Journal of Medical Physics
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REVIEW ARTICLE
Automated medical image segmentation techniques
Neeraj Sharma, Lalit M Aggarwal
January-March 2010, 35(1):3-14
DOI:10.4103/0971-6203.58777  PMID:20177565
Accurate segmentation of medical images is a key step in contouring during radiotherapy planning. Computed topography (CT) and Magnetic resonance (MR) imaging are the most widely used radiographic techniques in diagnosis, clinical studies and treatment planning. This review provides details of automated segmentation methods, specifically discussed in the context of CT and MR images. The motive is to discuss the problems encountered in segmentation of CT and MR images, and the relative merits and limitations of methods currently available for segmentation of medical images.
  13,523 601 40
ORIGINAL ARTICLES
Segmentation and classification of medical images using texture-primitive features: Application of BAM-type artificial neural network
Neeraj Sharma, Amit K Ray, Shiru Sharma, KK Shukla, Satyajit Pradhan, Lalit M Aggarwal
July-September 2008, 33(3):119-126
DOI:10.4103/0971-6203.42763  PMID:19893702
The objective of developing this software is to achieve auto-segmentation and tissue characterization. Therefore, the present algorithm has been designed and developed for analysis of medical images based on hybridization of syntactic and statistical approaches, using artificial neural network (ANN). This algorithm performs segmentation and classification as is done in human vision system, which recognizes objects; perceives depth; identifies different textures, curved surfaces, or a surface inclination by texture information and brightness. The analysis of medical image is directly based on four steps: 1) image filtering, 2) segmentation, 3) feature extraction, and 4) analysis of extracted features by pattern recognition system or classifier. In this paper, an attempt has been made to present an approach for soft tissue characterization utilizing texture-primitive features with ANN as segmentation and classifier tool. The present approach directly combines second, third, and fourth steps into one algorithm. This is a semisupervised approach in which supervision is involved only at the level of defining texture-primitive cell; afterwards, algorithm itself scans the whole image and performs the segmentation and classification in unsupervised mode. The algorithm was first tested on Markov textures, and the success rate achieved in classification was 100%; further, the algorithm was able to give results on the test images impregnated with distorted Markov texture cell. In addition to this, the output also indicated the level of distortion in distorted Markov texture cell as compared to standard Markov texture cell. Finally, algorithm was applied to selected medical images for segmentation and classification. Results were in agreement with those with manual segmentation and were clinically correlated.
  11,755 694 26
Dosimetric evaluation of Acuros XB dose calculation algorithm with measurements in predicting doses beyond different air gap thickness for smaller and larger field sizes
Suresh Rana, Kevin Rogers
January-March 2013, 38(1):9-14
DOI:10.4103/0971-6203.106600  PMID:23532180
In this study, dose prediction accuracy of Acuros XB (AXB) dose calculation algorithm beyond air gap thickness (range 2, 4, and 6 cm) in simple inhomogeneous phantoms was investigated. The evaluation of AXB was performed by comparing the doses calculated by AXB with the doses calculated by Anisotropic Analytical Algorithm (AAA) and the measured data for different field sizes (3 × 3, 5 × 5, and 10 × 10 cm 2 ) of a 6 MV photon beam. The dose computation was performed within Eclipse treatment planning system, and measurements were acquired with a cylindrical ionization chamber. Central axis depth dose comparisons were done in solid-water material region up to 5 cm distance from air/solid-water interface. The results of AXB had better agreement with measurements at all measured points than that of AAA. The discrepancies between AXB and measured data were seen from − 3.81% to + 0.9%, whereas the AAA differences with measurement from − 3.1% to − 10.9%. The combination of the smallest test field size and the largest air gap produced the highest range (1-5 cm distance from air/solid-water interface) in dose difference (AAA: −4.0% to − 10.6% and AXB: −3.8% to + 0.6%). The AAA computational time was about 8 times faster than that of AXB. In conclusion, AXB is more appropriate to use for dose predictions, especially when low-density heterogeneities are involved.
