In-phantom neutron dose measurement using Gafchromic film dosimeter for QA of BNCT beams.

In order to improve the quality assurance (QA) procedure for beams of boron neutron capture therapy (BNCT), this study introduced using the Gafchromic film dosimeter for neutron dose measurement of BNCT beams. The crucial part of this study was investigating an approach to employ the Gafchromic film dosimeter placed inside a PMMA phantom irradiated by a BNCT beam. The spatial distribution of neutron dose of the film was determined using measurements and Monte Carlo calculations. By employing the present approach, the two-dimensional distributions of the neutron dose component of the film at specific depths in the phantom were successfully obtained. The determined neutron dose profiles were in good agreement with the calculated ones. This study also confirmed the finding that the film dosimeter is sensitive to thermal neutrons by comparing the depth-capture-reaction-rate and depth-dose distributions. Results of this work not only proved the feasibility of using the proposed method for the QA measurement of beam delivery but also revealed the advantages of easy-handling and remarkable spatial resolution of the film dosimeter when applied to BNCT fields. The present work can help to verify the dose uniformity and output stability of BNCT beams prior to clinical irradiation.

Measurements of air kerma index in computed tomography: A comparison among methodologies.

As CT exams impart high doses to patients in comparison to other radiologist techniques, reliable dosimetry is required. In this work, dosimetry in CT beams was carried out in terms of air kerma index in air or in a phantom measured by a pencil ionization chamber, thermoluminescent (TL) detectors and radiochromic film. Calibration results showed the low energy dependence of all three dosimetric systems for the 100-120kV range, the very high uncertainty of the TL dosimeters in comparison to the other systems and high nonlinearity response in terms of air kerma of the radiochromic film. Measurements with the three systems in a 120kV CT protocol showed an acceptable agreement among the weighted air kerma index values, but TL dosimeters presented the highest uncertainties in the values.

Differential dose absorptions for various biological tissue equivalent materials using Gafchromic XR-QA2 film in diagnostic radiology.

Phantoms are devices that simulate human tissues including soft tissues, lungs, and bones in medical and health physics. The purpose of this work was to investigate the differential dose absorption in several commercially available low-cost materials as substitutes to human tissues using Gafchromic XR-QA2 film. The measurement of absorbed dose by different materials of various densities was made using the film to establish the relationship between the absorbed dose and the material density. Materials investigated included soft board materials, Perspex, chicken bone, Jeltrate, chalk, cow bone, marble, and aluminum, which have varying densities from 0.26 to 2.67gcm-3. The absorbed dose increased as the density and atomic number of the material increased. The absorbed dose to the density can be well represented by a polynomial function for the materials used.

In phantom assessment of superficial doses under TomoTherapy irradiation.

PURPOSE: Aim of this work is the assessment of build-up and superficial doses of different clinical Head&Neck plans delivered with Helical TomoTherapy (HT) (Accuray, Sunnyvale, CA). Depth dose profiles and superficial dose points were measured in order to evaluate the Treatment Planning System (TPS) capability of an accurate dose modeling in regions of disequilibrium. Geometries and scattering conditions were investigated, similar to the ones generally encountered in clinical treatments. METHODS: Measurements were performed with two dosimeters: Gafchromic® EBT3 films (Ashland Inc., Wayne, NJ) and a synthetic single crystal diamond detector (PTW-Frieburg microDiamond, MD). A modified version of the Alderson RANDO phantom was employed to house the detectors. A comparison with TPS data was carried out in terms of dose difference (DD) and distance-to-agreement (DTA). RESULTS: DD between calculated data and MD measurements are within 4% even in points with high spatial dose variation. For depth profiles, EBT3 data show a DDmax of 3.3% and DTAmax of 2.2mm, in low and high gradient regions, respectively, and compare well with MD data. EBT3 superficial points always results in measured doses lower than TPS evaluated ones, with a maximum DTA value of 1.5mm. CONCLUSIONS: Doses measured with the two devices are in good agreement and compare well with calculated data. The deviations found in the present work are within the reference tolerance level, suggesting that the HT TPS is capable of a precise dose estimation both in superficial regions and in correspondence with interfaces between air and PMMA.

