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Lozares-Cordero S, Bermejo-Barbanoj C, Badías-Herbera A, Ibáñez-Carreras R, Ligorred-Padilla L, Ponce-Ortega JM, González-Pérez V, Gandía-Martínez A, Font-Gómez JA, Blas-Borroy O, González-Ibáñez D. An open-source development based on photogrammetry for a real-time IORT treatment planning system. Phys Med 2023; 112:102622. [PMID: 37331081 DOI: 10.1016/j.ejmp.2023.102622] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 06/02/2023] [Accepted: 06/06/2023] [Indexed: 06/20/2023] Open
Abstract
PURPOSE This study presents a treatment planning system for intraoperative low-energy photon radiotherapy based on photogrammetry from real images of the surgical site taken in the operating room. MATERIAL AND METHODS The study population comprised 15 patients with soft-tissue sarcoma. The system obtains the images of the area to be irradiated with a smartphone or tablet, so that the absorbed doses in the tissue can be calculated from the reconstruction without the need for computed tomography. The system was commissioned using 3D printing of the reconstructions of the tumor beds. The absorbed doses at various points were verified using radiochromic films that were suitably calibrated for the corresponding energy and beam quality. RESULTS The average reconstruction time of the 3D model from the video sequence in the 15 patients was 229,6±7,0 s. The entire procedure, including video capture, reconstruction, planning, and dose calculation was 520,6±39,9 s. Absorbed doses were measured on the 3D printed model with radiochromic film, the differences between these measurements and those calculated by the treatment planning system were 1.4% at the applicator surface, 2.6% at 1 cm, 3.9% at 2 cm and 6.2% at 3 cm. CONCLUSIONS The study shows a photogrammetry-based low-energy photon IORT planning system, capable of obtaining real-time images inside the operating room, immediately after removal of the tumor and immediately before irradiation. The system was commissioned with radiochromic films measurements in 3D-printed model.
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Affiliation(s)
- Sergio Lozares-Cordero
- Physics and Radiation Protection Department, Miguel Servet University Hospital, Zaragoza, Spain.
| | | | - Alberto Badías-Herbera
- Higher Technical School of Industrial Engineering, Polytechnic University of Madrid, Spain
| | | | - Luis Ligorred-Padilla
- Esophagogastric Surgery and Sarcoma Unit (Department of General and Gastrointestinal Surgery), Miguel Servet University Hospital, Zaragoza, Spain
| | | | | | | | - José Antonio Font-Gómez
- Physics and Radiation Protection Department, Miguel Servet University Hospital, Zaragoza, Spain
| | - Olga Blas-Borroy
- Engineering and Maintenance Service, Miguel Servet University Hospital, Zaragoza, Spain
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2
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Lozares-Cordero S, Ibáñez-Carreras R, García-Barrios A, Castro-Moreno R, González-Rodríguez A, Sánchez-Casi M, Campos-Boned A, Gandía-Martínez A, Antonio Font-Gómez J, Jiménez-Puertas S, Villa-Gazulla D, Díez-Chamarro J, Hernández-Hernández M, González-Pérez V, Cisneros-Gimeno AI. End-To-End Procedure For IORT in Brain Metastases and Film Dosimetry. J Med Phys 2023; 48:175-180. [PMID: 37576088 PMCID: PMC10419752 DOI: 10.4103/jmp.jmp_18_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/14/2023] [Accepted: 05/18/2023] [Indexed: 08/15/2023] Open
Abstract
Purpose The study is intended to perform an end-to-end test of the entire intraoperative process using cadaver heads. A simulation of tumor removal was performed, followed by irradiation of the bed and measurement of absorbed doses with radiochromic films. Materials and Methods Low-energy X-ray intraoperative radiotherapy (IORT) was used for irradiation. A computed tomography study was performed at each site and the absorbed doses calculated by the treatment planning system, as well as absorbed doses with radiochromic films, were studied. Results The absorbed doses in the organs at risk (OAR) were evaluated in each case, obtaining maximum doses within the tolerance limits. The absorbed doses in the target were verified and the deviations were <1%. Conclusions These tests demonstrated that this comprehensive procedure is a reproducible quality assurance tool which allows continuous assessment of the dosimetric and geometric accuracy of clinical brain IORT treatments. Furthermore, the absorbed doses measured in both target and OAR are optimal for these treatments.
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Affiliation(s)
- Sergio Lozares-Cordero
- Department of Physics and Radiation Protection, Miguel Servet University Hospital, Zaragoza, Spain
| | - Reyes Ibáñez-Carreras
- Department of Radiation Oncology, Miguel Servet University Hospital, Zaragoza, Spain
| | - Alberto García-Barrios
- Department of Anatomy and Histology, School of Medicine, University of Zaragoza, Valencia, Spain
| | - Raquel Castro-Moreno
- Department of Physics and Radiation Protection, Miguel Servet University Hospital, Zaragoza, Spain
| | | | - Marta Sánchez-Casi
- Department of Physics and Radiation Protection, Miguel Servet University Hospital, Zaragoza, Spain
| | - Arantxa Campos-Boned
- Department of Radiation Oncology, Miguel Servet University Hospital, Zaragoza, Spain
| | - Almudena Gandía-Martínez
- Department of Physics and Radiation Protection, Miguel Servet University Hospital, Zaragoza, Spain
| | - José Antonio Font-Gómez
- Department of Physics and Radiation Protection, Miguel Servet University Hospital, Zaragoza, Spain
| | - Sara Jiménez-Puertas
- Department of Physics and Radiation Protection, Miguel Servet University Hospital, Zaragoza, Spain
| | - David Villa-Gazulla
- Department of Physics and Radiation Protection, Miguel Servet University Hospital, Zaragoza, Spain
| | - Javier Díez-Chamarro
- Department of Physics and Radiation Protection, Miguel Servet University Hospital, Zaragoza, Spain
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Roa D, Leon S, Paucar O, Gonzales A, Schwarz B, Olguin E, Moskvin V, Alva-Sanchez M, Glassell M, Correa N, Moyses H, Shankar A, Hamrick B, Sarria GR, Li B, Tajima T, Necas A, Guzman C, Challco R, Montoya M, Meza Z, Zapata M, Gonzales A, Marquez F, Neira R, Vilca W, Mendez J, Hernandez J. Monte Carlo simulations and phantom validation of low-dose radiotherapy to the lungs using an interventional radiology C-arm fluoroscope. Phys Med 2021; 94:24-34. [PMID: 34979431 DOI: 10.1016/j.ejmp.2021.12.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/30/2021] [Accepted: 12/27/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To use MC simulations and phantom measurements to investigate the dosimetry of a kilovoltage x-ray beam from an IR fluoroscope to deliver low-dose (0.3-1.0 Gy) radiotherapy to the lungs. MATERIALS AND METHODS PENELOPE was used to model a 125 kV, 5.94 mm Al HVL x-ray beam produced by a fluoroscope. The model was validated through depth-dose, in-plane/cross-plane profiles and absorbed dose at 2.5-, 5.1-, 10.2- and 15.2-cm depths against the measured beam in an acrylic phantom. CT images of an anthropomorphic phantom thorax/lungs were used to simulate 0.5 Gy dose distributions for PA, AP/PA, 3-field and 4-field treatments. DVHs were generated to assess the dose to the lungs and nearby organs. Gafchromic film was used to measure doses in the phantom exposed to PA and 4-field treatments, and compared to the MC simulations. RESULTS Depth-dose and profile results were within 3.2% and 7.8% of the MC data uncertainty, respectively, while dose gamma analysis ranged from 0.7 to 1.0. Mean dose to the lungs were 1.1-, 0.8-, 0.9-, and 0.8- Gy for the PA, AP/PA, 3-field, and 4-field after isodose normalization to cover ∼ 95% of each lung volume. Skin dose toxicity was highest for the PA and lowest for the 4-field, and both arrangements successfully delivered the treatment on the phantom. However, the dose distribution for the PA was highly non-uniform and produced skin doses up to 4 Gy. The dose distribution for the 4-field produced a uniform 0.6 Gy dose throughout the lungs, with a maximum dose of 0.73 Gy. The average percent difference between experimental and Monte Carlo values were -0.1% (range -3% to +4%) for the PA treatment and 0.3% (range -10.3% to +15.2%) for the 4-field treatment. CONCLUSION A 125 kV x-ray beam from an IR fluoroscope delivered through two or more fields can deliver an effective low-dose radiotherapy treatment to the lungs. The 4-field arrangement not only provides an effective treatment, but also significant dose sparing to healthy organs, including skin, compared to the PA treatment. Use of fluoroscopy appears to be a viable alternative to megavoltage radiation therapy equipment for delivering low-dose radiotherapy to the lungs.
