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At least 343 records · Page 19Linked to original sources

Computer aided detection for low-dose CT colonography.

The paper describes a method for automatic detection of colonic polyps, robust enough to be directly applied to low-dose CT colonographic datasets. Polyps are modeled using gray level intensity profiles and extended Gaussian images. Spherical harmonic decompositions ensure an easy comparison between a polyp candidate and a set of polypoid models, found in a previously built database. The detection sensitivity and specificity values are evaluated at different dose levels. Starting from the original raw-data (acquired at 55mAs), 5 patient datasets (prone and supine scans) are reconstructed at different dose levels (down to 5mAs), using different kernel filters and slice increments. Although the image quality decreases when lowering the acquisition mAs, all polyps above 6mm are successfully detected even at 15 mAs. Accordingly the effective dose can be reduced from 4.93mSv to 1.61 mSv, without affecting detection capabilities, particularly important when thinking of population screening.

Algorithms↗

2D and 3D dose distribution determination in proton beam radiotherapy with GafChromic film detectors.

This paper presents the results obtained using radiochromic (MD-55 GafChromic) film for the 2D and 3D dosimetric reconstruction of the dose delivered by a proton beam under the real conditions of a programme of radiotherapy treatment for ocular tumours. Standard microdensitometric measurements were used to determine the variation in film optical density (O.D.) vs dose. Calibration curves were obtained by least-square fitting of the experimental OD values using a second order polynomial. This allows conversion of O.D. to dose. With this procedure it was possible to determine the distribution of the dose delivered by the proton beam in a phantom composed of layers of GafChromic film, with high surface spatial resolution and, through sections, the complete mapping of the dose delivered to a volume subjected to irradiation, as in a course of radiotherapy treatment.

Eye Neoplasms↗

A Monte Carlo multiple source model applied to radiosurgery narrow photon beams.

Monte Carlo (MC) methods are nowadays often used in the field of radiotherapy. Through successive steps, radiation fields are simulated, producing source Phase Space Data (PSD) that enable a dose calculation with good accuracy. Narrow photon beams used in radiosurgery can also be simulated by MC codes. However, the poor efficiency in simulating these narrow photon beams produces PSD whose quality prevents calculating dose with the required accuracy. To overcome this difficulty, a multiple source model was developed that enhances the quality of the reconstructed PSD, reducing also the time and storage capacities. This multiple source model was based on the full MC simulation, performed with the MC code MCNP4C, of the Siemens Mevatron KD2 (6 MV mode) linear accelerator head and additional collimators. The full simulation allowed the characterization of the particles coming from the accelerator head and from the additional collimators that shape the narrow photon beams used in radiosurgery treatments. Eight relevant photon virtual sources were identified from the full characterization analysis. Spatial and energy distributions were stored in histograms for the virtual sources representing the accelerator head components and the additional collimators. The photon directions were calculated for virtual sources representing the accelerator head components whereas, for the virtual sources representing the additional collimators, they were recorded into histograms. All these histograms were included in the MC code, DPM code and using a sampling procedure that reconstructed the PSDs, dose distributions were calculated in a water phantom divided in 20000 voxels of 1 x 1 x 5 mm3. The model accurately calculates dose distributions in the water phantom for all the additional collimators; for depth dose curves, associated errors at 2sigma were lower than 2.5% until a depth of 202.5 mm for all the additional collimators and for profiles at various depths, deviations between measured and calculated values were less than 2.5% or 1 mm.

Algorithms↗

3D reconstruction of the proximal femur with low-dose digital stereoradiography.

OBJECTIVE: Accurate three-dimensional (3D) geometry of the proximal femur may be helpful for fracture risk evaluation, as well as for planning and assisting surgical procedures. The purpose of this study was to apply and validate a stereoradiographic 3D reconstruction method on the proximal femur from radiographic contours identified on bi-planar radiographs. MATERIALS AND METHODS: Twenty-five excised non-pathologic proximal femurs were investigated using a low-dose digital radiographic device. Three-dimensional personalized models were reconstructed using the Non-Stereo Corresponding Contours (NSCC) algorithm. Three-dimensional CT-scan reconstructions were defined as geometric references for the comparison protocol, in order to assess the accuracy and reproducibility of the personalized 3D stereoradiographic reconstructions. In addition, the reliability of a set of 3D parameters obtained from stereoradiographic models was evaluated. RESULTS: This study demonstrated the validity of the NSCC method when applied to the proximal femur, with good results for accuracy (mean error = 0.7 mm) and reproducibility (Wilcoxon test: p > 0.28). Moreover, a precision study for the set of 3D parameters yielded a coefficient of variation lower than 5%. CONCLUSIONS: Once this approach has been validated in vivo, it should find multiple applications in therapeutic fields (e.g., for surgical planning, computer assisted surgery, etc.), as well as in diagnostic contexts (e.g., equilibrium studies or osteoporosis fracture risk assessment).