Heterogeneity and scatter effects on Ir-192 brachytherapy dose distribution.

We studied the effects of the presence of an air cavity and scatter due to patient size on dose distribution near an Iriduim-192 brachytherapy source (Ir-192). The source was modeled using Monte Carlo (MC) code MCNP5. The Radial dose, gL(r), and the anisotropy function, F(r,θ) specified by the AAPM TG-43 have been determined and compared with the consensus data (AAPM report No. 229). We compared our MC results to the measured dose distribution using an EBT3 Gafchromic® film measurement. The dose was determined in the presence of an air cavity of 3, 5, and 7mm diameters located at 2mm distance from Ir-192. The dose was also determined for Ir-192 centered in 30×30×30cm3 and 80×80×80cm3 water phantoms. The MC results of gL(r) and F(r,θ) agreed with the consensus data to within 2% and 3%, respectively. The MC and the measured dose distributions agreed well with a maximum difference of 8.2% at the periphery of the film. The dose at 10cm from the Ir-192 source with a full scattering medium (80×80×80cm3) was 7% higher compared to the dose in (30×30×30cm3) water phantom. The dose to water in the presence of a 3, 5, and 7mm diameter air cavity increased by an average of 3%, 6%, and 9%, respectively, compared to the dose with no air cavity. Ignoring scatter effects and the heterogeneity correction in the presence of an air cavity can lead to significant errors in dose delivered to patients.

Characterization of stochastic noise and post-irradiation density growth for reflective-type radiochromic film in therapeutic photon beam dosimetry.

The aim of this study is to investigate the dosimetric uncertainty of stochastic noise and the post-irradiation density growth for reflective-type radiochromic film to obtain the appropriate dose from the exactly controlled film density. Film pieces were irradiated with 6-MV photon beams ranging from 0 to 400cGy. The pixel values (PVs) of these films were obtained using a flatbed scanner at elapsed times of 1min to 120h between the end of irradiation and the film scan. The means and standard deviations (SDs) of the PVs were calculated. The SDs of the converted dose scale, usd, and the dose increases resulting from the PV increases per ±29min at each elapsed time, utime, were computed. The combined dose uncertainties from these two factors, uc, were then calculated. A sharp increase in the PV occurred within the first 3h after irradiation, and a slight increase continued from 3h to 120h. usd was independent of post-irradiation elapsed time. Sharp decreases in utime were obtained within 1h after irradiation, and slight decreases in utime were observed from 1 to 24h after irradiation. uc first decreased 1h after irradiation and remained constant afterward. Assuming that the post-irradiation elapsed times of all of the related measurements are synchronized within ±29min, the elapsed time should be at least 1h in our system. It is important to optimize the scanning protocol for each institution with consideration of the required measurement uncertainty and acceptable latency time.

Effect of correction methods of radiochromic EBT2 films on the accuracy of IMRT QA.

Radiochromic films are dosimeters with more favorable characteristics than other two-dimensional (2D) radiation detectors. Transmission film scanners using a linear charge-coupled device (CCD) array have a drawback of variation in response along the detector array, which may result in a nonuniform transmission of signal over the scanned image. This study uses 2D gamma index analysis to compare two methods for correcting the nonuniform response of EBT2: the first method was based on the new red:blue method proposed by the manufacturer (to compensate for small nonuniformities in the film coating) and the second method, proposed by Menegotti et al. (2008), was based on dose-dependent matrix correction factors. The gamma index analysis shows that both the methods are comparably accurate for all the criteria values used for evaluation (1 mm/1%, 2 mm/2%, 3 mm/3%). Centers around the world use both the methods to correct EBT2 local heterogeneities, but it is important to note that the former method has several advantages such as less time consumption and easy implementation.