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Affiliation(s)
- D Roa
- Department of Radiation Oncology, University of California, Irvine Health, Orange, CA 92868, USA.
| | - S Leon
- Department of Radiology, University of Florida, Gainesville, FL 32610, USA
| | - O Paucar
- Facultad de Ingenieria Electrica y Electronica, Universidad Nacional de Ingenieria, Lima, Peru
| | - A Gonzales
- Facultad de Ciencias, Universidad Nacional de Ingenieria, Lima, Peru
| | - B Schwarz
- Department of Radiology, University of Florida, Gainesville, FL 32610, USA
| | - E Olguin
- Department of Radiology, University of Florida, Gainesville, FL 32610, USA
| | - V Moskvin
- Department of Radiation Oncology, St. Judes Children's Research Hospital, Memphis, TN 38105, USA
| | - M Alva-Sanchez
- Department of Exact and Applied Sciences, University of Health Sciences of Porto Alegre, Porto Alegre, Brazil
| | - M Glassell
- Department of Radiology, University of Florida, Gainesville, FL 32610, USA
| | - N Correa
- Department of Radiology, University of Florida, Gainesville, FL 32610, USA
| | - H Moyses
- Department of Radiation Oncology, University of California, Irvine Health, Orange, CA 92868, USA
| | - A Shankar
- Department of Radiology, University of Florida, Gainesville, FL 32610, USA
| | - B Hamrick
- Environmental Health and Safety, University of California, Irvine Health, Orange, CA 92868, USA
| | - G R Sarria
- University Hospital Bonn, Department of Radiation Oncology, University of Bonn, Bonn, Germany
| | - B Li
- Department of Radiation Oncology, University of California, San Francisco, CA 94115, USA
| | - T Tajima
- Department of Physics and Astronomy, University of California, Irvine, CA 92697, USA
| | - A Necas
- TAE Technologies, 1961 Pauling, Foothill Ranch, CA 92610, USA
| | - C Guzman
- Facultad de Medicina Humana, Universidad Ricardo Palma, Lima, Peru
| | - R Challco
- Facultad de Ciencias, Universidad Nacional de Ingenieria, Lima, Peru
| | - M Montoya
- Facultad de Ciencias, Universidad Nacional de Ingenieria, Lima, Peru
| | - Z Meza
- Facultad de Ciencias, Universidad Nacional de Ingenieria, Lima, Peru
| | - M Zapata
- Facultad de Ciencias, Universidad Nacional de Ingenieria, Lima, Peru
| | - A Gonzales
- Clinica Aliada contra el Cancer, Lima, Peru
| | - F Marquez
- Facultad de Ciencias Físicas, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - R Neira
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - W Vilca
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - J Mendez
- Facultad de Ciencias Naturales y Matemática, Universidad Nacional del Callao, Callao, Peru
| | - J Hernandez
- HRS Oncology International, Las Vegas, NV 89119, USA
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Characterization of Gafchromic™ film response against radionuclide activity. Appl Radiat Isot 2021; 178:109988. [PMID: 34688025 DOI: 10.1016/j.apradiso.2021.109988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 10/09/2021] [Accepted: 10/15/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE In this study, we used Gafchromic™ film XR-QA2 and RT-QA2 to characterize the film energy response against various radionuclides. We introduce a neutron depletion theoretical model that can describe film response as a function of cumulated activity. The film response was investigated with respect to different backscatter media such as polystyrene, perspex, lead and corrugated fibreboard carton (CFC). The sensitivity of the two types of film to different energies was also studied. Lastly, a film stack method was tested to allow the user to obtain sequential, cumulative doses at different time points. METHODS Pieces of Gafchromic™ film XR-QA2 and RT-QA2 were exposed to Am-241, Cs-137, Tc-99m, and I-131 to obtain various cumulative activities. After 24 h, each film piece was digitized by scanning it with an Epson Perfection V330 flatbed scanner to obtain 48-bit RGB TIFF images. Afterwards, each image was processed with the Image J software package. The film response was fitted to a theoretically derived function based on the neutron depletion model and the Beer-Lambert Law and compared with an existing fitting function. Layers of the film were also placed together and irradiated with the above-mentioned radionuclides to investigate the possibility of increasing the sensitivity of the film as a dosimeter. The energy response of the two types of film was investigated by irradiating pieces of film with different photon energies. RESULTS The theoretical response model fits OD vs cumulative activity accurately. XR-QA2 film shows good energy film response by using CFC as a backscatter material when using radionuclides. From the results, it is also evident that XR-QA2 is more sensitive to low energy gamma rays than RT-QA2. Its OD sensitivity can be increased by 2 ± 0.2 when using a double layer film and by 2.8 ± 0.3 when using a triple-layer film. By using a film stack, the experimental time can be decreased by using the second-order polynomial relationship obtained to relate the stacked film data to the single film data. CONCLUSIONS The neutron depletion theoretical model is accurate and contains less free parameters than higher-order polynomial fits. The Gafchromic™ XR-QA2 film is also better to use in nuclear medicine because of its higher sensitivity. The sensitivity of the film as a dosimeter can also be increased by using multiple layers of film. Experiment times can also be decreased by using the film stack method.
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Kidoń J, Polaczek-Grelik K, Żurek P, Wojakowski W, Ochala A. Exposure of the eye lens and brain for interventional cardiology staff. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2021; 17:298-304. [PMID: 34819966 PMCID: PMC8596714 DOI: 10.5114/aic.2021.109576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/12/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Occupational exposure to ionizing radiation for people working with an X-ray treatment unit is one of the highest in medicine. The epidemiological data analyzed by the International Commission on Radiological Protection (ICRP) indicate that the dose threshold for tissues located in the eye lens is or may be lower than previously thought. The new ICRP recommendations reduce the currently used threshold 7.5 times to the limit of 20 mSv per year. AIM To carry out measurements of equivalent doses for the lenses and scalps of cardiology interventional staff to determine the actual exposure. MATERIAL AND METHODS Personnel performing interventional cardiology procedures participated in the measurements. The measurements were performed using thermoluminescence dosimetry in two measurement periods. The operational quantities used in individual dosimetry were determined (dose equivalent for the scalp, dose equivalent for the eye lens). In both measurement periods, 69 operators and 12 nurses took part. RESULTS The maximum value of eye doses for cardiologists was 18.80 mSv per year, with a mean of 9.83 ±6.47 mSv/year (for all cases), 5.70 ±4.26 mSv/year (with safety glasses/headgear), 13.14 ±6.28 mSv/year (without safety glasses/headgear), and 6.28 ±1.76 mSv per year for the nurses. The values of brain doses fluctuate around 1 mSv per quarter. CONCLUSIONS Dose equivalents for the lenses of the eyes obtained by cardiologists may be close to or exceed the current dose limits.
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Affiliation(s)
- Joanna Kidoń
- Invasive Cardiology and Electrocardiology Department, Medical University of Silesia, Katowice, Poland
| | - Kinga Polaczek-Grelik
- Prof. K. Gibiński Memorial University Clinical Centre, Medical University of Silesia, Katowice, Poland
| | - Przemysław Żurek
- 2 Department of Cardiology, Upper Silesian Medical Center, Katowice, Poland
| | - Wojciech Wojakowski
- 3 Department of Cardiology, School of Medicine, Medical University of Silesia, Katowice, Poland
| | - Andrzej Ochala
- Invasive Cardiology and Electrocardiology Department, Medical University of Silesia, Katowice, Poland
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Méndez I, Rovira-Escutia JJ, Casar B. A protocol for accurate radiochromic film dosimetry using Radiochromic.com. Radiol Oncol 2021; 55:369-378. [PMID: 34384012 PMCID: PMC8366735 DOI: 10.2478/raon-2021-0034] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/01/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Radiochromic films have many applications in radiology and radiation therapy. Generally, the dosimetry system for radiochromic film dosimetry is composed of radiochromic films, flatbed scanner, and film analysis software. The purpose of this work is to present the effectiveness of a protocol for accurate radiochromic film dosimetry using Radiochromic.com as software for film analysis. MATERIALS AND METHODS Procedures for image acquisition, lot calibration, and dose calculation are explained and analyzed. Radiochromic.com enables state-of-the-art models and corrections for radiochromic film dosimetry, such as the Multigaussian model for multichannel film dosimetry, and lateral, inter-scan, and re-calibration corrections of the response. RESULTS The protocol presented here provides accurate dose results by mitigating the sources of uncertainty that affect radiochromic film dosimetry. CONCLUSIONS Appropriate procedures for film and scanner handling in combination with Radiochromic.com as software for film analysis make easy and accurate radiochromic film dosimetry feasible.
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Affiliation(s)
- Ignasi Méndez
- Department for dosimetry and quality of radiological procedures, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | | | - Bozidar Casar
- Department for dosimetry and quality of radiological procedures, Institute of Oncology Ljubljana, Ljubljana, Slovenia
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7
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Wong JHD, Zaili Z, Abdul Malik R, Bustam AZ, Saad M, Jamaris S, Mosiun JA, Mohd Taib NA, Ung NM, See M. Evaluation of skin dose and skin toxicity in patients undergoing intraoperative radiotherapy for early breast cancer. J Appl Clin Med Phys 2021; 22:139-147. [PMID: 34254425 PMCID: PMC8364274 DOI: 10.1002/acm2.13338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
PURPOSE This study aims to evaluate in vivo skin dose delivered by intraoperative radiotherapy (IORT) and determine the factors associated with an increased risk of radiation-induced skin toxicity. METHODOLOGY A total of 21 breast cancer patients who underwent breast-conserving surgery and IORT, either as IORT alone or IORT boost plus external beam radiotherapy (EBRT), were recruited in this prospective study. EBT3 film was calibrated in water and used to measure skin dose during IORT at concentric circles of 5 mm and 40 mm away from the applicator. For patients who also had EBRT, the maximum skin dose was estimated using the radiotherapy treatment planning system. Mid-term skin toxicities were evaluated at 3 and 6 months post-IORT. RESULTS The average skin dose at 5 mm and 40 mm away from the applicator was 3.07 ± 0.82 Gy and 0.99 ± 0.28 Gy, respectively. Patients treated with IORT boost plus EBRT received an additional skin dose of 41.07 ± 1.57 Gy from the EBRT component. At 3 months post-IORT, 86% of patients showed no evidence of skin toxicity. However, the number of patients suffering from skin toxicity increased from 15% to 38% at 6 months post-IORT. We found no association between the IORT alone or with the IORT boost plus EBRT and skin toxicity. Older age was associated with increased risk of skin toxicities. A mathematical model was derived to predict skin dose. CONCLUSION EBT3 film is a suitable dosimeter for in vivo skin dosimetry in IORT, providing patient-specific skin doses. Both IORT alone and IORT boost techniques resulted in similar skin toxicity rates.
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Affiliation(s)
- Jeannie Hsiu Ding Wong
- Department of Biomedical ImagingFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Zainor Zaili
- Department of Biomedical ImagingFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Rozita Abdul Malik
- Clinical Oncology UnitFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Anita Zarina Bustam
- Clinical Oncology UnitFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Marniza Saad
- Clinical Oncology UnitFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Suniza Jamaris
- Breast Surgery UnitDepartment of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
- Department of Surgery, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Joanne Aisha Mosiun
- Department of Surgery, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Nur Aishah Mohd Taib
- Breast Surgery UnitDepartment of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Ngie Min Ung
- Clinical Oncology UnitFaculty of MedicineUniversity of MalayaKuala LumpurMalaysia
| | - Mee‐Hoong See
- Breast Surgery UnitDepartment of Medicine, Faculty of MedicineUniversity of MalayaKuala LumpurMalaysia
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Calibration of Gafchromic XR-RV3 film under interventional radiology conditions. POLISH JOURNAL OF MEDICAL PHYSICS AND ENGINEERING 2021. [DOI: 10.2478/pjmpe-2021-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract
Introduction: The purpose of the study was the calibration of Gafchromic films in clinical interventional radiology conditions and the assessment of the influence of dose range, the shape of the fitting curve, and its practical application. The aim of the work was to show how practically perform calibration in a wide range of doses.