Aged↗

Mandibular reconstruction using a titanium plate: the impact of radiation therapy on plate preservation.

PURPOSE: To evaluate the soft tissue and bone tolerance of radiation therapy (RT) in patients undergoing radical composite resection and mandibular reconstruction using a bridging titanium plate with myocutaneous flap closure. METHODS AND MATERIALS: From 1990 to 1994, 47 patients with primary or recurrent oral cavity or oropharyngeal carcinomas were treated with radical composite resection and mandibular reconstruction using a bridging titanium plate with myocutaneous flap closure. Eleven patients received no RT (no RT), 10 patients received RT greater than 10 months from the time of surgery (remote RT), and 26 patients received RT within 12 weeks of surgery (perioperative RT). The radiation dose to the reconstructed mandible ranged from 45 to 75 Gy (median 63 Gy). The effect of the titanium plate on the radiation dose was measured using film dosimetry and soft tissue and bone-equivalent materials. The median follow-up was 17 months (range: 3-50 months). RESULTS: Late complications included four patients with osteomyelitis or necrosis, two plate exposures requiring flap revision, one chronic infection, two cases of chronic pain, two fistulae, and one case of trismus and malocclusion. The crude incidence of late complications by treatment was: (a) no RT: 3 of 11 patients (27%); (b) remote RT: 2 of 10 patients (20%); and (c) perioperative RT: 9 of 26 patients (35%). One patient in the no-RT group lost the plate due to chronic pain. Five patients in the perioperative RT group also had plate loss, four due to osteomyelitis and/or necrosis, and one due to pain related to a recurrent tumor. No patients in the remote RT group had plate loss. The actuarial prosthesis preservation rate at 2 years was 88% for the no RT, 100% for the remote RT, and 57% for the perioperative RT groups (p = 0.05). Phantom dose measurements showed that for parallel opposed 6 MV photon beams, there was no significant increase in the dose proximal or distal to the plate in either a soft tissue- or bone-equivalent phantom. CONCLUSIONS: The impact of radiation therapy on plate preservation after mandibular reconstructive surgery using a titanium plate may be dependent on the timing of RT relative to surgery. Significantly more mandibular reconstruction plates were lost when the involved mandible received RT in the perioperative period than when RT was delivered beyond 10 months from surgery or when no RT was given. The use of alloplastic implants such as titanium plates in conjunction with myocutaneous flap coverage for mandibular reconstruction is attractive because it allows immediate reconstruction of the defect and promotes a good functional and cosmetic result; however, administration of perioperative RT may result in a higher plate failure rate.

Adolescent↗

The development of distant pulmonary infiltrates following thoracic irradiation: the role of computed tomography with dosimetric reconstruction in diagnosis.

High doses of external beam radiotherapy are required to obtain local control of many intrathoracic neoplasms. Because spinal cord tolerance limits the radiation dose that can be given through anterior and posterior fields, it is often necessary to increase the dose to the primary tumor site using oblique or lateral fields. When pulmonary infiltrates develop following treatment in these patients, it is frequently difficult to distinguish between infection, recurrent tumor, and radiation pneumonitis. In nine patients in whom acute pulmonary infiltrates occurred following a course of thoracic irradiation, computed tomography (CT) with computed dosimetric reconstruction (CDR) were studied in an attempt to correlate the treatment volumes with the location and configuration of the infiltrates and in this way establish the source for the pulmonary abnormalities. In seven of these patients, the diagnosis was changed, and the resulting post-irradiation clinical therapy was altered as a consequence of this retrospective study.

Adult↗

Spatial accuracy of 3D reconstructed radioluminographs of serial tissue sections and resultant absorbed dose estimates.

