[PACS (Picture Archiving and Communication Systems). General principles and guidelines for its use].
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Ergonomics↗
Biomedical subjects
G Borasi
Publications and source records attributed to G Borasi.
[Quality evaluation of a personal dosimetry service].
In a hospital environment high quality personal dosimetry is demanded by two different considerations: first, the marked reduction in the radiation exposure levels of hospital workers during the last 10 years and second, the recent decrease in the allowed absorbed dose thresholds for the different categories of workers and for the general population. In fact, according to the new Italian Radioprotection Law (D.L. vo 230/95), the dose equivalent limit for the general population has been decreased to 1 mSv per year. This means that a dosimetric system should be able to measure, with acceptable precision and accuracy, dose levels as low as 0.1 mSv per observation period (generally 1 month or 45 days). This is quite a stringent requirement for this kind of dosimetry. During a tender, the performances of the whole body personal dosimetry systems by four Italian service providers were analyzed by irradiating more than 60 test samples for each provider with four different energies in a wide dose interval (0.01-100 mSv). The results show that all systems perform quite well in the 0.2-100 mSv dose range; on the contrary, in the 0.01-0.2 mSv dose range, significant differences appear between the services and TLD based systems perform better than film based ones. In particular, one of the two TLD based systems measured doses as low as 0.01 mSv. To conclude this very high sensitivity level really opens a new "observation window" on the low doses world. The use of higher quality (and, of course, more expensive) materials by this provider seems to be the key of its success.
Dose-Response Relationship, Radiation↗
Wiener spectrum of radiographic systems: comparison of different evaluation methods.
The noise power spectrum, or Wiener spectrum, of the radiographic mottle is a fundamental quantity in film-screen image quality evaluation. In this paper, using a high-quality computerized microdensitometer, two different acquisition and calculation methods for noise evaluation are compared. The first one is the classic (unidimensional) method used in film noise evaluation: a long and narrow slit (10 x 400 microns2) is used to delimit the microdensitometer light beam and the transmission data are collected by scanning the sample in a rectilinear pattern. A section of the two-dimensional Wiener spectrum is thus obtained. The second (two-dimensional) method is similar to that used in digital image noise evaluation: a square slit is used on the microdensitometer window and data are collected by scanning the sample on a square pattern. To evaluate the effect of different sampling frequencies, our data were acquired both selecting a 50 x 50 microns2 square slit and a 20 x 20 microns2 square slit. The two-dimensional Wiener spectrum thus obtained is then reduced to a unidimensional function. The measurements were made on two different films (Kodak Ortho G e Kodak T-MAT G) exposed with the same screen (Kodak Lanex Regular). These films have the same sensitivity but a different emulsion structure. One film (Ortho G) is made of irregular halide silver grains and the other (T-MAT G) of tabular grains. A satisfactory agreement between the two procedures was found which makes the comparison of data from the laboratories using microdensitometers and those using TV-grabbing system for film-screen evaluation meaningful.
Physical Phenomena↗
[Quality assurance in radiology: quality control of radiographic cassettes].
A "quality team" in radiology, whose members are the authors of this paper, has implemented a quality control program to test the cassettes with intensifying screen systems used in radiology departments. 149 systems-124 of them for general purpose radiology and 25 for mammography-were submitted to the following tests: visual inspection of radiographic cassettes and intensifying screens, screen-film contact, intensifying screen cleanliness and relative sensitivity of the intensifying screens. The results of each type of test are reported in detail in the paper, on a 3-point scale: good, sufficient and poor. The overall results of the quality control tests show 78% of general purpose radiology cassettes to qualify as good (69%) or sufficient (9%), while 22% were of poor quality. 88% of the mammographic cassettes qualified as good (76%) or sufficient (12%), while 12% were of poor quality. All tests were easy to perform and required limited resources. The necessary procedures to keep quality high over time are also reported. To conclude, the results obtained with our quality control program could be used as an effective tool to address and plan the turnover of the cassettes with intensifying screens which are usually used in diagnostic radiology practice.
Evaluation Studies as Topic↗
[Radiotherapy of the breast: changes in the volume of the lung covered in the treatment fields and resulting changes in dose distribution].
In breast cancer adjuvant therapy, respiratory movements continuously modify the irradiated volumes and the anatomical shape of this body region. Fifteen patients were submitted to 3 Computed Tomography (CT) sequences for treatment planning: the first one without any indications to the patient (the standard sequence) and the second and the third one with spontaneous stopped inspiration and expiration, respectively; the patient was always in the same position. The treatment was planned on standard CT images and then applied to the other sequences, maintaining all parameters unvaried, including isocenter position and treatment time. The lung volumes within the fields (and those included in the 95%, 100%, 105% isodoses referred to the prescribed dose) were evaluated with dose/volume histograms. The average irradiated lung was 69 cm3 (DS 28) in standard sequences, 136 cm3 (DS 67) in inspiration and 41 cm3 (DS 25) in expiration. The pulmonary volume within the above isodoses exhibited similar changes. In other words, the lung volume actually irradiated during the whole treatment is smaller than the one which can be calculated on standard CT sequences and it corresponds to expiration volume. The remaining part falls into a wide "twilight zone" relative to dose. Therefore, the true risk of lung toxicity can be similarly lower than the calculable one on standard CT images. Thus, the complication risk (based on dose/volume histograms and normal tissue control probability parameters) could be assessed in new prospective studies, introducing a corrective factor for the irradiated lung volume, because the latter is smaller than that shown by standard CT.
