually neglected in the process of obtaining the 'optimal' inverse treatment plan. Consequently, dose optimization may be significantly reduced when the 'optimal' beam profiles are converted to leaf/diaphragm positions via a leaf-sequencing interpreter. The work developed assessed the effects on the optimum treatment plan of the following leaf-sequencing algorithms: MSF-MLC, DMLC, and NOMOS MIMiC. An increase of 2.5%, 3.7% and 5.7% was observed for the PTV dose, when delivering a fluence profile with the DMLC, MSF, and NOMOS MIMiC techniques, respectively. An intensity-modulated beam optimization algorithm was developed to incorporate the delivery constraints into the optimization cycle. The optimization algorithm was based on the quasi-Newton method of iteratively solving minimization problems. The developed algorithm iteratively corrects the incident, pencil-beam-like fluence to incorporate the delivery constraints. In the case of the DMLC and MSF the optimization converged

Optimization of dose distributions for adjuvant locoregional radiotherapy of gastric cancer by IMRT

International Nuclear Information System (INIS)

Lohr, F.; Dobler, B.; Mai, S.; Hermann, B.; Tiefenbacher, U.; Wieland, P.; Steil, V.; Wenz, F.

2003-01-01

Background and Purpose: Locoregional relapse is a problem frequently encountered with advanced gastric cancer. Data from the randomized Intergroup trial 116 suggest effectiveness of adjuvant radiochemotherapy, albeit with significant toxicity. The potential of intensity-modulated radiotherapy (IMRT) to reduce toxicity by significantly reducing maximum and median doses to organs at risk while still applying sufficient dose to the target volume in the upper abdomen was studied. Patient and Methods: For a typical configuration of target volumes and organs, a step-and-shoot IMRT plan (eight beam orientations), developed as a class solution for treatment of tumors in the upper abdomen (Figures 1 to 3), a conventional plan, a combination of the conventional plan with a kidney-sparing boost plan, and a conventional plan with noncoplanar ap and pa fields for improved kidney sparing were compared with respect to coverage of target volume and dose to organs at risk with a dose of 45 Gy delivered as the median dose to the target volume. Results: When using the conventional three-dimensionally planned box techniques, the right kidney could be kept below tolerance, but median dose to the left kidney amounted to between 14.8 and 26.9 Gy, depending on the plan. IMRT reduced the median dose to the left kidney to 10.5 Gy, while still keeping the dose to the right kidney 90% of prescription dose were delivered to > 90% of target volume with IMRT (Table 1). Conclusion: IMRT has the potential to deliver efficient doses to target volumes in the upper abdomen, while delivering dose to organs at risk in a more advantageous fashion than a conventional technique. For clinical implementation, the possibility of extensive organ motion in the upper abdomen has to be taken into account for treatment planning and patient positioning. The multitude of potential risks related to its application has to be the subject of thorough follow-up and further studies. (orig.)

Dose uniformity of budesonide Easyhaler® under simulated real-life conditions and with low inspiration flow rates.

Science.gov (United States)

Haikarainen, Jussi; Rytilä, Paula; Roos, Sirkku; Metsärinne, Sirpa; Happonen, Anita

2017-01-01

Budesonide Easyhaler® multidose dry powder inhaler is approved for the treatment of asthma. Objectives were to determine the delivered dose (DD) uniformity of budesonide Easyhaler® in simulated real-world conditions and with different inspiration flow rates (IFRs). Three dose delivery studies were performed using 100, 200, and 400 µg/dose strengths of budesonide. Dose uniformity was assessed during in-use periods of 4-6 months after exposure to high temperature (30°C) and humidity (60% relative humidity) and after dropping and vibration testing. The influence of various IFRs (31, 43, and 54 L/min) on the DD was also investigated. Acceptable dose uniformity was declared when mean DD were within 80-120% of expected dose; all data reported descriptively. DD was constant (range: 93-109% of expected dose) at all in-use periods and after exposure to high temperature and humidity for a duration of up to 6 months. DD post-dropping and -vibration were unaffected (range 98-105% of expected dose). Similarly, DD was constant and within 10% of expected dose across all IFRs. Results indicate that budesonide Easyhaler® delivers consistently accurate doses in various real-life conditions. Budesonide Easyhaler® can be expected to consistently deliver a uniform dose and improve asthma control regardless of high temperature and humidity or varying IFR.

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)

Ipratropium bromide delivered by metered-dose aerosol to infant ...

African Journals Online (AJOL)

Two methods of administration of ipratropium bromide (Atrovent; Boehringer Ingelheim) to wheezing children'< 25 months of age were compared: (i) the conventional nebulisation (15 children); and (ii) a metered-dose aerosol plus spacer and mask (MDA group, 17 children). The drug induced a significant and similar fall in ...

Ipratropium bromide delivered by metered-dose aerosol to infant ...

African Journals Online (AJOL)

1990-08-21

Aug 21, 1990 ... Two methods of administration of ipratropium bromide. (Atrovent; Boehringer Ingelheim) to wheezing children'< 25 months of age were compared: (I) the conventional nebulisa- tion (15 children); and (iI) a metered-dose aerosol plus spacer and mask (MDA group, 17 children). The drug induced a significant ...

Measurement of radiation dose to the eye-lens with bilateral whole brain irradiation

International Nuclear Information System (INIS)

Kim, Ki Hwan; Park, Charn Il; Kang, Wee Saing; Choo, Dong Woon

1985-01-01

In 40 patients with metastatic brain tumor and acute lymphoblastic leukemia received whole brain irradiation, the dose delivered to the eye lens was measured using T.L.D. chips applied on the eyes as usual shield. The dose to the eye lens was expressed the relative dose to the mid brain dose. Radiotherapy was administrated using Co-60 teletherapy with bilateral whole brain irradiation. The results are as follows: 1. The dose to the right eye from its incipient field is 16.6% of tumor dose while the dose to the same eye from the opposite field is 41.2%. On left eye, 19.2% from incipient field while 39.2% from the opposite field. 2. Total received dose to right and left eyes is 28.9%, 29.8% of tumor dose respectively. 3. Comparing lens shield group with orbit shield group dose is 22.5%, 15.8% of tumor dose, respectively. 4. The dose delivered to the eye lens in ipsilateral side depends upon internal scattering, location of lead shield and penetrating dose of lead in itself. The dose in contralateral side depends upon divergency of radiation beam and patient's malposition. 5. The dose to the eye lens should be less than 10% of tumor dose with adequate shield, also not missing the chance of leptomeningeal recurrence because of overshielding.

Impact of the spinal cord position uncertainty on the dose received during head and neck helical tomotherapy

International Nuclear Information System (INIS)

Piotrowski, Tomasz; Kazmierska, Joanna; Sokolowski, Adam; Skorska, Malgorzata; Jodda, Agata; Ryczkowski, Adam; Cholewinski, Witold; Bak, Bartosz

2013-01-01

The study aims to establish the optimal planning risk volume (PRV) to the spinal cord (SC) for oropharyngeal cancer patients during adaptive radiation therapy with concurrent chemotherapy. Geometrical uncertainties of the SC were evaluated. Differences between planned and delivered maximum doses to each part of the SC were established for every fraction dose and for cumulative dose. Maximum doses were evaluated as a dose received in 0.5 and 1cm3 of the analysed part of the SC defined as C1–C2, C3–C4, C5–C6 and C7–Th1 where Cn was a n-th cervical vertebra (n=1, … , 7) and Th1 was the first thoracic vertebra. Finally, relations between dose differences and geometrical uncertainties were analysed using a relative risk (RR) and the importance of the PRV dose gradient to establish an optimal PRV for the SC. Prospective study based on the 875 observations from 25 oropharyngeal cancer patients was performed. The C1-C2 part of the SC is most exposed to risk of overdosage during chemoradiation for patients with oropharyngeal cancer due to its proximity to the clinical target volume (CTV). Doses received by other parts of the SC are smaller, with the lowest dose delivered to C7–Th1. For the C1–C2, delivered dose was higher than planned dose by 11%, while for the C7–Th1, this difference was smaller than 7%. The lowest movement of individual parts of the SC were detected for the C1–C2 and the highest for the C7–Th1. The standard deviations of the mean shift ranged respectively from 0.9 to 1.4mm and from 1.3 to 2.9mm. For each part of the SC delivered dose was smaller than planned dose to the PRV (RR<1). Our study showed that for chemoradiation of oropharyngeal cancer, using daily image guidance and proper plan adaptation scheme, the current PRV margin for the SC could be reduced to 4mm.

submitter Dose prescription in carbon ion radiotherapy: How to compare two different RBE-weighted dose calculation systems

CERN Document Server

Molinelli, Silvia; Mairani, Andrea; Matsufuji, Naruhiro; Kanematsu, Nobuyuki; Inaniwa, Taku; Mirandola, Alfredo; Russo, Stefania; Mastella, Edoardo; Hasegawa, Azusa; Tsuji, Hiroshi; Yamada, Shigeru; Vischioni, Barbara; Vitolo, Viviana; Ferrari, Alfredo; Ciocca, Mario; Kamada, Tadashi; Tsujii, Hirohiko; Orecchia, Roberto; Fossati, Piero

2016-01-01

Background and purpose: In carbon ion radiotherapy (CIRT), the use of different relative biological effectiveness (RBE) models in the RBE-weighted dose $(D_{RBE})$ calculation can lead to deviations in the physical dose $(D_{phy})$ delivered to the patient. Our aim is to reduce target $D_{phy}$ deviations by converting prescription dose values. Material and methods: Planning data of patients treated at the National Institute of Radiological Sciences (NIRS) were collected, with prescribed doses per fraction ranging from 3.6 Gy (RBE) to 4.6 Gy (RBE), according to the Japanese semi-empirical model. The $D_{phy}$ was Monte Carlo (MC) re-calculated simulating the NIRS beamline. The local effect model (LEM)_I was then applied to estimate $D_{RBE}$. Target median $D_{RBE}$ ratios between MC + LEM_I and NIRS plans determined correction factors for the conversion of prescription doses. Plans were re-optimized in a LEM_I-based commercial system, prescribing the NIRS uncorrected and corrected $D_{RBE}$. Results: The MC ...

Radiobiological responses for two cell lines following continuous low dose-rate (CLDR) and pulsed dose rate (PDR) brachytherapy

International Nuclear Information System (INIS)

Hanisch, Per Henrik; Furre, Torbjoern; Olsen, Dag Rune; Pettersen, Erik O.

2007-01-01

The iso-effective irradiation of continuous low-dose-rate (CLDR) irradiation was compared with that of various schedules of pulsed dose rate (PDR) irradiation for cells of two established human lines, T-47D and NHIK 3025. Complete single-dose response curves were obtained for determination of parameters α and β by fitting of the linear quadratic formula. Sublethal damage repair constants μ and T 1/2 were determined by split-dose recovery experiments. On basis of the acquired parameters of each cell type the relative effectiveness of the two regimens of irradiation (CLDR and PDR) was calculated by use of Fowler's radiobiological model for iso-effect irradiation for repeated fractions of dose delivered at medium dose rates. For both cell types the predicted and observed relative effectiveness was compared at low and high iso-effect levels. The results indicate that the effect of PDR irradiation predicted by Fowler's model is equal to that of CLDR irradiation for both small and large doses with T-47D cells. With NHIK 3025 cells PDR irradiation induces a larger effect than predicted by the model for small doses, while it induces the predicted effect for high doses. The underlying cause of this difference is unclear, but cell-cycle parameters, like G2-accumulation is tested and found to be the same for the two cell lines

Radiation-related operator's dose distribution according to LLD(recording level)

International Nuclear Information System (INIS)

Park, Jae Duck

2008-01-01

Recently, the area of radiation usage is being enlarged by the industry's advancement over the world. And, the usage of radiation generator and radioisotope is increasing every year. So, they are researching actively how to protect operators from the radiation that causes direct or indirect harmfulness to radiation-related operators of the related institutions. Therefore, in case of operator's dose, not only the main dosimeter's correctness but also the reasonal evaluation to the read values becomes the important factor. From this view, LLD's application to the read dose value is being embossed more importantly than any other thing. So, this study tried to find out what change was generated in the personal dose and the group dose when LLD was applied based on the internal real operator's read value, for 3 years, 2005 - 2007, and find out the personal dose change after dividing them into the exposure group and the supervising group based on the common people's personal dose (1 mSv/y)

Low dose iodine-131 therapy in solitary toxic thyroid nodules

International Nuclear Information System (INIS)

Prakash, Rajeev

1999-01-01

Forty patients with solitary hyperfunctioning thyroid nodules were treated with relatively low dose radioiodine therapy, 131 I doses were calculated taking into account thyroid mass and radioiodine kinetics to deliver 100 μCi/g of estimated nodule weight corrected for uptake. Patients remaining persistently hyperthyroid at four months after the initial therapy were retreated with a similarly calculated dose. Cure of the hyperthyroid state was achieved in all patients, total administered dose in individual cases ranging from 3-17 mCi. 28 of the 40 patients required a single therapy dose. 36 patients were euthyroid after a 4.5 year mean follow-up period. Four cases developed post therapy hypothyroidism requiring replacement therapy. Nodules regressed completely in nine cases following 131 I treatment, with partial regression in size in 19 patients. Control of hyperthyroid state in cases of solitary toxic thyroid nodules can be satisfactorily achieved using relatively low dose radioiodine therapy with low incidence of post therapy hypothyroidism. (author)

The importance of multidisciplinary teamwork and team climate for relational coordination among teams delivering care to older patients

NARCIS (Netherlands)

J.M. Hartgerink (Jacqueline); J.M. Cramm (Jane); T.J.E.M. Bakker (Ton); A.M. van Eijsden (A.); J.P. Mackenbach (Johan); A.P. Nieboer (Anna)

2013-01-01

textabstractAim: To identify predictors of relational coordination among professionals delivering care to older patients. Background: Relational coordination is known to enhance quality of care in hospitals. The underlying mechanisms, however, remain poorly understood. Design: This cross-sectional

Some aspects of the fetal doses given in ICRP Publication 88

International Nuclear Information System (INIS)

Phipps, A.W.; Harrison, J.D.; Fell, T.P.; Eckerman, K.F.; Nosske, D.

2003-01-01

The International Commission on Radiological Protection (ICRP) has recently published dose coefficients (dose per unit intake, Sv Bq -1 ) for the offspring of women exposed to radionuclides during or before pregnancy. These dose estimates include in utero doses to the embryo and fetus and doses delivered postnatally to the newborn child from radionuclides retained at birth. This paper considers the effect on doses of the time of radionuclide intake and examines the proportion of dose delivered in utero and postnatally for different radionuclides. Methods used to calculate doses to the fetal skeleton are compared. For many radionuclides, doses are greatest for intakes early in pregnancy but important exceptions for which doses are greatest for intakes later in pregnancy, are iodine isotopes and isotopes of the alkaline earth elements, including strontium. While radionuclides such as 131 I deliver dose largely in utero even for intakes late in pregnancy, others such as 239 Pu deliver dose largely postnatally, even for intakes early during pregnancy. For alpha emitters deposited in the skeleton, the assumption made is of uniform distribution of the radionuclide and of target cells for leukaemia and bone cancer in utero; that is, the developing bone structure is not considered. However, for beta emitters, the bone structure was considered. Both approaches can be regarded as reasonably conservative, given uncertainties in particular in the location of the target cells and the rapid growth and remodelling of the skeleton at this stage of development. (author)

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

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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)

An IMRT dose distribution study using commercial verification software

International Nuclear Information System (INIS)

Grace, M.; Liu, G.; Fernando, W.; Rykers, K.

2004-01-01

Full text: The introduction of IMRT requires users to confirm that the isodose distributions and relative doses calculated by their planning system match the doses delivered by their linear accelerators. To this end the commercially available software, VeriSoft TM (PTW-Freiburg, Germany) was trialled to determine if the tools and functions it offered would be of benefit to this process. The CMS Xio (Computer Medical System) treatment planning system was used to generate IMRT plans that were delivered with an upgraded Elekta SL15 linac. Kodak EDR2 film sandwiched in RW3 solid water (PTW-Freiburg, Germany) was used to measure the IMRT fields delivered with 6 MV photons. The isodose and profiles measured with the film generally agreed to within ± 3% or ± 3 mm with the planned doses, in some regions (outside the IMRT field) the match fell to within ± 5%. The isodose distributions of the planning system and the film could be compared on screen and allows for electronic records of the comparison to be kept if so desired. The features and versatility of this software has been of benefit to our IMRT QA program. Furthermore, the VeriSoft TM software allows for quick and accurate, automated planar film analysis.Copyright (2004) Australasian College of Physical Scientists and Engineers in Medicine

Peripheral dose measurement for CyberKnife radiosurgery with upgraded linac shielding

International Nuclear Information System (INIS)

Chuang, Cynthia F.; Larson, David A.; Zytkovicz, Andrea; Smith, Vernon; Petti, Paula L.

2008-01-01

The authors investigated the peripheral dose reduction for CyberKnife radiosurgery treatments after the installation of a linac shielding upgrade. As in a previous investigation, the authors considered two treatment plans, one for a hypothetical target in the brain and another for a target in the thorax, delivered to an anthropomorphic phantom. The results of the prior investigation showed that the CyberKnife delivered significantly higher peripheral doses than comparable model C Gamma Knife or IMRT treatments. Current measurements, after the linac shielding upgrade, demonstrate that the additional shielding decreased the peripheral dose, expressed as a percentage of the delivered monitor units (MU), by a maximum of 59%. The dose reduction was greatest for cranial-caudal distances from the field edge less than 30 cm, and at these distances, the CyberKnife peripheral dose, expressed as a percentage of the delivered MU, is now comparable to that measured for the other treatment modalities in our previous investigation. For distances between 30 and 70 cm from the field edge, the additional shielding reduced the peripheral dose by between 20% and 55%. At these distances, the CyberKnife peripheral dose remains higher than doses measured in our previous study for the model C Gamma Knife and IMRT

Effects of low priming dose irradiation on cell cycle arrest of HepG2 cells caused by high dose irradiation

International Nuclear Information System (INIS)

Xia Jingguang; Jin Xiaodong; Chinese Academy of Sciences, Beijing; Li Wenjian; Wang Jufang; Guo Chuanling; Gao Qingxiang

2005-01-01

Human hepatoma cells hepG2 were irradiated twice by 60 Co γ-rays with a priming dose of 5 cGy and a higher dose of 3 Gy performed 4h or 8h after the low dose irradiation. Effects of the priming dose irradiation on cell cycle arrest caused by high dose were examined with flow cytometry. Cells in G 2 /M phase accumulated temporarily after the 5 cGy irradiation, and proliferation of tumor cells was promoted significantly by the low dose irradiation. After the 3 Gy irradiation, G 2 phase arrest occurred, and S phase delayed temporally. In comparison with 3 kGy irradiation only, the priming dose delivered 4h prior to the high dose irradiation facilitated accumulation of hepG2 cells in G 2 /M phase, whereas the priming dose delivered 8h prior to the high dose irradiation helped the cells to overcome G 2 arrest. It was concluded that effects of the priming dose treatment on cell cycle arrest caused by high dose irradiation were dependent on time interval between the two irradiations. (authors)

Measurement of dosimetric parameters and dose verification in stereotactic radiosurgery (SRS)

International Nuclear Information System (INIS)

Reduan Abdullah; Nik Ruzman Nik Idris; Ahmad Lutfi Yusof; Mazurawati Mohamed

2013-01-01

Full-text: The purpose of this study was to measure the dosimetric parameters for small photon beams to be used as input data treatment planning computer system (TPS) and to verify dose calculated by TPS in Stereotactic Radiosurgery (SRS) procedure. The beam data required were Percentage Depth Dose (PDD), Off-axis Ratio (OAR), and Scatter Factor of Relative Output Factor. Small beams of 5 mm to 45 mm diameter circular cone collimators used in SRS were utilized for beam data measurements measured using pinpoint 3D ionization chamber (0.016 cc). For second part of this study, we reported the important quality assurance (QA) procedures before SRS treatment that influenced the dose delivery. These QA procedures consist of measurements on the accuracy in target localization and room laser alignment. The dose calculated to be delivered for treatment was verified using pinpoint 3D ionization chamber and TLD 100H. The mean deviation of measured dose using TLD 100H compared to calculated dose was 3.37 %. Beside that, pinpoint ionization 3D chamber give more accurate results of dose compared to TLD 100H. The measured dose using pinpoint 3D ionization chamber are good agreement with calculated dose by TPS with deviation of 2.17 %. The results are acceptable such as recommended by International Commission on Radiation Units and Measurements (ICRU) Report No. 50 (1993) that dose delivered to the target volume must be within ±5 % error. (author)

TU-PIS-Exhibit Hall-01: CT Dose Optimization Technologies II

International Nuclear Information System (INIS)

Driesser, I; Angel, E

2014-01-01

Partners in Solutions is an exciting new program in which AAPM partners with our vendors to present practical “hands-on” information about the equipment and software systems that we use in our clinics. The imaging topic this year is CT scanner dose optimization capabilities. Note that the sessions are being held in a special purpose room built on the Exhibit Hall Floor, to encourage further interaction with the vendors. Siemens‘ Commitment to the Right Dose in Computed Tomography Presentation Time: 11:15 - 11:45 AM Providing sustainable clinical results at highest patient safety: This is the challenge in medical imaging. Especially for Computed Tomography this means applying not simply the lowest, but the right dose for sound diagnostic imaging. Consequently, Siemens is committed to deliver the right dose in CT. In order to reduce radiation to the right dose, the first step is to provide the right dose technology. Through decades of research and development in CT imaging, Siemens CT has constantly introduced new ideas leading to a comprehensive portfolio of unique CARE technologies to deliver the right dose. For example automated kV adjustment based on patient size and the clinical question with CARE kV and three generations of iterative reconstruction. Based on the right dose technology, the next step is to actually scan at the right dose. For this, it is key to know the right dose targets for every examination. Siemens continuously involves CT experts to push developments further and outline how users can best adapt their procedures to the right dose. For users to know whether they met the right dose targets, it is therefore important to understand and monitor the actual absolute dose values. All scanners are delivered with defined default protocols which automatically use the available right dose technologies. Finally, to deliver the right dose not just in singular cases, but ideally to patients everywhere, organizations need then to manage dose across

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)

Comparison of surface doses from spot scanning and passively scattered proton therapy beams

International Nuclear Information System (INIS)

Arjomandy, Bijan; Sahoo, Narayan; Gillin, Michael; Cox, James; Lee, Andrew

2009-01-01

Proton therapy for the treatment of cancer is delivered using either passively scattered or scanning beams. Each technique delivers a different amount of dose to the skin, because of the specific feature of their delivery system. The amount of dose delivered to the skin can play an important role in choosing the delivery technique for a specific site. To assess the differences in skin doses, we measured the surface doses associated with these two techniques. For the purpose of this investigation, the surface doses in a phantom were measured for ten prostate treatment fields planned with passively scattered proton beams and ten patients planned with spot scanning proton beams. The measured doses were compared to evaluate the differences in the amount of skin dose delivered by using these techniques. The results indicate that, on average, the patients treated with spot scanning proton beams received lower skin doses by an amount of 11.8% ± 0.3% than did the patients treated with passively scattered proton beams. That difference could amount to 4 CGE per field for a prescribed dose of 76 CGE in 38 fractions treated with two equally weighted parallel opposed fields. (note)

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

Adapting protocols of CT imaging in a pediatric emergency department. Evaluation of image quality and dose

International Nuclear Information System (INIS)

Batista Arce, A.; Gonzalez Lopez, S.; Catalan Acosta, A.; Casares Magaz, O.; Hernandez Armas, O.; Hernandez Armas, J.

2011-01-01

The purpose of this study was to assess qualitatively the picture quality in relation to the radiation dose delivered in CT studies of computer tomograph Pediatric Emergency Department of Hospital Universitario de Canarias (HUC) in order to optimize the technical parameters used these radiological examinations so as to obtain optimal image quality at the lowest possible dose.

Studying the efficacy of escalated dose conformal radiation therapy in prostate carcinoma – Pakistan experience

Directory of Open Access Journals (Sweden)

Asad Zamir

2017-11-01

Conclusion: Our data were comparable to international studies of dose escalation using 3D and beneficial as compared to conventional radiation therapy delivered by 2D in terms of biochemical failure rate and treatment related toxicity.

An algorithm for intelligent sorting of CT-related dose parameters

Science.gov (United States)

Cook, Tessa S.; Zimmerman, Stefan L.; Steingal, Scott; Boonn, William W.; Kim, Woojin

2011-03-01

Imaging centers nationwide are seeking innovative means to record and monitor CT-related radiation dose in light of multiple instances of patient over-exposure to medical radiation. As a solution, we have developed RADIANCE, an automated pipeline for extraction, archival and reporting of CT-related dose parameters. Estimation of whole-body effective dose from CT dose-length product (DLP)-an indirect estimate of radiation dose-requires anatomy-specific conversion factors that cannot be applied to total DLP, but instead necessitate individual anatomy-based DLPs. A challenge exists because the total DLP reported on a dose sheet often includes multiple separate examinations (e.g., chest CT followed by abdominopelvic CT). Furthermore, the individual reported series DLPs may not be clearly or consistently labeled. For example, Arterial could refer to the arterial phase of the triple liver CT or the arterial phase of a CT angiogram. To address this problem, we have designed an intelligent algorithm to parse dose sheets for multi-series CT examinations and correctly separate the total DLP into its anatomic components. The algorithm uses information from the departmental PACS to determine how many distinct CT examinations were concurrently performed. Then, it matches the number of distinct accession numbers to the series that were acquired, and anatomically matches individual series DLPs to their appropriate CT examinations. This algorithm allows for more accurate dose analytics, but there remain instances where automatic sorting is not feasible. To ultimately improve radiology patient care, we must standardize series names and exam names to unequivocally sort exams by anatomy and correctly estimate whole-body effective dose.

An algorithm for intelligent sorting of CT-related dose parameters.

Science.gov (United States)

Cook, Tessa S; Zimmerman, Stefan L; Steingall, Scott R; Boonn, William W; Kim, Woojin

2012-02-01

Imaging centers nationwide are seeking innovative means to record and monitor computed tomography (CT)-related radiation dose in light of multiple instances of patient overexposure to medical radiation. As a solution, we have developed RADIANCE, an automated pipeline for extraction, archival, and reporting of CT-related dose parameters. Estimation of whole-body effective dose from CT dose length product (DLP)--an indirect estimate of radiation dose--requires anatomy-specific conversion factors that cannot be applied to total DLP, but instead necessitate individual anatomy-based DLPs. A challenge exists because the total DLP reported on a dose sheet often includes multiple separate examinations (e.g., chest CT followed by abdominopelvic CT). Furthermore, the individual reported series DLPs may not be clearly or consistently labeled. For example, "arterial" could refer to the arterial phase of the triple liver CT or the arterial phase of a CT angiogram. To address this problem, we have designed an intelligent algorithm to parse dose sheets for multi-series CT examinations and correctly separate the total DLP into its anatomic components. The algorithm uses information from the departmental PACS to determine how many distinct CT examinations were concurrently performed. Then, it matches the number of distinct accession numbers to the series that were acquired and anatomically matches individual series DLPs to their appropriate CT examinations. This algorithm allows for more accurate dose analytics, but there remain instances where automatic sorting is not feasible. To ultimately improve radiology patient care, we must standardize series names and exam names to unequivocally sort exams by anatomy and correctly estimate whole-body effective dose.

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

International Nuclear Information System (INIS)

Das, S.K.; Miften, M.M.; Zhou, S.; Bell, M.; Munley, M.T.; Whiddon, C.S.; Craciunescu, O.; Baydush, A.H.; Wong, T.; Rosenman, J.G.; Dewhirst, M.W.; Marks, L.B.

2004-01-01

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

Radiation dose from solar flares at ground level

International Nuclear Information System (INIS)

O'Brien, K.

1979-01-01

Wdowczyk and Wolfendale (Nature, 268, 510, 1977) concluded that a very large solar flare producing exposure of 10 4 rad at ground level (lethal to almost any organism) has a possible frequency of once per 10 5 -10 8 yr. In the work reported similar results were obtained using a more elaborate model. Flares occuring from February 1956 to August 1972 were analyzed. The flare size distribution above the earth's atmosphere, and neutron flux, dose and dose equivalent at ground level at the latitude of Deep River, Canada, were calculated. The probable frequency of flares delivering various doses are given. Doses larger than 100 rad which have significant somatic effects on man and other animals may be delivered once in 10 6 years. The probability of 10 4 rad was found to be 10 -8 /yr. These calculations apply only to high geomagnetic latitudes. Field reversals during which the geomagnetic field is much weaker than current values total about 10% of the past 4 million years. This suggests that a very large flare delivering a large dose worldwide at ground level cannot be ruled out. (author)

Biological effective dose studies in carcinoma of uterine cervix

International Nuclear Information System (INIS)

Yadav, Poonam; Ramasubramanian, V.

2008-01-01

Cancer of cervix is the second most common cancer worldwide among women. Several treatments related protocols of radiotherapy have been followed over few decades in its treatment for evaluating the response. These physical doses varying on the basics of fractionation size, dose rate and total dose needed to be indicated as biological effective dose (BED) to rationalize these treatments. The curative potential of radiation therapy in the management of carcinoma of the cervix is greatly enhanced by the use of intracavitary brachytherapy. Successful brachytherapy requires the high radiation dose to be delivered to the tumor where as minimum radiation dose reach to surrounding normal tissue. Present study is aimed to evaluate biologically effective dose in patients receiving high dose-rate brachytherapy plus external beam radiotherapy based on tumor cell proliferation values in cancer of the cervix patients. The study includes 30 patients' data as a retrospective analysis. In addition determine extent of a dose-response relationship existing between the biological effective dose at Point A and the bladder and rectum and the clinical outcomes

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)

Mammography dose in relation to body mass index, race, and menopausal status

Energy Technology Data Exchange (ETDEWEB)

Schubauer-Berigan, M.K.; Frey, G.D.; Baron, L.; Hoel, D.G

2002-07-01

Mammography dose increases with compressed breast thickness (CBT), but few studies have examined other correlates of dose. The purpose of this study was to evaluate the relation between factors such as race, age, body mass index (BMI), CBT, and menopausal status and mammography screening dose, measured for 509 women in a US population. A multiple linear regression model was developed for dose, based on consideration of these factors as well as examination characteristics. BMI and number of films during examination were positively related to dose. After adjusting for these factors, high CBT also leads to higher dose. Whites receive lower doses than black women, but differences are slight after controlling for the effects of CBT and BMI, which were significantly higher among black women. Pre-menopausal women receive higher doses, after adjusting for all other factors, than post-menopausal women. Jointly, these factors account for approximately 75% to 80% of the variability in dose among this study population. Because rates of overweight are increasing in the US, average doses from mammography may be increasing as well. (author)

Mammography dose in relation to body mass index, race, and menopausal status

International Nuclear Information System (INIS)

Schubauer-Berigan, M.K.; Frey, G.D.; Baron, L.; Hoel, D.G.

2002-01-01

Mammography dose increases with compressed breast thickness (CBT), but few studies have examined other correlates of dose. The purpose of this study was to evaluate the relation between factors such as race, age, body mass index (BMI), CBT, and menopausal status and mammography screening dose, measured for 509 women in a US population. A multiple linear regression model was developed for dose, based on consideration of these factors as well as examination characteristics. BMI and number of films during examination were positively related to dose. After adjusting for these factors, high CBT also leads to higher dose. Whites receive lower doses than black women, but differences are slight after controlling for the effects of CBT and BMI, which were significantly higher among black women. Pre-menopausal women receive higher doses, after adjusting for all other factors, than post-menopausal women. Jointly, these factors account for approximately 75% to 80% of the variability in dose among this study population. Because rates of overweight are increasing in the US, average doses from mammography may be increasing as well. (author)

Dose Escalated Liver Stereotactic Body Radiation Therapy at the Mean Respiratory Position

International Nuclear Information System (INIS)

Velec, Michael; Moseley, Joanne L.; Dawson, Laura A.; Brock, Kristy K.

