SEARCH · PubMed Health

Results for “Particle Accelerators”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,711 records · Page 95Linked to original sources

PubMed1994

Input/output characteristics of a matrix ion-chamber electronic portal imaging device.

The input/output characteristics of a matrix liquid ion-chamber electronic portal imaging device (EPID) are investigated to elucidate the imaging properties of EPIDs. The radiation input to the detector, represented by dose rate, and the pixel value output from the device are related by a characteristic curve. Various incident radiation intensities are obtained by changing the source-to-detector distance (SDD). For each incident radiation intensity, an electronic portal image is obtained using a field size of 5 x 5 cm2. The output pixel value of the EPID is represented by the average pixel value of a region of interest of 9 x 9 pixels centered at a selected point. The effects of various accelerator settings, such as the repetition-rate setting and photon energy, gantry angle, field size, SDD, and acquisition mode of the EPID on characteristic curves are investigated at the central axis. The off-axis response of the detector is also examined. The derivative of the pixel value with respect to the input dose rate is used to analyze the detector contrast. Results indicate that the output pixel value is not a linear function of the incident radiation intensity. The detector contrast is comparable between photon energies of 10 and 6 MV and increases at low dose rates. The response of the imaging device varies substantially with acquisition mode, but is less sensitive to the SDD used for calibration. Characteristic curves are consistent for different gantry angles at the central axis and with the off-axis locations when the gantry angle is used for imaging and calibration, but vary with off-axis locations when the gantry angle is not at the calibration direction. Characteristic curves are also found to vary with different field sizes, but are similar in shape.

Humans↗

PubMed1998

The dynamics of folic acid metabolism in an adult given a small tracer dose of 14C-folic acid.

Folate is an essential nutrient that is involved in many metabolic pathways, including amino acid interconversions and nucleotide (DNA) synthesis. In genetically susceptible individuals and populations, dysfunction of folate metabolism is associated with severe illness. Despite the importance of folate, major gaps exist in our quantitative understanding of folate metabolism in humans. The gaps exist because folate metabolism is complex, a suitable animal model that mimics human folate metabolism has not been identified, and suitable experimental protocols for in vivo studies in humans are not developed. In general, previous studies of folate metabolism have used large doses of high specific activity tritium and 14C-labeled folates in clinical patients. While stable isotopes such as deuterium and 13C-labeled folate are viewed as ethical alternatives to radiolabeled folates for studying metabolism, the lack of sensitive mass spectrometry methods to quantify them has impeded advancement of the field using this approach. In this chapter, we describe a new approach that uses a major analytical breakthrough, Accelerator Mass Spectrometry (AMS). Because AMS can detect attomole concentrations of 14C, small radioactive dosages (nCi) can be safely administered to humans and traced over long periods of time. The needed dosages are sufficiently small that the total radiation exposure is only a fraction of the natural annual background radiation of Americans, and the generated laboratory waste may legally be classified non-radioactive in many cases. The availability of AMS has permitted the longest (202 d) and most detailed study to date of folate metabolism in a healthy adult human volunteer. Here we demonstrate the feasibility of our approach and illustrate its potential by determining empirical kinetic values of folate metabolism. Our data indicate that the mean sojourn time for folate is in the range of 93 to 120 d. It took > or = 350 d for the absorbed portion of small bolus dose of 14C-folic acid to be eliminated completely from the body.

Area Under Curve↗

PubMed2001

[3 years experience with low dosage fractionated percutaneous teletherapy in subfoveal neovascularization. Clinical results].

