Comparison of sensitivity characteristics between GAFCHROMIC LD-V1 and GAFCHROMIC XR-QA2 in mammographic dosimetry.

In recent years, radiochromic films have begun to be used for dosimetry in mammography; however, the most sensitive GAFCHROMIC XR-QA2 (XR-QA2) film is no longer available owing to its discontinuation. In this study, we evaluated the sensitivity characteristics of GAFCHROMIC LD-V1 (LD-V1) as an alternative to XR-QA2 in the field of mammography, at a low dose and low energy. Our results show that the average ratio of the concentration change of LD-V1 divided by the concentration change of XR-QA2 at each absorbed dose was 53.7%, indicating the sensitivity of LD-V1 to be approximately half of XR-QA2. In addition, the linearity of the concentration change is sufficient even within a dose range of 0.59-14.52 mGy, which is lower than the manufacturer's recommended dose range. Therefore, the LD-V1 is capable of accurate dose assessment even with a low dose and the low level of energy used in mammography.

Dosimetry using a radiochromic film and a mammography phantom.

Mammography is one of the most effective diagnostic methods for the early detection of breast cancer; however, it poses the risk of radiation exposure. To date, mammography dosimetry has been performed according to the mean glandular dose; however, the actual exposure in the breast has not been assessed. Here, we have measured dose distributions and depth doses using both radiochromic films and mammographic phantoms, and a three-dimensional intra-mammary dose assessment was conducted. The absorbed dose distribution at the surface was markedly higher on the chest wall side but lower on the nipple side. The absorbed doses in the depth direction exponentially decreased. The glandular tissue near the surface may be irradiated with an absorbed dose of 7.0 mGy or higher. Since LD-V1 could be placed inside the phantom, the absorbed dose inside the breast could also be evaluated in three dimensions.

Evaluation of factors associated with the effectiveness of radiation protection glasses.

The effects of lead equivalent and lens area of radiation-protective eyewear on lens exposure control were examined. The simulated patient underwent 10-min X-ray fluoroscopy, and the lens dose of the simulated surgeon wearing radiation protection glasses was measured using lens dosemeters attached to the corner of the eye and eyeball. In total, 10 types of radiation protection glasses were selected for measurement. Correlation analysis of the equivalent dose in the lens of the eye with lead equivalence and lens area was performed. The equivalent dose in the lens of the eye of the corner of the eye was negatively correlated with the area of the lens. The equivalent dose in the lens of the eye and the eyeball showed a strong negative correlation with lead equivalence. Lens dosemeters worn at the corner of the eye may overestimate the equivalent dose in the lens of the eye. Moreover, the reduction in exposure of the lens was significantly influenced by the lead equivalent.

Development of a three-dimensional dose evaluation method for computed tomography.

During a single scan using computed tomography, an X-ray tube orbits along a 360°-circular path around the patient. A scan obtained using the half-cylindrical type phantoms with a radiochromic film sandwiched in between reveals a pixel value map illustrating the two-dimensional (2D) dose distribution. A three-dimensional (3D) dose distribution can be obtained with a 360° rotation of the 2D dose map. This study evaluates the concept and methodology of creating a 3D dose map to develop a phantom with a radiochromic film for obtaining the 3D dose distribution. The coronal and axial plane dose distributions were also evaluated. A single scan computed tomography image obtained using a half-cylindrical type of acrylic phantom with a sandwiched radiochromic film was studied. The diameters of the phantoms were 10 and 16 cm, and their lengths were 30 cm. A 2D image of the XR-QA2 film was obtained using an image scanner and image processing software. A red channel image was used to obtain the 3D dose distribution using a computing platform. A pseudo color was applied to the red channel image from which cross-sectional color images were obtained. Half of the cross-sectional pixel data were rotated by 360° to generate the data for each axial plane. The image created was saved, and a 3D pixel value map was constructed. The dose measurement procedure for the 3D dose distribution was developed using half-cylindrical acrylic phantoms with a radiochromic film.

THREE-DIMENSIONAL DOSIMETRY OF MAMMOGRAPHY USING A BLOCK CUBE BREAST PHANTOM AND RADIOCHROMIC FILM.

