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PubMedDate not supplied

Results of photon absorbed-dose measurements using the AAPM TG-21 protocol for accelerating potentials up to 26 MV.

The AAPM Task Group 21 protocol for the calibration of high-energy photon and electron beams was produced to accomplish essentially two goals: (1) incorporate the latest physical data available for calculating absorbed dose from ionization measurements and (2) to eliminate inconsistencies in absorbed dose measurements made with various ion chamber and phantom combinations. The ability of the protocol was assessed to consistently determine x-ray absorbed dose from measurements made with four Farmer-type chambers and one parallel-plate chamber in water, polystyrene, and acrylic phantoms. The measurements were performed using seven high-energy x-ray beams from 60Co to 26-MV nominal accelerating potential. The absorbed dose to water calculated from measurements made with the various chamber and phantom combinations were found to be consistent. The doses calculated for the two most common phantom materials, water and polystyrene, were found to be in excellent agreement. This resolved a 1.6% discrepancy in the absorbed dose determined from the two phantoms using the SCRAD protocol. The doses for acrylic phantoms were found to be approximately 1.2%, low for nominal accelerating potentials less than 8.8 MV. For accelerating potentials of 8.8 MV or greater the agreement was considerably better. The mean dose determined for the parallel-plate chamber from measurements in polystyrene was found to be within 0.7% of the mean dose determined using Farmer-type ion chambers in all phantom materials.

Humans↗

PubMedDate not supplied

Accelerator-based epithermal neutron beam design for neutron capture therapy.

Recent interest in the production of epithermal neutrons for use in boron neutron capture therapy (BNCT) has promoted an investigation into the feasibility of generating such neutrons with a high current proton accelerator. Energetic protons (2.5 MeV) on a 7Li target produce a spectrum of neutrons with maximum energy of roughly 800 keV. A number of combinations of D2O moderator, lead reflector, 6Li thermal neutron filtration, and D2O/6Li shielding will result in a useful epithermal flux of 1.6 x 10(8) n/s at the patient position. The neutron beam is capable of delivering 3000 RBE-cGy to a tumor at a depth of 7.5 cm in a total treatment time of 60-93 min (depending on RBE values used and based on a 24-cm diameter x 19-cm length D2O moderator). Treatment of deeper tumors with therapeutic advantage would also be possible. Maximum advantage depths (RBE weighted) of 8.2-9.2 (again depending on RBE values and precise moderator configuration) are obtained in a right-circular cylindrical phantom composed of brain-equivalent material with an advantage ratio of 4.7-6.3. A tandem cascade accelerator (TCA), designed and constructed at Science Research Laboratory (SRL) in Somerville MA, can provide the required proton beam parameters for BNCT of deep-seated tumors. An optimized configuration of materials required to shift the accelerator neutron spectrum down to therapeutically useful energies has been designed using Monte Carlo simulation in the Whitaker College Biomedical Imaging and Computation Laboratory at MIT. Actual construction of the moderator/reflector assembly is currently underway.

Boron↗

PubMedDate not supplied

Assessment of a linear accelerator for segmented conformal radiation therapy.

Segmented conformal radiation therapy is a new computer-controlled treatment technique under investigation in which the target volume is subdivided into thick transverse segments each of which is then treated individually by rectangular transverse abutting fields. In order to obtain uniform dose at abutments, the machine isocenter remains fixed in the patient and field edges are defined by independently moving focused collimator jaws to give matching geometric divergence. Mechanical variation in jaw and gantry positioning will create some dose variation at field abutments. Film dosimetry was used to study the radiation field positioning accuracy and precision of a commercial linear accelerator. A method of field position calibration was developed using multiple nonabutting fields exposed on the same radiograph. Verification of collimator jaw calibration measurements was performed using multiple abutting fields exposed on a single radiograph. Measurements taken over 5 months of clinical accelerator operation studied the effects of simple jaw motion, simple gantry motion, and combined jaw/gantry motion on jaw position precision and accuracy. The inherent precision and accuracy of radiation field positioning was found to be better than +/- 0.3 mm for both jaws with all types of motions except for the Y2 jaw under combined jaw/gantry motion. When the ability to deliver abutting beams was verified in clinical mode, the average dose variation at abutments was less than 6% at all gantry angles except for one. However, due to accelerator software limitations in clinical mode, the settings for collimator positions could not take advantage of the maximum accuracy of which the hardware is capable.(ABSTRACT TRUNCATED AT 250 WORDS)

Biophysical Phenomena↗

PubMed1994

An analytic calculation of the energy fluence spectrum of a linear accelerator.