Characterization of the effect of MRI on Gafchromic film dosimetry.

Magnetic resonance (MR) imaging of Gafchromic film causes perturbation to absolute dosimetry measurements; the purpose of this work was to characterize the perturbation and develop a correction method for it. Three sets of Gafchromic EBT2 film were compared: radiation (control), radiation followed by MR imaging (RAD + B), and MR imaging followed by radiation (B + RAD). The T1-weighted and T2-weighted MR imaging was performed using a 1.5T scanner with the films wedged between two chicken legs. Doses from 0 to 800 cGy were delivered with a 6MV linac. The time interval between radiation and MR imaging was less than 10 min. Film calibration was generated from the red channel. Microscopic imaging was performed on two pieces of film. The effect of specific absorption rate (SAR) was determined by exposing another three sets of films to low, medium, and high levels of SAR through a series of pulse sequences. No discernible preferential alignment was detected on the microscopic images of the irradiated film exposed to MRI. No imaging artifacts were introduced by Gafchromic film on any MR images. On average, 4% dose difference was observed between B + RAD or RAD + B and the control, using the same calibration curve. The pixel values between the B + RAD or RAD + B and the control films were found to follow a linear relationship pixel(Control) = 1.02 × pixel(B + RAD or RAD + B). By applying this correction, the average dose error was reduced to approximately 2%. The SAR experiment revealed a dose overestimation with increasing SAR even when the correction was applied. It was concluded that MR imaging introduces perturbation on Gafchromic film dose measurements by 4% on average, compared to calibrating the film without the presence of MRI. This perturbation can be corrected by applying a linear correction to the pixel values. Additionally, Gafchromic film did not introduce any imaging artifacts in any of the MR images acquired.

Experimental dosimetry in conformal breast teletherapy compared with the planning system.

The objective of this study was to compare and analyse the absorbed dose profiles from the conformal radiotherapy planning and experimental dosimetry taken in a breast anthropomorphic and anthropometric phantom. Conformal radiotherapy planning was elaborated in the Treatment Planning System (TPS). EBT2 Gafchromic radiochromic films were applied as dosimeters, positioned internally and superficially in the breast phantom. The standard radiation protocol was applied in the breast phantom. The films were digitalised, and their responses were analysed in RGB. The optical densities were processed, reproducing the spatial dose distribution.

How are we protecting ourselves from radiation exposure? A nationwide survey.

PURPOSE: We performed a nationwide survey of Brazilian urologists to study behaviors toward radiation exposure and the use of protective and monitoring equipment. METHODS: A 13-question e-mail questionnaire was sent to 4,526 Brazilian urologists; the questions addressed demographic characteristics, radiation exposure, and the utilization of shielding devices and dosimeters. The reasons why these devices were not used were also investigated. RESULTS: A total of 332 completed questionnaires were analyzed (7.3 %); the median age of the respondents was 43.3 ± 10.8 years. Lead aprons and thyroid protection are utilized in every procedure by 84.4 and 53.89 % of respondents, respectively. Protective eyeglasses are never used by 72.12 % of the respondents. Older urologists were more likely not to use adequate protection. Of the urologists who responded, 76.42 % never use dosimeters. CONCLUSION: This study shows an unsatisfactory utilization of radiation-shielding devices and dosimeters, revealing a low compliance to the as low as reasonably achievable principle among Brazilian urologists.

Compliance with the proper use of an individual radiation dosimeter among children and the effects of improper use on the measured dose: a retrospective study 18-20 months following Japan's 2011 Fukushima nuclear incident.

