Feasibility study of computational occupational dosimetry: evaluating a proof-of-concept in an endovascular and interventional cardiology setting.

Individual monitoring of radiation workers is essential to ensure compliance with legal dose limits and to ensure that doses are As Low As Reasonably Achievable. However, large uncertainties still exist in personal dosimetry and there are issues with compliance and incorrect wearing of dosimeters. The objective of the PODIUM (Personal Online Dosimetry Using Computational Methods) project was to improve personal dosimetry by an innovative approach: the development of an online dosimetry application based on computer simulations without the use of physical dosimeters. Occupational doses were calculated based on the use of camera tracking devices, flexible individualised phantoms and data from the radiation source. When combined with fast Monte Carlo simulation codes, the aim was to perform personal dosimetry in real-time. A key component of the PODIUM project was to assess and validate the methodology in interventional radiology workplaces where improvements in dosimetry are needed. This paper describes the feasibility of implementing the PODIUM approach in a clinical setting. Validation was carried out using dosimeters worn by Vascular Surgeons and Interventional Cardiologists during patient procedures at a hospital in Ireland. Our preliminary results from this feasibility study show acceptable differences of the order of 40% between calculated and measured staff doses, in terms of the personal dose equivalent quantity Hp(10), however there is a greater deviation for more complex cases and improvements are needed. The challenges of using the system in busy interventional rooms have informed the future needs and applicability of PODIUM. The availability of an online personal dosimetry application has the potential to overcome problems that arise from the use of current dosimeters. In addition, it should increase awareness of radiation protection among staff. Some limitations remain and a second phase of development would be required to bring the PODIUM method into operation in a hospital setting. However, an early prototype system has been tested in a clinical setting and the results from this two-year proof-of-concept PODIUM project are very promising for future development.

A benchmark for Monte Carlo simulations in gamma-ray spectrometry Part II: True coincidence summing correction factors.

The goal of this study is to provide a benchmark for the use of Monte Carlo simulation when applied to coincidence summing corrections. The examples are based on simple geometries: two types of germanium detectors and four kinds of sources, to mimic eight typical measurement conditions. The coincidence corrective factors are computed for four radionuclides. The exercise input files and calculation results with practical recommendations are made available for new users on a dedicated webpage.

Dose assesment with fast Monte Carlo codes in interventional radiology.

This study presents the performance of two fast Monte Carlo codes, PENELOPE/penEasyIR and MCGPU-IR in order to assess operator doses in interventional radiology. In particular, it aims to validate the calculations when workers are protected with shielding located between the patient and the operator. The experiments are performed in a calibration laboratory and measurements are gathered using Thermo EPD and Mirion DMC personal active dosemeters. Calculation efficiency of the fast Monte Carlo codes is approximately four orders of magnitude greater than for a standard Monte Carlo code. Satisfactory agreement between measurements and calculations is shown.

Fast Monte Carlo codes for occupational dosimetry in interventional radiology.

PURPOSE: Interventional radiology techniques cause radiation exposure both to patient and personnel. The radiation dose to the operator is usually measured with dosimeters located at specific points above or below the lead aprons. The aim of this study is to develop and validate two fast Monte Carlo (MC) codes for radiation transport in order to improve the assessment of individual doses in interventional radiology. The proposed methodology reduces the number of required dosemeters and provides immediate dose results. METHODS: Two fast MC simulation codes, PENELOPE/penEasyIR and MCGPU-IR, have been developed. Both codes have been validated by comparing fast MC calculations with the multipurpose PENELOPE MC code and with measurements during a realistic interventional procedure. RESULTS: The new codes were tested with a computation time of about 120 s to estimate operator doses while a standard simulation needs several days to obtain similar uncertainties. When compared with the standard calculation in simple set-ups, MCGPU-IR tends to underestimate doses (up to 5%), while PENELOPE/penEasyIR overestimates them (up to 18%). When comparing both fast MC codes with experimental values in realistic set-ups, differences are within 25%. These differences are within accepted uncertainties in individual monitoring. CONCLUSION: The study highlights the fact that computational dosimetry based on the use of fast MC codes can provide good estimates of the personal dose equivalent and overcome some of the limitations of occupational monitoring in interventional radiology. Notably, MCGPU-IR calculates both organ doses and effective dose, providing a better estimate of radiation risk.

