Yes / Within medical imaging variations in patient size can generate challenges, especially when selecting appropriate acquisition parameters. This experiment sought to evaluate the impact of increasing body part thickness on image quality (IQ) and effective dose (E) and identify optimum exposure parameters. Methods: An anthropomorphic pelvis phantom was imaged with additional layers (1e15 cm) of animal fat as a proxy for increasing body thickness. Acquisitions used the automatic exposure control (AEC), 100 cm source to image distance (SID) and a range of tube potentials (70e110 kVp). IQ was evaluated physically and perceptually. E was estimated using PCXMC software. Results: For all tube potentials, signal to noise ratio (SNR) and contrast to noise ratio (CNR) deceased as body part thickness increased. 70 kVp produced the highest SNR (46.6e22.6); CNR (42.8e17.6). Visual grading showed that the highest IQ scores were achieved using 70 and 75 kVp. As thickness increases, E increased exponentially (r ¼ 0.96; p < 0.001). Correlations were found between visual and physical IQ (SNR r ¼ 0.97, p < 0.001; CNR r ¼ 0.98, p < 0.001). Conclusion: To achieve an optimal IQ across the range of thicknesses, lower kVp settings were most effective. This is at variance with professional practice as there is a tendency for radiographers to increase kVp as thickness increases. Dose reductions were experienced at higher kVp settings and are a valid method for optimisation when imaging larger patients. / Hashemite University in Jordan, College of Radiographers Industry Partnership (CoRIPS)

Yes / An automated closed-loop dose control system balances the radiation dose delivered to patients and the quality of images produced in cardiac x-ray imaging systems. Using computer simulations, this study compared two designs of automatic x-ray dose control in terms of the radiation dose and quality of images produced. The first design, commonly in x-ray systems today, maintained a constant dose rate at the image receptor. The second design maintained a constant image quality in the output images. A computer model represented patients as a polymethylmetacrylate phantom (which has similar x-ray attenuation to soft tissue), containing a detail representative of an artery filled with contrast medium. The model predicted the entrance surface dose to the phantom and contrast to noise ratio of the detail as an index of image quality. Results showed that for the constant dose control system, phantom dose increased substantially with phantom size (x5 increase between 20 cm and 30 cm thick phantom), yet the image quality decreased by 43% for the same thicknesses. For the constant quality control, phantom dose increased at a greater rate with phantom thickness (>x10 increase between 20 cm and 30 cm phantom). Image quality based dose control could tailor the x-ray output to just achieve the quality required, which would reduce dose to patients where the current dose control produces images of too high quality. However, maintaining higher levels of image quality for large patients would result in a significant dose increase over current practice. / This work has been performed in the project PANORAMA, funded by grants from Belgium, Italy, France, the Netherlands, and the United Kingdom, and the ENIAC Joint Undertaking.

No / The aim of this research was to explore x-ray beam parameters with intent to optimize pediatric x-ray settings in the cardiac catheterization laboratory. This study examined the effects of peak x-ray tube voltage kVp and of copper Cu x-ray beam filtration independently on the image quality to dose balance for pediatric patient sizes. The impact of antiscatter grid removal on the image quality to dose balance was also investigated. Methods: Image sequences of polymethyl methacrylate phantoms approximating chest sizes typical of pediatric patients were captured using a modern flat-panel receptor based x-ray imaging system. Tin was used to simulate iodine-based contrast medium used in clinical procedures. Measurements of tin detail contrast and flat field image noise provided the contrast to noise ratio. Entrance surface dose ESD and effective dose E measurements were obtained to calculate the figure of merit FOM , CNR2 / dose, which evaluated the dose efficiency of the x-ray parameters investigated. The kVp, tube current mA , and pulse duration were set manually by overriding the system’s automatic dose control mechanisms. Images were captured with 0, 0.1, 0.25, 0.4, and 0.9 mm added Cu filtration, for 50, 55, 60, 65, and 70 kVp with the antiscatter grid in place, and then with it removed. Results: For a given phantom thickness, as the Cu filter thickness was increased, lower kVp was favored. Examining kVp alone, lower values were generally favored, more so for thinner phantoms. Considering ESD, the 8.5 cm phantom had the highest FOM at 50 kVp using 0.4 mm of Cu filtration. The 12 cm phantom had the highest FOM at 55 kVp using 0.9 mm Cu, and the 16 cm phantom had highest FOM at 55 kVp using 0.4 mm Cu. With regard to E, the 8.5 and 12 cm phantoms had the highest FOM at 50 kVp using 0.4 mm of Cu filtration, and the 16 cm phantom had the highest FOM at 50 kVp using 0.25 mm Cu. Antiscatter grid removal improved the FOM for a given set of x-ray conditions. Under aforesaid optimal settings, the 8.5 cm phantom FOM improved by 24% and 33% for ESD and E, respectively. Corresponding improvements were 26% and 24% for the 12 cm phantom and 6% and 15% for the 16 cm phantom. Conclusions: For pediatric patients, using 0.25–0.9 mm Cu filtration in the x-ray beam while maintaining 50–55 kVp, depending on patient size, provided optimal x-ray image quality to dose ratios. These settings, adjusted for x-ray tube loading limits and clinically acceptable image quality, should provide a useful strategy for optimizing iodine contrast agent based cardiac x-ray imaging. Removing the antiscatter grid improved the FOM for the 8.5 and 12 cm phantoms, therefore grid removal is recommended for younger children. Improvement for the 16 cm phantom declined into the estimated margin of error for the FOM; the need for grid removal for older children would depend on practical feasibility in the clinical environment. / Philips Healthcare