2014-01-01

Purpose: The dosimetric impact of dose probability based planning target volume (PTV) margins for liver cancer patients receiving stereotactic body radiation therapy (SBRT) was compared with standard PTV based on the internal target volume (ITV). Plan robustness was evaluated by accumulating the treatment dose to ensure delivery of the intended plan. Methods and Materials: Twenty patients planned on exhale CT for 27 to 50 Gy in 6 fractions using an ITV-based PTV and treated free-breathing were retrospectively evaluated. Isotoxic, dose escalated plans were created on midposition computed tomography (CT), representing the mean breathing position, using a dose probability PTV. The delivered doses were accumulated using biomechanical deformable registration of the daily cone beam CT based on liver targeting at the exhale or mean breathing position, for the exhale and midposition CT plans, respectively. Results: The dose probability PTVs were on average 38% smaller than the ITV-based PTV, enabling an average ± standard deviation increase in the planned dose to 95% of the PTV of 4.0 ± 2.8 Gy (9 ± 5%) on the midposition CT (P<.01). For both plans, the delivered minimum gross tumor volume (GTV) doses were greater than the planned nominal prescribed dose in all 20 patients and greater than the planned dose to 95% of the PTV in 18 (90%) patients. Nine patients (45%) had 1 or more GTVs with a delivered minimum dose more than 5 Gy higher with the midposition CT plan using dose probability PTV, compared with the delivered dose with the exhale CT plan using ITV-based PTV. Conclusions: For isotoxic liver SBRT planned and delivered at the mean respiratory, reduced dose probability PTV enables a mean escalation of 4 Gy (9%) in 6 fractions over ITV-based PTV. This may potentially improve local control without increasing the risk of tumor underdosing

Carcinogenesis induced by low-dose radiation

Directory of Open Access Journals (Sweden)

Piotrowski Igor

2017-11-01

Full Text Available Although the effects of high dose radiation on human cells and tissues are relatively well defined, there is no consensus regarding the effects of low and very low radiation doses on the organism. Ionizing radiation has been shown to induce gene mutations and chromosome aberrations which are known to be involved in the process of carcinogenesis. The induction of secondary cancers is a challenging long-term side effect in oncologic patients treated with radiation. Medical sources of radiation like intensity modulated radiotherapy used in cancer treatment and computed tomography used in diagnostics, deliver very low doses of radiation to large volumes of healthy tissue, which might contribute to increased cancer rates in long surviving patients and in the general population. Research shows that because of the phenomena characteristic for low dose radiation the risk of cancer induction from exposure of healthy tissues to low dose radiation can be greater than the risk calculated from linear no-threshold model. Epidemiological data collected from radiation workers and atomic bomb survivors confirms that exposure to low dose radiation can contribute to increased cancer risk and also that the risk might correlate with the age at exposure.

Effects of proton radiation dose, dose rate and dose fractionation on hematopoietic cells in mice

International Nuclear Information System (INIS)

Ware, J.H.; Rusek, A.; Sanzari, J.; Avery, S.; Sayers, C.; Krigsfeld, G.; Nuth, M.; Wan, X.S.; Kennedy, A.R.

2010-01-01

The present study evaluated the acute effects of radiation dose, dose rate and fractionation as well as the energy of protons in hematopoietic cells of irradiated mice. The mice were irradiated with a single dose of 51.24 MeV protons at a dose of 2 Gy and a dose rate of 0.05-0.07 Gy/min or 1 GeV protons at doses of 0.1, 0.2, 0.5, 1, 1.5 and 2 Gy delivered in a single dose at dose rates of 0.05 or 0.5 Gy/min or in five daily dose fractions at a dose rate of 0.05 Gy/min. Sham-irradiated animals were used as controls. The results demonstrate a dose-dependent loss of white blood cells (WBCs) and lymphocytes by up to 61% and 72%, respectively, in mice irradiated with protons at doses up to 2 Gy. The results also demonstrate that the dose rate, fractionation pattern and energy of the proton radiation did not have significant effects on WBC and lymphocyte counts in the irradiated animals. These results suggest that the acute effects of proton radiation on WBC and lymphocyte counts are determined mainly by the radiation dose, with very little contribution from the dose rate (over the range of dose rates evaluated), fractionation and energy of the protons.

Effects of proton radiation dose, dose rate and dose fractionation on hematopoietic cells in mice.

Science.gov (United States)

Ware, J H; Sanzari, J; Avery, S; Sayers, C; Krigsfeld, G; Nuth, M; Wan, X S; Rusek, A; Kennedy, A R

2010-09-01

The present study evaluated the acute effects of radiation dose, dose rate and fractionation as well as the energy of protons in hematopoietic cells of irradiated mice. The mice were irradiated with a single dose of 51.24 MeV protons at a dose of 2 Gy and a dose rate of 0.05-0.07 Gy/min or 1 GeV protons at doses of 0.1, 0.2, 0.5, 1, 1.5 and 2 Gy delivered in a single dose at dose rates of 0.05 or 0.5 Gy/min or in five daily dose fractions at a dose rate of 0.05 Gy/min. Sham-irradiated animals were used as controls. The results demonstrate a dose-dependent loss of white blood cells (WBCs) and lymphocytes by up to 61% and 72%, respectively, in mice irradiated with protons at doses up to 2 Gy. The results also demonstrate that the dose rate, fractionation pattern and energy of the proton radiation did not have significant effects on WBC and lymphocyte counts in the irradiated animals. These results suggest that the acute effects of proton radiation on WBC and lymphocyte counts are determined mainly by the radiation dose, with very little contribution from the dose rate (over the range of dose rates evaluated), fractionation and energy of the protons.

Risk of low-doses in radiodiagnosis; Risque des faibles doses en radiodiagnostic. Mythes, reglementation et rationalite

Energy Technology Data Exchange (ETDEWEB)

Cordoliani, Y.S.; Sarrazin, J.L.; Le Frian, G.; Soulie, D.; Leveque, C. [Hopital d`Instruction des Armees du Val-de-Grace, 75 - Paris (France)

1997-12-31

The effect of low doses of X-rays is inferred from the indubitable effects of high doses in human carcinogenesis, Genetic and teratogenic effects are mainly inferred from animal experimentation because clinical surveys of irradiated pregnant women have failed to demonstrate such consequences in the children, except for mental retardation after Japanese atomic bombing. Since no evidence of carcinogenic effect has been produced by epidemiological studies for doses lower than 500 mSv. the estimation of the risk due to low doses has been extrapolated from the linear relation between dose and cancers at high doses. Such an extrapolation gives a maximal risk which is falsely used as a probability of cancer. The actual risk lies between zero and this maximal number, and many epidemiologic surveys in people receiving doses much higher than the mean level of background irradiation failed to demonstrate higher rate of cancer. The explanation of this fact, which is supported by the most recent biological data, is the efficacy of the DNA repair system at low level of exposure to ionizing radiations. We expose the principles of regulation of radioprotection for workers, and give estimations of the doses delivered to the patients and the personnel by diagnostic investigations, by comparing these doses with those of natural irradiation. Practical aspect for conventional and computed radiology are exposed for patients and workers. (authors)

Low dose oxytocin delivered intranasally with Breath Powered device affects social-cognitive behavior: a randomized 4-way crossover trial with nasal cavity dimension assessment

OpenAIRE

Quintana, Daniel; Westlye, Lars Tjelta; Rustan, Øyvind; Tesli, Natalia; Poppy, Claire; Smevik, Hanne; Tesli, Martin Steen; Røine, Marianne; Mahmoud, Ramy; Smerud, Knut Terje; Djupesland, Per G.; Andreassen, Ole Andreas

2015-01-01

Despite the promise of intranasal oxytocin (OT) for modulating social behavior, recent work has provided mixed results. This may relate to suboptimal drug deposition achieved with conventional nasal sprays, inter-individual differences in nasal physiology and a poor understanding of how intranasal OT is delivered to the brain in humans. Delivering OT using a novel ?Breath Powered' nasal device previously shown to enhance deposition in intranasal sites targeted for nose-to-brain transport, we ...

High-dose total-body irradiation and autologous marrow reconstitution in dogs: dose-rate-related acute toxicity and fractionation-dependent long-term survival

International Nuclear Information System (INIS)

Deeg, H.J.; Storb, R.; Weiden, P.L.; Schumacher, D.; Shulman, H.; Graham, T.; Thomas, E.D.

1981-01-01

Beagle dogs treated by total-body irradiation (TBI) were given autologous marrow grafts in order to avoid death from marrow toxicity. Acute and delayed non-marrow toxicities of high single-dose (27 dogs) and fractionated TBI (20 dogs) delivered at 0.05 or 0.1 Gy/min were compared. Fractionated TBI was given in increments of 2 Gy every 6 hr for three increments per day. Acute toxicity and early mortality (<1 month) at identical total irradiation doses were comparable for dogs given fractionated or single-dose TBI. With single-dose TBI, 14, 16, and 18 Gy, respectively, given at 0.05 Gy/min, 0/5, 5/5, and 2/2 dogs died from acute toxicity; with 10, 12, and 14 Gy, respectively, given at 0.1 Gy/min, 1/5, 4/5, and 5/5 dogs died acutely. With fractionated TBI, 14 and 16 Gy, respectively, given at 0.1 Gy/min, 1/5, 4/5, and 2/2 dogs died auctely. Early deaths were due to radiation enteritis with or without associated septicemia (29 dogs; less than or equal to Day 10). Three dogs given 10 Gy of TBI at 0.1 Gy/min died from bacterial pneumonia; one (Day 18) had been given fractionated and two (Days 14, 22) single-dose TBI. Fifteen dogs survived beyond 1 month; eight of these had single-dose TBI (10-14 Gy) and all died within 7 months of irradiation from a syndrome consisting of hepatic damage, pancreatic fibrosis, malnutrition, wasting, and anemia. Seven of the 15 had fractionated TBI, and only one (14 Gy) died on Day 33 from hepatic failure, whereas 6 (10-14 Gy) are alive and well 250 to 500 days after irradiation. In conclusion, fractionated TBI did not offer advantages over single-dose TBI with regard to acute toxicity and early mortality; rather, these were dependent upon the total dose of TBI. The total acutely tolerated dose was dependent upon the exposure rate; however, only dogs given fractionated TBI became healthy long-term survivors

Acetaminophen dosing for children

Science.gov (United States)

... your child, call your provider. Proper Dosing of Suppositories If your child is vomiting or will not take oral medicine, you can use suppositories. Suppositories are placed in the anus to deliver ...

Comparison of doses delivered in clinical trials of neutron capture therapy in the USA

International Nuclear Information System (INIS)

Albritton, J.R.; Binns, P.J.; Riley, K.J.; Coderre, J.A.; Harling, O.K.; Kiger, W.S. III

2006-01-01

A combined 81 brain tumor patients have been treated in dose escalation trials of Neutron Capture Therapy (NCT) at Harvard-MIT and Brookhaven National Laboratory (BNL). Pooling the clinical outcomes from these trials will permit evaluation with more statistical rigor. However, differences in physical and computational dosimetry between the institutions make direct comparison of the clinical dosimetry difficult. This paper describes work performed to normalize the BNL clinical dosimetry to that of Harvard-MIT for combined dose response analysis. This normalization involved analysis of MIT measurements and calculations using the BNL treatment planning system (TPS), BNCT - Rtpe, for two different phantoms. The BNL TPS was calibrated to dose measurements made by MIT at the BMRR in the BNL calibration phantom, a Lucite cube, and then validated by MIT dose measurements at the BMMR in an ellipsoidal water phantom. Treatment plans for all BNL patients were recomputed using the newly determined TPS calibration, yielding reductions in reported mean brain doses of 19% on average in the initial 15 patients and 31% in the latter 38 patients. These reductions in reported doses have clinically significant implications for those relying on reported BNL doses as a basis for initial dose selection in clinical studies. (author)

Present dose limits and their relation to radiosensitivity of different organs and tissues

International Nuclear Information System (INIS)

Anon.

1987-01-01

Dose equivalent limits in relation to dose thresholds are considered for injury of various tissues and organs to evaluate the protection agains non-stochastic irradiation effects by the existing system of dose limitation for radiotherapeutic personnel. Data on tissue radiosensitivity in relation to non-stochastic effects, obtained from radiotherapeutic experience, are presented. Dose threshold values, derived for patients, with a correction in the direction of increase, may be applied to conditions of occupational exposure except for bone marrow, gonads and eye lens, where threshold doses are lower

Some thoughts on tolerance, dose, and fractionation in boron neutron capture therapy

International Nuclear Information System (INIS)

Gahbauer, R.; Goodman, J.; Blue, T.

1988-01-01

Unique to boron neutron capture therapy, the tolerance very strongly depends on the boron concentration in normal brain, skin and blood. If one first considers the ideal situation of a 2 KeV beam and a compound clearing from normal tissues and blood, the tolerance dose to epithermal beams relates to the maximum tolerated capture gamma dose and capture high LET dose, H (n,gamma)D and N(n,p) 14 C. The authors can relate this gamma and high LET dose to known clinical experience. Assuming gamma and high LET dose ratios as given by Fairchild and Bond, one may first choose a clearly safe high LET whole brain dose and calculate the unavoidably resulting gamma dose. To a first approximation 500 cGy of high LET dose results in 3,000 cGy gamma dose. One can speculate that this approximates the tolerance of whole brain to the 2 KeV beam with no contributing boron dose if the radiation is fractionated. It would clearly be beyond tolerance in a single fraction where most therapists would be uncomfortable to deliver even one third of the above doses

Intradermal inactivated poliovirus vaccine: a preclinical dose-finding study.

Science.gov (United States)

Kouiavskaia, Diana; Mirochnitchenko, Olga; Dragunsky, Eugenia; Kochba, Efrat; Levin, Yotam; Troy, Stephanie; Chumakov, Konstantin

2015-05-01

Intradermal delivery of vaccines has been shown to result in dose sparing. We tested the ability of fractional doses of inactivated poliovirus vaccine (IPV) delivered intradermally to induce levels of serum poliovirus-neutralizing antibodies similar to immunization through the intramuscular route. Immunogenicity of fractional doses of IPV was studied by comparing intramuscular and intradermal immunization of Wistar rats using NanoPass MicronJet600 microneedles. Intradermal delivery of partial vaccine doses induced antibodies at titers comparable to those after immunization with full human dose delivered intramuscularly. The results suggest that intradermal delivery of IPV may lead to dose-sparing effect and reduction of the vaccination cost. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Dose distribution following selective internal radiation therapy

International Nuclear Information System (INIS)

Fox, R.A.; Klemp, P.F.; Egan, G.; Mina, L.L.; Burton, M.A.; Gray, B.N.

1991-01-01

Selective Internal Radiation Therapy is the intrahepatic arterial injection of microspheres labelled with 90Y. The microspheres lodge in the precapillary circulation of tumor resulting in internal radiation therapy. The activity of the 90Y injected is managed by successive administrations of labelled microspheres and after each injection probing the liver with a calibrated beta probe to assess the dose to the superficial layers of normal tissue. Predicted doses of 75 Gy have been delivered without subsequent evidence of radiation damage to normal cells. This contrasts with the complications resulting from doses in excess of 30 Gy delivered from external beam radiotherapy. Detailed analysis of microsphere distribution in a cubic centimeter of normal liver and the calculation of dose to a 3-dimensional fine grid has shown that the radiation distribution created by the finite size and distribution of the microspheres results in an highly heterogeneous dose pattern. It has been shown that a third of normal liver will receive less than 33.7% of the dose predicted by assuming an homogeneous distribution of 90Y

Effective dose delivered by conventional radiology to Aosta Valley population between 2002 and 2009

Science.gov (United States)

Zenone, F; Aimonetto, S; Catuzzo, P; Peruzzo Cornetto, A; Marchisio, P; Natrella, M; Rosanò, A M; Meloni, T; Pasquino, M; Tofani, S

2012-01-01

Objective Medical diagnostic procedures can be considered the main man-made source of ionising radiation exposure for the population. Conventional radiography still represents the largest contribution to examination frequency. The present work evaluates procedure frequency and effective dose from the majority of conventional radiology examinations performed at the Radiological Department of Aosta Hospital from 2002 to 2009. Method Effective dose to the patient was evaluated by means of the software PCXMC. Data provided by the radiological information system allowed us to obtain collective effective and per caput dose. Results The biggest contributors to per caput effective dose from conventional radiology are vertebral column, abdomen, chest, pelvis and (limited to females) breast. Vertebral column, pelvis and breast procedures show a significant dose increment in the period of the study. The mean effective dose per inhabitant from conventional radiology increased from 0.131 mSv in 2002 to 0.156 mSv in 2009. Combining these figures with those from our study of effective dose from CT (0.55 mSv in 2002 to 1.03 mSv in 2009), the total mean effective dose per inhabitant increased from 0.68 mSv to 1.19 mSv. The contribution of CT increased from 81% to 87% of the total. In contrast, conventional radiology accounts for 85% of the total number of procedures, but only 13% of the effective dose. Conclusion The study has demonstrated that conventional radiography still represents the biggest contributor to examination frequency in Aosta Valley in 2009. However, the frequency of the main procedures did not change significantly between 2002 and 2009. PMID:21937611

Monte Carlo skin dose simulation in intraoperative radiotherapy of breast cancer using spherical applicators

Science.gov (United States)

Moradi, F.; Ung, N. M.; Khandaker, M. U.; Mahdiraji, G. A.; Saad, M.; Malik, R. Abdul; Bustam, A. Z.; Zaili, Z.; Bradley, D. A.

2017-08-01

The relatively new treatment modality electronic intraoperative radiotherapy (IORT) is gaining popularity, irradiation being obtained within a surgically produced cavity being delivered via a low-energy x-ray source and spherical applicators, primarily for early stage breast cancer. Due to the spatially dramatic dose-rate fall off with radial distance from the source and effects related to changes in the beam quality of the low keV photon spectra, dosimetric account of the Intrabeam system is rather complex. Skin dose monitoring in IORT is important due to the high dose prescription per treatment fraction. In this study, modeling of the x-ray source and related applicators were performed using the Monte Carlo N-Particle transport code. The dosimetric characteristics of the model were validated against measured data obtained using an ionization chamber and EBT3 film as dosimeters. By using a simulated breast phantom, absorbed doses to the skin for different combinations of applicator size (1.5-5 cm) and treatment depth (0.5-3 cm) were calculated. Simulation results showed overdosing of the skin (>30% of prescribed dose) at a treatment depth of 0.5 cm using applicator sizes larger than 1.5 cm. Skin doses were significantly increased with applicator size, insofar as delivering 12 Gy (60% of the prescribed dose) to skin for the largest sized applicator (5 cm diameter) and treatment depth of 0.5 cm. It is concluded that the recommended 0.5-1 cm distance between the skin and applicator surface does not guarantee skin safety and skin dose is generally more significant in cases with the larger applicators. Highlights: • Intrabeam x-ray source and spherical applicators were simulated and skin dose was calculated. • Skin dose for constant skin to applicator distance strongly depends on applicator size. • Use of larger applicators generally results in higher skin dose. • The recommended 0.5-1 cm skin to applicator distance does not guarantee skin

Relation between dose of bendrofluazide, antihypertensive effect, and adverse biochemical effects

DEFF Research Database (Denmark)

Carlsen, J E; Køber, L; Torp-Pedersen, C

1990-01-01

OBJECTIVE--To determine the relevant dose of bendrofluazide for treating mild to moderate hypertension. DESIGN--Double blind parallel group trial of patients who were given placebo for six weeks and then randomly allocated to various doses of bendrofluazide (1.25, 2.5, 5, or 10 mg daily) or place...... of bendrofluazide to treat mild to moderate hypertension is 1.25-2.5 mg a day. Higher doses caused more pronounced adverse biochemical effects including adverse lipid effects. Previous trials with bendrofluazide have used too high doses....... relations between dose and effect were shown for potassium, urate, glucose, total cholesterol, and apolipoprotein B concentrations. The 1.25 mg dose increased only urate concentrations, whereas the 10 mg dose affected all the above biochemical variables. CONCLUSION--The relevant range of doses...

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

Implication of fractionated dose exposures in therapeutic gain

International Nuclear Information System (INIS)

Kim, Hye-Jin; Lee, Min-Ho; Kim, Eun-Hee

2016-01-01

Radiation therapy pursues killing tumor cells while sparing normal cells from the radiation exposure. Stereotactic radiosurgery (SRS) is a cancer treatment modality that delivers a high dose in a single operation. This high-dose single operation shortens the treatment course, but can increase the risk of normal cell damage. Normal cell damage can be reduced by employing multi-directional exposures for an increasing number of isocenters. In this study, we investigated whether therapeutic benefits would be expected by employing new dose fractionation patterns at a high-dose single operation. The conventional single-dose operation in brain tumor radiosurgery is performed by delivering fractionated uniform doses. According to Figs. 2 and 3, the conventional radiosurgery might have obtained some therapeutic benefit by employing the fractionated uniform-dose exposures instead of a single-dose exposure. We suggest that further therapeutic gain be expected by employing the fractionated radiation exposures in an increasing dose pattern. Until ensuring our suggestion, the significance in gain of cell surviving should be verified for all three dose patterns with both normal and tumor cells. The investigation whether normal and tumor cells show the same responses to the fractionated dose exposures at lower and higher than 15 Gy of total dose is also reserved for future work

Microbeams, microdosimetry and specific dose

International Nuclear Information System (INIS)

Randers-Pehrson, H.

2002-01-01

Dose and its usefulness as a single parameter to describe the amount of radiation absorbed are well established for most situations. The conditions where the concept of dose starts to break down are well known, mostly from the study of microdosimetry. For low doses of high LET radiation it is noted that the process of taking the limiting value of the energy absorbed within a test volume divided by the mass within that volume yields either zero or a relatively large value. The problem is further exacerbated with microbeam irradiations where the uniformity of the energy deposition is experimentally manipulated on the spatial scale of cells being irradiated. Booz introduced a quantity to deal with these problems: the unfortunately named 'mean specific energy in affected volumes'. This quantity multiplied by the probability that a test volume has received an energy deposit is equal to dose (in situations where dose can be defined). I propose that Booz's quantity be renamed 'specific dose', that is the mean energy deposited divided by the mass within a specified volume. If we believe for instance that the nucleus of a cell is the critical volume for biological effects, we can refer to the nuclear specific dose. A microbeam experiment wherein 10 per cent of the cell nuclei were targeted with 10 alpha particles would be described as delivering a nuclear specific dose of 1.6 Gy to 10 per cent of the population. (author)

Low dose radiation in the treatment of HIV related benign lymphoepithelial lesions of the parotid gland

International Nuclear Information System (INIS)

Tchelebi, Anca E.; Ming Teng; Moscatello, Augustine; Moorthy, Chitti R.; Kaufmann, Thomas; Ahmed, Tauseef

1996-01-01

Purpose/Objective: To determine the effectiveness of Radiation Therapy (RT) in the treatment of human immunodeficiency virus (HIV) related benign lymphoepithelial (BLL) of the parotid gland. Materials and Methods: The records of 16 patients treated between 1991 to 1995 with BLL were retrospectively reviewed. Three patients had bilateral disease, thus 19 parotid glands were radiated. Only (2(16)) had AIDS. Virtually all patients were on antiretroviral therapy. There were 11 males and 5 females. The median age was 38 years (range 31 to 58 years). The median duration of parotid enlargement was 1.5 years (range 1 month to 6 years). All patients had biopsy prior to treatment. Histopathology revealed two patterns: solid or cystic. Patient were treated using electron beam RT. The beam energy was determined by computed transaxial tomography. The median dose delivered was 1000 cGy in 5 fractions over 5 days (range 600 cGy to 2160 cGy in daily fractions ranging from 180 cGy to 200 cGy). Results: Six parotid glands achieved a complete response (CR), 5 a partial response (PR), while 8 were non-responders (NR). Our overall response rate was therefore 58% Of the NR's, 3 patients were re-treated. Two achieved a PR, one was an NR. Toxicity was minimal and limited to mild xerostomia. Conclusion: RT in patients with HIV related BLL is well tolerated. Our preliminary results show that while this modality of treatment has marked activity in the solid pattern. Higher doses may be required for large lesions or cystic in nature

Intercomparison On Depth Dose Measurement

International Nuclear Information System (INIS)

Rohmah, N; Akhadi, M

1996-01-01

Intercomparation on personal dose evaluation system has been carried out between CSRSR-NAEA of Indonesia toward Standard Laboratory of JAERI (Japan) and ARL (Australia). The intercomparison was in 10 amm depth dose measurement , Hp (10), from the intercomparison result could be stated that personal depth dose measurement conducted by CSRSR was sufficiently good. Deviation of dose measurement result using personal dosemeter of TLD BG-1 type which were used by CSRSR in the intercomparison and routine photon personal dose monitoring was still in internationally agreed limit. Maximum deviation of reported doses by CSRSR compared to delivered doses for dosemeter irradiation by JAERI was -10.0 percent and by ARL was +29 percent. Maximum deviation permitted in personal dose monitoring is ± 50 percent

Ameliorative effects of low dose/low dose-rate irradiation on reactive oxygen species-related diseases model mice

International Nuclear Information System (INIS)

Nomura, Takaharu

2008-01-01

Living organisms have developed complex biological system which protects themselves against environmental radiation, and irradiation with proper dose, dose-rate and irradiation time can stimulate their biological responses against oxidative stress evoked by the irradiation. Because reactive oxygen species are involved in various human diseases, non-toxic low dose/low dose-rate radiation can be utilized for the amelioration of such diseases. In this study, we used mouse experimental models for fatty liver, nephritis, diabetes, and ageing to elucidate the ameliorative effect of low dose/low dose-rate radiation in relation to endogenous antioxidant activity. Single irradiation at 0.5 Gy ameliorates carbon tetrachloride-induced fatty liver. The irradiation increases hepatic anti-oxidative system involving glutathione and glutathione peroxidase, suggesting that endogenous radical scavenger is essential for the ameliorative effect of low dose radiation on carbon tetrachloride-induced fatty liver. Single irradiation at 0.5 Gy ameliorates ferric nitrilotriacetate-induced nephritis. The irradiation increases catalase and decreases superoxide dismutase in kidney. The result suggests that low dose radiation reduced generation of hydroxide radical generation by reducing cellular hydroperoxide level. Single irradiation at 0.5 Gy at 12 week of age ameliorates incidence of type I diabetes in non-obese diabetic (NOD) mice through the suppression of inflammatory activity of splenocytes, and resultant apoptosis of β-cells in pancreas. The irradiation activities of superoxide dismutase and catalase, which coordinately diminish intracellular reactive oxygen species. Continuous irradiation at 0.70 mGy/hr from 10 week of age elongates life span, and suppresses alopecia in type II diabetesmice. The irradiation improved glucose clearance without affecting insulin-resistance, and increased pancreatic catalase activity. The results suggest that continuous low dose-rate irradiation protect

Radiographic film: surface dose extrapolation techniques

International Nuclear Information System (INIS)

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

2004-01-01

Full text: Assessment of surface dose delivered from radiotherapy x-ray beams for optimal results should be performed both inside and outside the prescribed treatment fields An extrapolation technique can be used with radiographic film to perform surface dose assessment for open field high energy x-ray beams. This can produce an accurate 2 dimensional map of surface dose if required. Results have shown that surface % dose can be estimated within ±3% of parallel plate ionisation chamber results with radiographic film using a series of film layers to produce an extrapolated result. Extrapolated percentage dose assessment for 10cm, 20cmand 30cm square fields was estimated to be 15% ± 2%, 29% ± 3% and 38% ± 3% at the central axis and relatively uniform across the treatment field. Corresponding parallel plate ionisation chamber measurement are 16%, 27% and 37% respectively. Surface doses are also measured outside the treatment field which are mainly due to scattered electron contamination. To achieve this result, film calibration curves must be irradiated to similar x-ray field sizes as the experimental film to minimize quantitative variations in film optical density caused by varying x-ray spectrum with field size. Copyright (2004) Australasian College of Physical Scientists and Engineers in Medicine

The importance of multidisciplinary teamwork and team climate for relational coordination among teams delivering care to older patients.

Science.gov (United States)

Hartgerink, J M; Cramm, J M; Bakker, T J E M; van Eijsden, A M; Mackenbach, J P; Nieboer, A P

2014-04-01

To identify predictors of relational coordination among professionals delivering care to older patients. Relational coordination is known to enhance quality of care in hospitals. The underlying mechanisms, however, remain poorly understood. This cross-sectional study was part of a larger evaluation study examining the opportunity to prevent loss of function in older patients due to hospitalization in the Netherlands. This study was performed in spring 2010 among team members delivering care to older hospitalized patients (192 respondents; 44% response rate) in one hospital. Relational coordination was measured by the Relational Coordination survey; team climate by the Team Climate Inventory and questions were asked about participation in multidisciplinary team meetings and disciplines represented in these meetings. To account for the hierarchical structure, a multilevel analysis was performed. Correlation analysis revealed a positive relationship among being female, being a nurse and relational coordination; medical specialists showed a negative relationship. The number of disciplines represented during multidisciplinary team meetings and team climate were positively related with relational coordination. The multilevel analysis showed a positive relationship between the number of disciplines represented during multidisciplinary team meetings and team climate with relational coordination. The enhancement of team climate and attendance of diverse professionals during multidisciplinary team meetings are expected to improve relational coordination. Furthermore, this study underscores the importance of enhancing relational coordination between medical specialists and other professionals. © 2013 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.

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)

Quantifying the Reproducibility of Heart Position During Treatment and Corresponding Delivered Heart Dose in Voluntary Deep Inhalation Breath Hold for Left Breast Cancer Patients Treated With External Beam Radiotherapy

International Nuclear Information System (INIS)

McIntosh, Alyson; Shoushtari, Asal N.; Benedict, Stanley H.; Read, Paul W.; Wijesooriya, Krishni

2011-01-01

Purpose: Voluntary deep inhalation breath hold (VDIBH) reduces heart dose during left breast irradiation. We present results of the first study performed to quantify reproducibility of breath hold using bony anatomy, heart position, and heart dose for VDIBH patients at treatment table. Methods and Materials: Data from 10 left breast cancer patients undergoing VDIBH whole-breast irradiation were analyzed. Two computed tomography (CT) scans, free breathing (FB) and VDIBH, were acquired to compare dose to critical structures. Pretreatment weekly kV orthogonal images and tangential ports were acquired. The displacement difference from spinal cord to sternum across the isocenter between coregistered planning Digitally Reconstructed Radiographs (DRRs) and kV imaging of bony thorax is a measure of breath hold reproducibility. The difference between bony coregistration and heart coregistration was the measured heart shift if the patient is aligned to bony anatomy. Results: Percentage of dose reductions from FB to VDIBH: mean heart dose (48%, SD 19%, p = 0.002), mean LAD dose (43%, SD 19%, p = 0.008), and maximum left anterior descending (LAD) dose (60%, SD 22%, p = 0.008). Average breath hold reproducibility using bony anatomy across the isocenter along the anteroposterior (AP) plane from planning to treatment is 1 (range, 0–3; SD, 1) mm. Average heart shifts with respect to bony anatomy between different breath holds are 2 ± 3 mm inferior, 1 ± 2 mm right, and 1 ± 3 mm posterior. Percentage dose changes from planning to delivery: mean heart dose (7%, SD 6%); mean LAD dose, ((9%, SD 7%)S, and maximum LAD dose, (11%, SD 11%) SD 11%, p = 0.008). Conclusion: We observed excellent three-dimensional bony registration between planning and pretreatment imaging. Reduced delivered dose to heart and LAD is maintained throughout VDIBH treatment.