Calculation of photon dose by convolution methods requires a knowledge of the fluence spectrum of photons produced by the linear accelerator treatment head. But this spectrum is very difficult to measure accurately, and is often derived by Monte Carlo calculations modeling the elements of the treatment head. In this paper an analytic calculation technique and the corresponding computer tool for calculating the photon energy fluence spectral distribution at any point in a bremsstrahlung field are presented. Primary bremsstrahlung photon distributions are computed by modeling electron dispersion in layers in a thick target and using the thin target bremsstrahlung cross section formulas of Schiff. The first Compton scatter from all materials in a linear accelerator treatment head is computed analytically. Higher-order Compton scatter events and pair production annihilation photons are ignored, but the attenuation of both primary and first scattered photon fluence is computed. Predictions of the computer implementation of the model are compared to measurements of bremsstrahlung production in a thick target and to Monte Carlo calculations of the energy fluence emerging from a linear accelerator. Finally, the computer tool is used to investigate the source of collimator-dependent fluence fluctuations in air. In agreement with other measurements, the principal contribution to fluence outside the geometric field is found to be from scatter in the flattening filter.

Biophysical Phenomena↗

PubMed1995

A novel comprehensive quality control instrument for medical accelerators.

A comprehensive quality control instrument for calibration of medical accelerators that use photon, electron, or proton beams in teleradiotherapy is described. It employs a fluorescence screen, mounted on a central stage with four degrees of freedom, monitored by a CCD camera. A single set-up of the instrument enables one to perform mechanical, light laser, and radiation tests, at arbitrary angles of the accelerator gantry. The new device provides for quantitative evaluation of the tests performed and provides for documentation of the test results in real time. The device provides significant time savings with concurrent improvement in accuracy for tests performed during installation and acceptance processes, and the implementation of quality control procedures for medical accelerators.

Electrons↗

PubMed1998

Startup performance of the traveling wave versus standing wave linear accelerator.

The startup performance of medical linear accelerators is of increasing importance for modern radiotherapy techniques. The traveling wave-type linear accelerator of the SL series of Philips (now Elekta Oncology Systems) has been modified in its flight tube design to meet this goal of a fast rise time of the radiation field. The new slitless flight tube combined with a redesigned gun servo electronic now achieves start up times of the radiation comparable with those of a standing wave linear accelerator (Siemens Mevatron) according to our measurements.

Equipment Design↗

PubMed1999

Correlated histogram representation of Monte Carlo derived medical accelerator photon-output phase space.

We present a method for condensing the photon energy and angular distributions obtained from Monte Carlo simulations of medical accelerators. This method represents the output as a series of correlated histograms and as such is well-suited for inclusion as the photon-source package for Monte Carlo codes used to determine the dose distributions in photon teletherapy. The method accounts for the isocenter-plane variations of the photon energy spectral distributions with increasing distance from the beam central axis for radiation produced in the bremsstrahlung target as well as for radiation scattered by the various treatment machine components within the accelerator head. Comparison of the isocenter energy fluence computed by this algorithm with that of the underlying full-physics Monte Carlo photon phase space indicates that energy fluence errors are less than 1% of the maximum energy fluence for a range of open-field sizes. Comparison of jaw-edge penumbrae shows that the angular distributions of the photons are accurately reproduced. The Monte Carlo sampling efficiency (the fraction of generated photons which clear the collimator jaws) of the algorithm is approximately 83% for an open 10x10 field, rising to approximately 96% for an open 40x40 field. Data file sizes for a typical medical accelerator, at a given energy, are approximately 150 kB, compared to the 1 GB size of the underlying full-physics phase space file.

Computer Simulation↗

PubMed1999

Comparative measurements on a series of accelerators by the same vendor.

A series of comparative measurements were conducted during a 12-month period on a series of linear accelerators made by the same vendor. These measurements were conducted during acceptance and commissioning of six Varian model 2100C linear accelerators which had identical beam energies and beam modifiers. Nominal accelerating potentials, scatter measurements, depth doses, beam profiles, wedge and electron beam descriptors are presented. The results show highly similar beam parameters with observed variations being approximately equivalent to the precision of measurement. This similarity implies that a standard data set can be used to validate new commissioning data.