AIM: The effect of low dose fractionated percutaneous teletherapy to visual acuity and the changes in subfoveolar neovascular membranes in age-related macular degeneration were investigated. PATIENTS AND METHOD: 126 eyes of 118 patients (age 55-89 years; mean 74 ys.) were treated. Best distal and near visual acuity was assessed prior to (= initial visual acuity [IVA]) and 3, 6, 12, 18, 24, 30 and 36 months after teletherapy. Fluorescein angiography was performed prior to and 6, 12, 24 and 36 months after radiation therapy. For analysis patients were divided into different groups by IVA and membrane size. Maximal duration of observation was 36 months. Teletherapy was done by a 9-MeV photon linear accelerator through a lateral port in half-beam technique with a single dose of 2 Gy up to a total dose of 20 Gy within 12 days. RESULTS: No severe negative side effects have been observed. Eight patients reported of epiphora and four patients complained of transient sicca syndrome. Visual acuity decreased more than one line in the group IVA 0.05-0.2. The group IVA 0.3-0.5 remained unchanged for 1 year. We found a tendency for increased visual acuity in group IVA > or = 0.6 for 18 months. After that time both groups showed decreased visual acuity, but all these patients reported of reduced metamorphopsia and increased color and contrast perception. CONCLUSIONS: There is an influence of low dose fractionated percutaneous teletherapy on visual acuity, subfoveal neovascular membranes and metamorphopsia. IVA and duration of anamnesis play an important role. There seems to be no persistent effect; possibly increased dosage will bring a benefit.

Aged↗

PubMed2001

Cobalt 60 versus 15 MeV photons during total body irradiation: doses in the critical organs and complexicity of the procedure.

OBJECTIVES: The aim of this work was to compare the doses in critical organs, treatment duration, patient comfort and personnel workload during total body irradiation carried out alternatively with a Cobalt 60 and with 15 MeV photons at linear accelerator. PATIENTS AND METHODS: Twenty consecutive patients irradiated with a Cobalt unit and twenty irradiated with 15 MeV photons in a linear accelerator were used for comparison of the dose delivered. Each irradiation was repeated eight times during four consecutive days up to a total dose of 12.6 Gy in the whole body (below 10 Gy in the lungs). Lateral fields were used in six fractions, and anterior-posterior fields in two fractions. An electron boost to the thorax wall was added. Doses were calculated and measured in-vivo in ten transverse sections. RESULTS: For the patient taken as an example doses in the middle of the lungs were 10.7 Gy for Co-60 and 11.2 Gy for 15 MeV photons without compensators and 9.6 Gy, 9.6 Gy respectively when compensators were applied. Mean doses in the lungs in the group were 9.5 Gy for Co-60 and 9.7 Gy for X 15 MeV, respectively. Duration of the treatment was shorter with the use of the 15 MeV than that with Co-60 by about 20%. Repositioning of the patient during two fractions with the use of X 15 MeV could be eliminated and therefore the patient's comfort increased.

Cobalt Radioisotopes↗

PubMed2000

Estimation of the dose at the maze entrance for x-rays from radiotherapy linear accelerators.

Recent measurements have shown that the NCRP formula to estimate the x radiation dose at the maze entrance of high energy radiotherapy rooms underestimates the dose by an order of magnitude. In the present work the Monte Carlo Code MCNP was used to model a radiotherapy room and investigate the NCRP formula. The dose of the scattered photons was calculated for 6-MV and 10-MV x-rays for the following situations: primary beam in vacuum, primary beam with air in the room, collimated primary beam (by the jaws) with air in the room and primary beam collimated with air in the room, and phantom at 100-cm SSD. It was found that for 6-MV x-rays the dose, when these materials were present in the beam path, was 1.2, 1.6, 5.3, and 13.1 x 10(-22) Gy photon(-1), respectively. Therefore the presence of all these materials together increased the dose by a factor of 11. The dose due to leakage was calculated separately to be 9.1 x 10(-22) Gy photon(-1). This adds another factor of 8. The 10-MV results were similar to those at 6 MV. There was good agreement between MCNP calculations and the published measurements. The spectrum and average energy of scattered photons at different locations in the radiotherapy room and the maze were also calculated by MCNP.

Biophysical Phenomena↗

PubMed1984

Breakaway safety feature for an intra-oral cone system.