  10,542 483 10
Extrapolation chamber mounted on perspex for calibration of high energy photon and electron beams from a clinical linear accelerator
R Ravichandran, JP Binukumar, SS Sivakumar, K Krishnamurthy, CA Davis
January-March 2009, 34(1):31-36
DOI:10.4103/0971-6203.48718  PMID:20126563
The objective of the present study is to establish radiation standards for absorbed doses, for clinical high energy linear accelerator beams. In the nonavailability of a cobalt-60 beam for arriving at Nd, water values for thimble chambers, we investigated the efficacy of perspex mounted extrapolation chamber (EC) used earlier for low energy x-rays and beta dosimetry. Extrapolation chamber with facility for achieving variable electrode separations 10.5mm to 0.5mm using micrometer screw was used for calibrations. Photon beams 6 MV and 15 MV and electron beams 6 MeV and 15 MeV from Varian Clinac linacs were calibrated. Absorbed Dose estimates to Perspex were converted into dose to solid water for comparison with FC 65 ionisation chamber measurements in water. Measurements made during the period December 2006 to June 2008 are considered for evaluation. Uncorrected ionization readings of EC for all the radiation beams over the entire period were within 2% showing the consistency of measurements. Absorbed doses estimated by EC were in good agreement with in-water calibrations within 2% for photons and electron beams. The present results suggest that extrapolation chambers can be considered as an independent measuring system for absorbed dose in addition to Farmer type ion chambers. In the absence of standard beam quality (Co-60 radiations as reference Quality for Nd,water) the possibility of keeping EC as Primary Standards for absorbed dose calibrations in high energy radiation beams from linacs should be explored. As there are neither Standard Laboratories nor SSDL available in our country, we look forward to keep EC as Local Standard for hospital chamber calibrations. We are also participating in the IAEA mailed TLD intercomparison programme for quality audit of existing status of radiation dosimetry in high energy linac beams. The performance of EC has to be confirmed with cobalt-60 beams by a separate study, as linacs are susceptible for minor variations in dose output on different days.
  10,655 211 1
REVIEW ARTICLES
Whole body radiotherapy: A TBI-guideline
Ulrich Quast
January-March 2006, 31(1):5-12
DOI:10.4103/0971-6203.25664  PMID:21206634
Total Body Irradiation (TBI) is one main component in the interdisciplinary treatment of widely disseminated malignancies predominantly of haematopoietic diseases. Combined with intensive chemotherapy, TBI enables myeloablative high dose therapy and immuno­ablative conditioning treatment prior to subsequent transplantation of haematopoietic stem cells: bone marrow stem cells or peripheral blood progenitor stem cells. Jointly prepared by DEGRO and DGMP, the German Society of Radio-Oncology, and the German Association of Medical Physicists, this DEGRO/DGMP-Leitlinie Ganzkoerper-Strahlenbehandlung - DEGRO/DGMP Guideline Whole Body Radiotherapy, summarises the concepts, principles, facts and common methods of Total Body Irradiation and poses a set of recommendations for reliable and successful application of high dose large-field radiotherapy as essential part of this interdisciplinary, multi­modality treatment concept. The guideline is geared towards radio-oncologists, medical physicists, haematooncolo­gists, and all contributing to Whole Body Radiotherapy. To guide centres intending to start or actualise TBI criteria are included. The relevant treatment parameters are defined and a sample of a form is given for reporting TBI to international registries.
  9,919 871 13
ORIGINAL ARTICLES
Initial experience with an 11 MeV self-shielded medical cyclotron on operation and radiation safety
GS Pant, S Senthamizhchelvan
July-September 2007, 32(3):118-123
DOI:10.4103/0971-6203.35724  PMID:21157531
A self-shielded medical cyclotron (11 MeV) was commissioned at our center, to produce positron emitters, namely, 18 F, 15 O, 13 N and 11 C for positron emission tomography (PET) imaging. Presently the cyclotron has been exclusively used for the production of 18 F - for 18 F-FDG imaging. The operational parameters which influence the yield of 18 F - production were monitored. The radiation levels in the cyclotron and radiochemistry laboratory were also monitored to assess the radiation safety status in the facility. The target material, 18 O water, is bombarded with proton beam from the cyclotron to produce 18 F - ion that is used for the synthesis of 18 F-FDG. The operational parameters which influence the yield of 18 F - were observed during 292 production runs out of a total of more than 400 runs. The radiation dose levels were also measured in the facility at various locations during cyclotron production runs and in the radiochemistry laboratory during 18 F-FDG syntheses. It was observed that rinsing the target after delivery increased the number of production runs in a given target, as well as resulted in a better correlation between the duration of bombardment and the end of bombardment 18 F - activity with absolutely clean target after being rebuilt. The radiation levels in the cyclotron and radiochemistry laboratory were observed to be well within prescribed limits with safe work practice.
