Simple and low cost alternative method for detecting photoneutrons produced in some radiotherapy treatments using SSNTDs.

A simple and low cost alternative which is able to identify thermal and fast neutrons in a clinical environment of radiotherapy is presented. CR-39 and LR-115 Solid State Nuclear Track Detectors (SSNTDs) were used, estimating their viability. In order to register alpha tracks due to thermal neutrons, natural boric acid tablets were placed in close contact to the detector, whereas in order to detect epithermal neutrons, some were additionally covered in a thin cadmium layer. Different configurations were assembled, changing the position of the converter with respect to the detector and the incident neutron fluence, which was evaluated in different positions of a radiotherapy table. The contribution due to environmental 222Rn and its daughters to the track density registered by the detector during the measurements was found to be negligible. It is concluded that the designed experimental set up constitutes a trustworthy and affordable method to carry out neutron measurements with the recommended configurations provided for the CR-39 detector, and not with LR-115.

Skin color-specific and spectrally-selective naked-eye dosimetry of UVA, B and C radiations.

Spectrally-selective monitoring of ultraviolet radiations (UVR) is of paramount importance across diverse fields, including effective monitoring of excessive solar exposure. Current UV sensors cannot differentiate between UVA, B, and C, each of which has a remarkably different impact on human health. Here we show spectrally selective colorimetric monitoring of UVR by developing a photoelectrochromic ink that consists of a multi-redox polyoxometalate and an e- donor. We combine this ink with simple components such as filter paper and transparency sheets to fabricate low-cost sensors that provide naked-eye monitoring of UVR, even at low doses typically encountered during solar exposure. Importantly, the diverse UV tolerance of different skin colors demands personalized sensors. In this spirit, we demonstrate the customized design of robust real-time solar UV dosimeters to meet the specific need of different skin phototypes. These spectrally-selective UV sensors offer remarkable potential in managing the impact of UVR in our day-to-day life.

Preparing for the costs of XR-29 a new standard for CT radiation dose monitoring.

A new standard for computed tomography (CT) scanners, established by the Medical Imaging and Technology Alliance, is aimed at ensuring CT studies are performed on safe equipment that delivers high-quality images at the lowest possible radiation dose to patients. Starting in January, the Centers for Medicare & Medicaid Services will implement a new payment incentive, authorized by Congress in 2014, aimed at promoting healthcare providers' adoption of the new standard for all outpatient CT studies. Organizations that perform CT studies on an outpatient basis will need to develop a process to comply with the standards or face a reduction in payment per study.

The future of medical dosimetry.

The world of health care delivery is becoming increasingly complex. The purpose of this manuscript is to analyze current metrics and analytically predict future practices and principles of medical dosimetry. The results indicate five potential areas precipitating change factors: a) evolutionary and revolutionary thinking processes, b) social factors, c) economic factors, d) political factors, and e) technological factors. Outcomes indicate that significant changes will occur in the job structure and content of being a practicing medical dosimetrist. Discussion indicates potential variables that can occur within each process and change factor and how the predicted outcomes can deviate from normative values. Finally, based on predicted outcomes, future opportunities for medical dosimetrists are given.

Workforce and salary survey trends: opportunities and challenges for the American Association of Medical Dosimetrists.

The American Association of Medical Dosimetrists (AAMD) designed and directed 2 surveys of the AAMD membership. The first was in 2011 and the second in 2014. There were a number of questions common to both surveys, and this article seeks to evaluate these common questions to determine trends among the professional membership of the AAMD. It is demonstrated that the observed trends are consistent with the goals and objectives established by the leadership of the AAMD and the Medical Dosimetry Certification Board (MDCB) for the medical dosimetry community. In addition, certain challenges and opportunities involving the scope of practice for the medical dosimetry profession are discussed.

Using a simple apparatus to measure direct and diffuse photosynthetically active radiation at remote locations.