PERSONAL DOSIMETRY USING MONTE-CARLO SIMULATIONS FOR OCCUPATIONAL DOSE MONITORING IN INTERVENTIONAL RADIOLOGY: THE RESULTS OF A PROOF OF CONCEPT IN A CLINICAL SETTING.

Exposure levels to staff in interventional radiology (IR) may be significant and appropriate assessment of radiation doses is needed. Issues regarding measurements using physical dosemeters in the clinical environment still exist. The objective of this work was to explore the prerequisites for assessing staff radiation dose, based on simulations only. Personal dose equivalent, Hp(10), was assessed using simulations based on Monte Carlo methods. The position of the operator was defined using a 3D motion tracking system. X-ray system exposure parameters were extracted from the x-ray equipment. The methodology was investigated and the simulations compared to measurements during IR procedures. The results indicate that the differences between simulated and measured staff radiation doses, in terms of the personal dose equivalent quantity Hp(10), are in the order of 30-70 %. The results are promising but some issues remain to be solved, e.g. an automated tracking of movable parts such as the ceiling-mounted protection shield.

Determining the probability of locating peaks using computerized peak-location methods in gamma-ray spectra as a function of the relative peak-area uncertainty.

The probabilities of locating peaks with a high relative peak-area uncertainty were determined empirically with nine types of peak-location software used in laboratories engaged in gamma-ray spectrometry measurements. It was found that it is not possible to locate peaks with a probability of 0.95, when they have a relative peak-area uncertainty in excess of 50%. Locating peaks at these relatively high peak-area uncertainties with a probability greater than 0.95 is only possible in the library-driven mode, where the peak positions are supposed a-priori. The deficiencies of the library-driven mode and the possibilities to improve the probabilities of locating peaks are briefly discussed.

Dose calculations in aircrafts after Fukushima nuclear power plant accident - Preliminary study for aviation operations.

There is little information to decision support in air traffic management in case of nuclear releases into the atmosphere. In this paper, the dose estimation due to both, external exposure (i.e. cloud immersion, deposition inside and outside the aircraft), and due to internal exposure (i.e, inhalation of radionuclides inside the aircraft) to passengers and crew is calculated for a worst-case emergency scenario. The doses are calculated for different radionuclides and activities. Calculations are mainly considered according to International Commission on Radiological Protection (ICRP) recommendations and Monte Carlo simulations. In addition, a discussion on potential detectors installed inside the aircraft for monitoring the aerosol concentration and the ambient dose equivalent rate, H*(10), for during-flight monitoring and early warning is provided together with the evaluation of a response of a generic detector. The results show that the probability that a catastrophic nuclear accident would produce significant radiological doses to the passengers and crew of an aircraft is very low. In the worst-case scenarios studied, the maximum estimated effective dose was about 1 mSv during take-off or landing operations, which is the recommended yearly threshold for the public. However, in order to follow the ALARA (As Low As Reasonably Achievable) criteria and to avoid aircraft contamination, the installation of radiological detectors is considered. This would, on one hand help the pilot or corresponding decision maker to decide about the potential change of the route and, on the other, allow for gathering of 4D data for future studies.

Systematic influences on the areas of peaks in gamma-ray spectra that have a large statistical uncertainty.

A method is presented for calculating the expected number of counts in peaks that have a large relative peak-area uncertainty and appear in measured gamma-ray spectra. The method was applied to calculations of the correction factors for peaks occurring in the spectra of radon daughters. It was shown that the factors used for correcting the calculated peak areas to their expected values decrease with an increasing relative peak-area uncertainty. The accuracy of taking the systematic influence inducing the correction factors into account is given by the dispersion of the correction factors corresponding to specific peaks. It was shown that the highest accuracy is obtained in the peak analyses with the GammaVision and Gamma-W software.

Comparison of dose calculation algorithms in slab phantoms with cortical bone equivalent heterogeneities.

