Verification of dose distribution in high dose-rate brachytherapy for cervical cancer using a normoxic N-vinylpyrrolidone polymer gel dosimeter.

The polymer gel dosimeter has been proposed for use as a 3D dosimeter for complex dose distribution measurement of high dose-rate (HDR) brachytherapy. However, various shapes of catheter/applicator for sealed radioactive source transport used in clinical cases must be placed in the gel sample. The absorbed dose readout for the magnetic resonance (MR)-based polymer gel dosimeters requires calibration data for the dose-transverse relaxation rate (R2) response. In this study, we evaluated in detail the dose uncertainty and dose resolution of three calibration methods, the multi-sample and distance methods using the Ir-192 source and the linear accelerator (linac) method using 6MV X-rays. The use of Ir-192 sources increases dose uncertainty with steep dose gradients. We clarified that the uniformly irradiated gel sample improved the signal-to-noise ratio (SNR) due to the large slice thickness of MR images and could acquire an accurate calibration curve using the linac method. The curved tandem and ovoid applicator used for intracavitary irradiation of HDR brachytherapy for cervical cancer were reproduced with a glass tube to verify the dose distribution. The results of comparison with the treatment planning system (TPS) calculation by gamma analysis on the 3%/2 mm criterion were in good agreement with a gamma pass rate of 90%. In addition, the prescription dose could be evaluated accurately. We conclude that it is easy to place catheter/applicator in the polymer gel dosimeters, making them a useful tool for verifying the 3D dose distribution of HDR brachytherapy with accurate calibration methods.

Evaluation of a Generative Adversarial Network to Improve Image Quality and Reduce Radiation-Dose during Digital Breast Tomosynthesis.

In this study, we evaluated the improvement of image quality in digital breast tomosynthesis under low-radiation dose conditions of pre-reconstruction processing using conditional generative adversarial networks [cGAN (pix2pix)]. Pix2pix pre-reconstruction processing with filtered back projection (FBP) was compared with and without multiscale bilateral filtering (MSBF) during pre-reconstruction processing. Noise reduction and preserve contrast rates were compared using full width at half-maximum (FWHM), contrast-to-noise ratio (CNR), peak signal-to-noise ratio (PSNR), and structural similarity (SSIM) in the in-focus plane using a BR3D phantom at various radiation doses [reference-dose (automatic exposure control reference dose: AECrd), 50% and 75% reduction of AECrd] and phantom thicknesses (40 mm, 50 mm, and 60 mm). The overall performance of pix2pix pre-reconstruction processing was effective in terms of FWHM, PSNR, and SSIM. At ~50% radiation-dose reduction, FWHM yielded good results independently of the microcalcification size used in the BR3D phantom, and good noise reduction and preserved contrast. PSNR results showed that pix2pix pre-reconstruction processing represented the minimum in the error with reference FBP images at an approximately 50% reduction in radiation-dose. SSIM analysis indicated that pix2pix pre-reconstruction processing yielded superior similarity when compared with and without MSBF pre-reconstruction processing at ~50% radiation-dose reduction, with features most similar to the reference FBP images. Thus, pix2pix pre-reconstruction processing is promising for reducing noise with preserve contrast and radiation-dose reduction in clinical practice.

Whole Three-Dimensional Dosimetry of Carbon Ion Beams with an MRI-Based Nanocomposite Fricke Gel Dosimeter Using Rapid T1 Mapping Method.

MRI-based gel dosimeters are attractive systems for the evaluation of complex dose distributions in radiotherapy. In particular, the nanocomposite Fricke gel dosimeter is one among a few dosimeters capable of accurately evaluating the dose distribution of heavy ion beams. In contrast, reduction of the scanning time is a challenging issue for the acquisition of three-dimensional volume data. In this study, we investigated a three-dimensional dose distribution measurement method for heavy ion beams using variable flip angle (VFA), which is expected to significantly reduce the MRI scanning time. Our findings clarified that the whole three-dimensional dose distribution could be evaluated within the conventional imaging time (20 min) and quality of one cross-section.