Published Article / Worldwide, uterine cervical cancer is one of the most frequently occurring cancers in women, with more than 80% of these cases occurring in developing countries. The South African screening policy and screening program, implemented in 2001, attempt to reduce this incidence of cervical cancer in South Africa. It is essential to treat these women with the best modalities available. This retrospective study focused specifically on the curative potential of radiotherapy administered to patients at the Oncology Department, Bloemfontein, since a new modality of high dose-rate intracavitary brachytherapy was implemented in 1994. Late radiation complications were also investigated.

No description available.

Orientador: Tereza Cristina Cardoso Silva / Coorientador: Alicio Martins Junior / Banca: Guilherme de Paula Nogueira / Banca: Claudia Maria Bertan Membrive / Resumo: O objetivo do presente trabalho foi verificar os efeitos da administração de meia dose de GnRH na submucosa da vulva sobre os níveis de LH, progesterona, dinâmica folicular ovariana e taxa de concepção em rebanho leiteiro, utilizando o protocolo ―Ovsynch‖, modificado. As vacas (n = 13) e novilhas (n = 11) foram pré-sincronizadas com duas injeções de PGF2α, com intervalo de 14 dias e 12 dias. Após a última prostaglandina, foi iniciado o protocolo ―Ovsynch‖, modificado pela inclusão de duas injeções de PGF2α. No momento da aplicação da segunda dose de GnRH (GnRH-2) os animais foram distribuídos de maneira homogênea para os grupos: controle (CN; n = 8), animais recebendo 2,5 mL de cloreto de sódio 0,9% por via im, intramuscular (IM; n = 8), injetado 10,5 µg de GnRH por via intramuscular e submucosa da vulva (SV; n = 8), recebendo 5,25 µg de GnRH. As amostras de sangue foram colhidas no D0, D7, D9 e D17 para determinação da concentração sérica de progesterona, e para o LH, foram colhidas em cinco momentos no D9 (M-40, M0, M40, M80 e M120 min). Quanto ao LH, não houve diferença significativa entre os grupos IM e SV em todos os momentos, os quais foram significativamente maiores do que o CN, enquanto no SV, maiores valores de média foram obtidos para a área sob a curva de LH (ASC-LH) em comparação com os grupos IM e CN. Não houve diferença significativa entre os grupos quanto à concentração de progesterona, independente do dia avaliado. Todos os grupos apresentaram o mesmo número d... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The aim of this study was to verify the effects of low dose of GnRH administered in the vulva submucosa on LH and progesterone levels, ovarian dynamics and conception rate in dairy cattle using a modified Ovsynch protocol. Cows (n = 13) and heifers (n = 11) were pre-synchronized with two injections of PGF2α administered with a 14-days interval. Twelve days after the last prostaglandin dose a modified Ovsynch protocol was initiated and at the time of the second dose of GnRH (GnRH-2) the animals were homogeneously distributed to groups: control (CN; n = 8), receiving 2.5 mL of 0.9% sodium chloride, im, intramuscular (IM; n = 8,) receiving 10.5 μg of GnRH intramuscular; and vulva submucosa (VS; n = 8) with administration of 5.25 μg of GnRH. Blood samples were collected to determine serum progesterone concentration on D0, D7, D9 and D17, and the level of LH at five moments on D9 (M-40, M0, M40, M80 and M120 min). Higher levels of LH were observed in IM and VS groups in comparison with CN, however no significant difference was found between IM and VS for any time of evaluation. The higher mean value for the area under LH curve (AUC-LH) was found in VS than for IM and CN. There was no difference among groups for progesterone levels measured on in the different days of the protocol. The number of ovulated animals was similar among groups, but the time elapsed to ovulation was lower in IM and VS than in control group. The conception rate was higher in IM group, followed by CN and the... (Complete abstract click electronic access below) / Mestre

