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A Shukri

Publications and source records attributed to A Shukri.

14 recordsLinked to original sources

Entrance dose measurement: a simple and reliable technique.

Verification of tumor dose for patients undergoing external beam radiotherapy is an important part of quality assurance programs in radiation oncology. Among the various methods available, entrance dose in vivo is one reliable method used to verify the tumor dose delivered to a patient. In this work, entrance dose measurements using LiF:Mg;Ti and LiF:Mg;Cu;P thermoluminescent dosimeters (TLDs) without buildup cap was carried out. The TLDs were calibrated at the surface of a water equivalent phantom against the maximum dose, using 6- and 10-MV photon and 9-MeV electron beams. The calibration geometry was such that the TLDs were placed on the surface of the "solid-water" phantom and a calibrated ionization chamber was positioned inside the phantom at calibration depth. The calibrated TLDs were then utilized to measure the entrance dose during the treatment of actual patients. Measurements were also carried out in the same phantom simultaneously to check the stability of the system. The dose measured in the phantom using the TLDs calibrated for entrance dose to 6-and 10-MV photon beams was found to be close to the dose determined by the treatment planning system (TPS) with discrepancies of not more than 4.1% (mean 1.3%). Consequently, the measured entrance dose during dose delivery to the actual patients with a prescribed geometry was found to be compatible with a maximum discrepancy of 5.7% (mean 2.2%) when comparison was made with the dose determined by the TPS. Likewise, the measured entrance dose for electron beams in the phantom and in actual patients using the calibrated TLDs were also found to be close, with maximum discrepancies of 3.2% (mean 2.0%) and 4.8% (mean 2.3%), respectively. Careful implementation of this technique provides vital information with an ability to confidently accept treatment algorithms derived by the TPS or to re-evaluate the parameters when necessary.

Algorithms↗

A simplified approach for exit dose in vivo measurements in radiotherapy and its clinical application.

This is a study using LiF:Mg;Ti thermoluminescent dosimeter (TLD) rods in phantoms to investigate the effect of lack of backscatter on exit dose. Comparing the measured dose with anticipated dose calculated using tissue maximum ratio (TMR) or percentage depth dose (PDD) gives rise to a correction factor. This correction factor may be applied to in-vivo dosimetry results to derive true dose to a point within the patient. Measurements in a specially designed humanoid breast phantom as well as patients undergoing radiotherapy treatment were also been done. TLDs with reproducibility of within +/- 3% (1 SD) are irradiated in a series of measurements for 6 and 10 MV photon beams from a medical linear accelerator. The measured exit doses for the different phantom thickness for 6 MV beams are found to be lowered by 10.9 to 14.0% compared to the dose derived from theoretical estimation (normalized dose at dmax). The same measurements for 10 MV beams are lowered by 9.0 to 13.5%. The variations of measured exit dose for different field sizes are found to be within 2.5%. The exit doses with added backscatter material from 2 mm up to 15 cm, shows gradual increase and the saturated values agreed within 1.5% with the expected results for both beams. The measured exit doses in humanoid breast phantom as well as in the clinical trial on patients undergoing radiotherapy also agreed with the predicted results based on phantom measurements. The authors' viewpoint is that this technique provides sufficient information to design exit surface bolus to restore build down effect in cases where part of the exit surface is being considered as a target volume. It indicates that the technique could be translated for in vivo dose measurements, which may be a conspicuous step of quality assurance in clinical practice.

Breast↗

A novel approach of dose mapping using a humanoid breast phantom in radiotherapy.

A study of dose mapping techniques to investigate the dose distribution throughout a planned target volume (PTV) in a humanoid breast phantom exposed to a 6 MV photon beam similar to that of treatment conditions is described. For tangential breast irradiation using a 6 MV accelerator beam, the dose is mapped at various locations within the PTV using thermoluminescent dosemeters (TLDs) and radiographic films. An average size perspex breast phantom with the ability to hold the dosemeters was made. TLDs were exposed after packing them in various locations in a particular slice, as planned by the treatment planning system (TPS). To map the dose relative to the isocenter, films were exposed after tightly packing them in between phantom slices, parallel to the central axis of the beam. The dose received at every location was compared with the given dose as generated by the TPS. The mapped dose in each location in the isocentric slice from superficial to deep region was found to be in close agreement with the TPS generated dose to within +/-2%. Doses at greater depths and distant medial and lateral ends, however, were found to be lower by as much as 9.4% at some points. The mapped dose towards the superior region and closest inferior region from the isocenter was found to agree with those for TPS. Conversely, results for the farthest inferior region were found to be significantly different with a variance as much as 17.4% at some points, which is believed to be owing to the variation in size and shape of the contour. Results obtained from films confirmed this, showing similar trends in dose mapping. Considering the importance of accurate doses in radiotherapy, evaluating dose distribution using this technique and tool was found to be useful. This provides the opportunity to choose a technique and plan to provide optimum dose delivery for radiotherapy to the breast.

Breast↗

Determination of absorbed dose for photon and electron beams from a linear accelerator by comparing various protocols on different phantoms.