With an increasing number of high energy accelerators in operation, intra-oral electron radiotherapy is likely to become a more widely-used modality in the treatment of lesions of the oral cavity. However, there is one potential problem associated with this modality which concerns patient safety. There must never be any uncontrolled movement of the couch or gantry while the cone is in the patient's mouth, otherwise serious consequences could occur. In an effort to overcome this problem, a set of cones previously constructed by us for use in intra-oral electron radiotherapy has been modified to include a breakaway safety feature. This modification consists of separating the plate into which each of the treatment cones screws, into two pieces, the dividing line being in the shape of a cone frustum flaring out in the upward direction. A set of four spring plungers projecting into a notch on the inner ring prevents the cone from being pushed upwards without the application of an upward force. The amount of force required to push the cone upwards can be changed by adjusting the pressure of the spring plungers.

Brachytherapy↗

PubMed2003

A three-field breast treatment technique with precise geometric matching using multileaf collimator-equipped linear accelerators.

PURPOSE: Many authors have studied the problems associated with the three-field breast treatment, yet the proposed solutions present their own difficulties. This study presents a technique that overcomes these difficulties, reduces scatter to the contralateral breast, and improves setup reproducibility. METHODS AND MATERIALS: Patients are set up with both arms raised superiorly on a breast board. A precise field-match is achieved by rotating the couch and collimator of the tangents, while the supraclavicular field is half-beam blocked using an independent jaw. The posterior borders of the tangents are conformally defined by multileaf collimation. Measurements were performed to verify the field matching and evaluate scatter doses. RESULT: A smooth dose transition was found at the match line at all depths. Corner blocks and lower wedges were not used, which reduced the scatter to the contralateral breast compared with our prior technique. CONCLUSION: The technique achieves a precise match while removing constraints on the tangents' length and decreasing scatter dose. Procedures for simulation, planning, and treatment have been devised, along with a new patient setup routine incorporating orthogonal setup films and tattoos. This technique has been successfully implemented in routine treatment since September 2001. A program calculating the setup parameters is available at our website.

Breast Neoplasms↗

PubMed1998

New system for linear accelerator radiosurgery with a gantry-mounted video camera.

PURPOSE: We developed a positioning method that does not depend on the positioning mechanism originally annexed to the linac and investigated the positioning errors of the system. METHODS AND MATERIALS: A small video camera was placed at a location optically identical to the linac x-ray source. A target pointer comprising a convex lens and bull's eye was attached to the arc of the Leksell stereotactic system so that the lens would form a virtual image of the bull's eye (virtual target) at the position of the center of the arc. The linac gantry and target pointer were placed at the side and top to adjust the arc center to the isocenter by referring the virtual target. Coincidence of the target and the isocenter could be confirmed in any combination of the couch and gantry rotation. In order to evaluate the accuracy of the positioning, a tungsten ball was attached to the stereotactic frame as a simulated target, which was repeatedly localized and repositioned to estimate the magnitude of the error. The center of the circular field defined by the collimator was marked on the film. RESULTS: The differences between the marked centers of the circular field and the centers of the shadow of the simulated target were less than 0.3 mm.

Computer Terminals↗

PubMed2005

Tin foil as bolus material for therapeutic electron beams from the Varian Clinac 2100C/D.

Tin foils of sub-millimetre thickness have been investigated as bolus material for therapeutic electron beams from the Varian Clinac 2100C/D linear accelerator. Measurements with ionisation chamber and radiographic film in Plastic Water or water were performed under tin foil bolus to determine surface dose, therapeutic ranges, output factor correction, penumbra and dose outside the field edge. Appropriate thicknesses of tin foil for 90% dose at the surface were found to be approximately 0.3 mm for 6 MeV, and 0.4 mm for 9 MeV and 12 MeV. Enhanced therapeutic interval with tin foil bolus over water-equivalent bolus has previously been reported, but was found not to be evident for 12 MeV and for a small (4 x 4 cm2) 9 MeV field. The penumbra width of fields with tin foil and water-equivalent bolus were found to be within 2 mm, while the doses at 1 cm outside the field edge were within 1.5% of peak dose. Output factor corrections for fields with tin foil were measured as within 2% of unity. Air gaps between the tin foil and phantom surface up to 5 mm were observed to have minimal effect on output correction factor, relative surface dose, and therapeutic range.