  9,984 628 5
Magnetic resonance imaging for adaptive cobalt tomotherapy: A proposal
Tomas Kron, David Eyles, John L Schreiner, Jerry Battista
October-December 2006, 31(4):242-254
DOI:10.4103/0971-6203.29194  PMID:21206640
Magnetic resonance imaging (MRI) provides excellent soft tissue contrast for oncology applications. We propose to combine a MRI scanner with a helical tomotherapy (HT) system to enable daily target imaging for improved conformal radiation dose delivery to a patient. HT uses an intensity-modulated fan-beam that revolves around a patient, while the patient slowly advances through the plane of rotation, yielding a helical beam trajectory. Since the use of a linear accelerator to produce radiation may be incompatible with the pulsed radiofrequency and the high and pulsed magnetic fields required for MRI, it is proposed that a radioactive Cobalt-60 (60Co) source be used instead to provide the radiation. An open low field (0.25 T) MRI system is proposed where the tomotherapy ring gantry is located between two sets of Helmholtz coils that can generate a sufficiently homogenous main magnetic field. It is shown that the two major challenges with the design, namely acceptable radiation dose rate (and therefore treatment duration) and moving parts in strong magnetic field, can be addressed. The high dose rate desired for helical tomotherapy delivery can be achieved using two radiation sources of 220TBq (6000Ci) each on a ring gantry with a source to axis-of-rotation distance of 75 cm. In addition to this, a dual row multi-leaf collimator (MLC) system with 15 mm leaf width at isocentre and relatively large fan beam widths between 15 and 30 mm per row shall be employed. In this configuration, the unit would be well-suited for most pelvic radiotherapy applications where the soft tissue contrast of MRI will be particularly beneficial. Non-magnetic MRI compatible materials must be used for the rotating gantry. Tungsten, which is non-magnetic, can be used for primary collimation of the fan-beam as well as for the MLC, which allows intensity modulated radiation delivery. We propose to employ a low magnetic Cobalt compound, sycoporite (CoS) for the Cobalt source material itself. Rotational delivery is less susceptible to problems related to the use of a low energy megavoltage photon source while the helical delivery reduces the negative impact of the relatively large penumbra inherent in the use of Cobalt sources for radiotherapy. On the other hand, the use of a 60Co source ensures constant dose rate with gantry rotation and makes dose calculation in a magnetic field as easy as the range of secondary electrons is limited. The MR-integrated Cobalt tomotherapy unit, dubbed 'MiCoTo,' uses two independent physical principles for image acquisition and treatment delivery. It would offer excellent target definition and will allow following target motion during treatment using fast imaging techniques thus providing the best possible input for adaptive radiotherapy. As an additional bonus, quality assurance of the radiation delivery can be performed in situ using radiation sensitive gels imaged by MRI.
  9,859 693 18
BOOK REVIEW
The role of mathematics on human structure: By Swapan Kumar Adhikari
CA Jayachandran
April-June 2007, 32(2):77-78
  10,106 244 -
ORIGINAL ARTICLES
QA of intensity-modulated beams using dynamic MLC log files
M Dinesh Kumar, N Thirumavalavan, D Venugopal Krishna, M Babaiah
January-March 2006, 31(1):36-41
DOI:10.4103/0971-6203.25668  PMID:21206638
To evaluate the utility of Dynalog file information for planar dose verification in IMRT QA, a program is developed to convert Dynalog file data to DMLC field files. For this study, five predefined fluencies are planned and delivered using Varian, Eclipse 3D planning system and 6MV photon beam of Varian, Clinac DMX linear accelerator. To measure planar dose distribution, Kodak, EDR2 films are exposed in similar setup as planning setup. Dynalog files are recorded for each delivery and converted into DMLC field files using in-house program. Delivered dose distributions are calculated using DMLC field files from Dynalog files. Planned, Measured and Delivered dose distributions are compared using gamma evaluation in Scanditronix, Omni Pro IMRT software. The Planned and Delivered planar dose distributions agree within 2% dose difference and 2 mm DTA. Measured dose distributions agree within 4% dose difference and 4 mm DTA with Planned dose distribution. Our results show Dynalog file as a promising tool for dynamic IMRT QA.
