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Sample records for edema-induced dose reductions

  1. On the Need to Compensate for Edema-Induced Dose Reductions in Preplanned {sup 131}Cs Prostate Brachytherapy

    SciTech Connect

    Chen, Z. Jay Deng Jun; Roberts, Kenneth; Nath, Ravinder

    2008-01-01

    Purpose: Surgical trauma-induced edema and its protracted resolution can lead to significant dose reductions in preplanned {sup 131}Cs prostate brachytherapy. The purpose of this work was to examine whether these dose reductions should be actively compensated for and to estimate the magnitude of the additional irradiation needed for dose compensation. Methods and Materials: The quantitative edema resolution characteristics observed by Waterman et al. were used to examine the physical and radiobiologic effects of prostate edema in preplanned {sup 131}Cs implants. The need for dose compensation was assessed using the dose responses observed in {sup 125}I and {sup 103}Pd prostate implants. The biologically effective dose, calculated with full consideration of edema evolution, was used to estimate the additional irradiation needed for dose compensation. Results: We found that the edema-induced dose reduction in preplanned {sup 131}Cs implants could easily exceed 10% of the prescription dose for implants with moderate or large edema. These dose reductions could lead to a >10% reduction in the biochemical recurrence-free survival for individual patients if the effect of edema was ignored. For a prescribed dose of 120 Gy, the number of 2-Gy external beam fractions needed to compensate for a 5%, 10%, 15%, 20%, and 25% edema-induced dose reduction would be one, four, six, seven, and nine, respectively, for prostate cancer with a median potential doubling time of 42 days. The required additional irradiation increased for fast-growing tumors and/or those less efficient in sublethal damage repair. Conclusion: Compensation of edema-induced dose reductions in preplanned {sup 131}Cs prostate brachytherapy should be actively considered for those implants with moderate or large edema.

  2. Dose Reduction Techniques

    SciTech Connect

    WAGGONER, L.O.

    2000-05-16

    As radiation safety specialists, one of the things we are required to do is evaluate tools, equipment, materials and work practices and decide whether the use of these products or work practices will reduce radiation dose or risk to the environment. There is a tendency for many workers that work with radioactive material to accomplish radiological work the same way they have always done it rather than look for new technology or change their work practices. New technology is being developed all the time that can make radiological work easier and result in less radiation dose to the worker or reduce the possibility that contamination will be spread to the environment. As we discuss the various tools and techniques that reduce radiation dose, keep in mind that the radiological controls should be reasonable. We can not always get the dose to zero, so we must try to accomplish the work efficiently and cost-effectively. There are times we may have to accept there is only so much you can do. The goal is to do the smart things that protect the worker but do not hinder him while the task is being accomplished. In addition, we should not demand that large amounts of money be spent for equipment that has marginal value in order to save a few millirem. We have broken the handout into sections that should simplify the presentation. Time, distance, shielding, and source reduction are methods used to reduce dose and are covered in Part I on work execution. We then look at operational considerations, radiological design parameters, and discuss the characteristics of personnel who deal with ALARA. This handout should give you an overview of what it takes to have an effective dose reduction program.

  3. Cerebral edema induced in mice by a convulsive dose of soman. Evaluation through diffusion-weighted magnetic resonance imaging and histology

    SciTech Connect

    Testylier, Guy . E-mail: guytestylier@crssa.net; Lahrech, Hana; Montigon, Olivier; Foquin, Annie; Delacour, Claire; Bernabe, Denis; Segebarth, Christoph; Dorandeu, Frederic; Carpentier, Pierre

    2007-04-15

    Purpose: In the present study, diffusion-weighted magnetic resonance imaging (DW-MRI) and histology were used to assess cerebral edema and lesions in mice intoxicated by a convulsive dose of soman, an organophosphate compound acting as an irreversible cholinesterase inhibitor. Methods: Three hours and 24 h after the intoxication with soman (172 {mu}g/kg), the mice were anesthetized with an isoflurane/N{sub 2}O mixture and their brain examined with DW-MRI. After the imaging sessions, the mice were sacrificed for histological analysis of their brain. Results: A decrease in the apparent diffusion coefficient (ADC) was detected as soon as 3 h after the intoxication and was found strongly enhanced at 24 h. A correlation was obtained between the ADC change and the severity of the overall brain damage (edema and cellular degeneration): the more severe the damage, the stronger the ADC drop. Anesthesia was shown to interrupt soman-induced seizures and to attenuate edema and cell change in certain sensitive brain areas. Finally, brain water content was assessed using the traditional dry/wet weight method. A significant increase of brain water was observed following the intoxication. Conclusions: The ADC decrease observed in the present study suggests that brain edema in soman poisoning is mainly intracellular and cytotoxic. Since entry of water into Brain was also evidenced, this type of edema is certainly mixed with others (vasogenic, hydrostatic, osmotic). The present study confirms the potential of DW-MRI as a non-invasive tool for monitoring the acute neuropathological consequences (edema and neurodegeneration) of soman-induced seizures.

  4. Ability of eugenol to reduce tongue edema induced by Dieffenbachia picta Schott in mice.

    PubMed

    Dip, Etyene Castro; Pereira, Nuno Alvarez; Fernandes, Patricia Dias

    2004-05-01

    Dieffenbachia picta Schott (Araceae), known in Brazil as "comigo-ninguém-pode" is an ornamental plant with toxic properties. Its juice, when chewed, causes a painful edema of the oral mucous membranes, buccal ulcerations and tongue hypertrophy. This acute inflammation sometimes becomes severe enough to produce glottis obstruction, respiratory compromise and death. Eugenol (4-alil-2-metoxiphenol), the essential oil extracted from Caryophyllus aromaticus (Myrtaceae) is widely used in odontology. In this study, our objective was to standardize, in mice, a measurable methodology for the tongue edema induced by the topical application of the D. picta stem juice; evaluate the effects of eugenol in this model and compare the results with emergency treatment used in hospitals. Our results show that in spite of a small increase in edema a few minutes after administration, emergency treatment reduced by 70% the overall edema. When compared with the combination of the above drugs, eugenol, even at the smallest dose of 5 microg/kg, regardless of the chosen administration route, or the moment the treatment began, presents better results in the reduction and inhibition of the tongue edema induced by the D. picta juice.

  5. The Effects of Aquaporin-1 in Pulmonary Edema Induced by Fat Embolism Syndrome

    PubMed Central

    Zhang, Yiwei; Tian, Kun; Wang, Yan; Zhang, Rong; Shang, Jiawei; Jiang, Wei; Wang, Aizhong

    2016-01-01

    This study was designed to investigate the role of aquaporin1 (AQP1) in the pathologic process of pulmonary edema induced by fat embolism syndrome (FES) and the effects of a free fatty acid (FFA) mixture on AQP1 expression in pulmonary microvascular endothelial cells (PMVECs). In vivo, edema was more serious in FES mice compared with the control group. The expression of AQP1 and the wet-to-dry lung weight ratio (W/D) in the FES group were significantly increased compared with the control group. At the same time, inhibition of AQP1 decreased the pathological damage resulting from pulmonary edema. Then we performed a study in vitro to investigate whether AQP1 was induced by FFA release in FES. The mRNA and protein level of AQP1 were increased by FFAs in a dose- and time-dependent manner in PMVECs. In addition, the up-regulation of AQP1 was blocked by the inhibitor of p38 kinase, implicating the p38 MAPK pathway as involved in the FFA-induced AQP1 up-regulation in PMVECs. Our results demonstrate that AQP1 may play important roles in pulmonary edema induced by FES and can be regarded as a new therapy target for treatment of pulmonary edema induced by FES. PMID:27455237

  6. The Effects of Aquaporin-1 in Pulmonary Edema Induced by Fat Embolism Syndrome.

    PubMed

    Zhang, Yiwei; Tian, Kun; Wang, Yan; Zhang, Rong; Shang, Jiawei; Jiang, Wei; Wang, Aizhong

    2016-07-21

    This study was designed to investigate the role of aquaporin1 (AQP1) in the pathologic process of pulmonary edema induced by fat embolism syndrome (FES) and the effects of a free fatty acid (FFA) mixture on AQP1 expression in pulmonary microvascular endothelial cells (PMVECs). In vivo, edema was more serious in FES mice compared with the control group. The expression of AQP1 and the wet-to-dry lung weight ratio (W/D) in the FES group were significantly increased compared with the control group. At the same time, inhibition of AQP1 decreased the pathological damage resulting from pulmonary edema. Then we performed a study in vitro to investigate whether AQP1 was induced by FFA release in FES. The mRNA and protein level of AQP1 were increased by FFAs in a dose- and time-dependent manner in PMVECs. In addition, the up-regulation of AQP1 was blocked by the inhibitor of p38 kinase, implicating the p38 MAPK pathway as involved in the FFA-induced AQP1 up-regulation in PMVECs. Our results demonstrate that AQP1 may play important roles in pulmonary edema induced by FES and can be regarded as a new therapy target for treatment of pulmonary edema induced by FES.

  7. Pulmonary edema induced by calcium-channel blockade for tocolysis.

    PubMed

    Bal, Laurence; Thierry, Stéphane; Brocas, Elsa; Adam, Marie; Van de Louw, Andry; Tenaillon, Alain

    2004-09-01

    Nicardipine is used in the treatment of premature labor. There are no previous reports in the anesthesia literature of serious side effects associated with this drug. We report a case of pulmonary edema induced by nicardipine therapy for tocolysis in a pregnant 27-yr-old patient admitted to our hospital for preterm labor with intact membranes at 27 wk of gestation.

  8. Involvement of mast cells and histamine in edema induced in mice by Scolopendra viridicornis centipede venom.

    PubMed

    Távora, Bianca C L F; Kimura, Louise F; Antoniazzi, Marta M; Chiariello, Thiago M; Faquim-Mauro, Eliana L; Barbaro, Katia C

    2016-10-01

    Bites caused by Scolopendra viridicornis centipede are mainly characterized by burning pain, paresthesia and edema. On this regard, the aim of this work was to study the involvement of mast cells and histamine in edema induced by Scolopendra viridicornis (Sv) centipede venom. The edema was analyzed on mice paws. The mice were pretreated with cromolyn (mast cell degranulation inhibitor) and antagonists of histamine receptors, such as promethazine (H1R), cimetidine (H2R) and thioperamide (H3/H4R). The analyses were carried out at different times after the injection of Sv venom (15 μg) or PBS in the footpad of mice. Our results showed a significant inhibition of the edema induced by Sv venom injection in mice previously treated: cromolyn (38-91%), promethazine (50-59%) and thioperamide (around 30%). The treatment with cimetidine did not alter the edema induced by Sv venom. Histopathological analysis showed that Sv venom injection (15 μg) induced edema, leukocyte recruitment and mast cells degranulation, when compared with the PBS-injected mice. Direct effects of the Sv venom on mast cells were studied in PT-18 line (mouse mast cell) and RBL-2H3 cells (rat mast cells). The data showed that higher doses (3.8 and 7.5 μg) of Sv venom were cytotoxic for both cell lineages and induced morphological changes. However, lower doses of the venom induced degranulation of both mast cell lines, as well as the secretion of MCP-1, IL-6 and IL-1β. The production of PGD2 was only observed in the RBL-2H3 line incubated with Sv venom. Taking our results together, we demonstrated that upon Sv venom exposure, mast cells and histamine are crucial for the establishment of the local inflammatory reaction.

  9. Dose reduction at nuclear power plants

    SciTech Connect

    Baum, J.W.; Dionne, B.J.

    1983-01-01

    The collective dose equivalent at nuclear power plants increased from 1250 rem in 1969 to nearly 54,000 rem in 1980. This rise is attributable primarily to an increase in nuclear generated power from 1289 MW-y to 29,155 MW-y; and secondly, to increased average plant age. However, considerable variation in exposure occurs from plant to plant depending on plant type, refueling, maintenance, etc. In order to understand the factors influencing these differences, an investigation was initiated to study dose-reduction techniques and effectiveness of as low as reasonably achievable (ALARA) planning at light water plants. Objectives are to: identify high-dose maintenance tasks and related dose-reduction techniques; investigate utilization of high-reliability, low-maintenance equipment; recommend improved radioactive waste handling equipment and procedures; examine incentives for dose reduction; and compile an ALARA handbook.

  10. Simulation of dose reduction in tomosynthesis

    SciTech Connect

    Svalkvist, Angelica; Baath, Magnus

    2010-01-15

    Purpose: Methods for simulating dose reduction are valuable tools in the work of optimizing radiographic examinations. Using such methods, clinical images can be simulated to have been collected at other, lower, dose levels without the need of additional patient exposure. A recent technology introduced to healthcare that needs optimization is tomosynthesis, where a number of low-dose projection images collected at different angles is used to reconstruct section images of an imaged object. The aim of the present work was to develop a method of simulating dose reduction for digital radiographic systems, suitable for tomosynthesis. Methods: The developed method uses information about the noise power spectrum (NPS) at the original dose level and the simulated dose level to create a noise image that is added to the original image to produce an image that has the same noise properties as an image actually collected at the simulated dose level. As the detective quantum efficiency (DQE) of digital detectors operating at the low dose levels used for tomosynthesis may show a strong dependency on the dose level, it is important that a method for simulating dose reduction for tomosynthesis takes this dependency into account. By applying an experimentally determined relationship between pixel mean and pixel variance, variations in both dose and DQE in relevant dose ranges are taken into account. Results: The developed method was tested on a chest tomosynthesis system and was shown to produce NPS of simulated dose-reduced projection images that agreed well with the NPS of images actually collected at the simulated dose level. The simulated dose reduction method was also applied to tomosynthesis examinations of an anthropomorphic chest phantom, and the obtained noise in the reconstructed section images was very similar to that of an examination actually performed at the simulated dose level. Conclusions: In conclusion, the present article describes a method for simulating dose

  11. Transcriptional effects of gene dose reduction

    PubMed Central

    2014-01-01

    Large-scale gene dose reductions usually lead to abnormal phenotypes or death. However, male mammals, Drosophila, and Caenorhabditis elegans have only one X chromosome and thus can be considered as monosomic for a major chromosome. Despite the deleterious effects brought about by such gene dose reduction in the case of an autosome, X chromosome monosomy in males is natural and innocuous. This is because of the nearly full transcriptional compensation for X chromosome genes in males, as opposed to no or partial transcriptional compensation for autosomal one-dose genes arising due to deletions. Buffering, the passive absorption of disturbance due to enzyme kinetics, and feedback responses triggered by expression change contribute to partial compensation. Feed-forward mechanisms, which are active responses to genes being located on the X, rather than actual gene dose are important contributors to full X chromosome compensation. In the last decade, high-throughput techniques have provided us with the tools to effectively and quantitatively measure the small-fold transcriptional effects of dose reduction. This is leading to a better understanding of compensatory mechanisms. PMID:24581086

  12. Edema induced by Bothrops asper (Squamata: Viperidae) snake venom and its inhibition by Costa Rican plant extracts.

    PubMed

    Badilla, Beatriz; Chaves, Fernando; Mora, Gerardo; Poveda, Luis J

    2006-06-01

    We tested the capacity of leaf (Urera baccifera, Loasa speciosa, Urtica leptuphylla, Chaptalia nutans, and Satureja viminea) and root (Uncaria tomentosa) extracts to inhibit edema induced by Bothrops asper snake venom. Edema-forming activity was studied plethysmographically in the rat hind paw model. Groups of rats were injected intraperitoneally with various doses of each extract and, one hour later, venom was injected subcutaneously in the right hind paw. Edema was assessed at various time intervals. The edematogenic activity was inhibited in those animals that received an injection U. tomentosa, C. nutans or L. speciosa extract. The extract of U. baccifera showed a slight inhibition of the venom effect. Extract from S. viminea and, to a lesser extent that of U. leptuphylla, induced a pro-inflammatory effect, increasing the edema at doses of 250 mg/kg at one and two hours.

  13. Device for the reduction of population dose

    SciTech Connect

    Kihara, T.; Uchinoumi, K.; Akagi, F.; Antoku, S.

    1982-06-01

    Conventional dental radiographic procedures do not permit direct visualization of the radiation field or the central ray. As a result, it is necessary to use a beam diameter larger than the film in order to prevent an unnecessarily high number of cone cuts or other errors during visual alignment of the cone and film. The modification of a conventional dental x-ray cone which permits the central ray to be depicted by a beam of light is described. The use of the device significantly reduced the number of cone cuts, even when small beam diameters were used. Visualization of the central ray improved radiographic accuracy and has the potential to significantly reduce the over-all dose to the population by reducing the size of the field used for dental radiography.

  14. Dose reduction with adaptive bolus chasing computed tomography angiography.

    PubMed

    Cai, Zhijun; Bai, Er-Wei; Wang, Ge; Sharafuddin, Melhem J; Abada, Hicham T

    2010-01-01

    Computed Tomography (CT) has become an effective diagnosis and evaluating tool in clinical; however, its radiation exposure has drawn great attention as more and more CT scans are performed every year. How to reduce the radiation dose and meanwhile keep the resultant CT images diagnosable becomes an important research topic. In this paper, we propose a dose reduction approach along with the adaptive bolus chasing CT Angiography (CTA) techniques, which are capable of tracking the contrast bolus peak over all the blood vessel segments during the CTA scan. By modulating the tube current (and collimator width) online, we can reduce the total radiation dose and maintain the contrast to noise ratio (CNR) of the blood vessel. Numerical experiments on reference DSA data sets show that by using the proposed dose reduction method, the effective radiation dose can be saved about 39%.

  15. Dose Reduction with Adaptive Bolus Chasing Computed Tomography Angiography

    PubMed Central

    Cai, Zhijun; Bai, Er-Wei; Wang, Ge; Sharafuddin, Melhem J.; Abada, Hicham T.

    2010-01-01

    Computed Tomography (CT) has become an effective diagnosis and evaluating tool in clinical; however, its radiation exposure has drawn great attention as more and more CT scans are performed every year. How to reduce the radiation dose and meanwhile keep the resultant CT images diagnosable becomes an important research topic. In this paper, we propose a dose reduction approach along with the adaptive bolus chasing CT Angiography (CTA) techniques, which are capable of tracking the contrast bolus peak over all the blood vessel segments during the CTA scan. By modulating the tube current (and collimator width) online, we can reduce the total radiation dose and maintain the contrast to noise ratio (CNR) of the blood vessel. Numerical experiments on reference DSA data sets show that by using the proposed dose reduction method, the effective radiation dose can be saved about 39%. PMID:20421701

  16. Dose reduction improvements in storage basins of spent nuclear fuel

    SciTech Connect

    Huang, Fan-Hsiung F.

    1997-08-13

    Spent nuclear fuel in storage basins at the Hanford Site has corroded and contaminated basin water, which has leaked into the soil; the fuel also had deposited a layer of radioactive sludge on basin floors. The SNF is to be removed from the basins to protect the nearby Columbia River. Because the radiation level is high, measures have been taken to reduce the background dose rate to as low as reasonably achievable (ALARA) to prevent radiation doses from becoming the limiting factor for removal of the SW in the basins to long-term dry storage. All activities of the SNF Project require application of ALARA principles for the workers. On the basis of these principles dose reduction improvements have been made by first identifying radiological sources. Principal radiological sources in the basin are basin walls, basin water, recirculation piping and equipment. Dose reduction activities focus on cleaning and coating basin walls to permit raising the water level, hydrolasing piping, and placing lead plates. In addition, the transfer bay floor will be refinished to make decontamination easier and reduce worker exposures in the radiation field. The background dose rates in the basin will be estimated before each task commences and after it is completed; these dose reduction data will provide the basis for cost benefit analysis.

  17. Impact of new technologies on dose reduction in CT.

    PubMed

    Lee, Ting-Yim; Chhem, Rethy K

    2010-10-01

    The introduction of slip ring technology enables helical CT scanning in the late 1980's and has rejuvenated CT's role in diagnostic imaging. Helical CT scanning has made possible whole body scanning in a single breath hold and computed tomography angiography (CTA) which has replaced invasive catheter based angiography in many cases because of its easy of operation and lesser risk to patients. However, a series of recent articles and accidents have heightened the concern of radiation risk from CT scanning. Undoubtedly, the radiation dose from CT studies, in particular, CCTA studies, are among the highest dose studies in diagnostic imaging. Nevertheless, CT has remained the workhorse of diagnostic imaging in emergent and non-emergent situations because of their ubiquitous presence in medical facilities from large academic to small regional hospitals and their round the clock accessibility due to their ease of use for both staff and patients as compared to MR scanners. The legitimate concern of radiation dose has sparked discussions on the risk vs benefit of CT scanning. It is recognized that newer CT applications, like CCTA and perfusion, will be severely curtailed unless radiation dose is reduced. This paper discusses the various hardware and software techniques developed to reduce radiation dose to patients in CT scanning. The current average effective dose of a CT study is ∼10 mSv, with the implementation of dose reduction techniques discussed herein; it is realistic to expect that the average effective dose may be decreased by 2-3 fold.

  18. Strategies for reduction of radiation dose in cardiac multislice CT.

    PubMed

    Paul, Jean-François; Abada, Hicham T

    2007-08-01

    Because cardiac computed tomography (CT) (mainly coronary CT angiography) is a very promising technique, used more and more for coronary artery evaluation, the benefits and risks of this new low-invasive technique must be balanced. Radiation dose is a major concern for coronary CT angiography, especially in case of repeated examinations or in particular subgroups of patients (for example young female patients). Radiation dose to patient tends to increase from 16- to 64-slice CT. Radiation exposure in ECG-gated acquisitions may reach up to 40 mSv; considerable differences are attributable to the performance of CT machines, to technical dose-sparing tools, but also to radiological habits. Setting radiation dose at the lowest level possible should be a constant goal for the radiologist. Current technological tools are detailed in regard to their efficiency. Optimisation is necessary, by a judicious use of technological tools and also by individual adaptation of kV or mAs. This paper reviews the different current strategies for radiation dose reduction, keeping image quality constant. Data from the literature are discussed, and future technological developments are considered in regards to radiation dose reduction. The particular case of paediatric patients with congenital heart disease is also addressed.

  19. Patient specific tube current modulation for CT dose reduction

    NASA Astrophysics Data System (ADS)

    Jin, Yannan; Yin, Zhye; Yao, Yangyang; Wang, Hui; Wu, Mingye; Kalra, Mannudeep; De Man, Bruno

    2015-03-01

    Radiation exposure during CT imaging has drawn growing concern from academia, industry as well as the general public. Sinusoidal tube current modulation has been available in most commercial products and used routinely in clinical practice. To further exploit the potential of tube current modulation, Sperl et al. proposed a Computer-Assisted Scan Protocol and Reconstruction (CASPAR) scheme [6] that modulates the tube current based on the clinical applications and patient specific information. The purpose of this study is to accelerate the CASPAR scheme to make it more practical for clinical use and investigate its dose benefit for different clinical applications. The Monte Carlo simulation in the original CASPAR scheme was substituted by the dose reconstruction to accelerate the optimization process. To demonstrate the dose benefit, we used the CATSIM package generate the projection data and perform standard FDK reconstruction. The NCAT phantom at thorax position was used in the simulation. We chose three clinical cases (routine chest scan, coronary CT angiography with and without breast avoidance) and compared the dose level with different mA modulation schemes (patient specific, sinusoidal and constant mA) with matched image quality. The simulation study of three clinical cases demonstrated that the patient specific mA modulation could significantly reduce the radiation dose compared to sinusoidal modulation. The dose benefits depend on the clinical application and object shape. With matched image quality, for chest scan the patient specific mA profile reduced the dose by about 15% compared to the sinusoid mA modulation; for the organ avoidance scan the dose reduction to the breast was over 50% compared to the constant mA baseline.

  20. Dose reduction using a dynamic, piecewise-linear attenuator

    SciTech Connect

    Hsieh, Scott S.; Fleischmann, Dominik; Pelc, Norbert J.

    2014-02-15

    Purpose: The authors recently proposed a dynamic, prepatient x-ray attenuator capable of producing a piecewise-linear attenuation profile customized to each patient and viewing angle. This attenuator was intended to reduce scatter-to-primary ratio (SPR), dynamic range, and dose by redistributing flux. In this work the authors tested the ability of the attenuator to reduce dose and SPR in simulations. Methods: The authors selected four clinical applications, including routine full field-of-view scans of the thorax and abdomen, and targeted reconstruction tasks for an abdominal aortic aneurysm and the pancreas. Raw data were estimated by forward projection of the image volume datasets. The dynamic attenuator was controlled to reduce dose while maintaining peak variance by solving a convex optimization problem, assuminga priori knowledge of the patient anatomy. In targeted reconstruction tasks, the noise in specific regions was given increased weighting. A system with a standard attenuator (or “bowtie filter”) was used as a reference, and used either convex optimized tube current modulation (TCM) or a standard TCM heuristic. The noise of the scan was determined analytically while the dose was estimated using Monte Carlo simulations. Scatter was also estimated using Monte Carlo simulations. The sensitivity of the dynamic attenuator to patient centering was also examined by shifting the abdomen in 2 cm intervals. Results: Compared to a reference system with optimized TCM, use of the dynamic attenuator reduced dose by about 30% in routine scans and 50% in targeted scans. Compared to the TCM heuristics which are typically used withouta priori knowledge, the dose reduction is about 50% for routine scans. The dynamic attenuator gives the ability to redistribute noise and variance and produces more uniform noise profiles than systems with a conventional bowtie filter. The SPR was also modestly reduced by 10% in the thorax and 24% in the abdomen. Imaging with the dynamic

  1. Paediatric dose reduction with the introduction of digital fluorography.

    PubMed

    Mooney, R B; McKinstry, J

    2001-01-01

    Fluoroscopy guided examinations in a paediatric X ray department were initially carried out on a unit that used a conventional screen-film combination for spot-films. A new fluoroscopy unit was installed with the facilities of digital fluorography and last image hold. Comparison of equipment performance showed that the dose per image for screen-film and digital fluorography was 3 microGy and 0.4 microGy, respectively. Although the screen-film had superior image quality, the department's radiologist confirmed that digital fluorography provided a diagnostic image. Patient dose measurements showed that introduction of the new unit caused doses to fall by an average of 70%, although fluoroscopy time had not changed significantly. The new unit produced 40% less air kerma during fluoroscopy. The remaining 30% reduction in dose was due to the introduction of digital fluorography and last image hold facilities. It is concluded that the use of digital fluorography can be an effective way of reducing paediatric dose.

  2. Efficacy, Dose Reduction, and Resistance to High-dose Fluticasone in Patients with Eosinophilic Esophagitis

    PubMed Central

    Butz, Bridget K.; Wen, Ting; Gleich, Gerald J.; Furuta, Glenn T.; Spergel, Jonathan; King, Eileen; Kramer, Robert E.; Collins, Margaret H.; Stucke, Emily; Mangeot, Colleen; Jackson, W. Daniel; O’Gorman, Molly; Abonia, J. Pablo; Pentiuk, Scott; Putnam, Philip E.; Rothenberg, Marc E.

    2014-01-01

    Background & Aims We evaluated the efficacy and safety of high-dose swallowed fluticasone propionate (FP) and dose reduction in patients with eosinophilic esophagitis (EoE) and analyzed esophageal transcriptomes to identify mechanisms. Methods We conducted a randomized, multisite, double-blind, placebo-controlled trial of daily 1760 mcg FP in participants 3–30 years old with active EoE. Twenty-eight participants received FP and 14 received placebo. After 3 months, participants given FP who were in complete remission (CR) received 880 mcg FP daily, and participants in the FP or placebo groups who were not in CR continued or started, respectively, 1760 mcg FP daily for 3 additional months. The primary endpoint was histologic evidence for CR. Secondary endpoints were partial remission (PR), symptoms, compliance, esophageal gene expression, esophageal eosinophil count, and the relationship between clinical features and FP responsiveness. Results After 3 months, 65% of subjects given FP and no subjects given placebo were in CR (P=.0001); 12% of those given FP and 8% of those given placebo were in PR. In the FP group, 73% of subjects remained in CR and 20% were in PR after the daily dose was reduced by 50%. Extending FP therapy in FP-resistant participants did not induce remission. FP decreased heartburn severity (P=.041). Compliance, age, sex, atopic status, or anthropomorphic features were not associated with response to FP. Gene expression patterns in esophageal tissues of FP responders were similar to those of patients without EoE; there was evidence for heterogeneous steroid signaling in subjects that did not respond to FP. Conclusions Daily administration of a high dose of FP induces histologic remission in 65%–77% of patients with EoE after 3 months. A 50% dose reduction remained effective in 73%–93% of patients that initially responded to FP. Nonresponders had evidence of steroid resistance; histologic and molecular markers may predict resistance

  3. Iterative methods for dose reduction and image enhancement in tomography

    DOEpatents

    Miao, Jianwei; Fahimian, Benjamin Pooya

    2012-09-18

    A system and method for creating a three dimensional cross sectional image of an object by the reconstruction of its projections that have been iteratively refined through modification in object space and Fourier space is disclosed. The invention provides systems and methods for use with any tomographic imaging system that reconstructs an object from its projections. In one embodiment, the invention presents a method to eliminate interpolations present in conventional tomography. The method has been experimentally shown to provide higher resolution and improved image quality parameters over existing approaches. A primary benefit of the method is radiation dose reduction since the invention can produce an image of a desired quality with a fewer number projections than seen with conventional methods.

  4. Pectus excavatum: current imaging techniques and opportunities for dose reduction.

    PubMed

    Sarwar, Zahir U; DeFlorio, Robert; O'Connor, Stephen C

    2014-08-01

    Pectus excavatum (PE) is the most common congenital chest wall deformity in children. It affects 1 in every 300-1000 live births with a male to female ratio of 5:1. Most of the patients present in their first year of life. During the teenage years, patients may have exercise intolerance and psychological strain because of their chest wall deformity. The Nuss and Ravitch procedures are established methods of surgical correction of PE. An index of severity known best as the Haller index, typically evaluated with computed tomography scan, when measuring greater than 3.2 is considered to indicate moderate or severe PE and is a prerequisite for third-party insurance reimbursement for these corrective procedures. This article reviews the clinical features of PE, the role of imaging, and the opportunities for radiation dose reduction.

  5. Order of magnitude reduction of fluoroscopic x-ray dose

    NASA Astrophysics Data System (ADS)

    Bal, Abhinav; Robert, Normand; Machan, Lindsay; Deutsch, Meir; Kisselgoff, David; Babyn, Paul; Rowlands, John A.

    2012-03-01

    The role of fluoroscopic imaging is critical for diagnostic and image guided therapy. However, fluoroscopic imaging can require significant radiation leading to increased cancer risk and non-stochastic effects such as radiation burns. Our purpose is to reduce the exposure and dose to the patient by an order of magnitude in these procedures by use of the region of interest method. Method and Materials: Region of interest fluoroscopy (ROIF) uses a partial attenuator. The central region of the image has full exposure while the image periphery, there to provide context only, has a reduced exposure rate. ROIF using a static partial attenuator has been shown in our previous studies to reduce the dose area product (DAP) to the patient by at least 2.5 times. Significantly greater reductions in DAP would require improvements in flat panel detectors performance at low x-ray exposures or a different x-ray attenuation strategy. Thus we have investigated a second, dynamic, approach. We have constructed an x-ray shutter system allowing a normal x-ray exposure in the region of interest while reducing the number of x-ray exposures in the periphery through the rapid introduction, positioning and removal of an x-ray attenuating shutter to block radiation only for selected frames. This dynamic approach eliminates the DQE(0) loss associated with the use of static partial attenuator applied to every frame thus permitting a greater reduction in DAP. Results: We have compared the two methods by modeling and determined their fundamental limits.

  6. [Phantom Study on Dose Reduction Using Iterative Reconstruction in Low-dose Computed Tomography for Lung Cancer Screening].

    PubMed

    Minehiro, Kaori; Takata, Tadanori; Hayashi, Hiroyuki; Sakuda, Keita; Nunome, Haruka; Kawashima, Hiroko; Sanada, Shigeru

    2015-12-01

    We investigated dose reduction ability of an iterative reconstruction technology for low-dose computed tomography (CT) for lung cancer screening. The Sinogram Affirmed Iterative Reconstruction (SAFIRE) provided in a multi slice CT system, Somatom Definition Flash (Siemens Healthcare) was used. An anthropomorphic chest phantom (N-1, Kyoto Kagaku) was scanned at volume CT dose index (CTDIvol) of 0.50-11.86 mGy with 120 kV. For noise (standard deviation) and contrast-to-noise ratio (CNR) measurements, CTP486 and CTP515 modules in the Catphan (The Phantom Laboratory) were scanned. Radiological technologists were participated in the perceptual comparison. SAFIRE reduced the SD values by approximately 50% compared with filter back projection (FBP). The estimated dose reduction rates by SAFIRE determined from the perceptual comparison was approximately 23%, while 75% dose reduction rate was expected from the SD value reduction of 50%.

  7. Oral anticancer drugs: how limited dosing options and dose reductions may affect outcomes in comparative trials and efficacy in patients.

    PubMed

    Prasad, Vinay; Massey, Paul R; Fojo, Tito

    2014-05-20

    Historically, cancer medicine has avoided the problem of unequal dosing by comparing maximum-tolerated doses of intravenous regimens with proportionate dose reductions for toxicity. However, in recent years, with the development of numerous oral anticancer agents, dosing options are arbitrarily and increasingly limited by the size of pills. We contend that an underappreciated consequence of pill size is unequal dosing in comparative clinical trials and that this can have an impact on outcomes. We discuss how comparative effectiveness trials can be unbalanced and how the use of doses that are not sustainable might affect outcomes, especially marginal ones. We further argue that because of their poor tolerability and their limited dosing options, which often result in large dose adjustments in response to toxicity, the real-world clinical effectiveness of oral anticancer agents may be diminished and may not emulate results achieved in registration trials.

  8. Oral Anticancer Drugs: How Limited Dosing Options and Dose Reductions May Affect Outcomes in Comparative Trials and Efficacy in Patients

    PubMed Central

    Prasad, Vinay; Massey, Paul R.; Fojo, Tito

    2014-01-01

    Historically, cancer medicine has avoided the problem of unequal dosing by comparing maximum-tolerated doses of intravenous regimens with proportionate dose reductions for toxicity. However, in recent years, with the development of numerous oral anticancer agents, dosing options are arbitrarily and increasingly limited by the size of pills. We contend that an underappreciated consequence of pill size is unequal dosing in comparative clinical trials and that this can have an impact on outcomes. We discuss how comparative effectiveness trials can be unbalanced and how the use of doses that are not sustainable might affect outcomes, especially marginal ones. We further argue that because of their poor tolerability and their limited dosing options, which often result in large dose adjustments in response to toxicity, the real-world clinical effectiveness of oral anticancer agents may be diminished and may not emulate results achieved in registration trials. PMID:24711558

  9. Reduction of absorbed doses in radiography of the facial skeleton

    SciTech Connect

    Julin, P.; Kraepelien, T.

    1984-11-01

    Radiation absorbed doses from radiography of the paranasal sinuses and the facial skeleton were measured with thermoluminescent dosimeters (TLD) on a phantom head using high-sensitivity screens in an Orbix stand. The entrance doses to the skin of the head ranged from 0.31 to 2.9 mGy per exposure. The absorbed dose from a full series of sinus exposures averaged 0.33 mGy for the oral mucous membrane, 0.33 mGy for the maxillary sinus mucous membrane, 0.11 MgY for the parotid gland, 0.15 MgY for the submandibular gland, 0.61 mGy for the eye lens, and 0.75 mGy for the thyroid gland region. A leaded soft collar adapted to the thyroid region reduced the thyroid doses by more than one order of magnitude, but also reduced the image field.

  10. Radiation Dose Reduction Efficiency of Buildings after the Accident at the Fukushima Daiichi Nuclear Power Station

    PubMed Central

    Monzen, Satoru; Hosoda, Masahiro; Osanai, Minoru; Tokonami, Shinji

    2014-01-01

    Numerous radionuclides were released from the Fukushima Daiichi Nuclear Power Station (F1-NPS) in Japan following the magnitude 9.0 earthquake and tsunami on March 11, 2011. Local residents have been eager to calculate their individual radiation exposure. Thus, absorbed dose rates in the indoor and outdoor air at evacuation sites in the Fukushima Prefecture were measured using a gamma-ray measuring devices, and individual radiation exposure was calculated by assessing the radiation dose reduction efficiency (defined as the ratio of absorbed dose rate in the indoor air to the absorbed dose rate in the outdoor air) of wood, aluminum, and reinforced concrete buildings. Between March 2011 and July 2011, dose reduction efficiencies of wood, aluminum, and reinforced concrete buildings were 0.55±0.04, 0.15±0.02, and 0.19±0.04, respectively. The reduction efficiency of wood structures was 1.4 times higher than that reported by the International Atomic Energy Agency. The efficiency of reinforced concrete was similar to previously reported values, whereas that of aluminum structures has not been previously reported. Dose reduction efficiency increased in proportion to the distance from F1-NPS at 8 of the 18 evacuation sites. Time variations did not reflect dose reduction efficiencies at evacuation sites although absorbed dose rates in the outdoor air decreased. These data suggest that dose reduction efficiency depends on structure types, levels of contamination, and evacuee behaviors at evacuation sites. PMID:24999992

  11. Radiation dose reduction efficiency of buildings after the accident at the Fukushima Daiichi Nuclear Power Station.

    PubMed

    Monzen, Satoru; Hosoda, Masahiro; Osanai, Minoru; Tokonami, Shinji

    2014-01-01

    Numerous radionuclides were released from the Fukushima Daiichi Nuclear Power Station (F1-NPS) in Japan following the magnitude 9.0 earthquake and tsunami on March 11, 2011. Local residents have been eager to calculate their individual radiation exposure. Thus, absorbed dose rates in the indoor and outdoor air at evacuation sites in the Fukushima Prefecture were measured using a gamma-ray measuring devices, and individual radiation exposure was calculated by assessing the radiation dose reduction efficiency (defined as the ratio of absorbed dose rate in the indoor air to the absorbed dose rate in the outdoor air) of wood, aluminum, and reinforced concrete buildings. Between March 2011 and July 2011, dose reduction efficiencies of wood, aluminum, and reinforced concrete buildings were 0.55 ± 0.04, 0.15 ± 0.02, and 0.19 ± 0.04, respectively. The reduction efficiency of wood structures was 1.4 times higher than that reported by the International Atomic Energy Agency. The efficiency of reinforced concrete was similar to previously reported values, whereas that of aluminum structures has not been previously reported. Dose reduction efficiency increased in proportion to the distance from F1-NPS at 8 of the 18 evacuation sites. Time variations did not reflect dose reduction efficiencies at evacuation sites although absorbed dose rates in the outdoor air decreased. These data suggest that dose reduction efficiency depends on structure types, levels of contamination, and evacuee behaviors at evacuation sites.

  12. Decreasing Methadone Dose Via Anxiety Reduction: A Treatment Manual.

    ERIC Educational Resources Information Center

    Kushner, Marlene; And Others

    This manual describes a Relaxation-Information Presentation program based on the clinical observation that anxiety is a serious barrier to detoxification for many methadone clients, and on experimental evidence indicating that expectations may play a greater role in the discomfort experienced during detoxification than the actual methadone dose.…

  13. Reduction of absorbed doses in radiography of the facial skeleton

    SciTech Connect

    Julin, P.; Kraepelien, T.

    1984-11-01

    Radiation absorbed doses from radiography of the paranasal sinuses and the facial skeleton were measured with thermoluminescent dosimeters (TLD) on a phantom head using high-sensitivity screens in an Orbix stand. The entrance doses to the skin of the head ranged from 0.31 to 2.9 mGy per exposure. The absorbed dose from a full series of sinus exposures averaged 0.33 mGy for the oral mucous membrane, 0.33 mGy for the maxillary sinus mucous membrane, 0.11 mGy for the parotid gland, 0.15 mGy for the submandibular gland, 0.61 mGy for the eye lens, and 0.75 mGy for the thyroid gland region. A leaded soft collar adapted to the thyroid region reduced the thyroid doses by more than one order of magnitude, but also reduced the image field. The mean energy imparted from a full series of paranasal sinus projections was 4.8 mJ and from a total series of the facial skeleton, 7.9 mJ.

  14. Preliminary design review report for K Basin Dose Reduction Project

    SciTech Connect

    Blackburn, L.D.

    1996-01-01

    The strategy for reducing radiation dose, originating from radionuclides absorbed in the K East Basin concrete, is to raise the pool water level to provide additional shielding. This report documents a preliminary design review conducted to ensure that design approaches for cleaning/coating basin walls and modifying other basin components were appropriate. The conclusion of this review was that design documents presently conclusion of this review was that design documents presently completed or in process of modification are and acceptable basis for proceeding to complete the design.

  15. AN APPROACH TO REDUCTION OF UNCERTAINTIES IN INTERNAL DOSES RECONSTRUCTED FOR THE TECHA RIVER POPULATION

    SciTech Connect

    Degteva, M. O.; Shagina, N. B.; Tolstykh, E. I.; Bougrov, N. G.; Zalyapin, V. I.; Anspaugh, L. R.; Napier, Bruce A.

    2007-12-01

    A methodology is being developing for reduction of uncertainties in estimates of internal dose for residents of the Techa Riverside communities, who were exposed as a result of releases of radionuclides from the Mayak plutonium-production facility in 1949–1956. The “Techa River Dosimetry System” (TRDS) was specifically elaborated for reconstruction of doses. A preliminary analysis of uncertainty for doses estimated using the current version of the TRDS showed large ranges in the uncertainty of internal absorbed dose and led to suggestions of methods to reduce uncertainties. The new methodological approaches described in this paper will allow for significant reduction of uncertainties of 90Sr-dose. The major sources of reduction are in making use of individual measured values of 90Sr and through development of a Household Registry to associate unmeasured persons with measured persons living in the same household(s).

  16. Inter- and Intrafractional Movement-Induced Dose Reduction of Prostate Target Volume in Proton Beam Treatment

    SciTech Connect

    Yoon, Myonggeun; Kim, Dongwook; Shin, Dong Ho; Park, Sung Yong Lee, Se Byeong; Kim, Dae Yong; Kim, Joo Young; Pyo, Hong Ryull; Cho, Kwan Ho

    2008-07-15

    Purpose: To quantify proton radiotherapy dose reduction in the prostate target volume because of the three-dimensional movement of the prostate based on an analysis of dose-volume histograms (DVHs). Methods and Materials: Twelve prostate cancer patients underwent scanning in supine position, and a target contour was delineated for each using a proton treatment planning system. To simulate target movement, the contour was displaced from 3 to 15 mm in 3-mm intervals in the superior-to-inferior (SI), inferior-to-superior (IS), anterior-to-posterior (AP), posterior-to-anterior (PA), and left-to-right (LR) directions. Results: For both intra- and interfractional movements, the average coverage index and conformity index of the target were reduced in all directions. For interfractional movements, the magnitude of dose reduction was greater in the LR direction than in the AP, PA, SI. and IS directions. Although the reduction of target dose was proportional to the magnitude of intrafractional movement in all directions, a proportionality between dose reduction and the magnitude of interfractional target movement was clear only in the LR direction. Like the coverage index and conformity index, the equivalent uniform dose and homogeneity index showed similar reductions for both types of target movements. Conclusions: Small target movements can significantly reduce target proton radiotherapy dose during treatment of prostate cancer patients. Attention should be given to interfractional target movement along the longitudinal direction, as image-guided radiotherapy may be ineffective if margins are not sufficient.