Na elaboração do planejamento do tratamento de câncer com radiações ionizantes, o médico radioterapêuta, através dos protocolos clínicos, determina a dose de radiação diária para cada tipo específico de tumor e, junto com o físico, durante os procedimentos de simulação dos campos de tratamento, fazem a localização das áreas a serem tratadas. Em alguns casos, os campos de radiação apresentam dimensões extensas visando englobar todo o volume alvo, o que pode exigir a proteção de regiões anatômicas e órgãos vitais localizados no interior da área irradiada ou mesmo circunvizinhas ao volume alvo, a fim de se garantir o limite de dose absorvida tolerável por estes órgãos. Em geral, estes órgãos críticos localizam-se fora do eixo central do feixe de radiação, até mesmo próximo da periferia do campo, justificando a importância da determinação da dose de radiação em pontos situados fora do feixe central e do isocentro de tratamento, buscando dimensionar as colimações de proteção que dependem do seu posicionamento, da dose de tolerância do ponto anatômico e dos parâmetros radiométricos do equipamentos de radiação utilizados. Este trabalho apresenta uma análise da distribuição de dose absorvida em pontos situados fora do eixo central do feixe de radiação durante procedimentos de radioterapia com campos extensos e irregulares. O código computacional MCNP5 foi usado para construir duas modelagens do cabeçote de um acelerador linear clínico, utilizado como fonte de radiação, e simular o perfil radiométrico do feixe de tratamento para campos irregulares e alargados. Foram realizadas medidas experimentais da curva de Porcentagem de Dose Profunda (PDP) e perfil de dose utilizando câmara de ionização, detectores de diodos e filmes radiográficos. Os valores experimentais foram comparados com os perfis de dose simulados para realização do processo de validação dos cálculos. Após a validação, casos clínicos foram simulados como forma de aplicação da metodologia apresentada. / In treatment planning of radiotherapy, the radiotherapist determines the daily radiation dose for each specific type of tumor and, with the physicist, locates the areas to be treated during the simulation procedures of treatment fields. In some cases the radiation fields have large dimensions in order to cover the entire target volume, which may require protection of the vital organs and anatomical regions located within the irradiated area or surrounding the target volume, in order to ensure the limit absorbed dose tolerated by these agencies. In general, these critical organs are located off-axis beam, even near the periphery of the field, which explains the importance of determining the radiation dose at points outside of the central beam and the isocenter of treatment, aiming size the protection that depend on their location, the tolerance dose of the anatomical point and radiometric parameters of the radiation equipment used. This work presents an analysis of the distribution of absorbed dose at points outside the central axis of the beam during radiotherapy procedures with large and irregular fields. The MCNP5 code was used to construct the modeling of the head of a clinical linear accelerator, used as a radiation source, and simulate the profile of the beam treatment for irregular elds and extended. Measurements were made of the experimental curve Percentage Depth Dose (PDD) and dose prole using ionization chamber detectors, diodes and radiographic films. The experimental values were compared with dose profiles simulated to perform the validation process of the calculations. After validation, clinical cases were simulated as a way of applying the methodology presented.

A presença de material de alto número atômico adjacente ao tecido mole aumenta localmente a dose absorvida pelo tecido quando submetido à radiação. Este efeito ocorre devido aos fotoelétrons ejetados do material de alto número atômico. Dosímetros de gel polimérico com partículas de ouro foram utilizados para investigar este efeito. Foram realizados cálculos analíticos para estimar o aumento de dose e simulações com o método de Monte Carlo. A irradiação de amostras de gel polimérico (GP) puro e com 0,005 gAu/gGP utilizando um feixe de raios X produzido por um potencial de 150 kV filtrado com 4 mmAl e 5 mmCu resultou em uma dose absorvida pelas amostras com ouro aproximadamente 20% maior que a dose absorvida pelas amostras de gel polimérico puro. Os cálculos analíticos e a simulação com o método de Monte Carlo resultaram em um aumento de aproximadamente 30% na dose absorvida. / The presence of high-Z material adjacent to soft tissue, when submitted to irradiation, enhances locally the absorbed dose in these soft tissues. Such effect occurs due to the outscattering of photoelectrons from the high-Z material. Polymer gel dosimeters have been used to investigate this effect. Analytic calculations to estimate the dose enhancement and Monte Carlo simulations have been performed. Samples containing polymer gel (PG) with 0.005 gAu/gPG and pure polymer gel have been irradiated using an X-rays beam produced by 150 kV, filtered with 4 mm Al and 5 mm Cu, which resulted in an approximately 20% higher absorbed dose in the samples with gold in comparison to those with pure polymer gel. The analytic calculations and the Monte Carlo simulation resulted in a dose enhancement factor of approximately 30%.

