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Sample records for study dose definition

  1. On the definition of absorbed dose

    International Nuclear Information System (INIS)

    Grusell, Erik

    2015-01-01

    Purpose: The quantity absorbed dose is used extensively in all areas concerning the interaction of ionizing radiation with biological organisms, as well as with matter in general. The most recent and authoritative definition of absorbed dose is given by the International Commission on Radiation Units and Measurements (ICRU) in ICRU Report 85. However, that definition is incomplete. The purpose of the present work is to give a rigorous definition of absorbed dose. Methods: Absorbed dose is defined in terms of the random variable specific energy imparted. A random variable is a mathematical function, and it cannot be defined without specifying its domain of definition which is a probability space. This is not done in report 85 by the ICRU, mentioned above. Results: In the present work a definition of a suitable probability space is given, so that a rigorous definition of absorbed dose is possible. This necessarily includes the specification of the experiment which the probability space describes. In this case this is an irradiation, which is specified by the initial particles released and by the material objects which can interact with the radiation. Some consequences are discussed. Specific energy imparted is defined for a volume, and the definition of absorbed dose as a point function involves the specific energy imparted for a small mass contained in a volume surrounding the point. A possible more precise definition of this volume is suggested and discussed. Conclusions: The importance of absorbed dose motivates a proper definition, and one is given in the present work. No rigorous definition has been presented before. - Highlights: • A stringent definition of absorbed dose is given. • This requires the definition of an irradiation and a suitable probability space. • A stringent definition is important for an understanding of the concept absorbed dose

  2. The definition of the individual dose equivalent

    International Nuclear Information System (INIS)

    Ehrlich, Margarete

    1986-01-01

    A brief note examines the choice of the present definition of the individual dose equivalent, the new operational dosimetry quantity for external exposure. The consequences of the use of the individual dose equivalent and the danger facing the individual dose equivalent, as currently defined, are briefly discussed. (UK)

  3. Radon Exposure and the Definition of Low Doses-The Problem of Spatial Dose Distribution.

    Science.gov (United States)

    Madas, Balázs G

    2016-07-01

    Investigating the health effects of low doses of ionizing radiation is considered to be one of the most important fields in radiological protection research. Although the definition of low dose given by a dose range seems to be clear, it leaves some open questions. For example, the time frame and the target volume in which absorbed dose is measured have to be defined. While dose rate is considered in the current system of radiological protection, the same cancer risk is associated with all exposures, resulting in a given amount of energy absorbed by a single target cell or distributed among all the target cells of a given organ. However, the biological effects and so the health consequences of these extreme exposure scenarios are unlikely to be the same. Due to the heterogeneous deposition of radon progeny within the lungs, heterogeneous radiation exposure becomes a practical issue in radiological protection. While the macroscopic dose is still within the low dose range, local tissue doses on the order of Grays can be reached in the most exposed parts of the bronchial airways. It can be concluded that progress in low dose research needs not only low dose but also high dose experiments where small parts of a biological sample receive doses on the order of Grays, while the average dose over the whole sample remains low. A narrow interpretation of low dose research might exclude investigations with high relevance to radiological protection. Therefore, studies important to radiological protection should be performed in the frame of low dose research even if the applied doses do not fit in the dose range used for the definition of low doses.

  4. Terms and definitions in the field of radiological technique. Dose quantities and units

    International Nuclear Information System (INIS)

    1985-12-01

    The standard gives the terms and definitions of concepts, dose quantities and units. The radiation field condition 'secondary electron equilibrium', which forms part of the definition of standard ion dose, is given more precisely. The term 'free in air' is used in its original meaning, i.e. characterization of measuring conditions excluding avoidable stray radiation, which deviates from DIN 6814, part 3/06.72. Dosemeters for measurement of standard ion dose of air kerma are calibrated 'free in air', but this calibration condition is not part of the quantity definition. The quantities standard ion dose or air kerma therefore can also be measured in any other material. The qunatitative relationships between standard ion dose and the quantities 'exposure' and air kerma, as given in the ICRU publication 33 'Quantities and Units' (1980), are explained. The standard introduces the SI units Gray (for energy dose), Sievert (for dose equivalent), and Becquerel (for the activity of a radioactive substance). As the change to the SI units conceals the approximated equality of the numerical values of the standrd ion dose of photon radiation in roentgen, of the energy dose for soft tissue in rad, and of the dose equivalent in rem, new definitions are given in accordance with ICRU 33 for the quantities specified dose rate, dose rate constant, and area exposure product. These definitions use the terms 'energy dose' and 'kerma'. The dose concepts applied in the field of radiation protection, especially ambient dose and individual dose, are defined as dose equivalents in compliance with the Radiation Protection Ordinance. The relevant sections present information on the conversion of standard ion dose values to the corresponding values of kerma, energy dose, or dose equivalent. (orig./HP) [de

  5. A new definition for acoustic dose

    International Nuclear Information System (INIS)

    Duck, F A

    2011-01-01

    This paper discusses a recent proposal for definitions of acoustic dose and acoustic dose-rate. Acoustic dose is defined as the energy deposited by absorption of an acoustic wave per unit mass of the medium supporting the wave. Its time-derivative, acoustic dose-rate, Q m , in W kg -1 is central to the prediction of both rate of temperature rise and radiation force. These quantities have spatial and temporal dependency, depending on the local field parameters (acoustic pressure, particle velocity, intensity) and local material properties (absorption coefficient, α a , and mass density, ρ 0 ). Spatial and/or temporal averaging can be applied where appropriate. For plane-wave monochromatic conditions in a homogeneous medium, Q m =2α a I/ρ 0 , (I is the time-averaged intensity), a simple expression which may also incorporate frequency dependencies of energy deposition. Acoustic dose and acoustic does-rate are exact analogues for Specific Absorption and Specific Absorption Rate (SAR), quantities central to radiofrequency (RF) and microwave dosimetry. Acoustic dosimetry in the presence of tissue/gas interfaces remains a considerable challenge.

  6. A comparison of dose-volume constraints derived using peak and longitudinal definitions of late rectal toxicity

    International Nuclear Information System (INIS)

    Gulliford, Sarah L.; Partridge, Mike; Sydes, Matthew R.; Andreyev, Jervoise; Dearnaley, David P.

    2010-01-01

    Background and purpose: Accurate reporting of complications following radiotherapy is an important part of the feedback loop to improve radiotherapy techniques. The definition of toxicity is normally regarded as the maximum or peak (P) grade of toxicity reported over the follow-up period. An alternative definition (integrated longitudinal toxicity (ILT)) is proposed which takes into account both the severity and the duration of the complication. Methods and materials: In this work, both definitions of toxicity were used to derive dose-volume constraints for six specific endpoints of late rectal toxicity from a cohort of patients who received prostate radiotherapy in the MRC RT01 trial. The dose-volume constraints were derived using ROC analysis for 30, 40, 50, 60, 65 and 70 Gy. Results: Statistically significant dose-volume constraints were not derived for all dose levels tested for each endpoint and toxicity definition. However, where both definitions produced constraints, there was generally good agreement. Variation in the derived dose-volume constraints was observed to be larger between endpoints than between the two definitions of toxicity. For one endpoint (stool frequency (LENT/SOM)) statistically significant dose-volume constraints were only derived using ILT. Conclusions: The longitudinal definition of toxicity (ILT) produced results consistent with those derived using peak toxicity and in some cases provided additional information which was not seen by analysing peak toxicity alone.

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  8. Comparison of different contouring definitions of the rectum as organ at risk (OAR) and dose-volume parameters predicting rectal inflammation in radiotherapy of prostate cancer: which definition to use?

    Science.gov (United States)

    Nitsche, Mirko; Brannath, Werner; Brückner, Matthias; Wagner, Dirk; Kaltenborn, Alexander; Temme, Nils; Hermann, Robert M

    2017-02-01

    The objective of this retrospective planning study was to find a contouring definition for the rectum as an organ at risk (OAR) in curative three-dimensional external beam radiotherapy (EBRT) for prostate cancer (PCa) with a predictive correlation between the dose-volume histogram (DVH) and rectal toxicity. In a pre-study, the planning CT scans of 23 patients with PCa receiving definitive EBRT were analyzed. The rectum was contoured according to 13 different definitions, and the dose distribution was correlated with the respective rectal volumes by generating DVH curves. Three definitions were identified to represent the most distinct differences in the shapes of the DVH curves: one anatomical definition recommended by the Radiation Therapy Oncology Group (RTOG) and two functional definitions based on the target volume. In the main study, the correlation between different relative DVH parameters derived from these three contouring definitions and the occurrence of rectal toxicity during and after EBRT was studied in two consecutive collectives. The first cohort consisted of 97 patients receiving primary curative EBRT and the second cohort consisted of 66 patients treated for biochemical recurrence after prostatectomy. Rectal toxicity was investigated by clinical investigation and scored according to the Common Terminology Criteria for Adverse Events. Candidate parameters were the volume of the rectum, mean dose, maximal dose, volume receiving at least 60 Gy (V 60 ), area under the DVH curve up to 25 Gy and area under the DVH curve up to 75 Gy in dependence of each chosen rectum definition. Multivariable logistic regression considered other clinical factors such as pelvine lymphatics vs local target volume, diabetes, prior rectal surgery, anticoagulation or haemorrhoids too. In Cohort 1 (primary EBRT), the mean rectal volumes for definitions "RTOG", planning target volume "(PTV)-based" and "PTV-linked" were 100 cm 3 [standard deviation (SD) 43 cm 3 ], 60

  9. Definitive intraoperative very high-dose radiotherapy for localized osteosarcoma in the extremities

    International Nuclear Information System (INIS)

    Oya, Natsuo; Kokubo, Masaki; Mizowaki, Takashi; Shibamoto, Yuta; Nagata, Yasushi; Sasai, Keisuke; Nishimura, Yasumasa; Tsuboyama, Tadao; Toguchida, Junya; Nakamura, Takashi; Hiraoka, Masahiro

    2001-01-01

    Purpose: To evaluate the outcome and adverse effects in patients with osteosarcoma treated with very high-dose definitive intraoperative radiotherapy (IORT), with the intention of saving the affected limb. Methods and Materials: Thirty-nine patients with osteosarcoma in their extremities were treated with definitive IORT. The irradiation field included the tumor plus an adequate wide margin and excluded the major vessels and nerves. Forty-five to 80 Gy of electrons or X-rays were delivered. The median follow-up of the surviving patients was 124 months. Results: The cause-specific and relapse-free 5-year survival rate was 50% and 43%, respectively. Distant metastasis developed in 23 patients; 19 died and 4 were alive for >10 years. Nine local recurrences were found 4-29 months after IORT in the affected limb. No radiation-induced skin reaction or nerve palsy was observed in the patients treated with X-rays. Experiments using phantoms also confirmed that the scatter dose was below the toxic level in the IORT setting with X-rays. Conclusions: Very high-dose definitive IORT combined with preventive nailing and chemotherapy appeared to be a promising quality-of-life-oriented alternative to treating patients with osteosarcomas in the extremities, although the problem of recurrences from the surrounding unirradiated soft tissue remains to be solved

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

    International Nuclear Information System (INIS)

    Schytte, Tine; Hansen, Olfred; Stolberg-Rohr, Thomine; Brink, Carsten

    2010-01-01

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

  11. Terms and definitions in the field of radiological technique. Dose quantities and units. Begriffe und Benennungen in der radiologischen Technik. Dosisgroessen und Dosiseinheiten

    Energy Technology Data Exchange (ETDEWEB)

    1985-01-01

    The standard gives the terms and definitions of concepts, dose quantities and units. The radiation field condition 'secondary electron equilibrium', which forms part of the definition of standard ion dose, is given more precisely. The term 'free in air' is used in its original meaning, i.e. characterization of measuring conditions excluding avoidable stray radiation, which deviates from DIN 6814, part 3/06.72. Dosemeters for measurement of standard ion dose of air kerma are calibrated 'free in air', but this calibration condition is not part of the quantity definition. The quantities standard ion dose or air kerma therefore can also be measured in any other material. The qunatitative relationships between standard ion dose and the quantities 'exposure' and air kerma, as given in the ICRU publication 33 'Quantities and Units' (1980), are explained. The standard introduces the SI units Gray (for energy dose), Sievert (for dose equivalent), and Becquerel (for the activity of a radioactive substance). As the change to the SI units conceals the approximated equality of the numerical values of the standrd ion dose of photon radiation in roentgen, of the energy dose for soft tissue in rad, and of the dose equivalent in rem, new definitions are given in accordance with ICRU 33 for the quantities specified dose rate, dose rate constant, and area exposure product. These definitions use the terms 'energy dose' and 'kerma'. The dose concepts applied in the field of radiation protection, especially ambient dose and individual dose, are defined as dose equivalents in compliance with the Radiation Protection Ordinance. The relevant sections present information on the conversion of standard ion dose values to the corresponding values of kerma, energy dose, or dose equivalent.

  12. SU-E-T-578: On Definition of Minimum and Maximum Dose for Target Volume

    Energy Technology Data Exchange (ETDEWEB)

    Gong, Y; Yu, J; Xiao, Y [Thomas Jefferson University Hospital, Philadelphia, PA (United States)

    2015-06-15

    Purpose: This study aims to investigate the impact of different minimum and maximum dose definitions in radiotherapy treatment plan quality evaluation criteria by using tumor control probability (TCP) models. Methods: Dosimetric criteria used in RTOG 1308 protocol are used in the investigation. RTOG 1308 is a phase III randomized trial comparing overall survival after photon versus proton chemoradiotherapy for inoperable stage II-IIIB NSCLC. The prescription dose for planning target volume (PTV) is 70Gy. Maximum dose (Dmax) should not exceed 84Gy and minimum dose (Dmin) should not go below 59.5Gy in order for the plan to be “per protocol” (satisfactory).A mathematical model that simulates the characteristics of PTV dose volume histogram (DVH) curve with normalized volume is built. The Dmax and Dmin are noted as percentage volumes Dη% and D(100-δ)%, with η and d ranging from 0 to 3.5. The model includes three straight line sections and goes through four points: D95%= 70Gy, Dη%= 84Gy, D(100-δ)%= 59.5 Gy, and D100%= 0Gy. For each set of η and δ, the TCP value is calculated using the inhomogeneously irradiated tumor logistic model with D50= 74.5Gy and γ50=3.52. Results: TCP varies within 0.9% with η; and δ values between 0 and 1. With η and η varies between 0 and 2, TCP change was up to 2.4%. With η and δ variations from 0 to 3.5, maximum of 8.3% TCP difference is seen. Conclusion: When defined maximum and minimum volume varied more than 2%, significant TCP variations were seen. It is recommended less than 2% volume used in definition of Dmax or Dmin for target dosimetric evaluation criteria. This project was supported by NIH grants U10CA180868, U10CA180822, U24CA180803, U24CA12014 and PA CURE Grant.

  13. SU-E-T-578: On Definition of Minimum and Maximum Dose for Target Volume

    International Nuclear Information System (INIS)

    Gong, Y; Yu, J; Xiao, Y

    2015-01-01

    Purpose: This study aims to investigate the impact of different minimum and maximum dose definitions in radiotherapy treatment plan quality evaluation criteria by using tumor control probability (TCP) models. Methods: Dosimetric criteria used in RTOG 1308 protocol are used in the investigation. RTOG 1308 is a phase III randomized trial comparing overall survival after photon versus proton chemoradiotherapy for inoperable stage II-IIIB NSCLC. The prescription dose for planning target volume (PTV) is 70Gy. Maximum dose (Dmax) should not exceed 84Gy and minimum dose (Dmin) should not go below 59.5Gy in order for the plan to be “per protocol” (satisfactory).A mathematical model that simulates the characteristics of PTV dose volume histogram (DVH) curve with normalized volume is built. The Dmax and Dmin are noted as percentage volumes Dη% and D(100-δ)%, with η and d ranging from 0 to 3.5. The model includes three straight line sections and goes through four points: D95%= 70Gy, Dη%= 84Gy, D(100-δ)%= 59.5 Gy, and D100%= 0Gy. For each set of η and δ, the TCP value is calculated using the inhomogeneously irradiated tumor logistic model with D50= 74.5Gy and γ50=3.52. Results: TCP varies within 0.9% with η; and δ values between 0 and 1. With η and η varies between 0 and 2, TCP change was up to 2.4%. With η and δ variations from 0 to 3.5, maximum of 8.3% TCP difference is seen. Conclusion: When defined maximum and minimum volume varied more than 2%, significant TCP variations were seen. It is recommended less than 2% volume used in definition of Dmax or Dmin for target dosimetric evaluation criteria. This project was supported by NIH grants U10CA180868, U10CA180822, U24CA180803, U24CA12014 and PA CURE Grant

  14. Remarks and suggestions concerned with formulation of the definition of quantity ''committed dose'' and quantity ''radiation burden'' useful in estimates of population exposure

    International Nuclear Information System (INIS)

    Cwik, T.

    1990-01-01

    The paper contains remarks to the definitions of the quantity ''commited dose'' given in the publications of the ICRP. The suggestions are presented on the mode of formulating the definition of the quantity ''commited dose'' and the definition of the quantity denoted hitherto by the symbol H 50 . The other suggestions deal with introduction of the quantity ''radiation burden'', assigned for use in assessments of irradiation expressed ''per caput'' of population. 9 refs. (author)

  15. Reliability of individual doses relating to the epidemiological studies on nuclear industry workers in Japan (1). Historical changes on definition of radiation dose, historical changes on technical standards of measurement and radiation workplace

    International Nuclear Information System (INIS)

    Numakunai, Takao; Ishiguro, Hideharu; Kawada, Yasushi; Minami, Kentaro; Yoshimoto, Yasuhiko.

    1997-01-01

    Records of radiation workers collected in the Research Organization for Information of Science and Technology, concerning individual doses from 1957 to 1992 were used for epidemiological studies for obtaining the scientific information of the effect of low dose radiation. Since many changes were made on definition of radiation dose, dosimetry technology and so on during such a long time period, reliability of recorded individual doses and of their measurement should be evaluated for validation, which is the purpose of this paper. Followings were discussed and validation was made. Historical changes on standards for radiation protection: ICRP Recommendation and ICRU Report, and changes of law concerning radiation dose in Japan and of dose standards. Changes on dosimetry for radiation protection: ICRP Recommendation and working place dosimetry, trends of investigations for introduction of measured practical doses, ICRU sphere as a receptor, and introduction of measured practical doses. Characteristics of radiation field and radiation exposure: Radiation source and characteristics of radiation field; Research and development organizations for atomic power, atomic power plants, facilities for nuclear fuel, Classification of radiation works and characteristics of the exposure; BWR, PWR, GCR. Changes on the standards of individual dosemeter and on its use: method to use individual dosemeter and its installation, measurement of individual dose and Japanese Industrial Standard (JIS); Standard of the film badge for X and gamma rays, Standard of the film badge for neutron, Standard for thermoluminescence dosemeter, and changes on selection of the major apparatus and on its use. (K.H.)

  16. Dose-dependent deterioration of swallowing function after induction chemotherapy and definitive chemoradiotherapy for laryngopharyngeal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Haderlein, M.; Semrau, S.; Ott, O.; Speer, S.; Fietkau, R. [University Hospital Erlangen, Department of Radiation Oncology, Erlangen (Germany); Bohr, C. [University Hospital Erlangen, Department of Otorhinolaryngology, Head and Neck Surgery, Erlangen (Germany)

    2014-02-15

    To evaluate the influence of clinical, treatment- and dose-dependent factors on posttreatment swallowing function after induction chemotherapy and definitive chemoradiotherapy in a group of homogeneously treated laryngopharyngeal cancer patients. From 28 May 2008 to 15 February 2013, 45 patients with borderline inoperable laryngopharyngeal cancer that had responded well to induction chemotherapy were treated with definitive chemoradiotherapy. Median follow-up was 22 months. Swallowing function and clinical data were prospectively analyzed using the EORTC QLQ-C30 questionnaire. Swallowing structures were retrospectively delineated on the original treatment planning CT. Dose-volume histograms were calculated for swallowing structures and D{sub mean}, D{sub max} and V50-V64 values (in 2 Gy increments) were determined for each patient. Tumor volume and infiltration of the swallowing apparatus was defined by CT before induction chemotherapy. Of the 45 patients, 26 (57.8 %) fully regained swallowing function after chemoradiotherapy. A further 12 patients (26.7 %) were able to manage soft, pureed and/or liquid foods; the remaining 7 (15.6 %) were completely dependent on percutaneous endoscopic gastrostomy (PEG). Posttreatment swallowing function was significantly influenced by D{sub mean} to the superior pharyngeal constrictor muscle (PCM, p = 0.041). Correlations between late dysphagia and dose-volume relationships in the superior PCM and soft palate were also observed, which were significant from V60 (p = 0.043) and V58 for the soft palate and superior PCM, respectively. Of the evaluated clinical and tumor-related factors, only alcohol abuse (p = 0.024) had an influence on posttreatment swallowing function. Almost 50 % of patients had deterioration of swallowing function after definitive chemoradiotherapy for laryngopharyngeal cancer. The dose to anatomical structures responsible for swallowing function appears to play a role. Therefore, in selected patients, target

  17. Dose-dependent deterioration of swallowing function after induction chemotherapy and definitive chemoradiotherapy for laryngopharyngeal cancer

    International Nuclear Information System (INIS)

    Haderlein, M.; Semrau, S.; Ott, O.; Speer, S.; Fietkau, R.; Bohr, C.

    2014-01-01

    To evaluate the influence of clinical, treatment- and dose-dependent factors on posttreatment swallowing function after induction chemotherapy and definitive chemoradiotherapy in a group of homogeneously treated laryngopharyngeal cancer patients. From 28 May 2008 to 15 February 2013, 45 patients with borderline inoperable laryngopharyngeal cancer that had responded well to induction chemotherapy were treated with definitive chemoradiotherapy. Median follow-up was 22 months. Swallowing function and clinical data were prospectively analyzed using the EORTC QLQ-C30 questionnaire. Swallowing structures were retrospectively delineated on the original treatment planning CT. Dose-volume histograms were calculated for swallowing structures and D mean , D max and V50-V64 values (in 2 Gy increments) were determined for each patient. Tumor volume and infiltration of the swallowing apparatus was defined by CT before induction chemotherapy. Of the 45 patients, 26 (57.8 %) fully regained swallowing function after chemoradiotherapy. A further 12 patients (26.7 %) were able to manage soft, pureed and/or liquid foods; the remaining 7 (15.6 %) were completely dependent on percutaneous endoscopic gastrostomy (PEG). Posttreatment swallowing function was significantly influenced by D mean to the superior pharyngeal constrictor muscle (PCM, p = 0.041). Correlations between late dysphagia and dose-volume relationships in the superior PCM and soft palate were also observed, which were significant from V60 (p = 0.043) and V58 for the soft palate and superior PCM, respectively. Of the evaluated clinical and tumor-related factors, only alcohol abuse (p = 0.024) had an influence on posttreatment swallowing function. Almost 50 % of patients had deterioration of swallowing function after definitive chemoradiotherapy for laryngopharyngeal cancer. The dose to anatomical structures responsible for swallowing function appears to play a role. Therefore, in selected patients, target volume

  18. High-dose-rate brachytherapy as salvage modality for locally recurrent prostate cancer after definitive radiotherapy. A systematic review

    International Nuclear Information System (INIS)

    Chatzikonstantinou, Georgios; Zamboglou, Nikolaos; Roedel, Claus; Tselis, Nikolaos; Zoga, Eleni; Strouthos, Iosif; Butt, Saeed Ahmed

    2017-01-01

    To review the current status of interstitial high-dose-rate brachytherapy as a salvage modality (sHDR BRT) for locally recurrent prostate cancer after definitive radiotherapy (RT). A literature search was performed in PubMed using ''high-dose-rate, brachytherapy, prostate cancer, salvage'' as search terms. In all, 51 search results published between 2000 and 2016 were identified. Data tables were generated and summary descriptions created. The main outcome parameters used were biochemical control (BC) and toxicity scores. Eleven publications reported clinical outcome and toxicity with follow-up ranging from 4-191 months. A variety of dose and fractionation schedules were described, including 19.0 Gy in 2 fractions up to 42.0 Gy in 6 fractions. The 5-year BC ranged from 18-77%. Late grade 3 genitourinary and gastrointestinal toxicity was 0-32% and 0-5.1%, respectively. sHDR BRT appears as safe and effective salvage modality for the reirradiation of locally recurrent prostate cancer after definitive RT. (orig.) [de

  19. Volumes and doses for external radiotherapy - Definitions and recommendations; Volum og doser i ekstern straaleterapi - Definisjoner og anbefalinger

    Energy Technology Data Exchange (ETDEWEB)

    Levernes, Sverre (ed.)

    2012-07-01

    The report contains definitions of volume and dose parameters for external radiotherapy. In addition the report contains recommendations for use, documentation and minimum reporting for radiotherapy of the individual patient.(Author)

  20. Assessment of radioactive residues arising from radiolabel instability in a multiple dose tissue distribution study in rats

    International Nuclear Information System (INIS)

    Slatter, J.G.; Sams, J.P.; Easter, J.A.

    2003-01-01

    Our study objectives were to quantitatively determine the effect of radiolabel instability on terminal phase radioactive tissue residues in a multiple dose tissue distribution study, to quantitatively compare tissue residue artifacts (non drug-related radioactivity) from two chemically-distinct radiolabel locations, and to conduct a definitive multiple dose tissue distribution study using the better of the two radiolabeled compounds. We compared the excretion and tissue distribution in rats of [ 14 C]linezolid, radiolabeled in two different locations, after 7 consecutive once daily [ 14 C] oral doses. The radiolabels were in the acetamide (two carbon) and oxazolidinone (isolated carbon) functional groups. Terminal phase tissue residue and excretion data were compared to data from rats dosed orally with [ 14 C]sodium acetate. Drug-related radioactivity was excreted rapidly over 24 h. After a single dose, the acetamide and oxazolidinone radiolabel sites both gave 3% of dose as exhaled 14 CO 2 . After 7 daily [ 14 C] oral doses, terminal phase radioactive tissue residues were higher from the acetamide radiolabel, relative to the oxazolidinone radiolabel, and were primarily not drug-related. In the definitive tissue distribution study, low concentrations of drug-related radioactivity in skin and thyroid were observed. We conclude that although small amounts of radiolabel instability do not significantly affect single dose tissue radioactivity C max and area under the curve (AUC), artifacts arising from radiolabel instability can prolong the apparent terminal phase half life and complicate study data interpretation. When possible, it is always preferable to use a completely stable radiolabel site. (author)

  1. Assessment of radioactive residues arising from radiolabel instability in a multiple dose tissue distribution study in rats

    Energy Technology Data Exchange (ETDEWEB)

    Slatter, J.G. [Pharmacia Corp., Peapack, NJ (United States); Sams, J.P.; Easter, J.A. [Pharmacia Corp., Kalamazoo, MI (United States)] [and others

    2003-05-01

    Our study objectives were to quantitatively determine the effect of radiolabel instability on terminal phase radioactive tissue residues in a multiple dose tissue distribution study, to quantitatively compare tissue residue artifacts (non drug-related radioactivity) from two chemically-distinct radiolabel locations, and to conduct a definitive multiple dose tissue distribution study using the better of the two radiolabeled compounds. We compared the excretion and tissue distribution in rats of [{sup 14}C]linezolid, radiolabeled in two different locations, after 7 consecutive once daily [{sup 14}C] oral doses. The radiolabels were in the acetamide (two carbon) and oxazolidinone (isolated carbon) functional groups. Terminal phase tissue residue and excretion data were compared to data from rats dosed orally with [{sup 14}C]sodium acetate. Drug-related radioactivity was excreted rapidly over 24 h. After a single dose, the acetamide and oxazolidinone radiolabel sites both gave 3% of dose as exhaled {sup 14}CO{sub 2}. After 7 daily [{sup 14}C] oral doses, terminal phase radioactive tissue residues were higher from the acetamide radiolabel, relative to the oxazolidinone radiolabel, and were primarily not drug-related. In the definitive tissue distribution study, low concentrations of drug-related radioactivity in skin and thyroid were observed. We conclude that although small amounts of radiolabel instability do not significantly affect single dose tissue radioactivity C{sub max} and area under the curve (AUC), artifacts arising from radiolabel instability can prolong the apparent terminal phase half life and complicate study data interpretation. When possible, it is always preferable to use a completely stable radiolabel site. (author)

  2. Radiation dose reduction for CT lung cancer screening using ASIR and MBIR: a phantom study.

    Science.gov (United States)

    Mathieu, Kelsey B; Ai, Hua; Fox, Patricia S; Godoy, Myrna Cobos Barco; Munden, Reginald F; de Groot, Patricia M; Pan, Tinsu

    2014-03-06

    The purpose of this study was to reduce the radiation dosage associated with computed tomography (CT) lung cancer screening while maintaining overall diagnostic image quality and definition of ground-glass opacities (GGOs). A lung screening phantom and a multipurpose chest phantom were used to quantitatively assess the performance of two iterative image reconstruction algorithms (adaptive statistical iterative reconstruction (ASIR) and model-based iterative reconstruction (MBIR)) used in conjunction with reduced tube currents relative to a standard clinical lung cancer screening protocol (51 effective mAs (3.9 mGy) and filtered back-projection (FBP) reconstruction). To further assess the algorithms' performances, qualitative image analysis was conducted (in the form of a reader study) using the multipurpose chest phantom, which was implanted with GGOs of two densities. Our quantitative image analysis indicated that tube current, and thus radiation dose, could be reduced by 40% or 80% from ASIR or MBIR, respectively, compared with conventional FBP, while maintaining similar image noise magnitude and contrast-to-noise ratio. The qualitative portion of our study, which assessed reader preference, yielded similar results, indicating that dose could be reduced by 60% (to 20 effective mAs (1.6 mGy)) with either ASIR or MBIR, while maintaining GGO definition. Additionally, the readers' preferences (as indicated by their ratings) regarding overall image quality were equal or better (for a given dose) when using ASIR or MBIR, compared with FBP. In conclusion, combining ASIR or MBIR with reduced tube current may allow for lower doses while maintaining overall diagnostic image quality, as well as GGO definition, during CT lung cancer screening.

  3. Contribution to the study of fluoride dosing by using a membrane selective electrode

    International Nuclear Information System (INIS)

    Rivas, Jean de

    1972-01-01

    As the method of dosing fluoride ions by precipitation with lead fluorochloride is not very satisfying, the author reports the study of a new process for the dosing of the fluorine ion by using a selective electrode. After some generalities on selective electrodes (principle, types, operation principle) and some recalls and definitions (Galvani and Volta potential, stability constants of complexes, principles of diffusion in solids), the author reports the study of the diffusion potential in glass membranes, the study of the membrane potential, and the study of the ion exchange equilibrium. He presents methods of calculation of selectivity coefficients of membrane electrodes, and the reports experiments performed in laboratory

  4. On uncertainties in definition of dose equivalent

    International Nuclear Information System (INIS)

    Oda, Keiji

    1995-01-01

    The author has entertained always the doubt that in a neutron field, if the measured value of the absorbed dose with a tissue equivalent ionization chamber is 1.02±0.01 mGy, may the dose equivalent be taken as 10.2±0.1 mSv. Should it be 10.2 or 11, but the author considers it is 10 or 20. Even if effort is exerted for the precision measurement of absorbed dose, if the coefficient being multiplied to it is not precise, it is meaningless. [Absorbed dose] x [Radiation quality fctor] = [Dose equivalent] seems peculiar. How accurately can dose equivalent be evaluated ? The descriptions related to uncertainties in the publications of ICRU and ICRP are introduced, which are related to radiation quality factor, the accuracy of measuring dose equivalent and so on. Dose equivalent shows the criterion for the degree of risk, or it is considered only as a controlling quantity. The description in the ICRU report 1973 related to dose equivalent and its unit is cited. It was concluded that dose equivalent can be considered only as the absorbed dose being multiplied by a dimensionless factor. The author presented the questions. (K.I.)

  5. Measurement-based Monte Carlo simulation of high definition dose evaluation for nasopharyngeal cancer patients treated by using intensity modulated radiation therapy

    International Nuclear Information System (INIS)

    Yeh, C.Y.; Tung, C.J.; Lee, C.C.; Lin, M.H.; Chao, T.C.

    2014-01-01

    Measurement-based Monte Carlo (MBMC) simulation using a high definition (HD) phantom was used to evaluate the dose distribution in nasopharyngeal cancer (NPC) patients treated with intensity modulated radiation therapy (IMRT). Around nasopharyngeal cavity, there exists many small volume organs-at-risk (OARs) such as the optic nerves, auditory nerves, cochlea, and semicircular canal which necessitate the use of a high definition phantom for accurate and correct dose evaluation. The aim of this research was to study the advantages of using an HD phantom for MBMC simulation in NPC patients treated with IMRT. The MBMC simulation in this study was based on the IMRT treatment plan of three NPC patients generated by the anisotropic analytical algorithm (AAA) of the Eclipse treatment planning system (Varian Medical Systems, Palo Alto, CA, USA) using a calculation grid of 2 mm 2 . The NPC tumor was treated to a cumulative dose of 7000 cGy in 35 fractions using the shrinking-field sequential IMRT (SIMRT) method. The BEAMnrc MC Code was used to simulate a Varian EX21 linear accelerator treatment head. The HD phantom contained 0.5 × 0.5 × 1 mm 3 voxels for the nasopharyngeal area and 0.5 × 0.5 × 3 mm 3 for the rest of the head area. An efficiency map was obtained for the amorphous silicon aS1000 electronic portal imaging device (EPID) to adjust the weighting of each particle in the phase-space file for each IMRT beam. Our analysis revealed that small volume organs such as the eighth cranial nerve, semicircular canal, cochlea and external auditory canal showed an absolute dose difference of ≥200 cGy, while the dose difference for larger organs such as the parotid glands and tumor was negligible for the MBMC simulation using the HD phantom. The HD phantom was found to be suitable for Monte Carlo dose volume analysis of small volume organs. - Highlights: • HD dose evaluation for IMRT of NPC patients have been verified by the MC method. • MC results shows

  6. Observation of environmental radioactivity at definite time and definite point

    International Nuclear Information System (INIS)

    Inokoshi, Yukio; Fukuchi, Ryoichi; Irie, Takayuki; Hosoda, Nagako; Okano, Yasuhiro; Shindo, Koutaro

    1990-01-01

    The measurement of environmental radioactivity in Tokyo Metropolis was carried out. The objects of measurement were rainwater, atmospheric floating dusts, spatial dose and the activated sludge in sewage treatment plants. Rainwater, atmospheric floating dusts and spatial dose were analyzed mainly considering radioactive fallout, and activated sludge was analyzed mainly considering radioactive medical matters. For the analysis of nuclides, a Ge(Li) semiconductor detector was used, and spatial dose rate was measured with a DBM type dose rate meter. In activated sludge, the nuclides used for radioactive medicines were found, but in rainwater, atmospheric floating dusts and spatial dose, particular abnormality was not found. The objective of this investigation is to collect over long period at definite time and definite points the data on environmental radioactivity in Tokyo, thus to grasp the level of normal values, and in abnormal case, to clarify the cause and to evaluate the exposure dose. The instruments used, the method of measuring each object and the results are reported. (K.I.)

  7. [Evaluation of Organ Dose Estimation from Indices of CT Dose Using Dose Index Registry].

    Science.gov (United States)

    Iriuchijima, Akiko; Fukushima, Yasuhiro; Ogura, Akio

    Direct measurement of each patient organ dose from computed tomography (CT) is not possible. Most methods to estimate patient organ dose is using Monte Carlo simulation with dedicated software. However, dedicated software is too expensive for small scale hospitals. Not every hospital can estimate organ dose with dedicated software. The purpose of this study was to evaluate the simple method of organ dose estimation using some common indices of CT dose. The Monte Carlo simulation software Radimetrics (Bayer) was used for calculating organ dose and analysis relationship between indices of CT dose and organ dose. Multidetector CT scanners were compared with those from two manufactures (LightSpeed VCT, GE Healthcare; SOMATOM Definition Flash, Siemens Healthcare). Using stored patient data from Radimetrics, the relationships between indices of CT dose and organ dose were indicated as each formula for estimating organ dose. The accuracy of estimation method of organ dose was compared with the results of Monte Carlo simulation using the Bland-Altman plots. In the results, SSDE was the feasible index for estimation organ dose in almost organs because it reflected each patient size. The differences of organ dose between estimation and simulation were within 23%. In conclusion, our estimation method of organ dose using indices of CT dose is convenient for clinical with accuracy.

  8. Image quality of low-dose CCTA in obese patients: impact of high-definition computed tomography and adaptive statistical iterative reconstruction.

    Science.gov (United States)

    Gebhard, Cathérine; Fuchs, Tobias A; Fiechter, Michael; Stehli, Julia; Stähli, Barbara E; Gaemperli, Oliver; Kaufmann, Philipp A

    2013-10-01

    The accuracy of coronary computed tomography angiography (CCTA) in obese persons is compromised by increased image noise. We investigated CCTA image quality acquired on a high-definition 64-slice CT scanner using modern adaptive statistical iterative reconstruction (ASIR). Seventy overweight and obese patients (24 males; mean age 57 years, mean body mass index 33 kg/m(2)) were studied with clinically-indicated contrast enhanced CCTA. Thirty-five patients underwent a standard definition protocol with filtered backprojection reconstruction (SD-FBP) while 35 patients matched for gender, age, body mass index and coronary artery calcifications underwent a novel high definition protocol with ASIR (HD-ASIR). Segment by segment image quality was assessed using a four-point scale (1 = excellent, 2 = good, 3 = moderate, 4 = non-diagnostic) and revealed better scores for HD-ASIR compared to SD-FBP (1.5 ± 0.43 vs. 1.8 ± 0.48; p ASIR as compared to 1.4 ± 0.4 mm for SD-FBP (p ASIR (388.3 ± 109.6 versus 350.6 ± 90.3 Hounsfield Units, HU; p ASIR vs. SD-ASIR respectively). Compared to a standard definition backprojection protocol (SD-FBP), a newer high definition scan protocol in combination with ASIR (HD-ASIR) incrementally improved image quality and visualization of distal coronary artery segments in overweight and obese individuals, without increasing image noise and radiation dose.

  9. Application of organ tolerance dose-constraints in clinical studies in radiation oncology

    International Nuclear Information System (INIS)

    Doerr, Wolfgang; Herrmann, Thomas; Baumann, Michael

    2014-01-01

    In modern radiation oncology, tolerance dose-constraints for organs at risk (OAR) must be considered for treatment planning, but particularly in order to design clinical studies. Tolerance dose tables, however, only address one aspect of the therapeutic ratio of any clinical study, i.e., the limitation of adverse events, but not the desired potential improvement in the tumor effect of a novel treatment strategy. A sensible application of ''tolerance doses'' in a clinical situation requires consideration of various critical aspects addressed here: definition of tolerance dose, specification of an endpoint/symptom, consideration of radiation quality and irradiation protocol, exposed volume and dose distribution, and patient-related factors of radiosensitivity. The currently most comprehensive estimates of OAR radiation tolerance are in the QUANTEC compilations (2010). However, these tolerance dose values must only be regarded as a rough orientation and cannot answer the relevant question for the patients, i.e., if the study can achieve a therapeutic advantage; this can obviously be answered only by the final scientific analysis of the study results. Despite all limitations, the design of clinical studies should currently refer to the QUANTEC values for appreciation of the risk of complications, if needed supplemented by one's own data or further information from the literature. The implementation of a consensus on the safety interests of the patients and on an application and approval process committed to progress in medicine, with transparent quality-assuring requirements with regard to the structural safeguarding of the study activities, plays a central role in clinical research in radiation oncology. (orig.) [de

  10. Chernobyl liquidators. The people and the doses

    International Nuclear Information System (INIS)

    Belyakov, Oleg V.; Steinhaeusler, Friedrich; Trott, Klaus-Ruediger

    2000-01-01

    This study is an attempt to evaluate the data available from the scientific literature concerning clean-up workers, or so-called liquidators, of the Chernobyl accident. There are several different definitions of liquidators: Legal definitions of 'liquidators'. Their importance rests on the fact that some state Chernobyl registers are based on these definitions. Definitions from various scientific reports. Definitions for the purpose, which have been published in scientific papers and books. The simplified definition of liquidators would be people who were directly involved in clean-up operations in the exclusion zone in 1986-1991. Estimations of the number of liquidators vary from 100 000 to 800 000 people. Four major cohorts of liquidators are now split among Russia (168,000 people), Belarus (63,500 people), Ukraine (123,536 people) and the Baltic States (about 15,000 people from Estonia, Latvia and Lithuania). The definition of liquidator and the formation of cohort are the most critical factor in liquidator-related studies and not enough attention is paid to this matter by researchers. The term 'liquidator' describes a very heterogeneous group of people. Liquidators may be grouped according to work performed in the exclusion zone or affiliation to various organisations. The majority of liquidators in 1986-1987 were conscripts and reservists of the Soviet Union Army. According to data from Russian National Medical and Dosimetric Registry, 76% of liquidators were 25-39 years old at the moment of arrival to the Chernobyl area. Only about 1% of liquidators was women. From the results of biodosimetry we know that the average accumulated dose estimation for the liquidator group is about 0.2 Gy. The official documented average dose from the Russian National Medical Dosimetric Registry is 0.13 Gy. However, the liquidator group contains some overexposed subgroups with a higher accumulated dose. Individual dosimetry is only available for small subgroups of liquidators

  11. Chernobyl liquidators. The people and the doses

    Energy Technology Data Exchange (ETDEWEB)

    Belyakov, Oleg V. [Gray Laboratory Cancer Research Trust, Mount Vernon Hospital, Northwood (United Kingdom); Steinhaeusler, Friedrich [University of Salzburg, Institute of Physic and Biophysics, Salzburg (Austria); Trott, Klaus-Ruediger [Univ. of London, Queen Mary and Westfield College, St. Bartholomew' s and the Royal London Hospital School of Medicine and Dentistry, London (United Kingdom)

    2000-05-01

    This study is an attempt to evaluate the data available from the scientific literature concerning clean-up workers, or so-called liquidators, of the Chernobyl accident. There are several different definitions of liquidators: Legal definitions of 'liquidators'. Their importance rests on the fact that some state Chernobyl registers are based on these definitions. Definitions from various scientific reports. Definitions for the purpose, which have been published in scientific papers and books. The simplified definition of liquidators would be people who were directly involved in clean-up operations in the exclusion zone in 1986-1991. Estimations of the number of liquidators vary from 100 000 to 800 000 people. Four major cohorts of liquidators are now split among Russia (168,000 people), Belarus (63,500 people), Ukraine (123,536 people) and the Baltic States (about 15,000 people from Estonia, Latvia and Lithuania). The definition of liquidator and the formation of cohort are the most critical factor in liquidator-related studies and not enough attention is paid to this matter by researchers. The term 'liquidator' describes a very heterogeneous group of people. Liquidators may be grouped according to work performed in the exclusion zone or affiliation to various organisations. The majority of liquidators in 1986-1987 were conscripts and reservists of the Soviet Union Army. According to data from Russian National Medical and Dosimetric Registry, 76% of liquidators were 25-39 years old at the moment of arrival to the Chernobyl area. Only about 1% of liquidators was women. From the results of biodosimetry we know that the average accumulated dose estimation for the liquidator group is about 0.2 Gy. The official documented average dose from the Russian National Medical Dosimetric Registry is 0.13 Gy. However, the liquidator group contains some overexposed subgroups with a higher accumulated dose. Individual dosimetry is only available for small

  12. Terms and definitions in the field of radiological technique. Dose quantities and units. Draft. Begriffe und Benennungen in der radiologischen Technik. Dosisgroessen und Dosiseinheiten. Entwurf

    Energy Technology Data Exchange (ETDEWEB)

    1977-11-01

    This draft standard contains the definitions of the terms, quantities, and units important in dosimetry, while the methods of measurement and calculation are dealt with in other standards. Other than the standard of June 1972, this revised draft standard introduces the SI units of the energy dose, the Gray, and of the activity of a radioactive substance, the Becquerel. Important new measuring quantities are the standard energy dose and the dose equivalent index. The terms local dose and personnel dose are redefined in agreement with the Radiation Protection Ordinance of October 13, 1976.

  13. Terms and definitions in the field of radiological technique. Dose quantities and units. Draft. Begriffe und Benennungen in der radiologischen Technik. Dosisgroessen und Dosiseinheiten. Entwurf

    Energy Technology Data Exchange (ETDEWEB)

    1977-11-01

    The standard contains the definitions of terms, quantities and units important in dosimetry, while other standards deal with the measurement and calculation methods. As against the June 1972 edition, this amended standard introduces the SI units of the energy dose, the Gray (Gy), and of the activity of a radioactive substance, the Becquerel (Bq). Important new measuring quantities are the standard energy dose and the equivalent dose index. The terms local dose and personnel dose are redefined in accordance with the Radiation Protection Ordinance of Oct. 13th, 1976.

  14. Calculation methods for determining dose equivalent

    International Nuclear Information System (INIS)

    Endres, G.W.R.; Tanner, J.E.; Scherpelz, R.I.; Hadlock, D.E.

    1988-01-01

    A series of calculations of neutron fluence as a function of energy in an anthropomorphic phantom was performed to develop a system for determining effective dose equivalent for external radiation sources. critical organ dose equivalents are calculated and effective dose equivalents are determined using ICRP-26 methods. Quality factors based on both present definitions and ICRP-40 definitions are used in the analysis. The results of these calculations are presented and discussed

  15. Low doses effects and gamma radiations low dose rates

    International Nuclear Information System (INIS)

    Averbeck, D.

    1999-01-01

    This expose wishes for bringing some definitions and base facts relative to the problematics of low doses effects and low dose rates effects. It shows some already used methods and some actual experimental approaches by focusing on the effects of ionizing radiations with a low linear energy transfer. (N.C.)

  16. Low doses effects and gamma radiations low dose rates; Les effets des faibles doses et des faibles debits de doses de rayons gamma

    Energy Technology Data Exchange (ETDEWEB)

    Averbeck, D [Institut Curie, CNRS UMR 2027, 75 - Paris (France)

    1999-07-01

    This expose wishes for bringing some definitions and base facts relative to the problematics of low doses effects and low dose rates effects. It shows some already used methods and some actual experimental approaches by focusing on the effects of ionizing radiations with a low linear energy transfer. (N.C.)

  17. Application of radio-thermoluminescence to the experimental study of the dose equivalent index

    International Nuclear Information System (INIS)

    Katz, Elvira-Beatriz

    1980-01-01

    First, the Systems of dose limitation proposed by the ICRP since 1965 are analysed. The notion of 'critical organ' is replaced by the system based on the effective dose equivalent (ICRP 77). In the same document, the 'dose equivalent index' (H I ) is suggested as a secondary limit. Here, its first definition, later modifications, advantages, and inconveniences are discussed. The second part of the study is devoted to the experimental determination of H I for X and gamma (Co 60 ) beams by radioluminescent (RTL) dosimetry. In order to take into account the different chromatic relative sensitivities of the detectors used lithium fluoride (powder and pellets), lithium borate (pellets) and calcium sulfate activated by dysprosium (powder) these latter are measured within the (10-1250) keV energy range. With the help of the preceding values and the results of the RTL measurements carried out inside the ICRU spherical phantom, the corresponding absorbed doses are deduced in order to calculate H I . (author) [fr

  18. High-dose-rate brachytherapy as salvage modality for locally recurrent prostate cancer after definitive radiotherapy. A systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Chatzikonstantinou, Georgios; Zamboglou, Nikolaos; Roedel, Claus; Tselis, Nikolaos [J.W. Goethe University of Frankfurt, Department of Radiotherapy and Oncology, Frankfurt am Main (Germany); Zoga, Eleni [Sana Klinikum Offenbach, Department of Radiotherapy and Oncology, Offenbach am Main (Germany); Strouthos, Iosif [Medical Center - University of Freiburg, Department of Radiotherapy and Oncology, University of Freiburg, Freiburg (Germany); Butt, Saeed Ahmed [Sana Klinikum Offenbach, Department of Medical Physics and Engineering, Offenbach am Main (Germany)

    2017-09-15

    To review the current status of interstitial high-dose-rate brachytherapy as a salvage modality (sHDR BRT) for locally recurrent prostate cancer after definitive radiotherapy (RT). A literature search was performed in PubMed using ''high-dose-rate, brachytherapy, prostate cancer, salvage'' as search terms. In all, 51 search results published between 2000 and 2016 were identified. Data tables were generated and summary descriptions created. The main outcome parameters used were biochemical control (BC) and toxicity scores. Eleven publications reported clinical outcome and toxicity with follow-up ranging from 4-191 months. A variety of dose and fractionation schedules were described, including 19.0 Gy in 2 fractions up to 42.0 Gy in 6 fractions. The 5-year BC ranged from 18-77%. Late grade 3 genitourinary and gastrointestinal toxicity was 0-32% and 0-5.1%, respectively. sHDR BRT appears as safe and effective salvage modality for the reirradiation of locally recurrent prostate cancer after definitive RT. (orig.) [German] Zusammenfassende Darstellung relevanter Literatur zur interstitiellen High-Dose-Rate-Brachytherapie als Salvage-Modalitaet (sHDR-BRT) bei der Behandlung des lokal rezidivierten Prostatakarzinoms nach vorausgegangener definitiver Radiotherapie (RT). In der PubMed-Datenbank wurde eine Literaturrecherche mit den Suchbegriffen ''high-dose-rate, brachytherapy, prostate cancer, salvage'' durchgefuehrt. Zwischen den Jahren 2000 und 2016 wurden 51 Publikationen identifiziert. Die biochemische Kontrolle (BC) sowie das assoziierte Toxizitaetsprofil waren onkologische Hauptpunkte in der Analyse der beruecksichtigten Literatur. Von onkologischen Ergebnissen und Toxizitaeten berichteten 11 Publikationen bei einer medianen Nachbeobachtungszeit von 4-191 Monaten. Eine Variabilitaet von Dosis- und Fraktionierungsregimen wurde beschrieben mit totalen physikalischen Dosen von 19,0 Gy in 2 Fraktionen bis zu 42,0 Gy in 6 Fraktionen

  19. 40 CFR 61.91 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... included. The method for calculating effective dose equivalent and the definition of reference man are... 40 Protection of Environment 8 2010-07-01 2010-07-01 false Definitions. 61.91 Section 61.91... Other Than Radon From Department of Energy Facilities § 61.91 Definitions. As used in this subpart, all...

  20. Toward a definition of a threshold for harmless doses to the anal-sphincter region and the rectum

    International Nuclear Information System (INIS)

    Al-Abany, Massoud; Helgason, Asgeir R.; Agren Cronqvist, Anna-Karin; Lind, Bengt; Mavroidis, Panayiotis; Wersaell, Peter; Lind, Helena; Qvanta, Eva; Steineck, Gunnar

    2005-01-01

    Purpose: To investigate dysfunction caused by unwanted radiation to the anal-sphincter region and the rectum. Methods and materials: A questionnaire assessing bowel symptoms, sexual function, and urinary symptoms was sent to 72 patients with clinically localized prostatic adenocarcinoma treated by external beam radiation therapy at the Radiumhemmet, Karolinska Hospital, in Stockholm, Sweden, 2-4 years after treatment. The mean percentage dose-volume histograms for patients with and without the specific symptom were calculated. Results: Of the 65 patients providing information, 9 reported fecal leakage, 10 blood and mucus in stools, 10 defecation urgency, and 7 diarrhea or loose stools. None of the 19 and 13 patients who received, respectively, a dose of ≥35 Gy to ≤60% or ≥40 Gy to ≤40% of the anal-sphincter region volume reported fecal leakage (p < 0.05). In dose-volume histograms, a statistically significant correlation was found between radiation to the anal-sphincter region and the risk of fecal leakage in the interval 45-55 Gy. There was also a statistically significant correlation between radiation to the rectum and the risk of defecation urgency and diarrhea or loose stools in the interval 25-42 Gy. No relationship was found between anatomic rectal wall volume and the investigated late effects. Conclusions: Although the limited data in this study prevent the definition of a conclusive threshold regarding volume and dose to the anal-sphincter region and untoward morbidity, it seems that careful monitoring of unnecessary irradiation to this area should be done because it can potentially help reduce the risk of adverse effects, such as fecal leakage. Future studies should pay more attention to the anal-sphincter region and help to more rigorously define its radiotherapeutic tolerance

  1. 40 CFR 61.21 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... dose equivalent and the definition of reference man are outlined in the International Commission on... 40 Protection of Environment 8 2010-07-01 2010-07-01 false Definitions. 61.21 Section 61.21... Underground Uranium Mines § 61.21 Definitions. As used in this subpart, all terms not defined here have the...

  2. The experimental study and clinical application on the detection of pulmonary nodules with low-dose multislice spiral CT

    International Nuclear Information System (INIS)

    Wu Xiaohua; Ma Daqing; Zhang Zhongjia; Ji Jingling; Zhang Yansong

    2004-01-01

    Objective: To investigate the detection rate of pulmonary nodules ,especially nodules ≤5 mm, in variable low-doses, and to evaluate the imaging quality of low-dose MSCT. Methods: Six postmortem specimens of patients with pneumoconiosis after necropsy were fixed at end-inspiratory volume. The fixed specimens were examined by using MSCT with standard dose (130 mA) and low-dose (50, 30, 10 mA, respectively). Low-dose MSCT scans of 40 asymptomatic volunteers and 60 patients with pulmonary metastasis were also examined with 30 mA. The numbers of pulmonary nodules less than 5 mm at standard-dose and different low-dose were recorded. Nodules were assessed by diagnostic confidence ('definite nodule', 'questionable nodule', and 'definite not nodule'). The number of images with artifact in specimens and in 40 volunteers and 60 patients with pulmonary metastasis were recorded. Results: In specimen's study, the Kappa values of groups of low-dose (50, 30, 10 mA) were 0.515, 0.242, and 0.154, respectively. The group of 50 mA had a good coincidence with standard-dose group by U test. The sensitivity of group 50, 30, 10 mA was 88.0%, 78.4%, and 75.0%, respectively. The positive predictive values of which were 98%, 94%, and 93%, respectively. The correction rates of which were 85%, 73%, and 69%, respectively. In specimens' images, subtle linear artifact was showed only in paravertebral lung field in 21 images of 31 at the group of 10 mA. Linear artifacts that affected small nodule detection were showed in lung apexes in 3 of 100 subjects. Conclusion: Low-dose MSCT is expected to improve early detection of lung cancer. Pulmonary nodules less than 5 mm could be reliably detected at 50 mA tube current in specimens. Low-dose CT (30 mA) showed satisfactory imaging quality in our study. Low-dose CT screening for lung cancer may be applied if situation permits. (authors)

  3. Choline PET based dose-painting in prostate cancer - Modelling of dose effects

    International Nuclear Information System (INIS)

    Niyazi, Maximilian; Bartenstein, Peter; Belka, Claus; Ganswindt, Ute

    2010-01-01

    Several randomized trials have documented the value of radiation dose escalation in patients with prostate cancer, especially in patients with intermediate risk profile. Up to now dose escalation is usually applied to the whole prostate. IMRT and related techniques currently allow for dose escalation in sub-volumes of the organ. However, the sensitivity of the imaging modality and the fact that small islands of cancer are often dispersed within the whole organ may limit these approaches with regard to a clear clinical benefit. In order to assess potential effects of a dose escalation in certain sub-volumes based on choline PET imaging a mathematical dose-response model was developed. Based on different assumptions for α/β, γ50, sensitivity and specificity of choline PET, the influence of the whole prostate and simultaneous integrated boost (SIB) dose on tumor control probability (TCP) was calculated. Based on the given heterogeneity of all potential variables certain representative permutations of the parameters were chosen and, subsequently, the influence on TCP was assessed. Using schedules with 74 Gy within the whole prostate and a SIB dose of 90 Gy the TCP increase ranged from 23.1% (high detection rate of choline PET, low whole prostate dose, high γ50/ASTRO definition for tumor control) to 1.4% TCP gain (low sensitivity of PET, high whole prostate dose, CN + 2 definition for tumor control) or even 0% in selected cases. The corresponding initial TCP values without integrated boost ranged from 67.3% to 100%. According to a large data set of intermediate-risk prostate cancer patients the resulting TCP gains ranged from 22.2% to 10.1% (ASTRO definition) or from 13.2% to 6.0% (CN + 2 definition). Although a simplified mathematical model was employed, the presented model allows for an estimation in how far given schedules are relevant for clinical practice. However, the benefit of a SIB based on choline PET seems less than intuitively expected. Only under the

  4. Late effects of low doses and dose rates

    International Nuclear Information System (INIS)

    Paretzke, H.G.

    1980-01-01

    This paper outlines the spectrum of problems and approaches used in work on the derivation of quantitative prognoses of late effects in man of low doses and dose rates. The origins of principal problems encountered in radiation risks assessments, definitions and explanations of useful quantities, methods of deriving risk factors from biological and epidemiological data, and concepts of risk evaluation and problems of acceptance are individually discussed

  5. 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

  6. Calculation methods for determining dose equivalent

    International Nuclear Information System (INIS)

    Endres, G.W.R.; Tanner, J.E.; Scherpelz, R.I.; Hadlock, D.E.

    1987-11-01

    A series of calculations of neutron fluence as a function of energy in an anthropomorphic phantom was performed to develop a system for determining effective dose equivalent for external radiation sources. Critical organ dose equivalents are calculated and effective dose equivalents are determined using ICRP-26 [1] methods. Quality factors based on both present definitions and ICRP-40 definitions are used in the analysis. The results of these calculations are presented and discussed. The effective dose equivalent determined using ICRP-26 methods is significantly smaller than the dose equivalent determined by traditional methods. No existing personnel dosimeter or health physics instrument can determine effective dose equivalent. At the present time, the conversion of dosimeter response to dose equivalent is based on calculations for maximal or ''cap'' values using homogeneous spherical or cylindrical phantoms. The evaluated dose equivalent is, therefore, a poor approximation of the effective dose equivalent as defined by ICRP Publication 26. 3 refs., 2 figs., 1 tab

  7. Innovative design for a phase 1 trial with intra-patient dose escalation: The Crotoxin study

    Directory of Open Access Journals (Sweden)

    Jacques Medioni

    2017-09-01

    Full Text Available Introduction: Crotoxin has a broad antitumor activity but has shown frequent neurotoxic toxicity. To induce tolerance and limit this toxicity, we propose a new design with intra-patient dose escalation. Methods: A new Dose Limiting Toxicity definition was used. The concept of Target Ceiling Dose was introduced. Results: Dose Limiting Toxicity was the inability to dose escalate twice. Target Ceiling Dose was the highest planned dose to be administered to a patient and could change for patients along time. Recommended Dose was defined similarly as in a (3 + 3 conventional design. Conclusion: This innovant design was used and the clinical trial is now closed for inclusions. Results will be presented later. Keywords: Clinical trial, Phase 1, Intra-patient dose escalation, Cancer

  8. Application of organ tolerance dose-constraints in clinical studies in radiation oncology

    Energy Technology Data Exchange (ETDEWEB)

    Doerr, Wolfgang [Medical University/AKH Vienna, Dept. of Radiation Oncology/Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Comprehensive Cancer Center, Vienna (Austria); Technical University Dresden, Department of Radiotherapy and Radiation Oncology, OncoRay-National Center for Radiation Research in Oncology, Medical Faculty Carl Gustav Carus, Dresden (Germany); Task Group ' ' Tolerance Doses' ' of the German Society for Radiation Oncology (DEGRO), Berlin (Germany); Herrmann, Thomas [Task Group ' ' Tolerance Doses' ' of the German Society for Radiation Oncology (DEGRO), Berlin (Germany); Baumann, Michael [Technical University Dresden, Department of Radiotherapy and Radiation Oncology, OncoRay-National Center for Radiation Research in Oncology, Medical Faculty Carl Gustav Carus, Dresden (Germany); Task Group ' ' Tolerance Doses' ' of the German Society for Radiation Oncology (DEGRO), Berlin (Germany)

    2014-07-15

    In modern radiation oncology, tolerance dose-constraints for organs at risk (OAR) must be considered for treatment planning, but particularly in order to design clinical studies. Tolerance dose tables, however, only address one aspect of the therapeutic ratio of any clinical study, i.e., the limitation of adverse events, but not the desired potential improvement in the tumor effect of a novel treatment strategy. A sensible application of ''tolerance doses'' in a clinical situation requires consideration of various critical aspects addressed here: definition of tolerance dose, specification of an endpoint/symptom, consideration of radiation quality and irradiation protocol, exposed volume and dose distribution, and patient-related factors of radiosensitivity. The currently most comprehensive estimates of OAR radiation tolerance are in the QUANTEC compilations (2010). However, these tolerance dose values must only be regarded as a rough orientation and cannot answer the relevant question for the patients, i.e., if the study can achieve a therapeutic advantage; this can obviously be answered only by the final scientific analysis of the study results. Despite all limitations, the design of clinical studies should currently refer to the QUANTEC values for appreciation of the risk of complications, if needed supplemented by one's own data or further information from the literature. The implementation of a consensus on the safety interests of the patients and on an application and approval process committed to progress in medicine, with transparent quality-assuring requirements with regard to the structural safeguarding of the study activities, plays a central role in clinical research in radiation oncology. (orig.) [German] In der modernen Radioonkologie muessen Toleranzdosisgrenzen fuer die Risikoorgane (''organs at risk'', OAR) zur Behandlungsplanung, besonders aber zur Gestaltung klinischer Studien, herangezogen werden

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-01-15

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

  10. On the shortcomings of the new definition of the roentgen

    Energy Technology Data Exchange (ETDEWEB)

    Ivanov, V. I.

    1956-07-01

    In an analysis of the definition of the roentgen it is noted that the conditions of absorbed energy transformation are not stipulated. Other defects in the definition are analyzed and it is concluded that the definition is impracticable for very hard radiation dose assessment and that correction factors should be introduced in determining tissue doses for very soft rays. (J.R.D.)

  11. Clinical results of definitive-dose (50 Gy/25 fractions) preoperative chemoradiotherapy for unresectable esophageal cancer

    International Nuclear Information System (INIS)

    Ishikawa, Kazuki; Nakamatsu, Kiyoshi; Shiraishi, Osamu; Yasuda, Takushi; Nishimura, Yasumasa

    2015-01-01

    The clinical results of definitive-dose preoperative chemoradiotherapy (CRT) of 50 Gy/25 fractions/5 weeks for unresectable esophageal cancer were analyzed. Inclusion criteria were unresectable esophageal squamous cell carcinoma with T4b or mediastinal lymph nodes invading to the trachea or aorta. Radiation therapy of 50 Gy/25 fractions/5 weeks was combined concurrently with two courses of FP therapy (CDDP 70 mg/m 2 + 5-FU 700 mg/m 2 /d x 5 days: day 1-5, day 29-33). Tumor response was evaluated 4 weeks after completion of RT. Subtotal esophagectomy was planned 6-8 weeks after RT. Thirty patients (26 male and 4 female) aged from 50-78 years (median 66) were enrolled between 2008 and 2011. The clinical stages according to the 7th edition of UICC were stages II/III/IV, 1/23/6; T1/2/3/4, 1/1/4/24; and N0/1/2/3, 3/25/1/1. All 30 patients completed RT of 50 Gy/ 25 fractions. Initial tumor responses were 21 patients with resectable disease, 7 with unresectable disease, and 2 with progressive disease. Subtotal esophagectomy was performed in 18 (60%) of the 30 patients. Pathological complete response was obtained in five (28%) patients. There were two patients with hospitalization death after surgery (11%). Six of the 7 patients who still had unresectable disease were treated with 1-3 courses of docetaxel, CDDP and 5-FU. Three patients treated without surgery showed long-term survival. The 3-year locoregional control rate and the 3-year overall survival rate for the 30 patients were 70 and 49%, respectively. Definitive-dose preoperative CRT was feasible, and is a promising treatment strategy for unresectable esophageal cancer. (author)

  12. Estimating Effective Dose of Radiation From Pediatric Cardiac CT Angiography Using a 64-MDCT Scanner: New Conversion Factors Relating Dose-Length Product to Effective Dose.

    Science.gov (United States)

    Trattner, Sigal; Chelliah, Anjali; Prinsen, Peter; Ruzal-Shapiro, Carrie B; Xu, Yanping; Jambawalikar, Sachin; Amurao, Maxwell; Einstein, Andrew J

    2017-03-01

    The purpose of this study is to determine the conversion factors that enable accurate estimation of the effective dose (ED) used for cardiac 64-MDCT angiography performed for children. Anthropomorphic phantoms representative of 1- and 10-year-old children, with 50 metal oxide semiconductor field-effect transistor dosimeters placed in organs, underwent scanning performed using a 64-MDCT scanner with different routine clinical cardiac scan modes and x-ray tube potentials. Organ doses were used to calculate the ED on the basis of weighting factors published in 1991 in International Commission on Radiological Protection (ICRP) publication 60 and in 2007 in ICRP publication 103. The EDs and the scanner-reported dose-length products were used to determine conversion factors for each scan mode. The effect of infant heart rate on the ED and the conversion factors was also assessed. The mean conversion factors calculated using the current definition of ED that appeared in ICRP publication 103 were as follows: 0.099 mSv · mGy -1 · cm -1 , for the 1-year-old phantom, and 0.049 mSv · mGy -1 · cm -1 , for the 10-year-old phantom. These conversion factors were a mean of 37% higher than the corresponding conversion factors calculated using the older definition of ED that appeared in ICRP publication 60. Varying the heart rate did not influence the ED or the conversion factors. Conversion factors determined using the definition of ED in ICRP publication 103 and cardiac, rather than chest, scan coverage suggest that the radiation doses that children receive from cardiac CT performed using a contemporary 64-MDCT scanner are higher than the radiation doses previously reported when older chest conversion factors were used. Additional up-to-date pediatric cardiac CT conversion factors are required for use with other contemporary CT scanners and patients of different age ranges.

  13. Prospective Multi-Institutional Study of Definitive Radiotherapy With High-Dose-Rate Intracavitary Brachytherapy in Patients With Nonbulky (<4-cm) Stage I and II Uterine Cervical Cancer (JAROG0401/JROSG04-2)

    Energy Technology Data Exchange (ETDEWEB)

    Toita, Takafumi, E-mail: b983255@med.u-ryukyu.ac.jp [Department of Radiology, Graduate School of Medical Science, University of Ryukyus, Okinawa (Japan); Kato, Shingo [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Niibe, Yuzuru [Department of Radiology, School of Medicine, Kitasato University, Sagamihara (Japan); Ohno, Tatsuya [Gunma University Heavy Ion Medical Center, Maebashi (Japan); Kazumoto, Tomoko [Department of Radiology, Saitama Cancer Center, Saitama (Japan); Kodaira, Takeshi [Department of Radiation Oncology, Aichi Cancer Center, Nagoya (Japan); Kataoka, Masaaki [Department of Radiology, National Shikoku Cancer Center, Ehime (Japan); Shikama, Naoto [Department of Radiation Oncology, Saku Central Hospital, Saku (Japan); Kenjo, Masahiro [Department of Radiation Oncology, Graduate School of Medical Science, Hiroshima University, Hiroshima (Japan); Tokumaru, Sunao [Department of Radiology, Saga University, Saga (Japan); Yamauchi, Chikako [Department of Radiation Oncology, Shiga Medical Center for Adults, Moriyama (Japan); Suzuki, Osamu [Department of Radiation Oncology, Osaka Medical Center for Cancer, Osaka (Japan); Sakurai, Hideyuki [Proton Medical Research Center and Tsukuba University, Tsukuba (Japan); Numasaki, Hodaka; Teshima, Teruki [Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Osaka (Japan); Oguchi, Masahiko [Department of Radiation Oncology, Cancer Institute Hospital, Tokyo (Japan); Kagami, Yoshikazu [Radiation Oncology Division, National Cancer Center Hospital, Tokyo (Japan); Nakano, Takashi [Department of Radiation Oncology, Gunma University, Graduate School of Medicine, Maebashi (Japan); Hiraoka, Masahiro [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Graduate School of Medicine, Kyoto (Japan); Mitsuhashi, Norio [Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan)

    2012-01-01

    Purpose: To determine the efficacy of a definitive radiotherapy protocol using high-dose-rate intracavitary brachytherapy (HDR-ICBT) with a low cumulative dose schedule in nonbulky early-stage cervical cancer patients, we conducted a prospective multi-institutional study. Methods and Materials: Eligible patients had squamous cell carcinoma of the intact uterine cervix, Federation of Gynecologic Oncology and Obstetrics (FIGO) stages Ib1, IIa, and IIb, tumor size <40 mm in diameter (assessed by T2-weighted magnetic resonance imaging), and no pelvic/para-aortic lymphadenopathy. The treatment protocol consisted of whole-pelvis external beam radiotherapy (EBRT) of 20 Gy/10 fractions, pelvic EBRT with midline block of 30 Gy/15 fractions, and HDR-ICBT of 24 Gy/4 fractions (at point A). The cumulative biologically effective dose (BED) was 62 Gy{sub 10} ({alpha}/{beta} = 10) at point A. The primary endpoint was the 2-year pelvic disease progression-free (PDPF) rate. All patients received a radiotherapy quality assurance review. Results: Between September 2004 and July 2007, 60 eligible patients were enrolled. Thirty-six patients were assessed with FIGO stage Ib1; 12 patients with stage IIa; and 12 patients with stage IIb. Median tumor diameter was 28 mm (range, 6-39 mm). Median overall treatment time was 43 days. Median follow-up was 49 months (range, 7-72 months). Seven patients developed recurrences: 3 patients had pelvic recurrences (2 central, 1 nodal), and 4 patients had distant metastases. The 2-year PDPF was 96% (95% confidence interval [CI], 92%-100%). The 2-year disease-free and overall survival rates were 90% (95% CI, 82%-98%) and 95% (95% CI, 89%-100%), respectively. The 2-year late complication rates (according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer of Grade {>=}1) were 18% (95% CI, 8%-28%) for large intestine/rectum, 4% (95% CI, 0%-8%) for small intestine, and 0% for bladder. No Grade {>=}3 cases were

  14. Proposal concerning the absorbed dose conversion factor

    Energy Technology Data Exchange (ETDEWEB)

    Shiragai, A [National Inst. of Radiological Sciences, Chiba (Japan)

    1978-03-01

    New definitions of the absorbed dose conversion factors Csub(lambda) and Csub(E) are proposed. The absorbed dose in water is given by the product of absorbed dose conversion factor, exposure calibration factor, ionisation chamber reading, cap displacement correction factor and perturbation correction factor. At exposure calibration the material of the build-up cap must be the same as that of the chamber wall. An ionisation chamber of which the wall material is water-equivalent or air-equivalent may be used. In the latter case the wall must be thin. For these two cases absorbed dose conversion factors are introduced and it is recommended that either of the two sets should be adopted. Furthermore, if the chamber wall is neither water- nor air-equivalent, the factor by which these currently defined values should be multiplied is also given: again the wall must be thin. The ICRU definitions of Csub(lambda) and Csub(E) are inconsistent, as recently pointed out, while the definitions presented here are consistent.

  15. Continued Benefit to Androgen Deprivation Therapy for Prostate Cancer Patients Treated With Dose-Escalated Radiation Therapy Across Multiple Definitions of High-Risk Disease

    International Nuclear Information System (INIS)

    Stenmark, Matthew H.; Blas, Kevin; Halverson, Schuyler; Sandler, Howard M.; Feng, Felix Y.; Hamstra, Daniel A.

    2011-01-01

    Purpose: To analyze prognostic factors in patients with high-risk prostate cancer treated with dose-escalated external-beam radiation therapy (EBRT) and androgen deprivation (ADT). Methods and Materials: Between 1998 and 2008 at University of Michigan Medical Center, 718 men were consecutively treated with EBRT to at least 75 Gy. Seven definitions of high-risk prostate cancer, applying to 11–33% of patients, were evaluated. Biochemical failure (BF), salvage ADT use, metastatic progression, and prostate cancer–specific mortality (PCSM) were estimated by the Kaplan-Meier method and Cox proportional hazards regression. Results: Each high-risk definition was associated with increased BF (hazard ratio [HR] 2.8–3.9, p < 0.0001), salvage ADT use (HR 3.9–6.3, p < 0.0001), metastasis (HR 3.7–6.6, p < 0.0001), and PCSM (HR 3.7–16.2, p < 0.0001). Furthermore, an increasing number of high-risk features predicted worse outcome. Adjuvant ADT yielded significant reductions in both metastases (HR 0.19–0.38, p < 0.001) and PCSM (HR 0.38–0.50, p < 0.05) for all high-risk definitions (with the exception of clinical Stage T3–4 disease) but improved BF only for those with elevated Gleason scores (p < 0.03, HR 0.25–0.48). When treated with ADT and dose-escalated EBRT, patients with Gleason scores 8 to 10, without other high-risk features, had 8-year freedom from BF of 74%, freedom from distant metastases of 93%, and cause-specific survival of 92%, with salvage ADT used in 16% of patients. Conclusion: Adjuvant ADT results in a significant improvement in clinical progression and PCSM across multiple definitions of high-risk disease even with dose-escalated EBRT. There is a subset of patients, characterized by multiple high-risk features or the presence of Gleason Pattern 5, who remain at significant risk for metastasis and PCSM despite current treatment.

  16. Introduction to the new version of the standard DIN 6814, part 3 'dose magnitudes and dose units'

    Energy Technology Data Exchange (ETDEWEB)

    Harder, D

    1985-02-01

    The recent draft of the DIN standard on dose quantities and dose units is presented on original version and explained by the chairman of the Working Comittee Dosimetry. There are important modifications by the introduction of SI units, the new definitions of site dose and individual dose characteristic dose rate and dose rate constant, as well as by corrections of the notions ''secondary electron equilibrium'' and ''free in air''.

  17. Patient- and cohort-specific dose and risk estimation for abdominopelvic CT: a study based on 100 patients

    Science.gov (United States)

    Tian, Xiaoyu; Li, Xiang; Segars, W. Paul; Frush, Donald P.; Samei, Ehsan

    2012-03-01

    The purpose of this work was twofold: (a) to estimate patient- and cohort-specific radiation dose and cancer risk index for abdominopelvic computer tomography (CT) scans; (b) to evaluate the effects of patient anatomical characteristics (size, age, and gender) and CT scanner model on dose and risk conversion coefficients. The study included 100 patient models (42 pediatric models, 58 adult models) and multi-detector array CT scanners from two commercial manufacturers (LightSpeed VCT, GE Healthcare; SOMATOM Definition Flash, Siemens Healthcare). A previously-validated Monte Carlo program was used to simulate organ dose for each patient model and each scanner, from which DLP-normalized-effective dose (k factor) and DLP-normalized-risk index values (q factor) were derived. The k factor showed exponential decrease with increasing patient size. For a given gender, q factor showed exponential decrease with both increasing patient size and patient age. The discrepancies in k and q factors across scanners were on average 8% and 15%, respectively. This study demonstrates the feasibility of estimating patient-specific organ dose and cohort-specific effective dose and risk index in abdominopelvic CT requiring only the knowledge of patient size, gender, and age.

  18. Increasing Fractional Doses Increases the Probability of Benign PSA Bounce in Patients Undergoing Definitive HDR Brachytherapy for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hauck, Carlin R.; Ye, Hong; Chen, Peter Y.; Gustafson, Gary S.; Limbacher, Amy; Krauss, Daniel J., E-mail: Daniel.krauss@beaumont.edu

    2017-05-01

    Purpose: Prostate-specific antigen (PSA) bounce is a temporary elevation of the PSA level above a prior nadir. The purpose of this study was to determine whether the frequency of a PSA bounce following high-dose-rate (HDR) interstitial brachytherapy for the treatment of prostate cancer is associated with individual treatment fraction size. Methods and Materials: Between 1999 and 2014, 554 patients underwent treatment of low- or intermediate-risk prostate cancer with definitive HDR brachytherapy as monotherapy and had ≥3 subsequent PSA measurements. Four different fraction sizes were used: 950 cGy × 4 fractions, 1200 cGy × 2 fractions, 1350 cGy × 2 fractions, 1900 cGy × 1 fraction. Four definitions of PSA bounce were applied: ≥0.2, ≥0.5, ≥1.0, and ≥2.0 ng/mL above the prior nadir with a subsequent return to the nadir. Results: The median follow-up period was 3.7 years. The actuarial 3-year rate of PSA bounce for the entire cohort was 41.3%, 28.4%, 17.4%, and 6.8% for nadir +0.2, +0.5, +1.0, and +2.0 ng/mL, respectively. The 3-year rate of PSA bounce >0.2 ng/mL was 42.2%, 32.1%, 41.0%, and 59.1% for the 950-, 1200-, 1350-, and 1900-cGy/fraction levels, respectively (P=.002). The hazard ratio for bounce >0.2 ng/mL for patients receiving a single fraction of 1900 cGy compared with those receiving treatment in multiple fractions was 1.786 (P=.024). For patients treated with a single 1900-cGy fraction, the 1-, 2-, and 3-year rates of PSA bounce exceeding the Phoenix biochemical failure definition (nadir +2 ng/mL) were 4.5%, 18.7%, and 18.7%, respectively, higher than the rates for all other administered dose levels (P=.025). Conclusions: The incidence of PSA bounce increases with single-fraction HDR treatment. Knowledge of posttreatment PSA kinetics may aid in decision making regarding management of potential biochemical failures.

  19. Increasing Fractional Doses Increases the Probability of Benign PSA Bounce in Patients Undergoing Definitive HDR Brachytherapy for Prostate Cancer

    International Nuclear Information System (INIS)

    Hauck, Carlin R.; Ye, Hong; Chen, Peter Y.; Gustafson, Gary S.; Limbacher, Amy; Krauss, Daniel J.

    2017-01-01

    Purpose: Prostate-specific antigen (PSA) bounce is a temporary elevation of the PSA level above a prior nadir. The purpose of this study was to determine whether the frequency of a PSA bounce following high-dose-rate (HDR) interstitial brachytherapy for the treatment of prostate cancer is associated with individual treatment fraction size. Methods and Materials: Between 1999 and 2014, 554 patients underwent treatment of low- or intermediate-risk prostate cancer with definitive HDR brachytherapy as monotherapy and had ≥3 subsequent PSA measurements. Four different fraction sizes were used: 950 cGy × 4 fractions, 1200 cGy × 2 fractions, 1350 cGy × 2 fractions, 1900 cGy × 1 fraction. Four definitions of PSA bounce were applied: ≥0.2, ≥0.5, ≥1.0, and ≥2.0 ng/mL above the prior nadir with a subsequent return to the nadir. Results: The median follow-up period was 3.7 years. The actuarial 3-year rate of PSA bounce for the entire cohort was 41.3%, 28.4%, 17.4%, and 6.8% for nadir +0.2, +0.5, +1.0, and +2.0 ng/mL, respectively. The 3-year rate of PSA bounce >0.2 ng/mL was 42.2%, 32.1%, 41.0%, and 59.1% for the 950-, 1200-, 1350-, and 1900-cGy/fraction levels, respectively (P=.002). The hazard ratio for bounce >0.2 ng/mL for patients receiving a single fraction of 1900 cGy compared with those receiving treatment in multiple fractions was 1.786 (P=.024). For patients treated with a single 1900-cGy fraction, the 1-, 2-, and 3-year rates of PSA bounce exceeding the Phoenix biochemical failure definition (nadir +2 ng/mL) were 4.5%, 18.7%, and 18.7%, respectively, higher than the rates for all other administered dose levels (P=.025). Conclusions: The incidence of PSA bounce increases with single-fraction HDR treatment. Knowledge of posttreatment PSA kinetics may aid in decision making regarding management of potential biochemical failures.