Material and methods: Gafchromic XR–RV3 films were included in the study. The calibration was performed for A and B film series separately. Doses from the range of 0 – 8 Gy were used. Film dosimeters were read out in reflective mode with a commercial flatbed scanner.
Results: Among various degrees of a polynomial function, the best fit, which fulfilled the chosen criterion of 95% agreement between measured and reconstructed doses and simple equation criterion, was observed for third-degree polynomial. The fitting curve where the dose is the function of optical density (logMPV) was demonstrated to be more precise than the fitting curve based on MPV only. To minimize the difference between dose absorbed by the film and dose reconstructed from the fitting curve below 5% it is necessary to divide the calibration range of 0 – 8 Gy into two subranges for use in interventional radiology. This difference was set at a maximum level of 3.8% and 1.9% for the lowand high-dose range, respectively. Each series of films may have a slightly different calibration curve, especially for the low dose range. A deviation of up to 36% between two batches of Gafchromic film was observed.
Conclusions: For the third-degree polynomial fitting function (one of the recommended in the literature) calibration should be done into low and high dose ranges and for each batch separately. A systematic error higher than 20% could be introduced when the fitting curve from one film batch is applied to the other film batch.
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Jones AK, Kisiel ME, Rong XJ, Tam AL. Validation of a method for estimating peak skin dose from CT-guided procedures. J Appl Clin Med Phys 2021; 22:224-228. [PMID: 33955655 PMCID: PMC8200428 DOI: 10.1002/acm2.13261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
A method for estimating peak skin dose (PSD) from CTDIvol has been published but not validated. The objective of this study was to validate this method during CT‐guided ablation procedures. Radiochromic film was calibrated and used to measure PSD. Sixty‐eight patients were enrolled in this study, and measured PSD were collected for 46 procedures. CTDIvol stratified by axial and helical scanning was used to calculate an estimate of PSD using the method [1.2 × CTDIvol(helical) + 0.6 × CTDIvol(axial)], and both calculated PSD and total CTDIvol were compared to measured PSD using paired t‐tests on the log‐transformed data and Bland‐Altman analysis. Calculated PSD were significantly different from measured PSD (P < 0.0001, bias, 18.3%, 95% limits of agreement, −63.0% to 26.4%). Measured PSD were not significantly different from total CTDIvol (P = 0.27, bias, 3.97%, 95% limits of agreement, −51.6% to 43.7%). Considering that CTDIvol is reported on the console of all CT scanners, is not stratified by axial and helical scanning modes, and is immediately available to the operator during CT‐guided interventional procedures, it may be reasonable to use the scanner‐reported CTDIvol as an indicator of PSD during CT‐guided procedures. However, further validation is required for other models of CT scanner.
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Affiliation(s)
- A Kyle Jones
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Meghan E Kisiel
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - X John Rong
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alda L Tam
- Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Radiochromic Films for the Two-Dimensional Dose Distribution Assessment. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11052132] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Radiochromic films are mainly used for two-dimensional dose verification in photon, electron, and proton therapy treatments. Moreover, the radiochromic film types available today allow their use in a wide dose range, corresponding to applications from low-medical diagnostics to high-dose beam profile measurements in charged particle medical accelerators. An in-depth knowledge of the characteristics of radiochromic films, of their operating principles, and of the dose reading techniques is of paramount importance to exploit all the features of this interesting and versatile radiation detection system. This short review focuses on these main aspects by considering the most recent works on the subject.
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Lozares S, Font JA, Gandía A, Campos A, Flamarique S, Ibáñez R, Villa D, Alba V, Jiménez S, Hernández M, Casamayor C, Vicente I, Hernando E, Rubio P. In vivo dosimetry in low-voltage IORT breast treatments with XR-RV3 radiochromic film. Phys Med 2021; 81:173-181. [PMID: 33465753 DOI: 10.1016/j.ejmp.2020.12.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 12/30/2022] Open
Abstract
PURPOSE The objectives of the study were to establish a procedure for in vivo film-based dosimetry for intraoperative radiotherapy (IORT), evaluate the typical doses delivered to organs at risk, and verify the dose prescription. MATERIALS AND METHODS In vivo dose measurements were studied using XR-RV3 radiochromic films in 30 patients with breast cancer undergoing IORT using the Axxent® device (Xoft Inc.). The stability of the radiochromic films in the energy ranges used was verified by taking measurements at different depths. The stability of the scanner response was tested, and 5 different calibration curves were constructed for different beam qualities. Six pieces of film were placed in each of the 30 patients. All the pieces were correctly sterilized and checked to ensure that the process did not affect the outcome. All calibration and dose measurements were analyzed using the Radiochromic.com software application. RESULTS The doses were measured for 30 patients. The doses in contact with the applicator (prescription zone) were 19.8 ± 0.9 Gy. In the skin areas, the doses were as follows: 1-2 cm from the applicator, 1.86 ± 0.77 Gy; 2-5 cm, 0.73 ± 0.14 Gy; and greater than 5 cm, 0.28 ± 0.17 Gy. The dose delivered to the pectoral muscle (tungsten shielding disc) was 0.51 ± 0.27 Gy. CONCLUSIONS The study demonstrated the viability of XR-RV3 films for in vivo dose measurement in the dose and energy ranges applied in a complex procedure, such as breast IORT. The doses in organs at risk were far below the tolerances for cases such as those studied.
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Affiliation(s)
- Sergio Lozares
- Medical Physics Department. Miguel Servet University Hospital Zaragoza, Spain.
| | - Jose A Font
- Medical Physics Department. Miguel Servet University Hospital Zaragoza, Spain
| | - Almudena Gandía
- Medical Physics Department. Miguel Servet University Hospital Zaragoza, Spain
| | - Arantxa Campos
- Radiation Oncology Department. Miguel Servet University Hospital Zaragoza, Spain
| | - Sonia Flamarique
- Radiation Oncology Department. Miguel Servet University Hospital Zaragoza, Spain
| | - Reyes Ibáñez
- Radiation Oncology Department. Miguel Servet University Hospital Zaragoza, Spain
| | - David Villa
- Medical Physics Department. Miguel Servet University Hospital Zaragoza, Spain
| | - Verónica Alba
- Medical Physics Department. Miguel Servet University Hospital Zaragoza, Spain
| | - Sara Jiménez
- Medical Physics Department. Miguel Servet University Hospital Zaragoza, Spain
| | - Mónica Hernández
- Medical Physics Department. Miguel Servet University Hospital Zaragoza, Spain
| | - Carmen Casamayor
- Endocrine, Bariatric and Breast Surgery Unit. General and Digestive Surgery Department. Miguel Servet University Hospital Zaragoza, Spain
| | - Isabel Vicente
- Breast Unit. Gynaecology Department. Miguel Servet University Hospital Zaragoza, Spain
| | - Ernesto Hernando
- Endocrine, Bariatric and Breast Surgery Unit. General and Digestive Surgery Department. Miguel Servet University Hospital Zaragoza, Spain
| | - Patricia Rubio
- Breast Unit. Gynaecology Department. Miguel Servet University Hospital Zaragoza, Spain
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12
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Niroomand‐Rad A, Chiu‐Tsao S, Grams MP, Lewis DF, Soares CG, Van Battum LJ, Das IJ, Trichter S, Kissick MW, Massillon‐JL G, Alvarez PE, Chan MF. Report of AAPM Task Group 235 Radiochromic Film Dosimetry: An Update to TG‐55. Med Phys 2020; 47:5986-6025. [DOI: 10.1002/mp.14497] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022] Open
Affiliation(s)
| | | | | | | | | | | | - Indra J. Das
- Radiation Oncology Northwestern University Memorial Hospital Chicago IL USA
| | - Samuel Trichter
- New York‐Presbyterian HospitalWeill Cornell Medical Center New York NY USA
| | | | - Guerda Massillon‐JL
- Instituto de Fisica Universidad Nacional Autonoma de Mexico Mexico City Mexico
| | - Paola E. Alvarez
- Imaging and Radiation Oncology Core MD Anderson Cancer Center Houston TX USA
| | - Maria F. Chan
- Memorial Sloan Kettering Cancer Center Basking Ridge NJ USA
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13
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Järvinen J, Sierpowska J, Siiskonen T, Husso M, Järvinen H, Kiviniemi T, Rissanen TT, Lindholm C, Matikka H, Larjava HRS, Mäkelä TJ, Strengell S, Eskola M, Parviainen T, Hallinen E, Pirinen M, Kivelä A, Teräs M. CONTEMPORARY RADIATION DOSES IN INTERVENTIONAL CARDIOLOGY: A NATIONWIDE STUDY OF PATIENT SKIN DOSES IN FINLAND. RADIATION PROTECTION DOSIMETRY 2020; 188:181-190. [PMID: 31838516 DOI: 10.1093/rpd/ncz273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 10/13/2019] [Accepted: 10/25/2019] [Indexed: 06/10/2023]
Abstract
In contemporary interventional cardiology, for typical elderly patients, the most severe radiation-related harm to patients can be considered to come from skin exposures. In this paper, maximum local skin doses in cardiological procedures are explored with Gafchromic film dosimetry. Film and reader calibrations and reading were performed at the Secondary Standards Dosimetry Laboratory of the Radiation and Nuclear Safety Authority (STUK), and data were gathered from seven hospitals in Finland. As alert levels for early transient erythema, 200 Gycm2 kerma area product (KAP) and 2000 mGy air kerma levels for transcatheter aortic valve implantations (TAVI) procedures are proposed. The largest doses were measured in TAVI (4158.8 mGy) and percutaneous coronary interventions (PCI) (941.68 mGy). Accuracies of the GE DoseWatch and Siemens CareMonitor skin dose estimates were reasonable, but more results are needed to reliably assess and validate the tools' capabilities and reliabilities. Uncertainty of the Gafchromic dosimetry was estimated as 9.1% for a calibration with seven data points and 19.3% for a calibration with five data points.