This study developed a phantom with a shape similar to that of the breast and use GAFCHROMIC films that can be placed inside the phantom to measure the detailed breast dose distribution in mammography. GAFCHROMIC EBT3 was placed on the block cube breast phantom and irradiated with a mammography device to measure the absorbed dose distribution inside the phantom in the horizontal and depth directions. The dose distribution in the horizontal plane was the highest in the centre on the chest wall side, and it decreased in a fan shape. Along the depth of the phantom, the doses absorbed across the entire cross-section were 16.15 mGy at the surface and 7.51, 3.25 and 1.68 mGy at depths of 10, 20 and 30 mm, respectively. Compared with the mean glandular dose, the proposed method can measure breast dose distributions in greater detail and is applicable to various breast shapes.

USE OF ULTRAVIOLET RAY PRE-IRRADIATION TO IMPROVE THE ACCURACY OF LOW-DOSE MEASUREMENTS OF THE CT USING A GAFCHROMIC RTQA2 FILM.

The purpose of this study is to develop a method for use at extremely low-dose ranges and to decrease the uncertainty outside the recommended range of Gafchromic RTQA2 (RTQA2). By this method, the CT dose including the scattered radiation region can be grasped. The base density was increased by ultraviolet (UV)-ray preirradiation. RTQA2 was irradiated with UV-A rays for 26 and 40 h. Subsequently, RTQA2 was exposed to 2, 4, 6, 8, 10, 25, 50, 75, 100, 150, 200 and 250 mGy X-rays using a segmentation method. Calibration curves with and without UV-A irradiation were compared. The calibration curve with 40-h UV-A ray irradiation was the most linear, and a steeper slope area was not observed. The uncertainty in the calibration curve was reduced (p < 0.05). UV-A ray irradiation is an effective method for treating RTQA2; the accuracy in the extremely low-dose range of RTQA2 was improved.

THE CONCEPT OF X-RAY CT DOSE EVALUATION METHOD USING RADIOCHROMIC FILM AND FILM-FOLDING PHANTOM.

In this paper, we propose a novel radiochromic film (RCF)-based computed tomography (CT) dosimetry method, which is different from the method based on CT dose index. RCF dosimetry using Gafchromic QA2 films was performed using two lengths of film-folding phantoms. The phantom was exposed to X-ray CT through a single scan, while the RCF was sandwiched between the phantoms. We analysed the dose profile curve in two directions to investigate the dose distribution. We observed a difference in the dose distribution as the phantom size changed. Our results contradict with the results of previous studies such as Monte Carlo simulation or direct measurement. The ability to visually evaluate 2D dose distributions is an advantage of RCF dosimetry over other methods. This research investigated the ability of 2D X-ray CT dose evaluation using RCF and film-folding phantom.

Intensities of Incident and Transmitted Ultraviolet-A Rays through Gafchromic Films.

Gafchromic films have been applied to X-ray dosimetry in diagnostic radiology. To correct nonuniformity errors in Gafchromic films, X-rays in the double-exposure technique can be replaced with ultraviolet (UV)-A rays. Intensities of the incident and transmitted UV-A rays were measured. However, it is unclear whether the chemical color change of Gafchromic films affects the UV-A transmission intensity. Gafchromic EBT3 films were suitable to be used in this study because non-UV protection layers are present on both sides of the film. The film is placed between UV-A ray light-emitting diodes and a probe of a UV meter. Gafchromic EBT3 films were irradiated by UV-A rays for up to 60 min. Data for analysis were obtained in the subsequent 60 min. Images from before and after UV-A irradiation were subtracted. When using 375 nm UV-A, the mean ± standard deviation (SD) of the pixel values in the subtracted image was remarkably high (11,194.15 ± 586.63). However, the UV-A transmissivity remained constant throughout the 60 min irradiation period. The mean ± SD UV-A transmission intensity was 184.48 ± 0.50 µm/cm2. Our findings demonstrate that color density changes in Gafchromic EBT3 films do not affect their UV-A transmission. Therefore, Gafchromic films were irradiated by UV-A rays as a preexposure.