Usefulness of a Metal Artifact Reduction Algorithm in Digital Tomosynthesis Using a Combination of Hybrid Generative Adversarial Networks.

In this study, a novel combination of hybrid generative adversarial networks (GANs) comprising cycle-consistent GAN, pix2pix, and (mask pyramid network) MPN (CGpM-metal artifact reduction [MAR]), was developed using projection data to reduce metal artifacts and the radiation dose during digital tomosynthesis. The CGpM-MAR algorithm was compared with the conventional filtered back projection (FBP) without MAR, FBP with MAR, and convolutional neural network MAR. The MAR rates were compared using the artifact index (AI) and Gumbel distribution of the largest variation analysis using a prosthesis phantom at various radiation doses. The novel CGpM-MAR yielded an adequately effective overall performance in terms of AI. The resulting images yielded good results independently of the type of metal used in the prosthesis phantom (p < 0.05) and good artifact removal at 55% radiation-dose reduction. Furthermore, the CGpM-MAR represented the minimum in the model with the largest variation at 55% radiation-dose reduction. Regarding the AI and Gumbel distribution analysis, the novel CGpM-MAR yielded superior MAR when compared with the conventional reconstruction algorithms with and without MAR at 55% radiation-dose reduction and presented features most similar to the reference FBP. CGpM-MAR presents a promising method for metal artifact and radiation-dose reduction in clinical practice.

Improved digital chest tomosynthesis image quality by use of a projection-based dual-energy virtual monochromatic convolutional neural network with super resolution.

We developed a novel dual-energy (DE) virtual monochromatic (VM) very-deep super-resolution (VDSR) method with an unsharp masking reconstruction algorithm (DE-VM-VDSR) that uses projection data to improve the nodule contrast and reduce ripple artifacts during chest digital tomosynthesis (DT). For estimating the residual errors from high-resolution and multiscale VM images from the projection space, the DE-VM-VDSR algorithm employs a training network (mini-batch stochastic gradient-descent algorithm with momentum) and a hybrid super-resolution (SR) image [simultaneous algebraic reconstruction technique (SART) total-variation (TV) first-iterative shrinkage-thresholding algorithm (FISTA); SART-TV-FISTA] that involves subjective reconstruction with bilateral filtering (BF) [DE-VM-VDSR with BF]. DE-DT imaging was accomplished by pulsed X-ray exposures rapidly switched between low (60 kV, 37 projection) and high (120 kV, 37 projection) tube-potential kVp by employing a 40° swing angle. This was followed by comparison of images obtained employing the conventional polychromatic filtered backprojection (FBP), SART, SART-TV-FISTA, and DE-VM-SART-TV-FISTA algorithms. The improvements in contrast, ripple artifacts, and resolution were compared using the signal-difference-to-noise ratio (SDNR), Gumbel distribution of the largest variations, radial modulation transfer function (radial MTF) for a chest phantom with simulated ground-glass opacity (GGO) nodules, and noise power spectrum (NPS) for uniform water phantom. The novel DE-VM-VDSR with BF improved the overall performance in terms of SDNR (DE-VM-VDSR with BF: 0.1603, without BF: 0.1517; FBP: 0.0521; SART: 0.0645; SART-TV-FISTA: 0.0984; and DE-VM-SART-TV-FISTA: 0.1004), obtained a Gumbel distribution that yielded good images showing the type of simulated GGO nodules used in the chest phantom, and reduced the ripple artifacts. The NPS of DE-VM-VDSR with BF showed the lowest noise characteristics in the high-frequency region (~0.8 cycles/mm). The DE-VM-VDSR without BF yielded an improved resolution relative to that of the conventional reconstruction algorithms for radial MTF analysis (0.2-0.3 cycles/mm). Finally, based on the overall image quality, DE-VM-VDSR with BF improved the contrast and reduced the high-frequency ripple artifacts and noise.

Verification of dose distribution in high-dose-rate brachytherapy using a nanoclay-based radio-fluorogenic gel dosimeter.