  20. Automatic definition of prescription isodose for stereotactic irradiations of arteriovenous malformations

    International Nuclear Information System (INIS)

    Dejean, C.; Lefkopoulos, D.; Foulquier, J.N.; Schlienger, M.; Touboul, E.

    2001-01-01

    To evaluate dosimetric consequences generated by the automatic definition based on lesion coverage of prescription isodose. A clinical series of 124 arteriovenous malformations was analysed. Plan quality was quantified by the standard deviation of the differential dose volume histogram calculated in the lesion. We define two quantitative protocols based on lesion coverage for the automatic definition of prescription isodose using a volumetric definition of coverage (90% of lesion volume), and an isodose-based definition proposed) by RTOG (prescription isodose equals minimum isodose in the lesion divided by 0.9). We have evaluated the plans obtained for these two protocols, calculating several dose-volume indices. These indices are presented as a function of dose-volume histogram standard deviation in order to quantify the consequences of their variations for this representative series of plans. The margin our team tolerates is such that the sum of under-dosed lesion and overdosed healthy tissues factors remains lower than one. Protocol based on volumetric coverage gives results situated within this margin. Protocol based on RTOG definition produces conformation indices that could be greater than 1. The absolute dose would be decided taking into account examined dose-volume indices and clinical data. A protocol for automatic definition of prescription isodose using volumetric lesion coverage seems to be more judiciously adapted to arteriovenous malformation conformal plans in stereotactic conditions because of variations observed in the overdosage of healthy tissues. (authors)

  1. Dose-to-man studies

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    Dose-to-Man Studies focused on developing computer data handling and computer modules which permit easy, rapid assessment of the dose to southeastern United States populations from routine or accidental releases of radionuclides to atmospheric and stream systems

  2. Radiotherapy for non-small cell lung cancer: volume definition and patient selection. Annecy 1998 international Association for the study of lung cancer (IASLC) Workshop recommendations

    International Nuclear Information System (INIS)

    Mornex, F.; Loubeyre, P.; Van houtte, P.; Scalliet, P.

    1998-01-01

    Chemo-radiation is the standard treatment of unresectable, locally advanced non-small cell lung cancer, with a mean dose of 60-66 Gy, excluding escalation dose schemes. The standard treated volume includes primary tumor, ipsilateral hilar and mediastinal nodes, supraclavicular and contralateral nodes as well, regardless of the node status. This work tries to answer the question of the optimal volume to be treated. Drainage routes analysis is in favor of large volumes, while toxicity analysis favors small volumes. Combined modality treatment may increase the observed toxicity. The optimal volume definition is difficult, and requires available conformal therapy tools. Patients selection is another important issue. A volume definition is then attempted, based on the IASLC (International Association for the Study of Lung Cancer) Annecy workshop experience, highlighting the inter-observers discrepancies, and suggests basic recommendations to harmonize volume definition. (author)

  3. Radiation dose measurement in gastrointestinal studies

    International Nuclear Information System (INIS)

    Sulieman, A.; Elzaki, M.; Kappas, C.; Theodorou, K.

    2011-01-01

    Barium studies investigations (barium swallow, barium meal and barium enema) are the basic routine radiological examination, where barium sulphate suspension is introduced to enhance image contrast of gastrointestinal tracts. The aim of this study was to quantify the patients' radiation doses during barium studies and to estimate the organ equivalent dose and effective dose with those procedures. A total of 33 investigations of barium studies were measured by using thermoluminescence dosemeters. The result showed that the patient entrance surface doses were 12.6±10, 44.5±49 and 35.7±50 mGy for barium swallow, barium meal, follow through and enema, respectively. Effective doses were 0.2, 0.35 and 1.4 mSv per procedure for barium swallow, meal and enema respectively. Radiation doses were comparable with the previous studies. A written protocol for each procedure will reduce the inter-operator variations and will help to reduce unnecessary exposure. (authors)

  4. Angular dependence of shallow dose

    International Nuclear Information System (INIS)

    Alvarez, J.L.

    1986-01-01

    The theoretical response of a detector is discussed and compared to measurements of shallow dose with tissue and phantom response detectors. A definite energy dependent angular response of dose and measurement was observed which could not be explained by simple trigonometric arguments. The response is back scatter dependent and must be considered in detector design and dose measurements. It is not possible for standard detectors to follow this response

  5. Life sciences payload definition and integration study, task C and D. Volume 2: Payload definition, integration, and planning studies

    Science.gov (United States)

    1973-01-01

    The Life Sciences Payload Definition and Integration Study was composed of four major tasks. Tasks A and B, the laboratory definition phase, were the subject of prior NASA study. The laboratory definition phase included the establishment of research functions, equipment definitions, and conceptual baseline laboratory designs. These baseline laboratories were designated as Maxi-Nom, Mini-30, and Mini-7. The outputs of Tasks A and B were used by the NASA Life Sciences Payload Integration Team to establish guidelines for Tasks C and D, the laboratory integration phase of the study. A brief review of Tasks A and B is presented provide background continuity. The tasks C and D effort is the subject of this report. The Task C effort stressed the integration of the NASA selected laboratory designs with the shuttle sortie module. The Task D effort updated and developed costs that could be used by NASA for preliminary program planning.

  6. Neutron dosimetry. Terms and definitions. Preliminary standard. Neutronendosimetrie. Begriffe und Benennungen. Vornorm

    Energy Technology Data Exchange (ETDEWEB)

    1978-06-01

    With this standard, definitions and terms are introduced without references. Radiation field quantities and dose quantities are defined as differential quotients like in the consecutive parts of DIN 6814. The stochastic nature of radiation and of its interactions has been accounted for by the fact that each differential quotient is to be understood as the limiting value of the statistic expectancy value of the corresponding differential quotient. The present standard is limited to the definition of non-stochastic quantities for radiation field and dose. It does not include definitions of micro-dose quantities valid for all types of radiation.

  7. Nationwide Study of Humidifier Disinfectant Lung Injury in South Korea, 1994-2011. Incidence and Dose-Response Relationships.

    Science.gov (United States)

    Paek, Domyung; Koh, Younsuck; Park, Dong-Uk; Cheong, Hae-Kwan; Do, Kyung-Hyun; Lim, Chae-Man; Hong, Soo-Jong; Kim, Yong-Hwa; Leem, Jong-Han; Chung, Kyu Hyuck; Choi, Ye-Yong; Lee, Jong-Hyeon; Lim, Sin-Ye; Chung, Eun-Hee; Cho, Young Ah; Chae, Eun Jin; Joh, Joon-Sung; Yoon, Yup; Lee, Kyu-Hong; Choi, Bo Youl; Gwack, Jin

    2015-12-01

    Humidifier disinfectant lung injury is an acute lung disease attributed to recurrent inhalation of certain disinfectant aerosols emitted from room humidifiers. An outbreak of this toxic lung injury occurred in South Korea from 1995 until all humidifier disinfectant products were recalled from the consumer market by the government in 2011. A nationwide study was conducted to ascertain and classify all potential cases of humidifier disinfectant lung injury in Korea and to assess dose-response relationships. By several mechanisms, clinicians and the general public were invited to report all suspected cases of humidifier disinfectant lung injury to public health officials in South Korea. A committee was convened to define diagnostic criteria based on pathologic, radiologic, and clinical findings for index cases, combined with assessment of environmental exposure to humidifier disinfectants. Clinical review and environmental assessments were performed and later combined to determine overall likelihood of disease for each study participant, classified as definite, probable, possible, or unlikely. Survival time from exposure to onset of symptoms was analyzed to assess dose-response relationships. Three broad categories of risk factors were examined: (1) biological susceptibility, (2) temporal cycle of exposure and recovery, and (3) spatial conditions and density of disinfectant. Of 374 possible cases identified and reviewed, 329 were unanimously classified by the diagnostic committee, as follows: 117 definite, 34 probable, 38 possible and 140 unlikely cases. A total of 62 individuals with definite or probable disease died. Risk factors examined for polyhexamethyleneguanidine phosphate exposure that were found to be significant in shortening survival included age 4 years or younger at onset, use of disinfectant for 7 days per week, airborne density of 800 μg/m(3) or more of disinfectant, and daily exposure 11 or more hours in duration. Dose-response analysis indicated

  8. Radiation data definitions and compilation for equipment qualification data bank

    International Nuclear Information System (INIS)

    Bouquet, F.L.; Winslow, J.W.

    1986-01-01

    Dose definitions, physical properties, mechanical properties, electrical properties, and particle definitions are listed for insulators and dielectrics, elastomeric seals and gaskets, lubricants, adhesives, and coatings

  9. Statin intolerance - a question of definition.

    Science.gov (United States)

    Algharably, Engi Abdel-Hady; Filler, Iris; Rosenfeld, Stephanie; Grabowski, Katja; Kreutz, Reinhold

    2017-01-01

    Statin therapy is the backbone of pharmacologic therapy for low-density lipoproteins cholesterol lowering and plays a pivotal role in cardiovascular disease prevention. Statin intolerance is understood as the inability to continue using a statin to reduce individual cardiovascular risk sufficiently, due to the development of symptoms or laboratory abnormalities attributable to the initiation or dose escalation of a statin. Muscle symptoms are the most common side effects observed. Areas covered: The main aim of this article is to present a review on published definitions of statin intolerance. In addition, a brief review on clinical aspects and risk factors of statin intolerance is provided and features for a common definition for statin intolerance are suggested. Expert opinion: A definition of statin intolerance by major drug regulatory agencies is not available. In clinical studies, different definitions are chosen and results are not comparable; different medical associations do not agree on one common definition. There is an unmet need to establish a common definition of statin intolerance to ensure an appropriate clinical use of this important drug class. Further work is required to develop a consensus definition on statin intolerance that could have significant positive impact on both research and clinical management.

  10. Terms and definitions in the field of radiological technology. Begriffe und Benennungen in der radiologischen Technik

    Energy Technology Data Exchange (ETDEWEB)

    1983-01-01

    The radiation field condition ''secondary electron equilibrium'' as part of the definition for the standard ion dose is specified. The term ''free in air'' gets - contrary to DIN 6814, sec. 3, June 1972 issue - its original meaning, i.e. the definition of measuring conditions eliminating avoidable scatter. For measuring the standard ion dose, dose meters are calibrated ''free in air''. The quantity ''Standard ion dose'' can be measured in any material. The quantitative ratios between standard ion dose and the quantities ''exposure'' and ''air kerma'' as per ICRU report 33 ''Quantities and Units'' (1980) are described. The SI-units Gray, Sievert and Becquerel are introduced. For the quantities ''core dose rate'' ''dose rate constant'' and ''aereal dose product'' new definitions are given, according to the ICRU report 33, using the terms ''absorbed dose'' and ''kerma''.

  11. Controversies in external beam and high dose rate brachytherapy of oesophageal cancer

    International Nuclear Information System (INIS)

    Sur, R.K.; Levin, V.C.; Malas, Simon; Donde, Bernard

    1994-01-01

    Various controversies in the treatment of oesophageal carcinoma with external beam radiotherapy and high dose rate intracavitary irradiation have been reviewed. Conflicting results from different parts of the world has made it difficult to optimize the radiation dose that may give the best results. More studies and longer follow-up are needed before a definite conclusion can be made on the optimization of dose. (author). 18 refs., 2 tabs

  12. Dose painting based on tumor uptake of Cu-ATSM and FDG: a comparative study

    International Nuclear Information System (INIS)

    Clausen, Malene Martini; Hansen, Anders Elias; Lundemann, Michael; Hollensen, Christian; Pommer, Tobias; Munck af Rosenschöld, Per; Kristensen, Annemarie Thuri; Kjær, Andreas; McEvoy, Fintan J; Engelholm, Svend Aage

    2014-01-01

    Hypoxia and increased glycolytic activity of tumors are associated with poor prognosis. The purpose of this study was to investigate differences in radiotherapy (RT) dose painting based on the uptake of 2-deoxy-2-[ 18 F]-fluorodeoxyglucose (FDG) and the proposed hypoxia tracer, copper(II)diacetyl-bis(N 4 )-methylsemithiocarbazone (Cu-ATSM) using spontaneous clinical canine tumor models. Positron emission tomography/computed tomography scans of five spontaneous canine sarcomas and carcinomas were obtained; FDG on day 1 and 64 Cu-ATSM on day 2 and 3 (approx. 3 and 24 hours pi.). Sub-volumes for dose escalation were defined by a threshold-based method for both tracers and five dose escalation levels were formed in each sub-volume. Volumetric modulated arc therapy plans were optimized based on the dose escalation regions for each scan for a total of three dose plans for each dog. The prescription dose for the GTV was 45 Gy (100%) and it was linearly escalated to a maximum of 150%. The correlations between dose painting plans were analyzed with construction of dose distribution density maps and quality volume histograms (QVH). Correlation between high-dose regions was investigated with Dice correlation coefficients. Comparison of dose plans revealed varying degree of correlation between cases. Some cases displayed a separation of high-dose regions in the comparison of FDG vs. 64 Cu-ATSM dose plans at both time points. Among the Dice correlation coefficients, the high dose regions showed the lowest degree of agreement, indicating potential benefit of using multiple tracers for dose painting. QVH analysis revealed that FDG-based dose painting plans adequately covered approximately 50% of the hypoxic regions. Radiotherapy plans optimized with the current approach for cut-off values and dose region definitions based on FDG, 64 Cu-ATSM 3 h and 24 h uptake in canine tumors had different localization of the regional dose escalation levels. This indicates that 64 Cu-ATSM at two

  13. 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

  14. Dose-response characteristics of low- and intermediate-risk prostate cancer treated with external beam radiotherapy

    International Nuclear Information System (INIS)

    Cheung, Rex; Tucker, Susan L.; Lee, Andrew K.; Crevoisier, Renaud de; Dong Lei; Kamat, Ashish; Pisters, Louis; Kuban, Deborah

    2005-01-01

    Purpose: In this era of dose escalation, the benefit of higher radiation doses for low-risk prostate cancer remains controversial. For intermediate-risk patients, the data suggest a benefit from higher doses. However, the quantitative characterization of the benefit for these patients is scarce. We investigated the radiation dose-response relation of tumor control probability in low-risk and intermediate-risk prostate cancer patients treated with radiotherapy alone. We also investigated the differences in the dose-response characteristics using the American Society for Therapeutic Radiology and Oncology (ASTRO) definition vs. an alternative biochemical failure definition. Methods and materials: This study included 235 low-risk and 387 intermediate-risk prostate cancer patients treated with external beam radiotherapy without hormonal treatment between 1987 and 1998. The low-risk patients had 1992 American Joint Committee on Cancer Stage T2a or less disease as determined by digital rectal examination, prostate-specific antigen (PSA) levels of ≤10 ng/mL, and biopsy Gleason scores of ≤6. The intermediate-risk patients had one or more of the following: Stage T2b-c, PSA level of ≤20 ng/mL but >10 ng/mL, and/or Gleason score of 7, without any of the following high-risk features: Stage T3 or greater, PSA >20 ng/mL, or Gleason score ≥8. The logistic models were fitted to the data at varying points after treatment, and the dose-response parameters were estimated. We used two biochemical failure definitions. The ASTRO PSA failure was defined as three consecutive PSA rises, with the time to failure backdated to the mid-point between the nadir and the first rise. The second biochemical failure definition used was a PSA rise of ≥2 ng/mL above the current PSA nadir (CN + 2). The failure date was defined as the time at which the event occurred. Local, nodal, and distant relapses and the use of salvage hormonal therapy were also failures. Results: On the basis of the

  15. Radiation-Induced Cranial Nerve Palsy: A Cross-Sectional Study of Nasopharyngeal Cancer Patients After Definitive Radiotherapy

    International Nuclear Information System (INIS)

    Kong, Lin; Lu, Jiade J.; Liss, Adam L.; Hu Chaosu; Guo Xiaomao; Wu Yongru; Zhang Youwang

    2011-01-01

    Purpose: To address the characteristics and the causative factors of radiation-induced cranial nerve palsy (CNP) in nasopharyngeal carcinoma (NPC) patients with an extensive period of followed-up. Patients and Methods: A total of 317 consecutive and nonselected patients treated with definitive external-beam radiotherapy between November 1962 and February 1995 participated in this study. The median doses to the nasopharynx and upper neck were 71 Gy (range, 55-86 Gy) and 61 Gy (range, 34-72 Gy), respectively. Conventional fractionation was used in 287 patients (90.5%). Forty-five patients (14.2%) received chemotherapy. Results: The median follow-up was 11.4 years (range, 5.1-38.0 years). Ninety-eight patients (30.9%) developed CNP, with a median latent period of 7.6 years (range, 0.3-34 years). Patients had a higher rate of CNP (81 cases, 25.5%) in lower-group cranial nerves compared with upper group (44 cases, 13.9%) (χ 2 = 34.444, p 2 = 4.661, p = 0.031). The cumulative incidences of CNP were 10.4%, 22.4%, 35.5%, and 44.5% at 5, 10, 15, and 20 years, respectively. Multivariate analyses revealed that CNP at diagnosis, chemotherapy, total radiation dose to the nasopharynx, and upper neck fibrosis were independent risk factors for developing radiation-induced CNP. Conclusion: Radiation-induced fibrosis may play an important role in radiation-induced CNP. The incidence of CNP after definitive radiotherapy for NPC remains high after long-term follow-up and is dose and fractionation dependent.

  16. Dose reduction strategies for cardiac CT

    International Nuclear Information System (INIS)

    Midgley, S.M.; Einsiedel, P.; Langenberg, F.; Lui, E.

    2010-01-01

    Full text: Recent advances in CT technology have produced brighter X-ray sources. gantries capable of increased rotation speeds, faster scintil lation materials arranged into multiple rows of detectors, and associated advances in 3D reconstruction methods. These innovations have allowed multi-detector CT to be turned to the diagnosis of cardiac abnormalities and compliment traditional imaging techniques such as coronary angiography. This study examines the cardiac imaging solution offered by the Siemens Somatom Definition Dual Source 64 slice CT scanner. Our dose reduction strategies involve optimising the data acquisition protocols according to diagnostic task, patient size and heart rate. The relationship between scan parameters, image quality and patient dose is examined and verified against measurements with phantoms representing the standard size patient. The dose reduction strategies are reviewed with reference to survey results of patient dose. Some cases allow the insertion of shielding to protect radiosensitive organs, and results are presented to quantify the dose saving.

  17. Data base of dose coefficients called ecrin-V1-internet reference handbook; Base de donnees de coefficients de dose ecrin-V1-internet manuel de reference

    Energy Technology Data Exchange (ETDEWEB)

    Perrin, M.L

    2003-07-01

    The objective of this data base is to dispose on a only computer medium the values of radiation doses allowing to guarantee the tracing and the coherence of radiation doses received by man. These data are usable to evaluate the risks in the frame of studies or expertise. They include the doses coming from external irradiations, internal contamination by inhalation or ingestion and receive by workers or public. The definitions and reference values come from international publications (the list is given). (N.C.)

  18. Analysis of Biochemical Control and Prognostic Factors in Patients Treated With Either Low-Dose Three-Dimensional Conformal Radiation Therapy or High-Dose Intensity-Modulated Radiotherapy for Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Vora, Sujay A.; Wong, William W.; Schild, Steven E.; Ezzell, Gary A.; Halyard, Michele Y.

    2007-01-01

    Purpose: To identify prognostic factors and evaluate biochemical control rates for patients with localized prostate cancer treated with either high-dose intensity-modulated radiotherapy (IMRT) or conventional-dose three-dimensional conformal radiotherapy 3D-CRT. Methods: Four hundred sixteen patients with a minimum follow-up of 3 years (median, 5 years) were included. Two hundred seventy-one patients received 3D-CRT with a median dose of 68.4 Gy (range, 66-71 Gy). The next 145 patients received IMRT with a median dose of 75.6 Gy (range, 70.2-77.4 Gy). Biochemical control rates were calculated according to both American Society for Therapeutic Radiology and Oncology (ASTRO) consensus definitions. Prognostic factors were identified using both univariate and multivariate analyses. Results: The 5-year biochemical control rate was 60.4% for 3D-CRT and 74.1% for IMRT (p < 0.0001, first ASTRO Consensus definition). Using the ASTRO Phoenix definition, the 5-year biochemical control rate was 74.4% and 84.6% with 3D-RT and IMRT, respectively (p = 0.0326). Univariate analyses determined that PSA level, T stage, Gleason score, perineural invasion, and radiation dose were predictive of biochemical control. On multivariate analysis, dose, Gleason score, and perineural invasion remained significant. Conclusion: On the basis of both ASTRO definitions, dose, Gleason score, and perineural invasion were predictive of biochemical control. Intensity-modulated radiotherapy allowed delivery of higher doses of radiation with very low toxicity, resulting in improved biochemical control

  19. Neoadjuvant concurrent chemoradiotherapy followed by definitive high-dose radiotherapy or surgery for operable thoracic esophageal carcinoma

    International Nuclear Information System (INIS)

    Masao, Murakami; Yasumasa, Kuroda; Yosiaki, Okamoto; Koichi, Kono; Eisaku, Yoden; Fusako, Kusumi; Kiyoshi, Hajiro; Satoru, Matsusue; Hiroshi, Takeda

    1997-01-01

    Purpose: A prospective clinical trial was undertaken to investigate the feasibility of concurrent chemoradiotherapy for the esophageal carcinoma. Materials and Methods: Between June 1989 and May 1996, forty patients with operable squamous cell carcinoma of the thoracic esophagus (stage 0 to III: UICC 1987), aged 45 to 78 (mean:64), were enrolled in a study of neoadjuvant concurrent chemoradiotherapy followed by definitive high-dose radiotherapy (CRT group) or surgery (CRT-S group). Neoadjuvant chemoradiotherapy consisted of 44Gy in 40 fractions for 4 weeks (2.2Gy/2Fr./day) through 10MVX rays, with one or two courses of cisplatin (80-150mg/body, mean:90mg/m 2 , day 1, bolus injection) and 5-fluorouracil (500-1500mg/body/day, mean:600mg/m 2 , day 1-4, continuous infusion). After completion of neoadjuvant chemoradiotherapy, clinical complete response (CR) was observed in 16 patients, partial response (PR) in 22, and no change (NC) in 2. Thirty responding patients (CR:16, PR:14) entered in CRT group, and 10 non-responding patients (PR:8, NC:2) followed by surgery (CRT-S group). A cumulative median dose of 66Gy for Tis,T1 and 71Gy for T2-T4 tumor with/without high-dose-rate intraluminal brachytherapy, and one to three courses of chemotherapy were delivered in CRT group. Intraoperative radiotherapy for abdominal lymphatic system and postoperative supraclavicular irradiation were added in CRT-S group. Results: Clinical CR rate at the completion of treatment showed 90% in CRT group, and pathological CR rate 10% in CRT-S group. The overall median survival was 45 months, survival at 1, 2, 3 years being 100%, 72%, 56%, respectively. Loco-regional failure was observed in 7 patients (all in CRT group), distant failure in 6 (3 in CRT group, 3 in CRT-S group) and loco-regional with distant failure in 1 (CRT group). Four patients of loco-regional recurrence in CRT group were salvaged by surgery. Overall survival at 2-, 3-years for CRT vs. CRT-S group was 72%, 64% vs. (1(1)); 100

  20. Estimation and comparison of effective dose (E) in standard chest CT by organ dose measurements and dose-length-product methods and assessment of the influence of CT tube potential (energy dependency) on effective dose in a dual-source CT

    International Nuclear Information System (INIS)

    Paul, Jijo; Banckwitz, Rosemarie; Krauss, Bernhard; Vogl, Thomas J.; Maentele, Werner; Bauer, Ralf W.

    2012-01-01

    Highlights: ► The dual-energy protocol delivers the lowest effective dose of the investigated protocols for standard chest CT examinations, thus enabling functional imaging (like dual-energy perfusion) and can produce weighted images without dose penalty. ► The high-pitch protocol goes along with a 16% increase in dose compared to the standard 120 kV protocol and thus should preferably be used in pediatric, acute care settings (e.g. pulmonary embolism, aortic dissection and the like) or restless patients. ► The difference in effective dose estimates between ICRP 60 and 103 is minimal. ► Tube potential definitely has an effect on estimates of effective dose. - Abstract: Purpose: To determine effective dose (E) during standard chest CT using an organ dose-based and a dose-length-product-based (DLP) approach for four different scan protocols including high-pitch and dual-energy in a dual-source CT scanner of the second generation. Materials and methods: Organ doses were measured with thermo luminescence dosimeters (TLD) in an anthropomorphic male adult phantom. Further, DLP-based dose estimates were performed by using the standard 0.014 mSv/mGycm conversion coefficient k. Examinations were performed on a dual-source CT system (Somatom Definition Flash, Siemens). Four scan protocols were investigated: (1) single-source 120 kV, (2) single-source 100 kV, (3) high-pitch 120 kV, and (4) dual-energy with 100/Sn140 kV with equivalent CTDIvol and no automated tube current modulation. E was then determined following recommendations of ICRP publication 103 and 60 and specific k values were derived. Results: DLP-based estimates differed by 4.5–16.56% and 5.2–15.8% relatively to ICRP 60 and 103, respectively. The derived k factors calculated from TLD measurements were 0.0148, 0.015, 0.0166, and 0.0148 for protocol 1, 2, 3 and 4, respectively. Effective dose estimations by ICRP 103 and 60 for single-energy and dual-energy protocols show a difference of less than 0.04 m

  1. Dose rate and dose fractionation studies in total body irradiation of dogs

    International Nuclear Information System (INIS)

    Kolb, H.J.; Netzel, B.; Schaffer, E.; Kolb, H.

    1979-01-01

    Total body irradiation (TBI) with 800-900 rads and allogeneic bone marrow transplantation according to the regimen designated by the Seattle group has induced remissions in patients with otherwise refractory acute leukemias. Relapse of leukemia after bone marrow transplantation remains the major problem, when the Seattle set up of two opposing 60 Co-sources and a low dose rate is used in TBI. Studies in dogs with TBI at various dose rates confirmed observations in mice that gastrointestinal toxicity is unlike toxicity against hemopoietic stem cells and possibly also leukemic stem cells depending on the dose rate. However, following very high single doses (2400 R) and marrow infusion acute gastrointestinal toxicity was not prevented by the lowest dose rate studied (0.5 R/min). Fractionated TBI with fractions of 600 R in addition to 1200 R (1000 rads) permitted the application of total doses up to 300 R followed by marrow infusion without irreversible toxicity. 26 dogs given 2400-3000 R have been observed for presently up to 2 years with regard to delayed radiation toxicity. This toxicity was mild in dogs given single doses at a low dose rate or fractionated TBI. Fractionated TBI is presently evaluated with allogeneic transplants in the dog before being applied to leukemic patients

  2. Collective dose, conceptual basis and practical applications

    International Nuclear Information System (INIS)

    Bonka, H.

    1985-01-01

    In the ICRP Publications no. 22(1973) and no. 26(1977), the ICRP recommends that the maximum permissible whole-body dose by kept below the dose limits corresponding to the sum of all effective dose equivalents of the persons concerned, i.e. the collective dose. The effective dose equivalent is recommended by the ICRP for use as a new quantity for evaluating the stochastic radiation dose for individual persons. Examples are given by the author explaining cost-benefit analyses according to ICRP recommendations, especially discussing the definition of optimum local dose limits with regard to shielding design in nuclear installations. (DG) [de

  3. Choosing populations to study the health effects of low-dose ionizing radiation

    International Nuclear Information System (INIS)

    Dreyer, N.A.; Loughlin, J.E.; Friedlander, E.R.; Clapp, R.W.; Fahey, F.H.

    1981-01-01

    In January 1978, the United States Congress requested information about the utility of additional epidemiologic studies for quantifying the health effects of low-dose ionizing radiation. In our judgment, no single population can be recommended for study on purely scientific grounds, since the largest group offers only a small chance to obtain a definitive result. On the other hand, if social pressures and regulatory agencies mandate that such studies be attempted, we would recommend prospective cohort studies of occupational populations. We propose that a national worker registry be developed using ionizing radiation as the prototype for studying other occupational exposures. The problems related to studying low-level radiation are not unique, but apply equally to investigations dealing with a great variety of toxic agents. A national plan for collecting information on workers' exposure and health could provide a cost-efficient means to answer public health questions posed by the Congress, scientists and the public

  4. CT of multiple sclerosis: reassessment of delayed scanning with high doses of contrast material

    International Nuclear Information System (INIS)

    Spiegel, S.M.; Vinuela, F.; Fox, A.J.; Pelz, D.M.

    1985-01-01

    A prospective study involving 87 patients was carried out to evaluate the necessity for a high dose of contrast material in addition to delayed computed tomographic (CT) scanning for optimal detection of the lesions of multiple sclerosis in the brain. In patients with either clinically definite multiple sclerosis or laboratory-supported definite multiple sclerosis, CT scans were obtained with a uniform protocol. Lesions consistent with multiple sclerosis were demonstrated on the second scan in 54 patients. In 36 of these 54 patients, the high-dose delayed scan added information. These results are quite similar to those of a previous study from this institution using different patients, in whom the second scan was obtained immediately after the bolus injection of contrast material containing 40 g of organically bound iodine. The lack of real difference in the results of the two studies indicate that the increased dose, not just the delay in scanning, is necessary for a proper study

  5. Partial Remission Definition

    DEFF Research Database (Denmark)

    Andersen, Marie Louise Max; Hougaard, Philip; Pörksen, Sven

    2014-01-01

    OBJECTIVE: To validate the partial remission (PR) definition based on insulin dose-adjusted HbA1c (IDAA1c). SUBJECTS AND METHODS: The IDAA1c was developed using data in 251 children from the European Hvidoere cohort. For validation, 129 children from a Danish cohort were followed from the onset...

  6. Oncological outcomes from trimodality therapy receiving definitive doses of neoadjuvant chemoradiation (≥60 Gy and factors influencing consideration for surgery in stage III non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Melissa A.L. Vyfhuis, MD PhD

    2017-07-01

    Conclusions: Trimodality treatment significantly improves survival and FFR in patients with LA-NSCLC when definitive doses of radiation with neoadjuvant chemotherapy are employed. We identified important demographic features that predict the use of surgical intervention in patients with stage III NSCLC.

  7. Dose finding study of granisetron in patients receiving high-dose cisplatin chemotherapy. The Granisetron Study Group.

    Science.gov (United States)

    Riviere, A.

    1994-01-01

    The efficacy and safety of three different doses of granisetron (2 micrograms kg-1, group A; 10 micrograms kg-1, group B; 40 micrograms kg-1, group C) were compared in a randomised, double-blind study of 157 patients due to receive high-dose cisplatin therapy (mean dose > 97 mg m-2). In each group, up to two 3 mg rescue doses of granisetron were allowed if more than mild nausea or vomiting occurred. In group A 30.8%, in group B 61.5% and in group C 67.9% of patients were complete responders (i.e. no vomiting or nothing worse than mild nausea) during the first 24 h. These differences are significant between groups A and B, and A and C. There were no statistically significant differences in any efficacy variable between the 10 micrograms kg-1 and 40 micrograms kg-1 groups, although in each case the trend favoured the higher dose. Additional rescue doses resulted in resolved or improved symptoms in 95.3% for the first rescue dose and 93.3% for the second. Over the 7 days of the study, 82.7%, 82.7% and 86.8% of patients in groups A, B and C respectively were treated with granisetron alone. Headache was the most common side-effect, reported by 9.6% of patients; the majority of headaches were mild. There was no difference between the treatment groups regarding the adverse event rate. We concluded that prophylactic doses of 10 or 40 micrograms kg-1 lead to a safe and satisfactory degree of control of nausea and vomiting induced by high-dose cisplatin. PMID:8180032

  8. A study of the short- to long-phantom dose ratios for CT scanning without table translation

    Energy Technology Data Exchange (ETDEWEB)

    Li, Xinhua; Zhang, Da; Liu, Bob, E-mail: bliu7@mgh.harvard.edu [Division of Diagnostic Imaging Physics, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts 02114 and Webster Center for Advanced Research and Education in Radiation, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts 02114 (United States); Yang, Jie [Pinnacle Health - Fox Chase Regional Cancer Center, Harrisburg, Pennsylvania 17109 (United States)

    2014-09-15

    Purpose: For CT scanning in the stationary-table modes, AAPM Task Group 111 proposed to measure the midpoint dose on the central and peripheral axes of sufficiently long phantoms. Currently, a long cylindrical phantom is usually not available in many clinical facilities. The use of a long phantom is also challenging because of the heavy weight. In order to shed light on assessing the midpoint dose in CT scanning without table movement, the authors present a study of the short- to long-phantom dose ratios, and perform a cross-comparison of CT dose ratios on different scanner models. Methods: The authors performed Geant4-based Monte Carlo simulations with a clinical CT scanner (Somatom Definition dual source CT, Siemens Healthcare), and modeled dosimetry measurements using a 0.6 cm{sup 3} Farmer type chamber and a 10-cm long pencil ion chamber. The short (15 cm) to long (90 cm) phantom dose ratios were computed for two PMMA diameters (16 and 32 cm), two phantom axes (the center and the periphery), and a range of beam apertures (3–25 cm). The results were compared with the published data of previous studies with other multiple detector CT (MDCT) scanners and cone beam CT (CBCT) scanners. Results: The short- to long-phantom dose ratios changed with beam apertures but were insensitive to beam qualities (80–140 kV, the head and body bowtie filters) and MDCT and CBCT scanner models. Conclusions: The short- to long-phantom dose ratios enable medical physicists to make dosimetry measurements using the standard CT dosimetry phantoms and a Farmer chamber or a 10 cm long pencil chamber, and to assess the midpoint dose in long phantoms. This method provides an effective approach for the dosimetry of CBCT scanning in the stationary-table modes, and is useful for perfusion and interventional CT.

  9. A study of the short- to long-phantom dose ratios for CT scanning without table translation

    International Nuclear Information System (INIS)

    Li, Xinhua; Zhang, Da; Liu, Bob; Yang, Jie

    2014-01-01

    Purpose: For CT scanning in the stationary-table modes, AAPM Task Group 111 proposed to measure the midpoint dose on the central and peripheral axes of sufficiently long phantoms. Currently, a long cylindrical phantom is usually not available in many clinical facilities. The use of a long phantom is also challenging because of the heavy weight. In order to shed light on assessing the midpoint dose in CT scanning without table movement, the authors present a study of the short- to long-phantom dose ratios, and perform a cross-comparison of CT dose ratios on different scanner models. Methods: The authors performed Geant4-based Monte Carlo simulations with a clinical CT scanner (Somatom Definition dual source CT, Siemens Healthcare), and modeled dosimetry measurements using a 0.6 cm 3 Farmer type chamber and a 10-cm long pencil ion chamber. The short (15 cm) to long (90 cm) phantom dose ratios were computed for two PMMA diameters (16 and 32 cm), two phantom axes (the center and the periphery), and a range of beam apertures (3–25 cm). The results were compared with the published data of previous studies with other multiple detector CT (MDCT) scanners and cone beam CT (CBCT) scanners. Results: The short- to long-phantom dose ratios changed with beam apertures but were insensitive to beam qualities (80–140 kV, the head and body bowtie filters) and MDCT and CBCT scanner models. Conclusions: The short- to long-phantom dose ratios enable medical physicists to make dosimetry measurements using the standard CT dosimetry phantoms and a Farmer chamber or a 10 cm long pencil chamber, and to assess the midpoint dose in long phantoms. This method provides an effective approach for the dosimetry of CBCT scanning in the stationary-table modes, and is useful for perfusion and interventional CT

  10. Pattern of loco-regional failure after definitive radiotherapy for non-small cell lung cancer

    DEFF Research Database (Denmark)

    Schytte, Tine; Nielsen, Tine Bjørn; Brink, Carsten

    2014-01-01

    , and occurrence of distant metastasis. It is challenging to evaluate loco-regional control after definitive radiotherapy for NSCLC since it is difficult to distinguish between radiation-induced damage to the lung tissue and tumour progression/recurrence. In addition it may be useful to distinguish between...... intrapulmonary failure and mediastinal failure to be able to optimize radiotherapy in order to improve loco-regional control even though it is not easy to discriminate between the two sites of failure. Material and methods. This study is a retrospective analysis of 331 NSCLC patients treated with definitive...... with mediastinal relapse. Conclusion. We conclude that focus should be on increasing doses to intrapulmonary tumour volume, when dose escalation is applied to improve local tumour control in NSCLC patients treated with definitive radiotherapy, since most recurrences are located here....

  11. Dosimetric consequences of the shift towards computed tomography guided target definition and planning for breast conserving radiotherapy

    Directory of Open Access Journals (Sweden)

    Korevaar Erik W

    2008-01-01

    Full Text Available Abstract Background The shift from conventional two-dimensional (2D to three-dimensional (3D-conformal target definition and dose-planning seems to have introduced volumetric as well as geometric changes. The purpose of this study was to compare coverage of computed tomography (CT-based breast and boost planning target volumes (PTV, absolute volumes irradiated, and dose delivered to the organs at risk with conventional 2D and 3D-conformal breast conserving radiotherapy. Methods Twenty-five patients with left-sided breast cancer were subject of CT-guided target definition and 3D-conformal dose-planning, and conventionally defined target volumes and treatment plans were reconstructed on the planning CT. Accumulated dose-distributions were calculated for the conventional and 3D-conformal dose-plans, taking into account a prescribed dose of 50 Gy for the breast plans and 16 Gy for the boost plans. Results With conventional treatment plans, CT-based breast and boost PTVs received the intended dose in 78% and 32% of the patients, respectively, and smaller volumes received the prescribed breast and boost doses compared with 3D-conformal dose-planning. The mean lung dose, the volume of the lungs receiving > 20 Gy, the mean heart dose, and volume of the heart receiving > 30 Gy were significantly less with conventional treatment plans. Specific areas within the breast and boost PTVs systematically received a lower than intended dose with conventional treatment plans. Conclusion The shift towards CT-guided target definition and planning as the golden standard for breast conserving radiotherapy has resulted in improved target coverage at the cost of larger irradiated volumes and an increased dose delivered to organs at risk. Tissue is now included into the breast and boost target volumes that was never explicitly defined or included with conventional treatment. Therefore, a coherent definition of the breast and boost target volumes is needed, based on

  12. Dosimetric consequences of the shift towards computed tomography guided target definition and planning for breast conserving radiotherapy

    International Nuclear Information System (INIS)

    Laan, Hans Paul van der; Dolsma, Wil V; Maduro, John H; Korevaar, Erik W; Langendijk, Johannes A

    2008-01-01

    The shift from conventional two-dimensional (2D) to three-dimensional (3D)-conformal target definition and dose-planning seems to have introduced volumetric as well as geometric changes. The purpose of this study was to compare coverage of computed tomography (CT)-based breast and boost planning target volumes (PTV), absolute volumes irradiated, and dose delivered to the organs at risk with conventional 2D and 3D-conformal breast conserving radiotherapy. Twenty-five patients with left-sided breast cancer were subject of CT-guided target definition and 3D-conformal dose-planning, and conventionally defined target volumes and treatment plans were reconstructed on the planning CT. Accumulated dose-distributions were calculated for the conventional and 3D-conformal dose-plans, taking into account a prescribed dose of 50 Gy for the breast plans and 16 Gy for the boost plans. With conventional treatment plans, CT-based breast and boost PTVs received the intended dose in 78% and 32% of the patients, respectively, and smaller volumes received the prescribed breast and boost doses compared with 3D-conformal dose-planning. The mean lung dose, the volume of the lungs receiving > 20 Gy, the mean heart dose, and volume of the heart receiving > 30 Gy were significantly less with conventional treatment plans. Specific areas within the breast and boost PTVs systematically received a lower than intended dose with conventional treatment plans. The shift towards CT-guided target definition and planning as the golden standard for breast conserving radiotherapy has resulted in improved target coverage at the cost of larger irradiated volumes and an increased dose delivered to organs at risk. Tissue is now included into the breast and boost target volumes that was never explicitly defined or included with conventional treatment. Therefore, a coherent definition of the breast and boost target volumes is needed, based on clinical data confirming tumour control probability and normal

  13. Low dose irradiation and biological defense mechanisms

    International Nuclear Information System (INIS)

    Sugahara, Tsutomu; Sagan, L.A.; Aoyama, Takashi

    1992-01-01

    It has been generally accepted in the context of radiation protection that ionizing radiation has some adverse effect even at low doses. However, epidemiological studies of human populations cannot definitively show its existence or absence. Furthermore, recent studies of populations living in areas of different background radiation levels reported some decrease in adverse health effects at high background levels. Genetic studies of atomic bomb survivors failed to produce statistically significant findings on the mutagenic effects of ionizing radiation. A British study however, suggests that a father's exposure to low dose radiation on the job may increase his children's risk of leukemia. On the other hand, many experimental studies have raised the possibility that low doses of ionizing radiation may not be harmful or may even produce stimulating or adaptive responses. The term 'hormesis' has come to be used to describe these phenomena produced by low doses of ionizing radiation when they were beneficial for the organisms studied. At the end of the International Conference on Low Dose Irradiation one conclusion appeared to be justified: radiation produces an adaptive response, though it is not universally detected yet. The conference failed to obtain any consensus on risk assessment at low doses, but raised many problems to be dealt with by future studies. The editors therefore believe that the Proceedings will be useful for all scientists and people concerned with radiation protection and the biological effects of low-dose irradiation

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

    International Nuclear Information System (INIS)

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

    2012-01-01

    Purpose: The potential health risks associated with low levels of ionizing radiation have created a movement in the radiology community to optimize computed tomography (CT) imaging protocols to use the lowest radiation dose possible without compromising the diagnostic usefulness of the images. Despite efforts to use appropriate and consistent radiation doses, studies suggest that a great deal of variability in radiation dose exists both within and between institutions for CT imaging. In this context, the authors have developed an automated size-specific radiation dose monitoring program for CT and used this program to assess variability in size-adjusted effective dose from CT imaging. Methods: The authors radiation dose monitoring program operates on an independent health insurance portability and accountability act compliant dosimetry server. Digital imaging and communication in medicine routing software is used to isolate dose report screen captures and scout images for all incoming CT studies. Effective dose conversion factors (k-factors) are determined based on the protocol and optical character recognition is used to extract the CT dose index and dose-length product. The patient's thickness is obtained by applying an adaptive thresholding algorithm to the scout images and is used to calculate the size-adjusted effective dose (ED adj ). The radiation dose monitoring program was used to collect data on 6351 CT studies from three scanner models (GE Lightspeed Pro 16, GE Lightspeed VCT, and GE Definition CT750 HD) and two institutions over a one-month period and to analyze the variability in ED adj between scanner models and across institutions. Results: No significant difference was found between computer measurements of patient thickness and observer measurements (p= 0.17), and the average difference between the two methods was less than 4%. Applying the size correction resulted in ED adj that differed by up to 44% from effective dose estimates that were not

  15. Data base of dose coefficients called ecrin-V1-internet reference handbook

    International Nuclear Information System (INIS)

    Perrin, M.L.

    2003-07-01

    The objective of this data base is to dispose on a only computer medium the values of radiation doses allowing to guarantee the tracing and the coherence of radiation doses received by man. These data are usable to evaluate the risks in the frame of studies or expertise. They include the doses coming from external irradiations, internal contamination by inhalation or ingestion and receive by workers or public. The definitions and reference values come from international publications (the list is given). (N.C.)

  16. Comparative study of eye dose and chest dose received during radiopharmaceutical production processes

    International Nuclear Information System (INIS)

    Chindarkar, A.S.; Chavan, S.V.; Sawant, D.K.; Sahoo, L.; Gopalakrishnan, R.K.; Sneha, C.; Sachdev, S.S.; Dey, A.C.

    2018-01-01

    Radiopharmaceutical laboratory, BRIT, Vashi produces different radiopharmaceuticals of 131 I, 153 Sm, 99 Mo/ 99m Tc and 177 Lu. Principle gamma energies of these isotopes vary from 103 to 740 KeV and their maximum beta energies vary from 384 to 1214 KeV. In the light of the revised eye lens dose limit recommended in IAEA Basic Safety Standard Interim Edition No. GSR Part 3 (IAEA-2011), the study of radiation dose for eye lens was carried out using CaSO 4 : Dy based Thermo luminescence dosimeter (TLD). This TLD was worn at center of the forehead to measure eye lens dose. This TLD dose was then compared with chest TLD dose to deduce any correlation between these TLD doses. These TLD doses were assessed on quarterly basis. Eight quarter data of these TLD doses were compared

  17. Definition of dose intensity (DI), average relative DI and effective DI

    International Nuclear Information System (INIS)

    Alberto, P.

    1995-01-01

    The cytotoxic activity of cancer chemotherapy is related to the dose and to the amount of drug delivered per time unit. the significance of time in the effectiveness of a treatment program is frequently overlooked. The term of dose intensity (DI) is used to define the drug dose delivered per time unit and is expressed as mg/m 2 per week. A delay in the sequence of treatment cycles decreases the DI in the DI in the same proportion as a reduction of dose. Average relative DI corresponds to the mean DI of combined agents and is expressed as a fraction of a similar combination selected as a standard. Di is useful to compare the dose actually received with the prescribed dose. The relation of DI with tumor response or survival has not been fully demonstrated. A threshold DI level for therapeutic activity is evident. Above this threshold, a linear relationship of DI and effectiveness is not obvious, particularly regarding high-dose chemotherapy. The term of DI is more useful in its principle than in the significance of its calculated value. (authors). 19 refs., 3 tabs., 3 figs

  18. Collections of numerical data and definition. Volume 2: protection - dosimetry; Recueil de donnees numeriques et de definitions. Tome 2: protection - dosimetrie

    Energy Technology Data Exchange (ETDEWEB)

    Combrisson, J [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1955-07-01

    Collections of numerical data and definition about radiation protection and dosimetry are given. It firstly gives the definitions of the different units in radiation measurement. The radiation beam deep distribution in human tissue is graphically presented. It stated the rules to apply for human protection when exposed to accidental or long period irradiations. The recommended values for the relative biological effectiveness are also discussed.The recommendations of the Chalk River conference for the dose of tolerance are given. The report of the Subcommittee on Permissible Dose for Internal Radiation of the International Commission on Radiological Protection of June 1953 is presented. It gives the real half-life, the effective energy RBE, the maximum permissible dose for known radioisotopes as well as the maximum permissible concentration in air and water. The method of calculation for a known radioisotopes mixture is given. After the presentation of the chemical composition and characteristics of the body of an adult, the radioactive doses due to {beta} and {gamma} radioisotopes are discussed and requisite numerical data for the calculation of doses due to {beta} and {gamma} radiations are given. The influence of the thickness of a water or animal tissue layer on a {beta} irradiation is studied as well as the transport of electrons and {beta} particles in animal tissue. A graphic determining the lead thickness needed to obtain the dose of tolerance according the energy and the activity of a {gamma} source is given as well as the lead thickness needed to protect ourself from a radium source according the radium quantity and the distance from the source. (M.P.)

  19. A Monte Carlo study of the impact of the choice of rectum volume definition on estimates of equivalent uniform doses and the volume parameter

    International Nuclear Information System (INIS)

    Kvinnsland, Yngve; Muren, Ludvig Paul; Dahl, Olav

    2004-01-01

    Calculations of normal tissue complication probability (NTCP) values for the rectum are difficult because it is a hollow, non-rigid, organ. Finding the true cumulative dose distribution for a number of treatment fractions requires a CT scan before each treatment fraction. This is labour intensive, and several surrogate distributions have therefore been suggested, such as dose wall histograms, dose surface histograms and histograms for the solid rectum, with and without margins. In this study, a Monte Carlo method is used to investigate the relationships between the cumulative dose distributions based on all treatment fractions and the above-mentioned histograms that are based on one CT scan only, in terms of equivalent uniform dose. Furthermore, the effect of a specific choice of histogram on estimates of the volume parameter of the probit NTCP model was investigated. It was found that the solid rectum and the rectum wall histograms (without margins) gave equivalent uniform doses with an expected value close to the values calculated from the cumulative dose distributions in the rectum wall. With the number of patients available in this study the standard deviations of the estimates of the volume parameter were large, and it was not possible to decide which volume gave the best estimates of the volume parameter, but there were distinct differences in the mean values of the values obtained

  20. Automatic definition of targeted biological volumes for the radiotherapy applications; Definition automatique des volumes biologiques cibles pour les applications de radiotherapie

    Energy Technology Data Exchange (ETDEWEB)

    Hatt, M.; Visvikis, D. [LaTIM, U650 Inserm, 29 - Brest (France); Cheze-Le-Rest, C. [Service de medecine nucleaire, 29 - Brest (France); Pradier, O. [Service de radiotherapie, 29 - Brest (France)

    2009-10-15

    The proposed method: Fuzzy locally adaptive Bayesian (F.L.A.B.) showed its reliability and its precision on very complete collection of realistic simulated and real data. Its use in the context of radiotherapy allows to consider easily the studies implementation and scenari of dose painting or dose escalation, including in complex cases of heterogenous fixations. It is conceivable to apply F.L.A.B. on PET images with F.M.I.S.O. ({sup 18}F fluoro misonidazole) or F.L.T. (fluoro-L-thymidine) to complete the definition of the biological target volume. (N.C.)

  1. Radiation dose to the patient in radionuclide studies

    International Nuclear Information System (INIS)

    Roedler, H.D.

    1981-01-01

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

  2. Identifying the most successful dose (MSD) in dose-finding studies in cancer.

    Science.gov (United States)

    Zohar, Sarah; O'Quigley, John

    2006-01-01

    For a dose finding study in cancer, the most successful dose (MSD), among a group of available doses, is that dose at which the overall success rate is the highest. This rate is the product of the rate of seeing non-toxicities together with the rate of tumor response. A successful dose finding trial in this context is one where we manage to identify the MSD in an efficient manner. In practice we may also need to consider algorithms for identifying the MSD which can incorporate certain restrictions, the most common restriction maintaining the estimated toxicity rate alone below some maximum rate. In this case the MSD may correspond to a different level than that for the unconstrained MSD and, in providing a final recommendation, it is important to underline that it is subject to the given constraint. We work with the approach described in O'Quigley et al. [Biometrics 2001; 57(4):1018-1029]. The focus of that work was dose finding in HIV where both information on toxicity and efficacy were almost immediately available. Recent cancer studies are beginning to fall under this same heading where, as before, toxicity can be quickly evaluated and, in addition, we can rely on biological markers or other measures of tumor response. Mindful of the particular context of cancer, our purpose here is to consider the methodology developed by O'Quigley et al. and its practical implementation. We also carry out a study on the doubly under-parameterized model, developed by O'Quigley et al. but not

  3. A comparison of the angular dependence of effective dose and effective dose equivalent

    International Nuclear Information System (INIS)

    Sitek, M.A.; Gierga, D.P.; Xu, X.G.

    1996-01-01

    In ICRP (International Commission on Radiological Protection) Publication 60, the set of critical organs and their weighing factors were changed, defining the quantity effective dose, E. This quantity replaced the effective dose equivalent, H E , as defined by ICRP 26. Most notably, the esophagus was added to the list of critical organs. The Monte Carlo neutron/photon transport code MCNP was used to determine the effective dose to sex-specific anthropomorphic phantoms. The phantoms, developed in previous research, were modified to include the esophagus. Monte Carlo simulations were performed for monoenergetic photon beams of energies 0.08 MeV, 0.3 MeV, and 1.0 MeV for various azimuthal and polar angles. Separate organ equivalent doses were determined for male and female phantoms. The resulting organ equivalent doses were calculated from arithmetic mean averages. The angular dependence of effective dose was compared with that of effective dose equivalent reported in previous research. The differences between the two definitions and possible implications to regulatory agencies were summarized

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-11-15

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

  5. Application of maximum values for radiation exposure and principles for the calculation of radiation dose

    International Nuclear Information System (INIS)

    2000-01-01

    The guide sets out the mathematical definitions and principles involved in the calculation of the equivalent dose and the effective dose, and the instructions concerning the application of the maximum values of these quantities. further, for monitoring the dose caused by internal radiation, the guide defines the limits derived from annual dose limits (the Annual Limit on Intake and the Derived Air Concentration). Finally, the guide defines the operational quantities to be used in estimating the equivalent dose and the effective dose, and also sets out the definitions of some other quantities and concepts to be used in monitoring radiation exposure. The guide does not include the calculation of patient doses carried out for the purposes of quality assurance

  6. Application of maximum values for radiation exposure and principles for the calculation of radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    The guide sets out the mathematical definitions and principles involved in the calculation of the equivalent dose and the effective dose, and the instructions concerning the application of the maximum values of these quantities. further, for monitoring the dose caused by internal radiation, the guide defines the limits derived from annual dose limits (the Annual Limit on Intake and the Derived Air Concentration). Finally, the guide defines the operational quantities to be used in estimating the equivalent dose and the effective dose, and also sets out the definitions of some other quantities and concepts to be used in monitoring radiation exposure. The guide does not include the calculation of patient doses carried out for the purposes of quality assurance.

  7. Antipsychotic dose equivalents and dose-years: a standardized method for comparing exposure to different drugs.

    Science.gov (United States)

    Andreasen, Nancy C; Pressler, Marcus; Nopoulos, Peg; Miller, Del; Ho, Beng-Choon

    2010-02-01

    A standardized quantitative method for comparing dosages of different drugs is a useful tool for designing clinical trials and for examining the effects of long-term medication side effects such as tardive dyskinesia. Such a method requires establishing dose equivalents. An expert consensus group has published charts of equivalent doses for various antipsychotic medications for first- and second-generation medications. These charts were used in this study. Regression was used to compare each drug in the experts' charts to chlorpromazine and haloperidol and to create formulas for each relationship. The formulas were solved for chlorpromazine 100 mg and haloperidol 2 mg to derive new chlorpromazine and haloperidol equivalents. The formulas were incorporated into our definition of dose-years such that 100 mg/day of chlorpromazine equivalent or 2 mg/day of haloperidol equivalent taken for 1 year is equal to one dose-year. All comparisons to chlorpromazine and haloperidol were highly linear with R(2) values greater than .9. A power transformation further improved linearity. By deriving a unique formula that converts doses to chlorpromazine or haloperidol equivalents, we can compare otherwise dissimilar drugs. These equivalents can be multiplied by the time an individual has been on a given dose to derive a cumulative value measured in dose-years in the form of (chlorpromazine equivalent in mg) x (time on dose measured in years). After each dose has been converted to dose-years, the results can be summed to provide a cumulative quantitative measure of lifetime exposure. Copyright 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  8. The MSFC Collaborative Engineering Process for Preliminary Design and Concept Definition Studies

    Science.gov (United States)

    Mulqueen, Jack; Jones, David; Hopkins, Randy

    2011-01-01

    This paper describes a collaborative engineering process developed by the Marshall Space Flight Center's Advanced Concepts Office for performing rapid preliminary design and mission concept definition studies for potential future NASA missions. The process has been developed and demonstrated for a broad range of mission studies including human space exploration missions, space transportation system studies and in-space science missions. The paper will describe the design team structure and specialized analytical tools that have been developed to enable a unique rapid design process. The collaborative engineering process consists of integrated analysis approach for mission definition, vehicle definition and system engineering. The relevance of the collaborative process elements to the standard NASA NPR 7120.1 system engineering process will be demonstrated. The study definition process flow for each study discipline will be will be outlined beginning with the study planning process, followed by definition of ground rules and assumptions, definition of study trades, mission analysis and subsystem analyses leading to a standardized set of mission concept study products. The flexibility of the collaborative engineering design process to accommodate a wide range of study objectives from technology definition and requirements definition to preliminary design studies will be addressed. The paper will also describe the applicability of the collaborative engineering process to include an integrated systems analysis approach for evaluating the functional requirements of evolving system technologies and capabilities needed to meet the needs of future NASA programs.

  9. Dose intercomparison studies for standardization of high-dose dosimetry in Viet Nam

    International Nuclear Information System (INIS)

    Mai Hoang Hoa; Duong Nguyen Dinh; Kojima, T.

    1999-01-01

    The Irradiation Center of the Vietnam Atomic Energy Commission (IC-VAEC) is planning to establish a traceability system for high-dose dosimetry and to provide high-dose standards as a secondary standard dosimetry laboratory (SSDL) level in Vietnam. For countries which do not have a standard dosimetry laboratory, the participation in the International Dose Assurance Service (IDAS) operated by the International Atomic Energy Agency (IAEA) is the most common means to verify own dosimetry performance with a certain uncertainty. This is, however, only one-direction dose intercomparison with evaluation by IAEA including unknown parameter at participant laboratories. The SSDL level laboratory should have traceability as well as compatibility, ability to evaluate uncertainties of its own dosimetry performance by itself In the present paper, we reviewed our dosimetry performance through two-way dose intercomparison studies and self-evaluation of uncertainty in our dosimetry procedure. The performance of silver dichromate dosimeter as reference transfer dosimeter in IC-VAEC was studied through two-way blind dose intercomparison experiments between the IC-VAEC and JAERI. As another channel of dose intercomparison with IAEA, alanine dosimeters issued by IDAS were simultaneously irradiated with the IC-VAEC dichromate dosimeters at IC-VAEC and analyzed by IAEA. Dose intercomparison between IC-VAEC and JAERI results into a good agreement (better than ±2.5%), and IDAS results also show similar agreement within ±3.0%. The uncertainty was self-estimated on the basis of the JAERI alanine dosimetry, and a preliminary value of about 1.86% at a 68% confidence level is established. The results from these intercomparisons and our estimation of the uncertainty are consistent. We hope that our experience is valuable to other countries which do not have dosimetry standard laboratories and/or are planning to establish them. (author)

  10. Updated Outcome and Analysis of Tumor Response in Mobile Spine and Sacral Chordoma Treated With Definitive High-Dose Photon/Proton Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kabolizadeh, Peyman, E-mail: peyman.kabolizadeh@beaumont.org [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Chen, Yen-Lin; Liebsch, Norbert [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Hornicek, Francis J.; Schwab, Joseph H. [Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Choy, Edwin [Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Rosenthal, Daniel I. [Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States); Niemierko, Andrzej; DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts (United States)

    2017-02-01

    Purpose: Treatment of spine and sacral chordoma generally involves surgical resection, usually in conjunction with radiation therapy. In certain circumstances where resection may result in significant neurologic or organ dysfunction, patients can be treated definitively with radiation therapy alone. Herein, we report the outcome and the assessment of tumor response to definitive radiation therapy. Methods and Materials: A retrospective analysis was performed on 40 patients with unresected chordoma treated with photon/proton radiation therapy. Nineteen patients had complete sets of imaging scans. The soft tissue and bone compartments of the tumor were defined separately. Tumor response was evaluated by the modified Response Evaluation Criteria in Solid Tumors (RECIST) and volumetric analysis. Results: With a median follow-up time of 50.3 months, the rates of 5-year local control, overall survival, disease-specific survival, and distant failure were 85.4%, 81.9%, 89.4%, and 20.2%, respectively. Eighty-four computed tomographic and magnetic resonance imaging scans were reviewed. Among the 19 patients, only 4 local failures occurred, and the median tumor dose was 77.4 GyRBE. Analysis at a median follow-up time of 18 months showed significant volumetric reduction of the total target volume (TTV) and the soft tissue target volume (STTV) within the first 24 months after treatment initiation, followed by further gradual reduction throughout the rest of the follow-up period. The median maximum percentage volumetric regressions of TTV and STTV were 43.2% and 70.4%, respectively. There was only a small reduction in bone target volume over time. In comparison with the modified RECIST, volumetric analysis was more reliable, more reproducible, and could help in measuring minimal changes in the tumor volume. Conclusion: These results continue to support the use of high-dose definitive radiation therapy for selected patients with unresected spine and sacral chordomas

  11. Updated Outcome and Analysis of Tumor Response in Mobile Spine and Sacral Chordoma Treated With Definitive High-Dose Photon/Proton Radiation Therapy

    International Nuclear Information System (INIS)

    Kabolizadeh, Peyman; Chen, Yen-Lin; Liebsch, Norbert; Hornicek, Francis J.; Schwab, Joseph H.; Choy, Edwin; Rosenthal, Daniel I.; Niemierko, Andrzej; DeLaney, Thomas F.

    2017-01-01

    Purpose: Treatment of spine and sacral chordoma generally involves surgical resection, usually in conjunction with radiation therapy. In certain circumstances where resection may result in significant neurologic or organ dysfunction, patients can be treated definitively with radiation therapy alone. Herein, we report the outcome and the assessment of tumor response to definitive radiation therapy. Methods and Materials: A retrospective analysis was performed on 40 patients with unresected chordoma treated with photon/proton radiation therapy. Nineteen patients had complete sets of imaging scans. The soft tissue and bone compartments of the tumor were defined separately. Tumor response was evaluated by the modified Response Evaluation Criteria in Solid Tumors (RECIST) and volumetric analysis. Results: With a median follow-up time of 50.3 months, the rates of 5-year local control, overall survival, disease-specific survival, and distant failure were 85.4%, 81.9%, 89.4%, and 20.2%, respectively. Eighty-four computed tomographic and magnetic resonance imaging scans were reviewed. Among the 19 patients, only 4 local failures occurred, and the median tumor dose was 77.4 GyRBE. Analysis at a median follow-up time of 18 months showed significant volumetric reduction of the total target volume (TTV) and the soft tissue target volume (STTV) within the first 24 months after treatment initiation, followed by further gradual reduction throughout the rest of the follow-up period. The median maximum percentage volumetric regressions of TTV and STTV were 43.2% and 70.4%, respectively. There was only a small reduction in bone target volume over time. In comparison with the modified RECIST, volumetric analysis was more reliable, more reproducible, and could help in measuring minimal changes in the tumor volume. Conclusion: These results continue to support the use of high-dose definitive radiation therapy for selected patients with unresected spine and sacral chordomas

  12. Dose calculations using artificial neural networks: A feasibility study for photon beams

    Science.gov (United States)

    Vasseur, Aurélien; Makovicka, Libor; Martin, Éric; Sauget, Marc; Contassot-Vivier, Sylvain; Bahi, Jacques

    2008-04-01

    Direct dose calculations are a crucial requirement for Treatment Planning Systems. Some methods, such as Monte Carlo, explicitly model particle transport, others depend upon tabulated data or analytic formulae. However, their computation time is too lengthy for clinical use, or accuracy is insufficient, especially for recent techniques such as Intensity-Modulated Radiotherapy. Based on artificial neural networks (ANNs), a new solution is proposed and this work extends the properties of such an algorithm and is called NeuRad. Prior to any calculations, a first phase known as the learning process is necessary. Monte Carlo dose distributions in homogeneous media are used, and the ANN is then acquired. According to the training base, it can be used as a dose engine for either heterogeneous media or for an unknown material. In this report, two networks were created in order to compute dose distribution within a homogeneous phantom made of an unknown material and within an inhomogeneous phantom made of water and TA6V4 (titanium alloy corresponding to hip prosthesis). All NeuRad results were compared to Monte Carlo distributions. The latter required about 7 h on a dedicated cluster (10 nodes). NeuRad learning requires between 8 and 18 h (depending upon the size of the training base) on a single low-end computer. However, the results of dose computation with the ANN are available in less than 2 s, again using a low-end computer, for a 150×1×150 voxels phantom. In the case of homogeneous medium, the mean deviation in the high dose region was less than 1.7%. With a TA6V4 hip prosthesis bathed in water, the mean deviation in the high dose region was less than 4.1%. Further improvements in NeuRad will have to include full 3D calculations, inhomogeneity management and input definitions.

  13. Dose calculations using artificial neural networks: A feasibility study for photon beams

    International Nuclear Information System (INIS)

    Vasseur, Aurelien; Makovicka, Libor; Martin, Eric; Sauget, Marc; Contassot-Vivier, Sylvain; Bahi, Jacques

    2008-01-01

    Direct dose calculations are a crucial requirement for Treatment Planning Systems. Some methods, such as Monte Carlo, explicitly model particle transport, others depend upon tabulated data or analytic formulae. However, their computation time is too lengthy for clinical use, or accuracy is insufficient, especially for recent techniques such as Intensity-Modulated Radiotherapy. Based on artificial neural networks (ANNs), a new solution is proposed and this work extends the properties of such an algorithm and is called NeuRad. Prior to any calculations, a first phase known as the learning process is necessary. Monte Carlo dose distributions in homogeneous media are used, and the ANN is then acquired. According to the training base, it can be used as a dose engine for either heterogeneous media or for an unknown material. In this report, two networks were created in order to compute dose distribution within a homogeneous phantom made of an unknown material and within an inhomogeneous phantom made of water and TA6V4 (titanium alloy corresponding to hip prosthesis). All NeuRad results were compared to Monte Carlo distributions. The latter required about 7 h on a dedicated cluster (10 nodes). NeuRad learning requires between 8 and 18 h (depending upon the size of the training base) on a single low-end computer. However, the results of dose computation with the ANN are available in less than 2 s, again using a low-end computer, for a 150x1x150 voxels phantom. In the case of homogeneous medium, the mean deviation in the high dose region was less than 1.7%. With a TA6V4 hip prosthesis bathed in water, the mean deviation in the high dose region was less than 4.1%. Further improvements in NeuRad will have to include full 3D calculations, inhomogeneity management and input definitions

  14. Dose calculations using artificial neural networks: A feasibility study for photon beams

    Energy Technology Data Exchange (ETDEWEB)

    Vasseur, Aurelien [University of Franche-Comte, IRMA/CREST Femto-ST, Portes du Jura, 4 place Tharradin, BP 71427, 25211 Montbeliard Cedex (France); University of Franche-Comte, AND/LIFC, rue Engel Gros, 90016 Belfort (France)], E-mail: aurelien.vasseur@gmail.com; Makovicka, Libor; Martin, Eric [University of Franche-Comte, IRMA/CREST Femto-ST, Portes du Jura, 4 place Tharradin, BP 71427, 25211 Montbeliard Cedex (France); Sauget, Marc [University of Franche-Comte, IRMA/CREST Femto-ST, Portes du Jura, 4 place Tharradin, BP 71427, 25211 Montbeliard Cedex (France); University of Franche-Comte, AND/LIFC, rue Engel Gros, 90016 Belfort (France); Contassot-Vivier, Sylvain; Bahi, Jacques [University of Franche-Comte, AND/LIFC, rue Engel Gros, 90016 Belfort (France)

    2008-04-15

    Direct dose calculations are a crucial requirement for Treatment Planning Systems. Some methods, such as Monte Carlo, explicitly model particle transport, others depend upon tabulated data or analytic formulae. However, their computation time is too lengthy for clinical use, or accuracy is insufficient, especially for recent techniques such as Intensity-Modulated Radiotherapy. Based on artificial neural networks (ANNs), a new solution is proposed and this work extends the properties of such an algorithm and is called NeuRad. Prior to any calculations, a first phase known as the learning process is necessary. Monte Carlo dose distributions in homogeneous media are used, and the ANN is then acquired. According to the training base, it can be used as a dose engine for either heterogeneous media or for an unknown material. In this report, two networks were created in order to compute dose distribution within a homogeneous phantom made of an unknown material and within an inhomogeneous phantom made of water and TA6V4 (titanium alloy corresponding to hip prosthesis). All NeuRad results were compared to Monte Carlo distributions. The latter required about 7 h on a dedicated cluster (10 nodes). NeuRad learning requires between 8 and 18 h (depending upon the size of the training base) on a single low-end computer. However, the results of dose computation with the ANN are available in less than 2 s, again using a low-end computer, for a 150x1x150 voxels phantom. In the case of homogeneous medium, the mean deviation in the high dose region was less than 1.7%. With a TA6V4 hip prosthesis bathed in water, the mean deviation in the high dose region was less than 4.1%. Further improvements in NeuRad will have to include full 3D calculations, inhomogeneity management and input definitions.

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  16. Regulatory Forum Opinion Piece*: Retrospective Evaluation of Doses in the 26-week Tg.rasH2 Mice Carcinogenicity Studies: Recommendation to Eliminate High Doses at Maximum Tolerated Dose (MTD) in Future Studies.

    Science.gov (United States)

    Paranjpe, Madhav G; Denton, Melissa D; Vidmar, Tom J; Elbekai, Reem H

    2015-07-01

    High doses in Tg.rasH2 carcinogenicity studies are usually set at the maximum tolerated dose (MTD), although this dose selection strategy has not been critically evaluated. We analyzed the body weight gains (BWGs), mortality, and tumor response in control and treated groups of 29 Tg.rasH2 studies conducted at BioReliance. Based on our analysis, it is evident that the MTD was exceeded at the high and/or mid-doses in several studies. The incidence of tumors in high doses was lower when compared to the low and mid-doses of both sexes. Thus, we recommend that the high dose in male mice should not exceed one-half of the estimated MTD (EMTD), as it is currently chosen, and the next dose should be one-fourth of the EMTD. Because females were less sensitive to decrements in BWG, the high dose in female mice should not exceed two-third of EMTD and the next dose group should be one-third of EMTD. If needed, a third dose group should be set at one-eighth EMTD in males and one-sixth EMTD in females. In addition, for compounds that do not show toxicity in the range finding studies, a limit dose should be applied for the 26-week carcinogenicity studies. © 2014 by The Author(s).

  17. Early observed transient prostate-specific antigen elevations on a pilot study of external beam radiation therapy and fractionated MRI guided High Dose Rate brachytherapy boost

    International Nuclear Information System (INIS)

    Singh, Anurag K; Godette, Denise J; Stall, Bronwyn R; Coleman, C Norman; Camphausen, Kevin; Ménard, Cynthia; Guion, Peter; Susil, Robert C; Citrin, Deborah E; Ning, Holly; Miller, Robert W; Ullman, Karen; Smith, Sharon; Crouse, Nancy Sears

    2006-01-01

    To report early observation of transient PSA elevations on this pilot study of external beam radiation therapy and magnetic resonance imaging (MRI) guided high dose rate (HDR) brachytherapy boost. Eleven patients with intermediate-risk and high-risk localized prostate cancer received MRI guided HDR brachytherapy (10.5 Gy each fraction) before and after a course of external beam radiotherapy (46 Gy). Two patients continued on hormones during follow-up and were censored for this analysis. Four patients discontinued hormone therapy after RT. Five patients did not receive hormones. PSA bounce is defined as a rise in PSA values with a subsequent fall below the nadir value or to below 20% of the maximum PSA level. Six previously published definitions of biochemical failure to distinguish true failure from were tested: definition 1, rise >0.2 ng/mL; definition 2, rise >0.4 ng/mL; definition 3, rise >35% of previous value; definition 4, ASTRO defined guidelines, definition 5 nadir + 2 ng/ml, and definition 6, nadir + 3 ng/ml. Median follow-up was 24 months (range 18–36 mo). During follow-up, the incidence of transient PSA elevation was: 55% for definition 1, 44% for definition 2, 55% for definition 3, 33% for definition 4, 11% for definition 5, and 11% for definition 6. We observed a substantial incidence of transient elevations in PSA following combined external beam radiation and HDR brachytherapy for prostate cancer. Such elevations seem to be self-limited and should not trigger initiation of salvage therapies. No definition of failure was completely predictive

  18. 40 CFR 190.02 - Definitions.

    Science.gov (United States)

    2010-07-01

    ... materials from -the cycle. (c) General environment means the total terrestrial, atmospheric and aquatic... of the public means any individual that can receive a radiation dose in the general environment... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Definitions. 190.02 Section 190.02...

  19. Estimation and comparison of effective dose (E) in standard chest CT by organ dose measurements and dose-length-product methods and assessment of the influence of CT tube potential (energy dependency) on effective dose in a dual-source CT.

    Science.gov (United States)

    Paul, Jijo; Banckwitz, Rosemarie; Krauss, Bernhard; Vogl, Thomas J; Maentele, Werner; Bauer, Ralf W

    2012-04-01

    To determine effective dose (E) during standard chest CT using an organ dose-based and a dose-length-product-based (DLP) approach for four different scan protocols including high-pitch and dual-energy in a dual-source CT scanner of the second generation. Organ doses were measured with thermo luminescence dosimeters (TLD) in an anthropomorphic male adult phantom. Further, DLP-based dose estimates were performed by using the standard 0.014mSv/mGycm conversion coefficient k. Examinations were performed on a dual-source CT system (Somatom Definition Flash, Siemens). Four scan protocols were investigated: (1) single-source 120kV, (2) single-source 100kV, (3) high-pitch 120kV, and (4) dual-energy with 100/Sn140kV with equivalent CTDIvol and no automated tube current modulation. E was then determined following recommendations of ICRP publication 103 and 60 and specific k values were derived. DLP-based estimates differed by 4.5-16.56% and 5.2-15.8% relatively to ICRP 60 and 103, respectively. The derived k factors calculated from TLD measurements were 0.0148, 0.015, 0.0166, and 0.0148 for protocol 1, 2, 3 and 4, respectively. Effective dose estimations by ICRP 103 and 60 for single-energy and dual-energy protocols show a difference of less than 0.04mSv. Estimates of E based on DLP work equally well for single-energy, high-pitch and dual-energy CT examinations. The tube potential definitely affects effective dose in a substantial way. Effective dose estimations by ICRP 103 and 60 for both single-energy and dual-energy examinations differ not more than 0.04mSv. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  20. Competing definitions of schizophrenia: what can be learned from polydiagnostic studies?

    DEFF Research Database (Denmark)

    Jansson, Lennart B; Parnas, Josef

    2007-01-01

    of explicit conceptual analyses and empirical studies but defined through consensus with the purpose of improving reliability. The validity status of current definitions and of their predecessors remains unclear. The so-called "polydiagnostic approach" applies different definitions of a disorder to the same...... patient sample in order to compare these definitions on potential validity indicators. We reviewed 92 polydiagnostic sz studies published since the early 1970s. Different sz definitions show a considerable variation concerning frequency, concordance, reliability, outcome, and other validity measures....... The DSM-IV and the ICD-10 show moderate reliability but both definitions appear weak in terms of concurrent validity, eg, with respect to an aggregation of a priori important features. The first-rank symptoms of Schneider are not associated with family history of sz or with prediction of poor outcome...

  1. Concomitant chemoradiotherapy with high dose rate brachytherapy ...

    African Journals Online (AJOL)

    Concomitant chemoradiotherapy with high dose rate brachytherapy as a definitive treatment modality for locally advanced cervical cancer. T Refaat, A Elsaid, N Lotfy, K Kiel, W Small Jr, P Nickers, E Lartigau ...

  2. Radiation protection and environment day the low doses in everyday life; Radioprotection et environnement les faibles doses dans la vie quotidienne

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2007-07-01

    The consequences of low doses exposures are difficult to explore and the studies give often place to controversies. According to the are, differences exist in the methodological approaches. It results from it a confusion on the acceptable levels of exposure, even on the definition of low dose. This day organised by the sections 'non ionizing and research and health of the French society of radiation protection (S.F.R.P.), will be a meeting between professionals of different disciplines, to compare the approaches used for the ionizing and non ionizing radiations as well as the chemical and microbiological agents. It will allow to share the knowledge and the abilities and to progress on methodologies adapted to the evaluation and the management of risks in relation with low doses. (N.C.)

  3. Procedures for the definitive calibration of radiotherapy equipment

    International Nuclear Information System (INIS)

    1993-01-01

    Recommendations from the Institute of Physical Sciences in Medicine are given for the definition calibration of external beam radiotherapy treatment machines and radiation dose measuring equipment used in radiotherapy. (UK)

  4. Competing Definitions of Schizophrenia: What Can Be Learned From Polydiagnostic Studies?

    DEFF Research Database (Denmark)

    Jansson, Lennart Bertil; Parnas, Josef

    2006-01-01

    not a product of explicit conceptual analyses and empirical studies but defined through consensus with the purpose of improving reliability. The validity status of current definitions and of their predecessors remains unclear. The so-called "polydiagnostic approach" applies different definitions of a disorder...... to the same patient sample in order to compare these definitions on potential validity indicators. We reviewed 92 polydiagnostic sz studies published since the early 1970s. Different sz definitions show a considerable variation concerning frequency, concordance, reliability, outcome, and other validity...... measures. The DSM-IV and the ICD-10 show moderate reliability but both definitions appear weak in terms of concurrent validity, eg, with respect to an aggregation of a priori important features. The first-rank symptoms of Schneider are not associated with family history of sz or with prediction of poor...

  5. Developing a Framework for Analyzing Definitions: A Study of "The Feynman Lectures"

    Science.gov (United States)

    Wong, Chee Leong; Chu, Hye-Eun; Yap, Kueh Chin

    2014-01-01

    One important purpose of a definition is to explain the meaning of a word. Any problems associated with a definition may impede students' learning. However, research studies on the definitional problems from the perspective of physics education are limited. Physics educators may not be aware of the nature and extent of definitional problems.…

  6. The concept of the effective dose

    International Nuclear Information System (INIS)

    Jacobi, W.

    1975-01-01

    Irradiation of the human body by external or internal sources leads mostly to a simultaneous exposure of several organs. However, so far no clear and consistent recommendations for the combination of organ doses and the assessment of an exposure limit under such irradiation conditions are available. Following a proposal described in ICRP-publication 14 one possible concept for the combination of organ doses is discussed in this paper. This concept is based on the assumption that at low doses the total radiation detriment to the exposed person is given by the sum of radiation detriments to the single organs. Taking into account a linear dose-risk relationship, the sum of weighted organ doses leads to the definition of an 'Effective Dose'. The applicability and consequences of this 'Effective Dose Concept' are discussed especially with regard to the assessment of the maximum permissible intake of radionuclides into the human body and the combination of external and internal exposure. (orig.) [de

  7. On revision of definition of doses for radiation protection in ICRP 1990 recommendations

    International Nuclear Information System (INIS)

    Yoshizawa, Michio

    1995-01-01

    The recommendation of ICRP is to give the guideline to the organizations and experts concerned to radiation protection including regulatory authorities on the basic rule which becomes the basis of proper radiation protection, and the radiation protection in respective countries has been carried out, respecting this ICRP recommendation. In 1990, ICRP revised this basic recommendation, and published as Publication 60. In this 1990 recommendation, as the matters that give impact to the dose evaluation of external exposure, the introduction of the new concept of dose, namely radiation weighting factor and equivalent dose, the revision of radiation quality factor and so on are enumerated. As to the 1990 recommendation, absorbed dose and organ dose, radiation weighting factor, equivalent dose, effective dose, quality factor-LET relation, the summation with the former quantities and the operational quantity of ICRU are described. The reason why radiation weighting factor and equivalent dose were introduced are discussed, including the inference of the author. (K.I.)

  8. Terms and definitions in the field of radiological technique

    International Nuclear Information System (INIS)

    1977-10-01

    The standard gives terms required in the computer calculation of dose distributions. The terms are compiled especially for the problems of teletherapy; they are also used in the calculation of dose distributions for other applications of radiation. The terms and definitions of DIN 44 300 were taken into account as far as possible. (orig./HP) [de

  9. Collections of numerical data and definition. Volume 2: protection - dosimetry

    International Nuclear Information System (INIS)

    Combrisson, J.