Many agents using tumour-associated characteristics are deposited heterogeneously within tumour tissue. Consequently, tumour heterogeneity should be addressed when obtaining information on tumour biology or relating absorbed radiation dose to biological effect. We present a technique that enables radioluminographs of serial tumour sections to be reconstructed using automated computerized techniques, resulting in a three-dimensional map of the dose-rate distribution of a radiolabelled antibody. The purpose of this study is to assess the reconstruction accuracy. Furthermore, we estimate the potential error resulting from registration misalignment, for a range of beta-emitting radionuclides. We compare the actual dose-rate distribution with that obtained from the same activity distribution but with manually defined translational and rotational shifts. As expected, the error produced with the short-range 14C is much larger than that for the longer range 90Y; similarly values for the medium range 131I are between the two. Thus, the impact of registration inaccuracies is greater for short-range sources.

Adenocarcinoma↗

Development of an improved dosimetry system for the workers at the Mayak Production Association.

Databases are being created that contain verified and updated dosimetry and worker history information for workers at the Mayak Production Association. Many workers had significant external and internal exposures, particularly during the early years (1948-1952) of operation. These dosimetric and worker history data are to be used in companion epidemiology studies of stochastic and deterministic effects. The database contains both external and internal dose information and is being constructed from other databases that include radiochemical analyses of tissues, bioassay data, air sampling data, whole body counting data, and occupational and worker histories. The procedures, models, methods, and operational uncertainties will be documented and included in the database, technical reports, and publications. The cohort of the stochastic epidemiological study is expected to include about 19,000 persons while the cohort for the deterministic epidemiological study is expected to include about 600 persons. For external dosimetry, workplace gamma, beta, and neutron doses are being reconstructed. The models used for this incorporate issues such as known isotopes, composition, shielding, further analysis of film badge sensitivities, and records of direct measurements. Organ doses from external exposures are also being calculated. Methods for calculating dose uncertainties are being developed. For internal dosimetry, the organ doses have been calculated using the established FIB-1 biokinetic model. A new biokinetic model is being developed that includes more information of the solubility and biokinetics of the different chemical forms and particulate sizes of plutonium that were in the workplace. In addition, updated worker histories will be used to estimate doses to some workers where direct measurements were not made. A rigorous quality control procedure is being implemented to ensure that the correct dosimetry data is entering the various databases being used by the epidemiologists.

Beta Particles↗

A 1993 report on reconstruction of environmental exposures and uncertainties in support of epidemiological studies related to low-dose radiation.

Studies have been progressing for about eight years on the reconstruction of historical doses from past releases of radioactive materials to the environment. This work has been performed at the University of Utah and the Pacific Northwest National Laboratory in Richland, WA. This review provides an update on advances in the area of environmental dosimetry and illustrations of how techniques are being applied in epidemiological studies related to low-dose radiation. Two points will be emphasized. The first is the message of how much progress there has been in environmental dosimetry over the past decade and how this dosimetry, when combined with epidemiology, can result in powerful tools to yield a better understanding of risk from exposure. The second point to be emphasized is that our work focuses on dosimetry only, although it is important for different disciplines to work together to determine outcomes.

Bone Marrow↗

The EQUAL-ESTRO audit on geometric reconstruction techniques in brachytherapy.

BACKGROUND AND PURPOSE: A geometric check procedure of the reconstruction techniques used in brachytherapy treatment planning systems was developed by the EQUAL (European Quality Laboratory) Laboratory in the framework of the ESTRO's (European Society for Therapeutic Radiology and Oncology) project 'ESQUIRE' (Education Science and QUality assurance In Radiotherapy in Europe [Baumann M, Brada M. Towards equity in turbulent Europe ESTRO, European cooperation and the European Commission. Radiother Oncol 2005;75:251-2. Heeren G. The bright but ephemeral life of a rainbow. A chronical of seventeen years of intensive ESTRO-EU cooperation. Radiother Oncol 2005;75:253-7]) by the task group Braphyqs (Brachytherapy physics quality system). PATIENTS AND METHODS: The check is performed by using the so-called 'Baltas' phantom, mailed to the participating centres in order to check the local technique of geometric reconstruction used in dose calculation. RESULTS: To validate the procedures, the check was first tested among the members of the Braphyqs Network. Since November 2002, the system is open to other centres. Until now 152 reconstructions have been checked. Eighty-six percent of the results were within an acceptance level after the first check. For the remaining 14%, a second check has been proposed. The results of the re-checks are in most cases within an acceptance level, except for 2% of the reconstructions. CONCLUSIONS: The geometric check is available from the EQUAL Laboratory for all the brachytherapy centres. The decrease of the deviations observed between the two checks demonstrates the importance of this kind of external audit as some errors were revealed, which were not discovered before with techniques used in clinical quality control routines.