  9,133 848 6
Principles and limitations of NMR diffusion measurements
Jan Hrabe, Gurjinder Kaur, David N Guilfoyle
January-March 2007, 32(1):34-42
DOI:10.4103/0971-6203.31148  PMID:21217917
Diffusion spectroscopy, imaging and particularly diffusion tensor imaging have become popular thanks to their numerous clinical and research applications which span from brain stroke evaluation to fiber tracking. With a few exceptions, these methods are rooted in the classic Stejskal-Tanner formula for the diffusion-attenuated signal, usually obtained by solving the Bloch-Torrey partial differential equations. Here we derive the Stejskal-Tanner formula in the simplest possible manner, avoiding integrals and differential equations. This approach makes it easy to understand the origin of the diffusion signal attenuation, the effects of various diffusion sequence parameters, and also the numerous important pitfalls, which are discussed in the last section.
  9,130 665 4
INVITED ARTICLE
Determination of absorbed dose to water for high-energy photon and electron beams-comparison of the standards DIN 6800-2 (1997), IAEA TRS 398 (2000) and DIN 6800-2 (2006)
Golam Abu Zakaria, Wilhelm Schuette
January-March 2007, 32(1):3-11
DOI:10.4103/0971-6203.31143  PMID:21217912
For the determination of the absorbed dose to water for high-energy photon and electron beams the IAEA code of practice TRS-398 (2000) is applied internationally. In Germany, the German dosimetry protocol DIN 6800-2 (1997) is used. Recently, the DIN standard has been revised and published as Draft National Standard DIN 6800-2 (2006). It has adopted widely the methodology and dosimetric data of the code of practice. This paper compares these three dosimetry protocols systematically and identifies similarities as well as differences. The investigation was done with 6 and 18 MV photon as well as 5 to 21 MeV electron beams. While only cylindrical chambers were used for photon beams, measurements of electron beams were performed using cylindrical as well as plane-parallel chambers. The discrepancies in the determination of absorbed dose to water between the three protocols were 0.4% for photon beams and 1.5% for electron beams. Comparative measurements showed a deviation of less than 0.5% between our measurements following protocol DIN 6800-2 (2006) and TLD inter-comparison procedure in an external audit.
  8,885 883 -
ORIGINAL ARTICLES
Electron beam characteristics at extended source-to-surface distances for irregular cut-outs
T Arunkumar, Sanjay S Supe, M Ravikumar, S Sathiyan, M Ganesh
October-December 2010, 35(4):207-214
DOI:10.4103/0971-6203.71763  PMID:21170185
Electron beam therapy is widely used in the management of cancers. The rapid dose fall-off and the short range of an electron beam enable the treatment of lesions close to the surface, while sparing the underlying tissues. In an extended source-to-surface (SSD) treatment with irregular field sizes defined by cerrobend cutouts, underdosage of the lateral tissue may occur due to reduced beam flatness and uniformity. To study the changes in the beam characteristics, the depth dose, beam profile, and isodose distributions were measured at different SSDs for regular 10 Χ 10 cm 2 and 15 Χ 15 cm 2 cone, and for irregular cutouts of field size 6.5 Χ 9 cm 2 and 11.5 Χ 15 cm 2 for beam energies ranging from 6 to 20 MeV. The PDD, beam flatness, symmetry and uniformity index were compared. For lower energy (6 MeV), there was no change in the depth of maximum dose (R100) as SSD increased, but for higher energy (20 MeV), the R100 depth increased from 2 cm to 3 cm as SSD increased. This shows that as SSD increases there is an increase in the depth of the maximum dose for higher energy beams. There is a +7 mm shift in the R100 depth when compared with regular and irregular field sizes. The symmetry was found to be within limits for all the field sizes as the treatment distance extended as per International Electro technical Commision (IEC) protocol. There was a loss of beam flatness for irregular fields and it was more pronounced for lower energies as compared with higher energies, so that the clinically useful isodose level (80% and 90%) width decreases with increase in SSD. This suggests that target coverage at extended SSD with irregular cut-outs may be inadequate unless relatively large fields are used.