  17. Feasibility of normal tissue dose reduction in radiotherapy using low strength magnetic field

    PubMed Central

    Shin, Youngseob; Jung, In-Hye; Kwak, Jungwon

    2015-01-01

    Purpose Toxicity of mucosa is one of the major concerns of radiotherapy (RT), when a target tumor is located near a mucosal lined organ. Energy of photon RT is transferred primarily by secondary electrons. If these secondary electrons could be removed in an internal cavity of mucosal lined organ, the mucosa will be spared without compromising the target tumor dose. The purpose of this study was to present a RT dose reduction in near target inner-surface (NTIS) of internal cavity, using Lorentz force of magnetic field. Materials and Methods Tissue equivalent phantoms, composed with a cylinder shaped internal cavity, and adjacent a target tumor part, were developed. The phantoms were irradiated using 6 MV photon beam, with or without 0.3 T of perpendicular magnetic field. Two experimental models were developed: single beam model (SBM) to analyze central axis dose distributions and multiple beam model (MBM) to simulate a clinical case of prostate cancer with rectum. RT dose of NTIS of internal cavity and target tumor area (TTA) were measured. Results With magnetic field applied, bending effect of dose distribution was visualized. The depth dose distribution of SBM showed 28.1% dose reduction of NTIS and little difference in dose of TTA with magnetic field. In MBM, cross-sectional dose of NTIS was reduced by 33.1% with magnetic field, while TTA dose were the same, irrespective of magnetic field. Conclusion RT dose of mucosal lined organ, located near treatment target, could be modulated by perpendicular magnetic field. PMID:26484306

  18. Patients with Fabry disease after enzyme replacement therapy dose reduction versus treatment switch.

    PubMed

    Weidemann, Frank; Krämer, Johannes; Duning, Thomas; Lenders, Malte; Canaan-Kühl, Sima; Krebs, Alice; Guerrero González, Hans; Sommer, Claudia; Üçeyler, Nurcan; Niemann, Markus; Störk, Stefan; Schelleckes, Michael; Reiermann, Stefanie; Stypmann, Jörg; Brand, Stefan-Martin; Wanner, Christoph; Brand, Eva

    2014-04-01

    Because of the shortage of agalsidase-beta in 2009, many patients with Fabry disease were treated with lower doses or were switched to agalsidase-alfa. This observational study assessed end-organ damage and clinical symptoms during dose reduction or switch to agalsidase-alfa. A total of 105 adult patients with Fabry disease who had received agalsidase-beta (1.0 mg/kg body weight) for ≥1 year were nonrandomly assigned to continue this treatment regimen (regular-dose group, n=38), receive a reduced dose of 0.3-0.5 mg/kg (dose-reduction group, n=29), or switch to 0.2 mg/kg agalsidase-alfa (switch group) and were followed prospectively for 1 year. We assessed clinical events (death, myocardial infarction, severe arrhythmia, stroke, progression to ESRD); changes in cardiac, renal, and neurologic function; and Fabry-related symptoms (neuropathic pain, hypohidrosis, diarrhea, and disease severity scores). Organ function and Fabry-related symptoms remained stable in the regular-dose group. In contrast, estimated GFR decreased by about 3 ml/min per 1.73 m(2) (P=0.01) in the dose-reduction group, and the median albumin-to-creatinine ratio increased from 114 (0-606) mg/g to 216 (0-2062) mg/g (P=0.03) in the switch group. Furthermore, mean Mainz Severity Score Index scores and frequencies of pain attacks, chronic pain, gastrointestinal pain, and diarrhea increased significantly in the dose-reduction and switch groups. In conclusion, patients receiving regular agalsidase-beta dose had a stable disease course, but dose reduction led to worsening of renal function and symptoms. Switching to agalsidase-alfa is safe, but microalbuminuria may progress and Fabry-related symptoms may deteriorate.

  19. Method for inserting noise in digital mammography to simulate reduction in radiation dose

    NASA Astrophysics Data System (ADS)

    Borges, Lucas R.; de Oliveira, Helder C. R.; Nunes, Polyana F.; Vieira, Marcelo A. C.

    2015-03-01

    The quality of clinical x-ray images is closely related to the radiation dose used in the imaging study. The general principle for selecting the radiation is ALARA ("as low as reasonably achievable"). The practical optimization, however, remains challenging. It is well known that reducing the radiation dose increases the quantum noise, which could compromise the image quality. In order to conduct studies about dose reduction in mammography, it would be necessary to acquire repeated clinical images, from the same patient, with different dose levels. However, such practice would be unethical due to radiation related risks. One solution is to simulate the effects of dose reduction in clinical images. This work proposes a new method, based on the Anscombe transformation, which simulates dose reduction in digital mammography by inserting quantum noise into clinical mammograms acquired with the standard radiation dose. Thus, it is possible to simulate different levels of radiation doses without exposing the patient to new levels of radiation. Results showed that the achieved quality of simulated images generated with our method is the same as when using other methods found in the literature, with the novelty of using the Anscombe transformation for converting signal-independent Gaussian noise into signal-dependent quantum noise.

  20. Are phantoms useful for predicting the potential of dose reduction in full-field digital mammography?

    NASA Astrophysics Data System (ADS)

    Gennaro, Gisella; Katz, Luc; Souchay, Henri; Alberelli, Claudio; di Maggio, Cosimo

    2005-04-01

    A phantom study was performed in full-field digital mammography to investigate the opportunity and the magnitude of a possible dose reduction that would leave the image quality above the accepted thresholds associated with some classical phantoms. This preliminary work is intended to lay the groundwork for a future clinical study on the impact of dose reduction on clinical results. Three different mammography phantoms (ACR RMI 156, CIRS 11A and CDMAM 3.4) were imaged by a full-field digital mammography unit (GE Senographe 2000D) at different dose levels. Images were rated by three observers with softcopy reading and scoring methods specific to each phantom. Different types of data analysis were applied to the ACR (American College of Radiology) and the other two phantoms, respectively. With reference to the minimum acceptance score in screen/film accreditation programmes, the ACR phantom showed that about 45% dose reduction could be applied, while keeping the phantom scores above that threshold. A relative comparison was done for CIRS and CDMAM, for which no threshold is defined. CIRS scoring remained close to the reference level down to 40% dose reduction, the inter- and intra-observer variability being the main source of uncertainty. Contrast-detail curves provided by CDMAM overlapped down to 50% dose reduction, at least for object contrast values ranging between 30% and 3%. This multi-phantom study shows the potential of further reducing the dose in full-field digital mammography beyond the current values. A common dose reduction factor around 50% seems acceptable for all phantoms. However, caution is required before extrapolating the results for clinical use, given the limitations of these widely used phantoms, mainly related to their limited dynamic range and uniform background.

  1. SU-E-T-802: Verification of Implanted Cardiac Pacemaker Doses in Intensity-Modulated Radiation Therapy: Dose Prediction Accuracy and Reduction Effect of a Lead Sheet

    SciTech Connect

    Lee, J; Chung, J

    2015-06-15

    Purpose: To verify delivered doses on the implanted cardiac pacemaker, predicted doses with and without dose reduction method were verified using the MOSFET detectors in terms of beam delivery and dose calculation techniques in intensity-modulated radiation therapy (IMRT). Methods: The pacemaker doses for a patient with a tongue cancer were predicted according to the beam delivery methods [step-and-shoot (SS) and sliding window (SW)], intensity levels for dose optimization, and dose calculation algorithms. Dosimetric effects on the pacemaker were calculated three dose engines: pencil-beam convolution (PBC), analytical anisotropic algorithm (AAA), and Acuros-XB. A lead shield of 2 mm thickness was designed for minimizing irradiated doses to the pacemaker. Dose variations affected by the heterogeneous material properties of the pacemaker and effectiveness of the lead shield were predicted by the Acuros-XB. Dose prediction accuracy and the feasibility of the dose reduction strategy were verified based on the measured skin doses right above the pacemaker using mosfet detectors during the radiation treatment. Results: The Acuros-XB showed underestimated skin doses and overestimated doses by the lead-shield effect, even though the lower dose disagreement was observed. It led to improved dose prediction with higher intensity level of dose optimization in IMRT. The dedicated tertiary lead sheet effectively achieved reduction of pacemaker dose up to 60%. Conclusion: The current SS technique could deliver lower scattered doses than recommendation criteria, however, use of the lead sheet contributed to reduce scattered doses.Thin lead plate can be a useful tertiary shielder and it could not acuse malfunction or electrical damage of the implanted pacemaker in IMRT. It is required to estimate more accurate scattered doses of the patient with medical device to design proper dose reduction strategy.

  2. Functional depletion of capsaicin-sensitive primary afferent fibers attenuates rat pain-related behaviors and paw edema induced by the venom of scorpion Buthus martensi Karch.

    PubMed

    Bai, Zhan-Tao; Liu, Tong; Pang, Xue-Yan; Jiang, Feng; Cheng, Ming; Ji, Yong-Hua

    2008-10-01

    The role of capsaicin-sensitive primary afferent fibers in rat pain-related behaviors and paw edema induced by scorpion Buthus martensi Karch (BmK) venom was investigated in this study. It was found that functional depletion of capsaicin-sensitive primary afferent fibers with a single systemic injection of resiniferatoxin (RTX) dramatically decreased spontaneous nociceptive behaviors, prevented the development of primary mechanical and thermal hyperalgesia as well as mirror-image mechanical hyperalgesia. RTX treatment significantly attenuated BmK venom-induced c-Fos expression in all laminaes of bilateral L4-L5 lumbar spinal cord, especially in superficial laminaes. Moreover, RTX treatment markedly reduced the early paw edema induced by BmK venom. Thus, the results indicate that capsaicin-sensitive primary afferent fibers play a critical role in various pain-related behaviors and paw edema induced by BmK venom in rats.

  3. Objective assessment of image quality and dose reduction in CT iterative reconstruction

    SciTech Connect

    Vaishnav, J. Y. Jung, W. C.; Popescu, L. M.; Zeng, R.; Myers, K. J.

    2014-07-15

    Purpose: Iterative reconstruction (IR) algorithms have the potential to reduce radiation dose in CT diagnostic imaging. As these algorithms become available on the market, a standardizable method of quantifying the dose reduction that a particular IR method can achieve would be valuable. Such a method would assist manufacturers in making promotional claims about dose reduction, buyers in comparing different devices, physicists in independently validating the claims, and the United States Food and Drug Administration in regulating the labeling of CT devices. However, the nonlinear nature of commercially available IR algorithms poses challenges to objectively assessing image quality, a necessary step in establishing the amount of dose reduction that a given IR algorithm can achieve without compromising that image quality. This review paper seeks to consolidate information relevant to objectively assessing the quality of CT IR images, and thereby measuring the level of dose reduction that a given IR algorithm can achieve. Methods: The authors discuss task-based methods for assessing the quality of CT IR images and evaluating dose reduction. Results: The authors explain and review recent literature on signal detection and localization tasks in CT IR image quality assessment, the design of an appropriate phantom for these tasks, possible choices of observers (including human and model observers), and methods of evaluating observer performance. Conclusions: Standardizing the measurement of dose reduction is a problem of broad interest to the CT community and to public health. A necessary step in the process is the objective assessment of CT image quality, for which various task-based methods may be suitable. This paper attempts to consolidate recent literature that is relevant to the development and implementation of task-based methods for the assessment of CT IR image quality.

  4. Effects of dose limits reduction on the Argentine nuclear power plants

    SciTech Connect

    Palacios, E.; Curti, A.; Massera, G.; Spano, F.; Boutet, L. )

    1993-11-01

    Occupational doses are evaluated in different stages of the fuel cycle and in the operation of nuclear power plants. Trends in individual dose distribution and collective doses are analyzed. The most contributive working conditions to collective dose are identified and the implications of dose limit reduction recommended by the ICRP in 1990 are assessed. It is concluded that no relevant difficulties should appear in accomplishing the new recommendations except for implementation at Atucha I, a nuclear power plant designed in the 1960s. Some options to reduce individual and collective doses in this plant are analyzed. The change of fuel channels by new ones free from cobalt is essential to get effective improvement of occupational exposures.

  5. A study on the indirect urea dosing method in the Selective Catalytic Reduction system

    NASA Astrophysics Data System (ADS)

    Brzeżański, M.; Sala, R.

    2016-09-01

    This article presents the results of studies on concept solution of dosing urea in a gas phase in a selective catalytic reduction system. The idea of the concept was to heat-up and evaporate the water urea solution before introducing it into the exhaust gas stream. The aim was to enhance the processes of urea converting into ammonia, what is the target reductant for nitrogen oxides treatment. The study was conducted on a medium-duty Euro 5 diesel engine with exhaust line consisting of DOC catalyst, DPF filter and an SCR system with a changeable setup allowing to dose the urea in liquid phase (regular solution) and to dose it in a gas phase (concept solution). The main criteria was to assess the effect of physical state of urea dosed on the NOx conversion ratio in the SCR catalyst. In order to compare both urea dosing methods a special test procedure was developed which consisted of six test steps covering a wide temperature range of exhaust gas generated at steady state engine operation condition. Tests were conducted for different urea dosing quantities defined by the a equivalence ratio. Based on the obtained results, a remarkable improvement in NOx reduction was found for gas urea application in comparison to the standard liquid urea dosing. Measured results indicate a high potential to increase an efficiency of the SCR catalyst by using a gas phase urea and provide the basis for further scientific research on this type of concept.

  6. Dose reduction in CT using bismuth shielding: measurements and Monte Carlo simulations.

    PubMed

    Chang, Kyung-Hwan; Lee, Wonho; Choo, Dong-Myung; Lee, Choon-Sik; Kim, Youhyun

    2010-03-01

    In this research, using direct measurements and Monte Carlo calculations, the potential dose reduction achieved by bismuth shielding in computed tomography was evaluated. The patient dose was measured using an ionisation chamber in a polymethylmethacrylate (PMMA) phantom that had five measurement points at the centre and periphery. Simulations were performed using the MCNPX code. For both the bare and the bismuth-shielded phantom, the differences of dose values between experiment and simulation were within 9%. The dose reductions due to the bismuth shielding were 1.2-55% depending on the measurement points, X-ray tube voltage and the type of shielding. The amount of dose reduction was significant for the positions covered by the bismuth shielding (34 - 46% for head and 41 - 55% for body phantom on average) and negligible for other peripheral positions. The artefact on the reconstructed images were minimal when the distance between the shielding and the organs was >1 cm, and hence the shielding should be selectively located to protect critical organs such as the eye lens, thyroid and breast. The simulation results using the PMMA phantom was compared with those using a realistically voxelised phantom (KTMAN-2). For eye and breast, the simulation results using the PMMA and KTMAN-2 phantoms were similar with each other, while for thyroid the simulation results were different due to the discrepancy of locations and the sizes of the phantoms. The dose reductions achieved by bismuth and lead shielding were compared with each other and the results showed that the difference of the dose reductions achieved by the two materials was less than 2-3%.

  7. Dose reduction in CT using bismuth shielding: measurements and Monte Carlo simulations

    PubMed Central

    Chang, Kyung-Hwan; Lee, Wonho; Choo, Dong-Myung; Lee, Choon-Sik; Kim, Youhyun

    2010-01-01

    In this research, using direct measurements and Monte Carlo calculations, the potential dose reduction achieved by bismuth shielding in computed tomography was evaluated. The patient dose was measured using an ionisation chamber in a polymethylmethacrylate (PMMA) phantom that had five measurement points at the centre and periphery. Simulations were performed using the MCNPX code. For both the bare and the bismuth-shielded phantom, the differences of dose values between experiment and simulation were within 9 %. The dose reductions due to the bismuth shielding were 1.2–55 % depending on the measurement points, X-ray tube voltage and the type of shielding. The amount of dose reduction was significant for the positions covered by the bismuth shielding (34 − 46 % for head and 41 − 55 % for body phantom on average) and negligible for other peripheral positions. The artefact on the reconstructed images were minimal when the distance between the shielding and the organs was >1 cm, and hence the shielding should be selectively located to protect critical organs such as the eye lens, thyroid and breast. The simulation results using the PMMA phantom was compared with those using a realistically voxelised phantom (KTMAN-2). For eye and breast, the simulation results using the PMMA and KTMAN-2 phantoms were similar with each other, while for thyroid the simulation results were different due to the discrepancy of locations and the sizes of the phantoms. The dose reductions achieved by bismuth and lead shielding were compared with each other and the results showed that the difference of the dose reductions achieved by the two materials was less than 2–3 %. PMID:19959602

  8. Method for simulating dose reduction in digital mammography using the Anscombe transformation

    PubMed Central

    Borges, Lucas R.; de Oliveira, Helder C. R.; Nunes, Polyana F.; Bakic, Predrag R.; Maidment, Andrew D. A.; Vieira, Marcelo A. C.

    2016-01-01

    Purpose: This work proposes an accurate method for simulating dose reduction in digital mammography starting from a clinical image acquired with a standard dose. Methods: The method developed in this work consists of scaling a mammogram acquired at the standard radiation dose and adding signal-dependent noise. The algorithm accounts for specific issues relevant in digital mammography images, such as anisotropic noise, spatial variations in pixel gain, and the effect of dose reduction on the detective quantum efficiency. The scaling process takes into account the linearity of the system and the offset of the detector elements. The inserted noise is obtained by acquiring images of a flat-field phantom at the standard radiation dose and at the simulated dose. Using the Anscombe transformation, a relationship is created between the calculated noise mask and the scaled image, resulting in a clinical mammogram with the same noise and gray level characteristics as an image acquired at the lower-radiation dose. Results: The performance of the proposed algorithm was validated using real images acquired with an anthropomorphic breast phantom at four different doses, with five exposures for each dose and 256 nonoverlapping ROIs extracted from each image and with uniform images. The authors simulated lower-dose images and compared these with the real images. The authors evaluated the similarity between the normalized noise power spectrum (NNPS) and power spectrum (PS) of simulated images and real images acquired with the same dose. The maximum relative error was less than 2.5% for every ROI. The added noise was also evaluated by measuring the local variance in the real and simulated images. The relative average error for the local variance was smaller than 1%. Conclusions: A new method is proposed for simulating dose reduction in clinical mammograms. In this method, the dependency between image noise and image signal is addressed using a novel application of the Anscombe

  9. Working Face-to-Face for Pediatric CT Dose Reduction: A Community Toolkit

    PubMed Central

    Armao, Diane; Hartman, Terry; Shea, Christopher M.; Sams, Cassandra; Fordham, Lynn Ansley; Smith, J. Keith

    2016-01-01

    Although children are especially vulnerable to the health risks of ionizing radiation, approximately 8 million CTs are performed on children in the USA. Widespread dose variation is common, particularly in non-pediatric focused facilities. In this article we present our rationale and hands-on approach in developing and refining a toolkit aimed at helping a community hospital with pediatric CT dose reduction. PMID:27942250

  10. [Budget impact analysis of efavirenz daily dose reduction at the Verona University Hospital].

    PubMed

    Costa, Enrico; Biasi, Valeria; Concia, Ercole; Jommi, Claudio; Lattuada, Emanuela; Manfre, Silvia; Venturini, Francesca; Lanzafame, Massimiliano

    2014-06-01

    Efavirenz is a non-nucleoside-reverse-transcriptase-inhibitor used as part of highly-active-antiretroviral-therapy for the treatment of the human immunodeficiency virus (HIV) type 1 infection. The present paper aims to describing the impact of efavirenz dose reduction on the pharmaceutical budget at the Verona University Hospital. A budget impact analysis comparing two prescribing scenarios was conducted: all patients treated with the efavirenz full dose (600 mg per day) vs. a proportion of patients treated with a reduced dose (200-400 mg per day). All outpatients referring to the Infectious Disease Clinic in the period November 2009-October 2011 were selected. Out of 132 patients treated with efavirenz, 25 were not considered, mainly due to a too short treatment period. Of the remaining 107 patients, 68 received the full dose, while 39 received a reduced dosage. The analysis included the cost of the drug and of diagnostic tests, from the National Health Service perspective. The daily dose reduction of efavirenz saved 54,664 euros (a 30% expenditure reduction). In sum, new strategies for pharmaceutical system sustainability are necessary; despite forthcoming expiring patents of several drugs, spending on antiretroviral drugs is expected to rise. This paper suggests a way of linking clinical benefits and cost reduction.

  11. X-ray dose reduction by adaptive source equalization and electronic region-of-interest control

    NASA Astrophysics Data System (ADS)

    Burion, Steve; Sandman, Anne; Bechtel, Kate; Solomon, Edward; Funk, Tobias

    2011-03-01

    Radiation dose is particularly a concern in pediatric cardiac fluoroscopy procedures, which account for 7% of all cardiac procedures performed. The Scanning-Beam Digital X-ray (SBDX) fluoroscopy system has already demonstrated reduced dose in adult patients owing to its high-DQE photon-counting detector, reduced detected scatter, and the elimination of the anti-scatter grid. Here we show that the unique flexible illumination platform of the SBDX system will enable further dose area product reduction, which we are currently developing for pediatric patients, but which will ultimately benefit all patients. The SBDX system has a small-area detector array and a large-area X-ray source with up to 9,000 individually-controlled X-ray focal spots. Each focal spot illuminates a small fraction of the full field of view. To acquire a frame, each focal spot is activated for a fixed number of 1-microsecond periods. Dose reduction is made possible by reducing the number of activations of some of the X-ray focal spots during each frame time. This can be done dynamically to reduce the exposure in areas of low patient attenuation, such as the lung field. This spatially-adaptive illumination also reduces the dynamic range in the full image, which is visually pleasing. Dose can also be reduced by the user selecting a region of interest (ROI) where full image quality is to be maintained. Outside the ROI, the number of activations of each X-ray focal spot is reduced and the image gain is correspondingly increased to maintain consistent image brightness. Dose reduction is dependent on the size of the ROI and the desired image quality outside the ROI. We have developed simulation software that is based on real data and can simulate the performance of the equalization and ROI filtration. This software represents a first step toward real-time implementation of these dose-reduction methods. Our simulations have shown that dose area product reductions of 40% are possible using equalization

  12. Dose reduction with iterative reconstruction for coronary CT angiography: a systematic review and meta-analysis

    PubMed Central

    Willemink, Martin J; De Ruiter, Quirina M B; De Jong, Pim A; Schilham, Arnold M R; Krestin, Gabriel P; Leiner, Tim; Budde, Ricardo P J

    2016-01-01

    Objective: To investigate the achievable radiation dose reduction for coronary CT angiography (CCTA) with iterative reconstruction (IR) in adults and the effects on image quality. Methods: PubMed and EMBASE were searched, and original articles concerning IR for CCTA in adults using prospective electrocardiogram triggering were included. Primary outcome was the effective dose using filtered back projection (FBP) and IR. Secondary outcome was the effect of IR on objective and subjective image quality. Results: The search yielded 1616 unique articles, of which 10 studies (1042 patients) were included. The pooled routine effective dose with FBP was 4.2 mSv [95% confidence interval (CI) 3.5–5.0]. A dose reduction of 48% to a pooled effective dose of 2.2 mSv (95% CI 1.3–3.1) using IR was reported. Noise, contrast-to-noise ratio and subjective image quality were equal or improved in all but one study, whereas signal-to-noise ratio was decreased in two studies with IR at reduced dose. Conclusion: IR allows for CCTA acquisition with an effective dose of 2.2 mSv with preserved objective and subjective image quality. PMID:26562096

  13. Potential of combining iterative reconstruction with noise efficient detector design: aggressive dose reduction in head CT

    PubMed Central

    Bender, B; Schabel, C; Fenchel, M; Ernemann, U; Korn, A

    2015-01-01

    Objective: With further increase of CT numbers and their dominant contribution to medical exposure, there is a recent quest for more effective dose control. While reintroduction of iterative reconstruction (IR) has proved its potential in many applications, a novel focus is placed on more noise efficient detectors. Our purpose was to assess the potential of IR in combination with an integrated circuit detector (ICD) for aggressive dose reduction in head CT. Methods: Non-contrast low-dose head CT [190 mAs; weighted volume CT dose index (CTDIvol), 33.2 mGy] was performed in 50 consecutive patients, using a new noise efficient detector and IR. Images were assessed in terms of quantitative and qualitative image quality and compared with standard dose acquisitions (320 mAs; CTDIvol, 59.7 mGy) using a conventional detector and filtered back projection. Results: By combining ICD and IR in low-dose examinations, the signal to noise was improved by about 13% above the baseline level in the standard-dose control group. Both, contrast-to-noise ratio (2.02 ± 0.6 vs 1.88 ± 0.4; p = 0.18) and objective measurements of image sharpness (695 ± 84 vs 705 ± 151 change in Hounsfield units per pixel; p = 0.79) were fully preserved in the low-dose group. Likewise, there was no significant difference in the grading of several subjective image quality parameters when both noise-reducing strategies were used in low-dose examinations. Conclusion: Combination of noise efficient detector with IR allows for meaningful dose reduction in head CT without compromise of standard image quality. Advances in knowledge: Our study demonstrates the feasibility of almost 50% dose reduction in head CT dose (1.1 mSv per scan) through combination of novel dose-reducing strategies. PMID:25827204

  14. Effects of Low-Dose Mindfulness-Based Stress Reduction (MBSR-ld) on Working Adults

    ERIC Educational Resources Information Center

    Klatt, Maryanna D.; Buckworth, Janet; Malarkey, William B.

    2009-01-01

    Mindfulness-based stress reduction (MBSR) has produced behavioral, psychological, and physiological benefits, but these programs typically require a substantial time commitment from the participants. This study assessed the effects of a shortened (low-dose [ld]) work-site MBSR intervention (MBSR-ld) on indicators of stress in healthy working…

  15. Characterization of adaptive statistical iterative reconstruction algorithm for dose reduction in CT: A pediatric oncology perspective

    SciTech Connect

    Brady, S. L.; Yee, B. S.; Kaufman, R. A.

    2012-09-15

    Purpose: This study demonstrates a means of implementing an adaptive statistical iterative reconstruction (ASiR Trade-Mark-Sign ) technique for dose reduction in computed tomography (CT) while maintaining similar noise levels in the reconstructed image. The effects of image quality and noise texture were assessed at all implementation levels of ASiR Trade-Mark-Sign . Empirically derived dose reduction limits were established for ASiR Trade-Mark-Sign for imaging of the trunk for a pediatric oncology population ranging from 1 yr old through adolescence/adulthood. Methods: Image quality was assessed using metrics established by the American College of Radiology (ACR) CT accreditation program. Each image quality metric was tested using the ACR CT phantom with 0%-100% ASiR Trade-Mark-Sign blended with filtered back projection (FBP) reconstructed images. Additionally, the noise power spectrum (NPS) was calculated for three common reconstruction filters of the trunk. The empirically derived limitations on ASiR Trade-Mark-Sign implementation for dose reduction were assessed using (1, 5, 10) yr old and adolescent/adult anthropomorphic phantoms. To assess dose reduction limits, the phantoms were scanned in increments of increased noise index (decrementing mA using automatic tube current modulation) balanced with ASiR Trade-Mark-Sign reconstruction to maintain noise equivalence of the 0% ASiR Trade-Mark-Sign image. Results: The ASiR Trade-Mark-Sign algorithm did not produce any unfavorable effects on image quality as assessed by ACR criteria. Conversely, low-contrast resolution was found to improve due to the reduction of noise in the reconstructed images. NPS calculations demonstrated that images with lower frequency noise had lower noise variance and coarser graininess at progressively higher percentages of ASiR Trade-Mark-Sign reconstruction; and in spite of the similar magnitudes of noise, the image reconstructed with 50% or more ASiR Trade-Mark-Sign presented a more

  16. Dose reduction in LDR brachytherapy by implanted prostate gold fiducial markers

    SciTech Connect

    Landry, Guillaume; Reniers, Brigitte; Lutgens, Ludy; Murrer, Lars; Afsharpour, Hossein; Haas-Kock, Danielle de; Visser, Peter; Gils, Francis van; Verhaegen, Frank

    2012-03-15

    Purpose: The dosimetric impact of gold fiducial markers (FM) implanted prior to external beam radiotherapy of prostate cancer on low dose rate (LDR) brachytherapy seed implants performed in the context of combined therapy was investigated. Methods: A virtual water phantom was designed containing a single FM. Single and multi source scenarios were investigated by performing Monte Carlo dose calculations, along with the influence of varying orientation and distance of the FM with respect to the sources. Three prostate cancer patients treated with LDR brachytherapy for a recurrence following external beam radiotherapy with implanted FM were studied as surrogate cases to combined therapy. FM and brachytherapy seeds were identified on post implant CT scans and Monte Carlo dose calculations were performed with and without FM. The dosimetric impact of the FM was evaluated by quantifying the amplitude of dose shadows and the volume of cold spots. D{sub 90} was reported based on the post implant CT prostate contour. Results: Large shadows are observed in the single source-FM scenarios. As expected from geometric considerations, the shadows are dependent on source-FM distance and orientation. Large dose reductions are observed at the distal side of FM, while at the proximal side a dose enhancement is observed. In multisource scenarios, the importance of shadows appears mitigated, although FM at the periphery of the seed distribution caused underdosage (dose). In clinical cases, the FM reduced the dose to some voxels by up to 50% and generated shadows with extents of the order of 4 mm. Within the prostate contour, cold spots (<95% prescription dose) of the order of 20 mm{sup 3} were observed. D{sub 90} proved insensitive to the presence of FM for the cases selected. Conclusions: There is a major local impact of FM present in LDR brachytherapy seed implant dose distributions. Therefore, reduced tumor control could be expected from FM implanted in tumors, although

  17. Paediatric x-ray radiation dose reduction and image quality analysis.

    PubMed

    Martin, L; Ruddlesden, R; Makepeace, C; Robinson, L; Mistry, T; Starritt, H

    2013-09-01

    Collaboration of multiple staff groups has resulted in significant reduction in the risk of radiation-induced cancer from radiographic x-ray exposure during childhood. In this study at an acute NHS hospital trust, a preliminary audit identified initial exposure factors. These were compared with European and UK guidance, leading to the introduction of new factors that were in compliance with European guidance on x-ray tube potentials. Image quality was assessed using standard anatomical criteria scoring, and visual grading characteristics analysis assessed the impact on image quality of changes in exposure factors. This analysis determined the acceptability of gradual radiation dose reduction below the European and UK guidance levels. Chest and pelvis exposures were optimised, achieving dose reduction for each age group, with 7%-55% decrease in critical organ dose. Clinicians confirmed diagnostic image quality throughout the iterative process. Analysis of images acquired with preliminary and final exposure factors indicated an average visual grading analysis result of 0.5, demonstrating equivalent image quality. The optimisation process and final radiation doses are reported for Carestream computed radiography to aid other hospitals in minimising radiation risks to children.

  18. Effects of dose reduction on bone strength prediction using finite element analysis

    NASA Astrophysics Data System (ADS)

    Anitha, D.; Subburaj, Karupppasamy; Mei, Kai; Kopp, Felix K.; Foehr, Peter; Noel, Peter B.; Kirschke, Jan S.; Baum, Thomas

    2016-12-01

    This study aimed to evaluate the effect of dose reduction, by means of tube exposure reduction, on bone strength prediction from finite-element (FE) analysis. Fresh thoracic mid-vertebrae specimens (n = 11) were imaged, using multi-detector computed tomography (MDCT), at different intensities of X-ray tube exposures (80, 150, 220 and 500 mAs). Bone mineral density (BMD) was estimated from the mid-slice of each specimen from MDCT images. Differences in image quality and geometry of each specimen were measured. FE analysis was performed on all specimens to predict fracture load. Paired t-tests were used to compare the results obtained, using the highest CT dose (500 mAs) as reference. Dose reduction had no significant impact on FE-predicted fracture loads, with significant correlations obtained with reference to 500 mAs, for 80 mAs (R2  = 0.997, p < 0.001), 150 mAs (R2 = 0.998, p < 0.001) and 220 mAs (R2 = 0.987, p < 0.001). There were no significant differences in volume quantification between the different doses examined. CT imaging radiation dose could be reduced substantially to 64% with no impact on strength estimates obtained from FE analysis. Reduced CT dose will enable early diagnosis and advanced monitoring of osteoporosis and associated fracture risk.

  19. Effects of dose reduction on bone strength prediction using finite element analysis

    PubMed Central

    Anitha, D.; Subburaj, Karupppasamy; Mei, Kai; Kopp, Felix K.; Foehr, Peter; Noel, Peter B.; Kirschke, Jan S.; Baum, Thomas

    2016-01-01

    This study aimed to evaluate the effect of dose reduction, by means of tube exposure reduction, on bone strength prediction from finite-element (FE) analysis. Fresh thoracic mid-vertebrae specimens (n = 11) were imaged, using multi-detector computed tomography (MDCT), at different intensities of X-ray tube exposures (80, 150, 220 and 500 mAs). Bone mineral density (BMD) was estimated from the mid-slice of each specimen from MDCT images. Differences in image quality and geometry of each specimen were measured. FE analysis was performed on all specimens to predict fracture load. Paired t-tests were used to compare the results obtained, using the highest CT dose (500 mAs) as reference. Dose reduction had no significant impact on FE-predicted fracture loads, with significant correlations obtained with reference to 500 mAs, for 80 mAs (R2  = 0.997, p < 0.001), 150 mAs (R2 = 0.998, p < 0.001) and 220 mAs (R2 = 0.987, p < 0.001). There were no significant differences in volume quantification between the different doses examined. CT imaging radiation dose could be reduced substantially to 64% with no impact on strength estimates obtained from FE analysis. Reduced CT dose will enable early diagnosis and advanced monitoring of osteoporosis and associated fracture risk. PMID:27934902

  20. Characterization and quantification of cerebral edema induced by synchrotron x-ray microbeam radiation therapy

    NASA Astrophysics Data System (ADS)

    Serduc, Raphaël; van de Looij, Yohan; Francony, Gilles; Verdonck, Olivier; van der Sanden, Boudewijn; Laissue, Jean; Farion, Régine; Bräuer-Krisch, Elke; Siegbahn, Erik Albert; Bravin, Alberto; Prezado, Yolanda; Segebarth, Christoph; Rémy, Chantal; Lahrech, Hana

    2008-03-01

    Cerebral edema is one of the main acute complications arising after irradiation of brain tumors. Microbeam radiation therapy (MRT), an innovative experimental radiotherapy technique using spatially fractionated synchrotron x-rays, has been shown to spare radiosensitive tissues such as mammal brains. The aim of this study was to determine if cerebral edema occurs after MRT using diffusion-weighted MRI and microgravimetry. Prone Swiss nude mice's heads were positioned horizontally in the synchrotron x-ray beam and the upper part of the left hemisphere was irradiated in the antero-posterior direction by an array of 18 planar microbeams (25 mm wide, on-center spacing 211 mm, height 4 mm, entrance dose 312 Gy or 1000 Gy). An apparent diffusion coefficient (ADC) was measured at 7 T 1, 7, 14, 21 and 28 days after irradiation. Eventually, the cerebral water content (CWC) was determined by microgravimetry. The ADC and CWC in the irradiated (312 Gy or 1000 Gy) and in the contralateral non-irradiated hemispheres were not significantly different at all measurement times, with two exceptions: (1) a 9% ADC decrease (p < 0.05) was observed in the irradiated cortex 1 day after exposure to 312 Gy, (2) a 0.7% increase (p < 0.05) in the CWC was measured in the irradiated hemispheres 1 day after exposure to 1000 Gy. The results demonstrate the presence of a minor and transient cellular edema (ADC decrease) at 1 day after a 312 Gy exposure, without a significant CWC increase. One day after a 1000 Gy exposure, the CWC increased, while the ADC remained unchanged and may reflect the simultaneous presence of cellular and vasogenic edema. Both types of edema disappear within a week after microbeam exposure which may confirm the normal tissue sparing effect of MRT. For more information on this article, see medicalphysicsweb.org

  1. Data base on dose reduction research projects for nuclear power plants. Volume 5

    SciTech Connect

    Khan, T.A.; Yu, C.K.; Roecklein, A.K.

    1994-05-01

    This is the fifth volume in a series of reports that provide information on dose reduction research and health physics technology or nuclear power plants. The information is taken from two of several databases maintained by Brookhaven National Laboratory`s ALARA Center for the Nuclear Regulatory Commission. The research section of the report covers dose reduction projects that are in the experimental or developmental phase. It includes topics such as steam generator degradation, decontamination, robotics, improvements in reactor materials, and inspection techniques. The section on health physics technology discusses dose reduction efforts that are in place or in the process of being implemented at nuclear power plants. A total of 105 new or updated projects are described. All project abstracts from this report are available to nuclear industry professionals with access to a fax machine through the ACEFAX system or a computer with a modem and the proper communications software through the ACE system. Detailed descriptions of how to access all the databases electronically are in the appendices of the report.

  2. Measurement of dose reductions for superficial x-rays backscattered from bone interfaces.

    PubMed

    Butson, Martin J; Cheung, Tsang; Yu, Peter K N

    2008-09-07

    Accurate measurement and knowledge of dose delivered during superficial x-ray radiotherapy is required for patient dose assessment. Some tumours treated near the surface (within the first few centimetres) can have large posterior bone structures. This can cause perturbations to dose delivered due to changed backscatter contributions from the bony structure as compared to full water or tissue scattering conditions. Measured results have shown that up to 7.5% of Dmax reductions in dose can occur near the water/bone interface for 100 kVp, using 10 cm diameter field sizes when a 1 cm thick slab of bone is located at 2 cm depth. At smaller field sizes such as 2 cm diameter these values reduce to 2% for the same energy. Larger variations (up to 12.5% of maximum) have been seen at the phantom surface when the bone layer is directly behind the point of interest (within 0.5 mm) and smaller effects (up to 5% of maximum) at depths down to 5 cm. Interesting to note is the fact that for larger field sizes, an increase in percentage dose is found at the water/bone interface due to the production of low energy backscattered electrons similar to the effect found in lead. However, they are much smaller in magnitude and thus would not cause any significant dosimetric effects. In the case where large bony structures lie relatively close to the surface and the tissue above this region is being treated, a dosimeter such as radiochromic film can be used to estimate the dose reduction that may occur due to the changed backscatter conditions.

  3. Influence of dose reduction and iterative reconstruction on CT calcium scores: a multi-manufacturer dynamic phantom study.

    PubMed

    van der Werf, N R; Willemink, M J; Willems, T P; Greuter, M J W; Leiner, T

    2017-01-19

    To evaluate the influence of dose reduction in combination with iterative reconstruction (IR) on coronary calcium scores (CCS) in a dynamic phantom on state-of-the-art CT systems from different manufacturers. Calcified inserts in an anthropomorphic chest phantom were translated at 20 mm/s corresponding to heart rates between 60 and 75 bpm. The inserts were scanned five times with routinely used CCS protocols at reference dose and 40 and 80% dose reduction on four high-end CT systems. Filtered back projection (FBP) and increasing levels of IR were applied. Noise levels were determined. CCS, quantified as Agatston and mass scores, were compared to physical mass and scores at FBP reference dose. For the reference dose in combination with FBP, noise level variation between CT systems was less than 18%. Decreasing dose almost always resulted in increased CCS, while at increased levels of IR, CCS decreased again. The influence of IR on CCS was smaller than the influence of dose reduction. At reference dose, physical mass was underestimated 3-30%. All CT systems showed similar CCS at 40% dose reduction in combinations with specific reconstructions. For some CT systems CCS was not affected at 80% dose reduction, in combination with IR. This multivendor study showed that radiation dose reductions of 40% did not influence CCS in a dynamic phantom using state-of-the-art CT systems in combination with specific reconstruction settings. Dose reduction resulted in increased noise and consequently increased CCS, whereas increased IR resulted in decreased CCS.

  4. Performance evaluation of iterative reconstruction algorithms for achieving CT radiation dose reduction - a phantom study.

    PubMed

    Dodge, Cristina T; Tamm, Eric P; Cody, Dianna D; Liu, Xinming; Jensen, Corey T; Wei, Wei; Kundra, Vikas; Rong, X John

    2016-03-08

    The purpose of this study was to characterize image quality and dose performance with GE CT iterative reconstruction techniques, adaptive statistical iterative recontruction (ASiR), and model-based iterative reconstruction (MBIR), over a range of typical to low-dose intervals using the Catphan 600 and the anthropomorphic Kyoto Kagaku abdomen phantoms. The scope of the project was to quantitatively describe the advantages and limitations of these approaches. The Catphan 600 phantom, supplemented with a fat-equivalent oval ring, was scanned using a GE Discovery HD750 scanner at 120 kVp, 0.8 s rotation time, and pitch factors of 0.516, 0.984, and 1.375. The mA was selected for each pitch factor to achieve CTDIvol values of 24, 18, 12, 6, 3, 2, and 1 mGy. Images were reconstructed at 2.5 mm thickness with filtered back-projection (FBP); 20%, 40%, and 70% ASiR; and MBIR. The potential for dose reduction and low-contrast detectability were evaluated from noise and contrast-to-noise ratio (CNR) measurements in the CTP 404 module of the Catphan. Hounsfield units (HUs) of several materials were evaluated from the cylinder inserts in the CTP 404 module, and the modulation transfer function (MTF) was calculated from the air insert. The results were con-firmed in the anthropomorphic Kyoto Kagaku abdomen phantom at 6, 3, 2, and 1mGy. MBIR reduced noise levels five-fold and increased CNR by a factor of five compared to FBP below 6mGy CTDIvol, resulting in a substantial improvement in image quality. Compared to ASiR and FBP, HU in images reconstructed with MBIR were consistently lower, and this discrepancy was reversed by higher pitch factors in some materials. MBIR improved the conspicuity of the high-contrast spatial resolution bar pattern, and MTF quantification confirmed the superior spatial resolution performance of MBIR versus FBP and ASiR at higher dose levels. While ASiR and FBP were relatively insensitive to changes in dose and pitch, the spatial resolution for MBIR

  5. Imatinib dose reduction in patients with chronic myeloid leukemia in sustained deep molecular response.

    PubMed

    Cervantes, Francisco; Correa, Juan-Gonzalo; Pérez, Isabel; García-Gutiérrez, Valentín; Redondo, Sara; Colomer, Dolors; Jiménez-Velasco, Antonio; Steegmann, Juan-Luis; Sánchez-Guijo, Fermín; Ferrer-Marín, Francisca; Pereira, Arturo; Osorio, Santiago

    2017-01-01

    To determine whether a lower imatinib dose could minimize toxicity while maintaining the molecular response (MR), imatinib dose was reduced to 300 mg daily in 43 patients with chronic myeloid leukemia (CML) in sustained deep molecular response to first-line imatinib 400 mg daily. At the time of dose reduction, median duration of the deep response was 4.1 (interquartile range (IQR) 2.2-5.9) years; molecular response was MR(4), MR(4.5), and MR(5) of the international scale in 6, 28, and 9 patients, respectively. Toxicity grade was 1, 2, and 3 in 28, 8, and 1 patients, respectively; 6 patients underwent dose reduction without having side effects. With a median of 1.6 (IQR 0.7-3.2) years on imatinib 300 mg daily, only one patient lost the deep molecular response to MR(3). At the last follow-up, response was MR(3), MR(4), MR(4.5), and MR(5) in 1, 3, 9, and 30 patients, respectively. Toxicity improvement was observed in 23 (62.2 %) of the 37 patients with side effects, decreasing to grade 0 in 20 of them. All but one anemic patients improved (p = 0.01), the median Hb increase in this subgroup of patients being 1 g/dL. In CML patients with sustained deep response to the standard imatinib dose, reducing to 300 mg daily significantly improves tolerability and preserves efficacy.

  6. Effects of dose reduction on the detectability of standardized radiolucent lesions in digital panoramic radiography.

    PubMed

    Dula, K; Sanderink, G; van der Stelt, P F; Mini, R; Buser, D

    1998-08-01

    Dose reduction in digital panoramic radiography was studied. Intentional underexposure was performed with the Orthophos DS while six different human mandibles were radiographed. Exposure settings were 69 kV/15 mA (standard), 64 kV/16 mA, and 60 kV/16 mA. Standardized spherical defects, each either 1 or 1.25 mm in diameter, were simulated in 288 of 432 images, and seven observers decided whether defects were present or not. Areas under the receiver operating characteristics curves were calculated. They showed no significant differences in the detectability of the 1-mm defect at 69, 64, or 60 kV. For the 1.25-mm defect, no difference was found between the 69 and 60 kV images, but a statistically significant different detectability was found for 64 kV images in comparison with both 69 and 60 kV images. A dose reduction of up to 43% was ascertained with a Pedo-RT-Humanoid phantom when panoramic radiography was performed at 60 kV/16 mA. The conclusion is that with the Orthophos DS, it seems possible to reduce the dose rate of x-rays without loss of diagnostic quality in the case of radiolucent changes.

  7. Radiation dose reduction in digital radiography using wavelet-based image processing methods

    NASA Astrophysics Data System (ADS)

    Watanabe, Haruyuki; Tsai, Du-Yih; Lee, Yongbum; Matsuyama, Eri; Kojima, Katsuyuki

    2011-03-01

    In this paper, we investigate the effect of the use of wavelet transform for image processing on radiation dose reduction in computed radiography (CR), by measuring various physical characteristics of the wavelet-transformed images. Moreover, we propose a wavelet-based method for offering a possibility to reduce radiation dose while maintaining a clinically acceptable image quality. The proposed method integrates the advantages of a previously proposed technique, i.e., sigmoid-type transfer curve for wavelet coefficient weighting adjustment technique, as well as a wavelet soft-thresholding technique. The former can improve contrast and spatial resolution of CR images, the latter is able to improve the performance of image noise. In the investigation of physical characteristics, modulation transfer function, noise power spectrum, and contrast-to-noise ratio of CR images processed by the proposed method and other different methods were measured and compared. Furthermore, visual evaluation was performed using Scheffe's pair comparison method. Experimental results showed that the proposed method could improve overall image quality as compared to other methods. Our visual evaluation showed that an approximately 40% reduction in exposure dose might be achieved in hip joint radiography by using the proposed method.