Brachytherapy↗

Advanced single-slice rebinning in cone-beam spiral CT.

To achieve higher volume coverage at improved z-resolution in computed tomography (CT), systems with a large number of detector rows are demanded. However, handling an increased number of detector rows, as compared to today's four-slice scanners, requires to accounting for the cone geometry of the beams. Many so-called cone-beam reconstruction algorithms have been proposed during the last decade. None met all the requirements of the medical spiral cone-beam CT in regard to the need for high image quality, low patient dose and low reconstruction times. We therefore propose an approximate cone-beam algorithm which uses virtual reconstruction planes tilted to optimally fit 180 degrees spiral segments, i.e., the advanced single-slice rebinning (ASSR) algorithm. Our algorithm is a modification of the single-slice rebinning algorithm proposed by Noo et al. [Phys. Med. Biol. 44, 561-570 (1999)] since we use tilted reconstruction slices instead of transaxial slices to approximate the spiral path. Theoretical considerations as well as the reconstruction of simulated phantom data in comparison to the gold standard 180 degrees LI (single-slice spiral CT) were carried out. Image artifacts, z-resolution as well as noise levels were evaluated for all simulated scanners. Even for a high number of detector rows the artifact level in the reconstructed images remains comparable to that of 180 degrees LI. Multiplanar reformations of the Defrise phantom show none of the typical cone-beam artifacts usually appearing when going to larger cone angles. Image noise as well as the shape of the respective slice sensitivity profiles are equivalent to the single-slice spiral reconstruction, z-resolution is slightly decreased. The ASSR has the potential to become a practical tool for medical spiral cone-beam CT. Its computational complexity lies in the order of standard single-slice CT and it allows to use available 2D backprojection hardware.

Algorithms↗

Prediction of human observer performance by numerical observers: an experimental study.

Numerical observers are investigated for predicting the outcome of a free-response human observer study involving the detection of simulated pulmonary nodules in images reconstructed from low-dose computed tomography projection data by use of several reconstruction algorithms. A new way of calculating the figure of merit of a numerical observer is proposed wherein the detectability of signals in a particular image depends on the noise properties associated with that image and not the other images in the data set. The resulting variants of numerical observers are found to perform better than their traditional counterparts. In particular, the imagewise variant of the region-of-interest observer is found to predict best the rank ordering of algorithms by human observers for the free-response task.

Algorithms↗

An approach to 3D dose mapping using Gafchromic film.

The tissue equivalent composition of the Gafchromic films makes them particularly suitable for the mapping of 2D and 3D treatment fields. This paper presents the results obtained using MD-55 film for the verification of real radiotherapy treatments through proton beam irradiation of suitable phantoms at the Clatterbridge Centre for Oncology (CCO) in Bebington (UK). After exposure, the variation in optical density of the films was measured using a CCD100 Microdensitometer (source at 665 nm). Holes of calibrated diameter, made during the assembly phase of the phantom, are identified by the MIRA software, used for data analysis, and allow the rendering of the films. The surface dose distributions were obtained from the variation in optical density of each of the films making up the phantom. Their elaboration to duplicate their position within the phantom, performed by 3D-doctor software, allows the volumetric reconstruction of the dose distribution.

Algorithms↗

Attempted reconstruction of the immune system using low doses of interleukin 2 in chronic lymphocytic leukemia patients treated with 2-chlorodeoxyadenosine: results of a pilot study.

