Impact of pitch angle setup error and setup error correction on dose distribution in volumetric modulated arc therapy for prostate cancer.

In volumetric modulated arc therapy (VMAT) for prostate cancer, a positional and rotational error correction is performed according to the position and angle of the prostate. The correction often involves body leaning, and there is concern regarding variation in the dose distribution. Our purpose in this study was to evaluate the impact of body pitch rotation on the dose distribution regarding VMAT. Treatment plans were obtained retrospectively from eight patients with prostate cancer. The body in the computed tomography images for the original VMAT plan was shifted to create VMAT plans with virtual pitch angle errors of ±1.5° and ±3°. Dose distributions for the tilted plans were recalculated with use of the same beam arrangement as that used for the original VMAT plan. The mean value of the maximum dose differences in the dose distributions between the original VMAT plan and the tilted plans was 2.98 ± 0.96 %. The value of the homogeneity index for the planning target volume (PTV) had an increasing trend according to the pitch angle error, and the values of the D 95 for the PTV and D 2ml, V 50, V 60, and V 70 for the rectum had decreasing trends (p < 0.05). However, there was no correlation between differences in these indexes and the maximum dose difference. The pitch angle error caused by body leaning had little effect on the dose distribution; in contrast, the pitch angle correction reduced the effects of organ displacement and improved these indexes. Thus, the pitch angle setup error in VMAT for prostate cancer should be corrected.

[Image quality evaluation of new image reconstruction methods applying the iterative reconstruction].

The purpose of this study was to evaluate the image quality of an iterative reconstruction method, the iterative reconstruction in image space (IRIS), which was implemented in a 128-slices multi-detector computed tomography system (MDCT), Siemens Somatom Definition Flash (Definition). We evaluated image noise by standard deviation (SD) as many researchers did before, and in addition, we measured modulation transfer function (MTF), noise power spectrum (NPS), and perceptual low-contrast detectability using a water phantom including a low-contrast object with a 10 Hounsfield unit (HU) contrast, to evaluate whether the noise reduction of IRIS was effective. The SD and NPS were measured from the images of a water phantom. The MTF was measured from images of a thin metal wire and a bar pattern phantom with the bar contrast of 125 HU. The NPS of IRIS was lower than that of filtered back projection (FBP) at middle and high frequency regions. The SD values were reduced by 21%. The MTF of IRIS and FBP measured by the wire phantom coincided precisely. However, for the bar pattern phantom, the MTF values of IRIS at 0.625 and 0.833 cycle/mm were lower than those of FBP. Despite the reduction of the SD and the NPS, the low-contrast detectability study indicated no significant difference between IRIS and FBP. From these results, it was demonstrated that IRIS had the noise reduction performance with exact preservation for high contrast resolution and slight degradation of middle contrast resolution, and could slightly improve the low contrast detectability but with no significance.

[Investigation of image quality identification utilizing physical image quality measurement in direct- and indirect-type of flat panel detectors and computed radiography].

The purpose of this study was to investigate image quality identification methods among direct- and indirect-type flat panel detectors (FPDs) and a computed radiography (CR) system using two radiation qualities RQA3 and RQA5 defined in the IEC 61267 standard. For each system, the digital characteristic curve, the presampled modulation transfer function (MTF), and the normalized noise power spectrum (NNPS) were measured. Images for a burger phantom and a foot-bone phantom were processed by resolution identification utilizing two-dimensional Fourier transform, and then contrast-to-noise ratio (CNR) for each image was measured. For the RQA3, the direct FPD system indicated the highest DQE value, and for the RQA5 DQE value of indirect FPD system, it was a little higher than that of direct FPD system. The CNR results with the resolution identification displayed good accordance with the DQE results in both phantoms. From the DQE results, dose ratios for image quality identification were determined, and the CNRs of the dose-adjusted images were measured. The results for, the CNRs of all systems showed good coincidence. From these findings, they indicated that the DQE measurement is effective to determine the exposure parameters for equalizing the image quality of different types of radiographic systems.

[Optimization of X-ray conditions for full spine X-ray examinations in slot-scan digital radiography].

The purpose of this study was to optimize X-ray conditions for full spine X-ray examinations in slot-scan digital radiography (SSDR). Follow-up of spinal deformities, such as scoliosis, typically involves many radiographs of the patient throughout childhood and adolescence. The Radiation doses for the full spine X-ray examination should be minimized. Recently, SSDR has been introduced for full spine as well as lower extremity examinations. This system utilizes slot scanning geometry to acquire the radiographic images. X-ray energy characteristics of direct amorphous Selenium (a-Se) digital fluoroscopy and short time X-ray tube loads of this system were investigated. Orthopedists evaluated the irradiation time for full spine radiographs in various conditions using an observer study. Patient doses were measured with radiophotoluminescence glass dosimeters, which were implanted in various tissue and organ positions within an anthropomorphic phantom. In the optimization of conditions for SSDR, patient doses are reduced by approximately 60% compared to default setting.