To evaluate the dose values predicted by several calculation algorithms in two treatment planning systems, Monte Carlo (MC) simulations and measurements by means of various detectors were performed in heterogeneous layer phantoms with water- and bone-equivalent materials. Percentage depth doses (PDDs) were measured with thermoluminescent dosimeters (TLDs), metal-oxide semiconductor field-effect transistors (MOSFETs), plane parallel and cylindrical ionization chambers, and beam profiles with films. The MC code used for the simulations was the PENELOPE code. Three different field sizes (10 x 10, 5 x 5, and 2 x 2 cm2) were studied in two phantom configurations and a bone equivalent material. These two phantom configurations contained heterogeneities of 5 and 2 cm of bone, respectively. We analyzed the performance of four correction-based algorithms and one based on convolution superposition. The correction-based algorithms were the Batho, the Modified Batho, the Equivalent TAR implemented in the Cadplan (Varian) treatment planning system (TPS), and the Helax-TMS Pencil Beam from the Helax-TMS (Nucletron) TPS. The convolution-superposition algorithm was the Collapsed Cone implemented in the Helax-TMS. All the correction-based calculation algorithms underestimated the dose inside the bone-equivalent material for 18 MV compared to MC simulations. The maximum underestimation, in terms of root-mean-square (RMS), was about 15% for the Helax-TMS Pencil Beam (Helax-TMS PB) for a 2 x 2 cm2 field inside the bone-equivalent material. In contrast, the Collapsed Cone algorithm yielded values around 3%. A more complex behavior was found for 6 MV where the Collapsed Cone performed less well, overestimating the dose inside the heterogeneity in 3%-5%. The rebuildup in the interface bone-water and the penumbra shrinking in high-density media were not predicted by any of the calculation algorithms except the Collapsed Cone, and only the MC simulations matched the experimental values within the estimated uncertainties. The TLD and MOSFET detectors were suitable for dose measurement inside bone-equivalent materials, while parallel ionization chambers, applying the same calibration and correction factors as in water, systematically underestimated dose by 3%-5%.

Impact of Region-of-Interest Delineation Methods, Reconstruction Algorithms, and Intra- and Inter-Operator Variability on Internal Dosimetry Estimates Using PET.

PURPOSE: Human dosimetry studies play a central role in radioligand development for positron emission tomography (PET). Drawing regions of interest (ROIs) on the PET images is used to measure the dose in each organ. In the study aspects related to ROI delineation methods were evaluated for two radioligands of different biodistribution (intestinal vs urinary). PROCEDURES: PET images were simulated from a human voxel-based phantom. Several ROI delineation methods were tested: antero-posterior projections (AP), 3D sub-samples of the organs (S), and a 3D volume covering the whole-organ (W). Inter- and intra-operator variability ROI drawing was evaluated by using human data. RESULTS: The effective dose estimates using S and W methods were comparable to the true values. AP methods overestimated (49 %) the dose for the radioligand with intestinal biodistribution. Moreover, the AP method showed the highest inter-operator variability: 11 ± 1 %. CONCLUSIONS: The sub-sampled organ method showed the best balance between quantitative accuracy and inter- and intra-operator variability.

Comparison of two extremity dosemeters based on LiF:Mg,Cu,P thin detectors for mixed beta-gamma fields.

Two types of thin LiF:Mg,Cu,P detectors, GR-200F and MCP-Ns, have been characterised for use in the design of an extremity dosemeter for mixed beta-photon radiation fields. Both detectors consist of an extremely thin layer of sensitive material with effective thicknesses of 5 and 8 mg cm(-2), respectively, held in a 5 mg cm(-2) PVC ring holder. Dosimetric performance was analysed according to the ISO 12794 standard and compared with 240 mg cm(-2) TLD-100 measurements. In particular, the energy response was obtained for ISO narrow X-ray spectra, (137)Cs, (60)Co, (204)Tl and (90)Sr/(90)Y. From these measurements a mean calibration factor was calculated to estimate H(p)(0.07). Subsequently, the performance of the dosemeters was checked for a set of 10 different mixed photon and beta-photon fields. The study shows that the proposed dosemeters can estimate H(p)(0.07) in a wide range of mixed beta-photon fields with a maximum deviation from the given dose of 30% and an overall uncertainty of the order of 25% (k = 1). However, the results also highlight a large variability among the different thin detectors and, thus, the standard TLD-100 material is recommended whenever the workplace does not include low-energy beta radiation.

