Sensitivity enhancement of methacrylic acid gel dosimeters by incorporating iodine for computed tomography scans.

PURPOSE: Polymer gel dosimeters provide three-dimensional absorbed dose information and have gradually become a popular tool for quality assurance in radiotherapy. This study aims to incorporate iodine into the MAGAT-based gel as radiation sensitizer and investigate whether it can be used to measure the radiation dose and slice thickness for CT scans. METHODS: The nMAGAT(I) gel was doped with 0.03, 0.05, and 0.07-M iodine. The absorbed dose was delivered using a CT scanner (Alexion 16, Toshiba Medical Systems, Japan) with tube voltages of 80, 100, 120, and 135 kVp. The irradiated nMAGAT(I) gel was read using a cone beam optical CT scanner to produce dose-response curves. The nMAGAT(I) gel was used to obtain the slice sensitivity profile (SSP) and the CT dose index (CTDI) for quality assurance of CT scans. RESULTS: The 0.07-M iodine-doped nMAGAT(I) gel exhibited maximum sensitivity with the dose enhancement ratio of 2.12. The gel was chemically stable 24 h after its preparation, and the polymerization process was completed 24-48 h after the irradiation. For CT quality assurance, the full width at half maximum measured by the nMAGAT(I) gel matched the nominal slice thickness of CT. The CTDI at center, CTDI at peripheral, and weighted CTDI obtained by the nMAGAT(I) gel differed from those obtained by the ionization chamber by -4.2%, 3.1%, and 0.7%, respectively. CONCLUSIONS: The nMAGAT(I) gel can be used to assess radiation doses and slice thickness in CT scans, thus rendering it a potential quality assurance tool for CT and other radiological diagnostic applications.

Using an on-board cone-beam computed tomography scanner as an imaging modality for gel dosimetry: A feasibility study.

On-board cone-beam computed tomography (CBCT) was used to scan the N-isopropylacrylamide (NIPAM) gel dosimeter. A dose-response curve from 1 to 12 Gy was created. The dose profile and depth dose curve were measured, and the dose distribution acquired from CBCT was then compared with that obtained from a treatment planning system (TPS). The linearity of the dose-response curve obtained by CBCT scanning of the NIPAM gel was 0.985. The mean percent standard deviation of various doses was 12.8%. A 12- to 24-h post-irradiation time was required to achieve stable CBCT readouts. Both dose profile and depth dose were in agreement with the results of TPS. The dose difference at the isocenter between CBCT and TPS was 3.8%. The gamma evaluation under the conditions of 5% dose difference and 5 mm distance-to-agreement was performed with the pass rate of 92.6%. These results indicate that an on-board CBCT can be used for scanning gel dosimeters in clinical radiotherapy.

Quantification of Volumetric Bone Mineral Density of Proximal Femurs Using a Two-Compartment Model and Computed Tomography Images.

OBJECTIVES: Dual-energy X-ray absorptiometry (DXA) is frequently used to measure the areal bone mineral density (aBMD) in clinical practice. However, DXA measurements are affected by the bone thickness and the body size and are unable to indicate nonosseous areas within the trabecular bone. This study aims to quantify the volumetric bone mineral density (vBMD) using computed tomography (CT) images and the two-compartment model (TCM) methods. METHODS: The TCM method was proposed and validated by dipotassium phosphate (K2HPO4) phantoms and a standard forearm phantom. 28 cases with DXA scans and pelvic CT scans acquired within six months were retrospectively collected. The vBMD calculated by TCM was compared with the aBMD obtained from DXA. RESULTS: For the K2HPO4 phantoms with vBMD ranging from 0.135 to 0.467 g/cm3, the average difference between the real and calculated vBMD was 0.009 g/cm3 and the maximum difference was 0.019 g/cm3. For the standard forearm phantom with vBMD of 0.194, 0.103, and 0.054 g/cm3, the average differences between the real and calculated vBMD were 0.017, 0.014, and 0.011 g/cm3. In the clinical CT image validation, a good linear relationship between vBMD and aBMD was observed with the Pearson correlation coefficient of 0.920 (p < 0.01). CONCLUSIONS: The proposed TCM method in combination with the homemade cortical bone equivalent phantom provides accurate quantification and spatial distribution of bone mineral content.