  8. Dose reduction for cardiac CT using a registration-based approach

    SciTech Connect

    Wierzbicki, Marcin; Guiraudon, Gerard M.; Jones, Douglas L.; Peters, Terry

    2007-06-15

    Two reasons for the recent rise in radiation exposure from CT are increases in its clinical applicability and the desire to maintain high SNR while acquiring smaller voxels. To address this emerging dose problem, several strategies for reducing patient exposure have already been proposed. One method employed in cardiac imaging is ECG-driven modulation of the tube current between 100% at one time point in the cardiac cycle and a reduced fraction at the remaining phases. In this paper, we describe how images obtained during such acquisition can be used to reconstruct 4D data of consistent high quality throughout the cardiac cycle. In our approach, we assume that the mid-diastole (MD) phase is imaged with full dose. The MD image is then independently registered to lower dose images (lower SNR) at other frames, resulting in a set of transformations. Finally, the transformations are used to warp the MD frame through the cardiac cycle to generate the full 4D image. In addition, the transformations may be interpolated to increase the temporal sampling or to generate images at arbitrary time points. Our approach was validated using various data obtained with simulated and scanner-implemented dose modulation. We determined that as little as 10% of the total dose was required to reproduce full quality images with a 1 mm spatial error and an error in intensity values on the order of the image noise. Thus, our technique offers considerable dose reductions compared to standard imaging protocols, with minimal effects on the quality of the final data.

  9. Dose reduction for cardiac CT using a registration-based approach.

    PubMed

    Wierzbicki, Marcin; Guiraudon, Gérard M; Jones, Douglas L; Peters, Terry

    2007-06-01

    Two reasons for the recent rise in radiation exposure from CT are increases in its clinical applicability and the desire to maintain high SNR while acquiring smaller voxels. To address this emerging dose problem, several strategies for reducing patient exposure have already been proposed. One method employed in cardiac imaging is ECG-driven modulation of the tube current between 100% at one time point in the cardiac cycle and a reduced fraction at the remaining phases. In this paper, we describe how images obtained during such acquisition can be used to reconstruct 4D data of consistent high quality throughout the cardiac cycle. In our approach, we assume that the middiastole (MD) phase is imaged with full dose. The MD image is then independently registered to lower dose images (lower SNR) at other frames, resulting in a set of transformations. Finally, the transformations are used to warp the MD frame through the cardiac cycle to generate the full 4D image. In addition, the transformations may be interpolated to increase the temporal sampling or to generate images at arbitrary time points. Our approach was validated using various data obtained with simulated and scanner-implemented dose modulation. We determined that as little as 10% of the total dose was required to reproduce full quality images with a 1 mm spatial error and an error in intensity values on the order of the image noise. Thus, our technique offers considerable dose reductions compared to standard imaging protocols, with minimal effects on the quality of the final data.

  10. Dose reduction in CT urography and vasculature phantom studies using model-based iterative reconstruction.

    PubMed

    Page, Leland; Wei, Wei; Kundra, Vikas; Rong, John

    2016-11-08

    To evaluate the feasibility of radiation dose reduction using model-based iterative reconstruction (MBIR) for evaluating the ureters and vasculature in a phantom, a tissue-equivalent CT dose phantom was scanned using a 64-channel CT scan-ner. Tubes of varying diameters filled with different dilutions of a contrast agent, simulating ureters or vessels, were inserted into the center of the phantom. Each combination was scanned using an existing renal protocol at 140 kVp or 120 kVp, yielding a display volumetric CT dose index (CTDIvol) of 24 mGy. The scans were repeated using reduced scan techniques to achieve lower radiation doses down to 0.8 mGy. The images were reconstructed using filtered back-projection (FBP) and model-based iterative reconstruction (MBIR). The noise and contrast-to-noise ratio (CNR) was measured for each contrast object. Comparisons between the two reconstruction methods at different dose levels were evaluated using a factorial design. At each CTDIvol the measured image noise was lower using MBIR compared to FBP (p < 0.0001). At low doses, the percent change in measured image noise between FBP and MBIR was larger. For the 12 mm object simulating a ureter or large vessel with an HU of 600, the measured CNR using MBIR at a CTDIvol of 1.7 mGy was greater than the CNR of FBP at a CTIDvol of 24 mGy (p < 0.0001). For the 5 mm object simulating a medium-sized vessel with a HU of 250, the mea-sured CNR using MBIR at a CTDIvol of 1.7 mGy was equivalent to that of FBP at a CTDIvol of 24 mGy. For the 2 mm, 100 HU object simulating a small vessel, the measured CNR using MBIR at a CTDIvol of 1.7 mGy was equivalent to that of FBP at a CTDIvol of 24 mGy. Low-dose (3.6 mGy) CT imaging of vasculature and ureter phantoms using MBIR results in similar noise and CNR compared to FBP at approximately one-sixth the dose. This suggests that, using MBIR, a one milliSievert exam of the ureters and vasculature may be clinically possible whilst still maintaining adequate

  11. Effects of low-dose mindfulness-based stress reduction (MBSR-ld) on working adults.

    PubMed

    Klatt, Maryanna D; Buckworth, Janet; Malarkey, William B

    2009-06-01

    Mindfulness-based stress reduction (MBSR) has produced behavioral, psychological, and physiological benefits, but these programs typically require a substantial time commitment from the participants. This study assessed the effects of a shortened (low-dose [ld]) work-site MBSR intervention (MBSR-ld) on indicators of stress in healthy working adults to determine if results similar to those obtained in traditional MBSR could be demonstrated. Participants were randomized into MBSR-ld and wait-list control groups. Self-reported perceived stress, sleep quality, and mindfulness were measured at the beginning and end of the 6-week intervention. Salivary cortisol was assessed weekly. Significant reductions in perceived stress (p = .0025) and increases in mindfulness (p = .0149) were obtained for only the MBSR-ld group (n = 22). Scores on the global measure of sleep improved for the MBSR-ld group (p = .0018) as well as for the control group (p = .0072; n = 20). Implications and future research are discussed.

  12. Automatic selection of tube potential for radiation dose reduction in CT: A general strategy

    SciTech Connect

    Yu Lifeng; Li Hua; Fletcher, Joel G.; McCollough, Cynthia H.

    2010-01-15

    Purpose: To optimize radiation dose efficiency in CT while maintaining image quality, it is important to select the optimal tube potential. The selection of optimal tube potential, however, is highly dependent on patient size and diagnostic task. The purpose of this work was to develop a general strategy that allows for automatic tube potential selection for each individual patient and each diagnostic task. Methods: The authors propose a general strategy that allows automatic adaptation of the tube potential as a function of patient size and diagnostic task, using a novel index of image quality, ''iodine contrast to noise ratio with a noise constraint (iCNR{sub N}C),'' to characterize the different image quality requirements by various clinical applications. The relative dose factor (RDF) at each tube potential to achieve a target image quality was then determined as a function of patient size and the noise constraint parameter. A workflow was developed to automatically identify the optimal tube potential that is both dose efficient and practically feasible, incorporating patient size and diagnostic task. An experimental study using a series of semianthropomorphic thoracic phantoms was used to demonstrate how the proposed general strategy can be implemented and how the radiation dose reduction achievable by the tube potential selection depends on phantom sizes and noise constraint parameters. Results: The proposed strategy provides a flexible and quantitative way to select the optimal tube potential based on the patient size and diagnostic task. The noise constraint parameter {alpha} can be adapted for different clinical applications. For example, {alpha}=1 for noncontrast routine exams; {alpha}=1.1-1.25 for contrast-enhanced routine exams; and {alpha}=1.5-2.0 for CT angiography. For the five thoracic phantoms in the experiment, when {alpha}=1, the optimal tube potentials were 80, 100, 100, 120, 120, respectively. The corresponding RDFs (relative to 120 kV) were 78

  13. Characteristics of Movement-Induced Dose Reduction in Target Volume: A Comparison Between Photon and Proton Beam Treatment

    SciTech Connect

    Yoon, Myonggeun; Shin, Dongho; Kwak, Jungwon; Park, Soah; Lim, Young Kyung; Kim, Dongwook; Park, Sung Yong Lee, Se Byeong; Shin, Kyung Hwan; Kim, Tae Hyun; Cho, Kwan Ho

    2009-10-01

    We compared the main characteristics of movement-induced dose reduction during photon and proton beam treatment, based on an analysis of dose-volume histograms. To simulate target movement, a target contour was delineated in a scanned phantom and displaced by 3 to 20 mm. Although the dose reductions to the target in the 2 treatment systems were similar for transverse (perpendicular to beam direction) target motion, they were completely different for longitudinal (parallel to beam direction) target motion. While both modalities showed a relationship between the degree of target shift and the reduction in dose coverage, dose reduction showed a strong directional dependence in proton beam treatment. Clinical simulation of target movement for a prostate cancer patient showed that, although coverage and conformity indices for a 6-mm lateral movement of the prostate were reduced by 9% and 16%, respectively, for proton beam treatment, they were reduced by only 1% and 7%, respectively, for photon treatment. This difference was greater for a 15-mm target movement in the lateral direction, which lowered the coverage and conformity indices by 34% and 54%, respectively, for proton beam treatment, but changed little during photon treatment. In addition, we found that the equivalent uniform dose (EUD) and homogeneity index show similar characteristics during target movement. These results suggest that movement-induced dose reduction differs significantly between photon and proton beam treatment. Attention should be paid to the target margin in proton beam treatment due to the distinct characteristics of heavy ion beams.

  14. PWR Facility Dose Modeling Using MCNP5 and the CADIS/ADVANTG Variance-Reduction Methodology

    SciTech Connect

    Blakeman, Edward D; Peplow, Douglas E.; Wagner, John C; Murphy, Brian D; Mueller, Don

    2007-09-01

    The feasibility of modeling a pressurized-water-reactor (PWR) facility and calculating dose rates at all locations within the containment and adjoining structures using MCNP5 with mesh tallies is presented. Calculations of dose rates resulting from neutron and photon sources from the reactor (operating and shut down for various periods) and the spent fuel pool, as well as for the photon source from the primary coolant loop, were all of interest. Identification of the PWR facility, development of the MCNP-based model and automation of the run process, calculation of the various sources, and development of methods for visually examining mesh tally files and extracting dose rates were all a significant part of the project. Advanced variance reduction, which was required because of the size of the model and the large amount of shielding, was performed via the CADIS/ADVANTG approach. This methodology uses an automatically generated three-dimensional discrete ordinates model to calculate adjoint fluxes from which MCNP weight windows and source bias parameters are generated. Investigative calculations were performed using a simple block model and a simplified full-scale model of the PWR containment, in which the adjoint source was placed in various regions. In general, it was shown that placement of the adjoint source on the periphery of the model provided adequate results for regions reasonably close to the source (e.g., within the containment structure for the reactor source). A modification to the CADIS/ADVANTG methodology was also studied in which a global adjoint source is weighted by the reciprocal of the dose response calculated by an earlier forward discrete ordinates calculation. This method showed improved results over those using the standard CADIS/ADVANTG approach, and its further investigation is recommended for future efforts.

  15. Preliminary validation of a new methodology for estimating dose reduction protocols in neonatal chest computed radiographs

    NASA Astrophysics Data System (ADS)

    Don, Steven; Whiting, Bruce R.; Hildebolt, Charles F.; Sehnert, W. James; Ellinwood, Jacquelyn S.; Töpfer, Karin; Masoumzadeh, Parinaz; Kraus, Richard A.; Kronemer, Keith A.; Herman, Thomas; McAlister, William H.

    2006-03-01

    The risk of radiation exposure is greatest for pediatric patients and, thus, there is a great incentive to reduce the radiation dose used in diagnostic procedures for children to "as low as reasonably achievable" (ALARA). Testing of low-dose protocols presents a dilemma, as it is unethical to repeatedly expose patients to ionizing radiation in order to determine optimum protocols. To overcome this problem, we have developed a computed-radiography (CR) dose-reduction simulation tool that takes existing images and adds synthetic noise to create realistic images that correspond to images generated with lower doses. The objective of our study was to determine the extent to which simulated, low-dose images corresponded with original (non-simulated) low-dose images. To make this determination, we created pneumothoraces of known volumes in five neonate cadavers and obtained images of the neonates at 10 mR, 1 mR and 0.1 mR (as measured at the cassette plate). The 10-mR exposures were considered "relatively-noise-free" images. We used these 10 mR-images and our simulation tool to create simulated 0.1- and 1-mR images. For the simulated and original images, we identified regions of interest (ROI) of the entire chest, free-in-air region, and liver. We compared the means and standard deviations of the ROI grey-scale values of the simulated and original images with paired t tests. We also had observers rate simulated and original images for image quality and for the presence or absence of pneumothoraces. There was no statistically significant difference in grey-scale-value means nor standard deviations between simulated and original entire chest ROI regions. The observer performance suggests that an exposure >=0.2 mR is required to detect the presence or absence of pneumothoraces. These preliminary results indicate that the use of the simulation tool is promising for achieving ALARA exposures in children.

  16. Relationship between radiation dose reduction and image quality change in photostimulable phosphor luminescence X-ray imaging systems

    PubMed Central

    Sakurai, T; Kawamata, R; Kozai, Y; Kaku, Y; Nakamura, K; Saito, M; Wakao, H; Kashima, I

    2010-01-01

    Objectives The aim of the study was to clarify the change in image quality upon X-ray dose reduction and to re-analyse the possibility of X-ray dose reduction in photostimulable phosphor luminescence (PSPL) X-ray imaging systems. In addition, the study attempted to verify the usefulness of multiobjective frequency processing (MFP) and flexible noise control (FNC) for X-ray dose reduction. Methods Three PSPL X-ray imaging systems were used in this study. Modulation transfer function (MTF), noise equivalent number of quanta (NEQ) and detective quantum efficiency (DQE) were evaluated to compare the basic physical performance of each system. Subjective visual evaluation of diagnostic ability for normal anatomical structures was performed. The NEQ, DQE and diagnostic ability were evaluated at base X-ray dose, and 1/3, 1/10 and 1/20 of the base X-ray dose. Results The MTF of the systems did not differ significantly. The NEQ and DQE did not necessarily depend on the pixel size of the system. The images from all three systems had a higher diagnostic utility compared with conventional film images at the base and 1/3 X-ray doses. The subjective image quality was better at the base X-ray dose than at 1/3 of the base dose in all systems. The MFP and FNC-processed images had a higher diagnostic utility than the images without MFP and FNC. Conclusions The use of PSPL imaging systems may allow a reduction in the X-ray dose to one-third of that required for conventional film. It is suggested that MFP and FNC are useful for radiation dose reduction. PMID:20395461

  17. Assessment of patient dose reduction by bismuth shielding in CT using measurements, GEANT4 and MCNPX simulations.

    PubMed

    Mendes, M; Costa, F; Figueira, C; Madeira, P; Teles, P; Vaz, P

    2015-07-01

    This work reports on the use of two different Monte Carlo codes (GEANT4 and MCNPX) for assessing the dose reduction using bismuth shields in computer tomography (CT) procedures in order to protect radiosensitive organs such as eye lens, thyroid and breast. Measurements were performed using head and body PMMA phantoms and an ionisation chamber placed in five different positions of the phantom. Simulations were performed to estimate Computed Tomography Dose Index values using GEANT4 and MCNPX. The relative differences between measurements and simulations were <10 %. The dose reduction arising from the use of bismuth shielding ranges from 2 to 45 %, depending on the position of the bismuth shield. The percentage of dose reduction was more significant for the area covered by the bismuth shielding (36 % for eye lens, 39 % for thyroid and 45 % for breast shields).

  18. Aqueous and methanolic extracts of Caulerpa mexicana suppress cell migration and ear edema induced by inflammatory agents.

    PubMed

    Bitencourt, Mariana Angelica Oliveira; Dantas, Gracielle Rodrigues; Lira, Daysianne Pereira; Barbosa-Filho, Jose Maria; de Miranda, George Emmanuel Cavalcanti; Santos, Barbara Viviana de Oliveira; Souto, Janeusa Trindade

    2011-01-01

    The regulation of the inflammatory response is essential to maintaining homeostasis. Several studies have investigated new drugs that may contribute to avoiding or minimizing excessive inflammatory process. The aim of this study was to evaluate the effect of extracts of green algae Caulerpa mexicana on models inflammation. In mice, the inflammatory peritonitis model is induced by zymosan. Previous treatment of mice with aqueous and methanolic extracts of C. mexicana was able to suppress the cell migration to the peritoneal cavity, in a time-dependent but not in a dose-dependent manner. The treatment of mice with C. mexicana extracts also decreased the xylene-induced ear edema, exerting strong inhibitory leukocyte migration elicited by zymosan into the air pouch. We concluded that administration of the extracts resulted in a reduction of cell migration to different sites as well as a decrease in edema formation induced by chemical irritants. This study demonstrates for the first time the anti-inflammatory effect of aqueous and methanolic extracts from the green marine algae Caulerpa mexicana.

  19. Dose reduction assessment in dynamic CT myocardial perfusion imaging in a porcine balloon-induced-ischemia model

    NASA Astrophysics Data System (ADS)

    Fahmi, Rachid; Eck, Brendan L.; Vembar, Mani; Bezerra, Hiram G.; Wilson, David L.

    2014-03-01

    We investigated the use of an advanced hybrid iterative reconstruction (IR) technique (iDose4, Philips Health- care) for low dose dynamic myocardial CT perfusion (CTP) imaging. A porcine model was created to mimic coronary stenosis through partial occlusion of the left anterior descending (LAD) artery with a balloon catheter. The severity of LAD occlusion was adjusted with FFR measurements. Dynamic CT images were acquired at end-systole (45% R-R) using a multi-detector CT (MDCT) scanner. Various corrections were applied to the acquired scans to reduce motion and imaging artifacts. Absolute myocardial blood flow (MBF) was computed with a deconvolution-based approach using singular value decomposition (SVD). We compared a high and a low dose radiation protocol corresponding to two different tube-voltage/tube-current combinations (80kV p/100mAs and 120kV p/150mAs). The corresponding radiation doses for these protocols are 7.8mSv and 34.3mSV , respectively. The images were reconstructed using conventional FBP and three noise-reduction strengths of the IR method, iDose. Flow contrast-to-noise ratio, CNRf, as obtained from MBF maps, was used to quantitatively evaluate the effect of reconstruction on contrast between normal and ischemic myocardial tissue. Preliminary results showed that the use of iDose to reconstruct low dose images provide better or comparable CNRf to that of high dose images reconstructed with FBP, suggesting significant dose savings. CNRf was improved with the three used levels of iDose compared to FBP for both protocols. When using the entire 4D dynamic sequence for MBF computation, a 77% dose reduction was achieved, while considering only half the scans (i.e., every other heart cycle) allowed even further dose reduction while maintaining relatively higher CNRf.

  20. Radiation dose reduction in computed tomography (CT) using a new implementation of wavelet denoising in low tube current acquisitions

    NASA Astrophysics Data System (ADS)

    Tao, Yinghua; Brunner, Stephen; Tang, Jie; Speidel, Michael; Rowley, Howard; VanLysel, Michael; Chen, Guang-Hong

    2011-03-01

    Radiation dose reduction remains at the forefront of research in computed tomography. X-ray tube parameters such as tube current can be lowered to reduce dose; however, images become prohibitively noisy when the tube current is too low. Wavelet denoising is one of many noise reduction techniques. However, traditional wavelet techniques have the tendency to create an artificial noise texture, due to the nonuniform denoising across the image, which is undesirable from a diagnostic perspective. This work presents a new implementation of wavelet denoising that is able to achieve noise reduction, while still preserving spatial resolution. Further, the proposed method has the potential to improve those unnatural noise textures. The technique was tested on both phantom and animal datasets (Catphan phantom and timeresolved swine heart scan) acquired on a GE Discovery VCT scanner. A number of tube currents were used to investigate the potential for dose reduction.

  1. Radiation Dose Reduction during Radial Cardiac Catheterization: Evaluation of a Dedicated Radial Angiography Absorption Shielding Drape.

    PubMed

    Ertel, Andrew; Nadelson, Jeffrey; Shroff, Adhir R; Sweis, Ranya; Ferrera, Dean; Vidovich, Mladen I

    2012-01-01

    Objectives. Radiation scatter protection shield drapes have been designed with the goal of decreasing radiation dose to the operators during transfemoral catheterization. We sought to investigate the impact on operator radiation exposure of various shielding drapes specifically designed for the radial approach. Background. Radial access for cardiac catheterization has increased due to improved patient comfort and decreased bleeding complications. There are concerns for increased radiation exposure to patients and operators. Methods. Radiation doses to a simulated operator were measured with a RadCal Dosimeter in the cardiac catheterization laboratory. The mock patient was a 97.5 kg fission product phantom. Three lead-free drape designs were studied. The drapes were placed just proximal to the right wrist and extended medially to phantom's trunk. Simulated diagnostic coronary angiography included 6 minutes of fluoroscopy time and 32 seconds of cineangiography time at 4 standard angulated views (8 s each), both 15 frames/s. ANOVA with Bonferroni correction was used for statistical analysis. Results. All drape designs led to substantial reductions in operator radiation exposure compared to control (P < 0.0001). The greatest decrease in radiation exposure (72%) was with the L-shaped design. Conclusions. Dedicated radial shielding drapes decrease radiation exposure to the operator by up to 72% during simulated cardiac catheterization.

  2. Influence of scatter reduction method and monochromatic beams on image quality and dose in mammography.

    PubMed

    Moeckli, Raphaël; Verdun, Francis R; Fiedler, Stefan; Pachoud, Marc; Bulling, Shelley; Schnyder, Pierre; Valley, Jean-François

    2003-12-01

    In mammography, the image contrast and dose delivered to the patient are determined by the x-ray spectrum and the scatter to primary ratio S/P. Thus the quality of the mammographic procedure is highly dependent on the choice of anode and filter material and on the method used to reduce the amount of scattered radiation reaching the detector. Synchrotron radiation is a useful tool to study the effect of beam energy on the optimization of the mammographic process because it delivers a high flux of monochromatic photons. Moreover, because the beam is naturally flat collimated in one direction, a slot can be used instead of a grid for scatter reduction. We have measured the ratio S/P and the transmission factors for grids and slots for monoenergetic synchrotron radiation. In this way the effect of beam energy and scatter rejection method were separated, and their respective importance for image quality and dose analyzed. Our results show that conventional mammographic spectra are not far from optimum and that the use of a slot instead of a grid has an important effect on the optimization of the mammographic process. We propose a simple numerical model to quantify this effect.

  3. Stimulant Reduction Intervention using Dosed Exercise (STRIDE) - CTN 0037: Study protocol for a randomized controlled trial

    PubMed Central

    2011-01-01

    Background There is a need for novel approaches to the treatment of stimulant abuse and dependence. Clinical data examining the use of exercise as a treatment for the abuse of nicotine, alcohol, and other substances suggest that exercise may be a beneficial treatment for stimulant abuse, with direct effects on decreased use and craving. In addition, exercise has the potential to improve other health domains that may be adversely affected by stimulant use or its treatment, such as sleep disturbance, cognitive function, mood, weight gain, quality of life, and anhedonia, since it has been shown to improve many of these domains in a number of other clinical disorders. Furthermore, neurobiological evidence provides plausible mechanisms by which exercise could positively affect treatment outcomes. The current manuscript presents the rationale, design considerations, and study design of the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN) CTN-0037 Stimulant Reduction Intervention using Dosed Exercise (STRIDE) study. Methods/Design STRIDE is a multisite randomized clinical trial that compares exercise to health education as potential treatments for stimulant abuse or dependence. This study will evaluate individuals diagnosed with stimulant abuse or dependence who are receiving treatment in a residential setting. Three hundred and thirty eligible and interested participants who provide informed consent will be randomized to one of two treatment arms: Vigorous Intensity High Dose Exercise Augmentation (DEI) or Health Education Intervention Augmentation (HEI). Both groups will receive TAU (i.e., usual care). The treatment arms are structured such that the quantity of visits is similar to allow for equivalent contact between groups. In both arms, participants will begin with supervised sessions 3 times per week during the 12-week acute phase of the study. Supervised sessions will be conducted as one-on-one (i.e., individual) sessions, although other

  4. New noise reduction method for reducing CT scan dose: Combining Wiener filtering and edge detection algorithm

    NASA Astrophysics Data System (ADS)

    Anam, Choirul; Haryanto, Freddy; Widita, Rena; Arif, Idam

    2015-09-01

    New noise reduction method for reducing dose of CT scans has been proposed. The new method is expected to address the major problems in the noise reduction algorithm, i.e. the decreasing in the spatial resolution of the image. The proposed method was developed by combining adaptive Wiener filtering and edge detection algorithms. The first step, the image was filtered with a Wiener filter. Separately, edge detection operation performed on the original image using the Prewitt method. The next step, a new image was generated based on the edge detection operation. At the edge area, the image was taken from the original image, while at the non-edge area, the image was taken from the image that had been filtered with a Wiener filter. The new method was tested on a CT image of the spatial resolution phantom, which was scanned by different current-time multiplication, namely 80, 130 and 200 mAs, while other exposure factors were kept in constant conditions. The spatial resolution phantom consists of six sets of bar pattern made of plexi-glass and separated at some distance by water. The new image quality assessed from the amount of noise and the magnitude of spatial resolution. Noise was calculated by determining the standard deviation of the homogeneous regions, while the spatial resolution was assessed by observation of the area sets of the bar pattern. In addition, to evaluate the performance of this new method has also been tested on patient CT images. From the measurements, the new method can reduce the noise to an average 64.85%, with a spatial resolution does not decrease significantly. Visually, the third set bar on the image phantom (the distance between the bar 1.0 mm) can still be distinguished, as well as on the original image. Meanwhile, if the image is only processed using Wiener filter, the second set bar (the distance between the bar 1.3 mm) are distinguishable. Testing this new method to patient image, its results in relatively the same. Thus, using this

  5. Projection space denoising with bilateral filtering and CT noise modeling for dose reduction in CT

    SciTech Connect

    Manduca, Armando; Yu Lifeng; Trzasko, Joshua D.; Khaylova, Natalia; Kofler, James M.; McCollough, Cynthia M.; Fletcher, Joel G.

    2009-11-15

    -off than a series of commercial reconstruction kernels. This improvement in noise-resolution properties can be used for improving image quality in CT and can be translated into substantial dose reduction.

  6. Moving back: The radiation dose received from lumbar spine quantitative fluoroscopy compared to lumbar spine radiographs with suggestions for dose reduction

    PubMed Central

    Mellor, F.E.; Thomas, P.; Breen, A.

    2014-01-01

    Purpose Quantitative fluoroscopy is an emerging technology for assessing continuous inter-vertebral motion in the lumbar spine, but information on radiation dose is not yet available. The purposes of this study were to compare the radiation dose from quantitative fluoroscopy of the lumbar spine with lumbar spine radiographs, and identify opportunities for dose reduction in quantitative fluoroscopy. Methods Internationally reported dose area product (DAP) and effective dose data for lumbar spine radiographs were compared with the same for quantitative fluoroscopy and with data from a local hospital for functional radiographs (weight bearing AP, lateral, and/or flexion and extension) (n = 27). The effects of procedure time, age, weight, height and body mass index on the fluoroscopy dose were determined by multiple linear regression using SPSS v19 software (IBM Corp., Armonck, NY, USA). Results and conclusion The effective dose (and therefore the estimated risk) for quantitative fluoroscopy is 0.561 mSv which is lower than in most published data for lumbar spine radiography. The dose area product (DAP) for sagittal (flexion + extension) quantitative fluoroscopy is 3.94 Gy cm2 which is lower than local data for two view (flexion and extension) functional radiographs (4.25 Gy cm2), and combined coronal and sagittal dose from quantitative fluoroscopy (6.13 Gy cm2) is lower than for four view functional radiography (7.34 Gy cm2). Conversely DAP for coronal and sagittal quantitative fluoroscopy combined (6.13 Gy cm2) is higher than that published for both lumbar AP or lateral radiographs, with the exception of Nordic countries combined data. Weight, procedure time and age were independently positively associated with total dose, and height (after adjusting for weight) was negatively associated, thus as height increased, the DAP decreased. PMID:26512196

  7. SU-C-12A-07: Effect of Vertical Position On Dose Reduction Using X-Care

    SciTech Connect

    Silosky, M; Marsh, R

    2014-06-01

    Purpose: Reduction of absorbed dose to radiosensitive tissues is an important goal in diagnostic radiology. Siemens Medical has introduced a technique (X-CARE) to lower CT dose to anterior anatomy by reducing the tube current during 80° of rotation over radiosensitive tissues. Phantom studies have shown 30-40% dose reduction when phantoms are positioned at isocenter. However, for CT face and sinus exams, the center of the head is commonly positioned below isocenter. This work investigated the effects of vertical patient positioning on dose reduction using X-CARE. Methods: A 16cm Computed Tomography Dose Index phantom was scanned on a Siemens Definition Flash CT scanner using a routine head protocol, with the phantom positioned at scanner isocenter. Optically stimulated luminescent dosimeters were placed on the anterior and posterior sides of the phantom. The phantom was lowered in increments of 2cm and rescanned, up to 8cm below isocenter. The experiment was then repeated using the same scan parameters but adding the X-CARE technique. The mean dosimeter counts were determined for each phantom position, and the difference between XCARE and routine scans was plotted as a function of distance from isocenter. Results: With the phantom positioned at isocenter, using XCARE reduced dose to the anterior side of the phantom by 40%, compared to dose when X-CARE was not used. Positioned below isocenter, anterior dose was reduced by only 20-27%. Additionally, using X-CARE at isocenter reduced dose to the anterior portion of the phantom by 45.6% compared to scans performed without X-CARE 8cm below isocenter. Conclusion: While using X-CARE substantially reduced dose to the anterior side of the phantom, this effect was diminished when the phantom was positioned below isocenter, simulating common practice for face and sinus scans. This indicates that centering the head in the gantry will maximize the effect of X-CARE.

  8. 28-day intraocular pressure reduction with a single dose of brimonidine tartrate-loaded microspheres.

    PubMed

    Fedorchak, Morgan V; Conner, Ian P; Medina, Carlos A; Wingard, Jeremy B; Schuman, Joel S; Little, Steven R

    2014-08-01

    Treatment of glaucoma by intraocular pressure (IOP) reduction is typically accomplished through the administration of eye drops, the difficult and frequent nature of which contributes to extremely low adherence rates. Poor adherence to topical treatment regimens in glaucoma patients can lead to irreversible vision loss and increased treatment costs. Currently there are no approved treatments for glaucoma that address the inherent inefficiencies in drug delivery and patient adherence. Brimonidine tartrate (BT), a common glaucoma medication, requires dosing every 8-12 h, with up to 97% of patients not taking it as prescribed. This study provides proof-of-principle testing of a controlled release BT formulation. BT was encapsulated in poly(lactic-co-glycolic) acid microspheres and drug release was quantified using UV-Vis spectroscopy. For in vivo studies, rabbits were randomized to receive a single subconjunctival injection of blank (no drug) or BT-loaded microspheres or twice daily topical 0.2% BT drops. The microspheres released an average of 2.1 ± 0.37 μg BT/mg microspheres/day in vitro. In vivo, the percent decrease in IOP from baseline was significantly greater in the treated eye for both topical drug and drug-loaded microspheres versus blank microspheres throughout the 4-week study, with no evidence of migration or foreign body response. IOP measurements in the contralateral, untreated eyes also suggested a highly localized effect from the experimental treatment. A treatment designed using the release systems described in this study would represent a vast improvement over the current clinical standard of 56-84 topical doses over 28 days.

  9. Diuretics enhance effects of increased dose of candesartan on ambulatory blood pressure reduction in Japanese patients with uncontrolled hypertension treated with medium-dose angiotensin II receptor blockers.

    PubMed

    Sakima, Atsushi; Kita, Toshihiro; Nakada, Seigo; Yokota, Naoto; Tamaki, Noboru; Etoh, Takuma; Shimokubo, Toru; Kitamura, Kazuo; Takishita, Shuichi; Ohya, Yusuke

    2014-01-01

    Abstract Although blockade of the renin-angiotensin system by increasing the dose of angiotensin II receptor blockers (ARBs) is recommended to achieve clinical benefits in terms of blood pressure (BP) control and cardiovascular and renal outcomes, the effect of this increased dose on ambulatory BP monitoring has not been evaluated completely in Japanese patients with uncontrolled hypertension undergoing medium-dose ARB therapy. The primary objective of this study was to examine the effect of the relatively high dose of the ARB candesartan (12 mg/day) on 24-h systolic BP and the attainment of target BP levels in uncontrolled hypertension treated with a medium dose of ARBs. A total of 146 hypertensive patients (age: 69.9 ± 9.3 years; females: 65.8%) completed the study. After switching to candesartan at 12 mg/day, all these BP measurements decreased significantly (p<0.001). Attainment of the target office BP (p=0.0014) and 24-h BP levels (p=0.0296) also improved significantly. Subgroup analysis indicated that the reduction of 24-h systolic BP was larger in patients treated with diuretics than those without (p=0.0206). Multivariate analysis revealed a significant correlation between the combined ARB and diuretic therapy, and the change in 24-h systolic BP irrespective of preceding ARBs. In conclusion, the switching therapy to increased dose of candesartan caused significant reductions in office and ambulatory BP levels, and improved the attainment of target BP levels in patients with uncontrolled hypertension treated with a medium dose of ARBs. Combination with diuretics enhanced this effect.

  10. Dose reduction using prior image constrained compressed sensing (DR-PICCS)

    NASA Astrophysics Data System (ADS)

    Tang, Jie; Thériault Lauzier, Pascal; Chen, Guang-Hong

    2011-03-01

    A technique for dose reduction using prior image constrained compressed sensing (DR-PICCS) in computed tomography (CT) is proposed in this work. In DR-PICCS, a standard FBP reconstructed image is forward projected to get a fully sampled projection data set. Meanwhile, it is low-pass filtered and used as the prior image in the PICCS reconstruction framework. Next, the prior image and the forward projection data are used together by the PICCS algorithm to obtain a low noise DR-PICCS reconstruction, which maintains the spatial resolution of the original FBP images. The spatial resolution of DR-PICCS was studied using a Catphan phantom by MTF measurement. The noise reduction factor, CT number change and noise texture were studied using human subject data consisting of 20 CT colonography exams performed under an IRB-approved protocol. In each human subject study, six ROIs (two soft tissue, two colonic air columns, and two subcutaneous fat) were selected for the CT number and noise measurements study. Skewness and kurtosis were used as figures of merit to indicate the noise texture. A Bland-Altman analysis was performed to study the accuracy of the CT number. The results showed that, compared with FBP reconstructions, the MTF curve shows very little change in DR-PICCS reconstructions, spatial resolution loss is less than 0.1 lp/cm, and the noise standard deviation can be reduced by a factor of 3 with DR-PICCS. The CT numbers in FBP and DR-PICCS reconstructions agree well, which indicates that DR-PICCS does not change CT numbers. The noise textures indicators measured from DR-PICCS images are in a similar range as FBP images.

  11. Study of the radiation dose reduction capability of a CT reconstruction algorithm: LCD performance assessment using mathematical model observers

    NASA Astrophysics Data System (ADS)

    Fan, Jiahua; Tseng, Hsin-Wu; Kupinski, Matthew; Cao, Guangzhi; Sainath, Paavana; Hsieh, Jiang

    2013-03-01

    Radiation dose on patient has become a major concern today for Computed Tomography (CT) imaging in clinical practice. Various hardware and algorithm solutions have been designed to reduce dose. Among them, iterative reconstruction (IR) has been widely expected to be an effective dose reduction approach for CT. However, there is no clear understanding on the exact amount of dose saving an IR approach can offer for various clinical applications. We know that quantitative image quality assessment should be task-based. This work applied mathematical model observers to study detectability performance of CT scan data reconstructed using an advanced IR approach as well as the conventional filtered back-projection (FBP) approach. The purpose of this work is to establish a practical and robust approach for CT IR detectability image quality evaluation and to assess the dose saving capability of the IR method under study. Low contrast (LC) objects imbedded in head size and body size phantoms were imaged multiple times with different dose levels. Independent signal present and absent pairs were generated for model observer study training and testing. Receiver Operating Characteristic (ROC) curves for location known exact and location ROC (LROC) curves for location unknown as well as their corresponding the area under the curve (AUC) values were calculated. Results showed approximately 3 times dose reduction has been achieved using the IR method under study.

  12. Patients with Fabry Disease after Enzyme Replacement Therapy Dose Reduction and Switch-2-Year Follow-Up.

    PubMed

    Lenders, Malte; Canaan-Kühl, Sima; Krämer, Johannes; Duning, Thomas; Reiermann, Stefanie; Sommer, Claudia; Stypmann, Jörg; Blaschke, Daniela; Üçeyler, Nurcan; Hense, Hans-Werner; Brand, Stefan-Martin; Wanner, Christoph; Weidemann, Frank; Brand, Eva

    2016-03-01

    Because of the shortage of agalsidase-β supply between 2009 and 2012, patients with Fabry disease either were treated with reduced doses or were switched to agalsidase-α. In this observational study, we assessed end organ damage and clinical symptoms with special focus on renal outcome after 2 years of dose-reduction and/or switch to agalsidase-α. A total of 89 adult patients with Fabry disease who had received agalsidase-β (1.0 mg/kg body wt) for >1 year were nonrandomly assigned to continue this treatment regimen (regular-dose group, n=24), to receive a reduced dose of 0.3-0.5 mg/kg and a subsequent switch to 0.2 mg/kg agalsidase-α (dose-reduction-switch group, n=28), or to directly switch to 0.2 mg/kg agalsidase-α (switch group, n=37) and were followed-up for 2 years. We assessed clinical events (death, myocardial infarction, severe arrhythmia, stroke, progression to ESRD), changes in cardiac and renal function, Fabry-related symptoms (pain, hypohidrosis, diarrhea), and disease severity scores. Determination of renal function by creatinine and cystatin C-based eGFR revealed decreasing eGFRs in the dose-reduction-switch group and the switch group. The Mainz Severity Score Index increased significantly in these two groups (P=0.02 and P<0.001, respectively), and higher frequencies of gastrointestinal pain occurred during follow-up. In conclusion, after 2 years of observation, all groups showed a stable clinical disease course with respect to serious clinical events. However, patients under agalsidase-β dose-reduction and switch or a direct switch to agalsidase-α showed a decline of renal function independent of the eGFR formula used.

  13. Sex differences in nicotine self-administration in rats during progressive unit dose reduction: Implications for nicotine regulation policy

    PubMed Central

    Grebenstein, Patricia; Burroughs, Danielle; Zhang, Yan; LeSage, Mark G.

    2013-01-01

    Reducing the nicotine content in tobacco products is being considered by the FDA as a policy to reduce the addictiveness of tobacco products. Understanding individual differences in response to nicotine reduction will be critical to developing safe and effective policy. Animal and human research demonstrating sex differences in the reinforcing effects of nicotine suggests that males and females may respond differently to nicotine-reduction policies. However, no studies have directly examined sex differences in the effects of nicotine unit-dose reduction on nicotine self-administration (NSA) in animals. The purpose of the present study was to examine this issue in a rodent self-administration model. Male and female rats were trained to self-administer nicotine (0.06 mg/kg) under an FR 3 schedule during daily 23 h sessions. Rats were then exposed to saline extinction and reacquisition of NSA, followed by weekly reductions in the unit dose (0.03 to 0.00025 mg/kg) until extinction levels of responding were achieved. Males and females were compared with respect to baseline levels of intake, resistance to extinction, degree of compensatory increases in responding during dose reduction, and the threshold reinforcing unit dose of nicotine. Exponential demand-curve analysis was also conducted to compare the sensitivity of males and females to increases in the unit price (FR/unit dose) of nicotine (i.e., elasticity of demand or reinforcing efficacy). Females exhibited significantly higher baseline intake and less compensation than males. However, there were no sex differences in the reinforcement threshold or elasticity of demand. Dose–response relationships were very well described by the exponential demand function (r2 values > 0.96 for individual subjects). These findings suggest that females may exhibit less compensatory smoking in response to nicotine reduction policies, even though their nicotine reinforcement threshold and elasticity of demand may not differ from

  14. A method for patient dose reduction in dynamic contrast enhanced CT study

    SciTech Connect

    Mo Kim, Sun; Haider, Masoom A.; Milosevic, Michael; Jaffray, David A.; Yeung, Ivan W. T.

    2011-09-15

    Purpose: In dynamic contrast enhanced CT (DCE-CT) study, prolonged CT scanning with high temporal resolution is required to give accurate and precise estimates of kinetic parameters. However, such scanning protocol could lead to substantial radiation dose to the patient. A novel method is proposed to reduce radiation dose to patient, while maintaining high accuracy for kinetic parameter estimates in DCE-CT study. Methods: The method is based on a previous investigation that the arterial impulse response (AIR) in DCE-CT study can be predicted using a population-based scheme. In the proposed method, DCE-CT scanning is performed with relatively low temporal resolution, hence, giving rise to reduction in patient dose. A novel method is proposed to estimate the arterial input function (AIF) based on the coarsely sampled AIF. By using the estimated AIF in the tracer kinetic analysis of the coarsely sampled DCE-CT study, the calculated kinetic parameters are able to achieve a high degree of accuracy. The method was tested on a DCE-CT data set of 48 patients with cervical cancer scanned at high temporal resolution. A random cohort of 34 patients was chosen to construct the orthonormal bases of the AIRs via singular value decomposition method. The determined set of orthonormal bases was used to fit the AIFs in the second cohort (14 patients) at varying levels of down sampling. For each dataset in the second cohort, the estimated AIF was used for kinetic analyses of the modified Tofts and adiabatic tissue homogeneity models for each of the down-sampling schemes between intervals from 2 to 15 s. The results were compared with analyses done with the ''raw'' down-sampled AIF. Results: In the first group of 34 patients, there were 11 orthonormal bases identified to describe the AIRs. The AIFs in the second group were estimated in high accuracy based on the 11 orthonormal bases established in the first group along with down-sampled AIFs. Using the 11 orthonormal bases, the

  15. Effects of shielding the radiosensitive superficial organs of ORNL pediatric phantoms on dose reduction in computed tomography

    PubMed Central

    Akhlaghi, Parisa; Miri-Hakimabad, Hashem; Rafat-Motavalli, Laleh

    2014-01-01

    In computed tomography (CT), some superficial organs which have increased sensitivity to radiation, receive doses that are significant enough to be matter of concern. Therefore, in this study, the effects of using shields on the amount of dose reduction and image quality was investigated for pediatric imaging. Absorbed doses of breasts, eyes, thyroid and testes of a series of pediatric phantoms without and with different thickness of bismuth and lead were calculated by Monte Carlo simulation. Appropriate thicknesses of shields were chosen based on their weights, X-ray spectrum, and the amount of dose reduction. In addition, the effect of lead shield on image quality of a simple phantom was assessed quantitatively using region of interest (ROI) measurements. Considering the maximum reduction in absorbed doses and X-ray spectrum, using a lead shield with a maximum thickness of 0.4 mm would be appropriate for testes and thyroid and two other organs (which are exposed directly) should be protected with thinner shields. Moreover, the image quality assessment showed that lead was associated with significant increases in both noise and CT attenuation values, especially in the anterior of the phantom. Overall, the results suggested that shielding is a useful optimization tool in CT. PMID:25525312

  16. Exposure reductions encouraged by the determination of the effective dose equivalent for non-uniform exposures

    SciTech Connect

    Matheny, M.D.; Brown, C.G.; Dyer, S.G.

    1994-08-01

    DOE Order 5480.11 requires calculation of the effective dose equivalent (EDE) due to non-uniform radiation fields using ICRP-26 weighting factors. To comply with this requirement, Westinghouse Savannah River Company (WSRC) developed a simple dose calculation scheme based on a draft report by the External Dosimetry Working Group of the Health Physics Society Standards Committee. The calculations involved are fairly simple and provide a conservative dose estimate. The resulting EDE estimate provides a much better representation of the risk to the monitored individual than the more prevalent practice of assigning the highest measured dose. Details of the dose assessment methodology are included as an attachment.

  17. Skin and gonadal dose reduction during hip radiography of the bull.

    PubMed

    Wood, A K; Blockey, B; Reynolds, K M; Leith, I S; Burns, P A

    1979-10-01

    Radiology is being used to an increasing extent in the clinical diagnosis of hip lameness in bulls. Consequent gonadal doses may have important implications in later breeding programmes. Skin and gonadal doses were recorded during hip radiography of 18 bulls. An additional 0.13 mm copper filtration reduced skin dose by more than one third, but had no effect on gonadal dose. The average radiation dose to the gonads was approximately halved by completely surrounding the scrotum with lead sheeting 0.95 mm in thickness.

  18. The effect of dose reduction and feasibility of edge-preserving noise reduction on the detection of liver lesions using MSCT.