Dose-Response Relationship, Radiation↗

PubMed1985

Determination of ionisation chamber collection efficiency in a swept electron beam by means of thermoluminescent detectors and the "two-voltage" method.

Two methods for determining the collection efficiency of a 0.6 cm3 thimble ionisation chamber exposed to the swept electron beam of a linear accelerator Therac 20 Saturne (CGR MeV) have been compared. In one method the chamber signal has been compared to that of simultaneously exposed thermoluminescent LiF dosemeters (TLD), in the other the "two-voltage" method of Boag, adapted for swept beams, has been used. By variation of the electron energy between 20 and 13 MeV, of the focus-skin-distance (FSD) between 200 and 100 cm and of the monitor rate between 400 monitor units (m.u.) and 100 m.u. per minute, different values could be produced for the peak charge density M. The collection efficiency of the chamber, operating at a standard voltage of 250 V, decreases from 0.99 to 0.84 for a charge density increasing from 0.3 X 10(-4) C/m3 to 7.5 X 10(-4) C/m3, respectively. The maximum deviation observed between the TLD and the "two-voltage" method adopted for similar M is never more than 2% and mostly smaller than 1%. It can be concluded that, under the present experimental conditions, the calculated ionisation chamber collection efficiency is confirmed by the experimental method using TL dosimetry.

Animals↗

PubMed1987

Modern lateral external beam (lens sparing) radiotherapy for retinoblastoma.

A standard 6 MV linear accelerator X-ray beam has been adapted to produce a non-divergent and almost penumbra-free beam edge by a beam splitting and extended collimation system. Using a contact lens to provide the reference point on the front surface of the eye and an attached rod-and-scale measuring system that is linked to the sharp beam edge system, it has proved possible to place this field border with an exactitude of within 0.5 mm at a required distance behind the front surface of the eye. This system has been developed for the treatment of small retinoblastomas not amenable to focal treatment methods; the technique may have other applications. Data in this manuscript corroborate an earlier Dutch publication and extend the observations on the physics beam profile obtainable, the immobilization of the patient, the anaesthetic procedure, the contact lens system and the dose prescription. Both scanning densitometry and TLC measurements in an anthropomorphic head shell (with extractable eye) confirm the extreme precision and sharp beam profile obtainable by this technique.

Eye Neoplasms↗

PubMed1996

A quality assurance program for ancillary high technology devices on a dual-energy accelerator.

Our facility has added high-technology ancillary devices to our dual-energy linear accelerator. After commissioning and acceptance testing of dual asymmetric jaws, dynamic wedge, portal imaging, and multileaf collimation (MLC), quality assurance programs were instituted. The programs were designed to be both periodic and patient specific when required. In addition, when dosimetric aspects were affected by these technologies, additional quality assurance checks were added. Positional accuracy checks (light and radiation) are done for both asymmetric jaws and MLC. Each patient MLC field is checked against the original simulation or digitally reconstructed radiographs. Off-axis factors and output checks are performed for asymmetric fields. Dynamic wedge transmission factors and profiles are checked periodically, and a patient diode check is performed for every new dynamic wedge portal. On-line imaging checks encompass safety checks along with periodic measurement of contrast and spatial resolution. The most important quality assurance activity is the annual review of proper operation and procedures for each device. Our programs have been successful in avoiding patient-related errors or device malfunctions. The programs are a team effort involving physicists, maintenance engineers, and therapists.

Engineering↗

PubMed2006

Neutron dose calculation at the maze entrance of medical linear accelerator rooms.

Currently, teletherapy machines of cobalt and caesium are being replaced by linear accelerators. The maximum photon energy in these machines can vary from 4 to 25 MeV, and one of the great advantages of these equipments is that they do not have a radioactive source incorporated. High-energy (E > 10 MV) medical linear accelerators offer several physical advantages over lower energy ones: the skin dose is lower, the beam is more penetrating, and the scattered dose to tissues outside the target volume is smaller. Nevertheless, the contamination of undesirable neutrons in the therapeutic beam, generated by the high-energy photons, has become an additional problem as long as patient protection and occupational doses are concerned. The treatment room walls are shielded to attenuate the primary and secondary X-ray fluence, and this shielding is generally adequate to attenuate the neutrons. However, these neutrons are scattered through the treatment room maze and may result in a radiological problem at the door entrance, a high occupancy area in a radiotherapy facility. In this article, we used MCNP Monte Carlo simulation to calculate neutron doses in the maze of radiotherapy rooms and we suggest an alternative method to the Kersey semi-empirical model of neutron dose calculation at the entrance of mazes. It was found that this new method fits better measured values found in literature, as well as our Monte Carlo simulated ones.