Absolute and relative dose measurements with Gafchromic trade mark sign EBT film for high energy electron beams with different doses per pulse

International Nuclear Information System (INIS)

Fiandra, Christian; Ragona, Riccardo; Ricardi, Umberto; Anglesio, Silvia; Giglioli, Francesca Romana

2008-01-01

The authors have evaluated the accuracy, in absolute and relative dose measurements, of the Gafchromic trade mark sign EBT film in pulsed high-energy electron beams. Typically, the electron beams used in radiotherapy have a dose-per-pulse value of less than 0.1 mGy/pulse. However, very high dose-per-pulse electron beams are employed in certain linear accelerators dedicated to intraoperatory radiation therapy (IORT). In this study, the absorbed dose measurements with Gafchromic trade mark sign EBT in both low (less than 0.3 mGy per pulse) and high (30 and 70 mGy per pulse) dose-per-pulse electron beams were compared with ferrous sulfate chemical Fricke dosimetry (operated by the Italian Primary Standard Dosimetry Laboratory), a method independent of the dose per pulse. A summary of Gafchromic trade mark sign EBT in relative and absolute beam output determination is reported. This study demonstrates the independence of Gafchromic trade mark sign EBT absorption as a function of dose per pulse at different dose levels. A good agreement (within 3%) was found with Fricke dosimeters for plane-base IORT applicators. Comparison with a diode detector is presented for relative dose measurements, showing acceptable agreement both in the steep dose falloff zone and in the homogeneous dose region. This work also provides experimental values for recombination correction factor (K sat ) of a Roos (plane parallel) ionization chamber calculated on the basis of theoretical models for charge recombination.

Dose distribution in lungs and thyroid from scatter photons of x-ray mammography imaging

International Nuclear Information System (INIS)

Faghihi, R.; Mehdizadeh, S.

2006-01-01

The contribution of scatter photons in dose of mammography image in thyroid and lungs are studied. Thyroid and in the form of distribution function and total delivered dose studied by direct measurement with Thermoluminescence dosimeter. The results of measurements compared to other published measurements and the total dose compared to our modelling with Monte Carlo method.. Our phantoms for direct measurement of Dose are a compressed breast phantom placed on a female RANDO phantom. The results of modelling and measurement are in agreement for the total delivered dose to thyroid and lungs and comparable to doses reported by the other researcher

Control of doses delivered to patients in medical imagery. Progress report of the program of actions recommended by the ASN. January 2015

International Nuclear Information System (INIS)

2015-01-01

This report proposes an overview and an assessment of the various actions recommended by the ASN (the French Nuclear Safety Authority) for a better management of doses delivered to patients in the case of medical imagery. It indicates and discusses the progress noticed: actions which have been already performed, actions which are currently in progress, and actions which are still to be launched. These actions concern various aspects: the practice quality and safety (quality and safety management), the organisation, human resources and training, equipment and installation safety, radio-vigilance practices, relationships with patients, knowledge of practices and of exposures of patients and workers. Some highlights are outlined: some persistent lacks in human resources, some encouraging initiatives in the field of training, some progresses in the field of practice quality and safety, and some limited results regarding equipment (notably MRI) and installation safety

Externally Delivered Focused Ultrasound for Renal Denervation.

Science.gov (United States)

Neuzil, Petr; Ormiston, John; Brinton, Todd J; Starek, Zdenek; Esler, Murray; Dawood, Omar; Anderson, Thomas L; Gertner, Michael; Whitbourne, Rob; Schmieder, Roland E

2016-06-27

The aim of this study was to assess clinical safety and efficacy outcomes of renal denervation executed by an externally delivered, completely noninvasive focused therapeutic ultrasound device. Renal denervation has emerged as a potential treatment approach for resistant hypertension. Sixty-nine subjects received renal denervation with externally delivered focused ultrasound via the Kona Medical Surround Sound System. This approach was investigated across 3 consecutive studies to optimize targeting, tracking, and dosing. In the third study, treatments were performed in a completely noninvasive way using duplex ultrasound image guidance to target the therapy. Short- and long-term safety and efficacy were evaluated through use of clinical assessments, magnetic resonance imaging scans prior to and 3 and 24 weeks after renal denervation, and, in cases in which a targeting catheter was used to facilitate targeting, fluoroscopic angiography with contrast. All patients tolerated renal denervation using externally delivered focused ultrasound. Office blood pressure (BP) decreased by 24.6 ± 27.6/9.0 ± 15.0 mm Hg (from baseline BP of 180.0 ± 18.5/97.7 ± 13.7 mm Hg) in 69 patients after 6 months and 23.8 ± 24.1/10.3 ± 13.1 mm Hg in 64 patients with complete 1-year follow-up. The response rate (BP decrease >10 mm Hg) was 75% after 6 months and 77% after 1 year. The most common adverse event was post-treatment back pain, which was reported in 32 of 69 patients and resolved within 72 h in most cases. No intervention-related adverse events involving motor or sensory deficits were reported. Renal function was not altered, and vascular safety was established by magnetic resonance imaging (all patients), fluoroscopic angiography (n = 48), and optical coherence tomography (n = 5). Using externally delivered focused ultrasound and noninvasive duplex ultrasound, image-guided targeting was associated with substantial BP reduction without any major safety signals. Further

The importance of multidisciplinary teamwork and team climate for relational coordination among teams delivering care to older patients

OpenAIRE

Hartgerink, Jacqueline; Cramm, Jane; Bakker, Ton; Eijsden, A.; Mackenbach, Johan; Nieboer, Anna

2013-01-01

textabstractAim: To identify predictors of relational coordination among professionals delivering care to older patients. Background: Relational coordination is known to enhance quality of care in hospitals. The underlying mechanisms, however, remain poorly understood. Design: This cross-sectional study was part of a larger evaluation study examining the opportunity to prevent loss of function in older patients due to hospitalization in the Netherlands. Methods: This study was performed in sp...

The importance of multidisciplinary teamwork and team climate for relational coordination among teams delivering care to older patients

OpenAIRE

J.M. Hartgerink; J.M. Cramm; T.J.E.M. Bakker; A.M. van Eijsden; J.P. Mackenbach; A.P. Nieboer

2013-01-01

Aim To identify predictors of relational coordination among professionals delivering care to older patients. Background Relational coordination is known to enhance quality of care in hospitals. The underlying mechanisms, however, remain poorly understood. Design This cross-sectional study was part of a larger evaluation study examining the opportunity to prevent loss of function in older patients due to hospitalization in the Netherlands. Methods This study was performed in spring 2010 among ...

Therapeutic dose from a pyroelectric electron accelerator.

Science.gov (United States)

Fullem, T Z; Fazel, K C; Geuther, J A; Danon, Y

2009-11-01

Simple heating of pyroelectric crystals has been used as the basis for compact sources of X rays, electrons, ions and neutrons. We report on the evaluation of the feasibility of using a portable pyroelectric electron accelerator to deliver a therapeutic dose to tissue. Such a device could be mass produced as a handheld, battery-powered instrument. Experiments were conducted with several crystal sizes in which the crystal was heated inside a vacuum chamber and the emitted electrons were allowed to penetrate a thin beryllium window into the surrounding air. A Faraday cup was used to count the number of electrons that exited the window. The energy of these electrons was determined by measuring the energy spectrum of the X rays that resulted from the electron interactions with the Faraday cup. Based on these measurements, the dose that this source could deliver to tissue was calculated using Monte Carlo calculations. It was found that 10(13) electrons with a peak energy of the order of 100 keV were emitted from the beryllium window and could deliver a dose of 1664 Gy to a 2-cm-diameter, 110-microm-deep region of tissue located 1.5 cm from the window with air between the window and the tissue. This dose level is high enough to consider this technology for medical applications in which shallow energy deposition is beneficial.

Marrow, ovary, and breast doses delivered by CHR diagnostic x-ray examinations: an update

International Nuclear Information System (INIS)

Schlenker, R.A.; Oltman, B.G.

1977-01-01

The mean absorbed dose averaged over the marrow volume in a RANDO phantom is 232 +- 14 mrad and 175 +- 26 mrad when the ANL examination is made using 1 mm Al and 3 mm Al added filtration, respectively; it is 606 +- 69 mrad when the MIT examination is made. The absorbed dose averaged over the ovaries is 243 +- 25 mrad and 162 +- 38 mrad for 1 mm Al and 3 mm Al at ANL and 606 +- 40 mrad for the MIT examination. Breast doses are 388 +- 35 mrad, 226 +- 9 mrad, and 333 +- 103 mrad. Dose reduction could be achieved by using a faster film-screen combination for the MIT examination, by routinely using 3 mm Al added filtration at ANL and by improving the collimation at ANL

Intravascular ultrasound based dose assessment in endovascular brachytherapy

International Nuclear Information System (INIS)

Catalano, Gianpiero; Tamburini, Vittorio; Colombo, Antonio; Nishida, Takahiro; Parisi, Giovanni; Mazzetta, Chiara; Orecchia, Roberto

2003-01-01

Background: the role of endovascular brachytherapy in restenosis prevention is well documented. Dose is usually prescribed at a fixed distance from the source axis by angiographic quantification of vessel diameter. Recently, intravascular ultrasound (IVUS) was introduced in dose prescription, allowing a better evaluation of the vessel anatomy. This study retrospectively explores the difference between prescription following angiographic vessel sizing and delivered dose calculated with IVUS. Methods and results: Seventeen lesions were studied with IVUS, identifying on irradiated segment, three sections on which measuring minimal and maximal distance from the centre of IVUS catheter to the adventitia; using dedicated software, corresponding doses were calculated. The dose ranged widely, with maximal and minimal values of 71.6 and 4.9 Gy; furthermore, heterogeneity in dose among different sections was observed. In the central section, the maximal dose was 206% of the one prescribed with the QCA model at 2 mm from the source axis, while the minimal dose was 96%. In proximal and distal sections, respective values were 182, 45, 243, and 122%. Conclusions: Our analysis confirmed the dose inhomogeneity delivered with an angiographic fixed-dose prescription strategy. A dose variation was found along the irradiated segment due to the differences in vessel thickness. IVUS emerged as an important tool in endovascular brachytherapy, especially for irregular-shaped vessels

Sequentially delivered boost plans are superior to simultaneously delivered plans in head and neck cancer when the boost volume is located further away from the parotid glands

International Nuclear Information System (INIS)

Lamers-Kuijper, Emmy; Heemsbergen, Wilma; Mourik, Anke van; Rasch, Coen

2011-01-01

Purpose: To find parameters that predict which head and neck patients benefit from a sequentially delivered boost treatment plan compared to a simultaneously delivered plan, with the aim to spare the salivary glands. Methods and materials: We evaluated 50 recently treated head and neck cancer patients. Apart from the clinical plan with a sequentially (SEQ) given boost using an Intensity Modulated Radiotherapy Technique (IMRT), a simultaneous integrated boost (SIB) technique plan was constructed with the same beam set-up. The mean dose to the parotid glands was calculated and compared. The elective nodal areas were bilateral in all cases, with a boost on either one side or both sides of the neck. Results: When the parotid gland volume and the Planning Target Volume (PTV) for the boost overlap there is on average a lower dose to the parotid gland with a SIB technique (-1.2 Gy), which is, however, not significant (p = 0.08). For all parotid glands with no boost PTV overlap, there is a benefit from a SEQ technique compared to a SIB technique for the gland evaluated (on average a 2.5 Gy lower dose to the parotid gland, p < 0.001). When the distance between gland and PTV is 0-1 cm, this difference is on average 0.8 Gy, for 1-2 cm distance 2.9 Gy and for glands with a distance greater than 2 cm, 3.3 Gy. When the lymph nodes on the evaluated side are also included in the boost PTV, however, this relationship between the distance and the gain of a SEQ seems less clear. Conclusions: A sequentially delivered boost technique results in a better treatment plan for most cases, compared to a simultaneous integrated boost IMRT technique, if the boost PTV is more than 1 cm away from at least one parotid gland.

Dose-volume histogram analysis of hepatic toxicity related to carbon ion radiation therapy of hepatocellular carcinoma

International Nuclear Information System (INIS)

Yasuda, Shigeo; Kato, Hirotoshi; Tsujii, Hitohiko; Mizoe, Junetsu

2005-01-01

The purpose of this study is to analyze the correlation of hepatic toxicity with dose-volume factors of carbon ion radiotherapy in the liver. Forty-nine patients with hepatocellular carcinoma were treated with carbon ion radiotherapy delivered in 4 fractions over 4 to 7 days. Six patients received a total dose of 48 GyE and 43 received 52.8 GyE. The correlation of various blood biochemistry data with dose-volume histogram (DVH) data in non-cancerous liver were evaluated. The strongest significant correlation was seen between percent volume of non-cancerous liver with radiation dose more than 11 GyE (V 11 GyE ) and elevation of serum glutamic oxaloacetic transaminase (GOT) level as early adverse response after carbon ion beam radiation therapy (p=0.0003). In addition, significant correlation between DVH data and change of several other blood biochemistry data were also revealed in early phase. In late phase after carbon ion radiotherapy, the strongest significant correlation was seen between decrease of platelet count and V 26GyE (p=0.015). There was no significant correlation between other blood biochemistry data and DVH data in the late phase. It was suggested that dose-volume factors of carbon ion radiotherapy influenced only transient aggravation of liver function, which improved in the long term after irradiation. (author)

Dose and time relations in Hg(++)-induced tubular necrosis and regeneration

DEFF Research Database (Denmark)

Nielsen, J B; Andersen, H R; Andersen, O

1994-01-01

relationship is caused by a dose-related induction of kidney damage leading to increasing leakage of mercury through the kidneys. Histopathologic investigation revealed extensive necrosis of the proximal tubules in kidneys from mice exposed to 100 mumole HgCl2/kg or higher doses. Moreover, maximum renal damage...

Conventional patient specific IMRT QA and 3DVH verification of dose distribution for helical tomotherapy

International Nuclear Information System (INIS)

Sharma, Prabhat Krishna; Joshi, Kishore; Epili, D.; Gavake, Umesh; Paul, Siji; Reena, Ph.; Jamema, S.V.

2016-01-01

In recent years, patient-specific IMRT QA has transitioned from point dose measurements by ion chambers to films to 2D array measurements. 3DVH software has taken this transition a step further by estimating the 3D dose delivered to the patient volume from 2D diode measurements using a planned dose perturbation (PDP) algorithm. This algorithm was developed to determine, if the conventional IMRT QA though sensitive at detecting errors, has any predictive power in detecting dose errors of clinical significance related to dose to the target volume and organs at risk (OAR). The aim of this study is to compare the conventional IMRT patient specific QA and 3DVH dose distribution for patients treated with helical tomotherapy (HT)

Radiation dose measurements of an on-board imager X-ray unit using optically-stimulated luminescence dosimeters

International Nuclear Information System (INIS)

Smith, Leon; Haque, Mamoon; Hill, Robin; Morales, Johnny

2015-01-01

Cone beam computed tomography (CBCT) is now widely used to image radiotherapy patients prior to treatment for the purpose of accurate patient setup. However each CBCT image delivered to a patient increases the total radiation dose that they receive. The measurement of the dose delivered from the CBCT images is not readily performed in the clinic. In this study, we have used commercially available optically stimulated luminescence (OSLD) dosimeters to measure the dose delivered by the Varian OBI on a radiotherapy linear accelerator. Calibration of the OSLDs was achieved by using a therapeutic X-ray unit. The dose delivered by a head CBCT scan was found to be 3.2 ± 0.3 mGy which is similar in magnitude to the dose of a head computed tomography (CT) scan. The results of this study suggest that the radiation hazard associated with CBCT is of a similar nature to that of conventional CT scans. We have also demonstrated that the OSLDs are suitable for these low X-ray dose measurements.

Dose error analysis for a scanned proton beam delivery system

International Nuclear Information System (INIS)

Coutrakon, G; Wang, N; Miller, D W; Yang, Y

2010-01-01

All particle beam scanning systems are subject to dose delivery errors due to errors in position, energy and intensity of the delivered beam. In addition, finite scan speeds, beam spill non-uniformities, and delays in detector, detector electronics and magnet responses will all contribute errors in delivery. In this paper, we present dose errors for an 8 x 10 x 8 cm 3 target of uniform water equivalent density with 8 cm spread out Bragg peak and a prescribed dose of 2 Gy. Lower doses are also analyzed and presented later in the paper. Beam energy errors and errors due to limitations of scanning system hardware have been included in the analysis. By using Gaussian shaped pencil beams derived from measurements in the research room of the James M Slater Proton Treatment and Research Center at Loma Linda, CA and executing treatment simulations multiple times, statistical dose errors have been calculated in each 2.5 mm cubic voxel in the target. These errors were calculated by delivering multiple treatments to the same volume and calculating the rms variation in delivered dose at each voxel in the target. The variations in dose were the result of random beam delivery errors such as proton energy, spot position and intensity fluctuations. The results show that with reasonable assumptions of random beam delivery errors, the spot scanning technique yielded an rms dose error in each voxel less than 2% or 3% of the 2 Gy prescribed dose. These calculated errors are within acceptable clinical limits for radiation therapy.

SU-E-T-506: Dosimetric Verification of Photon MLC Delivered Electron Fields for Implementing MERT On An Artiste Linac

International Nuclear Information System (INIS)

Jin, L; Eldib, A; Li, J; Wang, L; Ma, C; Fan, J

2014-01-01

Purpose: To verify the dose accuracy of photon MLC delivered electron fields for implementing energy-intensity modulated electron radiotherapy (MERT) on an Artiste linac. Methods: It was proposed to deliver MERT on an Artiste linac at a short SSD (60 cm) to reduce beam penumbra caused by electron scatters. An in-house developed Monte Carlo (MC)-based dose calculation/optimization planning code was used for treatment planning. Our previous study showed that the measured dose distribution of a breast plan showed good agreement with the calculations in low-medium dose regions while the differences in high dose regions were outstanding. A continuous work found that the discrepancy is mainly caused by improper modeling in MC for the single focused MLC in the Artiste which was simplified as double focused in the previous MC simulations. With this remodeled MLC in the calculations, an energy-intensity modulated electron plan using 6, 9, 12 and 15 MeV was generated for a breast treatment on a breast phantom at a 60 cm SSD and recalculated regarding a solid water phantom. For a test study, four of MLC segments (each with a different energy) generated in the plan were delivered to the phantom and a film measurement was performed at the depth of 2 cm. The measured 2D dose distribution was then compared with calculations. Results: For composite doses of the four segments, measured 2D dose distributions overall agree well with the calculations (3mm/3%) in most area. The separate measurement for a single MLC segment for each of energies also showed the consistence with the calculations. Conclusion: After remodeling MLC in the MC calculations, the measured dose distribution for a subset of MLC segments from a MERT plan showed good agreement. Further detailed verification for the full plan will be the work in the next step

The contribution of interventional cardiology procedures to the population radiation dose in a ‘health-care level I’ representative region

Science.gov (United States)

Peruzzo Cornetto, Andrea; Aimonetto, Stefania; Pisano, Francesco; Giudice, Marcello; Sicuro, Marco; Meloni, Teodoro; Tofani, Santi

2016-01-01

This study evaluates per-procedure, collective and per capita effective dose to the population by interventional cardiology (IC) procedures performed during 2002–11 at the main hospital of Aosta Valley Region that can be considered as representative of the health-care level I countries, as defined by the UNSCEAR, based on its socio-demographic characteristics. IC procedures investigated were often multiple procedures in patients older than 60 y. The median extreme dose-area product values of 300 and 22 908 cGycm2 were found for standard pacemaker implantation and coronary angioplasty, respectively, while the relative mean per-procedure effective dose ranged from 0.7 to 47 mSv. A 3-fold increase in frequency has been observed together with a correlated increase in the delivered per capita dose (0.05–0.27 mSv y−1) and the collective dose (5.8–35 man Sv y−1). Doses increased particularly from 2008 onwards mainly because of the introduction of coronary angioplasty procedures in the authors’ institution. IC practice contributed remarkably in terms of effective dose to the population, delivering ∼10 % of the total dose by medical ionising radiation examination categories. PMID:26012484

Task related doses in spanish light water reactors over the period 1990-1996

International Nuclear Information System (INIS)

Aroca, J.; Montesinos, J.J.; O'Donnell, P.; Amor, I.; Butragueno, J.L.

1998-01-01

In order to evaluate in depth the effectiveness of the practical application of the ALARA principle in Spanish nuclear facilities -7 PWR (6 Westinghouse and 1 KWU-Siemens) and 2 BWR (Generic Electric), and to have a further overview of dose trends, the CSN has analysed the task related doses data over the period 1990-1996. The scope of this analysis includes the collective dose and relative relevance for 18 different refuelling outage tasks, some sub-tasks, 12 department staff, and the main consolidated dose reduction-techniques and good practices. Data has been collected from the outage reports NPPs provide according to the CSN 1.5 Safety Guide format. (Author)

Surface dose extrapolation measurements with radiographic film

International Nuclear Information System (INIS)

Butson, Martin J; Cheung Tsang; Yu, Peter K N; Currie, Michael

2004-01-01

Assessment of surface dose delivered from radiotherapy x-ray beams for optimal results should be performed both inside and outside the prescribed treatment fields. An extrapolation technique can be used with radiographic film to perform surface dose assessment for open field high energy x-ray beams. This can produce an accurate two-dimensional map of surface dose if required. Results have shown that the surface percentage dose can be estimated within ±3% of parallel plate ionization chamber results with radiographic film using a series of film layers to produce an extrapolated result. Extrapolated percentage dose assessment for 10 cm, 20 cm and 30 cm square fields was estimated to be 15% ± 2%, 29% ± 3% and 38% ± 3% at the central axis and relatively uniform across the treatment field. The corresponding parallel plate ionization chamber measurements are 16%, 27% and 37%, respectively. Surface doses are also measured outside the treatment field which are mainly due to scattered electron contamination. To achieve this result, film calibration curves must be irradiated to similar x-ray field sizes as the experimental film to minimize quantitative variations in film optical density caused by varying x-ray spectrum with field size. (note)

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)

Development of wireless communication system in real-time internal radiation dose measurement system using magnetic field

International Nuclear Information System (INIS)

Sato, Fumihiro; Shinohe, Kohta; Takura, Tetsuya; Matsuki, Hidetoshi; Yamada, Syogo; Sato, Tadakuni

2009-01-01

In radiation therapy, excessive radiation occurs because the actual delivered dose to the tumor is unknown. To overcome this problem, we need a system in which the delivered dose is measured inside the body, and the dose data are transmitted from the inside to the outside of the body. In this study, a wireless communication system, using magnetic fields was studied, and an internal circuit for obtaining radiation dose data from an x-ray detector was examined. As a result, a communication distance of 200 mm was obtained. An internal circuit was developed, and a signal transmission experiment was performed using the wireless communication system. As a result, the radiation dose data from an x-ray detector was transmitted over a communication distance of 200 mm, and the delivered dose was determined from the received signal

Dose-dependent social-cognitive effects of intranasal oxytocin delivered with novel Breath Powered device in adults with autism spectrum disorder: a randomized placebo-controlled double-blind crossover trial.

Science.gov (United States)

Quintana, D S; Westlye, L T; Hope, S; Nærland, T; Elvsåshagen, T; Dørum, E; Rustan, Ø; Valstad, M; Rezvaya, L; Lishaugen, H; Stensønes, E; Yaqub, S; Smerud, K T; Mahmoud, R A; Djupesland, P G; Andreassen, O A

2017-05-23

The neuropeptide oxytocin has shown promise as a treatment for symptoms of autism spectrum disorders (ASD). However, clinical research progress has been hampered by a poor understanding of oxytocin's dose-response and sub-optimal intranasal delivery methods. We examined two doses of oxytocin delivered using a novel Breath Powered intranasal delivery device designed to improve direct nose-to-brain activity in a double-blind, crossover, randomized, placebo-controlled trial. In a randomized sequence of single-dose sessions, 17 male adults with ASD received 8 international units (IU) oxytocin, 24IU oxytocin or placebo followed by four social-cognitive tasks. We observed an omnibus main effect of treatment on the primary outcome measure of overt emotion salience as measured by emotional ratings of faces (η 2 =0.18). Compared to placebo, 8IU treatment increased overt emotion salience (P=0.02, d=0.63). There was no statistically significant increase after 24IU treatment (P=0.12, d=0.4). The effects after 8IU oxytocin were observed despite no significant increase in peripheral blood plasma oxytocin concentrations. We found no significant effects for reading the mind in the eyes task performance or secondary outcome social-cognitive tasks (emotional dot probe and face-morphing). To our knowledge, this is the first trial to assess the dose-dependent effects of a single oxytocin administration in autism, with results indicating that a low dose of oxytocin can significantly modulate overt emotion salience despite minimal systemic exposure.

Contribution of the modulation of intensity and the optimization to deliver a dose adapted to the biological heterogeneities

International Nuclear Information System (INIS)

Kubs, F.

2007-10-01

The recent progress in functional imaging by Positron Emission Tomography (TEP) opens new perspectives in the delineation of target volumes in radiotherapy. The functional data is major; we can intend to adapt the irradiation doses on the tumor activity (TA) and to perform a dose escalation. Our objectives were (i) to characterize the TEP threshold, by quantifying the uncertainties of the target volume contour according to the lesion size and the threshold contour level, (ii) to set up the geometry suited to perform a high-precision irradiation based on the TA, (iii) to estimate the dosimetric impact of this new protocol and (iv) to verify that dosimetry is perfectly distributed. Three original phantoms were specially created to satisfy the constraints met, as well as two virtual phantoms containing 3 dose levels (dose level 3 = TA). Our results showed the importance of the effect threshold-volume on the planning in radiotherapy. To use this irradiation method, the diameter of 1 cm for the third level was able to be reached. A dose escalation of 20 Gy was possible between the second (70 Gy) and the third level (90 Gy). The dosimetric impact estimated on two real cases was suitable - increase of COIN (conformal index) from 0.6 to 0.8 and decrease of NTCP (normal tissue complication probability) of a factor 5 -. In absolute and relative dosimetry, the clinical tolerances were respected. So all the treatment process, going from the diagnosis with the TEP to reveal the TA, to the patient treatment made beforehand on phantom, and going through the ballistic and the dose calculation, was estimated and validated according to our objective to adapt the irradiation to the biological heterogeneities. However such high doses should be carefully estimated before being prescribed clinically and progress is also expected in imaging, because the minimal size which we can irradiate is on the limit of the resolution TEP. (author)

SU-E-J-181: Effect of Prostate Motion On Combined Brachytherapy and External Beam Dose Based On Daily Motion of the Prostate

Energy Technology Data Exchange (ETDEWEB)

Narayana, V; McLaughlin, P [Providence Cancer Center, Southfield, MI (United States); University of Michigan, Ann Arbor, MI (United States); Ealbaj, J [University of Michigan, Ann Arbor, MI (United States)

2015-06-15

Purpose: In this study, the adequacy of target expansions on the combined external beam and implant dose was examined based on the measured daily motion of the prostate. Methods: Thirty patients received an I–125 prostate implant prescribed to dose of 90Gy. This was followed by external beam to deliver a dose of 90Gyeq (external beam equivalent) to the prostate over 25 to 30 fractions. An ideal IMRT plan was developed by optimizing the external beam dose based on the delivered implant dose. The implant dose was converted to an equivalent external beam dose using the linear quadratic model. Patients were set up on the treatment table by daily orthogonal imaging and aligning the marker seeds in the prostate. Orthogonal images were obtained at the end of treatment to assess prostate intrafraction motion. Based on the observed motion of the markers between the initial and final images, 5 individual plans showing the actual dose delivered to the patient were calculated. A final true dose distribution was established based on summing the implant dose and the 5 external beam plans. Dose to the prostate, seminal vesicles, lymphnodes and normal tissues, rectal wall, urethra and lower sphincter were calculated and compared to ideal. On 18 patients who were sexually active, dose to the corpus cavernosum and internal pudendal artery was also calculated. Results: The average prostate motion in 3 orthogonal directions was less than 1 mm with a standard deviation of less than +2 mm. Dose and volume parameters showed that there was no decrease in dose to the targets and a marginal decrease in dose to in normal tissues. Conclusion: Dose delivered by seed implant moves with the prostate, decreasing the impact of intrafractions dose movement on actual dose delivered. Combined brachytherapy and external beam dose delivered to the prostate was not sensitive to prostate motion.

Task related doses in Spanish pressurized water reactors over the period 1988-1992

Energy Technology Data Exchange (ETDEWEB)

O`Donnell, P.; Labarta, T.; Amor, I. [Subdireccion de Proteccion Radiologica, Madrid (Spain)

1995-03-01

In order to evaluate in depth the collective dose trend and its correlation with the effectiveness of the practical application of the ALARA principle in Spanish nuclear facilities, and base the different policy lines to promote this criteria, the CSN has fullfilled an analysis of the task related doses data over the period 1988-1992. Previously, the CSN had required to the utilities the compilation of their refuelling outage collective dose from 1988 according with a predeterminate number of tasks, in order to have available a representative and retrospective set of data in an homogeneous way and coherent with the international data banks on occupational exposure in NPP, as the CEC and the NEA ones. The scope of this analysis was the following: first, the collective dose summaries for outage tasks and departments for PWR and for BWR, including the minimum, maximum and average dose (and statistics data) for 18 different refuelling outage tasks and 12 personal departments for each generation of each type of rector, the task and department related collective dose trends in each plant and in each generation, and second, the dose reduction techniques having been used during that period in each plant and the relative level of adoption. In this presentation the main results and conclusions of the first part of the study are reviewed for PWR.

A dose-effect correlation for radioiodine ablation in differentiated thyroid cancer

Energy Technology Data Exchange (ETDEWEB)

Flux, Glenn D; Chittenden, Sarah J; Buckley, Susan; Hindorf, Cecilia [Royal Marsden NHS Foundation Trust, Department of Physics, Sutton, Surrey (United Kingdom); Haq, Masud; Newbold, Kate; Harmer, Clive L [Royal Marsden NHS Foundation Trust, Thyroid Unit, Sutton, Surrey (United Kingdom)

2010-02-15

The aim of this study was to determine the range of absorbed doses delivered to thyroid remnants, blood, and red marrow from fixed administrations of radioiodine and to ascertain whether the success of ablation is more dependent on these absorbed doses than on the administered activity. Twenty-three patients received 3,000 MBq radioiodine following near-total thyroidectomy. The maximum absorbed dose to remnants was calculated from subsequent single photon emission tomography scans. Absorbed doses delivered to blood and red marrow were calculated from blood samples and from whole-body retention measurements. The protein bound iodine (PBI) was also calculated. Maximum absorbed doses to thyroid remnants ranged from 7 to 570 Gy. Eighteen of the 23 patients had a successful ablation. A significant difference was seen between the absorbed doses delivered to thyroid remnants, blood, and red marrow for those patients that had a successful ablation compared to those with a failed ablation (p = 0.030, p = 0.043 and p = 0.048, respectively). The difference between the PBI values acquired at day 1 and day 6 were also indicative of response (p = 0.074). A successful ablation is strongly dependent on the absorbed dose to the thyroid remnant. Dosimetry-based personalized treatment can prevent both sub-optimal administrations, which entails further radioiodine therapy, and excessive administration of radioactivity, which increases the potential for radiation toxicity. (orig.)

COMPARISON OF THE PERIPHERAL DOSES FROM DIFFERENT IMRT TECHNIQUES FOR PEDIATRIC HEAD AND NECK RADIATION THERAPY.

Science.gov (United States)

Toyota, Masahiko; Saigo, Yasumasa; Higuchi, Kenta; Fujimura, Takuya; Koriyama, Chihaya; Yoshiura, Takashi; Akiba, Suminori

2017-11-01

Intensity-modulated radiation therapy (IMRT) can deliver high and homogeneous doses to the target area while limiting doses to organs at risk. We used a pediatric phantom to simulate the treatment of a head and neck tumor in a child. The peripheral doses were examined for three different IMRT techniques [dynamic multileaf collimator (DMLC), segmental multileaf collimator (SMLC) and volumetric modulated arc therapy (VMAT)]. Peripheral doses were evaluated taking thyroid, breast, ovary and testis as the points of interest. Doses were determined using a radio-photoluminescence glass dosemeter, and the COMPASS system was used for three-dimensional dose evaluation. VMAT achieved the lowest peripheral doses because it had the highest monitor unit efficiency. However, doses in the vicinity of the irradiated field, i.e. the thyroid, could be relatively high, depending on the VMAT collimator angle. DMLC and SMLC had a large area of relatively high peripheral doses in the breast region. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

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

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

Do we need 3D tube current modulation information for accurate organ dosimetry in chest CT? Protocols dose comparisons.

