Cavity ionization chamber responses in the JAEA and the NMIJ high-energy photon reference fields for radiation protection.

A dosimeter should ideally be calibrated in a reference field with similar energy and doserate to that which the dosimeter is being used to measure. Environments around nuclear reactors and radiation therapy facilities have high-energy photons with energies exceeding that of60Co gamma rays, and controlling exposure to these photons is important. The Japan Atomic Energy Agency and National Metrology Institute of Japan have high-energy reference fields with energies above several megaelectronvolts for different types of accelerators. Their reference fields have different fluence-energy distributions. In this study, the energy dependencies of the two-cavity ionization chambers, which are often used by secondary standard laboratories, were experimentally and computationally evaluated for each high-energy field. These results agreed well within the relative expanded uncertainties (k= 2), and their capabilities for air kerma measurements in each high-energy reference field were confirmed. Therefore, the capabilities of the air-kerma measurements were verified in the two high-energy reference fields.

Improved air kerma determination in the radiation field of the X-ray tube used in medical imaging systems, considering the type and thickness of the filter.

In diagnostic radiology, the air kerma is an essential parameter. Radiologists consider the air kerma, when calculating organ doses and dangers to patients. The intensity of the radiation beam is represented by the air kerma, which is the value of energy wasted by a photon as it travels through air. Because of the heel effect in X-ray sources, air kerma varies throughout the field of medical imaging systems. One possible contributor to this discrepancy is the X-ray tube's voltage. In this study, an approach has been proposed for predicting the air kerma anywhere inside the field of X-ray beams utilized in medical diagnostic imaging systems. As a first step, a diagnostic imaging system was modelled using the Monte Carlo N-Particle platform. We used a tungsten target and aluminum and beryllium filters of varying thicknesses to recreate the X-ray tube. The air kerma has been measured in different parts of the conical X-ray beam that is working at 30, 50, 70, 90, 110, 130, and 150 kV. This gives enough data for training neural networks. The voltage of the X-ray tube, filter type, filter thickness, and the coordinates of each point used to calculate the air kerma were all inputs to the MLP neural network. The MLP architecture, known for its significant advancements in research and expanding applications, was trained to predict the quantity of air kerma as its output. Specifically, by considering X-ray tube filters of varying thicknesses, the trained MLP model demonstrated its capability to accurately predict the air kerma at every point within the X-ray field for a range of X-ray tube voltages typically used in medical diagnostic radiography (30-150 kV).

[Multicenter Survey on Phantom Entrance Surface Air Kerma of Angiography and IVR in Japan].

PURPOSE: In DRLs 2020, the entrance surface air kerma (Ka,e) was set to 17 mGy/min as the reference dose rate in fluoroscopy. But, Ka,e in fluoroscopy for different regions and Ka,e in exposure was not set. A multicenter survey was conducted to evaluate Ka,e by each area. METHODS: Ka,e for each area was analyzed for 79 facilities attending this survey (274 machines and 461 protocols). When the protocols were changed by the difference in disease, angiography, or IVR, the difference rate of Ka,e was evaluated. Ka,e before and after modifying the incident air kerma at the patient entrance reference point (Ka,r) and air kerma area product (PKA) difference rate were calculated when protocols were changed, considering the DRLs 2020. RESULTS: There were dose differences in Ka,e by each area. Compared to DRLs 2020, 36 protocols from 13 facilities modified their protocols, all of which reduced Ka,e. CONCLUSION: Although reducing Ka,e does not necessarily reduce Ka,r, and PKA, comparison of Ka,e by each area is expected to optimize medical exposure protection, including evaluation of quality control.

Evaluation of the measurement accuracy and uncertainty of a solid-state detector under diagnostic x-ray beam conditions.

