PubMed Health⌕ Search

Biomedical subjects

R Mini

Publications and source records attributed to R Mini.

14 recordsLinked to original sources

Introduction of a novel dose saving acquisition mode for the PortalVision aS500 EPID to facilitate on-line patient setup verification.

In external beam radiotherapy, electronic portal imaging becomes more and more an indispensable tool for the verification of the patient setup. For the safe clinical introduction of high dose conformal radiotherapy like intensity modulated radiation therapy, on-line patient setup verification is a prerequisite to ensure that the planned dosimetric coverage of the tumor volume is actually realized in the patient. Since the direction of setup fields often deviates from the direction of the treatment beams, extra dose is delivered to the patient during the acquisition of these portal images which may reach clinical relevance. The aim of this work was to develop a new acquisition mode for the PortalVision aS500 electronic portal imaging device from Varian Medical Systems that allows one to take portal images with reduced dose while keeping good image quality. The new acquisition mode, called RadMode, selectively enables and disables beam pulses during image acquisition allowing one to stop wasting valuable dose during the initial acquisition of "reset frames." Images of excellent quality can be taken with 1 MU only. This low dose per image facilitates daily setup verification with considerably reduced extra dose.

Electronics, Medical↗

Monte Carlo simulation of a dynamic MLC: implementation and applications.

PURPOSE: Study of behavior and influence of a multileaf collimator (MLC) on dose calculation, verification, and portal energy spectra in the case of intensity-modulated fields obtained with a step-and-shoot or a dynamic technique. METHODS: The 80-leaf MLC for the Varian Clinac 2300 C/D was implemented in a previously developed Monte Carlo (MC) based multiple source model (MSM) for a 6 MV photon beam. Using this model and the MC program GEANT, dose distributions, energy fluence maps and energy spectra at different portal planes were calculated for three different MLC applications. RESULTS: The comparison of MC-calculated dose distributions in the phantom and portal plane, with those measured with films showed an agreement within 3% and 1.5 mm for all cases studied. The deviations mainly occur in the extremes of the intensity modulation. The MC method allows to investigate, among other aspects, dose components, energy fluence maps, tongue-and-groove effects and energy spectra at portal planes. CONCLUSION: The MSM together with the implementation of the MLC is appropriate for a number of investigations in intensity-modulated radiation therapy (IMRT).

Computer Simulation↗

Comparative dose measurements by spiral tomography for preimplant diagnosis: the Scanora machine versus the Cranex Tome radiography unit.

Objective. The purpose of this study was to determine the dose profile of the Cranex Tome radiography unit and compare it with that of the Scanora machine. Study design. The radiation dose delivered by the Cranex Tome radiography unit during the cross-sectional mode was determined. Single tooth gaps in regions 3 (16) and 30 (46) were simulated. Dosimetry was carried out with 2 phantoms, a head and neck phantom and a full-body phantom loaded with 142 thermoluminescent dosimeters (TLD) and 280 TLD, respectively; all locations corresponded to radiosensitive organs or tissues. The recorded local mean organ doses were compared with those measured in another study evaluating the Scanora machine.Results. Generally, dose values from the Cranex Tome radiography unit reached only 50% to 60% of the values measured for the Scanora machine. The effective dose was calculated as 0.061 mSv and 0.04 mSv for tooth regions 3 (16) and 30 (46), respectively. Corresponding values for the Scanora machine were 0.117 mSv and 0.084 mSv.Conclusion. Cross-sectional imaging in the molar region of the upper and the lower jaw can be performed with the Cranex Tome unit, which delivers only approximately half of the dose that the Scanora machine delivers.

Anatomy, Cross-Sectional↗

Monte Carlo simulation of a dynamic MLC based on a multiple source model.

Detailed knowledge of the characteristics of the radiation field shaped by a multileaf collimator (MLC) is essential in intensity modulated radiotherapy (IMRT). A previously developed multiple source model (MSM) for a 6 MV beam was extended to a 15 MV beam and supplemented with an accurate model of an 80-leaf dynamic MLC. Using the supplemented MSM and the MC code GEANT, lateral dose distributions were calculated in a water phantom and a portal water phantom. A field which is normally used for the validation of the step and shoot technique and a field from a realistic IMRT treatment plan delivered with dynamic MLC are investigated. To assess possible spectral changes caused by the modulation of beam intensity by an MLC, the energy spectra in five portal planes were calculated for moving slits of different widths. The extension of the MSM to 15 MV was validated by analysing energy fluences, depth doses and dose profiles. In addition, the MC-calculated primary energy spectrum was verified with an energy spectrum which was reconstructed from transmission measurements. MC-calculated dose profiles using the MSM for the step and shoot case and for the dynamic MLC case are in very good agreement with the measured data from film dosimetry. The investigation of a 13 cm wide field shows an increase in mean photon energy of up to 16% for the 0.25 cm slit compared to the open beam for 6 MV and of up to 6% for 15 MV, respectively. In conclusion, the MSM supplemented with the dynamic MLC has proven to be a powerful tool for investigational and benchmarking purposes or even for dose calculations in IMRT.