Science.gov (United States)

Lopez-Rendon, Xochitl; Zhang, Guozhi; Coudyzer, Walter; Develter, Wim; Bosmans, Hilde; Zanca, Federica

2017-11-01

To compare the lung and breast dose associated with three chest protocols: standard, organ-based tube current modulation (OBTCM) and fast-speed scanning; and to estimate the error associated with organ dose when modelling the longitudinal (z-) TCM versus the 3D-TCM in Monte Carlo simulations (MC) for these three protocols. Five adult and three paediatric cadavers with different BMI were scanned. The CTDI vol of the OBTCM and the fast-speed protocols were matched to the patient-specific CTDI vol of the standard protocol. Lung and breast doses were estimated using MC with both z- and 3D-TCM simulated and compared between protocols. The fast-speed scanning protocol delivered the highest doses. A slight reduction for breast dose (up to 5.1%) was observed for two of the three female cadavers with the OBTCM in comparison to the standard. For both adult and paediatric, the implementation of the z-TCM data only for organ dose estimation resulted in 10.0% accuracy for the standard and fast-speed protocols, while relative dose differences were up to 15.3% for the OBTCM protocol. At identical CTDI vol values, the standard protocol delivered the lowest overall doses. Only for the OBTCM protocol is the 3D-TCM needed if an accurate (<10.0%) organ dosimetry is desired. • The z-TCM information is sufficient for accurate dosimetry for standard protocols. • The z-TCM information is sufficient for accurate dosimetry for fast-speed scanning protocols. • For organ-based TCM schemes, the 3D-TCM information is necessary for accurate dosimetry. • At identical CTDI vol , the fast-speed scanning protocol delivered the highest doses. • Lung dose was higher in XCare than standard protocol at identical CTDI vol .

Optimisation and evaluation of the foetal dose during a radiotherapy of the right parotid; Optimisation et evaluation de la dose foetale pendant une radiotherapie de la parotide droite

Energy Technology Data Exchange (ETDEWEB)

Marchesi, V.; Noel, A. [Centre Alexis-Vautrin, Unite de Radiophysique Medicale, 54 - Vandoeuvre-les-Nancy (France); Graff, P.; Beckendorf, V.; Peiffert, D. [Centre Alexis-Vautrin, Dept. de Radiotherapie, 54 - Vandoeuvre-les-Nancy (France); Noel, A. [Institut National Polytechnique de Lorraine, CRAN, CNRS UMR-7039, 54 - Vandoeuvre-les-Nancy (France)

2008-09-15

Purpose was to optimize and to estimate the dose delivered to the foetus during a postoperative irradiation of a 5-month twin pregnant woman presenting with adenocarcinoma of the right parotid. The treatment protocol aimed to deliver 66 Gy conformal radiation therapy on the tumour bed associated to a prophylactic irradiation of 50 Gy on the upper cervical nodes. A series of measurements allowed to estimate the delivered dose in the abdomen by the means of an ion chamber inserted in a water phantom placed side by side of an anthropomorphic Alderson Rando phantom simulating the body of the patient from the head to the pelvis. An appropriate optimisation of the number and orientation of beams were performed in order to minimize the peripheral dose, which is mostly dependent of the total number of monitor unit per fraction: cervical nodes and tumour site included in the same fields, limitation of the irradiated volume, 6 MV X-ray beams rather than Cobalt beams. The measured doses at the upper, in the middle and at the lower part of the abdomen were 17.0, 11.0 and 11.9 mGy, respectively, for the entire treatment, representing 0.025, 0.016 and 0.017%, respectively of the prescribed dose. The actions conducted to optimise the treatment allowed to lower doses delivered to the foetus under the limits proposed by international recommendations (100 mGy). Thus, the treatment of the pregnant patient had been performed with a minimized risk for the foetus. (authors)

Comparison between apparent viscosity related to irradiation dose for corn starch and black pepper

International Nuclear Information System (INIS)

Casandroiu, T.; Oprita, N.; Ferdes, O.S.

1999-01-01

Dose-effect relationship was studied in the rheoviscometric behaviour of geliffied suspensions of irradiated corn starch and black pepper, as the variation of the apparent viscosity and the shear stress related to the dose. Irradiation has been performed up to 16 kGy. Black pepper was ground and sieved to three particle sizes to analyse also the influence of particle size on the apparent viscosity variation by dose. The rheoviscometric measurements have been carried out by a rotationary viscometer on geliffied suspensions of starch and black pepper, into equivalent starch concentration and alkalinised suspensions for pepper. For starch, shear stress variation by dose is exponential, where the coefficients depend on the shear rate. For black pepper, the curves of apparent viscosity relation to dose also fit an exponential equation and the influence of particle size is discussed, too. Viscometric behaviour similar to irradiation of both corn starch and black pepper could be attributed to starch degradation at relatively high doses and should be used to develop an identification and control method for the ionizing treatment of starch-based food materials. (author)

Impact of peer delivered wellness coaching.

Science.gov (United States)

Swarbrick, Margaret; Gill, Kenneth J; Pratt, Carlos W

2016-09-01

People receiving publicly funded behavioral health services for severe mental disorders have shorter lifespans and significantly impaired health-related quality of life compared to the general population. The aim of this article was to explore how peer wellness coaching (PWC), a manualized approach to pursue specific physical wellness goals, impacted goal attainment and overall health related quality of life. Deidentified archival program evaluation data were examined to explore whether peer delivered wellness coaching had an impact on 33 service recipients with regard to goal attainment and health-related quality of life. Participants were served by 1 of 12 wellness coach trainees from a transformation transfer initiative grant who had been trained in the manualized approach. Coaching participants and their coaches reported significant progress toward the attainment of individually chosen goals, 2 to 4 weeks after establishing their goals. After 8 to 10 weeks of peer delivered wellness coaching, improvements were evident in the self-report of physical health, general health, and perceived health. These improvements were sustained 90 days later. PWC is potentially a promising practice for helping people choose and pursue individual goals and facilitating positive health and wellness changes. Rigorous controlled research with larger samples is needed to evaluate the benefits of peer delivered wellness coaching. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

SU-E-T-86: A Systematic Method for GammaKnife SRS Fetal Dose Estimation

Energy Technology Data Exchange (ETDEWEB)

Geneser, S; Paulsson, A; Sneed, P; Braunstein, S; Ma, L [UCSF Comprehensive Cancer Center, San Francisco, CA (United States)

2015-06-15

Purpose: Estimating fetal dose is critical to the decision-making process when radiation treatment is indicated during pregnancy. Fetal doses less than 5cGy confer no measurable non-cancer developmental risks but can produce a threefold increase in developing childhood cancer. In this study, we estimate fetal dose for a patient receiving Gamma Knife stereotactic radiosurgery (GKSRS) treatment and develop a method to estimate dose directly from plan details. Methods: A patient underwent GKSRS on a Perfexion unit for eight brain metastases (two infratentorial and one brainstem). Dose measurements were performed using a CC13, head phantom, and solid water. Superficial doses to the thyroid, sternum, and pelvis were measured using MOSFETs during treatment. Because the fetal dose was too low to accurately measure, we obtained measurements proximally to the isocenter, fitted to an exponential function, and extrapolated dose to the fundus of the uterus, uterine midpoint, and pubic synthesis for both the preliminary and delivered plans. Results: The R-squared fit for the delivered doses was 0.995. The estimated fetal doses for the 72 minute preliminary and 138 minute delivered plans range from 0.0014 to 0.028cGy and 0.07 to 0.38cGy, respectively. MOSFET readings during treatment were just above background for the thyroid and negligible for all inferior positions. The method for estimating fetal dose from plan shot information was within 0.2cGy of the measured values at 14cm cranial to the fetal location. Conclusion: Estimated fetal doses for both the preliminary and delivered plan were well below the 5cGy recommended limit. Due to Pefexion shielding, internal dose is primarily governed by attenuation and drops off exponentially. This is the first work that reports fetal dose for a GK Perfexion unit. Although multiple lesions were treated and the duration of treatment was long, the estimated fetal dose remained very low.

SU-E-T-86: A Systematic Method for GammaKnife SRS Fetal Dose Estimation

International Nuclear Information System (INIS)

Geneser, S; Paulsson, A; Sneed, P; Braunstein, S; Ma, L

2015-01-01

Purpose: Estimating fetal dose is critical to the decision-making process when radiation treatment is indicated during pregnancy. Fetal doses less than 5cGy confer no measurable non-cancer developmental risks but can produce a threefold increase in developing childhood cancer. In this study, we estimate fetal dose for a patient receiving Gamma Knife stereotactic radiosurgery (GKSRS) treatment and develop a method to estimate dose directly from plan details. Methods: A patient underwent GKSRS on a Perfexion unit for eight brain metastases (two infratentorial and one brainstem). Dose measurements were performed using a CC13, head phantom, and solid water. Superficial doses to the thyroid, sternum, and pelvis were measured using MOSFETs during treatment. Because the fetal dose was too low to accurately measure, we obtained measurements proximally to the isocenter, fitted to an exponential function, and extrapolated dose to the fundus of the uterus, uterine midpoint, and pubic synthesis for both the preliminary and delivered plans. Results: The R-squared fit for the delivered doses was 0.995. The estimated fetal doses for the 72 minute preliminary and 138 minute delivered plans range from 0.0014 to 0.028cGy and 0.07 to 0.38cGy, respectively. MOSFET readings during treatment were just above background for the thyroid and negligible for all inferior positions. The method for estimating fetal dose from plan shot information was within 0.2cGy of the measured values at 14cm cranial to the fetal location. Conclusion: Estimated fetal doses for both the preliminary and delivered plan were well below the 5cGy recommended limit. Due to Pefexion shielding, internal dose is primarily governed by attenuation and drops off exponentially. This is the first work that reports fetal dose for a GK Perfexion unit. Although multiple lesions were treated and the duration of treatment was long, the estimated fetal dose remained very low

Dose rate effect on low-dose hyper-radiosensitivity with cells in vitro

Energy Technology Data Exchange (ETDEWEB)

Kim, Geon-Min; Kim, Eun-Hee [Seoul National University, Seoul (Korea, Republic of)

2016-10-15

Low-dose hyper-radiosensitivity (HRS) is the phenomenon that mammalian cells exhibit higher sensitivity to radiation at low doses (< 0.5 Gy) than expected by the linear-quadratic model. At doses above 0.5Gy, the cellular response is recovered to the level expected by the linear-quadratic model. This transition is called the increased radio-resistance (IRR). HRS was first verified using Chinese hamster V79 cells in vitro by Marples and has been confirmed in studies with other cell lines including human normal and tumor cells. HRS is known to be induced by inactivation of ataxia telangiectasia-mutated (ATM), which plays a key role in repairing DNA damages. Considering the connection between ATM and HRS, one can infer that dose rate may affect cellular response regarding HRS at low doses. In this study, we quantitated the effect of dose rate on HRS by clonogenic assay with normal and tumor cells. The HRS of cells at low dose exposures is a phenomenon already known. In this study, we observed HRS of rat normal diencephalon cells and rat gliosarcoma cells at doses below 1 Gy. In addition, we found that dose rate mattered. HRS occurred at low doses, but only when total dose was delivered at a rate below certain level.

Dose-volume correlation in radiation-related late small-bowel complication

International Nuclear Information System (INIS)

Letschert, J.G.J.; Lebesque, J.V.; Boer, R.W. de; hart, A.A.M.; Barteling, H.

1990-01-01

The effects of the volume of irradiated small bowel on late small-bowel tolerance was studied, taking into account the equivalent total dose ant type of pre-irradiation surgical procedure. A method was developed to estimate small-bowel volumes in the high-bowel volumes were measured for three-field and AP-PA pelvic treatments (165 cm 3 and 400 cm 3 , respectively), extended AP-PA treatment of para-aortic and iliac nodes (1000 cm 3 ). In a retrospective study of 111 patientst irradiated after surgery for rectal or recto-sigmoid cancer to a dose of 45-50 Gy in 5 weeks, extended AP-PA pelvic treatment (n = 27) resulted in a high incidence of severe small-bowel complications (37%), whereas for limited (three-field) pelvic treatment (n = 84) the complication rate was 6%. These complication data together with data from the literature on postoperative radiation-related small-bowel complications were analysed using the maximum likelihood method to fit the data to the logistic form of the dose-response relation, taking the volume effect into account by a power law. The analysis indicated that the incidence of radiation-related small-bowel compllications was higher after rectal surgery than after other types of surgery, which might be explained by the development of more adhesions. For both types of surgery a volume exponent of the power-law of 0.26 ± 0.05 was established. This means that if the small-bowel volume is increased by a factor of 2, the total dose has to be reduced by 17% for the same incidence of small-bowel complications. (author). 45 refs.; 6 figs.; 4 tabs

Dose-response relation between physical activity and sick leave

NARCIS (Netherlands)

Proper, K.I.; Heuvel, S.G. van den; Vroome, E.M. de; Hildebrandt, V.H.; Beek, A.J. van der

2006-01-01

Objective: To investigate the dose-response relation between moderate and vigorous physical activity and sick leave in a working population. Methods: Data were used from three large Dutch databases: two continuous, cross sectional surveys among a representative sample of the Dutch population and one

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.

Comparative Dose Accuracy of Durable and Patch Insulin Infusion Pumps

Science.gov (United States)

Jahn, Luis G.; Capurro, Jorge J.; Levy, Brian L.

2013-01-01

Background: As all major insulin pump manufacturers comply with the international infusion pump standard EN 60601-2-24:1998, there may be a general assumption that all pumps are equal in insulin-delivery accuracy. This research investigates single-dose and averaged-dose accuracy of incremental basal deliveries for one patch model and three durable models of insulin pumps. Method: For each pump model, discrete single doses delivered during 0.5 U/h basal rate infusion over a 20 h period were measured using a time-stamped microgravimetric system. Dose accuracy was analyzed by comparing single doses and time-averaged doses to specific accuracy thresholds (±5% to ±30%). Results: The percentage of single doses delivered outside accuracy thresholds of ±5%, ±10%, and ±20% were as follows: Animas OneTouch® Ping® (43.2%, 14.3%, and 1.8%, respectively), Roche Accu-Chek® Combo (50.6%, 24.4%, and 5.5%), Medtronic Paradigm® RevelTM/VeoTM (54.2%, 26.7%, and 6.6%), and Insulet OmniPod® (79.1%, 60.5%, and 34.9%). For 30 min, 1 h, and 2 h averaging windows, the percentage of doses delivered outside a ±15% accuracy were as follows: OneTouch Ping (1.0%, 0.4%, and 0%, respectively), Accu-Chek Combo (4.2%, 3.5%, and 3.1%), Paradigm Revel/Veo (3.9%, 3.1%, and 2.2%), and OmniPod (33.9%, 19.9%, and 10.3%). Conclusions: This technical evaluation demonstrates significant differences in single-dose and averaged-dose accuracy among the insulin pumps tested. Differences in dose accuracy were most evident between the patch pump model and the group of durable pump models. Of the pumps studied, the Animas OneTouch Ping demonstrated the best single-dose and averaged-dose accuracy. Further research on the clinical relevance of these findings is warranted. PMID:23911184

On-line MR imaging for dose validation of abdominal radiotherapy

NARCIS (Netherlands)

Glitzner, M; Crijns, S P M; de Senneville, B Denis; Kontaxis, C; Prins, F M; Lagendijk, J J W; Raaymakers, B W

2015-01-01

For quality assurance and adaptive radiotherapy, validation of the actual delivered dose is crucial.Intrafractional anatomy changes cannot be captured satisfactorily during treatment with hitherto available imaging modalitites. Consequently, dose calculations are based on the assumption of static

Relative implications of protective responses versus damage induction at low dose and low-dose-rate exposures, using the microdose approach

Energy Technology Data Exchange (ETDEWEB)

Feinendegen, L.E

2003-07-01

In reviewing tissue effects of low-dose radiation (1) absorbed dose to tissue is replaced by the sum of energy deposited with track events in cell-equivalent tissue micromasses, i.e. with microdose hits, in the number of exposed micromasses and (2) induced cell damage and adaptive protection are related to microdose hits in exposed micromasses for a given radiation quality. DNA damage increases with the number of microdose hits. They also can induce adaptive protection, mainly against endogenous DNA damage. This protection involves cellular defenses, DNA repair and damage removal. With increasing numbers of low linear energy transfer (LET) microdose hits in exposed micromasses, adaptive protection first tends to outweigh damage and then (above 200 mGy) fails and largely disappears. These experimental data predict that cancer risk coefficients derived by epidemiology at high-dose irradiation decline at low doses and dose rates when adaptive protection outdoes DNA damage. The dose-risk function should include both linear and non-linear terms at low doses. (author)

Relative implications of protective responses versus damage induction at low dose and low-dose-rate exposures, using the microdose approach

International Nuclear Information System (INIS)

Feinendegen, L.E.

2003-01-01

In reviewing tissue effects of low-dose radiation (1) absorbed dose to tissue is replaced by the sum of energy deposited with track events in cell-equivalent tissue micromasses, i.e. with microdose hits, in the number of exposed micromasses and (2) induced cell damage and adaptive protection are related to microdose hits in exposed micromasses for a given radiation quality. DNA damage increases with the number of microdose hits. They also can induce adaptive protection, mainly against endogenous DNA damage. This protection involves cellular defenses, DNA repair and damage removal. With increasing numbers of low linear energy transfer (LET) microdose hits in exposed micromasses, adaptive protection first tends to outweigh damage and then (above 200 mGy) fails and largely disappears. These experimental data predict that cancer risk coefficients derived by epidemiology at high-dose irradiation decline at low doses and dose rates when adaptive protection outdoes DNA damage. The dose-risk function should include both linear and non-linear terms at low doses. (author)

A Voxel-Based Approach to Explore Local Dose Differences Associated With Radiation-Induced Lung Damage

Energy Technology Data Exchange (ETDEWEB)

Palma, Giuseppe [Institute of Biostructure and Bioimaging, National Research Council, Naples (Italy); Monti, Serena [IRCCS SDN, Naples (Italy); D' Avino, Vittoria [Institute of Biostructure and Bioimaging, National Research Council, Naples (Italy); Conson, Manuel [Institute of Biostructure and Bioimaging, National Research Council, Naples (Italy); Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples (Italy); Liuzzi, Raffaele [Institute of Biostructure and Bioimaging, National Research Council, Naples (Italy); Pressello, Maria Cristina [Department of Health Physics, S. Camillo-Forlanini Hospital, Rome (Italy); Donato, Vittorio [Department of Radiation Oncology, S. Camillo-Forlanini Hospital, Rome (Italy); Deasy, Joseph O. [Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY (United States); Quarantelli, Mario [Institute of Biostructure and Bioimaging, National Research Council, Naples (Italy); Pacelli, Roberto [Institute of Biostructure and Bioimaging, National Research Council, Naples (Italy); Department of Advanced Biomedical Sciences, Federico II University School of Medicine, Naples (Italy); Cella, Laura, E-mail: laura.cella@cnr.it [Institute of Biostructure and Bioimaging, National Research Council, Naples (Italy)

2016-09-01

Purpose: To apply a voxel-based (VB) approach aimed at exploring local dose differences associated with late radiation-induced lung damage (RILD). Methods and Materials: An interinstitutional database of 98 patients who were Hodgkin lymphoma (HL) survivors treated with postchemotherapy supradiaphragmatic radiation therapy was analyzed in the study. Eighteen patients experienced late RILD, classified according to the Radiation Therapy Oncology Group scoring system. Each patient's computed tomographic (CT) scan was normalized to a single reference case anatomy (common coordinate system, CCS) through a log-diffeomorphic approach. The obtained deformation fields were used to map the dose of each patient into the CCS. The coregistration robustness and the dose mapping accuracy were evaluated by geometric and dose scores. Two different statistical mapping schemes for nonparametric multiple permutation inference on dose maps were applied, and the corresponding P<.05 significance lung subregions were generated. A receiver operating characteristic (ROC)-based test was performed on the mean dose extracted from each subregion. Results: The coregistration process resulted in a geometrically robust and accurate dose warping. A significantly higher dose was consistently delivered to RILD patients in voxel clusters near the peripheral medial-basal portion of the lungs. The area under the ROC curves (AUC) from the mean dose of the voxel clusters was higher than the corresponding AUC derived from the total lung mean dose. Conclusions: We implemented a framework including a robust registration process and a VB approach accounting for the multiple comparison problem in dose-response modeling, and applied it to a cohort of HL survivors to explore a local dose–RILD relationship in the lungs. Patients with RILD received a significantly greater dose in parenchymal regions where low doses (∼6 Gy) were delivered. Interestingly, the relation between differences in the high-dose

Dose gradient curve: A new tool for evaluating dose gradient.

Science.gov (United States)

Sung, KiHoon; Choi, Young Eun

2018-01-01

Stereotactic radiotherapy, which delivers an ablative high radiation dose to a target volume for maximum local tumor control, requires a rapid dose fall-off outside the target volume to prevent extensive damage to nearby normal tissue. Currently, there is no tool to comprehensively evaluate the dose gradient near the target volume. We propose the dose gradient curve (DGC) as a new tool to evaluate the quality of a treatment plan with respect to the dose fall-off characteristics. The average distance between two isodose surfaces was represented by the dose gradient index (DGI) estimated by a simple equation using the volume and surface area of isodose levels. The surface area was calculated by mesh generation and surface triangulation. The DGC was defined as a plot of the DGI of each dose interval as a function of the dose. Two types of DGCs, differential and cumulative, were generated. The performance of the DGC was evaluated using stereotactic radiosurgery plans for virtual targets. Over the range of dose distributions, the dose gradient of each dose interval was well-characterized by the DGC in an easily understandable graph format. Significant changes in the DGC were observed reflecting the differences in planning situations and various prescription doses. The DGC is a rational method for visualizing the dose gradient as the average distance between two isodose surfaces; the shorter the distance, the steeper the dose gradient. By combining the DGC with the dose-volume histogram (DVH) in a single plot, the DGC can be utilized to evaluate not only the dose gradient but also the target coverage in routine clinical practice.

Dose verification for respiratory-gated volumetric modulated arc therapy

Energy Technology Data Exchange (ETDEWEB)

Qian Jianguo; Xing Lei; Liu Wu; Luxton, Gary, E-mail: gluxton@stanford.edu [Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA 94305 (United States)

2011-08-07

A novel commercial medical linac system (TrueBeam(TM), Varian Medical Systems, Palo Alto, CA) allows respiratory-gated volumetric modulated arc therapy (VMAT), a new modality for treating moving tumors with high precision and improved accuracy by allowing for regular motion associated with a patient's breathing during VMAT delivery. The purpose of this work is to adapt a previously-developed dose reconstruction technique to evaluate the fidelity of VMAT treatment during gated delivery under clinic-relevant periodic motion related to patient breathing. A Varian TrueBeam system was used in this study. VMAT plans were created for three patients with lung or pancreas tumors. Conventional 6 and 15 MV beams with flattening filter and high-dose-rate 10 MV beams with no flattening filter were used in these plans. Each patient plan was delivered to a phantom first without gating and then with gating for three simulated respiratory periods (3, 4.5 and 6 s). Using the adapted log-file-based dose reconstruction procedure supplemented with ion chamber array (Seven29(TM), PTW, Freiburg, Germany) measurements, the delivered dose was used to evaluate the fidelity of gated VMAT delivery. Comparison of Seven29 measurements with and without gating showed good agreement with gamma-index passing rates above 99% for 1%/1 mm dose accuracy/distance-to-agreement criteria. With original plans as reference, gamma-index passing rates were 100% for the reconstituted plans (1%/1 mm criteria) and 93.5-100% for gated Seven29 measurements (3%/3 mm criteria). In the presence of leaf error deliberately introduced into the gated delivery of a pancreas patient plan, both dose reconstruction and Seven29 measurement consistently indicated substantial dosimetric differences from the original plan. In summary, a dose reconstruction procedure was demonstrated for evaluating the accuracy of respiratory-gated VMAT delivery. This technique showed that under clinical operation, the TrueBeam system

Influence of the radio-tracer used in diagnostic nuclear medicine upon the dose at the nucleus of cellular localisation

International Nuclear Information System (INIS)

Gardin, I.; Faraggi, M.; Stievenart, J.L; Le Guludec, D.; Bok, B.

1997-01-01

In the classical dosimetry one supposes a uniform distribution of the radio-pharmaceuticals at the source organ level as well as a homogeneous distribution of the absorbed dose. This hypotheses are not always verified in biology, and the influence of the tracer localisation on the dose delivered at the cellular nucleus has been studied. The average dose delivered by the electron emission of different radio-isotopes used in diagnosis has been calculated by taking into account the radioactivity localized upon the target cell (Dself), and upon the neighbouring cells (Dcross). Nuclear, cytoplasmic and membranous localizations of the tracer were simulated for different cellular sizes. In the particular case of 99m Tc and cells of nuclear radius about 4 μm and cellular radios about 8 μ, Dcross is independent of the intra-cellular localisation of the tracer. On the contrary, for a nuclear localisation Dself is 52 and 157 times more important than for the cytoplasmic and membranous localisation, respectively. The dose at the cellular nucleus due to electron emission of 99m Tc is under-estimated by a factor 2.6 by classical dosimetry when the radioactivity is nuclear. On the contrary, the classical model over-estimates by a factor 1.2 the dose at nucleus for cytoplasmic and membranous localizations. This study shows that the dose delivered at cellular nucleus by the electron emissions of 99m Tc depends on the localisation of the tracer. The modelling proposed allows a better evaluation of the radiobiological hazards related to the administration of radiopharmaceuticals in diagnostic nuclear medicine

Time and dose-related changes in the thickness of pig skin after irradiation with single doses of 90Sr/90Y β-rays

International Nuclear Information System (INIS)

Rezvani, M.; Hamlet, R.; Hopewell, J.W.; Sieber, V.K.

1994-01-01

Time-related changes in pig skin thickness have been evaluated using a non-invasive ultrasound technique after exposure to a range of single doses of 90 Sr/ 90 Yr β-rays. The reduction in relative skin thickness developed in two distinct phases: the first was between 12 and 20 weeks postirradiation. No further changes were then seen until 52 weeks postirradiation when a second phase of skin thinning was observed. This was complete after 76 weeks and no further changes in relative skin thickness were seen in the maximum follow up period of 129 weeks. The timings of these phases of damage were independent of the radiation dose, however, the severity of both phases of radiation-induced skin thinning were dose related. (Author)

Importance of the Computed Tomography Dose Index (CTDI) and Dose Length Product (DLP)

International Nuclear Information System (INIS)

Rasolomboahanginjatovo, L.M.

2014-01-01

This work is under the auspice of the International Atomic Energy Agency (IAEA) projects (RAF/9/053) untitled S trengthening of the technical capacity for the protection patients and worker . The goal of this work is to highlight the importance of the Computed Tomography Dose Index (CTDI) and the Dose Length product (DLP). Measures were done at Polyclinic of Ilafy and CRDT Anosivavaka, Antananarivo, Madagascar. Doses were evaluated by use of pencil ionization chamber model 6000-10 connected with an electrometer RAD-CHECK model 06-256. Knowledge of dose indicator and Diagnostic Reference Level (DRL) allow the monitoring of scanner within the appropriate average dosimeter. It also insures the progressive determination for the most adapted dose requirements by choice of parameters available on scanner device. Measurements confirmed that doses from scanner devices of the two centers were under DRL requirements proposed by the IAEA, the European Commission (EC) and the National Radiological Protection Board (NRPB). The present results confirm that the patient delivered doses for the two centers are optimized. [fr

Relative response of the alanine dosimeter to medium energy x-rays.

Science.gov (United States)

Anton, M; Büermann, L

2015-08-07

The response of the alanine dosimeter to kilovoltage x-rays with respect to the dose to water was measured, relative to the response to Co-60 radiation.Two series of x-ray qualities were investigated, one ranging from 30 kV to 100 kV tube voltage (TW series), the other one ranging from 70 kV to 280 kV (TH series). Due to the use of the water calorimeter as a primary standard, the uncertainty of the delivered dose is significantly lower than for other published data. The alanine response was measured as described in a previous publication (Anton et al 2013 Phys. Med. Biol. 58 3259-82). The uncertainty component due to the alanine measurement and analysis is ⩽0.4%, the major part of the combined uncertainty of the relative response originates from the uncertainty of the delivered dose. The relative uncertainties of the relative response vary from ⩽2% for the TW series to ⩽1.1% for the TH series.Different from the behaviour of the alanine dosimeter for megavoltage x-rays or electrons, the relative response drops significantly from unity for Co-60 radiation to less than 64% for the TW quality with a tube voltage of 30 kV. In order to reproduce this behaviour through Monte Carlo simulations, not only the ratio of the absorbed dose to alanine to the absorbed dose to water has to be known, but also the intrinsic efficiency, i.e. the dependence of the number of free radicals generated per unit of absorbed dose on the photon energy. This quantity is not yet accessible for the TW series.For a possible use of the alanine dosimeter for kilovoltage x-rays, for example in electronic brachytherapy, users should rely on the measured data for the relative response which have become available with this publication.

Investigation of polymer composite for high dose dosimetry

International Nuclear Information System (INIS)

Pereira, E.L.M.; Batista, A.S.M.; Ribeiro, F.A.S.; Santos, A.P.; Faria, L.O.; Oliveira, A.H.

2017-01-01

Introduction: This paper presents the efficacy evaluation of PVDF and nanocomposites of the PVDF films for high gamma dosimetry. Our scope in this first part of our studies is the selection of the most promising film for future dosimetry trials, where the proportionality of response of the selected material will be investigated over a large range of doses and dose rates. Methods: Was prepared nanocomposites made by mixing Poly(vinylidene fluoride) (PVDF), zirconium oxide (ZrO 2 ) and multi-walled carbon nanotubes (MWCNTs) aiming to find dosimetric properties for applications in high dose dosimetry. The samples were irradiated with a Co-60 source at constant dose rate (16.7 kGy/h), with doses ranging from 100 to 2750 kGy. The UV-Vis and FTIR spectrophotometry have been used to monitor the appearing of C=C conjugated bonds and radio-oxidation of carbon (C=O). Results: FTIR spectrometry has that the absorbance intensities at 1715 cm -1 and 1730 cm -1 can be used for high dosimetry purposes for gamma doses ranging from 400 to 2750 kGy. In this range, it is possible to observe a linear relationship between Abs & Dose. Fading of signal was evaluated for one month and reproducibility in 2000 kGy dose. Conclusion: FTIR spectroscopic data revealed two optical absorption bands at 1715 cm -1 and 1730 cm -1 whose intensities are unambiguously related to gamma delivered dose ranging from 400 kGy to 2750 kGy. (author)

Dose titration to reduce dipyridamole-related headache.