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Affiliation(s)
- Jukka Järvinen
- Department of Cardiology, Turku Heart Centre, Turku University Hospital, Turku, 20521 Finland
- Department of Radiology, Turku University Hospital, Turku, 20521 Finland
- Department of Medical Physics, Turku University Hospital, Turku, 20521 Finland
| | - Joanna Sierpowska
- Department of Radiology, Central Hospital of Northern Karelia, Joensuu, 80210 Finland
| | - Teemu Siiskonen
- STUK - Radiation and Nuclear Safety Authority, Helsinki, 00880 Finland
| | - Minna Husso
- Department of Radiology, Imaging Centre, Kuopio University Hospital, Kuopio, 70210 Finland
| | - Hannu Järvinen
- STUK - Radiation and Nuclear Safety Authority, Helsinki, 00880 Finland
| | - Tuomas Kiviniemi
- Department of Cardiology, Turku Heart Centre, Turku University Hospital, Turku, 20521 Finland
| | - Tuomas T Rissanen
- Department of Radiology, Central Hospital of Northern Karelia, Joensuu, 80210 Finland
| | - Carita Lindholm
- STUK - Radiation and Nuclear Safety Authority, Helsinki, 00880 Finland
| | - Hanna Matikka
- Department of Radiology, Imaging Centre, Kuopio University Hospital, Kuopio, 70210 Finland
| | - Heli R S Larjava
- Department of Medical Imaging, Central Finland Health Care District, Jyväskylä, 40620 Finland
| | - Timo J Mäkelä
- Division of Cardiology, Department of Internal Medicine, Oulu University Hospital, Oulu, 90220 Finland
| | - Satu Strengell
- Cardiology division, Heart and lung center, Helsinki University Hospital, Helsinki, 00029 Finland
| | - Markku Eskola
- Department of Cardiology, Heart Hospital, Tampere University Hospital, Tampere, Finland and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, 33520 Finland
| | - Teuvo Parviainen
- STUK - Radiation and Nuclear Safety Authority, Helsinki, 00880 Finland
| | - Elina Hallinen
- STUK - Radiation and Nuclear Safety Authority, Helsinki, 00880 Finland
| | - Markku Pirinen
- STUK - Radiation and Nuclear Safety Authority, Helsinki, 00880 Finland
| | - Antti Kivelä
- Department of Radiology, Imaging Centre, Kuopio University Hospital, Kuopio, 70210 Finland
| | - Mika Teräs
- Department of Medical Physics, Turku University Hospital, Turku, 20521 Finland
- Institute of Biomedicine, University of Turku, Turku, 20521 Finland
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14
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Colombo PE, Rottoli F, Felisi M, De Mattia C, Riga S, Sutto M, Dillion C, Massey S, Torresin A. Validation of a dose tracking software for skin dose map calculation in interventional radiology. Phys Med 2020; 72:122-132. [DOI: 10.1016/j.ejmp.2020.03.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/02/2020] [Accepted: 03/03/2020] [Indexed: 02/02/2023] Open
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15
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Czub J, Braziewicz J, Wasilewski A, Wysocka-Rabin A, Wołowiec P, Wójcik A. Monte Carlo dosimetry using Fluka code and experimental dosimetry with Gafchromic EBT2 and XR-RV3 of self-built experimental setup for radiobiological studies with low-energy X-rays. Int J Radiat Biol 2020; 96:718-733. [DOI: 10.1080/09553002.2020.1721606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Joanna Czub
- Institute of Physics, Jan Kochanowski University, Kielce, Poland
| | - Janusz Braziewicz
- Institute of Physics, Jan Kochanowski University, Kielce, Poland
- Holy Cross Cancer Center, Kielce, Poland
| | | | | | | | - Andrzej Wójcik
- Department of Molecular Bioscience, Centre for Radiation Protection Research, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
- Institute of Biology, Jan Kochanowski University, Kielce, Poland
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16
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Experimental evaluation of a radiation dose management system-integrated 3D skin dose map by comparison with XR-RV3 Gafchromic® films. Phys Med 2019; 66:77-87. [DOI: 10.1016/j.ejmp.2019.09.234] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 09/10/2019] [Accepted: 09/14/2019] [Indexed: 11/22/2022] Open
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17
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Castilho AVB, Szjenfeld D, Nalli D, Fornazari V, Moreira AC, Medeiros RB. A Study of Radiation Doses to the Patient and Medical Team at Embolization Procedures. ACTA ACUST UNITED AC 2019. [DOI: 10.14407/jrpr.2019.44.3.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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18
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Massillon-Jl G, Cabrera-Santiago A, Xicohténcatl-Hernández N. Relative efficiency of Gafchromic EBT3 and MD-V3 films exposed to low-energy photons and its influence on the energy dependence. Phys Med 2019; 61:8-17. [PMID: 31151584 DOI: 10.1016/j.ejmp.2019.04.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 11/17/2022] Open
Abstract
Energy-dependence of Gafchromic films exposed to low-energy photons has been reported to be a function of absorbed-dose. However, these studies are based on a relative-response, R, which considers the absorbed-dose in water and not within the film sensitive-volume. This work investigated the relative-efficiency, REfilm, (ratio of absorbed-dose required to produce the same net optical density (netOD) by 60Co gamma and by x-ray) of Gafchromic EBT3 and MD-V3 films exposed to five x-ray beams from 20 kV to 160 kV and 60Co gamma rays. A factor that accounts for the energy-dependence, fx,Q,med, based on REfilm, phantom-material and depth at which the films are placed during irradiation was used to remove the influence of absorbed dose. Values of REfilm indicated that the absorbed dose from 60Co gamma rays needs to be 4 and 3 times larger than those from 20 kV x-rays to produce the same netOD within the EBT3 and MD-V3 sensitive volumes, respectively. Thus, saturation could help explain why Gafchromic films show under-response to very low doses from low-energy photon beams, regardless of film model. Furthermore, REfilm, was found to be nearly independent of netOD and colour-channels. Consequently, fx,Q,med is independent of the absorbed dose and colour-channels. In contrast, besides the variation with the photon energy, fx,Q,med varied with film model, depth and phantom material used during the irradiation. Thus, the results suggest that fx,Q,med is a more reliable wide-ranging parameter for evaluating the degree of energy-dependence of the film rather than the relative-response method commonly considered.
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Affiliation(s)
- Guerda Massillon-Jl
- Instituto de Física, Universidad Nacional Autónoma de México, 04510 Coyoacan, Mexico City, Mexico.
| | - Alexis Cabrera-Santiago
- Instituto de Física, Universidad Nacional Autónoma de México, 04510 Coyoacan, Mexico City, Mexico
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19
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Didier R, Bourhis D, Oueslati C, Nasr B, Le Ven F, Noël A, Jobic Y, Damien P, Pene‐Baverez D, Mansourati J, Nicol PP, Gilard M. In vivo validation of Dosemap software use in interventional cardiology with dosimetrics indicators and peak skin dose evaluation. Catheter Cardiovasc Interv 2019; 94:216-222. [DOI: 10.1002/ccd.28097] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/18/2018] [Accepted: 01/02/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Romain Didier
- Department of CardiologyBrest University Hospital Brest France
| | - David Bourhis
- Department of Radiation ProtectionBrest University Hospital Brest France
| | - Chaker Oueslati
- Department of CardiologyBrest University Hospital Brest France
| | - Bahaa Nasr
- Department of Vascular SurgeryBrest University Hospital Brest France
| | - Florent Le Ven
- Department of CardiologyBrest University Hospital Brest France
| | - Antoine Noël
- Department of CardiologyBrest University Hospital Brest France
| | - Yannick Jobic
- Department of CardiologyBrest University Hospital Brest France
| | - Pascal Damien
- Department of Radiation ProtectionBrest University Hospital Brest France
| | | | | | | | - Martine Gilard
- Department of CardiologyBrest University Hospital Brest France
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20
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Pasquino M, Cutaia C, Poli M, Valero C, Peroni G, De Benedictis M, Petrucci E, Stasi M. Patient’s Peak Skin Dose evaluation using Gafchromic films in interventional cardiology procedures and its correlation with other dose indicators. Phys Med 2018; 53:103-107. [DOI: 10.1016/j.ejmp.2018.08.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/16/2018] [Accepted: 08/17/2018] [Indexed: 10/28/2022] Open
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21
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Habib Geryes B, Hadid-Beurrier L, Waryn MJ, Jean-Pierre A, Farah J. Benchmarking the DACS-integrated Radiation Dose Monitor® skin dose mapping software using XR-RV3 Gafchromic® films. Med Phys 2018; 45:4683-4692. [DOI: 10.1002/mp.13125] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 08/01/2018] [Accepted: 08/03/2018] [Indexed: 11/07/2022] Open
Affiliation(s)
- Bouchra Habib Geryes
- Radiology Department; Necker Enfants Malades University Hospital; AP-HP; 149 Rue de Sèvres Paris 75015 France
| | - Lama Hadid-Beurrier
- Radiology Department; Lariboisière University Hospital; AP-HP; 2 Rue Ambroise Paré Paris 75010 France
| | - Marie-Joséphine Waryn
- Radiology Department; Jean Verdier Hospital; AP-HP; Avenue du 14 Juillet Bondy 93140 France
| | - Antonella Jean-Pierre
- Radiology Department; Lariboisière University Hospital; AP-HP; 2 Rue Ambroise Paré Paris 75010 France
| | - Jad Farah
- Radiology and Nuclear Medicine Division; Paris Sud University Hospitals; AP-HP; 78 Rue du Général Leclerc Le Kremlin-Bicêtre 94270 France
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22
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Greffier J, Goupil J, Larbi A, Stefanovic X, Pereira F, Moliner G, Ovtchinnikoff S, Beregi J, Frandon J. Assessment of patient's peak skin dose during abdominopelvic embolization using radiochromic (Gafchromic) films. Diagn Interv Imaging 2018; 99:321-329. [DOI: 10.1016/j.diii.2017.12.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/23/2017] [Accepted: 12/04/2017] [Indexed: 12/11/2022]
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23
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Jiao L, Li Q, Deng J, Okosi N, Xia J, Su M. Nanocellulose templated growth of ultra-small bismuth nanoparticles for enhanced radiation therapy. NANOSCALE 2018; 10:6751-6757. [PMID: 29589846 DOI: 10.1039/c7nr06462d] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
An unmet need in nanomedicine is to prepare biocompatible and renal clearable nanoparticles by controlling the diameter, composition and surface properties of the nanoparticles. This paper reports cellulose nanofiber templated synthesis of ultra-small bismuth nanoparticles, and their uses in enhanced X-ray radiation therapy. The interstitial spaces between adjacent fibers are the adsorption sites of bismuth ions and also stabilize nanoparticles generated by chemical reduction. The sizes of nanoparticles are tailored in the 2-10 nm range using cellulose nanofibers with various amounts of carboxyl groups. In vitro cytotoxicity, reactive oxygen species (ROS) and in vivo animal tests with tumor-bearing mice are studied in order to enhance X-ray radiation therapy using cellulose nanofiber-templated bismuth nanoparticles. Bismuth nanoparticles show strong X-ray attenuation ability, concentration-dependent cytotoxicity and high level production of ROS upon X-ray exposure, which is consistent with enhanced cellular damage and retarded growth of tumors in animals.