Dose evaluation in lung-equivalent media in high-energy photon external radiotherapy.

In high-energy photon external radiotherapy treatment planning systems (TPSs) are used to calculate the dose to the target volume and the dose distribution around it. Commonly used TPSs include algorithms based on measurements in water and often fail in the estimate of dose in the presence of heterogeneities. In this study TL detectors were used to study the reliability of the Cadplan (Varian) TPS in the presence of low-density heterogeneities such as the lung for 6 and 18 MV photon beams at different field sizes. TL measurements were compared with TPS calculations and Monte Carlo simulations performed with the PENELOPE MC code. In a phantom with lung heterogeneity, TL measurements and MC simulations agreed, with an average deviation inside the lung of 2%. In contrast, TPS results overestimated the dose inside the lung, with a maximum deviation of 39% for the 18 MV photon beam and a field size of 2 x 2 cm(2).

Comparison of different sampling methods for the determination of low-level radionuclides in air.

The aim of this work is to check the consistency of results given by different air dust samplers (flow-rates between 2 and 700m(3)/h) and measurement protocols at a single location. The study is focussed on (210)Pb since is the only nuclide that can be easily assessed through all the studied sampler types. Results from high- and mid-volume samplers agreed well to within the associated uncertainties. Gross beta activity from low-volume samplers can be used as a good indicator of the evolution of (210)Pb concentration in air.

AIR KERMA TO Hp(3) CONVERSION COEFFICIENTS FOR IEC 61267 RQR X-RAY RADIATION QUALITIES: APPLICATION TO DOSE MONITORING OF THE LENS OF THE EYE IN MEDICAL DIAGNOSTICS.

Recent studies highlight the fact that the new eye lens dose limit can be exceeded in interventional radiology procedures and that eye lens monitoring could be required for these workers. The recommended operational quantity for monitoring of eye lens exposure is the personal dose equivalent at 3 mm depth Hp(3) (ICRU 51). However, there are no available conversion coefficients in international standards, while in the literature coefficients have only been calculated for monoenergetic beams and for ISO 4037-1 X-ray qualities. The aim of this article is to provide air kerma to Hp(3) conversion coefficients for a cylindrical phantom made of ICRU-4 elements tissue-equivalent material for RQR radiation qualities (IEC-61267) from 40 to 120 kV and for angles of incidence from 0 to 180°, which are characteristic of medical workplace. Analytic calculations using interpolation techniques and Monte Carlo modelling have been compared.

Influence of long-range atmospheric transport pathways and climate teleconnection patterns on the variability of surface 210Pb and 7Be concentrations in southwestern Europe.

The variability of the atmospheric concentration of the 7Be and 210Pb radionuclides is strongly linked to the origin of air masses, the strength of their sources and the processes of wet and dry deposition. It has been shown how these processes and their variability are strongly affected by climate change. Thus, a deeper knowledge of the relationship between the atmospheric radionuclides variability measured close to the ground and these atmospheric processes could help in the analysis of climate scenarios. In the present study, we analyze the atmospheric variability of a 14-year time series of 7Be and 210Pb in a Mediterranean coastal city using a synergy of different indicators and tools such as: the local meteorological conditions, global and regional climate indexes and a lagrangian atmospheric transport model. We particularly focus on the relationships between the main pathways of air masses and sun spots occurrence, the variability of the local relative humidity and temperature conditions, and the main modes of regional climate variability, such as the North Atlantic Oscillation (NAO) and the Western Mediterranean Oscillation (WeMO). The variability of the observed atmospheric concentrations of both 7Be and 210Pb radionuclides was found to be mainly positively associated to the local climate conditions of temperature and to the pathways of air masses arriving at the station. Measured radionuclide concentrations significantly increase when air masses travel at low tropospheric levels from central Europe and the western part of the Iberian Peninsula, while low concentrations are associated with westerly air masses. We found a significant negative correlation between the WeMO index and the atmospheric variability of both radionuclides and no significant association was observed for the NAO index.