  9,430 145 3
INVITED PAPERS
The role of Cobalt-60 in modern radiation therapy: Dose delivery and image guidance
L John Schreiner, Chandra P Joshi, Johnson Darko, Andrew Kerr, Greg Salomons, Sandeep Dhanesar
July-September 2009, 34(3):133-136
DOI:10.4103/0971-6203.54846  PMID:20098559
The advances in modern radiation therapy with techniques such as intensity-modulated radiation therapy and image-guid­ed radiation therapy (IMRT and IGRT) have been limited almost exclusively to linear accel­erators. Investigations of modern Cobalt-60 (Co-60) radiation delivery in the context of IMRT and IGRT have been very sparse, and have been limited mainly to computer-modeling and treatment-planning exercises. In this paper, we report on the results of experiments using a tomotherapy benchtop apparatus attached to a conventional Co-60 unit. We show that conformal dose delivery is possible and also that Co-60 can be used as the radiation source in megavoltage computed tomography imaging. These results complement our modeling studies of Co-60 tomotherapy and provide a strong motivation for continuing development of modern Cobalt-60 treatment devices.
  9,113 343 7
ORIGINAL ARTICLES
Dosimetric comparison of linear accelerator-based stereotactic radiosurgery systems
SD Sharma, Sudhir Kumar, SS Dagaonkar, Geetika Bisht, S Dayanand, Reena Devi, SS Deshpande, S Chaudhary, BC Bhatt, S Kannan
January-March 2007, 32(1):18-23
DOI:10.4103/0971-6203.31145  PMID:21217914
Stereotactic radiosurgery (SRS) is a special radiotherapy technique used to irradiate intracranial lesions by 3-D arrangements of narrow photon beams eliminating the needs of invasive surgery. Three different tertiary collimators, namely BrainLab and Radionics circular cones and BrainLab micro multileaf collimator (mMLC), are used for linear accelerator-based SRS systems (X-Knife). Output factor (St), tissue maximum ratio (TMR) and off axis ratio (OAR) of these three SRS systems were measured using CC01 (Scanditronix/ Welhofer) and Pinpoint (PTW) cylindrical and Markus plane parallel ionization chambers as well as TLD and radiochromic film. Measurement results of CC01 and Pinpoint chambers were very close to each other which indicate that further reduction in volume and physical dimensions of cylindrical ionization chamber is not necessary for SRS/SRT dosimetry. Output factors of BrainLab and Radionics SRS cones were very close to each other while output factors of equivalent diameter mMLC field were different from SRS circular cones. TMR of the three SRS systems compared were very close to one another. OAR of Radionics cone and BrainLab mMLC were very close to each other, within 2%. However, OARs of BrainLab cone were found comparable to OARs of Radionics cone and BrainLab mMLC within maximum variation of 4%. In addition, user-measured similar data of other three mMLC X-Knives were compared with the mMLC X-Knife data measured in this work and found comparable. The concept of switching over to mMLC-based SRS/SRT is thus validated from dosimetric characteristics as well.
  8,611 766 4
Impact of 6MV photon beam attenuation by carbon fiber couch and immobilization devices in IMRT planning and dose delivery
RK Munjal, PS Negi, AG Babu, SN Sinha, AK Anand, T Kataria
April-June 2006, 31(2):67-71
DOI:10.4103/0971-6203.26690  PMID:21206667
Multiple fields in IMRT and optimization allow conformal dose to the target and reduced dose to the surroundings and the regions of interest. Thus we can escalate the dose to the target to achieve better tumor control with low morbidity. Orientation of multiple beams can be achieved by i) different gantry angles, ii) rotating patient's couch isocentrically. In doing so, one or more beam may pass through different materials like the treatment couch, immobilization cast fixation plate, head and neck rest or any other supportive device. Our observations for 6MV photon beam on PRIMUS-KXE2 with MED-TEC carbon fiber tabletop and 10 x 10 cm2 field size reveals that the maximum dose attenuation by the couch was of the order of 2.96% from gantry angle 120-160°. Attenuation due to cast fixation base plate of PMMA alone was of the order of 5.8-10.55% at gantry angle between 0 and 90°. Attenuation due to carbon fiber base plate alone was 3.8-7.98%. Attenuation coefficient of carbon fiber and PMMA was evaluated and was of the order of 0.082 cm-1 and 0.064 cm-1 respectively. Most of the TPS are configured for direct beam incidence attenuation correction factors only. Whereas when the beam is obliquely incident on the couch, base plate, headrest and any other immobilization device get attenuated more than the direct beam incidence. The correction factors for oblique incidence beam attenuation are not configured in most of the commercially available treatment planning systems. Therefore, such high variations in dose delivery could lead to under-dosage to the target volume for treatments requiring multiple fields in IMRT and 3D-CRT and need to be corrected for monitor unit calculations.
