In-situ calibration of clinical built-in KAP meters with traceability to a primary standard using a reference KAP meter.

The air kerma-area product (KAP) is used for settings of diagnostic reference levels. The International Atomic Energy Agency (IAEA) recommends that doses in diagnostic radiology (including the KAP values) be estimated with an accuracy of at least ± 7% (k = 2). Industry standards defined by the International Electrotechnical Commission (IEC) specify that the uncertainty of KAP meter measurements should be less than ± 25% (k = 2). Medical physicists willing to comply with the IAEA's recommendation need to apply correction factors to KAP values reported by x-ray units. The aim of this work is to present and evaluate a calibration method for built-in KAP meters on clinical x-ray units. The method is based on (i) a tandem calibration method, which uses a reference KAP meter calibrated to measure the incident radiation, (ii) measurements using an energy-independent ionization chamber to correct for the energy dependence of the reference KAP meter, and (iii) Monte Carlo simulations of the beam quality correction factors that correct for differences between beam qualities at a standard laboratory and the clinic. The method was applied to the KAP meter in a Siemens Aristos FX plus unit. It was found that values reported by the built-in KAP meter differed from the more accurate values measured by the reference KAP meter by more than 25% for high tube voltages (more than 140 kV) and heavily filtered beams (0.3 mm Cu). Associated uncertainties were too high to claim that the IEC's limit of 25% was exceeded. Nevertheless the differences were high enough to justify the need for a more accurate calibration of built-in KAP meters.

Calculating effective dose on a cone beam computed tomography device: 3D Accuitomo and 3D Accuitomo FPD.

OBJECTIVES: This study evaluates two methods for calculating effective dose, CT dose index (CTDI) and dose-area product (DAP) for a cone beam CT (CBCT) device: 3D Accuitomo at field size 30x40 mm and 3D Accuitomo FPD at field sizes 40x40 mm and 60x60 mm. Furthermore, the effective dose of three commonly used examinations in dental radiology was determined. METHODS: CTDI(100) measurements were performed in a CT head dose phantom with a pencil ionization chamber connected to an electrometer. The rotation centre was placed in the centre of the phantom and also, to simulate a patient examination, in the upper left cuspid region. The DAP value was determined with a plane-parallel transmission ionization chamber connected to an electrometer. A conversion factor of 0.08 mSv per Gy cm(2) was used to determine the effective dose from DAP values. Based on data from 90 patient examinations, DAP and effective dose were determined. RESULTS: CTDI(100) measurements showed an asymmetric dose distribution in the phantom when simulating a patient examination. Hence a correct value of CTDI(w) could not be calculated. The DAP value increased with higher tube current and tube voltage values. The DAP value was also proportional to the field size. The effective dose was found to be 11-77 microSv for the specific examinations. CONCLUSIONS: DAP measurement was found to be the best method for determining effective dose for the Accuitomo. Determination of specific conversion factors in dental radiology must, however, be further developed.

Absorbed dose in AgBr in direct film for photon energies ( < 150 keV): relation to optical density. Theoretical calculation and experimental evaluation.