Breast Neoplasms↗
Radiation transport in a radiotherapy room.
The photoneutron dose equivalent in a linac radiotherapy room and its entrance maze was investigated by means of Monte Carlo simulations under different conditions. Particularly, the effect of neutron absorbers and moderator layers placed on the maze walls was considered. The contribution of prompt gamma rays emitted in absorption reactions of thermal neutrons was also taken into account. The simulation results are compared with some experimental measurements in the therapy room and in the maze.
Gamma Rays↗
Transfer kinetics and coefficients of 90Sr, 134Cs, and 137Cs from forage contaminated by Chernobyl fallout to milk of cows.
A experiment was conducted to study kinetics, transfer coefficients, and biological half-lives of 90Sr, 134Cs, and 137Cs from feed to milk. A cow was fed a diet containing alfalfa hay contaminated by Chernobyl fallout for 14.5 wk. The time-dependent activity in milk was approximated by a two-compartment model with fast biological half-lives of 2, 0.9, and 1 d and slow biological half-lives of 36.9, 8.7, and 12.4 d for 90Sr, 134Cs, and 137Cs, respectively. The transfer coefficients determined in the experiment were 0.0008 d L-1 for 90Sr, 0.0029 d L-1 for 134Cs, and 0.0031 d L-1 for 137Cs. The biological elimination phases of 134Cs and 137Cs were described by a two-compartment model while a one-compartment model was proposed for 90Sr.
Accidents↗
The choice of radiographic film-screen systems: quality evaluation and purchasing specifications drafting. Report on A.I.F.B. Working Group activity.
The comparative evaluation of radiographic screen-film systems presents several problems from both the theoretical and the experimental points of view. From the theoretical point of view the main difficulties are related to the choice of the parameters best suited to express the "overall quality" of a system. This quantity is expressed as a product of image quality index and system sensitivity. As image quality index we assumed the signal-to-noise power ratio: this index depends in an explicit way on contrast, resolution and noise of the system. From the experimental point of view the main problem is that to measure some basic quantities, sophisticated and expensive equipment, like computer-controlled microdensitometers, is generally required. In this paper, we report the Italian Association of Biomedical Physicists Task group suggestions for measuring the basic physical parameters (with particular reference to the use of cost-effective equipment and for purchasing specification drafting). Using synthetic quality indices, the evaluation criteria of radiographic materials are directly derived from the general theory of radiographic image perception.
Physical Phenomena↗
Three-dimensional display of myocardial perfusion: detection of ischemic lesions using a new image subtraction method.
A recent, commercially available computer program for the three-dimensional (3D) display of single-photon emission tomography (SPET) data was used to study myocardial perfusion in patients with coronary artery disease (CAD). To enable the detection of small ischemic lesions, the authors proposed a new "distance-substraction" method: after suitable centering of the axial slices, 3D "distance-shaded" images of the stress study were subtracted from the corresponding views of the rest study. With this technique, small changes in surface-to-observer distance were highlighted, thus enabling us to detect nontransmural ischemic areas of the myocardium. General characteristics and possibilities of the subtraction technique were tested on a simple myocardial phantom. Some clinical results of the application of this method on CAD patients are presented and discussed. In CAD patients in whom only nontransmural ischemic lesions are present, the subtraction of "distance-shaded" images is decisive for a correct diagnosis.
Contrast Media↗
[Evaluation of the quality of screen-film radiographic systems: physical principles and methods of measurement].
Comparative evaluation of radiographic film-screen systems presents several problems from both the theoretical and the experimental point of view. From the theoretical point of view the main difficulties are related to the choice of the parameters best suited to express the "overall quality" of a system. From the practical point of view the main problem is that to measure some basic quantities (resolution and noise) sophisticated and expensive instruments are required. This paper deals with both these problems. To express image quality we have assumed the signal-to-noise power ratio: this index depends in a explicit way on contrast, resolution and noise of the system. The dependence on sensitivity is implicit and was derived using literature data. From a knowledge of the dependence of image quality on sensitivity it is possible to develop an "overall quality" index which is considered to express the "technological level" of the system. This index can be used in the comparative evaluation of the different systems. In this work some basic physical quantities (characteristic curve, sensitivity) were evaluated using standard instruments. To measure spatial resolution and noise an inexpensive, PC-based, TV-digitizer system was developed. As an example, both image and overall quality indices were evaluated on three mammographic systems which are typical of the three different "phases" of the development of this technique.
Evaluation Studies as Topic↗
[En-bloc treatment of tumors of the hypopharyngeal-laryngeal-tracheal tract with a new isocentric multipendular technic].