    1955-01-01

    Collections of numerical data and definition about radiation protection and dosimetry are given. It firstly gives the definitions of the different units in radiation measurement. The radiation beam deep distribution in human tissue is graphically presented. It stated the rules to apply for human protection when exposed to accidental or long period irradiations. The recommended values for the relative biological effectiveness are also discussed.The recommendations of the Chalk River conference for the dose of tolerance are given. The report of the Subcommittee on Permissible Dose for Internal Radiation of the International Commission on Radiological Protection of June 1953 is presented. It gives the real half-life, the effective energy RBE, the maximum permissible dose for known radioisotopes as well as the maximum permissible concentration in air and water. The method of calculation for a known radioisotopes mixture is given. After the presentation of the chemical composition and characteristics of the body of an adult, the radioactive doses due to β and γ radioisotopes are discussed and requisite numerical data for the calculation of doses due to β and γ radiations are given. The influence of the thickness of a water or animal tissue layer on a β irradiation is studied as well as the transport of electrons and β particles in animal tissue. A graphic determining the lead thickness needed to obtain the dose of tolerance according the energy and the activity of a γ source is given as well as the lead thickness needed to protect ourself from a radium source according the radium quantity and the distance from the source. (M.P.)

  10. 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

  11. Science Mission Definition Studies for TROPIX

    Science.gov (United States)

    Fennell, J. F.

    1997-01-01

    This document summarizes the results of mission definition studies for solar electric propulsion missions that have been carried out over the last approximately three years. The major output from the studies has been two proposals which were submitted to NASA in response to Announcements of Opportunity for missions and an ongoing Global Magnetospheric Dynamics mission study. The bulk of this report consists of copies of the proposals and preliminary materials from the GMD study that will be completed in the coming months.

  12. Automatic definition of targeted biological volumes for the radiotherapy applications

    International Nuclear Information System (INIS)

    Hatt, M.; Visvikis, D.; Cheze-Le-Rest, C.; Pradier, O.

    2009-01-01

    The proposed method: Fuzzy locally adaptive Bayesian (F.L.A.B.) showed its reliability and its precision on very complete collection of realistic simulated and real data. Its use in the context of radiotherapy allows to consider easily the studies implementation and scenari of dose painting or dose escalation, including in complex cases of heterogenous fixations. It is conceivable to apply F.L.A.B. on PET images with F.M.I.S.O. ( 18 F fluoro misonidazole) or F.L.T. (fluoro-L-thymidine) to complete the definition of the biological target volume. (N.C.)

  13. Low dose epidemiologic studies

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    In this chapter the BEIR committee has reviewed low-dose irradiation studies since the BEIR III report. They have considered the carcinogenic effectiveness of low-LET in populations exposed to radiation from a number of different sources: diagnostic radiography; fallout from nuclear weapons testing; nuclear installations; radiation in the workplace and high levels of natural background radiation

  14. An experimental Toxoplasma gondii dose response challenge model to study therapeutic or vaccine efficacy in cats.

    Directory of Open Access Journals (Sweden)

    Jan B W J Cornelissen

    Full Text Available High numbers of Toxoplasma gondii oocysts in the environment are a risk factor to humans. The environmental contamination might be reduced by vaccinating the definitive host, cats. An experimental challenge model is necessary to quantitatively assess the efficacy of a vaccine or drug treatment. Previous studies have indicated that bradyzoites are highly infectious for cats. To infect cats, tissue cysts were isolated from the brains of mice infected with oocysts of T. gondii M4 strain, and bradyzoites were released by pepsin digestion. Free bradyzoites were counted and graded doses (1000, 100, 50, 10, and 250 intact tissue cysts were inoculated orally into three cats each. Oocysts shed by these five groups of cats were collected from faeces by flotation techniques, counted microscopically and estimated by real time PCR. Additionally, the number of T. gondii in heart, tongue and brains were estimated, and serology for anti T. gondii antibodies was performed. A Beta-Poisson dose-response model was used to estimate the infectivity of single bradyzoites and linear regression was used to determine the relation between inoculated dose and numbers of oocyst shed. We found that real time PCR was more sensitive than microscopic detection of oocysts, and oocysts were detected by PCR in faeces of cats fed 10 bradyzoites but by microscopic examination. Real time PCR may only detect fragments of T. gondii DNA without the presence of oocysts in low doses. Prevalence of tissue cysts of T. gondii in tongue, heart and brains, and anti T. gondii antibody concentrations were all found to depend on the inoculated bradyzoite dose. The combination of the experimental challenge model and the dose response analysis provides a suitable reference for quantifying the potential reduction in human health risk due to a treatment of domestic cats by vaccination or by therapeutic drug application.

  15. Postoperative versus definitive chemoradiation in early-stage anal cancer. Results of a matched-pair analysis

    Energy Technology Data Exchange (ETDEWEB)

    Berger, B.; Menzel, M.; Bamberg, M.; Weinmann, M. [Tuebingen Univ. (Germany). Dept. of Radiation Oncology; Breucha, G. [Kreiskrankenhaus Hechingen, Tuebingen Univ. (Germany). Dept. of Surgery

    2012-07-15

    Background and purpose: The goal of the present study was to comparatively assess the results of definitive chemoradiation (CRT) with or without previous macroscopically complete resection in patients with early-stage node-negative (T1-2 N0) anal carcinoma. Patients and methods: A total of 20 patients with T1-2 N0 anal carcinoma who received radiotherapy (RT) with or without chemotherapy following incidental R0/1 tumor resection (S/CRT group) were selected. These were matched to 20 comparable patients who underwent definitive chemoradiation without previous surgery (CRT group). Major objectives of this analysis were treatment outcomes in terms of locoregional tumor control (LRC), overall survival (OS), colostomy-free survival, and toxicity. Results: Patients treated postoperatively received significantly lower RT doses (median 54.0 Gy vs. 59.7 Gy; p < 0.001) and less frequently concomitant chemotherapy than those treated definitely. The 5-year LRC and 5-year OS rates were 97.5% and 90.0%, respectively, without significant differences between the S/CRT and the CRT groups. The distribution of acute and late toxicities was comparable, and the 5-year colostomy-free survival was 95% in both groups. Conclusion: This matched-pair comparison of incidental R0/1 resection plus dose-reduced CRT with standard definitive CRT of early-stage anal cancer shows similar treatment results. Thus, dose-reduced RT with or without chemotherapy may be considered in R0/1 resected patients with T1-2 N0 anal carcinoma. (orig.)

  16. Absorbed dose thresholds and absorbed dose rate limitations for studies of electron radiation effects on polyetherimides

    Science.gov (United States)

    Long, Edward R., Jr.; Long, Sheila Ann T.; Gray, Stephanie L.; Collins, William D.

    1989-01-01

    The threshold values of total absorbed dose for causing changes in tensile properties of a polyetherimide film and the limitations of the absorbed dose rate for accelerated-exposure evaluation of the effects of electron radiation in geosynchronous orbit were studied. Total absorbed doses from 1 kGy to 100 MGy and absorbed dose rates from 0.01 MGy/hr to 100 MGy/hr were investigated, where 1 Gy equals 100 rads. Total doses less than 2.5 MGy did not significantly change the tensile properties of the film whereas doses higher than 2.5 MGy significantly reduced elongation-to-failure. There was no measurable effect of the dose rate on the tensile properties for accelerated electron exposures.

  17. Effects of small radiation doses

    International Nuclear Information System (INIS)

    Fuchs, G.

    1986-01-01

    The term 'small radiation dosis' means doses of about (1 rem), fractions of one rem as well as doses of a few rem. Doses like these are encountered in various practical fields, e.g. in X-ray diagnosis, in the environment and in radiation protection rules. The knowledge about small doses is derived from the same two forces, on which the radiobiology of human beings nearly is based: interpretation of the Hiroshima and Nagasaki data, as well as the experience from radiotherapy. Careful interpretation of Hiroshima dates do not provide any evidence that small doses can induce cancer, fetal malformations or genetic damage. Yet in radiotherapy of various diseases, e.g. inflammations, doses of about 1 Gy (100 rad) do no harm to the patients. According to a widespread hypothesis even very small doses may induce some types of radiation damage ('no threshold'). Nevertheless an alternative view is justified. At present no decision can be made between these two alternatives, but the usefullness of radiology is definitely better established than any damage calculated by theories or extrapolations. Based on experience any exaggerated fear of radiations can be met. (author)

  18. Topics on study of low dose-effect relationship

    Energy Technology Data Exchange (ETDEWEB)

    Yamada, Takeshi [Toho Univ., School of Medicine, Tokyo (Japan); Ohyama, Harumi

    1999-09-01

    It is not exceptional but usually observed that a dose-effect relationship in biosystem is not linear. Sometimes, the low dose-effect relationship appears entirely contrary to the expectation from high dose-effect. This is called a 'hormesis' phenomena. A high dose irradiation inflicts certainly an injury on biosystem. No matter how low the dose may be, an irradiation might inflict some injury on biosystem according to Linear Non-Threshold hypothesis(LNT). On the contrary to the expectation, a low dose irradiation stimulates immune system, and promotes cell proliferation. This is called 'radiation hormesis'. The studies of the radiation hormesis are made on from four points of view as follows: (1) radiation adaptive response, (2) revitalization caused by a low dose stimulation, (3) a low dose response unexpected from the LNT hypothesis, (4) negation of the LNT hypothesis. The various empirical proofs of radiation hormesis are introduced in the report. (M . Suetake)

  19. Topics on study of low dose-effect relationship

    International Nuclear Information System (INIS)

    Yamada, Takeshi; Ohyama, Harumi

    1999-01-01

    It is not exceptional but usually observed that a dose-effect relationship in biosystem is not linear. Sometimes, the low dose-effect relationship appears entirely contrary to the expectation from high dose-effect. This is called a 'hormesis' phenomena. A high dose irradiation inflicts certainly an injury on biosystem. No matter how low the dose may be, an irradiation might inflict some injury on biosystem according to Linear Non-Threshold hypothesis(LNT). On the contrary to the expectation, a low dose irradiation stimulates immune system, and promotes cell proliferation. This is called 'radiation hormesis'. The studies of the radiation hormesis are made on from four points of view as follows: (1) radiation adaptive response, (2) revitalization caused by a low dose stimulation, (3) a low dose response unexpected from the LNT hypothesis, (4) negation of the LNT hypothesis. The various empirical proofs of radiation hormesis are introduced in the report. (M . Suetake)

  20. Radiation doses to children during modified barium swallow studies

    International Nuclear Information System (INIS)

    Weir, Kelly A.; McMahon, Sandra M.; Long, Gillian; Bunch, Judith A.; Pandeya, Nirmala; Coakley, Kerry S.; Chang, Anne B.

    2007-01-01

    There are minimal data on radiation doses to infants and children undergoing a modified barium swallow (MBS) study. To document screening times, dose area product (DAP) and effective doses to children undergoing MBS and to determine factors associated with increased screening times and effective dose. Fluoroscopic data (screening time, DAP, kVp) for 90 consecutive MBS studies using pulse fluoroscopy were prospectively recorded; effective dose was calculated and data were analyzed for effects of behavior, number of swallow presentations, swallowing dysfunction and medical problems. Mean effective dose for the entire group was 0.0826 ± 0.0544 mSv, screening time 2.48 ± 0.81 min, and DAP 28.79 ± 41.72 cGy cm 2 . Significant differences were found across three age groups (≤1.0, >1.0-3.0 and >3.0 years) for effective dose (mean 0.1188, 0.0651 and 0.0529 mSv, respectively; P < 0.001), but not for screening time or DAP. Effective dose was correlated with screening time (P 0.007), DAP (P < 0.001), number of swallow presentations (P = 0.007), lower age (P = 0.017), female gender (P = 0.004), and height (P < 0.001). Screening time was correlated with total number of swallow presentations (P < 0.001) and DAP (P < 0.001). Screening times, DAP, effective dose, and child and procedural factors associated with higher effective doses are presented for children undergoing MBS studies. (orig.)

  1. Does the Reliability of Reporting in Injury Surveillance Studies Depend on Injury Definition?

    Science.gov (United States)

    Cross, Matthew; Williams, Sean; Kemp, Simon P.T.; Fuller, Colin; Taylor, Aileen; Brooks, John; Trewartha, Grant; Stokes, Keith

    2018-01-01

    Background: Choosing an appropriate definition for injury in injury surveillance studies is essential to ensure a balance among reporting reliability, providing an accurate representation of injury risk, and describing the nature of the clinical demand. Purpose: To provide guidance on the choice of injury definition for injury surveillance studies by comparing within- and between-team variability in injury incidence with >24-hour and >7-day time-loss injury definitions in a large multiteam injury surveillance study. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Injury data were reported for 2248 professional rugby union players from 15 Premiership Rugby clubs over 12 seasons. Within-team percentage coefficient of variation and mean between-team standard deviation (expressed as a percentage coefficient of variation) in injury incidence rates (injuries per 1000 player match hours) were calculated. For both variables, a comparison was made between >24-hour and >7-day injury incidence rates in terms of the magnitude of the observed effects. Results: The overall mean incidence across the population with a >24-hour time-loss injury definition was approximately double the reported incidence with the >7-day definition. There was a 10% higher between-team variation in match injury incidence rates with the >24-hour time-loss definition versus the >7-day definition. Conclusion: There was a likely higher degree of between-team variation in match injury incidence rates with a >24-hour time-loss definition than with a >7-day definition of injury. However, in professional sports settings, it is likely that the benefits of using a more inclusive definition of injury (improved understanding of clinical demand and the appropriate and accurate reporting of injury risk) outweigh the small increase in variation in reporting consistency. PMID:29581994

  2. Analysis and planning of dose-finding studies with active control

    International Nuclear Information System (INIS)

    Helms, Hans-Joachim

    2014-01-01

    In the clinical development of radiopharmaceuticals the dose finding plays an important role. The contribution is focused on the evaluation and planning of dose finding studies with active control. It is of primary interest to find the lowest dose that yields the same efficacy as the active control. Besides the target dose confidence intervals are of importance to describe the quality of the target dose estimation. The calculation of case numbers and the determination of the dose steps to be studied are challenging under practical conditions. The contribution covers the demonstration of the statistical model the parameter estimation and the asymptotic properties based on maximum likelihood theory, the spline-based evaluation of nonlinear dose finding studies with active control and the planning of design and number of cases.

  3. Does the Reliability of Reporting in Injury Surveillance Studies Depend on Injury Definition?

    Science.gov (United States)

    Cross, Matthew; Williams, Sean; Kemp, Simon P T; Fuller, Colin; Taylor, Aileen; Brooks, John; Trewartha, Grant; Stokes, Keith

    2018-03-01

    Choosing an appropriate definition for injury in injury surveillance studies is essential to ensure a balance among reporting reliability, providing an accurate representation of injury risk, and describing the nature of the clinical demand. To provide guidance on the choice of injury definition for injury surveillance studies by comparing within- and between-team variability in injury incidence with >24-hour and >7-day time-loss injury definitions in a large multiteam injury surveillance study. Cohort study (diagnosis); Level of evidence, 2. Injury data were reported for 2248 professional rugby union players from 15 Premiership Rugby clubs over 12 seasons. Within-team percentage coefficient of variation and mean between-team standard deviation (expressed as a percentage coefficient of variation) in injury incidence rates (injuries per 1000 player match hours) were calculated. For both variables, a comparison was made between >24-hour and >7-day injury incidence rates in terms of the magnitude of the observed effects. The overall mean incidence across the population with a >24-hour time-loss injury definition was approximately double the reported incidence with the >7-day definition. There was a 10% higher between-team variation in match injury incidence rates with the >24-hour time-loss definition versus the >7-day definition. There was a likely higher degree of between-team variation in match injury incidence rates with a >24-hour time-loss definition than with a >7-day definition of injury. However, in professional sports settings, it is likely that the benefits of using a more inclusive definition of injury (improved understanding of clinical demand and the appropriate and accurate reporting of injury risk) outweigh the small increase in variation in reporting consistency.

  4. Recommendations for the definition of clinical responder in insulin preservation studies.

    Science.gov (United States)

    Beam, Craig A; Gitelman, Stephen E; Palmer, Jerry P

    2014-09-01

    Clinical responder studies should contribute to the translation of effective treatments and interventions to the clinic. Since ultimately this translation will involve regulatory approval, we recommend that clinical trials prespecify a responder definition that can be assessed against the requirements and suggestions of regulatory agencies. In this article, we propose a clinical responder definition to specifically assist researchers and regulatory agencies in interpreting the clinical importance of statistically significant findings for studies of interventions intended to preserve β-cell function in newly diagnosed type 1 diabetes. We focus on studies of 6-month β-cell preservation in type 1 diabetes as measured by 2-h-stimulated C-peptide. We introduce criteria (bias, reliability, and external validity) for the assessment of responder definitions to ensure they meet U.S. Food and Drug Administration and European Medicines Agency guidelines. Using data from several published TrialNet studies, we evaluate our definition (no decrease in C-peptide) against published alternatives and determine that our definition has minimum bias with external validity. We observe that reliability could be improved by using changes in C-peptide later than 6 months beyond baseline. In sum, to support efficacy claims of β-cell preservation therapies in type 1 diabetes submitted to U.S. and European regulatory agencies, we recommend use of our definition. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  5. Design and statistical considerations for studies evaluating the efficacy of a single dose of the human papillomavirus (HPV) vaccine.

    Science.gov (United States)

    Sampson, Joshua N; Hildesheim, Allan; Herrero, Rolando; Gonzalez, Paula; Kreimer, Aimee R; Gail, Mitchell H

    2018-05-01

    Cervical cancer is a leading cause of cancer mortality in women worldwide. Human papillomavirus (HPV) types 16 and 18 cause about 70% of all cervical cancers. Clinical trials have demonstrated that three doses of either commercially available HPV vaccine, Cervarix ® or Gardasil ®, prevent most new HPV 16/18 infections and associated precancerous lesions. Based on evidence of immunological non-inferiority, 2-dose regimens have been licensed for adolescents in the United States, European Union, and elsewhere. However, if a single dose were effective, vaccine costs would be reduced substantially and the logistics of vaccination would be greatly simplified, enabling vaccination programs in developing countries. The National Cancer Institute (NCI) and the Agencia Costarricense de Investigaciones Biomédicas (ACIB) are conducting, with support from the Bill & Melinda Gates Foundation and the International Agency for Research on Cancer (IARC), a large 24,000 girl study to evaluate the efficacy of a 1-dose regimen. The first component of the study is a four-year non-inferiority trial comparing 1- to 2-dose regimens of the two licensed vaccines. The second component is an observational study that estimates the vaccine efficacy (VE) of each regimen by comparing the HPV infection rates in the trial arms to those in a contemporaneous survey group of unvaccinated girls. In this paper, we describe the design and statistical analysis for this study. We explain the advantage of defining non-inferiority on the absolute risk scale when the expected event rate is near 0 and, given this definition, suggest an approach to account for missing clinic visits. We then describe the problem of estimating VE in the absence of a randomized placebo arm and offer our solution. Copyright © 2018. Published by Elsevier Inc.

  6. Putting aside the LNT dilemma in the controllable dose concept

    International Nuclear Information System (INIS)

    Koblinger, Laszlo

    2000-01-01

    Recently, Professor R. Clarke, ICRP Chairman has published his proposal for a renewal of the basic radiation protection concept. The two main points of his proposed system are: (1) the term Controllable Dose is introduced, and (2) the protection philosophy is based on the individual. For practical uses terms like 'Action Level', 'Investigation Level' etc. are introduced. The outline of the new system promises a really less complex frame; no distinction between practices and interventions, unified treatment for occupational, medical and public exposures. There is, however, an inconsistency within the new system: Though linearity is not assumed, the relations between the definitions of the new terms of the system of protection and the doses assigned to them are still based on the LNT hypothesis. To avoid this discrepancy a new definition of Action Level is recommended as a conservative estimate of the lowest dose where harmful effects have ever been demonstrated. Other levels should be defined by the Action Level and Safety Factors applied on the doses. (author)

  7. Estimation of dose and exposure at sentinel node study

    International Nuclear Information System (INIS)

    Skopljak, A.; Kucukalic-Selimovic, E.; Beslic, N.; Begic, A.; Begovic-Hadzimuratovic, S.; Drazeta, Z.; Beganovic, A.

    2005-01-01

    The purpose of this study was to estimate the dose end exposure in staff involved in sentinel node procedure for breast cancer patients. The Institute of Nuclear Medicine in Sarajevo uses a protocol for lymphoscintigraphy of the sentinel node whereby 13 MBq of 9 9mT c nanocoll are used. In this study, we measured radiation doses and exposure of a nuclear medicine physician and a technologist, as well as a surgeon performing sentinel node lymphoscintigraphy and biopsy. Dose and exposure were calculated using the equation in which we have gamma constant for 9 9mT c. Calculations were made for different times of exposure and distance. In Table 1. we estimated the dose and exposure during sentinel node study. Radiation levels were very low and the most exposed hospital staff performing sentinel node study were nuclear medicine physicians. The doses on the hands of surgeons were negligible 8 hours after exposure.(author)

  8. A study on gamma dose rate in Seoul (I)

    International Nuclear Information System (INIS)

    Kim, You Hyun; Kim, Chang Kyun; Choi, Jong Hak; Kim, Jeong Min

    2001-01-01

    This study was conducted to find out gamma dose rate in Seoul, from January to December in 2000, and the following results were achieved : The annual gamma dose rate in Seoul was 17.24 μR/hr as average. The annual gamma dose rate in subway of Seoul was 14.96 μR/hr as average. The highest annual gamma dose rate was Dong-daemon ku. Annual gamma dose rate in Seoul was higher autumn than winter

  9. Reply to: Mounting evidence indicates that escalating doses of allopurinol are unnecessary for cardiovascular protection.

    Science.gov (United States)

    Coburn, Brian W; Michaud, Kaleb; Bergman, Debra A; Mikuls, Ted R

    2018-05-08

    We thank Dr. Bredemeier for his comments regarding our manuscript on allopurinol dose escalation and mortality. He raises important evidence to consider in support of an interesting hypothesis that dose escalation may be unnecessary for allopurinol's cardiovascular (CV) protection and may actually be related to adverse CV outcomes. While we agree that evidence exists suggesting that low doses of allopurinol may be sufficient for CV protection, we believe that the studies cited highlight a number of areas where knowledge gaps remain which preclude any definitive conclusions about the effect of dose escalation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  10. Calculation of the dose caused by internal radiation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    For the purposes of monitoring radiation exposure it is necessary to determine or to estimate the dose caused by both external and internal radiation. When comparing the value of exposure to the dose limits, account must be taken of the total dose incurred from different sources. This guide explains how to calculate the committed effective dose caused by internal radiation and gives the conversion factors required for the calculation. Application of the maximum values for radiation exposure is dealt with in ST guide 7.2, which also sets out the definitions of the quantities and concepts most commonly used in the monitoring of radiation exposure. The monitoring of exposure and recording of doses are dealt with in ST Guides 7.1 and 7.4.

  11. Dose reduction and optimization studies (ALARA) at nuclear power facilities

    International Nuclear Information System (INIS)

    Baum, J.W.; Meinhold, C.B.

    1983-01-01

    Brookhaven National Laboratory (BNL) has been commissioned by the Nuclear Regulatory Commission (NRC) to study dose-reduction techniques and effectiveness of as low as reasonably achievable (ALARA) planning at LWR plants. These studies have the following objectives: identify high-dose maintenance tasks; identify dose-reduction techniques; examine incentives for dose reduction; evaluate cost-effectiveness and optimization of dose-reduction techniques; and compile an ALARA handbook on data, engineering modifications, cost-effectiveness calculations, and other information of interest to ALARA practioners

  12. Dynamic Target Definition: A novel approach for PTV definition in ion beam therapy

    International Nuclear Information System (INIS)

    Cabal, Gonzalo A.; Jäkel, Oliver

    2013-01-01

    Purpose: To present a beam arrangement specific approach for PTV definition in ion beam therapy. Materials and methods: By means of a Monte Carlo error propagation analysis a criteria is formulated to assess whether a voxel is safely treated. Based on this a non-isotropical expansion rule is proposed aiming to minimize the impact of uncertainties on the dose delivered. Results: The method is exemplified in two cases: a Head and Neck case and a Prostate case. In both cases the modality used is proton beam irradiation and the sources of uncertainties taken into account are positioning (set up) errors and range uncertainties. It is shown how different beam arrangements have an impact on plan robustness which leads to different target expansions necessary to assure a predefined level of plan robustness. The relevance of appropriate beam angle arrangements as a way to minimize uncertainties is demonstrated. Conclusions: A novel method for PTV definition in on beam therapy is presented. The method show promising results by improving the probability of correct dose CTV coverage while reducing the size of the PTV volume. In a clinical scenario this translates into an enhanced tumor control probability while reducing the volume of healthy tissue being irradiated

  13. Preclinical Study of 68Ga-DOTATOC: Biodistribution Assessment in Syrian Rats and Evaluation of Absorbed Dose in Human Organs.

    Science.gov (United States)

    Naderi, Mojdeh; Zolghadri, Samaneh; Yousefnia, Hassan; Ramazani, Ali; Jalilian, Amir Reza

    2016-01-01

    Gallium-68 DOTA-DPhe 1 -Tyr 3 -Octreotide ( 68 Ga-DOTATOC) has been applied by several European centers for the treatment of a variety of human malignancies. Nevertheless, definitive dosimetric data are yet unavailable. According to the Society of Nuclear Medicine and Molecular Imaging, researchers are investigating the safety and efficacy of this radiotracer to meet Food and Drug Administration requirements. The aim of this study was to introduce the optimized procedure for 68 Ga-DOTATOC preparation, using a novel germanium-68 ( 68 Ge)/ 68 Ga generator in Iran and evaluate the absorbed doses in numerous organs with high accuracy. The optimized conditions for preparing the radiolabeled complex were determined via several experiments by changing the ligand concentration, pH, temperature and incubation time. Radiochemical purity of the complex was assessed, using high-performance liquid chromatography and instant thin-layer chromatography. The absorbed dose of human organs was evaluated, based on biodistribution studies on Syrian rats via Radiation Absorbed Dose Assessment Resource Method. 68 Ga-DOTATOC was prepared with radiochemical purity of >98% and specific activity of 39.6 MBq/nmol. The complex demonstrated great stability at room temperature and in human serum at 37°C at least two hours after preparation. Significant uptake was observed in somatostatin receptor-positive tissues such as pancreatic and adrenal tissues (12.83 %ID/g and 0.91 %ID/g, respectively). Dose estimations in human organs showed that the pancreas, kidneys and adrenal glands received the maximum absorbed doses (0.105, 0.074 and 0.010 mGy/MBq, respectively). Also, the effective absorbed dose was estimated at 0.026 mSv/MBq for 68 Ga-DOTATOC. The obtained results showed that 68 Ga-DOTATOC can be considered as an effective agent for clinical PET imaging in Iran.

  14. Study of teflon pads as high doses dosemeters

    International Nuclear Information System (INIS)

    Teixeira, Maria Ines; Caldas, Linda V.E.

    2013-01-01

    The aim of this work is to study the Teflon, which is used as a binder in the manufacture of dosimetric tablets, for the feasibility of this material as high dose dosemeter. In this paper we used the technique of thermally stimulated luminescence (OSL) to characterize the dosimetric properties of Teflon. Teflon samples were exposed to different doses of radiation, using a source of gamma radiation ( 60 Co). It was obtained dose-response curve between 100 Gy to 50 kGy and reproducibility of OSL response. The preliminary results show that Teflon is a useful material to high dose dosimetry

  15. Does initial 45Gy of pelvic intensity-modulated radiotherapy reduce late complications in patients with locally advanced cervical cancer? A cohort control study using definitive chemoradiotherapy with high-dose rate brachytherapy

    International Nuclear Information System (INIS)

    Chen, Shang-Wen; Liang, Ji-An; Hung, Yao-Ching; Yeh, Lian-Shung; Chang, Wei-Chun; Lin, Wu-Chou; Chien, Chun-Ru

    2013-01-01

    Comparing initial 45 Gy of pelvic intensity-modulated radiation therapy (IMRT) and non-IMRT in terms of the late toxicities associated with advanced cervical cancer that has also been treated with definitive concurrent chemoradiotherapy and high-dose rate intracavitary brachytherapy (HDRICB). This retrospective study included 320 stage IB2-IIIB cervical cancer patients treated with CCRT (83 IMRT and 237 non-IMRT). The two groups had similar stage and HDRICB ratings. Following 45 Gy to the pelvis, HDRICB of 24 Gy in four courses was prescribed. Late toxicities, including rectal complications (RC), bladder complications (BC) and non-rectal intestinal injury (NRRII), were scored by the Common Terminology Criteria for Adverse Events. A logistic regression was used to estimate the odds ratio (OR) of the complications. With a median follow-up duration of 33 and 77 months for IMRT and non-IMRT, 33 patients had Grade 2 or higher late RC (7.2% IMRT, 11.4% non-IMRT), whereas that for BC was 40 (9.6% IMRT, 13.5% non-IMRT) and for NRRII was 48 (12.0% IMRT, 16.0% non-IMRT). The cumulative rate for total grade 3 or higher gastrointestinal or genitourinary toxicities was 8.4% and 11.8% (p = 0.33). IMRT did not reduce the OR for all endpoints; however, the ORs for rectum and bladder reference doses to Point A were associated with RC and BC. Locally advanced cervical cancer patients treated with initial 45Gy of pelvic IMRT and HDRICB have similar treatment-related late toxicities as those treated with non-IMRT. Optimization of the brachytherapy scheme is essential to minimize late toxicities

  16. Limiting value definition in radiation protection physics, legislation and toxicology. Fundamentals, contrasts, perspectives

    International Nuclear Information System (INIS)

    Smeddinck, Ulrich; Koenig, Claudia

    2016-01-01

    The volume is the documentation of an ENTRIA workshop discussion on limiting value definition in radiation protection including the following contributions: Introduction in radiation protection -fundamentals concepts of limiting values, heterogeneity; evaluation standards for dose in radiation protection in the context of final repository search; definition of limiting values in toxicology; public participation to limiting value definition - a perspective for the radiation protection regulation; actual developments in radiation protection.

  17. Intra-voxel heterogeneity influences the dose prescription for dose-painting with radiotherapy: a modelling study

    NARCIS (Netherlands)

    Petit, S.F.; Dekker, A.L.A.J.; Seigneuric, R.; Murrer, L.H.P.; Riel, van N.A.W.; Nordsmark, M.; Overgaard, J.; Lambin, Ph.; Wouters, B.G.

    2009-01-01

    The purpose of this study was to increase the potential of dose redistribution by incorporating estimates of oxygen heterogeneity within imaging voxels for optimal dose determination. Cellular oxygen tension (pO2) distributions were estimated for imaging-size-based voxels by solving oxygen

  18. Dose perturbation due to the presence of a prostatic urethral stent in patients receiving pelvic radiotherapy: an in vitro study.

    Science.gov (United States)

    Gez, E; Cederbaum, M; Yachia, D; Bar-Deroma, R; Kuten, A

    1997-01-01

    Temporary metallic intraprostatic stent is a new alternative treatment for patients with urinary obstructive syndrome caused by prostate cancer. Definitive radiotherapy is a treatment of choice for localized prostate cancer. This study evaluates in vitro the effect of a urethral intraprostatic metallic stent on the dose absorbed by the surrounding tissue. The study was designed to mimic the conditions under which the prostatic stent is placed in the body during pelvic irradiation. A urethral stent composed of a 50% nickel-50% titanium alloy (Uracoil-InStent) was imbedded in material mimicking normal tissue (bolus) at a simulated body depth of 10 cm. The distribution of the absorbed dose of irradiation was determined by film dosimetry using Kodak X-Omat V film. Irradiation was done in a single field at the isocenter of a 6 MV linear accelerator with a field size of 7 x 7 cm. The degree of film blackening was in direct proportion to the absorbed dose. The measurements showed an increase in dose of up to 20% immediately before the stent and a decrease of up to 18% immediately after the stent. These changes occurred within a range of 1-3 mm from both sides of the stent. In practice, irradiation in prostate cancer is given by two pairs of opposed co-axial fields; a total of four fields (Box Technique). The dose perturbations are partly cancelled in a pair of opposed beams resulting in a net variation of +/- 4%; therefore, the presence of the intraprostatic stent should not influence radiotherapy planning for prostate cancer.

  19. Target definition in prostate, head, and neck

    NARCIS (Netherlands)

    Rasch, Coen; Steenbakkers, Roel; van Herk, Marcel

    2005-01-01

    Target definition is a major source of errors in both prostate and head and neck external-beam radiation treatment. Delineation errors remain constant during the course of radiation and therefore have a large impact on the dose to the tumor. Major sources of delineation variation are visibility of

  20. Micro-dosing for early biokinetic studies in humans

    International Nuclear Information System (INIS)

    Stenstroem, K.; Sydoff, M.; Mattsson, S.

    2010-01-01

    Micro-dosing is a new concept in drug development that-if implemented in the pharmaceutical industry-would mean that new drugs can be tested earlier in humans than done today. The human micro-dosing concept-or 'Phase 0'-may offer improved candidate selection, reduced failure rates in the drug development line and a reduction in the use of laboratory animals in early drug development, factors which will help to speed up drug development and also reduce the costs. Micro-dosing utilises sub-pharmacological amounts of the substance to open opportunities for early studies in man. Three technologies are used for micro-dosing: accelerator mass spectrometry (AMS), positron emission tomography and liquid chromatography-tandem mass spectrometry. This paper focuses on the principle of AMS and discusses the current status of micro-dosing with AMS. (authors)

  1. Assessment of internal doses

    CERN Document Server

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

    2002-01-01

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

  2. Study on the Construction of a High-definition Whole-body Voxel Model based on Cadaver's Color Photographic Anatomical Slice Images and Monte Carlo Dose Calculations

    International Nuclear Information System (INIS)

    Choi, Sang Hyoun

    2007-08-01

    Ajou University School of Medicine made the serially sectioned anatomical images from the Visible Korean Human (VKH) Project in Korea. The VKH images, which are the high-resolution color photographic images, show the organs and tissues in the human body very clearly at 0.2 mm intervals. In this study, we constructed a high-quality voxel model (VKH-Man) with a total of 30 organs and tissues by manual and automatic segmentation method using the serially sectioned anatomical image data from the Visible Korean Human (VKH) project in Korea. The height and weight of VKH-Man voxel model is 164 cm and 57.6 kg, respectively, and the voxel resolution is 1.875 x 1.875 x 2 mm 3 . However, this voxel phantom can be used to calculate the organ and tissue doses of only one person. Therefore, in this study, we adjusted the voxel phantom to the 'Reference Korean' data to construct the voxel phantom that represents the radiation workers in Korea. The height and weight of the voxel model (HDRK-Man) that is finally developed are 171 cm and 68 kg, respectively, and the voxel resolution is 1.981 x 1.981 x 2.0854 mm 3 . VKH-Man and HDRK-Man voxel model were implemented in a Monte Carlo particle transport simulation code for calculation of the organ and tissue doses in various irradiation geometries. The calculated values were compared with each other to see the effect of the adjustment and also compared with other computational models (KTMAN-2, ICRP-74 and VIP-Man). According to the results, the adjustment of the voxel model was found hardly affect the dose calculations and most of the organ and tissue equivalent doses showed some differences among the models. These results shows that the difference in figure, and organ topology affects the organ doses more than the organ size. The calculated values of the effective dose from VKH-Man and HDRK-Man according to the ICRP-60 and upcoming ICRP recommendation were compared. For the other radiation geometries (AP, LLAT, RLAT) except for PA

  3. An epidemiological study for the reduction of population radiation dose

    International Nuclear Information System (INIS)

    Gamo, Makoto

    1989-01-01

    The correlation of tube voltage with patient exposure was studied using effective dose as an indicator of dose reduction in intraoral radiography. The results were as follows: l. The salivary gland tissues contributed the most to the effective dose of intraoral radiography. 2. In the 50 to 90 kV range, there was no appreciable correlation between tube voltage and effective dose. 3. Therefore, it was suggested that adjusting the tube voltage for maximum image quality does not effect radiation protection. 4. This study reconfirmed the fact that increases in voltages up to 90 kV reduce skin doses. (author)

  4. 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

  5. Dose painting based on tumor uptake of Cu-ATSM and FDG

    DEFF Research Database (Denmark)

    Clausen, Malene Martini; Hansen, Anders Elias; Lundemann, Michael

    2014-01-01

    definitions based on FDG, 64Cu-ATSM 3 h and 24 h uptake in canine tumors had different localization of the regional dose escalation levels. This indicates that 64Cu-ATSM at two different time-points and FDG provide different biological information that has to be taken into account when using the dose painting...

  6. Outcomes of WHO Grade I Meningiomas Receiving Definitive or Postoperative Radiotherapy

    International Nuclear Information System (INIS)

    Tanzler, Emily; Morris, Christopher G.; Kirwan, Jessica M.; Amdur, Robert J.; Mendenhall, William M.

    2011-01-01

    Purpose: We analyzed long-term local control and complications in patients with either pathologically confirmed or clinical World Health Organization Grade I meningiomas treated with definitive or postoperative radiotherapy (RT) at the University of Florida. Methods: Between 1984 and 2006, 146 patients were treated with definitive (n = 88) or postoperative RT after subtotal resection (n = 57) or gross total resection (n = 1). Patients were treated with conventional (n = 41), stereotactic (n = 103), or intensity-modulated RT (n = 2) to a median dose of 52.7 Gy and followed for a median of 7.3 years (range, 0.6-22.0 years) Results: The local control rates at 5 and 10 years were as follows: definitive RT, 99% and 99%; postoperative RT, 96% and 93%; and overall, 97% and 96%, respectively. The 5- and 10-year cause-specific survival rates were as follows: definitive RT 94% and 94%, postoperative RT, 100% and 96%; and overall, 96% and 95%, respectively. The 5- and 10-year overall survival rates were as follows: definitive RT, 81% and 75%; postoperative RT, 96% and 85%; and overall, 87% and 79%, respectively. Severe RT complications occurred in 6.8% of patients; severe surgery-related complications occurred in 10 (17%) of 58 patients treated surgically. Conclusions: The likelihood of cure after definitive RT or following subtotal resection is excellent. However, a small population of patients experience severe complications, even at the moderate dose used for this disease.

  7. VSCE technology definition study

    Science.gov (United States)

    Howlett, R. A.; Hunt, R. B.

    1979-01-01

    Refined design definition of the variable stream control engine (VSCE) concept for advanced supersonic transports is presented. Operating and performance features of the VSCE are discussed, including the engine components, thrust specific fuel consumption, weight, noise, and emission system. A preliminary engine design is presented.

  8. Dosimetric study of volumetric arc modulation with RapidArc and intensity-modulated radiotherapy in patients with cervical cancer and comparison with 3-dimensional conformal technique for definitive radiotherapy in patients with cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Guy, Jean-Baptiste [Department of Radiation Oncology, Institut de Cancérologie de la Loire Lucien Neuwirth, Saint-Priest en Jarez (France); Falk, Alexander T. [Department of Radiation Oncology, Centre Antoine Lacassagne, Nice (France); Auberdiac, Pierre [Department of Radiation Oncology, Clinique Claude Bernard, Albi (France); Cartier, Lysian; Vallard, Alexis [Department of Radiation Oncology, Institut de Cancérologie de la Loire Lucien Neuwirth, Saint-Priest en Jarez (France); Ollier, Edouard [Department of Pharmacology-Toxicology, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Priest en Jarez (France); Trone, Jane-Chloé; Khodri, Moustapha [Department of Radiation Oncology, Institut de Cancérologie de la Loire Lucien Neuwirth, Saint-Priest en Jarez (France); Chargari, Cyrus [Department of Radiation Oncology, Hôpital d’instruction de Armées du Val-de-Grâce, Paris (France); Magné, Nicolas, E-mail: nicolas.magne@icloire.fr [Department of Radiation Oncology, Institut de Cancérologie de la Loire Lucien Neuwirth, Saint-Priest en Jarez (France)

    2016-04-01

    Introduction: For patients with cervical cancer, intensity-modulated radiation therapy (IMRT) improves target coverage and allows dose escalation while reducing the radiation dose to organs at risk (OARs). In this study, we compared dosimetric parameters among 3-dimensional conformal radiotherapy (3D-CRT), “step-and-shoot” IMRT, and volumetric intensity-modulated arc radiotherapy (VMAT) in a series of patients with cervical cancer receiving definitive radiotherapy. Computed tomography (CT) scans of 10 patients with histologically proven cervical cancer treated with definitive radiation therapy (RT) from December 2008 to March 2010 at our department were selected for this study. The gross tumor volume (GTV) and clinical target volume (CTV) were delineated following the guidelines of the Gyn IMRT consortium that included cervix, uterus, parametrial tissues, and the pelvic nodes including presacral. The median age was 57 years (range: 30 to 85 years). All 10 patients had squamous cell carcinoma with Federation of Gynecology and Obstetrics (FIGO) stage IB-IIIB. All patients were treated by VMAT. OAR doses were significantly reduced for plans with intensity-modulated technique compared with 3D-CRT except for the dose to the vagina. Between the 2 intensity-modulated techniques, significant difference was observed for the mean dose to the small intestine, to the benefit of VMAT (p < 0.001). There was no improvement in terms of OARs sparing for VMAT although there was a tendency for a slightly decreased average dose to the rectum: − 0.65 Gy but not significant (p = 0.07). The intensity modulation techniques have many advantages in terms of quality indexes, and particularly OAR sparing, compared with 3D-CRT. Following the ongoing technologic developments in modern radiotherapy, it is essential to evaluate the intensity-modulated techniques on prospective studies of a larger scale.

  9. Review of low dose-rate epidemiological studies and biological mechanisms of dose-rate effects on radiation induced carcinogenesis

    International Nuclear Information System (INIS)

    Iwasaki, Toshiyasu; Otsuka, Kensuke; Yoshida, Kazuo

    2015-01-01

    Radiation protection system adopts the linear non-threshold model with using dose and dose-rate effectiveness factor (DDREF). The dose-rate range where DDREF is applied is below 100 mGy per hour, and it is regarded that there are no dose-rate effects at very low dose rate, less than of the order of 10 mGy per year, even from the biological risk evaluation model based on cellular and molecular level mechanisms for maintenance of genetic integrity. Among low dose-rate epidemiological studies, studies of residents in high natural background areas showed no increase of cancer risks at less than about 10 mGy per year. On the other hand, some studies include a study of the Techa River cohort suggested the increase of cancer risks to the similar degree of Atomic bomb survivor data. The difference of those results was supposed due to the difference of dose rate. In 2014, International Commission on Radiological Protection opened a draft report on stem cell biology for public consultations. The report proposed a hypothesis based on the new idea of stem cell competition as a tissue level quality control mechanism, and suggested that it could explain the dose-rate effects around a few milligray per year. To verify this hypothesis, it would be needed to clarify the existence and the lowest dose of radiation-induced stem cell competition, and to elucidate the rate of stem cell turnover and radiation effects on it. As for the turnover, replenishment of damaged stem cells would be the important biological process. It would be meaningful to collect the information to show the difference of dose rates where the competition and the replenishment would be the predominant processes. (author)

  10. Inter-patient image registration algorithms to disentangle regional dose bioeffects.

    Science.gov (United States)

    Monti, Serena; Pacelli, Roberto; Cella, Laura; Palma, Giuseppe

    2018-03-20

    Radiation therapy (RT) technological advances call for a comprehensive reconsideration of the definition of dose features leading to radiation induced morbidity (RIM). In this context, the voxel-based approach (VBA) to dose distribution analysis in RT offers a radically new philosophy to evaluate local dose response patterns, as an alternative to dose-volume-histograms for identifying dose sensitive regions of normal tissue. The VBA relies on mapping patient dose distributions into a single reference case anatomy which serves as anchor for local dosimetric evaluations. The inter-patient elastic image registrations (EIRs) of the planning CTs provide the deformation fields necessary for the actual warp of dose distributions. In this study we assessed the impact of EIR on the VBA results in thoracic patients by identifying two state-of-the-art EIR algorithms (Demons and B-Spline). Our analysis demonstrated that both the EIR algorithms may be successfully used to highlight subregions with dose differences associated with RIM that substantially overlap. Furthermore, the inclusion for the first time of covariates within a dosimetric statistical model that faces the multiple comparison problem expands the potential of VBA, thus paving the way to a reliable voxel-based analysis of RIM in datasets with strong correlation of the outcome with non-dosimetric variables.

  11. Risk of solid cancer in low dose-rate radiation epidemiological studies and the dose-rate effectiveness factor.

    Science.gov (United States)

    Shore, Roy; Walsh, Linda; Azizova, Tamara; Rühm, Werner

    2017-10-01

    Estimated radiation risks used for radiation protection purposes have been based primarily on the Life Span Study (LSS) of atomic bomb survivors who received brief exposures at high dose rates, many with high doses. Information is needed regarding radiation risks from low dose-rate (LDR) exposures to low linear-energy-transfer (low-LET) radiation. We conducted a meta-analysis of LDR epidemiologic studies that provide dose-response estimates of total solid cancer risk in adulthood in comparison to corresponding LSS risks, in order to estimate a dose rate effectiveness factor (DREF). We identified 22 LDR studies with dose-response risk estimates for solid cancer after minimizing information overlap. For each study, a parallel risk estimate was derived from the LSS risk model using matching values for sex, mean ages at first exposure and attained age, targeted cancer types, and accounting for type of dosimetric assessment. For each LDR study, a ratio of the excess relative risk per Gy (ERR Gy -1 ) to the matching LSS ERR risk estimate (LDR/LSS) was calculated, and a meta-analysis of the risk ratios was conducted. The reciprocal of the resultant risk ratio provided an estimate of the DREF. The meta-analysis showed a LDR/LSS risk ratio of 0.36 (95% confidence interval [CI] 0.14, 0.57) for the 19 studies of solid cancer mortality and 0.33 (95% CI 0.13, 0.54) when three cohorts with only incidence data also were added, implying a DREF with values around 3, but statistically compatible with 2. However, the analyses were highly dominated by the Mayak worker study. When the Mayak study was excluded the LDR/LSS risk ratios increased: 1.12 (95% CI 0.40, 1.84) for mortality and 0.54 (95% CI 0.09, 0.99) for mortality + incidence, implying a lower DREF in the range of 1-2. Meta-analyses that included only cohorts in which the mean dose was LDR data provide direct evidence regarding risk from exposures at low dose rates as an important complement to the LSS risk estimates used

  12. Dose response study of PVA-Fx gel for three dimensional dose distribution

    International Nuclear Information System (INIS)

    Brindha, S.; Ayyangar, Komanduri M.; Shen, Bin; Saw, Cheng B.

    2001-01-01

    Modern radiotherapy techniques involve complex field arrangements using conformal and intensity modulated radiation that requires three dimensional treatment planning. The verification of these plans poses even more challenge. In 1984, Gore et al., proposed that ferrous gel dosimeters combined with magnetic resonance imaging (MRI) could be used to measure three dimensional radiation dose distributions. Since then, there has been much interest in the development of gel dosimetry to aid the determination of three dimensional dose distributions during field arrangements. In this work, preparation and study of the MR characteristics of a PVA-Fx gel reported in the literature is presented

  13. Dose-dependent transitions in mechanisms of toxicity: case studies

    International Nuclear Information System (INIS)

    Slikker, William; Andersen, Melvin E.; Bogdanffy, Matthew S.; Bus, James S.; Cohen, Steven D.; Conolly, Rory B.; David, Raymond M.; Doerrer, Nancy G.; Dorman, David C.; Gaylor, David W.; Hattis, Dale; Rogers, John M.; Setzer, R. Woodrow; Swenberg, James A.; Wallace, Kendall

    2004-01-01

    Experience with dose response and mechanisms of toxicity has shown that multiple mechanisms may exist for a single agent along the continuum of the full dose-response curve. It is highly likely that critical, limiting steps in any given mechanistic pathway may become overwhelmed with increasing exposures, signaling the emergence of new modalities of toxic tissue injury at these higher doses. Therefore, dose-dependent transitions in principal mechanisms of toxicity may occur, and could have significant impact on the interpretation of reference data sets for risk assessment. To illustrate the existence of dose-dependent transitions in mechanisms of toxicity, a group of academic, government, and industry scientists, formed under the leadership of the ILSI Health and Environmental Sciences Institute (HESI), developed a series of case studies. These case studies included acetaminophen, butadiene, ethylene glycol, formaldehyde, manganese, methylene chloride, peroxisome proliferator-activated receptor (PPAR), progesterone/hydroxyflutamide, propylene oxide, vinyl acetate, vinyl chloride, vinylidene chloride, and zinc. The case studies formed the basis for technical discourse at two scientific workshops in 2003

  14. Acute Toxicity in Definitive Versus Postprostatectomy Image-Guided Radiotherapy for Prostate Cancer

    International Nuclear Information System (INIS)

    Cheng, Jonathan C.; Schultheiss, Timothy E.; Nguyen, Khanh H.; Wong, Jeffrey Y.C.

    2008-01-01

    study have shown that acute rectal symptoms are dose-volume related. Postprostatectomy RT resulted in a greater incidence of acute GI toxicity than did definitive RT. For postoperative RT, it would be prudent to use different dose-volume limits

  15. Electron dose dependence of signal-to-noise ratio, atom contrast and resolution in transmission electron microscope images

    International Nuclear Information System (INIS)

    Lee, Z.; Rose, H.; Lehtinen, O.; Biskupek, J.; Kaiser, U.

    2014-01-01

    In order to achieve the highest resolution in aberration-corrected (AC) high-resolution transmission electron microscopy (HRTEM) images, high electron doses are required which only a few samples can withstand. In this paper we perform dose-dependent AC-HRTEM image calculations, and study the dependence of the signal-to-noise ratio, atom contrast and resolution on electron dose and sampling. We introduce dose-dependent contrast, which can be used to evaluate the visibility of objects under different dose conditions. Based on our calculations, we determine optimum samplings for high and low electron dose imaging conditions. - Highlights: • The definition of dose-dependent atom contrast is introduced. • The dependence of the signal-to-noise ratio, atom contrast and specimen resolution on electron dose and sampling is explored. • The optimum sampling can be determined according to different dose conditions

  16. Radiation protection and environment day the low doses in everyday life

    International Nuclear Information System (INIS)

    2007-01-01

    The consequences of low doses exposures are difficult to explore and the studies give often place to controversies. According to the are, differences exist in the methodological approaches. It results from it a confusion on the acceptable levels of exposure, even on the definition of low dose. This day organised by the sections 'non ionizing and research and health of the French society of radiation protection (S.F.R.P.), will be a meeting between professionals of different disciplines, to compare the approaches used for the ionizing and non ionizing radiations as well as the chemical and microbiological agents. It will allow to share the knowledge and the abilities and to progress on methodologies adapted to the evaluation and the management of risks in relation with low doses. (N.C.)

  17. Comparing definitions in guidelines and written standards - a case study: 'Trueness'

    International Nuclear Information System (INIS)

    Pavese, F

    2010-01-01

    This paper describes the structure of a repository initiated by IMEKO TC21 to allow the comparison of different definitions and use of the same term or concept in written standards and guidelines available internationally. The method used is illustrated for a case study: the critical concept of 'trueness' and its definitions.

  18. Towards more reliable automated multi-dose dispensing: retrospective follow-up study on medication dose errors and product defects.

    Science.gov (United States)

    Palttala, Iida; Heinämäki, Jyrki; Honkanen, Outi; Suominen, Risto; Antikainen, Osmo; Hirvonen, Jouni; Yliruusi, Jouko

    2013-03-01

    To date, little is known on applicability of different types of pharmaceutical dosage forms in an automated high-speed multi-dose dispensing process. The purpose of the present study was to identify and further investigate various process-induced and/or product-related limitations associated with multi-dose dispensing process. The rates of product defects and dose dispensing errors in automated multi-dose dispensing were retrospectively investigated during a 6-months follow-up period. The study was based on the analysis of process data of totally nine automated high-speed multi-dose dispensing systems. Special attention was paid to the dependence of multi-dose dispensing errors/product defects and pharmaceutical tablet properties (such as shape, dimensions, weight, scored lines, coatings, etc.) to profile the most suitable forms of tablets for automated dose dispensing systems. The relationship between the risk of errors in dose dispensing and tablet characteristics were visualized by creating a principal component analysis (PCA) model for the outcome of dispensed tablets. The two most common process-induced failures identified in the multi-dose dispensing are predisposal of tablet defects and unexpected product transitions in the medication cassette (dose dispensing error). The tablet defects are product-dependent failures, while the tablet transitions are dependent on automated multi-dose dispensing systems used. The occurrence of tablet defects is approximately twice as common as tablet transitions. Optimal tablet preparation for the high-speed multi-dose dispensing would be a round-shaped, relatively small/middle-sized, film-coated tablet without any scored line. Commercial tablet products can be profiled and classified based on their suitability to a high-speed multi-dose dispensing process.

  19. Low-Dose Tissue Plasminogen Activator in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Cheng, Ji-Wei; Zhang, Xiao-Jing; Cheng, Li-Shan; Li, Guo-Yi; Zhang, Li-Jun; Ji, Kang-Xiang; Zhao, Qing; Bai, Yu

    2018-02-01

    Intravenous thrombolysis using tissue plasminogen activator (tPA) improves significantly the neurologic function in patients with acute ischemic stroke (AIS). However, it brings financial burden to patients and is associated with symptomatic intracranial hemorrhage (SICH). Whether low-dose tPA can effectively reduce SICH and has the same efficacy as standard-dose tPA is still controversial. We searched for English clinical trials published before March, 2017on the comparison of the efficacy and safety between low and standard dose of tPA in the treatment of AIS using MEDLINE, Embase, and Cochrane Library. The modified Rankin scale (mRS) score was used as the primary efficacy outcome. The mRS1 corresponded to 0-1, whereas mRS2 corresponded to 0-2. The SICH and mortality were adopted as primary safety outcomes. Twelve high-quality studies were selected, including 7686 patients (low-dose: 2888, standard-dose: 4798). With no statistical heterogeneity, the fixed effects model was adopted in the analysis. Similarly to standard doses, low-dose tPA improved the mRS scores (mRS1: odds ratio [OR] = .92, 95% confidence interval [CI] .84-1.02; P = .12; mRS2: OR = .97, 95% CI .88-1.08; P = .57). Compared with standard-dose tPA, low-dose tPA reduced the incidence of SICH (by National Institute of Neurological Disorders and Stroke [NINDS] definition: OR = .71, 95% CI .57-0.89; P = .003; by Safe Implementation of Thrombolysis in Stroke Monitoring Study [SITS-MOST] definition: OR = .64, 95% CI .42-0.99; P = .04), while both reduced mortality (OR = .87, 95% CI .74-1.02; P = .08). Low-dose tPA is comparable to standard-dose tPA in improving the neurologic function and reducing mortality in AIS patients. Moreover, low-dose tPA can reduce the incidence of SICH compared with standard-dose tPA. Therefore, low-dose tPA is highly recommended in AIS patients. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  20. Radiobiological Determination of Dose Escalation and Normal Tissue Toxicity in Definitive Chemoradiation Therapy for Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Warren, Samantha, E-mail: Samantha.warren@oncology.ox.ac.uk [Department of Oncology, Gray Institute of Radiation Oncology and Biology, University of Oxford, Oxford (United Kingdom); Partridge, Mike [Department of Oncology, Gray Institute of Radiation Oncology and Biology, University of Oxford, Oxford (United Kingdom); Carrington, Rhys [Velindre Cancer Centre, Velindre Hospital, Cardiff (United Kingdom); Hurt, Chris [Wales Cancer Trials Unit, School of Medicine, Heath Park, Cardiff (United Kingdom); Crosby, Thomas [Velindre Cancer Centre, Velindre Hospital, Cardiff (United Kingdom); Hawkins, Maria A. [Department of Oncology, Gray Institute of Radiation Oncology and Biology, University of Oxford, Oxford (United Kingdom)

    2014-10-01

    Purpose: This study investigated the trade-off in tumor coverage and organ-at-risk sparing when applying dose escalation for concurrent chemoradiation therapy (CRT) of mid-esophageal cancer, using radiobiological modeling to estimate local control and normal tissue toxicity. Methods and Materials: Twenty-one patients with mid-esophageal cancer were selected from the SCOPE1 database (International Standard Randomised Controlled Trials number 47718479), with a mean planning target volume (PTV) of 327 cm{sup 3}. A boost volume, PTV2 (GTV + 0.5 cm margin), was created. Radiobiological modeling of tumor control probability (TCP) estimated the dose required for a clinically significant (+20%) increase in local control as 62.5 Gy/25 fractions. A RapidArc (RA) plan with a simultaneously integrated boost (SIB) to PTV2 (RA{sub 62.5}) was compared to a standard dose plan of 50 Gy/25 fractions (RA{sub 50}). Dose-volume metrics and estimates of normal tissue complication probability (NTCP) for heart and lungs were compared. Results: Clinically acceptable dose escalation was feasible for 16 of 21 patients, with significant gains (>18%) in tumor control from 38.2% (RA{sub 50}) to 56.3% (RA{sub 62.5}), and only a small increase in predicted toxicity: median heart NTCP 4.4% (RA{sub 50}) versus 5.6% (RA{sub 62.5}) P<.001 and median lung NTCP 6.5% (RA{sub 50}) versus 7.5% (RA{sub 62.5}) P<.001. Conclusions: Dose escalation to the GTV to improve local control is possible when overlap between PTV and organ-at-risk (<8% heart volume and <2.5% lung volume overlap for this study) generates only negligible increase in lung or heart toxicity. These predictions from radiobiological modeling should be tested in future clinical trials.

  1. Sensitivity of dose-finding studies to observation errors.

    Science.gov (United States)

    Zohar, Sarah; O'Quigley, John

    2009-11-01

    The purpose of Phase I designs is to estimate the MTD (maximum tolerated dose, in practice a dose with some given acceptable rate of toxicity) while, at the same time, minimizing the number of patients treated at doses too far removed from the MTD. Our purpose here is to investigate the sensitivity of conclusions from dose-finding designs to recording or observation errors. Certain toxicities may go undetected and, conversely, certain non-toxicities may be incorrectly recorded as dose-limiting toxicities. Recording inaccuracies would be expected to have an influence on final and within trial recommendations and, in this paper, we study in greater depth this question. We focus, in particular on three designs used currently; the standard '3+3' design, the grouped up-and-down design [M. Gezmu, N. Flournoy, Group up-and-down designs for dose finding. Journal of Statistical Planning and Inference 2006; 136 (6): 1749-1764.] and the continual reassessment method (CRM, [J. O'Quigley, M. Pepe, L. Fisher, Continual reassessment method: a practical design for phase 1 clinical trials in cancer. Biometrics 1990; 46 (1): 33-48.]). A non-toxicity incorrectly recorded as a toxicity (error of first kind) has a greater influence in general than the converse (error of second kind). These results are illustrated via figures which suggest that the standard '3+3' design in particular is sensitive to errors of the second kind. Such errors can have a very important impact on drug development in that, if carried through to the Phase 2 and Phase 3 studies, we can significantly increase the probability of failure to detect efficacy as a result of having delivered an inadequate dose.

  2. Selection of skin dose calculation methodologies

    International Nuclear Information System (INIS)

    Farrell, W.E.

    1987-01-01

    This paper reports that good health physics practice dictates that a dose assessment be performed for any significant skin contamination incident. There are, however, several methodologies that could be used, and while there is probably o single methodology that is proper for all cases of skin contamination, some are clearly more appropriate than others. This can be demonstrated by examining two of the more distinctly different options available for estimating skin dose the calculational methods. The methods compiled by Healy require separate beta and gamma calculations. The beta calculational method is the derived by Loevinger, while the gamma dose is calculated from the equation for dose rate from an infinite plane source with an absorber between the source and the detector. Healy has provided these formulas in graphical form to facilitate rapid dose rate determinations at density thicknesses of 7 and 20 mg/cm 2 . These density thicknesses equate to the regulatory definition of the sensitive layer of the skin and a more arbitrary value to account of beta absorption in contaminated clothing

  3. Studies of absorbed dose determinations and spatial dose distributions for high energy proton beams

    International Nuclear Information System (INIS)

    Hiraoka, Takeshi

    1982-01-01

    Absolute dose determinations were made with three types of ionization chamber and a Faraday cup. Methane based tissue equivalent (TE) gas, nitrogen, carbon dioxide, air were used as an ionizing gas with flow rate of 10 ml per minute. Measurements were made at the entrance position of unmodulated beams and for a beam of a spread out Bragg peak at a depth of 17.3 mm in water. For both positions, the mean value of dose determined by the ionization chambers was 0.993 +- 0.014 cGy for which the value of TE gas was taken as unity. The agreement between the doses estimated by the ionization chambers and the Faraday cup was within 5%. Total uncertainty estimated in the ionization chamber and the Faraday cup determinations is 6 and 4%, respectively. Common sources of error in calculating the dose from ionization chamber measurements are depend on the factors of ion recombination, W value, and mass stopping power ratio. These factors were studied by both experimentally and theoretically. The observed values for the factors show a good agreement to the predicted one. Proton beam dosimetry intercomparison between Japan and the United States was held. Good agreement was obtained with standard deviation of 1.6%. The value of the TE calorimeter is close to the mean value of all. In the proton spot scanning system, lateral dose distributions at any depth for one spot beam can be simulated by the Gaussian distribution. From the Gaussian distributions and the central axis depth doses for one spot beam, it is easy to calculate isodose distributions in the desired field by superposition of dose distribution for one spot beam. Calculated and observed isodose curves were agreed within 1 mm at any dose levels. (J.P.N.)

  4. Nuclear Radiation Degradation Study on HD Camera Based on CMOS Image Sensor at Different Dose Rates.

    Science.gov (United States)

    Wang, Congzheng; Hu, Song; Gao, Chunming; Feng, Chang

    2018-02-08

    In this work, we irradiated a high-definition (HD) industrial camera based on a commercial-off-the-shelf (COTS) CMOS image sensor (CIS) with Cobalt-60 gamma-rays. All components of the camera under test were fabricated without radiation hardening, except for the lens. The irradiation experiments of the HD camera under biased conditions were carried out at 1.0, 10.0, 20.0, 50.0 and 100.0 Gy/h. During the experiment, we found that the tested camera showed a remarkable degradation after irradiation and differed in the dose rates. With the increase of dose rate, the same target images become brighter. Under the same dose rate, the radiation effect in bright area is lower than that in dark area. Under different dose rates, the higher the dose rate is, the worse the radiation effect will be in both bright and dark areas. And the standard deviations of bright and dark areas become greater. Furthermore, through the progressive degradation analysis of the captured image, experimental results demonstrate that the attenuation of signal to noise ratio (SNR) versus radiation time is not obvious at the same dose rate, and the degradation is more and more serious with increasing dose rate. Additionally, the decrease rate of SNR at 20.0, 50.0 and 100.0 Gy/h is far greater than that at 1.0 and 10.0 Gy/h. Even so, we confirm that the HD industrial camera is still working at 10.0 Gy/h during the 8 h of measurements, with a moderate decrease of the SNR (5 dB). The work is valuable and can provide suggestion for camera users in the radiation field.

  5. Field study to evaluate radiation doses in dental practices

    International Nuclear Information System (INIS)

    Panzer, W.; Scheurer, C.

    1984-05-01

    An inexpensive and simple test device was developed and used in a field study to evaluate entrance dose, dose to an intra-oral film, filtration and field size under routine conditions in more than 150 dental practices. The test device consists of two films of different speed and a set of 5 thin copper filters for a filter analytical determination of the radiation quality. Dentists voluntarily participating in the study were asked to expose the test device like they usually do when examining a molar tooth. The main result was the evidence of a significant dose reduction compared to the findings of similar studies performed in 1970 and 1976. This reduction is due to a general shift to lower values and a complete disappearance of values above 45 mGy (5 R) which in 1970 were still more than 15%. In the same way the number of facilities showing insufficient filtration or collimation had decreased. Nevertheless, a large spread of dose values could still be observed, ranging from less than 0.45 mGy (50 mR) to more than 26 mGy (3 R), for the entrance dose. The most striking result, however, was that such an important parameter like the speed of the films used at the respective unit turned out to have no impact on the entrance dose. (orig./HP)

  6. Once-daily dosing of saquinavir and low-dose ritonavir in HIV-1-infected individuals: a pharmacokinetic pilot study

    NARCIS (Netherlands)

    van Heeswijk, R. P.; Veldkamp, A. I.; Mulder, J. W.; Meenhorst, P. L.; Lange, J. M.; Beijnen, J. H.; Hoetelmans, R. M.

    2000-01-01

    To investigate the steady-state pharmacokinetics of a once-daily dosing regimen of saquinavir soft gelatin capsules in combination with a low dose of ritonavir in HIV-1-infected individuals. Open-label, multi-dose, pharmacokinetic pilot study. Seven HIV-1-infected individuals who were treated with

  7. Outcome of stroke patients receiving different doses of recombinant tissue plasminogen activator.

    Science.gov (United States)

    Ong, Cheung-Ter; Wong, Yi-Sin; Wu, Chi-Shun; Su, Yu-Hsiang

    2017-01-01

    Intravenous recombinant tissue plasminogen activator (tPA) at a dose of 0.9 mg/kg body weight is associated with a high hemorrhagic transformation (HT) rate. Low-dose tPA (0.6 mg/kg) may have a lower hemorrhage rate but the mortality and disability rates at 90 days cannot be confirmed as non-inferior to standard-dose tPA. Whether the doses 0.7 and 0.8 mg/kg have better efficacy and safety needs further investigation. Therefore, this study is to compare the efficacy and safety of each dose of tPA (0.6, 0.7, 0.8, and 0.9 mg/kg body weight) and to investigate the factors affecting early neurological improvement (ENI) and early neurological deterioration (END). For this observational study, data were obtained from 274 patients who received tPA thrombolytic therapy in Chia-Yi Christian Hospital stroke unit. The tPA dose was given at the discretion of each physician. The definition of ENI was a >8 point improvement (compared with baseline) at 24 h following thrombolytic therapy or an improvement in the National Institutes of Health Stroke Score (NIHSS) to 0 or 1 toward the end of tPA infusion. The definition of END was a >4 point increase in NIHSS (compared with baseline) within 24 h of tPA infusion. The primary objective was to investigate whether 0.7 and 0.8 mg/kg of tPA have higher ENI rate, lower END rate, and better outcome at 6 months. Poor outcome was defined as having a modified Rankin Scale of 3 to 6 (range, 0 [no symptoms] to 6 [death]). The secondary objective was to investigate whether low-dose tPA has a lower risk of intracerebral HT than that with standard-dose tPA. We also investigated the factors affecting ENI, END, HT, and 6-month outcome. A total of 274 patients were included during the study period, of whom 260 were followed up for >6 months. There was a trend for the HT rate to increase as the dose increased ( P =0.02). The symptomatic HT rate was not significantly different among the low-dose and standard-dose groups. The ENI and END ( P =0.52) were

  8. Specification of absorbed dose for reporting a therapeutic irradiation

    International Nuclear Information System (INIS)

    Wambersie, A.; Chassagne, D.

    1981-01-01

    The problem of dose specification in external beam therapy with photons and electrons has been dealt with in ICRU Report 29 (1978). This problem arises from the fact that the absorbed dose distribution is usually not uniform in the target volume and that for the purpose of treatment reporting a nominal absorbed dose - which will be called target absorbed dose - has to be selected. When comparing the clinical results obtained between radiotherapy centres, the differences in the reported target absorbed doses which can be introduced by differences in the methods of dose specification often are much larger than the differences related to the dosimetric procedures themselves. This shows the importance of the problem. In this paper, some definitions of terms and concepts currently used in radiotherapy are first recalled: tumour volume, target volume, treatment volume, etc. These definitions have been proposed in ICRU Report 29 for photon and electron beams; they can be extended to any kind of irradiation. For external beam therapy with photons and electrons, the target absorbed dose is defined as the absorbed dose at selected point(s) (specification point(s)) having a meaningful relation to the target volume and/or the irradiation beams. Examples are discussed for typical cases. As far as interstitial and intracavitary therapy is concerned, the problem is more complex and no recommendations have so far been made by the ICRU Commission. A major difficulty arises from the sharp dose gradient as a function of the distance to the sources. The particular case of the treatment of cervix carcinoma is considered and some possible methods of specification are discussed: (1) the indication of the sources (in adequate units) and the duration of the application, (2) the absorbed doses at selected reference points (bladder, rectum, bony structures) and (3) the description of the tissue volume (height, width, thickness) encompassed by a given isodose surface (60Gy). (author)

  9. Chinese herbal dose in ancient and modern times: a comparative study.

    Science.gov (United States)

    He, Shimin

    2013-04-01

    Appropriate dose guarantees Chinese herb's safety and effectiveness. There are adult dose criteria for Chinese herbs in decoction in the Pharmacopoeia of the People's Republic of China (2010 Edition) at present. But Chinese herbs have been frequently used in much higher doses than the dose criteria. This study has been conducted to test the dependability of the dose criteria. Twenty Chinese herbs were selected as representatives and their adult doses in decoction in Bei Ji Qian Jin Yao Fang, a famous ancient literature, have been reviewed and compared with those in the Pharmacopoeia of the People's Republic of China (2010 Edition). The adult dose criteria for all these 20 Chinese herbs in the Pharmacopoeia of the People's Republic of China (2010 Edition) haven't covered those in Bei Ji Qian Jin Yao Fang. Furthermore, maximal adult doses in the dose criteria are much lower than those in Bei Ji Qian Jin Yao Fang. The dose criteria in the Pharmacopoeia of the People's Republic of China (2010 Edition) are not comprehensive enough. Studying ancient literatures is an effective method to gain precious Chinese herbs' dose data and helps for new dose criteria's establishment in the future.

  10. Point Organ Radiation Dose in Abdominal CT: Effect of Patient Off-Centering in an Experimental Human Cadaver Study.

    Science.gov (United States)

    Ali Khawaja, Ranish Deedar; Singh, Sarabjeet; Padole, Atul; Otrakji, Alexi; Lira, Diego; Zhang, Da; Liu, Bob; Primak, Andrew; Xu, George; Kalra, Mannudeep K

    2017-08-01

    To determine the effect of patient off-centering on point organ radiation dose measurements in a human cadaver scanned with routine abdominal CT protocol. A human cadaver (88 years, body-mass-index 20 kg/m2) was scanned with routine abdominal CT protocol on 128-slice dual source MDCT (Definition Flash, Siemens). A total of 18 scans were performed using two scan protocols (a) 120 kV-200 mAs fixed-mA (CTDIvol 14 mGy) (b) 120 kV-125 ref mAs (7 mGy) with automatic exposure control (AEC, CareDose 4D) at three different positions (a) gantry isocenter, (b) upward off-centering and (c) downward off-centering. Scanning was repeated three times at each position. Six thimble (in liver, stomach, kidney, pancreas, colon and urinary bladder) and four MOSFET dosimeters (on cornea, thyroid, testicle and breast) were placed for calculation of measured point organ doses. Organ dose estimations were retrieved from dose-tracking software (eXposure, Radimetrics). Statistical analysis was performed using analysis of variance. There was a significant difference between the trends of point organ doses with AEC and fixed-mA at all three positions (p 92% for both protocols; p < 0.0001). For both protocols, the highest mean difference in point doses was found for stomach and lowest for colon. Measured absorbed point doses in abdominal CT vary with patient-centering in the gantry isocenter. Due to lack of consideration of patient positioning in the dose estimation on automatic software-over estimation of the doses up to 92% was reported. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. 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.

  12. Dose escalation using conformal high-dose-rate brachytherapy improves outcome in unfavorable prostate cancer.

    Science.gov (United States)

    Martinez, Alvaro A; Gustafson, Gary; Gonzalez, José; Armour, Elwood; Mitchell, Chris; Edmundson, Gregory; Spencer, William; Stromberg, Jannifer; Huang, Raywin; Vicini, Frank

    2002-06-01

    To overcome radioresistance for patients with unfavorable prostate cancer, a prospective trial of pelvic external beam irradiation (EBRT) interdigitated with dose-escalating conformal high-dose-rate (HDR) prostate brachytherapy was performed. Between November 1991 and August 2000, 207 patients were treated with 46 Gy pelvic EBRT and increasing HDR brachytherapy boost doses (5.50-11.5 Gy/fraction) during 5 weeks. The eligibility criteria were pretreatment prostate-specific antigen level >or=10.0 ng/mL, Gleason score >or=7, or clinical Stage T2b or higher. Patients were divided into 2 dose levels, low-dose biologically effective dose 93 Gy (149 patients). No patient received hormones. We used the American Society for Therapeutic Radiology and Oncology definition for biochemical failure. The median age was 69 years. The mean follow-up for the group was 4.4 years, and for the low and high-dose levels, it was 7.0 and 3.4 years, respectively. The actuarial 5-year biochemical control rate was 74%, and the overall, cause-specific, and disease-free survival rate was 92%, 98%, and 68%, respectively. The 5-year biochemical control rate for the low-dose group was 52%; the rate for the high-dose group was 87% (p failure. The Radiation Therapy Oncology Group Grade 3 gastrointestinal/genitourinary complications ranged from 0.5% to 9%. The actuarial 5-year impotency rate was 51%. Pelvic EBRT interdigitated with transrectal ultrasound-guided real-time conformal HDR prostate brachytherapy boost is both a precise dose delivery system and a very effective treatment for unfavorable prostate cancer. We demonstrated an incremental beneficial effect on biochemical control and cause-specific survival with higher doses. These results, coupled with the low risk of complications, the advantage of not being radioactive after implantation, and the real-time interactive planning, define a new standard for treatment.

  13. Pilot study in the treatment of endometrial carcinoma with 3D image-based high-dose-rate brachytherapy using modified Heyman packing: Clinical experience and dose-volume histogram analysis

    International Nuclear Information System (INIS)

    Weitmann, Hajo Dirk; Poetter, Richard; Waldhaeusl, Claudia; Nechvile, Elisabeth; Kirisits, Christian; Knocke, Tomas Hendrik

    2005-01-01

    Purpose: The aim of this study was to evaluate dose distribution within uterus (clinical target volume [CTV]) and tumor (gross tumor volume [GTV]) and the resulting clinical outcome based on systematic three-dimensional treatment planning with dose-volume adaptation. Dose-volume assessment and adaptation in organs at risk and its impact on side effects were investigated in parallel. Methods and Materials: Sixteen patients with either locally confined endometrial carcinoma (n = 15) or adenocarcinoma of uterus and ovaries after bilateral salpingo-oophorectomy (n = 1) were included. Heyman packing was performed with mean 11 Norman-Simon applicators (3-18). Three-dimensional treatment planning based on computed tomography (n = 29) or magnetic resonance imaging (n = 18) was done in all patients with contouring of CTV, GTV, and organs at risk. Dose-volume adaptation was achieved by dwell location and time variation (intensity modulation). Twelve patients treated with curative intent received five to seven fractions of high-dose-rate brachytherapy (7 Gy per fraction) corresponding to a total dose of 60 Gy (2 Gy per fraction and α/β of 10 Gy) to the CTV. Four patients had additional external beam radiotherapy (range, 10-40 Gy). One patient had salvage brachytherapy and 3 patients were treated with palliative intent. A dose-volume histogram analysis was performed in all patients. On average, 68% of the CTV and 92% of the GTV were encompassed by the 60 Gy reference volume. Median minimum dose to 90% of CTV and GTV (D90) was 35.3 Gy and 74 Gy, respectively. Results: All patients treated with curative intent had complete remission (12/12). After a median follow-up of 47 months, 5 patients are alive without tumor. Seven patients died without tumor from intercurrent disease after median 22 months. The patient with salvage treatment had a second local recurrence after 27 months and died of endometrial carcinoma after 57 months. In patients treated with palliative intent

  14. 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...

  15. Definition of internal target volume and domestric study for hepatocellular carcinoma using four-dimensional CT

    International Nuclear Information System (INIS)

    Xi Mian; Liu Mengzhong; Deng Xiaowu; Zhang Li; Huang Xiaoyan; Cai Ling

    2009-01-01

    Objective: To define individualized internal target volume (ITV) for hepatocellular carcinoma using four-dimensional (4D) CT, and to compare the differences in target volume definition and dose distribution among 3D, 4D and respiratory-gated plans. Methods: 4DCT scanning was obtained for 12 patients with hepatocellular. Gross tumor volume (GTV), clinical target volume (CTV) and normal tissues were contoured on all 10 respiratory phases of 4DCT images. The 3D, 4D and gated treatment plans were prepared for each patient using three different planning target volumes (PTVs): 1) PTV 3D was derived from a single CTV plus conventional margins; 2) PTV 4D was derived from ITV 4D , which encompassed all 10 CTVs plus setup margins (SMs); 3) PT Gating was derived from ITV Gating , which encompassed 3 CTVs within gating-window at end-expiration plus SMs. The PTV volume and dose distribution were compared among different plans. Results: The PTV3D was the largest in all 12 patients, but still missed partial target volume in 5 patients when comparing with PTV4D. Both the 4D plans and the gated plans spared more normal tissues than the 3D plans, especially the liver. Without increasing normal tissue dose, the 4D plans allowed for increasing the calculated dose from (50.8 ± 2.0) Gy (3D plans) to (54.7 ± 3.3) Gy, and the gated plans could further increase the dose to (58.0 ± 3.9) Gy. Conclusions: The 4DCT-based plans can ensure optimal target coverage with less irradiation of normal tissues and allow dose escalation when compared with 3D plans. Respiratory gated radiotherapy can further reduce the target volumes to spare more surrounding tissues, especially for patients with large extent of respiratory mobility. (authors)

  16. Sodium phenylbutyrate in Huntington's disease: a dose-finding study.

    Science.gov (United States)

    Hogarth, Penelope; Lovrecic, Luca; Krainc, Dimitri

    2007-10-15

    Transcriptional dysregulation in Huntington's disease (HD) is mediated in part by aberrant patterns of histone acetylation. We performed a dose-finding study in human HD of sodium phenylbutyrate (SPB), a histone deacetylase inhibitor that ameliorates the HD phenotype in animal models. We used a dose-escalation/de-escalation design, using prespecified toxicity criteria and standard clinical and laboratory safety measures. The maximum tolerated dose was 15 g/day. At higher doses, toxicity included vomiting, lightheadedness, confusion, and gait instability. We saw no significant laboratory or electrocardiographic abnormalities. Gene expression changes in blood suggested an inverse dose-response. In conclusion, SPB at 12 to 15 g/day appears to be safe and well-tolerated in human HD. 2007 Movement Disorder Society

  17. High-Definition Computed Tomography for Coronary Artery Stent Imaging: a Phantom Study

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Wen Jie; Chen, Ke Min; Pang, Li Fang; Zhang, Huang; Pan, Zi Lai [Rui Jin Hospital, Medical School, Shanghai Jiao Tong University, Shangha (China); Guo, Ying; Li, Jian Ying [Beijing Economic and Technology Development Area, Beijing (China)

    2012-01-15

    To assess the performance of a high-definition CT (HDCT) for imaging small caliber coronary stents ({<=} 3 mm) by comparing different scan modes of a conventional 64-row standard-definition CT (SDCT). A cardiac phantom with twelve stents (2.5 mm and 3.0 mm in diameter) was scanned by HDCT and SDCT. The scan modes were retrospective electrocardiography (ECG)-gated helical and prospective ECG-triggered axial with tube voltages of 120 kVp and 100 kVp, respectively. The inner stent diameters (ISD) and the in-stent attenuation value (AVin-stent) and the in-vessel extra-stent attenuation value (AVin-vessel) were measured by two observers. The artificial lumen narrowing (ALN = [ISD - ISDmeasured]/ISD) and artificial attenuation increase between in-stent and in-vessel (AAI = AVin-stent - AVin-vessel) were calculated. All data was analyzed by intraclass correlation and ANOVA-test. The correlation coefficient of ISD, AVin-vessel and AVin-stent between the two observers was good. The ALNs of HDCT were statistically lower than that of SDCT (30 {+-} 5.7% versus 35 {+-} 5.4%, p < 0.05). HDCT had statistically lower AAI values than SDCT (15.7 {+-} 81.4 HU versus 71.4 {+-} 90.5 HU, p < 0.05). The prospective axial dataset demonstrated smaller ALN than the retrospective helical dataset on both HDCT and SDCT (p < 0.05). Additionally, there were no differences in ALN between the 120 kVp and 100 kVp tube voltages on HDCT (p = 0.05). High-definition CT helps improve measurement accuracy for imaging coronary stents compared to SDCT. HDCT with 100 kVp and the prospective ECG-triggered axial technique, with a lower radiation dose than 120 kVp application, may be advantageous in evaluating coronary stents with smaller calibers ({<=} 3 mm).