    PubMed

    Wessling, Johannes; Esseling, Rainer; Raupach, Rainer; Fockenberg, Stefanie; Osada, Nani; Gerss, Joachim; Heindel, Walter; Fischbach, Roman

    2007-07-01

    The purpose of this study was to assess the effect of dose reduction and the potential of noise reduction filters on image quality and the detection of liver lesions using MSCT. Twenty-nine patients with a total of 40 liver lesions underwent 16-slice CT (120 kV; 180 mAs). Virtual noise was added to CT raw datasets simulating effective mAs levels of 155, 130, 105, 80, 55, 30 and 10 mAs. All datasets were post-processed with an edge-preserving noise-reduction filter (ANR-3D), yielding a total of 15 datasets per patient. Ten radiologists performed independent evaluations of image quality, the presence of liver lesions and diagnostic confidence. Quantitative noise and contrast-to-noise ratios (CNR) were obtained. Superior image quality (P < 0.02), reduction of image noise (P < 0.001) and the increase of lesion-to-liver CNR (P < 0.001) were observed in images processed with the ANR-3D filter. Sensitivity for lesion detection remained unchanged down to 105 mAs (CTDI(w) 6.6 mGy) without filter and 80 mAs (CTDI(w) 5.1 mGy) with ANR-3D. Confidence was rated significantly higher for datasets reconstructed with ANR-3D. The use of a noise-reducing, but edge-preserving filter (ANR-3D) is a promising option to reduce further the radiation dose in liver CT.

  19. Yearly reduction of glucocorticoid dose by 50% as tapering schedule achieves complete remission for 124 pemphigus vulgaris patients.

    PubMed

    Wang, Mingyue; Gao, Yu; Peng, Yang; Zhao, Junyu; Chen, Xixue; Zhu, Xuejun

    2016-03-01

    Glucocorticoids are the first-line treatment for pemphigus vulgaris. Among 140 patients receiving systemic glucocorticoids, 124 patients achieved complete remission off or on a prednisone dose of ≤10 mg/day or less for 6 months or more. The mean average steroid controlling doses were 0.65, 0.62, 0.80, 1.08 and 1.38 mg/kg per day for the mucosal-dominant patients and the mild, moderate, severe and extensive cutaneous-involved patients, respectively (P < 0.001). The mean durations of the initial tapering after controlling doses started were 77.98, 48.78, 31.74 and 28.83 days when the disease was controlled with doses of 40 mg/day or less, 45-60 mg/day, 65-80 mg/day and more than 80 mg/day for the cutaneous-involved types, respectively (P < 0.005). Of the patients, 79.51% achieved complete remission within 3 years, 98.36% within 5 years and all within 6 years, which corresponded to a 50% yearly reduction of glucocorticoid dose. These successfully treated patients indicate that a severity-tailored initial dose of glucocorticoids, an initial tapering duration based on the initial dose and a subsequent 50% yearly tapering regimen may cure pemphigus vulgaris within 3-6 years.

  20. SU-E-I-37: Eye Lens Dose Reduction From CT Scan Using Organ Based Tube Current Modulation

    SciTech Connect

    Liu, H; Liu, T; Xu, X; Wu, J; Zhuo, W

    2015-06-15

    Purpose: To investigate the eye lens dose reduction by CT scan with organ based tube current modulation (OBTCM) using GPU Monte Carlo code ARCHER-CT. Methods: 36 X-ray sources and bowtie filters were placed around the patient head with the projection angle interval of 10° for one rotation of CT scan, each projection was simulated respectively. The voxel eye models with high resolution(0.1mm*0.1mm*0.1mm) were used in the simulation and different tube voltage including 80kVp, 100kVp, 120kVp and 140kVp were taken into consideration. Results: The radiation doses to the eye lens increased with the tube voltage raised from 80kVp to 140kVp, and the dose results from 0° (AP) direction are much higher than those from 180° (PA) direction for all the 4 different tube voltage investigated. This 360° projection dose characteristic enables organ based TCM, which can reduce the eye lens dose by more than 55%. Conclusion: As the eye lens belongs to superficial tissues, its radiation dose to external exposure like CT is direction sensitive, and this characteristic feature makes organ based TCM to be an effective way to reduce the eye lens dose, so more clinical use of this technique were recommended. National Nature Science Foundation of China(No.11475047)

  1. Dose reduction efforts for pediatric head CT imaging in Washington State trauma centers: follow-up survey results

    PubMed Central

    Kanal, Kalpana M.; Rivara, Frederick P.; Jarvik, Jeffrey G.; Vavilala, Monica S.

    2014-01-01

    Purpose To examine variation in pediatric trauma head CT imaging protocols in Washington State trauma centers (TCs) in 2012 and compare to a previous survey conducted in 2008/09. Methods A mixed-mode (online and paper) survey was sent to all adult and pediatric Washington State TCs (levels 1–5). Respondents provided information about the CT scanner used for pediatric head scans and technical information about pediatric dose reduction protocols. Mean head effective dose and organ dose for a female baby were estimated. Results were compared to previous data. Results Sixty-one of 76 TCs responded to the 2012 survey (response rate 80.3%; response rate in 2008/09 survey was 76%). In 2012, 91.7% reported having a dedicated pediatric protocol (87.7% in 2008/09). Protective shielding use ranged from 80 to 100% across both survey years. In 2012, 2.5 times more TCs provided sufficient information to conduct dose calculations than in 2008/09. Estimated mean CTDIvol was 23.1 mGy in 2012, compared to 34.8 mGy in 2008/09 (p=0.01). Estimated mean DLP was also significantly lower in 2012 than 2009/08 (307.6 mGy*cm vs. 430.1 mGy*cm, respectively; p=0.04). Wide variation in mean effective dose was observed for level 3 and 4 TCs in 2012, similar to variation observed in 2008/09 among level 4 TCs. Mean organ dose was significantly lower in 2012 for eye lens and brain, but higher for thyroid than 2008/09 (p<0.05). Conclusions While most Washington State TCs employ dose reduction protocols for pediatric head CTs, and some measures were lower in 2012, variation in protocols use and estimated dose continues to exist. More complete responses in 2012 suggest improved understanding of the importance of pediatric dose reduction efforts. Education and institutional protocols are necessary to reduce pediatric radiation dose from head CTs. PMID:24360905

  2. Full dose reduction potential of statistical iterative reconstruction for head CT protocols in a predominantly pediatric population

    PubMed Central

    Mirro, Amy E.; Brady, Samuel L.; Kaufman, Robert. A.

    2016-01-01

    Purpose To implement the maximum level of statistical iterative reconstruction that can be used to establish dose-reduced head CT protocols in a primarily pediatric population. Methods Select head examinations (brain, orbits, sinus, maxilla and temporal bones) were investigated. Dose-reduced head protocols using an adaptive statistical iterative reconstruction (ASiR) were compared for image quality with the original filtered back projection (FBP) reconstructed protocols in phantom using the following metrics: image noise frequency (change in perceived appearance of noise texture), image noise magnitude, contrast-to-noise ratio (CNR), and spatial resolution. Dose reduction estimates were based on computed tomography dose index (CTDIvol) values. Patient CTDIvol and image noise magnitude were assessed in 737 pre and post dose reduced examinations. Results Image noise texture was acceptable up to 60% ASiR for Soft reconstruction kernel (at both 100 and 120 kVp), and up to 40% ASiR for Standard reconstruction kernel. Implementation of 40% and 60% ASiR led to an average reduction in CTDIvol of 43% for brain, 41% for orbits, 30% maxilla, 43% for sinus, and 42% for temporal bone protocols for patients between 1 month and 26 years, while maintaining an average noise magnitude difference of 0.1% (range: −3% to 5%), improving CNR of low contrast soft tissue targets, and improving spatial resolution of high contrast bony anatomy, as compared to FBP. Conclusion The methodology in this study demonstrates a methodology for maximizing patient dose reduction and maintaining image quality using statistical iterative reconstruction for a primarily pediatric population undergoing head CT examination. PMID:27056425

  3. [Reduction of radiation dose to the worker in preparing the radiopharmaceutical solution by a simple shielding equipment].

    PubMed

    Miyazaki, Y; Inoue, H; Shiozaki, J; Higuchi, Y; Fujioka, M; Kawaguchi, K; Miyanaga, M; Aburano, T

    1987-01-01

    In order to reduce radiation dose to the hands of examiners who prepare and aspirate radiopharmaceuticals, we made a prototype of simplified manually-operated dispense system, which the syringe and the vial shield with lead were set in the small box made of lead and lead glass. The result showed that our dispense system allowed substantial reduction of radiation dose to the hands and rapid preparation of radiopharmaceuticals compared with the conventional lead shield syringe system, and allowed closer operation, smaller dead volume and lower cost compared with the conventional automatic system.

  4. Characterization of statistical prior image constrained compressed sensing (PICCS): II. Application to dose reduction

    SciTech Connect

    Lauzier, Pascal Theriault; Chen Guanghong

    2013-02-15

    Purpose: The ionizing radiation imparted to patients during computed tomography exams is raising concerns. This paper studies the performance of a scheme called dose reduction using prior image constrained compressed sensing (DR-PICCS). The purpose of this study is to characterize the effects of a statistical model of x-ray detection in the DR-PICCS framework and its impact on spatial resolution. Methods: Both numerical simulations with known ground truth and in vivo animal dataset were used in this study. In numerical simulations, a phantom was simulated with Poisson noise and with varying levels of eccentricity. Both the conventional filtered backprojection (FBP) and the PICCS algorithms were used to reconstruct images. In PICCS reconstructions, the prior image was generated using two different denoising methods: a simple Gaussian blur and a more advanced diffusion filter. Due to the lack of shift-invariance in nonlinear image reconstruction such as the one studied in this paper, the concept of local spatial resolution was used to study the sharpness of a reconstructed image. Specifically, a directional metric of image sharpness, the so-called pseudopoint spread function (pseudo-PSF), was employed to investigate local spatial resolution. Results: In the numerical studies, the pseudo-PSF was reduced from twice the voxel width in the prior image down to less than 1.1 times the voxel width in DR-PICCS reconstructions when the statistical model was not included. At the same noise level, when statistical weighting was used, the pseudo-PSF width in DR-PICCS reconstructed images varied between 1.5 and 0.75 times the voxel width depending on the direction along which it was measured. However, this anisotropy was largely eliminated when the prior image was generated using diffusion filtering; the pseudo-PSF width was reduced to below one voxel width in that case. In the in vivo study, a fourfold improvement in CNR was achieved while qualitatively maintaining sharpness

  5. Radiation dose reduction in invasive cardiology by restriction to adequate instead of optimized picture quality.

    PubMed

    Kuon, Eberhard; Dorn, Christian; Schmitt, Moritz; Dahm, Johannes B

    2003-05-01

    In this study, the cinegraphic image intensifier entrance dose level for coronary angiography was changed in four steps from dose level A (0.041 microGy frame(-1)), allowing high contrast, but coarse mottled background, to level D (0.164 microGy frame(-1)), affording high transparency and sharpness. Using this new approach throughout the course of 404 consecutive cardiac catheterizations, we reduced patient radiation exposures down to 11 to 16% of currently typical values: i.e., mean dose area products of 5.97 Gy cm2 (n = 91), 6.73 (n = 113), 8.11 (n = 91), and 8.90 (n = 109); cinegraphic dose area products of 2.34, 3.64, 4.56, and 5.49; and cinegraphic dose area products frame(-1) of 13.3, 19.8, 27.0, and 30.2 mGy cm2, for levels A, B, C, and D, respectively. The number of cinegraphic frames ranged within 168 to 182 per case. Our results show that during catheterization interventionalists should vary image intensifier entrance dose levels in accordance with documented structure, angulation, and body mass index. With the exception of cases with special requirements, lower dose levels typically guarantee an adequate image quality.

  6. Investigation into the effects of lead shielding for fetal dose reduction in CT pulmonary angiography.

    PubMed

    Kennedy, E V; Iball, G R; Brettle, D S

    2007-08-01

    This work aims to determine whether lead shielding can be used to decrease the radiation dose to the fetus during CT scans for the diagnosis of pulmonary embolism during early stage pregnancy. An anthropomorphic phantom was modified to contain a 15 cc ionization chamber at the site of the uterus to enable fetal dose to be measured. The effects of a range of scan parameters, positioning of lead and thicknesses of lead were investigated. Fetal dose was lower with lower values of kV(p) and mAs. An increasing thickness of lead decreased the radiation dose to the uterus, as did increasing the proportion of the patient covered by the lead shielding. Fetal dose increased exponentially as the edge of the scan volume moved closer to the point of measurement. In no experiment was the dose to the fetus increased by the presence of the lead. It was found that the fetal radiation dose from a CT scan following a pulmonary embolism protocol can be effectively reduced by the use of lead shielding.

  7. Effect of rare earth filtration on patient exposure, dose reduction, and image quality in oral panoramic radiology

    SciTech Connect

    Tyndall, D.A.; Washburn, D.B.

    1987-01-01

    Rare earth intensifying screen material (Gd2O2S:Tb) was added to the standard Al filtration of an oral panoramic x-ray unit, resulting in a beam capable of achieving reductions in patient dose without a loss of image quality. The added rare earth filtration technique resulted in patient dose reductions of 21-56%, depending on anatomic sites, when compared to the conventional Al filtration technique. Films generated from both techniques were measured densitometrically and evaluated by a panel of practicing clinicians. Diagnostically significant differences were minimal. The results indicate that use of rare earth filters in oral panoramic radiography is an effective means of reducing exposures of dental patients to ionizing radiation.

  8. Noise reduction with low dose CT data based on a modified ROF model.

    PubMed

    Zhu, Yining; Zhao, Mengliu; Zhao, Yunsong; Li, Hongwei; Zhang, Peng

    2012-07-30

    In order to reduce the radiation exposure caused by Computed Tomography (CT) scanning, low dose CT has gained much interest in research as well as in industry. One fundamental difficulty for low dose CT lies in its heavy noise pollution in the raw data which leads to quality deterioration for reconstructed images. In this paper, we propose a modified ROF model to denoise low dose CT measurement data in light of Poisson noise model. Experimental results indicate that the reconstructed CT images based on measurement data processed by our model are in better quality, compared to the original ROF model or bilateral filtering.

  9. Facial edema induced by isotretinoin use: a case and a review of the side effects of isotretinoin.

    PubMed

    Scheinfeld, Noah; Bangalore, Sripal

    2006-05-01

    Isotretinoin (13-cis-retinoic acid) is a retinoid that is used to treat cystic acne, comedonal acne, and other diseases. For the treatment of acne, isotretinoin is dosed at 0.5 to 2 mg/kg daily for 5 months with a target total dose of approximately 120 mg/kg. Its most common side effects are mucocutaneous and ocular in nature (ie, cheilitis, ocular sicca, and decreased dark adaptation). It can also cause xerosis. Patients should be made aware of these side effects before taking isotretinoin and also that utilization of moisturizers and eye drops can help to mitigate such side effects. Sometimes, however, the dose of isotretinoin needs to be decreased to reduce the induction of side effects. Isotretinoin's most significant side effect is the induction of birth defects if a fetus is exposed to isotretinoin, which is pregnancy category X. Isotretinoin should be used with 2 forms of birth control by fecund women. It can rarely increase serum levels of triglycerides, which can, if very elevated, be related to the development of pancreatitis and xanthomas. Isotretinoin's well-documented but rarer side effects include intracranial hypertension. It can induce bony changes. A review of the literature demonstrates that isotretinoin is not linked to depression and suicide. Facial swelling has been linked to isotretinoin use in 3 previous case reports. We note herein the first case of facial swelling that occurred in an acne patient being treated with isotretinoin who at the time the swelling developed had no cysts, comedones, pustules, or evidence of bacterial infection. Possible reasons for the patient's facial swelling include some type of retinoid induced angioedema, exacerbation of inflammation by isotretinoin, and isotretinoin induced capillary leak syndrome.

  10. Rapid Automated Treatment Planning Process to Select Breast Cancer Patients for Active Breathing Control to Achieve Cardiac Dose Reduction

    SciTech Connect

    Wang Wei; Purdie, Thomas G.; Rahman, Mohammad; Marshall, Andrea; Liu Feifei; Fyles, Anthony

    2012-01-01

    Purpose: To evaluate a rapid automated treatment planning process for the selection of patients with left-sided breast cancer for a moderate deep inspiration breath-hold (mDIBH) technique using active breathing control (ABC); and to determine the dose reduction to the left anterior descending coronary artery (LAD) and the heart using mDIBH. Method and Materials: Treatment plans were generated using an automated method for patients undergoing left-sided breast radiotherapy (n = 53) with two-field tangential intensity-modulated radiotherapy. All patients with unfavorable cardiac anatomy, defined as having >10 cm{sup 3} of the heart receiving 50% of the prescribed dose (V{sub 50}) on the free-breathing automated treatment plan, underwent repeat scanning on a protocol using a mDIBH technique and ABC. The doses to the LAD and heart were compared between the free-breathing and mDIBH plans. Results: The automated planning process required approximately 9 min to generate a breast intensity-modulated radiotherapy plan. Using the dose-volume criteria, 20 of the 53 patients were selected for ABC. Significant differences were found between the free-breathing and mDIBH plans for the heart V{sub 50} (29.9 vs. 3.7 cm{sup 3}), mean heart dose (317 vs. 132 cGy), mean LAD dose (2,047 vs. 594 cGy), and maximal dose to 0.2 cm{sup 3} of the LAD (4,155 vs. 1,507 cGy, all p <.001). Of the 17 patients who had a breath-hold threshold of {>=}0.8 L, 14 achieved a {>=}90% reduction in the heart V{sub 50} using the mDIBH technique. The 3 patients who had had a breath-hold threshold <0.8 L achieved a lower, but still significant, reduction in the heart V{sub 50}. Conclusions: A rapid automated treatment planning process can be used to select patients who will benefit most from mDIBH. For selected patients with unfavorable cardiac anatomy, the mDIBH technique using ABC can significantly reduce the dose to the LAD and heart, potentially reducing the cardiac risks.

  11. Prediction of Warfarin Dose Reductions in Puerto Rican Patients, Based on Combinatorial CYP2C9 and VKORC1 Genotypes

    PubMed Central

    Valentin, Isa Ivette; Vazquez, Joan; Rivera-Miranda, Giselle; Seip, Richard L; Velez, Meredith; Kocherla, Mohan; Bogaard, Kali; Cruz-Gonzalez, Iadelisse; Cadilla, Carmen L; Renta, Jessica Y; Felliu, Juan F; Ramos, Alga S; Alejandro-Cowan, Yirelia; Gorowski, Krystyna; Ruaño, Gualberto; Duconge, Jorge

    2012-01-01

    BACKGROUND The influence of CYP2C9 and VKORC1 polymorphisms on warfarin dose has been investigated in white, Asian, and African American populations but not in Puerto Rican Hispanic patients. OBJECTIVE To test the associations between genotypes, international normalized ratio (INR) measurements, and warfarin dosing and gauge the impact of these polymorphisms on warfarin dose, using a published algorithm. METHODS A retrospective warfarin pharmacogenetic association study in 106 Puerto Rican patients was performed. DNA samples from patients were assayed for 12 variants in both CYP2C9 and VKORC1 loci by HILOmet PhyzioType assay. Demographic and clinical nongenetic data were retrospectively collected from medical records. Allele and genotype frequencies were determined and Hardy-Weinberg equilibrium (HWE) was tested. RESULTS Sixty-nine percent of patients were carriers of at least one polymorphism in either the CYP2C9 or the VKORC1 gene. Double, triple, and quadruple carriers accounted for 22%, 5%, and 1%, respectively. No significant departure from HWE was found. Among patients with a given CYP2C9 genotype, warfarin dose requirements declined from GG to AA haplotypes; whereas, within each VKORC1 haplotype, the dose decreased as the number of CYP2C9 variants increased. The presence of these loss-of-function alleles was associated with more out-of-range INR measurements (OR = 1.38) but not with significant INR >4 during the initiation phase. Analyses based on a published pharmacogenetic algorithm predicted dose reductions of up to 4.9 mg/day in carriers and provided better dose prediction in an extreme subgroup of highly sensitive patients, but also suggested the need to improve predictability by developing a customized model for use in Puerto Rican patients. CONCLUSIONS This study laid important groundwork for supporting a prospective pharmacogenetic trial in Puerto Ricans to detect the benefits of incorporating relevant genomic information into a customized DNA

  12. Dose reduction in orthodontic lateral cephalography: dosimetric evaluation of a novel cephalographic thyroid protector (CTP) and anatomical cranial collimation (ACC)

    PubMed Central

    Rottke, D; van der Stelt, P F; Berkhout, W E R

    2015-01-01

    Objectives: To test the dose-reducing capabilities of a novel thyroid protection device and a recently introduced cranial collimator to be used in orthodontic lateral cephalography. Methods: Cephalographic thyroid protector (CTP) was designed to shield the thyroid while leaving the cervical vertebrae depicted. Using a RANDO® head phantom (The Phantom Laboratory, Salem, NY) equipped with dosemeters and a Proline XC (Planmeca, Helsinki, Finland) cephalograph, lateral cephalograms were taken, and the effective dose (ED) was calculated for four protocols: (1) without shielding; (2) with CTP; (3) with CTP and anatomical cranial collimator (ACC); and (4) with a thyroid collar (TC). Results: The ED for the respective protocols was (1) 8.51; (2) 5.39; (3) 3.50; and (4) 4.97 µSv. The organ dose for the thyroid was reduced from 30.17 to 4.50 µSv in Protocols 2 and 3 and to 3.33 µSv in Protocol 4. Conclusions: The use of just the CTP (Protocol 2) resulted in a 36.8% reduction of the ED of a lateral cephalogram. This was comparable to the classical TC (Protocol 4). A 58.8% reduction of the ED was obtained when combining CTP and ACC (Protocol 3). The dose to the radiosensitive thyroid gland was reduced by 85% in Protocols 2 and 3 and by 89% in Protocol 4. PMID:25564885

  13. Evaluation of exposure dose reduction in multislice CT coronary angiography (MS-CTA) with prospective ECG-gated helical scan

    NASA Astrophysics Data System (ADS)

    Ota, Takamasa; Tsuyuki, Masaharu; Okumura, Miwa; Sano, Tomonari; Kondo, Takeshi; Takase, Shinichi

    2008-03-01

    A novel low-dose ECG-gated helical scan method to investigate coronary artery diseases was developed. This method uses a high pitch for scanning (based on the patient's heart rate) and X-rays are generated only during the optimal cardiac phases. The dose reduction was obtained using a two-level approach: 1) To use a 64-slice CT scanner (Aquilion, Toshiba, Otawara, Tochigi, Japan) with a scan speed of 0.35 s/rot. to helically scan the heart at a high pitch based on the patient's heart rate. By changing the pitch from the conventional 0.175 to 0.271 for a heart rate of 60 bpm, the exposure dose was reduced to 65%. 2) To employ tube current gating that predicts the timing of optimal cardiac phases from the previous cardiac cycle and generates X-rays only during the required cardiac phases. The combination of high speed scanning with a high pitch and appropriate X-ray generation only in the cardiac phases from 60% to 90% allows the exposure dose to be reduced to 5.6 mSv for patients with a heart rate lower than 65 bpm. This is a dose reduction of approximately 70% compared to the conventional scanning method recommended by the manufacturer when segmental reconstruction is considered. This low-dose protocol seamlessly allows for wide scan ranges (e.g., aortic dissection) with the benefits of ECG-gated helical scanning: smooth continuity for longitudinal direction and utilization of data from all cardiac cycles.

  14. Reduction in mutation frequency by very low-dose gamma irradiation of Drosophila melanogaster germ cells.

    PubMed

    Ogura, Keiji; Magae, Junji; Kawakami, Yasushi; Koana, Takao

    2009-01-01

    To determine whether the linear no-threshold (LNT) model for stochastic effects of ionizing radiation is applicable to very low-dose radiation at a low dose rate, we irradiated immature male germ cells of the fruit fly, Drosophila melanogaster, with several doses of (60)Co gamma rays at a dose rate of 22.4 mGy/h. Thereafter, we performed the sex-linked recessive lethal mutation assay by mating the irradiated males with nonirradiated females. The mutation frequency in the group irradiated with 500 microGy was found to be significantly lower than that in the control group (P < 0.01), whereas in the group subjected to 10 Gy irradiation, the mutation frequency was significantly higher than that in the control group (P < 0.03). A J-shaped dose-response relationship was evident. Molecular experiments using DNA microarray and quantitative reverse transcription PCR indicated that several genes known to be expressed in response to heat or chemical stress and grim, a positive regulator of apoptosis, were up-regulated immediately after irradiation with 500 microGy. The involvement of an apoptosis function in the non-linear dose-response relationship was suggested.

  15. Reduction of bacterial titers by low-dose aspirin in experimental aortic valve endocarditis.

    PubMed Central

    Nicolau, D P; Freeman, C D; Nightingale, C H; Quintiliani, R; Coe, C J; Maderazo, E G; Cooper, B W

    1993-01-01

    Using a rabbit model of Staphylococcus aureus endocarditis, we studied the effects of aspirin on the natural progression of this infection. Compared with untreated animals, the aspirin-treated animals showed a 30% (P = 0.11) reduction in the weight of the vegetations and an 84% (P = 0.03) reduction in the bacterial titer of the vegetations. PMID:8454370

  16. Cannabidiol reverses the reduction in social interaction produced by low dose Delta(9)-tetrahydrocannabinol in rats.

    PubMed

    Malone, Daniel Thomas; Jongejan, Dennis; Taylor, David Alan

    2009-08-01

    While Delta(9)-tetrahydrocannabinol (THC) is the main psychoactive constituent of the cannabis plant, a non-psychoactive constituent is cannabidiol (CBD). CBD has been implicated as a potential treatment of a number of disorders including schizophrenia and epilepsy and has been included with THC in a 1:1 combination for the treatment of conditions such as neuropathic pain. This study investigated the effect of THC and CBD, alone or in combination, on some objective behaviours of rats in the open field. Pairs of rats were injected with CBD or vehicle followed by THC or vehicle and behaviour in the open field was assessed for 10 min. In vehicle pretreated rats THC (1 mg/kg) significantly reduced social interaction between rat pairs. Treatment with CBD had no significant effect alone, but pretreatment with CBD (20 mg/kg) reversed the THC-induced decreases in social interaction. A higher dose of THC (10 mg/kg) produced no significant effect on social interaction. However, the combination of high dose CBD and high dose THC significantly reduced social interaction between rat pairs, as well as producing a significant decrease in locomotor activity. This data suggests that CBD can reverse social withdrawal induced by low dose THC, but the combination of high dose THC and CBD impairs social interaction, possibly by decreasing locomotor activity.

  17. Reduction of Dose Delivered to Organs at Risk in Prostate Cancer Patients via Image-Guided Radiation Therapy

    SciTech Connect

    Pawlowski, Jason M.; Yang, Eddy S.; Malcolm, Arnold W.; Coffey, Charles W.; Ding, George X.

    2010-03-01

    Purpose: To determine whether image guidance can improve the dose delivered to target organs and organs at risk (OARs) for prostate cancer patients treated with intensity-modulated radiotherapy (IMRT). Methods and Materials: Eight prostate cancer patients were treated with IMRT to 76 Gy at 2 Gy per fraction. Daily target localization was performed via alignment of three intraprostatic fiducials and weekly kV-cone beam computed tomography (CBCT) scans. The prostate and OARs were manually contoured on each CBCT by a single physician. Daily patient setup shifts were obtained by comparing alignment of skin tattoos with the treatment position based on fiducials. Treatment fields were retrospectively applied to CBCT scans. The dose distributions were calculated using actual treatment plans (an 8-mm PTV margin everywhere except for 6-mm posteriorly) with and without image guidance shifts. Furthermore, the feasibility of margin reduction was evaluated by reducing planning margins to 4 mm everywhere except for 3 mm posteriorly. Results: For the eight treatment plans on the 56 CBCT scans, the average doses to 98% of the prostate (D98) were 102% (range, 99-104%) and 99% (range, 45-104%) with and without image guidance, respectively. Using margin reduction, the average D98s were 100% (range, 84-104%) and 92% (range, 40-104%) with and without image guidance, respectively. Conclusions: Currently, margins used in IMRT plans are adequate to deliver a dose to the prostate with conventional patient positioning using skin tattoos or bony anatomy. The use of image guidance may facilitate significant reduction of planning margins. Future studies to assess the efficacy of decreasing margins and improvement of treatment-related toxicities are warranted.

  18. Assessing image quality and dose reduction of a new x-ray computed tomography iterative reconstruction algorithm using model observers

    SciTech Connect

    Tseng, Hsin-Wu Kupinski, Matthew A.; Fan, Jiahua; Sainath, Paavana; Hsieh, Jiang

    2014-07-15

    Purpose: A number of different techniques have been developed to reduce radiation dose in x-ray computed tomography (CT) imaging. In this paper, the authors will compare task-based measures of image quality of CT images reconstructed by two algorithms: conventional filtered back projection (FBP), and a new iterative reconstruction algorithm (IR). Methods: To assess image quality, the authors used the performance of a channelized Hotelling observer acting on reconstructed image slices. The selected channels are dense difference Gaussian channels (DDOG).A body phantom and a head phantom were imaged 50 times at different dose levels to obtain the data needed to assess image quality. The phantoms consisted of uniform backgrounds with low contrast signals embedded at various locations. The tasks the observer model performed included (1) detection of a signal of known location and shape, and (2) detection and localization of a signal of known shape. The employed DDOG channels are based on the response of the human visual system. Performance was assessed using the areas under ROC curves and areas under localization ROC curves. Results: For signal known exactly (SKE) and location unknown/signal shape known tasks with circular signals of different sizes and contrasts, the authors’ task-based measures showed that a FBP equivalent image quality can be achieved at lower dose levels using the IR algorithm. For the SKE case, the range of dose reduction is 50%–67% (head phantom) and 68%–82% (body phantom). For the study of location unknown/signal shape known, the dose reduction range can be reached at 67%–75% for head phantom and 67%–77% for body phantom case. These results suggest that the IR images at lower dose settings can reach the same image quality when compared to full dose conventional FBP images. Conclusions: The work presented provides an objective way to quantitatively assess the image quality of a newly introduced CT IR algorithm. The performance of the

  19. Radiation therapy for early stage unfavorable Hodgkin lymphoma: is dose reduction feasible?

    PubMed

    Laskar, Siddhartha; Kumar, Deepak P; Khanna, Nehal; Menon, Hari; Sengar, Manju; Arora, Brijesh; Gujral, Sumeet; Shet, Tanuja; Sridhar, Epari; Rangarajan, Venkatesh; Muckaden, Mary Ann; Nair, Reena; Banavali, Shripad

    2014-10-01

    One hundred and fifty-one patients aged between 3 and 70 years with early stage unfavorable Hodgkin lymphoma were included. Patients received 4-6 cycles of ABVD (doxorubicin, bleomycin, vinblastine and dacarbazine) chemotherapy and involved field radiation therapy (IFRT). The most common histology was mixed cellularity (43%). The majority had stage IIAX disease. IFRT doses were 25.2 Gy/14 fractions and 34.2 Gy/19 fractions for adults with a complete response (CR) and partial response (PR), respectively, while the doses were 19.8 Gy/11 fractions and 30.6 Gy/17 fractions, respectively, for children. After 60 months (median), the 10-year progression-free survival (PFS) and overall survival (OS) were 88.4% and 93.2%, respectively. On univariate analysis, prognostic factors with significant impact on PFS were age ≥ 18 years, nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL) histology, extranodal disease and response to treatment. Extranodal disease had a significant impact on OS. On multivariate analysis, NLPHL histology (p = 0.001) and response at 3 months (p = 0.000) had a significant impact on PFS. There were no in-field relapses in patients with bulky disease receiving RT doses > 25.2 Gy. Chemotherapy related acute pulmonary toxicity was documented in 21.4% and 4.8% of patients after six and four cycles of ABVD chemotherapy (p = 0.041). Four cycles of ABVD and reduced dose IFRT resulted in optimal outcomes.

  20. Radiation dose reduction in computed tomography perfusion using spatial-temporal Bayesian methods

    NASA Astrophysics Data System (ADS)

    Fang, Ruogu; Raj, Ashish; Chen, Tsuhan; Sanelli, Pina C.

    2012-03-01

    In current computed tomography (CT) examinations, the associated X-ray radiation dose is of significant concern to patients and operators, especially CT perfusion (CTP) imaging that has higher radiation dose due to its cine scanning technique. A simple and cost-effective means to perform the examinations is to lower the milliampere-seconds (mAs) parameter as low as reasonably achievable in data acquisition. However, lowering the mAs parameter will unavoidably increase data noise and degrade CT perfusion maps greatly if no adequate noise control is applied during image reconstruction. To capture the essential dynamics of CT perfusion, a simple spatial-temporal Bayesian method that uses a piecewise parametric model of the residual function is used, and then the model parameters are estimated from a Bayesian formulation of prior smoothness constraints on perfusion parameters. From the fitted residual function, reliable CTP parameter maps are obtained from low dose CT data. The merit of this scheme exists in the combination of analytical piecewise residual function with Bayesian framework using a simpler prior spatial constrain for CT perfusion application. On a dataset of 22 patients, this dynamic spatial-temporal Bayesian model yielded an increase in signal-tonoise-ratio (SNR) of 78% and a decrease in mean-square-error (MSE) of 40% at low dose radiation of 43mA.

  1. Analysis and reduction of thermal dose errors in MRgFUS treatment.

    PubMed

    Zucconi, Fabio; Colombo, Paola E; Pasetto, Stefano; Lascialfari, Alessandro; Ticca, Cristiana; Torresin, Alberto

    2014-02-01

    ExAblate 2000 MRgFUS system (InSightec) installed in Ospedale Maggiore Niguarda Ca' Granda (Milano, Italy) is currently used to treat uterine fibroids. Through the magnetic resonance thermometry (PRF method), it is possible to monitor the temperature in the target in real-time and compute the treated region calculating the thermal dose. The purpose of this work is to investigate the errors in the temperature measurements and their effect on thermal dose. A low pass filtering of temperature maps is proposed to reduce the errors and therefore to improve the reliability of the treated regions calculated. The PRF method was studied through a calibration experiment on ex vivo pig muscle. The outcome resulted to be a very good linearity (p value 0.03) between phase and temperature in the range of interest, and an α value of -0.0109 ± 0.0002 ppm/°C. Temperature statistical uncertainty was evaluated by analyzing the temperature readout variability in specific gel provided by InSightec for daily quality assurance control. It resulted to be 1.89 ± 0.32 °C. A Monte Carlo simulation of the MRI temperature measurement and thermal dose calculations in our specific conditions of geometry and statistical uncertainty revealed that a low-pass filtering process on each temperature map can strongly reduce systematic errors in thermal dose evaluations (1.11 overestimation factor instead of 2.62 without filter); consequently the systematic errors on the size of the predicted ablated area are reduced as well.

  2. Occupational dose reduction at Department of Energy contractor facilities: Study of ALARA programs. Status 1990

    SciTech Connect

    Dionne, B.J.; Meinhold, C.B.; Khan, T.A.; Baum, J.W.

    1992-08-01

    This report provides the US Department of Energy (DOE) and its contractors with information that will be useful for reducing occupational radiation doses at DOE`s nuclear facilities. In 1989 and 1990, health physicists from the Brookhaven National Laboratory`s (BNL) ALARA Center visited twelve DOE contractor facilities with annual collective dose equivalents greater than 100 person-rem (100 person-cSv). The health physicists interviewed radiological safety staff, engineers, and training personnel who were responsible for dose control. The status of ALARA practices at the major contractor facilities was compared with the requirements and recommendation in DOE Order 5480.11 ``Radiation Protection for Occupational Workers`` and PNL-6577 ``Health Physics Manual of Good Practices for Reducing Radiation Exposure to Levels that are as Low as Reasonably Achievable.`` The information and data collected are described and examples of successful practices are presented. The findings on the status of the DOE Contractor ALARA Programs are summarized and evaluated. In addition, the supplement to this report contains examples of good-practice documents associated with implementing the major elements of a formally documented ALARA program for a major DOE contractor facility.

  3. Occupational dose reduction at Department of Energy contractor facilities: Bibliography of selected readings in radiation protection and ALARA; Volume 5

    SciTech Connect

    Dionne, B.J.; Sullivan, S.G.; Baum, J.W.

    1994-01-01

    Promoting the exchange of information related to implementation of the As Low as Reasonably Achievable (ALARA) philosophy is a continuing objective for the Department of Energy (DOE). This report was prepared by the Brookhaven National Laboratory (BNL) ALARA Center for the DOE Office of Health. It contains the fifth in a series of bibliographies on dose reduction at DOE facilities. The BNL ALARA Center was originally established in 1983 under the sponsorship of the Nuclear Regulatory Commission to monitor dose-reduction research and ALARA activities at nuclear power plants. This effort was expanded in 1988 by the DOE`s Office of Environment, Safety and Health, to include DOE nuclear facilities. This bibliography contains abstracts relating to various aspects of ALARA program implementation and dose-reduction activities, with a specific focus on DOE facilities. Abstracts included in this bibliography were selected from proceedings of technical meetings, journals, research reports, searches of the DOE Energy, Science and Technology Database (in general, the citation and abstract information is presented as obtained from this database), and reprints of published articles provided by the authors. Facility types and activities covered in the scope of this report include: radioactive waste, uranium enrichment, fuel fabrication, spent fuel storage and reprocessing, facility decommissioning, hot laboratories, tritium production, research, test and production reactors, weapons fabrication and testing, fusion, uranium and plutonium processing, radiography, and accelerators. Information on improved shielding design, decontamination, containments, robotics, source prevention and control, job planning, improved operational and design techniques, as well as on other topics, has been included. In addition, DOE/EH reports not included in previous volumes of the bibliography are in this volume (abstracts 611 to 684). This volume (Volume 5 of the series) contains 217 abstracts.

  4. Radiation dose reduction and new image modalities development for interventional C-arm imaging system

    NASA Astrophysics Data System (ADS)

    Niu, Kai

    Cardiovascular disease and stroke are the leading health problems and causes of death in the US. Due to the minimally invasive nature of the evolution of image guided techniques, interventional radiological procedures are becoming more common and are preferred in treating many cardiovascular diseases and strokes. In addition, with the recent advances in hardware and device technology, the speed and efficacy of interventional treatment has significantly improved. This implies that more image modalities can be developed based on the current C-arm system and patients treated in interventional suites can potentially experience better health outcomes. However, during the treatment patients are irradiated with substantial amounts of ionizing radiation with a high dose rate (digital subtraction angiography (DSA) with 3muGy/frame and 3D cone beam CT image with 0.36muGy/frame for a Siemens Artis Zee biplane system) and/or a long irradiation time (a roadmapping image sequence can be as long as one hour during aneurysm embolization). As a result, the patient entrance dose is extremely high. Despite the fact that the radiation dose is already substantial, image quality is not always satisfactory. By default a temporal average is used in roadmapping images to overcome poor image quality, but this technique can result in motion blurred images. Therefore, reducing radiation dose while maintaining or even improving the image quality is an important area for continued research. This thesis is focused on improving the clinical applications of C-arm cone beam CT systems in two ways: (1) Improve the performance of current image modalities on the C-arm system. (2) Develop new image modalities based on the current system. To be more specific, the objectives are to reduce radiation dose for current modalities (e.g., DSA, fluoroscopy, roadmapping, and cone beam CT) and enable cone beam CT perfusion and time resolved cone beam CT angiography that can be used to diagnose and triage acute

  5. Influence of thyroid volume reduction on absorbed dose in 131I therapy studied by using Geant4 Monte Carlo simulation

    NASA Astrophysics Data System (ADS)

    Ziaur, Rahman; Sikander, M. Mirza; Waheed, Arshed; Nasir, M. Mirza; Waheed, Ahmed

    2014-05-01

    A simulation study has been performed to quantify the effect of volume reduction on the thyroid absorbed dose per decay and to investigate the variation of energy deposition per decay due to β- and γ-activity of 131I with volume/mass of thyroid, for water, ICRP- and ICRU-soft tissue taken as thyroid material. A Monte Carlo model of the thyroid, in the Geant4 radiation transport simulation toolkit was constructed to compute the β- and γ-absorbed dose in the simulated thyroid phantom for various values of its volume. The effect of the size and shape of the thyroid on energy deposition per decay has also been studied by using spherical, ellipsoidal and cylindrical models for the thyroid and varying its volume in 1-25 cm3 range. The relative differences of Geant4 results for different models with each other and MCNP results lie well below 1.870%. The maximum relative difference among the Geant4 estimated results for water with ICRP and ICRU soft tissues is not more than 0.225%. S-values for ellipsoidal, spherical and cylindrical thyroid models were estimated and the relative difference with published results lies within 3.095%. The absorbed fraction values for beta particles show a good agreement with published values within 2.105% deviation. The Geant4 based simulation results of absorbed fractions for gammas again show a good agreement with the corresponding MCNP and EGS4 results (±6.667%) but have 29.032% higher values than that of MIRD calculated values. Consistent with previous studies, the reduction of the thyroid volume is found to have a substantial effect on the absorbed dose. Geant4 simulations confirm dose dependence on the volume/mass of thyroid in agreement with MCNP and EGS4 computed values but are substantially different from MIRD8 data. Therefore, inclusion of size/mass dependence is indicated for 131I radiotherapy of the thyroid.

  6. Reduction of eye lens radiation dose by orbital bismuth shielding in pediatric patients undergoing CT of the head: A Monte Carlo study

    SciTech Connect

    Perisinakis, Kostas; Raissaki, Maria; Tzedakis, Antonis; Theocharopoulos, Nicholas; Damilakis, John; Gourtsoyiannis, Nicholas

    2005-04-01

    Our aim in the study was to assess the eye lens dose reduction resulting from the use of radioprotective bismuth garments to shield the eyes of pediatric patients undergoing head CT. The Monte Carlo N-particle transport code and mathematical humanoid phantoms representing the average individual at different ages were used to determine eye lens dose reduction accomplished with bismuth shielding of the eye in the following simulated CT scans: (a) scanning of the orbits, (b) scanning of the whole head, and (c) 20 deg. angled scanning of the brain excluding the orbits. The effect of bismuth shielding on the eye lens dose was also investigated using an anthropomorphic phantom and thermoluminescence dosimetry (TLD). Eye lens dose reduction achieved by bismuth shielding was measured in 16 patients undergoing multiphase CT scanning of the head. The patient's scans were divided in the following: CT examinations where the eye globes were entirely included (n=5), partly included (n=6) and excluded (n=5) from the scanned region. The eye lens dose reduction depended mainly on the scan boundaries set by an operator. The average eye lens dose reduction determined by Monte Carlo simulation was 38.2%, 33.0% and <1% for CT scans of the orbits, whole head, and brain with an angled gantry, respectively. The difference between the Monte Carlo derived eye lens dose reduction factor values and corresponding values determined directly by using the anthropomorphic phantom head was found less than 5%. The mean eye lens dose reduction achieved by bismuth shielding in pediatric patients were 34%, 20% and <2% when eye globes were entirely included, partly included and excluded from the scanned region, respectively. A significant reduction in eye lens dose may be achieved by using superficial orbital bismuth shielding during pediatric head CT scans. However, bismuth garments should not be used in children when the eyes are excluded from the primarily exposed region.

  7. SU-F-18C-15: Model-Based Multiscale Noise Reduction On Low Dose Cone Beam Projection

    SciTech Connect

    Yao, W; Farr, J

    2014-06-15

    Purpose: To improve image quality of low dose cone beam CT for patient positioning in radiation therapy. Methods: In low dose cone beam CT (CBCT) imaging systems, Poisson process governs the randomness of photon fluence at x-ray source and the detector because of the independent binomial process of photon absorption in medium. On a CBCT projection, the variance of fluence consists of the variance of noiseless imaging structure and that of Poisson noise, which is proportional to the mean (noiseless) of the fluence at the detector. This requires multiscale filters to smoothen noise while keeping the structure information of the imaged object. We used a mathematical model of Poisson process to design multiscale filters and established the balance of noise correction and structure blurring. The algorithm was checked with low dose kilo-voltage CBCT projections acquired from a Varian OBI system. Results: From the investigation of low dose CBCT of a Catphan phantom and patients, it showed that our model-based multiscale technique could efficiently reduce noise and meanwhile keep the fine structure of the imaged object. After the image processing, the number of visible line pairs in Catphan phantom scanned with 4 ms pulse time was similar to that scanned with 32 ms, and soft tissue structure from simulated 4 ms patient head-and-neck images was also comparable with scanned 20 ms ones. Compared with fixed-scale technique, the image quality from multiscale one was improved. Conclusion: Use of projection-specific multiscale filters can reach better balance on noise reduction and structure information loss. The image quality of low dose CBCT can be improved by using multiscale filters.

  8. Fludarabine Allows Dose Reduction for Total Body Irradiation in Pediatric Hematopoietic Stem Cell Transplantation

    SciTech Connect

    Kornguth, David G. . E-mail: dkorngut@mdanderson.org; Mahajan, Anita; Woo, Shiao; Chan, Ka Wah; Antolak, John; Ha, Chul S.