Dose distributions have become more complex with the introduction of image-guided brachytherapy in high-dose-rate (HDR) brachytherapy treatments. Therefore, to correctly execute HDR, conducting a quality assurance programme for the remote after-loading system and verifying the dose distribution in the patient treatment plan are necessary. The characteristics of the dose distribution of HDR brachytherapy are that the dose is high near the source and rapidly drops when the distance from the source increases. Therefore, a measurement tool corresponding to the characteristic is required. In this study, using an Iridium-192 (Ir-192) source, we evaluated the basic characteristics of a nanoclay-based radio-fluorogenic gel (NC-RFG) dosimeter that is a fluorescent gel dosimeter using dihydrorhodamine 123 hydrochloride as a fluorescent probe. The two-dimensional dose distribution measurements were performed at multiple source positions to simulate a clinical plan. Fluorescence images of the irradiated NC-RFG were obtained at a high resolution (0.04 mm pixel-1) using a gel scanner with excitation at 465 nm. Good linearity was confirmed up to a dose range of 100 Gy without dose rate dependence. The dose distribution measurement at the five-point source position showed good agreement with the treatment planning system calculation. The pass ratio by gamma analysis was 92.1% with a 2%/1 mm criterion. The NC-RFG dosimeter demonstrates to have the potential of being a useful tool for quality assurance of the dose distribution delivered by HDR brachytherapy. Moreover, compared with conventional gel dosimeters such as polymer gel and Fricke gel dosimeters it solves the problems of diffusion, dose rate dependence and inhibition of oxygen-induced reactions. Furthermore, it facilitates dose data to be read in a short time after irradiation, which is useful for clinical use.

Development of a denoising convolutional neural network-based algorithm for metal artifact reduction in digital tomosynthesis for arthroplasty: A phantom study.

The present study aimed to develop a denoising convolutional neural network metal artifact reduction hybrid reconstruction (DnCNN-MARHR) algorithm for decreasing metal objects in digital tomosynthesis (DT) for arthroplasty by using projection data. For metal artifact reduction (MAR), we implemented a DnCNN-MARHR algorithm based on a training network (mini-batch stochastic gradient descent algorithm with momentum) to estimate the residual reference (140 keV virtual monochromatic [VM]) and object (70 kV with metal artifacts) images. For this, we used projection data and subtracted the estimated residual images from the object images, involving hybrid and subjectively reconstructed image usage (back projection and maximum likelihood expectation maximization [MLEM]). The DnCNN-MARHR algorithm was compared with the dual-energy material decomposition reconstruction algorithm (DEMDRA), VM, MLEM, established and commonly used filtered back projection (FBP), and a simultaneous algebraic reconstruction technique-total variation (SART-TV) with MAR processing. MAR was compared using artifact index (AI) and texture analysis. Artifact spread functions (ASFs) for images that were out-of-plane and in-focus were evaluated using a prosthesis phantom. The overall performance of the DnCNN-MARHR algorithm was adequate with regard to the ASF, and the derived images showed better results, without being influenced by the metal type (AI was almost equal to the best value for the DEMDRA). In the ASF analysis, the DnCNN-MARHR algorithm generated better MAR compared with that obtained employing usual algorithms for reconstruction using MAR processing. In addition, comparison of the difference (mean square error) between DnCNN-MARHR and the conventional algorithm resulted in the smallest VM. The DnCNN-MARHR algorithm showed the best performance with regard to image homogeneity in the texture analysis. The proposed algorithm is particularly useful for reducing artifacts in the longitudinal direction, and it is not affected by tissue misclassification.

Dose distribution verification in high-dose-rate brachytherapy using a highly sensitive normoxic N-vinylpyrrolidone polymer gel dosimeter.