Correction of nonuniformity error of Gafchromic EBT2 and EBT3.

This study investigates an X-ray dose measurement method for computed tomography using Gafchromic films. Nonuniformity of the active layer is a major problem in Gafchromic films. In radiotherapy, nonuniformity error is reduced by applying the double-exposure technique, but this is impractical in diagnostic radiology because of the heel effect. Therefore, we propose replacing the X-rays in the double-exposure technique with ultraviolet (UV)-A irradiation of Gafchromic EBT2 and EBT3. To improve the reproducibility of the scan position, Gafchromic EBT2 and EBT3 films were attached to a 3-mm-thick acrylic plate. The samples were then irradiated with a 10 W UV-A fluorescent lamp placed at a distance of 72cm for 30, 60, and 90 minutes. The profile curves were evaluated along the long and short axes of the film center, and the standard deviations of the pixel values were calculated over large areas of the films. Paired t-test was performed. UV-A irradiation exerted a significant effect on Gafchromic EBT2 (paired t-test; p = 0.0275) but not on EBT3 (paired t-test; p = 0.2785). Similarly, the homogeneity was improved in Gafchromic EBT2 but not in EBT3. Therefore, the double-exposure technique under UV-A irradiation is suitable only for EBT2 films.

Simplified method for creating a density-absorbed dose calibration curve for the low dose range from Gafchromic EBT3 film.

Radiochromic film dosimeters have a disadvantage in comparison with an ionization chamber in that the dosimetry process is time-consuming for creating a density-absorbed dose calibration curve. The purpose of this study was the development of a simplified method of creating a density-absorbed dose calibration curve from radiochromic film within a short time. This simplified method was performed using Gafchromic EBT3 film with a low energy dependence and step-shaped Al filter. The simplified method was compared with the standard method. The density-absorbed dose calibration curves created using the simplified and standard methods exhibited approximately similar straight lines, and the gradients of the density-absorbed dose calibration curves were -32.336 and -33.746, respectively. The simplified method can obtain calibration curves within a much shorter time compared to the standard method. It is considered that the simplified method for EBT3 film offers a more time-efficient means of determining the density-absorbed dose calibration curve within a low absorbed dose range such as the diagnostic range.

Ultraviolet exposure of Gafchromic XR-RV3 and XR-SP2 films.

Gafchromic film has been used for X-ray dose measurement in diagnostic examinations. Their use has been initiated for three-dimensional X-ray dose measurement by using the high-resolution characteristics of Gafchromic films in computed tomography. However, it is necessary to solve the problem of nonuniform thickness in the active layers of Gafchromic films. A double exposure technique using X-rays is performed in therapeutic radiology; it is difficult to use in a diagnostic examination because of the heel effect. Therefore, it is suggested that ultraviolet (UV) rays be substituted for X-rays. However, the appropriate UV wavelength is unknown. In this study, we aimed to determine which UV wavelengths are effective to expose Gafchromic XR-RV3 and XR-SP2. UV lamps with peak wavelengths of 245 nm, 310 nm, and 365 nm were used. The three UV wavelengths were used to irradiate Gafchromic XR-RV3 and XR-SP2 films for 60 min, and irradiation was repeated every 60 min for 600 min thereafter. Films were scanned after each irradiation period on a flatbed scanner. The images were split into their red-green-blue components, and red images were stored using ImageJ version 1.44o image analysis software. Regions of interest (ROI), 0.5 inches in diameter, were placed at the centers of the subtracted Gafchromic film images, and graphs of UV irradiation duration and mean pixel values were plotted. There were reactions to UV-A on both Gafchromic XR-RV3 and XR-SP2; those to UV-B were moderate. However, UV-C demonstrated few reactions with Gafchromic XR-RV3 and XR-SP2. From these results, irradiation with UV-A may be able to correct nonuniformity errors. Uniform UV-A irradiation of Gafchromic films with large areas is possible, and UV rays can be used as a substitute for X-rays in the double exposure technique.

Comparing three UV wavelengths for pre-exposing Gafchromic EBT2 and EBT3 films.