OBJECTIVE: An accurate measurement of x-ray beams is expected to reduce the uncertainties associated with estimating radiation risk to patients in clinical settings. To perform assessment tasks based on the readings of a solid-state detector (SSD) using semiconductor technology, the characteristics of the detector should be elucidated. In this study, we evaluated the measurement accuracy of a new SSD under diagnostic x-ray beam conditions in terms of air kerma, tube voltage, and half-value layer (HVL). The performance of the SSD was then compared with those of reference instruments. METHODS: The tube voltage was varied within the range of 50-120 kV in steps of 10 kV and the thickness and materials of additional filters were concurrently changed (several combinations were tested). In addition, the dose rate and energy dependence of the SSD were also investigated. These effects were analyzed based on statistical significance tests. Furthermore, the expanded uncertainties in the series of measurements were meticulously calculated. RESULTS: The results showed average relative differences of -3.26 ± 1.33%, 0.44 ± 1.01%, and -2.60 ± 3.31% for air kerma, tube voltage, and HVL, respectively. Furthermore, air kerma did not exhibit any dependence on dose rate and energy, in contrast to tube voltage and HVL measurements. CONCLUSION: The measurement values of the SSD fall within the acceptable range of uncertainty, highlighting its measurement accuracy and reliability. Furthermore, based on the characteristics elucidated by this study, valuable insights are provided concerning the assurance of appropriate measurement values in clinical settings.

Evaluation of the reduction of radiation dose received by pediatric patients in new-generation biplane angiocardiography: Randomized controlled study.

Objective: We aimed to evaluate the safety and efficacy of radiation dose reduction with a new-generation biplane angiocardiography system in patients undergoing transcatheter isolated patent ductus arteriosus (PDA) closure. Materials and methods: Fifty pediatric patients who underwent transcatheter PDA closure were randomly divided into two groups as normal radiation dose and low dose. Patients who required additional procedures other than PDA closure were excluded. PDA closure was performed according to the angiographic measurement of the defect. After the procedure, age, weight, sex, PDA measurements, and radiation measurements such as dose-area product (DAP, Gy.cm2) and air kerma (AK, mGy) were compared between the groups. Results: There was no statistically significant difference between the groups in age, sex, weight, PDA diameter, PDA type, device used, and device diameter (p > 0.05). While there was no statistically significant difference between the groups in terms of cine recording, number of recorded images, and fluoroscopy time (p > 0.05), there was a statistically significant difference between the total DAP, cine and fluoroscopy DAP, total AK, frontal and lateral tube AK, and DAP/kg (mGy.m2/kg) measurements (p < 0.05). Conclusion: Transcatheter PDA closure with a low radiation dose is as effective as that with a normal radiation dose. The radiation dose received by the patient during the procedure was significantly reduced. With the vision provided by this study, it seems possible to work with a low radiation dose in other groups of patients.

Accurate gamma-ray dose measurement up to 10 MeV by glass dosimeter with a sensitivity control filter for BNCT.

Glass dosimeters are very useful and convenient detection elements in radiation dosimetry. In this study, this glass dosimeter was applied to a BNCT treatment field. Boron Neutron Capture Therapy (BNCT) is a next-generation radiation therapy that can selectively kill only cancer cells. In the BNCT treatment field, both neutrons and secondary gamma-rays are generated. In other words, it is a mixed radiation field of neutrons and gamma-rays. We thus proposed a novel method to measure only gamma-ray dose in the mixed field using two RPLGD (Radiophoto-luminescence Glass Dosimeter) and two sensitivity control filters in order to control the dose response of the filtered RPLGD to be proportional to the air kerma coefficients, even if the gamma-ray energy spectrum is unknown. As the filter material iron was selected, and it was finally confirmed that reproduction of the air kerma coefficients was excellent within an error of 5.3% in the entire energy range up to 10 MeV. In order to validate this method, irradiation experiments were carried out using standard gamma-ray sources. As the result, the measured doses were in acceptably good agreement with the theoretical calculation results by PHITS. In the irradiation experiment with a volume source in a nuclear fuel storage room, the measured dose rates showed larger compared with survey meter values. In conclusion, the results of the standard sources showed the feasibility of this method, however for the volume source the dependence of the gamma-ray incident angle on the dosimeter was found to be not neglected. In the next step, it will be necessary to design a thinner filter in order to suppress the effect of the incident angle.

[Effect of Reducing Fluoroscopy Pulse Rates on Visibility of Devices and Radiation Dose in Percutaneous Coronary Intervention].