Plant canopy interception of photosynthetically active radiation (PAR) drives carbon dioxide (CO2), water and energy cycling in the soil-plant-atmosphere system. Quantifying intercepted PAR requires accurate measurements of total incident PAR above canopies and direct beam and diffuse PAR components. While some regional data sets include these data, e.g. from Atmospheric Radiation Measurement (ARM) Program sites, they are not often applicable to local research sites because of the variable nature (spatial and temporal) of environmental variables that influence incoming PAR. Currently available instrumentation that measures diffuse and direct beam radiation separately can be cost prohibitive and require frequent adjustments. Alternatively, generalized empirical relationships that relate atmospheric variables and radiation components can be used but require assumptions that increase the potential for error. Our goal here was to construct and test a cheaper, highly portable instrument alternative that could be used at remote field sites to measure total, diffuse and direct beam PAR for extended time periods without supervision. The apparatus tested here uses a fabricated, solar powered rotating shadowband and other commercially available parts to collect continuous hourly PAR data. Measurements of total incident PAR had nearly a one-to-one relationship with total incident radiation measurements taken at the same research site by an unobstructed point quantum sensor. Additionally, measurements of diffuse PAR compared favorably with modeled estimates from previously published data, but displayed significant differences that were attributed to the important influence of rapidly changing local environmental conditions. The cost of the system is about 50% less than comparable commercially available systems that require periodic, but not continual adjustments. Overall, the data produced using this apparatus indicates that this instrumentation has the potential to support ecological research via a relatively inexpensive method to collect continuous measurements of total, direct beam and diffuse PAR in remote locations.

Characterization of a low-cost PIN photodiode for dosimetry in diagnostic radiology.

A commercial silicon PIN-photodiode was tested and characterized as ionizing radiation detector for radiological applications. A current-to-voltage amplification stage was designed and realized in order to acquire the photodiode signal in current mode. The system was tested with clinical beams routinely used for radiography and mammography. A Monte Carlo simulation of the detector was performed with the MCNPX code in order to model and fully understand, in particular, the impact of the sensor casing on the low energy response of the device. A reproducible output linearity was found over the dose range 0.03-4.5 mGy of great clinical relevance. The system sensitivity was found to be stable at 0.2 V s Gy(-1) for effective X-ray energies between 17 and 40 keV. The batch-to-batch reproducibility of the diodes was also experimentally investigated for two different batches of 14 diodes each. An inter-comparison with dosimeters routinely used in medical physics (i.e. Barracuda MPD RTI) showed a linear correlation between PIN-photodiode readout and absorbed dose measured with Barracuda, in the range of doses received by mammography and radiology patients.

An anthropomorphic spine phantom for proton beam approval in NCI-funded trials.

As part of the approval process for the use of scattered or uniform scanning proton therapy in National Cancer Institute (NCI)-sponsored clinical trials, the Radiological Physics Center (RPC) mandates irradiation of two RPC anthropomorphic proton phantoms (prostate and spine). The RPC evaluates these irradiations to ensure that they agree with the institutions' treatment plans within criteria of the NCI-funded cooperative study groups. The purpose of this study was to evaluate the use of an anthropomorphic spine phantom for proton matched-field irradiation, and to assess its use as a credentialing tool for proton therapy beams. We used an anthropomorphic spine phantom made of human vertebral bodies embedded in a tissue substitute material called Muscle Substitute/Solid Rigid Number 4 (MS/SR4) comprising three sections: a posterior section containing the posterior surface and the spinous processes, and left and right (L/R) sections containing the vertebral bodies and the transverse processes. After feasibility studies at three institutions, the phantom, containing two thermoluminescent dosimeters (TLDs) for absolute dose measurements and two sheets of radiochromic film for relative dosimetry, was shipped consecutively to eight proton therapy centers participating in the approval study. At each center, the phantom was placed in a supine or prone position (according to the institution's spine treatment protocol) and imaged with computed tomography (CT). The images then were used with the institution's treatment planning system (TPS) to generate two matched fields, and the phantom was irradiated accordingly. The irradiated phantom was shipped to the RPC for analysis, and the measured values were compared with the institution's TPS dose and profiles using criteria of ± 7% for dose agreement and 5 mm for profile distance to agreement. All proton centers passed the dose criterion with a mean agreement of 3% (maximum observed agreement, 7%). One center failed the profile distance-to-agreement criterion on its initial irradiation, but its second irradiation passed the criterion. Another center failed the profile distance-to-agreement criterion, but no repeat irradiation was performed. Thus, seven of the eight institutions passed the film profile distance-to-agreement criterion with a mean agreement of 1.2 mm (maximum observed agreement 5 mm). We conclude that an anthropomorphic spine phantom using TLD and radiochromic film adequately verified dose delivery and field placement for matched-field treatments.