  18. Application of maximum values for radiation exposure and principles for the calculation of radiation doses

    International Nuclear Information System (INIS)

    2007-08-01

    The guide presents the definitions of equivalent dose and effective dose, the principles for calculating these doses, and instructions for applying their maximum values. The limits (Annual Limit on Intake and Derived Air Concentration) derived from dose limits are also presented for the purpose of monitoring exposure to internal radiation. The calculation of radiation doses caused to a patient from medical research and treatment involving exposure to ionizing radiation is beyond the scope of this ST Guide

  19. Reconsidering the International Association for the Study of Pain definition of pain.

    Science.gov (United States)

    Cohen, Milton; Quintner, John; van Rysewyk, Simon

    2018-03-01

    The definition of pain promulgated by the International Association for the Study of Pain (IASP) is widely accepted as a pragmatic characterisation of that human experience. Although the Notes that accompany it characterise pain as "always subjective," the IASP definition itself fails to sufficiently integrate phenomenological aspects of pain. This essay reviews the historical development of the IASP definition, and the commentaries and suggested modifications to it over almost 40 years. Common factors of pain experience identified in phenomenological studies are described, together with theoretical insights from philosophy and biology. A fuller understanding of the pain experience and of the clinical care of those experiencing pain is achievable through greater attention to the phenomenology of pain, the social "intersubjective space" in which pain occurs, and the limitations of language. Based on these results, a revised definition of pain is offered: Pain is a mutually recognizable somatic experience that reflects a person's apprehension of threat to their bodily or existential integrity.

  20. Goal Definition

    DEFF Research Database (Denmark)

    Bjørn, Anders; Laurent, Alexis; Owsianiak, Mikołaj

    2018-01-01

    The goal definition is the first phase of an LCA and determines the purpose of a study in detail. This chapter teaches how to perform the six aspects of a goal definition: (1) Intended applications of the results, (2) Limitations due to methodological choices, (3) Decision context and reasons...... for carrying out the study, (4) Target audience , (5) Comparative studies to be disclosed to the public and (6) Commissioner of the study and other influential actors. The instructions address both the conduct and reporting of a goal definition and are largely based on the ILCD guidance document (EC...

  1. Performance of gout definitions for genetic epidemiological studies: analysis of UK Biobank.

    Science.gov (United States)

    Cadzow, Murray; Merriman, Tony R; Dalbeth, Nicola

    2017-08-09

    Many different combinations of available data have been used to identify gout cases in large genetic studies. The aim of this study was to determine the performance of case definitions of gout using the limited items available in multipurpose cohorts for population-based genetic studies. This research was conducted using the UK Biobank Resource. Data, including genome-wide genotypes, were available for 105,421 European participants aged 40-69 years without kidney disease. Gout definitions and combinations of these definitions were identified from previous epidemiological studies. These definitions were tested for association with 30 urate-associated single-nucleotide polymorphisms (SNPs) by logistic regression, adjusted for age, sex, waist circumference, and ratio of waist circumference to height. Heritability estimates under an additive model were generated using GCTA version 1.26.0 and PLINK version 1.90b3.32 by partitioning the genome. There were 2066 (1.96%) cases defined by self-report of gout, 1652 (1.57%) defined by urate-lowering therapy (ULT) use, 382 (0.36%) defined by hospital diagnosis, 1861 (1.76%) defined by hospital diagnosis or gout-specific medications and 2295 (2.18%) defined by self-report of gout or ULT use. Association with gout at experiment-wide significance (P genetic epidemiological studies of gout.

  2. 131-I treatment in patients with hyperthyroidism using low fixed dose regimen

    International Nuclear Information System (INIS)

    Bochev, P.; Klisarova, A.; Chaushev, B.; Hristozov, K.; Tsvetanova, B.

    2007-01-01

    Treatment of hyperthyroidism is one of the major problems in thyroidology. The well known and widely exploited treatment modalities in patients with hyperthyroidism are antithyroid drugs, radioiodine treatment and thyroid surgery, the latter two being considered definitive. Radioiodine treatment is effective and well tolerated treating modality, which major disadvantage is the impossibility of exact calculation of the dose needed. Lots of dosage regimens are approved, including empirically chosen fixed dose regimen. The aim of the study is to define the overall success rate in patients with hyperthyroidism in subgroups Grave's disease and toxic nodular goiter treated with fixed dose 185MBq regimen. Of all treated patients a low fixed dose regimen was chosen in 43. All the patients were followed up clinically, with ultrasonography and hormone levels for a period of minimum 1 year. Part of the patients with persistent hyperthyroidism 6 months after the initial treatment receive a second dose of 185MBq 131-1. The overall success rate in the subgroup with Grave's disease was 87% by the time of the study, compared to a considerably lower success of 62% in patients with toxic nodular goiter. (authors)

  3. Definition of medical event is to be based on the total source strength for evaluation of permanent prostate brachytherapy: A report from the American Society for Radiation Oncology.

    Science.gov (United States)

    Nag, Subir; Demanes, D Jeffrey; Hagan, Michael; Rivard, Mark J; Thomadsen, Bruce R; Welsh, James S; Williamson, Jeffrey F

    2011-10-01

    The Nuclear Regulatory Commission deems it to be a medical event (ME) if the total dose delivered differs from the prescribed dose by 20% or more. A dose-based definition of ME is not appropriate for permanent prostate brachytherapy as it generates too many spurious MEs and thereby creates unnecessary apprehension in patients, and ties up regulatory bodies and the licensees in unnecessary and burdensome investigations. A more suitable definition of ME is required for permanent prostate brachytherapy. The American Society for Radiation Oncology (ASTRO) formed a working group of experienced clinicians to review the literature, assess the validity of current regulations, and make specific recommendations about the definition of an ME in permanent prostate brachytherapy. The working group found that the current definition of ME in §35.3045 as "the total dose delivered differs from the prescribed dose by 20 percent or more" was not suitable for permanent prostate brachytherapy since the prostate volume (and hence the resultant calculated prostate dose) is dependent on the timing of the imaging, the imaging modality used, the observer variability in prostate contouring, the planning margins used, inadequacies of brachytherapy treatment planning systems to calculate tissue doses, and seed migration within and outside the prostate. If a dose-based definition for permanent implants is applied strictly, many properly executed implants would be improperly classified as an ME leading to a detrimental effect on brachytherapy. The working group found that a source strength-based criterion, of >20% of source strength prescribed in the post-procedure written directive being implanted outside the planning target volume is more appropriate for defining ME in permanent prostate brachytherapy. ASTRO recommends that the definition of ME for permanent prostate brachytherapy should not be dose based but should be based upon the source strength (air-kerma strength) administered.

  4. The limiting dose rate and its importance in radiation protection

    International Nuclear Information System (INIS)

    Bakkiam, D.; Sonwani, Swetha; Arul Ananthakumar, A.; Mohankumar, Mary N.

    2012-01-01

    The concept of defining a low dose of ionizing radiation still remains unclear. Before attempting to define a low dose, it is more important to define a low-dose rate since effects at low dose-rates are different from those observed at higher dose-rates. Hence, it follows that low dose-rates rather than a low dose is an important criteria to determine radio-biological effects and risk factors i.e. stochastic health effects. Chromosomal aberrations induced by ionizing radiations are well fitted by quadratic model Y= áD + âD 2 + C with the linear coefficient of dose predominating for high LET radiations and low doses of low LET. At higher doses and dose rates of sparsely ionizing radiation, break pairs produced by inter-track action leads to the formation of exchange type aberrations and is dependent on dose rate. Whereas at lower doses and dose rates, intra-track action produces break pairs and resulting aberrations are in direct proportion to absorbed dose and independent of dose rate. The dose rate at which inter-track ceases to be observable and where intra-track action effectively becomes the sole contributor of lesion-pair formation is referred to as limiting dose rate (LDR). Once the LDR is reached further reduction in dose rates will not affect the slope of DR since breaks produced by independent charged particle tracks are widely separated in time to interact with each other for aberration yield. This linear dependency is also noticed for acute exposures at very low doses. Existing reports emphasizes the existence of LDR likely to be e6.3cGyh -1 . However no systematic studies have been conducted so far to determine LDR. In the present investigation DR curves were constructed for the dose rates 0.002 and 0.003 Gy/min and to define LDR at which a coefficient approaches zero. Extrapolation of limiting low dose rate data can be used to predict low dose effects regardless of dose rate and its definition ought to serve as a useful index for studies pertaining

  5. Nuclear Radiation Degradation Study on HD Camera Based on CMOS Image Sensor at Different Dose Rates

    Directory of Open Access Journals (Sweden)

    Congzheng Wang

    2018-02-01

    Full Text Available In this work, we irradiated a high-definition (HD industrial camera based on a commercial-off-the-shelf (COTS CMOS image sensor (CIS with Cobalt-60 gamma-rays. All components of the camera under test were fabricated without radiation hardening, except for the lens. The irradiation experiments of the HD camera under biased conditions were carried out at 1.0, 10.0, 20.0, 50.0 and 100.0 Gy/h. During the experiment, we found that the tested camera showed a remarkable degradation after irradiation and differed in the dose rates. With the increase of dose rate, the same target images become brighter. Under the same dose rate, the radiation effect in bright area is lower than that in dark area. Under different dose rates, the higher the dose rate is, the worse the radiation effect will be in both bright and dark areas. And the standard deviations of bright and dark areas become greater. Furthermore, through the progressive degradation analysis of the captured image, experimental results demonstrate that the attenuation of signal to noise ratio (SNR versus radiation time is not obvious at the same dose rate, and the degradation is more and more serious with increasing dose rate. Additionally, the decrease rate of SNR at 20.0, 50.0 and 100.0 Gy/h is far greater than that at 1.0 and 10.0 Gy/h. Even so, we confirm that the HD industrial camera is still working at 10.0 Gy/h during the 8 h of measurements, with a moderate decrease of the SNR (5 dB. The work is valuable and can provide suggestion for camera users in the radiation field.

  6. Stereotactic treatment. Definitions and literature overview

    International Nuclear Information System (INIS)

    Fontenla, D.P.

    2008-01-01

    The topics discussed include, among others, the following: Radiosurgery definitions; Stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT); Available uncertainties in SRS; Gamma knife; Linac-based SRS; Components of a radiosurgery system; Stereotactic hardware (brain lab); m3 linac attachment; Radiosurgery - clinical procedure; Cancer management; Rationale for SRT; Role of radiosurgery in the management of intracranial tumors; Indications for stereotactic SRS/SRT; Physical components required for SRS/SRT; Stereotactic patient set-up; Stereotactic CT scan for SRS; Physical components required for SRT: Relocatable head frame (GTC); Patient immobilization; Treatment planning system; Basic requirements for SRS dosimetry (Linac based); Stereotactic set-up QA (Linac); Stereotactic frames and QA; Beam dose measurements; Dose evaluation tools; Phantoms. (P.A.)

  7. Radiation dose and late failures in prostate cancer

    International Nuclear Information System (INIS)

    Morgan, Peter B.; Hanlon, Alexandra L.; Horwitz, Eric M.; Buyyounouski, Mark K.; Uzzo, Robert G.; Pollack, Alan

    2007-01-01

    Purpose: To quantify the impact of radiation dose escalation on the timing of biochemical failure (BF) and distant metastasis (DM) for prostate cancer treated with radiotherapy (RT) alone. Methods: The data from 667 men with clinically localized intermediate- and high-risk prostate cancer treated with three-dimensional conformal RT alone were retrospectively analyzed. The interval hazard rates of DM and BF, using the American Society for Therapeutic Radiology and Oncology (ASTRO) and Phoenix (nadir + 2) definitions, were determined. The median follow-up was 77 months. Results: Multivariate analysis showed that increasing radiation dose was independently associated with decreased ASTRO BF (p < 0.0001), nadir + 2 BF (p = 0.001), and DM (p = 0.006). The preponderance (85%) of ASTRO BF occurred at ≤4 years after RT, and nadir + 2 BF was more evenly spread throughout Years 1-10, with 55% of BF in ≤4 years. Radiation dose escalation caused a shift in the BF from earlier to later years. The interval hazard function for DM appeared to be biphasic (early and late peaks) overall and for the <74-Gy group. In patients receiving ≥74 Gy, a reduction occurred in the risk of DM in the early and late waves, although the late wave appeared reduced to a greater degree. Conclusion: The ASTRO definition of BF systematically underestimated late BF because of backdating. Radiation dose escalation diminished and delayed BF; the delay suggested that local persistence may still be present in some patients. For DM, a greater radiation dose reduced the early and late waves, suggesting that persistence of local disease contributed to both

  8. The Category of Definiteness Indefiniteness through the Prism of Functional Approach to Language Studies

    Directory of Open Access Journals (Sweden)

    Labetova Victoria

    2016-12-01

    Full Text Available Background: The studying of language phenomena with the emphasis on their functional component is topical for modern linguistics. This approach gives a boost to thinking over various (semantic, morphological, syntactic forms through the prism of their functional-semantic load. The analysis of the category of definiteness/indefiniteness from this point of view allows defining the actual theoretical categorial model and the system of its expressive means. Purpose: The aim of the article is to define the essence and the bounds of the category of definiteness/indefiniteness in the Ukrainian language and reveal its expressive potential. Results: The category of definiteness/indefiniteness is a universal category that is based on the symbiosis of psychic, cognitive and lingual spheres. Its functional potential is accumulated in cognitive and communicative fields so it is not restricted only to defining spheres of definiteness or indefiniteness. Not only do things or objects appear definite or indefinite in the process of communication or its interpretation but also their characteristics or properties may acquire these senses. The category of definiteness/indefiniteness correlates with other functional-semantic categories, which leads to its complicated and ramified field structure with diffuse and peripheral zones. Discussion: The studying of the widened structure of the functional-semantic field of definiteness/indefiniteness and organizing all possible (regular, typical, occasional, etc. means of its expression is a perspective approach. It is important to study the category of definiteness/indefiniteness in different types of discourse to reveal the logic of its functioning.

  9. Doses for post-Chernobyl epidemiological studies: are they reliable?

    Science.gov (United States)

    Drozdovitch, Vladimir; Chumak, Vadim; Kesminiene, Ausrele; Ostroumova, Evgenia; Bouville, André

    2016-09-01

    On 26 April 2016, thirty years will have elapsed since the occurrence of the Chernobyl accident, which has so far been the most severe in the history of the nuclear reactor industry. Numerous epidemiological studies were conducted to evaluate the possible health consequences of the accident. Since the credibility of the association between the radiation exposure and health outcome is highly dependent on the adequacy of the dosimetric quantities used in these studies, this paper makes an effort to overview the methods used to estimate individual doses and the associated uncertainties in the main analytical epidemiological studies (i.e. cohort or case-control) related to the Chernobyl accident. Based on the thorough analysis and comparison with other radiation studies, the authors conclude that individual doses for the Chernobyl analytical epidemiological studies have been calculated with a relatively high degree of reliability and well-characterized uncertainties, and that they compare favorably with many other non-Chernobyl studies. The major strengths of the Chernobyl studies are: (1) they are grounded on a large number of measurements, either performed on humans or made in the environment; and (2) extensive effort has been invested to evaluate the uncertainties associated with the dose estimates. Nevertheless, gaps in the methodology are identified and suggestions for the possible improvement of the current dose estimates are made.

  10. Comparison between evaluating methods about the protocols of different dose distributions in radiotherapy

    International Nuclear Information System (INIS)

    Ju Yongjian; Chen Meihua; Sun Fuyin; Zhang Liang'an; Lei Chengzhi

    2004-01-01

    Objective: To study the relationship between tumor control probability (TCP) or equivalent uniform dose (EUD) and the heterogeneity degree of the dose changes with variable biological parameter values of the tumor. Methods: According to the definitions of TCP and EUD, calculating equations were derived. The dose distributions in the tumor were assumed to be Gaussian ones. The volume of the tumor was divided into several voxels, and the absorbed doses of these voxels were simulated by Monte Carlo methods. Then with the different values of radiosensitivity (α) and potential doubling time of the clonogens (T p ), the relationships between TCP or EUD and the standard deviation of dose (S d ) were evaluated. Results: The TCP-S d curves were influenced by the variable α and T p values, but the EUD-S d curves showed little variation. Conclusion: When the radiotherapy protocols with different dose distributions are compared, if the biological parameter values of the tumor have been known exactly, it's better to use the TCP, otherwise the EUD will be preferred

  11. High-dose rate fractionated interstitial radiotherapy for oropharyngeal carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Nose, Takayuki; Inoue, Toshihiko; Inoue, Takehiro; Teshima, Teruki; Murayama, Shigeyuki [Osaka Univ. (Japan). Faculty of Medicine

    1995-03-01

    The limitations of treating oropharyngeal cancer patients with definitive external radiotherapy are the complications of salivary glands, taste buds, mandible and temporomandibular joints. To avoid these complications we started interstitial radiotherapy as boost after 46 Gy of external radiotherapy. Ten cases (retromolar trigone; 1, soft palate; 1, base of tongue; 3, lateral wall; 5) were treated with this method and seven cases were controlled locally. With short follow-up period, xerostomia and dysgeusia are less than definitive external radiotherapy as clinical impression and no in-field recurrences have been experienced. With markedly increased tumor dose, the local control rate can be improved. This treatment method will be an alternative to definitive external radiotherapy to gain better QOL and higher control rate. (author).

  12. Design study on dose evaluation method for employees at severe accident

    International Nuclear Information System (INIS)

    Yoshida, Yoshitaka; Irie, Takashi; Kohriyama, Tamio; Kudo, Seiichi; Nishimura, Kazuya

    2002-01-01

    If a severe accident occurs in a pressurized water reactor plant, it is required to estimate dose values of operators engaged in emergency such as accident management, repair of failed parts. However, it might be difficult to measure radiation dose rate during the progress of an accident, because radiation monitors are not always installed in areas where the emergency activities are required. In this study, we analyzed the transport of radioactive materials in case of a severe accident, investigated a method to obtain radiation dose rate in the plant from estimated radioactive sources, made up a prototype analyzing system from this design study, and then evaluated its availability. As a result, we obtained the following: (1) A new dose evaluation method was established to predict the radiation dose rate at any point in the plant during a severe accident scenario. (2) This evaluation of total dose including access route and time for emergency activities is useful for estimating radiation dose limit for these employee actions. (3) The radiation dose rate map is effective for identifying high radiation areas and for choosing a route with lower radiation dose rate. (author)

  13. Occupational dose measurement in interventional cardiology, dosimetry comparison study

    International Nuclear Information System (INIS)

    Ahmad, A.M.A.

    2008-05-01

    The number of cardiology interventional procedures has significantly increased recently. This is due to the reliability of the diagnostic equipment to diagnose many heart disease. In the procedures the x-ray used results in increasing radiation doses to the staff. The cardiologists and other staff members in interventional cardiology are usually working close to the area under examination and receive the dose primarily from scattered radiation from the patient. Therefore workers in interventional cardiology are expected to receive high doses. This study overviews the status of occupational exposure at the three cardiology centers at three different hospitals in Khartoum compared with that received by workers at other medical practices (radiotherapy, nuclear medicine and diagnostic radiology) in the Institute of Nuclear and Technology (INMO) at El Gezira. The TLD Harshaw 6600 reader was used in the assessment of effective dose for Hp (10). Two TLDs were used by each worker at the three cardiology centres, one worn under a protective apron and the other worn outside and above the apron as specified by the ICRP. Each worker at the other sections was facilitated with one dosimeter to be worn on the chest. The annual doses received by 14 cardiologists, 13 nurses and 9 technologists at the three cardiology centres were in the range: (0.84-4.77), (0.15-2.08), (0.32-1.10) mSv respectively. In the INMO the annual doses received by 7 doctors, 5 nurses and 14 technologists were in the range: (0.12-0.51), (0.11-0.65), (0.03-1.39) mSv respectively. The results showed that the annual doses received by the workers do not exceed 20 mSv. The study also indicated that doses received by workers in interventional cardiology, in particular the cardiologists are high compared to that received at the other medical sections.(Author)

  14. Study of the CT peripheral dose variation in a head phantom

    International Nuclear Information System (INIS)

    Mourao, Arnaldo P.

    2009-01-01

    The computed tomography is frequently used for the brain diagnosis and it is responsible for the largest doses in the head among the X-ray examinations. Established indexes define a reference dose value for a scan routine; however the dose value has a longitudinal variation in the scan. The purpose of this study is to investigate the variation of the peripheral doses in the head scan using a polymethylmethacrylate head phantom. The studies were performed using two different computed tomography scanners in the option single slice with a routine of a head adult protocol (i.e. default protocol in the scanner software). Radiation doses were measured using thermoluminescent dosimeter (LiF - TLD) rod model, distributed inside the PMMA head phantom in periphery and central area. The results allowed registering the variation dose curve, longitudinally the scan, for the peripheral area and to determine the MSAD value. The peripheral maximum dose value measured can be compared with the maximum dose value in the center of the phantom in each different routine (author)

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

    Science.gov (United States)

    Stambaugh, Cassandra; Nelms, Benjamin E; Dilling, Thomas; Stevens, Craig; Latifi, Kujtim; Zhang, Geoffrey; Moros, Eduardo; Feygelman, Vladimir

    2013-09-01

    The effects of respiratory motion on the tumor dose can be divided into the gradient and interplay effects. While the interplay effect is likely to average out over a large number of fractions, it may play a role in hypofractionated [stereotactic body radiation therapy (SBRT)] treatments. This subject has been extensively studied for intensity modulated radiation therapy but less so for volumetric modulated arc therapy (VMAT), particularly in application to hypofractionated regimens. Also, no experimental study has provided full four-dimensional (4D) dose reconstruction in this scenario. The authors demonstrate how a recently described motion perturbation method, with full 4D dose reconstruction, is applied to describe the gradient and interplay effects during VMAT lung SBRT treatments. VMAT dose delivered to a moving target in a patient can be reconstructed by applying perturbations to the treatment planning system-calculated static 3D dose. Ten SBRT patients treated with 6 MV VMAT beams in five fractions were selected. The target motion (motion kernel) was approximated by 3D rigid body translation, with the tumor centroids defined on the ten phases of the 4DCT. The motion was assumed to be periodic, with the period T being an average from the empirical 4DCT respiratory trace. The real observed tumor motion (total displacement ≤ 8 mm) was evaluated first. Then, the motion range was artificially increased to 2 or 3 cm. Finally, T was increased to 60 s. While not realistic, making T comparable to the delivery time elucidates if the interplay effect can be observed. For a single fraction, the authors quantified the interplay effect as the maximum difference in the target dosimetric indices, most importantly the near-minimum dose (D99%), between all possible starting phases. For the three- and five-fractions, statistical simulations were performed when substantial interplay was found. For the motion amplitudes and periods obtained from the 4DCT, the interplay effect

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

    International Nuclear Information System (INIS)

    Stambaugh, Cassandra; Nelms, Benjamin E.; Dilling, Thomas; Stevens, Craig; Latifi, Kujtim; Zhang, Geoffrey; Moros, Eduardo; Feygelman, Vladimir

    2013-01-01

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

  17. Regulatory Forum Opinion Piece*: Retrospective Evaluation of Doses in the 26-week Tg.rasH2 Mice Carcinogenicity Studies: Recommendation to Eliminate High Doses at Maximum Tolerated Dose in Future Studies. A Response to the Counterpoints.

    Science.gov (United States)

    Paranjpe, Madhav G; Denton, Melissa D; Vidmar, Tom J; Elbekai, Reem H

    2016-01-01

    We recently conducted a retrospective analysis of data collected from 29 Tg.rasH2 carcinogenicity studies conducted at our facility to determine how successful was the strategy of choosing the high dose of the 26-week studies based on an estimated maximum tolerated dose (MTD). As a result of our publication, 2 counterviews were expressed. Both counterviews illustrate very valid points in their interpretation of our data. In this article, we would like to highlight clarifications based on several points and issues they have raised in their papers, namely, the dose-level selection, determining if MTD was exceeded in 26-week studies, and a discussion on the number of dose groups to be used in the studies. © The Author(s) 2015.

  18. Dysphagia after definitive radiotherapy for head and neck cancer. Correlation of dose-volume parameters of the pharyngeal constrictor muscles

    Energy Technology Data Exchange (ETDEWEB)

    Deantonio, L.; Masini, L. [University Hospital ' Maggiore della Carita' , Novara (Italy). Radiotherapy; Brambilla, M. [University Hospital ' Maggiore della Carita' , Novara (Italy). Medical Physics; Pia, F. [University Hospital ' Maggiore della Carita' , Novara (Italy). Otolaryngology; University of ' Piemonte Orientale' , Novara (Italy). Dept. of Medical Sciences; Krengli, M. [University Hospital ' Maggiore della Carita' , Novara (Italy). Radiotherapy; University of ' Piemonte Orientale' , Novara (Italy). Dept. of Translational Medicine and BRMA

    2013-03-15

    Background: Dysphagia is a complication of head and neck cancer patients undergoing radiotherapy (RT). We analysed frequency and severity of swallowing dysfunction and correlated these findings with dose-volume histograms (DVHs) of the pharyngeal constrictor muscles. Methods: A total of 50 patients treated by radical RT were enrolled. DVHs of constrictor muscles were correlated with acute and late dysphagia and with the items of three quality of life questionnaires. Results: Mean dose to superior and middle constrictor muscles (SCM, MCM), partial volume of SCM and MCM receiving a dose {>=} 50 Gy dose to the whole constrictor muscles {>=} 60 Gy and tumour location were associated to late dysphagia at univariate analysis. Mean dose to the MCM was the only statistically significant predictor of late dysphagia at the multivariable analysis. Conclusion: The study shows a significant relationship between long-term dysphagia and mean doses to SCM, MCM, whole constrictor muscles, and oropharyngeal tumour. This finding suggests a potential advantage in reducing the RT dose to swallowing structures to avoid severe dysphagia. (orig.)

  19. Dysphagia after definitive radiotherapy for head and neck cancer. Correlation of dose-volume parameters of the pharyngeal constrictor muscles

    International Nuclear Information System (INIS)

    Deantonio, L.; Masini, L.; Brambilla, M.; Pia, F.; University of 'Piemonte Orientale', Novara; Krengli, M.; University of 'Piemonte Orientale', Novara

    2013-01-01

    Background: Dysphagia is a complication of head and neck cancer patients undergoing radiotherapy (RT). We analysed frequency and severity of swallowing dysfunction and correlated these findings with dose-volume histograms (DVHs) of the pharyngeal constrictor muscles. Methods: A total of 50 patients treated by radical RT were enrolled. DVHs of constrictor muscles were correlated with acute and late dysphagia and with the items of three quality of life questionnaires. Results: Mean dose to superior and middle constrictor muscles (SCM, MCM), partial volume of SCM and MCM receiving a dose ≥ 50 Gy dose to the whole constrictor muscles ≥ 60 Gy and tumour location were associated to late dysphagia at univariate analysis. Mean dose to the MCM was the only statistically significant predictor of late dysphagia at the multivariable analysis. Conclusion: The study shows a significant relationship between long-term dysphagia and mean doses to SCM, MCM, whole constrictor muscles, and oropharyngeal tumour. This finding suggests a potential advantage in reducing the RT dose to swallowing structures to avoid severe dysphagia. (orig.)

  20. The impact of increasing dose on overall survival in prostate cancer

    International Nuclear Information System (INIS)

    Hall, Matthew D.; Schultheiss, Timothy E.; Smith, David D.; Tseng, Bertrand P.; Wong, Jeffrey Y. C.

    2015-01-01

    To assess the impact of increasing dose on overall survival (OS) for prostate cancer patients. Treatment data were obtained on more than 20,000 patients in the National Oncology Data Alliance®, a proprietary database of merged tumor registries, who were treated for prostate cancer with definitive radiotherapy between 1995 and 2006. Eligible patients had complete data on total dose, T stage, use and timing of androgen deprivation therapy (ADT), and treatment start date (n = 20,028). Patients with prior malignancies were excluded. On multivariate analysis, dose, T stage, grade, marital status, age, and neoadjuvant ADT were significant predictors of OS. Hazard ratios for OS declined monotonically with increasing dose, reaching 0.63 (95 % Confidence Interval 0.53–0.76) at ≥80 Gy. On subset analysis, neoadjuvant ADT significantly improved OS in high risk patients but was not significant in lower risk patients. The dose response was maintained across all risk groups. Medical comorbidities were balanced across all dose strata and sensitivity analysis demonstrated that other prognostic factors were unlikely to explain the observed dose response. This study suggests that increasing dose significantly improves OS in prostate cancer patients treated with radiotherapy. The online version of this article (doi:10.1186/s13014-015-0419-3) contains supplementary material, which is available to authorized users

  1. What is desirable and feasible in dose reconstruction for application in epidemiological studies?

    International Nuclear Information System (INIS)

    Bouville, A.; Anspaugh, L.; Beebe, G.W.

    1996-01-01

    Formal epidemiologic studies are intended to increase scientific knowledge about the quantitative risk that is associated with radiation exposure. Dosimetric data are needed for such studies. What dosimetric data are desirable? Doses are needed for a large number of people with a large gradation of radiation exposures in order to ensure a sufficient power for the epidemiological study. The characteristics of the desirable doses are, in some respects, different from those calculated for radiation protection purposes. The desirable data are: absorbed doses to the individual organs or tissues of interest, instead of effective doses; absorbed doses delivered over limited time periods, instead of committed doses; doses specific to the individuals that are subjects in the epidemiological studies, instead of average doses over population groups; and very accurate and precise doses. What dosimetric data are feasible? Most of the characteristics of the desirable dosimetric data are usually achievable. However, uncertainties can be fairly large and estimated with a large degree of subjectivity. Also, for practical reasons, it may not be feasible to estimate individual doses for all subjects

  2. A study on mice exposure dose for low-dose gamma-irradiation using glass dosimeter

    Energy Technology Data Exchange (ETDEWEB)

    Noh, Sung Jin; Kim, Hyo Jin; Kim, Hyun; Jeong, Dong Hyeok; Son, Tae Gen; Kim, Jung Ki; Yang, Kwang Mo; Kang, Yeong Rok [Research Center, Dongnam Institute of Radiological and Medical Sciences, Busan (Korea, Republic of); Nam, Sang Hee [Dept. of Biomedical Engineering, Inje University, Gimhae (Korea, Republic of)

    2015-12-15

    The low dose radiation is done for a long period, thus researchers have to know the exact dose distribution for the irradiated mouse. This research has been conducted in order to find out methods in transmitting an exact dose to mouse in a mouse irradiation experiment carried out using {sup 137}C{sub s} irradiation equipment installed in the DIRAMS (Dongnam Institution of Radiological and Medical Sciences) research center. We developed a single mouse housing cage and shelf with adjustable geometric factors such as distance and angle from collimator. The measurement of irradiated dose showed a maximal 42% difference of absorbed dose from the desired dose in the conventional irradiation system, whereas only 6% difference of the absorbed dose was measured in the self-developed mouse apartment system. In addition, multi mice housing showed much difference of the absorbed dose in between head and body, compared to single mouse housing in the conventional irradiation system. This research may allow further research about biological effect assessment for the low dose irradiation using the self-developed mouse apartment to provide more exact doses which it tries to transmit, and to have more reliability for the biological analysis results.

  3. Survey Definitions of Gout for Epidemiologic Studies: Comparison With Crystal Identification as the Gold Standard

    NARCIS (Netherlands)

    Dalbeth, N.; Schumacher, H.R.; Fransen, J.; Neogi, T.; Jansen, T.L; Brown, M.; Louthrenoo, W.; Vazquez-Mellado, J.; Eliseev, M.; McCarthy, G.; Stamp, L.K.; Perez-Ruiz, F.; Sivera, F.; Ea, H.K.; Gerritsen, M.; Scire, C.A.; Cavagna, L.; Lin, C.; Chou, Y.Y.; Tausche, A.K.; Rocha Castelar-Pinheiro, G. da; Janssen, M; Chen, J.H.; Cimmino, M.A.; Uhlig, T.; Taylor, W.J.

    2016-01-01

    OBJECTIVE: To identify the best-performing survey definition of gout from items commonly available in epidemiologic studies. METHODS: Survey definitions of gout were identified from 34 epidemiologic studies contributing to the Global Urate Genetics Consortium (GUGC) genome-wide association study.

  4. Young age under 60 years is not a contraindication to treatment with definitive dose escalated radiotherapy for prostate cancer

    International Nuclear Information System (INIS)

    Klayton, Tracy L.; Ruth, Karen; Horwitz, Eric M.; Uzzo, Robert G.; Kutikov, Alexander; Chen, David Y.T.; Sobczak, Mark; Buyyounouski, Mark K.

    2011-01-01

    Background: It is widely believed that younger prostate cancer patients are at greater risk of recurrence following radiotherapy (RT). Methods: From 1992 to 2007, 2168 (395 age ⩽60) men received conformal RT alone for prostate cancer at our institution (median dose = 76 Gy, range: 72–80). Multivariable analysis (MVA) was used to identify significant predictors for BF and PCSM. Cumulative incidence was estimated using the competing risk method (Fine and Gray) for BF (Phoenix definition) and PCSM to account for the competing risk of death. Results: With a median follow-up of 72.2 months (range: 24.0–205.1), 8-year BF was 27.1% for age ⩽60 vs. 23.7% for age >60 (p = 0.29). Eight-year PCSM was 3.0% for age ⩽60 vs. 2.0% for age >60 (p = 0.52). MVA for BF identified initial PSA [adjusted HR = 1.7 (PSA 10–20), 2.6 (PSA >20), p 12 months), p < 0.01] as significant, but not age or ADT <12 months. MVA for PCSM identified Gleason score [adjusted HR = 3.0 (G8–10), p = 0.01] and T-stage [adjusted HR = 8.7 (T3-4), p < 0.01] as significant, but not age, PSA, or ADT. Conclusion: This is the largest, most mature study of younger men treated with RT for prostate cancer that confirms young age is not prognostic for BF.

  5. Results of Definitive Chemoradiotherapy for Unresectable Esophageal Cancer

    International Nuclear Information System (INIS)

    Noh, O Kyu; Je, Hyoung Uk; Kim, Sung Bae

    2008-01-01

    To investigate the treatment outcome and failure patterns after definitive chemoradiation therapy in locally advanced, unresectable esophageal cancer. Materials and Methods: From February 1994 to December 2002, 168 patients with locally advanced unresectable or medically inoperable esophageal cancer were treated by definitive chemoradiation therapy. External beam radiation therapy (EBRT) (42-46 Gy) was delivered to the region encompassing the primary tumor and involved lymph nodes, while the supraclavicular fossa and celiac area were included in the treatment area as a function of disease location. The administered cone-down radiation dose to the gross tumor went up to 54-66 Gy, while the fraction size of the EBRT was 1.8-2.0 Gy/fraction qd or 1.2 Gy/fraction bid. An optional high dose rate (HDR) intraluminal brachytherapy (BT) boost was also administered (Ir-192, 9-12 Gy/3 -4 fx). Two cycles of concurrent FP chemotherapy (5-FU 1,000 mg/m2/day, days 2-6, 30-34, cisplatin 60 mg/m2/day, days 1, 29) were delivered during radiotherapy with the addition of two more cycles. Results: One hundred sixty patients were analyzable for this review [median follow-up time: 10 months (range 1-149 months)]. The number of patients within AJCC stages I, II, III, and IV was 5 (3.1%), 38 (23.8%), 68 (42.5%), and 49 (30.6%), respectively. A HDR intraluminal BT was performed in 26 patients. The 160 patients had a median EBRT radiation dose of 59.4 Gy (range 44.4-66) and a total radiation dose, including BT, of 60 Gy (range 44.4-72), while 144 patients received a dose higher than 40 Gy. Despite the treatment, the disease recurrence rate was 101/160 (63.1%). Of these, the patterns of recurrence were local in 20 patients (12.5%), persistent disease and local progression in 61 (38.1%), distant metastasis in 15 (9.4%), and concomitant local and distant failure in 5 (3.1%). The overall survival rate was 31.8% at 2 years and 14.2% at 5 years (median 11.1 months). Disease-free survival was 29

  6. Results of Definitive Chemoradiotherapy for Unresectable Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Noh, O Kyu; Je, Hyoung Uk; Kim, Sung Bae [Ulsan University College of Medicine, Seoul (Korea, Republic of)] (and others)

    2008-12-15

    To investigate the treatment outcome and failure patterns after definitive chemoradiation therapy in locally advanced, unresectable esophageal cancer. Materials and Methods: From February 1994 to December 2002, 168 patients with locally advanced unresectable or medically inoperable esophageal cancer were treated by definitive chemoradiation therapy. External beam radiation therapy (EBRT) (42-46 Gy) was delivered to the region encompassing the primary tumor and involved lymph nodes, while the supraclavicular fossa and celiac area were included in the treatment area as a function of disease location. The administered cone-down radiation dose to the gross tumor went up to 54-66 Gy, while the fraction size of the EBRT was 1.8-2.0 Gy/fraction qd or 1.2 Gy/fraction bid. An optional high dose rate (HDR) intraluminal brachytherapy (BT) boost was also administered (Ir-192, 9-12 Gy/3 -4 fx). Two cycles of concurrent FP chemotherapy (5-FU 1,000 mg/m2/day, days 2-6, 30-34, cisplatin 60 mg/m2/day, days 1, 29) were delivered during radiotherapy with the addition of two more cycles. Results: One hundred sixty patients were analyzable for this review [median follow-up time: 10 months (range 1-149 months)]. The number of patients within AJCC stages I, II, III, and IV was 5 (3.1%), 38 (23.8%), 68 (42.5%), and 49 (30.6%), respectively. A HDR intraluminal BT was performed in 26 patients. The 160 patients had a median EBRT radiation dose of 59.4 Gy (range 44.4-66) and a total radiation dose, including BT, of 60 Gy (range 44.4-72), while 144 patients received a dose higher than 40 Gy. Despite the treatment, the disease recurrence rate was 101/160 (63.1%). Of these, the patterns of recurrence were local in 20 patients (12.5%), persistent disease and local progression in 61 (38.1%), distant metastasis in 15 (9.4%), and concomitant local and distant failure in 5 (3.1%). The overall survival rate was 31.8% at 2 years and 14.2% at 5 years (median 11.1 months). Disease-free survival was 29

  7. An effective dose of ketamine for eliminating pain during injection of propofol: a dose response study.

    Science.gov (United States)

    Wang, M; Wang, Q; Yu, Y Y; Wang, W S

    2013-09-01

    Ketamine can completely eliminate pain associated with propofol injection. However, the effective dose of ketamine to eliminate propofol injection pain has not been determined. The purpose of this study was to determine the effective dose of ketamine needed to eliminate pain in 50% and 95% of patients (ED50 and ED95, respectively) during propofol injections. This study was conducted in a double-blinded fashion and included 50 patients scheduled for elective gynecological laparoscopy under general anesthesia. The initial dose of ketamine used in the first patient was 0.25mg/kg. The dosing modifications were in increments or decrements of 0.025 mg/kg. Ketamine was administered 15 seconds before injecting propofol (2.5mg/kg), which was injected at a rate of 1mL/s. Patients were asked to rate their pain during propofol injection every 5s econds using a 0-3 pain scale. The highest pain score was recorded. The ED50, ED95 and 95% confidence intervals (CI) were determined by probit analyses. The dose of ketamine ranged from 0.175 to 0.275 mg/kg. The ED50 and ED95 of ketamine for eliminating pain during propofol injection were 0.227 mg/kg and 0.283 mg/kg, respectively (95%CI: 0.211-0.243 mg/kg and 0.26-0.364 mg/kg, respectively). Ketamine at an approximate dose of 0.3mg/kg was effective in eliminating pain during propofol injection. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  8. TU-F-18A-03: Improving Tissue Segmentation for Monte Carlo Dose Calculation Using DECT Data

    International Nuclear Information System (INIS)

    Di, Salvio A; Bedwani, S; Carrier, J

    2014-01-01

    Purpose: To develop a new segmentation technique using dual energy CT (DECT) to overcome limitations related to segmentation from a standard Hounsfield unit (HU) to electron density (ED) calibration curve. Both methods are compared with a Monte Carlo analysis of dose distribution. Methods: DECT allows a direct calculation of both ED and effective atomic number (EAN) within a given voxel. The EAN is here defined as a function of the total electron cross-section of a medium. These values can be effectively acquired using a calibrated method from scans at two different energies. A prior stoichiometric calibration on a Gammex RMI phantom allows us to find the parameters to calculate EAN and ED within a voxel. Scans from a Siemens SOMATOM Definition Flash dual source system provided the data for our study. A Monte Carlo analysis compares dose distribution simulated by dosxyz-nrc, considering a head phantom defined by both segmentation techniques. Results: Results from depth dose and dose profile calculations show that materials with different atomic compositions but similar EAN present differences of less than 1%. Therefore, it is possible to define a short list of basis materials from which density can be adapted to imitate interaction behavior of any tissue. Comparison of the dose distributions on both segmentations shows a difference of 50% in dose in areas surrounding bone at low energy. Conclusion: The presented segmentation technique allows a more accurate medium definition in each voxel, especially in areas of tissue transition. Since the behavior of human tissues is highly sensitive at low energies, this reduces the errors on calculated dose distribution. This method could be further developed to optimize the tissue characterization based on anatomic site

  9. TU-F-18A-03: Improving Tissue Segmentation for Monte Carlo Dose Calculation Using DECT Data

    Energy Technology Data Exchange (ETDEWEB)

    Di, Salvio A; Bedwani, S; Carrier, J [CHUM - Notre-Dame, Montreal, QC (Canada)

    2014-06-15

    Purpose: To develop a new segmentation technique using dual energy CT (DECT) to overcome limitations related to segmentation from a standard Hounsfield unit (HU) to electron density (ED) calibration curve. Both methods are compared with a Monte Carlo analysis of dose distribution. Methods: DECT allows a direct calculation of both ED and effective atomic number (EAN) within a given voxel. The EAN is here defined as a function of the total electron cross-section of a medium. These values can be effectively acquired using a calibrated method from scans at two different energies. A prior stoichiometric calibration on a Gammex RMI phantom allows us to find the parameters to calculate EAN and ED within a voxel. Scans from a Siemens SOMATOM Definition Flash dual source system provided the data for our study. A Monte Carlo analysis compares dose distribution simulated by dosxyz-nrc, considering a head phantom defined by both segmentation techniques. Results: Results from depth dose and dose profile calculations show that materials with different atomic compositions but similar EAN present differences of less than 1%. Therefore, it is possible to define a short list of basis materials from which density can be adapted to imitate interaction behavior of any tissue. Comparison of the dose distributions on both segmentations shows a difference of 50% in dose in areas surrounding bone at low energy. Conclusion: The presented segmentation technique allows a more accurate medium definition in each voxel, especially in areas of tissue transition. Since the behavior of human tissues is highly sensitive at low energies, this reduces the errors on calculated dose distribution. This method could be further developed to optimize the tissue characterization based on anatomic site.

  10. Importance of protocol target definition on the ability to spare normal tissue: An IMRT and 3D-CRT planning comparison for intraorbital tumors

    International Nuclear Information System (INIS)

    Hein, Patrick A.; Gladstone, David J.; Bellerive, Marc R.; Hug, Eugen B.

    2005-01-01

    Purpose: We selected five intraorbital tumor sites that are frequently found in clinical practice in children diagnosed with orbital rhabdomyosarcoma and performed three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated photon radiotherapy (IMRT) planning. Results of target coverage and doses to critical structures were compared. The goal of this study was to evaluate and to document realistic expectations as to organ-sparing capabilities of modern radiation therapy planning technologies with a focus on lens-sparing irradiation. Furthermore, we investigated potential added benefits of IMRT compared with 3D-CRT and the influence of protocol volume criteria definitions on the ability to obtain normal tissue dose sparing using the orbit as an example of a complex anatomic site. Methods and Materials: The five intraorbital tumor sites were placed retrobulbar, temporal, nasal, in the upper inner and upper outer quadrant, the latter two more complex in shape. Gross tumor volume (GTV), clinical target volume (CTV), and planning target volume (PTV) were defined in image-fused computed tomography and magnetic resonance data sets. 3D-CRT and IMRT photon plans, using equal beam angles and collimation for direct comparison, were designed to 45 Gy prescription dose according to Intergroup Rhabdomyosarcoma Study Group-D9602 (IRSG-D9602) protocol (Intergroup Rhabdomyosarcoma Study V [IRS-V] protocol) for Stage I, Clinical Group 3 orbital rhabdomyosarcoma. To compare the impact of changed target definitions in IMRT planning, additional IMRT plans were generated using modified volume and dose coverage criteria. The minimum dose constraint (95%) of the PTV was substituted by a required minimum volume coverage (95%) with the prescribed dose. Dose-volume histograms (DVHs) were obtained, including target volumes, lens, optic nerves, optic chiasm, lacrimal gland, bony orbit, pituitary gland, frontal and temporal lobes. Results: Protocol target volume coverage criteria

  11. Repeated dose studies with pure Epigallocatechin-3-gallate demonstrated dose and route dependant hepatotoxicity with associated dyslipidemia

    Directory of Open Access Journals (Sweden)

    Balaji Ramachandran

    Full Text Available EGCG (Epigallocatechin-3-gallate is the major active principle catechin found in green tea. Skepticism regarding the safety of consuming EGCG is gaining attention, despite the fact that it is widely being touted for its potential health benefits, including anti-cancer properties. The lack of scientific data on safe dose levels of pure EGCG is of concern, while EGCG has been commonly studied as a component of GTE (Green tea extract and not as a single active constituent. This study has been carried out to estimate the maximum tolerated non-toxic dose of pure EGCG and to identify the treatment related risk factors. In a fourteen day consecutive treatment, two different administration modalities were compared, offering an improved [i.p (intraperitoneal] and limited [p.o (oral] bioavailability. A trend of dose and route dependant hepatotoxicity was observed particularly with i.p treatment and EGCG increased serum lipid profile in parallel to hepatotoxicity. Fourteen day tolerable dose of EGCG was established as 21.1 mg/kg for i.p and 67.8 mg/kg for p.o. We also observed that, EGCG induced effects by both treatment routes are reversible, subsequent to an observation period for further fourteen days after cessation of treatment. It was demonstrated that the severity of EGCG induced toxicity appears to be a function of dose, route of administration and period of treatment. Keywords: EGCG, Green tea, Serum lipids, Dose dependant toxicity, Route dependant toxicity, Liver toxicity, Dyslipidemia

  12. More on the problem of roentgen definition

    Energy Technology Data Exchange (ETDEWEB)

    Yudin, M. F.

    1956-07-01

    A further substantiation is presented of the proposal found in Comments on the Problem of the New Definition for the Units of X- and Gamma-Radiations and Radioactivity (DC-58-9)-84(p.1-13)) that the roentgen can be applied for doses produced by radiation for which the average work of ionization can be estimated as equal to 33 ev. (J.R.D.)

  13. Analysis of agreement among definitions of metabolic syndrome in nondiabetic Turkish adults: a methodological study

    Directory of Open Access Journals (Sweden)

    Bersot Thomas P

    2007-12-01

    Full Text Available Abstract Background We aimed to explore the agreement among World Health Organization (WHO, European Group for the Study of Insulin Resistance (EGIR, National Cholesterol Education Program (NCEP, American College of Endocrinology (ACE, and International Diabetes Federation (IDF definitions of the metabolic syndrome. Methods 1568 subjects (532 men, 1036 women, mean age 45 and standard deviation (SD 13 years were evaluated in this cross-sectional, methodological study. Cardiometabolic risk factors were determined. Insulin sensitivity was calculated by HOMA-IR. Agreement among definitions was determined by the kappa statistic. ANOVA and post hoc Tukey's test were used to compare multiple groups. Results The agreement between WHO and EGIR definitions was very good (kappa: 0.83. The agreement between NCEP, ACE, and IDF definitions was substantial to very good (kappa: 0.77–0.84. The agreement between NCEP or ACE or IDF and WHO or EGIR definitions was fair (kappa: 0.32–0.37. The age and sex adjusted prevalence of metabolic syndrome was 38% by NCEP, 42% by ACE and IDF, 20% by EGIR and 19% by WHO definition. The evaluated definitions were dichotomized after analysis of design, agreement and prevalence: insulin measurement requiring definitions (WHO and EGIR and definitions not requiring insulin measurement (NCEP, ACE, IDF. One definition was selected from each set for comparison. WHO-defined subjects were more insulin resistant than subjects without the metabolic syndrome (mean and SD for log HOMA-IR, 0.53 ± 0.14 vs. 0.07 ± 0.23, respectively, p 0.05, but lower log HOMA-IR values (p Conclusion The metabolic syndrome definitions that do not require measurement of insulin levels (NCEP, ACE and IDF identify twice more patients with insulin resistance and increased Framingham risk scores and are more useful than the definitions that require measurement of insulin levels (WHO and EGIR.

  14. Dose-Escalation Study for Cardiac Radiosurgery in a Porcine Model

    Energy Technology Data Exchange (ETDEWEB)

    Blanck, Oliver, E-mail: oliver.blanck@uksh.de [Department of Radiation Oncology, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck (Germany); CyberKnife Center Northern Germany, Guestrow (Germany); Bode, Frank [Medical Department II, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck (Germany); Gebhard, Maximilian [Institute of Pathology, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck (Germany); Hunold, Peter [Department of Radiology and Nuclear Medicine, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck (Germany); Brandt, Sebastian [Department of Anaesthesiology and Intensive Care Medicine, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck (Germany); Bruder, Ralf [Institute for Robotics and Cognitive Systems, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck (Germany); Grossherr, Martin [Department of Anaesthesiology and Intensive Care Medicine, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck (Germany); Vonthein, Reinhard [Institute of Medical Biometry and Statistics, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck (Germany); Rades, Dirk [Department of Radiation Oncology, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck (Germany); Dunst, Juergen [Department of Radiation Oncology, University of Luebeck and University Medical Center Schleswig-Holstein, Campus Luebeck (Germany); University Copenhagen (Denmark)

    2014-07-01

    Purpose: To perform a proof-of-principle dose-escalation study to radiosurgically induce scarring in cardiac muscle tissue to block veno-atrial electrical connections at the pulmonary vein antrum, similar to catheter ablation. Methods and Materials: Nine mini-pigs underwent pretreatment magnetic resonance imaging (MRI) evaluation of heart function and electrophysiology assessment by catheter measurements in the right superior pulmonary vein (RSPV). Immediately after examination, radiosurgery with randomized single-fraction doses of 0 and 17.5-35 Gy in 2.5-Gy steps were delivered to the RSPV antrum (target volume 5-8 cm{sup 3}). MRI and electrophysiology were repeated 6 months after therapy, followed by histopathologic examination. Results: Transmural scarring of cardiac muscle tissue was noted with doses ≥32.5 Gy. However, complete circumferential scarring of the RSPV was not achieved. Logistic regressions showed that extent and intensity of fibrosis significantly increased with dose. The 50% effective dose for intense fibrosis was 31.3 Gy (odds ratio 2.47/Gy, P<.01). Heart function was not affected, as verified by MRI and electrocardiogram evaluation. Adjacent critical structures were not damaged, as verified by pathology, demonstrating the short-term safety of small-volume cardiac radiosurgery with doses up to 35 Gy. Conclusions: Radiosurgery with doses >32.5 Gy in the healthy pig heart can induce circumscribed scars at the RSPV antrum noninvasively, mimicking the effect of catheter ablation. In our study we established a significant dose-response relationship for cardiac radiosurgery. The long-term effects and toxicity of such high radiation doses need further investigation in the pursuit of cardiac radiosurgery for noninvasive treatment of atrial fibrillation.

  15. Towards tracer dose reduction in PET studies: Simulation of dose reduction by retrospective randomized undersampling of list-mode data.

    Science.gov (United States)

    Gatidis, Sergios; Würslin, Christian; Seith, Ferdinand; Schäfer, Jürgen F; la Fougère, Christian; Nikolaou, Konstantin; Schwenzer, Nina F; Schmidt, Holger

    2016-01-01

    Optimization of tracer dose regimes in positron emission tomography (PET) imaging is a trade-off between diagnostic image quality and radiation exposure. The challenge lies in defining minimal tracer doses that still result in sufficient diagnostic image quality. In order to find such minimal doses, it would be useful to simulate tracer dose reduction as this would enable to study the effects of tracer dose reduction on image quality in single patients without repeated injections of different amounts of tracer. The aim of our study was to introduce and validate a method for simulation of low-dose PET images enabling direct comparison of different tracer doses in single patients and under constant influencing factors. (18)F-fluoride PET data were acquired on a combined PET/magnetic resonance imaging (MRI) scanner. PET data were stored together with the temporal information of the occurrence of single events (list-mode format). A predefined proportion of PET events were then randomly deleted resulting in undersampled PET data. These data sets were subsequently reconstructed resulting in simulated low-dose PET images (retrospective undersampling of list-mode data). This approach was validated in phantom experiments by visual inspection and by comparison of PET quality metrics contrast recovery coefficient (CRC), background-variability (BV) and signal-to-noise ratio (SNR) of measured and simulated PET images for different activity concentrations. In addition, reduced-dose PET images of a clinical (18)F-FDG PET dataset were simulated using the proposed approach. (18)F-PET image quality degraded with decreasing activity concentrations with comparable visual image characteristics in measured and in corresponding simulated PET images. This result was confirmed by quantification of image quality metrics. CRC, SNR and BV showed concordant behavior with decreasing activity concentrations for measured and for corresponding simulated PET images. Simulation of dose

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-09-15

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

  17. Dose response of rat retinal microvessels to proton dose schedules used clinically: a pilot study

    International Nuclear Information System (INIS)

    Archambeau, John O.; Mao, Xiao W.; McMillan, Paul J.; Gouloumet, Vanessa L.; Oeinck, Steven C.; Grove, Roger; Yonemoto, Leslie T.; Slater, Jerry D.; Slater, James M.

    2000-01-01

    Purpose: This preclinical rat pilot study quantifies retinal microvessel, endothelial, and pericyte population changes produced by proton irradiation Methods and Materials: The left eyes of rats were irradiated with single doses of 8, 14, 20, and 28 Gy protons; right eyes, with two fractions. Animals were euthanized, and eyes were removed; elastase digests were prepared, and cell populations were counted in sample fields. Results were compared with unirradiated controls. Results: Progressive time- and dose-dependent endothelial cell loss occurred following all schedules. Cell loss was significantly different from control values (p 0 phase of the mitotic cycle. 28 Gy produced photoreceptor cell loss. Conclusion: The retinal digest is an elegant bioassay to quantify the microvessel population response. Single- and split-dose schedules appear to yield similar outcomes, in terms of endothelial cell density

  18. Study of absorbed dose distribution to high energy electron beams

    International Nuclear Information System (INIS)

    Cecatti, E.R.

    1983-01-01

    The depth absorbed dose distribution by electron beams was studied. The influence of the beam energy, the energy spread, field size and design characteristics of the accelerator was relieved. Three accelerators with different scattering and collimation systems were studied leading todifferent depth dose distributions. A theoretical model was constructed in order to explain the increase in the depth dose in the build-up region with the increase of the energy. The model utilizes a three-dimensional formalism based on the Fermi-Eyges multiple scattering theory, with the introduction of modifications that takes into account the criation of secondary electrons. (Author) [pt

  19. An approach to calculating absorbed doses to organs of high radiation sensitivity in diagnostic radioisotope examinations in vivo

    International Nuclear Information System (INIS)

    Staniszewska, M.A.; Jankowski, J.

    1984-01-01

    A method is presented of dose calculations for internal exposures of organ-sources and organ-targets. Variations of absorbed doses depending on sex and age of the patients investigated with the use of radionuclides are discussed. Definitions of the effective and collective dose equivalents are also given. 8 refs., 1 tab. (author)

  20. Estimation of the optimal dosing regimen of escitalopram in dogs: A dose occupancy study with [11C]DASB.

    Directory of Open Access Journals (Sweden)

    Olivia Taylor

    Full Text Available Although the favourable characteristics of escitalopram as being the most selective serotonin reuptake inhibitor and having an increased therapeutic efficacy via binding on an additional allosteric binding site of the serotonin transporter, its dosing regimen has not yet been optimized for its use in dogs. This study aimed to estimate the optimal dosing frequency and the required dose for achieving 80% occupancy of the serotonin transporters in the basal ganglia. The dosing frequency was investigated by determining the elimination half-life after a four day oral pre-treatment period with 0.83 mg/kg escitalopram (3 administrations/day and a subsequent i.v. injection 0.83 mg/kg. Blood samples were taken up to 12 hours after i.v. injection and the concentration of escitalopram in plasma was analysed via LC-MSMS. The dose-occupancy relationship was then determined by performing two PET scans in five adult beagles: a baseline PET scan and a second scan after steady state conditions were achieved following oral treatment with a specific dose of escitalopram ranging from 0.5 to 2.5 mg/kg/day. As the elimination half-life was determined to be 6.7 hours a dosing frequency of three administrations a day was proposed for the second part of the study. Further it was opted for a treatment period of four days, which well exceeded the minimum period to achieve steady state conditions. The optimal dosing regimen to achieve 80% occupancy in the basal ganglia and elicit a therapeutic effect, was calculated to be 1.85 mg/kg/day, divided over three administrations. Under several circumstances, such as insufficient response to other SSRIs, concurrent drug intake or in research studies focused on SERT, the use of escitalopram can be preferred over the use of the already for veterinary use registered fluoxetine, however, in case of long-term treatment with escitalopram, regularly cardiac screening is recommended.

  1. Estimation of the optimal dosing regimen of escitalopram in dogs: A dose occupancy study with [11C]DASB.

    Science.gov (United States)

    Taylor, Olivia; Van Laeken, Nick; Polis, Ingeborgh; Dockx, Robrecht; Vlerick, Lise; Dobbeleir, Andre; Goethals, Ingeborg; Saunders, Jimmy; Sadones, Nele; Baeken, Chris; De Vos, Filip; Peremans, Kathelijne

    2017-01-01

    Although the favourable characteristics of escitalopram as being the most selective serotonin reuptake inhibitor and having an increased therapeutic efficacy via binding on an additional allosteric binding site of the serotonin transporter, its dosing regimen has not yet been optimized for its use in dogs. This study aimed to estimate the optimal dosing frequency and the required dose for achieving 80% occupancy of the serotonin transporters in the basal ganglia. The dosing frequency was investigated by determining the elimination half-life after a four day oral pre-treatment period with 0.83 mg/kg escitalopram (3 administrations/day) and a subsequent i.v. injection 0.83 mg/kg. Blood samples were taken up to 12 hours after i.v. injection and the concentration of escitalopram in plasma was analysed via LC-MSMS. The dose-occupancy relationship was then determined by performing two PET scans in five adult beagles: a baseline PET scan and a second scan after steady state conditions were achieved following oral treatment with a specific dose of escitalopram ranging from 0.5 to 2.5 mg/kg/day. As the elimination half-life was determined to be 6.7 hours a dosing frequency of three administrations a day was proposed for the second part of the study. Further it was opted for a treatment period of four days, which well exceeded the minimum period to achieve steady state conditions. The optimal dosing regimen to achieve 80% occupancy in the basal ganglia and elicit a therapeutic effect, was calculated to be 1.85 mg/kg/day, divided over three administrations. Under several circumstances, such as insufficient response to other SSRIs, concurrent drug intake or in research studies focused on SERT, the use of escitalopram can be preferred over the use of the already for veterinary use registered fluoxetine, however, in case of long-term treatment with escitalopram, regularly cardiac screening is recommended.

  2. Exploring Stakeholder Definitions within the Aerospace Industry: A Qualitative Case Study

    Science.gov (United States)

    Hebert, Jonathan R.

    A best practice in the discipline of project management is to identify all key project stakeholders prior to the execution of a project. When stakeholders are properly identified, they can be consulted to provide expert advice on project activities so that the project manager can ensure the project stays within the budget and schedule constraints. The problem addressed by this study is that managers fail to properly identify key project stakeholders when using stakeholder theory because there are multiple conflicting definitions for the term stakeholder. Poor stakeholder identification has been linked to multiple negative project outcomes such as budget and schedules overruns, and this problem is heightened in certain industries such as aerospace. The purpose of this qualitative study was to explore project managers' and project stakeholders' perceptions of how they define and use the term stakeholder within the aerospace industry. This qualitative exploratory single-case study had two embedded units of analysis: project managers and project stakeholders. Six aerospace project managers and five aerospace project stakeholders were purposively selected for this study. Data were collected through individual semi-structured interviews with both project managers and project stakeholders. All data were analyzed using Yin's (2011) five-phased cycle approach for qualitative research. The results indicated that the aerospace project managers and project stakeholder define the term stakeholder as "those who do the work of a company." The participants build upon this well-known concept by adding that, "a company should list specific job titles" that correspond to their company specific-stakeholder definition. Results also indicated that the definition of the term stakeholder is used when management is assigning human resources to a project to mitigate or control project risk. Results showed that project managers tended to include the customer in their stakeholder definitions

  3. Studies of health effects of low dose radiation and its application to medicare

    International Nuclear Information System (INIS)

    Yamaoka, Kiyonori; Ishida, Kenji; Iwasaki, Toshiyasu; Koana, Takao; Magae, Junji; Watanabe, Masami; Sakamoto, Kiyohiko

    2008-01-01

    The articles contain following 7 topics of low dose radiation effects. Studies of Health Effects of Low dose Radiation and Its Application to Medicare'', describes the indication of Rn therapy and investigations of its usefulness mechanism mainly in Misasa Spa, Okayama Pref. ''Challenges for the Paradigm Shift (CRIEPI Studies)'', introduces studies against the paradigm that radiation dose is linearly and proportionally hazardous. ''Studies of High Background Radiation Area (CRIEPI Studies)'', describes global HBRA studies on chromosome affection and effect of smoking in HBRA. ''Is the Radiation Effect on Man Proportional to Dose? (CRIEPI Studies)'', describes studies of immature sperm irradiated at low dose against Linear-Non-threshold Theory (LNT) hypothesis. ''Induction of Radiation Resistance by Low Dose Radiation and Assessment of Its Effect in Models of Human Diseases (CRIEPI Studies)'', explains the adoptive response in radiation effect, suppression of carcinogenesis and immune regulation by previous low dose radiation in the mouse, and improvement of diabetes in the db/db mouse. ''Modulation of Biological Effects of Low Dose Radiation: Adoptive Response, Bystander Effect, Genetic Instability and Radiation Hormesis'', summarizes findings of each item. ''Cancer Treatment with Low dose Radiation to the Whole Body'', describes basic studies in the mouse tumor in relation to suppression of carcinogenesis and metastasis, immune activation and treatment, and successful clinical studies in patients with ovary, colon cancers and malignant lymphoma where survival has been significantly improved: a base of recent European Organization for Research and Treatment of Cancer (EORTC) clinical trials. The mechanism is essentially based on immune activation of patients to cure the disease. (R.T.)

  4. Doses in mammography. Preliminary study

    International Nuclear Information System (INIS)

    Marquez P, F.; Acosta R, N.; Universidad Nacional Mayor de San Marcos, Lima; Benavente, T.; Universidad Nacional Mayor de San Marcos, Lima; Poma, M.

    2002-01-01

    Mammography is the most important method to detect lesions in the breast with this technique one can detect small tumours before clear clinical symptoms appear. Mammographic image of require high quality standards due that the extremely low contrast between the normal and pathological areas in the breast, eg.g., they have similar attenuation and absorption coefficient. The x-ray mammographic systems, used in this study are Senographe 500t and Senographe DMR, a detector with a RadCal ionization chambers calibrated to the qualities of mammographic x-ray beams, and a breast simulator that is a phantoms of polymethylmethacrylate (PMMA) of several thicknesses with the equivalence of 50% of the glandular tissue. The results obtained indicate that the values of doses at the entrance surface of a breast (DES) are greater the reference value 20 mGy to 5,0 cm of PMMA and the values of the mean glandular dose (MGD) exceed the reference value of 2,1 mGy for 5,1 cm of compressed thick breast. We consider that the values high of the EDS and MGD are due that the x-ray systems no meeting in good condition or for used of x-ray spectra no suitable, so is recommendable be carried out test of quality control to the x-ray systems and also realize studies, or characterize the of x-ray mammographic spectra

  5. An experimental study on the mechanical properties of rat brain tissue using different stress-strain definitions.

    Science.gov (United States)

    Karimi, Alireza; Navidbakhsh, Mahdi

    2014-07-01

    There are different stress-strain definitions to measure the mechanical properties of the brain tissue. However, there is no agreement as to which stress-strain definition should be employed to measure the mechanical properties of the brain tissue at both the longitudinal and circumferential directions. It is worth knowing that an optimize stress-strain definition of the brain tissue at different loading directions may have implications for neuronavigation and surgery simulation through haptic devices. This study is aimed to conduct a comparative study on different results are given by the various definitions of stress-strain and to recommend a specific definition when testing brain tissues. Prepared cylindrical samples are excised from the parietal lobes of rats' brains and experimentally tested by applying load on both the longitudinal and circumferential directions. Three stress definitions (second Piola-Kichhoff stress, engineering stress, and true stress) and four strain definitions (Almansi-Hamel strain, Green-St. Venant strain, engineering strain, and true strain) are used to determine the elastic modulus, maximum stress and strain. The highest non-linear stress-strain relation is observed for the Almansi-Hamel strain definition and it may overestimate the elastic modulus at different stress definitions at both the longitudinal and circumferential directions. The Green-St. Venant strain definition fails to address the non-linear stress-strain relation using different definitions of stress and triggers an underestimation of the elastic modulus. The results suggest the application of the true stress-true strain definition for characterization of the brain tissues mechanics since it gives more accurate measurements of the tissue's response using the instantaneous values.

  6. Definition of the dose(tempo)-distribution in the biological irradiation-facility of the RIVM

    International Nuclear Information System (INIS)

    Bader, F.J.M.

    1990-02-01

    The RIVM biological irradiation facility (BBF) for the irradiation of biological samples and small animals is a self shielded device and can be safely operated in an existing laboratory environment. There are two 137 Cs sources (15TBq) in a bilateral geometry to give maximum dose uniformity. The easily accessible irradiation chamber is housed in a rotating lead shielding. The dosimetry of BBF was performed by the Dosimetry Section of the RIVM. Experiments were made to determine the absorbed dose in plastic tubes filled with water and the dose distribution over the tube-holder. Separate experiments were made to determine the absorbed dose during the rotation of the irradiation chamber and to check the irradiation timer. For the experiments LiF:Mg,Ti (TLD-100) extruded ribbons were used. The TLDs were calibrated in a collimated beam of 137 Cs gamma rays. The determination of the absorbed dose in water was based on a users biological irradiation set up. The TLDs were individually sealed in thin plastic foil and put in plastic tubes filled for 1/3 with water. The tubes were vertically placed in the tube-holder and placed in the centre of the irradiation chamber. The results show that the absorbed dose in water (determined on January 1, 1990) is equal to 0.97 Gy/timer-unit, with a total uncertainty of 7 percent (1σ). During the rotation of the irradiation chamber the absorbed dose (determined on January 1, 1990) is equal to 0.38 Gy, with a total uncertainty of 15 percent (1σ). The variation of the dose distribution was determined at 15 different measurement points distributed over the tube-holder. The dosis in the measurement point in the centre of the tube-holder was taken as reference value. The maximum observed deviation over the other 14 measurement points amounts to -16 percent of it. The BBF-timer was checked against a special timer. The results indicate that within a range from 2-11 'timer-units' no differences are present. (author). 6 refs.; 6 figs.; 3 fotos

  7. Dose escalation using conformal high-dose-rate brachytherapy improves outcome in unfavorable prostate cancer

    International Nuclear Information System (INIS)

    Martinez, Alvaro A.; Gustafson, Gary; Gonzalez, Jose; Armour, Elwood; Mitchell, Chris; Edmundson, Gregory; Spencer, William; Stromberg, Jannifer; Huang, Raywin; Vicini, Frank

    2002-01-01

    Purpose: To overcome radioresistance for patients with unfavorable prostate cancer, a prospective trial of pelvic external beam irradiation (EBRT) interdigitated with dose-escalating conformal high-dose-rate (HDR) prostate brachytherapy was performed. Methods and Materials: Between November 1991 and August 2000, 207 patients were treated with 46 Gy pelvic EBRT and increasing HDR brachytherapy boost doses (5.50-11.5 Gy/fraction) during 5 weeks. The eligibility criteria were pretreatment prostate-specific antigen level ≥10.0 ng/mL, Gleason score ≥7, or clinical Stage T2b or higher. Patients were divided into 2 dose levels, low-dose biologically effective dose 93 Gy (149 patients). No patient received hormones. We used the American Society for Therapeutic Radiology and Oncology definition for biochemical failure. Results: The median age was 69 years. The mean follow-up for the group was 4.4 years, and for the low and high-dose levels, it was 7.0 and 3.4 years, respectively. The actuarial 5-year biochemical control rate was 74%, and the overall, cause-specific, and disease-free survival rate was 92%, 98%, and 68%, respectively. The 5-year biochemical control rate for the low-dose group was 52%; the rate for the high-dose group was 87% (p<0.001). Improvement occurred in the cause-specific survival in favor of the brachytherapy high-dose level (p=0.014). On multivariate analysis, a low-dose level, higher Gleason score, and higher nadir value were associated with increased biochemical failure. The Radiation Therapy Oncology Group Grade 3 gastrointestinal/genitourinary complications ranged from 0.5% to 9%. The actuarial 5-year impotency rate was 51%. Conclusion: Pelvic EBRT interdigitated with transrectal ultrasound-guided real-time conformal HDR prostate brachytherapy boost is both a precise dose delivery system and a very effective treatment for unfavorable prostate cancer. We demonstrated an incremental beneficial effect on biochemical control and cause

  8. Competing Definitions of Schizophrenia: What Can Be Learned From Polydiagnostic Studies?

    DEFF Research Database (Denmark)

    Jansson, Lennart Bertil; Parnas, Josef

    2007-01-01

    The contemporary diagnoses of schizophrenia (sz)—Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and International Classification of Diseases,10th Revision (ICD-10)—are widely considered as important scientific achievements. However, these algorithms were...... not a product of explicit conceptual analyses and empirical studies but defined through consensus with the purpose of improving reliability. The validity status of current definitions and of their predecessors remains unclear. The so-called "polydiagnostic approach" applies different definitions of a disorder...

  9. A simple method for estimating the effective dose in dental CT. Conversion factors and calculation for a clinical low-dose protocol

    International Nuclear Information System (INIS)

    Homolka, P.; Kudler, H.; Nowotny, R.; Gahleitner, A.; Wien Univ.

    2001-01-01

    An easily appliable method to estimate effective dose including in its definition the high radio-sensitivity of the salivary glands from dental computed tomography is presented. Effective doses were calculated for a markedly dose reduced dental CT protocol as well as for standard settings. Data are compared with effective doses from the literature obtained with other modalities frequently used in dental care. Methods: Conversion factors based on the weighted Computed Tomography Dose Index were derived from published data to calculate effective dose values for various CT exposure settings. Results: Conversion factors determined can be used for clinically used kVp settings and prefiltrations. With reduced tube current an effective dose for a CT examination of the maxilla of 22 μSv can be achieved, which compares to values typically obtained with panoramic radiography (26 μSv). A CT scan of the mandible, respectively, gives 123 μSv comparable to a full mouth survey with intraoral films (150 μSv). Conclusion: For standard CT scan protocols of the mandible, effective doses exceed 600 μSv. Hence, low dose protocols for dental CT should be considered whenever feasable, especially for paediatric patients. If hard tissue diagnoses is performed, the potential of dose reduction is significant despite the higher image noise levels as readability is still adequate. (orig.) [de

  10. Study of dose distribution in high energy photon beam used in radiotherapy

    International Nuclear Information System (INIS)

    Rafaravavy, R.; Raoelina Andriambololona; Bridier, A.

    2007-01-01

    The dose distribution in a medium traversed by a photon beam depends on beam energy, field size and medium nature. Percent depth dose (PDD), Dose Profile (DP) and Opening Collimator Factor (OCF) curves will be established to study this distribution. So, the PDD curves are composed by tree parts: the build-up region, the maximal dose and the quasi-equilibrium region. The maximum dose depth and the dose in depth increase with increasing photon beam energy but the dose surface decreases. The PDD increases with increasing field size.

  11. College Students' Definitions of Intimate Partner Violence: A Comparative Study of Three Chinese Societies.

    Science.gov (United States)

    Jiao, Yanpeng; Sun, Ivan Y; Farmer, Ashley K; Lin, Kai

    2016-04-01

    Although a large number of studies have been conducted worldwide to examine various aspects of intimate partner violence (IPV), comparative study of people's views on such violence in Chinese societies has been scarce. Using survey data collected from more than 850 college students in China, Hong Kong, and Taiwan, this study specifically assessed the impact of attitudes toward gender role and violence, personal and vicarious experience, demographic characteristics, and locality on students' definitions of IPV. The Taiwanese students were most likely to define a broader range of abusive behavior as IPV, followed by Hong Kong and Beijing students. Gender role and violence attitudes appeared to be most important predictors of IPV definitions. College students who supported the notion of male dominance were more likely to have a narrower definition of IPV, whereas those who viewed domestic violence as crime were more inclined to have a broader definition of IPV. Implications for future research and policy were discussed. © The Author(s) 2014.

  12. Dose-dependent optically stimulated luminescence of synthetic quartz at room temperature

    International Nuclear Information System (INIS)

    Kale, Y.D.; Gandhi, Y.H.; Gartia, R.K.

    2008-01-01

    Physical conditions such as annealing temperature, duration of annealing, ionizing radiation, etc., play a significant role in the applications of optically stimulated luminescence (OSL) dating as well as OSL dosimetry. Many efforts are made to understand the effect of these physical parameters on quartz specimens owing to its use in such applications. Such factors induce changes in OSL decay pattern. The definite correlation between color centers and luminescence sensitivity can be established on account of such pre-treatments to the specimen. The purpose of present investigations is to study the effect of ionizing radiation under identical physical conditions on OSL properties measured at room temperature. The shapes of decay curve and dose-response data are considered for this purpose. This study can reveal the changes in color centers in response to the pre-conditions to the specimen. It was found that the OSL decay remains slow and OSL properties change systematically with the rise in beta dose up to a critical dose; however, it changes the pattern when the beta exposure to the specimen was increased higher than the critical dose. This critical dose was found to be different for different temperature of annealing. The shape of decay curve up to the critical dose was also studied by considering the difference of OSL intensities between two successive durations from the observed OSL decay data. The results are explained based on the changes in available shallow traps during OSL measurement at room temperature with changes in pre-conditions to the specimens. The results also have been confirmed with the corresponding changes in ESR signals

  13. Take with Food: Study Tests Lowering Dose of Prostate Cancer Drug

    Science.gov (United States)

    ... Cancer Currents Blog Cancer Currents Blog Take with Food: Study Tests Lowering Dose of Prostate Cancer Drug Subscribe April ... to this page included, e.g., “Take with Food: Study Tests Lowering Dose of Prostate Cancer Drug was originally ...

  14. Efficacy and Tolerability of High-Dose Escitalopram in Posttraumatic Stress Disorder.

    Science.gov (United States)

    Qi, Wei; Gevonden, Martin; Shalev, Arieh

    2017-02-01

    Open-label trials suggest that escitalopram (up to 20 mg/d) is an effective treatment for some, but not all posttraumatic stress disorder (PTSD) patients. Higher doses of escitalopram effectively reduced major depression symptoms in patients who had not responded to regular doses. The current study examines the efficacy, tolerability, and adherence to high-dose escitalopram in PTSD. Forty-five PTSD patients received 12 weeks of gradually increasing doses of escitalopram reaching 40 mg daily at 4 weeks. Among those, 12 participants received regular doses of antidepressants at study onset including escitalopram (n = 7). The Clinician-Administered PTSD Scale (CAPS) evaluated PTSD symptoms severity before treatment, at 3 months (upon treatment termination), and at 6 months (maintenance effect). A 20% reduction in CAPS scores was deemed clinically significant. Adverse events and medication adherence were monitored at each clinical session. Linear mixed-models analysis showed a significant reduction of mean CAPS scores (11.5 ± 18.1 points) at 3 months and maintenance of gains by 6 months (F2,34.56 = 8.15, P = 0.001). Eleven participants (34.3%) showed clinically significant improvement at 3 months. Only 9 participants (20%) left the study. There were no serious adverse events and few mild ones with only 2 adverse events (diarrhea, 11.1%; drowsiness, 11.1%) reported by more than 10% of participants. High doses of escitalopram are tolerable and well adhered to in PTSD. Their beneficial effect at a group level is due to a particularly good response in a subset of patients.Variability in prior pharmacological treatment precludes a definite attribution of the results to high doses of escitalopram.

  15. Multilevel mechanisms of stimulatory effect of low dose radiation on immunity

    International Nuclear Information System (INIS)

    Shu-Zeng Liu

    1992-01-01

    Attention is paid to the effects of low level ionizing radiation on humans. The conference is devoted to low dose radiation and defense mechanisms of the body. Due to the importance of the immune system in body resistance, special attention has been given to host defense mechanisms following exposure to different doses of ionizing radiation. The immune system has long been known to be highly sensitive to moderate to high doses of ionizing radiation with immuno-depression as one of the most important causes of death in acute radiation syndrome. However, the dose-effect relationship of immune functions has been found to be quite different in the low dose range, especially with doses within 0.1 Gy. With doses above 0.5 Gy most immunologic parameters show a dose dependent depression. With doses between 0.1-0.5 Gy there may be no definite changes in immune functions. Doses within 0.1 Gy, given in single or chronic exposures, have been found to stimulate many immune responses. (author). 16 refs., 2 figs., 7 tabs

  16. Low dose ionizing radiation exposure and cardiovascular disease mortality: cohort study based on Canadian national dose registry of radiation workers

    International Nuclear Information System (INIS)

    Zielinski, J. M.; Band, P. R.; Ashmore, P. J.; Jiang, H.; Shilnikova, N. S.; Tait, V. K.; Krewski, D.