The goal of our study was to clarify the effect of low pulse rate fluoroscopy applying in percutaneous coronary intervention (PCI) on devices' visibility and radiation dose. Four types of fluoroscopy conditions combined with two pulse rates (7.5 and 15 pulses/s) and two types of adaptive temporal filters (ATFs) (weak and strong) were used. Samples for visibility evaluation were acquired with moving phantom and devices such as stent, balloon, and guidewire. Trailing artifacts and the visibility of stent were evaluated by Scheffe's method of paired comparisons. Incident air kerma (Ka,r) and kerma area product (PKA) in the clinic were obtained under two fluoroscopic pulse rate conditions (7.5 and 15 pulses/s). As a result, in 7.5 pulses/s fluoroscopy, trailing artifacts were decreased by using weak ATF with the median value of PKA and Ka,r reduced by about 50%, but stent visibility was decreased compared to 15 pulses/s. Therefore, a combination of 7.5 pulses/s fluoroscopy and suitable ATF can bring dose reduction with avoiding trailing artifacts, but dose per pulse should be adjusted to maintain the stent visibility.

An Approach to Establishing Diagnostic Reference Levels in Interventional Pediatric Cardiology from Different Regions of Brazil.

Diagnostic reference levels (DRLs) are a pivotal strategy to be implemented since pediatric interventional cardiology procedures are increasing. This work aimed to propose an initial set of Brazilian DRLs for pediatric interventional diagnostic and therapeutic (D&T) procedures. A retrospective study was carried out in four Brazilian states, distributed across the three regions of the country. Data were collected from pediatric patients undergoing cardiac interventional procedures (CIPs), including their age and anthropometric characteristics, and at least four parameters (number of images, exposure time, air kerma-area product-PKA, and cumulative air kerma). Data from 279 patients undergoing CIPs were gathered (147 diagnostic and 132 therapeutic procedures). There were no significant differences in exposure time and the number of images between the D&T procedures. A wide range of PKA was observed when the therapeutic procedures were compared to diagnostics for all age groups. There were significant differences between the D&T procedures, whether grouping data by patient weight or age. In terms of cumulative air kerma, it was noted that no value exceeded the level to trigger a monitoring process for patients. This study shows that it is possible to adopt them as the first proposal to establish national DRLs considering pediatric patient groups.

Air kerma reference field with high energy photons using a 15 MeV electron beam from a clinical linear accelerator.

In the medical and nuclear fields, there are environments where exposure to photons with energies above several MeV can result in problems. The National Metrology Institute of Japan has developed a high-energy photon field using a 15 MeV electron beam of a clinical linear accelerator with a copper target and an aluminium filter unit to facilitate dosimeter calibration in terms of air kerma. To determine the air kerma rate, the energy fluence distribution at a reference point was calculated, and both calculations and experiments evaluated the effective energy and spatial dose distribution. Moreover, to validate the air kerma measurement, two commercial cavity chambers were calibrated in a developed photon field. The results obtained exhibited a 4% difference compared with those in a Co-60γ-ray reference field.

[Questionnaire Survey on IVR Dose Management in Tokai Region].

PURPOSE: National diagnostic reference levels in Japan 2020 (DRLs 2020) have been published. In the field of angiography, in addition to the fluoroscopic dose rate, incident air kerma at the patient entrance reference point displayed on the equipment (Ka,r: mGy) and air kerma-area product displayed on the equipment (PKA: Gycm2) were set. A questionnaire survey was conducted at each facility in the Tokai region to confirm the status of medical radiation dose control in the region. METHOD: A questionnaire survey was conducted at each facility in the Tokai region. The items were fluoroscopic dose rate in each area (head and neck, cardiac, chest and abdomen, and limbs), DA and DSA dose rates, and dose area product meter (Ka,r, PKA) for the main procedures in each area. RESULT: The median values in this study were lower than those in the DRLs 2020, indicating that appropriate dose control is being implemented in the Tokai region. The trends of fluoroscopic and radiographic dose rates were different in each area, and there was some variation among the facilities. CONCLUSION: We believe that the incorporation of fluoroscopic and radiographic dose rates by area into the DRLs will facilitate more appropriate dose control at each facility in the future.