Body Burden↗

PubMed2006

Dose uncertainty due to aperture effects in dynamic fields.

Dosimetry of intensity modulated radiation therapy requires accurate modeling of the beamlets that comprise each treatment segment. Planning systems such as Varian Eclipse and Philips Pinnacle recommend measuring dose distributions and output factors for fields as small as possible, generally down to at least 2 x 2 cm2. Conventionally, we perform these measurements for regular fields, defined by the secondary collimators. In practice, it is the multileaf collimation system (MLC) that defines the intensity map and provides dynamic dose modulation in either a moving window or segmented step-and-shoot mode. For this review we have only considered the latter delivery mode. Using this method, we have studied aperture motion effects on the dynamic collimator scatter (S(c)), total scatter (S(c,p)), and phantom scatter (S(p)) factors for various combinations of collimator settings (4 x 4-14 x 40 cm2) and dynamically stepped leaf gaps (0.1 to 1.0 cm) in comparison with those for static field factors. For two different Varian linear accelerators, we found similar results in a systematic dependence of collimator scatter on gap width and collimator setting. As the gap increases from 0.1 to 1.0 cm the dynamic collimator scatter factors converge from a maximum difference of about 30% toward the static field values. At the same time, there is no measurable difference between dynamic field phantom scatter factors and those conventionally obtained for static fields. Second, we evaluated the two planning systems as to how well they account for collimator scatter by attempting to mimic the dynamic apertures used above by planning and measuring dose distributions to several small, cylindrical targets for a similar range of fixed collimator settings. We found that the ratio of measured-to-planned doses as a function of target size were similar to the measured, dynamic S(c) data for the Varian Eclipse planning system, indicating underestimation of dose for targets smaller than 1 cm diameter, but were close to unity for the Philips Pinnacle system, suggestive of the underlying differences in the dose calculation algorithms. We discuss the measurements and results and potential impact on the dosimetry of small clinical targets.

Air↗

PubMed1996

Flattening-filter-based empirical methods to parametrize the head scatter factor.

Parametrizing the collimator scatter factor, Sc (or head scatter factor), of a linear accelerator by the side of the equivalent square of the collimator setting at the isocenter does not accurately predict the change in Sc when the width and length of a rectangular field are exchanged. We have studied two methods based on measurements of square fields to predict Sc's of rectangular fields more accurately. The first method parametrizes Sc by the side of the equivalent square of the flattening filter region visible from the point of calculation. The Sc's of rectangular fields were predicted to an accuracy of 1% from measurements with square fields. The second method computes Sc of rectangular configurations by integrating radiation that can reach the point of calculation from a point source at the target and a second extended source at the flattering filter. The radial distribution of the extended source at the level of the flattering filter is computed from Sc of square fields measured at the isocenter. Effects of extended distance are modeled by separately performing inverse square law corrections for the two sources. This method also predicted the measured values to within 1% accuracy.

Biometry↗

PubMed1987

[Activation of solid materials in a medical linear electron accelerator].

Using the medical linear electron accelerator SL 75/20 supplied by Philips and employing a radiation time of 15 minutes with the 16 MeV high-energy photon stage, we measured the radioactivities induced by photons and neutrons, at the output elements (target, compensator body, wedge filter, diaphragms), at the positioning table of the patient and at a barium oxide concrete wall, via Ge(Li) spectrometry. The resulting local dose rates were determined. The radioactivity that is mainly caused by the nuclides W 187, Sb 120, Cu 64, Cu 62, Ni 57, Mn 56, Al 28, Mg 27 and Al 26 m results (with the exception of the target) in a local gamma-Dose rate of the order of 10 mu Sv/h, respectively. beta radiation, however, is expected to markedly increase these values. The total dose rate of 15 mSv/h in the target region, which retains this indeed rather high level even 7 minutes after radiation has been discontinued, makes it imperative to control the local dose rate and if necessary--depending on the irradiation conditions--to introduce waiting times of several hours if manipulations in this area have to be performed.