Protocols developed for high-energy dosimetry IAEA (Technical Reports Series No. 277, 1997), AAPM (Med. Phys. 10 (1983) 741: Med. Phys. 18 (1991) 73: Med. Phys. 21 (1994) 1251), IPEMB (Phys. Med. Biol. 41 (1996) 2557), and HPA (Phys. Med. Biol. 28 (1983) 1097) have continued to enhance precision in dose measurements and the optimization of radiotherapy procedures. While recent dosimetry protocols, including those due to the IAEA and IPEMB, have made a number of improvements compared with previous protocols, it is further desirable to develop absolute dosimetry methods of dose measurements. Measurements based on careful implementation of procedures contained within the various protocols have been carried out in an effort to determine the extent to which discrepancies exist among the protocols. Dose in water at dmax was measured using cylindrical and parallel-plate ionization chambers for 6 MV photon beams and 5 and 12 MeV electron beams. Results obtained from the use of the AAPM and HPA protocols for 6 MV photon beams were found to be 0.9% larger and 0.1% smaller, respectively, than those measured following the IAEA protocol. Calibration dose measurements for 5 and 12 MeV electron beams in water phantoms were found to agree to within 1%, this being well within recommendations from the ICRU and other sources regarding the accuracy of dose delivery.

Algorithms↗

A study of Rhizophora spp wood phantom for dosimetric purposes using high-energy photon and electron beams.

Previous scattering and depth-dose investigations involving use of the Malaysian hardwood Rhizophora spp have shown this medium to produce good agreement with measurements made in water. Present study extends the comparison, now including measurements of percentage depth-dose made for photons at 6MV and 5 and 12MeV electron beams. For the 6 MV photon and 5 MeV electron beams, discrepancies between percentage depth-dose for Rhizophora spp and water, at all depths, are found to be within 2.6 and 2.4% respectively. At 12 MeV electron energies, measured percentage depth-doses in Rhizophora spp beyond 3.5cm depth are found to be in significant discord with those for water. The absorbed dose in water measured in Rhizophora spp at d(max) for all three beams produces discrepancies of no more than 1.1% when compared with measurements made in water.

Electrons↗

Hydroxyurea treatment for chronic myeloid leukaemia during pregnancy.

A patient being treated for chronic myeloid leukaemia with hydroxyurea became pregnant. Despite an increase in the dose of hydroxyurea (to 3 g per day) during the pregnancy, her white blood cell count could only be controlled at about 150 x 10(9)/l. A healthy baby girl was born at 37 weeks with normal blood counts and no evidence of congenital abnormality. There are now five reports of the use of hydroxyurea in pregnancy, and where leukapheresis is not available it may be the treatment of choice.

Adult↗

The use of chemical weapons. Conducting an investigation using survey epidemiology.

The use of chemical weapons in conflict represents a breach of international law as well as a grave violation of human rights. Investigating allegations of their use often is difficult. A basic tool is the survey interview. Experience has shown that a rigorous epidemiologic approach should be taken. A primary emphasis should be designing the study so that consistency of responses can be analyzed to judge the validity of the testimony. Only when the testimony can withstand this scrutiny is it possible to surmise the possible identity of agents employed. Securing samples of the putative agent is of obvious importance. Two recent investigations are discussed herein, one conducted by US Army medical researchers on allegations of chemical weapons use against the Hmong in Laos and another mounted by us on allegations of poison-gas attack against the Iraqi Kurds.

Chemical Warfare Agents↗

Prenatal diagnosis of congenital methemoglobinemia with mental retardation.

A case of congenital enzymopenic methemoglobinemia associated with severe mental retardation is described. The deficiency of cytochrome b5 reductase activity in the erythrocytes and the leukocytes of the propositus is demonstrated by kinetic measurement and by disc gel electrophoresis. Analysis of cultured amniotic fluid cells during a second pregnancy of the mother revealed an almost complete deficiency of the enzyme. The absence of cytochrome b5 reductase activity in the blood from the aborted fetus confirmed the prenatal diagnosis. The data presented support the opinion that in pregnancies at risk for the severe form of congenital enzymopenic methemoglobinemia, prenatal diagnosis is warranted.

Amniocentesis↗

The dissociation of some 111In chelates in the presence of transferrin and haemoglobin studied by PAC.

The interaction of [111In]Tris-chelates with protein molecules in aqueous solution at room temperature has been studied using time-integral and time-differential PAC. Increasing amounts of apo-transferrin were added to solutions of [111In]tropolonate, -acetylacetonate, -oxinate and -oxine sulphate, and of haemoglobin to [111In]tropolonate. The transfer of 111In from chelate to protein was monitored by time-integral PAC measurements. Analysis of these data in erms of stability constants showed that with added transferrin complete dissociation of each 111In chelate occurred with increasing protein concentration, the radiolabel being sequestered by the protein molecules. Confirmation of this was provided by time-differential PAC measurements at four tropolone:transferrin relative concentrations, and in the pure systems. A value for the first stability constant of transferrin is presented. Analysis of time-integral PAC data showed that added haemoglobin did not cause complete dissociation of [111In]tropolonate, a [111In]tropolone-haemoglobin complex being formed. Time-differential PAC studies of the [111In]tropolonate:haemoglobin and [111In]haemoglobin systems at 77 K and 295 K supported this conclusion, revealing quadrupole frequencies of 14.0 +/- 0.6 MHz in [111In]haemoglobin and 9.1 +/- 1.1 MHz in the mixed system.

Drug Stability↗