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Affiliation(s)
- Li Jiao
- Department of Chemical Engineering, Northeastern University, Boston, Massachusetts 02115, USA.
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24
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Magnier F, Poulin M, Van Ngoc Ty C, Osmond E, Bonniaud G, Coulot J, Pereira B, Boyer L, Guersen J, Cassagnes L. Comparison of Patient Skin Dose Evaluated Using Radiochromic Film and Dose Calculation Software. Cardiovasc Intervent Radiol 2018; 41:762-771. [PMID: 29417266 DOI: 10.1007/s00270-018-1888-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 01/22/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE To compare, in an interventional radiology setting, peak skin doses (PSDs) delivered as calculated using a dedicated software tool and as measured using radiochromic film. To assess the utility of this dose calculation software tool in routine clinical practice. MATERIALS AND METHODS First, radiochromic films were positioned on the examination table in the back of an adult anthropomorphic phantom to measure PSD, and X-ray examinations were simulated. Then, films were again positioned in the patient's back for 59 thoracic or abdominopelvic endovascular interventions. The results obtained with the radiochromic films were taken as a reference and were statistically compared with those of the software. RESULTS With measured PSDs ranging from 100 to 7000 mGy, the median software-film difference was 8.5%. Lin's concordance coefficient was 0.98 [0.97; 0.99] (p < 0.001), meaning that concordance was excellent between the two methods. For the films where PSD exceeded 1000 mGy, the median difference in the measured value was 8.7% [- 1.3; 21.1], with a maximum discrepancy of 34%. Lin's concordance coefficient was 0.98 [0.96; 1] (p < 0.001), meaning that concordance was excellent between the two methods. CONCLUSION Comparison between radiochromic films and the software tool showed that the software is a suitable tool for a simple and reliable estimation of PSD. The software seems to be a good alternative to films, whose use remains complex.
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Affiliation(s)
- Florian Magnier
- Pôle d'Imagerie Diagnostique et de Radiologie Interventionnelle, CHU, 63003, Clermont-Ferrand, France. .,Plateforme régionale de physique médicale, Centre Jean Perrin, 63011, Clermont-Ferrand, France.
| | - Maxime Poulin
- Pôle d'Imagerie Diagnostique et de Radiologie Interventionnelle, CHU, 63003, Clermont-Ferrand, France
| | | | - Estelle Osmond
- Pôle d'Imagerie Diagnostique et de Radiologie Interventionnelle, CHU, 63003, Clermont-Ferrand, France
| | | | | | - Bruno Pereira
- Biostatistics Unit (Délégation Recherche Clinique & Innovation), CHU, 63003, Clermont-Ferrand, France
| | - Louis Boyer
- Pôle d'Imagerie Diagnostique et de Radiologie Interventionnelle, CHU, 63003, Clermont-Ferrand, France.,ISIT, UMR 6284 CNRS, Université d'Auvergne, 63001, Clermont-Ferrand, France
| | - Joel Guersen
- Pôle d'Imagerie Diagnostique et de Radiologie Interventionnelle, CHU, 63003, Clermont-Ferrand, France
| | - Lucie Cassagnes
- Pôle d'Imagerie Diagnostique et de Radiologie Interventionnelle, CHU, 63003, Clermont-Ferrand, France.,ISIT, UMR 6284 CNRS, Université d'Auvergne, 63001, Clermont-Ferrand, France
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25
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Jarvinen H, Farah J, Siiskonen T, Ciraj-Bjelac O, Dabin J, Carinou E, Domienik-Andrzejewska J, Kluszczynski D, Knežević Ž, Kopec R, Majer M, Malchair F, Negri A, Pankowski P, Sarmento S, Trianni A. Feasibility of setting up generic alert levels for maximum skin dose in fluoroscopically guided procedures. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.01.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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26
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Hammer CG, Rosen BS, Fagerstrom JM, Culberson WS, DeWerd LA. Experimental investigation of GafChromic®
EBT3 intrinsic energy dependence with kilovoltage x rays, 137
Cs, and 60
Co. Med Phys 2017; 45:448-459. [DOI: 10.1002/mp.12682] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 10/13/2017] [Accepted: 11/07/2017] [Indexed: 11/10/2022] Open
Affiliation(s)
- Cliff G. Hammer
- Department of Medical Physics; School of Medicine and Public Health; University of Wisconsin-Madison; Madison WI 53705 USA
| | - Benjamin Saul Rosen
- Department of Radiation Oncology; University of Michigan; Ann Arbor MI 48109 USA
| | | | - Wesley S. Culberson
- Department of Medical Physics; School of Medicine and Public Health; University of Wisconsin-Madison; Madison WI 53705 USA
| | - Larry A. DeWerd
- Department of Medical Physics; School of Medicine and Public Health; University of Wisconsin-Madison; Madison WI 53705 USA
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27
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Licona I, Figueroa-Medina E, Gamboa-deBuen I. Dose distributions and percentage depth dose measurements for a total skin electron therapy. RADIAT MEAS 2017. [DOI: 10.1016/j.radmeas.2016.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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28
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Souza S, d'Errico F, Azimi B, Baldassare A, Alves A, Valença J, Barros V, Cascone M, Lazzeri L. OSL films for in-vivo entrance dose measurements. RADIAT MEAS 2017. [DOI: 10.1016/j.radmeas.2017.07.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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29
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Uniyal SC, Chaturvedi V, Sharma SD, Rawat A. PATIENT DOSIMETRY DURING INTERVENTIONAL CARDIAC PROCEDURES IN A DEDICATED CATHETERIZATION LABORATORY. RADIATION PROTECTION DOSIMETRY 2017; 175:201-208. [PMID: 27744352 DOI: 10.1093/rpd/ncw286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 09/25/2016] [Indexed: 06/06/2023]
Abstract
Cardiac interventions often result in high radiation dose to patient's skin, so a reliable indicator in terms of a commonly used dose descriptor is required to monitor skin exposures. In the present study, Gafchromic XR-RV3 film was used to measure the peak skin dose (PSD) during 40 coronary angiography (CA) and 50 percutaneous transluminal coronary angioplasty (PTCA) procedures. Corresponding values of kerma-area product (PKA), fluoroscopy time (FT) and reference air-kerma (Ka,r) were recorded and correlated with PSD. Doses to patient's eyes and thyroid were also measured by using thermoluminescent dosimeters (TLDs) during PTCA procedures. The average dose to thyroid was about six times higher than the average dose to eyes. The mean values of PSD, PKA and FT were 1140 mGy, 97 Gy cm2 and 15.7 min for PTCA and 290 mGy, 21.1 Gy cm2 and 2.4 min for CA procedures, respectively. One in seven patients of PTCA procedure received PSD >2 Gy. With respect to FT, PKA may be used as a better predictor of skin exposures because the correlation of PSD with PKA was found better than with FT for both CA and PTCA procedures.
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Affiliation(s)
- Satish C Uniyal
- Department of Radiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun 248016, India
| | - Vineet Chaturvedi
- Department of Radiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun 248016, India
| | - Sunil D Sharma
- Radiological Physics and Advisory Division, Bhabha Atomic Research Centre, Anushaktinagar, Mumbai 400094, India
| | - Anurag Rawat
- Department of Cardiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Jolly Grant, Dehradun 248016, India
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Assessment of peak skin dose in interventional cardiology: A comparison between Gafchromic film and dosimetric software em.dose. Phys Med 2017; 38:16-22. [DOI: 10.1016/j.ejmp.2017.05.044] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 04/08/2017] [Accepted: 05/02/2017] [Indexed: 11/19/2022] Open
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31
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Greffier J, Moliner G, Pereira F, Cornillet L, Ledermann B, Schmutz L, Lomma M, Cayla G, Beregi JP. Assessment of Patient's Peak Skin Dose Using Gafchromic Films During Interventional Cardiology Procedures: Routine Experience Feedback. RADIATION PROTECTION DOSIMETRY 2017; 174:395-405. [PMID: 27522056 DOI: 10.1093/rpd/ncw191] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Accepted: 04/22/2016] [Indexed: 06/06/2023]
Abstract
To assess the interest of Gafchromic films in detection of patient's peak skin dose (PSD) in interventional cardiology. A prospective study of 112 patients was conducted (July-December 2015). Three diagnostic and therapeutic procedures were evaluated: coronary angiography (CA), coronary angiography and coronary angioplasty for one or two vessels disease (CA-PTCA) and coronary angioplasty of complex chronic total occlusion (CTO). Dosimetric indicators (DIs) were collected and PSD were measured with Gafchromic films. Dose distribution was evaluated within 10 'Thorax Body-zone' defined by the system. Correlations between PSD and DI or dose distribution were computed. Delivered dose increased in complex procedures. The PSD were 0.121 ± 0.063 Gy for CA, 0.256 ± 0.142 Gy for CA-PTCA and 1.116 ± 0.721 Gy for CTO. High correlations were observed for PSD and DI as well for dose distribution within the 'Thorax Body-zone'. Film dosimetry is suggested for CTO procedures since the threshold of 2 Gy for skin injuries is likely to be exceeded.