Electrons↗

PubMed2001

Shielding assessment of a mobile electron accelerator for intraoperative radiotherapy.

A new approach to intraoperative radiotherapy makes use of a mobile electron linear accelerator delivering therapeutic radiation doses in an operating room suite. This unconventional technology has raised questions concerning protection for personnel and the necessity of shielding the adjoining areas. In this study, the leakage and scatter radiation from the mobile electron accelerator is measured and characterized in a series of spherical projections. An analysis is performed to determine the need for shielding or, alternatively, patient-based load restrictions in the operating room. This investigation provides a resource to assess shielding and/or patient load restrictions for any facility performing intraoperative radiotherapy with a similar unit. The data presented indicates that the mobile electron accelerator may be operated in an area with little or no shielding under nominal patient load expectations.

Electrons↗

PubMed1977

Fluid and electrolyte shifts in women during +Gz acceleration after 15 days' bed rest.

Twelve women (23-34 yr), comprising a bed-rest (BR) group of eight subjects and an ambulatory (AMB) group of four subjects, were centrifuged after 14 days of ambulatory control (C),after 15 days of a 17-day BR period, and on the third day of recovery (R). Venous blood was taken before and after the third +3.0 G acceleration run (1.8 G/min). Relative to (C), the +Gz tolerance after BR was reduced -49.0% (P less than 0.05) in the BR group and -38.7% (NS) in the AMB group; during (R) the BR group regained up to 89.4% and the AMB group up to 87.1% of their (C) tolerances. In each of the three test periods, the shifts in plasma Na, Cl, PO4, and osmotic contents, which accompanied +Gz, followed the outward shift of plasma volume (PV). The correlation of the shift of PV during acceleration with the +Gz tolerance was 0.72 (P less than 0.01). During acceleration, the PV and electrolyte loss for both groups after BR was about half the loss of (C) and (R). Compared with (C) and (R) values, potassium shifts were variable but the mean corpuscular volume and mean corpuscular Hb contents and concentrations were unchanged during all +Gz runs; The results indicate that: 1) the higher the (C) + Gz tolerance, the greater the tolerance decline due to BR; 2) relative confinement and reduced activity contribute as much to the reduction in tolerance as does the horizontal body position during BR; 3) bed-rest deconditioning has no effect on the erythrocyte volume during +3.0 Gz; and 4) about one-half the loss in tolerance after BR can be attributed to PV and electrolyte shifts.

Acceleration↗

PubMed1994

Response of human cerebral blood flow to +Gz accelerations.

Intolerance symptoms associated with high sustained +Gz (head to foot) accelerations are attributed to lack of cerebral perfusion. To determine the response of cerebral circulation to +Gz stress, cerebral blood flow (CBF) was measured in humans with the transcranial Doppler method while cephalic arterial blood pressure was calculated simultaneously using a photoplethysmographic technique. Nine volunteers performed four randomized centrifuge runs at +2 to +5 Gz with a 0.4-G/s onset rate for 30 s. Compared with the control values, for +2-, +3-, +4-, and +5-Gz profiles, CBF was reduced by 19 +/- 7, 26 +/- 8, 49 +/- 26, and 61 +/- 29% (SD), respectively, at the end of the onset and by 18 +/- 4, 21 +/- 11, 27 +/- 7, and 47 +/- 29%, respectively, in the last 20 s of the plateau of acceleration. At the end of the onset and during the plateau of +Gz acceleration, CBF was less reduced than cephalic arterial blood pressure, suggesting that some mechanisms would occur to maintain cerebral perfusion under +Gz stress. These protective mechanisms are likely due to a siphon effect and/or an autoregulatory compensation.

Acceleration↗

PubMed1994

Cortical blood flow and +Gz acceleration in conscious rabbits.