PARduino: a simple and inexpensive device for logging photosynthetically active radiation.

Photosynthetically active radiation (PAR, 400-700 nm) is one of the primary controls of forest carbon and water relations. In complex terrain, PAR has high spatial variability. Given the high cost of commercial datalogging equipment, spatially distributed measurements of PAR have been typically modeled using geographic coordinates and terrain indices. Here, we present a design for a low-cost, field-deployable device for measuring and recording PAR built around an Arduino microcontroller-named PARduino. PARduino provides for widely distributed sensor arrays and tests the feasibility of using open-source, hobbyist-grade electronics for collecting scientific data. PARduino components include a quantum sensor, an EME Systems signal converter/amplifier and an Arduino Pro Mini microcontroller. Additional components include a real-time clock, a microSD Flash memory card and a custom printed circuit board. The components were selected for ease of assembly. We found strong agreement between the PARduino datalogger system and National Institute of Standards and Technology traceable sensors logged by an industry standard datalogger (slope = 0.99, SE < 0.01, P < 0.01; intercept = - 14.84, SE = 0.78, P < 0.01). The average difference between the two systems was 22.0 µmol m(-2) s(-1) with PARduino typically underestimating PAR. The average percentage difference between systems was 3.49%. On average, PARduino performed within the factory absolute calibration of the PAR sensor; however, larger errors occurred at low PAR levels. Using open-source technologies such as this can make it possible to develop a spatially distributed sensor network within the constraints of a typical research budget.

Design and characterization of an economical (192)Ir hemi-brain small animal irradiator.

PURPOSE: To describe the design and dosimetric characterization of a simple and economical small animal irradiator. MATERIALS AND METHODS: A high dose rate (HDR) (192)Ir brachytherapy source from a commercially available afterloader was used with a 1.3 cm thick tungsten collimator to provide sharp beam penumbra suitable for hemi-brain irradiation of mice. The unit was equipped with continuous gas anesthesia to allow robust animal immobilization. Dosimetric characterization of the device was performed with Gafchromic film measurements. RESULTS: The tungsten collimator provided a sharp penumbra suitable for hemi-brain irradiation, and dose rates on the order of 200 cGy/minute were achieved. The sharpness of the penumbra attainable with this device compares favorably to those measured experimentally for 6 MV photons, and 6 and 20 MeV electron beams from a linear accelerator, and was comparable to those measured for a 300 kVp orthovoltage beam and a Monte Carlo simulated 90 MeV proton beam. CONCLUSIONS: Due to its simplicity and low cost, the apparatus described is an attractive alternative for small animal irradiation experiments requiring steep dose gradients.

[Valorisation of brachytherapy and medico-economic considerations]. / Curiethérapie : valorisation et aspects médico-économiques.

Economic data in the literature for brachytherapy are still sparse and heterogeneous, with few controlled prospective studies and a perspective most often limited to those of the provider (health insurances). Moreover, these observation and conclusions are difficult to generalize in France. The prospective health economic studies performed in France in the framework of a national program to sustain innovative and costly therapies (STIC program) launched by the French cancer national institute are therefore of most importance. With the exception of prostate brachytherapy with permanent seeds, the valorisation of the brachytherapy activity by the French national health insurance does not take into account the degree of complexity and the real costs supported by health institutions (i.e. no specific valorisation for 3D image-based treatment planning and dose optimization and for the use of pulsed dose rate brachytherapy).

X-rays sensing properties of MEH-PPV, Alq3 and additive components: a new organic dosimeter as a candidate for minimizing the risk of accidents of patients undergoing radiation oncology.