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Affiliation(s)
- J Greffier
- Department of Radiology, Nîmes University Hospital, Medical Imaging Group Nîmes, EA 2415, Bd Prof Robert Debré, 30029 Nîmes Cedex, France
| | - G Moliner
- Department of Radiology, Nîmes University Hospital, Medical Imaging Group Nîmes, EA 2415, Bd Prof Robert Debré, 30029 Nîmes Cedex, France
| | - F Pereira
- Department of Radiology, Nîmes University Hospital, Medical Imaging Group Nîmes, EA 2415, Bd Prof Robert Debré, 30029 Nîmes Cedex, France
| | - L Cornillet
- Department of Cardiology, Nîmes University Hospital, Bd Prof Robert Debré, 30029 Nîmes Cedex, France
| | - B Ledermann
- Department of Cardiology, Nîmes University Hospital, Bd Prof Robert Debré, 30029 Nîmes Cedex, France
| | - L Schmutz
- Department of Cardiology, Nîmes University Hospital, Bd Prof Robert Debré, 30029 Nîmes Cedex, France
| | - M Lomma
- Department of Biostatistics, Epidemiology, Public Health and Bio-informatics, Nîmes University Hospital, Bd Prof Robert Debré, 30029 Nîmes Cedex, France
| | - G Cayla
- Department of Cardiology, Nîmes University Hospital, Bd Prof Robert Debré, 30029 Nîmes Cedex, France
| | - J P Beregi
- Department of Radiology, Nîmes University Hospital, Medical Imaging Group Nîmes, EA 2415, Bd Prof Robert Debré, 30029 Nîmes Cedex, France
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Akhilesh P, Kulkarni AR, Jamhale SH, Sharma SD, Kumar R, Datta D. Estimation of Eye Lens Dose During Brain Scans Using Gafchromic Xr-QA2 Film in Various Multidetector CT Scanners. RADIATION PROTECTION DOSIMETRY 2017; 174:236-241. [PMID: 27247444 DOI: 10.1093/rpd/ncw132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 05/06/2016] [Indexed: 06/05/2023]
Abstract
The purpose of this study was to estimate eye lens dose during brain scans in 16-, 64-, 128- and 256-slice multidetector computed tomography (CT) scanners in helical acquisition mode and to test the feasibility of using radiochromic film as eye lens dosemeter during CT scanning. Eye lens dose measurements were performed using Gafchromic XR-QA2 film on a polystyrene head phantom designed with outer dimensions equivalent to the head size of a reference Indian man. The response accuracy of XR-QA2 film was validated by using thermoluminescence dosemeters. The eye lens dose measured using XR-QA2 film on head phantom for plain brain scanning in helical mode ranged from 43.8 to 45.8 mGy. The XR-QA2 film measured dose values were in agreement with TLD measured dose values within a maximum variation of 8.9%. The good correlation between the two data sets confirms the viability of using XR-QA2 film for eye lens dosimetry.
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Affiliation(s)
- Philomina Akhilesh
- Radiological Physics and Advisory Division, Bhabha Atomic Research Centre, CT&CRS Building, Anushaktinagar, Mumbai 400094, India
| | - Arti R Kulkarni
- Radiological Safety Division, Atomic Energy Regulatory Board, Niyamak Bhavan, Anushaktinagar, Mumbai 400094, India
| | - Shramika H Jamhale
- Radiological Physics and Advisory Division, Bhabha Atomic Research Centre, CT&CRS Building, Anushaktinagar, Mumbai 400094, India
| | - S D Sharma
- Radiological Physics and Advisory Division, Bhabha Atomic Research Centre, CT&CRS Building, Anushaktinagar, Mumbai 400094, India
| | - Rajesh Kumar
- Radiological Physics and Advisory Division, Bhabha Atomic Research Centre, CT&CRS Building, Anushaktinagar, Mumbai 400094, India
| | - D Datta
- Radiological Physics and Advisory Division, Bhabha Atomic Research Centre, CT&CRS Building, Anushaktinagar, Mumbai 400094, India
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Fetterly KA, Schueler BA, Grams MP, Sturchio GM. Estimating head and neck tissue dose from x-ray scatter to physicians performing x-ray guided cardiovascular procedures: a phantom study. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2017; 37:43-58. [PMID: 27941226 DOI: 10.1088/1361-6498/37/1/43] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Physicians performing x-ray guided interventional procedures have a keen interest in radiation safety. Radiation dose to tissues and organs of the head and neck are of particular interest because they are not routinely protected by wearable radiation safety devices. This study was conducted to facilitate estimation of radiation dose to tissues of the head and neck of interventional physicians based on the dose recorded by a personal dosimeter worn on the left collar. Scatter beam qualities maximum energy and HVL were measured for 40 scatter beams emitting from an anthropomorphic patient phantom. Variables of the scatter beams included scatter angle (35° and 90°), primary beam peak tube potential (60, 80, 100, and 120 kVp), and 5 Cu spectral filter thicknesses (0-0.9 mm). Four reference scatter beam qualities were selected to represent the range of scatter beams realized in a typical practice. A general radiographic x-ray tube was tuned to produce scatter-equivalent radiographic beams and used to simultaneously expose the head and neck of an anthropomorphic operator phantom and radiochromic film. The geometric relationship between the x-ray source of the scatter-equivalent beams and the operator phantom was set to mimic that between a patient and physician performing an invasive cardiovascular procedure. Dose to the exterior surface of the operator phantom was measured with both 3 × 3 cm2 pieces of film and personal dosimeters positioned at the location of the left collar. All films were scanned with a calibrated flatbed scanner, which converted the film's reflective density to dose. Films from the transverse planes of the operator phantom provided 2D maps of the dose distribution within the phantom. These dose maps were normalized by the dose at the left collar, providing 2D percent of left collar dose (LCD) maps. The percent LCD maps were overlain with bony anatomy CT images of the operator phantom and estimates of percent LCD to the left, right and whole brain, brain stem, lenses of the eyes, and carotid arteries were calculated. Per expectation, results indicated greater percent dose to superficial versus deep tissues and increasing percent dose to deep tissues with increasing scatter-equivalent beam energy and HVL. The results enable estimation of the scatter dose to tissues of the head and neck of interventional physicians based on occupational dose measured by a personal dosimeter worn at the collar outside the protective apron.
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Andrade G, Khoury HJ, Garzón WJ, Dubourcq F, Bredow MF, Monsignore LM, Abud DG. Radiation Exposure of Patients and Interventional Radiologists during Prostatic Artery Embolization: A Prospective Single-Operator Study. J Vasc Interv Radiol 2017; 28:517-521. [PMID: 28259503 DOI: 10.1016/j.jvir.2017.01.005] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 01/06/2017] [Accepted: 01/07/2017] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To prospectively analyze the radiation exposure of patients and interventional radiologists during prostatic artery embolization (PAE). MATERIALS AND METHODS Twenty-five consecutive PAE procedures performed with an Artis zee system in a single center by an interventional radiologist were prospectively monitored. The mean age, weight, and prostate volume of the patients were 65.7 year (range, 43-85 y), 71.4 kg (range, 54-88 kg), and 79 cm3 (range, 36-157 cm3), respectively. In addition to Digital Imaging and Communications in Medicine radiation data, direct measures were also obtained. Radiochromic film was used to evaluate peak skin dose (PSD). The radiologist wore a protective apron and a thyroid collar, and a ceiling-suspended screen and a table curtain were used. To estimate the absorbed doses, nine pairs of dosimeters were attached to the operator's body. RESULTS The average fluoroscopy time was 30.9 minutes (range, 15.5-48.3 min). The mean total dose-area product (DAP) was 450.7 Gy·cm2 (range, 248.3-791.73 Gy·cm2) per procedure. Digital subtraction angiography was responsible for 71.5% of the total DAP, followed by fluoroscopy and cone-beam computed tomography. The mean PSD was 2,420.3 mGy (range, 1,390-3,616 mGy). The average effective dose for the interventional radiologist was 17 μSv (range, 4-47 μSv); values for the eyes, hands, and feet were obtained, and were all greater on the left side. CONCLUSIONS PAE may lead to high x-ray exposures to patients and interventional radiologists.
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Affiliation(s)
- Gustavo Andrade
- AngioRad-Interventional Radiology, Ribeirão Preto, Brazil; Faculty of Medicine, Universidade de São Paulo, Ribeirão Preto, Brazil.
| | - Helen J Khoury
- Nuclear Energy Department, Universidade Federal de Pernambuco, Ribeirão Preto, Brazil
| | - William J Garzón
- Nuclear Energy Department, Universidade Federal de Pernambuco, Ribeirão Preto, Brazil
| | | | | | | | - Daniel G Abud
- Faculty of Medicine, Universidade de São Paulo, Ribeirão Preto, Brazil
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Safari M, Wong J, Kadir K, Sani F, Ng K. A method to reduce patient's eye lens dose in neuro-interventional radiology procedures. Radiat Phys Chem Oxf Engl 1993 2016. [DOI: 10.1016/j.radphyschem.2016.03.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Karambatsakidou A, Omar A, Chehrazi B, Rück A, Scherp Nilsson J, Fransson A. SKIN DOSE, EFFECTIVE DOSE AND RELATED RISK IN TRANSCATHETER AORTIC VALVE IMPLANTATION (TAVI) PROCEDURES: IS THE CANCER RISK ACCEPTABLE FOR YOUNGER PATIENTS? RADIATION PROTECTION DOSIMETRY 2016; 169:225-231. [PMID: 26743262 DOI: 10.1093/rpd/ncv526] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aim of this study was to estimate conversion coefficients for maximum entrance skin dose (MESD) and effective dose (E) for patients undergoing transcatheter aortic valve implantation (TAVI) and to evaluate the risk of exposure-induced cancer death (REID) for prospectively younger patients. Effective doses and risks were estimated for 22 patients using PCXMC whereas MESDs were estimated for a sub-group of 15 patients using Gafchromic film. The estimated conversion coefficients for skin dose [CCS = MESD/dose-area product (DAP)] and E (CCE = E/DAP) were 9.7±1.5 and 0.24±0.02 mSv/Gy cm(2), respectively. The REID ranged from 1:9900 to 1:1400 and by decreasing the age of examination to 40-50 y of age, the REID increased with a factor of 2 for females and 1.5 for males. The organ at risk was the lung. Currently, the patient population is elderly with radiation-induced skin injuries as the main risk. The risk of cancer induction should additionally be considered if younger patient populations are to be treated.