This study was designed to investigate the immunostimulatory effect of low dose Il-2 treatment in B-CLL patients previously treated with 2-chlorodeoxyadenosine (2CdA) in whom severe depletion of T lymphocyte subsets was observed. Four patients enrolled into the study had previously been treated with 3-6 courses of 2CdA. All patients suffered from recurrent infections and showed CD4+ and CD8+ immunosuppression. Recombinant Il-2 was given subcutaneously at a dose of 100 micrograms (1.8 x 10(6)IU) daily for 6 weeks. The drug was administered between 2CdA courses. These preliminary studies showed a marked increase in T cell subsets after Il-2 treatment. All patients displayed an increase of NK cells and there was increased expression of Il-2 receptors (CD 25 and CD 122) on lymphocytes. It is possible that the combination of cytotoxic therapy with 2CdA and low dose rIl-2 could stimulate the T-cell immune system and may be a promising regimen in patients with B-CLL with severe depletion in T-cell subsets.

Antineoplastic Agents↗

Risk-based approach to appraise valve closure in the clam Corbicula fluminea in response to waterborne metals.

We developed a risk-based approach to assess how the valve closure behavior of Asiatic clam Corbicula fluminea responds to waterborne copper (Cu) and cadmium (Cd). We reanalyzed the valve closure response data from published literature to reconstruct the response time-dependent dose-response profiles based on an empirical three-parameter Hill equation model. We integrated probabilistic exposure profiles of measured environmental Cu and Cd concentrations in the western coastal areas of Taiwan with the reconstructed dose-response relationships at different integration times of response to quantitatively estimate the valve response risk. The risk assessment results implicate exposure to waterborne Cu and Cd may pose no significant risk to clam valve activity in the short-time response periods (e.g., <30 min), yet a relative high risk for valve closure response to waterborne Cu at response times greater than 120 min is alarming. We successfully linked reconstructed dose-response profiles and EC50-time relationships associated with the fitted daily valve opening/closing rhythm characterized by a three-parameter lognormal function to predict the time-varying bivalve closure rhythm response to waterborne metals. We parameterized the proposed predictive model that should encourage a risk-management framework for discussion of future design of biological monitoring systems.

Animals↗

Dose and volume effects on fibrosis after breast conservation therapy.

PURPOSE: To analyze factors involved in the development of fibrosis in the boost area after breast conservation therapy (BCT) in patients treated with continuous low dose rate iridium implants following 50 Gy whole breast irradiation. METHODS AND MATERIALS: Fibrosis was estimated by palpation in 404 patients by four physicians. The median follow-up (FUP) duration was 70 months (range 30-133 months). Original implant data were used for reconstruction and dose-volume calculations. The total dose of the external whole breast irradiation and iridium implants was expressed in Normalized Total Dose (NTD): the total dose given in fractions of 2 Gy, which is biologically equivalent to the actual dose given according to the linear-quadratic model, using an alpha/beta value of 2 Gy, and 1.5 h for the recovery half-life of sublethal damage repair. To identify predictors of fibrosis we used a proportional odds model in a polychotomous logistic regression analysis. RESULTS: Seven independent factors were identified that were related to the severity of fibrosis: age, duration of FUP, clinical T-size, photon beam energy, NTD level, implant volume, and adjuvant chemotherapy. From the proportional odds model, a volume exponent could be estimated (0.16 +/- 0.04) that enabled us to determine dose-effect relations for different volumes. A 10-fold higher risk of fibrosis was seen when the total dose was above 79 Gy as compared with doses lower than 70 Gy. A fourfold increase in risk of fibrosis was seen for each 100 cm3 increase in irradiated boost volume. The use of adjuvant chemotherapy resulted in a twofold increase in the risk of fibrosis (dose modifying factor approximately 1.08). The application of Co-60 beams had a similar effect. The relative odds for the other factors were smaller (1.4 for each 10 years of older age, and 1.2 for clinical T-size over 20 mm). The FUP-period had a nonlinear effect: relative odds 2.2 at 6 years, 3.6 at 7-8 years, and 2.8 at 9-11 years. The dose rate (mean 0.57, range 0.26-0.89 Gy/h) had no influence on the development of fibrosis and there was no correlation between dose rate and irradiated volume. CONCLUSIONS: To optimize cosmetic results after BCT, both the total dose and the irradiated volume should be kept as low as possible. Minimum effective dose levels still have to be established. The boost volume can be minimized by more conformal brachytherapy techniques and optimal localization. It may be worthwhile to take adjuvant chemotherapy into account in decisions on boost dose levels.

Adult↗