Computer Simulation↗

A multiple source model for 6 MV photon beam dose calculations using Monte Carlo.

A multiple source model (MSM) for the 6 MV beam of a Varian Clinac 2300 C/D was developed by simulating radiation transport through the accelerator head for a set of square fields using the GEANT Monte Carlo (MC) code. The corresponding phase space (PS) data enabled the characterization of 12 sources representing the main components of the beam defining system. By parametrizing the source characteristics and by evaluating the dependence of the parameters on field size, it was possible to extend the validity of the model to arbitrary rectangular fields which include the central 3 x 3 cm2 field without additional precalculated PS data. Finally, a sampling procedure was developed in order to reproduce the PS data. To validate the MSM, the fluence, energy fluence and mean energy distributions determined from the original and the reproduced PS data were compared and showed very good agreement. In addition, the MC calculated primary energy spectrum was verified by an energy spectrum derived from transmission measurements. Comparisons of MC calculated depth dose curves and profiles, using original and PS data reproduced by the MSM, agree within 1% and 1 mm. Deviations from measured dose distributions are within 1.5% and 1 mm. However, the real beam leads to some larger deviations outside the geometrical beam area for large fields. Calculated output factors in 10 cm water depth agree within 1.5% with experimentally determined data. In conclusion, the MSM produces accurate PS data for MC photon dose calculations for the rectangular fields specified.

Algorithms↗

Effects of dose reduction on the detectability of standardized radiolucent lesions in digital panoramic radiography.

Dose reduction in digital panoramic radiography was studied. Intentional underexposure was performed with the Orthophos DS while six different human mandibles were radiographed. Exposure settings were 69 kV/15 mA (standard), 64 kV/16 mA, and 60 kV/16 mA. Standardized spherical defects, each either 1 or 1.25 mm in diameter, were simulated in 288 of 432 images, and seven observers decided whether defects were present or not. Areas under the receiver operating characteristics curves were calculated. They showed no significant differences in the detectability of the 1-mm defect at 69, 64, or 60 kV. For the 1.25-mm defect, no difference was found between the 69 and 60 kV images, but a statistically significant different detectability was found for 64 kV images in comparison with both 69 and 60 kV images. A dose reduction of up to 43% was ascertained with a Pedo-RT-Humanoid phantom when panoramic radiography was performed at 60 kV/16 mA. The conclusion is that with the Orthophos DS, it seems possible to reduce the dose rate of x-rays without loss of diagnostic quality in the case of radiolucent changes.

Fluorides↗

Hypothetical mortality risk associated with spiral tomography of the maxilla and mandible prior to endosseous implant treatment.

Radiation dose delivered from the SCANORA radiography unit during the cross-sectional mode for dentotangential projections was determined. With regard to oral implantology, patient situations of an edentulous maxilla and mandible as well as a single tooth gap in regions 16 and 46 were simulated. Radiation doses were measured between 0.2 and 22.5 mGy to organs and tissues in the head and neck region when the complete maxilla or mandible was examined. When examining a single tooth gap, only 8% to 40% of that radiation dose was generally observed. Based on these results, the mortality risk was estimated according to a calculation model recommended by the Committee on the Biological Effects of Ionizing Radiations. The mortality risk ranged from 31.4 x 10(-6) for 20-year-old men to 4.8 x 10(-6) for 65-year-old women when cross-sectional imaging of the complete maxilla was performed. The values decreased by 70% when a single tooth gap in the molar region of the maxilla was radiographed. The figures for the mortality risk for examinations of the complete mandible were similar to those for the complete maxilla, but the mortality risk decreased by 80% if only a single tooth gap in the molar region of the mandible was examined. Calculations according to the International Commission on Radiological Protection carried out for comparison did not reveal the decrease of the mortality risk with age and resulted in a higher risk value in comparison to the group of 35-year old individuals in calculations according to the Committee on the Biological Effects of Ionizing Radiations.

Adult↗

Anatomic variations of surgical importance in ethmoid labyrinth and sphenoid sinus. A study of radiological anatomy.

The present study was performed on axial and coronal CT scans of 100 patients, most of whom were affected by nasal polyposis. Five observers had to analyse the radiograms and answer a questionnaire including the following items: presence of a supraorbital recess; identification of anterior and posterior ethmoidal canals; dehiscences in the lamina papyracea; pneumatized middle turbinate; presence of a sphenomaxillary plate; presence of Haller's cells; presence of Onodi's cells; relationships of the optic canal; relationships of the internal carotid artery; relationships of the maxillary nerve; relationships of the vidian nerve; level difference between the ethmoid roof and nasal vault; depth of the sphenoethmoidal recess. The data obtained were compared with those drawn from anatomical studies. The fair agreement between them proves the value of CT as an alternative method for studying paranasal sinuses anatomy.

Ethmoid Bone↗

[Radiation protection in diagnostic radiology].