    2007-07-15

    Purpose: To examine, in the setting of total body irradiation (TBI) for the preparation of pediatric hematopoietic stem cell transplantation (HSCT), whether TBI dose can be reduced without compromising the efficacy of a regimen consisting of fludarabine and radiotherapy; and whether there is any increased risk of pulmonary toxicity due to the radiosensitizing effect of fludarabine. Methods and Materials: A total of 52 pediatric patients with hematologic malignancies received TBI-based conditioning regimens in preparation for allogeneic HSCT. Twenty-three patients received 12 Gy in 4 daily fractions in combination with cyclophosphamide, either alone or with other chemotherapeutic and biologic agents. Twenty-nine patients received 9 Gy in 3 fractions in conjunction with fludarabine and melphalan. Clinical and radiation records were reviewed to determine engraftment, pulmonary toxicity (according to Radiation Therapy Oncology Group criteria), transplant-related mortality, recurrence of primary disease, and overall survival. Results: The two groups of patients had comparable pretransplant clinical characteristics. For the 12-Gy and 9-Gy regimens, the engraftment (89% and 93%; p = 0.82), freedom from life-threatening pulmonary events (65% and 79%; p = 0.33), freedom from relapse (60% and 73%; p = 0.24), and overall survival (26% and 47%; p = 0.09) were not statistically different. Conclusions: The addition of fludarabine and melphalan seems to allow the dose of TBI to be lowered to 9 Gy without loss of engraftment or antitumor efficacy.

  9. Radiation dose reduction in thoracic and abdomen-pelvic CT using tube current modulation: a phantom study.

    PubMed

    Sabarudin, Akmal; Mustafa, Zakira; Nassir, Khadijah Mohd; Hamid, Hamzaini Abdul; Sun, Zhonghua

    2015-01-01

    This phantom study was designed to compare the radiation dose in thoracic and abdomen-pelvic CT scans with and without use of tube current modulation (TCM). Effective dose (ED) and size-specific dose estimation (SSDE) were calculated with the absorbed doses measured at selective radiosensitive organs using a thermoluminescence dosimeter-100 (TLD-100). When compared to protocols without TCM, the ED and SSDE were reduced significantly with use of TCM for both the thoracic and abdomen-pelvic CT. With use of TCM, the ED was 6.50±0.29 mSv for thoracic and 6.01±0.20 mSv for the abdomen-pelvic CT protocols. However without use of TCM, the ED was 20.07±0.24 mSv and 17.30±0.41 mSv for the thoracic and abdomen-pelvic CT protocols, respectively. The corresponding SSDE was 10.18±0.48 mGy and 11.96±0.27 mGy for the thoracic and abdomen-pelvic CT protocols with TCM, and 31.56±0.43 mGy and 33.23±0.05 mGy for thoracic and abdomen-pelvic CT protocols without TCM, respectively. The highest absorbed dose was measured at the breast with 8.58±0.12 mGy in the TCM protocols and 51.52±14.72 mGy in the protocols without TCM during thoracic CT. In the abdomen-pelvic CT, the absorbed dose was highest at the skin with 9.30±1.28 mGy and 29.99±2.23 mGy in protocols with and without use of TCM, respectively. In conclusion, the TCM technique results in significant dose reduction; thus it is to be highly recommended in routine thoracic and abdomen-pelvic CT. PACS numbers: 87.57.Q-, 87.57.qp, 87.53.Bn.

  10. Radiation dose reduction in thoracic and abdomen-pelvic CT using tube current modulation: a phantom study.

    PubMed

    Sabarudin, Akmal; Mustafa, Zakira; Nassir, Khadijah Mohd; Hamid, Hamzaini Abdul; Sun, Zhonghua

    2014-01-08

    This phantom study was designed to compare the radiation dose in thoracic and abdomen-pelvic CT scans with and without use of tube current modulation (TCM). Effective dose (ED) and size-specific dose estimation (SSDE) were calculated with the absorbed doses measured at selective radiosensitive organs using a thermoluminescence dosimeter-100 (TLD-100). When compared to protocols without TCM, the ED and SSDE were reduced significantly with use of TCM for both the thoracic and abdomen-pelvic CT. With use of TCM, the ED was 6.50 ± 0.29 mSv for thoracic and 6.01 ± 0.20 mSv for the abdomen-pelvic CT protocols. However without use of TCM, the ED was 20.07 ± 0.24 mSv and 17.30 ± 0.41 mSv for the thoracic and abdomen-pelvic CT protocols, respectively. The corresponding SSDE was 10.18 ± 0.48 mGy and 11.96 ± 0.27 mGy for the thoracic and abdomen-pelvic CT protocols with TCM, and 31.56 ± 0.43 mGy and 33.23 ± 0.05 mGy for thoracic and abdomen-pelvic CT protocols without TCM, respectively. The highest absorbed dose was measured at the breast with 8.58 ± 0.12 mGy in the TCM protocols and 51.52 ± 14.72 mGy in the protocols without TCM during thoracic CT. In the abdomen-pelvic CT, the absorbed dose was highest at the skin with 9.30 ± 1.28mGy and 29.99 ± 2.23 mGy in protocols with and without use of TCM, respectively. In conclusion, the TCM technique results in significant dose reduction; thus it is to be highly recommended in routine thoracic and abdomen-pelvic CT.

  11. Occupational dose reduction at nuclear power plants: Annotated bibliography of selected readings in radiation protection and ALARA. Volume 8

    SciTech Connect

    Sullivan, S.G.; Khan, T.A.; Xie, J.W.

    1995-05-01

    The ALARA Center at Brookhaven National Laboratory publishes a series of bibliographies of selected readings in radiation protection and ALARA in a continuing effort to collect and disseminate information on radiation dose reduction at nuclear power plants. This volume 8 of the series. The abstracts in this bibliography were selected form proceedings of technical meetings and conference journals, research reports, and searches of the Energy Science and Technology database of the US Department of Energy. The subject material of these abstracts relates to the many aspects of radiation protection and dose reduction, and ranges form use of robotics, to operational health physics, to water chemistry. Material on the design, planning, and management of nuclear power stations is included, as well as information on decommissioning and safe storage efforts. Volume 8 contains 232 abstracts, an author index, and a subject index. The author index is specific for this volume. The subject index is cumulative and lists all abstract numbers from volumes 1 to 8. The numbers in boldface indicate the abstracts in this volume; the numbers not in boldface represent abstracts in previous volumes.

  12. Occupational dose reduction at nuclear power plants: Annotated bibliography of selected readings in radiation protection and ALARA. Volume 7

    SciTech Connect

    Kaurin, D.G.; Khan, T.A.; Sullivan, S.G.; Baum, J.W.

    1993-07-01

    The ALARA Center at Brookhaven National Laboratory publishes a series of bibliographies of selected readings in radiation protection and ALARA in the continuing effort to collect and disseminate information on radiation dose reduction at nuclear power plants. This is volume 7 of the series. The abstracts in this bibliography were selected from proceedings of technical meetings and conferences, journals, research reports, and searches of the Energy Science and Technology database of the US Department of Energy. The subject material of these abstracts relates to radiation protection and dose reduction, and ranges from use of robotics to operational health physics, to water chemistry. Material on the design, planning, and management of nuclear power stations is included, as well as information on decommissioning and safe storage efforts. Volume 7 contains 293 abstract, an author index, and a subject index. The author index is specific for this volume. The subject index is cumulative and lists all abstract numbers from volumes 1 to 7. The numbers in boldface indicate the abstracts in this volume; the numbers not in boldface represent abstracts in previous volumes.

  13. A multiscale filter for noise reduction of low-dose cone beam projections

    NASA Astrophysics Data System (ADS)

    Yao, Weiguang; Farr, Jonathan B.

    2015-08-01

    The Poisson or compound Poisson process governs the randomness of photon fluence in cone beam computed tomography (CBCT) imaging systems. The probability density function depends on the mean (noiseless) of the fluence at a certain detector. This dependence indicates the natural requirement of multiscale filters to smooth noise while preserving structures of the imaged object on the low-dose cone beam projection. In this work, we used a Gaussian filter, \\text{exp}≤ft(-{{x}2}/2σ f2\\right) as the multiscale filter to de-noise the low-dose cone beam projections. We analytically obtained the expression of {σf} , which represents the scale of the filter, by minimizing local noise-to-signal ratio. We analytically derived the variance of residual noise from the Poisson or compound Poisson processes after Gaussian filtering. From the derived analytical form of the variance of residual noise, optimal σ f2 is proved to be proportional to the noiseless fluence and modulated by local structure strength expressed as the linear fitting error of the structure. A strategy was used to obtain the reliable linear fitting error: smoothing the projection along the longitudinal direction to calculate the linear fitting error along the lateral direction and vice versa. The performance of our multiscale filter was examined on low-dose cone beam projections of a Catphan phantom and a head-and-neck patient. After performing the filter on the Catphan phantom projections scanned with pulse time 4 ms, the number of visible line pairs was similar to that scanned with 16 ms, and the contrast-to-noise ratio of the inserts was higher than that scanned with 16 ms about 64% in average. For the simulated head-and-neck patient projections with pulse time 4 ms, the visibility of soft tissue structures in the patient was comparable to that scanned with 20 ms. The image processing took less than 0.5 s per projection with 1024   ×   768 pixels.

  14. Reduction in stray radiation dose using a body-shielding device during external radiation therapy.

    PubMed

    Zhang, Shuxu; Jiang, Shaohui; Zhang, Quanbin; Lin, Shengqu; Wang, Ruihao; Zhou, Xiang; Zhang, Guoqian; Lei, Huaiyu; Yu, Hui

    2017-03-01

    With the purpose of reducing stray radiation dose (SRD) in out-of-field region (OFR) during radiotherapy with 6 MV intensity-modulated radiation therapy (IMRT), a body-shielding device (BSD) was prepared according to the measurements obtained in experimental testing. In experimental testing, optimal shielding conditions, such as 1 mm lead, 2 mm lead, and 1 mm lead plus 10 mm bolus, were investigated along the medial axis of a phantom using thermoluminescent dosimeters (TLDs). The SRDs at distances from field edge were then measured and analyzed for a clinical IMRT treatment plan for nasopharyngeal carcinoma before and after shielding using the BSD. In addition, SRDs in anterior, posterior, left and right directions of phantom were investigated with and without shielding, respectively. Also, the SRD at the bottom of treatment couch was measured. SRD decreased exponentially to a constant value with increasing distance from field edge. The shielding rate was 50%-80%; however, there were no significant differences in SRDs when shielded by 1 mm lead, 2 mm lead, or 1 mm lead plus 10 mm bolus (P>0.05). Importantly, the 10 mm bolus absorbed back-scattering radiation due to the interaction between photons and lead. As a result, 1 mm lead plus 10 mm bolus was selected to prepare the BSD. After shielding with BSD, total SRDs in the OFR decreased to almost 50% of those without shielding when irradiated with IMRT beams. Due to the effects of treatment couch and gantry angle, SRDs at distances were not identical in anterior, posterior, left and right direction of phantom without BSD. As higher dose in anterior and lower dose in posterior, SRDs were substantial similarities after shielding. There was no significant difference in SRDs for left and right directions with or without shielding. Interestingly, SRDs in the four directions were similar after shielding. From these results, the BSD developed in this study may significantly reduce SRD in the OFR during

  15. A multiscale filter for noise reduction of low-dose cone beam projections.

    PubMed

    Yao, Weiguang; Farr, Jonathan B

    2015-08-21

    The Poisson or compound Poisson process governs the randomness of photon fluence in cone beam computed tomography (CBCT) imaging systems. The probability density function depends on the mean (noiseless) of the fluence at a certain detector. This dependence indicates the natural requirement of multiscale filters to smooth noise while preserving structures of the imaged object on the low-dose cone beam projection. In this work, we used a Gaussian filter, exp(-x2/2σ(2)(f)) as the multiscale filter to de-noise the low-dose cone beam projections. We analytically obtained the expression of σ(f), which represents the scale of the filter, by minimizing local noise-to-signal ratio. We analytically derived the variance of residual noise from the Poisson or compound Poisson processes after Gaussian filtering. From the derived analytical form of the variance of residual noise, optimal σ(2)(f)) is proved to be proportional to the noiseless fluence and modulated by local structure strength expressed as the linear fitting error of the structure. A strategy was used to obtain the reliable linear fitting error: smoothing the projection along the longitudinal direction to calculate the linear fitting error along the lateral direction and vice versa. The performance of our multiscale filter was examined on low-dose cone beam projections of a Catphan phantom and a head-and-neck patient. After performing the filter on the Catphan phantom projections scanned with pulse time 4 ms, the number of visible line pairs was similar to that scanned with 16 ms, and the contrast-to-noise ratio of the inserts was higher than that scanned with 16 ms about 64% in average. For the simulated head-and-neck patient projections with pulse time 4 ms, the visibility of soft tissue structures in the patient was comparable to that scanned with 20 ms. The image processing took less than 0.5 s per projection with 1024   ×   768 pixels.

  16. Effects of a radiation dose reduction strategy for computed tomography in severely injured trauma patients in the emergency department: an observational study

    PubMed Central

    2011-01-01

    Background Severely injured trauma patients are exposed to clinically significant radiation doses from computed tomography (CT) imaging in the emergency department. Moreover, this radiation exposure is associated with an increased risk of cancer. The purpose of this study was to determine some effects of a radiation dose reduction strategy for CT in severely injured trauma patients in the emergency department. Methods We implemented the radiation dose reduction strategy in May 2009. A prospective observational study design was used to collect data from patients who met the inclusion criteria during this one year study (intervention group) from May 2009 to April 2010. The prospective data were compared with data collected retrospectively for one year prior to the implementation of the radiation dose reduction strategy (control group). By comparison of the cumulative effective dose and the number of CT examinations in the two groups, we evaluated effects of a radiation dose reduction strategy. All the patients met the institutional adult trauma team activation criteria. The radiation doses calculated by the CT scanner were converted to effective doses by multiplication by a conversion coefficient. Results A total of 118 patients were included in this study. Among them, 33 were admitted before May 2009 (control group), and 85 were admitted after May 2009 (intervention group). There were no significant differences between the two groups regarding baseline characteristics, such as injury severity and mortality. Additionally, there was no difference between the two groups in the mean number of total CT examinations per patient (4.8 vs. 4.5, respectively; p = 0.227). However, the mean effective dose of the total CT examinations per patient significantly decreased from 78.71 mSv to 29.50 mSv (p < 0.001). Conclusions The radiation dose reduction strategy for CT in severely injured trauma patients effectively decreased the cumulative effective dose of the total CT

  17. Noise correlation in CBCT projection data and its application for noise reduction in low-dose CBCT

    SciTech Connect

    Zhang, Hua; Ouyang, Luo; Wang, Jing E-mail: jing.wang@utsouthwestern.edu; Ma, Jianhua E-mail: jing.wang@utsouthwestern.edu; Huang, Jing; Chen, Wufan

    2014-03-15

    Purpose: To study the noise correlation properties of cone-beam CT (CBCT) projection data and to incorporate the noise correlation information to a statistics-based projection restoration algorithm for noise reduction in low-dose CBCT. Methods: In this study, the authors systematically investigated the noise correlation properties among detector bins of CBCT projection data by analyzing repeated projection measurements. The measurements were performed on a TrueBeam onboard CBCT imaging system with a 4030CB flat panel detector. An anthropomorphic male pelvis phantom was used to acquire 500 repeated projection data at six different dose levels from 0.1 to 1.6 mAs per projection at three fixed angles. To minimize the influence of the lag effect, lag correction was performed on the consecutively acquired projection data. The noise correlation coefficient between detector bin pairs was calculated from the corrected projection data. The noise correlation among CBCT projection data was then incorporated into the covariance matrix of the penalized weighted least-squares (PWLS) criterion for noise reduction of low-dose CBCT. Results: The analyses of the repeated measurements show that noise correlation coefficients are nonzero between the nearest neighboring bins of CBCT projection data. The average noise correlation coefficients for the first- and second-order neighbors are 0.20 and 0.06, respectively. The noise correlation coefficients are independent of the dose level. Reconstruction of the pelvis phantom shows that the PWLS criterion with consideration of noise correlation (PWLS-Cor) results in a lower noise level as compared to the PWLS criterion without considering the noise correlation (PWLS-Dia) at the matched resolution. At the 2.0 mm resolution level in the axial-plane noise resolution tradeoff analysis, the noise level of the PWLS-Cor reconstruction is 6.3% lower than that of the PWLS-Dia reconstruction. Conclusions: Noise is correlated among nearest neighboring

  18. Reductions in carotid chemoreceptor activity with low-dose dopamine improves baroreflex control of heart rate during hypoxia in humans.

    PubMed

    Mozer, Michael T; Holbein, Walter W; Joyner, Michael J; Curry, Timothy B; Limberg, Jacqueline K

    2016-07-01

    The purpose of the present investigation was to examine the contribution of the carotid body chemoreceptors to changes in baroreflex control of heart rate with exposure to hypoxia. We hypothesized spontaneous cardiac baroreflex sensitivity (scBRS) would be reduced with hypoxia and this effect would be blunted when carotid chemoreceptor activity was reduced with low-dose dopamine. Fifteen healthy adults (11 M/4 F) completed two visits randomized to intravenous dopamine or placebo (saline). On each visit, subjects were exposed to 5-min normoxia (~99% SpO2), followed by 5-min hypoxia (~84% SpO2). Blood pressure (intra-arterial catheter) and heart rate (ECG) were measured continuously and scBRS was assessed by spectrum and sequence methodologies. scBRS was reduced with hypoxia (P < 0.01). Using the spectrum analysis approach, the fall in scBRS with hypoxia was attenuated with infusion of low-dose dopamine (P < 0.01). The decrease in baroreflex sensitivity to rising pressures (scBRS "up-up") was also attenuated with low-dose dopamine (P < 0.05). However, dopamine did not attenuate the decrease in baroreflex sensitivity to falling pressures (scBRS "down-down"; P > 0.05). Present findings are consistent with a reduction in scBRS with systemic hypoxia. Furthermore, we show this effect is partially mediated by the carotid body chemoreceptors, given the fall in scBRS is attenuated when activity of the chemoreceptors is reduced with low-dose dopamine. However, the improvement in scBRS with dopamine appears to be specific to rising blood pressures. These results may have important implications for impairments in baroreflex function common in disease states of acute and/or chronic hypoxemia, as well as the experimental use of dopamine to assess such changes.

  19. Quantification and reduction of peripheral dose from leakage radiation on Siemens Primus accelerators in electron therapy mode.

    PubMed

    Yeboah, Collins; Karotki, Alex; Hunt, Dylan; Holly, Rick

    2010-06-15

    In this work, leakage radiation from EA200 series electron applicators on Siemens Primus accelerators is quantified, and its penetration ability in water and/or the shielding material Xenolite-NL established. Initially, measurement of leakage from 10 x 10 - 25 x 25 cm2 applicators was performed as a function of height along applicator and of lateral distance from applicator body. Relative to central-axis ionization maximum in solid water, the maximum leakage in air observed with a cylindrical ion chamber with 1 cm solid water buildup cap at a lateral distance of 2 cm from the front and right sidewalls of applicators were 17% and 14%, respectively; these maxima were recorded for 18 MeV electron beams and applicator sizes of >or=20 x 20 cm2. In the patient plane, the applicator leakage gave rise to a broad peripheral dose off-axis distance peak that shifted closer to the field edge as the electron energy increases. The maximum peripheral dose from normally incident primary electron beams at a depth of 1 cm in a water phantom was observed to be equal to 5% of the central-axis dose maximum and as high as 9% for obliquely incident beams with angles of obliquity dose curves showed that the "practical range" of the leakage electrons in water varies from approximately 1.4 to 5.7 cm as the primary electron beam energy is raised from 6 to 18 MeV. Next, transmission measurements of leakage radiation through the shielding material Xenolite-NL showed a 4 mm thick sheet of this material is required to attenuate the leakage from 9 MeV beams by two-thirds, and that for every additional 3 MeV increase in the primary electron beam energy, an additional Xenolite-NL thickness of roughly 2 mm is needed to achieve the aforementioned attenuation level. Finally, attachment of a 1 mm thick sheet of lead to the outer surface of applicator sidewalls resulted in a reduction of the peripheral dose by up to 80% and 74% for 9 and 18MeV beams

  20. Design and functionalities of the MADOR® software suite for dose-reduction management after DTPA therapy.

    PubMed

    Leprince, B; Fritsch, P; Bérard, P; Roméo, P-H

    2016-03-01

    A software suite on biokinetics of radionuclides and internal dosimetry intended for the occupational health practitioners of nuclear industry and for expert opinions has been developed under Borland C++ Builder™. These computing tools allow physicians to improve the dosimetric follow-up of workers in agreement with the French regulations and to manage new internal contaminations by radionuclides such as Pu and/or Am after diethylene triamine penta-acetic acid treatments. In this paper, the concept and functionalities of the first two computing tools of this MADOR(®) suite are described. The release 0.0 is the forensic application, which allows calculating the derived recording levels for intake by inhalation or ingestion of the main radioisotopes encountered in occupational environment. Indeed, these reference values of activity are convenient to interpret rapidly the bioassay measurements and make decisions as part of medical monitoring. The release 1.0 addresses the effect of DTPA treatments on Pu/Am biokinetics and the dose benefit. The forensic results of the MADOR(®) suite were validated by comparison with reference data.

  1. Reduction of aspirin-induced fecal blood loss with low-dose misoprostol tablets in man

    SciTech Connect

    Cohen, M.M.; Clark, L.; Armstrong, L.; D'Souza, J.

    1985-07-01

    Misoprostol (SC-29333), a synthetic prostaglandin E1 methyl ester analog, was given simultaneously with acetylsalicylic acid in a double-blind, placebo-controlled randomized prospective study of 32 healthy human male subjects. Fecal blood loss was measured for eight days using the /sup 51/Cr-labeled red blood cell technique. Aspirin (650 mg qid) and misoprostol (25 micrograms qid) or placebo were given during days 3, 4, and 5. There was a significant (P less than 0.05) increase in median blood loss (modified Friedman test) from 0.81 to 6.05 ml/day in the aspirin with placebo group (N = 16). Median blood loss was increased (from 0.75 to 3.75 ml/day) in the aspirin with misoprostol group (N = 16), but this was significantly less (Mann-Whitney U test, P less than 0.01) than the placebo group. Mean serum salicylate concentrations in the placebo and misoprostol groups were similar (7.8 and 6.8 micrograms/ml, respectively). There were no significant changes in laboratory values in any of the subjects studied, nor were any major side-effects encountered. This study demonstrates that oral misoprostol reduces aspirin-induced gastrointestinal bleeding even when administered simultaneously and at a dose level below its threshold for significant acid inhibition. This indicates a potential role for misoprostol in the prevention of gastric mucosal damage in selected patients.

  2. Toward a dose reduction strategy using model-based reconstruction with limited-angle tomosynthesis

    NASA Astrophysics Data System (ADS)

    Haneda, Eri; Tkaczyk, J. E.; Palma, Giovanni; Iordache, Rǎzvan; Zelakiewicz, Scott; Muller, Serge; De Man, Bruno

    2014-03-01

    Model-based iterative reconstruction (MBIR) is an emerging technique for several imaging modalities and appli- cations including medical CT, security CT, PET, and microscopy. Its success derives from an ability to preserve image resolution and perceived diagnostic quality under impressively reduced signal level. MBIR typically uses a cost optimization framework that models system geometry, photon statistics, and prior knowledge of the recon- structed volume. The challenge of tomosynthetic geometries is that the inverse problem becomes more ill-posed due to the limited angles, meaning the volumetric image solution is not uniquely determined by the incom- pletely sampled projection data. Furthermore, low signal level conditions introduce additional challenges due to noise. A fundamental strength of MBIR for limited-views and limited-angle is that it provides a framework for constraining the solution consistent with prior knowledge of expected image characteristics. In this study, we analyze through simulation the capability of MBIR with respect to prior modeling components for limited-views, limited-angle digital breast tomosynthesis (DBT) under low dose conditions. A comparison to ground truth phantoms shows that MBIR with regularization achieves a higher level of fidelity and lower level of blurring and streaking artifacts compared to other state of the art iterative reconstructions, especially for high contrast objects. The benefit of contrast preservation along with less artifacts may lead to detectability improvement of microcalcification for more accurate cancer diagnosis.

  3. [State of the art and future trends in technology for computed tomography dose reduction].

    PubMed

    Calzado Cantera, A; Hernández-Girón, I; Salvadó Artells, M; Rodríguez González, R

    2013-12-01

    The introduction of helical and multislice acquisitions in CT scanners together with decreased image reconstruction times has had a tremendous impact on radiological practice. Technological developments in the last 10 to 12 years have enabled very high quality images to be obtained in a very short time. Improved image quality has led to an increase in the number of indications for CT. In parallel to this development, radiation exposure in patients has increased considerably. Concern about the potential health risks posed by CT imaging, reflected in diverse initiatives and actions by official organs and scientific societies, has prompted the search for ways to reduce radiation exposure in patients without compromising diagnostic efficacy. To this end, good practice guidelines have been established, special applications have been developed for scanners, and research has been undertaken to optimize the clinical use of CT. Noteworthy technical developments incorporated in scanners include the different modes of X-ray tube current modulation, automatic selection of voltage settings, selective organ protection, adaptive collimation, and iterative reconstruction. The appropriate use of these tools to reduce radiation doses requires thorough knowledge of how they work.

  4. Impact of dose reductions on efficacy outcome in heart transplant patients receiving enteric-coated mycophenolate sodium or mycophenolate mofetil at 12 months post-transplantation.

    PubMed

    Segovia, Javier; Gerosa, Gino; Almenar, Luis; Livi, Ugolino; Viganò, Mario; Arizón, Jose Maria; Yonan, Nizar; Di Salvo, Thomas G; Renlund, Dale G; Kobashigawa, Jon A

    2008-01-01

    Mycophenolic acid (MPA) dose reduction is associated with increased risk of rejection and graft loss in renal transplantation. This analysis investigated the impact of MPA dose changes with enteric-coated mycophenolate sodium (EC-MPS) or mycophenolate mofetil (MMF) in de novo heart transplant recipients. In a 12-month, single-blind trial, 154 patients (EC-MPS, 78; MMF, 76) were randomized to either EC-MPS (1080 mg bid) or MMF (1500 mg bid) in combination with cyclosporine and steroids. The primary efficacy variable was the incidence of treatment failure, comprising a composite of biopsy-proven (BPAR) and treated acute rejection, graft loss or death. Significantly fewer patients receiving EC-MPS required > or =2 dose reductions than patients on MMF (26.9% vs. 42.1% of patients, p = 0.048). Accordingly, the average daily dose of EC-MPS as a percentage of the recommended dose was significantly higher than for MMF (88.4% vs. 79.0%, p = 0.016). Among patients requiring > or =1 dose reduction, the incidence of treated BPAR grade > or =3A was significantly lower with EC-MPS compared with MMF (23.4% vs. 44.0%, p = 0.032). These data suggest that EC-MPS-treated heart transplant patients are less likely to require multiple dose reductions than those on MMF which may be associated with a significantly lower risk of treated BPAR > or =3A.

  5. Multicentric survey on dose reduction/interruption of cancer drug therapy in 12.472 patients: indicators of suspected adverse reactions.

    PubMed

    Casadei Gardini, Andrea; Tenti, Elena; Masini, Carla; Nanni, Oriana; Scarpi, Emanuela; Valgiusti, Martina; Restuccia, Silvia; Gallani, Maria Laura; Palazzini, Simonetta; Bianchini, Erica; Menozzi, Silvia; Maugeri, Antonio; Amadori, Dino; Minguzzi, Martina; Frassineti, Giovanni Luca

    2016-06-28

    Antiblastic drugs have a high number of potential side-effects. Paradoxically, according to the National Network of Pharmacovigilance, the number of reported adverse reactions to these agents is proportionally lower than that registered for non antiblastic drugs. Critical phenomena such as treatment interruptions and significant dose reductions within the first two months of use may be indicators of adverse drug reactions. The aim of the present study was to increase our knowledge of pharmacovigilance to facilitate the actions taken to improve the risk-benefit profile of cancer drugs and, consequently, their safety. This retrospective observational survey was carried out on prescriptions from 1st January 2012 to 31st December 2012.Dose reductions of more than 10% during the first 90 days of therapy were considered as a surrogate indicator of an adverse reaction. Dose interruptions during the first 60 days of therapy were taken into consideration. Of the12,472 patients 1,248 underwent a dose reduction. The drugs that most often required a dose reduction were paclitaxel and oxaliplatin (17.4% and 17.3%, respectively), docetaxel (14.8%), carboplatin (15%), fluorouracil (10.7%) and, among oral medications, capecitabine (6.9%). Of the 1896 patients treated with the same drugs, 9.7% interrupted treatment. Patients required a lower dose reduction than that reported by other authors. Around 15% of cases underwent a 30% dose reduction within three months of starting therapy, indicating a possible adverse reaction. Constant monitoring of dose prescription and continuous training of medical and nursing staff are clearly needed to increase awareness of the importance of reporting adverse events.

  6. A comparison of mantle versus involved-field radiotherapy for Hodgkin's lymphoma: reduction in normal tissue dose and second cancer risk

    PubMed Central

    Koh, Eng-Siew; Tran, Tu Huan; Heydarian, Mostafa; Sachs, Rainer K; Tsang, Richard W; Brenner, David J; Pintilie, Melania; Xu, Tony; Chung, June; Paul, Narinder; Hodgson, David C

    2007-01-01

    Background Hodgkin's lymphoma (HL) survivors who undergo radiotherapy experience increased risks of second cancers (SC) and cardiac sequelae. To reduce such risks, extended-field radiotherapy (RT) for HL has largely been replaced by involved field radiotherapy (IFRT). While it has generally been assumed that IFRT will reduce SC risks, there are few data that quantify the reduction in dose to normal tissues associated with modern RT practice for patients with mediastinal HL, and no estimates of the expected reduction in SC risk. Methods Organ-specific dose-volume histograms (DVH) were generated for 41 patients receiving 35 Gy mantle RT, 35 Gy IFRT, or 20 Gy IFRT, and integrated organ mean doses were compared for the three protocols. Organ-specific SC risk estimates were estimated using a dosimetric risk-modeling approach, analyzing DVH data with quantitative, mechanistic models of radiation-induced cancer. Results Dose reductions resulted in corresponding reductions in predicted excess relative risks (ERR) for SC induction. Moving from 35 Gy mantle RT to 35 Gy IFRT reduces predicted ERR for female breast and lung cancer by approximately 65%, and for male lung cancer by approximately 35%; moving from 35 Gy IFRT to 20 Gy IFRT reduces predicted ERRs approximately 40% more. The median reduction in integral dose to the whole heart with the transition to 35 Gy IFRT was 35%, with a smaller (2%) reduction in dose to proximal coronary arteries. There was no significant reduction in thyroid dose. Conclusion The significant decreases estimated for radiation-induced SC risks associated with modern IFRT provide strong support for the use of IFRT to reduce the late effects of treatment. The approach employed here can provide new insight into the risks associated with contemporary IFRT for HL, and may facilitate the counseling of patients regarding the risks associated with this treatment. PMID:17362522

  7. Adaptive Iterative Dose Reduction Using Three Dimensional Processing (AIDR3D) Improves Chest CT Image Quality and Reduces Radiation Exposure

    PubMed Central

    Yamashiro, Tsuneo; Miyara, Tetsuhiro; Honda, Osamu; Kamiya, Hisashi; Murata, Kiyoshi; Ohno, Yoshiharu; Tomiyama, Noriyuki; Moriya, Hiroshi; Koyama, Mitsuhiro; Noma, Satoshi; Kamiya, Ayano; Tanaka, Yuko; Murayama, Sadayuki

    2014-01-01

    Objective To assess the advantages of Adaptive Iterative Dose Reduction using Three Dimensional Processing (AIDR3D) for image quality improvement and dose reduction for chest computed tomography (CT). Methods Institutional Review Boards approved this study and informed consent was obtained. Eighty-eight subjects underwent chest CT at five institutions using identical scanners and protocols. During a single visit, each subject was scanned using different tube currents: 240, 120, and 60 mA. Scan data were converted to images using AIDR3D and a conventional reconstruction mode (without AIDR3D). Using a 5-point scale from 1 (non-diagnostic) to 5 (excellent), three blinded observers independently evaluated image quality for three lung zones, four patterns of lung disease (nodule/mass, emphysema, bronchiolitis, and diffuse lung disease), and three mediastinal measurements (small structure visibility, streak artifacts, and shoulder artifacts). Differences in these scores were assessed by Scheffe's test. Results At each tube current, scans using AIDR3D had higher scores than those without AIDR3D, which were significant for lung zones (p<0.0001) and all mediastinal measurements (p<0.01). For lung diseases, significant improvements with AIDR3D were frequently observed at 120 and 60 mA. Scans with AIDR3D at 120 mA had significantly higher scores than those without AIDR3D at 240 mA for lung zones and mediastinal streak artifacts (p<0.0001), and slightly higher or equal scores for all other measurements. Scans with AIDR3D at 60 mA were also judged superior or equivalent to those without AIDR3D at 120 mA. Conclusion For chest CT, AIDR3D provides better image quality and can reduce radiation exposure by 50%. PMID:25153797

  8. Effect of the reduction of skin contamination on the internal dose of creosote workers exposed to polycyclic aromatic hydrocarbons.

    PubMed

    Van Rooij, J G; Van Lieshout, E M; Bodelier-Bade, M M; Jongeneelen, F J

    1993-06-01

    Ten creosote-exposed workers of a wood impregnation plant participated in this study, which took place in two consecutive weeks on a Monday, after a weekend off. On one of the two days each worker wore Tyvek coveralls underneath his normal workclothes. Dermal contamination measurements (pyrene on exposure pads) and biological monitoring (urinary 1-OH-pyrene) were performed to measure the reduction of both the skin contamination and the internal dose. The total pyrene skin contamination of workers not wearing coveralls ranged between 47 and 1510 micrograms.d-1 (0.2-7.5 mumol.d-1). On the average, the coveralls reduced the pyrene contamination on the workers' skin by about 35 (SD 63)%. The excreted amount of 1-OH-pyrene in urine decreased significantly from 6.6 to 3.2 micrograms (30.2 to 14.7 nmol). Multiple regression analysis showed that skin contamination by polycyclic aromatic hydrocarbons is the main determinant of the internal exposure dose of creosote workers.

  9. Dose reduction by moving a region of interest (ROI) beam attenuator to follow a moving object of interest

    NASA Astrophysics Data System (ADS)

    Panse, Ashish S.; Swetadri Vasan, S. N.; Jain, A.; Bednarek, D. R.; Rudin, S.

    2012-03-01

    Region-of-interest (ROI) fluoroscopy takes advantage of the fact that most neurovascular interventional activity is performed in only a small portion of an x-ray imaging field of view (FOV). The ROI beam filter is an attenuating material that reduces patient dose in the area peripheral to the object of interest. This project explores a method of moving the beam-attenuator aperture with the object of interest such that it always remains in the ROI. In this study, the ROI attenuator, which reduces the dose by 80% in the peripheral region, is mounted on a linear stage placed near the xray tube. Fluoroscopy is performed using the Microangiographic Fluoroscope (MAF) which is a high-resolution, CCD-based x-ray detector. A stainless-steel stent is selected as the object of interest, and is moved across the FOV and localized using an object-detection algorithm available in the IMAQ Vision package of LabVIEW. The ROI is moved to follow the stent motion. The pixel intensities are equalized in both FOV regions and an adaptive temporal filter dependent on the motion of the object of interest is implemented inside the ROI. With a temporal filter weight of 5% for the current image in the peripheral region, the SNR measured is 47.8. The weights inside the ROI vary between 10% and 33% with a measured SNR of 57.9 and 35.3 when the object is stationary and moving, respectively. This method allows patient dose reduction as well as maintenance of superior image quality in the ROI while tracking the object.

  10. Dose reduction by moving a region of interest (ROI) beam attenuator to follow a moving object of interest.

    PubMed

    Panse, Ashish S; Swetadri Vasan, S N; Jain, A; Bednarek, D R; Rudin, S

    2012-01-01

    Region-of-interest (ROI) fluoroscopy takes advantage of the fact that most neurovascular interventional activity is performed in only a small portion of an x-ray imaging field of view (FOV). The ROI beam filter is an attenuating material that reduces patient dose in the area peripheral to the object of interest. This project explores a method of moving the beam-attenuator aperture with the object of interest such that it always remains in the ROI. In this study, the ROI attenuator, which reduces the dose by 80% in the peripheral region, is mounted on a linear stage placed near the x-ray tube. Fluoroscopy is performed using the Microangiographic Fluoroscope (MAF) which is a high-resolution, CCD-based x-ray detector. A stainless-steel stent is selected as the object of interest, and is moved across the FOV and localized using an object-detection algorithm available in the IMAQ Vision package of LabVIEW. The ROI is moved to follow the stent motion. The pixel intensities are equalized in both FOV regions and an adaptive temporal filter dependent on the motion of the object of interest is implemented inside the ROI. With a temporal filter weight of 5% for the current image in the peripheral region, the SNR measured is 47.8. The weights inside the ROI vary between 10% and 33% with a measured SNR of 57.9 and 35.3 when the object is stationary and moving, respectively. This method allows patient dose reduction as well as maintenance of superior image quality in the ROI while tracking the object.

  11. Feedback on the use of the MX6 Mox Fuel transport cask: reduction of the dose uptake during operations

    SciTech Connect

    Blachet, L.; Lallemant, Th.

    2007-07-01

    In the framework of the quality, safety and environment policy of AREVA, TN International has implemented a global management system according to ISO 9001, OHSAS 18001 and ISO 14001 requirements with certification obtained from third part organization (1). The design of the MX6 cask is an example of the implementation of this system in order to guarantee safety and the health of everyone involved and the protection of the environment. The MX6 design has allowed ALARA dose rates for the workers during all the phases of use of the cask, to be significantly reduced compared to previous design. The MX6 cask was developed by TN International for the transport of either BWR or PWR fresh MOX fuel assemblies. Replacing the previous SIEMENS type III and SIEMENS BWR packaging, the MX6 has been firstly used in the German Nuclear Power Plants. Complying with the TS-R-1 (IAEA 1996) regulations, the MX6 cask is based on innovative solutions implemented at each step of the design and the manufacturing. Its design includes an efficient neutron shielding for high Plutonium content and an easy use content restraining system. The large payload of the MX6 cask, 6 PWR MOX fuel assemblies or 16 BWR MOX fuel assemblies, minimizes the doses uptake during its unloading at the NPP. Moreover, new sequences of loading and unloading operations were proposed for testing and implementation in each Nuclear Facility. Concurrently, total dose uptakes by the operators were assessed in order to prove the efficiency of the packaging and the proposed sequences. In this paper, the main contributors to the transports to Germany with the MX6 cask will present their involvement and feedback for the reduction of the dose uptakes by the operators during the loading and unloading operations. Presently in use at GUNDREMMINGEN and ISAR Nuclear Power Plants (NPPs), the MX6 cask use will be extended to other German and Swiss NPPs from 2006 onwards. (1) AFAQ-AFNOR Certification for ISO 9001, OHSAS 18001 and ISO

  12. Radiation dose reduction to the breast in thoracic CT: Comparison of bismuth shielding, organ-based tube current modulation, and use of a globally decreased tube current

    SciTech Connect

    Wang Jia; Duan Xinhui; Christner, Jodie A.; Leng Shuai; Yu Lifeng; McCollough, Cynthia H.

    2011-11-15

    Purpose: The purpose of this work was to evaluate dose performance and image quality in thoracic CT using three techniques to reduce dose to the breast: bismuth shielding, organ-based tube current modulation (TCM) and global tube current reduction. Methods: Semi-anthropomorphic thorax phantoms of four different sizes (15, 30, 35, and 40 cm lateral width) were used for dose measurement and image quality assessment. Four scans were performed on each phantom using 100 or 120 kV with a clinical CT scanner: (1) reference scan; (2) scan with bismuth breast shield of an appropriate thickness; (3) scan with organ-based TCM; and (4) scan with a global reduction in tube current chosen to match the dose reduction from bismuth shielding. Dose to the breast was measured with an ion chamber on the surface of the phantom. Image quality was evaluated by measuring the mean and standard deviation of CT numbers within the lung and heart regions. Results: Compared to the reference scan, dose to the breast region was decreased by about 21% for the 15-cm phantom with a pediatric (2-ply) shield and by about 37% for the 30, 35, and 40-cm phantoms with adult (4-ply) shields. Organ-based TCM decreased the dose by 12% for the 15-cm phantom, and 34-39% for the 30, 35, and 40-cm phantoms. Global lowering of the tube current reduced breast dose by 23% for the 15-cm phantom and 39% for the 30, 35, and 40-cm phantoms. In phantoms of all four sizes, image noise was increased in both the lung and heart regions with bismuth shielding. No significant increase in noise was observed with organ-based TCM. Decreasing tube current globally led to similar noise increases as bismuth shielding. Streak and beam hardening artifacts, and a resulting artifactual increase in CT numbers, were observed for scans with bismuth shields, but not for organ-based TCM or global tube current reduction. Conclusions: Organ-based TCM produces dose reduction to the breast similar to that achieved with bismuth shielding for

  13. Little Evidence for Usefulness of Biomarkers for Predicting Successful Dose Reduction or Discontinuation of a Biologic Agent in Rheumatoid Arthritis: A Systematic Review

    PubMed Central

    van den Ende, Cornelia H.; Beeren, Fenna M. M.; Been, Evelien M. J.; van den Hoogen, Frank H. J.; den Broeder, Alfons A.