In this paper, we report our experimental design in searching a smart and easy-to-read dosimeter used to detect 6 MV X-rays for improving patient safety in radiation oncology. The device was based on an organic emissive solutions of poly(2-methoxy-5(2'-ethylhexyloxy)-p-phenylenevinylene) (MEH-PPV), aluminum-tris-(8-hydroxyquinoline) (Alq3) and additive components which were characterized by UV-Vis absorption, photoluminescence and CIE color coordinate diagram. The optical properties of MEH-PPV/Alq3 solutions have been examined as function of radiation dose over the range of 0-100 Gy. It has shown that MEH-PPV/Alq3 solutions are specifically sensitive to X-rays, since the effect of radiation on this organic system is strongly correlated with the efficient spectral overlap between Alq3 emission and the absorption of degraded MEH-PPV, which alters the color and photoemission of MEH-PPV/Alq3 mixtures from red to yellow, and then to green. The rate of this change is more sensitive when MEH-PPV/Alq3 is irradiated in the presence of benzoyl peroxide than when in the presence of hindered phenolic stabilizers, respectively, an accelerator and an inhibitor to activate or inhibit free radical formation. This gives rise to optimize the response curve of the dosimeter. It is clear from the experimental results that organic emissive semiconductors have potential to be used as dedicated and low-cost dosimeters to provide an independent check of beam output of a linear accelerator and therefore to give patients the opportunity to have information on the dose prescription or equipment-related problems a few minutes before being exposed to radiation.

Low-cost extrapolation method for maximal LTE radio base station exposure estimation: test and validation.

An experimental validation of a low-cost method for extrapolation and estimation of the maximal electromagnetic-field exposure from long-term evolution (LTE) radio base station installations are presented. No knowledge on downlink band occupation or service characteristics is required for the low-cost method. The method is applicable in situ. It only requires a basic spectrum analyser with appropriate field probes without the need of expensive dedicated LTE decoders. The method is validated both in laboratory and in situ, for a single-input single-output antenna LTE system and a 2×2 multiple-input multiple-output system, with low deviations in comparison with signals measured using dedicated LTE decoders.

Computed tomography for preoperative planning in minimal-invasive total hip arthroplasty: radiation exposure and cost analysis.

Computed tomography (CT) was used for preoperative planning of minimal-invasive total hip arthroplasty (THA). 92 patients (50 males, 42 females, mean age 59.5 years) with a mean body-mass-index (BMI) of 26.5 kg/m(2) underwent 64-slice CT to depict the pelvis, the knee and the ankle in three independent acquisitions using combined x-, y-, and z-axis tube current modulation. Arthroplasty planning was performed using 3D-Hip Plan(®) (Symbios, Switzerland) and patient radiation dose exposure was determined. The effects of BMI, gender, and contralateral THA on the effective dose were evaluated by an analysis-of-variance. A process-cost-analysis from the hospital perspective was done. All CT examinations were of sufficient image quality for 3D-THA planning. A mean effective dose of 4.0 mSv (SD 0.9 mSv) modeled by the BMI (p<0.0001) was calculated. The presence of a contralateral THA (9/92 patients; p=0.15) and the difference between males and females were not significant (p=0.08). Personnel involved were the radiologist (4 min), the surgeon (16 min), the radiographer (12 min), and administrative personnel (4 min). A CT operation time of 11 min and direct per-patient costs of 52.80 € were recorded. Preoperative CT for THA was associated with a slight and justifiable increase of radiation exposure in comparison to conventional radiographs and low per-patient costs.

[Economic assessment of pulsed dose-rate (PDR) brachytherapy with optimized dose distribution for cervix carcinoma]. / Evaluation économique de la curiethérapie de débit pulsé gynécologique (PDR) avec optimisation de la dose pour les cancers du col utérin.