Gafchromic films are used for X-ray dose measurements during diagnostic examinations and have begun to be used for three-dimensional X-ray dose measurements using the high-resolution characteristics of Gafchromic films for computed tomography. However, the problem of unevenness in Gafchromic film active layers needs to be resolved. Double exposures using X-rays are performed during therapeutic radiology, although this is difficult for a diagnostic examination because of a heel effect. Thus, it has been suggested that ultraviolet (UV) radiation be used as a substitute for X-rays. However, the appropriate UV wavelength has not been determined. Thus, we conducted this study to decide an appropriate UV wavelength. UV peak wavelengths of 245 nm (UV-A), 310 nm (UV-B), and 365 nm (UV-C) were used to irradiate EBT2 and EBT3 films. Each UV wavelength was irradiated for 5, 15, 30, and 60 min, and irradiation was then repeated every 60 min up to 360 min. Gafchromic films were scanned after every irradiation using a flatbed scanner. Images were split into RGB images, and red images were analyzed using ImageJ, version 1.44, image analysis software. A region of interest (ROI) one-half inch in diameter was placed in the center of subtracted Gafchromic film images, and UV irradiation times were plotted against mean pixel values. There were reactions in the front and back of Gafchromic EBT3 and the back of Gafchromic EBT2 with UV-A and UV-B. However, UV-C resulted in some reactions in both sides of Gafchromic EBT2 and EBT3. The UV-A and UV-B wavelengths should be used.

Evaluation of GAFCHROMIC EBT2 dosimetry for the low dose range using a flat-bed scanner with the reflection mode.

Recently developed radiochromic films can easily be used to measure absorbed doses because they do not need development processing and indicate a density change that depends on the absorbed dose. However, in GAFCHROMIC EBT2 dosimetry (GAF-EBT2) as a radiochromic film, the precision of the measurement was compromised, because of non-uniformity problems caused by image acquisition using a flat-bed scanner with a transmission mode. The purpose of this study was to improve the precision of the measurement using a flat-bed scanner with a reflection mode at the low absorbed dose dynamic range of GAF-EBT2. The calibration curves of the absorbed dose versus the film density for GAF-EBT2 were provided. X-rays were exposed in the range between ~0 and 120 mGy in increments of about 12 mGy. The results of the method using a flat-bed scanner with the transmission mode were compared with those of the method using the same scanner with the reflection mode. The results should that the determination coefficients (r (2) ) for the straight-line approximation of the calibration curve using the reflection mode were higher than 0.99, and the gradient using the reflection mode was about twice that of the one using the transmission mode. The non-uniformity error that is produced by a flat-bed scanner with the transmission mode setting could be almost eliminated by converting from the transmission mode to the reflection mode. In light of these findings, the method using a flat-bed scanner with the reflection mode (only using uniform white paper) improved the precision of the measurement for the low absorbed dose range.

Sonographic measurement of transient synovitis in children: diagnostic value of joint effusion.

In an evaluation of the diagnostic criteria for ultrasonography (US) of transient synovitis in children, in a prospective study, 34 consecutive children with a painful hip underwent US. The ultrasonographic joint space (UJS) and the effusion space were measured in both hips, and the width of the UJS thickness in the asymptomatic hips was compared with that in the symptomatic hips. US showed the presence of a joint effusion in 31 of the 34 children and a bilateral effusion in 3. The US diagnostic criterion for hip effusion consists of a UJS thickness difference >2.0 mm between asymptomatic and symptomatic hips. However, we found that 8 of the 31 UJS measurements compared between symptomatic hips and asymptomatic hips exhibited differences of <2 mm. We suggest that effusion space measurements are possible for accurate visualization of synovitis, rather than the recording of differences in UJS measurements between hips.

Improved detection of gastric cancer during screening by additional radiographs as judged necessary by the radiographer.