Rapid technological advances in high-dose-rate brachytherapy have led to a requirement for greater accuracy in treatment planning system calculations and in the verification of dose distributions. In high-dose-rate brachytherapy, it is important to measure the dose distribution in the low-dose region at a position away from the source in addition to the high-dose range in the proximity of the source. The aim of this study was to investigate the accuracy of a treatment plan designed for prostate cancer in the low-dose range using a normoxic N-vinylpyrrolidone-based polymer gel (VIPET gel) dosimeter containing inorganic salt as a sensitizer (iVIPET). The dose response was evaluated on the basis of the transverse relaxation rate (R2) measured by magnetic resonance scanning. In the verification of the treatment plan, gamma analysis showed that the dose distributions obtained from the polymer gel dosimeter were in good agreement with those calculated by the treatment planning system. The gamma passing rate according to the 2%/2 mm criterion was 97.9%. The iVIPET gel dosimeter provided better accuracy for low doses than the normal VIPET gel dosimeter, demonstrating the potential to be a useful tool for quality assurance of the dose distribution delivered by high-dose-rate brachytherapy.

Development of a novel algorithm for metal artifact reduction in digital tomosynthesis using projection-based dual-energy material decomposition for arthroplasty: A phantom study.

In this study, a novel dual-energy (DE) material decomposition reconstruction algorithm (DEMDRA) was developed using projection data with the aim of reducing metal artifacts during digital tomosynthesis (DT) for implants. Using the three-material decomposition method and decomposition projection data specific for each material, a novel DEMDRA was implemented to reduce metal artifacts via weighted hybrid reconstructed images [maximum likelihood expectation maximization (MLEM) and shift-and-add (SAA)]. Pulsed X-ray exposures with rapid switching between low and high tube potential kVp were used for DE-DT imaging, and the images were compared using conventional filtered back projection (FBP), MLEM, the simultaneous algebraic reconstruction technique total variation (SART-TV), virtual monochromatic processing, and metal artifact reduction (MAR)-processing algorithms. The reductions in metal artifacts were compared using an artifact index (AI), Gumbel distribution of the largest variations, and the artifact spread functions (ASFs) for prosthesis phantom. The novel DEMDRA yielded an adequately effective overall performance in terms of the AI, and the resulting images yielded good results independently of the type of metal used in the prosthetic phantom, as well as good noise artifact removal, particularly at greater distances from metal objects. Furthermore, the DEMDRA represented the minimum in the model of largest variations. Regarding the ASF analysis, the novel DEMDRA yielded superior metal artifact reduction when compared with conventional reconstruction algorithms with and without MAR processing. Finally, the DEMDRA was particularly useful for reducing high-frequency artifacts.

Use of a Total Variation Minimization Iterative Reconstruction Algorithm to Evaluate Reduced Projections during Digital Breast Tomosynthesis.

PURPOSE: We evaluated the efficacies of the adaptive steepest descent projection onto convex sets (ASD-POCS), simultaneous algebraic reconstruction technique (SART), filtered back projection (FBP), and maximum likelihood expectation maximization (MLEM) total variation minimization iterative algorithms for reducing exposure doses during digital breast tomosynthesis for reduced projections. METHODS: Reconstructions were evaluated using normal (15 projections) and half (i.e., thinned-out normal) projections (seven projections). The algorithms were assessed by determining the full width at half-maximum (FWHM), and the BR3D Phantom was used to evaluate the contrast-to-noise ratio (CNR) for the in-focus plane. A mean similarity measure of structural similarity (MSSIM) was also used to identify the preservation of contrast in clinical cases. RESULTS: Spatial resolution tended to deteriorate in ASD-POCS algorithm reconstructions involving a reduced number of projections. However, the microcalcification size did not affect the rate of FWHM change. The ASD-POCS algorithm yielded a high CNR independently of the simulated mass lesion size and projection number. The ASD-POCS algorithm yielded a high MSSIM in reconstructions from reduced numbers of projections. CONCLUSIONS: The ASD-POCS algorithm can preserve contrast despite a reduced number of projections and could therefore be used to reduce radiation doses.

Automated source tracking with a pinhole imaging system during high-dose-rate brachytherapy treatment.