The authors propose a new technique for the treatment of hypopharyngeal-laryngeal-tracheal tract tumors using cobalt-60 irradiation. This technique allows the simultaneous irradiation of both primary tumor and cervical lymph nodes. Therapeutically effective doses can be administered without affecting the spinal cord. The above-mentioned technique consists of 3 isocentric rotations, the widest one carried out by interposing a small lead bar shielding in the middle of the field. Dose distributions obtained in an Alderson-Rando phantom and in a patient are reported.
Cobalt Radioisotopes↗
Some remarks on secondary protective barrier calculation for radiographic installations: NCRP Report No. 49 revisited.
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Mathematics↗
[Radiation exposure of the embryo and the fetus: real risks or unjustified fears?].
The authors discuss the problem of radiation damage to the individual developing in utero, and summarize the information available in the literature on the subject. Additional risks induced by ionizing radiations are classified with reference to gestational age and dose absorbed by the fetus. Such risks concern the possibility of mental retardation from the 8th to the 15th gestational week, and of developing a malignant disease from the 3rd to the 15th gestational week. We report the dose values received by the fetus as a result of both radiodiagnostic examinations and the Chernobyl nuclear accident: the doses were generally very low, which leads us to the conclusion that additional risks are of the same order of magnitude as the fluctuations in the natural congenital malformations. Thus, prenatal irradiation for diagnostic examinations does not generally represent a reason to recommend therapeutic abortion. However, it is always important to carry out a careful evaluation of the dose absorbed by the fetus and to correctly inform the mother about eventual radiation-induced risks.
Embryo, Mammalian↗
High-resolution 1H NMR spectroscopy in the diagnosis of breast cancer.
Surgical specimens from 22 patients with infiltrating ductal carcinoma of the breast were analyzed by high-resolution 1H NMR spectroscopy at 80 and 300 MHz. Results were compared with those obtained from 9 benign (proliferative dysplasia without atypia) breast samples. NMR spectra at 80 MHz showed well-resolved water and lipid peaks so it was possible to calculate specific T1 and T2 relaxation times. The longitudinal T1 relaxation process of the water was found to be properly represented by a monoexponential function, whereas the transverse T2 decay was well accounted for by a biexponential model. Relaxation time measurements of the water were found to be a valuable tool in breast tissue characterization, in particular (a) mean T1 values from malignant and control populations are well distinguished (P less than 0.0008); (b) mean T2 values of both fast and slow components from the two populations are statistically different (P less than 0.0001) and no overlap exists in the distributions of the second component. Three-hundred-megahertz spectra allowed a detailed analysis of the lipidic component of the sample: malignant tumors were found to present in the region 1.3-1.2 ppm a species characterized by a very slow transverse relaxation time (T2 = 200-1000 ms).
Body Water↗
Cross reactions in radioimmunoassay: a mathematical model for correcting assay results, as exemplified by eliminating the interference of intact thyrotropin in an assay of its beta subunit.
To correct the results of a radioimmunoassay for beta-thyrotropin (TSH) subunit by eliminating the proportion ascribable to intact TSH, we have devised a method that experimentally reproduces the conditions under which the interference develops. Beta-TSH subunit was assayed in several preparations containing known concentrations of both beta-TSH and TSH. The TSH-induced overestimation of beta-TSH was linearly related to the concentration of antigen in the sample. At a constant concentration of TSH, therefore, the following equation is applicable: F = aE + b, where F is the measured (but overestimated) concentration of beta-TSH, E is the actual concentration of beta-TSH, and a and b are the slope and the intercept of the regression line, respectively. a and b, once expressed as a function of TSH, allow the correction of the overestimation. The analysis of the results according to the mass action and conservation laws shows that the antiserum is more avid for the interferent (intact TSH) than for the antigen (beta-TSH).
False Positive Reactions↗
[Staging of prostatic carcinoma. Accuracy of magnetic resonance].
Twenty-nine prostatic cancer patients were evaluated for staging purpose by Magnetic Resonance (MR). MR findings were correlated with the pathologic examination in 18/29 patients who underwent radical prostatectomy. Four MR staging parameters were evaluated individually: periprostatic fat; periprostatic venous plexus; seminal vesicles and pelvic adenopathy. MR correctly staged 16/18 patients, with one case of overstaging and one case of understaging. The diagnostic accuracy of MR in differentiating intracapsular stage B from extracapsular stage C was 87%, with a sensitivity of 90% and a specificity of 87%. MR and CT results agreed in 4 of the 7 operated patients who were examined with both techniques; in 3 cases there was disagreement, and MR was correct.
Aged↗
NMR evidence for multi-component spin lattice relaxation time in a case of cryoglobulinemia.
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Cryoglobulinemia↗
[White and black in nuclear magnetic resonance (NMR). Impulse sequences and their significance in the NMR image].
In order to understand how pulse sequences affect what is black and what is white in Nuclear Magnetic Resonance (NMR) images, the tissue parameters (proton density; relaxation times T1 and T2) are related to the operator selectable controls (type of pulse sequence; repetition time TR; interpulse delay TI; echo delay TE). The pulse sequences "Saturation Recovery"; "Inversion Recovery"; "Spin Echo" are discussed. The authors also analyze the effect of flowing blood on NMR images.
Brain↗