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Affiliation(s)
- A Karambatsakidou
- Department of Medical Physics, Karolinska University Hospital, S-171 76 Stockholm, Sweden
| | - A Omar
- Department of Medical Physics, Karolinska University Hospital, S-171 76 Stockholm, Sweden
| | - B Chehrazi
- Department of Medical Physics, Karolinska University Hospital, S-171 76 Stockholm, Sweden
| | - A Rück
- Department of Cardiology, Karolinska University Hospital, S-171 76 Stockholm, Sweden
| | - J Scherp Nilsson
- Department of Medical Physics, Karolinska University Hospital, S-171 76 Stockholm, Sweden
| | - A Fransson
- Department of Medical Physics, Karolinska University Hospital, S-171 76 Stockholm, Sweden
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Garzón WJ, Andrade G, Dubourcq F, Abud DG, Bredow M, Khoury HJ, Kramer R. Prostatic artery embolization: radiation exposure to patients and staff. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2016; 36:246-254. [PMID: 27025551 DOI: 10.1088/0952-4746/36/2/246] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The aim of this study was to evaluate the radiation doses to patients and staff received from the first cases of prostatic artery embolization (PAE) conducted in a public hospital in Recife, Brazil. Five PAE procedures for 5 men diagnosed with benign prostatic hyperplasia were investigated. In order to characterize patient exposure, dosimetric quantities, such as the air kerma-area product (P KA), the cumulative air kerma at the interventional reference point (Ka,r), the number of images, etc, were registered. To evaluate the possibility for deterministic effects, the peak skin dose (PSD) was measured using radiochromic films. For evaluation of personal dose equivalent and effective dose to the medical staff, thermoluminescent dosemeters (TLD-100) were used. The effective dose was estimated using the double dosimetry alghoritm of von Boetticher. The results showed that the mean patient's PSD per procedure was 2674.2 mGy. With regard to the medical staff, the mean, minimum and maximum effective doses estimated per procedure were: 18 μSv, 12 μSv and 21 μSv respectively. High personal equivalent doses were found for the feet, hands and lens of the eye, due to the use of multiple left anterior oblique projections and the improper use of the suspended lead screen and the lead curtain during procedures.
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Affiliation(s)
- W J Garzón
- Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
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38
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Dabin J, Negri A, Farah J, Ciraj-Bjelac O, Clairand I, De Angelis C, Domienik J, Jarvinen H, Kopec R, Majer M, Malchair F, Novák L, Siiskonen T, Vanhavere F, Trianni A, Knežević Ž. Characterisation of grids of point detectors in maximum skin dose measurement in fluoroscopically-guided interventional procedures. Phys Med 2015; 31:1112-1117. [DOI: 10.1016/j.ejmp.2015.08.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 08/26/2015] [Accepted: 08/28/2015] [Indexed: 10/22/2022] Open
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39
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Influence of the calibration conditions of Gafchromic film on the measurement of skin dose in interventional radiology. Phys Med 2015. [DOI: 10.1016/j.ejmp.2015.10.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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40
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Goertz L, Tsiamas P, Karellas A, Sajo E, Zygmanski P. Monte Carlo simulation of a prototypical patient dosimetry system for fluoroscopic procedures. Phys Med Biol 2015; 60:5891-909. [DOI: 10.1088/0031-9155/60/15/5891] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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41
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Bordier C, Klausz R, Desponds L. Accuracy of a dose map method assessed in clinical and anthropomorphic phantom situations using Gafchromic films. RADIATION PROTECTION DOSIMETRY 2015; 165:244-249. [PMID: 25802467 DOI: 10.1093/rpd/ncv034] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A dose map method has been integrated on GE x-ray angiographic systems to provide an indication of the local dose distributed on a patient envelope representative of individual patient shapes. Tests have been performed to assess the accuracy of the method by using Gafchromic XR-RV3 films in an anthropomorphic phantom situation and in a clinical situation. Dose values inside different exposed areas have been compared between the film and the dose map method. The dose map results show a good visual agreement for the anthropomorphic phantom situation, and the local doses agreed within better than 15 % compared with the Gafchromic films in both situations.
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Affiliation(s)
- C Bordier
- Detection and Guidance Solutions, Image Quality and Dose Center of Excellence, GE Healthcare, 283 rue de la Minière, Buc 78530, France
| | - R Klausz
- Detection and Guidance Solutions, Image Quality and Dose Center of Excellence, GE Healthcare, 283 rue de la Minière, Buc 78530, France
| | - L Desponds
- Detection and Guidance Solutions, Image Quality and Dose Center of Excellence, GE Healthcare, 283 rue de la Minière, Buc 78530, France
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Editor's Choice – Minimizing Radiation Exposure During Endovascular Procedures: Basic Knowledge, Literature Review, and Reporting Standards. Eur J Vasc Endovasc Surg 2015; 50:21-36. [DOI: 10.1016/j.ejvs.2015.01.014] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 01/27/2015] [Indexed: 12/30/2022]
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Soliman K, Bakkari M. Examination of the relevance of using radiochromic films in measuring entrance skin dose distribution in conventional digital mammography. RADIATION PROTECTION DOSIMETRY 2015; 165:373-375. [PMID: 25852183 DOI: 10.1093/rpd/ncv126] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Based on manufacturer specifications, radiochromic films are sensitive enough to be used for dosimetry in digital mammography (DM). The aim of this work was to study the feasibility of measuring entrance surface dose (ESD) distribution using Gafchromic XR-QA2 films. The films were irradiated following a standard clinical two-view screening mammography protocol using a full-field digital mammography (FFDM) imaging system. The films were then digitised using a flatbed scanner. The calibration curve relating the readings from a calibrated ionisation chamber and the films' net optical density (NOD) could not be obtained. The examination of the calibration data revealed non-sensitivity of the films to resolve dose differences below 20 mGy at 28 kVp. Therefore, radiochromic films were found not to be suitable for measuring ESD profiles in DM. A 2D map of the NOD of the irradiated films obtained using in-house developed MATLAB computer program is presented.
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Affiliation(s)
- K Soliman
- Department of Medical Physics, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh 11159, Saudi Arabia
| | - M Bakkari
- Department of Medical Physics, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh 11159, Saudi Arabia
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Khoury HJ, Garzon WJ, Andrade G, Lunelli N, Kramer R, de Barros VSM, Huda A. Radiation exposure to patients and medical staff in hepatic chemoembolisation interventional procedures in Recife, Brazil. RADIATION PROTECTION DOSIMETRY 2015; 165:263-267. [PMID: 25870436 DOI: 10.1093/rpd/ncv075] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The purpose of this study was to evaluate patient and medical staff absorbed doses received from transarterial chemoembolisation of hepatocellular carcinoma, which is the most common primary liver tumour worldwide. The study was performed in three hospitals in Recife, capital of the state of Pernambuco, located in the Brazilian Northeastern region. Two are public hospitals (A and B), and one is private (C). For each procedure, the number of images, irradiation parameters (kV, mA and fluoroscopy time), the air kerma-area product (PKA) and the cumulative air kerma (Ka,r) at the reference point were registered. The maximum skin dose (MSD) of the patient was estimated using radiochromic film. For the medical staff dosimetry, thermoluminescence dosemeters (TLD-100) were attached next to the eyes, close to the thyroid (above the shielding), on the thorax under the apron, on the wrist and on the feet. The effective dose to the staff was estimated using the algorithm of von Boetticher. The results showed that the mean value of the total PKA was 267.49, 403.83 and 479.74 Gy cm(2) for Hospitals A, B and C, respectively. With regard to the physicians, the average effective dose per procedure was 17 µSv, and the minimum and maximum values recorded were 1 and 41 µSy, respectively. The results showed that the feet received the highest doses followed by the hands and lens of the eye, since the physicians did not use leaded glasses and the equipment had no lead curtain.
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Affiliation(s)
- H J Khoury
- Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - W J Garzon
- Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - G Andrade
- IMIP-Institute of Medicine Dr. Fernando Figueira, Recife, PE, Brazil
| | - N Lunelli
- Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - R Kramer
- Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - V S M de Barros
- Nuclear Energy Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - A Huda
- California State University, Fresno, CA, USA
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Farah J, Trianni A, Ciraj-Bjelac O, Clairand I, De Angelis C, Delle Canne S, Hadid L, Huet C, Jarvinen H, Negri A, Novák L, Pinto M, Siiskonen T, Waryn MJ, Knežević Ž. Characterization of XR-RV3 GafChromic®
films in standard laboratory and in clinical conditions and means to evaluate uncertainties and reduce errors. Med Phys 2015; 42:4211-26. [DOI: 10.1118/1.4922132] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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46
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Farah J, Trianni A, Carinou E, Ciraj-Bjelac O, Clairand I, Dabin J, De Angelis C, Domienik J, Jarvinen H, Kopec R, Majer M, Malchair F, Negri A, Novák L, Siiskonen T, Vanhavere F, Knežević Ž. Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of European alert thresholds. RADIATION PROTECTION DOSIMETRY 2015; 164:138-142. [PMID: 25316909 DOI: 10.1093/rpd/ncu314] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
To help operators acknowledge patient dose during interventional procedures, EURADOS WG-12 focused on measuring patient skin dose using XR-RV3 gafchromic films, thermoluminescent detector (TLD) pellets or 2D TL foils and on investigating possible correlation to the on-line dose indicators such as fluoroscopy time, Kerma-area product (KAP) and cumulative air Kerma at reference point (CK). The study aims at defining non-centre-specific European alert thresholds for skin dose in three interventional procedures: chemoembolization of the liver (CE), neuroembolization (NE) and percutaneous coronary interventions (PCI). Skin dose values of >3 Gy (ICRP threshold for skin injuries) were indeed measured in these procedures confirming the need for dose indicators that correlate with maximum skin dose (MSD). However, although MSD showed fairly good correlation with KAP and CK, several limitations were identified challenging the set-up of non-centre-specific European alert thresholds. This paper presents preliminary results of this wide European measurement campaign and focuses on the main challenges in the definition of European alert thresholds.