We examined whether superficial cortical blood flow (CBF) of nonanesthetized rabbits (n = 11) is affected by gravitational (G) stress. Blood flow was measured by laser-Doppler flowmetry through a chronic Plexiglas window implanted over the parietal cortex. Mean arterial blood pressure (MABP) was recorded via an aortic catheter with the pressure transducer situated at the level of the head. The electrocorticogram (ECoG) was also studied in seven rabbits. The animals were exposed to tail-to-head acceleration [6, 10, 15, and 20 G acceleration (Gz) for 1 min]. MABP fell with increasing acceleration (regression line equation: MABP = -7.0 Gz + 129.1; P < 0.001, r = 0.85), whereas CBF was statistically either not different from or greater than control. In one rabbit exposed to 20 Gz, high voltage and slow waves were observed on the ECoG and these changes were preceded by a decrease in CBF to 66% of control. We conclude that the stress and the siphon effect may account for the maintenance of elevated CBF despite low or negative MABP until the occurrence of vascular collapse that induces loss of consciousness.

Acceleration↗

PubMed1992

Velocity- and acceleration-sensitive units in the trunk lateral line of the trout.

1. The two main types of lateral line organs of lower vertebrates are the superficial neuromasts (SN), with a cupula that protrudes in the surrounding water, and the canal neuromasts (CN), located in the lateral line canal. The scales of the trunk lateral line canal of fish contain SNs as well as CNs. In this study, we examine whether there exist two functional classes of afferent fibers in the trunk lateral line nerve of the rainbow trout that can be attributed to the SNs and CNs. 2. The response properties of the afferent fibers in the trunk lateral line nerve have been determined during stimulation with sinusoidally varying water motion generated by a small vibrating sphere. Linear frequency response analysis revealed the presence of two distinct populations of afferent fibers in the lateral line nerve. The fibers belonging to the two populations showed significant differences in the frequency at which the sensitivity was maximal, the low-frequency response slope and the low-frequency asymptotic phase angle. 3. One population of fibers has a maximum sensitivity at 36 +/- 13 (SD) Hz (n = 22) and responds up to this frequency to water velocity. The low-frequency slope of the frequency response of these fibers was 20 +/- 3 (SD) dB/decade and the low-frequency phase lead was 121 +/- 11 degrees (mean +/- SD), both with respect to sphere displacement. The fibers of the other population have a maximum sensitivity at 93 +/- 14 (SD) Hz (n = 12) and respond up to this frequency to water acceleration. The low-frequency slope of these fibers was 35 +/- 5 (SD) dB/decade, and the low-frequency phase lead was 188 +/- 13 degrees (mean +/- SD). 4. Analysis of the stochastic properties of the spontaneous activity of both types of fibers revealed that the mean firing rate of the fibers responding to water velocity (26 +/- 12 spikes/s, mean +/- SD; n = 22) was significantly higher than that of the fibers responding to acceleration (36 +/- 11 spikes/s, mean +/- SD; n = 12). The other statistical properties of the spontaneous activity were found to be indistinguishable. 5. From comparison of the results with the available quantitative data on frequency responses of lateral line organs in other species, it has been concluded that the fibers responding (< or = 40 Hz) to water velocity innervate SNs and that the fibers responding (< or = 90 Hz) to water acceleration innervate CNs.(ABSTRACT TRUNCATED AT 400 WORDS)

Acceleration↗

PubMed2000

Serotonin-induced spike narrowing in a locomotor pattern generator permits increases in cycle frequency during accelerations.

During serotonin-induced swim acceleration in the pteropod mollusk Clione limacina, interneurons of the central pattern generator (CPG) exhibit significant action potential narrowing. Spike narrowing is apparently necessary for increases in cycle frequency during swim acceleration because, in the absence of narrowing, the combined duration of the spike and the inhibitory postsynaptic potential (IPSP) of a single cycle is greater than the available cycle duration. Spike narrowing could negatively influence synaptic efficacy in all interneuron connections, including reciprocal inhibitory connections between the two groups of antagonistic CPG interneurons as well as the interneuron-to-motoneuron connections. Thus compensatory mechanisms must exist to produce the overall excitatory behavioral change of swim acceleration. Such mechanisms include 1) a baseline depolarization of interneurons, which brings them closer to spike threshold, 2) enhancement of their postinhibitory rebound, and 3) direct modulation of swim motoneurons and muscles, all through inputs from serotonergic modulatory neurons.

Acceleration↗

PubMed2002

Independent control of acceleration and direction of the hand when hitting moving targets.