The transportation accuracy of sealed radioisotope sources influences the therapeutic effect of high-dose-rate (HDR) brachytherapy. We have developed a pinhole imaging system for tracking an Ir-192 radiation source during HDR brachytherapy treatment. Our system consists of a dual-pinhole collimator, a scintillator, and a charge-coupled device (CCD) camera. We acquired stereo-shifted images to infer the source position in three dimensions using a dual pinhole collimator with 1.0 mm diameter pinholes. The CCD camera captured consecutive images of scintillation light that corresponds to the source positions every 2 s. The system automatically tracks scintillation light points using template-matching technique and measured the source positions therefrom. By integrating a series of CCD images, we could infer the source dwell time from the pixel values in the integrated image. We investigated the tracking accuracy of our system in monitoring simulated brachytherapy as it would be performed for cervical cancer by using water as a stand-in for human tissue. Ir-192 pellet was moved through a water tank using tandem and ovoid applicators. The CCD camera captured clear images of the scintillation light produced by the underwater Ir-192 source in conditions equivalent to common clinical situations. The differences between the measured and the reference 3D source positions and dwell times were 1.5 ± 0.7 mm and 0.8 ± 0.4 s, respectively. This system has the potential to track in vivo Ir-192 source in real time and may prove a useful tool for quality assurance during HDR brachytherapy treatments in clinical settings.

Combining Segmented Grey and White Matter Images Improves Voxel-based Morphometry for the Case of Dilated Lateral Ventricles.

PURPOSE: To evaluate the error in segmented tissue images and to show the usefulness of the brain image in voxel-based morphometry (VBM) using Statistical Parametric Mapping (SPM) 12 software and 3D T1-weighted magnetic resonance images (3D-T1WIs) processed to simulate idiopathic normal pressure hydrocephalus (iNPH). MATERIALS AND METHODS: VBM analysis was performed on sagittal 3D-T1WIs obtained in 22 healthy volunteers using a 1.5T MR scanner. Regions of interest for the lateral ventricles of all subjects were carefully outlined on the original 3D-T1WIs, and two types of simulated 3D-T1WI were also prepared (non-dilated 3D-T1WI as normal control and dilated 3D-T1WI to simulate iNPH). All simulated 3D-T1WIs were segmented into gray matter, white matter, and cerebrospinal fluid images, and normalized to standard space. A brain image was made by adding the gray and white matter images. After smoothing with a 6-mm isotropic Gaussian kernel, group comparisons (dilated vs non-dilated) were made for gray and white matter, cerebrospinal fluid, and brain images using a paired t-test. RESULTS: In evaluation of tissue volume, estimation error was larger using gray or white matter images than using the brain image, and estimation errors in gray and white matter volume change were found for the brain surface. CONCLUSION: To our knowledge, this is the first VBM study to show the possibility that VBM of gray and white matter volume on the brain surface may be more affected by individual differences in the level of dilation of the lateral ventricles than by individual differences in gray and white matter volumes. We recommend that VBM evaluation in patients with iNPH should be performed using the brain image rather than the gray and white matter images.

The Effect of Single-Scan and Scan-Pair Intensity Inhomogeneity Correction Methods on Repeatability of Voxel-Based Morphometry With Multiple Magnetic Resonance Scanners.

OBJECTIVE: The aim of this study was to investigate the effects of single-scan and scan-pair intensity inhomogeneity correction methods on the repeatability of voxel-based morphometry (VBM) using images acquired with multiple magnetic resonance (MR) scanners. METHODS: Three-dimensional T1-weighed MR images of the brain were obtained from 22 healthy participants using each of 5 MR scanners, yielding 110 images (5 scanners × 22 subjects) in total. Six patterns of intensity inhomogeneity corrections (no correction, single-scan corrections, and scan-pair correction, and their combinations) were applied in the VBM procedure to investigate the effect of the corrections on the repeatability of gray and white matter volume measurements. RESULTS: Single-scan and scan-pair intensity inhomogeneity corrections significantly reduced the variance in spatially normalized gray and white matter volumes. However, combining the 2 methods did not significantly improve the repeatability when evaluated as whole brain. CONCLUSIONS: Single-scan and scan-pair intensity inhomogeneity corrections improved the repeatability of gray and white matter volumes obtained by multiple MR scanners and assessed by VBM.

Depressive symptoms in Parkinson's disease are related to decreased left hippocampal volume: correlation with the 15-item shortened version of the Geriatric Depression Scale.