  8,451 654 21
Evaluation of gafchromic EBT film for intensity modulated radiation therapy dose distribution verification
A Sankar, PG Goplakrishna Kurup, V Murali, Komanduri M Ayyangar, R Mothilal Nehru, J Velmurugan
April-June 2006, 31(2):78-82
DOI:10.4103/0971-6203.26693  PMID:21206669
This work was undertaken with the intention of investigating the possibility of clinical use of commercially available self-developing radiochromic film - Gafchromic EBT film - for IMRT dose verification. The dose response curves were generated for the films using VXR-16 film scanner. The results obtained with EBT films were compared with the results of Kodak EDR2 films. It was found that the EBT film has a linear response between the dose ranges of 0 and 600 cGy. The dose-related characteristics of the EBT film, like post-irradiation color growth with time, film uniformity and effect of scanning orientation, were studied. There is up to 8.6% increase in the color density between 2 and 40 h after irradiation. There was a considerable variation, up to 8.5%, in the film uniformity over its sensitive region. The quantitative difference between calculated and measured dose distributions was analyzed using Gamma index with the tolerance of 3% dose difference and 3 mm distance agreement. EDR2 films showed good and consistent results with the calculated dose distribution, whereas the results obtained using EBT were inconsistent. The variation in the film uniformity limits the use of EBT film for conventional large field IMRT verification. For IMRT of smaller field size (4.5 x 4.5 cm), the results obtained with EBT were comparable with results of EDR2 films.
  8,164 705 5
REVIEW ARTICLES
Positron emission tomography: An overview
AK Shukla, Utham Kumar
January-March 2006, 31(1):13-21
DOI:10.4103/0971-6203.25665  PMID:21206635
The rate of glucose utilization in tumor cells is significantly enhanced as compared to normal cells and this biochemical characteristic is utilized in PET imaging using FDG as a major workhorse. The PET systems as well as cyclotrons producing positron emitting radiopharmaceuticals have undergone continuous technological refinements. While PET (CT) systems enable fusion images as well as precise attenuation correction, the self-shielded cyclotrons developed provide dedicated systems for in-house production of a large number of PET radiopharmaceuticals. The application of PET images in oncology includes those of pulmonary, colorectal, breast, lymphoma, head & neck, bone, ovarian and GI cancers. The PET has been recognized as promising diagnostic tool to predict biological and physiological changes at the molecular level and hence offer a potential area for future applications including Stem Cell research.
  7,929 826 3
REVIEW ARTICLE
Recent developments of optically stimulated luminescence materials and techniques for radiation dosimetry and clinical applications
AS Pradhan, JI Lee, JL Kim
July-September 2008, 33(3):85-99
DOI:10.4103/0971-6203.42748  PMID:19893698
During the last 10 years, optically stimulated luminescence (OSL) has emerged as a formidable competitor not only to thermoluminescence dosimetry (TLD) but also to several other dosimetry systems. Though a large number of materials have been synthesized and studied for OSL, Al 2 O 3 :C continues to dominate the dosimetric applications. Re-investigations of OSL in BeOindicate that this material might provide an alternative to Al 2 O 3 :C. Study of OSL of electronic components of mobile phones and ID cards appears to have opened up a feasibility of dosimetry and dose reconstruction using the electronic components of gadgets of everyday use in the events of unforeseen situations of radiological accidents, including the event of a dirty bomb by terrorist groups. Among the newly reported materials, a very recent development of NaMgF 3 :Eu 2+ appears fascinating because of its high OSL sensitivity and tolerable tissue equivalence. In clinical dosimetry, an OSL as a passive dosimeter could do all that TLD can do, much faster with a better or at least the same efficiency; and in addition, it provides a possibility of repeated readout unlike TLD, in which all the dose information is lost in a single readout. Of late, OSL has also emerged as a practical real-time dosimeter for in vivo measurements in radiation therapy (for both external beams and brachytherapy) and in various diagnostic radiological examinations including mammography and CT dosimetry. For in vivo measurements, a probe of Al 2 O 3 :C of size of a fraction of a millimeter provides the information on both the dose rate and the total dose from the readout of radioluminescence and OSL signals respectively, from the same probe. The availability of OSL dosimeters in various sizes and shapes and their performance characteristics as compared to established dosimeters such as plastic scintillation dosimeters, diode detectors, MOSFET detectors, radiochromic films, etc., shows that OSL may soon become the first choice for point dose measurements in clinical applications. A brief review of the recent developments is presented.