Human subjects were asked to hit moving targets as quickly as they could. Nevertheless the speed with which the subjects moved toward identical stimuli differed between trials. We examined whether the subjects compensated for a lower initial acceleration by aiming further ahead of the target. We found that the initial acceleration of the hand and its initial direction were hardly correlated. Thus subjects did not aim further ahead when they hit more slowly. This supports our earlier suggestion that the acceleration of the hand and the direction in which it moves are controlled separately.

Acceleration↗

PubMed2002

Imatinib induces durable hematologic and cytogenetic responses in patients with accelerated phase chronic myeloid leukemia: results of a phase 2 study.

Chronic myelogenous leukemia (CML) is caused by expression of the BCR-ABL tyrosine kinase oncogene, the product of the t(9;22) Philadelphia translocation. Patients with CML in accelerated phase have rapidly progressive disease and are characteristically unresponsive to existing therapies. Imatinib (formerly STI571) is a rationally developed, orally administered inhibitor of the Bcr-Abl kinase. A total of 235 CML patients were enrolled in this study, of whom 181 had a confirmed diagnosis of accelerated phase. Patients were treated with imatinib at 400 or 600 mg/d and were evaluated for hematologic and cytogenetic response, time to progression, survival, and toxicity. Imatinib induced hematologic response in 82% of patients and sustained hematologic responses lasting at least 4 weeks in 69% (complete in 34%). The rate of major cytogenetic response was 24% (complete in 17%). Estimated 12-month progression-free and overall survival rates were 59% and 74%, respectively. Nonhematologic toxicity was usually mild or moderate, and hematologic toxicity was manageable. In comparison to 400 mg, imatinib doses of 600 mg/d led to more cytogenetic responses (28% compared to 16%), longer duration of response (79% compared to 57% at 12 months), time to disease progression (67% compared to 44% at 12 months), and overall survival (78% compared to 65% at 12 months), with no clinically relevant increase in toxicity. Orally administered imatinib is an effective and well-tolerated treatment for patients with CML in accelerated phase. A daily dose of 600 mg is more effective than 400 mg, with similar toxicity.

Adult↗

PubMed2004

The effects of knee contact angle on impact forces and accelerations.

This article will summarize findings from several studies that together allow: 1) the examination of the effect that knee contact angle has on the severity of the resulting impact, 2) examination of the relationship between vertical ground reaction impact forces and leg impact accelerations, and 3) exploration of the adaptations that occur in response to running during changing environmental conditions. Changing the knee flexion angle at contact can alter the effective mass during activities in which the foot impacts the ground. It has been shown that increasing the knee flexion angle at ground contact can reduce the peak vertical ground reaction impact force, but it can also increase the peak impact acceleration at the leg. Attenuation can be calculated from accelerometers on the leg and the head and combined with the leg acceleration values to give a more accurate impression of the severity of the impact. Lower-extremity joint contact angles can be used to examine the kinematic adaptations that take place in response to changing environmental conditions. One common adaptation that can occur when the internal or external environment is not ideal is an increase in the knee flexion angle at contact. More extended knee contact angles can increase the forces experienced by the body and therefore increase injury potential. Increased knee flexion may give the runner a larger margin for dealing with kinematic errors but this benefit likely has an associated metabolic cost that will reduce performance.

Acceleration↗

PubMed1983

The cost of radiotherapy treatments on a linear accelerator.

The cost of delivering a radiotherapy treatment on a linear accelerator is calculated. Items included in the cost are: cost of the accelerator itself, a simulator, a treatment planning computer, the treatment room, and the salaries of the radiographers and physicists concerned, as well as machine operating costs and interest charges. The cost of a beam direction shell is also calculated. The different costs are reduced to statements of cost per year (see Table IV for summary), and from these the cost of a course of treatment for a patient is arrived at on the basis of 800 patients treated per year. The cost comes out at pounds 137, plus pounds 70 for a beam direction shell, if one is used. Because the capital costs of radiotherapy treatment equipment are very substantial, it is often assumed that radiotherapy is a very expensive form of treatment. An analysis of treatment cost is presented, initially in terms of cost per year for equipment, special buildings, and staff at 1981 prices. Reduction of these figures to mean treatment cost per patient is based on the DHSS guideline for provision of radiotherapy services (HC(78)32), which suggests a figure of 800 patients to be treated per year as the number justifying the provision of a linear accelerator.

Costs and Cost Analysis↗