Optimal conversion coefficient from easily measurable dose to effective dose with consideration to radiation quality for posterior-anterior chest radiography.

Effective dose is sometimes used to compare medical radiation exposure to patients and natural radiation for providing explanations about radiation exposure to patients, but its calculation is lengthy and requires dedicated measuring devices. The purpose of this study was to identify the most suitable conversion coefficient for conversion of easily measurable dose to effective dose in posterior-anterior chest radiography, and to evaluate its accuracy by direct measurement. We constructed an examination environment using Monte Carlo simulation, and evaluated the variation in conversion coefficients from incident air kerma (IAK), entrance-surface air kerma (ESAK), and air kerma-area product (KAP) to effective dose when the irradiation field size and radiation quality were changed. Effective doses were also measured directly using thermoluminescence dosimeters and compared with the effective dose obtained from conversion coefficients. The KAP conversion coefficient most effectively suppressed the effect of irradiation field size, and was then used to set conversion coefficients for various half-value layers. The optimal conversion coefficient was 0.00023 [mSv/(mGy·cm2)] at 120 kVp (half-value layer = 5.5 mmAl). Evaluation of the direct measurements obtained with various radiation qualities revealed that the accuracy of the conversion coefficient was maintained at ≤ 11%. The proposed conversion coefficient can be easily calculated even in facilities that do not have equipment for measuring effective dose, and might enable the use of effective dose for providing explanations about radiation exposure to patients.

Diagnostic Reference Levels in Interventional Pediatric Cardiology: Two-Year Experience in a Tertiary Referral Hospital in Latin America.

The goal of the present study was to propose the first local diagnostic reference levels (DRLs) for interventional pediatric cardiology procedures in a large hospital in Colombia. The data collection period was from April 2020 to July 2022. The local DRLs were calculated as the 3rd quartile of patient-dose distributions for the kerma-area product (Pka) values. The sample of collected clinical procedures (255) was divided into diagnostic and therapeutic procedures and grouped into five weight and five age bands. The Pka differences found between diagnostic and therapeutic procedures were statistically significant in all weight and age bands, except for the 1-5-year age group. The local DRLs for weight bands were 3.82 Gy·cm2 (<5 kg), 7.39 Gy·cm2 (5-<15 kg), 19.72 Gy·cm2 (15-<30 kg), 28.99 Gy·cm2 (30-<50 kg), and 81.71 Gy·cm2 (50-<80 kg), respectively. For age bands, the DRLs were 3.97 Gy·cm2 (<1 y), 9.94 Gy·cm2 (1-<5 y), 20.82 Gy·cm2 (5-<10 y), 58.00 Gy·cm2 (10-<16 y), and 31.56 Gy·cm2 (<16 y), respectively. In conclusion, when comparing our results with other existing DRL values, we found that they are similar to other centers and thus there is scope to continue optimizing the radiation dose values. This will contribute to establishing national DRLs for Colombia in the near future.

Effect of shape of automatic dose rate control and wedge compensation filter on radiation dose in an angiography system with a flat-panel detector.

The purpose was to investigate air-kerma area product (PKA) and entrance surface air-kerma rate ([Formula: see text]a,e) on the effect of the shape of automatic dose rate control (ADRC) in the presence of a wedge compensation filter. We compared and evaluated the variability of the X-ray output using a combination of wedge compensation filters and the ADRC. Two ADRC shapes (round and square) and three poly-methyl-methacrylate thicknesses (15, 20, and 25 cm) were used. A wedge compensation filter was inserted 2 cm at a time, up to 6 cm. When the wedge compensation filter was inserted to 6 cm for 20 cm of poly-methyl-methacrylate, the X-ray output fluctuated significantly. The PKA was reduced by 39% when the wedge compensation filter was inserted to 6 cm and by 59% when it was inserted to 4 cm under round-type for 20 cm poly-methyl-methacrylate. The shape of the ADRC affects [Formula: see text]a,e and PKA.

Air kerma rate from radionuclides distributed in forest ecosystem.