Background The relationship between hippocampal and amygdaloid volumes and depression in patients with Parkinson's disease (PD) is a controversial issue. Purpose To investigate the correlation between the 15-item shortened version of the Geriatric Depression Scale (GDS-15) and gray matter volume in PD. Material and Methods In the present study, 46 participants with PD were scanned with 3 T magnetic resonance imaging (MRI) to obtain three-dimensional (3D) T1-weighted (T1W) images. Neurologists specializing in movement disorders performed clinical evaluations of the participants (e.g. GDS-15, Mini-Mental State Examination, PD duration, age, sex). Statistical Parametric Mapping 8 software was used for image gray matter segmentation and for a correlation analysis between gray matter volume and GDS-15 score. Results The results showed a significant negative correlation between GDS-15 score and left hippocampal volume, and between GDS-15 score and right parahippocampal gyrus volume. No significant positive correlations were found in the whole brain. Conclusion The current results provide new evidence regarding the relationship between depression in PD and hippocampal volume.

Evaluation of digital tomosynthesis reconstruction algorithms used to reduce metal artifacts for arthroplasty: A phantom study.

To investigate methods to reduce metal artifacts during digital tomosynthesis for arthroplasty, we evaluated five algorithms with and without metal artifact reduction (MAR)-processing tested under different radiation doses (0.54, 0.47, and 0.33mSv): adaptive steepest descent projection onto convex sets (ASD-POCS), simultaneous algebraic reconstruction technique total variation (SART-TV), filtered back projection (FBP), maximum likelihood expectation maximization (MLEM), and SART. The algorithms were assessed by determining the artifact index (AI) and artifact spread function (ASF) on a prosthesis phantom. The AI data were statistically analyzed by two-way analysis of variance. Without MAR-processing, the greatest degree of effectiveness of the MLEM algorithm for reducing prosthetic phantom-related metal artifacts was achieved by quantification using the AI (MLEM vs. ASD-POCS, SART-TV, SART, and FBP; all P<0.05). With MAR-processing, the greatest degree of effectiveness of the MLEM, ASD-POCS, SART-TV, and SART algorithms for reducing prosthetic phantom-related metal artifacts was achieved by quantification using the AI (MLEM, ASD-POCS, SART-TV, and SART vs. FBP; all P<0.05). When assessed by ASF, metal artifact reduction was largest for the MLEM algorithm without MAR-processing and ASD-POCS, SART-TV, and SART algorithm with MAR-processing. In ASF, the effect of metal artifact reduction was always greater at reduced radiation doses, regardless of which reconstruction algorithm with and without MAR-processing was used. In this phantom study, the MLEM algorithm without MAR-processing and ASD-POCS, SART-TV, and SART algorithm with MAR-processing gave improved metal artifact reduction.

Mis-segmentation in voxel-based morphometry due to a signal intensity change in the putamen.

The aims of this study were to demonstrate an association between changes in the signal intensity of the putamen on three-dimensional T1-weighted magnetic resonance images (3D-T1WI) and mis-segmentation, using the voxel-based morphometry (VBM) 8 toolbox. The sagittal 3D-T1WIs of 22 healthy volunteers were obtained for VBM analysis using the 1.5-T MR scanner. We prepared five levels of 3D-T1WI signal intensity (baseline, same level, background level, low level, and high level) in regions of interest containing the putamen. Groups of smoothed, spatially normalized tissue images were compared to the baseline group using a paired t test. The baseline was compared to the other four levels. In all comparisons, significant volume changes were observed around and outside the area that included the signal intensity change. The present study demonstrated an association between a change in the signal intensity of the putamen on 3D-T1WI and changed volume in segmented tissue images.

Influence of hooks and a lag screw on internal fixation plates for lateral malleolar fracture: a biomechanical and ergonomic study.