    2009-01-01

    The purpose of our study was to assess the risk of cardiovascular disease (CVD) mortality in a Canadian cohort of 337 397 individuals (169 256 men and 168 141 women) occupationally exposed to ionizing radiation and included in the National Dose Registry (NDR) of Canada. Material and Methods: Exposure to high doses of ionizing radiation, such as those received during radiotherapy, leads to increased risk of cardiovascular diseases. The emerging evidence of excess risk of CVDs after exposure to doses well below those previously considered as safe warrants epidemiological studies of populations exposed to low levels of ionizing radiation. In the present study, the cohort consisted of employees at nuclear power stations (nuclear workers) as well as medical, dental and industrial workers. The mean whole body radiation dose was 8.6 mSv for men and 1.2 mSv for women. Results: During the study period (1951 - 1995), as many as 3 533 deaths from cardiovascular diseases have been identified (3 018 among men and 515 among women). In the cohort, CVD mortality was significantly lower than in the general population of Canada. The cohort showed a significant dose response both among men and women. Risk estimates of CVD mortality in the NDR cohort, when expressed as excess relative risk per unit dose, were higher than those in most other occupational cohorts and higher than in the studies of Japanese atomic bomb survivors. Conclusions: The study has demonstrated a strong positive association between radiation dose and the risk of CVD mortality. Caution needs to be exercised when interpreting these results, due to the potential bias introduced by dosimetry uncertainties, the possible record linkage errors, and especially by the lack of adjustment for non-radiation risk factors. (authors)

  17. Increasing the Stimulation Dose of rFSH in Unexpected Poor Responders Is Not Associated with Better IVF Outcome

    Directory of Open Access Journals (Sweden)

    Levent Tutuncu

    2012-01-01

    Full Text Available The aim of this retrospective study is to determine whether increasing the stimulation dose of rFSH in unexpected poor responders is associated with better in vitro fertilization (IVF outcome or not. A total of forty eligible women who fulfilled our definition of poor responders and who did not achieve an ongoing pregnancy in the first cycle and returned for a second higher rFSH dose IVF cycle with a long-agonist protocol were included to the study. The first low-dose cycles and the second high-dose cycles were compared to each other. Main outcome measures of the study were duration of stimulation, number of follicles, number of oocytes retrieved, number of embryos, and E2 level on day of hCG injection. There were no significant differences in duration of stimulation, number of follicles, number of oocytes retrieved, number of embryos, and E2 level on day of hCG injection between the first low- and second high-dose cycles. Daily dose and total dose of rFSH were significantly higher in the second high-dose cycles. Increasing the dose of rFSH in a second stimulation cycle after first unsuccessful treatment cycle will add only to the cost and discomfort of the treatment and might adversely affect pregnancy rates.

  18. Word Definitional Skills in School age Persian Speaking Children: A Developmental Study on Form

    Directory of Open Access Journals (Sweden)

    Talieh Zarifian

    2015-09-01

    Full Text Available Objectives: Word definitional skills (WDSs were classified according to the quality of both semantic content and syntactic form. The aim of the present study was to investigate the syntactic development in WDSs in typically developing school- age children. Methods: In this cross-sectional and descriptive-analytical study,  150 of typically developing school-age children participated by the  multistage sampling method in the second to sixth grade from primary schools in 1, 7 and 17 municipal  districts of Tehran. The definition skill was assessed with word definition task. The reliability was assessed by two independent values and the validity was determined by the content. The results were  analyzed by the SPSS (22th version  statistical software and with the method of independent- samples T test, univariate analysis of variance and Tukey test. Results: The form analysis revealed that all children use phrase/clause  or simple sentence, transitional form and Aristotelian form frequently, but by increasing the age, definitions were developed from simple syntactic structure into Aristotelian form, in fact mean score of the form in word definition was significantly increased by age (P<0.001. Discussion: Owing to the findings of this study, the development of word definitional skills in terms of form was developed from phrase/clause or simple sentence and transitional form responses into Aristotelian form. Also WDSs are closely related to academic success and the development of literacy.

  19. Building a Definition of Irritability From Academic Definitions and Lay Descriptions.

    Science.gov (United States)

    Barata, Paula C; Holtzman, Susan; Cunningham, Shannon; O'Connor, Brian P; Stewart, Donna E

    2016-04-08

    The current work builds a definition of irritability from both academic definitions and lay perspectives. In Study 1, a quantitative content analysis of academic definitions resulted in eight main content categories (i.e., behaviour, emotion or affect, cognition, physiological, qualifiers, irritant, stability or endurance, and other). In Study 2, a community sample of 39 adults participated in qualitative interviews. A deductive thematic analysis resulted in two main themes. The first main theme dealt with how participants positioned irritability in relation to other negative states. The second dealt with how participants constructed irritability as both a loss of control and as an experience that should be controlled. The discussion integrates the findings of both studies and provides a concise, but comprehensive definition.

  20. Repeated dose studies with pure Epigallocatechin-3-gallate demonstrated dose and route dependant hepatotoxicity with associated dyslipidemia.

    Science.gov (United States)

    Ramachandran, Balaji; Jayavelu, Subramani; Murhekar, Kanchan; Rajkumar, Thangarajan

    2016-01-01

    EGCG (Epigallocatechin-3-gallate) is the major active principle catechin found in green tea. Skepticism regarding the safety of consuming EGCG is gaining attention, despite the fact that it is widely being touted for its potential health benefits, including anti-cancer properties. The lack of scientific data on safe dose levels of pure EGCG is of concern, while EGCG has been commonly studied as a component of GTE (Green tea extract) and not as a single active constituent. This study has been carried out to estimate the maximum tolerated non-toxic dose of pure EGCG and to identify the treatment related risk factors. In a fourteen day consecutive treatment, two different administration modalities were compared, offering an improved [i.p (intraperitoneal)] and limited [p.o (oral)] bioavailability. A trend of dose and route dependant hepatotoxicity was observed particularly with i.p treatment and EGCG increased serum lipid profile in parallel to hepatotoxicity. Fourteen day tolerable dose of EGCG was established as 21.1 mg/kg for i.p and 67.8 mg/kg for p.o. We also observed that, EGCG induced effects by both treatment routes are reversible, subsequent to an observation period for further fourteen days after cessation of treatment. It was demonstrated that the severity of EGCG induced toxicity appears to be a function of dose, route of administration and period of treatment.

  1. Radiation therapy tolerance doses for treatment planning

    International Nuclear Information System (INIS)

    Lyman, J.T.

    1987-01-01

    To adequately plan acceptable dose distributions for radiation therapy treatments it is necessary to ensure that normal structures do not receive unacceptable doses. Acceptable doses are generally those that are below a stated tolerance dose for development of some level of complication. To support the work sponsored by the National Cancer Institute, data for the tolerance of normal tissues or organs to low-LET radiation has been compiled from a number of sources. These tolerance dose data are ostensibly for uniform irradiation of all or part of an organ, and are for either 5% (TD 5 ) or 50% (TD 50 ) complication probability. The ''size'' of the irradiated organ is variously stated in terms of the absolute volume or the fraction of the organ volume irradiated, or the area or the length of the treatment field. The accuracy of these data is questionable. Much of the data represent doses that one or several experienced therapists have estimated could be safely given rather than quantitative analyses of clinical observations. Because these data have been obtained from multiple sources with possible different criteria for the definition of a complication, there are sometimes different values for what is apparently the same end point. 20 refs., 1 fig., 1 tab

  2. Definitive radiotherapy for extramedullary plasmacytomas of the head and neck.

    Science.gov (United States)

    Michalaki, V J; Hall, J; Henk, J M; Nutting, C M; Harrington, K J

    2003-10-01

    Extramedullary plasmacytoma of the head and neck region (EMPHN) is an uncommon malignant plasma cell neoplasm. In this study we conducted a retrospective analysis of our experience of EMPHN with particular emphasis on the role of definitive radiotherapy. From 1982 to 2001, 10 patients (6 males, 4 females) with EMPHN were treated in our institution. Of nine patients treated at initial diagnosis, all received definitive radiotherapy. One patient treated at relapse underwent surgical resection followed by post-operative radiotherapy. The median age at diagnosis was 55 years (range 35-84 years). The disease was most frequently localized in the paranasal sinuses (50%). All nine patients who received definitive radiotherapy at a dose of 40-50 Gy achieved a complete response. The median follow up period was 29 months (range 7-67 months). Four patients (40%) relapsed, three have died of their disease. Two patients (20%) with paranasal sinus disease subsequently relapsed with multiple myeloma at 10 months and 24 months, respectively. Our results indicate that treatment of EMPHN with radiotherapy achieves excellent rates of local control. The relapse rate in neck nodes of 10% does not justify elective irradiation of the uninvolved neck.

  3. Zero-gravity cloud physics laboratory: Candidate experiments definition and preliminary concept studies

    Science.gov (United States)

    Eaton, L. R.; Greco, R. V.; Hollinden, A. B.

    1973-01-01

    The candidate definition studies on the zero-g cloud physics laboratory are covered. This laboratory will be an independent self-contained shuttle sortie payload. Several critical technology areas have been identified and studied to assure proper consideration in terms of engineering requirements for the final design. Areas include chambers, gas and particle generators, environmental controls, motion controls, change controls, observational techniques, and composition controls. This unique laboratory will allow studies to be performed without mechanical, aerodynamics, electrical, or other type techniques to support the object under study. This report also covers the candidate experiment definitions, chambers and experiment classes, laboratory concepts and plans, special supporting studies, early flight opportunities and payload planning data for overall shuttle payload requirements assessments.

  4. Definition of Videogames

    Directory of Open Access Journals (Sweden)

    Grant Tavinor

    2008-01-01

    Full Text Available Can videogames be defined? The new field of games studies has generated three somewhat competing models of videogaming that characterize games as new forms of gaming, narratives, and interactive fictions. When treated as necessary and sufficient condition definitions, however, each of the three approaches fails to pick out all and only videogames. In this paper I argue that looking more closely at the formal qualities of definition helps to set out the range of definitional options open to the games theorist. A disjunctive definition of videogaming seems the most appropriate of these definitional options. The disjunctive definition I offer here is motivated by the observation that there is more than one characteristic way of being a videogame.

  5. Pulsed total dose damage effect experimental study on EPROM

    International Nuclear Information System (INIS)

    Luo Yinhong; Yao Zhibin; Zhang Fengqi; Guo Hongxia; Zhang Keying; Wang Yuanming; He Baoping

    2011-01-01

    Nowadays, memory radiation effect study mainly focus on functionality measurement. Measurable parameters is few in china. According to the present situation, threshold voltage testing method was presented on floating gate EPROM memory. Experimental study of pulsed total dose effect on EPROM threshold voltage was carried out. Damage mechanism was analysed The experiment results showed that memory cell threshold voltage negative shift was caused by pulsed total dose, memory cell threshold voltage shift is basically coincident under steady bias supply and no bias supply. (authors)

  6. Fallout, radiation doses near Dounreay, and childhood leukaemia

    International Nuclear Information System (INIS)

    Darby, S.C.; Doll, Richard

    1987-01-01

    Possible explanations for the recently reported increased incidence of childhood leukaemia around Dounreay were examined in the light of changes in the national incidence of leukaemia that occurred during the period of exposure to fallout from international testing of nuclear weapons in the atmosphere. It was concluded that the increase could not be accounted for by underestimate of the risk of leukaemia per unit dose of radiation at low doses and low dose rates, nor by underestimate of the relative biological efficiency of high compared with low linear energy transfer radiation. One possible explanation was underestimation of doses to the red bone marrow due to the discharges at Dounreay relative to dose from fallout, though investigation of ways in which this might have occurred did not suggest anything definite. Other explanations included a misconception of the site of origin of childhood leukaemia, outbreaks of an infectious disease and exposure to other, unidentified environmental agents. These findings weigh against the hypothesis that the recent increase in childhood leukaemia near Dounreay might be accounted for by radioactive discharges from nuclear plants, unless the doses to the stem cells from which childhood leukaemia originates have been grossly underestimated. (author)

  7. Definitions of medication-overuse headache in population-based studies and their implications on prevalence estimates

    DEFF Research Database (Denmark)

    Westergaard, Maria L; Hansen, Ebba Holme; Glümer, Charlotte

    2014-01-01

    Case definitions of medication-overuse headache (MOH) in population-based research have changed over time. This study aims to review MOH prevalence reports with respect to these changes, and to propose a practical case definition for future studies based on the ICHD-3 beta....

  8. Zero-gravity cloud physics laboratory: Experiment program definition and preliminary laboratory concept studies

    Science.gov (United States)

    Eaton, L. R.; Greco, E. V.

    1973-01-01

    The experiment program definition and preliminary laboratory concept studies on the zero G cloud physics laboratory are reported. This program involves the definition and development of an atmospheric cloud physics laboratory and the selection and delineations of a set of candidate experiments that must utilize the unique environment of zero gravity or near zero gravity.

  9. Study of radiation dose reduction of buildings of different sizes and materials

    International Nuclear Information System (INIS)

    Furuta, Takuya; Takahashi, Fumiaki

    2015-01-01

    The dependence of radiation dose reduction on the sizes and materials of buildings was studied by numerical analyses using the Monte Carlo simulation code, PHITS. The dose rates inside the buildings were calculated by simulating gamma-ray transport from radioactive cesium deposited at the ground surface. Three building models were developed: the wooden house, the open-space concrete building, and the thin-wall building, to study the effect of building size and construction material on dose reduction inside these structures. Here the floor-area sizes of the building models were varied to clarify the influence of building configuration on dose reduction. The results demonstrated that the dose rates inside the buildings linearly decreased with increasing floor area on a logarithmic scale for all types of buildings considered. The calculated dose distribution inside a building indicated that the distance from the outer walls was a determining factor for the dose rate at each position in the building. The obtained tendency was verified by comparison with data reflecting the dose reduction of typical buildings in Japan. (author)

  10. Impact of target reproducibility on tumor dose in stereotactic radiotherapy of targets in the lung and liver.

    Science.gov (United States)

    Wulf, Jörn; Hädinger, Ulrich; Oppitz, Ulrich; Thiele, Wibke; Flentje, Michael

    2003-02-01

    Previous analyses of target reproducibility in extracranial stereotactic radiotherapy have revealed standard security margins for planning target volume (PTV) definition of 5mm in axial and 5-10mm in longitudinal direction. In this study the reproducibility of the clinical target volume (CTV) of lung and liver tumors within the PTV over the complete course of hypofractionated treatment is evaluated. The impact of target mobility on dose to the CTV is assessed by dose-volume histograms (DVH). Twenty-two pulmonary and 21 hepatic targets were treated with three stereotactic fractions of 10 Gy to the PTV-enclosing 100%-isodose with normalization to 150% at the isocenter. A conformal dose distribution was related to the PTV, which was defined by margins of 5-10mm added to the CTV. Prior to each fraction a computed tomography (CT)-simulation over the complete target volume was performed resulting in a total of 60 CT-simulations for lung and 58 CT-simulations for hepatic targets. The CTV from each CT-simulation was segmented and matched with the CT-study used for treatment planning. A DVH of the simulated CTV was calculated for each fraction. The target coverage (TC) of dose to the simulated CTV was defined as the proportion of the CTV receiving at least the reference dose (100%). A decrease of TC to or=95% at each fraction of treatment. Pulmonary targets with increased breathing mobility and liver tumors >100 cm(3) are at risk for target deviation exceeding the standard security margins for PTV-definition at least for one fraction and require individual evaluation of sufficient margins.

  11. Antipsychotic treatment dosing profile in patients with schizophrenia evaluated with electronic monitoring (MEMS®).

    Science.gov (United States)

    Acosta, Francisco J; Ramallo-Fariña, Yolanda; Bosch, Esperanza; Mayans, Teresa; Rodríguez, Carlos J; Caravaca, Ana

    2013-05-01

    Although the Medication Event Monitoring System (MEMS®) device offers accurate information on treatment dosing profile, such profile has never been studied in patients with schizophrenia. Enhancing our knowledge on this issue would help in developing intervention strategies to improve adherence to antipsychotic treatment in these patients. 74 outpatients with schizophrenia were monitored with the MEMS device for a 3-month period, for evaluation of antipsychotic treatment dosing profile, possible influence of medication schedule-related variables, adherence to treatment--considering dose intake within prescribed timeframes--and possible Hawthorne's effect of using the MEMS device. Dose-omission gaps occurred in 18.7% of monitoring days, most frequently during weekends, almost significantly. Almost one-third of prescribed doses were taken out of prescribed time. Neither the prescribed number of daily doses nor the indicated time of the day for dose intake (breakfast, dinner), were associated with correct antipsychotic dosing. Excess-dose was rare in general, and more frequent out of prescribed dose timeframe. No Hawthorne's effect was found for the MEMS device. Adherence reached only 35% according to a definition that included dose intake within prescribed timeframes. Antipsychotic treatment dosing was considerably irregular among patients with schizophrenia. Strategies to reduce dose-omission gaps and increase dosing within prescribed timeframes seem to be necessary. Gaining knowledge on precise oral antipsychotic dosing profiles or the influence of schedule-related variables may be useful to design strategies towards enhancing adherence. There appears to be no Hawthorne's effect associated with the use of MEMS devices in outpatients with schizophrenia. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Dual energy CT of the chest: how about the dose?

    Science.gov (United States)

    Schenzle, Jan C; Sommer, Wieland H; Neumaier, Klement; Michalski, Gisela; Lechel, Ursula; Nikolaou, Konstantin; Becker, Christoph R; Reiser, Maximilian F; Johnson, Thorsten R C

    2010-06-01

    New generation Dual Source computed tomography (CT) scanners offer different x-ray spectra for Dual Energy imaging. Yet, an objective, manufacturer independent verification of the dose required for the different spectral combinations is lacking. The aim of this study was to assess dose and image noise of 2 different Dual Energy CT settings with reference to a standard chest scan and to compare image noise and contrast to noise ratios (CNR). Also, exact effective dose length products (E/DLP) conversion factors were to be established based on the objectively measured dose. An anthropomorphic Alderson phantom was assembled with thermoluminescent detectors (TLD) and its chest was scanned on a Dual Source CT (Siemens Somatom Definition) in dual energy mode at 140 and 80 kVp with 14 x 1.2 mm collimation. The same was performed on another Dual Source CT (Siemens Somatom Definition Flash) at 140 kVp with 0.8 mm tin filter (Sn) and 100 kVp at 128 x 0.6 mm collimation. Reference scans were obtained at 120 kVp with 64 x 0.6 mm collimation at equivalent CT dose index of 5.4 mGy*cm. Syringes filled with water and 17.5 mg iodine/mL were scanned with the same settings. Dose was calculated from the TLD measurements and the dose length products of the scanner. Image noise was measured in the phantom scans and CNR and spectral contrast were determined in the iodine and water samples. E/DLP conversion factors were calculated as ratio between the measured dose form the TLDs and the dose length product given in the patient protocol. The effective dose measured with TLDs was 2.61, 2.69, and 2.70 mSv, respectively, for the 140/80 kVp, the 140 Sn/100 kVp, and the standard 120 kVp scans. Image noise measured in the average images of the phantom scans was 11.0, 10.7, and 9.9 HU (P > 0.05). The CNR of iodine with optimized image blending was 33.4 at 140/80 kVp, 30.7 at 140Sn/100 kVp and 14.6 at 120 kVp. E/DLP conversion factors were 0.0161 mSv/mGy*cm for the 140/80 kVp protocol, 0.0181 m

  13. New definition for the partial remission period in children and adolescents with type 1 diabetes

    DEFF Research Database (Denmark)

    Mortensen, Henrik B; Hougaard, Philip; Swift, Peter

    2009-01-01

    OBJECTIVE To find a simple definition of partial remission in type 1 diabetes that reflects both residual beta-cell function and efficacy of insulin treatment. RESEARCH DESIGN AND METHODS A total of 275 patients aged ..., stimulated C-peptide during a challenge was used as a measure of residual beta-cell function. RESULTS By multiple regression analysis, a negative association between stimulated C-peptide and A1C (regression coefficient -0.21, P ... the definition of an insulin dose-adjusted A1C (IDAA1C) as A1C (percent) + [4 x insulin dose (units per kilogram per 24 h)]. A calculated IDAA1C 300 pmol/l was used to define partial remission. The IDAA1C

  14. A Monte Carlo Study of dose enhancement according to the enhancement agents

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Hoon; Kim, Chang Soo [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Busan (Korea, Republic of); Hwang, Chul Hwan [Dept. of Radiation Oncology, Pusan National University Hospital, Busan (Korea, Republic of)

    2017-03-15

    Dose enhancement effects at megavoltage (MV) X and γ-ray energies, and the effects of different energy levels on incident energy, dose enhancement agents, and concentrations were analyzed using Monte Carlo simulations. Gold, gadolinium, Iodine, and iron oxide (Fe2O3) were compared as dose enhancement agents. For incident energy, 4, 6, 10 and 15 MV X-ray spectra produced by a linear accelerator and a Co60 γ-ray were used. The dose enhancement factor (DEF) was calculated using an ICRU Slab phantom for concentrations of 7, 18, and 30 mg/g. The DEF was higher at higher concentrations of dose enhancement agents and at lower incident energies. The calculated DEF ranged from 1.035 to 1.079, and dose enhancement effects were highest for iron oxide, followed by iodine, gadolinium, and gold. Thus, this study contributes to improving the therapeutic ratio by delivering larger doses of radiation to tumor volume, and provides data to support further in vivo and in vitro studies.

  15. 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)

  16. Laparoscopic cholecystectomy under spinal anesthesia: comparative study between conventional-dose and low-dose hyperbaric bupivacaine

    Directory of Open Access Journals (Sweden)

    Imbelloni LE

    2011-10-01

    Full Text Available Luiz Eduardo Imbelloni1, Raphael Sant'Anna2, Marcos Fornasari2, José Carlos Fialho21Department of Anesthesiology, Faculty of Medecine Nova Esperança, Hospital de Mangabeira, João Pessoa, 2Hospital Rio Laranjeiras, Rio de Janeiro, BrazilBackground: Laparoscopic cholecystectomy has the advantages of causing less postoperative pain and requiring a short hospital stay, and therefore is the treatment of choice for cholelithiasis. This study was designed to compare spinal anesthesia using hyperbaric bupivacaine given as a conventional dose by lumbar puncture or as a low-dose by thoracic puncture.Methods: A total of 140 patients with symptomatic gallstone disease were randomized to undergo laparoscopic cholecystectomy with low-pressure CO2 pneumoperitoneum under spinal anesthesia using either conventional lumbar spinal anesthesia (hyperbaric bupivacaine 15 mg and fentanyl 20 mg or low-dose thoracic spinal anesthesia (hyperbaric bupivacaine 7.5 mg and fentanyl 20 µg. Intraoperative parameters, postoperative pain, complications, recovery time, and patient satisfaction at follow-up were compared between the two treatment groups.Results: All procedures were completed under spinal anesthesia, with no cases needing conversion to general anesthesia. Values for time for block to reach the T3 dermatomal level, duration of motor and sensory block, and hypotensive events were significantly lower with low-dose bupivacaine. Postoperative pain was higher for low-dose hyperbaric bupivacaine at 6 and 12 hours. All patients were discharged after 24 hours. Follow-up 1 week postoperatively showed all patients to be satisfied and to be keen advocates of spinal anesthesia.Conclusion: Laparoscopic cholecystectomy can be performed successfully under spinal anesthesia. A small dose of hyperbaric bupivacaine 7.5 mg and 20 µg fentanyl provides adequate spinal anesthesia for laparoscopy and, in comparison with hyperbaric bupivacaine 15% and fentanyl 20 µg, causes markedly

  17. [What is a "poison"? Proposal of definition].

    Science.gov (United States)

    Guitart, Raimon; Giménez, Nuria

    2012-02-18

    We discuss different interpretations of the term poison as well as the need of bringing up to date the changes in this matter according to the science progress. A clear and exact definition is proposed after analysing the factors that affect the relativity of the concept and its boundaries. The proposal for a definition is presented taking into account the most broadly extended concepts concerning its significance. That is to say: "a poison is, for human beings and their non-pathogenic and non-harmful biological environment, an electromagnetic or corpuscular radiation, or a non-infectious chemical agent, structured no larger in size than a small particle or fibre that, after being generated internally or after contact, penetration and/or absorption by a live organism, in sufficiently high dose, can produce or produces a direct or indirect adverse effect unrelated to its temperature or measurable electrical potential difference". The scientific knowledge needs accurate definitions to avoid ambiguities. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  18. Low-Dose and Standard-Dose Unenhanced Helical Computed Tomography for the Assessment of Acute Renal Colic: Prospective Comparative Study

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bong Soo; Hwang, Im Kyung; Choi, Yo Won; Namkung, Sook; Kim, Heung Cheol; Hwang, Woo Cheol; Choi, Kuk Myung; Park, Ji Kang; Han, Tae Il; Kang, Weechang [Cheju National Univ. College of Medicine, Jeju (Korea, Republic of). Dept. of Diagnostic Radiology

    2005-11-01

    Purpose: To compare the efficacy of low-dose and standard-dose computed tomography (CT) for the diagnosis of ureteral stones. Material and Methods: Unenhanced helical CT was performed with both a standard dose (260 mAs, pitch 1.5) and a low dose (50 mAs, pitch 1.5) in 121 patients suspected of having acute renal colic. The two studies were prospectively and independently interpreted for the presence and location of ureteral stones, abnormalities unrelated to stone disease, identification of secondary signs, i.e. hydronephrosis and perinephric stranding, and tissue rim sign. The standard-dose CT images were interpreted by one reviewer and the low-dose CT images independently by two reviewers unaware of the standard-dose CT findings. The findings of the standard and low-dose CT scans were compared with the exact McNemar test. Interobserver agreements were assessed with kappa analysis. The effective radiation doses resulting from two different protocols were calculated by means of commercially available software to which the Monte-Carlo phantom model was given. Results: The sensitivity, specificity, and accuracy of standard-dose CT for detecting ureteral stones were 99%, 93%, and 98%, respectively, whereas for the two reviewers the sensitivity of low-dose CT was 93% and 95%, specificity 86%, and accuracy 92% and 94%. We found no significant differences between standard-dose and low-dose CT in the sensitivity and specificity for diagnosing ureter stones ( P >0.05 for both). However, the sensitivity of low-dose CT for detection of 19 stones less than or equal to 2 mm in diameter was 79% and 68%, respectively, for the two reviewers. Low-dose CT was comparable to standard-dose CT in visualizing hydronephrosis and the tissue rim sign. Perinephric stranding was far less clear on low-dose CT. Low-dose CT had the same diagnostic performance as standard-dose CT in diagnosing alternative diseases. Interobserver agreement between the two low-dose CT reviewers in the diagnosis of

  19. Increasing Use of Dose-Escalated External Beam Radiation Therapy for Men With Nonmetastatic Prostate Cancer

    International Nuclear Information System (INIS)

    Swisher-McClure, Samuel; Mitra, Nandita; Woo, Kaitlin; Smaldone, Marc; Uzzo, Robert; Bekelman, Justin E.

    2014-01-01

    Purpose: To examine recent practice patterns, using a large national cancer registry, to understand the extent to which dose-escalated external beam radiation therapy (EBRT) has been incorporated into routine clinical practice for men with prostate cancer. Methods and Materials: We conducted a retrospective observational cohort study using the National Cancer Data Base, a nationwide oncology outcomes database in the United States. We identified 98,755 men diagnosed with nonmetastatic prostate cancer between 2006 and 2011 who received definitive EBRT and classified patients into National Comprehensive Cancer Network (NCCN) risk groups. We defined dose-escalated EBRT as total prescribed dose of ≥75.6 Gy. Using multivariable logistic regression, we examined the association of patient, clinical, and demographic characteristics with the use of dose-escalated EBRT. Results: Overall, 81.6% of men received dose-escalated EBRT during the study period. The use of dose-escalated EBRT did not vary substantially by NCCN risk group. Use of dose-escalated EBRT increased from 70.7% of patients receiving treatment in 2006 to 89.8% of patients receiving treatment in 2011. On multivariable analysis, year of diagnosis and use of intensity modulated radiation therapy were significantly associated with receipt of dose-escalated EBRT. Conclusions: Our study results indicate that dose-escalated EBRT has been widely adopted by radiation oncologists treating prostate cancer in the United States. The proportion of patients receiving dose-escalated EBRT increased nearly 20% between 2006 and 2011. We observed high utilization rates of dose-escalated EBRT within all disease risk groups. Adoption of intensity modulated radiation therapy was strongly associated with use of dose-escalated treatment

  20. Application of a New Established System for Toxic Doses in Children With 4-Hydroxycoumarin Rodenticide Intoxication

    Directory of Open Access Journals (Sweden)

    Li Ye

    2018-05-01

    Full Text Available The toxic dose of rodenticides in children is extremely difficult to be determined because of the uncertain exposure history. We established and validated a method to identify the toxic dose in children of 4-hydroxycoumarin (TDCH. Items were selected by Delphi method and weighted by analytic hierarchy process. Toxic doses were classified into three categories: high dose (>24 points, medium (15-24 and low (<15. Sixty-five children with 4-hydroxycoumarin rodenticide intoxication were included in the study. There were 29(44.6%, 8(12.3%, 28(43.1% cases in high, medium, and low dose respectively. Patients in high-dose were more likely to have intentionally attempted suicide (5/29, 17.2% or had no definite history of ingestion (17/29, 58.6%, arrived at the hospital later than 24 h (26/29, 90%, been misdiagnosed initially (25/29, 86.2%, not treated by gastric lavage (27/29, 93.1%, and developed severe hemorrhage. While most patients in low-dose were younger than 6 years (26/28, 92.9%, all have experienced accidental exposure, arrived at the hospital, and received gastric lavage within 24 h, obtained a definite diagnosis, and be asymptomatic. Of 38 patients arrived at hospital within 48 h, patients a score48h ≥ 15 had higher incidence of coagulopathy (6/8, 75.0% than patients with a score48h < 15 (3/30, 10.0%. Of all patients, 37 in the high and medium dose with a score ≥ 15 has higher incidence (35/37, 94.6% of prolonged administration with vitamin K1 (≥1 month than other 28 patients with a score < 15 (0/28, 0%. The TDCH system could not only be used in evaluating toxic doses and predicting coagulopathy in the early stage, but also helps to guide appropriate treatment. Patients with a score48h ≥ 15 were in the high bleeding risk category. And patients with a scores ≥ 15 required treatment with vitamin K1 for more than a month.

  1. What can be learned from epidemiologic studies of persons exposed to low doses of radiation?

    International Nuclear Information System (INIS)

    Gilbert, E.S.

    1993-04-01

    The main objective of radiation risk assessment is to determine the risk of various adverse health effects associated with exposure to low doses and low dose rates. Extrapolation of risks from studies of persons exposed at high doses (generally exceeding 1 Sv) and dose rates has been the primary approach used to achieve this objective. The study of Japanese atomic bomb survivors in Hiroshima and Nagasaki has played an especially important role in risk assessment efforts. A direct assessment of the dose-response function based on studies of persons exposed at low doses and dose rates is obviously desirable. This paper focuses on the potential of both current and future nuclear workers studies for investigating the dose-response functions at low doses, and also discusses analyses making use of the low dose portion of the atomic bomb survivor data. Difficulties in using these data are the statistical imprecision of estimated dose-response parameters, and potential bias resulting from confounding factors and from uncertainties in dose estimates

  2. Comparison of image quality in head CT studies with different dose-reduction strategies

    DEFF Research Database (Denmark)

    Johansen, Jeppe; Nielsen, Rikke; Fink-Jensen, Vibeke

    The number of multi-detector CT examinations is increasing rapidly. They allow high quality reformatted images providing accurate and precise diagnosis at maximum speed. Brain examinations are the most commonly requested studies, and although they come at a lower effective dose than body CT, can...... account to a considerable radiation dose as many patients undergo repeated studies. Therefore, various dose-reduction strategies are applied such as automated tube current and voltage modulation and recently different iterative reconstruction algorithms. However, the trade-off of all dose......-reduction maneuvers is reduction of image quality due to image noise or artifacts. The aim of our study was therefore to find the best diagnostic images with lowest possible dose. We present results of dose- and image quality optimizing strategies of brain CT examinations at our institution. We compare sequential...

  3. Does expert opinion match the operational definition of the Lupus Low Disease Activity State (LLDAS)? A case-based construct validity study.

    Science.gov (United States)

    Golder, Vera; Huq, Molla; Franklyn, Kate; Calderone, Alicia; Lateef, Aisha; Lau, Chak Sing; Lee, Alfred Lok Hang; Navarra, Sandra Teresa V; Godfrey, Timothy; Oon, Shereen; Hoi, Alberta Yik Bun; Morand, Eric Francis; Nikpour, Mandana

    2017-06-01

    To evaluate the construct validity of the Lupus Low Disease Activity State (LLDAS), a treatment target in systemic lupus erythematosus (SLE). Fifty SLE case summaries based on real patients were prepared and assessed independently for meeting the operational definition of LLDAS. Fifty international rheumatologists with expertise in SLE, but with no prior involvement in the LLDAS project, responded to a survey in which they were asked to categorize the disease activity state of each case as remission, low, moderate, or high. Agreement between expert opinion and LLDAS was assessed using Cohen's kappa. Overall agreement between expert opinion and the operational definition of LLDAS was 77.96% (95% CI: 76.34-79.58%), with a Cohen's kappa of 0.57 (95% CI: 0.55-0.61). Of the cases (22 of 50) that fulfilled the operational definition of LLDAS, only 5.34% (59 of 22 × 50) of responses classified the cases as moderate/high activity. Of the cases that did not fulfill the operational definition of LLDAS (28 of 50), 35.14% (492 of 28 × 50) of responses classified the cases as remission/low activity. Common reasons for discordance were assignment to remission/low activity of cases with higher corticosteroid doses than defined in LLDAS (prednisolone ≤ 7.5mg) or with SLEDAI-2K >4 due to serological activity (high anti-dsDNA antibody and/or low complement). LLDAS has good construct validity with high overall agreement between the operational definition of LLDAS and expert opinion. Discordance of results suggests that the operational definition of LLDAS is more stringent than expert opinion at defining a low disease activity state. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. The impact of digital imaging on patient doses during barium studies

    International Nuclear Information System (INIS)

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

    1995-01-01

    Barium studies performed on 10 digital and four non-digital fluoroscopic systems were monitored with dose-area product meters as part of a Regional Patient Dosimetry Audit programme. The data have been collected using a computer to read and reset the dose-area product meter and also to collect patient and examination details. A comparison of dose-area product measurements from digital and non-digital fluoroscopy units on over 10 000 barium studies is presented. The data have been corrected according to patient size. The mean size corrected dose-area product for a barium meal examination was found to be 7.62 Gy cm -2 for a digital set compared with 15.45 Gy cm -2 for a non-digital set with 2462 and 1308 patients included in each measurement series, respectively. Dose-area products were also a factor of approximately two lower for barium enema, barium swallow and barium follow-through examinations performed on digital systems. (author)

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

    International Nuclear Information System (INIS)

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

    1979-01-01

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

  6. Substantial dose reduction in modern multi-slice spiral computed tomography (MSCT)-guided craniofacial and skull base surgery

    International Nuclear Information System (INIS)

    Widmann, G.; Fasser, M.; Jaschke, W.; Bale, R.; Schullian, P.; Zangerl, A.; Puelacher, W.; Kral, F.; Riechelmann, H.

    2012-01-01

    Purpose: Reduction of the radiation exposure involved in image-guided craniofacial and skull base surgery is an important goal. The purpose was to evaluate the influence of low-dose protocols in modern multi-slice spiral computed tomography (MSCT) on target registration errors (TREs). Materials and Methods: An anthropomorphic skull phantom with target markers at the craniofacial bone and the anterior skull base was scanned in Sensation Open (40-slice), LightSpeed VCT (64-slice) and Definition Flash (128-slice). Identical baseline protocols (BP) at 120 kV/100 mAs were compared to the following low-dose protocols (LD) in care dose/dose modulation: (LD-I) 100 kV/35ref. mAs, (LD-II) 80 kV/40 - 41ref. mAs, and (LD-III) 80 kV/15 - 17ref. mAs. CTDIvol and DLP were obtained. TREs using an optical navigation system were calculated for all scanners and protocols. Results were statistically analyzed in SPSS and compared for significant differences (p ≤ 0.05). Results: CTDIvol for the Sensation Open/LightSpeed VCT/Definition Flash showed: (BP) 22.24 /32.48 /14.32 mGy; (LD-I) 4.61 /3.52 /1,62 mGy; (LD-II) 3.15 /2.01 /0.87 mGy; and (LD-III) na/0.76 /0.76 mGy. Differences between the BfS (Bundesamt fuer Strahlenschutz) reference CTDIvol of 9 mGy and the lowest CTDIvol were approximately 3-fold for Sensation Open, and 12-fold for the LightSpeed VCT and Definition Flash. A total of 33 registrations and 297 TRE measurements were performed. In all MSCT scanners, the TREs did not significantly differ between the low-dose and the baseline protocols. Conclusion: Low-dose protocols in modern MSCT provided substantial dose reductions without significant influence on TRE and should be strongly considered in image-guided surgery. (orig.)

  7. Definitive Brachytherapy for Kaposi's Sarcoma

    International Nuclear Information System (INIS)

    Williams, A.; Ezzell, G.; Zalupski, M.; Fontanesi, J.

    1996-01-01

    Purpose: To assess the efficacy and possible complications in patients diagnosed with Kaposi's sarcoma and treated with definitive brachytherapy. Methods and Materials: Between January, 1995 and December, 1995, four patients with Kaposi's sarcoma (KS) were treated with brachytherapy. Three patients, all with positive HIV status were treated using Iridium 192 (Ir-192) sources via a high-dose rate remote afterloader. One patient with endemic KS was treated using the application of catheters loaded with Californium 252. Eight sites were treated and included scalp, feet, nose, penis, hand, neck, and back. Dose rate for Ir-192 was 330cGy/fx to a total dose of 990cGy. The Californium was delivered as 100nGy/b.i.d. to a total dose of 900nGy. Follow-up as ranged from 2-6 months. Results: All four patients remain alive. Seven of eight sites have had complete clinical response and each patient has reported durable pain relief that has not subsided through last follow-up of 1/96. Two of eight sites, both treated with surface mold technique with Californium 252 developed moist desquamation. The remaining six sites did not demonstrate significant toxicity. Conclusion: Brachytherapy can offer Kaposi's sarcoma patients results that are equivalent to external beam radiation therapy, with minimal complications, a shorter treatment time and potential cost effectiveness

  8. An overview of measuring and modelling dose and risk from ionising radiation for medical exposures

    International Nuclear Information System (INIS)

    Tootell, Andrew; Szczepura, Katy; Hogg, Peter

    2014-01-01

    Purpose: This paper gives an overview of the methods that are used to calculate dose and risk from exposure to ionizing radiation as a support to other papers in this special issue. Background: The optimization of radiation dose is a legal requirement in medical exposures. This review paper aims to provide the reader with knowledge of dose by providing definitions and concepts of absorbed, effective and equivalent dose. Criticisms of the use of effective dose to infer the risk of an exposure to an individual will be discussed and an alternative approach considering the lifetime risks of cancer incidence will be considered. Prior to any dose or risk calculation, data concerning the dose absorbed by the patient needs to be collected. This paper will describe and discuss the main concepts and methods that can be utilised by a researcher in dose assessments. Concepts behind figures generated by imaging equipment such as dose-area-product, computed tomography dose index, dose length product and their use in effective dose calculations will be discussed. Processes, advantages and disadvantages in the simulation of exposures using the Monte Carlo method and direct measurement using digital dosimeters or thermoluminescent dosimeters will be considered. Beyond this special issue, it is proposed that this paper could serve as a teaching or CPD tool for personnel working or studying medical imaging

  9. Dose profile study in head CT scans using radiochromic films

    International Nuclear Information System (INIS)

    Ladino G, A. M.; Prata M, A.

    2016-10-01

    Diagnostic images of computed tomography generate higher doses than other methods of diagnostic radiology using X-ray beam attenuation. Clinical applications of CT have been increased by technological advances, what leads to a wide variety of scanner in the Brazilian technological pool. It has been difficult to implement dose reduction strategies because of the lack of proper guidance on computed tomography examinations. However, CT scanners allow adjusting acquisition parameter according to the patients physical profile and diagnostic application for which the scan is intended. The knowledge of the dose distribution is important because changes in image acquisition parameters may provide dose reduction. In this study, it was used a cylindrical head phantom in PMMA with 5 openings, what allows dose measurement in 5 regions. In a GE CT scanner, Discovery model of 64 channels, the central slice of the head phantom was irradiated and the absorbed doses were measured using a pencil ionization chamber. Radiochromic film strips were placed in the peripheral and in the central region of the head phantom and was performed a scan of 10 cm in the phantom central region. The scan was performed using the head scanning protocol of the radiobiology service, with a voltage of 120 kV. After scanning, the radiochromic film strips were digitalized and their digital images were used to have the dose longitudinal profiles. The dose values recorded have variation in a range of 18.66 to 23.57 mGy. In the results it was compared the dose index values obtained by the pencil chamber measurement to the dose longitudinal profiles recorded by the film strips. (Author)

  10. Dose profile study in head CT scans using radiochromic films

    Energy Technology Data Exchange (ETDEWEB)

    Ladino G, A. M.; Prata M, A., E-mail: amlgphys@gmail.com [Universidade Federal de Minas Gerais, Departamento de Engenharia Nuclear, Av. Pte. Antonio Carlos 6627, 31270-901 Belo Horizonte, Minas Gerais (Brazil)

    2016-10-15

    Diagnostic images of computed tomography generate higher doses than other methods of diagnostic radiology using X-ray beam attenuation. Clinical applications of CT have been increased by technological advances, what leads to a wide variety of scanner in the Brazilian technological pool. It has been difficult to implement dose reduction strategies because of the lack of proper guidance on computed tomography examinations. However, CT scanners allow adjusting acquisition parameter according to the patients physical profile and diagnostic application for which the scan is intended. The knowledge of the dose distribution is important because changes in image acquisition parameters may provide dose reduction. In this study, it was used a cylindrical head phantom in PMMA with 5 openings, what allows dose measurement in 5 regions. In a GE CT scanner, Discovery model of 64 channels, the central slice of the head phantom was irradiated and the absorbed doses were measured using a pencil ionization chamber. Radiochromic film strips were placed in the peripheral and in the central region of the head phantom and was performed a scan of 10 cm in the phantom central region. The scan was performed using the head scanning protocol of the radiobiology service, with a voltage of 120 kV. After scanning, the radiochromic film strips were digitalized and their digital images were used to have the dose longitudinal profiles. The dose values recorded have variation in a range of 18.66 to 23.57 mGy. In the results it was compared the dose index values obtained by the pencil chamber measurement to the dose longitudinal profiles recorded by the film strips. (Author)

  11. Estimate of dose in interventional radiology: a study of cases

    International Nuclear Information System (INIS)

    Pinto, N.; Braz, D.; Lopes, R.; Vallim, M.; Padilha, L.; Azevedo, F.; Barroso, R.

    2006-01-01

    Values of absorbed dose taken by patients and professionals involved in interventional radiology can be significant mainly for the reason of these proceedings taking long time of fluoroscopy There are many methods to estimate and reduce doses of radiation in the interventional radiology, particularly because the fluoroscopy is responsible for the high dose contribution in the patient and in the professional. The aim of this work is the thermoluminescent dosimetry to estimate the dose values of the extremities of the professionals involved in the interventional radiology and the product dose-area was investigated using a Diamentor. This evaluation is particularly useful for proceedings that interest multiple parts of the organism. In this study were used thermoluminescent dosimeters (LiF:Mg, Ti - Harshaw) to estimate the dose values of the extremities of the professionals and to calibrate them. They were irradiated with X rays at 50 mGy, in Kerma in air and read in the reader Harshaw-5500. The product dose-area (D.A.P.) were obtained through the Diamentor (M2-P.T.W.) calibrated in Cgy.cm 2 fixed in the exit of the X-rays tube. The patients of these study were divided in three groups: individuals submitted to proceedings of embolization, individuals submitted to cerebral and renal arteriography and individuals submitted to proceedings of Transjungular Inthahepatic Porta Systemic Stent Shunt (TIPS). The texts were always carried out by the same group: radiologist doctor), an auxiliary doctor and a nursing auxiliary. The section of interventional radiology has an Angiostar Plus Siemens equipment type arc C, in which there is trifocal Megalix X-ray tube and a intensifier of image from Sirecon 40-4 HDR/33 HDR. In this work the dose estimated values were 137.25 mSv/year for the doctors, 40.27 mSv/year for the nursing and 51.95 mSv/year for the auxiliary doctor and they are below the rule, but in this study it was not taken in consideration the emergency texts as they were

  12. Calculation of absorbed dose of anchorage-dependent cells from internal beta-rays irradiation

    International Nuclear Information System (INIS)

    Chen Jianwei; Huang Gang; Li Shijun

    2001-01-01

    Objective: To elicit the formula of internal dosimetry in anchorage-dependent cells by beta-emitting radionuclides from uniformly distributed volume sources. Methods: By means of the definition of absorbed dose and the MIRD (Medical International Radiation Dose) scheme the formula of internal dosimetry was reasonably deduced. Firstly, studying the systems of suspension culture cells. Then, taking account of the speciality of the systems of the anchorage-dependent cells and the directions of irradiation, the absorbed dose of anchorage -dependent cells was calculated by the accumulated radioactivity, beta-ray energy, and the volume of the cultured systems. Results: The formula of internal dosimetry of suspension culture cells and anchorage-dependent cells were achieved. At the same time, the formula of internal dosimetry of suspension culture cells was compared with that of MIRD and was confirmed accurate. Conclusion: The formula of internal dosimetry is concise, reliable and accurate

  13. Georgia fishery study: implications for dose calculations

    International Nuclear Information System (INIS)

    Turcotte, M.D.S.

    1983-01-01

    Fish consumption will contribute a major portion of the estimated individual and population doses from L-Reactor liquid releases and Cs-137 remobilization in Steel Creek. It is therefore important that the values for fish consumption used in dose calculations be as realistic as possible. Since publication of the L-Reactor Environmental Information Document (EID), data have become available on sport fishing in the Savannah River. These data provide SRP with site-specific sport fish harvest and consumption values for use in dose calculations. The Georgia fishery data support the total population fish consumption and calculated dose reported in the EID. The data indicate, however, that both the EID average and maximum individual fish consumption have been underestimated, although each to a different degree. The average fish consumption value used in the EID is approximately 3% below the lower limit of the fish consumption range calculated using the Georgia data. A fish consumption value of 11.3 kg/yr should be used to recalculate dose to the average individual from L-Reactor restart. Maximum fish consumption in the EID has been underestimated by approximately 60%, and doses to the maximum individual should also be recalculated. Future dose calculations should utilize an average fish consumption value of 11.3 kg/yr, and a maximum fish consumption value of 34 kg/yr

  14. Pragmatic criteria of the definition of neonatal near miss: a comparative study.

    Science.gov (United States)

    Kale, Pauline Lorena; Jorge, Maria Helena Prado de Mello; Laurenti, Ruy; Fonseca, Sandra Costa; Silva, Kátia Silveira da

    2017-12-04

    The objective of this study was to test the validity of the pragmatic criteria of the definitions of neonatal near miss, extending them throughout the infant period, and to estimate the indicators of perinatal care in public maternity hospitals. A cohort of live births from six maternity hospitals in the municipalities of São Paulo, Niterói, and Rio de Janeiro, Brazil, was carried out in 2011. We carried out interviews and checked prenatal cards and medical records. We compared the pragmatic criteria (birth weight, gestational age, and 5' Apgar score) of the definitions of near miss of Pileggi et al., Pileggi-Castro et al., Souza et al., and Silva et al. We calculated sensitivity, specificity (gold standard: infant mortality), percentage of deaths among newborns with life-threatening conditions, and rates of near miss, mortality, and severe outcomes per 1,000 live births. A total 7,315 newborns were analyzed (completeness of information > 99%). The sensitivity of the definition of Pileggi-Castro et al. was higher, resulting in a higher number of cases of near miss, Souza et al. presented lower value, and Pileggi et al. and de Silva et al. presented intermediate values. There is an increase in sensitivity when the period goes from 0-6 to 0-27 days, and there is a decrease when it goes to 0-364 days. Specificities were high (≥ 97%) and above sensitivities (54% to 77%). One maternity hospital in São Paulo and one in Niterói presented, respectively, the lowest and highest rates of infant mortality, near miss, and frequency of births with life-threatening conditions, regardless of the definition. The definitions of near miss based exclusively on pragmatic criteria are valid and can be used for monitoring purposes. Based on the perinatal literature, the cutoff points adopted by Silva et al. were more appropriate. Periodic studies could apply a more complete definition, incorporating clinical, laboratory, and management criteria, including congenital anomalies

  15. Effective dose evaluation for BNCT treatment in the epithermal neutron beam at THOR

    Energy Technology Data Exchange (ETDEWEB)

    Wang, J.N. [Department of Engineering and System Science, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Rd., Hsinchu 30013, Taiwan (China)] [Division of Health Physics, Institute of Nuclear Energy Research, No. 1000, Wenhua Rd., Jiaan Village, Longtan Township, Taoyuan County 32546, Taiwan (China); Huang, C.K. [Institute of Nuclear Engineering and Science, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Rd., Hsinchu 30013, Taiwan (China); Tsai, W.C. [Department of Engineering and System Science, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Rd., Hsinchu 30013, Taiwan (China); Liu, Y.H. [Nuclear Science and Technol. Develop. Center, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Rd., Hsinchu 30013, Taiwan (China); Jiang, S.H., E-mail: shjiang@mx.nthu.edu.tw [Department of Engineering and System Science, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Rd., Hsinchu 30013, Taiwan (China)] [Institute of Nuclear Engineering and Science, National Tsing Hua University, No. 101, Section 2, Kuang-Fu Rd., Hsinchu 30013, Taiwan (China)

    2011-12-15

    This paper aims to evaluate the effective dose as well as equivalent doses of several organs of an adult hermaphrodite mathematical phantom according to the definition of ICRP Publication 60 for BNCT treatments of brain tumors in the epithermal neutron beam at THOR. The MCNP5 Monte Carlo code was used for the calculation of the average absorbed dose of each organ. The effective doses for a typical brain tumor treatment with a tumor treatment dose of 20 Gy-eq were evaluated to be 0.59 and 0.35 Sv for the LLAT and TOP irradiation geometries, respectively. In addition to the stochastic effect, it was found that it is also likely to produce deterministic effects, such as cataracts and depression of haematopoiesis.

  16. SU-F-R-39: Effects of Radiation Dose Reduction On Renal Cell Carcinoma Discrimination Using Multi-Phasic CT Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Wahi-Anwar, M; Young, S; Lo, P; Raman, S; Kim, H; Brown, M; McNitt-Gray, M; Coy, H; Ashen-Garry, D; Pace-Soler, E [UCLA School of Medicine, Los Angeles, CA (United States)

    2016-06-15

    Purpose: A method to discriminate different types of renal cell carcinoma (RCC) was developed using attenuation values observed in multiphasic contrast-enhanced CT. This work evaluates the sensitivity of this RCC discrimination task at different CT radiation dose levels. Methods: We selected 5 cases of kidney lesion patients who had undergone four-phase CT scans covering the abdomen to the lilac crest. Through an IRB-approved study, the scans were conducted on 64-slice CT scanners (Definition AS/Definition Flash, Siemens Healthcare) using automatic tube-current modulation (TCM). The protocol included an initial baseline unenhanced scan, followed by three post-contrast injection phases. CTDIvol (32 cm phantom) measured between 9 to 35 mGy for any given phase. As a preliminary study, we limited the scope to the cortico-medullary phase—shown previously to be the most discriminative phase. A previously validated method was used to simulate a reduced dose acquisition via adding noise to raw CT sinogram data, emulating corresponding images at simulated doses of 50%, 25%, and 10%. To discriminate the lesion subtype, ROIs were placed in the most enhancing region of the lesion. The mean HU value of an ROI was extracted and used to discriminate to the worst-case RCC subtype, ranked in the order of clear cell, papillary, chromophobe and the benign oncocytoma. Results: Two patients exhibited a change of worst case RCC subtype between original and simulated scans, at 25% and 10% doses. In one case, the worst-case RCC subtype changed from oncocytoma to chromophobe at 10% and 25% doses, while the other case changed from oncocytoma to clear cell at 10% dose. Conclusion: Based on preliminary results from an initial cohort of 5 patients, worst-case RCC subtypes remained constant at all simulated dose levels except for 2 patients. Further study conducted on more patients will be needed to confirm our findings. Institutional research agreement, Siemens Healthcare; Past recipient

  17. SU-F-R-39: Effects of Radiation Dose Reduction On Renal Cell Carcinoma Discrimination Using Multi-Phasic CT Imaging

    International Nuclear Information System (INIS)

    Wahi-Anwar, M; Young, S; Lo, P; Raman, S; Kim, H; Brown, M; McNitt-Gray, M; Coy, H; Ashen-Garry, D; Pace-Soler, E

    2016-01-01

    Purpose: A method to discriminate different types of renal cell carcinoma (RCC) was developed using attenuation values observed in multiphasic contrast-enhanced CT. This work evaluates the sensitivity of this RCC discrimination task at different CT radiation dose levels. Methods: We selected 5 cases of kidney lesion patients who had undergone four-phase CT scans covering the abdomen to the lilac crest. Through an IRB-approved study, the scans were conducted on 64-slice CT scanners (Definition AS/Definition Flash, Siemens Healthcare) using automatic tube-current modulation (TCM). The protocol included an initial baseline unenhanced scan, followed by three post-contrast injection phases. CTDIvol (32 cm phantom) measured between 9 to 35 mGy for any given phase. As a preliminary study, we limited the scope to the cortico-medullary phase—shown previously to be the most discriminative phase. A previously validated method was used to simulate a reduced dose acquisition via adding noise to raw CT sinogram data, emulating corresponding images at simulated doses of 50%, 25%, and 10%. To discriminate the lesion subtype, ROIs were placed in the most enhancing region of the lesion. The mean HU value of an ROI was extracted and used to discriminate to the worst-case RCC subtype, ranked in the order of clear cell, papillary, chromophobe and the benign oncocytoma. Results: Two patients exhibited a change of worst case RCC subtype between original and simulated scans, at 25% and 10% doses. In one case, the worst-case RCC subtype changed from oncocytoma to chromophobe at 10% and 25% doses, while the other case changed from oncocytoma to clear cell at 10% dose. Conclusion: Based on preliminary results from an initial cohort of 5 patients, worst-case RCC subtypes remained constant at all simulated dose levels except for 2 patients. Further study conducted on more patients will be needed to confirm our findings. Institutional research agreement, Siemens Healthcare; Past recipient

  18. Correlation-study about the ambient dose rate and the weather conditions

    Science.gov (United States)

    Furuya, Masato; Hatano, Yuko; Aoyama, Tomoo; Igarashi, Yasuhito; Kita, Kazuyuki; Ishizuka, Masahide

    2016-04-01

    The long-term radiation risks are believed to be heavily affected by the resuspension process. We therefore focus on the surface-atmosphere exchange process of released radioactive materials in this study. Radioactive materials were deposited on the soil and float in the air, and such complicated process are influenced by the weather conditions deeply. We need to reveal the correlation between the weather conditions and the ambient dose rate. In this study, we study the correlation between the weather conditions and the ambient dose rate with the correction of the decrease due to the radioactive decay. We found that there is a negative correlation between the ambient dose rate and the soil water content by the correlation coefficient. Using this result, we reconstruct the ambient dose rate from the weather conditions by the multiple regression analysis and found that the reconstructed data agree with the observation very well. Using Kalman filter, which can be sequentially updates the state estimate, we obtained such a good agreement.

  19. Capecitabine based postoperative accelerated chemoradiation of pancreatic carcinoma. A dose-escalation study

    International Nuclear Information System (INIS)

    Morganti, Alessio G.; Picardi, Vincenzo; Ippolito, Edy; Massaccesi, Mariangela; Macchia, Gabriella; Deodato, Francesco; Caravatta, Luciana; Tambaro, Rosa; Mignogna, Samantha; Cellini, Numa; Valentini, Vincenzo; Mattiucci, Gian Carlo; Di Lullo, Liberato; Giglio, Gianfranco; Caprino, Paola; Sofo, Luigi; Ingrosso, Marcello

    2010-01-01

    The objective of this study was to evaluate the safety of escalating up to 55 Gy within five weeks, the dose of external beam radiotherapy to the previous tumor site concurrently with a fixed daily dose of capecitabine, in patients with resected pancreatic cancer. Material and methods. Patients with resected pancreatic carcinoma were eligible for this study. Capecitabine was administered at a daily dose of 1600 mg/m 2 . Regional lymph nodes received a total radiation dose of 45 Gy with 1.8 Gy per fractions. The starting radiation dose to the tumor bed was 50.0 Gy (2.0 Gy/fraction, 25 fractions). Escalation was achieved up to a total dose of 55.0 Gy by increasing the fraction size by 0.2 Gy (2.2 Gy/fraction), while keeping the duration of radiotherapy to five weeks (25 fractions). A concomitant boost technique was used. Dose limiting toxicity (DLT) was defined as any grade>3 hematologic toxicity, grade>2 liver, renal, neurologic, gastrointestinal, or skin toxicity, by RTOG criteria, or any toxicity producing prolonged (> 10 days) radiotherapy interruption. Results and discussion. Twelve patients entered the study (median age: 64 years). In the first cohort (six patients), no patient experienced DLT. Similarly in the second cohort, no DLT occurred. All 12 patients completed the planned regimen of therapy. Nine patients experienced grade 1-2 nausea and/or vomiting. Grade 2 hematological toxicity occurred in four patients. The results of our study indicate that a total radiation dose up to 55.0 Gy/5 weeks can be safely administered to the tumor bed, concurrently with capecitabine (1600 mg/m 2 ) in patients with resected pancreatic carcinoma.

  20. 34 CFR 658.4 - What definitions apply to the Undergraduate International Studies and Foreign Language Program?

    Science.gov (United States)

    2010-07-01

    ... International Studies and Foreign Language Program? 658.4 Section 658.4 Education Regulations of the Offices of... UNDERGRADUATE INTERNATIONAL STUDIES AND FOREIGN LANGUAGE PROGRAM General § 658.4 What definitions apply to the Undergraduate International Studies and Foreign Language Program? The definitions in 34 CFR 655.4 apply to this...

  1. Dose factors for contamination of skin and clothing

    International Nuclear Information System (INIS)

    Henrichs, K.; Eiberweiser, C.; Paretzke, H.G.

    1985-11-01

    Methods are described for quantifying the radiation dose administered through radioactive contamination of the skin (and of clothing, in an approximative manner). The calculated results are presented in tables. The dose values established are of significance with regard to radiological assessment of contamination for the definition of dose limits, and for use as a criterion to select appropriate decontamination activities. Alpha, beta and monoenergetic electrons are of importance for estimating the absorbed dose in various skin depths, whereas for other body regions (as e.g. body organs) photon radiation has to be considered. The calculations are based on the assumption of homogeneous exposure of the skin, with the linear extension being large compared to the range of the emitted particle radiation. In order to be able to take into account potential penetration of radioactivity into deeper skin layers by diffusion or solution processes, the calculations have been made for contamination into various depths of the horny layers of the epidermis. The scheme of specific absorbed fraction (SAF) served as a basis for the uniform treatment of different radiation types for the calculation of dose values. (orig./HP) [de

  2. Dose. Detriment. Limit assessment

    International Nuclear Information System (INIS)

    Breckow, J.

    2015-01-01

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

  3. The induction by x rays of chromosome aberrations in male guinea-pigs, rabbits and golden hamsters. 3. Dose-response relationship after single doses of X-rays to spermatogonia

    Energy Technology Data Exchange (ETDEWEB)

    Lyon, M F; Cox, B D

    1975-09-01

    The induction by X-rays of translocations in spermatogonia was studied by cytological means in spermatocytes derived from them. In the rabbit and guinea-pig, hump-shaped dose-response curves were obtained, with a linear relationship at the low doses. The shapes of the curves were similar to those reported for the mouse, except that the maximum occurred at 600-700 rad in the mouse as opposed to 300 rad in the guinea-pig and rabbit. Unlike the guinea-pig and rabbit, the golden hamster showed a hump dose-response curve without a definite peak value and with little decrease in yield at high radiation doses. Over the low dose range 100-300 rad, the slopes of the curves of translocation yield were in the order: mouse (highest), rabbit, guinea-pig and hamster. Data on sterile periods suggested that the amount of spermatogonial killing in the rabbit and guinea-pig was as great or greater than in the mouse, and that in the golden hamster it was most severe. It is suggested that the differing shapes of the dose-response curves can be explained by a lower sensitivity to translocation induction in the test species and, also especially in the golden hamster, a greater sensitivity to cell killing. The possibility of extrapolating from these data to other species is discussed.

  4. Alternate day treatment and late effects: The concept of an effective dose per fraction

    International Nuclear Information System (INIS)

    Courdi, A.; Hery, M.; Gabillat, J.M.

    1990-01-01

    Although most institutions treat all fields each day, some radiotherapists continue to adopt an alternate day schedule. The resulting daily variations of the dose per fraction in laterally located targets have been analyzed using the linear-quadratic model. Patients with breast carcinoma treated with definitive radiotherapy in 1974-1975 with one field a day were studied. An effective dose per fraction was derived, with a value higher than the average dose per fraction received by the reference point. The greater the fluctuations between the doses per fraction on successive days, the higher the effective dose per fraction. The corresponding cell survival due to alternate treatment as compared to survival with daily treatment depends on the alpha/beta ratio. For a late effect with low alpha/beta ratio, an alternate treatment may lead to almost 10-fold increase in cell kill in these lateral targets such as those responsible for subcutaneous sclerosis as compared to daily treatment of all fields with the same total dose. Taking the average effective dose per fraction in our series, the increase in cell kill was 4-fold. Acute effects would suffer less damage due to alternate treatment because of a high alpha/beta ratio. Treatment on an alternate schedule should be restricted to palliative radiotherapy

  5. Mars power system concept definition study. Volume 2: Appendices

    Science.gov (United States)

    Littman, Franklin D.

    1994-01-01

    This report documents the work performed by Rockwell International's Rocketdyne Division on NASA Contract No. NAS3-25808 (Task Order No. 16) entitled 'Mars Power System Definition Study'. This work was performed for NASA's Lewis Research Center (LeRC). The report is divided into two volumes as follows: Volume 1 - Study Results; and Volume 2 - Appendices. The results of the power system characterization studies, operations studies, and technology evaluations are summarized in Volume 1. The appendices include complete, standalone technology development plans for each candidate power system that was investigated.

  6. Determination of dose equivalent with tissue-equivalent proportional counters

    International Nuclear Information System (INIS)

    Dietze, G.; Schuhmacher, H.; Menzel, H.G.

    1989-01-01

    Low pressure tissue-equivalent proportional counters (TEPC) are instruments based on the cavity chamber principle and provide spectral information on the energy loss of single charged particles crossing the cavity. Hence such detectors measure absorbed dose or kerma and are able to provide estimates on radiation quality. During recent years TEPC based instruments have been developed for radiation protection applications in photon and neutron fields. This was mainly based on the expectation that the energy dependence of their dose equivalent response is smaller than that of other instruments in use. Recently, such instruments have been investigated by intercomparison measurements in various neutron and photon fields. Although their principles of measurements are more closely related to the definition of dose equivalent quantities than those of other existing dosemeters, there are distinct differences and limitations with respect to the irradiation geometry and the determination of the quality factor. The application of such instruments for measuring ambient dose equivalent is discussed. (author)

  7. Acute respiratory infection case definitions for young children: a systematic review of community-based epidemiologic studies in South Asia.

    Science.gov (United States)

    Roth, Daniel E; Gaffey, Michelle F; Smith-Romero, Evelyn; Fitzpatrick, Tiffany; Morris, Shaun K

    2015-12-01

    To explore the variability in childhood acute respiratory infection case definitions for research in low-income settings where there is limited access to laboratory or radiologic investigations. We conducted a systematic review of community-based, longitudinal studies in South Asia published from January 1990 to August 2013, in which childhood acute respiratory infection outcomes were reported. Case definitions were classified by their label (e.g. pneumonia, acute lower respiratory infection) and clinical content 'signatures' (array of clinical features that would be always present, conditionally present or always absent among cases). Case definition heterogeneity was primarily assessed by the number of unique case definitions overall and by label. We also compared case definition-specific acute respiratory infection incidence rates for studies reporting incidence rates for multiple case definitions. In 56 eligible studies, we found 124 acute respiratory infection case definitions. Of 90 case definitions for which clinical content was explicitly defined, 66 (73%) were unique. There was a high degree of content heterogeneity among case definitions with the same label, and some content signatures were assigned multiple labels. Within studies for which incidence rates were reported for multiple case definitions, variation in content was always associated with a change in incidence rate, even when the content differed by a single clinical feature. There has been a wide variability in case definition label and content combinations to define acute upper and lower respiratory infections in children in community-based studies in South Asia over the past two decades. These inconsistencies have important implications for the synthesis and translation of knowledge regarding the prevention and treatment of childhood acute respiratory infection. © 2015 John Wiley & Sons Ltd.

  8. Study of genomic instability induced by low dose ionizing radiation

    International Nuclear Information System (INIS)

    Seoane, A.; Crudeli, C.; Dulout, F.

    2006-01-01

    The crews of commercial flights and services staff of radiology and radiotherapy from hospitals are exposed to low doses of ionizing radiation. Genomic instability includes those adverse effects observed in cells, several generations after the exposure occurred. The purpose of this study was to analyze the occurrence of genomic instability by very low doses of ionizing radiation [es

  9. Impact of target reproducibility on tumor dose in stereotactic radiotherapy of targets in the lung and liver

    International Nuclear Information System (INIS)

    Wulf, Joern; Haedinger, Ulrich; Oppitz, Ulrich; Thiele, Wibke; Flentje, Michael

    2003-01-01

    Background and purpose: Previous analyses of target reproducibility in extracranial stereotactic radiotherapy have revealed standard security margins for planning target volume (PTV) definition of 5 mm in axial and 5-10 mm in longitudinal direction. In this study the reproducibility of the clinical target volume (CTV) of lung and liver tumors within the PTV over the complete course of hypofractionated treatment is evaluated. The impact of target mobility on dose to the CTV is assessed by dose-volume histograms (DVH). Materials and methods: Twenty-two pulmonary and 21 hepatic targets were treated with three stereotactic fractions of 10 Gy to the PTV-enclosing 100%-isodose with normalization to 150% at the isocenter. A conformal dose distribution was related to the PTV, which was defined by margins of 5-10 mm added to the CTV. Prior to each fraction a computed tomography (CT)-simulation over the complete target volume was performed resulting in a total of 60 CT-simulations for lung and 58 CT-simulations for hepatic targets. The CTV from each CT-simulation was segmented and matched with the CT-study used for treatment planning. A DVH of the simulated CTV was calculated for each fraction. The target coverage (TC) of dose to the simulated CTV was defined as the proportion of the CTV receiving at least the reference dose (100%). Results: A decrease of TC to 3 . Conclusions: Target reproducibility was precise within the reference isodose in 91% of lung and 81% of liver tumors with a TC of the complete CTV ≥95% at each fraction of treatment. Pulmonary targets with increased breathing mobility and liver tumors >100 cm 3 are at risk for target deviation exceeding the standard security margins for PTV-definition at least for one fraction and require individual evaluation of sufficient margins

  10. Analysis of risk factors for schizophrenia with two different case definitions: a nationwide register-based external validation study.

    Science.gov (United States)

    Sørensen, Holger J; Larsen, Janne T; Mors, Ole; Nordentoft, Merete; Mortensen, Preben B; Petersen, Liselotte

    2015-03-01

    Different case definitions of schizophrenia have been used in register based research. However, no previous study has externally validated two different case definitions of schizophrenia against a wide range of risk factors for schizophrenia. We investigated hazard ratios (HRs) for a wide range of risk factors for ICD-10 DCR schizophrenia using a nationwide Danish sample of 2,772,144 residents born in 1955-1997. We compared one contact only (OCO) (the case definition of schizophrenia used in Danish register based studies) with two or more contacts (TMC) (a case definition of at least 2 inpatient contacts with schizophrenia). During the follow-up, the OCO definition included 15,074 and the TMC 7562 cases; i.e. half as many. The TMC case definition appeared to select for a worse illness course. A wide range of risk factors were uniformly associated with both case definitions and only slightly higher risk estimates were found for the TMC definition. Choosing at least 2 inpatient contacts with schizophrenia (TMC) instead of the currently used case definition would result in almost similar risk estimates for many well-established risk factors. However, this would also introduce selection and include considerably fewer cases and reduce power of e.g. genetic studies based on register-diagnosed cases only. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Study on fine quartz pre-dose techniques

    International Nuclear Information System (INIS)

    Leung, P.L.; Stokes, M.J.; Wang Weida; Xia Junding

    1996-01-01

    When using the pre-dose technique in ceramic dating, it is essential to add a calibration dose and to eliminate the background dose. For doing this measurement the sample requires multiple activation following multiple administration of a test dose to induce simulated 'ancient' thermoluminescence (TL). However, the procedures introduce many factors that are difficultly corrected. The authors compare existing two kinds of measurement procedures and proposes a new procedure involving single activation following a single test dose administration. An experiment using the single activation procedure is carried out with natural fine quartz where the results obtained exhibit only 0.07 relative error. It appears that this new procedure increases the precision of the ancient TL measurement by about 0.04 and 0.11 over those of existing two kinds of procedures. In addition this method can give realistic values in TL dating for relatively 'young' samples aged tens to hundreds of years where the standard high temperature TL method is relatively insensitive

  12. Monitoring of eye lens doses in radiation protection

    International Nuclear Information System (INIS)

    Bordy, J.M.

    2015-01-01

    Mainly due to the ICRP recommendation to decrease the exposure limit for eye lenses, the eye lens dosimetry has to be reconsidered. This paper gives an overview of the issues raised after this recommendation; that is to say, the choice and definition of the operational quantity to be monitored, the type testing and calibration of dosimeters aimed at measuring eyes lens 'doses', the design of existing eye lens dosimeters and their wearing conditions. Finally, a criterion to choose between a direct measurement of the personal dose equivalent at three millimeters depth, H p (3), with a dedicated dosimeter, and an indirect evaluation of H p (3) through whole-body monitoring is presented. (authors)

  13. DETERMINATION OF SUPERFICIAL ABSORBED DOSE FROM EXTERNAL EXPOSURE OF WEAKLY PENETRATING RADIATIONS

    Institute of Scientific and Technical Information of China (English)

    陈丽姝

    1994-01-01

    The methods of determining the superficial absorbed dose distributions in a water phantom by means of the experiments and available theories have been reported.The distributions of beta dose were measured by an extrapolation ionization chamber at definite depthes corresponding to some superficial organs and tissues such as the radiosensitive layer of the skin,cornea,sclera,anterior chamber and lens of eyeball.The ratios among superficial absorbed dose D(0.07) and average absorbed doses at the depthes 1,2,3,4,5 and 6mm are also obtained with Cross's methods.They can be used for confining the deterministic effects of some superficial tissues and organs such as the skin and the components of eyeball for weakly penetrating radiations.

  14. Dose-Dependent Effect of Statin Pretreatment on Preventing the Periprocedural Complications of Carotid Artery Stenting.

    Science.gov (United States)

    Hong, Jeong-Ho; Sohn, Sung-Il; Kwak, Jaehyuk; Yoo, Joonsang; Chang, Hyuk Won; Kwon, O-Ki; Jung, Cheolkyu; Chung, Inyoung; Bae, Hee-Joon; Lee, Ji Sung; Han, Moon-Ku

    2017-07-01

    We investigated whether statin pretreatment can dose dependently reduce periprocedural complications in patients undergoing carotid artery stenting because of symptomatic carotid artery stenosis. We enrolled a consecutive series of 397 symptomatic carotid artery stenosis (≥50% stenosis on conventional angiography) treated with carotid artery stenting at 2 tertiary university hospitals over a decade. Definition of periprocedural complications included any stroke, myocardial infarction, and death within 1 month after or during the procedure. Statin pretreatment was divided into 3 categories according to the atorvastatin equivalent dose: none (n=158; 39.8%), standard dose (statin use were 12.0%, 4.5%, and 1.2%. After adjustment, a change in the atorvastatin dose category was associated with reduction in the odds of periprocedural complications for each change in dose category (standard-dose statin: odds ratio, 0.24; 95% confidence interval, 0.07-0.81; high-dose statin: odds ratio, 0.11; 95% confidence interval, 0.01-0.96; P for trend=0.01). Administration of antiplatelet drugs was also an independent factor in periprocedural complications (OR, 0.18; 95% CI, 0.05-0.69). This study shows that statin pretreatment may reduce the incidence of periprocedural complications dose dependently in patients with symptomatic carotid artery stenting. © 2017 American Heart Association, Inc.

  15. Evaluation of radiation dose in pediatric head CT examination: a phantom study

    Science.gov (United States)

    Norhasrina Nik Din, Nik; Zainon, Rafidah; Rahman, Ahmad Taufek Abdul

    2018-01-01

    The aim of this study was to evaluate the radiation dose in pediatric head Computed Tomography examination. It was reported that decreasing tube voltage in CT examination can reduce the dose to patients significantly. A head phantom was scanned with dual-energy CT at 80 kV and 120 kV. The tube current was set using automatic exposure control mode and manual setting. The pitch was adjusted to 1.4, 1.45 and 1.5 while the slice thickness was set at 5 mm. The dose was measured based on CT Dose Index (CTDI). Results from this study have shown that the image noise increases substantially with low tube voltage. The average dose was 2.60 mGy at CT imaging parameters of 80 kV and 10 - 30 mAs. The dose increases up to 17.19 mGy when the CT tube voltage increases to 120 kV. With the reduction of tube voltage from 120 kV to 80 kV, the radiation dose can be reduced by 12.1% to 15.1% without degradation of contrast-to-noise ratio.

  16. Encrusted cystitis after definitive radiotherapy for cervical cancer: a case report

    Directory of Open Access Journals (Sweden)

    Elisabetta Perrucci

    2016-10-01

    Full Text Available Purpose : Encrusted cystitis is a rare chronic inflammatory disease characterized by calcified plaques of the bladder, previously altered by varies conditions as urological procedures, caused by urea-splitting bacteria. Only one case has been reported on encrusted cystitis occurring after surgery and radiation therapy for a pelvic neoplasm. We report on encrusted cystitis occurred after definitive radiotherapy for bulky uterine cervix cancer, and examine the doses to the bladder wall and the procedure of radiation treatment performed as a possible cause of the onset of the disease. Case presentation : A 52-year-old female developed encrusted cystitis, caused by Corynebacterium spp., after 14 months from definitive chemo-radiotherapy and 2/D brachytherapy treatment for FIGO stage IB2 uterine cervix cancer. For pelvic radiotherapy, the mean bladder dose was 48.47 Gy (range 31.20–51.91; maximal bladder point doses at each brachytherapy insertions were 7.62 Gy, 4.94 Gy and 6.27 Gy at first, second, and third fraction, respectively. Total biological effective dose (BED at bladder point was 140.05 Gy3. The patient was administered antibiotic therapy with linezolid and urine acidification with vitamin C; dietary norms were also suggested. After therapy, complete remission of symptoms and radiological findings were achieved, and the planned surgery for removing the calcified plaques was not completed. After 5 years from the cervical cancer diagnosis, the patient was disease-free without urinary symptoms. Conclusions : The high doses administered to the bladder wall and the repeated catheterizations performed at each brachytherapy insertions may have favored the infection and promoted the occurrence of the encrusted cystitis.

  17. Consensus on the Definition of Advanced Parkinson’s Disease: A Neurologists-Based Delphi Study (CEPA Study

    Directory of Open Access Journals (Sweden)

    Maria-Rosario Luquin

    2017-01-01

    Full Text Available To date, no consensus exists on the key factors for diagnosing advanced Parkinson disease (APD. To obtain consensus on the definition of APD, we performed a prospective, multicenter, Spanish nationwide, 3-round Delphi study (CEPA study. An ad hoc questionnaire was designed with 33 questions concerning the relevance of several clinical features for APD diagnosis. In the first-round, 240 neurologists of the Spanish Movement Disorders Group participated in the study. The results obtained were incorporated into the questionnaire and both, results and questionnaire, were sent out to and fulfilled by 26 experts in Movement Disorders. Review of results from the second-round led to a classification of symptoms as indicative of “definitive,” “probable,” and “possible” APD. This classification was confirmed by 149 previous participating neurologists in a third-round, where 92% completely or very much agreed with the classification. Definitive symptoms of APD included disability requiring help for the activities of daily living, presence of motor fluctuations with limitations to perform basic activities of daily living without help, severe dysphagia, recurrent falls, and dementia. These results will help neurologists to identify some key factors in APD diagnosis, thus allowing users to categorize the patients for a homogeneous recognition of this condition.

  18. Study of total ionization dose effects in electronic devices

    International Nuclear Information System (INIS)

    Nidhin, T.S.; Bhattacharyya, Anindya; Gour, Aditya; Behera, R.P.; Jayanthi, T.

    2018-01-01

    Radiation effects in electronic devices are a major challenge in the dependable application developments of nuclear power plant instrumentation and control systems. The main radiation effects are total ionization dose (TID) effects, displacement damage dose (DDD) effects and single event effects (SEE). In this study, we are concentrating on TID effects in electronic devices. The focus of the study is mainly on SRAM based field programmable gate arrays (FPGA) along with that the devices of our interest are voltage regulators, flash memory and optocoupler. The experiments are conducted by exposing the devices to gamma radiation in power off condition and the degradation in the performances are analysed

  19. Validity of the concept of absorbed dose as a physical quantity

    International Nuclear Information System (INIS)

    Tada, Jun-Ichiro; Katoh, Kazuaki.

    1995-01-01

    The concept of the 'absorbed dose' of ionizing radiation is scrutinized from physical point of view. It is shown that the concept and definition of the quantity in the ICRU system is disqualified as a physical quantity and the absorbed dose can not always be a 'measure of cause' in describing causality relation between radiation and effects on matter. The current absorbed dose depends even on the energy that have already been brought out from the matter, contrary to the intention of introducing the quantity. Trials to remove these difficulties are made. However, it is also shown there still exists an essential problem that cannot be solved by improving the formulation. (author)

  20. Hotspots Definition Study

    International Nuclear Information System (INIS)

    De Pater, F.; Brinkman, S.; Schellekens, E.

    2010-03-01

    In the Dutch research programme Climate changes Spatial Planning (CcSP) many scientific projects are carried out. They often take a multidisciplinary approach to the climate issue. However, more attention needed to be given to embedding the programme into practice. Therefore, the board decided to start a hotspot programme. A hotspot was defined as a pilot project in a sector, place or region in which spatial planning and climate change play an important role in the physical shape and land use of the area and where conflicts of interest are found between these and other factors. The hotspot programme started with a definition study. This report is the result of this study. The goal of the study was to identify, describe and evaluate possible hotspots. In two workshops with policy-makers from national and regional governments, consultancy firms and nature conservation organizations, a large number of potential hotspots were identified. Fifteen were selected after the workshops took place and described in detail. The selection was done using a set of conditional criteria, criteria that all had to be met. Two potential hotspots were withdrawn after the selection. Since the Board of the CcSP programme expressed its interest in financing six to seven hotspots, a prioritization was made, using prioritizing criteria. Also the potential hotspots were assessed looking at regional distribution, thematic coverage and target groups. After this assessment and an analysis of the hotspots taking some other factors into account (eg. some hotspots were very similar or one could easily be incorporated in another one) five hotspots were selected: Kampen, Biesbosch-Haringvliet, Zuidplaspolder, Delta Waters and Tilburg. Options to fill the last two places were: Grounds for Change, Noordoostpolder, Oude Vaart Valley and Arnhem/Nijmegen (KAN). For these remaining potential hotspots draft terms of reference were drawn as basis for a project proposals. These terms of reference are added to

  1. Outline of recent studies on dosimetry for external radiations

    International Nuclear Information System (INIS)

    Yamaguchi, Yasuhiro; Iwai, Satoshi.