Electrons↗

PubMed1993

Entrance and exit dose regions for a Clinac-2100C.

PURPOSE: While significant advances have taken place in confirming dose in homogeneous media and accounting for changes due to distant heterogeneities, interface dosimetry is still a dose assessment problem. The entrance and exit surfaces of the patient are a prime example where dose assessment is questionable, but important, in many clinical situations. METHODS AND MATERIALS: Data were taken to examine the effect of such parameters as field size, source-to-skin distance, blocking tray, compensation materials (lead, aluminum and brass) and various patient support materials (Mylar, graphite, thermal plastic, and foam) on the surface doses from a dual energy (6 MV, 18 MV) linear accelerator. Measurements were conducted with a thin window parallel-plate chamber. RESULTS: Relative surface dose was found to have a proportional dependence on field size for both energies with surface doses ranging from 6% to 53%. A surface depth dose of 22.6% for a 15 cm field was measured for the low energy beam while a surface dose of 22.3% was observed for the 18 MV beam. The surface dose increased significantly for short source to skin distances and with the presence of a blocking tray. Compensating filter materials had little influence on surface dose. However, patient support devices such as Alpha Cradle and the graphite of the table can increase the surface dose to as much as 92%. CONCLUSION: We found there was a loss in dose at the exit surface (in comparison with percent depth dose tables, which assume infinite depth) on the order of 15% and 11% for the 6 MV and 18 MV beams, respectively. However, this loss is quickly compensated for with the introduction of most inherent backscattering media, [which in fact can increase the dose] for example, graphite in the patient support assembly tabletop.

Humans↗

PubMed2004

Clinical outcomes of stereotactic radiotherapy for stage I non-small cell lung cancer using a novel irradiation technique: patient self-controlled breath-hold and beam switching using a combination of linear accelerator and CT scanner.

We have developed a novel irradiation technique for lung cancer that combines a linear accelerator and CT scanner with patient-controlled breath-hold and radiation beam switching. We applied this technique to stereotactic three-dimensional (3D) conformal radiotherapy for stage I non-small cell lung cancer (NSCLC) and evaluated the primary therapeutic outcomes. A total of 35 patients with stage I (15 IA, 20 IB) primary NSCLC (20 adeno, 13 squamous cell, and 2 others) were treated with this technique. Patients ranged from 65 to 92 years old (median, 78 years). Twenty-three (66%) patients were medically inoperable due to mainly chronic pulmonary disease or high age. Three-dimensional treatment plans were made using 10 different non-coplanar dynamic arcs. The total dose of 60 Gy was delivered in 10 fractions (over 5-8 days) at the minimum dose point in the planning target volume (PTV) using a 6 MV X-ray. After adjusting the isocenter of the PTV to the planned position by a unit comprising CT and linear accelerator, irradiation was performed under patient-controlled breath-hold and radiation beam switching. All patients completed the treatment course without complaint. Complete response (CR) and partial response (PR) rates were 8/35 (23%) and 25/35 (71%), respectively. Pulmonary complications of National Cancer Institute-Common Toxicity Criteria grade >2 were noted in three (9%) patients. During follow-up (range, 6-30 months; median, 13 months), two (6%) patients developed local progression and five (14%) developed distant or regional lymph node metastases. Two-year overall survival rates for total patients and medically operable patients were 58 and 83%, respectively. In conclusion, this new irradiation technique, utilizing patient-controlled radiation beam switching under self-breath-hold after precise alignment of the isocenter, allows safe high-dose stereotactic radiotherapy with sufficient margins around the CTV and reduced treatment times. Based on the initial results, excellent local control with minimal complications is expected for stage I NSCLC.

Aged↗