PURPOSE: Our study aims at evaluating the cost of pulsed dose-rate (PDR) brachytherapy with optimized dose distribution versus traditional treatments (iridium wires, cesium, non-optimized PDR). Issues surrounding reimbursement were also explored. MATERIALS AND METHODS: This prospective, multicentre, non-randomised study conducted in the framework of a project entitled "Support Program for Costly Diagnostic and Therapeutic Innovations" involved 21 hospitals. Patients with cervix carcinoma received either classical brachytherapy or the innovation. The direct medical costs of staff and equipment, as well as the costs of radioactive sources, consumables and building renovation were evaluated from a hospital point of view using a microcosting approach. Subsequent costs per brachytherapy were compared between the four strategies. RESULTS: The economic study included 463 patients over two years. The main resources categories associated with PDR brachytherapy (whether optimized or not) were radioactive sources (1053euro) and source projectors (735euro). Optimized PDR induced higher cost of imagery and dosimetry (respectively 130euro and 367euro) than non-optimized PDR (47euro and 75euro). Extra costs of innovation over the less costly strategy (iridium wires) reached more than 2100euro per treatment, but could be reduced by half in the hypothesis of 40 patients treated per year (instead of 24 in the study). CONCLUSION: Aside from staff, imaging and dosimetry, the current hospital reimbursements largely underestimated the cost of innovation related to equipment and sources.

Cost-effectiveness of the modifications in the quality assurance system in radiotherapy in the example of in-vivo dosimetry.

PURPOSE: To present the methodology for the evaluation of cost-effectiveness of the quality assurance protocol modifications associated with increasing demands on accuracy and reliability in radiotherapy and to present results on cost-effectiveness of in-vivo dosimetry as the chosen example of a technical procedure. MATERIAL AND METHODS: In-vivo dosimetry was used as an example of a quality assurance procedure, whose modifications have an impact on several procedures in the QA system and thus on the cost of radiotherapy. An analysis of 6864 patients, treated between 2001 and 2005 for tumours in the head and neck, breast, pelvis, or lung, was performed. The quality of radiotherapy was expressed as the accuracy of dose delivery and the cost was estimated from labour, equipment and materials. RESULTS: Modifications implemented in the quality assurance protocol have gradually improved the quality of irradiation. Mean deviations between measured and calculated doses, recorded for several groups of treatment sites, were reduced from -1.5% to 0.5%, 3.4% to 1.4%, 3.9% to 0.1% and -2.1% to 1.8% for head and neck, breast, pelvis and lung respectively. The standard deviations of the measured values decreased also consistently. Total monthly cost in radiotherapy (related to in-vivo dosimetry) increased from euro 4376 to euro 10,696 while the unitary cost of radiotherapy procedures remained at the same level. The predominant cost component of in-vivo dosimetry was labour, limited at first to physics staff and later extended to quality assurance personnel and technicians. CONCLUSION: The application of the presented methodology revealed cost-effectiveness relationships in tested technical procedures.

The cost effectiveness of in vivo dosimetry is not proven.

In vivo dosimetry is a check of the radiotherapy treatment process. Recently, it has been argued that in vivo dosimetry at the start of every patient's radiotherapy is cost effective. We have examined and extended the cost effectiveness argument and show that the model does not deliver the stated benefits.

Acrylonitrile Butadiene Styrene (ABS) plastic based low cost tissue equivalent phantom for verification dosimetry in IMRT.

A novel IMRT phantom was designed and fabricated using Acrylonitrile Butadiene Styrene (ABS) plastic. Physical properties of ABS plastic related to radiation interaction and dosimetry were compared with commonly available phantom materials for dose measurements in radiotherapy. The ABS IMRT phantom has provisions to hold various types of detectors such as ion chambers, radiographic/radiochromic films, TLDs, MOSFETs, and gel dosimeters. The measurements related to pre-treatment dose verification in IMRT of carcinoma prostate were carried out using ABS and Scanditronics-Wellhoffer RW3 IMRT phantoms for five different cases. Point dose data were acquired using ionization chamber and TLD discs while Gafchromic EBT and radiographic EDR2 films were used for generating 2-D dose distributions. Treatment planning system (TPS) calculated and measured doses in ABS plastic and RW3 IMRT phantom were in agreement within +/-2%. The dose values at a point in a given patient acquired using ABS and RW3 phantoms were found comparable within 1%. Fluence maps and dose distributions of these patients generated by TPS and measured in ABS IMRT phantom were also found comparable both numerically and spatially. This study indicates that ABS plastic IMRT phantom is a tissue equivalent phantom and dosimetrically it is similar to solid/plastic water IMRT phantoms. Though this material is demonstrated for IMRT dose verification but it can be used as a tissue equivalent phantom material for other dosimetry purposes in radiotherapy.