    2017-01-01

    Objective To systematically review studies addressing prediction of successful dose reduction or discontinuation of a biologic agent in rheumatoid arthritis (RA). Methods PubMed, Embase, and Cochrane Library databases were searched for studies that examined the predictive value of biomarkers for successful dose reduction or discontinuation of a biologic agent in RA. Two reviewers independently selected studies, and extracted data and assessed the risk of bias. A biomarker was classified as a “potential predictor” if the univariate association was either strong (odds ratio or hazard ratio >2.0 or <0.5) or statistically significant. For biomarkers that were studied multiple times, qualitative best‐evidence synthesis was performed separately for the prediction of successful dose reduction and discontinuation. Biomarkers that were defined in ≥75% of the studies as potential predictors were regarded as “predictor” for the purposes of our study. Results Of 3,029 nonduplicate articles initially searched, 16 articles regarding 15 cohorts were included in the present study. Overall, 17 biomarkers were studied multiple times for the prediction of successful dose reduction, and 33 for the prediction of successful discontinuation of a biologic agent. Three predictors were identified: higher adalimumab trough level for successful dose reduction and lower Sharp/van der Heijde erosion score and shorter symptom duration at the start of a biologic agent for successful discontinuation. Conclusion The predictive value of a wide variety of biomarkers for successful dose reduction or discontinuation of biologic treatment in RA has been investigated. We identified only 3 biomarkers as predictors, in just 2 studies. The strength of the evidence is limited by the low quality of the included studies and the likelihood of reporting bias and multiple testing. PMID:27696778

  14. High interindividual variability in dose-dependent reduction in speed of movement after exposing C. elegans to shock waves

    PubMed Central

    Angstman, Nicholas B.; Kiessling, Maren C.; Frank, Hans-Georg; Schmitz, Christoph

    2015-01-01

    In blast-related mild traumatic brain injury (br-mTBI) little is known about the connections between initial trauma and expression of individual clinical symptoms. Partly due to limitations of current in vitro and in vivo models of br-mTBI, reliable prediction of individual short- and long-term symptoms based on known blast input has not yet been possible. Here we demonstrate a dose-dependent effect of shock wave exposure on C. elegans using shock waves that share physical characteristics with those hypothesized to induce br-mTBI in humans. Increased exposure to shock waves resulted in decreased mean speed of movement while increasing the proportion of worms rendered paralyzed. Recovery of these two behavioral symptoms was observed during increasing post-traumatic waiting periods. Although effects were observed on a population-wide basis, large interindividual variability was present between organisms exposed to the same highly controlled conditions. Reduction of cavitation by exposing worms to shock waves in polyvinyl alcohol resulted in reduced effect, implicating primary blast effects as damaging components in shock wave induced trauma. Growing worms on NGM agar plates led to the same general results in initial shock wave effect in a standard medium, namely dose-dependence and high interindividual variability, as raising worms in liquid cultures. Taken together, these data indicate that reliable prediction of individual clinical symptoms based on known blast input as well as drawing conclusions on blast input from individual clinical symptoms is not feasible in br-mTBI. PMID:25705183

  15. SU-E-T-329: Dosimetric Impact of Implementing Metal Artifact Reduction Methods and Metal Energy Deposition Kernels for Photon Dose Calculations

    SciTech Connect

    Huang, J; Followill, D; Howell, R; Liu, X; Mirkovic, D; Stingo, F; Kry, S

    2015-06-15

    Purpose: To investigate two strategies for reducing dose calculation errors near metal implants: use of CT metal artifact reduction methods and implementation of metal-based energy deposition kernels in the convolution/superposition (C/S) method. Methods: Radiochromic film was used to measure the dose upstream and downstream of titanium and Cerrobend implants. To assess the dosimetric impact of metal artifact reduction methods, dose calculations were performed using baseline, uncorrected images and metal artifact reduction Methods: Philips O-MAR, GE’s monochromatic gemstone spectral imaging (GSI) using dual-energy CT, and GSI imaging with metal artifact reduction software applied (MARs).To assess the impact of metal kernels, titanium and silver kernels were implemented into a commercial collapsed cone C/S algorithm. Results: The CT artifact reduction methods were more successful for titanium than Cerrobend. Interestingly, for beams traversing the metal implant, we found that errors in the dimensions of the metal in the CT images were more important for dose calculation accuracy than reduction of imaging artifacts. The MARs algorithm caused a distortion in the shape of the titanium implant that substantially worsened the calculation accuracy. In comparison to water kernel dose calculations, metal kernels resulted in better modeling of the increased backscatter dose at the upstream interface but decreased accuracy directly downstream of the metal. We also found that the success of metal kernels was dependent on dose grid size, with smaller calculation voxels giving better accuracy. Conclusion: Our study yielded mixed results, with neither the metal artifact reduction methods nor the metal kernels being globally effective at improving dose calculation accuracy. However, some successes were observed. The MARs algorithm decreased errors downstream of Cerrobend by a factor of two, and metal kernels resulted in more accurate backscatter dose upstream of metals. Thus

  16. Infliximab Dose Reduction Sustains the Clinical Treatment Effect in Active HLAB27 Positive Ankylosing Spondylitis: A Two-Year Pilot Study

    PubMed Central

    Mörck, Boel; Bremell, Tomas; Forsblad-d'Elia, Helena

    2013-01-01

    The rationale of the study was to evaluate the efficacy of infliximab (IFX) treatment in patients with ankylosing spondylitis (AS) and to determine whether IFX dose reduction and interval extension sustains the treatment effect. Nineteen patients were included and treated with IFX 5 mg/kg every 6 weeks for 56 weeks. All patients concomitantly received MTX with median dose 7.5 mg/weekly. During the second year, the IFX dose was reduced to 3 mg/kg every 8 weeks. Eighteen patients completed the 1-year and 15 patients the 2-year trial. The ≥50% improvement at week 16 from baseline of BASDAI was achieved in 16/19 (84%) patients. Significant reductions in BASDAI, BASFI, and BASMI scores, decrease in ESR and CRP, and improvement in SF-36 were observed at weeks 16 and 56. The MRI-defined inflammatory changes in the sacroiliac joints disappeared in 10/15 patients (67%) already at 16 weeks. IFX treatment effect was sustained throughout the second year after IFX dose reduction and interval extension. We conclude that IFX treatment is effective in well-established active AS and a dose reduction sustains the treatment effect. These observations are of clinical importance and open the opportunity to reduce the drug costs. This trial is registered with ClinicalTrials.gov NCT01850121. PMID:24089587

  17. Dose reduction and its influence on diagnostic accuracy and radiation risk in digital mammography: an observer performance study using an anthropomorphic breast phantom

    PubMed Central

    Svahn, Tony; Hemdal, Bengt; Ruschin, Mark; Chakraborty, Dev P; Andersson, Ingvar; Tingberg, Anders; Mattsson, Sören

    2008-01-01

    This study aimed to investigate the effect of dose reduction on diagnostic accuracy and radiation risk in digital mammography. Simulated masses and microcalcifications were positioned in an anthropomorphic breast phantom. Thirty digital images, 14 with lesions, 16 without, were acquired of the phantom using a Mammomat Novation (Siemens, Erlangen, Germany) at each of three dose levels. These corresponded to 100%, 50% and 30% of the normally used average glandular dose (AGD; 1.3 mGy for a standard breast). Eight observers interpreted the 90 unprocessed images in a free-response study and the data was analyzed with the jackknife free-response receiver operating characteristic (JAFROC) method. Observer performance was assessed using the JAFROC figure of merit (FOM). The benefit of radiation risk reduction was estimated based on several risk models. There was no statistically significant difference in performance, as described by the FOM, between the 100% and the 50% dose levels. However, the FOMs for both the 100% and the 50% dose were significantly different from the corresponding quantity for the 30% dose level (F-statistic = 4.95, p-value = 0.01). A dose reduction of 50% would result in 3-9 fewer breast cancer fatalities per 100,000 women undergoing annual screening from the age of 40 to 49 years. The results of the study indicate a possibility of reducing the dose to the breast to half of the dose level currently used. This has to be confirmed in clinical studies and possible differences depending on lesion type should be further examined. PMID:17704316

  18. Potential for dose-escalation and reduction of risk in pancreatic cancer using IMRT optimization with lexicographic ordering and gEUD-based cost functions

    SciTech Connect

    Spalding, Aaron C.; Jee, Kyung-Wook; Vineberg, Karen; Jablonowski, Marla; Fraass, Benedick A.; Pan, Charlie C.; Lawrence, Theodore S.; Ten Haken, Randall K.; Ben-Josef, Edgar

    2007-02-15

    Radiotherapy for pancreatic cancer is limited by the tolerance of local organs at risk (OARs) and frequent overlap of the planning target volume (PTV) and OAR volumes. Using lexicographic ordering (LO), a hierarchical optimization technique, with generalized equivalent uniform dose (gEUD) cost functions, we studied the potential of intensity modulated radiation therapy (IMRT) to increase the dose to pancreatic tumors and to areas of vascular involvement that preclude surgical resection [surgical boost volume (SBV)]. We compared 15 forward planned three-dimensional conformal (3DCRT) and IMRT treatment plans for locally advanced unresectable pancreatic cancer. We created IMRT plans optimized using LO with gEUD-based cost functions that account for the contribution of each part of the resulting inhomogeneous dose distribution. LO-IMRT plans allowed substantial PTV dose escalation compared with 3DCRT; median increase from 52 Gy to 66 Gy (a=-5,p<0.005) and median increase from 50 Gy to 59 Gy (a=-15,p<0.005). LO-IMRT also allowed increases to 85 Gy in the SBV, regardless of a value, along with significant dose reductions in OARs. We conclude that LO-IMRT with gEUD cost functions could allow dose escalation in pancreas tumors with concomitant reduction in doses to organs at risk as compared with traditional 3DCRT.

  19. Occupational dose reduction at Department of Energy contractor facilities: Bibliography of selected readings in radiation protection and ALARA

    SciTech Connect

    Dionne, B.J.; Sullivan, S.G.; Baum, J.W.

    1993-12-01

    This bibliography contains abstracts relating to various aspects of ALARA program implementation and dose reduction activities, with a focus on DOE facilities. Abstracts included in this bibliography were selected from proceedings of technical meetings, journals, research reports, searches of the DOE Energy, Science and Technology Database (in general, the citation and abstract information is presented as obtained from this database), and reprints of published articles provided by the authors. Facility types and activities covered in the scope of this report include: radioactive waste, uranium enrichment, fuel fabrication, spent fuel storage and reprocessing, facility decommissioning, hot laboratories, tritium production, research, test and production reactors, weapons fabrication and testing, fusion, uranium and plutonium processing, radiography, and aocelerators. Information on improved shielding design, decontamination, containments, robotics, source prevention and control, job planning, improved operational and design techniques, as well as on other topics, has been included. In addition, DOE/EH reports not included in previous volumes of the bibliography are in this volume (abstracts 611 to 684). This volume (Volume 5 of the series) contains 217 abstracts. An author index and a subject index are provided to facilitate use. Both indices contain the abstract numbers from previous volumes, as well as the current volume. Information that the reader feels might be included in the next volume of this bibliography should be submitted to the BNL ALARA Center.

  20. Radiation dose reduction using a neck detection algorithm for single spiral brain and cervical spine CT acquisition in the trauma setting.

    PubMed

    Ardley, Nicholas D; Lau, Ken K; Buchan, Kevin

    2013-12-01

    Cervical spine injuries occur in 4-8 % of adults with head trauma. Dual acquisition technique has been traditionally used for the CT scanning of brain and cervical spine. The purpose of this study was to determine the efficacy of radiation dose reduction by using a single acquisition technique that incorporated both anatomical regions with a dedicated neck detection algorithm. Thirty trauma patients for brain and cervical spine CT were included and were scanned with the single acquisition technique. The radiation doses from the single CT acquisition technique with the neck detection algorithm, which allowed appropriate independent dose administration relevant to brain and cervical spine regions, were recorded. Comparison was made both to the doses calculated from the simulation of the traditional dual acquisitions with matching parameters, and to the doses of retrospective dual acquisition legacy technique with the same sample size. The mean simulated dose for the traditional dual acquisition technique was 3.99 mSv, comparable to the average dose of 4.2 mSv from 30 previous patients who had CT of brain and cervical spine as dual acquisitions. The mean dose from the single acquisition technique was 3.35 mSv, resulting in a 16 % overall dose reduction. The images from the single acquisition technique were of excellent diagnostic quality. The new single acquisition CT technique incorporating the neck detection algorithm for brain and cervical spine significantly reduces the overall radiation dose by eliminating the unavoidable overlapping range between 2 anatomical regions which occurs with the traditional dual acquisition technique.

  1. Feasibility of patient dose reduction based on various noise suppression filters for cone-beam computed tomography in an image-guided patient positioning system

    NASA Astrophysics Data System (ADS)

    Kamezawa, Hidemi; Arimura, Hidetaka; Shirieda, Katsutoshi; Kameda, Noboru; Ohki, Masafumi

    2016-05-01

    We investigated the feasibility of patient dose reduction based on six noise suppression filters for cone-beam computed tomography (CBCT) in an image-guided patient positioning (IGPP) system. A midpoint dose was employed as a patient dose index. First, a reference dose (RD) and low-dose (LD)-CBCT images were acquired with a reference dose and various low doses. Second, an automated rigid registration was performed for three axis translations to estimate patient setup errors between a planning CT image and the LD-CBCT images processed by six noise suppression filters (averaging filter, median filter, Gaussian filter, edge-preserving smoothing filter, bilateral filter, and adaptive partial median filter (AMF)). Third, residual errors representing the patient positioning accuracy were calculated as Euclidean distances between the setup error vectors estimated using the LD-CBCT and RD-CBCT images. Finally, the residual errors as a function of the patient dose index were estimated for LD-CBCT images processed by six noise suppression filters, and then the patient dose indices for the filtered LD-CBCT images were obtained at the same residual error as the RD-CBCT image. This approach was applied to an anthropomorphic phantom and four cancer patients. The patient dose for the LD-CBCT images was reduced to 19% of that for the RD-CBCT image for the phantom by using AMF, while keeping a same residual error of 0.47 mm as the RD-CBCT image by applying the noise suppression filters to the LD-CBCT images. The average patient dose was reduced to 31.1% for prostate cancer patients, and it was reduced to 82.5% for a lung cancer patient by applying the AMF. These preliminary results suggested that the proposed approach based on noise suppression filters could decrease the patient dose in IGPP systems.

  2. Feasibility of patient dose reduction based on various noise suppression filters for cone-beam computed tomography in an image-guided patient positioning system.

    PubMed

    Kamezawa, Hidemi; Arimura, Hidetaka; Shirieda, Katsutoshi; Kameda, Noboru; Ohki, Masafumi

    2016-05-07

    We investigated the feasibility of patient dose reduction based on six noise suppression filters for cone-beam computed tomography (CBCT) in an image-guided patient positioning (IGPP) system. A midpoint dose was employed as a patient dose index. First, a reference dose (RD) and low-dose (LD)-CBCT images were acquired with a reference dose and various low doses. Second, an automated rigid registration was performed for three axis translations to estimate patient setup errors between a planning CT image and the LD-CBCT images processed by six noise suppression filters (averaging filter, median filter, Gaussian filter, edge-preserving smoothing filter, bilateral filter, and adaptive partial median filter (AMF)). Third, residual errors representing the patient positioning accuracy were calculated as Euclidean distances between the setup error vectors estimated using the LD-CBCT and RD-CBCT images. Finally, the residual errors as a function of the patient dose index were estimated for LD-CBCT images processed by six noise suppression filters, and then the patient dose indices for the filtered LD-CBCT images were obtained at the same residual error as the RD-CBCT image. This approach was applied to an anthropomorphic phantom and four cancer patients. The patient dose for the LD-CBCT images was reduced to 19% of that for the RD-CBCT image for the phantom by using AMF, while keeping a same residual error of 0.47 mm as the RD-CBCT image by applying the noise suppression filters to the LD-CBCT images. The average patient dose was reduced to 31.1% for prostate cancer patients, and it was reduced to 82.5% for a lung cancer patient by applying the AMF. These preliminary results suggested that the proposed approach based on noise suppression filters could decrease the patient dose in IGPP systems.

  3. A double-blind randomized clinical trial of different doses of transdermal nicotine patch for smoking reduction and cessation in long-term hospitalized schizophrenic patients.

    PubMed

    Chen, Hsing-Kang; Lan, Tsuo-Hung; Wu, Bo-Jian

    2013-02-01

    There have been many studies of smoking cessation using nicotine replacement therapy (NRT) with schizophrenic patients, but none exploring the smoking-reduction effects of varying doses of NRT in long-stay patients with schizophrenia. This study aimed to examine the effect of different doses of the nicotine transdermal patch on smoking-reduction and cessation outcomes in long-term hospitalized schizophrenic patients. A total of 184 subjects participated in a randomized, controlled, double-blind 8-week clinical trial. Participants were randomized into two groups using two different doses of NRT: a high-dose NRT group (31.2 mg for the first 4 weeks, then 20.8 mg for 4 weeks, n = 92) or a low-dose NRT group (20.8 mg for 8 weeks, n = 92). The 7-day point prevalence of abstinence was 2.7 % (5/184). Participants in the low-dose NRT group reduced smoking by 3.1 more cigarettes on average than those in the high-dose group (p = 0.005). However, a repeated measures analysis of variance revealed that the main effect of changes in the number of cigarettes smoked, comparing the two types of treatment across periods, was not significant (p = 0.35, partial eta square = 0.018). In summary, among a cohort of chronic institutionalized schizophrenic patients, smoking cessation and reduction outcomes were not correlated with NRT dose, and the cessation rate was much lower than rates in similar studies. It indicates that long-term hospitalized schizophrenic patients have more difficulties with quitting smoking. More effective integrative smoking cessation programs should be addressed for these patients.

  4. NIH-funded study shows 20 percent reduction in lung cancer mortality with low-dose CT compared to chest X-ray: | Division of Cancer Prevention

    Cancer.gov

    Scientists have found a 20 percent reduction in deaths from lung cancer among current or former heavy smokers who were screened with low-dose helical computed tomography (CT) versus those screened by chest X-ray. The primary research results from the National Lung Screening Trial (NLST) were published online today in the New England Journal of Medicine. |

  5. Angular on-line tube current modulation in multidetector CT examinations of children and adults: The influence of different scanning parameters on dose reduction

    SciTech Connect

    Papadakis, Antonios E.; Perisinakis, Kostas; Damilakis, John

    2007-07-15

    The purpose of this study was to assess the potential of angular on-line tube current modulation on dose reduction in pediatric and adult patients undergoing multidetector computed tomography (MDCT) examinations. Five physical anthropomorphic phantoms that simulate the average individual as neonate, 1-year-old, 5-year-old, 10-year-old, and adult were employed in the current study. Phantoms were scanned with the use of on-line tube current modulation (TCM). Percent dose reduction (%DR) factors achieved by applying TCM, were determined for standard protocols used for head and neck, shoulder, thorax, thorax and abdomen, abdomen, abdomen and pelvis, pelvis, and whole body examinations. A preliminary study on the application of TCM in MDCT examinations of adult patients was performed to validate the results obtained in anthropomorphic phantoms. Dose reduction was estimated as the percentage difference of the modulated milliamperes for each scan and the preset milliamperes prescribed by the scan protocol. The dose reduction in children was found to be much lower than the corresponding reduction achieved for adults. For helical scans the %DR factors, ranged between 1.6% and 7.4% for the neonate, 2.9% and 8.7% for the 1-year old, 2% and 6% for the 5-year-old, 5% and 10.9% for the 10-year-old, and 10.4% and 20.7% for the adult individual. For sequential scans the corresponding %DR factors ranged between 1.3% and 6.7%, 4.5% and 11%, 4.2% and 6.6%, 6.4% and 12.3%, and 8.9% and 23.3%, respectively. Broader beam collimations are associated with decreased %DR factors, when other scanning parameters are held constant. TCM did not impair image noise. In adult patients, the %DR values were found to be in good agreement with the corresponding results obtained in the anthropomorphic adult phantom. In conclusion, on-line TCM may be considered as a valuable tool for reducing dose in routine CT examinations of pediatric and adult patients. However, the dose reduction achieved with TCM

  6. Radiation dose reduction using a CdZnTe-based computed tomography system: Comparison to flat-panel detectors

    SciTech Connect

    Le, Huy Q.; Ducote, Justin L.; Molloi, Sabee

    2010-03-15

    Purpose: Although x-ray projection mammography has been very effective in early detection of breast cancer, its utility is reduced in the detection of small lesions that are occult or in dense breasts. One drawback is that the inherent superposition of parenchymal structures makes visualization of small lesions difficult. Breast computed tomography using flat-panel detectors has been developed to address this limitation by producing three-dimensional data while at the same time providing more comfort to the patients by eliminating breast compression. Flat panels are charge integrating detectors and therefore lack energy resolution capability. Recent advances in solid state semiconductor x-ray detector materials and associated electronics allow the investigation of x-ray imaging systems that use a photon counting and energy discriminating detector, which is the subject of this article. Methods: A small field-of-view computed tomography (CT) system that uses CdZnTe (CZT) photon counting detector was compared to one that uses a flat-panel detector for different imaging tasks in breast imaging. The benefits afforded by the CZT detector in the energy weighting modes were investigated. Two types of energy weighting methods were studied: Projection based and image based. Simulation and phantom studies were performed with a 2.5 cm polymethyl methacrylate (PMMA) cylinder filled with iodine and calcium contrast objects. Simulation was also performed on a 10 cm breast specimen. Results: The contrast-to-noise ratio improvements as compared to flat-panel detectors were 1.30 and 1.28 (projection based) and 1.35 and 1.25 (image based) for iodine over PMMA and hydroxylapatite over PMMA, respectively. Corresponding simulation values were 1.81 and 1.48 (projection based) and 1.85 and 1.48 (image based). Dose reductions using the CZT detector were 52.05% and 49.45% for iodine and hydroxyapatite imaging, respectively. Image-based weighting was also found to have the least beam

  7. Radiation dose reduction using a CdZnTe-based computed tomography system: Comparison to flat-panel detectors

    PubMed Central

    Le, Huy Q.; Ducote, Justin L.; Molloi, Sabee

    2010-01-01

    Purpose: Although x-ray projection mammography has been very effective in early detection of breast cancer, its utility is reduced in the detection of small lesions that are occult or in dense breasts. One drawback is that the inherent superposition of parenchymal structures makes visualization of small lesions difficult. Breast computed tomography using flat-panel detectors has been developed to address this limitation by producing three-dimensional data while at the same time providing more comfort to the patients by eliminating breast compression. Flat panels are charge integrating detectors and therefore lack energy resolution capability. Recent advances in solid state semiconductor x-ray detector materials and associated electronics allow the investigation of x-ray imaging systems that use a photon counting and energy discriminating detector, which is the subject of this article. Methods: A small field-of-view computed tomography (CT) system that uses CdZnTe (CZT) photon counting detector was compared to one that uses a flat-panel detector for different imaging tasks in breast imaging. The benefits afforded by the CZT detector in the energy weighting modes were investigated. Two types of energy weighting methods were studied: Projection based and image based. Simulation and phantom studies were performed with a 2.5 cm polymethyl methacrylate (PMMA) cylinder filled with iodine and calcium contrast objects. Simulation was also performed on a 10 cm breast specimen. Results: The contrast-to-noise ratio improvements as compared to flat-panel detectors were 1.30 and 1.28 (projection based) and 1.35 and 1.25 (image based) for iodine over PMMA and hydroxylapatite over PMMA, respectively. Corresponding simulation values were 1.81 and 1.48 (projection based) and 1.85 and 1.48 (image based). Dose reductions using the CZT detector were 52.05% and 49.45% for iodine and hydroxyapatite imaging, respectively. Image-based weighting was also found to have the least beam

  8. Dose Reduction Study in Vaginal Balloon Packing Filled With Contrast for HDR Brachytherapy Treatment;HDR; Uterine cervix cancer; Vaginal balloon packing; Contrast; Monte Carlo

    SciTech Connect

    Saini, Amarjit S.; Zhang, Geoffrey G.; Finkelstein, Steven E.; Biagioli, Matthew C.

    2011-07-15

    Purpose: Vaginal balloon packing is a means to displace organs at risk during high dose rate brachytherapy of the uterine cervix. We tested the hypothesis that contrast-filled vaginal balloon packing reduces radiation dose to organs at risk, such as the bladder and rectum, in comparison to water- or air-filled balloons. Methods and Materials: In a phantom study, semispherical vaginal packing balloons were filled with air, saline solution, and contrast agents. A high dose rate iridium-192 source was placed on the anterior surface of the balloon, and the diode detector was placed on the posterior surface. Dose ratios were taken with each material in the balloon. Monte Carlo (MC) simulations, by use of the MC computer program DOSXYZnrc, were performed to study dose reduction vs. balloon size and contrast material, including commercially available iodine- and gadolinium-based contrast agents. Results: Measured dose ratios on the phantom with the balloon radius of 3.4 cm were 0.922 {+-} 0.002 for contrast/saline solution and 0.808 {+-} 0.001 for contrast/air. The corresponding ratios by MC simulations were 0.895 {+-} 0.010 and 0.781 {+-} 0.010. The iodine concentration in the contrast was 23.3% by weight. The dose reduction of contrast-filled balloon ranges from 6% to 15% compared with water-filled balloon and 11% to 26% compared with air-filled balloon, with a balloon size range between 1.4 and 3.8 cm, and iodine concentration in contrast of 24.9%. The dose reduction was proportional to the contrast agent concentration. The gadolinium-based contrast agents showed less dose reduction because of much lower concentrations in their solutions. Conclusions: The dose to the posterior wall of the bladder and the anterior wall of the rectum can be reduced if the vaginal balloon is filled with contrast agent in comparison to vaginal balloons filled with saline solution or air.

  9. Exhaling a budesonide inhaler through the nose results in a significant reduction in dose requirement of budesonide nasal spray in patients having asthma with rhinitis.

    PubMed

    Shaikh, W A

    1999-01-01

    Budesonide, an inhaled corticosteroid is used routinely in the treatment of bronchial asthma and rhinitis. Although inhaled corticosteroids in therapeutic doses are unlikely to result in systemic side effects, there is as yet skepticism about their routine and prolonged use. The aim of this study was to determine whether budesonide inhalation through a metered dose inhaler, when exhaled through the nose could result in a reduction in the dose requirement of budesonide metered nasal spray in patients having perennial allergic asthma with rhinitis. This study was an open, parallel, comparative, crossover trial in which 49 young patients having perennial allergic asthma with rhinitis were divided into two groups and administered either a combination of budesonide metered dose inhaler with a budesonide nasal spray or a budesonide inhaler alone, which was to be exhaled through the nose. Both groups were later crossed over and weekly symptom scores and peak nasal inspiratory flow rates were monitored during each phase of the study. Finally, patients who volunteered from both groups were instructed to note the reduction in dose requirement of budesonide nasal spray while using a budesonide inhaler and exhaling it through the nose. The results of this study reveal that when a budesonide inhaler is exhaled through the nose, it results in an improvement in symptom scores and peak nasal inspiratory flow rates, which were significantly less than those obtained in the group using both a budesonide nasal spray and a metered dose inhaler. In addition, exhaling budesonide through the nose results in a 40.1% reduction in the dose requirement of a budesonide nasal spray, which is statistically significant (p < 0.001).

  10. SU-E-T-373: Evaluation and Reduction of Contralateral Skin /subcutaneous Dose for Tangential Breast Irradiation

    SciTech Connect

    Butson, M; Carroll, S; Whitaker, M; Odgers, D; Martin, D; Hinds, S; Kader, J; Ho, K; Amos, S; Toohey, J

    2015-06-15

    Purpose: Tangential breast irradiation is a standard treatment technique for breast cancer therapy. One aspect of dose delivery includes dose delivered to the skin caused by electron contamination. This effect is especially important for highly oblique beams used on the medical tangent where the electron contamination deposits dose on the contralateral breast side. This work aims to investigate and predict as well as define a method to reduce this dose during tangential breast radiotherapy. Methods: Analysis and calculation of breast skin and subcutaneous dose is performed using a Varian Eclipse planning system, AAA algorithm for 6MV x-ray treatments. Measurements were made using EBT3 Gafchromic film to verify the accuracy of planning data. Various materials were tested to assess their ability to remove electron contamination on the contralateral breast. Results: Results showed that the Varian Eclipse AAA algorithm could accurately estimate contralateral breast dose in the build-up region at depths of 2mm or deeper. Surface dose was underestimated by the AAA algorithm. Doses up to 12% of applied dose were seen on the contralateral breast surface and up to 9 % at 2mm depth. Due to the nature of this radiation, being mainly low energy electron contamination, a bolus material could be used to reduce this dose to less than 3%. This is accomplished by 10 mm of superflab bolus or by 1 mm of lead. Conclusion: Contralateral breast skin and subcutaneous dose is present for tangential breast treatment and has been measured to be up to 12% of applied dose from the medial tangent beam. This dose is deposited at shallow depths and is accurately calculated by the Eclipse AAA algorithm at depths of 2mm or greater. Bolus material placed over the contralateral can be used to effectively reduce this skin dose.

  11. Examining Margin Reduction and Its Impact on Dose Distribution for Prostate Cancer Patients Undergoing Daily Cone-Beam Computed Tomography

    SciTech Connect

    Hammoud, Rabih Patel, Samir H.; Pradhan, Deepak; Kim, Jinkoo; Guan, Harrison; Li Shidong; Movsas, Benjamin

    2008-05-01

    Purpose: To examine the dosimetric impact of margin reduction and quantify residual error after three-dimensional (3D) image registration using daily cone-beam computed tomography (CBCT) for prostate cancer patients. Methods and Materials: One hundred forty CBCTs from 5 prostate cancer patients were examined. Two intensity-modulated radiotherapy plans were generated on CT simulation on the basis of two planning target volume (PTV) margins: 10 mm all around the prostate and seminal vesicles except 6 mm posteriorly (10/6) and 5 mm all around except 3 mm posteriorly (5/3). Daily CBCT using the Varian On-Board Imaging System was acquired. The 10/6 and 5/3 simulation plans were overlaid onto each CBCT, and each CBCT plan was calculated. To examine residual error, PlanCT/CBCT intensity-based 3D image registration was performed for prostate localization using center of mass and maximal border displacement. Results: Prostate coverage was within 2% between the 10/6 and 5/3 plans. Seminal vesicle coverage was reduced with the 5/3 plan compared with the 10/6 plan, with coverage difference within 7%. The 5/3 plan allowed 30-50% sparing of bladder and rectal high-dose regions. For residual error quantification, center of mass data show that 99%, 93%, and 96% of observations fall within 3 mm in the left-right, anterior-posterior, and superior-inferior directions, respectively. Maximal border displacement observations range from 79% to 99%, within 5 mm for all directions. Conclusion: Cone-beam CT dosimetrically validated a 10/6 margin when soft-tissue localization is not used. Intensity-based 3D image registration has the potential to improve target localization and to provide guidelines for margin definition.

  12. Sci—Fri AM: Mountain — 02: A comparison of dose reduction methods on image quality for cone beam CT

    SciTech Connect

    Webb, R; Buckley, LA

    2014-08-15

    Modern radiotherapy uses highly conformai dose distributions and therefore relies on daily image guidance for accurate patient positioning. Kilovoltage cone beam CT is one technique that is routinely used for patient set-up and results in a high dose to the patient relative to planar imaging techniques. This study uses an Elekta Synergy linac equipped with XVI cone beam CT to investigate the impact of various imaging parameters on dose and image quality. Dose and image quality are assessed as functions of x-ray tube voltage, tube current and the number of projections in the scan. In each case, the dose measurements confirm that as each parameter increases the dose increases. The assessment of high contrast resolution shows little dependence on changes to the image technique. However, low contrast visibility suggests a trade off between dose and image quality. Particularly for changes in tube potential, the dose increases much faster as a function of voltage than the corresponding increase in low contrast image quality. This suggests using moderate values of the peak tube voltage (100 – 120 kVp) since higher values result in significant dose increases with little gain in image quality. Measurements also indicate that increasing tube current achieves the greatest degree of improvement in the low contrast visibility. The results of this study highlight the need to establish careful imaging protocols to limit dose to the patient and to limit changes to the imaging parameters to those cases where there is a clear clinical requirement for improved image quality.

  13. Dose reduction of scattered photons from concrete walls lined with lead: Implications for improvement in design of megavoltage radiation therapy facility mazes

    SciTech Connect

    Al-Affan, I. A. M. Hugtenburg, R. P.; Piliero, M.; Bari, D. S.; Al-Saleh, W. M.; Evans, S.; Al-Hasan, M.; Al-Zughul, B.; Al-Kharouf, S.; Ghaith, A.

    2015-02-15

    Purpose: This study explores the possibility of using lead to cover part of the radiation therapy facility maze walls in order to absorb low energy photons and reduce the total dose at the maze entrance of radiation therapy rooms. Methods: Experiments and Monte Carlo simulations were utilized to establish the possibility of using high-Z materials to cover the concrete walls of the maze in order to reduce the dose of the scattered photons at the maze entrance. The dose of the backscattered photons from a concrete wall was measured for various scattering angles. The dose was also calculated by the FLUKA and EGSnrc Monte Carlo codes. The FLUKA code was also used to simulate an existing radiotherapy room to study the effect of multiple scattering when adding lead to cover the concrete walls of the maze. Monoenergetic photons were used to represent the main components of the x ray spectrum up to 10 MV. Results: It was observed that when the concrete wall was covered with just 2 mm of lead, the measured dose rate at all backscattering angles was reduced by 20% for photons of energy comparable to Co-60 emissions and 70% for Cs-137 emissions. The simulations with FLUKA and EGS showed that the reduction in the dose was potentially even higher when lead was added. One explanation for the reduction is the increased absorption of backscattered photons due to the photoelectric interaction in lead. The results also showed that adding 2 mm lead to the concrete walls and floor of the maze reduced the dose at the maze entrance by up to 90%. Conclusions: This novel proposal of covering part or the entire maze walls with a few millimeters of lead would have a direct implication for the design of radiation therapy facilities and would assist in upgrading the design of some mazes, especially those in facilities with limited space where the maze length cannot be extended to sufficiently reduce the dose.

  14. A study on the dependence of exposure dose reduction and image evaluation on the distance from the dental periapical X-ray machine

    NASA Astrophysics Data System (ADS)

    Joo, Kyu-Ji; Shin, Jae-Woo; Dong, Kyung-Rae; Lim, Chang-Seon; Chung, Woon-Kwan; Kim, Young-Jae

    2013-11-01

    Reducing the exposure dose from a periapical X-ray machine is an important aim in dental radiography. Although the radiation exposure dose is generally low, any radiation exposure is harmful to the human body. Therefore, this study developed a method that reduces the exposure dose significantly compared to that encountered in a normal procedure, but still produces an image with a similar resolution. The correlation between the image resolution and the exposure dose of the proposed method was examined with increasing distance between the dosimeter and the X-ray tube. The results were compared with those obtained from the existing radiography method. When periapical radiography was performed once according to the recommendations of the International Commission on Radiological Protection (ICRP), the measured skin surface dose was low at 7 mGy or below. In contrast, the skin surface dose measured using the proposed method was only 1.57 mGy, showing a five-fold reduction. These results suggest that further decreases in dose might be achieved using the proposed method.

  15. A Combination of Spatial and Recursive Temporal Filtering for Noise Reduction when Using Region of Interest (ROI) Fluoroscopy for Patient Dose Reduction in Image Guided Vascular Interventions with Significant Anatomical Motion

    PubMed Central

    Nagesh, S.V. Setlur; Khobragade, P.; Ionita, C.; Bednarek, D.R; Rudin, S.

    2015-01-01

    Because x-ray based image-guided vascular interventions are minimally invasive they are currently the most preferred method of treating disorders such as stroke, arterial stenosis, and aneurysms; however, the x-ray exposure to the patient during long image-guided interventional procedures could cause harmful effects such as cancer in the long run and even tissue damage in the short term. ROI fluoroscopy reduces patient dose by differentially attenuating the incident x-rays outside the region-of-interest. To reduce the noise in the dose-reduced regions previously recursive temporal filtering was successfully demonstrated for neurovascular interventions. However, in cardiac interventions, anatomical motion is significant and excessive recursive filtering could cause blur. In this work the effects of three noise-reduction schemes, including recursive temporal filtering, spatial mean filtering, and a combination of spatial and recursive temporal filtering, were investigated in a simulated ROI dose-reduced cardiac intervention. First a model to simulate the aortic arch and its movement was built. A coronary stent was used to simulate a bio-prosthetic valve used in TAVR procedures and was deployed under dose-reduced ROI fluoroscopy during the simulated heart motion. The images were then retrospectively processed for noise reduction in the periphery, using recursive temporal filtering, spatial filtering and a combination of both. Quantitative metrics for all three noise reduction schemes are calculated and are presented as results. From these it can be concluded that with significant anatomical motion, a combination of spatial and recursive temporal filtering scheme is best suited for reducing the excess quantum noise in the periphery. This new noise-reduction technique in combination with ROI fluoroscopy has the potential for substantial patient-dose savings in cardiac interventions. PMID:26900203

  16. A Combination of Spatial and Recursive Temporal Filtering for Noise Reduction when Using Region of Interest (ROI) Fluoroscopy for Patient Dose Reduction in Image Guided Vascular Interventions with Significant Anatomical Motion.

    PubMed

    Nagesh, S V Setlur; Khobragade, P; Ionita, C; Bednarek, D R; Rudin, S

    2015-02-21

    Because x-ray based image-guided vascular interventions are minimally invasive they are currently the most preferred method of treating disorders such as stroke, arterial stenosis, and aneurysms; however, the x-ray exposure to the patient during long image-guided interventional procedures could cause harmful effects such as cancer in the long run and even tissue damage in the short term. ROI fluoroscopy reduces patient dose by differentially attenuating the incident x-rays outside the region-of-interest. To reduce the noise in the dose-reduced regions previously recursive temporal filtering was successfully demonstrated for neurovascular interventions. However, in cardiac interventions, anatomical motion is significant and excessive recursive filtering could cause blur. In this work the effects of three noise-reduction schemes, including recursive temporal filtering, spatial mean filtering, and a combination of spatial and recursive temporal filtering, were investigated in a simulated ROI dose-reduced cardiac intervention. First a model to simulate the aortic arch and its movement was built. A coronary stent was used to simulate a bio-prosthetic valve used in TAVR procedures and was deployed under dose-reduced ROI fluoroscopy during the simulated heart motion. The images were then retrospectively processed for noise reduction in the periphery, using recursive temporal filtering, spatial filtering and a combination of both. Quantitative metrics for all three noise reduction schemes are calculated and are presented as results. From these it can be concluded that with significant anatomical motion, a combination of spatial and recursive temporal filtering scheme is best suited for reducing the excess quantum noise in the periphery. This new noise-reduction technique in combination with ROI fluoroscopy has the potential for substantial patient-dose savings in cardiac interventions.

  17. A combination of spatial and recursive temporal filtering for noise reduction when using region of interest (ROI) fluoroscopy for patient dose reduction in image guided vascular interventions with significant anatomical motion

    NASA Astrophysics Data System (ADS)

    Setlur Nagesh, S. V.; Khobragade, P.; Ionita, C.; Bednarek, D. R.; Rudin, S.

    2015-03-01

    Because x-ray based image-guided vascular interventions are minimally invasive they are currently the most preferred method of treating disorders such as stroke, arterial stenosis, and aneurysms; however, the x-ray exposure to the patient during long image-guided interventional procedures could cause harmful effects such as cancer in the long run and even tissue damage in the short term. ROI fluoroscopy reduces patient dose by differentially attenuating the incident x-rays outside the region-of-interest. To reduce the noise in the dose-reduced regions previously recursive temporal filtering was successfully demonstrated for neurovascular interventions. However, in cardiac interventions, anatomical motion is significant and excessive recursive filtering could cause blur. In this work the effects of three noise-reduction schemes, including recursive temporal filtering, spatial mean filtering, and a combination of spatial and recursive temporal filtering, were investigated in a simulated ROI dose-reduced cardiac intervention. First a model to simulate the aortic arch and its movement was built. A coronary stent was used to simulate a bioprosthetic valve used in TAVR procedures and was deployed under dose-reduced ROI fluoroscopy during the simulated heart motion. The images were then retrospectively processed for noise reduction in the periphery, using recursive temporal filtering, spatial filtering and a combination of both. Quantitative metrics for all three noise reduction schemes are calculated and are presented as results. From these it can be concluded that with significant anatomical motion, a combination of spatial and recursive temporal filtering scheme is best suited for reducing the excess quantum noise in the periphery. This new noise-reduction technique in combination with ROI fluoroscopy has the potential for substantial patient-dose savings in cardiac interventions.

  18. Massive reduction of tumour load and normalisation of hyperprolactinaemia after high dose cabergoline in metastasised prolactinoma causing thoracic syringomyelia

    PubMed Central

    van Uum, S H M; van Alfen, N; Wesseling, P; van Lindert, E; Pieters, G; Nooijen, P; Hermus, A

    2004-01-01

    On administration of high dose cabergoline, 0.5 mg twice a day orally, the plasma prolactin levels decreased within one month and then normalised within 26 months. Tumour load reduced considerably but unfortunately, her signs and symptoms did not improve. This case illustrates that a high dose dopamine agonist might be an important therapeutic option in patients with a metastasised prolactinoma. PMID:15377706

  19. Radiation dose reduction for patients with extranodal NK/T-cell lymphoma with complete response after initial induction chemotherapy

    PubMed Central

    Wang, Liang; Bi, Xi-wen; Xia, Zhong-jun; Huang, Hui-qiang; Jiang, Wen-qi; Zhang, Yu-jing

    2016-01-01

    Previous studies have found that radiotherapy (RT) dose less than 50 Gy resulted in inferior outcomes for early stage extranodal NK/T-cell lymphoma (ENKTL). Nowadays, induction chemotherapy (CT) followed by RT consolidation is often used. For patients who get complete response (CR) after CT, whether RT dose can be safely reduced or not remains unknown. This retrospective study compared the survival outcomes between patients who received higher dose (>50 Gy) and lower dose (≤50 Gy) RT after CR was attained by CT. One hundred and forty four patients of early stage ENKTL got CR after induction CT and received RT consolidation. Thirty-one patients received lower dose RT (median 46 Gy, range, 36–50 Gy), and 113 patients received higher dose RT (median 56 Gy, range, 52–66 Gy). In univariate survival analysis, age >60, local tumor invasion, and non-asparaginase-based CT were associated with inferior progression-free survival (PFS) and overall survival (OS). However, there were no differences in PFS and OS between patients treated with higher and lower dose RT, which was confirmed in the multivariate survival analysis. Furthermore, reduced dose RT did not affect local control rate. Most common RT-related side effects were grade 1/2 mucositis and dermatitis, and the incidence rate of grade 3 mucositis or dermatitis was lower in patients treated with reduced dose RT (9.7% vs 15.0% for mucositis, and 6.5% vs 17.7% for dermatitis). In conclusion, this study found that RT dose could be safely reduced without compromising survival outcomes and further improved RT-related side effects. Prospective randomized controlled trials are warranted to validate our findings. PMID:27713641

  20. Assessment of the dose reduction potential of a model-based iterative reconstruction algorithm using a task-based performance metrology

    SciTech Connect

    Samei, Ehsan; Richard, Samuel

    2015-01-15

    Purpose: Different computed tomography (CT) reconstruction techniques offer different image quality attributes of resolution and noise, challenging the ability to compare their dose reduction potential against each other. The purpose of this study was to evaluate and compare the task-based imaging performance of CT systems to enable the assessment of the dose performance of a model-based iterative reconstruction (MBIR) to that of an adaptive statistical iterative reconstruction (ASIR) and a filtered back projection (FBP) technique. Methods: The ACR CT phantom (model 464) was imaged across a wide range of mA setting on a 64-slice CT scanner (GE Discovery CT750 HD, Waukesha, WI). Based on previous work, the resolution was evaluated in terms of a task-based modulation transfer function (MTF) using a circular-edge technique and images from the contrast inserts located in the ACR phantom. Noise performance was assessed in terms of the noise-power spectrum (NPS) measured from the uniform section of the phantom. The task-based MTF and NPS were combined with a task function to yield a task-based estimate of imaging performance, the detectability index (d′). The detectability index was computed as a function of dose for two imaging tasks corresponding to the detection of a relatively small and a relatively large feature (1.5 and 25 mm, respectively). The performance of MBIR in terms of the d′ was compared with that of ASIR and FBP to assess its dose reduction potential. Results: Results indicated that MBIR exhibits a variability spatial resolution with respect to object contrast and noise while significantly reducing image noise. The NPS measurements for MBIR indicated a noise texture with a low-pass quality compared to the typical midpass noise found in FBP-based CT images. At comparable dose, the d′ for MBIR was higher than those of FBP and ASIR by at least 61% and 19% for the small feature and the large feature tasks, respectively. Compared to FBP and ASIR, MBIR

  1. An investigation of kV CBCT image quality and dose reduction for volume-of-interest imaging using dynamic collimation

    SciTech Connect

    Parsons, David E-mail: james.robar@cdha.nshealth.ca; Robar, James L. E-mail: james.robar@cdha.nshealth.ca

    2015-09-15

    Purpose: The focus of this work was to investigate the improvements in image quality and dose reduction for volume-of-interest (VOI) kilovoltage-cone beam CT (CBCT) using dynamic collimation. Methods: A prototype iris aperture was used to track a VOI during a CBCT acquisition. The current aperture design is capable of 1D translation as a function of gantry angle and dynamic adjustment of the iris radius. The aperture occupies the location of the bow-tie filter on a Varian On-Board Imager system. CBCT and planar image quality were investigated as a function of aperture radius, while maintaining the same dose to the VOI, for a 20 cm diameter cylindrical water phantom with a 9 mm diameter bone insert centered on isocenter. Corresponding scatter-to-primary ratios (SPR) were determined at the detector plane with Monte Carlo simulation using EGSnrc. Dose distributions for various sizes VOI were modeled using a dynamic BEAMnrc library and DOSXYZnrc. The resulting VOI dose distributions were compared to full-field distributions. Results: SPR was reduced by a factor of 8.4 when decreasing iris diameter from 21.2 to 2.4 cm (at isocenter). Depending upon VOI location and size, dose was reduced to 16%–90% of the full-field value along the central axis plane and down to 4% along the axis of rotation, while maintaining the same dose to the VOI compared to full-field techniques. When maintaining constant dose to the VOI, this change in iris diameter corresponds to a factor increase of approximately 1.6 in image contrast and a factor decrease in image noise of approximately 1.2. This results in a measured gain in contrast-to-noise ratio by a factor of approximately 2.0. Conclusions: The presented VOI technique offers improved image quality for image-guided radiotherapy while sparing the surrounding volume of unnecessary dose compared to full-field techniques.

  2. A Monte Carlo study on quantifying the amount of dose reduction by shielding the superficial organs of an Iranian 11-year-old boy

    PubMed Central

    Akhlaghi, Parisa; Hoseinian-Azghadi, Elie; Miri-Hakimabad, Hashem; Rafat-Motavalli, Laleh

    2016-01-01

    A method for minimizing organ dose during computed tomography examinations is the use of shielding to protect superficial organs. There are some scientific reports that usage of shielding technique reduces the surface dose to patients with no appreciable loss in diagnostic quality. Therefore, in this Monte Carlo study based on the phantom of a 11-year-old Iranian boy, the effect of using an optimized shield on dose reduction to body organs was quantified. Based on the impact of shield on image quality, lead shields with thicknesses of 0.2 and 0.4 mm were considered for organs exposed directly and indirectly in the scan range, respectively. The results showed that there is 50%–62% reduction in amounts of dose for organs located fully or partly in the scan range at different tube voltages and modeling the true location of all organs in human anatomy, especially the ones located at the border of the scan, range affects the results up to 49%. PMID:28144117

  3. [The reduction of the dose to the lung in whole-body irradiation with cobalt-60 gamma rays (author's transl)].