Science.gov (United States)

Chang, Yeu-Jhy; Ryu, Shan-Jin; Lee, Tsong-Hai

2006-01-01

Combination of low-dose aspirin and modified-release dipyridamole (ASA+MR-DP) provides a significantly increased benefit in stroke prevention over aspirin alone. However, headaches were reported in more patients receiving dipyridamole-containing agents than in those receiving placebo. We undertook a randomized, double-blind, placebo-controlled trial to evaluate which dosing regimens of ASA+MR-DP have better tolerance. This trial randomized 146 patients with a history of ischemic cerebrovascular disease into three groups: placebo (days 1-28), reduced dose (placebo on days 1-4, ASA+MR-DP once daily before bed during days 5-14, and b.i.d. on days 15-28), and regular dose (placebo on days 1-4, and ASA+MR-DP b.i.d. on days 5-28). Using Chinese diary card, headache was assessed as mean cumulated headache (Sigma frequency x intensity/occurrence days x study days) over the study period, and was graded 0-4 according to Cancer Therapy Evaluation Program, Common Toxicity Criteria, Version 2.0. Intent-to-treat patients after randomization was 46 in placebo group, 45, reduced dose, and 49, regular dose. Among commonly reported adverse effects, headache of any grade occurred significantly more in the regular dose group (38.8%), as compared to the other two groups (p < 0.05). Mean cumulated headache was higher (p < 0.05) in the regular dose group than in the reduced group during days 5-14. Of 27 patients who dropped out, 15 (55.6%) were due to headache, which was substantially more in regular dose (8, 53.3%), though the difference was statistically insignificant. Initial reduced dose treatment with ASA+MR-DP may cause fewer headaches than regular dosing, and seems better tolerated by those susceptible to phosphodiesterase inhibitor-induced headache. Copyright 2006 S. Karger AG, Basel.

Rectal dose during radiotherapy: how much is too much?

International Nuclear Information System (INIS)

Booth, J.; Adelaide University,

2002-01-01

Full text: The clinical intent of radiotherapy for prostate cancer is to deposit high radiation dose to the prostate and as low as possible to healthy tissue. The rectum is one adjacent structure that is very sensitive to side effects including rectal bleeding, stricture, and ulceration. The dose that the rectum receives is often difficult to predict because its position and size will differ on each treatment day from the original planning CT images. The aim of this work is to use current measured values from the literature on rectal wall motion to mathematically model the dynamic rectal wall. The model is used with a pre calculated dose distribution to evaluate the difference between planned anticipated and actually delivered rectal radiation doses. The dose delivered will depend on the status of the rectum in the preliminary planning CT scan. Deviations from the planned dose were larger if the rectum was empty in the planning CT scan (ΔD = ± 25%) than if it was full (ΔD = ± 15%). If the planning CT scan demonstrated the rectum in the mean treatment position the dose variation is reduced (ΔD = ± 10%). These results support the conclusion that care should be taken to plan treatments using CT images that contain reproducible information

Three-Week Bright-Light Intervention Has Dose-Related Effects on Threat-Related Corticolimbic Reactivity and Functional Coupling

DEFF Research Database (Denmark)

Fisher, Patrick M; Madsen, Martin K; Mc Mahon, Brenda

2014-01-01

environmental stimuli (e.g., threat) and may underlie these effects. Serotonin signaling modulates this circuit and is implicated in the pathophysiology of seasonal and other affective disorders. METHODS: We evaluated the effects of a bright-light intervention protocol on threat-related corticolimbic reactivity......-related amygdala and prefrontal reactivity in a dose-dependent manner. Conversely, amygdala-prefrontal and intraprefrontal functional coupling increased significantly in a dose-dependent manner. Genotype status significantly moderated bright-light intervention effects on intraprefrontal functional coupling....... CONCLUSIONS: This is the first study to evaluate the effects of clinically relevant bright-light intervention on threat-related brain function. We show that amygdala-prefrontal reactivity and communication are significantly affected by bright-light intervention, an effect partly moderated by genotype...

A cost comparison of introducing and delivering pneumococcal, rotavirus and human papillomavirus vaccines in Rwanda.

Science.gov (United States)

Ngabo, Fidèle; Levin, Ann; Wang, Susan A; Gatera, Maurice; Rugambwa, Celse; Kayonga, Celestin; Donnen, Philippe; Lepage, Philippe; Hutubessy, Raymond

2015-12-16

Detailed cost evaluations of delivery of new vaccines such as pneumococcal conjugate, human papillomavirus (HPV), and rotavirus vaccines in low and middle-income countries are scarce. This paper differs from others by comparing the costs of introducing multiple vaccines in a single country and then assessing the financial and economic impact at the time and implications for the future. The objective of the analysis was to understand the introduction and delivery cost per dose or per child of the three new vaccines in Rwanda to inform domestic and external financial resource mobilization. Start-up, recurrent, and capital costs from a government perspective were collected in 2012. Since pneumococcal conjugate and HPV vaccines had already been introduced, cost data for those vaccines were collected retrospectively while prospective (projected) costing was done for rotavirus vaccine. The financial unit cost per fully immunized child (or girl for HPV vaccine) of delivering 3 doses of each vaccine (without costs related to vaccine procurement) was $0.37 for rotavirus (RotaTeq(®)) vaccine, $0.54 for pneumococcal (Prevnar(®)) vaccine in pre-filled syringes, and $10.23 for HPV (Gardasil (®)) vaccine. The financial delivery costs of Prevnar(®) and RotaTeq(®) were similar since both were delivered using existing health system infrastructure to deliver infant vaccines at health centers. The total financial cost of delivering Gardasil(®) was higher than those of the two infant vaccines due to greater resource requirements associated with creating a new vaccine delivery system in for a new target population of 12-year-old girls who have not previously been served by the existing routine infant immunization program. The analysis indicates that service delivery strategies have an important influence on costs of introducing new vaccines and costs per girl reached with HPV vaccine are higher than the other two vaccines because of its delivery strategy. Documented information

Mobile-Dose: A Dose-Meter Designed for Use in Automatic Machineries for Dose Manipulation in Nuclear Medicine

Science.gov (United States)

de Asmundis, Riccardo; Boiano, Alfonso; Ramaglia, Antonio

2008-06-01

Mobile-Dose has been designed for a very innovative use: the integration in a robotic machinery for automatic preparation of radioactive doses, to be injected to patients in Nuclear Medicine Departments, with real time measurement of the activity under preparation. Mobile-Dose gives a constant measurement of the dose during the filling of vials or syringes, triggering the end of the filling process based on a predefined dose limit. Several applications of Mobile-Dose have been delivered worldwide, from Italian hospitals and clinics to European and Japanese ones. The design of such an instrument and its integration in robotic machineries, was required by an Italian company specialised in radiation protection tools for nuclear applications, in the period 2001-2003. At the time of its design, apparently no commercial instruments with a suitable interfacing capability to the external world existed: we designed it in order to satisfy all the strict requirements coming from the medical aspects (precision within 10%, repeatability, stability, time response) and from the industrial conceiving principles that are mandatory to ensure a good reliability in such a complicated environment. The instrument is suitable to be used in standalone mode too, thanks to its portability and compactness and to the intelligent operator panel programmed for this purpose.

Fast in vivo volume dose reconstruction via reference dose perturbation

International Nuclear Information System (INIS)

Lu, Weiguo; Chen, Mingli; Mo, Xiaohu; Parnell, Donald; Olivera, Gustavo; Galmarini, Daniel

2014-01-01

Purpose: Accurate on-line reconstruction of in-vivo volume dose that accounts for both machine and patient discrepancy is not clinically available. We present a simple reference-dose-perturbation algorithm that reconstructs in-vivo volume dose fast and accurately. Methods: We modelled the volume dose as a function of the fluence map and density image. Machine (output variation, jaw/leaf position errors, etc.) and patient (setup error, weight loss, etc.) discrepancies between the plan and delivery were modelled as perturbation of the fluence map and density image, respectively. Delivered dose is modelled as perturbation of the reference dose due to change of the fluence map and density image. We used both simulated and clinical data to validate the algorithm. The planned dose was used as the reference. The reconstruction was perturbed from the reference and accounted for output-variations and the registered daily image. The reconstruction was compared with the ground truth via isodose lines and the Gamma Index. Results: For various plans and geometries, the volume doses were reconstructed in few seconds. The reconstruction generally matched well with the ground truth. For the 3%/3mm criteria, the Gamma pass rates were 98% for simulations and 95% for clinical data. The differences mainly appeared on the surface of the phantom/patient. Conclusions: A novel reference-dose-perturbation dose reconstruction model is presented. The model accounts for machine and patient discrepancy from planning. The algorithm is simple, fast, yet accurate, which makes online in-vivo 3D dose reconstruction clinically feasible.

Comparative in vitro evaluation of four corticosteroid metered dose inhalers : Consistency of delivered dose and particle size distribution

NARCIS (Netherlands)

de Vries, Tjalling W; Rottier, Bart L; Gjaltema, Doetie; Hagedoorn, Paul; Frijlink, Henderik W; de Boer, Anne H

2009-01-01

Introduction: Recent developments concerning pressurized metered dose inhalers (pMDIs) with inhaled corticosteroids (ICS) are the introduction of ciclesonide and the replacement of propellants. As the results of in vivo studies depend on pMDI performance, it is necessary to evaluate pMDIs in vitro

Simulation of computed tomography dose based on voxel phantom

Science.gov (United States)

Liu, Chunyu; Lv, Xiangbo; Li, Zhaojun

2017-01-01

Computed Tomography (CT) is one of the preferred and the most valuable imaging tool used in diagnostic radiology, which provides a high-quality cross-sectional image of the body. It still causes higher doses of radiation to patients comparing to the other radiological procedures. The Monte-Carlo method is appropriate for estimation of the radiation dose during the CT examinations. The simulation of the Computed Tomography Dose Index (CTDI) phantom was developed in this paper. Under a similar conditions used in physical measurements, dose profiles were calculated and compared against the measured values that were reported. The results demonstrate a good agreement between the calculated and the measured doses. From different CT exam simulations using the voxel phantom, the highest absorbed dose was recorded for the lung, the brain, the bone surface. A comparison between the different scan type shows that the effective dose for a chest scan is the highest one, whereas the effective dose values during abdomen and pelvis scan are very close, respectively. The lowest effective dose resulted from the head scan. Although, the dose in CT is related to various parameters, such as the tube current, exposure time, beam energy, slice thickness and patient size, this study demonstrates that the MC simulation is a useful tool to accurately estimate the dose delivered to any specific organs for patients undergoing the CT exams and can be also a valuable technique for the design and the optimization of the CT x-ray source.

Tomotherapy dose distribution verification using MAGIC-f polymer gel dosimetry

International Nuclear Information System (INIS)

Pavoni, J. F.; Pike, T. L.; Snow, J.; DeWerd, L.; Baffa, O.

2012-01-01

Purpose: This paper presents the application of MAGIC-f gel in a three-dimensional dose distribution measurement and its ability to accurately measure the dose distribution from a tomotherapy unit. Methods: A prostate intensity-modulated radiation therapy (IMRT) irradiation was simulated in the gel phantom and the treatment was delivered by a TomoTherapy equipment. Dose distribution was evaluated by the R2 distribution measured in magnetic resonance imaging. Results: A high similarity was found by overlapping of isodoses of the dose distribution measured with the gel and expected by the treatment planning system (TPS). Another analysis was done by comparing the relative absorbed dose profiles in the measured and in the expected dose distributions extracted along indicated lines of the volume and the results were also in agreement. The gamma index analysis was also applied to the data and a high pass rate was achieved (88.4% for analysis using 3%/3 mm and of 96.5% using 4%/4 mm). The real three-dimensional analysis compared the dose-volume histograms measured for the planning volumes and expected by the treatment planning, being the results also in good agreement by the overlapping of the curves. Conclusions: These results show that MAGIC-f gel is a promise for tridimensional dose distribution measurements.

Tomotherapy dose distribution verification using MAGIC-f polymer gel dosimetry

Energy Technology Data Exchange (ETDEWEB)

Pavoni, J. F.; Pike, T. L.; Snow, J.; DeWerd, L.; Baffa, O. [Departamento de Fisica, Faculdade de Filosofia Ciencias e Letras de Ribeirao Preto-Universidade de Sao Paulo, Av. Bandeirantes, 3900 - CEP 14040-901 - Bairro Monte Alegre - Ribeirao Preto, SP (Brazil); Medical Radiation Research Center, Department of Medical Physics, University of Wisconsin, 1111 Highland Avenue, B1002 WIMR, Madison, Wisconsin 53705-2275 (United States); Departamento de Fisica, Faculdade de Filosofia Ciencias e Letras de Ribeirao Preto-Universidade de Sao Paulo, Av. Bandeirantes, 3900 - CEP 14040-901 - Bairro Monte Alegre - Ribeirao Preto, SP (Brazil)

2012-05-15

Purpose: This paper presents the application of MAGIC-f gel in a three-dimensional dose distribution measurement and its ability to accurately measure the dose distribution from a tomotherapy unit. Methods: A prostate intensity-modulated radiation therapy (IMRT) irradiation was simulated in the gel phantom and the treatment was delivered by a TomoTherapy equipment. Dose distribution was evaluated by the R2 distribution measured in magnetic resonance imaging. Results: A high similarity was found by overlapping of isodoses of the dose distribution measured with the gel and expected by the treatment planning system (TPS). Another analysis was done by comparing the relative absorbed dose profiles in the measured and in the expected dose distributions extracted along indicated lines of the volume and the results were also in agreement. The gamma index analysis was also applied to the data and a high pass rate was achieved (88.4% for analysis using 3%/3 mm and of 96.5% using 4%/4 mm). The real three-dimensional analysis compared the dose-volume histograms measured for the planning volumes and expected by the treatment planning, being the results also in good agreement by the overlapping of the curves. Conclusions: These results show that MAGIC-f gel is a promise for tridimensional dose distribution measurements.

In vivo dosimetry with semiconductors in medium dose rate (MDR) brachytherapy for cervical cancer.

Science.gov (United States)

Allahverdi, Mahmoud; Jaberi, Ramin; Aghili, Mehdi; Ghahremani, Fatemeh; Geraily, Ghazale

2013-03-01

This study was performed to evaluate the role of in vivo dosimetry with semiconductor detectors in gynaecological medium dose rate brachytherapy, and to compare the actual doses delivered to organs at risk (as measured using in vivo dosimetry) with those calculated during treatment planning. Doses to the rectum and bladder were measured in a group of patients with cervical carcinoma using semiconductor detectors and compared to the doses calculated using a treatment planning system. 36 applications of brachytherapy at dose rates of 1.8-2.3 Gy/h were performed in the patients. The mean differences between the measured and calculated doses were 3 % for the rectum and 11 % for the bladder. The main reason for the differences between the measured and calculated doses was patient movement. To reduce the risk of large errors in the dose delivered, in vivo dosimetry should be performed in addition to treatment planning system computations.

Do we need 3D tube current modulation information for accurate organ dosimetry in chest CT? Protocols dose comparisons

Energy Technology Data Exchange (ETDEWEB)

Lopez-Rendon, Xochitl; Develter, Wim [KU Leuven, Department of Imaging and Pathology, Division of Medical Physics and Quality Assessment, Leuven (Belgium); Zhang, Guozhi; Coudyzer, Walter; Zanca, Federica [University Hospitals of the KU Leuven, Department of Radiology, Leuven (Belgium); Bosmans, Hilde [KU Leuven, Department of Imaging and Pathology, Division of Medical Physics and Quality Assessment, Leuven (Belgium); University Hospitals of the KU Leuven, Department of Radiology, Leuven (Belgium)

2017-11-15

To compare the lung and breast dose associated with three chest protocols: standard, organ-based tube current modulation (OBTCM) and fast-speed scanning; and to estimate the error associated with organ dose when modelling the longitudinal (z-) TCM versus the 3D-TCM in Monte Carlo simulations (MC) for these three protocols. Five adult and three paediatric cadavers with different BMI were scanned. The CTDI{sub vol} of the OBTCM and the fast-speed protocols were matched to the patient-specific CTDI{sub vol} of the standard protocol. Lung and breast doses were estimated using MC with both z- and 3D-TCM simulated and compared between protocols. The fast-speed scanning protocol delivered the highest doses. A slight reduction for breast dose (up to 5.1%) was observed for two of the three female cadavers with the OBTCM in comparison to the standard. For both adult and paediatric, the implementation of the z-TCM data only for organ dose estimation resulted in 10.0% accuracy for the standard and fast-speed protocols, while relative dose differences were up to 15.3% for the OBTCM protocol. At identical CTDI{sub vol} values, the standard protocol delivered the lowest overall doses. Only for the OBTCM protocol is the 3D-TCM needed if an accurate (<10.0%) organ dosimetry is desired. (orig.)

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

Science.gov (United States)

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

2016-09-25

Inhaled drugs all too often deliver only a fraction of the emitted dose to the target lung site due to deposition in the extrathoracic region (i.e., mouth and throat), which can lead to increased variation in lung exposure, and in some instances increases in local and systemic side effects. For aerosol medications, improved targeting to the lungs may be achieved by tailoring the micromeritic properties of the particles (e.g., size, density, rugosity) to minimize deposition in the mouth-throat and maximize the total lung dose. This study evaluated a co-solvent spray drying approach to modulate particle morphology and dose delivery characteristics of engineered powder formulations of insulin microparticles. The binary co-solvent system studied included water as the primary solvent mixed with an organic co-solvent, e.g., ethanol. Factors such as the relative rate of evaporation of each component of a binary co-solvent mixture, and insulin solubility in each component were considered in selecting feedstock compositions. A water-ethanol co-solvent mixture with a composition range considered suitable for modulating particle shell formation during drying was selected for experimental investigation. An Alberta Idealized Throat model was used to evaluate the in vitro total lung dose of a series of spray dried insulin formulations engineered with different bulk powder properties and delivered with two prototype inhalers that fluidize and disperse powder using different principles. The in vitro total lung dose of insulin microparticles was improved and favored for powders with low bulk density and small primary particle size, with reduction of deposition in the extrathoracic region. The results demonstrated that a total lung dose >95% of the delivered dose can be achieved with engineered particles, indicating a high degree of lung targeting, almost completely bypassing deposition in the mouth-throat. Copyright © 2016 Elsevier B.V. All rights reserved.

Electroporation-delivered transdermal neostigmine in rats: equivalent action to intravenous administration.

Science.gov (United States)

Berkó, Szilvia; Szűcs, Kálmán F; Balázs, Boglárka; Csányi, Erzsébet; Varju, Gábor; Sztojkov-Ivanov, Anita; Budai-Szűcs, Mária; Bóta, Judit; Gáspár, Róbert

2016-01-01

Transdermal electroporation has become one of the most promising noninvasive methods for drug administration, with greatly increased transport of macromolecules through the skin. The cecal-contracting effects of repeated transdermal electroporation delivery and intravenous administration of neostigmine were compared in anesthetized rats. The cecal contractions were detected with implantable strain gauge sensors, and the plasma levels of neostigmine were followed by high-performance liquid chromatography. Both intravenously and EP-administered neostigmine (0.2-66.7 μg/kg) increased the cecal contractions in a dose-dependent manner. For both the low doses and the highest dose, the neostigmine plasma concentrations were the same after the two modes of administration, while an insignificantly higher level was observed at a dose of 20 μg/kg after intravenous administration as compared with the electroporation route. The contractile responses did not differ significantly after the two administration routes. The results suggest that electroporation-delivered neostigmine elicits action equivalent to that observed after intravenous administration as concerning both time and intensity. Electroporation permits the delivery of even lower doses of water-soluble compounds through the skin, which is very promising for clinical practice.

Dose volume assessment of high dose rate 192IR endobronchial implants

International Nuclear Information System (INIS)

Cheng, B. Saw; Korb, Leroy J.; Pawlicki, Todd; Wu, Andrew

1996-01-01

Purpose: To study the dose distributions of high dose rate (HDR) endobronchial implants using the dose nonuniformity ratio (DNR) and three volumetric irradiation indices. Methods and Materials: Multiple implants were configured by allowing a single HDR 192 Ir source to step through a length of 6 cm along an endobronchial catheter. Dwell times were computed to deliver a dose of 5 Gy to points 1 cm away from the catheter axis. Five sets of source configurations, each with different dwell position spacings from 0.5 to 3.0 cm, were evaluated. Three-dimensional (3D) dose distributions were then generated for each source configuration. Differential and cumulative dose-volume curves were generated to quantify the degree of target volume coverage, dose nonuniformity within the target volume, and irradiation of tissues outside the target volume. Evaluation of the implants were made using the DNR and three volumetric irradiation indices. Results: The observed isodose distributions were not able to satisfy all the dose constraints. The ability to optimally satisfy the dose constraints depended on the choice of dwell position spacing and the specification of the dose constraint points. The DNR and irradiation indices suggest that small dwell position spacing does not result in a more homogeneous dose distribution for the implant. This study supports the existence of a relationship between the dwell position spacing and the distance from the catheter axis to the reference dose or dose constraint points. Better dose homogeneity for an implant can be obtained if the spacing of the dwell positions are about twice the distance from the catheter axis to the reference dose or dose constraint points

Thermal neutron dose calculation in synovium membrane for BNCS

International Nuclear Information System (INIS)

Abdalla, Khalid; Naqvi, A.A.; Maalej, N.; El-Shahat, B.

2006-01-01

A D(d,n) reaction based setup has been optimized for Boron Neutron Capture Synovectomy (BNCS). The polyethylene moderator and graphite reflector sizes were optimized to deliver the highest ratio of thermal to fast neutron yield. The neutron dose was calculated at various depths in a knee phantom loaded with boron to determine therapeutic ratios of synovium dose/skin dose and synovium dose/bone dose. Normalized to same boron loading in synovium, the values of the therapeutic ratios obtained in the present study are 12-30 times higher than the published values. (author)

Fetal dose evaluation during breast cancer radiotherapy

International Nuclear Information System (INIS)

Antypas, Christos; Sandilos, Panagiotis; Kouvaris, John; Balafouta, Ersi; Karinou, Eleftheria; Kollaros, Nikos; Vlahos, Lambros

1998-01-01

Purpose: The aim of the work was to estimate the radiation dose delivered to the fetus in a pregnant patient irradiated for breast cancer. Methods and Materials: A 45-year woman was treated for left breast cancer using a 6 MV photon beam with two isocentric opposing tangential unwedged fields. Daily dose was 2.3 Gy at 95% isodose line given by two fields/day, 5 days/week. A total dose of 46 Gy was given in 20 fractions over a 4-week period. Pregnancy confirmed during the second therapeutic week. Treatment lasted between the second and sixth gestation week. Radiation dose to fetus was estimated from in vivo and phantom measurements using thermoluminescence dosimeters and an ionization chamber. In vivo measurements were performed by inserting either a catheter with TL dosimeters or ionization chamber into the patient's rectum. Phantom measurements were performed by simulating the treatment conditions on an anthropomorphic phantom. Results: TLD measurements (in vivo and phantom) revealed fetal dose to be 0.085% of the tumor dose, corresponding to a cumulative fetal dose of 3.9 cGy for the entire treatment of 46 Gy. Chamber measurements (in vivo and phantom) revealed a fetal dose less than the TLD result: 0.079 and 0.083% of the tumor dose corresponding to cumulative fetal dose of 3.6 cGy and 3.8 cGy for in vivo and phantom measurement, respectively. Conclusions: It was concluded that the cumulative dose delivered to the unshielded fetus was 3.9 cGy for a 46 Gy total tumor dose. The estimated fetal dose is low compared to the total tumor dose given due to the early stage of pregnancy, the large distance between fundus-radiation field, and the fact that no wedges and/or lead blocks were used. No deterministic biological effects of radiation on the live-born embryo are expected. The lifetime risk for radiation-induced fatal cancer is higher than the normal incidence, but is considered as inconsequential

Contralateral breast dose from chest wall and breast irradiation: local experience

International Nuclear Information System (INIS)

Alzoubi, A.; Kandaiya, S.; Shukri, A.; Elsherbieny, E.

2010-01-01

Full text: Second cancer induction in the contralateral breast (CB) is an issue of some concern in breast radiotherapy especially for women under the age of 45 years at the time of treatment. The CB dose from 2-field and 3-field techniques in post-mastectomy chest wall irradiations in an anthropomorphic phantom as well as in patients were measured using thermoluminescent dosimeters (TLDs) at the local radiotherapy center. Breast and chest wall radiotherapy treatments were planned conformally (3D-CRT) and delivered using 6-MV photons. The measured CB dose at the surface fell sharply with distance from the field edge. However, the average ratio of the measured to the calculated CB dose using the pencil beam algorithm at the surface was approximately 53%. The mean and median measured internal dose at the posterior border of CB in a phantom was 5.47 ± 0.22 c G y and 5.44 c G y, respectively. The internal CB dose was relatively independent of depth. In the present study the internal CB dose is 2.1-4.1 % of the prescribed dose which is comparable to the values reported by other authors.

Intradermal Inactivated Poliovirus Vaccine: A Preclinical Dose-Finding Study

OpenAIRE

Kouiavskaia, Diana; Mirochnitchenko, Olga; Dragunsky, Eugenia; Kochba, Efrat; Levin, Yotam; Troy, Stephanie; Chumakov, Konstantin

2014-01-01

Intradermal delivery of vaccines has been shown to result in dose sparing. We tested the ability of fractional doses of inactivated poliovirus vaccine (IPV) delivered intradermally to induce levels of serum poliovirus-neutralizing antibodies similar to immunization through the intramuscular route. Immunogenicity of fractional doses of IPV was studied by comparing intramuscular and intradermal immunization of Wistar rats using NanoPass MicronJet600 microneedles. Intradermal delivery of partial...

Conformal intensity-modulated radiotherapy (IMRT) delivered by robotic linac - testing IMRT to the limit?

International Nuclear Information System (INIS)

Webb, S.

1999-01-01

In this paper it is proposed that intensity-modulated radiotherapy (IMRT) could be delivered optimally by a short-length linac mounted on a robotic arm. The robot would allow the linac to 'plant' narrow pencils of photon radiation with any orientation (excluding zones within which the linac and couch might collide) relative to the planning target volume (PTV). The treatment is specified by the trajectory of the robot and by the number of monitor units (MUs) delivered at each robotic orientation. An inverse-planning method to determine the optimum robotic trajectory is presented. It is shown that for complex PTVs, specifically those with concavities in their outline, the conformality of the treatment is improved by the use of a complex trajectory in comparison with a less complex constrained trajectory and this improvement is quantified. It is concluded that robotic linac delivery would lead to a great flexibility in those IMRT treatments requiring very complicated dose distributions with complex 3D shapes. However, even using very fast computers, the goal of determining whether robotic linac delivery is the ultimate IMRT cannot be conclusively reached at present. (author)

Dose sculpting with generalized equivalent uniform dose

International Nuclear Information System (INIS)

Wu Qiuwen; Djajaputra, David; Liu, Helen H.; Dong Lei; Mohan, Radhe; Wu, Yan

2005-01-01

With intensity-modulated radiotherapy (IMRT), a variety of user-defined dose distribution can be produced using inverse planning. The generalized equivalent uniform dose (gEUD) has been used in IMRT optimization as an alternative objective function to the conventional dose-volume-based criteria. The purpose of this study was to investigate the effectiveness of gEUD optimization to fine tune the dose distributions of IMRT plans. We analyzed the effect of gEUD-based optimization parameters on plan quality. The objective was to determine whether dose distribution to selected structures could be improved using gEUD optimization without adversely altering the doses delivered to other structures, as in sculpting. We hypothesized that by carefully defining gEUD parameters (EUD 0 and n) based on the current dose distributions, the optimization system could be instructed to search for alternative solutions in the neighborhood, and we could maintain the dose distributions for structures already satisfactory and improve dose for structures that need enhancement. We started with an already acceptable IMRT plan optimized with any objective function. The dose distribution was analyzed first. For structures that dose should not be changed, a higher value of n was used and EUD 0 was set slightly higher/lower than the EUD value at the current dose distribution for critical structures/targets. For structures that needed improvement in dose, a higher to medium value of n was used, and EUD 0 was set to the EUD value or slightly lower/higher for the critical structure/target at the current dose distribution. We evaluated this method in one clinical case each of head and neck, lung and prostate cancer. Dose volume histograms, isodose distributions, and relevant tolerance doses for critical structures were used for the assessment. We found that by adjusting gEUD optimization parameters, the dose distribution could be improved with only a few iterations. A larger value of n could lead to

Paediatric urological investigations - dose comparison between urology-related and CT irradiation

Energy Technology Data Exchange (ETDEWEB)

Page, Mark; Florescu, Cosmin [Southern Health, Diagnostic Imaging, Melbourne (Australia); Johnstone, Lilian [Monash Children' s Hospital, Department of Paediatrics, Melbourne (Australia); Habteslassie, Daniel [Monash University, Department of Medicine, Melbourne (Australia); Ditchfield, Michael [Southern Health, Diagnostic Imaging, Melbourne (Australia); Monash Children' s Hospital, Diagnostic Imaging, Melbourne (Australia); Monash University, Department of Medicine, Melbourne (Australia)

2013-07-15

Urological investigation in children frequently involves high radiation doses; however, the issue of radiation for these investigations receives little attention compared with CT. To compare the radiation dose from paediatric urological investigations with CT, which is commonly regarded as the more major source of radiation exposure. We conducted a retrospective audit in a tertiary paediatric centre of the number and radiation dose of CT scans, micturating cystourethrography exams and urological nuclear medicine scans from 2006 to 2011. This was compared with radiation doses in the literature and an audit of the frequency of these studies in Australia. The tertiary centre audit demonstrated that the ratio of the frequency of urological to CT examinations was 0.8:1 in children younger than 17 years. The ratio of the radiation dose of urological to CT examinations was 0.7:1. The ratio in children younger than 5 years was 1.9:1. In Australia the frequency of urological procedures compared with CT was 0.4:1 in children younger than 17 years and 3.1:1 in those younger than 5 years. The ratio of radiation-related publications was 1:9 favouring CT. The incidence and radiation dose of paediatric urological studies is comparable to those of CT. Nevertheless the radiation dose of urological procedures receives considerably less attention in the literature. (orig.)

Relationship of dose rate and total dose to responses of continuously irradiated beagles

International Nuclear Information System (INIS)

Fritz, T.E.; Norris, W.P.; Tolle, D.V.; Seed, T.M.; Poole, C.M.; Lombard, L.S.; Doyle, D.E.

1978-01-01

Young-adult beagles were exposed continuously (22 hours/day) to 60 Co γ rays in a specially constructed facility. The exposure rates were either 5, 10, 17, or 35 R/day, and the exposures were terminated at either 600, 1400, 2000, or 4000 R. A total of 354 dogs were irradiated; 221 are still alive as long-term survivors, some after more than 2000 days. The data on survival of these dogs, coupled with data from similar preliminary experiments, allow an estimate of the LD 50 for γ-ray exposures given at a number of exposure rates. They also allow comparison of the relative importance of dose rate and total dose, and the interaction of these two variables, in the early and late effects after protracted irradiation. The LD 50 for the beagle increases from 258 rad delivered at 15 R/minute to approximately 3000 rad at 10 R/day. Over this entire range, the LD 50 is dependent upon hematopoietic damage. At 5 R/day and less, no meaningful LD 50 can be determined; there is nearly normal continued hematopoietic function, survival is prolonged, and the dogs manifest varied individual responses in other organ systems. Although the experiment is not complete, interim data allow several important conclusions. Terminated exposures, while not as effective as radiation continued until death, can produce myelogenous leukemia at the same exposure rate, 10 R/day. More importantly, at the same total accumulated dose, lower exposure rates are more damaging than higher rates on the basis of the rate and degree of hematological recovery that occurs after termination of irradiation. Thus, the rate of hematologic depression, the nadir of the depression, and the rate of recovery are dependent upon exposure rate; the latter is inversely related and the former two are directly related to exposure rate

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

Extracorporeal adsorption therapy: A Method to improve targeted radiation delivered by radiometal-labeled monoclonal antibodies

International Nuclear Information System (INIS)

Nemecek, Eneida R.; Green, Damian J.; Fisher, Darrell R.; Pagal, John M.; Lin, Yukang; Gopal, A. K.; Durack, Lawrence D.; Rajendran, Joseph G.; Wilbur, D. S.; Nilsson, Rune; Sandberg, Bengt; Press, Oliver W.