OBJECTIVES: To identify profiles of children who did not properly use individual radiation dosimeters following Japan's 2011 Fukushima nuclear incident, and to assess how much error is generated by improper dosimeter use. PARTICIPANTS: The participants in this study comprised 1637 school children who participated in the external radiation exposure screening programme administrated by Minamisoma City (located 20-30 km from the Fukushima nuclear plant) between 18 and 20 months after the Fukushima incident. METHODS: We assessed the factors associated with improper use (non-use) of the dosimeters at specific time periods during the day (school commuting hours, at school, at home, outdoors and at bedtime) using logistic regression analyses. Ratios of the measured dose to regression estimates of the 'expected' dose (referred to as an error due to non-use) were also examined. RESULTS: Only 119 children (7.3%) used the dosimeters properly in all time periods. This low rate was attributed primarily to non-use when children were in the home and outdoors, rather than at school. School level, air dose rate at home, gender, membership in outdoor sports clubs and time spent outdoors on weekends, were significantly associated with improper use, after adjustment for covariates. Data from children who did not wear the dosimeters to school and outdoors had statistically significant (but clinically insignificant) errors (ratio: 1.13, p<0.01; and 0.97, p<0.05, respectively), whereas improper use of the dosimeters at school, at home and at bedtime did not generate significant errors. CONCLUSIONS: Well-targeted rigorous instructions on the use of the dosimeter are required, with particular focus on time periods other than school hours. However, given the small dose error due to the improper use of the dosimeters, even if the dosimeters are improperly used, solid evaluation of the radiation exposure may be possible with some accuracy.

Military participants at U.S. Atmospheric nuclear weapons testing--methodology for estimating dose and uncertainty.

Methods were developed to calculate individual estimates of exposure and dose with associated uncertainties for a sub-cohort (1,857) of 115,329 military veterans who participated in at least one of seven series of atmospheric nuclear weapons tests or the TRINITY shot carried out by the United States. The tests were conducted at the Pacific Proving Grounds and the Nevada Test Site. Dose estimates to specific organs will be used in an epidemiological study to investigate leukemia and male breast cancer. Previous doses had been estimated for the purpose of compensation and were generally high-sided to favor the veteran's claim for compensation in accordance with public law. Recent efforts by the U.S. Department of Defense (DOD) to digitize the historical records supporting the veterans' compensation assessments make it possible to calculate doses and associated uncertainties. Our approach builds upon available film badge dosimetry and other measurement data recorded at the time of the tests and incorporates detailed scenarios of exposure for each veteran based on personal, unit, and other available historical records. Film badge results were available for approximately 25% of the individuals, and these results assisted greatly in reconstructing doses to unbadged persons and in developing distributions of dose among military units. This article presents the methodology developed to estimate doses for selected cancer cases and a 1% random sample of the total cohort of veterans under study.

Methodology for characterizing seeds under development for brachytherapy by means of radiochromic and photographic films.

The development of new medical devices possess a number of challenges, including designing, constructing, and assaying prototypes. In the case of new brachytherapy seeds, this is also true. In this paper, a methodology for rapid dosimetric characterization of (125)I brachytherapy seeds during the early stages of their development is introduced. The characterization methodology is based on the joint use of radiochromic and personal monitoring photographic films in order to determine the planar anisotropy due to the radiation field produced by the seed under development, by means of isodose curves. To evaluate and validate the process, isodose curves were obtained with both types of films after irradiation with a commercial (125)I brachytherapy seed.

Isodose curve mappings measured while undergoing rotation for quality assurance testing of a 137Cs irradiator.

To enable accurate and reproducible dosimetry for biological sample irradiation in a 137Cs irradiator, routine quality assurance of the dose rate and isodose distributions should be considered. Our previous work demonstrated a means for accurate dose rate quality assurance and for quality assurance of isodose distributions of non-rotational samples. This work presents a means to accurately and cost effectively measure dose distributions within a 137Cs irradiator using rotational geometry, which geometry represent a more typical use of these irradiators. A simple apparatus was developed to hold radiochromic film and was constructed of polymethyl methacrylate. The rotational quality assurance device allowed the comparison of measured radiochromic film vs. manufacturer provided isodose distributions. A good agreement was discovered between the two data sets along the central vertical axis of rotation in the 137Cs irradiator, but a 40-50% smaller 100% isodose region in the horizontal direction. These findings may lead to limiting the overall size of a sample capable of being uniformly irradiated by the 137Cs irradiator at this research institution. The authors propose the construction and use of a simple rotational quality assurance device for routine quality assurance of 137Cs irradiators.