    1995-01-01

    On the opportunity of adopting the new basic recommendation of ICRP in 1990, the research on the method of evaluating external radiation exposure dose has become to be carried out actively. In this recommendation, the definition of the dose used for radiation protection was changed largely, accordingly, the necessity to prepare the dose conversion factor based on the new definition and so on has arisen. Also in Japan, the research for this purpose has been carried out, and in January, 1995, the workshop on the recent method for evaluating external radiation exposure dose was held at Japan Atomic Energy Research Institute. In this report, the contents discussed at the workshop and the outline of the recent studies on this subject are described. As the international trend of dose evaluation, the recommendation of ICRP in 1990, the ICRU report 51 and the ICRP publication 71 by the joint ICRP/ICRU task group are introduced. In Japan, the studies have been advanced centering around the reassessment of dose conversion factors for photons, electrons and neutrons. The dose evaluation for photons, electrons and neutrons, and the dose evaluation around high energy accelerators are explained. Many problems to be solved still remain as the subjects of research for hereafter. (K.I.)

  2. The irradiation dose for the inhibition of the sprouting of Baraka variety potatoes

    International Nuclear Information System (INIS)

    Perez Rivero, B.; Salcines, R.; Prieto, E.

    1990-01-01

    Baraka variety potatoes graded in the packing house, were irradiated with doses of 0.08; 0.10; 0.15 and 0.20 kGy after a two weeks curing period. The potatoes were stored for five months at 12 0 +- 2 0 C and relative humidity of 85 to 95%, and to determine the percentages of sprouting, rotting and loss in weight. It was concluded that doses of 0.08 kGy or more inhibited definitively the sprouting process. Less total losses and better commercial quality were obtained with a dose of 0.08 kGy the last of the store. 13 refs

  3. How common is domestic violence against women? The definition of partner abuse in prevalence studies.

    Science.gov (United States)

    Hegarty, K; Roberts, G

    1998-02-01

    We systematically reviewed studies of the prevalence of domestic violence. Selected overseas community studies were compared with all Australian prevalence studies found to be published. Twelve-month prevalence estimates of partner abuse in Australia varied from 2.1 per cent to 28.0 per cent, depending mainly on the definition of domestic violence used in each study. Implications of the lack of a precise definition result in varying operationalised definitions of partner abuse, from all types of violence in relationships (including a single minor violent incident), through to only those violent incidents that are classified as a crime. Recommendations for any future prevalence studies in this field include the need to collect frequency data which reflected the fact that partner abuse against women is a complex behavioural phenomenon involving emotional, physical and sexual abuse against a partner, not just simply physical incidents.

  4. Long-term dose-response studies of inhaled or injected radionuclides

    International Nuclear Information System (INIS)

    Boecker, B.B.; Muggenburg, B.A.; Miller, S.C.; Bradley, P.L.

    1994-01-01

    This report describes the scientific progress in, and current status of, life-span studies of the long-term health risks in Beagle dogs of chronic irradiation from internally deposited radionuclides or from an external source. The reporting period for this document is the 2-year period from October 1, 1991 through September 30, 1993. Studies that were initiated at three different laboratories (Inhalation Toxicology Research Institute, ITRI, University of Utah, and Argonne National Laboratory, ANL) are presented here because they are being completed at ITRI. All living dogs in the Utah-initiated studies were transferred to the ITRI facility for the remainder of their life-span observations and measurements in September 1987. This report is the fourth in a series of reports dealing with the current status and progress of both the Utah and ITRI studies. Other life-span studies involving dogs exposed to gamma radiation from an external source were initiated and conducted for many years at ANL. In 1991, the decision was made to discontinue the chronic irradiation of the remaining living dogs and to transfer all remaining dogs to ITRI for care, clinical observations, and pathological observations at death or euthanasia. This report provides the current status of these dogs. Status reports on the Utah and ITRI studies comprise most of this report. The ITRI-related section presents brief statements of project objectives, the general procedures used in these studies, and some study-specific features for each of the 19 studies being conducted with either beta- or alpha-emitting radionuclides. Dose- and effect-modifying factors being addressed in these studies include total dose, dose rate, LET, solubility, nonuniformity of dose, species, age, sex, health status, and mode of exposure. Recent additions to experimental protocols for studies in which dogs are still alive involve the collection and analysis of tumor tissues using currently available molecular biology techniques

  5. Bullying by Definition: An Examination of Definitional Components of Bullying

    Science.gov (United States)

    Goldsmid, Susan; Howie, Pauline

    2014-01-01

    Lack of definitional consensus remains an important unresolved issue within bullying research. This study examined the ability of definitional variables to predict overall level of victimisation (distress, power inequity, and provocation as predictors) and bullying (intention to harm, power inequity, and provocation as predictors) in 246…

  6. Monte Carlo simulation study on dose enhancement by gold nanoparticles in brachytherapy

    International Nuclear Information System (INIS)

    Cho, Sungkoo; Jeong, Jonghwi; Kim, Chanhyeong; Yoon, Myonggeun

    2010-01-01

    Radiation dose enhancement by injection of a high atomic number (Z) material into tumor volumes has been studied for various radiation sources and different concentrations of gold nanoparticles. Brachytherapy employs low energy photons of less than ∼0.5 MeV, which indeed is the optimal energy range for radiation dose enhancement by introduction of high-Z material. The present study uses the MCNPX TM code to estimate the dose enhancement by gold nanoparticles for the four common brachytherapy sources ( 137 Cs, 192 Ir, 125 I, and 103 Pd). Additionally, cisplatin (H 6 Cl 2 N 2 Pt), a platinum-based chemotherapeutic drug, was used to evaluate the dose enhancement. The simulated source models were evaluated with reference to the calculated TG-43 parameter values. The dose enhancement in the tumor region due to the gold nanoparticles and cisplatin was evaluated according to the dose enhancement factor (DEF). The maximum values of the average DEFs were found to be 1.03, 1.11, 3.43, and 2.17 for the 137 Cs, 192 Ir, 125 I, and 103 Pd sources, respectively. The dose enhancement values for the low-energy sources were significantly higher than those for the high-energy sources. The dose enhancement due to cisplatin was calculated by using the same approach and was found to be comparable to that of the gold nanoparticles. The maximum value of the average DEF for cisplatin was 1.12 for the 5% concentration level in water and a 192 Ir source. We confirmed that cisplatin could be applied to cancer therapy that combines chemotherapeutic drugs with radiation therapy. The results presented herein will be used to study dose enhancement in tumor regions using various radiation modalities with high atomic number materials.

  7. Dose proportionality and pharmacokinetics of carvedilol sustained-release formulation: a single dose-ascending 10-sequence incomplete block study

    Directory of Open Access Journals (Sweden)

    Kim YH

    2015-06-01

    Full Text Available Yo Han Kim,1 Hee Youn Choi,1 Yook-Hwan Noh,1 Shi Hyang Lee,1 Hyeong-Seok Lim,1 Chin Kim,2 Kyun-Seop Bae11Department of Clinical Pharmacology and Therapeutics, College of Medicine, University of Ulsan, Asan Medical Center, 2Chong Kun Dang Clinical Research and Clinical Epidemiology and Medical Information, CKD Pharmaceuticals, Seoul, Republic of KoreaBackground: Carvedilol is a third-generation β-blocker indicated for congestive heart failure and high blood pressure. The aim of this study was to investigate the dose proportionality of the carvedilol sustained-release (SR formulation in healthy male subjects.Methods: An open-label, single dose-ascending, 10-sequence, 3-period balanced incomplete block study was performed using healthy male subjects. In varying sequences, each subject received three of five carvedilol SR formulations (8, 16, 32, 64, or 128 mg once. The treatment periods were separated by a washout period of 7 days. Serial blood samples were collected up to 48 h after dosing. The plasma concentrations of carvedilol were determined by using validated liquid chromatography–tandem mass spectrometry. Pharmacokinetic parameters including the area under the plasma concentration–time curve (AUC from time 0 to the last measurable time (AUClast, AUC extrapolated to infinity (AUCinf, and the measured peak plasma concentration (Cmax were obtained by noncompartmental analysis. Dose proportionality was evaluated if the ln–ln plots of AUClast, AUCinf, and Cmax versus dose were linear and the 90% confidence intervals (CIs of the slopes were within 0.9195 and 1.0805. Tolerability was assessed by vital signs, electrocardiogram, clinical laboratory tests, and monitoring of adverse events (AEs throughout the study.Results: A total of 31 subjects were enrolled, and 30 completed the study. The assessment of dose proportionality meets the statistical criteria; the point estimates of slope were 1.0104 (90% CI: 0.9849–1.0359 for AUClast, 1

  8. Committed dose equivalent in the practice of radiological protection

    International Nuclear Information System (INIS)

    Nenot, J.C.; Piechowski, J.

    1985-01-01

    In the case of internal exposure, the dose is not received at the moment of exposure, as happens with external exposure, since the incorporated radionuclide irradiates the various organs and tissues during the time it is present in the body. By definition, the committed dose equivalent corresponds to the received dose integrated over 50 years from the date of intake. In order to calculate it, one has to know the intake activity and the value of the committed dose equivalent per unit of intake activity. The uncertainties of the first parameter are such that the committed dose equivalent can only be regarded as an order of magnitude and not as a very accurate quantity. The use of it is justified, however, for, like the dose equivalent for external exposure, it expresses the risk of stochastic effects for the individual concerned since these effects, should they appear, would do so only after a latent period which is generally longer than the dose integration time. Moreover, the use of the committed dose equivalent offers certain advantages for dosimetric management, especially when it is simplified. A practical problem which may arise is that the annual dose limit is apparently exceeded by virtue of the fact that one is taking account, in the first year, of doses which will actually be received only in the following years. These problems are rare enough in practice to be dealt with individually in each case. (author)

  9. Motion-encoded dose calculation through fluence/sinogram modification

    International Nuclear Information System (INIS)

    Lu, Weiguo; Olivera, Gustavo H.; Mackie, Thomas R.

    2005-01-01

    Conventional radiotherapy treatment planning systems rely on a static computed tomography (CT) image for planning and evaluation. Intra/inter-fraction patient motions may result in significant differences between the planned and the delivered dose. In this paper, we develop a method to incorporate the knowledge of intra/inter-fraction patient motion directly into the dose calculation. By decomposing the motion into a parallel (to beam direction) component and perpendicular (to beam direction) component, we show that the motion effects can be accounted for by simply modifying the fluence distribution (sinogram). After such modification, dose calculation is the same as those based on a static planning image. This method is superior to the 'dose-convolution' method because it is not based on 'shift invariant' assumption. Therefore, it deals with material heterogeneity and surface curvature very well. We test our method using extensive simulations, which include four phantoms, four motion patterns, and three plan beams. We compare our method with the 'dose-convolution' and the 'stochastic simulation' methods (gold standard). As for the homogeneous flat surface phantom, our method has similar accuracy as the 'dose-convolution' method. As for all other phantoms, our method outperforms the 'dose-convolution'. The maximum motion encoded dose calculation error using our method is within 4% of the gold standard. It is shown that a treatment planning system that is based on 'motion-encoded dose calculation' can incorporate random and systematic motion errors in a very simple fashion. Under this approximation, in principle, a planning target volume definition is not required, since it already accounts for the intra/inter-fraction motion variations and it automatically optimizes the cumulative dose rather than the single fraction dose

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-12-05

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

  11. Definitions of Physical Concepts: A Study of Physics Teachers' Knowledge and Views. Research Report

    Science.gov (United States)

    Galili, Igal; Lehavi, Yaron

    2006-01-01

    A study was made of the ability of a population of high-school physics teachers to define physics concepts and of their views regarding the importance of such definitions. It was found possible to arrange the definitions accumulated in categories, and the classification so obtained was consonant with that of the philosophy of science. Although the…

  12. A comparative study on the elastic modulus of polyvinyl alcohol sponge using different stress-strain definitions.

    Science.gov (United States)

    Karimi, Alireza; Navidbakhsh, Mahdi; Alizadeh, Mansour; Razaghi, Reza

    2014-10-01

    There have been different stress-strain definitions to measure the elastic modulus of spongy materials, especially polyvinyl alcohol (PVA) sponge. However, there is no agreement as to which stress-strain definition should be implemented. This study was aimed to show how different results are given by the various definitions of stress-strain used, and to recommend a specific definition when testing spongy materials. A fabricated PVA sponge was subjected to a series of tensile tests in order to measure its mechanical properties. Three stress definitions (second Piola-Kichhoff stress, engineering stress, and true stress) and four strain definitions (Almansi-Hamel strain, Green-St. Venant strain, engineering strain, and true strain) were used to determine the elastic modulus. The results revealed that the Almansi-Hamel strain definition exhibited the highest non-linear stress-strain relation and, as a result, may overestimate the elastic modulus at different stress definitions (second Piola-Kichhoff stress, engineering stress, and true stress). The Green-St. Venant strain definition failed to address the non-linear stress-strain relation using different definitions of stress and invoked an underestimation of the elastic modulus values. Engineering stress and strain definitions were only valid for small strains and displacements, which make them impractical when analyzing spongy materials. The results showed that the effect of varying the stress definition on the maximum stress measurements was significant but not when calculating the elastic modulus. It is important to consider which stress-strain definition is employed when characterizing the mechanical properties of spongy materials. Although the true stress-true strain definition exhibits a non-linear relation, we favor it in spongy materials mechanics as it gives more accurate measurements of the material's response using the instantaneous values.

  13. The calculation of dose from external photon exposures using reference human phantoms and Monte-Carlo methods. Pt. 1

    International Nuclear Information System (INIS)

    Kramer, R.; Zankl, M.; Williams, G.; Drexler, G.

    1982-12-01

    By the help of a Monte-Carlo program the dose that single organs, organ groups and bigger or smaller parts of body would receive on an average, caused by an irradiation definitely fixed by the geometry of irradiation and photon energy, can be determined. Thus the phantom in connection with the Monte-Carlo program can be used for several considerations as for example - calculation of dose from occupational exposures - calculation of dose from diagnostic procedures - calculation of dose from radiotherapy procedures. (orig.)

  14. The philosophy of dose limitation

    International Nuclear Information System (INIS)

    Recht, P.

    1981-01-01

    The evolution of concepts and terms appearing in the European Rules of 15 July 1980 is briefly described. After a period where ''tolerance doses'' represent definite limits which should be respected, appears the concept of a ''as low as possible'' and ''as low as practicable'' level. The hypothesis that any exposure represents a risk which should be avoided is taken into account in the later evolution. As a consequence one has to examine the advantages and disadvantages in other words to make a cost-benefit analysis. This evolution leads to the concepts of justification and optimization used at the present time. (author)

  15. Fundamental studies on miniature dose meter using variable capacitance Si-diode

    International Nuclear Information System (INIS)

    Inoue, Yoshio

    1976-01-01

    The results of fundamental studies on development of a miniature dose meter using a semiconductor applicable for dosimetry in both intracavitary and external radiotherapy are described. Many different instruments have been applied in clinical dosimetry for regional lesions, mostly in phantom studies, e. g. the small sized ionization chamber, the fluoroluminescence glass dose meter and the thermoluminescence dose meter. However, there are considerable problems regarding safety, reproducibility, and simplicity for regional dosimetry of intracavitary lesions, such as genitourinary, gastrointestinal and respiratory malignancies. To overcome these problems, an attempt was made to develop a miniature catheter type detector using a variable capacitance Si-diode for gamma ray dosimetry. The newly developed miniature dose meter using a semiconductor has the following characteristics. As the tip of detector (23mm long and 3mm in diameter) is very small, the apparatus unit is easy to manipulate in the dosimetry of intracavitary lesions. As no voltage is supplied to the detector, there is no danger of electric shock from in vivo studies. A strict linearity existed between the radiation dose rate and the generated voltage even when the range of experimental irradiation dose rate was extremely wide. The sensitivity of the detector was affected by the environmental temperature, but it was easy to correct the sensitivity by applying a special calibration chart to the value derived from a thermister enclosed in the detector. Even with the experimental irradiation of more than 50,000R, no changes in the sensitivity of the detector were observed. Thus, the durability of the apparatus was shown to be excellent. (auth.)

  16. Cardiac-Specific Conversion Factors to Estimate Radiation Effective Dose From Dose-Length Product in Computed Tomography.

    Science.gov (United States)

    Trattner, Sigal; Halliburton, Sandra; Thompson, Carla M; Xu, Yanping; Chelliah, Anjali; Jambawalikar, Sachin R; Peng, Boyu; Peters, M Robert; Jacobs, Jill E; Ghesani, Munir; Jang, James J; Al-Khalidi, Hussein; Einstein, Andrew J

    2018-01-01

    This study sought to determine updated conversion factors (k-factors) that would enable accurate estimation of radiation effective dose (ED) for coronary computed tomography angiography (CTA) and calcium scoring performed on 12 contemporary scanner models and current clinical cardiac protocols and to compare these methods to the standard chest k-factor of 0.014 mSv·mGy -1 cm -1 . Accurate estimation of ED from cardiac CT scans is essential to meaningfully compare the benefits and risks of different cardiac imaging strategies and optimize test and protocol selection. Presently, ED from cardiac CT is generally estimated by multiplying a scanner-reported parameter, the dose-length product, by a k-factor which was determined for noncardiac chest CT, using single-slice scanners and a superseded definition of ED. Metal-oxide-semiconductor field-effect transistor radiation detectors were positioned in organs of anthropomorphic phantoms, which were scanned using all cardiac protocols, 120 clinical protocols in total, on 12 CT scanners representing the spectrum of scanners from 5 manufacturers (GE, Hitachi, Philips, Siemens, Toshiba). Organ doses were determined for each protocol, and ED was calculated as defined in International Commission on Radiological Protection Publication 103. Effective doses and scanner-reported dose-length products were used to determine k-factors for each scanner model and protocol. k-Factors averaged 0.026 mSv·mGy -1 cm -1 (95% confidence interval: 0.0258 to 0.0266) and ranged between 0.020 and 0.035 mSv·mGy -1 cm -1 . The standard chest k-factor underestimates ED by an average of 46%, ranging from 30% to 60%, depending on scanner, mode, and tube potential. Factors were higher for prospective axial versus retrospective helical scan modes, calcium scoring versus coronary CTA, and higher (100 to 120 kV) versus lower (80 kV) tube potential and varied among scanner models (range of average k-factors: 0.0229 to 0.0277 mSv·mGy -1 cm -1 ). Cardiac k

  17. Feasibility study on standardization of 131I dose in hyperthyrodisom treatment

    International Nuclear Information System (INIS)

    Tang Yi

    2011-01-01

    To explore feasibility of standardization of 131 I dose in Graves' hyperthyroidism treatment, the data of 681 Graves' disease cases treated with 131 I was retrospective studied. The software was developed to re-calculate the 131 I doses for the patients and compared with original doses given by traditional method. 313 patients with complete information were taken and divided to three groups base on the remedial effect, Cured Group (123 patients), Uncured Group (125 patients) and Hypothyroid Group (65 patients). The results showed that there was no statistically significant difference between the 131 I dose for Graves' hyperthyroidism treatment calculated by two methods (P>0.05). There was obviously statistically significant difference in hypothyroid Group (P 131 I calculated by software method (174.27 MBq) was less than that of traditional method (190.18 MBq). In uncured group, there was still obviously statistically significant difference (P 131 I calculated by software method (187.22 MBq) was more than that of the traditional method (169.46 MBq). In cured group, there was no statistically significant difference (P>0.005), the mean dose of 131 I calculated by software method (185 MBq) was slightly smaller than that of the traditional method(192.03 MBq). The results indicate the calculation of standard 131 I dose for Graves' hyperthyroidism treatment by software developed in this study is feasible. (authors)

  18. Dose profile measurements during respiratory-gated lung stereotactic radiotherapy: A phantom study

    International Nuclear Information System (INIS)

    Jong, W L; Ung, N M; Wong, J H D; Ng, K H

    2016-01-01

    During stereotactic body radiotherapy, high radiation dose (∼60 Gy) is delivered to the tumour in small fractionation regime. In this study, the dosimetric characteristics were studied using radiochromic film during respiratory-gated and non-gated lung stereotactic body radiotherapy (SBRT). Specifically, the effect of respiratory cycle and amplitude, as well as gating window on the dosimetry were studied. In this study, the dose profiles along the irradiated area were measured. The dose profiles for respiratory-gated radiation delivery with different respiratory or tumour motion amplitudes, gating windows and respiratory time per cycle were in agreement with static radiation delivery. The respiratory gating system was able to deliver the radiation dose accurately (±1.05 mm) in the longitudinal direction. Although the treatment time for respiratory-gated SBRT was prolonged, this approach can potentially reduce the margin for internal tumour volume without compromising the tumour coverage. In addition, the normal tissue sparing effect can be improved. (paper)

  19. Radiation dose of staff during positron emission tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Hachiya, Takenori; Shoji, Yasuaki; Hagami, Eiichi; Aizawa, Yasuo; Onodera, Hiroshi; Kan, Mikio; Sasaki, Nobuo; Toyoshima, Eiji; Sugawara, Shigeki

    1989-04-01

    In this paper, the radiation dose of the PET staff including blood sampling operators (medical doctors), PET operators (radio technologists), nurses, blood analysts (medical technologists), radiochemists and cyclotron operators in the cyclotron-PET unit was evaluated. The dose was measured using the film-badges for whole body and TLD ring-badges for fingers. These data were obtained from June, 1986 to May, 1987. In the average dose per month, those with the highest dose were radiochemists. The whole body dose was 1.08 mSv (108 mrem) for /gamma/-ray, 520 /mu/Sv (52 mrem) for /beta/-ray and the dose for fingers, 7.6mSv (760 mrem). The total dose per year both for /gamma/ and /beta/-ray was 19.2 mSv (1.92 rem) for whole body and 91.2 mSv (9.12 rem) for fingers. The staff with the lowest whole body dose for /gamma/-ray per month was blood analysts whose dose was 30 /mu/Sv (3 mrem). For the staff consisting of doctors, radiotechnologists and nurses, the whole body dose per month was 70-170/mu/Sv (7-17 mrem) for /gamma/-ray, 20 /mu/Sv (2 mrem) for /beta/-ray and the dose for fingers per month was 210-540 /mu/Sv (21-54 mrem). For cyclotron operators, the dose was 90 /mu/Sv (9 mrem) for /gamma/-ray, 30 /mu/Sv (3 mrem) for /beta/-ray and the dose for fingers was 160 /mu/Sv (16 mrem). For cyclotron operators and radiochemists, the whole body dose for the neutron ray was measured by solid state nuclear track detector (SSNTD), but the dose was found to be negligible. (author).

  20. Radiation doses and risks from internal emitters

    International Nuclear Information System (INIS)

    Harrison, John; Day, Philip

    2008-01-01

    This review updates material prepared for the UK Government Committee Examining Radiation Risks from Internal Emitters (CERRIE) and also refers to the new recommendations of the International Commission on Radiological Protection (ICRP) and other recent developments. Two conclusions from CERRIE were that ICRP should clarify and elaborate its advice on the use of its dose quantities, equivalent and effective dose, and that more attention should be paid to uncertainties in dose and risk estimates and their implications. The new ICRP recommendations provide explanations of the calculation and intended purpose of the protection quantities, but further advice on their use would be helpful. The new recommendations refer to the importance of understanding uncertainties in estimates of dose and risk, although methods for doing this are not suggested. Dose coefficients (Sv per Bq intake) for the inhalation or ingestion of radionuclides are published as reference values without uncertainty. The primary purpose of equivalent and effective dose is to enable the summation of doses from different radionuclides and from external sources for comparison with dose limits, constraints and reference levels that relate to stochastic risks of whole-body radiation exposure. Doses are calculated using defined biokinetic and dosimetric models, including reference anatomical data for the organs and tissues of the human body. Radiation weighting factors are used to adjust for the different effectiveness of different radiation types, per unit absorbed dose (Gy), in causing stochastic effects at low doses and dose rates. Tissue weighting factors are used to take account of the contribution of individual organs and tissues to overall detriment from cancer and hereditary effects, providing a simple set of rounded values chosen on the basis of age- and sex-averaged values of relative detriment. While the definition of absorbed dose has the scientific rigour required of a basic physical quantity

  1. Dose planning and dose delivery in radiation therapy

    International Nuclear Information System (INIS)

    Knoeoes, T.

    1991-01-01

    A method has been developed for calibration of CT-numbers to volumetric electron density distributions using tissue substitutes of known elemental composition and experimentally determined electron density. This information have been used in a dose calculation method based on photon and electron interaction processes. The method utilizes a convolution integral between the photon fluence matrix and dose distribution kernels. Inhomogeneous media are accounted for using the theorems of Fano and O'Connor for scaling dose distribution kernels in proportion to electron density. For clinical application of a calculated dose plan, a method for prediction of accelerator output have been developed. The methods gives the number of monitor units that has to be given to obtain a certain absorbed dose to a point inside an irregular, inhomogeneous object. The method for verification of dose distributions outlined in this study makes it possible to exclude the treatment related variance contributions, making an objective evaluation of dose calculations with experiments feasible. The methods for electron density determination, dose calculation and prediction of accelerator output discussed in this study will all contribute to an increased accuracy in the mean absorbed dose to the target volume. However, a substantial gain in the accuracy for the spatial absorbed dose distribution will also follow, especially using CT for mapping of electron density together with the dose calculation algorithm. (au)

  2. Design study on dose evaluation method for employees at severe accident

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Yoshitaka; Irie, Takashi; Kohriyama, Tamio [Institute of Nuclear Safety Systems Inc., Mihama, Fukui (Japan); Kudo, Seiichi [Mitsubishi Heavy Industries Ltd., Tokyo (Japan); Nishimura, Kazuya [Computer Software Development Co., Ltd., Tokyo (Japan)

    2001-09-01

    When we assume a severe accident in a nuclear power plant, it is required for rescue activity in the plant, accident management, repair work of failed parts and evaluation of employees to obtain radiation dose rate distribution or map in the plant and estimated dose value for the above works. However it might be difficult to obtain them accurately along the progress of the accident, because radiation monitors are not always installed in the areas where the accident management is planned or the repair work is thought for safety-related equipments. In this work, we analyzed diffusion of radioactive materials in case of a severe accident in a pressurized water reactor plant, investigated a method to obtain radiation dose rate in the plant from estimated radioactive sources, made up a prototype analyzing system by modeling a specific part of components and buildings in the plant from this design study on dose evaluation method for employees at severe accident, and then evaluated its availability. As a result, we obtained the followings: (1) A new dose evaluation method was established to predict the radiation dose rate in any point in the plant during a severe accident scenario. (2) This evaluation of total dose including moving route and time for the accident management and the repair work is useful for estimating radiation dose limit for these actions of the employees. (3) The radiation dose rate map is effective for identifying high radiation areas and for choosing a route with lower radiation dose rate. (author)

  3. Design study on dose evaluation method for employees at severe accident

    International Nuclear Information System (INIS)

    Yoshida, Yoshitaka; Irie, Takashi; Kohriyama, Tamio; Kudo, Seiichi; Nishimura, Kazuya

    2001-01-01

    When we assume a severe accident in a nuclear power plant, it is required for rescue activity in the plant, accident management, repair work of failed parts and evaluation of employees to obtain radiation dose rate distribution or map in the plant and estimated dose value for the above works. However it might be difficult to obtain them accurately along the progress of the accident, because radiation monitors are not always installed in the areas where the accident management is planned or the repair work is thought for safety-related equipments. In this work, we analyzed diffusion of radioactive materials in case of a severe accident in a pressurized water reactor plant, investigated a method to obtain radiation dose rate in the plant from estimated radioactive sources, made up a prototype analyzing system by modeling a specific part of components and buildings in the plant from this design study on dose evaluation method for employees at severe accident, and then evaluated its availability. As a result, we obtained the followings: (1) A new dose evaluation method was established to predict the radiation dose rate in any point in the plant during a severe accident scenario. (2) This evaluation of total dose including moving route and time for the accident management and the repair work is useful for estimating radiation dose limit for these actions of the employees. (3) The radiation dose rate map is effective for identifying high radiation areas and for choosing a route with lower radiation dose rate. (author)

  4. The relationship between the bladder volume and optimal treatment planning in definitive radiotherapy for localized prostate cancer

    International Nuclear Information System (INIS)

    Nakamura, Naoki; Sekiguchi, Kenji; Akahane, Keiko; Shikama, Naoto; Takahashi, Osamu; Hama, Yukihiro; Nakagawa, Keiichi

    2012-01-01

    Background and purpose: There is no current consensus regarding the optimal bladder volumes in definitive radiotherapy for localized prostate cancer. The aim of this study was to clarify the relationship between the bladder volume and optimal treatment planning in radiotherapy for localized prostate cancer. Material and methods: Two hundred and forty-three patients underwent definitive radiotherapy with helical tomotherapy for intermediate- and high-risk localized prostate cancer. The prescribed dose defined as 95 % of the planning target volume (PTV) receiving 100 % of the prescription dose was 76 Gy in 38 fractions. The clinical target volume (CTV) was defined as the prostate with a 5-mm margin and 2 cm of the proximal seminal vesicle. The PTV was defined as the CTV with a 5-mm margin. Treatment plans were optimized to satisfy the dose constraints defined by in-house protocols for PTV and organs at risk (rectum wall, bladder wall, sigmoid colon and small intestine). If all dose constraints were satisfied, the plan was defined as an optimal plan (OP). Results: An OP was achieved with 203 patients (84%). Mean bladder volume (± 1 SD) was 266 ml (± 130 ml) among those with an OP and 214 ml (±130 ml) among those without an OP (p = 0.02). Logistic regression analysis also showed that bladder volumes below 150 ml decreased the possibility of achieving an OP. However, the percentage of patients with an OP showed a plateau effect at bladder volumes above 150 ml. Conclusions. Bladder volume is a significant factor affecting OP rates. However, our results suggest that bladder volumes exceeding 150 ml may not help meet planning dose constraints

  5. Early termination of prostate cancer hyperfractionated dose escalation study

    International Nuclear Information System (INIS)

    Forman, Jeffrey D; Porter, Arthur T; Kocheril, Paul; Grignon, David; Orton, Colin

    1996-01-01

    Purpose: This study was initiated to determine the maximum tolerable dose of hyperfractionated radiation in patients with locally advanced prostate cancer. Materials and Methods: Forty-nine patients with locally advanced prostate cancer (T3-T4 Nx, 0, 1 M0 and/or Gleason Score ≥ 8) were treated on the first two steps of a prospective dose-escalation study using hyperfractionated conformal radiotherapy. The first 25 patients received a minimum dose of 78Gy to the clinical tumor volume (CTV) including the prostate, seminal vesicle and a 5mm margin at 1.3Gy b.i.d. The second group (24 patients) received a minimum dose to the CTV of 82.8Gy at 1.15Gy b.i.d. Twenty eight patients received neo-adjuvant hormonal therapy in conjunction with their radiation (8 of 25 patients at 78Gy and 20 of 24 patients at 82.8Gy). Toxicity was scored according to the RTOG grading scale. Efficacy was evaluated by PSA levels and ultrasound guided biopsies. Median follow up was 36 and 18 months for the 78Gy and 82.8Gy dose levels, respectively. Results: No grade 3 or 4 gastrointestinal (GI) or genitourinary (GU) toxicity was noted. At 36 months, the actuarial probability of Grade 2 GI and GU toxicity were 16 and 20%, respectively. Twelve to 18 months following radiation, 41 patients (86%) underwent ultrasound guided biopsy. At 78Gy, 60% of 20 patients had a biopsy which was negative or showed a marked therapeutic effect. At 82.8Gy, these combined rates were 95% in the 21 patients who had biopsies. Nine patients (50%) who did not receive neo-adjuvant hormones had positive biopsies. No patient who received neo-adjuvant hormones plus 78Gy (5 patients) or 82.8Gy (18 patients) had a positive biopsy. Conclusion: Proceeding to the next dose level (87.4Gy) was justified by the lack of severe chronic toxicity. However, in view of the high rate of histologic sterilization when hyperfractionated irradiation was given in conjunction with neo-adjuvant hormonal therapy, it was felt to be unethical to

  6. The relation of metabolic syndrome according to five definitions to cardiovascular risk factors - a population-based study

    Directory of Open Access Journals (Sweden)

    Lai Ming-May

    2009-12-01

    Full Text Available Abstract Background Although National Cholesterol Education Program (NCEP, International Diabetes Federation (IDF, American Heart Association and National Heart, Lung and Blood Institute (AHA/NHLBI, World Health Organization (WHO, and the European Group for the Study of Insulin Resistance (EGIR definitions of metabolic syndrome (MetS have been commonly used by studies, little is known about agreement among these five definitions. We examined the agreement among these five definitions and explored their relationship with risk factors of cardiovascular disease in a Taiwan population. Methods A total of 1305 subjects aged 40 years and over in Taiwan were analyzed. Biomedical markers and anthropometric indices were measured. Agreement among definitions was determined by the kappa statistic. Logistic regression models were fit to estimate the odds of a high cardiovascular risk group for five definitions of MetS. Results The agreement among the NCEP, IDF, and AHA/NHLBI definitions was from substantial to very good, and agreement between the WHO and EGIR definitions was also substantial. All MetS definitions were significantly associated prevalence of microalbuminuria, elevated highly sensitive CRP (hs-CRP, and arterial stiffness only in women. In men, MetS by NCEP and AHA/NHLBI was associated with elevated level of hs-CRP and arterial stiffness. MetS by WHO and EGIR were significantly associated with microalbuminuria. And MetS by WHO was the only MetS definition that significantly associated with prevalence of arterial stiffness (OR: 2.75, 95% CI: 1.22-6.19. Conclusions The associations of these five definitions with cardiovascular risk factors were similar in women, and it was evident that the five definitions performed better in women than in men, with higher ORs observed in relation to arterial stiffness, elevated hs-CRP, and higher Framingham risk scores.

  7. Current issues surrounding the definition of trans-fatty acids: implications for health, industry and food labels.

    Science.gov (United States)

    Wang, Ye; Proctor, Spencer D

    2013-10-01

    The definition of trans-fatty acids (TFA) was established by the Codex Alimentarius to guide nutritional and legislative regulations to reduce TFA consumption. Currently, conjugated linoleic acid (CLA) is excluded from the TFA definition based on evidence (primarily preclinical studies) implying health benefits on weight management and cancer prevention. While the efficacy of CLA supplements remains inconsistent in randomised clinical trials, evidence has emerged to associate supplemental CLA with negative health outcomes, including increased subclinical inflammation and oxidative stress (particularly at high doses). This has resulted in concerns regarding the correctness of excluding CLA from the TFA definition. Here we review recent clinical and preclinical literature on health implications of CLA and ruminant TFA, and highlight several issues surrounding the current Codex definition of TFA and how it may influence interpretation for public health. We find that CLA derived from ruminant foods differ from commercial CLA supplements in their isomer composition/distribution, consumption level and bioactivity. We conclude that health concerns associated with the use of supplemental CLA do not repudiate the exclusion of all forms of CLA from the Codex TFA definition, particularly when using the definition for food-related purposes. Given the emerging differential bioactivity of TFA from industrial v. ruminant sources, we advocate that regional nutrition guidelines/policies should focus on eliminating industrial forms of trans-fat from processed foods as opposed to all TFA per se.

  8. Low radiation doses - Book of presentations (slides)

    International Nuclear Information System (INIS)

    2013-03-01

    This document brings together all the available presentations (slides) of the conference on low radiation doses organised by the 'research and health' department of the French society of radiation protection (SFRP). Ten presentations are available and deal with he following topics: 1 - Cyto-toxicity, geno-toxicity: comparative approach between ionizing radiations and other geno-toxic agents (F. Nesslany, Institut Pasteur, Lille); Succession of events occurring after a radio-induced DNA damage (D. Averbeck, IRSN/CEA); Importance of stem cells in the response to ionizing radiations (J. Lebeau, CEA); Relation between energy deposition at the sub-cell scale and early biological effects (C. Villagrasa, IRSN); Natural history of breast cancer: predisposition, susceptibility with respect to irradiation (S. Rivera, IGR); Pediatrics scanner study and the EPI-CT project (M.O Bernier, IRSN); What future for an irradiated cell: survival or apoptosis? (E. Sage, Institut Curie); Differential effect of a 137 Cs chronic contamination on the different steps of the atheromatous pathology (T. Ebrahimian, IRSN); Variability of the individual radiosensitivity (S. Chevillard, CEA); What definitions for individual sensitivity? (A. Schmidt, CEA); Low doses: some philosophical remarks (A. Grinbaum, CEA)

  9. Local dose enhancement in radiation therapy: Monte Carlo simulation study

    International Nuclear Information System (INIS)

    Silva, Laura E. da; Nicolucci, Patricia

    2014-01-01

    The development of nanotechnology has boosted the use of nanoparticles in radiation therapy in order to achieve greater therapeutic ratio between tumor and healthy tissues. Gold has been shown to be most suitable to this task due to the high biocompatibility and high atomic number, which contributes to a better in vivo distribution and for the local energy deposition. As a result, this study proposes to study, nanoparticle in the tumor cell. At a range of 11 nm from the nanoparticle surface, results have shown an absorbed dose 141 times higher for the medium with the gold nanoparticle compared to the water for an incident energy spectrum with maximum photon energy of 50 keV. It was also noted that when only scattered radiation is interacting with the gold nanoparticles, the dose was 134 times higher compared to enhanced local dose that remained significant even for scattered radiation. (author)

  10. Relapse of imported Plasmodium vivax malaria is related to primaquine dose: a retrospective study

    Directory of Open Access Journals (Sweden)

    Townell Nicola

    2012-06-01

    Full Text Available Abstract Background Relapsing Plasmodium vivax infection results in significant morbidity for the individual and is a key factor in transmission. Primaquine remains the only licensed drug for prevention of relapse. To minimize relapse rates, treatment guidelines have recently been revised to recommend an increased primaquine dose, aiming to achieve a cumulative dose of ≥6 mg/kg, i.e. ≥420 mg in a 70 kg patient. The aims of this study were to characterize the epidemiology of P. vivax infection imported into Queensland Australia, to determine the rates of relapse, to investigate the use of primaquine therapy, and its efficacy in the prevention of relapse. Methods A retrospective study was undertaken of laboratory confirmed P. vivax infection presenting to the two major tertiary hospitals in Queensland, Australia between January 1999 and January 2011. Primaquine dosing was classified as no dose, low dose ( Results Twenty relapses occurred following 151 primary episodes of P. vivax infection (13.2%. Relapses were confirmed among 3/21 (14.2%, 9/50 (18.0%, 1/54 (1.9% and 7/18 (38.9% of patients administered no dose, low dose, high dose and unknown primaquine dose respectively. High dose primaquine therapy was associated with a significantly lower rate of relapse compared to patients who were prescribed low dose therapy (OR 11.6, 95% CI 1.5-519, p = 0.005. Conclusions Relapse of P. vivax infection is more likely in patients who received low dose primaquine therapy. This study supports the recommendations that high dose primaquine therapy is necessary to minimize relapse of P. vivax malaria.

  11. Contrast monitoring techniques in CT pulmonary angiography: An important and underappreciated contributor to breast dose

    Energy Technology Data Exchange (ETDEWEB)

    Mitchell, D.P., E-mail: dpmmitchell@gmail.com; Rowan, M., E-mail: mrowan@mater.ie; Loughman, E., E-mail: eloughman@mater.ie; Ridge, C.A., E-mail: cridge@mater.ie; MacMahon, P.J., E-mail: pmacmahon@mater.ie

    2017-01-15

    Objective: The aims of our study were to evaluate the contribution of contrast-monitoring techniques to breast dose in pregnant and non-pregnant women, and to investigate the effect of a reduced peak kilovoltage (kV) monitoring scan protocol on breast dose and Computed Tomography Pulmonary Angiography (CTPA) diagnostic quality. Materials and methods: Single center retrospective study of 221 female patients undergoing a reduced kV 80 kV contrast-monitoring CTPA protocol compared to 281 patients using the conventional 120 kV contrast-monitoring protocol (Siemens Somatom Definition AS + ). 99 pregnant patients analyzed separately. ImPACT dosimetry software was used to calculate dose. Group subsets were evaluated to assess CTPA diagnostic quality. Results: The contrast-monitoring component of a CTPA study constituted 27% of the overall breast dose when using a standard 120 kV protocol compared to only 7% of the overall breast dose in the 80 kV study group. The dose to the breast from the contrast-monitoring component alone was reduced by 79% in the non-pregnant patients (0.36mGy ± 0.37 versus 1.7mGy ± 1.02; p < 0.001), and by 88% in the pregnant population (0.25 mGy ± 0.67 versus 2.24mGy ± 1.61; p < 0.001). There was no statistical difference in CTPA diagnostic quality or timing. Conclusion: Despite a short scan length and relatively small DLP, contrast-monitoring techniques (test-bolus or bolus-tracked) set at 120 kV can account for 27% of the overall breast dose accrued from a CTPA study. By decreasing the kilovoltage of the contrast-monitoring component, a significant reduction in breast dose for pregnant and non-pregnant female patients can be achieved without affecting CTPA quality or timing.

  12. Correspondence of the ICRP database of dose coefficients (1996) to 2007 recommendations of the ICRP

    International Nuclear Information System (INIS)

    Kadatskaya, M.M.

    2012-01-01

    The new IAEA international safety standards, issued in 2011, recommend in practical implementation of the 2007 Recommendations of the ICRP continue to use dosimetric database developed in 1996. This article presents method and results of the calculation of committed effective dose of internal exposure in accordance with the new definition of this quantity given in 2007 Recommendations of the ICRP. It is shown that in the control of internal doses in accordance with the 2007 Recommendations of the ICRP it is allowed to use dose factors which were released in 1996. (authors)

  13. Healthy ageing in the Nun Study: definition and neuropathologic correlates.

    Science.gov (United States)

    Tyas, Suzanne L; Snowdon, David A; Desrosiers, Mark F; Riley, Kathryn P; Markesbery, William R

    2007-11-01

    Although the concept of healthy ageing has stimulated considerable interest, no generally accepted definition has been developed nor has its biological basis been determined. To develop a definition of healthy ageing and investigate its association with longevity and neuropathology. Analyses were based on cognitive, physical, and post-mortem assessments from 1991 to 1998 in the Nun Study, a longitudinal study of ageing in participants 75+ years at baseline. We defined three mutually exclusive levels of healthy ageing (excellent, very good, and good) based on measures of global cognitive function, short-term memory, basic and instrumental activities of daily living, and self-rated function. Mortality analyses were based on 636 participants; neuropathologic analyses were restricted to 221 who had died and were autopsied. Only 11% of those meeting criteria for the excellent level of healthy ageing at baseline subsequently died, compared with 24% for the very good, 39% for the good, and 60% for the remaining participants. Survival curves showed significantly greater longevity with higher levels of healthy ageing. The risk of not attaining healthy ageing, adjusted for age, increased two-fold in participants with brain infarcts alone, six-fold in those with Alzheimer neuropathology alone, and more than thirteen-fold in those with both brain infarcts and Alzheimer neuropathology. The biological validity of our definition of healthy ageing is supported by its strong association with mortality and longevity. Avoiding Alzheimer and stroke neuropathology is critical to the maintenance of healthy ageing, and the presence of both pathologies dramatically decreases the likelihood of healthy ageing.

  14. High-dose proton beam therapy for sinonasal mucosal malignant melanoma

    International Nuclear Information System (INIS)

    Fuji, Hiroshi; Yoshikawa, Shusuke; Kasami, Masako; Murayama, Shigeyuki; Onitsuka, Tetsuro; Kashiwagi, Hiroya; Kiyohara, Yoshio

    2014-01-01

    The significance of definitive radiotherapy for sinonasal mucosal melanoma (SMM) is sill controvertial. This study was to evaluate the role of high-dose proton beam therapy (PBT) in patients with SMM. The cases of 20 patients with SMM localized to the primary site who were treated by PBT between 2006 and 2012 were retrospectively analyzed. The patterns of overall survival and morbidity were assessed. The median follow-up time was 35 months (range, 6–77 months). The 5-year overall and disease-free survival rates were 51% and 38%, respectively. Four patients showed local failure, 2 showed regrowth of the primary tumor, and 2 showed new sinonasal tumors beyond the primary site. The 5-year local control rate after PBT was 62%. Nodal and distant failure was seen in 7 patients. Three grade 4 late toxicities were observed in tumor-involved optic nerve. Our findings suggested that high-dose PBT is an effective local treatment that is less invasive than surgery but with comparable outcomes

  15. Engineering Definitional Interpreters

    DEFF Research Database (Denmark)

    Midtgaard, Jan; Ramsay, Norman; Larsen, Bradford

    2013-01-01

    A definitional interpreter should be clear and easy to write, but it may run 4--10 times slower than a well-crafted bytecode interpreter. In a case study focused on implementation choices, we explore ways of making definitional interpreters faster without expending much programming effort. We imp...

  16. Developing a comprehensive definition of sustainability.

    Science.gov (United States)

    Moore, Julia E; Mascarenhas, Alekhya; Bain, Julie; Straus, Sharon E

    2017-09-02

    Understanding sustainability is one of the significant implementation science challenges. One of the big challenges in researching sustainability is the lack of consistent definitions in the literature. Most implementation studies do not present a definition of sustainability, even when assessing sustainability. The aim of the current study was to systematically develop a comprehensive definition of sustainability based on definitions already used in the literature. We searched for knowledge syntheses of sustainability and abstracted sustainability definitions from the articles identified through any relevant systematic and scoping reviews. The constructs in the abstracted sustainability definitions were mapped to an existing definition. The comprehensive definition of sustainability was revised to include emerging constructs. We identified four knowledge syntheses of sustainability, which identified 209 original articles. Of the 209 articles, 24 (11.5%) included a definition of sustainability. These definitions were mapped to three constructs from an existing definition, and nine new constructs emerged. We reviewed all constructs and created a revised definition: (1) after a defined period of time, (2) a program, clinical intervention, and/or implementation strategies continue to be delivered and/or (3) individual behavior change (i.e., clinician, patient) is maintained; (4) the program and individual behavior change may evolve or adapt while (5) continuing to produce benefits for individuals/systems. All 24 definitions were remapped to the comprehensive definition (percent agreement among three coders was 94%). Of the 24 definitions, 17 described the continued delivery of a program (70.8%), 17 mentioned continued outcomes (70.8%), 13 mentioned time (54.2%), 8 addressed the individual maintenance of a behavior change (33.3%), and 6 described the evolution or adaptation (25.0%). We drew from over 200 studies to identify 24 existing definitions of sustainability

  17. Two examples of indication specific radiation dose calculations in dental CBCT and Multidetector CT scanners.

    Science.gov (United States)

    Stratis, Andreas; Zhang, Guozhi; Lopez-Rendon, Xochitl; Politis, Constantinus; Hermans, Robert; Jacobs, Reinhilde; Bogaerts, Ria; Shaheen, Eman; Bosmans, Hilde

    2017-09-01

    To calculate organ doses and estimate the effective dose for justification purposes in patients undergoing orthognathic treatment planning purposes and temporal bone imaging in dental cone beam CT (CBCT) and Multidetector CT (MDCT) scanners. The radiation dose to the ICRP reference male voxel phantom was calculated for dedicated orthognathic treatment planning acquisitions via Monte Carlo simulations in two dental CBCT scanners, Promax 3D Max (Planmeca, FI) and NewTom VGi evo (QR s.r.l, IT) and in Somatom Definition Flash (Siemens, DE) MDCT scanner. For temporal bone imaging, radiation doses were calculated via MC simulations for a CBCT protocol in NewTom 5G (QR s.r.l, IT) and with the use of a software tool (CT-expo) for Somatom Force (Siemens, DE). All procedures had been optimized at the acceptance tests of the devices. For orthognathic protocols, dental CBCT scanners deliver lower doses compared to MDCT scanners. The estimated effective dose (ED) was 0.32mSv for a normal resolution operation mode in Promax 3D Max, 0.27mSv in VGi-evo and 1.18mSv in the Somatom Definition Flash. For temporal bone protocols, the Somatom Force resulted in an estimated ED of 0.28mSv while for NewTom 5G the ED was 0.31 and 0.22mSv for monolateral and bilateral imaging respectively. Two clinical exams which are carried out with both a CBCT or a MDCT scanner were compared in terms of radiation dose. Dental CBCT scanners deliver lower doses for orthognathic patients whereas for temporal bone procedures the doses were similar. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  18. Comparative study of dose descriptor in pediatric computed tomography exams

    International Nuclear Information System (INIS)

    Finatto, Jerusa Dalbosco; Silva, Ana Maria Marques da; Froner, Ana Paula Pastre; Pimentel, Juliana

    2014-01-01

    This work aims to investigate the dose descriptor, volumetric Computed Tomography Dose Index (CTDI), a pediatric patients sample undergoing to skull CT, comparing the results with the diagnostic reference levels of the literature. Were collected volumetric CTDI values of all skull CT exams performed retrospectively in children of 0-10 years of age in a period of 12 months in a large hospital size. Patients, in a total of 103, were divided into four groups, where the criterion of separation used was age, trying to use the same division used in international references dose descriptors. In all acquisitions we used the pediatric protocol and the Automatic Exposure Control (AEC) available on the equipment. The CDTI values, with and without the use of AEC for pediatric studies, were compared. There was a reduction of approximately 100% in the absorbed dose value due to the use of the AEC. From the data collected and analyzed in this work, it is concluded that the use of dose reduction systems is relevant, such as the Care Dose, to maintain volumetric CTDI values within the reference levels. Also it is important the observation of range of children age to the appropriate choice of parameters used in the test protocol. The values obtained are according to the diagnostic reference levels from the literature

  19. Consensus statement on injury definitions and data collection procedures for studies of injuries in rugby union

    Science.gov (United States)

    Fuller, Colin W; Molloy, Michael G; Bagate, Christian; Bahr, Roald; Brooks, John H M; Donson, Hilton; Kemp, Simon P T; McCrory, Paul; McIntosh, Andrew S; Meeuwisse, Willem H; Quarrie, Kenneth L; Raftery, Martin; Wiley, Preston

    2007-01-01

    Wide variations in the definitions and methodologies used for studies of injuries in rugby union have created inconsistencies in reported data and made interstudy comparisons of results difficult. The International Rugby Board established a Rugby Injury Consensus Group (RICG) to reach an agreement on the appropriate definitions and methodologies to standardise the recording of injuries and reporting of studies in rugby union. The RICG reviewed the consensus definitions and methodologies previously published for football (soccer) at a meeting in Dublin in order to assess their suitability for and application to rugby union. Following this meeting, iterative draft statements were prepared and circulated to members of the RICG for comment; a follow‐up meeting was arranged in Dublin, at which time all definitions and procedures were finalised. At this stage, all authors confirmed their agreement with the consensus statement. The agreed document was presented to and approved by the International Rugby Board Council. Agreement was reached on definitions for injury, recurrent injury, non‐fatal catastrophic injury, and training and match exposures, together with criteria for classifying injuries in terms of severity, location, type, diagnosis and causation. The definitions and methodology presented in this consensus statement for rugby union are similar to those proposed for football. Adoption of the proposals presented in this consensus statement should ensure that more consistent and comparable results will be obtained from studies of injuries within rugby union. PMID:17452684

  20. Estimating the human exposure to chemical substances and radiation. Definition report

    International Nuclear Information System (INIS)

    Vermeire, T.G.; Van Veen, M.P.

    1995-06-01

    This report aims at boosting the human exposure assessment activities of the RIVM with regard to chemical substances and radiation. It is the result of thorough discussions with RIVM-experts. The report starts with an overview of past developments in the area of human exposure assessment at the RIVM and continues describing recent projects. Major developments outside the Institute are also discussed. An attempt is made to harmonize definitions which are relevant for exposure assessment, i.e. definitions on exposure, intake, uptake and dose. Important gaps in the human exposure assessment work at the RIVM are identified, leading to proposals for future work. 2 figs., 31 refs., 3 appendices

  1. A population-based study of dosing and persistence with anti-dementia medications.

    LENUS (Irish Health Repository)

    Brewer, Linda

    2013-02-27

    PURPOSE: Cholinesterase inhibitors and memantine are the mainstay of pharmacological intervention for the cognitive symptoms of Alzheimer\\'s disease (AD). This study assessed the adequacy of dosing and persistence with AD medications and the predictors of these variables in the \\'real world\\' (outside the clinical trial setting). METHODS: The Health Service Executive-Primary Care Reimbursement Services prescription claims database in the Republic of Ireland contains prescription information for 1.6 million people. Patients aged >70 years who received at least two prescriptions for donepezil, rivastigmine, galantamine and memantine between January 2006 and December 2010 were included in the study. Rates of dose-maximisation were recorded by examining the initiation dose of each AD drug commenced during the study period and any subsequent dose titrations. Non-persistence was defined by a gap in prescribing of more than 63 consecutive days. Predictors of dose-maximisation and non-persistence were also analysed. RESULTS: Between January 2006 and December 2010, 20,729 patients aged >70 years received a prescription for an AD medication. Despite most patients on donepezil and memantine receiving a prescription for the maximum drug dose, this dose was maintained for 2 consecutive months in only two-thirds of patients. Patients were significantly more likely to have their doses of donepezil and memantine maximised if prescribed in more recent years (2010 vs. 2007). Rates of non-persistence were 30.1 % at 6 months and 43.8 % at 12 months. Older age [75+ vs. <75 years; hazards ratio (HR) 1.16, 95 % confidence interval (CI) 1.06-1.27] and drug type (rivastigmine vs. donepezil; HR 1.15, 95 % CI 1.03-1.27) increased the risk of non-persistence. Non-persistence was lower for those commencing therapy in more recent years (2010 vs. 2007; HR 0.81, 95 % CI 0.73-0.89, p < 0.001) and for those on multiple anti-dementia medications (HR 0.59, 95 % CI 0

  2. Close contact dose: a radioiodine therapy case study

    International Nuclear Information System (INIS)

    Tuchyna, T.

    2002-01-01

    Full text: External radiation dose rates were measured immediately post administration and periodically thereafter at 0.3 and 1.0 m from a patient who received a 555 MBq therapeutic dose of I-131. The dose received by the partner during the close contact period of sleep was measured with an anthropomorphic RANDO phantom representing a standard man with ICRP60 organs critical for dosimetry. RANDO occupied the same bed as the patient at a skin to skin distance of 30 cm with up to 30 TLD rods (1 x 1 x 6mm, LiF:Mg) inserted at critical organ positions within the phantom. The measurements were compared with empirical estimates provided by the Close Contact Dose Spreadsheet (Cormack and Shearer, 1998). The measured external dose rate of 19.3microSv/hr obtained immediately post administration rose slightly, to 26.3microSv/hr during the first 12 hours, however subsequently demonstrated a slow decrease. The TLDs embed- ded in RANDO recorded a dose of 0.24mSv during the hours of sleep. The total dose received by the partner over the two days was 0.29mSv, which compared favourably with a figure of 0.31mSv obtained by the Close Contact Dose Spreadsheet. The doses received demonstrate the validity of restricting patient partner contact during the hours of sleep within the first few days post administration. Monitoring of the bedroom, bed linen, bathroom, toilet and personal effects showed slight levels of contamination ranging from background to 20 cps. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

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

    OpenAIRE

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

    2018-01-01

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

  4. A Phase 1/2 Study of Definitive Chemoradiation Therapy Using Docetaxel, Nedaplatin, and 5-Fluorouracil (DNF-R) for Esophageal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ohnuma, Hiroyuki; Sato, Yasushi; Hirakawa, Masahiro; Okagawa, Yutaka; Osuga, Takahiro; Hayashi, Tsuyoshi; Sato, Tsutomu; Miyanishi, Koji; Kobune, Masayoshi; Takimoto, Rishu [Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine, Sapporo (Japan); Sagawa, Tamotsu [Division of Gastroenterology, Hokkaido Cancer Center, Sapporo (Japan); Hori, Masakazu; Someya, Masanori; Nakata, Kensei; Sakata, Koh-ichi [Department of Radiology, Sapporo Medical University School of Medicine, Sapporo (Japan); Takayama, Tetsuji [Department of Gastroenterology and Oncology, University of Tokushima, Tokushima (Japan); Kato, Junji, E-mail: jkato@sapmed.ac.jp [Department of Medical Oncology and Hematology, Sapporo Medical University School of Medicine, Sapporo (Japan)

    2015-10-01

    Purpose: Patient survival in esophageal cancer (EC) remains poor. The purpose of this study was to investigate a regimen of definitive chemoradiation therapy (CRT) that exerts good local control of EC. We performed a phase 1/2 study to assess the safety and efficacy of CRT with docetaxel, nedaplatin, and 5-fluorouracil (DNF-R). Methods and Materials: Eligible patients presented with stage IB to IV EC. Patients received 2 cycles of docetaxel (20, 30, or 40 mg/m{sup 2}) and nedaplatin (50 mg/m{sup 2}) on days 1 and 8 and a continuous infusion of 5-fluorouracil (400 mg/m{sup 2}/day) on days 1 to 5 and 8 to 12, every 5 weeks, with concurrent radiation therapy (59.4 Gy/33 fractions). The recommended dose (RD) was determined using a 3 + 3 design. Results: In the phase 1 study, the dose-limiting toxicities were neutropenia and thrombocytopenia. The RD of docetaxel was determined to be 20 mg/m{sup 2}. In the phase 2 study, grade 3 to 4 acute toxicities included neutropenia (42.8%), febrile neutropenia (7.14%), thrombocytopenia (17.9%), and esophagitis (21.4%). Grade 3 to 4 late radiation toxicity included esophagostenosis (10.7%). The complete response rate was 82.1% (95% confidence interval: 67.9-96.3%). Both the median progression-free survival and overall survival were 41.2 months. Conclusions: DNF-R showed good tolerability and strong antitumor activity, suggesting that it is a potentially effective therapeutic regimen for EC.

  5. A Phase 1/2 Study of Definitive Chemoradiation Therapy Using Docetaxel, Nedaplatin, and 5-Fluorouracil (DNF-R) for Esophageal Cancer

    International Nuclear Information System (INIS)

    Ohnuma, Hiroyuki; Sato, Yasushi; Hirakawa, Masahiro; Okagawa, Yutaka; Osuga, Takahiro; Hayashi, Tsuyoshi; Sato, Tsutomu; Miyanishi, Koji; Kobune, Masayoshi; Takimoto, Rishu; Sagawa, Tamotsu; Hori, Masakazu; Someya, Masanori; Nakata, Kensei; Sakata, Koh-ichi; Takayama, Tetsuji; Kato, Junji

    2015-01-01

    Purpose: Patient survival in esophageal cancer (EC) remains poor. The purpose of this study was to investigate a regimen of definitive chemoradiation therapy (CRT) that exerts good local control of EC. We performed a phase 1/2 study to assess the safety and efficacy of CRT with docetaxel, nedaplatin, and 5-fluorouracil (DNF-R). Methods and Materials: Eligible patients presented with stage IB to IV EC. Patients received 2 cycles of docetaxel (20, 30, or 40 mg/m 2 ) and nedaplatin (50 mg/m 2 ) on days 1 and 8 and a continuous infusion of 5-fluorouracil (400 mg/m 2 /day) on days 1 to 5 and 8 to 12, every 5 weeks, with concurrent radiation therapy (59.4 Gy/33 fractions). The recommended dose (RD) was determined using a 3 + 3 design. Results: In the phase 1 study, the dose-limiting toxicities were neutropenia and thrombocytopenia. The RD of docetaxel was determined to be 20 mg/m 2 . In the phase 2 study, grade 3 to 4 acute toxicities included neutropenia (42.8%), febrile neutropenia (7.14%), thrombocytopenia (17.9%), and esophagitis (21.4%). Grade 3 to 4 late radiation toxicity included esophagostenosis (10.7%). The complete response rate was 82.1% (95% confidence interval: 67.9-96.3%). Both the median progression-free survival and overall survival were 41.2 months. Conclusions: DNF-R showed good tolerability and strong antitumor activity, suggesting that it is a potentially effective therapeutic regimen for EC

  6. Xerostomia after radiotherapy. What matters - mean total dose or dose to each parotid gland?

    International Nuclear Information System (INIS)

    Tribius, S.; Sommer, J.; Prosch, C.; Bajrovic, A.; Kruell, A.; Petersen, C.; Muenscher, A.; Blessmann, M.; Todorovic, M.; Tennstedt, P.

    2013-01-01

    Purpose: Xerostomia is a debilitating side effect of radiotherapy in patients with head and neck cancer. We undertook a prospective study of the effect on xerostomia and outcomes of sparing one or both parotid glands during radiotherapy for patients with squamous cell carcinoma of the head and neck. Methods and materials: Patients with locally advanced squamous cell carcinoma of the head and neck received definitive (70 Gy in 2 Gy fractions) or adjuvant (60-66 Gy in 2 Gy fractions) curative-intent radiotherapy using helical tomotherapy with concurrent chemotherapy if appropriate. Group A received < 26 Gy to the left and right parotids and group B received < 26 Gy to either parotid. Results: The study included 126 patients; 114 (55 in group A and 59 in group B) had follow-up data. There were no statistically significant differences between groups in disease stage. Xerostomia was significantly reduced in group A vs. group B (p = 0.0381). Patients in group A also had significantly less dysphagia. Relapse-free and overall survival were not compromised in group A: 2-year relapse-free survival was 86% vs. 72% in group B (p = 0.361); 2-year overall survival was 88% and 76%, respectively (p = 0.251). Conclusion: This analysis suggests that reducing radiotherapy doses to both parotid glands to < 26 Gy can reduce xerostomia and dysphagia significantly without compromising survival. Sparing both parotids while maintaining target volume coverage and clinical outcome should be the treatment goal and reporting radiotherapy doses delivered to the individual parotids should be standard practice. (orig.)

  7. Xerostomia after radiotherapy. What matters - mean total dose or dose to each parotid gland?

    Energy Technology Data Exchange (ETDEWEB)

    Tribius, S.; Sommer, J.; Prosch, C.; Bajrovic, A.; Kruell, A.; Petersen, C. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Radiation Oncology; Muenscher, A. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Otorhinolaryngology and Head and Neck Surgery; Blessmann, M. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Oral and Maxillofacial Surgery; Todorovic, M. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Medical Physics; Tennstedt, P. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Martini-Clinic, Prostate Cancer Center

    2013-03-15

    Purpose: Xerostomia is a debilitating side effect of radiotherapy in patients with head and neck cancer. We undertook a prospective study of the effect on xerostomia and outcomes of sparing one or both parotid glands during radiotherapy for patients with squamous cell carcinoma of the head and neck. Methods and materials: Patients with locally advanced squamous cell carcinoma of the head and neck received definitive (70 Gy in 2 Gy fractions) or adjuvant (60-66 Gy in 2 Gy fractions) curative-intent radiotherapy using helical tomotherapy with concurrent chemotherapy if appropriate. Group A received < 26 Gy to the left and right parotids and group B received < 26 Gy to either parotid. Results: The study included 126 patients; 114 (55 in group A and 59 in group B) had follow-up data. There were no statistically significant differences between groups in disease stage. Xerostomia was significantly reduced in group A vs. group B (p = 0.0381). Patients in group A also had significantly less dysphagia. Relapse-free and overall survival were not compromised in group A: 2-year relapse-free survival was 86% vs. 72% in group B (p = 0.361); 2-year overall survival was 88% and 76%, respectively (p = 0.251). Conclusion: This analysis suggests that reducing radiotherapy doses to both parotid glands to < 26 Gy can reduce xerostomia and dysphagia significantly without compromising survival. Sparing both parotids while maintaining target volume coverage and clinical outcome should be the treatment goal and reporting radiotherapy doses delivered to the individual parotids should be standard practice. (orig.)

  8. Dose-response study of thimerosal-induced murine systemic autoimmunity

    International Nuclear Information System (INIS)

    Havarinasab, S.; Lambertsson, L.; Qvarnstroem, J.; Hultman, P.

    2004-01-01

    The organic compound ethylmercurithiosalicylate (thimerosal), which is primarily present in the tissues as ethylmercury, has caused illness and several deaths due to erroneous handling when used as a disinfectant or as a preservative in medical preparations. Lately, possible health effects of thimerosal in childhood vaccines have been much discussed. Thimerosal is a well-known sensitizing agent, although usually of no clinical relevance. In rare cases, thimerosal has caused systemic immune reactions including acrodynia. We have studied if thimerosal might induce the systemic autoimmune condition observed in genetically susceptible mice after exposure to inorganic mercury. A.SW mice were exposed to 1.25-40 mg thimerosal/l drinking water for 70 days. Antinucleolar antibodies, targeting the 34-kDa protein fibrillarin, developed in a dose-related pattern and first appeared after 10 days in the two highest dose groups. The lowest observed adverse effect level (LOAEL) for antifibrillarin antibodies was 2.5 mg thimerosal/l, corresponding to an absorbed dose of 147 μg Hg/kg bw and a concentration of 21 and 1.9 μg Hg/g in the kidney and lymph nodes, respectively. The same LOAEL was found for tissue immune-complex deposits. The total serum concentration of IgE, IgG1, and IgG2a showed a significant dose-related increase in thimerosal-treated mice, with a LOAEL of 5 mg thimerosal/l for IgG1 and IgE, and 20 mg thimerosal/l for IgG2a. The polyclonal B-cell activation showed a significant dose-response relationship with a LOAEL of 10 mg thimerosal/l. Therefore, thimerosal induces in genetically susceptible mice a systemic autoimmune syndrome very similar to that seen after treatment with inorganic mercury, although a higher absorbed dose of Hg is needed using thimerosal. The autoimmune syndrome induced by thimerosal is different from the weaker and more restricted autoimmune reaction observed after treatment with an equipotent dose of methylmercury

  9. Definitive Radiotherapy of Non-Small Cell Lung Cancer

    International Nuclear Information System (INIS)

    Lee, Jong Young; Park, Kyung Ran

    1995-01-01

    Purpose : The effect of dose escalation of up to 6500 cGy on local control and survival was investigated in locally advanced non-small cell lung cancer. Materials and Methods : Ninety eight patients with biopsy-proven unresectable non-small cell lung cancer without distant metastases or medically inoperable patients with lower-stage were treated with definitive radiotherapy alone. Group A were treated by thoracic irradiation, 6000 cGy or less in total tumor dose with daily fractions of 180 to 200 cGy: and group B was treated with 6500 cGy of same daily fractions. Results : The actuarial overall survival rate for the entire group was 54% at 1 year, 26.6% at 2 years and 16.4% at 3 years with a median survival time of 13 months. Statistically significant prognostic factors that affect survival rate were stage and N-stage. However, no improvement in local control and survival has been seen with higher dose radiotherapy(group B). Conclusion : Dose escalation of up to 6500 cGy was no effect on local control and survival rate. To increase the survival rate of non-small cell lung cancer hyperfractionated radiotherapy or concurrent chemoradiotherapy should be considered

  10. Prognostic factors, patterns of recurrence and toxicity for patients with esophageal cancer undergoing definitive radiotherapy or chemo-radiotherapy

    International Nuclear Information System (INIS)

    Haefner, Matthias F.; Lang, Kristin; Krug, David; Koerber, Stefan A.; Debus, Juergen; Sterzing, Florian; Uhlmann, Lorenz; Kieser, Meinhard

    2015-01-01

    The aim of this study was to evaluate the effectiveness and tolerability of definitive chemo-radiation or radiotherapy alone in patients with esophageal cancer. We retrospectively analyzed the medical records of n = 238 patients with squamous cell carcinoma or adenocarcinoma of the esophagus treated with definitive radiotherapy with or without concomitant chemotherapy at our institution between 2000 and 2012. Patients of all stages were included to represent actual clinical routine. We performed univariate and multivariate analysis to identify prognostic factors for overall survival (OS) and progression-free survival (PFS). Moreover, treatment-related toxicity and patterns of recurrence were assessed. Patients received either chemo-radiation (64%), radiotherapy plus cetuximab (10%) or radiotherapy alone (26%). In 69%, a boost was applied, resulting in a median cumulative dose of 55.8 Gy; the remaining 31% received a median total dose of 50 Gy. For the entire cohort, the median OS and PFS were 15.0 and 11.0 months, respectively. In multivariate analysis, important prognostic factors for OS and PFS were T stage (OS: P = 0.005; PFS: P = 0.006), M stage (OS: P = 0.015; PFS: P = 0.003), concomitant chemotherapy (P < 0.001) and radiation doses of >55 Gy (OS: P = 0.019; PFS: P = 0.022). Recurrences occurred predominantly as local in-field relapse or distant metastases. Toxicity was dominated by nutritional impairment (12.6% with G3/4 dysphagia) and chemo-associated side effects. Definitive chemo-radiation in patients with esophageal cancer results in survival rates comparable with surgical treatment approaches. However, local and distant recurrence considerably restrict prognosis. Further advances in radio-oncological treatment strategies are necessary for improving outcome. (author)

  11. Definition of IGRT

    International Nuclear Information System (INIS)

    Lief, Eugene

    2008-01-01

    Two definitions of image-guided radiation therapy (IGRT) are cited: 'Frequent imaging in the treatment room during a course of radiotherapy to guide the treatment process' and 'Any use of planar imaging, volumetric imaging or volumetric cine imaging, marker localization, marker tracking, patient surface imaging or patient surface tracking to improve the precision of radiation-therapy delivery'. Also cited are the sentences 'IGRT refers broadly to treatment delivery using modern imaging methods, such as CT, MRI, PET and Ultrasound, in target and non-target structures and in RT definition, design and delivery...' and 'IGRT includes, but is not limited to, 3DCRT, IMRT: stereotactic radiosurgery, stereotactic RT, and brachytherapy...'. Purposes include: Precise patient positioning; Automatic localization of bony structures or implanted fiducial markers; Imaging and positioning of soft tissue tumors and critical structures; Margin reduction and healthy organ sparing; and Delivering the desired dose distribution. On the negative side are the following factors: Physics staffing at treatment delivery Longer treatment times: 1 min. arm deployment, setup for scan, 1 min. gantry rotation - volume image acquisition, 30 sec. reconstruction (depends on resolution), 30 sec. load CT and CB into registration; Registration: from few sec. to few min.; Feasible if the number of treatments is low. The history of IGRT is mentioned, instrumentation is described using ample photographs, and many applications are shown. (P.A.)

  12. Study of External Radiation Expose Dose on Hands of Nuclear Medicine Workers

    International Nuclear Information System (INIS)

    Park, Jun Chul; Pyo, Sung Jae

    2012-01-01

    The aims of this study are to assess external radiation exposed doses of body and hands of nuclear medicine workers who handle radiation sources, and to measure radiation exposed doses of the hands induced by a whole body bone scan with high frequency and handling a radioactive sources like 99m Tc-HDP and 18 F-FDG in the PET/CT examination. Skillful workers, who directly dispense and inject from radiation sources, were asked to wear a TLD on the chest and ring finger. Then, radiation exposed dose and duration exposed from daily radiation sources for each section were measured by using a pocket dosimeter for the accumulated external doses and the absorbed dose to the hands. In the survey of four medical institutions in Incheon Metropolitan City, only one of four institutions has a radiation dosimeter for local area like hands. Most of institutions uses radiation shielding devices for the purpose of protecting the body trunk, not local area. Even some institutions were revealed not to use such a shielding device. The exposed doses on the hands of nuclear medicine workers who directly handles radioactive sources were approximately twice as much as those on the body. The radiation exposure level for each section of the whole body bone scan with high frequency and that of the PET/CT examination showed that radiation doses were revealed in decreasing order of synthesis of radioactive medicine and installation to a dispensing container, dispensing, administering and transferring. Furthermore, there were statistically significant differences of radiation exposure doses of the hands before and after wearing a syringe shielder in administration of a radioactive sources. In this study, although it did not reach the permissible effective dose for nuclear medicine, the occupational workers were exposed by relatively higher dose level than the non-occupational workers. Therefore, the workers, who closely exposed to radioactive sources should be in compliance with safety

  13. Evaluation of the image quality criteria and study of doses in a mammography department

    International Nuclear Information System (INIS)

    Alcantara, Marcela Costa

    2009-01-01

    The mammographic image quality criteria published by European Commission were implemented in three mammography equipment of a same radiology department in a hospital of Sao Paulo city. Among the mammography equipment, two use the screen-film system and one of them uses the indirect digital system. During the data collection, it was noted the need to conduct a study about image rejection in each mammography equipment. Therefore, this study was realized and, after that, the results in each mammography equipment of image rejection and image percentage that present each quality criterion it were compared. At the same time of this studies, it was realized other study about surface entrance dose and average glandular dose. These doses it was estimated based on different methods published by different groups of researcher, for all combinations anode filter available in the equipment. To estimate the surface entrance dose following the methodology published in Avenue's' guide and the average glandular dose following the Wu' methodology, it was developed a phantom, in different thicknesses of acrylic, to simulate a breast. Finally, the image quality it was associated with the dose received by patient. The digital equipment shows better results in the evaluation of quality criteria, lower rate of image rejection and lower values of average glandular dose and surface entrance dose in all methods studied. But it is not sufficient, because is not adequate for patients with great breast. (author)

  14. Case studies can support definitions of workplace innovation in practice

    NARCIS (Netherlands)

    Vaas, F.; Žiauberytė-Jakštienė, R.; Oeij, P.R.

    2017-01-01

    Many practitioners find it problematic to understand and describe workplace innovation (WPI). Whereas there are well-known definitions of WPI, these remain highly abstract. We argue that, for practitioners, case examples of WPI best practices can be a valuable addition to these definitions. In this

  15. A preliminary study on the definitions and differences of main types of business arrangements

    Directory of Open Access Journals (Sweden)

    Anderson Tiago Peixoto Gonçalves

    2012-08-01

    Full Text Available With the growth of competitiveness and market requirements, several companies have been jointly organized with the aim of forming partnerships, forming the so-called Business Arrangements, to ensure that competitive advantages are achieved. This article came from the need to review the definitions and differences between the main types of existing Business Arrangements, as in the literature have been used different nomenclatures and classifications, either in terms of how the Arrangement is managed, how it is organized, the according to which members carry out their activities, how is the flow of resources and information, the degree of coordination and interaction, the form of production organization, and the strategies adopted. It is a basic research, descriptive and literature, which sought to collect the relevant sources, definitions about each Arrangement to meet the goal of the article is to study the definitions and differences between the main types of Business Arrangements. The article is justified by the scarcity of uniform definitions in the literature that make it possible to visualize the differences between each of the types of Arrangements, especially those in which the definitions are more similar.

  16. In vitro study of dose rate effect on Leksell Gamma Knife Perfexion

    International Nuclear Information System (INIS)

    Pastykova, V.; Novotny, J. jr.; Vachelova, J.; Davidkova, M.; Liscak, R.

    2018-01-01

    The main purpose of the study is to evaluate the radiobiological effect of the dose rate changes in Leksell Gamma Knife (LGK) clinical conditions. In principle there are two reasons why dose rate on LGK is reduced during patient irradiation: 1) Co-60 sources decay with a half-life of 5.26 years and 2) using multiple iso-centers and conformal treatment plans (e.g. with blocked beams). This pilot study is an experimental work performed in vitro with medulloblastoma DAOY cells. Are there effects caused by low dose rate which could negatively influence the clinical outcome of the radiosurgery? (authors)

  17. A comprehensive comparative study of the pre-dose effect for three quartz crystals of different origin

    International Nuclear Information System (INIS)

    Kitis, G.; Pagonis, V.; Chen, R.; Polymeris, G.

    2006-01-01

    The study of the thermoluminescence (TL) sensitivity of quartz due to heat and irradiation treatments is of importance in dating and retrospective dosimetry. A comprehensive comparative study of the pre-dose effect was carried out for three types of quartz of different origin. Complete TL vs. dose and sensitivity S vs. pre-dose curves were obtained for the dose range of 0.1 < D < 400 Gy. Additional complete sensitivity vs. pre-dose curves were obtained for samples which underwent a combined pre-dose irradiation and a subsequent heat treatment to 500 deg. C. Although the TL vs. dose curves showed very different behaviours, the sensitivity vs. pre-dose curves showed several common characteristics. The sensitivity vs. pre-dose curves showed abrupt changes ∼10 Gy. The sensitivity after a combined pre-dose irradiation and heat treatment to 500 deg. C showed a very gradual change in the whole dose range studied. These results are explained qualitatively by using the modified Zimmerman model for quartz. (authors)

  18. Brainstem dose is associated with patient-reported acute fatigue in head and neck cancer radiation therapy.

    Science.gov (United States)

    Ferris, Matthew J; Zhong, Jim; Switchenko, Jeffrey M; Higgins, Kristin A; Cassidy, Richard J; McDonald, Mark W; Eaton, Bree R; Patel, Kirtesh R; Steuer, Conor E; Baddour, H Michael; Miller, Andrew H; Bruner, Deborah W; Xiao, Canhua; Beitler, Jonathan J

    2018-01-01

    Radiation (RT) dose to the central nervous system (CNS) has been implicated as a contributor to treatment-related fatigue in head and neck cancer (HNC) patients undergoing radiation therapy (RT). This study evaluates the association of RT dose to CNS structures with patient-reported (PRO) fatigue scores in a population of HNC patients. At pre-RT (baseline), 6th week of RT, and 1-month post-RT time points, Multidimensional Fatigue Inventory (MFI-20) scores were prospectively obtained from 124 patients undergoing definitive treatment for HNC. Medulla, pons, midbrain, total brainstem, cerebellum, posterior fossa, and pituitary dosimetry were evaluated using summary statistics and dose-volume histograms, and associations with MFI-20 scores were analyzed. Maximum dose (Dmax) to the brainstem and medulla was significantly associated with MFI-20 scores at 6th week of RT and 1-month post-RT time points, after controlling for baseline scores (p<0.05). Each 1Gy increase in medulla Dmax resulted in an increase in total MFI-20 score over baseline of 0.30 (p=0.026), and 0.25 (p=0.037), at the 6th week of RT and 1-month post-RT, respectively. Each 1Gy increase in brainstem Dmax resulted in an increase in total MFI-20 score over baseline of 0.30 (p=0.027), and 0.25 (p=0.037) at the 6th week of RT, 1-month post-RT, respectively. Statistically significant associations were not found between dosimetry for the other CNS structures and MFI-20 scores. In this analysis of PRO fatigue scores from a population of patients undergoing definitive RT for HNC, maximum dose to the brainstem and medulla was associated with a significantly increased risk of acute patient fatigue. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Biokinetic study of 131I following ablation dose administration

    International Nuclear Information System (INIS)

    Nascimento, A.C.H.; Lipsztein, J.L.; Lucena, E.A.; Dantas, B.M.; Rebelo, A.M.O.; Mello, R.C.

    2002-01-01

    Aim: The aim of this investigation is to study biokinetics from internally 131 I deposited for thyroid cancer patients during radioiodine therapy (2 to 3 days), after ablation dose administration (3.7 GBq). These data will help in the elaboration of a metabolic model, which will permit absorbed dose assessment for this specific case, since the biokinetic models for iodine available in scientific literature can not be applied to thyroidectomized patient's studies. Material and Methods: Four females patients, between 22 and 50 years old, without metastases, between 1.9 to 6% of remnant thyroid tissue uptake, agreed to contribute to this study. For the in vivo bioassay, periodical measurements were performed along internment time (2 to 3 days), just after Na 131 I dose administration (3.7 GBq). For this, we used the counting system for Nuclear Medicine model 13S002, IEN/CNEN- Brazil, which was adapted with lead filters, in order to allow the work with high rate counting. The measurements were performed in two geometries: thyroid region and thigh. Results: For each patient, we have done approximately 26 measurements for both geometries, starting at the first hour following dose administration until the release from hospital of patient. The results of counting rate (cps) were plotted against time (h). The measurements suggest a relation between remnant thyroid tissue uptake values and the time where counting rates start decreasing. In addition, it was observed a correlation between remnant thyroid tissue radioactive burdens and the circulating iodine through time. Conclusion: It is necessary to follow-up a greater number of patients aiming to confirm the observed correlations and with a greater number of measurements during the first 24 hours, in other to delimit the time range of increasing and decreasing counting rate

  20. Diagnosis of cerebral metastases by means of standard doses of Gadobutrol versus a high-dose protocol. Intraindividual evaluation of a phase-II high-dose study

    International Nuclear Information System (INIS)

    Vogl, T.J.; Friebe, C.E.; Balzer, T.; Mack, M.G.; Steiner, S.; Schedel, H.; Pegios, W.; Lanksch, W.; Banzer, D.; Felix, R.