2008-01-01

Many investigators have demonstrated the ability to treat hematologic malignancies with radiolabeled monoclonal antibodies targeting hematopoietic antigens such as anti-CD20 and anti-CD45. [1-5] Although the remission rates achieved with radioimmunotherapy (RIT) are relatively high, many patients subsequently relapse presumably due to suboptimal delivery of enough radiation to eradicate the malignancy. The dose-response of leukemia and lymphoma to radiation has been proven. Substantial amounts of radiation can be delivered by RIT if followed by hematopoietic cell transplantation to rescue the bone marrow from myeloablation.[ref] However, the maximum dose of RIT that can be used is still limited by toxicity to normal tissues affected by nonspecific delivery of radiation. Efforts to improve RIT focus on improving the therapeutic ratios of radiation in target versus non-target tissues by removing the fraction of radioisotope that fails to bind to target tissues and circulates freely in the bloodstream perfusing non-target tissues. Our group and others have explored several alternatives for removal of unbound circulating antibody. [refs] One such method, extracorporeal adsorption therapy (ECAT) consists of removing unbound antibody by a method similar to plasmapheresis after critical circulation time and distribution of antibody into target tissues have been achieved. Preclinical studies of ECAT in murine xenograft models demonstrated significant improvement in therapeutic ratios of radioactivity. Chen and colleagues demonstrated that a 2-hour ECAT procedure could remove 40 to 70% of the radioactivity from liver, lung and spleen. [ref] Although isotope concentration in the tumor was initially unaffected, a 50% decrease was noted approximately 36 hours after the procedure. This approach was also evaluated in a limited phase I pilot study of patients with refractory B-cell lymphoma. [ref] After radiographic confirmation of tumor localization of a test dose of anti-CD20

Low-Dose, Ionizing Radiation and Age-Related Changes in Skeletal Microarchitecture

Directory of Open Access Journals (Sweden)

Joshua S. Alwood

2012-01-01

Full Text Available Osteoporosis can profoundly affect the aged as a consequence of progressive bone loss; high-dose ionizing radiation can cause similar changes, although less is known about lower doses (≤100 cGy. We hypothesized that exposure to relatively low doses of gamma radiation accelerates structural changes characteristic of skeletal aging. Mice (C57BL/6J-10 wk old, male were irradiated (total body; 0-sham, 1, 10 or 100 cGy 137Cs and tissues harvested on the day of irradiation, 1 or 4 months later. Microcomputed tomography was used to quantify microarchitecture of high turnover, cancellous bone. Irradiation at 100 cGy caused transient microarchitectural changes over one month that were only evident at longer times in controls (4 months. Ex vivo bone cell differentiation from the marrow was unaffected by gamma radiation. In conclusion, acute ionizing gamma irradiation at 100 cGy (but not at 1 cGy or 10 cGy exacerbated microarchitectural changes normally found during progressive, postpubertal aging prior to the onset of age-related osteoporosis.

An absolute dose determination of helical tomotherapy accelerator, TomoTherapy High-Art II

International Nuclear Information System (INIS)

Bailat, Claude J.; Buchillier, Thierry; Pachoud, Marc; Moeckli, Raphaeel; Bochud, Francois O.

2009-01-01

therefore measured the dose using a Farmer-type instrument (model NE 2571) as well. Results: We found the tomotherapy TPR 20,10 value to be around 0.629, which is close to a 4 MV conventional linear accelerator value. During static irradiation, the secondary standard and the alanine dosimeters were compatible within 0.5%. The A1SL relative deviation to the secondary standard was 1.2% and the NE2571 relative deviation to the secondary standard was -1.7%. The measurement in dynamic helical mode found the different dosimeters compatible within 1.4% and the alanine dosimeters and the secondary standard were even found under 0.2%. Conclusions: We found that the different methods are all within uncertainties as well as globally coherent, and the specific limitations of the various dosimeters are discussed in order to help the medical physicist design an independent reference system. We demonstrated that, taking into account the particular reference conditions, one can use an ionization chamber calibrated for conventional linear accelerators to assert the absolute dose delivered by a tomotherapy accelerator.

Estimation of delivered doses to the fetus in a external radiation therapy treatment of megavoltage

International Nuclear Information System (INIS)

Ruggeri, Ricardo M.; Mairal, Liliana; Scarabino, Mara L.; Colombo, Soledad; Sardi, Mabel

2013-01-01

This work, stimulated by the entrance to our radiotherapy service several cases of central nervous system injury in pregnant patients, involves the estimation of doses to the fetus from the comparative analysis and verification of theoretical and experimental data. Um phantom was designed with the pregnant morphology about 28 weeks gestation, with inserts for waterproof ionization chamber in the head and abdominal area. From the scan of the anthropomorphic phantom were reproduced in 3D planner treatments comprised of pregnant patients, estimating the dose in the lesion and at different points in the abdominal area. With the phantom in the beam of radiation treatment conditions were measured with the camera dose at the same points of the abdomen mentioned and the isocenter of the injury. The dose was also measured on surface of the abdominal area with diode array to establish correlation with the measured dose ionization chamber calibrated with water. The work provided medical radiotherapists fundamental experimental data for elevated risk assessment framework for radiation protection of the fetus. It also set the reference calibration for in vivo dosimetry in the abdominal area in pregnant patients treated for external radiotherapy. The results obtained with the implemented dosimetry design will determine the procedures that will form the operating rules institution and thus how professionals working within it

Radiation apparatus with distance mapper for dose control

International Nuclear Information System (INIS)

Saunders, A.M.

1990-01-01

The patent describes apparatus for delivering a radiation dose. It comprises: radiation source means for producing a beam of ionizing gamma ray or x-ray radiation directed so as to deliver a dose of the radiation to an area of a target surface, a light source emitting a light beam in a direction transverse to the direction of the ionizing radiation beam, a photodetector, positioned to receive light scattered from the target surface, means for scanning the light beam over the area of the target surface, means for forming a three-dimensional surface profile map of the area of the target surface without movement of the radiation source means or the light source, and means responsive to the surface profile map for adjusting the dose of radiation from the radiation source over the area of the target surface, so that the radiation source means and the light source may be operated simultaneously

Automatic dispensing of liquid nitrogen in submilliliter doses

Science.gov (United States)

Milner, C. J.

1984-10-01

Well-controlled doses of 0.2 to 0.5 ml of liquid nitrogen are delivered, on electrical signal (not more than once per 5 s), as fills of a miniature bucket raised by an automatic hoist. The bucket is lifted, brimming, from the storage flask and then moved sideways until over the receiver. At this point, a steel ball, which has been resting in and sealing a drain hole in the bucket, is lifted from its seat by a magnet fixed alongside the (now descending) bucket. Design features are outlined: some alternative designs, valving liquid through a short drain tube fixed in the storage flask, are briefly reviewed. In tests the device delivered 74 g (approx. 260 doses) during 63 min, the loss by evaporation meanwhile being 11 g from the bucket, implying a transfer efficiency of 87%. An indirect measure indicated the dose sizes as 354±10 μl approximately.

Assessing doses of radiotherapy with the risk of developing cancer in the head and neck

International Nuclear Information System (INIS)

Yu, Cheng-Ching; Hsu, Fang-Yuh; Yu, Wan-Hsuan; Liu, Mu-Tai; Huang, Sheng-Shien

2011-01-01

Radiation is known to be a major cause of cancer in normal tissue. After treatment with radiotherapy, for young patients or the patients can survive for a long time, the radiation-induced cancer risk is noteworthy. This research investigated the dose delivered by the treatment of intensity modulated radiation therapy (IMRT) for head and neck cancer, such as NPC and oral cancer, and assessed the risk of developing radiation-induced secondary cancer in non-targeted normal tissues. A Rando phantom was used to simulate a patient with NPC or oral cancer, and thermoluminescent dosimeter (TLD) chips were placed inside the phantom to estimate the doses delivered by IMRT. In summary, the risks to patients with NPC was somewhat higher than for those with oral cancer, because the region of the PTV was lower, requiring larger field sizes be used for cases of NPC. The smaller the field size used, the less the risk was of developing secondary cancer. In addition, the higher the value of MU used, the higher the dose delivered to normal tissues was. The risk of radiation-induced secondary cancer was proportional to the delivered dose.

Neutrons in active proton therapy. Parameterization of dose and dose equivalent

Energy Technology Data Exchange (ETDEWEB)

Schneider, Uwe; Haelg, Roger A. [Univ. of Zurich (Switzerland). Dept. of Physics; Radiotherapy Hirslanden AG, Aarau (Switzerland); Lomax, Tony [Paul Scherrer Institute, Villigen (Switzerland). Center for Proton Therapy

2017-08-01

One of the essential elements of an epidemiological study to decide if proton therapy may be associated with increased or decreased subsequent malignancies compared to photon therapy is an ability to estimate all doses to non-target tissues, including neutron dose. This work therefore aims to predict for patients using proton pencil beam scanning the spatially localized neutron doses and dose equivalents. The proton pencil beam of Gantry 1 at the Paul Scherrer Institute (PSI) was Monte Carlo simulated using GEANT. Based on the simulated neutron dose and neutron spectra an analytical mechanistic dose model was developed. The pencil beam algorithm used for treatment planning at PSI has been extended using the developed model in order to calculate the neutron component of the delivered dose distribution for each treated patient. The neutron dose was estimated for two patient example cases. The analytical neutron dose model represents the three-dimensional Monte Carlo simulated dose distribution up to 85 cm from the proton pencil beam with a satisfying precision. The root mean square error between Monte Carlo simulation and model is largest for 138 MeV protons and is 19% and 20% for dose and dose equivalent, respectively. The model was successfully integrated into the PSI treatment planning system. In average the neutron dose is increased by 10% or 65% when using 160 MeV or 177 MeV instead of 138 MeV. For the neutron dose equivalent the increase is 8% and 57%. The presented neutron dose calculations allow for estimates of dose that can be used in subsequent epidemiological studies or, should the need arise, to estimate the neutron dose at any point where a subsequent secondary tumour may occur. It was found that the neutron dose to the patient is heavily increased with proton energy.

Tracking the dose distribution in radiation therapy by accounting for variable anatomy

International Nuclear Information System (INIS)

Schaly, B; Kempe, J A; Bauman, G S; Battista, J J; Van Dyk, J

2004-01-01

The goal of this research is to calculate the daily and cumulative dose distribution received by the radiotherapy patient while accounting for variable anatomy, by tracking the dose distribution delivered to tissue elements (voxels) that move within the patient. Non-linear image registration techniques (i.e., thin-plate splines) are used along with a conventional treatment planning system to combine the dose distributions computed for each 3D computed tomography (CT) study taken during treatment. For a clinical prostate case, we demonstrate that there are significant localized dose differences due to systematic voxel motion in a single fraction as well as in 15 cumulative fractions. The largest positive dose differences in rectum, bladder and seminal vesicles were 29%, 2% and 24%, respectively, after the first fraction of radiation treatment compared to the planned dose. After 15 cumulative fractions, the largest positive dose differences in rectum, bladder and seminal vesicles were 23%, 32% and 18%, respectively, compared to the planned dose. A sensitivity analysis of control point placement is also presented. This method provides an important understanding of actual delivered doses and has the potential to provide quantitative information to use as a guide for adaptive radiation treatments

Correction of conebeam CT values using a planning CT for derivation of the 'dose of the day'

International Nuclear Information System (INIS)

Zijtveld, Mathilda van; Dirkx, Maarten; Heijmen, Ben

2007-01-01

Background and purpose: Verification of the actually delivered 3D dose distribution during each treatment fraction ('dose of the day') is the most complete and clinical relevant 'in-vivo' check of an IMRT treatment. To do this, during patient treatment portal dose images are routinely acquired with our electronic portal imaging device to derive the delivered fluence map for each treatment field. In addition, a conebeam CT scan is acquired just prior to treatment to derive the patient geometry at the time of treatment. However, the use of conebeam CT scans for dose calculation is hampered by inaccuracies in the conversion of CT values to electron densities due to an enlarged scatter contribution. Materials and methods: In this work, a method is described for mapping of Hounsfield Units of the planning CT to the conebeam CT scan, while accounting for non-rigidity in the anatomy, e.g. related to weight loss, in an approximate way. The method was validated for head and neck cancer patients by comparing dose distributions calculated using adjusted Hounsfield Units with a golden standard. Results and conclusions: The observed dose differences were less than 1% in the majority of points, and in at least 96% of the points a 3D γ analysis resulted in γ values of less than 1 when applying a 2%/2 mm criterion, showing that this straightforward approach allows for an accurate dose calculation based on conebeam CT scans

Optimisation and evaluation of the foetal dose during a radiotherapy of the right parotid

International Nuclear Information System (INIS)

Marchesi, V.; Noel, A.; Graff, P.; Beckendorf, V.; Peiffert, D.; Noel, A.

2008-01-01

Purpose was to optimize and to estimate the dose delivered to the foetus during a postoperative irradiation of a 5-month twin pregnant woman presenting with adenocarcinoma of the right parotid. The treatment protocol aimed to deliver 66 Gy conformal radiation therapy on the tumour bed associated to a prophylactic irradiation of 50 Gy on the upper cervical nodes. A series of measurements allowed to estimate the delivered dose in the abdomen by the means of an ion chamber inserted in a water phantom placed side by side of an anthropomorphic Alderson Rando phantom simulating the body of the patient from the head to the pelvis. An appropriate optimisation of the number and orientation of beams were performed in order to minimize the peripheral dose, which is mostly dependent of the total number of monitor unit per fraction: cervical nodes and tumour site included in the same fields, limitation of the irradiated volume, 6 MV X-ray beams rather than Cobalt beams. The measured doses at the upper, in the middle and at the lower part of the abdomen were 17.0, 11.0 and 11.9 mGy, respectively, for the entire treatment, representing 0.025, 0.016 and 0.017%, respectively of the prescribed dose. The actions conducted to optimise the treatment allowed to lower doses delivered to the foetus under the limits proposed by international recommendations (100 mGy). Thus, the treatment of the pregnant patient had been performed with a minimized risk for the foetus. (authors)

Dosimetry in high dose rate endoluminal brachytherapy

International Nuclear Information System (INIS)

Uno, Takashi; Kotaka, Kikuo; Itami, Jun

1994-01-01

In endoluminal brachytherapy for the tracheobronchial tree, esophagus, and bile duct, a reference point for dose calculation has been often settled at 1 cm outside from the middle of source travel path. In the current study, a change in the ratio of the reference point dose on the convex to concave side (Dq/Dp) was calculated, provided the source travel path bends as is the case in most endoluminal brachytherapies. Point source was presumed to move stepwise at 1 cm interval from 4 to 13 locations. Retention time at each location was calculated by personal computer so as to deliver equal dose at 1 cm from the linear travel path. With the retention time remaining constant, the change of Dq/Dp was assessed by bending the source travel path. Results indicated that the length of the source travel path and radius of its curve influenced the pattern of change in Dq/Dp. Therefore, it was concluded that the difference in reference dose on the convex and concave side of the curved path is not negligible under certain conditions in endoluminal brachytherapy. In order to maintain the ratio more than 0.9, relatively greater radius was required when the source travel path was decreased. (author)

SU-E-T-802: Verification of Implanted Cardiac Pacemaker Doses in Intensity-Modulated Radiation Therapy: Dose Prediction Accuracy and Reduction Effect of a Lead Sheet

Energy Technology Data Exchange (ETDEWEB)

Lee, J [Dept. of Radiation Oncology, Konkuk University Medical Center, Seoul (Korea, Republic of); Chung, J [Dept. of Radiation Oncology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

2015-06-15

Purpose: To verify delivered doses on the implanted cardiac pacemaker, predicted doses with and without dose reduction method were verified using the MOSFET detectors in terms of beam delivery and dose calculation techniques in intensity-modulated radiation therapy (IMRT). Methods: The pacemaker doses for a patient with a tongue cancer were predicted according to the beam delivery methods [step-and-shoot (SS) and sliding window (SW)], intensity levels for dose optimization, and dose calculation algorithms. Dosimetric effects on the pacemaker were calculated three dose engines: pencil-beam convolution (PBC), analytical anisotropic algorithm (AAA), and Acuros-XB. A lead shield of 2 mm thickness was designed for minimizing irradiated doses to the pacemaker. Dose variations affected by the heterogeneous material properties of the pacemaker and effectiveness of the lead shield were predicted by the Acuros-XB. Dose prediction accuracy and the feasibility of the dose reduction strategy were verified based on the measured skin doses right above the pacemaker using mosfet detectors during the radiation treatment. Results: The Acuros-XB showed underestimated skin doses and overestimated doses by the lead-shield effect, even though the lower dose disagreement was observed. It led to improved dose prediction with higher intensity level of dose optimization in IMRT. The dedicated tertiary lead sheet effectively achieved reduction of pacemaker dose up to 60%. Conclusion: The current SS technique could deliver lower scattered doses than recommendation criteria, however, use of the lead sheet contributed to reduce scattered doses.Thin lead plate can be a useful tertiary shielder and it could not acuse malfunction or electrical damage of the implanted pacemaker in IMRT. It is required to estimate more accurate scattered doses of the patient with medical device to design proper dose reduction strategy.

SU-E-T-802: Verification of Implanted Cardiac Pacemaker Doses in Intensity-Modulated Radiation Therapy: Dose Prediction Accuracy and Reduction Effect of a Lead Sheet

International Nuclear Information System (INIS)

Lee, J; Chung, J

2015-01-01

Purpose: To verify delivered doses on the implanted cardiac pacemaker, predicted doses with and without dose reduction method were verified using the MOSFET detectors in terms of beam delivery and dose calculation techniques in intensity-modulated radiation therapy (IMRT). Methods: The pacemaker doses for a patient with a tongue cancer were predicted according to the beam delivery methods [step-and-shoot (SS) and sliding window (SW)], intensity levels for dose optimization, and dose calculation algorithms. Dosimetric effects on the pacemaker were calculated three dose engines: pencil-beam convolution (PBC), analytical anisotropic algorithm (AAA), and Acuros-XB. A lead shield of 2 mm thickness was designed for minimizing irradiated doses to the pacemaker. Dose variations affected by the heterogeneous material properties of the pacemaker and effectiveness of the lead shield were predicted by the Acuros-XB. Dose prediction accuracy and the feasibility of the dose reduction strategy were verified based on the measured skin doses right above the pacemaker using mosfet detectors during the radiation treatment. Results: The Acuros-XB showed underestimated skin doses and overestimated doses by the lead-shield effect, even though the lower dose disagreement was observed. It led to improved dose prediction with higher intensity level of dose optimization in IMRT. The dedicated tertiary lead sheet effectively achieved reduction of pacemaker dose up to 60%. Conclusion: The current SS technique could deliver lower scattered doses than recommendation criteria, however, use of the lead sheet contributed to reduce scattered doses.Thin lead plate can be a useful tertiary shielder and it could not acuse malfunction or electrical damage of the implanted pacemaker in IMRT. It is required to estimate more accurate scattered doses of the patient with medical device to design proper dose reduction strategy

A scintillating GEM detector for 2D dose imaging in hadron therapy

NARCIS (Netherlands)

Seravalli, E.

2008-01-01

The main aim of radiotherapy techniques is to deliver the dose to the target volume while sparing as much as possible the healthy tissue. Dose verifications prior the treatment of the patient are mandatory in order to guarantee high accuracy to the treatment. We have developed a 2D dose imaging

Investigation of polymer composite for high dose dosimetry

Energy Technology Data Exchange (ETDEWEB)

Pereira, E.L.M.; Batista, A.S.M., E-mail: adriananuclear@yahoo.com.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil); Ribeiro, F.A.S.; Santos, A.P.; Faria, L.O.; Oliveira, A.H. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

2017-07-01

Introduction: This paper presents the efficacy evaluation of PVDF and nanocomposites of the PVDF films for high gamma dosimetry. Our scope in this first part of our studies is the selection of the most promising film for future dosimetry trials, where the proportionality of response of the selected material will be investigated over a large range of doses and dose rates. Methods: Was prepared nanocomposites made by mixing Poly(vinylidene fluoride) (PVDF), zirconium oxide (ZrO{sub 2}) and multi-walled carbon nanotubes (MWCNTs) aiming to find dosimetric properties for applications in high dose dosimetry. The samples were irradiated with a Co-60 source at constant dose rate (16.7 kGy/h), with doses ranging from 100 to 2750 kGy. The UV-Vis and FTIR spectrophotometry have been used to monitor the appearing of C=C conjugated bonds and radio-oxidation of carbon (C=O). Results: FTIR spectrometry has that the absorbance intensities at 1715 cm{sup -1} and 1730 cm{sup -1} can be used for high dosimetry purposes for gamma doses ranging from 400 to 2750 kGy. In this range, it is possible to observe a linear relationship between Abs & Dose. Fading of signal was evaluated for one month and reproducibility in 2000 kGy dose. Conclusion: FTIR spectroscopic data revealed two optical absorption bands at 1715 cm{sup -1} and 1730 cm{sup -1} whose intensities are unambiguously related to gamma delivered dose ranging from 400 kGy to 2750 kGy. (author)

Dose rate to the inner ear during Moessbauer experiments

International Nuclear Information System (INIS)

Kliauga, P.; Khanna, S.M.

1983-01-01

The most widely used technique for studying vibrations of the inner ear utilises the Moessbauer effect; this requires placement of a radioactive source on the basilar membrane. This source, although small in size and less than 37 MBq(1 mCi) in strength, is placed in close proximity to sensitive receptor cells. Using a series solution for the radiation field of a rectangular source the absorbed dose rate delivered to receptor cells at various depths and at points off-axis from the centre of the source is calculated. It is concluded that the dose delivered during the course of a Moessbauer experiment may well be sufficient to damage receptor cells and cause a loss of response. (author)

The relative biological effectiveness of radiations of different quality

International Nuclear Information System (INIS)

Anon.

1990-01-01

This paper is a review of the literature relevant to the selection of relative biological effectiveness (RBE) values for use in arriving at values of the quality factor (Q). Emphasis is placed on response to small ( M . In a wide variety of systems, the RBE M for fast (fission) neutrons, with low doses and dose rates, appears to be of the order of 20 or more compared to moderately filtered 250 kVp x rays and 40 or more compared to higher energy gamma rays. These values, which are much larger than those observed with large doses delivered at high dose rates, are due mainly, but not entirely, to a decrease in the slope of the curve for the ow-LET reference radiation at low dose

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.)

Influence of radiation-dose pattern from inhaled beta--gamma-emitting radionuclides on canine peripheral lymphocytes

International Nuclear Information System (INIS)

Jones, R.K.; Boecker, B.B.; Pickrell, J.A.; Hobbs, C.H.; McClellan, R.O.

1976-01-01

As part of studies assess the biological hazards associated with inhaled radionuclides, periodic hematologic evaluations were performed on beagle dogs given a single nose-only exposure to aerosols of beta--gamma-emitting isotopes. The physical form and specific radionuclides selected produced radiation-dose patterns representative of those which might be encountered in the event of human accidental exposures. Dogs received graded lung burdens of either 90 Y, 91 Y, 144 Ce, or 90 Sr, each in fused clay. Differences in the effective half-lives of these radionuclides resulted in a spectrum of cumulative radiation doses to lung delivered at a variety of dose rates. Since the form in which the radionuclides were inhaled was relatively insoluble, the lung and intrathoracic tissues represented the primary recipient of the dose. Regardless of the effective half-life of radionuclide retention, a dose-related depression of peripheral lymphocytes was observed at various times after inhalation exposure. The time at which maximum depression and subsequent recovery occurred, however, was most directly related to the effective half-life of the radionuclide. Of special interest was the persistence of lymphopenia through 2 1 / 2 years after exposure to 144 Ce and 90 Sr in fused clay where, other than tracheobronchial lymph nodes, the lymphoid tissue received very little radiation dose. The possible mechanisms responsible for lymphocyte depression from these various radiation-dose patterns are discussed

Factors affecting radiation doses from dedicated rail transport of spent reactor fuel

International Nuclear Information System (INIS)

Martin, J.E.

1988-01-01

This paper reports there are two exposure control concerns associated with the shipment of spent reactor fuel in dedicated trains -- compliance with transportation regulations for maximum allowable radiation levels, and minimizing the dose received by the general public. This article examines the methods used to calculate the dose equivalent rates alongside stationary (transport regulations) and moving trains (public exposure) of various lengths. The factors examined include the source term, the effect of overlapping radiation fields, the speed of the train, and the location of the population relative to the train. Trains made up of series of cars that individually meet transport regulations can, as a whole, exceed transport vehicle dose equivalent rate limits by up to 23% due to overlapping radiation fields. For moving trains and the worst case analyzed -- a person located 20 feet from the tracks and a train speed of 5 mph --- 141 rail cars would have to pass by to deliver a dose equivalent of 1 mrem

Radiation Dose to the Esophagus From Breast Cancer Radiation Therapy, 1943-1996: An International Population-Based Study of 414 Patients

International Nuclear Information System (INIS)

Lamart, Stephanie; Stovall, Marilyn; Simon, Steven L.; Smith, Susan A.; Weathers, Rita E.; Howell, Rebecca M.; Curtis, Rochelle E.; Aleman, Berthe M.P.; Travis, Lois; Kwon, Deukwoo; Morton, Lindsay M.

2013-01-01

Purpose: To provide dosimetric data for an epidemiologic study on the risk of second primary esophageal cancer among breast cancer survivors, by reconstructing the radiation dose incidentally delivered to the esophagus of 414 women treated with radiation therapy for breast cancer during 1943-1996 in North America and Europe. Methods and Materials: We abstracted the radiation therapy treatment parameters from each patient’s radiation therapy record. Treatment fields included direct chest wall (37% of patients), medial and lateral tangentials (45%), supraclavicular (SCV, 64%), internal mammary (IM, 44%), SCV and IM together (16%), axillary (52%), and breast/chest wall boosts (7%). The beam types used were 60 Co (45% of fields), orthovoltage (33%), megavoltage photons (11%), and electrons (10%). The population median prescribed dose to the target volume ranged from 21 Gy to 40 Gy. We reconstructed the doses over the length of the esophagus using abstracted patient data, water phantom measurements, and a computational model of the human body. Results: Fields that treated the SCV and/or IM lymph nodes were used for 85% of the patients and delivered the highest doses within 3 regions of the esophagus: cervical (population median 38 Gy), upper thoracic (32 Gy), and middle thoracic (25 Gy). Other fields (direct chest wall, tangential, and axillary) contributed substantially lower doses (approximately 2 Gy). The cervical to middle thoracic esophagus received the highest dose because of its close proximity to the SCV and IM fields and less overlying tissue in that part of the chest. The location of the SCV field border relative to the midline was one of the most important determinants of the dose to the esophagus. Conclusions: Breast cancer patients in this study received relatively high incidental radiation therapy doses to the esophagus when the SCV and/or IM lymph nodes were treated, whereas direct chest wall, tangentials, and axillary fields contributed lower doses

Radiation dose to the esophagus from breast cancer radiation therapy, 1943-1996: an international population-based study of 414 patients.

Science.gov (United States)

Lamart, Stephanie; Stovall, Marilyn; Simon, Steven L; Smith, Susan A; Weathers, Rita E; Howell, Rebecca M; Curtis, Rochelle E; Aleman, Berthe M P; Travis, Lois; Kwon, Deukwoo; Morton, Lindsay M

2013-07-15

To provide dosimetric data for an epidemiologic study on the risk of second primary esophageal cancer among breast cancer survivors, by reconstructing the radiation dose incidentally delivered to the esophagus of 414 women treated with radiation therapy for breast cancer during 1943-1996 in North America and Europe. We abstracted the radiation therapy treatment parameters from each patient's radiation therapy record. Treatment fields included direct chest wall (37% of patients), medial and lateral tangentials (45%), supraclavicular (SCV, 64%), internal mammary (IM, 44%), SCV and IM together (16%), axillary (52%), and breast/chest wall boosts (7%). The beam types used were (60)Co (45% of fields), orthovoltage (33%), megavoltage photons (11%), and electrons (10%). The population median prescribed dose to the target volume ranged from 21 Gy to 40 Gy. We reconstructed the doses over the length of the esophagus using abstracted patient data, water phantom measurements, and a computational model of the human body. Fields that treated the SCV and/or IM lymph nodes were used for 85% of the patients and delivered the highest doses within 3 regions of the esophagus: cervical (population median 38 Gy), upper thoracic (32 Gy), and middle thoracic (25 Gy). Other fields (direct chest wall, tangential, and axillary) contributed substantially lower doses (approximately 2 Gy). The cervical to middle thoracic esophagus received the highest dose because of its close proximity to the SCV and IM fields and less overlying tissue in that part of the chest. The location of the SCV field border relative to the midline was one of the most important determinants of the dose to the esophagus. Breast cancer patients in this study received relatively high incidental radiation therapy doses to the esophagus when the SCV and/or IM lymph nodes were treated, whereas direct chest wall, tangentials, and axillary fields contributed lower doses. Published by Elsevier Inc.

Radiation Dose to the Esophagus From Breast Cancer Radiation Therapy, 1943-1996: An International Population-Based Study of 414 Patients

Energy Technology Data Exchange (ETDEWEB)

Lamart, Stephanie, E-mail: stephanie.lamart@nih.gov [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Stovall, Marilyn [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Simon, Steven L. [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Smith, Susan A.; Weathers, Rita E.; Howell, Rebecca M. [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Curtis, Rochelle E. [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States); Aleman, Berthe M.P. [Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam (Netherlands); Travis, Lois [Rubin Center for Cancer Survivorship and Department of Radiation Oncology, University of Rochester Medical Center, Rochester, New York (United States); Kwon, Deukwoo [Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida (United States); Morton, Lindsay M. [Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland (United States)

2013-07-15

Purpose: To provide dosimetric data for an epidemiologic study on the risk of second primary esophageal cancer among breast cancer survivors, by reconstructing the radiation dose incidentally delivered to the esophagus of 414 women treated with radiation therapy for breast cancer during 1943-1996 in North America and Europe. Methods and Materials: We abstracted the radiation therapy treatment parameters from each patient’s radiation therapy record. Treatment fields included direct chest wall (37% of patients), medial and lateral tangentials (45%), supraclavicular (SCV, 64%), internal mammary (IM, 44%), SCV and IM together (16%), axillary (52%), and breast/chest wall boosts (7%). The beam types used were {sup 60}Co (45% of fields), orthovoltage (33%), megavoltage photons (11%), and electrons (10%). The population median prescribed dose to the target volume ranged from 21 Gy to 40 Gy. We reconstructed the doses over the length of the esophagus using abstracted patient data, water phantom measurements, and a computational model of the human body. Results: Fields that treated the SCV and/or IM lymph nodes were used for 85% of the patients and delivered the highest doses within 3 regions of the esophagus: cervical (population median 38 Gy), upper thoracic (32 Gy), and middle thoracic (25 Gy). Other fields (direct chest wall, tangential, and axillary) contributed substantially lower doses (approximately 2 Gy). The cervical to middle thoracic esophagus received the highest dose because of its close proximity to the SCV and IM fields and less overlying tissue in that part of the chest. The location of the SCV field border relative to the midline was one of the most important determinants of the dose to the esophagus. Conclusions: Breast cancer patients in this study received relatively high incidental radiation therapy doses to the esophagus when the SCV and/or IM lymph nodes were treated, whereas direct chest wall, tangentials, and axillary fields contributed lower

Inactivated poliovirus type 2 vaccine delivered to rat skin via high density microprojection array elicits potent neutralising antibody responses.