Experimental determination of the radial dose distribution in high gradient regions around 192Ir wires: comparison of electron paramagnetic resonance imaging, films, and Monte Carlo simulations.

PURPOSE: The experimental determination of doses at proximal distances from radioactive sources is difficult because of the steepness of the dose gradient. The goal of this study was to determine the relative radial dose distribution for a low dose rate 192Ir wire source using electron paramagnetic resonance imaging (EPRI) and to compare the results to those obtained using Gafchromic EBT film dosimetry and Monte Carlo (MC) simulations. METHODS: Lithium formate and ammonium formate were chosen as the EPR dosimetric materials and were used to form cylindrical phantoms. The dose distribution of the stable radiation-induced free radicals in the lithium formate and ammonium formate phantoms was assessed by EPRI. EBT films were also inserted inside in ammonium formate phantoms for comparison. MC simulation was performed using the MCNP4C2 software code. RESULTS: The radical signal in irradiated ammonium formate is contained in a single narrow EPR line, with an EPR peak-to-peak linewidth narrower than that of lithium formate (approximately 0.64 and 1.4 mT, respectively). The spatial resolution of EPR images was enhanced by a factor of 2.3 using ammonium formate compared to lithium formate because its linewidth is about 0.75 mT narrower than that of lithium formate. The EPRI results were consistent to within 1% with those of Gafchromic EBT films and MC simulations at distances from 1.0 to 2.9 mm. The radial dose values obtained by EPRI were about 4% lower at distances from 2.9 to 4.0 mm than those determined by MC simulation and EBT film dosimetry. CONCLUSIONS: Ammonium formate is a suitable material under certain conditions for use in brachytherapy dosimetry using EPRI. In this study, the authors demonstrated that the EPRI technique allows the estimation of the relative radial dose distribution at short distances for a 192Ir wire source.

Radiation exposure in emergency physicians working in an urban ED: a prospective cohort study.

OBJECTIVE: The National Council on Radiation Protection (NCRP) limits health care-associated occupational exposures to radiation to 5000 mrem/y. Previous studies suggested that emergency physicians were not exposed over this limit. Their relevance to contemporary practice is unknown. We hypothesized that emergency physicians are currently exposed to radiation levels above the NCRP limits. METHODS: This prospective cohort study was conducted at an urban, academic, level I trauma center emergency department (ED). Thermoluminescent dosimeter radiation badges were placed on the torso and ring finger of all physicians staffing the ED during May 2008. Thermoluminescent dosimeter badges were affixed to 8 portable phones that are carried by physicians in the ED 24 hours a day. At the end of the study period, exposure dose for each subject was estimated. RESULTS: Seventy-five physicians enrolled in the study; 41 residents worked a median of 94 hours and 34 attendings worked a median of 54 hours. Compliance for physician badge wearing was 99%, ring wearing was 98%, and phone wearing was 100%. Two subjects had detectable levels of radiation on their torso thermoluminescent dosimeters of 4 and 1 mrem, respectively. One phone badge had a detectable level of 1 mrem. The annual extrapolated exposure for the subject with the highest radiation level would have been 50 mrem, below the 5000 mrem exposure limit for health care workers. CONCLUSION: Emergency physicians working in an urban, academic, level I trauma center ED do not appear to be at risk of exceeding the NCRP dose limits for ionizing radiation exposure to their torso or extremities.

Evaluation of calculation algorithms implemented in different commercial planning systems on an anthropomorphic breast phantom using film dosimetry.