For every diagnostical X-ray radiation exposure the applied dose has to be limited to the smallest possible value. Within the scope of a general Swiss survey it has been found that in the various medical practices and hospitals the applied doses varied quite strongly. The main reasons leading to an overdose were the operating conditions of the X-ray and film processing equipment, the film and foil materials and improper filming techniques. The applied single dose served as a measure for the radiation protection assessment of diagnostical X-ray exposures. To prevent this in the future, individual patients who are exposed to unnecessary radiation loads should be regularly checked in quality-ensuring tests.

Humans↗

[Radiation burden of organs in fluoroscopic studies].

Various conventional and modern fluoroscope units had been examined with an anthropomorphic phantom to determine the applied average organ doses. The aim of our investigation was to compare these doses with those normally delivered to the patients during a conventional X-ray examination of the thorax. As was to be expected, the doses resulting from conventional fluoroscopic units are much higher than the doses from modern units. As shown by means of our measurements, the efforts of advanced technology permit to reduce the dose rate up to a factor of 30. I.e., the doses resulting from modern fluoroscopic units are even smaller than the doses received during a conventional thoracic X-ray examination, what means a great improvement for this examination technic.

Fluoroscopy↗

[Exposure of the Swiss population to radiation from diagnostic x-ray studies].

A new study is presently being conducted on the exposure of the Swiss population to radiation by diagnostic measures. This study is performed by the Department of Medical Radiation Physics of the University of Berne in collaboration with the Federal Health Bureau and the Swiss Institute for Health and Hospital Matters. In earlier studies the genetically significant exposure of the population and subsequently the median exposure of the red bone marrow had been investigated, whereas now the risk exposure to radiation of as far as possible practically all the risk-relevant organs will be studied. Prior to the initiation of the study, all results of earlier investigations during 1957, 1971 and 1978 were collected and analysed. It was found that the published results are hardly comparable, since the first study was based on individual X-ray examinations and the two subsequent studies on the localised X-ray examinations. To ensure that all data are now comparable, the results of the three studies were appropriately recalculated. Although certain assumptions had to be made that cannot be fully verified any more in view of the time that has elapsed, the collected results will provide a fairly reliable overview of the present-day state of knowledge in this particular field.

Adult↗

[How strongly does the radiation burden of diagnostic x-ray studies depend on the imaging technic?].

The radiation burden of an individual patient caused by a radiological examination depends strongly on the technical parameters, such as kV and mAs. As an inquiry among 150 swiss physicians showed, rather different irradiation techniques are used for the same examination. Depending on these irradiation techniques, the doses may vary by almost a factor of ten. These large variations in dose indicate that in some clinics or hospitals the radiographic techniques and the film processing are at fault. This fact has to be accounted for by future efforts of quality assurance in diagnostic radiology.

Humans↗

Hypothetical mortality risk associated with spiral computed tomography of the maxilla and mandible.

In the present study, dose measurements have been conducted following examination of the maxilla and mandible with spiral computed tomography (CT). The measurements were carried out with 2 phantoms, a head and neck phantom and a full body phantom. The analysis of applied thermoluminescent dosimeters yielded radiation doses for organs and tissues in the head and neck region between 0.6 and 16.7 mGy when 40 axial slices and 120 kV/165 mAs were used as exposure parameters. The effective dose was calculated as 0.58 and 0.48 mSv in the maxilla and mandible, respectively. Tested methods for dose reduction showed a significant decrease of radiation dose from 40 to 65%. Based on these results, the mortality risk was estimated according to calculation models recommended by the Committee on the Biological Effects of Ionizing Radiations and by the International Commission on Radiological Protection. Both models resulted in similar values. The mortality risk ranges from 46.2 x 10.6 for 20-year-old men to 11.2 x 10(-6) for 65-year-old women. Using 2 methods of dose reduction, the mortality risk decreased by approximately 50 to 60% to 19.1 x 10(-6) for 20-year-old men and 5.5 x 10(-6) for 65-year-old women. It can be concluded that a CT scan of the maxillofacial complex causes a considerable radiation dose when compared with conventional radiographic examinations. Therefore, a careful indication for this imaging technique and dose reduction methods should be considered in daily practice.

Adult↗

The radiographic assessment of implant patients: decision-making criteria.

Indications for the most frequently used imaging modalities in implant dentistry are proposed based on clinical need and biologic risk for the patient. To calculate the biologic risk, the authors carried out dose measurements. They demonstrated that the risk from a periapical radiograph is 20% of that from a panoramic radiograph. A panoramic radiograph and a series of 4 conventional tomographs of a single-tooth gap in the molar region carry 5% and 13% of the risk from computed tomography of the maxilla, respectively. Panoramic radiography is considered the standard radiographic examination for treatment planning of implant patients, because it imparts a low dose while giving the best radiographic survey. Periapical radiographs are used to elucidate details or to complete the findings obtained from the panoramic radiograph. Other radiographic methods, such as conventional film tomography or computed tomography, are applied only in special circumstances, film tomography being preferred for smaller regions of interest and computed tomography being justified for the complete maxilla or mandible when methods for dose reduction are followed. During follow-up, intraoral radiography is considered the standard radiographic examination, particularly for implants in the anterior region of the maxilla or for scientific studies. In patients requiring more than 5 periapical images, panoramic radiography is preferred.

Decision Making↗