This study evaluates the air kerma rate in radioactively contaminated forests. The air kerma rates created by plane sources of monoenergetic photons in the energy range 0.02-3 MeV located at different depths in soil up to 50 g cm-2 and at different heights in the forest medium from 0.05 to 50 m were calculated using numeric solution of the transport (Boltzmann) equation. To simplify the practical use of the results obtained by solving the Boltzmann equation, the study additionally includes approximation formulae for calculating air kerma rate separately from contaminated soil, crowns and trunks of trees in a forest ecosystem for 20 radionuclides - fission products that significantly contribute to the external dose. Biomaterial of trunks and crowns was modeled as uniformly distributed in corresponding layers and homogeneously mixed with air. Different distributions of radionuclides in soil were considered including plane source located at different depths, exponential and uniform distribution. Based on the results, the effect of forest biomass presence as an absorbing and scattering medium on the air kerma rate at 1 m above soil was evaluated. The estimated relative difference in air kerma rate at 1 m above soil in the forest medium and in free air for monoenergetic photon sources with energies 0.1 MeV, 0.66 MeV and 3 MeV did not correlate significantly with the energy of photons. Its maximum value in forest medium with biomass density of 5 kg m-3 was 15-20% for the source at soil depth ∼0.3 g cm-2, decreasing to less than 5% when it is at soil depth greater than 7 g cm-2. An example calculation of the air kerma rate dynamics is presented for the initial period after radioactive fallout considering weathering processes (rainfall and wind action) that contribute to the transfer of activity from the canopies to the forest floor. The differences in air kerma rate values, as an integral characteristic of the gamma radiation field from a radioactive cloud in the forest and in the open area, were evaluated.

A formalism for traceable dosimetry in superficial electronic brachytherapy (eBT).

Objective. Despite the number of treatments performed with electronic brachytherapy (eBT) there is no uniform methodology for reference dosimetry for international traceability to primary dosimetry standards in different eBT systems. The objective of this study is to propose a formalism for traceability reference dosimetry in superficial eBT, that is easy to apply in the clinic. This method was investigated for an Elekta Esteya with one applicator.Approach. The calibration x-ray spectrum at the primary standards dosimetry laboratory was matched to the measured eBT photon spectrum. Subsequently, two ionization chambers of different types were calibrated at the primary standard dosimetry laboratory (PSDL) in terms of air kerma against a primary standard. The chambers were used to measure ionization chamber reading ratios in-air at different distances from the applicator. Monte Carlo based air kerma ratios were calculated at different positions from the eBT applicator as well as backscatter factors in water and average mass energy absorption ratios in water and in air. Relative measurements with radiochromic films were performed in a water phantom to determine the ratio of absorbed dose to water,Dw, at the surface toDwat 1 cm depth in water. These were compared with Monte Carlo calculations.Main results. Calculations and measurements were combined to estimate theDwat the surface and at 1 cm depth in water. Ionization chamber agreement of the surface dose was 1.7%, within an uncertainty of 6.8% (k= 2). They agreed with the manufacturer dosimetry within 1.8%, with an uncertainty of 5.0% (k= 2). The feasibility of the formalism and methodology for the Esteya system was demonstrated.Significance. This study proposes a method for harmonization of traceable reference dosimetry for eBT contact treatments which does not involve a detailed simulation of the ionization chamber. The method demonstrated feasibility for one eBT system using one surface applicator. In the future the method could be applied for different eBT systems.

Air Kerma Calculation in Diagnostic Medical Imaging Devices Using Group Method of Data Handling Network.