A Novel Two-Compartment Model for Calculating Bone Volume Fractions and Bone Mineral Densities From Computed Tomography Images.

Osteoporosis is a disease characterized by a degradation of bone structures. Various methods have been developed to diagnose osteoporosis by measuring bone mineral density (BMD) of patients. However, BMDs from these methods were not equivalent and were incomparable. In addition, partial volume effect introduces errors in estimating bone volume from computed tomography (CT) images using image segmentation. In this study, a two-compartment model (TCM) was proposed to calculate bone volume fraction (BV/TV) and BMD from CT images. The TCM considers bones to be composed of two sub-materials. Various equivalent BV/TV and BMD can be calculated by applying corresponding sub-material pairs in the TCM. In contrast to image segmentation, the TCM prevented the influence of the partial volume effect by calculating the volume percentage of sub-material in each image voxel. Validations of the TCM were performed using bone-equivalent uniform phantoms, a 3D-printed trabecular-structural phantom, a temporal bone flap, and abdominal CT images. By using the TCM, the calculated BV/TVs of the uniform phantoms were within percent errors of ±2%; the percent errors of the structural volumes with various CT slice thickness were below 9%; the volume of the temporal bone flap was close to that from micro-CT images with a percent error of 4.1%. No significant difference (p >0.01) was found between the areal BMD of lumbar vertebrae calculated using the TCM and measured using dual-energy X-ray absorptiometry. In conclusion, the proposed TCM could be applied to diagnose osteoporosis, while providing a basis for comparing various measurement methods.

Small-Field Measurements of 3D Polymer Gel Dosimeters through Optical Computed Tomography.

With advances in therapeutic instruments and techniques, three-dimensional dose delivery has been widely used in radiotherapy. The verification of dose distribution in a small field becomes critical because of the obvious dose gradient within the field. The study investigates the dose distributions of various field sizes by using NIPAM polymer gel dosimeter. The dosimeter consists of 5% gelatin, 5% monomers, 3% cross linkers, and 5 mM THPC. After irradiation, a 24 to 96 hour delay was applied, and the gel dosimeters were read by a cone beam optical computed tomography (optical CT) scanner. The dose distributions measured by the NIPAM gel dosimeter were compared to the outputs of the treatment planning system using gamma evaluation. For the criteria of 3%/3 mm, the pass rates for 5 × 5, 3 × 3, 2 × 2, 1 × 1, and 0.5 × 0.5 cm2 were as high as 91.7%, 90.7%, 88.2%, 74.8%, and 37.3%, respectively. For the criteria of 5%/5 mm, the gamma pass rates of the 5 × 5, 3 × 3, and 2 × 2 cm2 fields were over 99%. The NIPAM gel dosimeter provides high chemical stability. With cone-beam optical CT readouts, the NIPAM polymer gel dosimeter has potential for clinical dose verification of small-field irradiation.

Association between leukaemia and X-ray in children: a nationwide study.

AIM: The frequency of employing radiography is increasing. Long-term risks of performing X-ray procedures on children and adolescents for medical diagnosis have raised significant concerns. METHODS: In this study, we adopt the case-control methodology to evaluate the relationship between the incidence rate of acute leukaemia and exposure to radiation during diagnostic X-ray examinations for children. Based on 1998-2010 data obtained from the Taiwan Bureau of National Health Insurance database, we selected 58 children with leukaemia and randomly selected an additional 232 children as the control group. RESULTS: The mean age of children with leukaemia is 8.92 ± 5.24 years. The risk of leukaemia in children who underwent X-ray examinations increased 2.14-fold (95% CI, 1.18-3.87). In this study, we identified that, when undergoing X-ray examinations, the risk of leukaemia in children increased for both sex and age groups. Specifically, the relationship between leukaemia and X-ray in boys (OR = 3.28, 95%CI, 1.33-8.07) and in ages of 6 to 11 years (OR = 2.58, 95%CI, 1.09-6.10) was significant. Overall, the risk of leukaemia in children who underwent X-ray examinations progressively increased from a ratio of 1.65 to 3.14. Moreover, an identical trend was observed for boys (1.85 to 6.42). CONCLUSION: Exposure to X-ray increased the risk of leukaemia in children.