Science.gov (United States)

Muller, David A; Pearson, Frances E; Fernando, Germain J P; Agyei-Yeboah, Christiana; Owens, Nick S; Corrie, Simon R; Crichton, Michael L; Wei, Jonathan C J; Weldon, William C; Oberste, M Steven; Young, Paul R; Kendall, Mark A F

2016-02-25

Polio eradication is progressing rapidly, and the live attenuated Sabin strains in the oral poliovirus vaccine (OPV) are being removed sequentially, starting with type 2 in April 2016. For risk mitigation, countries are introducing inactivated poliovirus vaccine (IPV) into routine vaccination programs. After April 2016, monovalent type 2 OPV will be available for type 2 outbreak control. Because the current IPV is not suitable for house-to-house vaccination campaigns (the intramuscular injections require health professionals), we developed a high-density microprojection array, the Nanopatch, delivered monovalent type 2 IPV (IPV2) vaccine to the skin. To assess the immunogenicity of the Nanopatch, we performed a dose-matched study in rats, comparing the immunogenicity of IPV2 delivered by intramuscular injection or Nanopatch immunisation. A single dose of 0.2 D-antigen units of IPV2 elicited protective levels of poliovirus antibodies in 100% of animals. However, animals receiving IPV2 by IM required at least 3 immunisations to reach the same neutralising antibody titres. This level of dose reduction (1/40th of a full dose) is unprecedented for poliovirus vaccine delivery. The ease of administration coupled with the dose reduction observed in this study points to the Nanopatch as a potential tool for facilitating inexpensive IPV for mass vaccination campaigns.

Time and dose-related changes in the thickness of pig skin after irradiation with single doses of [sup 90]Sr/[sup 90]Y [beta]-rays

Energy Technology Data Exchange (ETDEWEB)

Rezvani, M.; Hamlet, R.; Hopewell, J.W.; Sieber, V.K. (Churchill Hospital, Oxford (United Kingdom))

1994-04-01

Time-related changes in pig skin thickness have been evaluated using a non-invasive ultrasound technique after exposure to a range of single doses of [sup 90]Sr/[sup 90]Yr [beta]-rays. The reduction in relative skin thickness developed in two distinct phases: the first was between 12 and 20 weeks postirradiation. No further changes were then seen until 52 weeks postirradiation when a second phase of skin thinning was observed. This was complete after 76 weeks and no further changes in relative skin thickness were seen in the maximum follow up period of 129 weeks. The timings of these phases of damage were independent of the radiation dose, however, the severity of both phases of radiation-induced skin thinning were dose related. (Author).

Radiation therapy and concurrent fixed dose amifostine with escalating doses of twice-weekly gemcitabine in advanced pancreatic cancer

International Nuclear Information System (INIS)

Yavuz, A. Aydin; Aydin, Fazil; Yavuz, Melek N.; Ilis, Esra; Ozdemir, Feyyaz

2001-01-01

Purpose: To determine the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of twice-weekly gemcitabine (TW-G) when administered in conjunction with fixed dose amifostine (A) during external radiotherapy (RT) in patients with advanced pancreatic cancer. Methods and Materials: Ten patients with previously untreated, locally advanced, or asymptomatic-metastatic pancreatic adenocarcinoma were enrolled in this study. RT was delivered by using the standard four-field technique (1.8 Gy daily fractions, 45 Gy followed by a boost of 5.4 Gy, in 5-1/2 weeks). The starting dose of TW-G was 60 mg/m 2 (i.v., 30-min infusion), which is equal to the upper limit of previously reported MTD of TW-G when given without A during RT. A was given just before the TW-G, at a fixed dose of 340 mg/m 2 (i.v., rapid infusion). TW-G doses were escalated by 30-mg/m 2 increments in successive cohorts of 3 to 6 additional patients until DLT was observed. Toxicities were graded using the Radiation Therapy Oncology Group and National Cancer Institute Common Toxicity Criteria, version 2.0. Results: In general, therapy was well tolerated in patients treated at the first two dose levels of 60 mg/m 2 and 90 mg/m 2 . The DLT of TW-G given in conjunction with A during RT were neutropenia, thrombocytopenia, and nausea/vomiting at the dose level of 120 mg/m 2 . Of the 10 patients eligible for a median follow-up of 10 months, 5 remain alive; 1 complete responder, 3 partial responders, and 1 with stable disease. Conclusion: A dose of TW-G at a level of 90 mg/m 2 produced tolerable toxicity and it may possess significant activity when delivered in conjunction with 340 mg/m 2 dose of A during RT of the upper abdomen. Due to the higher MTD of TW-G seen in our study, we consider that the A supplementation may optimize the therapeutic index of TW-G-based chemoradiotherapy protocols in patients with pancreatic carcinoma

Procedure for the delivering of personal short-term visitor dosimeters

CERN Document Server

2016-01-01

Update of the administrative procedure for delivering a personal short-term visitor dosimeter to associated members of CERN’s personnel.   Associated members of the CERN personnel may request a short term visitor dosimeter if working only in Supervised Radiation Areas and for a period of less than two months in a calendar year. Such a dosimeter is delivered without the need to provide the usual regular documents: radiation passport, certificate from the home institute or medical certificate. Periodic verification will ensure that holders of these personal dosimeters do not exceed the maximum allowed personal dose for this type of dosimeter, which is the same as the limit for members of the public at 1 mSv per year. From now on, the two-month period can be spread over a calendar year, offering greater flexibility to users coming to CERN for multiple short periods. Please return unused dosimeters Persons leaving CERN for a period of more than one month should return their dosimeter to the D...

Evaluation of delivered monitor unit accuracy of gated step-and-shoot IMRT using a two-dimensional detector array

Energy Technology Data Exchange (ETDEWEB)

Cheong, Kwang-Ho; Kang, Sei-Kwon; Lee, MeYeon; Kim, Su SSan; Park, SoAh; Hwang, Tae-Jin; Kim, Kyoung Ju; Oh, Do Hoon; Bae, Hoonsik; Suh, Tae-Suk [Department of Radiation Oncology, Hallym University College of Medicine, Seoul, 431070 (Korea, Republic of) and Department of Biomedical Engineering, College of Medicine, Catholic University of Korea, Seoul 137701 (Korea, Republic of); Department of Radiation Oncology, Hallym University College of Medicine, Seoul 431070 (Korea, Republic of); Department of Biomedical Engineering, College of Medicine, Catholic University of Korea, Seoul 137701 (Korea, Republic of)

2010-03-15

Purpose: To overcome the problem of organ motion in intensity-modulated radiation therapy (IMRT), gated IMRT is often used for the treatment of lung cancer. In this study, the authors investigated the accuracy of the delivered monitor units (MUs) from each segment during gated IMRT using a two-dimensional detector array for user-specific verification purpose. Methods: The authors planned a 6 MV photon, seven-port step-and-shoot lung IMRT delivery. The respiration signals for gated IMRT delivery were obtained from the one-dimensional moving phantom using the real-time position management (RPM) system (Varian Medical Systems, Palo Alto, CA). The beams were delivered using a Clinac iX (Varian Medical Systems, Palo Alto, CA) with the Millennium 120 MLC. The MatriXX (IBA Dosimetry GmbH, Germany) was validated through consistency and reproducibility tests as well as comparison with measurements from a Farmer-type ion chamber. The authors delivered beams with varying dose rates and duty cycles and analyzed the MatriXX data to evaluate MU delivery accuracy. Results: There was quite good agreement between the planned segment MUs and the MUs computed from the MatriXX within {+-}2% error. The beam-on times computed from the MatriXX data were almost identical for all cases, and they matched well with the RPM beam-on and beam-off signals. A slight difference was observed between them, but it was less than 40 ms. The gated IMRT delivery demonstrated an MU delivery accuracy that was equivalent to ungated IMRT, and the delivered MUs with a gating signal agreed with the planned MUs within {+-}0.5 MU regardless of dose rate and duty cycle. Conclusions: The authors can conclude that gated IMRT is able to deliver an accurate dose to a patient during a procedure. The authors believe that the methodology and results can be transferred to other vendors' devices, particularly those that do not provide MLC log data for a verification purpose.

Pharmacokinetics of heparin and related polysaccharides

International Nuclear Information System (INIS)

Boneu, B.; Dol, F.; Caranobe, C.; Sie, P.; Houin, G.

1989-01-01

The pharmacodynamic profile of standard heparin (SH), a low molecular weight derivative (CY 216) and of dermatan sulfate (DS), a new potential antithrombotic drug, was investigated in the rabbit over a large range of doses. After bolus i.v. injection of low doses, the biological activity of SH disappeared exponentially; however, its half-life was prolonged when the dose injected increased, and over 158 micrograms/kg (100 anti-factor Xa U/kg) the biological activity disappeared as a concave-convex curve. CY 216 disappeared more slowly than SH at low doses but faster than SH at higher doses. More than 90% of the DS biological activity present 1 minute after the i.v. injection disappeared exponentially without dose-dependent effects. Increasing doses of the three drugs were then delivered for 5 h under continuous infusions. Below 500 micrograms/kg/h the DS and CY 216 plateau concentrations were higher than that of SH while above this dose the SH concentration was higher than that of DS and CY 216. These observations may be explained by the results of pharmacokinetics experiments where 125 I-labeled compounds were delivered by bolus i.v. injection in association with increasing doses of their unlabeled counterparts. For SH there was a 10-fold difference between the half-life of the lower dose (32 micrograms/kg or 5 anti-factor Xa U/kg) and that of the higher dose (3200 micrograms/kg); it was demonstrated that the half-life of SH continuously shortened as its plasma concentration decreased. In contrast the CY 216 and DS half-lives were very close, independent of the dose delivered, and therefore longer than that of SH at low doses and shorter than that of SH at higher doses

Analysis of Cumulative Dose to Implanted Pacemaker According to Various IMRT Delivery Methods: Optimal Dose Delivery Versus Dose Reduction Strategy

Energy Technology Data Exchange (ETDEWEB)

Lee, Jeong Woo; Hong, Se Mie [Dept. of Radiation Oncology, Konkuk University Medical Center, Seoul (Korea, Republic of)

2011-11-15

Cancer patients with implanted cardiac pacemaker occasionally require radiotherapy. Pacemaker may be damaged or malfunction during radiotherapy due to ionizing radiation or electromagnetic interference. Although radiotherapy should be planned to keep the dose to pacemaker as low as possible not to malfunction ideally, current radiation treatment planning (RTP) system does not accurately calculate deposited dose to adjacent field border or area beyond irradiated fields. In terms of beam delivery techniques using multiple intensity modulated fields, dosimetric effect of scattered radiation in high energy photon beams is required to be detailed analyzed based on measurement data. The aim of this study is to evaluate dose discrepancies of pacemaker in a RTP system as compared to measured doses. We also designed dose reduction strategy limited value of 2 Gy for radiation treatment patients with cardiac implanted pacemaker. Total accumulated dose of 145 cGy based on in-vivo dosimetry was satisfied with the recommendation criteria to prevent malfunction of pacemaker in SS technique. However, the 2 mm lead shielder enabled the scattered doses to reduce up to 60% and 40% in the patient and the phantom, respectively. The SS technique with the lead shielding could reduce the accumulated scattered doses less than 100 cGy. Calculated and measured doses were not greatly affected by the beam delivery techniques. In-vivo and measured doses on pacemaker position showed critical dose discrepancies reaching up to 4 times as compared to planned doses in RTP. The current SS technique could deliver lower scattered doses than recommendation criteria, but use of 2 mm lead shielder contributed to reduce scattered doses by 60%. The tertiary lead shielder can be useful to prevent malfunction or electrical damage of implanted pacemakers during radiotherapy. It is required to estimate more accurate scattered doses of the patient or medical device in RTP to design proper dose reduction strategy.

Analysis of Cumulative Dose to Implanted Pacemaker According to Various IMRT Delivery Methods: Optimal Dose Delivery Versus Dose Reduction Strategy

International Nuclear Information System (INIS)

Lee, Jeong Woo; Hong, Se Mie

2011-01-01

Cancer patients with implanted cardiac pacemaker occasionally require radiotherapy. Pacemaker may be damaged or malfunction during radiotherapy due to ionizing radiation or electromagnetic interference. Although radiotherapy should be planned to keep the dose to pacemaker as low as possible not to malfunction ideally, current radiation treatment planning (RTP) system does not accurately calculate deposited dose to adjacent field border or area beyond irradiated fields. In terms of beam delivery techniques using multiple intensity modulated fields, dosimetric effect of scattered radiation in high energy photon beams is required to be detailed analyzed based on measurement data. The aim of this study is to evaluate dose discrepancies of pacemaker in a RTP system as compared to measured doses. We also designed dose reduction strategy limited value of 2 Gy for radiation treatment patients with cardiac implanted pacemaker. Total accumulated dose of 145 cGy based on in-vivo dosimetry was satisfied with the recommendation criteria to prevent malfunction of pacemaker in SS technique. However, the 2 mm lead shielder enabled the scattered doses to reduce up to 60% and 40% in the patient and the phantom, respectively. The SS technique with the lead shielding could reduce the accumulated scattered doses less than 100 cGy. Calculated and measured doses were not greatly affected by the beam delivery techniques. In-vivo and measured doses on pacemaker position showed critical dose discrepancies reaching up to 4 times as compared to planned doses in RTP. The current SS technique could deliver lower scattered doses than recommendation criteria, but use of 2 mm lead shielder contributed to reduce scattered doses by 60%. The tertiary lead shielder can be useful to prevent malfunction or electrical damage of implanted pacemakers during radiotherapy. It is required to estimate more accurate scattered doses of the patient or medical device in RTP to design proper dose reduction strategy.

Parameterization of solar flare dose

International Nuclear Information System (INIS)

Lamarche, A.H.; Poston, J.W.

1996-01-01

A critical aspect of missions to the moon or Mars will be the safety and health of the crew. Radiation in space is a hazard for astronauts, especially high-energy radiation following certain types of solar flares. A solar flare event can be very dangerous if astronauts are not adequately shielded because flares can deliver a very high dose in a short period of time. The goal of this research was to parameterize solar flare dose as a function of time to see if it was possible to predict solar flare occurrence, thus providing a warning time. This would allow astronauts to take corrective action and avoid receiving a dose greater than the recommended limit set by the National Council on Radiation Protection and Measurements (NCRP)

Cardiac Toxicity After Radiotherapy for Stage III Non–Small-Cell Lung Cancer: Pooled Analysis of Dose-Escalation Trials Delivering 70 to 90 Gy

Science.gov (United States)

Eblan, Michael J.; Deal, Allison M.; Lipner, Matthew; Zagar, Timothy M.; Wang, Yue; Mavroidis, Panayiotis; Lee, Carrie B.; Jensen, Brian C.; Rosenman, Julian G.; Socinski, Mark A.; Stinchcombe, Thomas E.; Marks, Lawrence B.

2017-01-01

Purpose The significance of radiotherapy (RT) –associated cardiac injury for stage III non–small-cell lung cancer (NSCLC) is unclear, but higher heart doses were associated with worse overall survival in the Radiation Therapy Oncology Group (RTOG) 0617 study. We assessed the impact of heart dose in patients treated at our institution on several prospective dose-escalation trials. Patients and Methods From 1996 to 2009, 127 patients with stage III NSCLC (Eastern Cooperative Oncology Group performance status, 0 to 1) received dose-escalated RT to 70 to 90 Gy (median, 74 Gy) in six trials. RT plans and cardiac doses were reviewed. Records were reviewed for the primary end point: symptomatic cardiac events (symptomatic pericardial effusion, acute coronary syndrome, pericarditis, significant arrhythmia, and heart failure). Cardiac risk was assessed by noting baseline coronary artery disease and calculating the WHO/International Society of Hypertension score. Competing risks analysis was used. Results In all, 112 patients were analyzed. Median follow-up for surviving patients was 8.8 years. Twenty-six patients (23%) had one or more events at a median of 26 months to first event (effusion [n = 7], myocardial infarction [n = 5], unstable angina [n = 3], pericarditis [n = 2], arrhythmia [n = 12], and heart failure [n = 1]). Heart doses (eg, heart mean dose; hazard ratio, 1.03/Gy; P = .002,), coronary artery disease (P < .001), and WHO/International Society of Hypertension score (P = .04) were associated with events on univariable analysis. Heart doses remained significant on multivariable analysis that accounted for baseline risk. Two-year competing risk–adjusted event rates for patients with heart mean dose < 10 Gy, 10 to 20 Gy, or ≥ 20 Gy were 4%, 7%, and 21%, respectively. Heart doses were not associated with overall survival. Conclusion Cardiac events were relatively common after high-dose thoracic RT and were independently associated with both heart dose and

Effect of edema, relative biological effectiveness, and dose heterogeneity on prostate brachytherapy

International Nuclear Information System (INIS)

Wang, Jian Z.; Mayr, Nina A.; Nag, Subir; Montebello, Joseph; Gupta, Nilendu; Samsami, Nina; Kanellitsas, Christos

2006-01-01

Many factors influence response in low-dose-rate (LDR) brachytherapy of prostate cancer. Among them, edema, relative biological effectiveness (RBE), and dose heterogeneity have not been fully modeled previously. In this work, the generalized linear-quadratic (LQ) model, extended to account for the effects of edema, RBE, and dose heterogeneity, was used to assess these factors and their combination effect. Published clinical data have shown that prostate edema after seed implant has a magnitude (ratio of post- to preimplant volume) of 1.3-2.0 and resolves exponentially with a half-life of 4-25 days over the duration of the implant dose delivery. Based on these parameters and a representative dose-volume histogram (DVH), we investigated the influence of edema on the implant dose distribution. The LQ parameters (α=0.15 Gy -1 and α/β=3.1 Gy) determined in earlier studies were used to calculate the equivalent uniform dose in 2 Gy fractions (EUD 2 ) with respect to three effects: edema, RBE, and dose heterogeneity for 125 I and 103 Pd implants. The EUD 2 analysis shows a negative effect of edema and dose heterogeneity on tumor cell killing because the prostate edema degrades the dose coverage to tumor target. For the representative DVH, the V 100 (volume covered by 100% of prescription dose) decreases from 93% to 91% and 86%, and the D 90 (dose covering 90% of target volume) decrease from 107% to 102% and 94% of prescription dose for 125 I and 103 Pd implants, respectively. Conversely, the RBE effect of LDR brachytherapy [versus external-beam radiotherapy (EBRT) and high-dose-rate (HDR) brachytherapy] enhances dose effect on tumor cell kill. In order to balance the negative effects of edema and dose heterogeneity, the RBE of prostate brachytherapy was determined to be approximately 1.2-1.4 for 125 I and 1.3-1.6 for 103 Pd implants. These RBE values are consistent with the RBE data published in the literature. These results may explain why in earlier modeling studies

Reduced-Nicotine Cigarettes in Young Smokers: Impact of Nicotine Metabolism on Nicotine Dose Effects.

Science.gov (United States)

Faulkner, Paul; Ghahremani, Dara G; Tyndale, Rachel F; Cox, Chelsea M; Kazanjian, Ari S; Paterson, Neil; Lotfipour, Shahrdad; Hellemann, Gerhard S; Petersen, Nicole; Vigil, Celia; London, Edythe D

2017-07-01

The use of cigarettes delivering different nicotine doses allows evaluation of the contribution of nicotine to the smoking experience. We compared responses of 46 young adult smokers to research cigarettes, delivering 0.027, 0.110, 0.231, or 0.763 mg nicotine, and conventional cigarettes. On five separate days, craving, withdrawal, affect, and sustained attention were measured after overnight abstinence and again after smoking. Participants also rated each cigarette, and the nicotine metabolite ratio (NMR) was used to identify participants as normal or slow metabolizers. All cigarettes equally alleviated craving, withdrawal, and negative affect in the whole sample, but normal metabolizers reported greater reductions of craving and withdrawal than slow metabolizers, with dose-dependent effects. Only conventional cigarettes and, to a lesser degree, 0.763-mg nicotine research cigarettes increased sustained attention. Finally, there were no differences between ratings of lower-dose cigarettes, but the 0.763-mg cigarettes and (even more so) conventional cigarettes were rated more favorably than lower-dose cigarettes. The findings indicate that smoking-induced relief of craving and withdrawal reflects primarily non-nicotine effects in slow metabolizers, but depends on nicotine dose in normal metabolizers. By contrast, relief of withdrawal-related attentional deficits and cigarette ratings depend on nicotine dose regardless of metabolizer status. These findings have bearing on the use of reduced-nicotine cigarettes to facilitate smoking cessation and on policy regarding regulation of nicotine content in cigarettes. They suggest that normal and slow nicotine metabolizers would respond differently to nicotine reduction in cigarettes, but that irrespective of metabolizer status, reductions to <0.763 mg/cigarette may contribute to temporary attentional deficits.

Relative dose efficiencies of antiscatter grids and air gaps in pediatric radiography

International Nuclear Information System (INIS)

McDaniel, D.L.; Cohen, G.; Wagner, L.K.; Robinson, L.H.

1984-01-01

The relative dose efficiencies (RDE) of various antiscatter grids and air gaps were determined for conditions simulating those found in pediatric radiography, using phantoms representing a newborn child, a 5-yr-old and a 10-yr-old child. Our data indicate than an air gap is best for the newborn, due to the low levels of scatter. The 8:1 fiber grid or 15.2-cm air gap without a grid can improve dose efficiency (DE) for the 5-yr-old child by 20%--25% relative to the 3.3-cm air gap and no-grid technique, while for the 10-yr-old child, DE can be improved by 40% with an 8:1 fiber grid

SU-E-J-89: Motion Effects On Organ Dose in Respiratory Gated Stereotactic Body Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Wang, T; Zhu, L [Georgia Institute of Technology, Atlanta, GA (Georgia); Khan, M; Landry, J; Rajpara, R; Hawk, N [Emory University, Atlanta, GA (United States)

2014-06-01

Purpose: Existing reports on gated radiation therapy focus mainly on optimizing dose delivery to the target structure. This work investigates the motion effects on radiation dose delivered to organs at risk (OAR) in respiratory gated stereotactic body radiation therapy (SBRT). A new algorithmic tool of dose analysis is developed to evaluate the optimality of gating phase for dose sparing on OARs while ensuring adequate target coverage. Methods: Eight patients with pancreatic cancer were treated on a phase I prospective study employing 4DCT-based SBRT. For each patient, 4DCT scans are acquired and sorted into 10 respiratory phases (inhale-exhale- inhale). Treatment planning is performed on the average CT image. The average CT is spatially registered to other phases. The resultant displacement field is then applied on the plan dose map to estimate the actual dose map for each phase. Dose values of each voxel are fitted to a sinusoidal function. Fitting parameters of dose variation, mean delivered dose and optimal gating phase for each voxel over respiration cycle are mapped on the dose volume. Results: The sinusoidal function accurately models the dose change during respiratory motion (mean fitting error 4.6%). In the eight patients, mean dose variation is 3.3 Gy on OARs with maximum of 13.7 Gy. Two patients have about 100cm{sup 3} volumes covered by more than 5 Gy deviation. The mean delivered dose maps are similar to plan dose with slight deformation. The optimal gating phase highly varies across the patient, with phase 5 or 6 on about 60% of the volume, and phase 0 on most of the rest. Conclusion: A new algorithmic tool is developed to conveniently quantify dose deviation on OARs from plan dose during the respiratory cycle. The proposed software facilitates the treatment planning process by providing the optimal respiratory gating phase for dose sparing on each OAR.

A dose error evaluation study for 4D dose calculations

Science.gov (United States)

Milz, Stefan; Wilkens, Jan J.; Ullrich, Wolfgang

2014-10-01

Previous studies have shown that respiration induced motion is not negligible for Stereotactic Body Radiation Therapy. The intrafractional breathing induced motion influences the delivered dose distribution on the underlying patient geometry such as the lung or the abdomen. If a static geometry is used, a planning process for these indications does not represent the entire dynamic process. The quality of a full 4D dose calculation approach depends on the dose coordinate transformation process between deformable geometries. This article provides an evaluation study that introduces an advanced method to verify the quality of numerical dose transformation generated by four different algorithms. The used transformation metric value is based on the deviation of the dose mass histogram (DMH) and the mean dose throughout dose transformation. The study compares the results of four algorithms. In general, two elementary approaches are used: dose mapping and energy transformation. Dose interpolation (DIM) and an advanced concept, so called divergent dose mapping model (dDMM), are used for dose mapping. The algorithms are compared to the basic energy transformation model (bETM) and the energy mass congruent mapping (EMCM). For evaluation 900 small sample regions of interest (ROI) are generated inside an exemplary lung geometry (4DCT). A homogeneous fluence distribution is assumed for dose calculation inside the ROIs. The dose transformations are performed with the four different algorithms. The study investigates the DMH-metric and the mean dose metric for different scenarios (voxel sizes: 8 mm, 4 mm, 2 mm, 1 mm 9 different breathing phases). dDMM achieves the best transformation accuracy in all measured test cases with 3-5% lower errors than the other models. The results of dDMM are reasonable and most efficient in this study, although the model is simple and easy to implement. The EMCM model also achieved suitable results, but the approach requires a more complex

Quality audit for dose determination in the field of radiotherapy using TLD

International Nuclear Information System (INIS)

Kharita, M. H.; Anjak, O.

2010-08-01

Quality audit is one of the important procedures in radiotherapy centers in order to verify the accuracy of the delivered radiation doses. The aim of this work is to establish a procedure for dose audit using TL dosimeters and to apply this procedure in radiotherapy centers. TL Dosimeters were distributed to several radiotherapy centers in Syria and Lebanon (4 with Co-60 and 14 with high energy photon beam radiotherapy units). They were exposed to 2 Gy in order to make an intercomparison study of the absorbed dose in water determined under reference conditions. The results show that only two beams were outside the accepted range, which is ±3.5%. and the were within the accepted range. External Quality audit is one of the important procedures in field of radiotherapy dosimeter in order to verify the accuracy of the radiation doses delivered to patients. (Author)

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.

SU-E-T-766: Treatment Planning Comparison Study On Two Different Multileaf Collimators Delivered with Volumetric Modulated Arc Therapy

Energy Technology Data Exchange (ETDEWEB)

Zhang, R; Xiaomei, F; Bai, W [The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei (China); Zhang, X [The First Hospital of Hebei Medical University, Shijiazhuang, Hebei (China); Gao, Y [Hebei General Hospital, Shijiazhuang, Hebei (China)

2015-06-15

Purpose: To compare and evaluate the performance of two different multileaf collimators(MLCi2 and Agility) delivery with volumetric modulated arc therapy techniques. Methods: Treatment plans were graded four (Low, Moderate, Moderate-High and High complexity) accorrding to the complexity. This includes 1 Low complexity(brain metastasis), 2 Moderate complexity(Lung and Liver), 1 Moderate-High complexity(prostate) and 1 High complexity ( head and neck) cases. Total dose of 60 Gy was given for all the plans. All cases were desigined two VMAT plans, one with MLCi2(group A) and the other with Agility(group B). All plans were done on Elekta VMAT with Monaco treatment planning system. All plans were generated with 6 MV X-rays for both Plan A and Plan B. Plans were evaluated based on the ability to meet the dose volume histogram, radiation conformity index, estimated radiation delivery time, dose homogeneity index(HI) and monitor units(MU) needed to deliver the prescribed dose. Results: Plans of group B achieved the best HI (HI = 1.05 Vs. 1.06) at the Low complexity cases while plans of group A were slightly better at the high complexity cases (HI = 1.12 Vs. 1.14). Faster VMAT plan delivery with Agility than with MLCi2 as plan complexity increased (Low complexity:52s Vs.52s, Moderate complexity:58s Vs. 55s, Moderate-High complexity: 171s Vs.152s, High complexity : 326s Vs. 202s ), especially for the most complex paradigms delivered time can be decresed 38%. No Significant changes were observed between the group B and group A plans in terms of the healthy tissue mean dose and MU. Both plans respected the planning objective for all organs at risk. Conclusion: The study concludes that VMAT plans with the novel Agility MLC can significant decrease the delivering time at the high complexity cases, while a slight compromise in the dose homogeneity index should be noted. This work was supported by The Medical Science Foundation of The health department of Hebei Province (No

SU-E-T-766: Treatment Planning Comparison Study On Two Different Multileaf Collimators Delivered with Volumetric Modulated Arc Therapy

International Nuclear Information System (INIS)

Zhang, R; Xiaomei, F; Bai, W; Zhang, X; Gao, Y

2015-01-01

Purpose: To compare and evaluate the performance of two different multileaf collimators(MLCi2 and Agility) delivery with volumetric modulated arc therapy techniques. Methods: Treatment plans were graded four (Low, Moderate, Moderate-High and High complexity) accorrding to the complexity. This includes 1 Low complexity(brain metastasis), 2 Moderate complexity(Lung and Liver), 1 Moderate-High complexity(prostate) and 1 High complexity ( head and neck) cases. Total dose of 60 Gy was given for all the plans. All cases were desigined two VMAT plans, one with MLCi2(group A) and the other with Agility(group B). All plans were done on Elekta VMAT with Monaco treatment planning system. All plans were generated with 6 MV X-rays for both Plan A and Plan B. Plans were evaluated based on the ability to meet the dose volume histogram, radiation conformity index, estimated radiation delivery time, dose homogeneity index(HI) and monitor units(MU) needed to deliver the prescribed dose. Results: Plans of group B achieved the best HI (HI = 1.05 Vs. 1.06) at the Low complexity cases while plans of group A were slightly better at the high complexity cases (HI = 1.12 Vs. 1.14). Faster VMAT plan delivery with Agility than with MLCi2 as plan complexity increased (Low complexity:52s Vs.52s, Moderate complexity:58s Vs. 55s, Moderate-High complexity: 171s Vs.152s, High complexity : 326s Vs. 202s ), especially for the most complex paradigms delivered time can be decresed 38%. No Significant changes were observed between the group B and group A plans in terms of the healthy tissue mean dose and MU. Both plans respected the planning objective for all organs at risk. Conclusion: The study concludes that VMAT plans with the novel Agility MLC can significant decrease the delivering time at the high complexity cases, while a slight compromise in the dose homogeneity index should be noted. This work was supported by The Medical Science Foundation of The health department of Hebei Province (No

Sources of variability in OSL dose measurements using single grains of quartz

International Nuclear Information System (INIS)

Thomsen, K.J.; Murray, A.S.; Boetter-Jensen, L.

2005-01-01

In luminescence-based measurements of dose distributions in unheated mineral samples, the observed spread in dose values is usually attributed to four main factors: fluctuations in the number of photons counted, incomplete zeroing of any prior trapped charge (including signals arising from thermal transfer), heterogeneity in dosimetry, and instrument reproducibility. For correct interpretation of measured dose distributions in retrospective dosimetry, it is important to understand the relative importance of these components, and to establish whether other factors also contribute to the observed spread. In this preliminary study, dose distributions have been studied using single grains of heated and laboratory irradiated quartz. By heating the sample, the contribution from incomplete zeroing was excluded and at the same time the sample was sensitised. The laboratory gamma irradiation was designed to deliver a uniform dose to the sample. Thus it was anticipated that statistical fluctuations in the number of photons counted and instrument reproducibility, both quantifiable entities, should be able to account for all the observed variance in the measured dose distributions. We examine this assumption in detail, and discuss the origins and importance of the residual variance in our data

Measurement of the dose distribution at the gammatron in homogeneous water phantoms with films and ionization chambers

International Nuclear Information System (INIS)

Mark, B.

1978-01-01

The check of the analytic function for the depth-dose-curve by means of computer calculations of films shows, that only with the knowledge of the phantom depth factor the film is able to deliver quick and relatively simple gives information on the degree of the decrease of the dose with increasing phantom depth. Outside of the effective beam the deviation between the values, determines photometrically and ionometrically is up to 100 per cent. The analytic function could be veryfied well ionometrically. The transversal distributions were also checked, that are the basis for the dose calculation in a pendulum irradiation. A good agreement was found between the ionometrical and film-dosimetrical values. (orig.) [de

Outdoor solar UVA dose assessment with EBT2 radiochromic film using spectrophotometer and densitometer measurements

International Nuclear Information System (INIS)

Abukassem, I.; Bero, M.A.