    PubMed

    Hochhäuser, E; Balk, O A

    1980-09-01

    In order to reduce the exposure of the lung and oesophagus during whole-body irradiation with cobalt-60 gamma rays the dose rate delivered to the lungs and the neck is diminished by means of a filter. Because of its special shape, sternum and columna vertebralis obtain the unreduced dose. The filter is constructed for irradiation in antero-posterior direction. A fixed position of the patient is not necessary.

  4. Cone beam CT with zonal filters for simultaneous dose reduction, improved target contrast and automated set-up in radiotherapy.

    PubMed

    Moore, C J; Marchant, T E; Amer, A M

    2006-05-07

    Cone beam CT (CBCT) using a zonal filter is introduced. The aims are reduced concomitant imaging dose to the patient, simultaneous control of body scatter for improved image quality in the tumour target zone and preserved set-up detail for radiotherapy. Aluminium transmission diaphragms added to the CBCT x-ray tube of the Elekta Synergytrade mark linear accelerator produced an unattenuated beam for a central "target zone" and a partially attenuated beam for an outer "set-up zone". Imaging doses and contrast noise ratios (CNR) were measured in a test phantom for transmission diaphragms 12 and 24 mm thick, for 5 and 10 cm long target zones. The effect on automatic registration of zonal CBCT to conventional CT was assessed relative to full-field and lead-collimated images of an anthropomorphic phantom. Doses along the axis of rotation were reduced by up to 50% in both target and set-up zones, and weighted dose (two thirds surface dose plus one third central dose) was reduced by 10-20% for a 10 cm long target zone. CNR increased by up to 15% in zonally filtered CBCT images compared to full-field images. Automatic image registration remained as robust as that with full-field images and was superior to CBCT coned down using lead-collimation. Zonal CBCT significantly reduces imaging dose and is expected to benefit radiotherapy through improved target contrast, required to assess target coverage, and wide-field edge detail, needed for robust automatic measurement of patient set-up error.

  5. SU-C-18C-06: Radiation Dose Reduction in Body Interventional Radiology: Clinical Results Utilizing a New Imaging Acquisition and Processing Platform

    SciTech Connect

    Kohlbrenner, R; Kolli, KP; Taylor, A; Kohi, M; Fidelman, N; LaBerge, J; Kerlan, R; Gould, R

    2014-06-01

    Purpose: To quantify the patient radiation dose reduction achieved during transarterial chemoembolization (TACE) procedures performed in a body interventional radiology suite equipped with the Philips Allura Clarity imaging acquisition and processing platform, compared to TACE procedures performed in the same suite equipped with the Philips Allura Xper platform. Methods: Total fluoroscopy time, cumulative dose area product, and cumulative air kerma were recorded for the first 25 TACE procedures performed to treat hepatocellular carcinoma (HCC) in a Philips body interventional radiology suite equipped with Philips Allura Clarity. The same data were collected for the prior 85 TACE procedures performed to treat HCC in the same suite equipped with Philips Allura Xper. Mean values from these cohorts were compared using two-tailed t tests. Results: Following installation of the Philips Allura Clarity platform, a 42.8% reduction in mean cumulative dose area product (3033.2 versus 1733.6 mGycm∧2, p < 0.0001) and a 31.2% reduction in mean cumulative air kerma (1445.4 versus 994.2 mGy, p < 0.001) was achieved compared to similar procedures performed in the same suite equipped with the Philips Allura Xper platform. Mean total fluoroscopy time was not significantly different between the two cohorts (1679.3 versus 1791.3 seconds, p = 0.41). Conclusion: This study demonstrates a significant patient radiation dose reduction during TACE procedures performed to treat HCC after a body interventional radiology suite was converted to the Philips Allura Clarity platform from the Philips Allura Xper platform. Future work will focus on evaluation of patient dose reduction in a larger cohort of patients across a broader range of procedures and in specific populations, including obese patients and pediatric patients, and comparison of image quality between the two platforms. Funding for this study was provided by Philips Healthcare, with 5% salary support provided to authors K. Pallav

  6. Role of cardiac ultrafast cameras with CZT solid-state detectors and software developments on radiation absorbed dose reduction to the patients.

    PubMed

    Gunalp, Bengul

    2015-07-01

    Myocardial perfusion imaging (MPI) is one the most contributing nuclear medicine technique to the annual population dose. The purpose of this study is to compare radiation-absorbed doses to the patients examined by conventional cardiac SPECT (CSPECT) camera and ultrafast cardiac (UFC) camera with cadmium-zinc-telluride (CZT) solid-state detectors. Total injected activity was reduced by 50 % when both stress and rest images were acquired and by 75 % when only stress images were taken with UFC camera. As a result of this, the mean total effective dose was found significantly lower with UFC camera (2.2 ± 1.2 mSv) than CSPECT (7.7 ± 3.8 mSv) (p < 0.001). Further dose reduction was obtained by reducing equivocal test results and unnecessary additional examinations with UFC camera. Using UFC camera, MPI can be conveniently used for the detection of coronary artery disease (CAD) much less increasing annual population radiation dose as it had been before.

  7. Effective Dose Reduction to Cardiac Structures Using Protons Compared With 3DCRT and IMRT in Mediastinal Hodgkin Lymphoma

    SciTech Connect

    Hoppe, Bradford S.; Flampouri, Stella; Su Zhong; Latif, Naeem; Dang, Nam H.; Lynch, James; Joyce, Michael; Sandler, Eric

    2012-10-01

    Purpose: We investigated the dosimetric impact of proton therapy (PT) on various cardiac subunits in patients with Hodgkin lymphoma (HL). Methods and Materials: From June 2009 through December 2010, 13 patients were enrolled on an institutional review board-approved protocol for consolidative involved-node radiotherapy (INRT) for HL. Three separate treatment plans were developed prospectively by using three-dimensional conformal radiotherapy (3DCRT), intensity-modulated radiotherapy (IMRT), and PT. Cardiac subunits were retrospectively contoured on the 11 patients with intravenous-contrast simulation scans, and the doses were calculated for all treatment plans. A Wilcoxon paired test was performed to evaluate the statistical significance (p < 0.05) of 3DCRT and IMRT compared with PT. Results: The mean heart doses were 21 Gy, 12 Gy, and 8 Gy (relative biologic effectiveness [RBE]) with 3DCRT, IMRT, and PT, respectively. Compared with 3DCRT and IMRT, PT reduced the mean doses to the left and right atria; the left and right ventricles; the aortic, mitral, and tricuspid valves; and the left anterior descending, left circumflex, and right circumflex coronary arteries. Conclusions: Compared with 3DCRT and IMRT, PT reduced the radiation doses to all major cardiac subunits. Limiting the doses to these structures should translate into lower rates of cardiac toxicities.

  8. SU-C-207-05: A Comparative Study of Noise-Reduction Algorithms for Low-Dose Cone-Beam Computed Tomography

    SciTech Connect

    Mukherjee, S; Yao, W

    2015-06-15

    Purpose: To study different noise-reduction algorithms and to improve the image quality of low dose cone beam CT for patient positioning in radiation therapy. Methods: In low-dose cone-beam CT, the reconstructed image is contaminated with excessive quantum noise. In this study, three well-developed noise reduction algorithms namely, a) penalized weighted least square (PWLS) method, b) split-Bregman total variation (TV) method, and c) compressed sensing (CS) method were studied and applied to the images of a computer–simulated “Shepp-Logan” phantom and a physical CATPHAN phantom. Up to 20% additive Gaussian noise was added to the Shepp-Logan phantom. The CATPHAN phantom was scanned by a Varian OBI system with 100 kVp, 4 ms and 20 mA. For comparing the performance of these algorithms, peak signal-to-noise ratio (PSNR) of the denoised images was computed. Results: The algorithms were shown to have the potential in reducing the noise level for low-dose CBCT images. For Shepp-Logan phantom, an improvement of PSNR of 2 dB, 3.1 dB and 4 dB was observed using PWLS, TV and CS respectively, while for CATPHAN, the improvement was 1.2 dB, 1.8 dB and 2.1 dB, respectively. Conclusion: Penalized weighted least square, total variation and compressed sensing methods were studied and compared for reducing the noise on a simulated phantom and a physical phantom scanned by low-dose CBCT. The techniques have shown promising results for noise reduction in terms of PSNR improvement. However, reducing the noise without compromising the smoothness and resolution of the image needs more extensive research.

  9. Can a revised paediatric radiation dose reduction CT protocol be applied and still maintain anatomical delineation, diagnostic confidence and overall imaging quality?

    PubMed Central

    Siriwanarangsun, P; Tanaanantarak, P; Krisanachinda, A

    2014-01-01

    Objective: To compare multidetector CT (MDCT) radiation doses between default settings and a revised dose reduction protocol and to determine whether the diagnostic confidence can be maintained with imaging quality made under the revised protocol in paediatric head, chest and abdominal CT studies. Methods: The study retrospectively reviewed head, chest, abdominal and thoracoabdominal MDCT studies, comparing 231 CT studies taken before (Phase 1) and 195 CT studies taken after (Phase 2) the implemented revised protocol. Image quality was assessed using a five-point grading scale based on anatomical criteria, diagnostic confidence and overall quality. Image noise and dose–length product (DLP) were collected and compared. Results: The relative dose reductions between Phase 1 and Phase 2 were statistically significant in 35%, 51% and 54% (p < 0.001) of head, chest and abdominal CT studies, respectively. There were no statistically significant differences in overall image quality score comparisons in the head (p = 0.3), chest (p = 0.7), abdominal (p = 0.7) and contiguous thoracic (p = 0.1) and abdominal (p = 0.2) CT studies, with the exception of anatomical quality in definition of bronchial walls and delineation of intrahepatic portal branches in thoracoabdominal CTs, and diagnostic confidence in mass lesion in head CTs, liver lesion (>1 cm), splanchnic venous thrombosis, pancreatitis in abdominal CTs, and emphysema and aortic dissection in thoracoabdominal CTs. Conclusion: Paediatric CT radiation doses can be significantly reduced from manufacturer's default protocol while still maintaining anatomical delineation, diagnostic confidence and overall imaging quality. Advances in knowledge: Revised paediatric CT protocol can provide a half DLP reduction while preserving overall imaging quality. PMID:24959737

  10. Dose-dependent reduction of hazardous alcohol use in a placebo-controlled trial of naltrexone for smoking cessation.

    PubMed

    O'Malley, Stephanie S; Krishnan-Sarin, Suchitra; McKee, Sherry A; Leeman, Robert F; Cooney, Ned L; Meandzija, Boris; Wu, Ran; Makuch, Robert W

    2009-06-01

    The opiate antagonist naltrexone (Ntx) has demonstrated efficacy in the treatment of alcohol dependence and as a component of treatment to reduce heavy drinking. At present, there are no published dose-ranging clinical trials of the oral preparation for treatment of problem drinking. The present study evaluated the effects of Ntx on alcohol use among the subset of hazardous drinkers (n=102) who participated in a placebo-controlled, dose-ranging trial of oral Ntx (25-mg, 50-mg and 100-mg doses) combined with open-label transdermal nicotine patch for enhancing smoking cessation. On the primary outcome--no hazardous drinking (drinking that exceeded weekly or daily limits) during treatment--25 mg and 50 mg Ntx were superior to placebo (each p<0.05). These findings remained after controlling for baseline predictors or smoking abstinence during treatment. Time to remission of hazardous drinking was examined as a secondary outcome with definitions of hazardous drinking based on weekly limits, daily limits and the combination of weekly and daily limits and the results were consistent with the primary findings. In conclusion, the findings suggest that Ntx can reduce the risk of hazardous drinking in smokers who are not seeking or receiving alcohol treatment, providing strong evidence for the pharmacological effects of Ntx on drinking. This effect appears to favour lower doses that may be better tolerated and less expensive than the higher 100-mg dose. Given its efficacy and favourable side-effect profile, the 25-mg dose should be considered for future studies of combination therapy.

  11. Dose Dependent Reduction of Hazardous Alcohol Use in a Placebo-Controlled Trial of Naltrexone for Smoking Cessation

    PubMed Central

    O’Malley, Stephanie S.; Krishnan-Sarin, Suchitra; McKee, Sherry A.; Leeman, Robert F.; Cooney, Ned L.; Meandzija, Boris; Wu, Ran; Makuch, Robert W.

    2011-01-01

    The opiate antagonist naltrexone has demonstrated efficacy in the treatment of alcohol dependence and as a component of treatment to reduce heavy drinking. At present, there are no published dose-ranging clinical trials of the oral preparation for treatment of problem drinking. The present study evaluated the effects of naltrexone on alcohol use among the subset of hazardous drinkers (N = 102) who participated in a placebo-controlled, dose-ranging trial of oral naltrexone (25 mg, 50 mg and 100 mg doses) combined with open-label transdermal nicotine patch for enhancing smoking cessation. On the primary outcome—no hazardous drinking (drinking that exceeded weekly or daily limits) during treatment—25 mg and 50 mg naltrexone were superior to placebo (each p < 0.05). These findings remained after controlling for baseline predictors or smoking abstinence during treatment. Time to remission of hazardous drinking was examined as a secondary outcome with definitions of hazardous drinking based on weekly limits, daily limits and the combination of weekly and daily limits and the results were consistent with the primary findings. In conclusion, the findings suggest that naltrexone can reduce the risk of hazardous drinking in smokers who are not seeking or receiving alcohol treatment, providing strong evidence for the pharmacological effects of naltrexone on drinking. This effect appears to favor lower doses that may be better tolerated and less expensive than the higher 100 mg dose. Given its efficacy and favorable side effect profile, the 25 mg dose should be considered for future studies of combination therapy. PMID:18796184

  12. TH-A-18C-03: Noise Correlation in CBCT Projection Data and Its Application for Noise Reduction in Low-Dose CBCT

    SciTech Connect

    ZHANG, H; Huang, J; Ma, J; Chen, W; Ouyang, L; Wang, J

    2014-06-15

    Purpose: To study the noise correlation properties of cone-beam CT (CBCT) projection data and to incorporate the noise correlation information to a statistics-based projection restoration algorithm for noise reduction in low-dose CBCT. Methods: In this study, we systematically investigated the noise correlation properties among detector bins of CBCT projection data by analyzing repeated projection measurements. The measurements were performed on a TrueBeam on-board CBCT imaging system with a 4030CB flat panel detector. An anthropomorphic male pelvis phantom was used to acquire 500 repeated projection data at six different dose levels from 0.1 mAs to 1.6 mAs per projection at three fixed angles. To minimize the influence of the lag effect, lag correction was performed on the consecutively acquired projection data. The noise correlation coefficient between detector bin pairs was calculated from the corrected projection data. The noise correlation among CBCT projection data was then incorporated into the covariance matrix of the penalized weighted least-squares (PWLS) criterion for noise reduction of low-dose CBCT. Results: The analyses of the repeated measurements show that noise correlation coefficients are non-zero between the nearest neighboring bins of CBCT projection data. The average noise correlation coefficients for the first- and second- order neighbors are about 0.20 and 0.06, respectively. The noise correlation coefficients are independent of the dose level. Reconstruction of the pelvis phantom shows that the PWLS criterion with consideration of noise correlation (PWLS-Cor) results in a lower noise level as compared to the PWLS criterion without considering the noise correlation (PWLS-Dia) at the matched resolution. Conclusion: Noise is correlated among nearest neighboring detector bins of CBCT projection data. An accurate noise model of CBCT projection data can improve the performance of the statistics-based projection restoration algorithm for low-dose

  13. Quantifying the image quality and dose reduction of respiratory triggered 4D cone-beam computed tomography with patient-measured breathing

    NASA Astrophysics Data System (ADS)

    Cooper, Benjamin J.; O'Brien, Ricky T.; Kipritidis, John; Shieh, Chun-Chien; Keall, Paul J.

    2015-12-01

    Respiratory triggered four dimensional cone-beam computed tomography (RT 4D CBCT) is a novel technique that uses a patient’s respiratory signal to drive the image acquisition with the goal of imaging dose reduction without degrading image quality. This work investigates image quality and dose using patient-measured respiratory signals for RT 4D CBCT simulations. Studies were performed that simulate a 4D CBCT image acquisition using both the novel RT 4D CBCT technique and a conventional 4D CBCT technique. A set containing 111 free breathing lung cancer patient respiratory signal files was used to create 111 pairs of RT 4D CBCT and conventional 4D CBCT image sets from realistic simulations of a 4D CBCT system using a Rando phantom and the digital phantom, XCAT. Each of these image sets were compared to a ground truth dataset from which a mean absolute pixel difference (MAPD) metric was calculated to quantify the degradation of image quality. The number of projections used in each simulation was counted and was assumed as a surrogate for imaging dose. Based on 111 breathing traces, when comparing RT 4D CBCT with conventional 4D CBCT, the average image quality was reduced by 7.6% (Rando study) and 11.1% (XCAT study). However, the average imaging dose reduction was 53% based on needing fewer projections (617 on average) than conventional 4D CBCT (1320 projections). The simulation studies have demonstrated that the RT 4D CBCT method can potentially offer a 53% saving in imaging dose on average compared to conventional 4D CBCT in simulation studies using a wide range of patient-measured breathing traces with a minimal impact on image quality.

  14. SU-E-J-183: Quantifying the Image Quality and Dose Reduction of Respiratory Triggered 4D Cone-Beam Computed Tomography with Patient- Measured Breathing

    SciTech Connect

    Cooper, B; OBrien, R; Kipritidis, J; Keall, P

    2014-06-01

    Purpose: Respiratory triggered four dimensional cone-beam computed tomography (RT 4D CBCT) is a novel technique that uses a patient's respiratory signal to drive the image acquisition with the goal of imaging dose reduction without degrading image quality. This work investigates image quality and dose using patient-measured respiratory signals for RT 4D CBCT simulations instead of synthetic sinusoidal signals used in previous work. Methods: Studies were performed that simulate a 4D CBCT image acquisition using both the novel RT 4D CBCT technique and a conventional 4D CBCT technique from a database of oversampled Rando phantom CBCT projections. A database containing 111 free breathing lung cancer patient respiratory signal files was used to create 111 RT 4D CBCT and 111 conventional 4D CBCT image datasets from realistic simulations of a 4D RT CBCT system. Each of these image datasets were compared to a ground truth dataset from which a root mean square error (RMSE) metric was calculated to quantify the degradation of image quality. The number of projections used in each simulation is counted and was assumed as a surrogate for imaging dose. Results: Based on 111 breathing traces, when comparing RT 4D CBCT with conventional 4D CBCT the average image quality was reduced by 7.6%. However, the average imaging dose reduction was 53% based on needing fewer projections (617 on average) than conventional 4D CBCT (1320 projections). Conclusion: The simulation studies using a wide range of patient breathing traces have demonstrated that the RT 4D CBCT method can potentially offer a substantial saving of imaging dose of 53% on average compared to conventional 4D CBCT in simulation studies with a minimal impact on image quality. A patent application (PCT/US2012/048693) has been filed which is related to this work.

  15. Dose Addition Models Based on Biologically Relevant Reductions in Fetal Testosterone Accurately Predict Postnatal Reproductive Tract Alterations by a Phthalate Mixture in Rats

    PubMed Central

    Howdeshell, Kembra L.; Rider, Cynthia V.; Wilson, Vickie S.; Furr, Johnathan R.; Lambright, Christy R.; Gray, L. Earl

    2015-01-01

    Challenges in cumulative risk assessment of anti-androgenic phthalate mixtures include a lack of data on all the individual phthalates and difficulty determining the biological relevance of reduction in fetal testosterone (T) on postnatal development. The objectives of the current study were 2-fold: (1) to test whether a mixture model of dose addition based on the fetal T production data of individual phthalates would predict the effects of a 5 phthalate mixture on androgen-sensitive postnatal male reproductive tract development, and (2) to determine the biological relevance of the reductions in fetal T to induce abnormal postnatal reproductive tract development using data from the mixture study. We administered a dose range of the mixture (60, 40, 20, 10, and 5% of the top dose used in the previous fetal T production study consisting of 300 mg/kg per chemical of benzyl butyl (BBP), di(n)butyl (DBP), diethyl hexyl phthalate (DEHP), di-isobutyl phthalate (DiBP), and 100 mg dipentyl (DPP) phthalate/kg; the individual phthalates were present in equipotent doses based on their ability to reduce fetal T production) via gavage to Sprague Dawley rat dams on GD8-postnatal day 3. We compared observed mixture responses to predictions of dose addition based on the previously published potencies of the individual phthalates to reduce fetal T production relative to a reference chemical and published postnatal data for the reference chemical (called DAref). In addition, we predicted DA (called DAall) and response addition (RA) based on logistic regression analysis of all 5 individual phthalates when complete data were available. DA ref and DA all accurately predicted the observed mixture effect for 11 of 14 endpoints. Furthermore, reproductive tract malformations were seen in 17–100% of F1 males when fetal T production was reduced by about 25–72%, respectively. PMID:26350170

  16. Computed tomography pulmonary angiography using a 20% reduction in contrast medium dose delivered in a multiphasic injection

    PubMed Central

    Chen, Mitchell; Mattar, Gaith; Abdulkarim, Jamal A

    2017-01-01

    AIM To evaluate the feasibility of reducing the dose of iodinated contrast agent in computed tomography pulmonary angiography (CTPA). METHODS One hundred and twenty-seven patients clinically suspected of having pulmonary embolism underwent spiral CTPA, out of whom fifty-seven received 75 mL and the remaining seventy a lower dose of 60 mL of contrast agent. Both doses were administered in a multiphasic injection. A minimum opacification threshold of 250 Hounsfield units (HU) in the main pulmonary artery is used for assessing the technical adequacy of the scans. RESULTS Mean opacification was found to be positively correlated to patient age (Pearson’s correlation 0.4255, P < 0.0001) and independent of gender (male:female, 425.6 vs 450.4, P = 0.34). When age is accounted for, the study and control groups did not differ significantly in their mean opacification in the main (436.8 vs 437.9, P = 0.48), left (416.6 vs 419.8, P = 0.45) or the right pulmonary arteries (417.3 vs 423.5, P = 0.40). The number of sub-optimally opacified scans (the mean opacification in the main pulmonary artery < 250 HU) did not differ significantly between the study and control groups (7 vs 10). CONCLUSION A lower dose of iodine contrast at 60 mL can be feasibly used in CTPA without resulting in a higher number of sub-optimally opacified scans.

  17. Reduction of the secondary neutron dose in passively scattered proton radiotherapy, using an optimized pre-collimator/collimator

    PubMed Central

    Brenner, David J; Elliston, Carl D; Hall, Eric J; Paganetti, Harald

    2013-01-01

    Proton radiotherapy represents a potential major advance in cancer therapy. Most current proton beams are spread out to cover the tumor using passive scattering and collimation, resulting in an extra whole-body high-energy neutron dose, primarily from proton interactions with the final collimator. There is considerable uncertainty as to the carcinogenic potential of low doses of high-energy neutrons, and thus we investigate whether this neutron dose can be significantly reduced without major modifications to passively scattered proton beam lines. Our goal is to optimize the design features of a patient-specific collimator or pre-collimator/collimator assembly. There are a number of often contradictory design features, in terms of geometry and material, involved in an optimal design. For example, plastic or hybrid plastic/metal collimators have a number of advantages. We quantify these design issues, and investigate the practical balances that can be achieved to significantly reduce the neutron dose without major alterations to the beamline design or function. Given that the majority of proton therapy treatments, at least for the next few years, will use passive scattering techniques, reducing the associated neutron-related risks by simple modifications of the collimator assembly design is a desirable goal. PMID:19779218

  18. Insight into illness and its relationship to illness severity, cognition and estimated antipsychotic dopamine receptor occupancy in schizophrenia: An antipsychotic dose reduction study.

    PubMed

    Gerretsen, Philip; Takeuchi, Hiroyoshi; Ozzoude, Miracle; Graff-Guerrero, Ariel; Uchida, Hiroyuki

    2017-05-01

    Little is known about the influence of D2 receptor occupancy on impaired insight into illness (III)-a core feature of schizophrenia. III is associated with illness severity and cognitive dysfunction. Comparably, supratherapeutic D2 receptor occupancy can impair cognition. However, it is unclear how illness severity, cognition, and D2 receptor occupancy interact to influence III in schizophrenia. The aim of this study was to explore the influence of antipsychotic dose reduction on the relationships of illness severity and cognition to III. III was assessed at baseline and 28 weeks post-antipsychotic dose reduction in 16 participants with schizophrenia and plasma antipsychotic concentrations. III was assessed primarily with the Schedule for the Assessment of Insight-Japanese version, and secondarily with the Positive and Negative Syndrome Scale item G12. Correlation and regression analyses were performed to explore III's relationship to illness severity, cognition, and estimated D2 receptor occupancy (Est.D2). Cognition and Est.D2 predicted III at baseline. At 28 weeks post-reduction, illness severity and Est.D2 predicted III. Our findings suggest a complex relationship may exist among III, illness severity, cognition and Est.D2. At higher D2 receptor occupancies, III is influenced by cognitive dysfunction, whereas, at lower occupancies, illness severity has a stronger effect on III.

  19. Structural changes caused by radiation-induced reduction and radiolysis: the effect of X-ray absorbed dose in a fungal multicopper oxidase.

    PubMed

    De la Mora, Eugenio; Lovett, Janet E; Blanford, Christopher F; Garman, Elspeth F; Valderrama, Brenda; Rudino-Pinera, Enrique

    2012-05-01

    X-ray radiation induces two main effects at metal centres contained in protein crystals: radiation-induced reduction and radiolysis and a resulting decrease in metal occupancy. In blue multicopper oxidases (BMCOs), the geometry of the active centres and the metal-to-ligand distances change depending on the oxidation states of the Cu atoms, suggesting that these alterations are catalytically relevant to the binding, activation and reduction of O(2). In this work, the X-ray-determined three-dimensional structure of laccase from the basidiomycete Coriolopsis gallica (Cg L), a high catalytic potential BMCO, is described. By combining spectroscopic techniques (UV-Vis, EPR and XAS) and X-ray crystallography, structural changes at and around the active copper centres were related to pH and absorbed X-ray dose (energy deposited per unit mass). Depletion of two of the four active Cu atoms as well as low occupancies of the remaining Cu atoms, together with different conformations of the metal centres, were observed at both acidic pH and high absorbed dose, correlating with more reduced states of the active coppers. These observations provide additional evidence to support the role of flexibility of copper sites during O(2) reduction. This study supports previous observations indicating that interpretations regarding redox state and metal coordination need to take radiation effects explicitly into account.

  20. Structural changes caused by radiation-induced reduction and radiolysis: the effect of X-ray absorbed dose in a fungal multicopper oxidase

    PubMed Central

    De la Mora, Eugenio; Lovett, Janet E.; Blanford, Christopher F.; Garman, Elspeth F.; Valderrama, Brenda; Rudino-Pinera, Enrique

    2012-01-01

    X-ray radiation induces two main effects at metal centres contained in protein crystals: radiation-induced reduction and radiolysis and a resulting decrease in metal occupancy. In blue multicopper oxidases (BMCOs), the geometry of the active centres and the metal-to-ligand distances change depending on the oxidation states of the Cu atoms, suggesting that these alterations are catalytically relevant to the binding, activation and reduction of O2. In this work, the X-ray-determined three-dimensional structure of laccase from the basidiomycete Coriolopsis gallica (Cg L), a high catalytic potential BMCO, is described. By combining spectroscopic techniques (UV–Vis, EPR and XAS) and X-ray crystallography, structural changes at and around the active copper centres were related to pH and absorbed X-­ray dose (energy deposited per unit mass). Depletion of two of the four active Cu atoms as well as low occupancies of the remaining Cu atoms, together with different conformations of the metal centres, were observed at both acidic pH and high absorbed dose, correlating with more reduced states of the active coppers. These observations provide additional evidence to support the role of flexibility of copper sites during O2 reduction. This study supports previous observations indicating that interpretations regarding redox state and metal coordination need to take radiation effects explicitly into account. PMID:22525754

  1. Radiation-Induced Noncancer Risks in Interventional Cardiology: Optimisation of Procedures and Staff and Patient Dose Reduction

    PubMed Central

    Khairuddin Md Yusof, Ahmad

    2013-01-01

    Concerns about ionizing radiation during interventional cardiology have been increased in recent years as a result of rapid growth in interventional procedure volumes and the high radiation doses associated with some procedures. Noncancer radiation risks to cardiologists and medical staff in terms of radiation-induced cataracts and skin injuries for patients appear clear potential consequences of interventional cardiology procedures, while radiation-induced potential risk of developing cardiovascular effects remains less clear. This paper provides an overview of the evidence-based reviews of concerns about noncancer risks of radiation exposure in interventional cardiology. Strategies commonly undertaken to reduce radiation doses to both medical staff and patients during interventional cardiology procedures are discussed; optimisation of interventional cardiology procedures is highlighted. PMID:24027768

  2. Variability in CT lung-nodule quantification: Effects of dose reduction and reconstruction methods on density and texture based features

    PubMed Central

    Lo, P.; Young, S.; Kim, H. J.; Brown, M. S.

    2016-01-01

    Purpose: To investigate the effects of dose level and reconstruction method on density and texture based features computed from CT lung nodules. Methods: This study had two major components. In the first component, a uniform water phantom was scanned at three dose levels and images were reconstructed using four conventional filtered backprojection (FBP) and four iterative reconstruction (IR) methods for a total of 24 different combinations of acquisition and reconstruction conditions. In the second component, raw projection (sinogram) data were obtained for 33 lung nodules from patients scanned as a part of their clinical practice, where low dose acquisitions were simulated by adding noise to sinograms acquired at clinical dose levels (a total of four dose levels) and reconstructed using one FBP kernel and two IR kernels for a total of 12 conditions. For the water phantom, spherical regions of interest (ROIs) were created at multiple locations within the water phantom on one reference image obtained at a reference condition. For the lung nodule cases, the ROI of each nodule was contoured semiautomatically (with manual editing) from images obtained at a reference condition. All ROIs were applied to their corresponding images reconstructed at different conditions. For 17 of the nodule cases, repeat contours were performed to assess repeatability. Histogram (eight features) and gray level co-occurrence matrix (GLCM) based texture features (34 features) were computed for all ROIs. For the lung nodule cases, the reference condition was selected to be 100% of clinical dose with FBP reconstruction using the B45f kernel; feature values calculated from other conditions were compared to this reference condition. A measure was introduced, which the authors refer to as Q, to assess the stability of features across different conditions, which is defined as the ratio of reproducibility (across conditions) to repeatability (across repeat contours) of each feature. Results: The

  3. Severe Hyperbilirubinemia in an HIV-HCV-Coinfected Patient Starting the 3D Regimen That Resolved After TDM-Guided Atazanavir Dose Reduction.

    PubMed

    Cattaneo, Dario; Riva, Agostino; Clementi, Emilio; Milazzo, Laura; Gervasoni, Cristina

    2016-06-01

    The combination of ombitasvir, dasabuvir, and paritaprevir/ritonavir (considered as the 3D regimen) has proven to be associated with high sustained virologic response and optimal tolerability in hepatitis C virus-infected patients. Here, we describe an HIV-HCV-coinfected patient who experienced a grade 4 hyperbilirubinemia and a 2.5-fold increase in the atazanavir plasma trough concentrations few days after the start of 3D-based antiviral therapy who benefited from an atazanavir dose reduction guided by therapeutic drug monitoring.

  4. Improved dose calculation accuracy for low energy brachytherapy by optimizing dual energy CT imaging protocols for noise reduction using sinogram affirmed iterative reconstruction.

    PubMed

    Landry, Guillaume; Gaudreault, Mathieu; van Elmpt, Wouter; Wildberger, Joachim E; Verhaegen, Frank

    2016-03-01

    The goal of this study was to evaluate the noise reduction achievable from dual energy computed tomography (CT) imaging (DECT) using filtered backprojection (FBP) and iterative image reconstruction algorithms combined with increased imaging exposure. We evaluated the data in the context of imaging for brachytherapy dose calculation, where accurate quantification of electron density ρe and effective atomic number Zeff is beneficial. A dual source CT scanner was used to scan a phantom containing tissue mimicking inserts. DECT scans were acquired at 80 kVp/140Sn kVp (where Sn stands for tin filtration) and 100 kVp/140Sn kVp, using the same values of the CT dose index CTDIvol for both settings as a measure for the radiation imaging exposure. Four CTDIvol levels were investigated. Images were reconstructed using FBP and sinogram affirmed iterative reconstruction (SAFIRE) with strength 1,3 and 5. From DECT scans two material quantities were derived, Zeff and ρe. DECT images were used to assign material types and the amount of improperly assigned voxels was quantified for each protocol. The dosimetric impact of improperly assigned voxels was evaluated with Geant4 Monte Carlo (MC) dose calculations for an (125)I source in numerical phantoms. Standard deviations for Zeff and ρe were reduced up to a factor ∼2 when using SAFIRE with strength 5 compared to FBP. Standard deviations on Zeff and ρe as low as 0.15 and 0.006 were achieved for the muscle insert representing typical soft tissue using a CTDIvol of 40 mGy and 3mm slice thickness. Dose calculation accuracy was generally improved when using SAFIRE. Mean (maximum absolute) dose errors of up to 1.3% (21%) with FBP were reduced to less than 1% (6%) with SAFIRE at a CTDIvol of 10 mGy. Using a CTDIvol of 40mGy and SAFIRE yielded mean dose calculation errors of the order of 0.6% which was the MC dose calculation precision in this study and no error was larger than ±2.5% as opposed to errors of up to -4% with FPB. This

  5. Acute neurogenic airway plasma exudation and edema induced by inhaled wood smoke in guinea pigs: role of tachykinins and hydroxyl radical.

    PubMed

    Lin, Y S; Kou, Y R

    2000-04-07

    We studied the mechanisms underlying the wood smoke-induced acute airway injury in 120 anaesthetized guinea pigs. Five minutes after airway exposure, various doses of wood smoke produced a dose-dependent increase in Evans blue dye contents at all airway levels measured. Additionally, inhaled wood smoke produced submucosal edema of the trachea and bronchus, and peribronchial edema. These acute airway responses were nearly abolished by pretreatment with CP-96,345 alone [a tachykinin NK(1) receptor antagonist; (2S, 3S)-cis-2-(diphenylmethyl)-N-((2-methoxyphenyl)-methyl)-1-azabicyc lo( 2.2.2.)-octan-3-amine] or with a combination of CP-96,345 and dimethylthiourea (a hydroxyl radical scavenger), and were attenuated by pretreatment with dimethylthiourea alone, yet were not affected by pretreatment with SR-48,968 [a tachykinin NK(2) receptor antagonist; (S)-N-methyl-N(4-(4-acetylamino-4-phenylpiperidino)-2-(3, 4-dichlorophenyl)-butyl)benzamide], with a combination of CP-96,344 and SR-48,965 (inactive enantiomers), with MK-886 [a leukotriene biosynthesis inhibitor; L-663, 536(3-(1-(4-chlorobenzyl)-3-t-butyl-thio-5-isopropylindol-2-yl)-2, 2-dimethylpropanoic acid], with indomethacin (a cyclooxygenase inhibitor), or with N(G)-nitro-L-arginine methyl ester (a nitric oxide (NO) synthase inhibitor). The activity of airway neutral endopeptidase (an enzyme for tachykinin degradation) was not influenced by wood smoke at 5-min post-exposure. We conclude that both endogenous tachykinins and hydroxyl radical play an important role in producing smoke-induced acute airway plasma exudation and airway edema in guinea pigs. The contribution of tachykinins to these neurogenic responses is mediated via the activation of tachykinin NK(1) receptors and partly via a hydroxyl radical mechanism, and is not associated with inactivation of neutral endopeptidase.

  6. Noise reduction for low-dose helical CT by 3D penalized weighted least-squares sinogram smoothing

    NASA Astrophysics Data System (ADS)

    Wang, Jing; Li, Tianfang; Lu, Hongbing; Liang, Zhengrong

    2006-03-01

    Helical computed tomography (HCT) has several advantages over conventional step-and-shoot CT for imaging a relatively large object, especially for dynamic studies. However, HCT may increase X-ray exposure significantly to the patient. This work aims to reduce the radiation by lowering the X-ray tube current (mA) and filtering the low-mA (or dose) sinogram noise. Based on the noise properties of HCT sinogram, a three-dimensional (3D) penalized weighted least-squares (PWLS) objective function was constructed and an optimal sinogram was estimated by minimizing the objective function. To consider the difference of signal correlation among different direction of the HCT sinogram, an anisotropic Markov random filed (MRF) Gibbs function was designed as the penalty. The minimization of the objection function was performed by iterative Gauss-Seidel updating strategy. The effectiveness of the 3D-PWLS sinogram smoothing for low-dose HCT was demonstrated by a 3D Shepp-Logan head phantom study. Comparison studies with our previously developed KL domain PWLS sinogram smoothing algorithm indicate that the KL+2D-PWLS algorithm shows better performance on in-plane noise-resolution trade-off while the 3D-PLWS shows better performance on z-axis noise-resolution trade-off. Receiver operating characteristic (ROC) studies by using channelized Hotelling observer (CHO) shows that 3D-PWLS and KL+2DPWLS algorithms have similar performance on detectability in low-contrast environment.

  7. Dose reduction in skeletal and chest radiography using a large-area flat-panel detector based on amorphous silicon and thallium-doped cesium iodide: technical background, basic image quality parameters, and review of the literature.

    PubMed

    Völk, Markus; Hamer, Okka W; Feuerbach, Stefan; Strotzer, Michael

    2004-05-01

    The two most frequently performed diagnostic X-ray examinations are those of the extremities and of the chest. Thus, dose reduction in the field of conventional skeletal and chest radiography is an important issue and there is a need to reduce man-made ionizing radiation. The large-area flat-panel detector based on amorphous silicon and thallium-doped cesium iodide provides a significant reduction of radiation dose in skeletal and chest radiography compared with traditional imaging systems. This article describes the technical background and basic image quality parameters of this 43 x 43-cm digital system, and summarizes the available literature (years 2000-2003) concerning dose reduction in experimental and clinical studies. Due to its high detective quantum efficiency and dynamic range compared with traditional screen-film systems, a dose reduction of up to 50% is possible without loss of image quality.

  8. TH-A-18C-11: An Investigation of KV CBCT Image Quality and Dose Reduction for Volume-Of-Interest Imaging Using Dynamic Collimation

    SciTech Connect

    Parsons, D; Robar, J

    2014-06-15

    Purpose: The focus of this work was to investigate the improvements in image quality and dose reduction for volume-of-interest (VOI) kV-CBCT using dynamic collimation. Methods: A prototype iris aperture was used to track a VOI during a CBCT acquisition. The current aperture design is capable of one-dimensional translation as a function of gantry angle and dynamic adjustment of the iris radius. The aperture occupies the location of the bow-tie filter on a Varian OBI system. CBCT and planar image quality was investigated as a function of aperture radius, while maintaining the same dose to the VOI, for a 20 cm diameter cylindrical water phantom with a 9 mm diameter bone insert centered on isocenter. Corresponding scatter-to-primary ratios (SPR) were determined at the detector plane with Monte Carlo simulation using EGSnrc. Dose distributions for various anatomical sites were modeled using a dynamic BEAMnrc library and DOSXYZnrc. The resulting VOI dose distributions were compared to full-field distributions. Results: SPR was reduced by a factor of 8.4 when decreasing iris diameter from 21.2 cm to 2.4 cm (at isocenter). Similarly, this change in iris diameter corresponds to a factor increase of approximately 1.4 and 1.5 in image contrast for CBCT and planar images, respectively, and similarly a factor decrease in image noise of approximately 1.7 and 1.5. This results in a measured gain in contrast-to-noise ratio of a factor of approximately 2.3 for both CBCT and planar images. Depending upon the anatomical site, dose was reduced to 10%–70% of the full field value along the central axis plane and down to 2% along the axial planes, while maintaining the same dose to the VOI compared to full-field techniques. Conclusion: The presented VOI technique offers improved image quality for image-guided radiotherapy while sparing the surrounding volume of unnecessary dose compared to full-field techniques.

  9. Dose reduction in fluoroscopic interventions using a combination of a region of interest (ROI) x-ray attenuator and spatially different, temporally variable temporal filtering

    NASA Astrophysics Data System (ADS)

    Swetadri Vasan, S. N.; Pope, Liza; Ionita, Ciprian N.; Titus, A. H.; Bednarek, D. R.; Rudin, S.

    2013-03-01

    A novel dose reduction technique for fluoroscopic interventions involving a combination of a material x-ray region of interest (ROI) attenuator and spatially different, temporally variable ROI temporal recursive filter, was used to guide the catheter to the ROI in three live animal studies, two involving rabbits and one involving a sheep. In the two rabbit studies presented , a catheter was guided to the entrance of the carotid artery. With the added ROI attenuator the image under the high attenuation region is very noisy. By using temporal filtering with a filter weight of 0.6 on previous frames, the noise is reduced. In the sheep study the catheter was guided to the descending aorta of the animal. The sheep offered a relatively higher attenuation to the incident x-rays and thus a higher temporal filter weight of 0.8 on previous frames was used during the procedure to reduce the noise to levels acceptable by the interventionalist. The image sequences from both studies show that significant dose reduction of 5-6 times can be achieved with acceptable image quality outside the ROI by using the above mentioned technique. Even though the temporal filter weighting outside the ROI is higher, the consequent lag does not prevent perception of catheter movement.

  10. Dose Reduction in Fluoroscopic Interventions Using a Combination of a Region of Interest (ROI) X-Ray Attenuator and Spatially-Different, Temporally-Variable Temporal Filtering.

    PubMed

    Vasan, S N Swetadri; Pope, Liza; Ionita, Ciprian N; Titus, A H; Bednarek, D R; Rudin, S

    2013-03-06

    A novel dose reduction technique for fluoroscopic interventions involving a combination of a material x-ray region of interest (ROI) attenuator and spatially different, temporally variable ROI temporal recursive filter, was used to guide the catheter to the ROI in three live animal studies, two involving rabbits and one involving a sheep. In the two rabbit studies presented, a catheter was guided to the entrance of the carotid artery. With the added ROI attenuator the image under the high attenuation region is very noisy. By using temporal filtering with a filter weight of 0.6 on previous frames, the noise is reduced. In the sheep study the catheter was guided to the descending aorta of the animal. The sheep offered a relatively higher attenuation to the incident x-rays and thus a higher temporal filter weight of 0.8 on previous frames was used during the procedure to reduce the noise to levels acceptable by the interventionalist. The image sequences from both studies show that significant dose reduction of 5-6 times can be achieved with acceptable image quality outside the ROI by using the above mentioned technique. Even though the temporal filter weighting outside the ROI is higher, the consequent lag does not prevent perception of catheter movement.

  11. A dose-response relationship for marketable yield reduction of two lettuce (Lactuca sativa L.) cultivars exposed to tropospheric ozone in Southern Europe.

    PubMed

    Marzuoli, Riccardo; Finco, Angelo; Chiesa, Maria; Gerosa, Giacomo

    2016-12-27

    The present study investigated the response to ozone (O3) of two cultivars (cv.'Romana' and cv. 'Canasta') of irrigated lettuce grown in an open-top chamber (OTC) experiment in Mediterranean conditions. Two different levels of O3 were applied, ambient O3 in non-filtered OTCs (NF-OTCs) and -40% of ambient O3 in charcoal-filtered OTCs (CF-OTCs), during four consecutive growing cycles. At the end of each growing cycle, the marketable yield (fresh biomass) was assessed while during the growing periods, measurements of the stomatal conductance at leaf level were performed and used to define a stomatal conductance model for calculation of the phytotoxic ozone dose (POD) absorbed by the plants.Results showed that O3 caused statistically significant yield reductions in the first and in the last growing cycle. In general, the marketable yield of the NF-OTC plants was always lower than the CF-OTC plants for both cultivars, with mean reductions of -18.5 and -14.5% for 'Romana' and 'Canasta', respectively. On the contrary, there was no statistically significant difference in marketable yield due to the cultivar factor or to the interaction between O3 and cultivar in any of the growing cycle performed.Dose-response relationships for the marketable relative yield based on the POD values were calculated according to different flux threshold values (Y). The best regression fit was obtained using an instantaneous flux threshold of 6 nmol O3 m(-2) s(-1) (POD6); the same value was obtained also for other crops. According to the generic lettuce dose-response relationship, an O3 critical level of 1 mmol O3 m(-2) of POD6 for a 15% of marketable yield loss was found.