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Affiliation(s)
- J Farah
- Laboratoire de Dosimétrie des Rayonnements Ionisants, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), BP17, PRP-HOM/SDE/LDRI BP 17, Fontenay-aux-Roses Cedex 92262, France
| | - A Trianni
- Udine University Hospital (AOUD), Ple S. Maria della Misericordia, 15, Udine 33100, Italy
| | - E Carinou
- Greek Atomic Energy Commission (GAEC), PO Box 60092, Ag. Paraskevi, Athens 15310, Greece
| | - O Ciraj-Bjelac
- VINCA Institute of Nuclear Sciences (VINCA), PO Box 522, Belgrade 11001, Serbia
| | - I Clairand
- Laboratoire de Dosimétrie des Rayonnements Ionisants, Institut de Radioprotection et de Sûreté Nucléaire (IRSN), BP17, PRP-HOM/SDE/LDRI BP 17, Fontenay-aux-Roses Cedex 92262, France
| | - J Dabin
- Belgian Nuclear Research Centre (SCK-CEN), Boeretang 200, Mol BE-2400, Belgium
| | - C De Angelis
- Istituto Superiore di Sanità (ISS), Viale Regina Elena 299, Rome 00161, Italy
| | - J Domienik
- Nofer Institute of Occupational Medicine (NIOM), 8 Sw. Teresy, Str., Łódź 91-348, Poland
| | - H Jarvinen
- Radiation and Nuclear Safety Authority (STUK), PO Box 14, Helsinki 00881, Finland
| | - R Kopec
- Institute of Nuclear Physics (IFJ PAN), ul Radzikowskiego 152, Kraków PL-31-342, Poland
| | - M Majer
- Ruđer Bošković Institute (RBI), Bijenička c. 54, Zagreb 10000, Croatia
| | - F Malchair
- Centre Hospitalier Universitaire de Liège (CHUL), Avenue de l'Hôpital, Liège 4000, Belgium
| | - A Negri
- Istituto Oncologico Veneto (IOV), Via Gattamelata 64, Padova 35124, Italy
| | - L Novák
- National Radiation Protection Institute (NRPI), Bartoškova 28, Prague 4 140 00, Czech Republic
| | - T Siiskonen
- Radiation and Nuclear Safety Authority (STUK), PO Box 14, Helsinki 00881, Finland
| | - F Vanhavere
- Belgian Nuclear Research Centre (SCK-CEN), Boeretang 200, Mol BE-2400, Belgium
| | - Ž Knežević
- Ruđer Bošković Institute (RBI), Bijenička c. 54, Zagreb 10000, Croatia
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Li B, Behrman RH. An investigation into factors affecting the precision of CT radiation dose profile width measurements using radiochromic films. Med Phys 2015; 42:1765-72. [DOI: 10.1118/1.4914396] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Jones AK, Ensor JE, Pasciak AS. How accurately can the peak skin dose in fluoroscopy be determined using indirect dose metrics? Med Phys 2015; 41:071913. [PMID: 24989391 DOI: 10.1118/1.4884020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Skin dosimetry is important for fluoroscopically-guided interventions, as peak skin doses (PSD) that result in skin reactions can be reached during these procedures. There is no consensus as to whether or not indirect skin dosimetry is sufficiently accurate for fluoroscopically-guided interventions. However, measuring PSD with film is difficult and the decision to do so must be madea priori. The purpose of this study was to assess the accuracy of different types of indirect dose estimates and to determine if PSD can be calculated within ± 50% using indirect dose metrics for embolization procedures. METHODS PSD were measured directly using radiochromic film for 41 consecutive embolization procedures at two sites. Indirect dose metrics from the procedures were collected, including reference air kerma. Four different estimates of PSD were calculated from the indirect dose metrics and compared along with reference air kerma to the measured PSD for each case. The four indirect estimates included a standard calculation method, the use of detailed information from the radiation dose structured report, and two simplified calculation methods based on the standard method. Indirect dosimetry results were compared with direct measurements, including an analysis of uncertainty associated with film dosimetry. Factors affecting the accuracy of the different indirect estimates were examined. RESULTS When using the standard calculation method, calculated PSD were within ± 35% for all 41 procedures studied. Calculated PSD were within ± 50% for a simplified method using a single source-to-patient distance for all calculations. Reference air kerma was within ± 50% for all but one procedure. Cases for which reference air kerma or calculated PSD exhibited large (± 35%) differences from the measured PSD were analyzed, and two main causative factors were identified: unusually small or large source-to-patient distances and large contributions to reference air kerma from cone beam computed tomography or acquisition runs acquired at large primary gantry angles. When calculated uncertainty limits [-12.8%, 10%] were applied to directly measured PSD, most indirect PSD estimates remained within ± 50% of the measured PSD. CONCLUSIONS Using indirect dose metrics, PSD can be determined within ± 35% for embolization procedures. Reference air kerma can be used without modification to set notification limits and substantial radiation dose levels, provided the displayed reference air kerma is accurate. These results can reasonably be extended to similar procedures, including vascular and interventional oncology. Considering these results, film dosimetry is likely an unnecessary effort for these types of procedures when indirect dose metrics are available.
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Affiliation(s)
- A Kyle Jones
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Joe E Ensor
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030
| | - Alexander S Pasciak
- Department of Radiology, The University of Tennessee Medical Center, Knoxville, Tennessee 37920
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Dunkerley DAP, Tomkowiak MT, Slagowski JM, McCabe BP, Funk T, Speidel MA. Monte Carlo simulation of inverse geometry x-ray fluoroscopy using a modified MC-GPU framework. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2015; 9412:94120S. [PMID: 26113765 PMCID: PMC4476537 DOI: 10.1117/12.2081684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Scanning-Beam Digital X-ray (SBDX) is a technology for low-dose fluoroscopy that employs inverse geometry x-ray beam scanning. To assist with rapid modeling of inverse geometry x-ray systems, we have developed a Monte Carlo (MC) simulation tool based on the MC-GPU framework. MC-GPU version 1.3 was modified to implement a 2D array of focal spot positions on a plane, with individually adjustable x-ray outputs, each producing a narrow x-ray beam directed toward a stationary photon-counting detector array. Geometric accuracy and blurring behavior in tomosynthesis reconstructions were evaluated from simulated images of a 3D arrangement of spheres. The artifact spread function from simulation agreed with experiment to within 1.6% (rRMSD). Detected x-ray scatter fraction was simulated for two SBDX detector geometries and compared to experiments. For the current SBDX prototype (10.6 cm wide by 5.3 cm tall detector), x-ray scatter fraction measured 2.8-6.4% (18.6-31.5 cm acrylic, 100 kV), versus 2.1-4.5% in MC simulation. Experimental trends in scatter versus detector size and phantom thickness were observed in simulation. For dose evaluation, an anthropomorphic phantom was imaged using regular and regional adaptive exposure (RAE) scanning. The reduction in kerma-area-product resulting from RAE scanning was 45% in radiochromic film measurements, versus 46% in simulation. The integral kerma calculated from TLD measurement points within the phantom was 57% lower when using RAE, versus 61% lower in simulation. This MC tool may be used to estimate tomographic blur, detected scatter, and dose distributions when developing inverse geometry x-ray systems.
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Affiliation(s)
| | | | | | - Bradley P McCabe
- Dept. of Radiation Oncology, University of Chicago, Chicago, IL, USA
| | - Tobias Funk
- Triple Ring Technologies, Inc, Newark, CA, USA
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Bordier C, Klausz R, Desponds L. Patient dose map indications on interventional X-ray systems and validation with Gafchromic XR-RV3 film. RADIATION PROTECTION DOSIMETRY 2015; 163:306-318. [PMID: 24939865 DOI: 10.1093/rpd/ncu181] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
To help avoiding secondary effects of interventional procedures like skin damage, a dose map method has been developed to provide an indication of the local dose on a surface representative of individual patient shapes. To minimise user interactions, patient envelope shapes are automatically determined depending on simple patient data information. Local doses are calculated in 1-cm² areas depending on the estimated air kerma, table and gantry positions and system settings, taking into account the table and mattress attenuations and estimated backscatter from the patient. These local doses are cumulated for each location of the patient envelope during the clinical procedure. To assess the accuracy of the method, Gafchromic XR-RV3 films have been used in several operating configurations. Good visual agreements on cumulated dose localisation were obtained within the 1-cm² precision of the map and the dose values agreed within 24.9 % accuracy. The resulting dose map method has been integrated into GE Healthcare X-Ray angiographic systems and should help in the management of the dose by the users during the procedure.
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Affiliation(s)
- C Bordier
- Detection and Guidance Solutions, Image Quality and Dose Center of Excellence, GE Healthcare, 283 rue de la Minière, Buc 78530, France
| | - R Klausz
- Detection and Guidance Solutions, Image Quality and Dose Center of Excellence, GE Healthcare, 283 rue de la Minière, Buc 78530, France
| | - L Desponds
- Detection and Guidance Solutions, Image Quality and Dose Center of Excellence, GE Healthcare, 283 rue de la Minière, Buc 78530, France
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