PURPOSE: The aim of this study was to determine whether additional radiographs, as judged necessary by the radiographer, improves cancer detection during gastric cancer screening. MATERIALS AND METHODS: We analyzed 144 gastric cancer cases among 137 744 individuals who underwent X-ray screening for gastric cancer. Radiographs were obtained by 17 radiographers at a screening center in Japan from April 2004 to March 2008. Additional radiographs were taken based on the radiographer's judgment in cases of suspected cancer. During double-blind reinterpretation of the cancer case radiographs by two radiologists, we determined the number of cancer cases that were detected by standard radiographs alone. We next determined the number of cancer cases detected using both standard radiographs and additional radiographs. RESULTS: Compared to the number of cancer cases detected with standard radiographs alone (120 cases detected, 24 cases undetected), the number of cancer cases detected with both standard and additional radiographs (137 cases detected, 7 cases undetected) significantly increased (17 cases; P < 0.001, McNemar test). CONCLUSION: We found that taking additional radiographs, when judged necessary by the radiographer during radiographic gastric cancer screening, improves cancer detection.

Functional residual capacity breath hold for subtraction image of dynamic liver MRI.

PURPOSE: In dynamic liver magnetic resonance imaging (MRI) studies, there are problems with misregistration when subtraction images are processed. For reduction of the misregistration, a functional residual capacity (FRC) phase breath-hold (FRC B-H) method was used. MATERIAL AND METHODS: Sixty patients (32 males and 28 females, aged 33-85 years, median age 69 years) were examined. The subjects were chronologically categorized into two groups: a voluntary expiratory (VE) B-H group and a FRC B-H group. The blood-flow phase images were classified as plain, arterial, portal and parenchymal phases. To evaluate the reproducibility of liver positions between VE B-H and FRC B-H in each phase (between Plain and Arterial, Arterial and Portal, Plain and Parenchymal), the misregistration areas were compared on the top of the liver. RESULTS: The misregistration area between Plain-Arterial, Arterial-Portal and Plain-Parenchymal in VE B-H was 731.0+/-1153.6, 1134.9+/-1357.2 and 628.4+/-844.5 (cm(2)), respectively. The misregistration area between each phase in FRC B-H was 386.4+/-874.9, 574.5+/-1086.1 and 279.8+/-551.2 (cm(2)), respectively. Using the Mann-Whitney U-test as quantitative analysis, the difference in misregistration areas between two groups was statistically significant (p<0.05). Differences in the qualitative analysis were also significant according to the chi(2) test (p<0.05). CONCLUSION: The liver positions with FRC B-H were markedly more reproducible than those with VE B-H. To improve the registration accuracy of subtraction dynamic liver MRI, the FRC B-H should be used.

High resolution T2 weighted liver MR imaging using functional residual capacity breath-hold with a 1.0-Tesla scanner.

PURPOSE: During acquisition of rapid high resolution (HR) T2 weighted (T2W) liver magnetic resonance (MR) images using a 1.0-Tesla (T) scanner, the liver is segmented into odd and even sections that are acquired at two different times using the multi-breath-hold (MBH) strategy. Misalignment between the two breath-hold (B-H) images may result in the occurrence of a blind area and a decrease in diagnostic accuracy. Here, a functional residual capacity (FRC) B-H method was developed to overcome this problem. MATERIAL AND METHODS: Twenty-five volunteers were enrolled. The sagittal images were reconstructed from whole liver transverse images. When the B-H phases are different, misalignment may occur in the craniocaudal and anterior-posterior (AP) directions. In this study, misalignments of the abdominal wall were measured in the AP direction. The misalignment was compared between four B-H phases, maximum inspiration (MI), maximum expiration (ME), voluntary expiration (VE) and FRC using one-way repeated measures ANOVA. Differences between groups were compared using the t-test for multi-group comparisons. In addition, qualitative analysis of misalignment was performed between VE and FRC in 52 clinical patients and the chi(2) test was performed. RESULTS: The misalignment widths of FRC, ME, MI and VE B-Hs were 2.7+/-3.8, 6.4+/-7.4, 9.1+/-8.4 and 6.0+/-6.7 mm, respectively. Misalignment of the liver position using FRC was significantly smaller than for the other B-H methods (p<0.05). Significant differences between the VE B-H and FRC B-H were also observed in the qualitative analysis (p<0.05). CONCLUSION: The liver positions obtained when using FRC B-H were significantly more reproducible than when using the other B-H methods. The FRC B-H method resulted in a reduction in the blind area and an extension of the diagnostic area to the whole liver.