This study was conducted to estimate thyroid dose and the associated risk for thyroid cancer induction from common head and neck computed tomography (CT) examinations during childhood. The Monte Carlo N-particle transport code was employed to simulate the routine CT scanning of the brain, paranasal sinuses, inner ear and neck performed on sequential and/or spiral modes. The mean thyroid dose was calculated using mathematical phantoms representing a newborn infant and children of 1year, 5 years, 10 years and 15 years old. To verify Monte Carlo results, dose measurements were carried out on physical anthropomorphic phantoms using thermoluminescent dosemeters (TLDs). The scattered dose to thyroid from head CT examinations varied from 0.6 mGy to 8.7 mGy depending upon the scanned region, the pediatric patient's age and the acquisition mode used. Primary irradiation of the thyroid gland during CT of the neck resulted in an absorbed dose range of 15.2-52.0 mGy. The mean difference between Monte Carlo calculations and TLD measurements was 11.8%. Thyroid exposure to scattered radiation from head CT scanning is associated with a low but not negligible risk of cancer induction of 4-65 per million patients. Neck CT can result in an increased risk for development of thyroid malignancies up to 390 per million patients.
Our aim in the present study was to investigate the effects of initial electron beam characteristics on Monte Carlo calculated absorbed dose distribution for a linac 6 MV photon beam. Moreover, the range of values of these parameters was derived, so that the resulted differences between measured and calculated doses were less than 1%. Mean energy, radial intensity distribution and energy spread of the initial electron beam, were studied. The method is based on absorbed dose comparisons of measured and calculated depth-dose and dose-profile curves. All comparisons were performed at 10.0 cm depth, in the umbral region for dose-profile and for depths past maximum for depth-dose curves. Depth-dose and dose-profile curves were considerably affected by the mean energy of electron beam, with dose profiles to be more sensitive on that parameter. The depth-dose curves were unaffected by the radial intensity of electron beam. In contrast, dose-profile curves were affected by the radial intensity of initial electron beam for a large field size. No influence was observed in dose-profile or depth-dose curves with respect to energy spread variations of electron beam. Conclusively, simulating the radiation source of a photon beam, two of the examined parameters (mean energy and radial intensity) of the electron beam should be tuned accurately, so that the resulting absorbed doses are within acceptable precision. The suggested method of evaluating these crucial but often poorly specified parameters may be of value in the Monte Carlo simulation of linear accelerator photon beams.
This study aims to investigate the possibility of generating stereological estimations of total intracranial volume (TIV) on CT scans. The study group included 16 consecutive patients referred for a cranial CT examination. The TIV was estimated using the stereological point counting technique. Volume measurements were optimized by systematically sampling CT sections and by defining an optimum spacing between test points of the grid. The intraobserver and interobserver variability of the optimized volumetric technique was determined. Stereological TIV estimations were compared with the respective planimetric measurements. The application of a test grid with a point spacing of 2.4 cm on 6-8 systematically sampled CT sections provided TIV estimations with a coefficient of error of less than 5%. The intraobserver and interobserver coefficient of variation values were found to be 2.4 and 4.0%, respectively. The 95% limits of agreement between stereological and planimetric TIV measurements were equal to -91.4 and 103.4 cm3. The mean time (+/- SD) needed to obtain stereological TIV estimations was 2.9 +/- 0.6 min. The application of the optimized stereological technique on CT scans enables the efficient estimation of TIV.
Purpose:To compare the conventional technique of manual planimetry with the point counting technique for estimating liver volume from magnetic resonance imaging (MRI) data. Materials and Methods:This study comprised abdominal MR examinations of 38 consecutive patients. Evaluation of the images showed that liver size appeared normal in 27 patients and increased in 11. Liver volume was estimated using the techniques of planimetry and point counting. Both techniques were used in combination with the Cavalieri method of modern design stereology. A systematic slice sampling procedure was performed to estimate liver volumes using both volumetric techniques. The point counting technique was optimized by altering the point spacing of the grid. The agreement between the two techniques was found. Measurement repeatability of both volumetric techniques was also evaluated.Results: Both techniques allowed the same degree of optimization through the procedure of systematic section sampling. The application of a point spacing of 2.5 cm reduced the time measurement by a factor of 3.5 in relation with the time needed with planimetry. An excellent agreement was observed between the two volumetric techniques with mean differences (ϮSD) of 2.4 Ϯ 41.6 cm 3 and 8.5 Ϯ 49.8 cm 3 for the patients presenting normal and increased liver sizes, respectively. Both techniques were highly reproducible. Conclusion:The point counting technique could be considered a more efficient approach than planimetry for estimating liver volume from MRI, due to its speed and simplicity.
The aims of this study were: (a) to determine conceptus dose resulting from brain radiotherapy; (b) to investigate the necessity of using shielding devices over patient's abdomen during treatment; and (c) to estimate the components of conceptus dose. Radiation doses received by conceptus were measured using anthropomorphic phantoms simulating pregnancy at 4, 12 and 24 weeks gestation and thermoluminescent dosemeters. All irradiations were performed with two lateral and opposed fields approximating the minimum, medium and maximum field size used during treatment of brain malignancies. For a treatment course delivering 65 Gy to tumour without using shielding equipment, conceptus dose never exceeded 100 mGy. Appropriate positioning of 5.1 cm of lead over the phantom's abdomen provided reduction of conceptus dose from 26% to 71%, depending upon gestational age, field size and distance from the field isocentre. The contribution of scatter arising from within the phantom to the conceptus dose was small compared with that from head leakage and collimator scatter. Our dosimetric results indicate that the construction of special shielding equipment is not a prerequisite for treating brain malignancies during pregnancy. However, based on the concept that exposures in women of childbearing age should be kept as low as reasonably achievable, we suggest that shielding devices should be used whenever possible.
The current study aimed to: a) utilize Monte Carlo simulation methods for the assessment of radiation doses imparted to all organs at risk to develop secondary radiation induced cancer, for patients undergoing radiotherapy for breast cancer; and b) evaluate the effect of breast size on dose to organs outside the irradiation field. A simulated linear accelerator model was generated. The in‐field accuracy of the simulated photon beam properties was verified against percentage depth dose (PDD) and dose profile measurements on an actual water phantom. Off‐axis dose calculations were verified with thermoluminescent dosimetry (TLD) measurements on a humanoid physical phantom. An anthropomorphic mathematical phantom was used to simulate breast cancer radiotherapy with medial and lateral fields. The effect of breast size on the calculated organ dose was investigated. Local differences between measured and calculated PDDs and dose profiles did not exceed 2% for the points at depths beyond the depth of maximum dose and the plateau region of the profile, respectively. For the penumbral regions of the dose profiles, the distance to agreement (DTA) did not exceed 2 mm. The mean difference between calculated out‐of‐field doses and TLD measurements was 11.4%±5.9%. The calculated doses to peripheral organs ranged from 2.32 cGy up to 161.41 cGy depending on breast size and thus the field dimensions applied, as well as the proximity of the organs to the primary beam. An increase to the therapeutic field area by 50% to account for the large breast led to a mean organ dose elevation by up to 85.2% for lateral exposure. The contralateral breast dose ranged between 1.4% and 1.6% of the prescribed dose to the tumor. Breast size affects dose deposition substantially.PACS numbers: 87.10.rt, 87.56.bd, 87.53.Bn, 87.55.K‐, 87.55.ne, 87.56.jf, 87.56.J‐
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