Eye lens dose in interventional cardiology.

The ICRP has recently recommended reducing the occupational exposure dose limit for the lens of the eye to 20 mSv y(-1), averaged over a period of 5 y, with no year exceeding 50 mSv, instead of the current 150 mSv y(-1). This reduction will have important implications for interventional cardiology and radiology (IC/IR) personnel. In this work, lens dose received by a staff working in IC is studied in order to determine whether eye lens dose monitoring or/and additional radiological protection measures are required. Eye lens dose exposure was monitored in 10 physicians and 6 nurses. The major IC procedures performed were coronary angiography and percutaneous transluminal coronary angioplasty. The personnel were provided with two thermoluminescent dosemeters (TLDs): one calibrated in terms of Hp(3) located close to the left ear of the operator and a whole-body dosemeter calibrated in terms of Hp(10) and Hp(0.07) positioned on the lead apron. The estimated annual eye lens dose for physicians ranged between 8 and 60 mSv, for a workload of 200 procedures y(-1). Lower doses were collected for nurses, with estimated annual Hp(3) between 2 and 4 mSv y(-1). It was observed that for nurses the Hp(0.07) measurement on the lead apron is a good estimate of eye lens dose. This is not the case for physicians, where the influence of both the position and use of protective devices such as the ceiling shield is very important and produces large differences among doses both at the eyes and on the thorax. For physicians, a good correlation between Hp(3) and dose area product is shown.

Thermoluminescence dosimetry applied to in vivo dose measurements for total body irradiation techniques.

BACKGROUND AND PURPOSE: In total body irradiation (TBI) treatments in vivo dosimetry is recommended because it makes it possible to ensure the accuracy and quality control of dose delivery. The aim of this work is to set up an in vivo thermoluminescence dosimetry (TLD) system to measure the dose distribution during the TBI technique used prior to bone marrow transplant. Some technical problems due to the presence of lung shielding blocks are discussed. MATERIALS AND METHODS: Irradiations were performed in the Hospital de la Santa Creu i Sant Pau by means of a Varian Clinac-1800 linear accelerator with 18 MV X-ray beams. Different TLD calibration experiments were set up to optimize in vivo dose assessment and to analyze the influence on dose measurement of shielding blocks. An algorithm to estimate midplane doses from entrance and exit doses is proposed and the estimated dose in critical organs is compared to internal dose measurements performed in an Alderson anthropomorphic phantom. RESULTS: The predictions of the dose algorithm, even in heterogeneous zones of the body such as the lungs, are in good agreement with the experimental results obtained with and without shielding blocks. The differences between measured and predicted values are in all cases lower than 2%. CONCLUSIONS: The TLD system described in this work has been proven to be appropriate for in vivo dosimetry in TBI irradiations. The described calibration experiments point out the difficulty of calibrating an in vivo dosimetry system when lung shielding blocks are used.

Midplane dose determination during total body irradiation using in vivo dosimetry.