  7,694 761 28
ORIGINAL ARTICLES
Performance evaluation of a dedicated computed tomography scanner used for virtual simulation using in-house fabricated CT phantoms
DS Sharma, SD Sharma, KK Sanu, S Saju, DD Deshpande, S Kannan
January-March 2006, 31(1):28-35
DOI:10.4103/0971-6203.25667  PMID:21206637
Comprehensive tests on single slice CT scanner was carried out using in-house fabricated phantoms/test tools following AAPM recommended methods to independently validate the auto-performance test (APT) results. Test results of all the electromechanical parameters were found within the specified limits. Radiation and sensitivity profile widths were within ± 0.05 cm of the set slice thickness. Effective energy corresponding to nominal kVp of 80, 110 and 130 were 49.99, 55.08 and 59.48 keV, respectively. Percentage noise obtained by APT was 1.32% while the independently measured value was 0.38%. Observed contrast resolutions by independent method at 0.78% and 12% contrast difference were 4 mm and 1.25 mm (= 4 lp/cm) respectively. However, high contrast resolution (limiting spatial resolution) by APT at 50, 10 and 2% MTF levels were 9, 12.5 and 14.1 lp/cm respectively. Difference in calculated and measured CT numbers of water, air, teflon, acrylic, polystyrene and polypropylene were in the range of 0 to 24 HU, while this difference was 46 and 94 HU in case of nylon and bakelite respectively. The contrast scale determined using CT linearity phantom was 1.998×10-4 cm-1/CT number. CT dose index (CTDI) and weighted CTDI (CTDIw) measured at different kVp for standard head and body phantoms were smaller than manufacturer-specified and system-calculated values and were found within the manufacturer-specified limit of ± 20%. Measured CTDIs on surface (head: 3.6 cGy and body: 2.6 cGy) and at the center (3.3 cGy, head; and 1.2 cGy, body) were comparable to reported values of other similar CT scanners and were also within the industry-quoted CTDI range. Comprehensive QA and independent validation of APT results are necessary to obtain baseline data for CT virtual simulation.
  7,874 540 3
An ideal blood mimicking fluid for doppler ultrasound phantoms
H Samavat, JA Evans
October-December 2006, 31(4):275-278
DOI:10.4103/0971-6203.29198  PMID:21206644
In order to investigate the problems of detecting tumours by ultrasound it is very important to have a portable Doppler flow test object to use as a standardising tool. The flow Doppler test objects are intended to mimic the flow in human arteries. To make the test meaningful, the acoustic properties of the main test object components (tissue and blood mimic) should match closely the properties of the corresponding human tissues, while the tube should ideally have little influence. The blood mimic should also represent the haemodynamic properties of blood. An acceptable flow test object has been designed to closely mimic blood flow in arteries. We have evaluated the properties of three blood mimicking fluid: two have been described recently in the literature, the third is a local design. One of these has emerged as being particularly well matched to the necessary characteristics for in-vitro work.
  7,344 405 6
EDITORIAL
Prostate brachytherapy: HDR or seed implant
KR Das
October-December 2006, 31(4):239-241
DOI:10.4103/0971-6203.29193  PMID:21206639
  7,157 410 -
Quality of high-energy X-ray radiotherapy beams: Issues of adequacy of routine experimental verification
SD Sharma
January-March 2008, 33(1):1-2
DOI:10.4103/0971-6203.39416  PMID:20041044
  6,795 695 3
ORIGINAL ARTICLES
Development of patient support devices for execution of clinical radiotherapy for cancer patients: A preliminary report
NK Babu, Bakshish Singh, S Namrata, BK Mohanti, R Ravichandran, KE Ghamrawy
October-December 2006, 31(4):255-261
DOI:10.4103/0971-6203.29195  PMID:21206641
The present paper illustrates our attempt to design and test the reproducibility of low-cost patient positioning devices prepared in-house in our radiotherapy department. Rigid thermocole boards with angulations, scales and support were designed as breast, pelvis and head positioning devices. Reproducibility and accuracy were tested by serial electronic portal imaging detector imaging. The positioning devices (with or without superimposed moulds) showed variations within 2-3 mm on serial treatment days which were within acceptable limits. It is therefore concluded that low-cost patient positioning devices for head, breast and pelvis (the common sites of treatments in radiotherapy) can be fabricated from available materials in-house. These have been shown to be resulting in accurate immobilization, can be customized for particular techniques and are considerably cheaper than commercially available solutions.