BACKGROUND: For internal fixation of AO classification Type B lateral malleolar fracture, insertion of lag screws into the fracture plane and fixation with a one-third tubular plate as a neutralization plate are the standard treatment procedures. The one-third tubular plate is processed to a hook shape and hung on the distal end of the fibula. In this study, to compare the function of the hook and lag screws of a one-third tubular plate and LCP for osteosynthesis of lateral malleolar fracture, mechanical indices of internal fixation were compared among the one-third tubular plates with lag screws with and without the hook and a locking compression plate. METHODS: As mechanical tests, a compression test was performed in which compression in the bone axis direction produced by supporting the body weight was simulated, and a torsion test was performed in which external rotation of the bone axis caused by plantar flexion of the ankle joint was simulated. Muscle strength during walking and the force and torque acting on the ankle and knee joints were determined using inverse dynamic analysis. Finite element analysis was performed to analyze the function of hooks and lag screws. The joint reaction force determined by inverse dynamic analysis was adopted as the loading condition of finite element analysis. RESULTS: A stiffness equivalent to that of healthy bone could be achieved by all three internal fixations. It was clarified that the presence of the hook does not make a difference in stiffness. Displacement of the one-third tubular plate was small regardless of the presence or absence of the hook compared with those of locking compression plates. CONCLUSIONS: The presence of the hook did not make any difference in stiffness, suggesting that active preparation of the hook is unnecessary. We also clarified that lag screws inhibit displacement.

[Polymer Gel Dosimetry for the High-Dose-Rate Brachytherapy Using Ir-192 Source].

High-dose-rate (HDR) brachytherapy is performed with the remote after-loading system (RALS) to transport an Ir-192 source directly to inside or near the tumor. Quality assurance (QA) of equipment should be performed at sufficient frequency to ensuring safety and quality of HDR brachytherapy treatment. Polymer gel dosimeters have been attracting attention in recent years as a QA tools of HDR brachytherapy, because they can measure the three-dimensional steep dose gradients around HDR sources. In this paper, we introduce our preliminary results using VIPET polymer gel dosimeters for Ir-192 HDR brachytherapy dosimetry.

Adverse effects of metallic artifacts on voxel-wise analysis and tract-based spatial statistics in diffusion tensor imaging.

Background Diffusion tensor imaging (DTI) is a magnetic resonance imaging (MRI) technique that reflects the Brownian motion of water molecules constrained within brain tissue. Fractional anisotropy (FA) is one of the most commonly measured DTI parameters, and can be applied to quantitative analysis of white matter as tract-based spatial statistics (TBSS) and voxel-wise analysis. Purpose To show an association between metallic implants and the results of statistical analysis (voxel-wise group comparison and TBSS) for fractional anisotropy (FA) mapping, in DTI of healthy adults. Material and Methods Sixteen healthy volunteers were scanned with 3-Tesla MRI. A magnetic keeper type of dental implant was used as the metallic implant. DTI was acquired three times in each participant: (i) without a magnetic keeper (FAnon1); (ii) with a magnetic keeper (FAimp); and (iii) without a magnetic keeper (FAnon2) as reproducibility of FAnon1. Group comparisons with paired t-test were performed as FAnon1 vs. FAnon2, and as FAnon1 vs. FAimp. Results Regions of significantly reduced and increased local FA values were revealed by voxel-wise group comparison analysis (a P value of less than 0.05, corrected with family-wise error), but not by TBSS. Conclusion Metallic implants existing outside the field of view produce artifacts that affect the statistical analysis (voxel-wise group comparisons) for FA mapping. When statistical analysis for FA mapping is conducted by researchers, it is important to pay attention to any dental implants present in the mouths of the participants.

[Investigation of an Optimum Determination Method of Exposure Index for Posterior-Anterior Chest Radiographs Using an Auto Exposure Control].

Fifty posterior-anterior chest radiographs taken using an auto exposure control were evaluated in order to find an optimum determination method of the exposure index (EI). Four types of the relevant image regions were tested: (a) full image, (b) central 25% area, (c) full image excluding direct x-ray area, and (d) pulmonary area only, whereas four types of the value of interest (VOI) were adopted to each relevant image region: mean, median, mode, and middle. When the target EI was determined as the average of the 50 images, the deviation index (DI) was within ±1.0 only if pulmonary area was selected as the relevant image region, with the VOI of mean, median, and middle. This result strongly suggests that pulmonary area should be selected as the relevant image region of an EI when an auto exposure control is used.