The air kerma, which is the amount of energy given off by a radioactive substance, is essential for medical specialists who use radiation to diagnose cancer problems. The amount of energy that a photon has when it hits something can be described as the air kerma (the amount of energy that was deposited in the air when the photon passed through it). Radiation beam intensity is represented by this value. Hospital X-ray equipment has to account for the heel effect, which means that the borders of the picture obtain a lesser radiation dosage than the center, and that air kerma is not symmetrical. The voltage of the X-ray machine can also affect the uniformity of the radiation. This work presents a model-based approach to predict air kerma at various locations inside the radiation field of medical imaging instruments, making use of just a small number of measurements. Group Method of Data Handling (GMDH) neural networks are suggested for this purpose. Firstly, a medical X-ray tube was modeled using Monte Carlo N Particle (MCNP) code simulation algorithm. X-ray tubes and detectors make up medical X-ray CT imaging systems. An X-ray tube's electron filament, thin wire, and metal target produce a picture of the electrons' target. A small rectangular electron source modeled electron filaments. An electron source target was a thin, 19,290 kg/m3 tungsten cube in a tubular hoover chamber. The electron source-object axis of the simulation object is 20° from the vertical. For most medical X-ray imaging applications, the kerma of the air was calculated at a variety of discrete locations within the conical X-ray beam, providing an accurate data set for network training. Various locations were taken into account in the aforementioned voltages inside the radiation field as the input of the GMDH network. For diagnostic radiology applications, the trained GMDH model could determine the air kerma at any location in the X-ray field of view and for a wide range of X-ray tube voltages with a Mean Relative Error (MRE) of less than 0.25%. This study yielded the following results: (1) The heel effect is included when calculating air kerma. (2) Computing the air kerma using an artificial neural network trained with minimal data. (3) An artificial neural network quickly and reliably calculated air kerma. (4) Figuring out the air kerma for the operating voltage of medical tubes. The high accuracy of the trained neural network in determining air kerma guarantees the usability of the presented method in operational conditions.

Radiation dose during interventional cardiology procedures: portable C-arm vs. a new generation fluoroscopy system.

INTRODUCTION: Occupational exposure to ionizing radiation poses health risks for veterinary interventionalists. There are limited veterinary studies evaluating radiation dose in the cardiac catheterization laboratory. The purpose of this study was to report direct radiation dose exposure to patients during common interventional cardiology procedures and compare these doses between two fluoroscopy units. ANIMALS: One hundred and fifty-four client-owned dogs. MATERIALS AND METHODS: Patient dose during procedures using a portable C-arm were retrospectively analyzed and compared to those performed in a contemporary interventional suite. Fluoroscopy equipment, procedure type, operator, patient weight, fluoroscopy time, dose area product, and air kerma were recorded and statistically modeled using univariable and multivariable linear regression to evaluate the effect of each factor. RESULTS: Patient dose population (154 dogs), comprised 61 patent ductus arteriosus occlusions, 60 balloon pulmonary valvuloplasties, and 33 pacemaker implantations. Patient dose was significantly lower in the group utilizing a newer generation fluoroscopy unit vs. the group utilizing an older portable C-arm, positively correlated with patient weight, and highest during balloon pulmonary valvuloplasties compared to patent ductus arteriosus occlusions or pacemaker implantations (all P<0.010). DISCUSSION: Newer fluoroscopy systems can be equipped with technologies that improve image quality while reducing patient dose and radiation exposure to interventional personnel. CONCLUSIONS: We documented a significant reduction in patient radiation dose using a newer fluoroscopy system as compared to an older portable C-arm for interventional cardiology procedures in animals. Improved knowledge of patient radiation dose factors may promote better radiation safety protocols in veterinary interventional cardiology.

Use of secondary air kerma from dose area product and fluoroscopy time for preventive effective dose estimation in interventional radiology procedures for staff.

INTRODUCTION: interventional radiology workers are potentially exposed to high levels of ionizing radiation, therefore preventive dose estimation is mandatory for the correct risk classification of staff. Effective dose (ED) is a radiation protection quantity strictly related to the secondary air kerma (KS), using appropriate multiplicative conversion factors (ICRP 106). The aim of this work is to evaluate the accuracy ofKSestimated from physically measurable quantities such as dose-area product (DAP) or fluoroscopy time (FT). METHODS: radiological units (n= 4) were characterized in terms of primary beam air kerma and DAP-meter response, consequently defining a DAP-meter correction factor (CF) for each unit.KS, scattered from an anthropomorphic phantom and measured by a digital multimeter, was then compared with the value estimated from DAP and FT. Different combinations of tube voltages, field sizes, current and scattering angles were used to simulate the variation of working conditions. Further measurements were performed to estimate the couch transmission factor for different phantom placements on the operational couch, defining a CF as the mean transmission factor. RESULTS: when no CFs were applied, the measuredKSshowed a median percentage difference of between 33.8% and 115.7% with respect toKSevaluated from DAP, and between -46.3% and 101.8% forKSevaluated from FT. By contrast, when previously defined CFs were applied to the evaluatedKS, the median percentage difference between the measuredKSand the value evaluated from DAP ranged from between -7.94% and 15.0%, and between -66.2% and 17.2% for that evaluated from FT. CONCLUSION: when appropriate CF are applied, the preventive ED estimation from the median DAP value seems to be more conservative and easier to obtain with respect to the one obtained from the FT value. Further measurements should be performed with a personal dosimeter during routine activities to assess the properKSto ED conversion factor.