    1995-01-01

    In a clinical phase-II study 20 patients who had been diagnosed as having brain metastases with CT or MRT were studied prospectively with Gadobutrol, a new nonionic, low osmolality contrast agent. Each patient received an initial injection of 0.1 mmol/kg body weight and an additional dose of 0.2 mmol/kg Gadobutrol 10 min later. Spinecho images were obtained before and after the two applications of Gadobutrol. Dynamic scanning (Turbo-FLASH) was performed for 3 min after each injection of the contrast agent. Both quantitative and qualitative data were intraindividually evaluated. The primary tumor was a bronchial carcinoma in 11 cases; in 9 other cases there were different primary tumors. Forty-eight hours after the use of Gadobutrol there were no adverse signs in the clinical examination, vital signs or blood and urine chemistry. Statistical analysis (Friedman test and Wilcoxon test) of the C/N ratios between tumor and white matter, percentage enhancement, and visual assessment rating revealed statistically significant superiority of high-dose Gadobutrol injection in comparison to the standard dose. The percentage enhancement increased on average from 104% after 0.1 mmol/kg to 162% after 0.3 mmol/kg Gadobutrol. Qualitative delineation and contrast of the lesions increased significantly. The use of high-dose Gadobutrol improved the detection of 36 additional lesions in 6 patients. (orig./VHE) [de

  1. Organ dose conversion coefficients for voxel models of the reference male and female from idealized photon exposures

    Science.gov (United States)

    Schlattl, H.; Zankl, M.; Petoussi-Henss, N.

    2007-04-01

    A new series of organ equivalent dose conversion coefficients for whole body external photon exposure is presented for a standardized couple of human voxel models, called Rex and Regina. Irradiations from broad parallel beams in antero-posterior, postero-anterior, left- and right-side lateral directions as well as from a 360° rotational source have been performed numerically by the Monte Carlo transport code EGSnrc. Dose conversion coefficients from an isotropically distributed source were computed, too. The voxel models Rex and Regina originating from real patient CT data comply in body and organ dimensions with the currently valid reference values given by the International Commission on Radiological Protection (ICRP) for the average Caucasian man and woman, respectively. While the equivalent dose conversion coefficients of many organs are in quite good agreement with the reference values of ICRP Publication 74, for some organs and certain geometries the discrepancies amount to 30% or more. Differences between the sexes are of the same order with mostly higher dose conversion coefficients in the smaller female model. However, much smaller deviations from the ICRP values are observed for the resulting effective dose conversion coefficients. With the still valid definition for the effective dose (ICRP Publication 60), the greatest change appears in lateral exposures with a decrease in the new models of at most 9%. However, when the modified definition of the effective dose as suggested by an ICRP draft is applied, the largest deviation from the current reference values is obtained in postero-anterior geometry with a reduction of the effective dose conversion coefficient by at most 12%.

  2. Organ dose conversion coefficients for voxel models of the reference male and female from idealized photon exposures

    International Nuclear Information System (INIS)

    Schlattl, H; Zankl, M; Petoussi-Henss, N

    2007-01-01

    A new series of organ equivalent dose conversion coefficients for whole body external photon exposure is presented for a standardized couple of human voxel models, called Rex and Regina. Irradiations from broad parallel beams in antero-posterior, postero-anterior, left- and right-side lateral directions as well as from a 360 deg. rotational source have been performed numerically by the Monte Carlo transport code EGSnrc. Dose conversion coefficients from an isotropically distributed source were computed, too. The voxel models Rex and Regina originating from real patient CT data comply in body and organ dimensions with the currently valid reference values given by the International Commission on Radiological Protection (ICRP) for the average Caucasian man and woman, respectively. While the equivalent dose conversion coefficients of many organs are in quite good agreement with the reference values of ICRP Publication 74, for some organs and certain geometries the discrepancies amount to 30% or more. Differences between the sexes are of the same order with mostly higher dose conversion coefficients in the smaller female model. However, much smaller deviations from the ICRP values are observed for the resulting effective dose conversion coefficients. With the still valid definition for the effective dose (ICRP Publication 60), the greatest change appears in lateral exposures with a decrease in the new models of at most 9%. However, when the modified definition of the effective dose as suggested by an ICRP draft is applied, the largest deviation from the current reference values is obtained in postero-anterior geometry with a reduction of the effective dose conversion coefficient by at most 12%

  3. Single and Multiple Ascending-dose Studies of Oral Delafloxacin: Effects of Food, Sex, and Age.

    Science.gov (United States)

    Hoover, Randall; Hunt, Thomas; Benedict, Michael; Paulson, Susan K; Lawrence, Laura; Cammarata, Sue; Sun, Eugene

    2016-01-01

    The objective of this report is describe the results of 2 studies that examined the pharmacokinetic parameters, safety profile, and tolerability of single and multiple ascending doses of oral delafloxacin and the effects of food, sex, and age on oral delafloxacin pharmacokinetic parameters, safety profile, and tolerability. The first study contained 3 parts and used unformulated delafloxacin in a capsule. Part 1 was a randomized, double-blind, placebo-controlled, single (50, 100, 200, 400, 800, 1200, and 1600 mg) ascending-dose study of oral delafloxacin in healthy men. Part 2 was a single-dose crossover study in which 20 men received 250 mg delafloxacin with or without food. Part 2 also included a parallel group, double-blind, placebo-controlled study in 16 women and 16 elderly men and women who were randomized (3:1) to receive 250 mg delafloxacin or placebo. Part 3 was a randomized, double-blind, placebo-controlled, multiple (100, 200, 400, 800, 1200 mg once daily for 5 days) ascending-dose study of oral delafloxacin in healthy men. The second study was a single-dose, randomized, 3-period crossover study in which participants received 900 mg delafloxacin (2 × 450-mg tablets) under fasted conditions, with a high-fat meal, or fasted with a high-fat meal 2 hours after dosing. Serial blood samples were collected, and plasma pharmacokinetic parameters of delafloxacin were determined. Delafloxacin Cmax and AUC0-∞ increased with increasing oral dose over the dose range of 50 to 1600 mg. The increases in delafloxacin AUC0-∞ were dose proportional at doses of ≥200 mg. Steady state was reached by day 3 of dosing with minimal accumulation of delafloxacin. The Cmax of delafloxacin was decreased slightly in the presence of food. No sex difference in delafloxacin pharmacokinetic parameters was observed. In the elderly men and women, mean delafloxacin Cmax and AUC0-∞ were 35% higher than observed for young adults, which could be partially explained by a decrease in

  4. Antipsychotic dose escalation as a trigger for Neuroleptic Malignant Syndrome (NMS: literature review and case series report

    Directory of Open Access Journals (Sweden)

    Langan Julie

    2012-11-01

    Full Text Available Abstract Background “Neuroleptic malignant syndrome” (NMS is a potentially fatal idiosyncratic reaction to any medication which affects the central dopaminergic system. Between 0.5% and 1% of patients exposed to antipsychotics develop the condition. Mortality rates may be as high as 55% and many risk factors have been reported. Although rapid escalation of antipsychotic dose is thought to be an important risk factor, to date it has not been the focus of a published case series or scientifically defined. Description We aimed to identify cases of NMS and review risk factors for its development with a particular focus on rapid dose escalation in the 30 days prior to onset. A review of the literature on rapid dose escalation was undertaken and a pragmatic definition of “rapid dose escalation” was made. NMS cases were defined using DSM-IV criteria and systematically identified within a secondary care mental health service. A ratio of titration rate was calculated for each NMS patient and “rapid escalators” and “non rapid escalators” were compared. 13 cases of NMS were identified. A progressive mean dose increase 15 days prior to the confirmed episode of NMS was observed (241.7 mg/day during days 1–15 to 346.9 mg/day during days 16–30 and the mean ratio of dose escalation for NMS patients was 1.4. Rapid dose escalation was seen in 5/13 cases and non rapid escalators had markedly higher daily cumulative antipsychotic dose compared to rapid escalators. Conclusions Rapid dose escalation occurred in less than half of this case series (n = 5, 38.5%, although there is currently no consensus on the precise definition of rapid dose escalation. Cumulative antipsychotic dose – alongside other known risk factors - may also be important in the development of NMS.

  5. The Definition and Treatment of Bulimarexia in College Women--A Pilot Study.

    Science.gov (United States)

    Boskind-Ledahl, Marlene; White, William C., Jr.

    1978-01-01

    A study of college women suffering from bulimarexia, a cyclical eating disorder characterized by bingeing/purging behaviors and abnormally low self-esteem, indicates the importance of sociocultural factors in female role definition. (JMF)

  6. Analysis of dose, dose-rate and treatment time in the production of injuries by radium treatment for cancer of the uterine cervix; and reply by K.H. Lee

    International Nuclear Information System (INIS)

    Saunders, J.E.

    1977-01-01

    The author of the first letter has detected several errors and inconsistencies in the treatment of the data in a recent paper (Lee, K.H., Kagan, A.R., Nussbaum, H., Wollin, M., Winkley, J.H., and Norman, A., 1976, Br. J. Radiol., vol. 49, 430). Valid conclusions about the relative importance of time or dose-rate could not be based on this data. The reply, from one of the authors of the original paper, accepts many of the errata, and enumerates the changes which should be made. Replotting dose-treatment time and dose-dose rate does not however invalidate the conclusion that dose-rate is more important than time in analysing the risk of normal tissue injury. It is not claimed that the Strandqvist separation line in the dose-dose rate plane is better than in the dose-time plane. An improved definition of a region of low injury risk is given by a horizontal line at 4500 rad maximum dose and a vertical line at 60 rad/h maximum dose-rate on the dose-dose rate plot. Dose-rate is expected to be more important than time as a modifying factor of dose, both on the basis of radiobiological data and of clinical experience. Radiotherapists must balance the risks of radiotherapy-tumour recurrence with those of normal tissue injury, and increased attention should therefore be paid to regions of high and low dose-rate. (U.K.)

  7. Convolution-based estimation of organ dose in tube current modulated CT

    Science.gov (United States)

    Tian, Xiaoyu; Segars, W. Paul; Dixon, Robert L.; Samei, Ehsan

    2016-05-01

    Estimating organ dose for clinical patients requires accurate modeling of the patient anatomy and the dose field of the CT exam. The modeling of patient anatomy can be achieved using a library of representative computational phantoms (Samei et al 2014 Pediatr. Radiol. 44 460-7). The modeling of the dose field can be challenging for CT exams performed with a tube current modulation (TCM) technique. The purpose of this work was to effectively model the dose field for TCM exams using a convolution-based method. A framework was further proposed for prospective and retrospective organ dose estimation in clinical practice. The study included 60 adult patients (age range: 18-70 years, weight range: 60-180 kg). Patient-specific computational phantoms were generated based on patient CT image datasets. A previously validated Monte Carlo simulation program was used to model a clinical CT scanner (SOMATOM Definition Flash, Siemens Healthcare, Forchheim, Germany). A practical strategy was developed to achieve real-time organ dose estimation for a given clinical patient. CTDIvol-normalized organ dose coefficients ({{h}\\text{Organ}} ) under constant tube current were estimated and modeled as a function of patient size. Each clinical patient in the library was optimally matched to another computational phantom to obtain a representation of organ location/distribution. The patient organ distribution was convolved with a dose distribution profile to generate {{≤ft(\\text{CTD}{{\\text{I}}\\text{vol}}\\right)}\\text{organ, \\text{convolution}}} values that quantified the regional dose field for each organ. The organ dose was estimated by multiplying {{≤ft(\\text{CTD}{{\\text{I}}\\text{vol}}\\right)}\\text{organ, \\text{convolution}}} with the organ dose coefficients ({{h}\\text{Organ}} ). To validate the accuracy of this dose estimation technique, the organ dose of the original clinical patient was estimated using Monte Carlo program with TCM profiles explicitly modeled. The

  8. Dynamics of Situation Definition

    Science.gov (United States)

    Park, Dongseop; Moro, Yuji

    2006-01-01

    Situation definition is the process and product of actors' interpretive activities toward a given situation. By reviewing a number of psychological studies conducted in experimental settings, we found that the studies have only explicated a part of the situation definition process and have neglected its dynamic aspects. We need to focus on the…

  9. Dose conversion coefficients for photon exposure of the human eye lens

    Science.gov (United States)

    Behrens, R.; Dietze, G.

    2011-01-01

    In recent years, several papers dealing with the eye lens dose have been published, because epidemiological studies implied that the induction of cataracts occurs even at eye lens doses of less than 500 mGy. Different questions were addressed: Which personal dose equivalent quantity is appropriate for monitoring the dose to the eye lens? Is a new definition of the dose quantity Hp(3) based on a cylinder phantom to represent the human head necessary? Are current conversion coefficients from fluence to equivalent dose to the lens sufficiently accurate? To investigate the latter question, a realistic model of the eye including the inner structure of the lens was developed. Using this eye model, conversion coefficients for electrons have already been presented. In this paper, the same eye model—with the addition of the whole body—was used to calculate conversion coefficients from fluence (and air kerma) to equivalent dose to the lens for photon radiation from 5 keV to 10 MeV. Compared to the values adopted in 1996 by the International Commission on Radiological Protection (ICRP), the new values are similar between 40 keV and 1 MeV and lower by up to a factor of 5 and 7 for photon energies at about 10 keV and 10 MeV, respectively. Above 1 MeV, the new values (calculated without kerma approximation) should be applied in pure photon radiation fields, while the values adopted by the ICRP in 1996 (calculated with kerma approximation) should be applied in case a significant contribution from secondary electrons originating outside the body is present.

  10. Dose conversion coefficients for photon exposure of the human eye lens

    International Nuclear Information System (INIS)

    Behrens, R; Dietze, G

    2011-01-01

    In recent years, several papers dealing with the eye lens dose have been published, because epidemiological studies implied that the induction of cataracts occurs even at eye lens doses of less than 500 mGy. Different questions were addressed: Which personal dose equivalent quantity is appropriate for monitoring the dose to the eye lens? Is a new definition of the dose quantity H p (3) based on a cylinder phantom to represent the human head necessary? Are current conversion coefficients from fluence to equivalent dose to the lens sufficiently accurate? To investigate the latter question, a realistic model of the eye including the inner structure of the lens was developed. Using this eye model, conversion coefficients for electrons have already been presented. In this paper, the same eye model-with the addition of the whole body-was used to calculate conversion coefficients from fluence (and air kerma) to equivalent dose to the lens for photon radiation from 5 keV to 10 MeV. Compared to the values adopted in 1996 by the International Commission on Radiological Protection (ICRP), the new values are similar between 40 keV and 1 MeV and lower by up to a factor of 5 and 7 for photon energies at about 10 keV and 10 MeV, respectively. Above 1 MeV, the new values (calculated without kerma approximation) should be applied in pure photon radiation fields, while the values adopted by the ICRP in 1996 (calculated with kerma approximation) should be applied in case a significant contribution from secondary electrons originating outside the body is present.

  11. Necessary accuracy of dose estimation during cohort epidemiologic study after irradiation

    International Nuclear Information System (INIS)

    Orlov, M.Yu.; Stepanenko, V.F.; Khoshi, M.; Takada, Dzh.

    2003-01-01

    Effect of breadth of dose ranges on values of radiation risk was estimated. Ratios of observed numbers of mortalities because of leukemia in the cohort in 1950 - 1974 under deferent radiation dose to expected number of mortalities in this cohort only under background radiation were used as degree of risk. Data of cooperative Japan-American Program LSS (Life Span Study) were applied in the researches. It is established that required for the risk assessment with uncertainty 20 - 30 % the accuracy of dose estimation comprises 30 - 35 % in the range 1 - 5 rad and 5 - 10 % in the range 5 - 30 rad [ru

  12. Foetal dose conversion coefficients for ICRP-compliant pregnant models from idealised proton exposures

    International Nuclear Information System (INIS)

    Taranenko, V.; Xu, X. G.

    2009-01-01

    Protection of pregnant women and their foetus against external proton irradiations poses a unique challenge. Assessment of foetal dose due to external protons in galactic cosmic rays and as secondaries generated in aircraft walls is especially important during high-altitude flights. This paper reports a set of fluence to absorbed dose conversion coefficients for the foetus and its brain for external monoenergetic proton beams of six standard configurations (the antero-posterior, the postero-anterior, the right lateral, the left lateral, the rotational and the isotropic). The pregnant female anatomical definitions at each of the three gestational periods (3, 6 and 9 months) are based on newly developed RPI-P series of models whose organ masses were matched within 1% with the International Commission on Radiological Protection reference values. Proton interactions and the transport of secondary particles were carefully simulated using the Monte Carlo N-Particle extended code (MCNPX) and the phantoms consisting of several million voxels at 3 mm resolution. When choosing the physics models in the MCNPX, it was found that the advanced Cascade-Exciton intranuclear cascade model showed a maximum of 9% foetal dose increase compared with the default model combination at intermediate energies below 5 GeV. Foetal dose results from this study are tabulated and compared with previously published data that were based on simplified anatomy. The comparison showed a strong dependence upon the source geometry, energy and gestation period: The dose differences are typically less than 20% for all sources except ISO where systematically 40-80% of higher doses were observed. Below 200 MeV, a larger discrepancy in dose was found due to the Bragg peak shift caused by different anatomy. The tabulated foetal doses represent the latest and most detailed study to date offering a useful set of data to improve radiation protection dosimetry against external protons. (authors)

  13. Locoregional control after intensity-modulated radiotherapy for nasopharyngeal carcinoma with an anatomy-based target definition

    International Nuclear Information System (INIS)

    Kawashima, Mitsuhiko; Ariji, Takaki; Kameoka, Satoru

    2013-01-01

    The objective of the study was to evaluate locoregional control after intensity-modulated radiotherapy for nasopharyngeal cancer using a target definition along with anatomical boundaries. Forty patients with biopsy-proven squamous cell or non-keratinizing carcinoma of the nasopharynx who underwent intensity-modulated radiotherapy between April 2006 and November 2009 were reviewed. There were 10 females and 30 males with a median age of 48 years (range, 17-74 years). More than half of the patients had T3/4 (n=21) and/or N2/3 (n=24) disease. Intensity-modulated radiotherapy was administered as 70 Gy/33 fractions with or without concomitant chemotherapy. The clinical target volume was contoured along with muscular fascia or periosteum, and the prescribed radiotherapy dose was determined for each anatomical compartment and lymph node level in the head and neck. One local recurrence was observed at Meckel's cave on the periphery of the high-risk clinical target volume receiving a total dose of <63 Gy. Otherwise, six locoregional failures were observed within irradiated volume receiving 70 Gy. Local and nodal control rates at 3 years were 91 and 89%, respectively. Adverse events were acceptable, and 25 (81%) of 31 patients who were alive without recurrence at 2 years had xerostomia of ≤ Grade 1. The overall survival rate at 3 years was 87%. Target definition along with anatomically defined boundaries was feasible without compromise of the therapeutic ratio. It is worth testing this method further to minimize the unnecessary irradiated volume and to standardize the target definition in intensity-modulated radiotherapy for nasopharyngeal cancer. (author)

  14. Mars power system concept definition study. Volume 1: Study results

    Science.gov (United States)

    Littman, Franklin D.

    1994-01-01

    A preliminary top level study was completed to define power system concepts applicable to Mars surface applications. This effort included definition of power system requirements and selection of power systems with the potential for high commonality. These power systems included dynamic isotope, Proton Exchange Membrane (PEM) regenerative fuel cell, sodium sulfur battery, photovoltaic, and reactor concepts. Design influencing factors were identified. Characterization studies were then done for each concept to determine system performance, size/volume, and mass. Operations studies were done to determine emplacement/deployment maintenance/servicing, and startup/shutdown requirements. Technology development roadmaps were written for each candidate power system (included in Volume 2). Example power system architectures were defined and compared on a mass basis. The dynamic isotope power system and nuclear reactor power system architectures had significantly lower total masses than the photovoltaic system architectures. Integrated development and deployment time phasing plans were completed for an example DIPS and reactor architecture option to determine the development strategies required to meet the mission scenario requirements.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-06-01

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

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

    International Nuclear Information System (INIS)

    Shusharina, N; Khan, F; Choi, N; Sharp, G

    2014-01-01

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

  17. Prospective ECG triggering versus low-dose retrospective ECG-gated 128-channel CT coronary angiography: comparison of image quality and radiation dose

    International Nuclear Information System (INIS)

    Feng, Q.; Yin, Y.; Hua, X.; Zhu, R.; Hua, J.; Xu, J.

    2010-01-01

    Aim: To evaluate image quality and radiation dose for 128-detector prospective electrocardiogram (ECG)-gated computed tomography coronary angiography (CTCA) compared with a low-dose retrospective ECG-gated imaging protocol. Materials and methods: Thirty-one and 47 patients suspected of having coronary artery disease were enrolled into groups examined using prospective and low-dose retrospective ECG-gated CT protocols respectively. All examinations were performed on a 128-detector CT system (Definition AS, Siemens Healthcare, Forchheim, Germany). Prospective CTCA was performed using following parameters: tube voltage 100 kV; tube current 205 mAs; centre of acquisition window 70% of the RR interval. The tube current for low-dose retrospective ECG-gated CTCA was full dose during 40-70% of the RR interval and partial dose for the rest of RR interval. The pitch varied between 0.2 and 0.5 depending on heart rate and patient size. Image quality of coronary arteries was evaluated using a four-point grading scale. The signal-to-noise ratios (SNRs) of enhanced arteries and myocardium were also measured, corresponding contrast-to-noise ratios (CNRs) were calculated, and the radiation doses received were recorded. Results: There was a significant difference in the image quality scores between the retrospective and prospective gating protocols (Chi-square = 15.331, p = 0.009). There was no significant difference between the SNRs of the contrasted artery and myocardium in these two groups, but the CNRs were increased in the prospective group. The mean radiation dose of prospective gating group was 2.71 ± 0.67 mSv (range, 1.67-3.59 mSv), which was significantly lower than that of the retrospective group (p < 0.001). Conclusion: Prospective CT angiography can achieve lower radiation dose than that of low-dose retrospective CT angiography, with preserved image quality.

  18. Prospective ECG triggering versus low-dose retrospective ECG-gated 128-channel CT coronary angiography: comparison of image quality and radiation dose

    Energy Technology Data Exchange (ETDEWEB)

    Feng, Q.; Yin, Y.; Hua, X.; Zhu, R.; Hua, J. [Department of Radiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai (China); Xu, J., E-mail: xujianr@hotmail.co [Department of Radiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai (China)

    2010-10-15

    Aim: To evaluate image quality and radiation dose for 128-detector prospective electrocardiogram (ECG)-gated computed tomography coronary angiography (CTCA) compared with a low-dose retrospective ECG-gated imaging protocol. Materials and methods: Thirty-one and 47 patients suspected of having coronary artery disease were enrolled into groups examined using prospective and low-dose retrospective ECG-gated CT protocols respectively. All examinations were performed on a 128-detector CT system (Definition AS, Siemens Healthcare, Forchheim, Germany). Prospective CTCA was performed using following parameters: tube voltage 100 kV; tube current 205 mAs; centre of acquisition window 70% of the RR interval. The tube current for low-dose retrospective ECG-gated CTCA was full dose during 40-70% of the RR interval and partial dose for the rest of RR interval. The pitch varied between 0.2 and 0.5 depending on heart rate and patient size. Image quality of coronary arteries was evaluated using a four-point grading scale. The signal-to-noise ratios (SNRs) of enhanced arteries and myocardium were also measured, corresponding contrast-to-noise ratios (CNRs) were calculated, and the radiation doses received were recorded. Results: There was a significant difference in the image quality scores between the retrospective and prospective gating protocols (Chi-square = 15.331, p = 0.009). There was no significant difference between the SNRs of the contrasted artery and myocardium in these two groups, but the CNRs were increased in the prospective group. The mean radiation dose of prospective gating group was 2.71 {+-} 0.67 mSv (range, 1.67-3.59 mSv), which was significantly lower than that of the retrospective group (p < 0.001). Conclusion: Prospective CT angiography can achieve lower radiation dose than that of low-dose retrospective CT angiography, with preserved image quality.

  19. 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.

  20. 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.

  1. Intensity modulated radiotherapy (IMRT) with concurrent chemotherapy as definitive treatment of locally advanced esophageal cancer

    International Nuclear Information System (INIS)

    Roeder, Falk; Nicolay, Nils H; Nguyen, Tam; Saleh-Ebrahimi, Ladan; Askoxylakis, Vasilis; Bostel, Tilman; Zwicker, Felix; Debus, Juergen; Timke, Carmen; Huber, Peter E

    2014-01-01

    To report our experience with increased dose intensity-modulated radiation and concurrent systemic chemotherapy as definitive treatment of locally advanced esophageal cancer. We analyzed 27 consecutive patients with histologically proven esophageal cancer, who were treated with increased-dose IMRT as part of their definitive therapy. The majority of patients had T3/4 and/or N1 disease (93%). Squamous cell carcinoma was the dominating histology (81%). IMRT was delivered in step-and-shoot technique in all patients using an integrated boost concept. The boost volume was covered with total doses of 56-60 Gy (single dose 2-2.14 Gy), while regional nodal regions received 50.4 Gy (single dose 1.8 Gy) in 28 fractions. Concurrent systemic therapy was scheduled in all patients and administered in 26 (96%). 17 patients received additional adjuvant systemic therapy. Loco-regional control, progression-free and overall survival as well as acute and late toxicities were retrospectively analyzed. In addition, quality of life was prospectively assessed according to the EORTC QLQs (QLQ-OG25, QLQ-H&N35 and QLQ-C30). Radiotherapy was completed as planned in all but one patient (96%), and 21 patients received more than 80% of the planned concurrent systemic therapy. We observed ten locoregional failures, transferring into actuarial 1-, 2- and 3-year-locoregional control rates of 77%, 65% and 48%. Seven patients developed distant metastases, mainly to the lung (71%). The actuarial 1-, 2- and 3-year-disease free survival rates were 58%, 48% and 36%, and overall survival rates were 82%, 61% and 56%. The concept was well tolerated, both in the clinical objective examination and also according to the subjective answers to the QLQ questionnaire. 14 patients (52%) suffered from at least one acute CTC grade 3/4 toxicity, mostly hematological side effects or dysphagia. Severe late toxicities were reported in 6 patients (22%), mostly esophageal strictures and ulcerations. Severe side effects to

  2. Consensus definitions and application guidelines for control groups in cerebrospinal fluid biomarker studies in multiple sclerosis

    DEFF Research Database (Denmark)

    Teunissen, Charlotte; Menge, Til; Altintas, Ayse

    2013-01-01

    The choice of appropriate control group(s) is critical in cerebrospinal fluid (CSF) biomarker research in multiple sclerosis (MS). There is a lack of definitions and nomenclature of different control groups and a rationalized application of different control groups. We here propose consensus......). Furthermore, we discuss the application of these control groups in specific study designs, such as for diagnostic biomarker studies, prognostic biomarker studies and therapeutic response studies. Application of these uniform definitions will lead to better comparability of biomarker studies and optimal use...

  3. Satellite Power Systems (SPS) concept definition study. Volume 6: SPS technology requirements and verification

    Science.gov (United States)

    Hanley, G.

    1978-01-01

    Volume 6 of the SPS Concept Definition Study is presented and also incorporates results of NASA/MSFC in-house effort. This volume includes a supporting research and technology summary. Other volumes of the final report that provide additional detail are as follows: (1) Executive Summary; (2) SPS System Requirements; (3) SPS Concept Evolution; (4) SPS Point Design Definition; (5) Transportation and Operations Analysis; and Volume 7, SPS Program Plan and Economic Analysis.

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

    Directory of Open Access Journals (Sweden)

    Salvatore Leotta

    2018-02-01

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

  5. Determinants of antibody persistence across doses and continents after single-dose rVSV-ZEBOV vaccination for Ebola virus disease: an observational cohort study.

    Science.gov (United States)

    Huttner, Angela; Agnandji, Selidji Todagbe; Combescure, Christophe; Fernandes, José F; Bache, Emmanuel Bache; Kabwende, Lumeka; Ndungu, Francis Maina; Brosnahan, Jessica; Monath, Thomas P; Lemaître, Barbara; Grillet, Stéphane; Botto, Miriam; Engler, Olivier; Portmann, Jasmine; Siegrist, Denise; Bejon, Philip; Silvera, Peter; Kremsner, Peter; Siegrist, Claire-Anne

    2018-04-04

    The recombinant vesicular stomatitis virus (rVSV) vaccine expressing the Zaire Ebola virus (ZEBOV) glycoprotein is efficacious in the weeks following single-dose injection, but duration of immunity is unknown. We aimed to assess antibody persistence at 1 and 2 years in volunteers who received single-dose rVSV-ZEBOV in three previous trials. In this observational cohort study, we prospectively followed-up participants from the African and European phase 1 rVSV-ZEBOV trials, who were vaccinated once in 2014-15 with 300 000 (low dose) or 10-50 million (high dose) plaque-forming units (pfu) of rVSV-ZEBOV vaccine to assess ZEBOV glycoprotein (IgG) antibody persistence. The primary outcome was ZEBOV glycoprotein-specific IgG geometric mean concentrations (GMCs) measured yearly by ELISA compared with 1 month (ie, 28 days) after immunisation. We report GMCs up to 2 years (Geneva, Switzerland, including neutralising antibodies up to 6 months) and 1 year (Lambaréné, Gabon; Kilifi, Kenya) after vaccination and factors associated with higher antibody persistence beyond 6 months, according to multivariable analyses. Trials and the observational study were registered at ClinicalTrials.gov (Geneva: NCT02287480 and NCT02933931; Kilifi: NCT02296983) and the Pan-African Clinical Trials Registry (Lambaréné PACTR201411000919191). Of 217 vaccinees from the original studies (102 from the Geneva study, 75 from the Lambaréné study, and 40 from the Kilifi study), 197 returned and provided samples at 1 year (95 from the Geneva study, 63 from the Lambaréné, and 39 from the Kilifi study) and 90 at 2 years (all from the Geneva study). In the Geneva group, 44 (100%) of 44 participants who had been given a high dose (ie, 10-50 million pfu) of vaccine and who were seropositive at day 28 remained seropositive at 2 years, whereas 33 (89%) of 37 who had been given the low dose (ie, 300 000 pfu) remained seropositive for 2 years (p=0·042). In participants who had received a high dose

  6. Clinical Effects and Antivenom Dosing in Brown Snake (Pseudonaja spp.) Envenoming — Australian Snakebite Project (ASP-14)

    Science.gov (United States)

    Allen, George E.; Brown, Simon G. A.; Buckley, Nicholas A.; O’Leary, Margaret A.; Page, Colin B.; Currie, Bart J.; White, Julian; Isbister, Geoffrey K.

    2012-01-01

    Background Snakebite is a global health issue and treatment with antivenom continues to be problematic. Brown snakes (genus Pseudonaja) are the most medically important group of Australian snakes and there is controversy over the dose of brown snake antivenom. We aimed to investigate the clinical and laboratory features of definite brown snake (Pseudonaja spp.) envenoming, and determine the dose of antivenom required. Methods and Finding This was a prospective observational study of definite brown snake envenoming from the Australian Snakebite Project (ASP) based on snake identification or specific enzyme immunoassay for Pseudonaja venom. From January 2004 to January 2012 there were 149 definite brown snake bites [median age 42y (2–81y); 100 males]. Systemic envenoming occurred in 136 (88%) cases. All envenomed patients developed venom induced consumption coagulopathy (VICC), with complete VICC in 109 (80%) and partial VICC in 27 (20%). Systemic symptoms occurred in 61 (45%) and mild neurotoxicity in 2 (1%). Myotoxicity did not occur. Severe envenoming occurred in 51 patients (38%) and was characterised by collapse or hypotension (37), thrombotic microangiopathy (15), major haemorrhage (5), cardiac arrest (7) and death (6). The median peak venom concentration in 118 envenomed patients was 1.6 ng/mL (Range: 0.15–210 ng/mL). The median initial antivenom dose was 2 vials (Range: 1–40) in 128 patients receiving antivenom. There was no difference in INR recovery or clinical outcome between patients receiving one or more than one vial of antivenom. Free venom was not detected in 112/115 patients post-antivenom with only low concentrations (0.4 to 0.9 ng/ml) in three patients. Conclusions Envenoming by brown snakes causes VICC and over a third of patients had serious complications including major haemorrhage, collapse and microangiopathy. The results of this study support accumulating evidence that giving more than one vial of antivenom is unnecessary in brown snake

  7. Measurement and estimation of maximum skin dose to the patient for different interventional procedures

    International Nuclear Information System (INIS)

    Cheng Yuxi; Liu Lantao; Wei Kedao; Yu Peng; Yan Shulin; Li Tianchang

    2005-01-01

    Objective: To determine the dose distribution and maximum skin dose to the patient for four interventional procedures: coronary angiography (CA), hepatic angiography (HA), radiofrequency ablation (RF) and cerebral angiography (CAG), and to estimate the definitive effect of radiation on skin. Methods: Skin dose was measured using LiF: Mg, Cu, P TLD chips. A total of 9 measuring points were chosen on the back of the patient with two TLDs placed at each point, for CA, HA and RF interventional procedures, whereas two TLDs were placed on one point each at the postero-anterior (PA) and lateral side (LAT) respectively, during the CAG procedure. Results: The results revealed that the maximum skin dose to the patient was 1683.91 mGy for the HA procedure with a mean value of 607.29 mGy. The maximum skin dose at the PA point was 959.3 mGy for the CAG with a mean value of 418.79 mGy; While the maximum and the mean doses at the LAT point were 704 mGy and 191.52 mGy, respectively. For the RF procedure the maximum dose was 853.82 mGy and the mean was 219.67 mGy. For the CA procedure the maximum dose was 456.1 mGy and the mean was 227.63 mGy. Conclusion: All the measured dose values in this study are estimated ones which could not provide the accurate maximum value because it is difficult to measure using a great deal of TLDs. On the other hand, the small area of skin exposed to high dose could be missed as the distribution of the dose is successive. (authors)

  8. Image-guided intensity-modulated radiotherapy for prostate cancer: Dose constraints for the anterior rectal wall to minimize rectal toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, Jennifer L., E-mail: peterson.jennifer2@mayo.edu [Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL (United States); Buskirk, Steven J. [Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL (United States); Heckman, Michael G.; Diehl, Nancy N. [Section of Biostatistics, Mayo Clinic Florida, Jacksonville, FL (United States); Bernard, Johnny R. [Section of Biostatistics, Mayo Clinic Florida, Jacksonville, FL (United States); Department of Radiation Oncology, Southern Ohio Medical Center, Portsmouth, OH (United States); Tzou, Katherine S.; Casale, Henry E.; Bellefontaine, Louis P.; Serago, Christopher; Kim, Siyong; Vallow, Laura A.; Daugherty, Larry C.; Ko, Stephen J. [Department of Radiation Oncology, Mayo Clinic Florida, Jacksonville, FL (United States)

    2014-04-01

    Rectal adverse events (AEs) are a major concern with definitive radiotherapy (RT) treatment for prostate cancer. The anterior rectal wall is at the greatest risk of injury as it lies closest to the target volume and receives the highest dose of RT. This study evaluated the absolute volume of anterior rectal wall receiving a high dose to identify potential ideal dose constraints that can minimize rectal AEs. A total of 111 consecutive patients with Stage T1c to T3a N0 M0 prostate cancer who underwent image-guided intensity-modulated RT at our institution were included. AEs were graded according to the Common Terminology Criteria for Adverse Events, version 4.0. The volume of anterior rectal wall receiving 5 to 80 Gy in 2.5-Gy increments was determined. Multivariable Cox regression models were used to identify cut points in these volumes that led to an increased risk of early and late rectal AEs. Early AEs occurred in most patients (88%); however, relatively few of them (13%) were grade ≥2. At 5 years, the cumulative incidence of late rectal AEs was 37%, with only 5% being grade ≥2. For almost all RT doses, we identified a threshold of irradiated absolute volume of anterior rectal wall above which there was at least a trend toward a significantly higher rate of AEs. Most strikingly, patients with more than 1.29, 0.73, or 0.45 cm{sup 3} of anterior rectal wall exposed to radiation doses of 67.5, 70, or 72.5 Gy, respectively, had a significantly increased risk of late AEs (relative risks [RR]: 2.18 to 2.72; p ≤ 0.041) and of grade ≥ 2 early AEs (RR: 6.36 to 6.48; p = 0.004). Our study provides evidence that definitive image-guided intensity-modulated radiotherapy (IG-IMRT) for prostate cancer is well tolerated and also identifies dose thresholds for the absolute volume of anterior rectal wall above which patients are at greater risk of early and late complications.

  9. Image-guided intensity-modulated radiotherapy for prostate cancer: Dose constraints for the anterior rectal wall to minimize rectal toxicity

    International Nuclear Information System (INIS)

    Peterson, Jennifer L.; Buskirk, Steven J.; Heckman, Michael G.; Diehl, Nancy N.; Bernard, Johnny R.; Tzou, Katherine S.; Casale, Henry E.; Bellefontaine, Louis P.; Serago, Christopher; Kim, Siyong; Vallow, Laura A.; Daugherty, Larry C.; Ko, Stephen J.

    2014-01-01

    Rectal adverse events (AEs) are a major concern with definitive radiotherapy (RT) treatment for prostate cancer. The anterior rectal wall is at the greatest risk of injury as it lies closest to the target volume and receives the highest dose of RT. This study evaluated the absolute volume of anterior rectal wall receiving a high dose to identify potential ideal dose constraints that can minimize rectal AEs. A total of 111 consecutive patients with Stage T1c to T3a N0 M0 prostate cancer who underwent image-guided intensity-modulated RT at our institution were included. AEs were graded according to the Common Terminology Criteria for Adverse Events, version 4.0. The volume of anterior rectal wall receiving 5 to 80 Gy in 2.5-Gy increments was determined. Multivariable Cox regression models were used to identify cut points in these volumes that led to an increased risk of early and late rectal AEs. Early AEs occurred in most patients (88%); however, relatively few of them (13%) were grade ≥2. At 5 years, the cumulative incidence of late rectal AEs was 37%, with only 5% being grade ≥2. For almost all RT doses, we identified a threshold of irradiated absolute volume of anterior rectal wall above which there was at least a trend toward a significantly higher rate of AEs. Most strikingly, patients with more than 1.29, 0.73, or 0.45 cm 3 of anterior rectal wall exposed to radiation doses of 67.5, 70, or 72.5 Gy, respectively, had a significantly increased risk of late AEs (relative risks [RR]: 2.18 to 2.72; p ≤ 0.041) and of grade ≥ 2 early AEs (RR: 6.36 to 6.48; p = 0.004). Our study provides evidence that definitive image-guided intensity-modulated radiotherapy (IG-IMRT) for prostate cancer is well tolerated and also identifies dose thresholds for the absolute volume of anterior rectal wall above which patients are at greater risk of early and late complications

  10. United States-assisted studies on dose reconstruction in the former Soviet Union

    International Nuclear Information System (INIS)

    Anspaugh, L.R.; Bouville, A.

    1995-12-01

    Following the Chernobyl accident, the US and the USSR entered into an agreement to work on the safety of civilian nuclear reactors; one aspect of that work was to study the environmental transport and health effects of radionuclides released by the accident. After the break-up of the USSR separate agreements were established between the US and Ukraine, Belarus, and Russia to continue work on dose reconstruction and epidemiologic studies of health effects from exposure to external radiation and the incorporation of radionuclides. Studies in Belarus and Ukraine related to the Chernobyl accident now emphasize epidemiologic: studies of childhood-thyroid cancer and leukemia, and eye-lens-cataract formation in liquidators. Supporting studies on dose reconstruction emphasize a variety of ecological, physical, and biological techniques. Studies being conducted in Russia currently emphasize health effects in the workers and the population around the Mayak Industrial Association. As this production complex is an analogue of the US Hanford Works, advantage is being taken of the US experience in conducting a similar, recently completed dose-reconstruction study. In all cases the primary work on dose reconstruction is being performed by scientists from the former Soviet Union. US assistance is in the form of expert consultation and participation, exchange visits, provision of supplies and equipment, and other forms of local assistance

  11. Validation of self-reported cannabis dose and potency: an ecological study.

    Science.gov (United States)

    van der Pol, Peggy; Liebregts, Nienke; de Graaf, Ron; Korf, Dirk J; van den Brink, Wim; van Laar, Margriet

    2013-10-01

    To assess the reliability and validity of self-reported cannabis dose and potency measures. Cross-sectional study comparing self-reports with objective measures of amount of cannabis and delta-9-tetrahydrocannabinol (THC) concentration. Ecological study with assessments at participants' homes or in a coffee shop. Young adult frequent cannabis users (n = 106) from the Dutch Cannabis Dependence (CanDep) study. The objectively measured amount of cannabis per joint (dose in grams) was compared with self-reported estimates using a prompt card and average number of joints made from 1 g of cannabis. In addition, objectively assessed THC concentration in the participant's cannabis was compared with self-reported level of intoxication, subjective estimate of cannabis potency and price per gram of cannabis. Objective estimates of doses per joint (0.07-0.88 g/joint) and cannabis potency (1.1-24.7%) varied widely. Self-reported measures of dose were imprecise, but at group level, average dose per joint was estimated accurately with the number of joints made from 1 g [limit of agreement (LOA) = -0.02 g, 95% confidence interval (CI) = -0.29; 0.26], whereas the prompt card resulted in serious underestimation (LOA = 0.14 g, 95% CI = -0.10; 0.37). THC concentration in cannabis was associated with subjective potency ['average' 3.77% (P = 0.002) and '(very) strong' 5.13% more THC (P cannabis] and with cannabis price (about 1% increase in THC concentration per euro spent on 1 g of cannabis, P cannabis use appear at best to be associated weakly with objective measures. Of the self-report measures, number of joints per gram, cannabis price and subjective potency have at least some validity. © 2013 Society for the Study of Addiction.

  12. The Study of External Radiation Dose for Radiation Worker at PRSG-BATAN Serpong

    International Nuclear Information System (INIS)

    Sunarningsih; Mashudi; A Lilik W; Yosep S

    2012-01-01

    The study of External radiation dose for radiation worker at PRSG-BATAN Serpong has been carried out. The sample is taken from the System Reactor division (BSR), Operation Reactor division, (BOR) Safety division UPN, UJM and head of PRSG by setting Thermoluminescence Dosemeter (TLD) on the chest, then is detected by a tool TLD reader model 6600. The aim of this study is to evaluate the occupational exposure dose that has been accepted by the radiation worker for the last five years. The result in average doses at BSR is 0,99 mSv, BOR is 3,27 mSv, at BK is 0,69 mSv and UPN + UJM + head of PRSG is 0,03 mSv. The result highest doses at BSR is 6,58 mSv, BOR is 28,94 mSv, BK is 4,24 mSv, and UPN UJM Head of PRSG is 0,52 mSv. Dose interval radiation worker at PRSG BATAN ttd - 28,98 mSv. To overall the external personal dose acceptant for radiation worker at PRSG BATAN one below maximum permissible dose acceptant that allowed by BAPETEN, that is 20 mSv in average every year during five years. (author)

  13. Real-time dose calculation and visualization for the proton therapy of ocular tumours

    Energy Technology Data Exchange (ETDEWEB)

    Pfeiffer, Karsten [Medizinische Physik, Deutsches Krebsforschungszentrum, INF 280, D-69120 Heidelberg (Germany). E-mail: k.pfeiffer at dkfz.de; Bendl, Rolf [Medizinische Physik, Deutsches Krebsforschungszentrum, INF 280, D-69120 Heidelberg (Germany). E-mail: r.bendl at dkfz.de

    2001-03-01

    A new real-time dose calculation and visualization was developed as part of the new 3D treatment planning tool OCTOPUS for proton therapy of ocular tumours within a national research project together with the Hahn-Meitner Institut Berlin. The implementation resolves the common separation between parameter definition, dose calculation and evaluation and allows a direct examination of the expected dose distribution while adjusting the treatment parameters. The new tool allows the therapist to move the desired dose distribution under visual control in 3D to the appropriate place. The visualization of the resulting dose distribution as a 3D surface model, on any 2D slice or on the surface of specified ocular structures is done automatically when adapting parameters during the planning process. In addition, approximate dose volume histograms may be calculated with little extra time. The dose distribution is calculated and visualized in 200 ms with an accuracy of 6% for the 3D isodose surfaces and 8% for other objects. This paper discusses the advantages and limitations of this new approach. (author)

  14. Study of dose calculation and beam parameters optimization with genetic algorithm in IMRT

    International Nuclear Information System (INIS)

    Chen Chaomin; Tang Mutao; Zhou Linghong; Lv Qingwen; Wang Zhuoyu; Chen Guangjie

    2006-01-01

    Objective: To study the construction of dose calculation model and the method of automatic beam parameters selection in IMRT. Methods: The three-dimension convolution dose calculation model of photon was constructed with the methods of Fast Fourier Transform. The objective function based on dose constrain was used to evaluate the fitness of individuals. The beam weights were optimized with genetic algorithm. Results: After 100 iterative analyses, the treatment planning system produced highly conformal and homogeneous dose distributions. Conclusion: the throe-dimension convolution dose calculation model of photon gave more accurate results than the conventional models; genetic algorithm is valid and efficient in IMRT beam parameters optimization. (authors)

  15. Study of a new glass matrix by thermoluminescent technique for high-dose dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, Pamela Z.; Carvalho, Gabriel S. Marchiori de; Cunha, Diego M. da; Dantas, Noelio O.; Silva, Anielle C.A.; Neves, Lucio P.; Perini, Ana P., E-mail: anapaula.perini@ufu.br [Universidade Federal de Uberlandia (UFU), MG (Brazil). Instituto de Fisica; Linda, V.E. Caldas [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Carrera, Betzabel N.S.; Watanabe, Shigueo [Universidade de Sao Paulo (IF/USP), Sao Paulo, SP (Brazil). Instituto de Fisica

    2016-07-01

    The thermoluminescence technique is widely used for both personal and for high-dose dosimetry. In this work, the thermoluminescence technique was utilized to study a new glass matrix, with nominal composition of 20Li{sub 2}CO{sub 3}.10Al{sub 2}O{sub 3}.30BaO.40B{sub 2}O{sub 3} (mol%), irradiated with different doses in a {sup 60}Co source. The glow curves and the dose-response curve were obtained for radiation doses of 10, 50, 100, 200 e 700 Gy. The results showed that this new glass matrix has potential use in high-dose dosimetry. (author)

  16. A study on the annual equivalent doses received by cardiologists in a UK hospital

    International Nuclear Information System (INIS)

    Fong, R.Y.L.; Ryan, E.; Alonso-Arrizabalaga, S.

    2001-01-01

    A dose assessment study was carried out to determine the likely annual equivalent doses received by various parts of a cardiologist's body. High sensitivity GR-200 thermoluminescent dosemeters were attached to cardiologists' foreheads, little fingers, wrists, elbows, knees and ankles. Three common cardiology procedures were investigated, namely, percutaneous transluminal coronary angioplasty (PTCA), permanent pacemaker insertion (PPM) and left heart catheterisation (LHC). Dose monitoring was done on a case-by-case basis. Data on ten cases of each procedure were gathered. The projected annual equivalent doses were computed by averaging the ten doses measured at each site for each examination type and finding out from the cardiologists how many cases of PTCA, PPM and LHC they do in a year. Results in this study show that for the lens of the eye, the projected annual equivalent dose is below 10 mSv and for the other body parts, it is below 100 mSv per year. The study demonstrated that the methodology used can help to optimise radiation protection in diagnostic radiology. (author)

  17. Study on the evaluation of radiation doses in dental radiography. Doses and risks due to dental full mouth examination

    Energy Technology Data Exchange (ETDEWEB)

    Sugimoto, K [Kanagawa Dental Coll., Yokosuka (Japan)

    1980-09-01

    Radiation doses and possible biological risks due to dental full mouth examination (adult: 10-film technique, child: 6-film technique) were evaluated based on preliminary experiments and statistical surveillance of patients' records. Dosimetrical studies were performed by using head and neck phantoms and a dental x-ray tube. Radiation doses were measured by x-ray films and thermoluminescence dosimeters. For the obtained doses of skin, eyes, thyroid gland and bone marrow, the biological risk of leukemia and thyroid cancer was discussed on the statistical basis of patients at Kanagawa Dental College Hospital. The major findings were as follows: The total number of patients who recieved full mouth x-ray examination at Kanagawa Dental College Hospital in 1978 was 1,099. The number of male patients was 382 (3,804 films) and that of female patients was 717 (7,138 films). In both sexes, the number of patients was the greatest in the group of 8 - 14 years of age. The collective doses of bone marrow due to full mouth 10-film examination performed at Kanagawa Dental College Hospital in 1978 were approximately 6.0 rad, which could induce leukemia with a probability of 1/8,000. The collective doses of thyroid gland were approximately 13 rad, which could induce lethal thyroid cancer with a probability of 1/15,000. The radiation dose due to the dental radiography for examination at Kanagawa Dental College Hospital was proved to be apparently below the level that could actually induce radiation injuries. But the collective radiation doses due to dental examination in Japan as a whole were approximately 8,000 times greater than that in Kanagawa Dental College Hospital.

  18. Use of model-based iterative reconstruction (MBIR) in reduced-dose CT for routine follow-up of patients with malignant lymphoma: dose savings, image quality and phantom study

    International Nuclear Information System (INIS)

    Herin, Edouard; Chiaradia, Melanie; Cavet, Madeleine; Deux, Jean-Francois; Rahmouni, Alain; Gardavaud, Francois; Beaussart, Pauline; Richard, Philippe; Haioun, Corinne; Itti, Emmanuel; Luciani, Alain

    2015-01-01

    To evaluate both in vivo and in phantom studies, dose reduction, and image quality of body CT reconstructed with model-based iterative reconstruction (MBIR), performed during patient follow-ups for lymphoma. This study included 40 patients (mean age 49 years) with lymphoma. All underwent reduced-dose CT during follow-up, reconstructed using MBIR or 50 % advanced statistical iterative reconstruction (ASIR). All had previously undergone a standard dose CT with filtered back projection (FBP) reconstruction. The volume CT dose index (CTDIvol), the density measures in liver, spleen, fat, air, and muscle, and the image quality (noise and signal to noise ratio, SNR) (ANOVA) observed using standard or reduced-dose CT were compared both in patients and a phantom study (Catphan 600) (Kruskal Wallis). The CTDIvol was decreased on reduced-dose body CT (4.06 mGy vs. 15.64 mGy p < 0.0001). SNR was higher in reduced-dose CT reconstructed with MBIR than in 50 % ASIR or than standard dose CT with FBP (patients, p ≤ 0.01; phantoms, p = 0.003). Low contrast detectability and spatial resolution in phantoms were not altered on MBIR-reconstructed CT (p ≥ 0.11). Reduced-dose CT with MBIR reconstruction can decrease radiation dose delivered to patients with lymphoma, while keeping an image quality similar to that obtained on standard-dose CT. (orig.)

  19. Use of model-based iterative reconstruction (MBIR) in reduced-dose CT for routine follow-up of patients with malignant lymphoma: dose savings, image quality and phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Herin, Edouard; Chiaradia, Melanie; Cavet, Madeleine; Deux, Jean-Francois; Rahmouni, Alain [AP-HP, Hopitaux Universitaires Henri Mondor, Imagerie Medicale, Creteil (France); Universite Paris Est Creteil, Faculte de Medecine, Creteil (France); Gardavaud, Francois; Beaussart, Pauline [AP-HP, Hopitaux Universitaires Henri Mondor, Imagerie Medicale, Creteil (France); Richard, Philippe [GE Healthcare France, Buc (France); Haioun, Corinne [Universite Paris Est Creteil, Faculte de Medecine, Creteil (France); AP-HP, Hopitaux Universitaires Henri Mondor, Hemopathies Lymphoides, Creteil (France); Itti, Emmanuel [Universite Paris Est Creteil, Faculte de Medecine, Creteil (France); AP-HP, Hopitaux Universitaires Henri Mondor, Medecine Nucleaire, Creteil (France); Luciani, Alain [AP-HP, Hopitaux Universitaires Henri Mondor, Imagerie Medicale, Creteil (France); Universite Paris Est Creteil, Faculte de Medecine, Creteil (France); INSERM Unite U 955, Creteil (France); AP-HP, Groupe Henri Mondor Albert Chenevier, Imagerie Medicale, CHU Henri Mondor, Creteil Cedex (France)

    2015-08-15

    To evaluate both in vivo and in phantom studies, dose reduction, and image quality of body CT reconstructed with model-based iterative reconstruction (MBIR), performed during patient follow-ups for lymphoma. This study included 40 patients (mean age 49 years) with lymphoma. All underwent reduced-dose CT during follow-up, reconstructed using MBIR or 50 % advanced statistical iterative reconstruction (ASIR). All had previously undergone a standard dose CT with filtered back projection (FBP) reconstruction. The volume CT dose index (CTDIvol), the density measures in liver, spleen, fat, air, and muscle, and the image quality (noise and signal to noise ratio, SNR) (ANOVA) observed using standard or reduced-dose CT were compared both in patients and a phantom study (Catphan 600) (Kruskal Wallis). The CTDIvol was decreased on reduced-dose body CT (4.06 mGy vs. 15.64 mGy p < 0.0001). SNR was higher in reduced-dose CT reconstructed with MBIR than in 50 % ASIR or than standard dose CT with FBP (patients, p ≤ 0.01; phantoms, p = 0.003). Low contrast detectability and spatial resolution in phantoms were not altered on MBIR-reconstructed CT (p ≥ 0.11). Reduced-dose CT with MBIR reconstruction can decrease radiation dose delivered to patients with lymphoma, while keeping an image quality similar to that obtained on standard-dose CT. (orig.)

  20. Critical groups vs. representative person: dose calculations due to predicted releases from USEXA

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, N.L.D., E-mail: nelson.luiz@ctmsp.mar.mil.br [Centro Tecnologico da Marinha (CTM/SP), Sao Paulo, SP (Brazil); Rochedo, E.R.R., E-mail: elainerochedo@gmail.com [Instituto de Radiprotecao e Dosimetria (lRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Mazzilli, B.P., E-mail: mazzilli@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2013-07-01

    The critical group cf Centro Experimental Aramar (CEA) site was previously defined based 00 the effluents releases to the environment resulting from the facilities already operational at CEA. In this work, effective doses are calculated to members of the critical group considering the predicted potential uranium releases from the Uranium Hexafluoride Production Plant (USEXA). Basically, this work studies the behavior of the resulting doses related to the type of habit data used in the analysis and two distinct situations are considered: (a) the utilization of average values obtained from official institutions (IBGE, IEA-SP, CNEN, IAEA) and from the literature; and (b) the utilization of the 95{sup tb} percentile of the values derived from distributions fit to the obtained habit data. The first option corresponds to the way that data was used for the definition of the critical group of CEA done in former assessments, while the second one corresponds to the use of data in deterministic assessments, as recommended by ICRP to estimate doses to the so--called 'representative person' . (author)

  1. Critical groups vs. representative person: dose calculations due to predicted releases from USEXA

    International Nuclear Information System (INIS)

    Ferreira, N.L.D.; Rochedo, E.R.R.; Mazzilli, B.P.

    2013-01-01

    The critical group cf Centro Experimental Aramar (CEA) site was previously defined based 00 the effluents releases to the environment resulting from the facilities already operational at CEA. In this work, effective doses are calculated to members of the critical group considering the predicted potential uranium releases from the Uranium Hexafluoride Production Plant (USEXA). Basically, this work studies the behavior of the resulting doses related to the type of habit data used in the analysis and two distinct situations are considered: (a) the utilization of average values obtained from official institutions (IBGE, IEA-SP, CNEN, IAEA) and from the literature; and (b) the utilization of the 95 tb percentile of the values derived from distributions fit to the obtained habit data. The first option corresponds to the way that data was used for the definition of the critical group of CEA done in former assessments, while the second one corresponds to the use of data in deterministic assessments, as recommended by ICRP to estimate doses to the so--called 'representative person' . (author)

  2. Representation and preservation of the water-energy dose unit

    International Nuclear Information System (INIS)

    Roos, M.

    1992-01-01

    To represent the water-energy dose unit for high-energy photon and electron radiation, the chemical procedure was expanded into a fundamental measuring technique, and established as a primary normal measuring device of the Federal Republic of Germany. In addition, the water-energy calorimetric dosemeter, a definition measuring method, is being developed which seems to be destined for making a contribution, over the longer term, to reducing measuring uncertainties in dosimetry. (orig./DG) [de

  3. In vivo measurement of urethral dose profiles

    International Nuclear Information System (INIS)

    Toye, W.C.; Royal Melbourne Institute of Technology,; Duchesne, G.M.; Das, K.R.; Cee, A.; Mameghan, H.; Johnston, P.N.

    2001-01-01

    Full text: Quality assurance becomes a critical requirement when radiographs are routinely used in planning of treatments. In HDR prostate brachytherapy, the surrounding organs at risk of complications are the bladder and the rectum. However, of particular concern is the urethra that runs centrally through the prostate gland, as an unavoidably high dose can occur in the central region in order to achieve a minimum peripheral dose to a small target volume. Although high urethral doses have previously been related to increased urinary symptoms, some recent studies have not found such a correlation. The aim of this study was firstly, to identify dosimetric indicators of urethral morbidity following HDR prostate brachytherapy (4F x of 5.0 Gy), and secondly, to test the validity of calculated dose values. The in vivo measurements utilised a TLD (LiF:Mg,Ti) train formed by loading eight TLD rods alternating with 1,0 cm brass spacers into a fine plastic flexible tube. The length and diameter of plastic tubing was approximately 45cm and 0.15cm respectively, while the train length was 11.8 cm from the tip of the tube. The TLD train was placed into the central lumen of an 18 F three-way urethral catheter prior to its insertion. Significant urinary morbidity was defined prospectively as a score of a total of 3 or more points for severity from 5 symptoms categories. The five symptoms evaluated were hesitancy, frequency/nocturia, dysuria, haematuria and incontinence. The introduction of in vivo measurements to enhance the existing dosimetric analysis may be required to fully test the quantitative relationships (e.g. dose-volume ratios). Placement of TLDs within the urethra results in measurements whose accuracy is unaffected by internal organ motion as the hollow urethra must move with the prostate. The dose recorded by the TLDs is determined independently of the predictive algorithm used by the treatment planning system, and prostate location errors (e.g. due to image

  4. Tolerance doses for treatment planning

    International Nuclear Information System (INIS)

    Lyman, J.T.

    1985-10-01

    Data for the tolerance of normal tissues or organs to (low-LET) radiation has been compiled from a number of sources which are referenced at the end of this document. This tolerance dose data are ostensibly for uniform irradiation of all or part of an organ, and are for either 5% (TD 5 ) or 50% (TD 50 ) complication probability. The ''size'' of the irradiated organ is variously stated in terms of the absolute volume or the fraction of the organ volume irradiated, or the area or the length of the treatment field. The accuracy of these data is questionable. Much of the data represents doses that one or several experienced therapists have estimated could be safely given rather than quantitative analyses of clinical observations. Because these data have been obtained from multiple sources with possible different criteria for the definition of a complication, there are sometimes different values for what is apparently the same endpoint. The data from some sources shows a tendancy to be quantized in 5 Gy increments. This reflects the size of possible round off errors. It is believed that all these data have been accumulated without the benefit of 3-D dose distributions and therefore the estimates of the size of the volume and/or the uniformity of the irradiation may be less accurate than is now possible. 19 refs., 4 figs

  5. Correlation of ultra-low dose chest CT findings with physiologic measures of asbestosis

    Energy Technology Data Exchange (ETDEWEB)

    Manners, David [Sir Charles Gairdner Hospital, Department of Respiratory Medicine, Nedlands, WA (Australia); Wong, Patrick; Murray, Conor; Teh, Joelin [Royal Perth Hospital, Department of Diagnostic Imaging, Perth (Australia); Kwok, Yi Jin [Sir Charles Gairdner Hospital, Department of Diagnostic Imaging, Nedlands, WA (Australia); De Klerk, Nick; Franklin, Peter [University of Western Australia, School of Population Health, Perth, WA (Australia); Alfonso, Helman; Reid, Alison [Curtin University, School of Public Health, Perth, WA (Australia); Musk, A.W.B. [Sir Charles Gairdner Hospital, Department of Respiratory Medicine, Nedlands, WA (Australia); University of Western Australia, School of Population Health, Perth, WA (Australia); University of Western Australia, School of Medicine and Pharmacology, Perth, WA (Australia); Brims, Fraser J.H. [Sir Charles Gairdner Hospital, Department of Respiratory Medicine, Nedlands, WA (Australia); University of Western Australia, School of Population Health, Perth, WA (Australia); Curtin University, Curtin Medical School, Perth (Australia)

    2017-08-15

    The correlation between ultra low dose computed tomography (ULDCT)-detected parenchymal lung changes and pulmonary function abnormalities is not well described. This study aimed to determine the relationship between ULDCT-detected interstitial lung disease (ILD) and measures of pulmonary function in an asbestos-exposed population. Two thoracic radiologists independently categorised prone ULDCT scans from 143 participants for ILD appearances as absent (score 0), probable (1) or definite (2) without knowledge of asbestos exposure or lung function. Pulmonary function measures included spirometry and diffusing capacity to carbon monoxide (DLCO). Participants were 92% male with a median age of 73.0 years. CT dose index volume was between 0.6 and 1.8 mGy. Probable or definite ILD was reported in 63 (44.1%) participants. Inter-observer agreement was good (k = 0.613, p < 0.001). There was a statistically significant correlation between the ILD score and both forced expiratory volume in 1 second (FEV{sub 1}) and forced vital capacity (FVC) (r = -0.17, p = 0.04 and r = -0.20, p = 0.02). There was a strong correlation between ILD score and DLCO (r = -0.34, p < 0.0001). Changes consistent with ILD on ULDCT correlate well with corresponding reductions in gas transfer, similar to standard CT. In asbestos-exposed populations, ULDCT may be adequate to detect radiological changes consistent with asbestosis. (orig.)

  6. Correlation of ultra-low dose chest CT findings with physiologic measures of asbestosis

    International Nuclear Information System (INIS)

    Manners, David; Wong, Patrick; Murray, Conor; Teh, Joelin; Kwok, Yi Jin; De Klerk, Nick; Franklin, Peter; Alfonso, Helman; Reid, Alison; Musk, A.W.B.; Brims, Fraser J.H.

    2017-01-01

    The correlation between ultra low dose computed tomography (ULDCT)-detected parenchymal lung changes and pulmonary function abnormalities is not well described. This study aimed to determine the relationship between ULDCT-detected interstitial lung disease (ILD) and measures of pulmonary function in an asbestos-exposed population. Two thoracic radiologists independently categorised prone ULDCT scans from 143 participants for ILD appearances as absent (score 0), probable (1) or definite (2) without knowledge of asbestos exposure or lung function. Pulmonary function measures included spirometry and diffusing capacity to carbon monoxide (DLCO). Participants were 92% male with a median age of 73.0 years. CT dose index volume was between 0.6 and 1.8 mGy. Probable or definite ILD was reported in 63 (44.1%) participants. Inter-observer agreement was good (k = 0.613, p < 0.001). There was a statistically significant correlation between the ILD score and both forced expiratory volume in 1 second (FEV 1 ) and forced vital capacity (FVC) (r = -0.17, p = 0.04 and r = -0.20, p = 0.02). There was a strong correlation between ILD score and DLCO (r = -0.34, p < 0.0001). Changes consistent with ILD on ULDCT correlate well with corresponding reductions in gas transfer, similar to standard CT. In asbestos-exposed populations, ULDCT may be adequate to detect radiological changes consistent with asbestosis. (orig.)

  7. Entrances skin dose distribution maps for interventional neuroradiological procedures: A preliminary study

    International Nuclear Information System (INIS)

    Rampado, O.; Ropolo, R.

    2005-01-01

    Does estimation in interventional neuroradiology can be useful to limit skin radiation injuries. The purpose of this study was to evaluate the role of entrance skin dose (ESD) maps in planning exposure condition optimisation. Thirteen cerebral angiography and five embolisation procedures were monitored, measuring ESD, dose-area product (DAP) and other operational parameters. A transmission ionisation chamber, simultaneously measuring air kerma and DAP, measured dose-related quantities. Data acquisition software collected dosimetric and geometrical data during the interventional procedure and provided a distribution map of ESD on a standard phantom digital image, with maximum value estimation. Values of 88-1710 mGy for maximum skin dose and 16.7-343 Gy cm 2 for DAP were found. These data confirm the possibility of deterministic effects during therapeutic interventional neuroradiological procedures like cerebral embolisation. ESD maps are useful to retrospectively study the exposure characteristics of a procedure and plan patient exposure optimisation. (authors)

  8. Can results from animal studies be used to estimate dose or low dose effects in humans

    International Nuclear Information System (INIS)

    Thomas, J.M.; Eberhardt, L.L.

    1981-01-01

    A method has been devised to extrapolate biological equilibrium levels between animal species and subsequently to humans. Our initial premise was based on the observation that radionuclide retention is normally a function of metabolism so that direct or indirect measures could be described by a power law based on body weights of test animal species. However, we found that such interspecies comparisons ought to be based on the coefficient of the power equation rather than on the exponential parameter. The method is illustrated using retention data obtained from five non-ruminant species (including humans) that were fed radionuclides with different properties. It appears that biological equilibrium level for radionuclides in man can be estimated using data from mice, rats, and dogs. The need to extrapolate low-dose effects data obtained from small animals (usually rodents) to humans is not unique to radiation dosimetry or radiation protection problems. Therefore, some quantitative problems connected with estimating low-dose effects from other disciplines have been reviewed, both because of the concern about effects induced by the radionuclide moiety of a radiopharmaceutical and those of the nonradioactive component. The possibility of extrapolating low-dose effects calculated from animal studies to human is discussed

  9. Can results from animal studies be used to estimate dose or low dose effects in humans

    International Nuclear Information System (INIS)

    Thomas, J.M.; Eberhardt, L.L.

    1981-01-01

    We have devised a method to extrapolate biological equilibrium levels between animal species and subsequently to humans. Our initial premise was based on the observation that radionuclide retention is normally a function of metabolism so that direct or indirect measures could be described by a power law based on body weights of test animal species. However, we found that such interspecies comparisons ought to be based on the coefficient of the power equation rather than on the exponential parameter. The method is illustrated using retention data obtained from five non-ruminant species (including humans) that were fed radionuclides with different properties. It appears that biological equilibrium level for radionuclides in man can be estimated using data from mice, rats and dogs. The need to extrapolate low-dose effects data obtained from small animals (usually rodents) to humans is not unique to radiation dosimetry or radiation protection problems. Therefore, researchers have reviewed some quantitative problems connected with estimating low-dose effects from other disciplines, both because of the concern about effects induced by the radionuclide moiety of a radiopharmaceutical and those of the nonradioactive component. The possibility of extrapolating low-dose effects calculated from animal studies to humans is discussed

  10. Simulation studies for the in-vivo dose verification of particle therapy

    International Nuclear Information System (INIS)

    Rohling, Heide

    2015-01-01

    An increasing number of cancer patients is treated with proton beams or other light ion beams which allow to deliver dose precisely to the tumor. However, the depth dose distribution of these particles, which enables this precision, is sensitive to deviations from the treatment plan, as e.g. anatomical changes. Thus, to assure the quality of the treatment, a non-invasive in-vivo dose verification is highly desired. This monitoring of particle therapy relies on the detection of secondary radiation which is produced by interactions between the beam particles and the nuclei of the patient's tissue. Up to now, the only clinically applied method for in-vivo dosimetry is Positron Emission Tomography which makes use of the β + -activity produced during the irradiation (PT-PET). Since from a PT-PET measurement the applied dose cannot be directly deduced, the simulated distribution of β + -emitting nuclei is used as a basis for the analysis of the measured PT-PET data. Therefore, the reliable modeling of the production rates and the spatial distribution of the β + -emitters is required. PT-PET applied during instead of after the treatment is referred to as in-beam PET. A challenge concerning in-beam PET is the design of the PET camera, because a standard full-ring scanner is not feasible. Thus, for in-beam PET and PGI dedicated detection systems and, moreover, profound knowledge about the corresponding radiation fields are required. Using various simulation codes, this thesis contributes to the modelling of the β + -emitters and photons produced during particle irradiation, as well as to the evaluation and optimization of hardware for both techniques. Concerning the modeling of the production of the relevant β + -emitters, the abilities of the Monte Carlo simulation code PHITS and of the deterministic, one-dimensional code HIBRAC were assessed. HIBRAC was substantially extended to enable the modeling of the depth-dependent yields of specific nuclides. For proton

  11. Safety of dose escalation by simultaneous integrated boosting radiation dose within the primary tumor guided by 18FDG-PET/CT for esophageal cancer

    International Nuclear Information System (INIS)

    Yu, Wen; Cai, Xu-Wei; Liu, Qi; Zhu, Zheng-Fei; Feng, Wen; Zhang, Qin; Zhang, Ying-Jian; Yao, Zhi-Feng; Fu, Xiao-Long

    2015-01-01

    Purpose: To observe the safety of selective dose boost to the pre-treatment high 18 F-deoxyglucose (FDG) uptake areas of the esophageal GTV. Methods: Patients with esophageal squamous cell carcinoma were treated with escalating radiation dose of 4 levels, with a simultaneous integrated boost (SIB) to the pre-treatment 50% SUVmax area of the primary tumor. Patients received 4 monthly cycles of cisplatin and fluorouracil. Dose-limiting toxicity (DLT) was defined as any Grade 3 or higher acute toxicities causing continuous interruption of radiation for over 1 week. Results: From April 2012 to February 2014, dose has been escalated up to LEVEL 4 (70 Gy). All of the 25 patients finished the prescribed dose without DLT, and 10 of them developed Grade 3 acute esophagitis. One patient of LEVEL 2 died of esophageal hemorrhage within 1 month after completion of radiotherapy, which was not definitely correlated with treatment yet. Late toxicities remained under observation. With median follow up of 8.9 months, one-year overall survival and local control was 69.2% and 77.4%, respectively. Conclusions: Dose escalation in esophageal cancer based on 18 FDG-PET/CT has been safely achieved up to 70 Gy using the SIB technique. Acute toxicities were well tolerated, whereas late toxicities and long-term outcomes deserved further observation

  12. The continual reassessment method: comparison of Bayesian stopping rules for dose-ranging studies.

    Science.gov (United States)

    Zohar, S; Chevret, S

    2001-10-15

    The continual reassessment method (CRM) provides a Bayesian estimation of the maximum tolerated dose (MTD) in phase I clinical trials and is also used to estimate the minimal efficacy dose (MED) in phase II clinical trials. In this paper we propose Bayesian stopping rules for the CRM, based on either posterior or predictive probability distributions that can be applied sequentially during the trial. These rules aim at early detection of either the mis-choice of dose range or a prefixed gain in the point estimate or accuracy of estimated probability of response associated with the MTD (or MED). They were compared through a simulation study under six situations that could represent the underlying unknown dose-response (either toxicity or failure) relationship, in terms of sample size, probability of correct selection and bias of the response probability associated to the MTD (or MED). Our results show that the stopping rules act correctly, with early stopping by using the two first rules based on the posterior distribution when the actual underlying dose-response relationship is far from that initially supposed, while the rules based on predictive gain functions provide a discontinuation of inclusions whatever the actual dose-response curve after 20 patients on average, that is, depending mostly on the accumulated data. The stopping rules were then applied to a data set from a dose-ranging phase II clinical trial aiming at estimating the MED dose of midazolam in the sedation of infants during cardiac catheterization. All these findings suggest the early use of the two first rules to detect a mis-choice of dose range, while they confirm the requirement of including at least 20 patients at the same dose to reach an accurate estimate of MTD (MED). A two-stage design is under study. Copyright 2001 John Wiley & Sons, Ltd.

  13. Entyvio lengthen dose-interval study: lengthening vedolizumab dose interval and the risk of clinical relapse in inflammatory bowel disease.

    Science.gov (United States)

    Chan, Webber; Lynch, Nicole; Bampton, Peter; Chang, Jeff; Chung, Alvin; Florin, Timothy; Hetzel, David J; Jakobovits, Simon; Moore, Gregory; Pavli, Paul; Radford-Smith, Graham; Thin, Lena; Baraty, Brandon; Haifer, Craig; Yau, Yunki; Leong, Rupert W L

    2018-07-01

    Vedolizumab (VDZ), an α4β7 anti-integrin antibody, is efficacious in the induction and maintenance of remission in ulcerative colitis (UC) and Crohn's disease (CD). In the GEMINI long-term safety study, enrolled patients received 4-weekly VDZ. Upon completion, patients were switched to 8-weekly VDZ in Australia. The clinical success rate of treatment de-escalation for patients in remission on VDZ has not been described previously. To determine the proportion of patients who relapsed after switching from 4 to 8-weekly VDZ, the mean time to relapse, and the recapture rate when switching back to 8-weekly dosing. This was a retrospective, observational, multicenter study of patients previously recruited into GEMINI long-term safety in Australia. Data on the demographics and biochemical findings were collected. There were 34 patients [23 men, mean age 49.1 (±13.1) years] and their mean disease duration was 17.6 (±8.5) years. The mean 4-weekly VDZ infusion duration was 286.5 (±48.8) weeks. A total of five (15%) patients relapsed on dose-interval increase (4/17 UC, 1/17 CD) at a median duration from dose interval lengthening to flare of 14 weeks (interquartile range=6-25). Eighty percent (4/5) of patients re-entered remission following dose-interval decrease back to 4-weekly. No clinical predictors of relapse could be determined because of the small cohort size. The risk of patients relapsing when switching from 4 to 8-weekly VDZ ∼15% and is similar between CD and UC. Dose-interval decrease recaptures 80% of patients who relapsed. Therapeutic drug monitoring of VDZ may be of clinical relevance.

  14. Study of distribution dose for chest radiography using the computational model ALDERSON/EGSnrc

    International Nuclear Information System (INIS)

    Muniz, B.C.; Menezes, C.J.M.

    2017-01-01

    Numerical dosimetry uses Computational Exposure Models (MCE) to perform dose studies in situations of radiation exposure without the need for individuals to be exposed. MCEs are essentially composed of a simulator of the radioactive source, a Monte Carlo code, and a phantom of voxels representing the human anatomy. The objective of this work was to perform a study of the dose distribution in the thoracic region in radiographic exams using the MCE ALDERSON / EGSnrc. For that, virtual simulations were performed using Monte Carlo Method techniques to calculate the dose in the simulator of voxels representative of the thoracic region. The results show that most beam energy was deposited in the skeleton for all simulated radiological techniques, while smaller fractions were deposited in the lungs and soft tissue. For example, at 90 kV voltage, 14% of the energy was deposited in the bone medium, while lungs and soft tissue receive only 5 and 3%, respectively. It is concluded that the ALDERSON / EGSnrc MCE can be used for studies of the dose distribution on chest radiographs used in radiodiagnosis practice, thus optimizing dose absorbed in the patient in clinical exams

  15. Time and dose-related changes in lung perfusion after definitive radiotherapy for NSCLC

    DEFF Research Database (Denmark)

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

    2018-01-01

    BACKGROUND AND PURPOSE: To examine radiation-induced changes in regional lung perfusion per dose level in 58 non-small-cell lung cancer (NSCLC) patients treated with intensity-modulated radiotherapy (IMRT). MATERIAL AND METHODS: NSCLC patients receiving chemo-radiotherapy (RT) of minimum 60 Gy we...

  16. Dose coefficients in pediatric and adult abdominopelvic CT based on 100 patient models

    Science.gov (United States)

    Tian, Xiaoyu; Li, Xiang; Segars, W. Paul; Frush, Donald P.; Paulson, Erik K.; Samei, Ehsan

    2013-12-01

    Recent studies have shown the feasibility of estimating patient dose from a CT exam using CTDIvol-normalized-organ dose (denoted as h), DLP-normalized-effective dose (denoted as k), and DLP-normalized-risk index (denoted as q). However, previous studies were limited to a small number of phantom models. The purpose of this work was to provide dose coefficients (h, k, and q) across a large number of computational models covering a broad range of patient anatomy, age, size percentile, and gender. The study consisted of 100 patient computer models (age range, 0 to 78 y.o.; weight range, 2-180 kg) including 42 pediatric models (age range, 0 to 16 y.o.; weight range, 2-80 kg) and 58 adult models (age range, 18 to 78 y.o.; weight range, 57-180 kg). Multi-detector array CT scanners from two commercial manufacturers (LightSpeed VCT, GE Healthcare; SOMATOM Definition Flash, Siemens Healthcare) were included. A previously-validated Monte Carlo program was used to simulate organ dose for each patient model and each scanner, from which h, k, and q were derived. The relationships between h, k, and q and patient characteristics (size, age, and gender) were ascertained. The differences in conversion coefficients across the scanners were further characterized. CTDIvol-normalized-organ dose (h) showed an exponential decrease with increasing patient size. For organs within the image coverage, the average differences of h across scanners were less than 15%. That value increased to 29% for organs on the periphery or outside the image coverage, and to 8% for distributed organs, respectively. The DLP-normalized-effective dose (k) decreased exponentially with increasing patient size. For a given gender, the DLP-normalized-risk index (q) showed an exponential decrease with both increasing patient size and patient age. The average differences in k and q across scanners were 8% and 10%, respectively. This study demonstrated that the knowledge of patient information and CTDIvol/DLP values may

  17. Dose coefficients in pediatric and adult abdominopelvic CT based on 100 patient models

    International Nuclear Information System (INIS)

    Tian, Xiaoyu; Samei, Ehsan; Li, Xiang; Segars, W Paul; Frush, Donald P; Paulson, Erik K

    2013-01-01

    Recent studies have shown the feasibility of estimating patient dose from a CT exam using CTDI vol -normalized-organ dose (denoted as h), DLP-normalized-effective dose (denoted as k), and DLP-normalized-risk index (denoted as q). However, previous studies were limited to a small number of phantom models. The purpose of this work was to provide dose coefficients (h, k, and q) across a large number of computational models covering a broad range of patient anatomy, age, size percentile, and gender. The study consisted of 100 patient computer models (age range, 0 to 78 y.o.; weight range, 2–180 kg) including 42 pediatric models (age range, 0 to 16 y.o.; weight range, 2–80 kg) and 58 adult models (age range, 18 to 78 y.o.; weight range, 57–180 kg). Multi-detector array CT scanners from two commercial manufacturers (LightSpeed VCT, GE Healthcare; SOMATOM Definition Flash, Siemens Healthcare) were included. A previously-validated Monte Carlo program was used to simulate organ dose for each patient model and each scanner, from which h, k, and q were derived. The relationships between h, k, and q and patient characteristics (size, age, and gender) were ascertained. The differences in conversion coefficients across the scanners were further characterized. CTDI vol -normalized-organ dose (h) showed an exponential decrease with increasing patient size. For organs within the image coverage, the average differences of h across scanners were less than 15%. That value increased to 29% for organs on the periphery or outside the image coverage, and to 8% for distributed organs, respectively. The DLP-normalized-effective dose (k) decreased exponentially with increasing patient size. For a given gender, the DLP-normalized-risk index (q) showed an exponential decrease with both increasing patient size and patient age. The average differences in k and q across scanners were 8% and 10%, respectively. This study demonstrated that the knowledge of patient information and CTDI vol

  18. MO-E-17A-06: Organ Dose in Abdomen-Pelvis CT: Does TG 111 Equilibrium Dose Concept Better Accounts for KVp Dependence Than Conventional CTDI?