2015-01-01

Direct measurements of solar ultraviolet radiations (UVRs) have an important role in the protection of humans against UVR hazard. This work presents simple technique based on the application of EBT2 GAFCHROMIC R film for direct solar UVA dose assessment. It demonstrates the effects of different parts of the solar spectrum (UVB, visible and infrared) on performed UVA field measurements and presents the measurement uncertainty budget. The gradient of sunlight exposure level permitted the authors to establish the mathematical relationships between the measured solar UVA dose and two measured quantities: the first was the changes in spectral absorbance at the wavelength 633 nm (A 633 ) and the second was the optical density (OD). The established standard relations were also applied to calculate the solar UVA dose variations during the whole day; 15 min of exposure each hour between 8:00 and 17:00 was recorded. Results show that both applied experimental methods, spectrophotometer absorbance and densitometer OD, deliver comparable figures for EBT2 solar UVA dose assessment with relative uncertainty of 11 % for spectral absorbance measurements and 15 % for OD measurements. (authors)

The real-world dose-relativity of sevelamer hydrochloride and lanthanum carbonate monotherapy in patients with end-stage renal disease.

Science.gov (United States)

Wilson, Rosamund J; Keith, Michael S; Preston, Peter; Copley, J Brian

2013-12-01

Sevelamer hydrochloride (SH) and lanthanum carbonate (LC) are calcium-free phosphate binders used for the management of hyperphosphatemia in patients with end-stage renal disease (ESRD). The objective of this analysis was to evaluate the real-world dose-relativity between SH and LC monotherapy in US patients with ESRD. This was a post hoc analysis of a 16-week, real-world study (Vemuri et al. in BMC Nephrol 12:49, 2011) of the efficacy of conversion to LC monotherapy from other phosphate binders. The SH:LC dose-relativity ratio, based on the mean daily dose, was calculated in the subset of patients from the Vemuri study who converted from SH to LC monotherapy and had available SH and LC dose data. A total of 950 patients converted from SH to LC monotherapy and had recorded dose data. The post hoc analysis population comprised 691 patients with available dose data for both SH at baseline and LC at week 16. The mean (SD) serum phosphate level at baseline was 5.91 (1.66) mg/dL. After conversion to LC monotherapy for 16 weeks, the mean (SD) serum phosphate level was 5.93 (1.85) mg/dL. The mean (SD) daily baseline SH dose was 7,703 (3,642) mg and the mean (SD) daily LC dose at week 16 was 2,800 (939) mg (9.6 versus 2.8 tablets, respectively; P relativity ratio of 2.8. The median individual patient SH:LC dose-relativity ratio was 2.6 (95% CI 2.6-2.8). Across baseline SH dose subgroups (2,400-4,800, >4,800-7,200, >7,200-9,600, and >9,600 mg/day), the mean daily SH dose was 4,051, 7,047, 9,253, and 13,150 mg, respectively. In comparison, the mean daily LC dose was 2,445-3,156 mg. Thus, patients requiring baseline SH doses >7,200 mg/day (41% of the analysis population) had higher SH:LC dose-relativity ratios of 3.1-4.2 (median individual patient ratios 3.1-4.0). In this post hoc analysis of real-world dose-relativity, the overall SH:LC dose-relativity ratio was 2.8 (median individual patient ratio 2.6 (95% CI 2.6-2.8). These findings are consistent with the World Health

Dynamic CT for Parathyroid Adenoma Detection: How Does Radiation Dose Compare With Nuclear Medicine?

Science.gov (United States)

Czarnecki, Caroline A; Einsiedel, Paul F; Phal, Pramit M; Miller, Julie A; Lichtenstein, Meir; Stella, Damien L

2018-05-01

Dynamic CT is increasingly used for preoperative localization of parathyroid adenomas, but concerns remain about the radiation effective dose of CT compared with that of 99m Tc-sestamibi scintigraphy. The purpose of this study was to compare the radiation dose delivered by three-phase dynamic CT with that delivered by 99m Tc-sestamibi SPECT/CT performed in accordance with our current protocols and to assess the possible reduction in effective dose achieved by decreasing the scan length (i.e., z-axis) of two phases of the dynamic CT protocol. The effective dose of a 99m Tc-sestamibi nuclear medicine parathyroid study performed with and without coregistration CT was calculated and compared with the effective dose of our current three-phase dynamic CT protocol as well as a proposed protocol involving CT with reduced scan length. The median effective dose for a 99m Tc-sestamibi nuclear medicine study was 5.6 mSv. This increased to 12.4 mSv with the addition of coregistration CT, which is higher than the median effective dose of 9.3 mSv associated with the dynamic CT protocol. Reducing the scan length of two phases in the dynamic CT protocol could reduce the median effective dose to 6.1 mSv, which would be similar to that of the dose from the 99m Tc-sestamibi study alone. Dynamic CT used for the detection of parathyroid adenoma can deliver a lower radiation dose than 99m Tc-sestamibi SPECT/CT. It may be possible to reduce the dose further by decreasing the scan length of two of the phases, although whether this has an impact on accuracy of the localization needs further investigation.

Job-related mortality risks of Hanford workers and their relation to cancer effects of measured doses of external radiation

International Nuclear Information System (INIS)

Kneale, G.W.; Mancuso, T.F.; Stewart, A.M.

1983-01-01

If we exclude all persons who were classified as clerical workers we find that over 40% of the Hanford workers had either professional or technical qualifications (professional workers). The ratio of professional to manual workers was equally high for safe and dangerous occupations but during the period 1944-77 professional workers who were doing the most dangerous work had too many deaths by comparison with other persons with similar qualifications, and manual workers doing equally dangerous work had too few deaths by comparison with other manual workers. In practice, this means that in any analysis of dose-related cancer risks of Hanford workers it is essential to control for job-related mortality risks as well as all the usual factors such as sex, dates of birth and hire and duration of employment. The results of including all these factors in a cohort analysis of Hanford data by the method of regression models in life tables are described and also the reasons why it was concluded that the risk per unit dose is increased at low dose levels (i.e. the dose-response curve is curvilinear downwards). (author)

Evaluation of build-up dose from 6 MV X-rays under pelvic and abdominal patient immobilisation devices

Energy Technology Data Exchange (ETDEWEB)

Cheung Tsang; Butson, M.J.Martin J. E-mail: mbutson@usa.netmbutson@guessmail.com; Yu, P.K.N

2002-06-01

The use of pelvic and abdominal immobilisation devices in radiotherapy is required for accurate positioning and repositioning of patients during their fractionated treatment delivered normally over a period of 5-6 weeks. 6 MV X-rays produced by a medical linear accelerator have a skin sparing effect whereby the skin dose delivered is considerably less than that received by the tumour. The treatment through a vacuum compressed immobilisation device (Vacbag) however increases the dose delivered to the skin by interactions of the X-rays within the Vacbag material. For example, the basal layer doses increased from 16% for an open field to 52% of maximum with a bag thickness of 2.5 cm for a 10 cmx10 cm field at 6 MV X-ray energy. At the same field size the dermal skin layer (1 mm depth) doses increased from 44% (no bag) to 60% for a bag thickness of 2.5 cm at 6 MV X-rays. The Vacbag should be placed outside the treatment field whenever possible to keep skin dose to a minimum level.

Evaluation of build-up dose from 6 MV X-rays under pelvic and abdominal patient immobilisation devices

International Nuclear Information System (INIS)

Cheung Tsang; Butson, M.J.Martin J.; Yu, P.K.N.

2002-01-01

The use of pelvic and abdominal immobilisation devices in radiotherapy is required for accurate positioning and repositioning of patients during their fractionated treatment delivered normally over a period of 5-6 weeks. 6 MV X-rays produced by a medical linear accelerator have a skin sparing effect whereby the skin dose delivered is considerably less than that received by the tumour. The treatment through a vacuum compressed immobilisation device (Vacbag) however increases the dose delivered to the skin by interactions of the X-rays within the Vacbag material. For example, the basal layer doses increased from 16% for an open field to 52% of maximum with a bag thickness of 2.5 cm for a 10 cmx10 cm field at 6 MV X-ray energy. At the same field size the dermal skin layer (1 mm depth) doses increased from 44% (no bag) to 60% for a bag thickness of 2.5 cm at 6 MV X-rays. The Vacbag should be placed outside the treatment field whenever possible to keep skin dose to a minimum level

Delivering service adaptation with 3G technology

NARCIS (Netherlands)

Liotta, A.; Yew, A.; Bohoris, C.; Pavlou, G.; Feridun, M.; Kropf, P.G.; Babin, G.

2002-01-01

Now that 3G technologies have reached their maturity, newly advanced services can be delivered to the mobile user. These include context- aware services, adaptable services and Virtual Home Environment (VHE)-like services. Important research issues relate, however, to managing such services through

The biological bases of the dose-effect relationship; Les bases biologiques de la relation dose-effet

Energy Technology Data Exchange (ETDEWEB)

Lafuma, J

2001-06-01

In radiation protection, the recent data in epidemiology, in animal experimentation and on the base researches are no more compatible with a linear dose-effect relationship without threshold and do not account for the radiological risks at low doses. The cancers should be accelerated by radiations as any pathology linked to the ageing and for which threshold exit. Relative to the genetic risk it is known today that the natural exposure that lasts for several generations has not lead excess of hereditary illness as it was to be feared in 1959 for several countries. Considering that for populations the exposure levels induced by human activities have already been, under these ones of average natural exposures the genetic risk can be negligible and it is the somatic risk alone, with its thresholds that has to be into account. (N.C.)

Establishment of source related dose constraints for members of the public. Interim report for comment

International Nuclear Information System (INIS)

1992-09-01

The International Commission on Radiological Protection is proposing a new concept that it terms a ''dose constraint''. A dose constraint is an individual-related criterion applied to a single radiation source, and fixes an upper value for exposure of the critical group from that source. A dose restraint sets a ceiling on the levels of individual dose that can be considered in the optimization of radiological protection for a single source. 6 refs, 1 fig., 2 tabs

The calculation of relative output factor and depth dose for irregular electron fields in water

International Nuclear Information System (INIS)

Dunscombe, Peter; McGhee, Peter; Chu, Terence

1996-01-01

Purpose: A technique, based on sector integration and interpolation, has been developed for the computation of both relative output factor and depth dose of irregular electron fields in water. The purpose of this study was to determine the minimum experimental data set required for the technique to yield results within accepted dosimetric tolerances. Materials and Methods: PC based software has been written to perform the calculations necessary to dosimetrically characterize irregular shaped electron fields. The field outline is entered via digitiser and the SSD and energy via the keyboard. The irregular field is segmented into sectors of specified angle (2 deg. was used for this study) and the radius of each sector computed. The central ray depth dose is reconstructed by summing the contributions from each sector deduced from calibration depth doses measured for circular fields. Relative output factors and depth doses at SSDs at which calibrations were not performed are found by interpolation. Calibration data were measured for circular fields from 2 to 9 cm diameter at 100, 105, 110, and 115 cm SSD. A clinical cut out can be characterized in less than 2 minutes including entry of the outline using this software. The performance of the technique was evaluated by comparing calculated relative output factors, surface dose and the locations of d 80 , d 50 and d 20 with experimental measurements on a variety of cut out shapes at 9 and 18 MeV. The calibration data set (derived from circular cut outs) was systematically reduced to identify the minimum required to yield an accuracy consistent with current recommendations. Results: The figure illustrates the ability of the technique to calculate the depth dose for an irregular field (shown in the insert). It was found that to achieve an accuracy of 2% in relative output factor and 2% or 2 mm (our criterion) in percentage depth dose, calibration data from five circular fields at the four SSDs spanning the range 100-115 cm

SU-E-J-154: Deformable Image Registration Based Delivered Dose Estimation for Head and Neck Radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Kumarasiri, A; Liu, C; Chetvertkov, M; Gordon, J; Siddiqui, F; Chetty, I; Kim, J [Henry Ford Health System, Detroit, MI (United States)

2014-06-01

Purpose: To estimate the accumulated dose to targets and organs at risk (OAR) for head and neck (H'N) radiotherapy using 3 deformable image registration (DIR) algorithms. Methods: Five H'N patients, who had daily CBCTs taken during the course of treatment, were retrospectively studied. All plans had 5 mm CTV-to-PTV expansions. To overcome the small field of view (FOV) limitations and HU uncertainties of CBCTs, CT images were deformably registered using a parameter-optimized B-spline DIR algorithm (Elastix, elastix.isi.uu.nl) and resampled onto each CBCT with a 4 cm uniform FOV expansion. The dose of the day was calculated on these resampled CT images. Calculated daily dose matrices were warped and accumulated to the planning CT using 3 DIR algorithms; SmartAdapt (Eclipse/Varian), Velocity (Velocity Medical Solutions), and Elastix. Dosimetric indices for targets and OARs were determined from the DVHs and compared with corresponding planned quantities. Results: The cumulative dose deviation was less than 2%, on average, for PTVs from the corresponding plan dose, for all algorithms/patients. However, the parotids show as much as a 37% deviation from the intended dose, possibly due to significant patient weight loss during the first 3 weeks of treatment (15.3 lbs in this case). The mean(±SD) cumulative dose deviations of the 5 patients estimated using the 3 algorithms (SmartAdapt, Velocity, and Elastix) were (0.8±0.9%, 0.5±0.9%, 0.6±1.3%) for PTVs, (1.6±1.9%, 1.4±2.0%, 1.7±1.9%) for GTVs, (10.4±12.1%, 10.7±10.6%, 6.5±10.1%) for parotid glands, and (4.5±4.6%, 3.4±5.7%, 3.9±5.7%) for mucosa, respectively. The differences among the three DIR algorithms in the estimated cumulative mean doses (1SD (in Gy)) were: 0.1 for PTVs, 0.1 for GTVs, 1.9 for parotid glands, and 0.4 for mucosa. Conclusion: Results of this study are suggestive that more frequent plan adaptation for organs, such as the parotid glands, might be beneficial during the course of H

SU-E-J-154: Deformable Image Registration Based Delivered Dose Estimation for Head and Neck Radiotherapy

International Nuclear Information System (INIS)

Kumarasiri, A; Liu, C; Chetvertkov, M; Gordon, J; Siddiqui, F; Chetty, I; Kim, J

2014-01-01

Purpose: To estimate the accumulated dose to targets and organs at risk (OAR) for head and neck (H'N) radiotherapy using 3 deformable image registration (DIR) algorithms. Methods: Five H'N patients, who had daily CBCTs taken during the course of treatment, were retrospectively studied. All plans had 5 mm CTV-to-PTV expansions. To overcome the small field of view (FOV) limitations and HU uncertainties of CBCTs, CT images were deformably registered using a parameter-optimized B-spline DIR algorithm (Elastix, elastix.isi.uu.nl) and resampled onto each CBCT with a 4 cm uniform FOV expansion. The dose of the day was calculated on these resampled CT images. Calculated daily dose matrices were warped and accumulated to the planning CT using 3 DIR algorithms; SmartAdapt (Eclipse/Varian), Velocity (Velocity Medical Solutions), and Elastix. Dosimetric indices for targets and OARs were determined from the DVHs and compared with corresponding planned quantities. Results: The cumulative dose deviation was less than 2%, on average, for PTVs from the corresponding plan dose, for all algorithms/patients. However, the parotids show as much as a 37% deviation from the intended dose, possibly due to significant patient weight loss during the first 3 weeks of treatment (15.3 lbs in this case). The mean(±SD) cumulative dose deviations of the 5 patients estimated using the 3 algorithms (SmartAdapt, Velocity, and Elastix) were (0.8±0.9%, 0.5±0.9%, 0.6±1.3%) for PTVs, (1.6±1.9%, 1.4±2.0%, 1.7±1.9%) for GTVs, (10.4±12.1%, 10.7±10.6%, 6.5±10.1%) for parotid glands, and (4.5±4.6%, 3.4±5.7%, 3.9±5.7%) for mucosa, respectively. The differences among the three DIR algorithms in the estimated cumulative mean doses (1SD (in Gy)) were: 0.1 for PTVs, 0.1 for GTVs, 1.9 for parotid glands, and 0.4 for mucosa. Conclusion: Results of this study are suggestive that more frequent plan adaptation for organs, such as the parotid glands, might be beneficial during the course of H'N RT. This

Effects of Positioning Uncertainty and Breathing on Dose Delivery and Radiation Pneumonitis Prediction in Breast Cancer

International Nuclear Information System (INIS)

Mavroidis, Panayiotis; Axelsson, Sofie; Hyoedynmaa, Simo; Rajala, Juha; Pitkaenen, Maunu A.; Lind, Bengt K.; Brahme, Anders

2002-01-01

The quality of the radiation therapy delivered in the treatment of breast cancer is susceptible to setup errors and organ motion uncertainties. For 60 breast cancer patients (24 resected with negative node involvement, 13 resected with positive node involvement and 23 ablated) who were treated with three different irradiation techniques, these uncertainties are simulated. The delivered dose distributions in the lung were recalculated taking positioning uncertainty and breathing effects into account. In this way the real dose distributions delivered to the patients are more closely determined. The positioning uncertainties in the anteroposterior (AP) and the craniocaudal (CC) directions are approximated by Gaussian distributions based on the fact that setup errors are random. Breathing is assumed to have a linear behavior because of the chest wall movement during expiration and inspiration. The combined frequency distribution of the positioning and breathing distributions is obtained by convolution. By integrating the convolved distribution over a number of intervals, the positions and the weights of the fields that simulate the original 'effective fields' are calculated. Opposed tangential fields are simulated by a set of 5 pairs of fields in the AP direction and 3 such sets in the CC direction. Opposed AP + PA fields are simulated by a set of 3 pairs of fields in the AP direction and 3 such sets in the CC direction. Single frontal fields are simulated by a set of 5 fields. In radiotherapy for breast cancer, the lung is often partly within the irradiated volume even though it is a sensitive organ at risk. The influence of the deviation in the dose delivered by the original and the adjusted treatment plans on the clinical outcome is estimated by using the relative seriality model and the biologically effective uniform dose concept. Radiation pneumonitis is used as the clinical endpoint for lung complications. The adjusted treatment plans show larger lung

CONTRASTING DOSE-RATE EFFECTS OF GAMMA-IRRADIATION ON RAT SALIVARY-GLAND FUNCTION

NARCIS (Netherlands)

VISSINK, A; DOWN, JD; KONINGS, AWT

The aim of this study was to investigate the effects of Co-60 irradiation delivered at high (HDR) and low (LDR) dose-rates on rat salivary gland function. Total-body irradiation (TBI; total doses 7.5, 10 and 12.5 Gy) was applied from a Co-60 source at dose-rates of 1 cGy/min (LDR) and 40 cGy/min

Basic evaluation of signal transmission in a real-time internal radiation dose measurement system

International Nuclear Information System (INIS)

Shinohe, K.; Takura, T.; Sato, F.; Matsuki, H.; Yamada, S.; Sato, T.

2009-01-01

In radiation therapy, excessive exposure to radiation occurs because the dose actually delivered to the tumor is not known. As a result, a patient suffers from side effects. To solve this problem, a system is needed in which the delivered dose is measured inside the body and the dose data are transmitted from inside to outside of the body during radiation therapy. If such a system is realized, it will be possible to treat cancer safely and effectively. The proposed real-time internal radiation dose measurement system consists of an implantable dosimeter, a wireless communication system, and a wireless feeding system. In this study, a wireless communication system that uses magnetic fields was investigated. As a result, a communication distance of 200 mm was obtained. It was confirmed that radiation dose data could be transmitted outside the body when the communication distance is the required 200 mm. (author)

Variable beam dose rate and DMLC IMRT to moving body anatomy

International Nuclear Information System (INIS)

Papiez, Lech; Abolfath, Ramin M.

2008-01-01

Derivation of formulas relating leaf speeds and beam dose rates for delivering planned intensity profiles to static and moving targets in dynamic multileaf collimator (DMLC) intensity modulated radiation therapy (IMRT) is presented. The analysis of equations determining algorithms for DMLC IMRT delivery under a variable beam dose rate reveals a multitude of possible delivery strategies for a given intensity map and for any given target motion patterns. From among all equivalent delivery strategies for DMLC IMRT treatments specific subclasses of strategies can be selected to provide deliveries that are particularly suitable for clinical applications providing existing delivery devices are used. Special attention is devoted to the subclass of beam dose rate variable DMLC delivery strategies to moving body anatomy that generalize existing techniques of such deliveries in Varian DMLC irradiation methodology to static body anatomy. Few examples of deliveries from this subclass of DMLC IMRT irradiations are investigated to illustrate the principle and show practical benefits of proposed techniques.

Variable beam dose rate and DMLC IMRT to moving body anatomy

Energy Technology Data Exchange (ETDEWEB)

Papiez, Lech; Abolfath, Ramin M. [Department of Radiation Oncology, UTSouthwestern Medical Center, Dallas, Texas 75390 (United States)

2008-11-15

Derivation of formulas relating leaf speeds and beam dose rates for delivering planned intensity profiles to static and moving targets in dynamic multileaf collimator (DMLC) intensity modulated radiation therapy (IMRT) is presented. The analysis of equations determining algorithms for DMLC IMRT delivery under a variable beam dose rate reveals a multitude of possible delivery strategies for a given intensity map and for any given target motion patterns. From among all equivalent delivery strategies for DMLC IMRT treatments specific subclasses of strategies can be selected to provide deliveries that are particularly suitable for clinical applications providing existing delivery devices are used. Special attention is devoted to the subclass of beam dose rate variable DMLC delivery strategies to moving body anatomy that generalize existing techniques of such deliveries in Varian DMLC irradiation methodology to static body anatomy. Few examples of deliveries from this subclass of DMLC IMRT irradiations are investigated to illustrate the principle and show practical benefits of proposed techniques.

Positron emission tomography for the dose monitoring of intra-fractionally moving targets in ion beam therapy

International Nuclear Information System (INIS)

Stuetzer, Kristin

2014-01-01

Ion beam therapy (IBT) is a promising treatment option in radiotherapy. The characteristic physical and biological properties of light ion beams allow for the delivery of highly tumor conformal dose distributions. Related to the sparing of surrounding healthy tissue and nearby organs at risk, it is feasible to escalate the dose in the tumor volume to reach higher tumor control and survival rates. Remarkable clinical outcome was achieved with IBT for radio-resistant, deep-seated, static and well fixated tumor entities. Presumably, more patients could benefit from the advantages of IBT if it would be available for more frequent tumor sites. Those located in the thorax and upper abdominal region are commonly subjected to intra-fractional, respiration related motion. Different motion-compensated dose delivery techniques have been developed for active field shaping with scanned pencil beams and are at least available under experimental conditions at the GSI Helmholtzzentrum fuer Schwerionenforschung (GSI) in Darmstadt, Germany. Since minor unexpected anatomical changes e.g. related to patient mispositioning, tumour shrinkage or tissue swelling could already lead to remarkable deviations between planned and delivered dose distribution, a valuable dose monitoring system is desired for IBT. So far, positron emission tomography (PET) is the only in vivo, in situ and non-invasive qualitative dose monitoring method applied under clinical conditions. Conclusions about the delivered dose distribution can be drawn indirectly from a comparison between two β + -activity distributions: the measured one and an expected one generated by a Monte-Carlo simulation. Dedicated phantoms mainly made up of polymethyl methacrylate (PMMA) and a motion table for regular one-dimensional (1D) motion patterns have been designed and manufactured for the experiments. Furthermore, the general applicability of the 4D MLEM algorithm for more complex motion patterns has been demonstrated by the

SU-E-J-93: Parametrisation of Dose to the Mucosa of the Anterior Rectal Wall in Transrectal Ultrasound Guided High-Dose-Rate Brachytherapy of the Prostate

Energy Technology Data Exchange (ETDEWEB)

Aitkenhead, A; Hamlett, L; Wood, D; Choudhury, A [The Christie Hospital NHS Foundation Trust, Manchester, Greater Manchester (United Kingdom)

2014-06-01

Purpose: In high-dose-rate (HDR) brachytherapy of the prostate, radiation is delivered from a number of radioactive sources which are inserted via catheter into the target volume. The rectal mucosa also receives dose during the treatment, which may lead to late toxicity effects. To allow possible links between rectal dose and toxicity to be investigated, suitable methods of parametrising the rectal dose are needed. Methods: During treatment of a series of 95 patients, anatomy and catheter locations were monitored by transrectal ultrasound, and target volume positions were contoured on the ultrasound scan by the therapist. The anterior rectal mucosal wall was identified by contouring the transrectal ultrasound balloon within the ultrasound scan. Source positions and dwell times, along with the dose delivered to the patient were computed using the Oncentra Prostate treatment planning system (TPS). Data for the series of patients were exported from the TPS in Dicom format, and a series of parametrisation methods were developed in a Matlab environment to assess the rectal dose. Results: Contours of the anterior rectal mucosa were voxelised within Matlab to allow the dose to the rectal mucosa to be analysed directly from the 3D dose grid. Dose parametrisations based on dose-surface (DSH) and dose-line (DLH) histograms were obtained. Both lateral and longitudinal extents of the mucosal dose were parametrised using dose-line histograms in the relevant directions. Conclusion: We have developed a series of dose parametrisations for quantifying the dose to the rectal mucosa during HDR prostate brachytherapy which are suitable for future studies investigating potential associations between mucosal dose and late toxicity effects. The geometry of the transrectal probe standardises the rectal anatomy, making this treatment technique particularly suited to studies of this nature.

SU-E-J-93: Parametrisation of Dose to the Mucosa of the Anterior Rectal Wall in Transrectal Ultrasound Guided High-Dose-Rate Brachytherapy of the Prostate

International Nuclear Information System (INIS)

Aitkenhead, A; Hamlett, L; Wood, D; Choudhury, A

2014-01-01

Purpose: In high-dose-rate (HDR) brachytherapy of the prostate, radiation is delivered from a number of radioactive sources which are inserted via catheter into the target volume. The rectal mucosa also receives dose during the treatment, which may lead to late toxicity effects. To allow possible links between rectal dose and toxicity to be investigated, suitable methods of parametrising the rectal dose are needed. Methods: During treatment of a series of 95 patients, anatomy and catheter locations were monitored by transrectal ultrasound, and target volume positions were contoured on the ultrasound scan by the therapist. The anterior rectal mucosal wall was identified by contouring the transrectal ultrasound balloon within the ultrasound scan. Source positions and dwell times, along with the dose delivered to the patient were computed using the Oncentra Prostate treatment planning system (TPS). Data for the series of patients were exported from the TPS in Dicom format, and a series of parametrisation methods were developed in a Matlab environment to assess the rectal dose. Results: Contours of the anterior rectal mucosa were voxelised within Matlab to allow the dose to the rectal mucosa to be analysed directly from the 3D dose grid. Dose parametrisations based on dose-surface (DSH) and dose-line (DLH) histograms were obtained. Both lateral and longitudinal extents of the mucosal dose were parametrised using dose-line histograms in the relevant directions. Conclusion: We have developed a series of dose parametrisations for quantifying the dose to the rectal mucosa during HDR prostate brachytherapy which are suitable for future studies investigating potential associations between mucosal dose and late toxicity effects. The geometry of the transrectal probe standardises the rectal anatomy, making this treatment technique particularly suited to studies of this nature

Dose assessment following an overexposure of a worker at a Swiss nuclear power plant.

Science.gov (United States)

Bailat, Claude J; Laedermann, Jean-Pascal; Baechler, Sébastien; Desorgher, Laurent; Aroua, Abbas; Bochud, François O

2017-12-01

The aim of this work was to assess the doses received by a diver exposed to a radiation source during maintenance work in the fuel transfer pool at a Swiss nuclear power plant, and to define whether the statutory limit was breached or not. Onsite measurements were carried out and different scenarios were simulated using the MicroShield Software and the MCNPX Monte Carlo radiation transport code to estimate the activity of the irradiating object as well as the doses to the limbs and the effective dose delivered to the operator. The activity of the object was estimated to 1.8 TBq. From the various dose estimations, a conservative value of 7.5 Sv was proposed for the equivalent dose to the skin on the hands and an effective dose of 28 mSv. The use of different experimental and calculation methods allowed us to accurately estimate the activity of the object and the dose delivered to the diver, useful information for making a decision on the most appropriate scheme of follow up for the patient.

Relationship of dose rate and total dose to responses of continuously irradiated beagles

International Nuclear Information System (INIS)

Fritz, T.E.; Norris, W.P.; Tolle, D.V.; Seed, T.M.; Poole, C.M.; Lombard, L.S.; Doyle, D.E.

1978-01-01

Young-adult beagles were exposed continuously (22 hours/day) to 60 Co gamma rays in a specially constructed facility. The exposure rates were 5, 19, 17 or 35 R/day, and the exposures were terminated at 600, 1400, 2000 or 4000 R. A total of 354 dogs were irradiated; 221 are still alive as long-term survivors, some after more than 2000 days. The data on survival of these dogs, coupled with data from similar preliminary experiments, allow an estimate of the LD 50 for gamma-ray exposures given at a number of exposure rates. They also allow comparison of the relativeimportance of dose rate and total dose, and the interaction of these two variables, in the early and late effects after protracted irradiation. The LD 50 for the beagle increases from 344 R (258 rads) delivered at 15 R/minute to approximately 4000 R (approximately 3000 rads) at 10 R/day. Over this entire range, the LD 50 is dependent upon haematopoietic damage. At 5 R/day and less, no definitive LD 50 can be determined; there is nearly normal continued haematopoietic function, survival is prolonged, and the dogs manifest varied individual responses in the organ systems. Although the experiment is not complete, interim data allow serveral important conclusions. Terminated exposures, while not as effective as irradiation continued until death, can produce myelogenous leukaemia at the same exposure rate, 10 R/day. More importantly, at the same total accumulated dose, lower exposure rates appear more damaging than higher rates on the basis of the rate and degree of haematological recovery that occurs after termination of irradiation. Thus, the rate of haematologic depression, the nadir of the depression and the rate of recovery are dependent upon exposure rate; the latter is inversely related and the first two are directly related to exposure rate. ( author)

Preparation of an application for the control of the dose delivered by equipment of computed tomography (CT)

International Nuclear Information System (INIS)

Torres Cabrera, R.; Agulla Otero, M.; Hernando Gonzalez, I.

2013-01-01

Although TC are native digital equipment, the collection and treatment of the doses given to the patients it continues to present difficulties to date, especially in the still very large number of teams that do not produce a formal report of dose (SR). This work shows the experience gained in the development of an application that allows the calculation, monitoring and control of the dose given to patients by teams of TC. (Author)

Acute cognitive effects of high doses of dextromethorphan relative to triazolam in humans

Science.gov (United States)

Carter, Lawrence P.; Reissig, Chad J.; Johnson, Matthew W.; Klinedinst, Margaret A.; Griffiths, Roland R.

2012-01-01

BACKGROUND Although concerns surrounding high-dose dextromethorphan (DXM) abuse have recently increased, few studies have examined the acute cognitive effects of high doses of DXM. The aim of this study was to compare the cognitive effects of DXM with those of triazolam and placebo. METHODS Single, acute, oral doses of DXM (100, 200, 300, 400, 500, 600, 700, 800 mg/70 kg), triazolam (0.25, 0.5 mg /70 kg), and placebo were administered p.o. to twelve healthy volunteers with histories of hallucinogen use, under double-blind conditions, using an ascending dose run-up design. Effects on cognitive performance were examined at baseline and after drug administration for up to 6 hours. RESULTS Both triazolam and DXM produced acute impairments in attention, working memory, episodic memory, and metacognition. Impairments observed following doses of 100-300 mg/70 kg DXM were generally smaller in magnitude than those observed after 0.5 mg/70 kg triazolam. Doses of DXM that impaired performance to the same extent as triazolam were in excess of 10-30 times the therapeutic dose of DXM. CONCLUSION The magnitude of the doses required for these effects and the absence of effects on some tasks within the 100-300 mg/70 kg dose range of DXM, speak to the relatively broad therapeutic window of over-the-counter DXM preparations when used appropriately. However, the administration of supratherapeutic doses of DXM resulted in acute cognitive impairments on all tasks that were examined. These findings are likely relevant to cases of high-dose DXM abuse. PMID:22989498