Determination of an air kerma-rate correction factor for the S7600 Xoft AxxentⓇ source model.

PURPOSE: The purpose of this work was to provide guidance for the lack of an air-kerma rate standard for the S7600 Xoft Axxent® source by providing a correction factor to apply to the National Institute of Standards and Technology (NIST) traceable S7500 well chamber (WC) calibration coefficient before the development of an S7600 standard at NIST. METHODS AND MATERIALS: The Attix free air chamber (FAC) at the University of Wisconsin Medical Radiation Research Center was used to measure the air-kerma rate at 50 cm for six S7500 and six S7600 sources. These same sources were then measured using five standard imaging HDR1000+ WCs. The measurements made with the FAC were used to calculate source-specific WC calibration coefficients for the S7500 and S7600 source. These results were compared to the NIST traceable calibration coefficients for the S7500 source. The average results for each WC were then averaged together, and a ratio of the S7600 to S7500 WC calibration coefficients was determined. RESULTS: The average S7600 air-kerma rate measurement with the FAC was 7% lower than the average air-kerma rate measurements of the S7500 source. On average, the S7500 determined WC calibration coefficients agreed within ±1% of the NIST traceable S7500 values. The S7600 WC calibration coefficients were up to 16% less than the NIST traceable S7500 values. The final correction factor determined to be applied to the NIST traceable S7500 value was 0.8415 with an associated uncertainty of ±8.1% at k = 2. CONCLUSIONS: This work provides a suggested correction factor for the S7600 Xoft Axxent source such that the sources can be accurately implemented in the clinical setting.

An audit of patient radiation doses in interventional radiology at a South African hospital.

Background: Interventional radiology (IR) is becoming more relevant in patient care and is associated with increased patient radiation exposure and radiation-induced adverse effects. Diagnostic reference levels (DRLs) are crucial for radiation control. There is a paucity of published DRLs for IR in South Africa and sub-Saharan Africa. Objectives: This study aimed to determine local DRLs for fluoroscopically-guided IR procedures and compare the achieved DRLs with published local and international DRLs. Method: Retrospective, descriptive, single-centre study. Kerma air product (KAP), reference point air kerma (Ka,r) and fluoroscopy time (FT) were collected for patients (12 years and older) who underwent IR procedures at a university hospital from 01 January 2019 to 31 December 2019. The 75th percentile of the distribution of each dose parameter (KAP, Ka,r and FT) per procedure was calculated and taken as the local diagnostic reference levels (LDRL). The established LDRLs were compared to published DRLs. Results: A total of 564 cases were evaluated. The 13 most frequent procedures (with 15 or more cases) represented 86.1% (487/564). Percutaneous transhepatic biliary drainage was the most common procedure (n = 146, 25.9%). Diagnostic cerebral angiogram DRLs exceeded the published DRL data ranges for all parameters (DRL 209.3), and interventional cerebral angiogram exceeded published ranges (DRL 275). Uterine artery embolisation (UAE) exceeded these ranges for KAP and Ka,r. (KAP-954.9 Gy/cm2, Ka,r-2640.8 mGy). Conclusion: The LDRLs for diagnostic cerebral angiogram, interventional cerebral angiogram and UAE exceeded published international DRL ranges. These procedures require radiation optimisation as recommended by the International Commission on Radiological Protection (ICRP). Contribution: In addition to informing radiation protection practices at the level of the institution, the established LDRLs contribute towards Regional and National DRLs.