BACKGROUND AND PURPOSE: During TBI techniques an accurate determination of the dose distribution is very difficult when using commercial treatment planning systems. In order to determine the midplane dose, an algorithm was developed based on the use of in vivo dosimetry. MATERIALS AND METHODS: Scanditronix EDP-30 diodes were placed at the entrance and the exit surface for in vivo dosimetry. The proposed algorithm was validated firstly in a regular and homogeneous phantom of different thickness with an ionization chamber and TL dosimeters and secondly in an Alderson anthropomorphic phantom with TL dosimeters. In this study, in vivo measurements were evaluated in 60 patients and furthermore, in 20 of them, the midplane dose calculated with this algorithm was compared with the method described by Rizzotti A, Compri C, Garusi GF. Dose evaluation to patients irradiated by 60Co beams, by means of direct measurement on the incident and on the exit surfaces. Radiother. Oncol. 1985;3:279-283. RESULTS: No differences were found between the two methods. The differences between dose values calculated with both methods and dose values measured with the ionization chamber and TL dosimeters were within +/-22% and +/-4%, respectively, in the regular and homogeneous phantom and within +/-2% in the Alderson phantom. The algorithm was useful in calculating the midplane dose when heterogeneities as lungs were present. Even when partial transmission blocks were used to reduce the dose to the lungs, the algorithm with modified correction factors gave a midplane lung dose in the Alderson phantom within 1.3% of the measurements with TL dosimeters. For 360 patients' measurements in each A-P and P-A field, the relative deviations were analyzed between the measured and calculated entrance, exit dose and midplane dose and the prescribed dose, always applying the temperature correction factor. These deviations at the entrance dose were within +/-4%. Greater deviations were found for the exit dose measurements. Deviations larger than +/-10% corresponded in general to obese patients, with a thickness over 25 cm. The relative deviations between the total received and prescribed midplane doses in 60 patients were within +/-3%. CONCLUSIONS: The results indicate excellent correspondence between the total prescribed and calculated midplane doses using this algorithm while also no significant differences were found when the Rizzotti method was used. Comparison between doses measured with TL dosimeters in the core of Alderson phantom lungs and doses calculated from in vivo measurements showed that the proposed algorithm could be used in the presence of heterogeneities even when partial transmission blocks were used. The temperature correction factor must be applied in order to avoid a 2-3% dose overestimation.

Comparison of dose calculation algorithms in phantoms with lung equivalent heterogeneities under conditions of lateral electronic disequilibrium.

An extensive set of benchmark measurement of PDDs and beam profiles was performed in a heterogeneous layer phantom, including a lung equivalent heterogeneity, by means of several detectors and compared against the predicted dose values by different calculation algorithms in two treatment planning systems. PDDs were measured with TLDs, plane parallel and cylindrical ionization chambers and beam profiles with films. Additionally, Monte Carlo simulations by means of the PENELOPE code were performed. Four different field sizes (10 x 10, 5 x 5, 2 x 2, and 1 x 1 cm2) and two lung equivalent materials (CIRS, p(w)e=0.195 and St. Bartholomew Hospital, London, p(w)e=0.244-0.322) were studied. The performance of four correction-based algorithms and one based on convolution-superposition was analyzed. The correction-based algorithms were the Batho, the Modified Batho, and the Equivalent TAR implemented in the Cadplan (Varian) treatment planning system and the TMS Pencil Beam from the Helax-TMS (Nucletron) treatment planning system. The convolution-superposition algorithm was the Collapsed Cone implemented in the Helax-TMS. The only studied calculation methods that correlated successfully with the measured values with a 2% average inside all media were the Collapsed Cone and the Monte Carlo simulation. The biggest difference between the predicted and the delivered dose in the beam axis was found for the EqTAR algorithm inside the CIRS lung equivalent material in a 2 x 2 cm2 18 MV x-ray beam. In these conditions, average and maximum difference against the TLD measurements were 32% and 39%, respectively. In the water equivalent part of the phantom every algorithm correctly predicted the dose (within 2%) everywhere except very close to the interfaces where differences up to 24% were found for 2 x 2 cm2 18 MV photon beams. Consistent values were found between the reference detector (ionization chamber in water and TLD in lung) and Monte Carlo simulations, yielding minimal differences (0.4%+/-1.2%). The penumbra broadening effect in low density media was not predicted by any of the correction-based algorithms, and the only one that matched the experimental values and the Monte Carlo simulations within the estimated uncertainties was the Collapsed Cone Algorithm.

Implementing new recommendations for calibrating personal dosemeters.

This paper analyses the differences between the calibration procedures for personal dosemeters recommended by ICRU 47 and ISO 4037-3. The tissue equivalence of the PMMA and the ISO water slab phantoms are analysed by means of the Penelope Monte Carlo code for monoenergetic and filtered X ray photon beams and compared with the results of two other independent codes. The influence of the calibration method is also verified experimentally, both on a thermoluminescence and an electronic personal dosemeter. Good consistency between both calibration procedures is shown provided that a correction factor for backscatter differences between the PMMA and the ICRU phantom is introduced. The Monte Carlo simulation is used to determine this correction to a greater accuracy.