    International Nuclear Information System (INIS)

    Li, X; Morgan, A; Davros, W; Dong, F; Primak, A; Segars, W

    2014-01-01

    Purpose: In CT imaging, a desirable quality assurance (QA) dose quantity should account for the dose variability across scan parameters and scanner models. Recently, AAPM TG 111 proposed to use equilibrium dose-pitch product, in place of CT dose index (CTDI100), for scan modes involving table translation. The purpose of this work is to investigate whether this new concept better accounts for the kVp dependence of organ dose than the conventional CTDI concept. Methods: The adult reference female extended cardiac-torso (XCAT) phantom was used for this study. A Monte Carlo program developed and validated for a 128-slice CT system (Definition Flash, Siemens Healthcare) was used to simulate organ dose for abdomenpelvis scans at five tube voltages (70, 80, 100, 120, 140 kVp) with a pitch of 0.8 and a detector configuration of 2x64x0.6 mm. The same Monte Carlo program was used to simulate CTDI100 and equilibrium dose-pitch product. For both metrics, the central and peripheral values were used together with helical pitch to calculate a volume-weighted average, i.e., CTDIvol and (Deq)vol, respectively. Results: While other scan parameters were kept constant, organ dose depended strongly on kVp; the coefficient of variation (COV) across the five kVp values ranged between 70–75% for liver, spleen, stomach, pancreas, kidneys, colon, small intestine, bladder, and ovaries, all of which were inside the primary radiation beam. One-way analysis of variance (ANOVA) for the effect of kVp was highly significant (p=3e−30). When organ dose was normalized by CTDIvol, the COV across the five kVp values reduced to 7–16%. The effect of kVp was still highly significant (p=4e−4). When organ dose was normalized by (Deq)vol, the COV further reduced to 4−12%. The effect of kVp was borderline significant (p=0.04). Conclusion: In abdomen-pelvis CT, TG 111 equilibrium dose concept better accounts for kVp dependence than the conventional CTDI. This work is supported by a faculty startup

  19. MO-E-17A-06: Organ Dose in Abdomen-Pelvis CT: Does TG 111 Equilibrium Dose Concept Better Accounts for KVp Dependence Than Conventional CTDI?

    Energy Technology Data Exchange (ETDEWEB)

    Li, X [Cleveland State University, Cleveland, OH (United States); Morgan, A; Davros, W [Cleveland State University, Cleveland, OH (United States); Cleveland Clinic, Cleveland, Ohio (United States); Dong, F [Cleveland Clinic, Cleveland, Ohio (United States); Primak, A [Siemens Medical Solutions USA, Inc. (United States); Segars, W [Duke University, Durham, NC (United States)

    2014-06-15

    Purpose: In CT imaging, a desirable quality assurance (QA) dose quantity should account for the dose variability across scan parameters and scanner models. Recently, AAPM TG 111 proposed to use equilibrium dose-pitch product, in place of CT dose index (CTDI100), for scan modes involving table translation. The purpose of this work is to investigate whether this new concept better accounts for the kVp dependence of organ dose than the conventional CTDI concept. Methods: The adult reference female extended cardiac-torso (XCAT) phantom was used for this study. A Monte Carlo program developed and validated for a 128-slice CT system (Definition Flash, Siemens Healthcare) was used to simulate organ dose for abdomenpelvis scans at five tube voltages (70, 80, 100, 120, 140 kVp) with a pitch of 0.8 and a detector configuration of 2x64x0.6 mm. The same Monte Carlo program was used to simulate CTDI100 and equilibrium dose-pitch product. For both metrics, the central and peripheral values were used together with helical pitch to calculate a volume-weighted average, i.e., CTDIvol and (Deq)vol, respectively. Results: While other scan parameters were kept constant, organ dose depended strongly on kVp; the coefficient of variation (COV) across the five kVp values ranged between 70–75% for liver, spleen, stomach, pancreas, kidneys, colon, small intestine, bladder, and ovaries, all of which were inside the primary radiation beam. One-way analysis of variance (ANOVA) for the effect of kVp was highly significant (p=3e−30). When organ dose was normalized by CTDIvol, the COV across the five kVp values reduced to 7–16%. The effect of kVp was still highly significant (p=4e−4). When organ dose was normalized by (Deq)vol, the COV further reduced to 4−12%. The effect of kVp was borderline significant (p=0.04). Conclusion: In abdomen-pelvis CT, TG 111 equilibrium dose concept better accounts for kVp dependence than the conventional CTDI. This work is supported by a faculty startup

  20. The study of mean glandular dose in mammography in Yazd and the factors affecting it

    International Nuclear Information System (INIS)

    Bouzarjomehri, F.; Mostaar, A.; Ghasemi, A.; Ehramposh, M. H.; Khosravi, H.

    2006-01-01

    The objective of this study was to determine the mean glandular dose resulting from mammography examinations in Yazd, southeastern Iran and to identify the factors affecting it. Patients and Methods: This survey was conducted during May to December 2005 to estimate the mean glandular dose for women undergoing mammography and to report the distribution of dose. compressed breast thickness, glandular tissue content, and mammography technique used. The clinical data were collected from 946 mammograms taken from 246 women who were referred to four mammography centers. The mammography instruments in these centers were four modern units with a molybdenum anode and either molybdenum or rhodium filter. The exposure conditions of each mammogram were recorded. The breast glandular content of each mammogram was estimated by a radiologist. The mean glandular dose was calculated based on measuring the normalized entrance skin dose in air. half value layer, kVp, mAs, breast thickness and glandular content. Half value layer, kVp and entrance skin dose were measured by a solid-state detector. The analytical method of Sobol et al. was used for calculation of mean glandular dose . Results: The mean±SD mean glandular dose per film was.2±0.6 mGy for cranio caudal and 1.63±O.9 mGy for mediolateral oblique views. The mean±SD mean glandular dose per woman was 5.5 3.1.mGy. A positive correlation was found between the beam Half value layer with mean glandular dose (r=O.38) and the breast thickness with mean glandular dose (r=O.5). Conclusion: The mean±SD mean glandular dose per film of 1.42±0.8 mGy in present study was lower than most of similar reports. However, the mean mean glandular dose per woman was higher than that in other studies

  1. Effect of Disease Definition on Perceived Burden of Acute Respiratory Infections in Children: A Prospective Cohort Study Based on Symptom Diaries.

    Science.gov (United States)

    Zoch, Beate; Günther, Annette; Karch, André; Mikolajczyk, Rafael

    2017-10-01

    Acute respiratory infections (ARIs) are among the most frequent childhood diseases in Western countries. Assessment of ARI episodes for research purposes is usually based on parent-administered retrospective questionnaires or prospective symptom diaries. The aim of our analysis was to compare the effect of ARI definitions on the corresponding disease burden in a prospective cohort study using symptom diaries. A literature search was performed to identify definitions of ARI used in research studies. The definitions were applied to a symptom diary dataset from a cohort study of 1-3-year-old children conducted in the winter season 2013/2014. We compared the total number of ARI episodes, the total number of days with ARI and the median and mean duration of ARI episodes resulting from the use of the different definitions. Six ARI definitions were identified in the literature. Depending on ARI definition, the total number of ARI episodes and the total number of days with ARI in our dataset varied by a factor of 1.69 and 1.53, respectively, between the lowest and the highest. The median duration of the episodes ranged from 7 to 10 days. Different definitions led to considerable differences in the number and duration of ARI episodes, making direct comparisons of studies with different methods questionable. We propose the use of a standardized ARI definition in upcoming cohort studies working with diary data. This process could be conducted using a Delphi survey with experts in this study field.

  2. Multiple dose study of the combined radiosensitizers Ro 03-8799 (pimonidazole) and SR 2508 (etanidazole)

    International Nuclear Information System (INIS)

    Bleehen, N.M.; Newman, H.F.; Maughan, T.S.; Workman, P.

    1989-01-01

    The hypoxic cell radiosensitizers Ro 03-8799 and SR 2508 have different clinical toxicities. The former produces an acute but transient central nervous system syndrome, whereas the latter produces cumulative peripheral neuropathy. Following single dose studies, an escalating multiple dose schedule using both drugs in combination showed no unexpected adverse reactions at lower doses. This study identifies the clinical tolerance and pharmacokinetics when doses in the region of the maximal tolerated dose are given to 26 patients receiving infusions of 0.75 g/m2 Ro 03-8799 and 2 g/m2 SR 2508 three times per week. At 15 doses, 3/4 patients experienced WHO grade 2 peripheral neuropathy, whereas at 12 doses 1/9 developed grade 2 and 6/9 developed grade 1 neuropathies. This represents a lower dose of SR 2508 than can be given alone suggesting that some interaction between the two drugs does exist in terms of chronic peripheral neurotoxicity. Pharmacokinetic studies show no adverse interactions between the two drugs and minimal inter-patient variation. From bivariate analysis, cumulative AUC for Ro 03-8799 has the most significant correlation with the development of peripheral neuropathy. Tumor drug concentrations normalized to the administered dose show mean values of 34 micrograms/g Ro 03-8799 and 76 micrograms/g SR 2508 30 minutes after infusion. These could be expected to produce a single dose sensitizer enhancement ratio of 1.5. The combination of the two sensitizers at the maximum tolerable dose may be expected to give an increased therapeutic efficacy over either drug alone

  3. Simulative study on dose distribution of 103Pd stent in blood-vessel

    International Nuclear Information System (INIS)

    Yuan Shuyu; Dai Guangfu; Xu Zhiyong; Sun Fuyin; Xu Shuhe; Ma Fengwu

    2003-01-01

    Objective: To evaluate the dose distribution of 103 Pd stent in the blood-vessel. Methods: Simulative study on dose distribution of endovascular 103 Pd stent was conducted with thermoluminescence dosimeter. The vessel wall was substituted by muscle equivalent material in this simulative study. Results: When radioactivity of the study 103 Pd stent was 9.8 MBq the absorbed dose from the stent surface by muscle equivalent material was 9.8 Gy at 17 d (the half-life period of 103 Pd). The radioactivity of 103 Pd stent surface rapidly attenuated over the radial distance. 80% of the radioactivity at the area that was radially 0.4 mm apart from the stent surface was absorbed by the simulative blood-vessel wall. Conclusion: Endovascular 103 Pd stent does not exert significant injury on the surrounding organs or tissues

  4. Robust ray-tracing algorithms for interactive dose rate evaluation

    International Nuclear Information System (INIS)

    Perrotte, L.

    2011-01-01

    More than ever, it is essential today to develop simulation tools to rapidly evaluate the dose rate received by operators working on nuclear sites. In order to easily study numerous different scenarios of intervention, computation times of available softwares have to be all lowered. This mainly implies to accelerate the geometrical computations needed for the dose rate evaluation. These computations consist in finding and sorting the whole list of intersections between a big 3D scene and multiple groups of 'radiative' rays meeting at the point where the dose has to be measured. In order to perform all these computations in less than a second, we first propose a GPU algorithm that enables the efficient management of one big group of coherent rays. Then we present a modification of this algorithm that guarantees the robustness of the ray-triangle intersection tests through the elimination of the precision issues due to floating-point arithmetic. This modification does not require the definition of scene-dependent coefficients ('epsilon' style) and only implies a small loss of performance (less than 10%). Finally we propose an efficient strategy to handle multiple ray groups (corresponding to multiple radiative objects) which use the previous results.Thanks to these improvements, we are able to perform an interactive and robust dose rate evaluation on big 3D scenes: all of the intersections (more than 13 million) between 700 000 triangles and 12 groups of 100 000 rays each are found, sorted along each ray and transferred to the CPU in 470 milliseconds. (author) [fr

  5. Cumulative radiation dose caused by radiologic studies in critically ill trauma patients.

    Science.gov (United States)

    Kim, Patrick K; Gracias, Vicente H; Maidment, Andrew D A; O'Shea, Michael; Reilly, Patrick M; Schwab, C William

    2004-09-01

    Critically ill trauma patients undergo many radiologic studies, but the cumulative radiation dose is unknown. The purpose of this study was to estimate the cumulative effective dose (CED) of radiation resulting from radiologic studies in critically ill trauma patients. The study group was composed of trauma patients at an urban Level I trauma center with surgical intensive care unit length of stay (LOS) greater than 30 days. The radiology records were reviewed. A typical effective dose per study for each type of plain film radiograph, computed tomographic scan, fluoroscopic study, and nuclear medicine study was used to calculate CED. Forty-six patients met criteria. The mean surgical intensive care unit and hospital LOS were 42.7 +/- 14.0 and 59.5 +/- 28.5 days, respectively. The mean Injury Severity Score was 32.2 +/- 15.0. The mean number of studies per patient was 70.1 +/- 29.0 plain film radiographs, 7.8 +/- 4.1 computed tomographic scans, 2.5 +/- 2.6 fluoroscopic studies, and 0.065 +/- 0.33 nuclear medicine study. The mean CED was 106 +/- 59 mSv per patient (range, 11-289 mSv; median, 104 mSv). Among age, mechanism, Injury Severity Score, and LOS, there was no statistically significant predictor of high CED. The mean CED in the study group was 30 times higher than the average yearly radiation dose from all sources for individuals in the United States. The theoretical additional morbidity attributable to radiologic studies was 0.78%. From a radiobiologic perspective, risk-to-benefit ratios of radiologic studies are favorable, given the importance of medical information obtained. Current practice patterns regarding use of radiologic studies appear to be acceptable.

  6. High definition versus standard definition white light endoscopy for detecting dysplasia in patients with Barrett's esophagus.

    Science.gov (United States)

    Sami, S S; Subramanian, V; Butt, W M; Bejkar, G; Coleman, J; Mannath, J; Ragunath, K

    2015-01-01

    High-definition endoscopy systems provide superior image resolution. The aim of this study was to assess the utility of high definition compared with standard definition endoscopy system for detecting dysplastic lesions in patients with Barrett's esophagus. A retrospective cohort study of patients with non-dysplastic Barrett's esophagus undergoing routine surveillance was performed. Data were retrieved from the central hospital electronic database. Procedures performed for non-surveillance indications, Barrett's esophagus Prague C0M1 classification with no specialized intestinal metaplasia on histology, patients diagnosed with any dysplasia or cancer on index endoscopy, and procedures using advanced imaging techniques were excluded. Logistic regression models were constructed to estimate adjusted odds ratios and 95% confidence intervals comparing outcomes with standard definition and high-definition systems. The high definition was superior to standard definition system in targeted detection of all dysplastic lesions (odds ratio 3.27, 95% confidence interval 1.27-8.40) as well as overall dysplasia detected on both random and target biopsies (odds ratio 2.36, 95% confidence interval 1.50-3.72). More non-dysplastic lesions were detected with the high-definition system (odds ratio 1.16, 95% confidence interval 1.01-1.33). There was no difference between high definition and standard definition endoscopy in the overall (random and target) high-grade dysplasia or cancers detected (odds ratio 0.93, 95% confidence interval 0.83-1.04). Trainee endoscopists, number of biopsies taken, and male sex were all significantly associated with a higher yield for dysplastic lesions. The use of the high-definition endoscopy system is associated with better targeted detection of any dysplasia during routine Barrett's esophagus surveillance. However, high-definition endoscopy cannot replace random biopsies at present time. © 2014 International Society for Diseases of the Esophagus.

  7. Re-irradiation of recurrent esophageal cancer after primary definitive radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Suk; Lee, Chang Geol; Kim, Kyung Hwan; Kim, Tae Hyung [Dept. of Radiation Oncology, Yonsei University Health System, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2012-12-15

    For recurrent esophageal cancer after primary definitive radiotherapy, no general treatment guidelines are available. We evaluated the toxicities and clinical outcomes of re-irradiation (re-RT) for recurrent esophageal cancer. We analyzed 10 patients with recurrent esophageal cancer treated with re-RT after primary definitive radiotherapy. The median time interval between primary radiotherapy and re-RT was 15.6 months (range, 4.8 to 36.4 months). The total dose of primary radiotherapy was a median of 50.4 Gy (range, 50.4 to 63.0 Gy). The total dose of re-RT was a median of 46.5 Gy (range, 44.0 to 50.4 Gy). The median follow-up period was 4.9 months (range, 2.6 to 11.4 months). The tumor response at 3 months after the end of re-RT was complete response (n = 2), partial response (n = 1), stable disease (n = 2), and progressive disease (n = 5). Grade 5 tracheoesophageal fistula developed in three patients. The time interval between primary radiotherapy and re-RT was less than 12 months in two of these three patients. Late toxicities included grade 1 dysphagia (n = 1). Re-RT of recurrent esophageal cancer after primary radiotherapy can cause severe toxicity.

  8. Re-irradiation of recurrent esophageal cancer after primary definitive radiotherapy

    International Nuclear Information System (INIS)

    Kim, Young Suk; Lee, Chang Geol; Kim, Kyung Hwan; Kim, Tae Hyung

    2012-01-01

    For recurrent esophageal cancer after primary definitive radiotherapy, no general treatment guidelines are available. We evaluated the toxicities and clinical outcomes of re-irradiation (re-RT) for recurrent esophageal cancer. We analyzed 10 patients with recurrent esophageal cancer treated with re-RT after primary definitive radiotherapy. The median time interval between primary radiotherapy and re-RT was 15.6 months (range, 4.8 to 36.4 months). The total dose of primary radiotherapy was a median of 50.4 Gy (range, 50.4 to 63.0 Gy). The total dose of re-RT was a median of 46.5 Gy (range, 44.0 to 50.4 Gy). The median follow-up period was 4.9 months (range, 2.6 to 11.4 months). The tumor response at 3 months after the end of re-RT was complete response (n = 2), partial response (n = 1), stable disease (n = 2), and progressive disease (n = 5). Grade 5 tracheoesophageal fistula developed in three patients. The time interval between primary radiotherapy and re-RT was less than 12 months in two of these three patients. Late toxicities included grade 1 dysphagia (n = 1). Re-RT of recurrent esophageal cancer after primary radiotherapy can cause severe toxicity.

  9. The effectiveness of low-dose and high-dose tranexamic acid in posterior lumbar interbody fusion: a double-blinded, placebo-controlled randomized study.

    Science.gov (United States)

    Kim, Ki-Tack; Kim, Cheung-Kue; Kim, Yong-Chan; Juh, Hyung-Suk; Kim, Hyo-Jong; Kim, Hyeon-Soo; Hong, Se Jung; Hey, Hwee Weng Dennis

    2017-11-01

    Tranexamic acid is a proven drug used for reduction of intraoperative blood loss in spinal surgery. However, optimal dosing considering risk/benefits is not well established owing to the heterogeneity in patient selection and surgical procedures of previous studies. This study aimed to evaluate the effectiveness and safety of various tranexamic acid regimens in reducing perioperative blood loss in single-level posterior lumbar interbody fusion (PLIF). Patients were randomly grouped into three different interventions: low-dose tranexamic acid (LD), high-dose tranexamic acid (HD), and placebo-controlled (PC) groups. The HD and LD groups received 10 and 5 mg/kg of bolus loading dose and 2 and 1 mg/kg of continuous infusion until 5 h after surgery, respectively. Data on patient demographics and preoperative and 24-h postoperative laboratory values were collected. Outcome parameters include intraoperative blood loss, 24-h postoperative blood loss, and blood loss during removal of the last drain. Seventy-two patients (mean age 63.3 ± 7.6 years) showed similar baseline characteristics. Intraoperatively, blood loss was reduced by the administration of tranexamic acid (P = 0.04), contributed predominantly by a difference between the LD and HD groups (123 mL; P tranexamic acid use were noted. Tranexamic acid administration for single-level PLIF was effective and safe in reducing perioperative blood loss in a dose-dependent manner. An HD regimen comprising 10 mg/kg of bolus loading dose and 2 mg/kg/h of continuous infusion is recommended. Level 1 study according to Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence.

  10. Defining a dose-response relationship for prostate external beam radiotherapy

    International Nuclear Information System (INIS)

    Trada, Yuvnik; Plank, Ash; Martin, Jarad

    2013-01-01

    We aimed to quantify a relationship between radiotherapy dose and freedom from biochemical failure (FFBF) in low- and intermediate-risk prostate cancer. To reduce confounding we used data with a standardised end–point, mature follow-up, low competing risk of metastatic failure, conventional fractionation and separate reporting for outcomes with hormonal therapy (HT). A systematic review of the literature was carried out. Studies that reported the use of radiotherapy alone in 1.8–2Gy fractions in low- and intermediate-risk prostate cancer were included. The primary end–point was Phoenix definition 5-year FFBF. A logistic regression was used to quantify the dose–response relationship. Data from eight studies with 3037 patients met the inclusion criteria. The data from 810 low-risk patients and 2245 intermediate-risk patients were analysed. A strong association between radiotherapy dose and FFBF was found in low- and intermediate-risk patients managed with radiotherapy alone. In low-risk patients not treated with HT the dose required to achieve 50% biochemical tumour control (TCD 50 ) is 52.0 Gy and the slope of the dose–response curve at TCD 50 (γ 50 ) is 2.1%/Gy. At 78Gy this represented a FFBF of 90.3%. In intermediate-risk patients not treated with HT the TCD 50 is 64.7Gy and γ 50 is 3.2%/Gy. At 78 Gy this translated into a FFBF of 84.3%. HT had a small effect for low-risk patients and an inconsistent effect for intermediate-risk men. A strong association was found between radiation dose and biochemical outcome in both low- and intermediate-risk patients. Standardised reporting of results from future studies will make future analyses more robust.

  11. Defending definitions of life.

    Science.gov (United States)

    Mix, Lucas John

    2015-01-01

    Over the past 10 years, it has become unpopular to talk about definitions of life, under the assumption that attempts at a precise definition are counterproductive. Recent attempts have failed to meet strict philosophical criteria for definitions and have failed to reach consensus. I argue that provisional definitions are necessary for clear communications. Our current knowledge of biology justifies a number of universal claims about the category of life. Whether or not "life" represents a natural category, it maps to a number of important, observable processes. Given the importance of those processes and the extent of our knowledge, plural explicit definitions of life (and related categories) will be necessary for progress in astrobiology and origin-of-life studies as well as biology in general. I propose concrete categories related to, but not necessarily coextensive with, life for clear communication and hypothesis formation: Woese life, Darwin life, Haldane life.

  12. Study of the Radiochromic Film for High Dose Measurement in Radiation Processing

    Directory of Open Access Journals (Sweden)

    CHEN Yi-zhen

    2016-02-01

    Full Text Available To establish the radiochromic film dosimeter for high dose level measurement during radiation processing, By corresponding formula and its preparation process research, batches of radiochromic film dosimeters were prepared using nylon as substrate and pararosaniline cyanide as dye. In Co-60 gamma reference radiation field, dosimetry response performance of radiochromic film was studied and results showed that the repeatability was good to 1.0%. The response curves demonstrated good linearity in the dose range of 5-210 kGy, and the signal of radiochromic film dosimeters after irradiation under the condition of low temperature storage within 2 weeks was stable. In addition, the radiochromic film dosimeters were not found to have noticeable dose rate dependence in the range of this experiment. In the linear dose range, radiochromic film dosimeter measures the absorbed dose, with extended uncertainty 4.2% (k=2 for Co-60 gamma rays. The film was suitable as dosimeters for the parameters measurement of the electron beam on the accelerator.

  13. 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

  14. Study on cellular survival adaptive response induced by low dose irradiation of 153Sm

    International Nuclear Information System (INIS)

    Zhu Shoupeng; Xiao Dong

    1999-01-01

    The present study engages in determining whether low dose irradiation of 153 Sm could cut down the responsiveness of cellular survival to subsequent high dose exposure of 153 Sm so as to make an inquiry into approach the protective action of adaptive response by second irradiation of 153 Sm. Experimental results indicate that for inductive low dose of radionuclide 153 Sm 3.7 kBq/ml irradiated beforehand to cells has obvious resistant effect in succession after high dose irradiation of 153 Sm 3.7 x 10 2 kBq/ml was observed. Cells exposed to low dose irradiation of 153 Sm become adapted and therefore the subsequent cellular survival rate induced by high dose of 153 Sm is sufficiently higher than high dose of 153 Sm merely. It is evident that cellular survival adaptive response could be induced by pure low dose irradiation of 153 Sm only

  15. A review of Down's syndrome studies and ionizing radiation

    International Nuclear Information System (INIS)

    Rose, K.S.B.

    1994-01-01

    This review collates results from 3 high dose (> 0.1 Gy) and 23 low dose epidemiological studies of parental radiation exposure and Down's syndrome incidence. A pattern of consistent results appears in 13 studies of irradiation received by women for diagnostic purposes. The pattern is an increase in Down's syndrome, the increase being approximately equivalent to an ovarian doubling dose of 20 mGy. The value is definitely not compatible with results from the high dose studies. Results from the other 10 low dose studies were used to test this value but most proved to be unsuitable for a variety of reasons. However, no associations between levels of high natural background and Down's syndrome have been observed in either New England or Aberdeen, which are areas in developed countries where reliable statistics ar collected. (author)

  16. Beyond the traditional definition of breakthrough pain: an observational study.

    Science.gov (United States)

    Gatti, Antonio; Gentili, Marta; Iorno, Vittorio; Mammucari, Massimo; Tufaro, Giuseppe; Lazzari, Marzia; Sabato, Alessandro Fabrizio

    2013-03-01

    Breakthrough pain (BTP) is traditionally defined as a transitory pain flare in opioid-treated patients with chronic background pain. This definition has, however, been challenged in recent years. This study aimed to analyze BTP prevalence in different pain conditions. This was a prospective, non-interventional, observational study conducted from June to September 2011 in two Italian pain treatment reference centres. Consecutive patients aged >18 years with oncological or non-oncological pain were eligible for this study; background pain was acute/ subacute (3 months). The characteristics of pain were evaluated by means of a structured interview by physicians, and patients were asked to complete a dedicated clinical study form. The following outcomes were assessed: chronic pain duration (in patients with chronic pain), BTP prevalence, and number and severity of daily BTP episodes. All outcomes were assessed in four populations of patients with: (a) chronic oncological pain; (b) chronic non-oncological pain; (c) non-chronic oncological pain; (d) non-chronic non-oncological pain. The correlation between BTP and gender was also investigated. Of 1,270 patients with chronic pain, 1,086 had non-oncological pain (85.5%). Most patients (68.6%) with non-oncological pain were female (P = 0.001). Pain duration was significantly longer in non-oncological pain versus oncological pain groups (P = 0.002). BTP prevalence was lower in non-oncological patients (P definition. BTP frequency and severity is similar in oncological and non-oncological pain.

  17. Quality Investing – Industry versus Academic Definitions

    NARCIS (Netherlands)

    G.S. Kyosev (Georgi); M.X. Hanauer (Matthias); J.J. Huij (Joop); S.D. Lansdorp (Simon)

    2016-01-01

    textabstractIn this study we provide an overview of common quality definitions that are currently used in the industry and those used in academic studies, and we outline the differences between these definitions. We show that there is a large dispersion in the definitions that are used for the

  18. 34 CFR 656.7 - What definitions apply?

    Science.gov (United States)

    2010-07-01

    ..., DEPARTMENT OF EDUCATION NATIONAL RESOURCE CENTERS PROGRAM FOR FOREIGN LANGUAGE AND AREA STUDIES OR FOREIGN LANGUAGE AND INTERNATIONAL STUDIES General § 656.7 What definitions apply? The following definitions apply... 34 Education 3 2010-07-01 2010-07-01 false What definitions apply? 656.7 Section 656.7 Education...

  19. Studies on the dose distribution and treatment technique of high energy electron beams

    International Nuclear Information System (INIS)

    Lee, D.H.; Chu, S.S.

    1978-01-01

    Some important properties of high energy electron beams from the linear accelerator, LMR-13, installed in the Yonsei Cancer Center were studied. The results of experimental studies on the problems associated with the 8, 10, and 12 MeV electron beam therapy were as followings; The ionization type dosemeters calibrated by 90 Sr standard source were suitable to the measurements of the outputs and the obsorbed doses in accuracy point of view, and dose measurements using ionization chambers were difficult when measuring doses in small field size and the regions of rapid fall off. The electron energies were measured precisely with an energy spectrometer, and the practical electron energy was calculated within 5% error in the maximum range of the high energy electron beam in water. The correcting factors of perturbated dose distributions owing to radiation field, energy, and materials of the treatment cone were checked and described systematically and thus the variation of dose distributions due to the non-homogeneities of tissues and slopping skin surfaces were completely compensated. The electron beams were adequately diffused using the scatterers, and minimized the bremsstrahlung, irradiation field size, and materials of scatterers. Thus, the therapeutic capacity with the limited electron energy could be extended by improving the dose distributions. (author)

  20. 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.

  1. Computational model design specification for Phase 1 of the Hanford Environmental Dose Reconstruction Project

    Energy Technology Data Exchange (ETDEWEB)

    Napier, B.A.

    1991-07-01

    The objective of the Hanford Environmental Dose Reconstruction (HEDR) Project is to estimate the radiation dose that individuals could have received as a result of emission from nuclear operations at Hanford since their inception in 1944. The purpose of this report is to outline the basic algorithm and necessary computer calculations to be used to calculate radiation doses specific and hypothetical individuals in the vicinity of Hanford. The system design requirements, those things that must be accomplished, are defined. The system design specifications, the techniques by which those requirements are met, are outlined. Included are the basic equations, logic diagrams, and preliminary definition of the nature of each input distribution. 4 refs., 10 figs., 9 tabs.

  2. Computational model design specification for Phase 1 of the Hanford Environmental Dose Reconstruction Project

    International Nuclear Information System (INIS)

    Napier, B.A.

    1991-07-01

    The objective of the Hanford Environmental Dose Reconstruction (HEDR) Project is to estimate the radiation dose that individuals could have received as a result of emission from nuclear operations at Hanford since their inception in 1944. The purpose of this report is to outline the basic algorithm and necessary computer calculations to be used to calculate radiation doses specific and hypothetical individuals in the vicinity of Hanford. The system design requirements, those things that must be accomplished, are defined. The system design specifications, the techniques by which those requirements are met, are outlined. Included are the basic equations, logic diagrams, and preliminary definition of the nature of each input distribution. 4 refs., 10 figs., 9 tabs

  3. A simulation study on the dose distribution for a single beam of the gamma knife

    International Nuclear Information System (INIS)

    Chen, Chin-cheng; Jiang, Shiang-Huei; Lee, Chung-chi; Shiau, Cheng-Ying

    2000-01-01

    The purpose of this study is to evaluate the impact of the tissue heterogeneity on the dose distribution for a single beam of the gamma knife. The EGS4 Monte Carlo code was used to simulate both depth and radial profiles of the radiation dose in homogeneous and heterogeneous phantoms, respectively. The results are compared with the dose distribution calculated using the mathematical model of Gamma Plan, the treatment planning system of the gamma knife. The skull and sinus heterogeneity were simulated by a Teflon shell and an air shell, respectively. It was found that the tissue heterogeneity caused significant perturbation on the absolute depth dose at the focus as well as on the depth-dose distribution near the phantom surface and/or at the interface but little effect on the radial dose distribution. The effect of the beam aperture on the depth-dose distribution was also investigated in this study. (author)

  4. A demonstration of dose modeling at Yucca Mountain

    International Nuclear Information System (INIS)

    Miley, T.B.; Eslinger, P.W.

    1992-11-01

    The U. S. Environmental Protection Agency is currently revising the regulatory guidance for high-level nuclear waste disposal. In its draft form, the guidelines contain dose limits. Since this is likely to be the case in the final regulations, it is essential that the US Department of Energy be prepared to calculate site-specific doses for any potential repository location. This year, Pacific Northwest Laboratory (PNL) has made a first attempt to estimate doses for the potential geologic repository at Yucca Mountain, Nevada as part of a preliminary total-systems performance assessment. A set of transport scenarios was defined to assess the cumulative release of radionuclides over 10,000 years under undisturbed and disturbed conditions at Yucca Mountain. Dose estimates were provided for several of the transport scenarios modeled. The exposure scenarios used to estimate dose in this total-systems exercise should not, however, be considered a definitive set of scenarios for determining the risk of the potential repository. Exposure scenarios were defined for waterborne and surface contamination that result from both undisturbed and disturbed performance of the potential repository. The exposure scenarios used for this analysis were designed for the Hanford Site in Washington. The undisturbed performance scenarios for which exposures were modeled are gas-phase release of 14 C to the surface and natural breakdown of the waste containers with waterborne release. The disturbed performance scenario for which doses were estimated is exploratory drilling. Both surface and waterborne contamination were considered for the drilling intrusion scenario

  5. Tacit definitions of informal caregiving.

    Science.gov (United States)

    Wrubel, J; Richards, T A; Folkman, S; Acree, M C

    2001-01-01

    This study describes three tacit definitions of informal caregiving and explores the extent to which differences in these tacit definitions explain variation in caregivers' negative mood over time. There is a growing need to understand the sources of stress and gratification for informal caregivers. Tacit definitions of informal caregiving refer to caregivers' understanding of what caregiving entails. These definitions are tacit because they arise from caregivers' taken-for-granted understanding rather than formally articulated positions concerning caregiving. A random sample of 60 men, all of whom were caregiving partners of men with acquired immunodeficiency syndrome (AIDS), was drawn from a larger cohort of 253 participants in the University of California San Francisco (UCSF) Coping Project (1990-1997). The caregivers were assessed bimonthly for 2 years with procedures that included a semi-structured interview focusing on a recent stressful event involving caregiving, and quantitative measures of well-being. Interpretive phenomenological case studies of the narrative accounts of the 60 caregivers produced three tacit definitions of caregiving - engagement, conflict and distance. These three tacit definitions were distinguished by differences in learning about caregiving, involvement in health care decisions, caregiving activities and reported sources of stress. The three groups differed on measures of dyadic adjustment, depression, anger and anxiety. Better understanding of caregivers' tacit definitions can facilitate and enhance effective support and interventions for caregivers.

  6. Duration of post-vaccination immunity to yellow fever in volunteers eight years after a dose-response study.

    Science.gov (United States)

    de Menezes Martins, Reinaldo; Maia, Maria de Lourdes S; de Lima, Sheila Maria Barbosa; de Noronha, Tatiana Guimarães; Xavier, Janaina Reis; Camacho, Luiz Antonio Bastos; de Albuquerque, Elizabeth Maciel; Farias, Roberto Henrique Guedes; da Matta de Castro, Thalita; Homma, Akira

    2018-06-27

    In 2009, Bio-Manguinhos conducted a dose-response study with the yellow fever vaccine, administering the vaccine in the usual mean dose of 27,476 IU (full dose, reference) and in tapered doses (10,447 IU, 3013 IU, 587 IU, 158 IU, and 31 IU) by the usual subcutaneous route and usual volume (0.5 mL). Tapered doses were obtained by dilution in the manufacturer's laboratory, and the test batches presented industrial quality. Doses down to 587 IU showed similar immunogenicity to the full dose (27,476, reference), while the 158 IU and 31 IU doses displayed lower immunogenicity. Seropositivity was maintained at 10 months, except in the group that received the 31 IU dose. The current study aims to determine whether yellow fever seropositivity was maintained eight years after YF vaccination in non-revaccinated individuals. According to the current study's results, seropositivity was maintained in 85% of 318 participants and was similar across groups. The findings support the use of the yellow fever vaccine in fractional doses during outbreaks, but each fractional dose should have at least 587 IU. This study also supports the minimum dose required by WHO, 1000 IU. Clinicaltrials.gov NCT 03338231. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Definitions of love in a sample of British women: an empirical study using Q methodology.

    Science.gov (United States)

    Watts, Simon; Stenner, Paul

    2014-09-01

    Social psychological research has increasingly acknowledged that any pretensions to a singular theory of love should be replaced with a concern about its affirmation and what people actually say and do in love's name. Lee's (1977) love styles research and Sternberg's (1995) theory of love as a story are prime examples. Despite traditional definitions of love in western cultures being dominated by feminine images and tales of gender difference, however, the personal definitions and experiences of women have received comparatively little empirical attention, particularly in recent years and despite some well-documented changes in their cultural circumstances. This study remedies that situation through presentation of a Q methodological study in which a convenience sample of 59 British women were asked to Q sort 54 single-word descriptors of love to define love as they had experienced it. Factor analysis of the resulting Q sorts revealed six distinct definitions of love, interpreted as 'attraction, passion & romance', 'unconditional love', 'sex & fun', 'friendship & spirituality', 'a permanent commitment', and 'separate people, separate lives'. The six definitions are then discussed in terms of their allegiance to traditionally feminine and/or masculine values and as a means of highlighting the changing face of Britain's relational culture. © 2013 The British Psychological Society.

  8. Studies of workers exposed to low doses of external radiation

    International Nuclear Information System (INIS)

    Gilbert, E.S.

    1991-04-01

    Currently, several epidemiologic studies of workers who have been exposed occupationally to low levels of radiation are being conducted, and include studies of workers in the United States, Great Britain, and Canada involved in the production of both defense materials and nuclear power. This paper focuses on studies that evaluate the possible adverse effects resulting from external exposure to radiation. The radiation risk estimates that have been used to establish radiation protection standards for workers and others have been obtained mainly from studies of persons exposed at high doses and dose rates. However, questions remain with regard to the extrapolation process that has been necessary for estimating low-level radiation risks. Occupational studies provide a direct assessment of risk based on data on persons exposed at the actual levels of interest. If current risk estimates are correct, these studies have very little chance of detecting risk, but can still be used to provide useful upper limits on risks. The studies are also adequate to detect serious underestimation of risks. 36 refs., 3 figs., 3 tabs

  9. Dose delivery study for a novel compact proton accelerator

    Energy Technology Data Exchange (ETDEWEB)

    Kraus, Kim Melanie

    2014-01-15

    Proton therapy has played an important role in the treatment of cancer with radiation therapy for more than 60 years. Active spot scanning to deliver highly conformal dose to the tumor has been developed. However, the availability of proton therapy to the patients is still limited, partly, due to the high costs and sizes of large proton therapy centers. Therefore, a novel compact proton single room facility based on a linear accelerator mounted on a gantry has been proposed, named TULIP (TUrning LInac for Proton therapy). This accelerator allows for active energy variation on a milliseconds time scale. This work aims to assess the possibilities of dose delivery with TULIP to exploit its beneficial features with respect to dose delivery. We developed a software tool, simulating the dose delivery to the tumor. By means of this software tool, we assessed different delivery methods and found 3D spot scanning to be superior to rotational dose delivery with regard to dose and irradiation time. In a second part, we expanded the investigations to dose delivery to moving targets. Due to fast energy variation, we found TULIP to be preferably suitable for rescanning, confirmed by irradiation times of only a few minutes.

  10. Dose delivery study for a novel compact proton accelerator

    International Nuclear Information System (INIS)

    Kraus, Kim Melanie

    2014-01-01

    Proton therapy has played an important role in the treatment of cancer with radiation therapy for more than 60 years. Active spot scanning to deliver highly conformal dose to the tumor has been developed. However, the availability of proton therapy to the patients is still limited, partly, due to the high costs and sizes of large proton therapy centers. Therefore, a novel compact proton single room facility based on a linear accelerator mounted on a gantry has been proposed, named TULIP (TUrning LInac for Proton therapy). This accelerator allows for active energy variation on a milliseconds time scale. This work aims to assess the possibilities of dose delivery with TULIP to exploit its beneficial features with respect to dose delivery. We developed a software tool, simulating the dose delivery to the tumor. By means of this software tool, we assessed different delivery methods and found 3D spot scanning to be superior to rotational dose delivery with regard to dose and irradiation time. In a second part, we expanded the investigations to dose delivery to moving targets. Due to fast energy variation, we found TULIP to be preferably suitable for rescanning, confirmed by irradiation times of only a few minutes.

  11. Adaptive statistical iterative reconstruction reduces patient radiation dose in neuroradiology CT studies

    Energy Technology Data Exchange (ETDEWEB)

    Komlosi, Peter; Zhang, Yanrong; Leiva-Salinas, Carlos; Ornan, David; Grady, Deborah [University of Virginia, Department of Radiology and Medical Imaging, Division of Neuroradiology, PO Box 800170, Charlottesville, VA (United States); Patrie, James T.; Xin, Wenjun [University of Virginia, Department of Public Health Sciences, Charlottesville, VA (United States); Wintermark, Max [University of Virginia, Department of Radiology and Medical Imaging, Division of Neuroradiology, PO Box 800170, Charlottesville, VA (United States); Centre Hospitalier Universitaire Vaudois, Department of Radiology, Lausanne (Switzerland)

    2014-03-15

    Adaptive statistical iterative reconstruction (ASIR) can decrease image noise, thereby generating CT images of comparable diagnostic quality with less radiation. The purpose of this study is to quantify the effect of systematic use of ASIR versus filtered back projection (FBP) for neuroradiology CT protocols on patients' radiation dose and image quality. We evaluated the effect of ASIR on six types of neuroradiologic CT studies: adult and pediatric unenhanced head CT, adult cervical spine CT, adult cervical and intracranial CT angiography, adult soft tissue neck CT with contrast, and adult lumbar spine CT. For each type of CT study, two groups of 100 consecutive studies were retrospectively reviewed: 100 studies performed with FBP and 100 studies performed with ASIR/FBP blending factor of 40 %/60 % with appropriate noise indices. The weighted volume CT dose index (CTDI{sub vol}), dose-length product (DLP) and noise were recorded. Each study was also reviewed for image quality by two reviewers. Continuous and categorical variables were compared by t test and free permutation test, respectively. For adult unenhanced brain CT, CT cervical myelography, cervical and intracranial CT angiography and lumbar spine CT both CTDI{sub vol} and DLP were lowered by up to 10.9 % (p < 0.001), 17.9 % (p = 0.005), 20.9 % (p < 0.001), and 21.7 % (p = 0.001), respectively, by using ASIR compared with FBP alone. Image quality and noise were similar for both FBP and ASIR. We recommend routine use of iterative reconstruction for neuroradiology CT examinations because this approach affords a significant dose reduction while preserving image quality. (orig.)

  12. Adaptive statistical iterative reconstruction reduces patient radiation dose in neuroradiology CT studies

    International Nuclear Information System (INIS)

    Komlosi, Peter; Zhang, Yanrong; Leiva-Salinas, Carlos; Ornan, David; Grady, Deborah; Patrie, James T.; Xin, Wenjun; Wintermark, Max

    2014-01-01

    Adaptive statistical iterative reconstruction (ASIR) can decrease image noise, thereby generating CT images of comparable diagnostic quality with less radiation. The purpose of this study is to quantify the effect of systematic use of ASIR versus filtered back projection (FBP) for neuroradiology CT protocols on patients' radiation dose and image quality. We evaluated the effect of ASIR on six types of neuroradiologic CT studies: adult and pediatric unenhanced head CT, adult cervical spine CT, adult cervical and intracranial CT angiography, adult soft tissue neck CT with contrast, and adult lumbar spine CT. For each type of CT study, two groups of 100 consecutive studies were retrospectively reviewed: 100 studies performed with FBP and 100 studies performed with ASIR/FBP blending factor of 40 %/60 % with appropriate noise indices. The weighted volume CT dose index (CTDI vol ), dose-length product (DLP) and noise were recorded. Each study was also reviewed for image quality by two reviewers. Continuous and categorical variables were compared by t test and free permutation test, respectively. For adult unenhanced brain CT, CT cervical myelography, cervical and intracranial CT angiography and lumbar spine CT both CTDI vol and DLP were lowered by up to 10.9 % (p < 0.001), 17.9 % (p = 0.005), 20.9 % (p < 0.001), and 21.7 % (p = 0.001), respectively, by using ASIR compared with FBP alone. Image quality and noise were similar for both FBP and ASIR. We recommend routine use of iterative reconstruction for neuroradiology CT examinations because this approach affords a significant dose reduction while preserving image quality. (orig.)

  13. Uncertainties in Assesment of the Vaginal Dose for Intracavitary Brachytherapy of Cervical Cancer using a Tandem-ring Applicator

    International Nuclear Information System (INIS)

    Berger, Daniel; Dimopoulos, Johannes; Georg, Petra; Georg, Dietmar; Poetter, Richard; Kirisits, Christian

    2007-01-01

    Purpose: The vagina has not been widely recognized as organ at risk in brachytherapy for cervical cancer. No widely accepted dose parameters are available. This study analyzes the uncertainties in dose reporting for the vaginal wall using tandem-ring applicators. Methods and Materials: Organ wall contours were delineated on axial magnetic resonance (MR) slices to perform dose-volume histogram (DVH) analysis. Different DVH parameters were used in a feasibility study based on 40 magnetic resonance imaging (MRI)-based treatment plans of different cervical cancer patients. Dose to the most irradiated, 0.1 cm 3 , 1 cm 3 , 2 cm 3 , and at defined points on the ring surface and at 5-mm tissue depth were reported. Treatment-planning systems allow different methods of dose point definition. Film dosimetry was used to verify the maximum dose at the surface of the ring applicator in an experimental setup. Results: Dose reporting for the vagina is extremely sensitive to geometrical uncertainties with variations of 25% for 1 mm shifts. Accurate delineation of the vaginal wall is limited by the finite pixel size of MRI and available treatment-planning systems. No significant correlation was found between dose-point and dose-volume parameters. The DVH parameters were often related to noncontiguous volumes and were not able to detect very different situations of spatial dose distributions inside the vaginal wall. Deviations between measured and calculated doses were up to 21%. Conclusions: Reporting either point dose values or DVH parameters for the vaginal wall is based on high inaccuracies because of contouring and geometric positioning. Therefore, the use of prospective dose constraints for individual treatment plans is not to be recommended at present. However, for large patient groups treated within one protocol correlation with vaginal morbidity can be evaluated

  14. A study on the evaluation of radiation doses in dental radiography

    International Nuclear Information System (INIS)

    Sugimoto, Koju

    1980-01-01

    Radiation doses and possible biological risks due to dental full mouth examination (adult: 10-film technique, child: 6-film technique) were evaluated based on preliminary experiments and statistical surveillance of patients' records. Dosimetrical studies were performed by using head and neck phantoms and a dental x-ray tube. Radiation doses were measured by x-ray films and thermoluminescence dosimeters. For the obtained doses of skin, eyes, thyroid gland and bone marrow, the biological risk of leukemia and thyroid cancer was discussed on the statistical basis of patients at Kanagawa Dental College Hospital. The major findings were as follows: The total number of patients who recieved full mouth x-ray examination at Kanagawa Dental College Hospital in 1978 was 1,099. The number of male patients was 382 (3,804 films) and that of female patients was 717 (7,138 films). In both sexes, the number of patients was the greatest in the group of 8 - 14 years of age. The collective doses of bone marrow due to full mouth 10-film examination performed at Kanagawa Dental College Hospital in 1978 were approximately 6.0 rad, which could induce leukemia with a probability of 1/8,000. The collective doses of thyroid gland were approximately 13 rad, which could induce lethal thyroid cancer with a probability of 1/15,000. The radiation dose due to the dental radiography for examination at Kanagawa Dental College Hospital was proved to be apparently below the level that could actually induce radiation injuries. But the collective radiation doses due to dental examination in Japan as a whole were approximately 8,000 times greater than that in Kanagawa Dental College Hospital. (J.P.N.)

  15. Population dose from nuclear medicine studies (DOMNES). Contribution of Project DOMNES to Dose Datemed2

    International Nuclear Information System (INIS)

    Ramirez, M. L.; Ruiz, A.; Ferrer, N.; Alonso Farto, J. C.; Alvarez, C.; Rodriguez, M.

    2013-01-01

    The DOMNES Project is created in 2001 to carry out a survey on nuclear medicine procedures used in the Spanish health centers, their frequency and the doses given to patients. In addition, it reports information to Dose Data Project Med 2, focusing on radiology exams. (Author)

  16. The Impact of a One-Dose versus Two-Dose Oral Cholera Vaccine Regimen in Outbreak Settings: A Modeling Study

    Science.gov (United States)

    Azman, Andrew S.; Luquero, Francisco J.; Ciglenecki, Iza; Grais, Rebecca F.; Sack, David A.; Lessler, Justin

    2015-01-01

    Background In 2013, a stockpile of oral cholera vaccine (OCV) was created for use in outbreak response, but vaccine availability remains severely limited. Innovative strategies are needed to maximize the health impact and minimize the logistical barriers to using available vaccine. Here we ask under what conditions the use of one dose rather than the internationally licensed two-dose protocol may do both. Methods and Findings Using mathematical models we determined the minimum relative single-dose efficacy (MRSE) at which single-dose reactive campaigns are expected to be as or more effective than two-dose campaigns with the same amount of vaccine. Average one- and two-dose OCV effectiveness was estimated from published literature and compared to the MRSE. Results were applied to recent outbreaks in Haiti, Zimbabwe, and Guinea using stochastic simulations to illustrate the potential impact of one- and two-dose campaigns. At the start of an epidemic, a single dose must be 35%–56% as efficacious as two doses to avert the same number of cases with a fixed amount of vaccine (i.e., MRSE between 35% and 56%). This threshold decreases as vaccination is delayed. Short-term OCV effectiveness is estimated to be 77% (95% CI 57%–88%) for two doses and 44% (95% CI −27% to 76%) for one dose. This results in a one-dose relative efficacy estimate of 57% (interquartile range 13%–88%), which is above conservative MRSE estimates. Using our best estimates of one- and two-dose efficacy, we projected that a single-dose reactive campaign could have prevented 70,584 (95% prediction interval [PI] 55,943–86,205) cases in Zimbabwe, 78,317 (95% PI 57,435–100,150) in Port-au-Prince, Haiti, and 2,826 (95% PI 2,490–3,170) cases in Conakry, Guinea: 1.1 to 1.2 times as many as a two-dose campaign. While extensive sensitivity analyses were performed, our projections of cases averted in past epidemics are based on severely limited single-dose efficacy data and may not fully capture

  17. The Impact of a One-Dose versus Two-Dose Oral Cholera Vaccine Regimen in Outbreak Settings: A Modeling Study.

    Directory of Open Access Journals (Sweden)

    Andrew S Azman

    2015-08-01

    Full Text Available In 2013, a stockpile of oral cholera vaccine (OCV was created for use in outbreak response, but vaccine availability remains severely limited. Innovative strategies are needed to maximize the health impact and minimize the logistical barriers to using available vaccine. Here we ask under what conditions the use of one dose rather than the internationally licensed two-dose protocol may do both.Using mathematical models we determined the minimum relative single-dose efficacy (MRSE at which single-dose reactive campaigns are expected to be as or more effective than two-dose campaigns with the same amount of vaccine. Average one- and two-dose OCV effectiveness was estimated from published literature and compared to the MRSE. Results were applied to recent outbreaks in Haiti, Zimbabwe, and Guinea using stochastic simulations to illustrate the potential impact of one- and two-dose campaigns. At the start of an epidemic, a single dose must be 35%-56% as efficacious as two doses to avert the same number of cases with a fixed amount of vaccine (i.e., MRSE between 35% and 56%. This threshold decreases as vaccination is delayed. Short-term OCV effectiveness is estimated to be 77% (95% CI 57%-88% for two doses and 44% (95% CI -27% to 76% for one dose. This results in a one-dose relative efficacy estimate of 57% (interquartile range 13%-88%, which is above conservative MRSE estimates. Using our best estimates of one- and two-dose efficacy, we projected that a single-dose reactive campaign could have prevented 70,584 (95% prediction interval [PI] 55,943-86,205 cases in Zimbabwe, 78,317 (95% PI 57,435-100,150 in Port-au-Prince, Haiti, and 2,826 (95% PI 2,490-3,170 cases in Conakry, Guinea: 1.1 to 1.2 times as many as a two-dose campaign. While extensive sensitivity analyses were performed, our projections of cases averted in past epidemics are based on severely limited single-dose efficacy data and may not fully capture uncertainty due to imperfect

  18. [Clinical applications of dosing algorithm in the predication of warfarin maintenance dose].

    Science.gov (United States)

    Huang, Sheng-wen; Xiang, Dao-kang; An, Bang-quan; Li, Gui-fang; Huang, Ling; Wu, Hai-li

    2011-12-27

    To evaluate the feasibility of clinical application for genetic based dosing algorithm in the predication of warfarin maintenance dose in Chinese population. The clinical data were collected and blood samples harvested from a total of 126 patients undergoing heart valve replacement. The genotypes of VKORC1 and CYP2C9 were determined by melting curve analysis after PCR. They were divided randomly into the study and control groups. In the study group, the first three doses of warfarin were prescribed according to the predicted warfarin maintenance dose while warfarin was initiated at 2.5 mg/d in the control group. The warfarin doses were adjusted according to the measured international normalized ratio (INR) values. And all subjects were followed for 50 days after an initiation of warfarin therapy. At the end of a 50-day follow-up period, the proportions of the patients on a stable dose were 82.4% (42/51) and 62.5% (30/48) for the study and control groups respectively. The mean durations of reaching a stable dose of warfarin were (27.5 ± 1.8) and (34.7 ± 1.8) days and the median durations were (24.0 ± 1.7) and (33.0 ± 4.5) days in the study and control groups respectively. Significant differences existed in the durations of reaching a stable dose between the two groups (P = 0.012). Compared with the control group, the hazard ratio (HR) for the duration of reaching a stable dose was 1.786 in the study group (95%CI 1.088 - 2.875, P = 0.026). The predicted dosing algorithm incorporating genetic and non-genetic factors may shorten the duration of achieving efficiently a stable dose of warfarin. And the present study validates the feasibility of its clinical application.

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

    Science.gov (United States)

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

    2013-07-01

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

  20. A single institution study of radiation dose received from CT imaging: A comparison to Malaysian NDRL

    Science.gov (United States)

    Osman, N. D.; Shamsuri, S. B. M.; Tan, Y. W.; Razali, M. A. S. M.; Isa, S. M.

    2017-05-01

    Advancement of CT technology has led to an increase in CT scanning as it improves the diagnosis. However, it is important to assess health risk of patients associated with ionising radiation received from CT. This study evaluated current dose distributions at Advanced Medical and Dental Institute (AMDI), Malaysia and was used to establish Local Diagnostic Reference Level (LDRL). Dose indicators such as CT Dose Index (CTDIvol and CTDIw) and Dose-Length Product (DLP) were gathered for all routine CT examinations performed at the Imaging Unit, AMDI from January 2015 to June 2016. The first and third quartile values for each dose indicator were determined. A total of 364 CT studies were performed during that period with the highest number of cases being Thorax-Abdomen-Pelvis (TAP) study (57% of total study). The CTDIw ranged between 2.0 mGy to 23.4 mGy per procedure. DLP values were ranged between 94 mGy.cm to 1687 mGy.cm. The local dose data was compared with the national DRL to monitor the current CT practice at AMDI and LDRL will be established from the calculated third quartile values of dose distribution. From the results, some of the local dose values exceeded the Malaysian and further evaluation is important to ensure the dose optimisation for patients.

  1. A single institution study of radiation dose received from CT imaging: A comparison to Malaysian NDRL

    International Nuclear Information System (INIS)

    Osman, N D; Shamsuri, S B M; Razali, M A S M; Isa, S M; Tan, Y W

    2017-01-01

    Advancement of CT technology has led to an increase in CT scanning as it improves the diagnosis. However, it is important to assess health risk of patients associated with ionising radiation received from CT. This study evaluated current dose distributions at Advanced Medical and Dental Institute (AMDI), Malaysia and was used to establish Local Diagnostic Reference Level (LDRL). Dose indicators such as CT Dose Index (CTDI vol and CTDI w ) and Dose-Length Product (DLP) were gathered for all routine CT examinations performed at the Imaging Unit, AMDI from January 2015 to June 2016. The first and third quartile values for each dose indicator were determined. A total of 364 CT studies were performed during that period with the highest number of cases being Thorax-Abdomen-Pelvis (TAP) study (57% of total study). The CTDI w ranged between 2.0 mGy to 23.4 mGy per procedure. DLP values were ranged between 94 mGy.cm to 1687 mGy.cm. The local dose data was compared with the national DRL to monitor the current CT practice at AMDI and LDRL will be established from the calculated third quartile values of dose distribution. From the results, some of the local dose values exceeded the Malaysian and further evaluation is important to ensure the dose optimisation for patients. (paper)

  2. 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.

  3. Do dose area product meter measurements reflect radiation doses ...

    African Journals Online (AJOL)

    This study determined the correlation between radiation doses absorbed by health care workers and dose area product meter (DAP) measurements at Universitas Hospital, Bloemfontein. The DAP is an instrument which accurately measures the radiation emitted from the source. The study included the interventional ...

  4. Assessment of ambient gamma dose rate around a prospective uranium mining area of South India - A comparative study of dose by direct methods and soil radioactivity measurements

    Science.gov (United States)

    Karunakara, N.; Yashodhara, I.; Sudeep Kumara, K.; Tripathi, R. M.; Menon, S. N.; Kadam, S.; Chougaonkar, M. P.

    Indoor and outdoor gamma dose rates were evaluated around a prospective uranium mining region - Gogi, South India through (i) direct measurements using a GM based gamma dose survey meter, (ii) integrated measurement days using CaSO4:Dy based thermo luminescent dosimeters (TLDs), and (iii) analyses of 273 soil samples for 226Ra, 232Th, and 40K activity concentration using HPGe gamma spectrometry. The geometric mean values of indoor and outdoor gamma dose rates were 104 nGy h-1 and 97 nGy h-1, respectively with an indoor to outdoor dose ratio of 1.09. The gamma dose rates and activity concentrations of 226Ra, 232Th, and 40K varied significantly within a small area due to the highly localized mineralization of the elements. Correlation study showed that the dose estimated from the soil radioactivity is better correlated with that measured directly using the portable survey meter, when compared to that obtained from TLDs. This study showed that in a region having localized mineralization in situ measurements using dose survey meter provide better representative values of gamma dose rates.

  5. Studying and measuring the gamma radiation doses in Homs city

    International Nuclear Information System (INIS)

    Sofaan, A. H.

    2001-01-01

    The gamma radiation dose was measured in Homs city by using many portable dosimeters (electronic dosimeter and Geiger-Muller). The measurements were carried out in the indoor and outdoor buildings, for different time period, through one year (1999-2000). High purity germanium detector with low back ground radiation (HpGe) was used to determine radiation element contained in some building and the surrounding soil. The statistical analysis laws were applied to make sure that the measured dose distribution around average value is normal distribution. The measurement indicates that the gamma indoor dose varies from 312μSv/y to 511μSv/y, with the average annual dose of 385μSv/y. However the gamma outdoor dose rate varies from 307μSv/y to 366μSv/y with an average annual dose 385μSv/y. The annual outdoor gamma radiation dose is about %16 lower than the outdoor dose in Homs City. These measurements have indicated that environmental gamma doses in Homs City are relatively low. This is because that most of the soils and rocks in the area are limestone. (author)

  6. 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

  7. Comparative Analysis of Institutional Policy Definitions of Plagiarism: A Pan-Canadian University Study

    Science.gov (United States)

    Eaton, Sarah Elaine

    2017-01-01

    This article shares the findings of a study investigating institutional policy definitions of plagiarism at twenty English-speaking Canadian universities. The types of primary sources consulted for this study included: (1) university academic calendars for 2016-2017, (2) institutional policies on academic misconduct, and (3) student academic codes…

  8. Effect of Definition on Incidence and Prognosis of Type 2 Myocardial Infarction.

    Science.gov (United States)

    Nestelberger, Thomas; Boeddinghaus, Jasper; Badertscher, Patrick; Twerenbold, Raphael; Wildi, Karin; Breitenbücher, Dominik; Sabti, Zaid; Puelacher, Christian; Rubini Giménez, Maria; Kozhuharov, Nikola; Strebel, Ivo; Sazgary, Lorraine; Schneider, Deborah; Jann, Janina; du Fay de Lavallaz, Jeanne; Miró, Òscar; Martin-Sanchez, F Javier; Morawiec, Beata; Kawecki, Damian; Muzyk, Piotr; Keller, Dagmar I; Geigy, Nicolas; Osswald, Stefan; Reichlin, Tobias; Mueller, Christian

    2017-09-26

    Uncertainties regarding the most appropriate definition and treatment of type 2 myocardial infarction (T2MI) due to supply-demand mismatch have contributed to inconsistent adoption in clinical practice. This study sought a better understanding of the effect of the definition of T2MI on its incidence, treatment, and event-related mortality, thereby addressing an important unmet clinical need. The final diagnosis was adjudicated in patients presenting with symptoms suggestive of myocardial infarction by 2 independent cardiologists by 2 methods: 1 method required the presence of coronary artery disease, a common interpretation of the 2007 universal definition (T2MI 2007 ); and 1 method did not require coronary artery disease, the 2012 universal definition (T2MI 2012 ). Overall, 4,015 consecutive patients were adjudicated. The incidence of T2MI based on the T2MI 2007 definition was 2.8% (n = 112). The application of the more liberal T2MI 2012 definition resulted in an increase of T2MI incidence of 6% (n = 240), a relative increase of 114% (128 reclassified patients, defined as T2MI 2012reclassified ). Among T2MI 2007 , 6.3% of patients received coronary revascularization, 22% dual-antiplatelet therapy, and 71% high-dose statin therapy versus 0.8%, 1.6%, and 31% among T2MI 2012reclassified patients, respectively (all p < 0.01). Cardiovascular mortality at 90 days was 0% among T2MI 2012reclassified , which was similar to patients with noncardiac causes of chest discomfort (0.2%), and lower than T2MI 2007 (3.6%) and type 1 myocardial infarction (T1MI) (4.8%) (T2MI 2012reclassified vs. T2MI 2007 and T1MI: p = 0.03 and 0.01, respectively). T2MI 2012reclassified has a substantially lower event-related mortality rate compared with T2MI 2007 and T1MI. (Advantageous Predictors of Acute Coronary Syndromes Evaluation [APACE] Study; NCT00470587). Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  9. Optimisation of CT procedures by dose reduction in abdominal-pelvic studies of chronic patients

    International Nuclear Information System (INIS)

    Calvo, D.; Rodriguez, A.M.; Peinado, M.A.; Fernandez, B.; Fernandez, B.M.; Jimenez, J.R.

    2006-01-01

    Full text of publication follows: Objectives: CT explorations are responsible of a significant increase of collective dose during last twenty years. However, by adapting the procedures to the specific diagnostic requirements of each kind of exploration, dose values can be decreased. This can be specially interesting for chronic patients who undergo several CT controls. The aim of this research is to contrast CT image diagnostic quality by comparing those techniques commonly used in our hospital with lower dose ones. Materials and methods: In a first phase, a study on phantom has been developed to evaluate image quality variations obtained with standard a several low dose techniques. Dose reduction was quantified as well by means of C.T.D.I. w measurements on an abdominal phantom. Both aspects were taken into account to determine a dose threshold below image quality degradation was considered unacceptable from a diagnostic point of view. Subsequently, a group of 50 chronic patients under follow -up was selected to undergo a control CT but with a low dose-technique. Image diagnostic quality was compared with that of previous controls obtained using the standard technique. Three experimented radiologist carried out this evaluation over a sample of six particular slices located at the abdomen and pelvis using an ordinal scale. Such a scale gradate the confidence level of the image for each radiologist. This evaluation was repeated one and two months later without knowledge of previous results to calculate inter and intra -observer variability. Conclusions: CT studies can be carried out with a significant dose reduction preserving their diagnostic capabilities. A quantitative evaluation will be offered at the end of the study, still running. (authors)

  10. GACT: a Genome build and Allele definition Conversion Tool for SNP imputation and meta-analysis in genetic association studies.

    Science.gov (United States)

    Sulovari, Arvis; Li, Dawei

    2014-07-19

    Genome-wide association studies (GWAS) have successfully identified genes associated with complex human diseases. Although much of the heritability remains unexplained, combining single nucleotide polymorphism (SNP) genotypes from multiple studies for meta-analysis will increase the statistical power to identify new disease-associated variants. Meta-analysis requires same allele definition (nomenclature) and genome build among individual studies. Similarly, imputation, commonly-used prior to meta-analysis, requires the same consistency. However, the genotypes from various GWAS are generated using different genotyping platforms, arrays or SNP-calling approaches, resulting in use of different genome builds and allele definitions. Incorrect assumptions of identical allele definition among combined GWAS lead to a large portion of discarded genotypes or incorrect association findings. There is no published tool that predicts and converts among all major allele definitions. In this study, we have developed a tool, GACT, which stands for Genome build and Allele definition Conversion Tool, that predicts and inter-converts between any of the common SNP allele definitions and between the major genome builds. In addition, we assessed several factors that may affect imputation quality, and our results indicated that inclusion of singletons in the reference had detrimental effects while ambiguous SNPs had no measurable effect. Unexpectedly, exclusion of genotypes with missing rate > 0.001 (40% of study SNPs) showed no significant decrease of imputation quality (even significantly higher when compared to the imputation with singletons in the reference), especially for rare SNPs. GACT is a new, powerful, and user-friendly tool with both command-line and interactive online versions that can accurately predict, and convert between any of the common allele definitions and between genome builds for genome-wide meta-analysis and imputation of genotypes from SNP-arrays or deep

  11. Study of dose effect relationship at low doses for non quantitative reactions of skin intestinal mucosa and lung

    International Nuclear Information System (INIS)

    Dutreix, J.; Wambersie, A.

    1977-01-01

    Most of the biological reactions observed in animal experiments or in clinical studies are non quantitative and they only allow assessing an inequality between the effects produced by different irradiations. The method used in non quantitative studies is actually based on the relative contribution of irreparable events and reparable to the cell killing. It provides for the cell population involved in non quantitative biological effects some data which can be expressed in term of a cell survival curve. Such data can be useful in Radiation therapy particularly for maximizing the difference between biological effects by a proper choice of the fraction size. The initial part of the cell survival curve, within the range of doses actually used appears to be a straight exponential. This should allow the extrapolation to very low doses in the range of interest to Radiation Protection

  12. Radiation dose to children in diagnostic radiology. Measurements and methods for clinical optimisation studies

    Energy Technology Data Exchange (ETDEWEB)

    Almen, A J

    1995-09-01

    A method for estimating mean absorbed dose to different organs and tissues was developed for paediatric patients undergoing X-ray investigations. The absorbed dose distribution in water was measured for the specific X-ray beam used. Clinical images were studied to determine X-ray beam positions and field sizes. Size and position of organs in the patient were estimated using ORNL phantoms and complementary clinical information. Conversion factors between the mean absorbed dose to various organs and entrance surface dose for five different body sizes were calculated. Direct measurements on patients estimating entrance surface dose and energy imparted for common X-ray investigations were performed. The examination technique for a number of paediatric X-ray investigations used in 19 Swedish hospitals was studied. For a simulated pelvis investigation of a 1-year old child the entrance surface dose was measured and image quality was estimated using a contrast-detail phantom. Mean absorbed doses to organs and tissues in urography, lung, pelvis, thoracic spine, lumbar spine and scoliosis investigations was calculated. Calculations of effective dose were supplemented with risk calculations for special organs e g the female breast. The work shows that the examination technique in paediatric radiology is not yet optimised, and that the non-optimised procedures contribute to a considerable variation in radiation dose. In order to optimise paediatric radiology there is a need for more standardised methods in patient dosimetry. It is especially important to relate measured quantities to the size of the patient, using e g the patient weight and length. 91 refs, 17 figs, 8 tabs.

  13. Radiation dose to children in diagnostic radiology. Measurements and methods for clinical optimisation studies

    International Nuclear Information System (INIS)

    Almen, A.J.

    1995-09-01

    A method for estimating mean absorbed dose to different organs and tissues was developed for paediatric patients undergoing X-ray investigations. The absorbed dose distribution in water was measured for the specific X-ray beam used. Clinical images were studied to determine X-ray beam positions and field sizes. Size and position of organs in the patient were estimated using ORNL phantoms and complementary clinical information. Conversion factors between the mean absorbed dose to various organs and entrance surface dose for five different body sizes were calculated. Direct measurements on patients estimating entrance surface dose and energy imparted for common X-ray investigations were performed. The examination technique for a number of paediatric X-ray investigations used in 19 Swedish hospitals was studied. For a simulated pelvis investigation of a 1-year old child the entrance surface dose was measured and image quality was estimated using a contrast-detail phantom. Mean absorbed doses to organs and tissues in urography, lung, pelvis, thoracic spine, lumbar spine and scoliosis investigations was calculated. Calculations of effective dose were supplemented with risk calculations for special organs e g the female breast. The work shows that the examination technique in paediatric radiology is not yet optimised, and that the non-optimised procedures contribute to a considerable variation in radiation dose. In order to optimise paediatric radiology there is a need for more standardised methods in patient dosimetry. It is especially important to relate measured quantities to the size of the patient, using e g the patient weight and length. 91 refs, 17 figs, 8 tabs

  14. Neuromuscular dose-response studies: determining sample size.

    Science.gov (United States)

    Kopman, A F; Lien, C A; Naguib, M

    2011-02-01

    Investigators planning dose-response studies of neuromuscular blockers have rarely used a priori power analysis to determine the minimal sample size their protocols require. Institutional Review Boards and peer-reviewed journals now generally ask for this information. This study outlines a proposed method for meeting these requirements. The slopes of the dose-response relationships of eight neuromuscular blocking agents were determined using regression analysis. These values were substituted for γ in the Hill equation. When this is done, the coefficient of variation (COV) around the mean value of the ED₅₀ for each drug is easily calculated. Using these values, we performed an a priori one-sample two-tailed t-test of the means to determine the required sample size when the allowable error in the ED₅₀ was varied from ±10-20%. The COV averaged 22% (range 15-27%). We used a COV value of 25% in determining the sample size. If the allowable error in finding the mean ED₅₀ is ±15%, a sample size of 24 is needed to achieve a power of 80%. Increasing 'accuracy' beyond this point requires increasing greater sample sizes (e.g. an 'n' of 37 for a ±12% error). On the basis of the results of this retrospective analysis, a total sample size of not less than 24 subjects should be adequate for determining a neuromuscular blocking drug's clinical potency with a reasonable degree of assurance.

  15. Hepatocyte membrane injury and bleb formation following low dose comfrey toxicity in rats.

    Science.gov (United States)

    Yeong, M L; Wakefield, S J; Ford, H C

    1993-04-01

    Comfrey, a popular herbal remedy, contains hepatotoxic pyrrolizidine alkaloids and has been implicated in recent human toxicity. Although alkaloids from other plant sources have been extensively researched, studies on the hepatotoxic effects of comfrey alkaloids are scant. The effects of high dose comfrey toxicity have been studied and the present investigation was undertaken to identify changes associated with relatively low dose toxicity. Eight young adult rats were dosed weekly for six weeks with 50 mg/kg of comfrey derived alkaloids. The animals were dissected one week after the last dose and the livers examined by light and electron microscopy. Changes at the light microscopic level showed vascular congestion, mild zone 3 necrosis and loss of definition of hepatocyte cellular membranes. Extensive ultrastructural abnormalities were identified in the form of endothelial sloughing and the loss of hepatocyte microvilli. A striking finding was florid bleb formation on the sinusoidal borders of hepatocytes. Many blebs were shed into the space of Disse and extruded to fill, and sometimes occlude, sinusoidal lumina. Platelets were frequently found in areas of bleb formation. There was evidence of late damage in collagenization of Disse's space. Hepatocyte bleb formation is known to occur under a variety of pathological conditions but there is little to no information in the literature on the effects, if any, of bleb formation on fibrogenesis and the microcirculation and its role in the pathogenesis of liver disease. The pyrrolizidine alkaloids of comfrey may serve as an experimental tool to study the process of bleb formation and the intimate relationship between hepatocyte and sinusoidal injury in the liver.

  16. A new study on the effects of low doses

    International Nuclear Information System (INIS)

    Dousset, M.; Jammet, H.

    1986-01-01

    A study conducted by prof. Rose has investigated mortality among 39540 employees of the UKAEA, from 1946 to 1978. The three main points are: 1. General mortality and mortality from malignant diseases are lower than in the population of England and Wales (74 and 79 per cent respectively), thus showing no major difference between workers monitored for exposure to radiation and other workers. 2. For monitored workers, the only death cause for which there is a statistically significant correlation with radiation exposure is prostate cancer; there are many cases especially in workers with doses exceeding 0.05 Sv (5 rem) and monitored for tritium. Such a correlation has never been found in any other epidemiologic survey of workers exposed to low-level doses, Hanford (USA) workers especially; conversely, mortality from either multiple myeloma or pancreas cancer is not found here. These facts plead for a cautious interpretation of the results as a whole. 3. A linear representation of the variations of leukemia and cancer mortality vs exposure results in lines, the slopes of which are 3 times higher than those of the lines adopted by ICRP; however, the 95% confidence intervals (-2.7 + 12.4 and -22 + 52.5) are such that the results are compatible with a null effect (slope 0) and even with a benefic effect (negative slope). They are therefore compatible with ICRP estimations. A recent attempt to evaluate the two main investigations on low-dose occupational exposures (UKAEA and Hanford) suggests a dose-response relationship very near that of ICRP [fr

  17. Infusion dose requirement of rocuronium in patients on phenytoin therapy - A prospective comparative study.

    Science.gov (United States)

    Sheshadri, Veena; Radhakrishnan, Arathi; Halemani, Kusuma; Keshavan, Venkatesh H

    2017-10-01

    Patients with intracranial tumour are usually on anticonvulsants. Patients on phenytoin therapy demonstrate rapid metabolism of nondepolarising muscle relaxants secondary to enzyme induction. Infusion dose requirement of rocuronium in such patients has been sparingly studied. We studied the continuous infusion dose requirement of rocuronium bromide in patients on phenytoin therapy and its correlation with serum levels of phenytoin. Seventy-five patients scheduled for supratentorial tumour surgery were included in the study. Patients not on phenytoin were taken as control. The primary outcome variable studied was the infusion dose requirement of rocuronium in patients on phenytoin. Based on pre-operative serum phenytoin levels, study group patients were divided into two groups: sub-therapeutic level group (phenytoin level 10 μg/mL). Following anaesthesia induction, rocuronium bromide 0.6 mg/kg was administered to achieve tracheal intubation. Rocuronium infusion was titrated to maintain zero response on the train-of-four response. Demographic data were comparable. Patients receiving phenytoin required higher infusion dose compared to the control group (0.429 ± 0.2 mg/kg/h vs. 0.265 ± 0.15 mg/kg/h, P rocuronium (0.429 ± 0.205 mg/kg/h vs. 0.429 ± 0.265 mg/kg/h ( P = 0.815). The recovery was faster in the phenytoin group compared to the control group. Haowever, it was not clinically significant. The infusion dose requirement of rocuronium bromide in patients on phenytoin is higher and the serum levels of phenytoin does not influence the dose required.

  18. Occupational eye lens doses in interventional cardiology. A multicentric study

    International Nuclear Information System (INIS)

    Sánchez, R M; Vano, E; Fernández, J M; Pifarré, X; Ordiales, J M; Rovira, J J; Carrera, F; Goicolea, J; Fernández-Ortiz, A

    2016-01-01

    New European regulation regarding radiological protection of workers and more specifically the new occupational dose limit for the eye lens recently reduced to 20 mSv yr −1 may affect interventional cardiologists. This paper presents a set of measurements of occupational doses performed in five interventional cardiology centres and then compared with the new dose limit. The measurement of occupational doses was performed over the apron at chest level using electronic dosemeters recording H p (10). In one of the centres, scatter dose at goggles was also measured with optically stimulated luminescence dosemeters calibrated in terms of H p (0.07). An average H p (10) over the apron of 46 μSv/procedure was measured for cardiologists. Lower doses were noted in other professionals like second cardiologists, nurses or anaesthetists. Procedures for valvular and other structural heart diseases involved the highest occupational doses, averaging over 100 μSv/procedure. Important differences in occupational doses among centres may be indicative of different radiation protection habits. The new occupational dose limit for the eye lens is likely to be exceeded by those among the interventionalists who do not use protection tools (ceiling suspended screen and/or goggles) even with standard workloads. (paper)

  19. Towards the definition of Institutional diagnostic reference levels in paediatric interventional cardiology procedures in Greece.

    Science.gov (United States)

    Kottou, S; Kollaros, N; Plemmenos, C; Mastorakou, I; Apostolopoulou, S C; Tsapaki, V

    2018-02-01

    This study aimed to evaluate paediatric radiation doses in a dedicated cardiology hospital, with the objective of characterising patterns in dose variation. The ultimate purpose was to define Local (Institutional) Diagnostic Reference Levels (LDRLs) for different types of paediatric cardiac interventional procedures (IC), according to patient age. From a total of 710 cases performed during three consecutive years, by operators with more than 15 years of experience, the age was noted in only 477 IC procedures. The median values obtained for Fluoroscopy Time (FT), Number of Frames (N) and Kerma Area Product (P KA ) by age range were 5.8 min, 1322 and 2.0 Gy.cm 2 for definition of LDRLs presents challenges mainly due to the multiple clinical and technical factors affecting the outcome. On the other hand the lack of paediatric IC DRLs makes the identification of good practices more difficult. A consensus is needed on IC procedures nomenclature and grouping in order to allow a common assessment and comparison of doses. Copyright © 2018 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  20. Evaluation of an electron Monte Carlo dose calculation algorithm for treatment planning.

    Science.gov (United States)

    Chamberland, Eve; Beaulieu, Luc; Lachance, Bernard

    2015-05-08

    The purpose of this study is to evaluate the accuracy of the electron Monte Carlo (eMC) dose calculation algorithm included in a commercial treatment planning system and compare its performance against an electron pencil beam algorithm. Several tests were performed to explore the system's behavior in simple geometries and in configurations encountered in clinical practice. The first series of tests were executed in a homogeneous water phantom, where experimental measurements and eMC-calculated dose distributions were compared for various combinations of energy and applicator. More specifically, we compared beam profiles and depth-dose curves at different source-to-surface distances (SSDs) and gantry angles, by using dose difference and distance to agreement. Also, we compared output factors, we studied the effects of algorithm input parameters, which are the random number generator seed, as well as the calculation grid size, and we performed a calculation time evaluation. Three different inhomogeneous solid phantoms were built, using high- and low-density materials inserts, to clinically simulate relevant heterogeneity conditions: a small air cylinder within a homogeneous phantom, a lung phantom, and a chest wall phantom. We also used an anthropomorphic phantom to perform comparison of eMC calculations to measurements. Finally, we proceeded with an evaluation of the eMC algorithm on a clinical case of nose cancer. In all mentioned cases, measurements, carried out by means of XV-2 films, radiographic films or EBT2 Gafchromic films. were used to compare eMC calculations with dose distributions obtained from an electron pencil beam algorithm. eMC calculations in the water phantom were accurate. Discrepancies for depth-dose curves and beam profiles were under 2.5% and 2 mm. Dose calculations with eMC for the small air cylinder and the lung phantom agreed within 2% and 4%, respectively. eMC calculations for the chest wall phantom and the anthropomorphic phantom also