In the radiological process it is necessary to develop tools so as to explore how X-rays can be used in the most effective way. Evaluation of models to derive measures of image quality and risk-related parameters is one possibility of getting such a tool. Modelling the image receptor, an important part of the imaging chain, is then required. The aim of this work was to find convenient and accurate ways of describing the blackening of direct dental films by X-rays. Since the beginning of the 20th century, the relation between optical density and photon interactions in the silver bromide in X-ray films has been investigated by many authors. The first attempts used simple quantum theories with no consideration of underlying physical interaction processes. The theories were gradually made more realistic by the introduction of dosimetric concepts and cavity theory. A review of cavity theories for calculating the mean absorbed dose in the AgBr grains of the film emulsion is given in this work. The cavity theories of GREENING (15) and SPIERS-CHARLTON (37) were selected for calculating the mean absorbed dose in the AgBr grains relative to the air collision kerma (Kc,air) of the incident photons of Ultra-speed and Ektaspeed (intraoral) films using up-to-date values of interaction coefficients. GREENING'S theory is a multi-grain theory and the results depend on the relative amounts of silver bromide and gelatine in the emulsion layer. In the single grain theory of SPIERS-CHARLTON, the shape and size of the silver bromide grain are important. Calculations of absorbed dose in the silver bromide were compared with measurements of optical densities in Ultra-speed and Ektaspeed films for a broad range (25-145 kV) of X-ray energy. The calculated absorbed dose values were appropriately averaged over the complete photon energy spectrum, which was determined experimentally using a Compton spectrometer. For the whole range of tube potentials used, the measured optical densities of the films were found to be proportional to the mean absorbed dose in the AgBr grains calculated according to GREENING'S theory. They were also found to be proportional to the collision kerma in silver bromide (Kc,AgBr) indicating proportionality between Kc,AgBr and the mean absorbed dose in silver bromide. While GREENING'S theory shows that the quotient of the mean absorbed dose in silver bromide and Kc,AgBr varies with photon energy, this is not apparent when averaged over the broad (diagnostic) X-ray energy spectra used here. Alternatively, proportionality between Kc,AgBr and the mean absorbed dose in silver bromide can be interpreted as resulting from a combination of the SPIERS-CHARLTON theory, valid at low photon energies ( < 30 keV) and GREENING'S theory, which is strictly valid at energies above 50 keV. This study shows that the blackening of non-screen films can be related directly to the energy absorbed in the AgBr grains of the emulsion layer and that, for the purpose of modelling the imaging chain in intraoral radiography, film response can be represented by Kc,AgBr (at the position of the film) independent of photon energy. The importance of taking the complete X-ray energy spectrum into full account in deriving Kc,AgBr is clearly demonstrated, showing that the concept of effective energy must be used with care.

Effects of contrast equalization on energy imparted to the patient: a comparison of two dental generators and two types of intraoral film.

Technical evolution in maxillofacial radiology has in the last decade provided faster films and the constant potential generator. The consequences of these innovations for radiographic contrast and energy imparted to the patient are analysed. On the basis of physical measurements a test model has been developed for correcting exposure parameters in order to maintain or restore image contrast. These measurements are expressed in and developed from basic radiological concepts and physical formulas presented in an earlier paper (Helmrot E. et al., Dentomaxillofac. Radiol. 1991; 20: 135-46). The test model can also be used to demonstrate the balance between contrast and energy imparted to the patient in the radiographic process. Changing to constant potential generators and faster film may each result in a degradation in contrast, which is possible to restore by a controlled adjustment of the kV-setting. Maintenance of constant image quality results in a slight reduction in the net gain in energy imparted, due to the generator and/or film shift. When, for example, a conventional single-pulse generator operated at 65kVp tube potential was replaced by a modern constant potential unit, the kV-setting had to be decreased by 5 to 8 kV to maintain the same radiographic contrast. This correction could be done without increasing energy imparted to the patient, taking into account the fact that the spectral characters of the photon energy are not identical. If, in addition, faster intraoral film with lower film contrast was introduced, together with the constant potential unit, the kV-setting had to be further decreased to maintain the radiographic contrast.(ABSTRACT TRUNCATED AT 250 WORDS)

Influence of scattered radiation and tube potential on radiographic contrast: comparison of two different dental X-ray films.

The fundamental concept in image quality of contrast has been analysed in terms of its elements; film, radiation and object contrast, and the theoretical formula to describe their interrelationship have been evaluated. Experiments were designed to investigate the dependence of radiographic contrast on the kV, the type of generator and dental film used (D and E speed). An ivory wedge was used as the object, both alone and within a polymethyl methacrylate phantom as scattering medium. Precise definition and control of the X-ray generators were achieved by means of measurements of the primary X-ray spectra using a Compton spectrometer. D speed was found to have higher film contrast than E speed when compared at the same optical density, due to its lower base and fog and lower level of saturation in these experiments. On the other hand, E speed was found to have wider latitude. The experimental object was reproduced with the highest radiographic contrast using D-speed film and, with a given type of generator, this increased when the kV was decreased. While no difference in scatter/primary ratios was observed using the two different films, a weak dependence on kV in the range from 36 to 77 kV was found and confirmed by Monte Carlo calculations. The results indicate that the D and E speed films used had equal energy absorption properties; the difference in radiographic performance is due to their different film characteristics. The importance of controlling the physical parameters (photon energy spectrum, base and fog and optical density level) when comparing image qualities is clearly demonstrated.