  7,014 393 2
Performance characterization of siemens primus linear accelerator under small monitor unit and small segments for the implementation of step-and-shoot intensitymodulated radiotherapy
P Reena, S Dayananda, Rajeshri Pai, SV Jamema, Tejpal Gupta, D Deepak, S Rajeev
October-December 2006, 31(4):269-274
DOI:10.4103/0971-6203.29197  PMID:21206643
Implementation of step-and-shoot intensity-modulated radiotherapy (IMRT) needs careful understanding of the accelerator start-up characteristic to ensure accurate and precise delivery of radiation dose to patient. The dosimetric characteristic of a Siemens Primus linear accelerator (LA) which delivers 6 and 18 MV x-rays at the dose rate of 300 and 500 monitor unit (MU) per minutes (min) respectively was studied under the condition of small MU ranging from 1 to 100. Dose monitor linearity was studied at different dose calibration parameter (D1_C0) by measuring ionization at 10 cm depth in a solid water phantom using a 0.6 cc ionization chamber. Monitor unit stability was studied from different intensity modulated (IM) groups comprising various combinations of MU per field and number of fields. Stability of beam flatness and symmetry was investigated under normal and IMRT mode for 20×20 cm2 field under small MU using a 2D Profiler kept isocentrically at 5 cm depth. Inter segment response was investigated form 1 to 10 MU by measuring the dose per MU from various IM groups, each consisting of four segments with inter-segment separation of 2 cm. In the range 1-4 MU, the dose linearity error was more than 5% (max -32% at 1 MU) for 6 MV x-rays at factory calibrated D1_C0 value of 6000. The dose linearity error was reduced to -10.95% at 1 MU, within -3% for 2 and 3 MU and ±1% for MU ≥4 when the D1_C0 was subsequently tuned at 4500. For 18 MV x-rays, the dose linearity error at factory calibrated D1_C0 value of 4400 was within ±1% for MU ≥ 3 with maximum of -13.5 observed at 1 MU. For both the beam energies and MU/field ≥ 4, the stability of monitor unit tested for different IM groups was within ±1% of the dose from the normal treatment field. This variation increases to -2.6% for 6 MV and -2.7% for 18 MV x-rays for 2 MU/field. No significant variation was observed in the stability of beam profile measured from normal and IMRT mode. The beam flatness was within 3% for 6 MV x-rays and more than 3% (Max 3.5%) for 18 MV x-rays at lesser irradiation time ≤ 3 MU. The beam stability improves with the increase in irradiation time. Both the beam energies show very good symmetry (≤ 2%) at all irradiation time. For all the three segment sizes studied, the nonlinearity was observed at smaller MU/segment in both the energies. When the MU/segment is ≥ 4, all segment size shows fairly linear relation with dose/MU. The smaller segment size shows larger nonlinearity at smaller MU/segment and become more linear at larger MU/segment. Based on our study, we conclude that the Primus LA from Siemens installed at our hospital is ideally suited for step-and-shoot IMRT preferably for radiation ON time ³4MU per segment.
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A simple plan evaluation index based on the dose to critical structures in radiotherapy
Ramachandran Prabhakar, Goura K Rath
October-December 2011, 36(4):192-197
DOI:10.4103/0971-6203.89965  PMID:22228927
The dose to critical structures plays a very important role in treatment plan evaluation and forms a major challenging parameter in radiotherapy treatment planning. In this study, a simple index, Plan Normal tissue complication Index (PNI) has been proposed for treatment plan evaluation based on the dose to surrounding critical structures. To demonstrate the proposed index, four different critical treatment sites that include the prostate, upper abdominal cancer, lung, and head and neck were selected for this study. A software progam (PNIcalc) has been developed to compute the PNI from the exported dose-volume histogram data and from the tissue tolerance data published by Emami et al. and Kehwar et al. The software also shows the parameters that exceed the threshold limits of dose-volume parameters presented in the QUANTEC recommendations (2010). In all the studied cases, PNI gave an overall picture of the dose received by the critical structures and also indicate the fractional volume exceeding the tolerance limit. The proposed index, PNI gives a quick comparison and selection of treatment plans that result in reduced dose to the critical structures. It can be used as an additional tool for routine treatment plan evaluation in external beam radiotherapy.
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