PURPOSE: To evaluate the accuracy of dose calculation algorithms of different planning systems for postoperative tangential radiotherapy in breast cancer. MATERIAL AND METHODS: On a CT dataset of an anthropomorphic phantom, a structure set of the left lung, clinical target volume (CTV), planning target volume, heart, and external contour were delineated. The dataset was processed by six radiation oncology centers participating in this multicenter dosimetry project. Conventional plans with two tangential wedged fields were generated in MasterPlan, Pinnacle, Eclipse, TMS, and PrecisePLAN. Plan calculations were done using the beam data of local linacs. The dose distributions were verified under local conditions with Gafchromic-EBT films. RESULTS: In all planning systems, deviations between calculation and measurement were around +/-3% in the CTV in the measured plane. Only small areas with deviations of +/-5% were detected. Pencil-beam (PB) calculations overestimated the dose inside the lung by up to 23%. Collapsed cone (CC) underestimated the lung dose by up to 6%. CONCLUSION: CC calculates the dose distribution more accurately than PB. Inside regions with electron disequilibrium, however, the dose is slightly underestimated.

Dose area product evaluations with Gafchromic XR-R films and a flat-bed scanner.

Gafchromic XR-R films are a useful tool to evaluate entrance skin dose in interventional radiology. Another dosimetric quantity of interest in diagnostic and interventional radiology is the dose area product (DAP). In this study, a method to evaluate DAP using Gafchromic XR-R films and a flat-bed scanner was developed and tested. Film samples were exposed to an x-ray beam of 80 kVp over a dose range of 0-10 Gy. DAP measurements with films were obtained from the digitalization of a film sample positioned over the x-ray beam window during the exposure. DAP values obtained with this method were compared for 23 cardiological interventional procedures with DAP values displayed by the equipment. The overall one-sigma dose measurement uncertainty depended on the absorbed dose, with values below 6% for doses above 1 Gy. A maximum discrepancy of 16% was found, which is of the order of the differences in the DAP measurements that may occur with different calibration procedures. Based on the results presented, after an accurate calibration procedure and a thorough inspection of the relationship between the actual dose and the direct measured quantity (net optical density or net pixel value variation), Gafchromic XR-R films can be used to assess the DAP.

Visible absorption spectra of radiation exposed SIRAD dosimeters.

SIRAD badge dosimeters are a new type of personal dosimeter designed to measure radiation exposure up to 200 R and give a visual qualitative measurement of exposure. This is performed using the active dosimeter window, which contains a radiochromic material amalgamated in the badge assembly. When irradiated, the badges active window turns blue, which can be matched against the given colour chart for a qualitative assessment of the exposure received. Measurements have been performed to analyse the absorption spectra of the active window, and results show that the window automatically turns a blue colour upon irradiation and produces two peaks in the absorption spectra located at 617 nm and 567 nm. When analysed with a common computer desktop scanner, the optical density response of the film to radiation exposure is non-linear but reproducible. The net OD of the film was 0.21 at 50 R exposure and 0.31 at 200 R exposure when irradiated with a 6 MV x-ray energy beam. When compared to the calibration colour strips at 6 MV x-ray energy the film's OD response matches relatively well within 3.5%. An approximate 8% reduction in measured OD to exposure was seen for 250 kVp x-rays compared to 6 MV x-rays. The film provides an adequate measurement and visually qualitative assessment of radiation exposure for levels in the range of 0 to 200 R.

The quality of dental radiography in the Czech Republic--results of a TLD and film postal audit.

Since 2002, the postal audit in dental radiography has been supplementing standard quality control (QC) tools for dental intraoral X-ray machines. An aim of the audit is to check basic X-ray machine parameters (field size, exposure reproducibility), and a quality of the whole process of diagnostic imaging (entrance surface air-kerma measurement, a check of film processing and an image quality evaluation). The standard QC tests, performed by private companies, check mainly the X-ray unit. Conversely, the audit gives better information about the patient examination practices. During the period of January 2002 to May 2004 approximately 4000 audits were performed. The results confirmed that main problems in dental radiography are due to incorrect film processing, non-optimised setting of the exposure parameters and use of obsolete X-ray machines. Only approximately 30% of performed audits were satisfactory with respect to all checked parameters.