O objetivo deste trabalho foi estabelecer uma metodologia de calibração em termos de dose absorvida na água para câmaras de ionização de placas paralelas a serem utilizadas em feixes de radiação X de energia baixa (10 kV a 100 kV) para fins terapêuticos. Atualmente, no Brasil nenhum laboratório de calibração está oferecendo este tipo de serviço. Para o estabelecimento desta metodologia de calibração foram utilizadas duas câmaras de ionização PTW modelos 23344. Ambas as câmaras foram caracterizadas e testadas qualitativamente segundo recomendações de normas internacionais. Os testes de caracterização realizados foram: a medição da taxa de dose mínima efetiva, a curva de saturação, a eficiência da coleção de íons, a resposta quanto ao efeito da polaridade e a linearidade da câmara com a resposta. Os testes de controle de qualidade aplicados foram: estabilidade em curto e longo prazos, fuga de corrente sem irradiação, fuga de corrente após-irradiação e tempo de estabilização. Para a implantação da metodologia, foram estabelecidas as qualidades de radiação de T-10 a T-100, seguindo as recomendações do código de prática da AIEA. Desta forma, foi possível determinar a grandeza de referência, dose absorvida na água, utilizando-se as duas câmaras de ionizações e em todas as qualidades estabelecidas. / The objective of this study was to establish a calibration methodology in terms of absorbed dose to water for parallel plate ionization chambers to be used in low energy X rays beams (10kV to 100kV) for therapy purposes. Currently, in Brazil no calibration laboratory is offering this type of service. In order to establish this calibration methodology was used two ionization chambers PTW models 23344. Both chambers were characterized and tested qualitatively according to recommendations of international standards. The characterization tests performed were: measuring the effective minimum dose rate, the saturation curve, the efficiency of ions collection, polarity effect and the linearity of the ionization chamber with the response. The quality control tests applied were: stability in the short and long term, leakage current without irradiation, leakage current after irradiation and settling time. For the implementation of the methodology, the radiation qualities the T- 10 to T-100 were established, following the recommendations of the IAEA code of practice. Thus, it was possible to determine the magnitude of reference absorbed dose in water, using the two ionization chambers in the all established qualities.

Um sistema de referência para determinação do equivalente de dose pessoal, HP (10), e um programa de controle da qualidade de sistemas geradores de raios X utilizados em radioproteção inclui a verificação periódica da constância dos feixes de raios X empregados na calibração de instrumentos medidores de radiação em laboratórios de calibração de instrumentos. Neste trabalho foram desenvolvidas duas câmaras de ionização de placas paralelas inseridas em objetos simuladores de tronco humano. Uma das câmaras de ionização possui eletrodo coletor de grafite, para a medida do equivalente de dose pessoal; a segunda câmara de ionização foi confeccionada com eletrodo coletor de alumínio para, juntamente com a primeira câmara de ionização, formarem um sistema Tandem. A dependência energética diferente da resposta das duas câmaras de ionização é que permite a formação do sistema Tandem, que apresenta grande utilidade na verificação da constância de feixes de radiação X. Foram ainda implantados feixes padronizados de radiação X de energias médias (48 keV a 118 keV), nível radioproteção, por meio do desenvolvimento de uma metodologia dosimétrica e da análise dos parâmetros físicos destes feixes. As câmaras desenvolvidas foram testadas em relação às suas características operacionais e foram calibradas em feixes de radiação X, níveis radioproteção, radiodiagnóstico, mamografia e radioterapia, e ainda em campos de radiação gama, seguindo as recomendações internacionais. Apresentaram bom desempenho. Foi estabelecido o procedimento da determinação do equivalente de dose pessoal, Hp (10). / A reference system for the determination of the personal dose equivalent, HP (10), and a quality control program of X-ray equipments used in radioprotection require the periodic verification of the X-ray beams constancy. In this work, two parallel-plate ionization chambers were developed with inner electrodes of different materials, and inserted into PMMA slab phantoms. One ionization chamber was developed with inner carbon electrodes and the other with inner aluminium electrodes. The two ionization chambers can be used as a Tandem system. The different energy response of the two ionization chambers allowed the development of the Tandem system that is very useful for the checking of the constancy of beam qualities. Standard intermediary energy X-ray beams (from 48 keV to 118 keV), radioprotection level, were established through the development of a dosimetric methodology and the analysis of their physical parameters. The ionization chambers were studied in relation to their operational characteristics, and they were calibrated in X-ray beams (radioprotection, diagnostic radiology, mammography and radiotherapy levels) in accordance to international recommendations. They presented good performance. The determination procedure of personal dose equivalent, HP (10), was established.