  12. Statistical model based iterative reconstruction in clinical CT systems. Part III. Task-based kV/mAs optimization for radiation dose reduction

    PubMed Central

    Li, Ke; Gomez-Cardona, Daniel; Hsieh, Jiang; Lubner, Meghan G.; Pickhardt, Perry J.; Chen, Guang-Hong

    2015-01-01

    Purpose: For a given imaging task and patient size, the optimal selection of x-ray tube potential (kV) and tube current-rotation time product (mAs) is pivotal in achieving the maximal radiation dose reduction while maintaining the needed diagnostic performance. Although contrast-to-noise (CNR)-based strategies can be used to optimize kV/mAs for computed tomography (CT) imaging systems employing the linear filtered backprojection (FBP) reconstruction method, a more general framework needs to be developed for systems using the nonlinear statistical model-based iterative reconstruction (MBIR) method. The purpose of this paper is to present such a unified framework for the optimization of kV/mAs selection for both FBP- and MBIR-based CT systems. Methods: The optimal selection of kV and mAs was formulated as a constrained optimization problem to minimize the objective function, Dose(kV,mAs), under the constraint that the achievable detectability index d′(kV,mAs) is not lower than the prescribed value of d℞′ for a given imaging task. Since it is difficult to analytically model the dependence of d′ on kV and mAs for the highly nonlinear MBIR method, this constrained optimization problem is solved with comprehensive measurements of Dose(kV,mAs) and d′(kV,mAs) at a variety of kV–mAs combinations, after which the overlay of the dose contours and d′ contours is used to graphically determine the optimal kV–mAs combination to achieve the lowest dose while maintaining the needed detectability for the given imaging task. As an example, d′ for a 17 mm hypoattenuating liver lesion detection task was experimentally measured with an anthropomorphic abdominal phantom at four tube potentials (80, 100, 120, and 140 kV) and fifteen mA levels (25 and 50–700) with a sampling interval of 50 mA at a fixed rotation time of 0.5 s, which corresponded to a dose (CTDIvol) range of [0.6, 70] mGy. Using the proposed method, the optimal kV and mA that minimized dose for the

  13. A sublethal dose of thiamethoxam causes a reduction in xylem feeding by the bird cherry-oat aphid (Rhopalosiphum padi), which is associated with dehydration and reduced performance.

    PubMed

    Daniels, M; Bale, J S; Newbury, H J; Lind, R J; Pritchard, J

    2009-08-01

    The active ingestion of xylem sap by aphids is hypothesised to be an important mechanism for rehydration. When starved bird cherry-oat aphids (Rhopalosiphum padi) were allowed to feed on wheat (Triticum aestivum) treated with a sublethal dose of the xylem-mobile neonicotinoid thiamethoxam, analysis of feeding behaviours using the electrical penetration graph revealed a reduction in xylem feeding that was reversed on removal of the toxin. To test the importance of xylem-feeding behaviour as a rehydration mechanism, the effects of the sublethal dose of thiamethoxam on aphid water content, honeydew excretion, growth and fecundity were investigated. Body water contents of starved R. padi feeding on wheat treated with thiamethoxam were significantly reduced compared to aphids feeding on wheat treated with distilled water (74.5+/-0.23 and 75.6+/-0.18%, respectively). In addition, the sublethal dose of thiamethoxam had detrimental effects on aphid performance. At reproductive maturity, aphids that had been born on wheat treated with thiamethoxam were significantly smaller (as measured by body plan area; 1.07+/-0.03mm(2)), lighter (0.31+/-0.04mg) and less fecund (2.85+/-0.36nymphs/day) than aphids born on wheat treated with distilled water (1.87+/-0.02mm(2), 0.72+/-0.03mg, 11.28+/-0.58nymphs/day, respectively). Regardless of whether the observed impairment of xylem feeding is due to a neurotoxic or an antifeedant effect, these results have important implications for commercial crop protection as the behaviour-modifying effects of the sublethal dose of thiamethoxam may change the efficacy of this pesticide throughout the growing season.

  14. Regularized ML reconstruction for time/dose reduction in 18F-fluoride PET/CT studies

    NASA Astrophysics Data System (ADS)

    De Bernardi, Elisabetta; Magnani, Patrizia; Gianolli, Luigi; Carla Gilardi, Maria; Bettinardi, Valentino

    2015-01-01

    We are proposing a regularized reconstruction strategy for the detection of bone lesions in 18F-fluoride whole body PET images obtained with 1 min/bed using the anatomical information provided by co-registered CT images. Bones are recognized on CT images and then transposed into the PET volume framework. During PET reconstruction, two different priors are used for bone and non-bone voxels: the relative difference prior in bone and the P-Gaussian prior in non-bone. After a tuning of the priors’ parameters, the reconstruction strategy has been tested on 6 18F-fluoride PET/CT studies, on a total of 67 lesions. Regularized images provided results comparable to the standard 3 min/bed images, in terms image quality, lesion activity, noise level and noise correlation. The proposed strategy therefore appears to be a useful tool to reduce the acquisition time or the injected dose in 18F-fluoride PET studies.

  15. Toward time resolved 4D cardiac CT imaging with patient dose reduction: estimating the global heart motion

    NASA Astrophysics Data System (ADS)

    Taguchi, Katsuyuki; Segars, W. Paul; Fung, George S. K.; Tsui, Benjamin M. W.

    2006-03-01

    Coronary artery imaging with multi-slice helical computed tomography is a promising noninvasive imaging technique. The current major issues include the insufficient temporal resolution and large patient dose. We propose an image reconstruction method which provides a solution to both of the problems. The method uses an iterative approach repeating the following four steps until the difference between the two projection data sets falls below a certain criteria in step-4: 1) estimating or updating the cardiac motion vectors, 2) reconstructing the time-resolved 4D dynamic volume images using the motion vectors, 3) calculating the projection data from the current 4D images, 4) comparing them with the measured ones. In this study, we obtain the first estimate of the motion vector. We use the 4D NCAT phantom, a realistic computer model for the human anatomy and cardiac motions, to generate the dynamic fan-beam projection data sets as well to provide a known truth for the motion. Then, the halfscan reconstruction with the sliding time-window technique is used to generate cine images: f(t, r r). Here, we use one heart beat for each position r so that the time information is retained. Next, the magnitude of the first derivative of f(t, r r) with respect to time, i.e., |df/dt|, is calculated and summed over a region-of-interest (ROI), which is called the mean-absolute difference (MAD). The initial estimation of the vector field are obtained using MAD for each ROI. Results of the preliminary study are presented.

  16. Reduction of circulating regulatory T cells by intravenous high-dose interferon alfa-2b treatment in melanoma patients.

    PubMed

    Mozzillo, Nicola; Ascierto, Paolo

    2012-10-01

    High-dose interferon alfa-2b (IFNα-2b) is the only approved adjuvant systemic therapy for resected, high risk melanoma in the United States (Fecher and Flaherty, in Natl Compr Cancer Netw 7:295-304, 2009). Recently, two important meta-analyses of randomized trials (Wheatley et al., in J Clin Oncol, 2007; Mocellin et al. in J Natl Cancer Inst, 2010) investigating IFNα-2b versus observation in high risk melanoma patients, showed that adjuvant IFNα-2b has an impact both on relapse-free survival (RFS) and overall survival (OS) independently by dosage, duration and route compared with observation in high risk melanoma patients. Despite of an absolute benefits of 3 % (Wheatley et al., in J Clin Oncol, 2007), this treatment is associated with significant toxicity, which impacts on patient quality of life. A better understanding of the mechanism of action may help to potentiate the clinical efficacy and reduce the toxicity of IFNα-2b/Peg-IFNα-2b. Numerous studies suggest that interferon's mechanism of action in melanoma is primarily immunomodulatory (Table 1) (de La Salmoniere, in Clin Cancer Res 6:4713-4718, 2000; Stuckert, in J Clin Oncol 25:8506, 2007; Gogas et al., in N Engl J Med 354:709-718, 2006; Moschos et al., in J Clin Oncol 24:3164-3171, 2006; Ascierto and Kirkwood, in J Transl Med 6:62, 2008) Recent efforts to elucidate the mechanism of action for interferon have focused upon signal transducers and activators of transcription (STAT) (Simons et al., in J Transl Med 9:52, 2011) signaling and immunoregulatory responses mediated by regulatory T cells (Tregs) (Wang et al., in Clin Cancer Res 13:1523-1531, 2007; Clin Cancer Res 14:8314-8320, 2008). Tregs are a suppressive CD4+ T cell population that is present, along with primed effector T cells, in tumor and tumor-draining lymph nodes (Hiura et al. in J Immunol 175:5058-5066, 2005). Tregs express high levels of surface antigens such as CD25, cytotoxic T lymphocyte associated antigen 4 (CTLA-4), and

  17. Predictors of and health- and fall-related program outcomes resulting from complete and adequate doses of a fall risk reduction program.

    PubMed

    Mielenz, Thelma J; Durbin, Laura L; Hertzberg, Fern; Nobile-Hernandez, Diana; Jia, Haomiao

    2016-10-07

    Falls are dangerous and costly for older adults. The A Matter of Balance/Volunteer Lay Leader (AMOB/VLL) program is an evidence-based fall risk reduction program that could help reduce this burden. This study introduced a door-through-door transportation program to improve program delivery (N = 126). Characteristics predicting completion of all eight AMOB/VLL sessions were identified using logistic regression. Individual growth models were employed to determine the immediate, intermediate, and long-term goal outcomes resulting from receiving an adequate dose of the program (five to eight sessions). Self-restriction of activities due to fear of falling (OR 5.04, 95 % CI 1.86-13.69) and a lower frequency of moderate and vigorous physical activity (OR 1.14, 95 % CI 1.04-1.27) were significantly predictive of receiving a complete dose. Three outcome goals were significant, including (1) immediate-improved self-efficacy of managing medications and treatments, (2) intermediate-reduced activity limitations, and (3) intermediate-reduced physical disability. Self-restriction of activities due to a fear of falling and physical activity levels may be simple and effective screening questions to prevent AMOB/VLL attrition. In our study, those who did receive the program improved on a specific type of self-efficacy and on self-reported physical functioning.

  18. Maintenance of remission following 2 years of standard treatment then dose reduction with abatacept in patients with early rheumatoid arthritis and poor prognosis

    PubMed Central

    Westhovens, Rene; Robles, Manuel; Ximenes, Antonio Carlos; Wollenhaupt, Jurgen; Durez, Patrick; Gomez-Reino, Juan; Grassi, Walter; Haraoui, Boulos; Shergy, William; Park, Sung-Hwan; Genant, Harry; Peterfy, Charles; Becker, Jean-Claude; Murthy, Bindu

    2015-01-01

    Objectives To evaluate maintenance of response while reducing intravenous abatacept dose from ∼10 mg/kg to ∼5 mg/kg in patients with early rheumatoid arthritis (RA) who achieved disease activity score (DAS)28 (erythrocyte sedimentation rate, ESR) <2.6. Methods This 1-year, multinational, randomised, double-blind substudy evaluated the efficacy and safety of ∼10 mg/kg and ∼5 mg/kg abatacept in patients with early RA with poor prognosis who had reached DAS28 (ESR) <2.6 at year 2 of the AGREE study. The primary outcome was time to disease relapse (defined as additional disease-modifying antirheumatic drugs, ≥2 courses high-dose steroids, return to open-label abatacept ∼10 mg/kg, or DAS28 (C reactive protein) ≥3.2 at two consecutive visits). Results 108 patients were randomised (∼10 mg/kg, n=58; ∼5 mg/kg, n=50). Three and five patients, respectively, discontinued, and four per group returned to open-label abatacept. Relapse over time and the proportion of patients relapsing were similar in both groups (31% (∼10 mg/kg) vs 34% (∼5 mg/kg); HR: 0.87 (95% CI 0.45 to 1.69)). Mean steady-state trough serum concentration for the ∼10 mg/kg group was 20.3–24.1 µg/mL, compared with 8.8–12.0 µg/mL for the ∼5 mg/kg group. Conclusions This exploratory study suggests that abatacept dose reduction may be an option in patients with poor prognosis early RA who achieve DAS28 (ESR) <2.6 after ≥1 year on abatacept (∼10 mg/kg). Trial registration number NCT00989235. PMID:25550337

  19. Glycolic acid inhibits enzymatic, hemorrhagic and edema-inducing activities of BaP1, a P-I metalloproteinase from Bothrops asper snake venom: insights from docking and molecular modeling.

    PubMed

    Pereañez, Jaime Andrés; Patiño, Arley Camilo; Rey-Suarez, Paola; Núñez, Vitelbina; Henao Castañeda, Isabel Cristina; Rucavado, Alexandra

    2013-09-01

    Glycolic acid (GA) (2-Hydroxyethanoic acid) is widely used as chemical peeling agent in Dermatology and, more recently, as a therapeutic and cosmetic compound in the field of skin care and disease treatment. In this work we tested the inhibitory ability of glycolic acid on the enzymatic, hemorrhagic and edema-inducing activities of BaP1, a P-I metalloproteinase from Bothrops asper venom, which induces a variety of toxic actions. Glycolic acid inhibited the proteolytic activity of BaP1 on azocasein, with an IC₅₀ of 1.67 mM. The compound was also effective at inhibiting the hemorrhagic activity of BaP1 in skin and muscle in experiments involving preincubation of enzyme and inhibitor prior to injection. When BaP1 was injected i.m. and then, at the same site, different concentrations of glycolic acid were administered at either 0 or 5 min, 7 mM solutions of the inhibitor partially abrogated hemorrhagic activity when administered at 0 min. Moreover, glycolic acid inhibited, in a concentration-dependent manner, edema-forming activity of BaP1 in the footpad. In order to have insights on the mode of action of glycolic acid, UV-vis and intrinsic fluorescence studies were performed. Results of these assays suggest that glycolic acid interacts directly with BaP1 and chelates the Zn²⁺ ion at the active site. These findings were supported by molecular docking results, which suggested that glycolic acid forms hydrogen bonds with residues Glu143, Arg110 and Ala111 of the enzyme. Additionally, molecular modeling results suggest that the inhibitor chelates Zn²⁺, with a distance of 3.58 Å, and may occupy part of substrate binding cleft of BaP1. Our results suggest that glycolic acid is a candidate for the development of inhibitors to be used in snakebite envenomation.

  20. A high-resolution photon-counting breast CT system with tensor-framelet based iterative image reconstruction for radiation dose reduction

    PubMed Central

    Ding, Huanjun; Gao, Hao; Zhao, Bo; Cho, Hyo-Min; Molloi, Sabee

    2016-01-01

    Both computer simulations and experimental phantom studies were carried out to investigate the radiation dose reduction with tensor framelet based iterative image reconstruction (TFIR) for a dedicated high-resolution spectral breast computed tomography (CT) based on a silicon strip photon-counting detector. The simulation was performed with a 10 cm-diameter water phantom including three contrast materials (polyethylene, 8 mg/ml iodine and B-100 bone-equivalent plastic). In the experimental study, the data were acquired with a 1.3 cm-diameter polymethylmethacrylate (PMMA) phantom containing iodine in three concentrations (8, 16 and 32 mg/ml) at various radiation doses (1.2, 2.4 and 3.6 mGy) and then CT images were reconstructed using filtered-back-projection (FBP) technique and TFIR technique, respectively. The image quality between these two techniques was evaluated by the quantitative analysis on contrast-to-noise ratio (CNR) and spatial resolution that was evaluated using the tasked-based modulation transfer function (MTF). Both simulation and experimental results indicated that the task-based MTF obtained from TFIR reconstruction with one-third of the radiation dose was comparable to that from FBP reconstruction for low contrast target. For high contrast target, TFIR was substantially superior to FBP reconstruction in term of spatial resolution. In addition, TFIR was able to achieve a factor of 1.6 to 1.8 increase in CNR depending on the target contrast level. This study demonstrates that TFIR can reduce the required radiation dose by a factor of two-third for a CT image reconstruction compared to FBP technique. It achieves much better CNR and spatial resolution for high contrast target in addition to retaining similar spatial resolution for low contrast target. This TFIR technique has been implemented with a graphic processing unit (GPU) system and it takes approximately 10 seconds to reconstruct a single-slice CT image, which can be potentially used in a

  1. Noncardiac Pulmonary Edema induced by Sitagliptin Treatment

    PubMed Central

    Belice, Tahir; Yuce, Suleyman; Kizilkaya, Bayram; Kurt, Aysel; Cure, Erkan

    2014-01-01

    A 74-year-old male patient with type 2 diabetes mellitus admitted to the emergency department with the complaints of progressive breathlessness, dry cough, and swollen lower extremities. Our patient had type 2 diabetes mellitus and hypertension for 3 years. His HbA1c was not within the target range so sitagliptin was added to on-going therapy. After 1 week of starting sitagliptin therapy, even though the patient had not heart failure he applied to the emergency department with a complaint of dyspnea. The cardiovascular safety and efficacy of many anti-hyperglycemic agents such as sitagliptin, saxagliptin are unclear. Our case has shown that dipeptidyl peptidase 4 inhibitors may cause pulmonary edema. Hence, it should be used with cautious, especially in patients with heart failure. PMID:25657966

  2. Pulmonary edema induced by intravenous ethchlorvynol.

    PubMed

    Conces, D J; Kreipke, D L; Tarver, R D

    1986-11-01

    The intravenous injection of ethchlorvynol is an uncommon cause of noncardiac pulmonary edema. Two cases of intravenous ethchlorvynol-induced pulmonary edema are presented. The patients fell asleep after injecting the liquid contents of Placydil capsules (ethchlorvynol) and awoke several hours later with severe dyspnea. Arterial blood gases demonstrated marked hypoxia. Chest radiographs revealed bilateral diffuse alveolar densities. The patients' symptoms and radiographic findings resolved after several days of supportive care. Changes in the lung caused by ethchlorvynol may be the result of direct effect of the drug on the lung.

  3. Delayed mTOR Inhibition with Low Dose of Everolimus Reduces TGFβ Expression, Attenuates Proteinuria and Renal Damage in the Renal Mass Reduction Model

    PubMed Central

    Kurdián, Melania; Herrero-Fresneda, Inmaculada; Lloberas, Nuria; Gimenez-Bonafe, Pepita; Coria, Virginia; Grande, María T.; Boggia, José; Malacrida, Leonel; Torras, Joan; Arévalo, Miguel A.; González-Martínez, Francisco; López-Novoa, José M.; Grinyó, Josep; Noboa, Oscar

    2012-01-01

    Background The immunosuppressive mammalian target of rapamycin (mTOR) inhibitors are widely used in solid organ transplantation, but their effect on kidney disease progression is controversial. mTOR has emerged as one of the main pathways regulating cell growth, proliferation, differentiation, migration, and survival. The aim of this study was to analyze the effects of delayed inhibition of mTOR pathway with low dose of everolimus on progression of renal disease and TGFβ expression in the 5/6 nephrectomy model in Wistar rats. Methods This study evaluated the effects of everolimus (0.3 mg/k/day) introduced 15 days after surgical procedure on renal function, proteinuria, renal histology and mechanisms of fibrosis and proliferation. Results Everolimus treated group (EveG) showed significantly less proteinuria and albuminuria, less glomerular and tubulointerstitial damage and fibrosis, fibroblast activation cell proliferation, when compared with control group (CG), even though the EveG remained with high blood pressure. Treatment with everolimus also diminished glomerular hypertrophy. Everolimus effectively inhibited the increase of mTOR developed in 5/6 nephrectomy animals, without changes in AKT mRNA or protein abundance, but with an increase in the pAKT/AKT ratio. Associated with this inhibition, everolimus blunted the increased expression of TGFβ observed in the remnant kidney model. Conclusion Delayed mTOR inhibition with low dose of everolimus significantly prevented progressive renal damage and protected the remnant kidney. mTOR and TGFβ mRNA reduction can partially explain this anti fibrotic effect. mTOR can be a new target to attenuate the progression of chronic kidney disease even in those nephropathies of non-immunologic origin. PMID:22427849

  4. Daily injections of fluoxetine induce dose-dependent desensitization of hypothalamic 5-HT1A receptors: reductions in neuroendocrine responses to 8-OH-DPAT and in levels of Gz and Gi proteins.

    PubMed

    Raap, D K; Evans, S; Garcia, F; Li, Q; Muma, N A; Wolf, W A; Battaglia, G; Van De Kar, L D

    1999-01-01

    The present studies examined the dose-response relationship of fluoxetine-induced desensitization of hypothalamic postsynaptic 5-HT1A receptors, as measured from the reduced neuroendocrine responses to a 5-HT1A agonist. Because hypothalamic Gz proteins mediate the ACTH and oxytocin responses to 5-HT1A receptor activation, we also determined the effect of fluoxetine on the levels of Gz proteins in the hypothalamus. Rats were injected daily for 14 days with saline or with fluoxetine doses of 0.3, 1, 3, 5, 7. 5, or 10 mg/kg/day. Fluoxetine produced a dose-dependent reduction in the oxytocin, ACTH, and corticosterone responses to the 5-HT1A agonist 8-hydroxy-2-(dipropylamino)tetralin (8-OH-DPAT, 50 micrograms/kg, s.c.). The lowest fluoxetine dose that significantly, although incompletely, reduced the neuroendocrine responses to 8-OH-DPAT was 5 mg/kg/day. The 10 mg/kg/day dose of fluoxetine maximally inhibited all neuroendocrine responses to 8-OH-DPAT. Hypothalamic levels of Gz protein were reduced by both the 7.5 and 10 mg/kg/day doses of fluoxetine, whereas Gi1 protein levels were reduced only after the highest dose (10 mg/kg/day) of fluoxetine. Gi2, Gi3, and Go levels were not reduced by any fluoxetine dose. Cytosolic levels of Gi1 and Gz proteins were unaltered, indicating that reductions in Gz and Gi1 proteins are not caused by a redistribution of the proteins from the membrane into the cytosol. The results from the present study indicate that fluoxetine-induced desensitization of hypothalamic postsynaptic 5-HT1A receptor systems is dose-dependent and may be caused in part by reductions in the hypothalamic levels of Gz proteins.

  5. Reductions in milk Δ9-desaturation ratios to oral dosing of cobalt-acetate are accompanied by the downregulation of SCD1 in lactating ewes.

    PubMed

    Toral, P G; Hervás, G; Frutos, P

    2015-03-01

    Oral administration of cobalt has been proven to alter milk fatty acid (FA) composition consistent with an inhibition of mammary stearoyl-coenzyme A desaturase (SCD) activity in ruminants, but the mechanisms explaining its mode of action remain uncertain. In this study, Co (as Co-acetate) was dosed to lactating ewes with the aims of examining mammary gene expression during Co-induced changes in milk FA composition, and estimating the endogenous synthesis of SCD products in milk of sheep fed an 18:3n-3-enriched diet. Twelve Assaf ewes fed a diet supplemented with 2% linseed oil were allocated to 2 experimental groups and received an oral drench supplying either 0 (control) or 9 mg of Co/kg of body weight per day. Treatments were administered in 3 equal doses at 8-h intervals for 6 d. No effects of Co administration on animal performance were observed. The changes in milk FA (namely, reductions in most cis-9-containing FA) were consistent with an inhibition of SCD in the absence of detectable effects on the relative importance of mammary de novo synthesis and FA uptake. The high proportion of endogenous cis-9 trans-11 18:2 observed in this study (89%) would agree with a greater supply of trans-11 18:1 of ruminal origin in ewes fed linseed oil, compared with previous estimates in sheep fed a diet without lipid supplementation. Differences between studies could also be related to diet-induced changes in SCD activity. Altogether, both mechanisms would support that basal diet composition is a major determinant of the relative contribution of Δ9-desaturation to milk FA profile. Similarly, the consumption of a diet rich in 18:3n-3 might also explain the low proportion of milk cis-9 18:1 estimated to derive from Δ9-desaturation (29%). The administration of Co to ewes fed linseed oil allowed to discriminate minor 18:3 isomers in milk, such as cis-9 trans-12 cis-15 18:3, as SCD products. Finally, Co dosing lowered the mRNA abundance of SCD1 in the mammary secretory tissue

  6. Massive training artificial neural network (MTANN) for reduction of false positives in computerized detection of lung nodules in low-dose computed tomography.

    PubMed

    Suzuki, Kenji; Armato, Samuel G; Li, Feng; Sone, Shusuke; Doi, Kunio

    2003-07-01

    In this study, we investigated a pattern-recognition technique based on an artificial neural network (ANN), which is called a massive training artificial neural network (MTANN), for reduction of false positives in computerized detection of lung nodules in low-dose computed tomography (CT) images. The MTANN consists of a modified multilayer ANN, which is capable of operating on image data directly. The MTANN is trained by use of a large number of subregions extracted from input images together with the teacher images containing the distribution for the "likelihood of being a nodule." The output image is obtained by scanning an input image with the MTANN. The distinction between a nodule and a non-nodule is made by use of a score which is defined from the output image of the trained MTANN. In order to eliminate various types of non-nodules, we extended the capability of a single MTANN, and developed a multiple MTANN (Multi-MTANN). The Multi-MTANN consists of plural MTANNs that are arranged in parallel. Each MTANN is trained by using the same nodules, but with a different type of non-nodule. Each MTANN acts as an expert for a specific type of non-nodule, e.g., five different MTANNs were trained to distinguish nodules from various-sized vessels; four other MTANNs were applied to eliminate some other opacities. The outputs of the MTANNs were combined by using the logical AND operation such that each of the trained MTANNs eliminated none of the nodules, but removed the specific type of non-nodule with which the MTANN was trained, and thus removed various types of non-nodules. The Multi-MTANN consisting of nine MTANNs was trained with 10 typical nodules and 10 non-nodules representing each of nine different non-nodule types (90 training non-nodules overall) in a training set. The trained Multi-MTANN was applied to the reduction of false positives reported by our current computerized scheme for lung nodule detection based on a database of 63 low-dose CT scans (1765

  7. Use of ORP (oxidation-reduction potential) to control oxygen dosing for online sulfide oxidation in anaerobic treatment of high sulfate wastewater.

    PubMed

    Khanal, S K; Shang, C; Huang, J C

    2003-01-01

    In this study, oxidation-reduction potential (ORP) was used as a controlling parameter to regulate oxygen dosing to the recycled biogas for online sulfide oxidation in an upflow anaerobic filter (UAF) system. The UAF was operated with a constant influent COD of 18,000 mg/L, but with different influent sulfates of 1000, 3000 and 6000 mg/L. The reactor was initially operated under a natural ORP of -290 mV (without oxygen injection), and was then followed by oxygenation to raise its ORP by 25 mV above the natural level for each influent sulfate condition. At 6,000 mg/L sulfate without oxygen injection, the dissolved sulfide reached 733.8 mg S/L with a corresponding free sulfide of 250.3 mg S/L, thus showing a considerable inhibition to methanogens. Upon oxygenation to raise its ORP to -265 mV (i.e., a 25 mV increase), the dissolved sulfide was reduced by more than 98.5% with a concomitant 45.9% increase of the methane yield. Under lower influent sulfate levels of 1,000 and 3,000 mg/L, the levels of sulfides produced, even under the natural ORP, did not impose any noticeable toxicity to methanogens. Upon oxygenation to raise the ORP by +25 mV, the corresponding methane yields were actually reduced by 15.5% and 6.2%, respectively. However, such reductions were not due to the adverse impact of the elevated ORP; instead, they were due to a diversion of some organic carbon to support the facultative activities inside the reactor as a result of excessive oxygenation. In other words, to achieve satisfactory sulfide oxidation for the lower influent sulfate conditions, it was not necessary to raise the ORP by as much as +25 mV. The ORP increase actually needed depended on both the influent sulfate and also actual wastewater characteristics. This study had proved that the ORP controlled oxygenation was reliable for achieving consistent online sulfide control.

  8. SU-E-J-243: Possibility of Exposure Dose Reduction of Cone-Beam Computed Tomography in An Image Guided Patient Positioning System by Using Various Noise Suppression Filters

    SciTech Connect

    Kamezawa, H; Arimura, H; Ohki, M; Shirieda, K; Kameda, N

    2014-06-01

    Purpose: To investigate the possibility of exposure dose reduction of the cone-beam computed tomography (CBCT) in an image guided patient positioning system by using 6 noise suppression filters. Methods: First, a reference dose (RD) and low-dose (LD)-CBCT (X-ray volume imaging system, Elekta Co.) images were acquired with a reference dose of 86.2 mGy (weighted CT dose index: CTDIw) and various low doses of 1.4 to 43.1 mGy, respectively. Second, an automated rigid registration for three axes was performed for estimating setup errors between a planning CT image and the LD-CBCT images, which were processed by 6 noise suppression filters, i.e., averaging filter (AF), median filter (MF), Gaussian filter (GF), bilateral filter (BF), edge preserving smoothing filter (EPF) and adaptive partial median filter (AMF). Third, residual errors representing the patient positioning accuracy were calculated as an Euclidean distance between the setup error vectors estimated using the LD-CBCT image and RD-CBCT image. Finally, the relationships between the residual error and CTDIw were obtained for 6 noise suppression filters, and then the CTDIw for LD-CBCT images processed by the noise suppression filters were measured at the same residual error, which was obtained with the RD-CBCT. This approach was applied to an anthropomorphic pelvic phantom and two cancer patients. Results: For the phantom, the exposure dose could be reduced from 61% (GF) to 78% (AMF) by applying the noise suppression filters to the CBCT images. The exposure dose in a prostate cancer case could be reduced from 8% (AF) to 61% (AMF), and the exposure dose in a lung cancer case could be reduced from 9% (AF) to 37% (AMF). Conclusion: Using noise suppression filters, particularly an adaptive partial median filter, could be feasible to decrease the additional exposure dose to patients in image guided patient positioning systems.

  9. MO-F-CAMPUS-I-04: Patient Eye-Lens Dose Reduction in Routine Brain CT Examinations Using Organ-Based Tube Current Modulation and In-Plane Bismuth Shielding

    SciTech Connect

    Tsai, Hui-Yu; Liao, Ying-Lan; Chen, Jun-Rong

    2015-06-15

    Purpose: The purpose of this study is to assess eye-lens dose for patients who underwent brain CT examinations using two dose reduction Methods: organ-based tube current modulation (OBTCM) and in-plane bismuth shielding method. Methods: This study received institutional review board approval; written informed consent to participate was obtained from all patients. Ninety patients who underwent the routine brain CT examination were randomly assigned to three groups, ie. routine, OBTCM, and bismuth shield. The OBTCM technique reduced the tube current when the X-ray tube rotates in front of patients’ eye-lens region. The patients in the bismuth shield group were covered one-ply bismuth shield in the eyes’ region. Eye-lens doses were measured using TLD-100H chips and the total effective doses were calculated using CT-Expo according to the CT scanning parameters. The surface doses for patients at off-center positions were assessed to evaluate the off-centering effect. Results: Phantom measurements indicates that OBTCM technique could reduced by 26% to 28% of the surface dose to the eye lens, and increased by 25% of the surface dose at the opposed incident direction at the angle of 180°. Patients’ eye-lens doses were reduced 16.9% and 30.5% dose of bismuth shield scan and OBTCM scan, respectively compared to the routine scan. The eye-lens doses were apparently increased when the table position was lower than isocenter. Conclusion: Reducing the dose to the radiosensitive organs, such as eye lens, during routine brain CT examinations could lower the radiation risks. The OBTCM technique and in-plane bismuth shielding could be used to reduce the eye-lens dose. The eye-lens dose could be effectively reduced using OBTCM scan without interfering the diagnostic image quality. Patient position relative the CT gantry also affects the dose level of the eye lens. This study was supported by the grants from the Ministry of Science and Technology of Taiwan (MOST103-2314-B-182

  10. TU-EF-204-09: A Preliminary Method of Risk-Informed Optimization of Tube Current Modulation for Dose Reduction in CT

    SciTech Connect

    Gao, Y; Liu, B; Kalra, M; Caracappa, P; Liu, T; Li, X; Xu, X

    2015-06-15

    Purpose: X-rays from CT scans can increase cancer risk to patients. Lifetime Attributable Risk of Cancer Incidence for adult patients has been investigated and shown to decrease as patient age. However, a new risk model shows an increasing risk trend for several radiosensitive organs for middle age patients. This study investigates the feasibility of a general method for optimizing tube current modulation (TCM) functions to minimize risk by reducing radiation dose to radiosensitive organs of patients. Methods: Organ-based TCM has been investigated in literature for eye lens dose and breast dose. Adopting the concept in organ-based TCM, this study seeks to find an optimized tube current for minimal total risk to breasts and lungs by reducing dose to these organs. The contributions of each CT view to organ dose are determined through simulations of CT scan view-by-view using a GPU-based fast Monte Carlo code, ARCHER. A Linear Programming problem is established for tube current optimization, with Monte Carlo results as weighting factors at each view. A pre-determined dose is used as upper dose boundary, and tube current of each view is optimized to minimize the total risk. Results: An optimized tube current is found to minimize the total risk of lungs and breasts: compared to fixed current, the risk is reduced by 13%, with breast dose reduced by 38% and lung dose reduced by 7%. The average tube current is maintained during optimization to maintain image quality. In addition, dose to other organs in chest region is slightly affected, with relative change in dose smaller than 10%. Conclusion: Optimized tube current plans can be generated to minimize cancer risk to lungs and breasts while maintaining image quality. In the future, various risk models and greater number of projections per rotation will be simulated on phantoms of different gender and age. National Institutes of Health R01EB015478.

  11. Effect of Radiation Dose Reduction and Reconstruction Algorithm on Image Noise, Contrast, Resolution, and Detectability of Subtle Hypoattenuating Liver Lesions at Multidetector CT: Filtered Back Projection versus a Commercial Model-based Iterative Reconstruction Algorithm.

    PubMed

    Solomon, Justin; Marin, Daniele; Roy Choudhury, Kingshuk; Patel, Bhavik; Samei, Ehsan

    2017-02-07

    Purpose To determine the effect of radiation dose and iterative reconstruction (IR) on noise, contrast, resolution, and observer-based detectability of subtle hypoattenuating liver lesions and to estimate the dose reduction potential of the IR algorithm in question. Materials and Methods This prospective, single-center, HIPAA-compliant study was approved by the institutional review board. A dual-source computed tomography (CT) system was used to reconstruct CT projection data from 21 patients into six radiation dose levels (12.5%, 25%, 37.5%, 50%, 75%, and 100%) on the basis of two CT acquisitions. A series of virtual liver lesions (five per patient, 105 total, lesion-to-liver prereconstruction contrast of -15 HU, 12-mm diameter) were inserted into the raw CT projection data and images were reconstructed with filtered back projection (FBP) (B31f kernel) and sinogram-affirmed IR (SAFIRE) (I31f-5 kernel). Image noise (pixel standard deviation), lesion contrast (after reconstruction), lesion boundary sharpness (average normalized gradient at lesion boundary), and contrast-to-noise ratio (CNR) were compared. Next, a two-alternative forced choice perception experiment was performed (16 readers [six radiologists, 10 medical physicists]). A linear mixed-effects statistical model was used to compare detection accuracy between FBP and SAFIRE and to estimate the radiation dose reduction potential of SAFIRE. Results Compared with FBP, SAFIRE reduced noise by a mean of 53% ± 5, lesion contrast by 12% ± 4, and lesion sharpness by 13% ± 10 but increased CNR by 89% ± 19. Detection accuracy was 2% higher on average with SAFIRE than with FBP (P = .03), which translated into an estimated radiation dose reduction potential (±95% confidence interval) of 16% ± 13. Conclusion SAFIRE increases detectability at a given radiation dose (approximately 2% increase in detection accuracy) and allows for imaging at reduced radiation dose (16% ± 13), while maintaining low

  12. GnRH dose reduction decreases pituitary LH release and ovulatory response but does not affect corpus luteum (CL) development and function in llamas.

    PubMed

    Silva, M E; Colazo, M G; Ratto, M H

    2012-06-01

    Gonadotrophin releasing hormone (GnRH) is commonly used in llamas to induce ovulation; however, the consequence of reduced doses of GnRH on luteinizing hormone (LH) release, ovulatory response, and subsequent corpus luteum (CL) development and function have apparently not been investigated. Hence, we examined the effect of gradual reduction of gonadorelin acetate (GnRH) dosage on pituitary LH release, ovulatory response, CL development, and plasma progesterone concentrations in llamas. Non-pregnant, non-lactating adult llamas were examined once daily by transrectal ultrasonography, and those with a follicle ≥8 mm in diameter that had grown for three consecutive days were randomly assigned to receive 50 (GnRH50, n = 23), 25 (GnRH25, n = 29), 12.5 (GnRH12.5, n = 29), or 6.25 μg (GnRH6.25, n = 29) of GnRH, or 0.5 mL of PBS (Control group, n = 16) im. In a subset (7 or 8 animals/group), intense blood sampling was done to measure LH concentrations. All females were examined by ultrasonography every 12 h from treatment (Day 0) to Day 2 to determinate ovulation, and thereafter on alternate days until Day 16 to evaluate CL development (9-13 animals/group). Also, blood samples for progesterone determination were taken (9 or 10 animals/group) on alternate days from Days 0-16. Ovulatory response (%) was highest (P < 0.05) in the GnRH50 (82.6), intermediate in the GnRH25 (72.3) and GnRH12.5 (75.9) groups, and lowest in the GnRH6.25 group (48.3). No ovulations were detected in the Control group. Mean peak LH concentrations (ng/mL) were highest (P < 0.05) for GnRH50 (6.2), intermediate for GnRH25 (4.4) and GnRH12.5 (2.9), and lowest for GnRH6.25 (2.2) groups. In addition, based on regression analysis, llamas with an LH peak <4 ng/mL were less likely to ovulate. Llamas given 50 μg of GnRH released more (P < 0.05) pituitary LH and had an LH surge of longer duration than those given 25, 12.5, or 6.25 μg. However, in those that ovulated, neither GnRH treatment nor treatment by

  13. Impact of Safety-Related Dose Reductions or Discontinuations on Sustained Virologic Response in HCV-Infected Patients: Results from the GUARD-C Cohort

    PubMed Central

    Foster, Graham R.; Coppola, Carmine; Derbala, Moutaz; Ferenci, Peter; Orlandini, Alessandra; Reddy, K. Rajender; Tallarico, Ludovico; Shiffman, Mitchell L.; Ahlers, Silke; Bakalos, Georgios; Hassanein, Tarek

    2016-01-01

    Background Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. Methods A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0–9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. Results SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced ≥1 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with ≥1 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not ≥5. Conclusions In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with

  14. Monte Carlo study of the potential reduction in out-of-field dose using a patient-specific aperture in pencil beam scanning proton therapy.

    PubMed

    Dowdell, Stephen J; Clasie, Benjamin; Depauw, Nicolas; Metcalfe, Peter; Rosenfeld, Anatoly B; Kooy, Hanne M; Flanz, Jacob B; Paganetti, Harald

    2012-05-21

    This study is aimed at identifying the potential benefits of using a patient-specific aperture in proton beam scanning. For this purpose, an accurate Monte Carlo model of the pencil beam scanning (PBS) proton therapy (PT) treatment head at Massachusetts General Hospital (MGH) was developed based on an existing model of the passive double-scattering (DS) system. The Monte Carlo code specifies the treatment head at MGH with sub-millimeter accuracy. The code was configured based on the results of experimental measurements performed at MGH. This model was then used to compare out-of-field doses in simulated DS treatments and PBS treatments. For the conditions explored, the penumbra in PBS is wider than in DS, leading to higher absorbed doses and equivalent doses adjacent to the primary field edge. For lateral distances greater than 10 cm from the field edge, the doses in PBS appear to be lower than those observed for DS. We found that placing a patient-specific aperture at nozzle exit during PBS treatments can potentially reduce doses lateral to the primary radiation field by over an order of magnitude. In conclusion, using a patient-specific aperture has the potential to further improve the normal tissue sparing capabilities of PBS.

  15. Inverse determination of the penalty parameter in penalized weighted least-squares algorithm for noise reduction of low-dose CBCT

    SciTech Connect

    Wang, Jing; Guan, Huaiqun; Solberg, Timothy

    2011-07-15

    Purpose: A statistical projection restoration algorithm based on the penalized weighted least-squares (PWLS) criterion can substantially improve the image quality of low-dose CBCT images. The performance of PWLS is largely dependent on the choice of the penalty parameter. Previously, the penalty parameter was chosen empirically by trial and error. In this work, the authors developed an inverse technique to calculate the penalty parameter in PWLS for noise suppression of low-dose CBCT in image guided radiotherapy (IGRT). Methods: In IGRT, a daily CBCT is acquired for the same patient during a treatment course. In this work, the authors acquired the CBCT with a high-mAs protocol for the first session and then a lower mAs protocol for the subsequent sessions. The high-mAs projections served as the goal (ideal) toward, which the low-mAs projections were to be smoothed by minimizing the PWLS objective function. The penalty parameter was determined through an inverse calculation of the derivative of the objective function incorporating both the high and low-mAs projections. Then the parameter obtained can be used for PWLS to smooth the noise in low-dose projections. CBCT projections for a CatPhan 600 and an anthropomorphic head phantom, as well as for a brain patient, were used to evaluate the performance of the proposed technique. Results: The penalty parameter in PWLS was obtained for each CBCT projection using the proposed strategy. The noise in the low-dose CBCT images reconstructed from the smoothed projections was greatly suppressed. Image quality in PWLS-processed low-dose CBCT was comparable to its corresponding high-dose CBCT. Conclusions: A technique was proposed to estimate the penalty parameter for PWLS algorithm. It provides an objective and efficient way to obtain the penalty parameter for image restoration algorithms that require predefined smoothing parameters.

  16. Feasible Dose Reduction in Routine Chest Computed Tomography Maintaining Constant Image Quality Using the Last Three Scanner Generations: From Filtered Back Projection to Sinogram-affirmed Iterative Reconstruction and Impact of the Novel Fully Integrated Detector Design Minimizing Electronic Noise

    PubMed Central

    Ebner, Lukas; Knobloch, Felix; Huber, Adrian; Landau, Julia; Ott, Daniel; Heverhagen, Johannes T; Christe, Andreas

    2014-01-01

    Objective: The aim of the present study was to evaluate a dose reduction in contrast-enhanced chest computed tomography (CT) by comparing the three latest generations of Siemens CT scanners used in clinical practice. We analyzed the amount of radiation used with filtered back projection (FBP) and an iterative reconstruction (IR) algorithm to yield the same image quality. Furthermore, the influence on the radiation dose of the most recent integrated circuit detector (ICD; Stellar detector, Siemens Healthcare, Erlangen, Germany) was investigated. Materials and Methods: 136 Patients were included. Scan parameters were set to a thorax routine: SOMATOM Sensation 64 (FBP), SOMATOM Definition Flash (IR), and SOMATOM Definition Edge (ICD and IR). Tube current was set constantly to the reference level of 100 mA automated tube current modulation using reference milliamperes. Care kV was used on the Flash and Edge scanner, while tube potential was individually selected between 100 and 140 kVp by the medical technologists at the SOMATOM Sensation. Quality assessment was performed on soft-tissue kernel reconstruction. Dose was represented by the dose length product. Results: Dose-length product (DLP) with FBP for the average chest CT was 308 mGy*cm ± 99.6. In contrast, the DLP for the chest CT with IR algorithm was 196.8 mGy*cm ± 68.8 (P = 0.0001). Further decline in dose can be noted with IR and the ICD: DLP: 166.4 mGy*cm ± 54.5 (P = 0.033). The dose reduction compared to FBP was 36.1% with IR and 45.6% with IR/ICD. Signal-to-noise ratio (SNR) was favorable in the aorta, bone, and soft tissue for IR/ICD in combination compared to FBP (the P values ranged from 0.003 to 0.048). Overall contrast-to-noise ratio (CNR) improved with declining DLP. Conclusion: The most recent technical developments, namely IR in combination with integrated circuit detectors, can significantly lower radiation dose in chest CT examinations. PMID:25161807

  17. SU-E-I-62: Assessing Radiation Dose Reduction and CT Image Optimization Through the Measurement and Analysis of the Detector Quantum Efficiency (DQE) of CT Images Using Different Beam Hardening Filters

    SciTech Connect

    Collier, J; Aldoohan, S; Gill, K

    2014-06-01

    Purpose: Reducing patient dose while maintaining (or even improving) image quality is one of the foremost goals in CT imaging. To this end, we consider the feasibility of optimizing CT scan protocols in conjunction with the application of different beam-hardening filtrations and assess this augmentation through noise-power spectrum (NPS) and detector quantum efficiency (DQE) analysis. Methods: American College of Radiology (ACR) and Catphan phantoms (The Phantom Laboratory) were scanned with a 64 slice CT scanner when additional filtration of thickness and composition (e.g., copper, nickel, tantalum, titanium, and tungsten) had been applied. A MATLAB-based code was employed to calculate the image of noise NPS. The Catphan Image Owl software suite was then used to compute the modulated transfer function (MTF) responses of the scanner. The DQE for each additional filter, including the inherent filtration, was then computed from these values. Finally, CT dose index (CTDIvol) values were obtained for each applied filtration through the use of a 100 mm pencil ionization chamber and CT dose phantom. Results: NPS, MTF, and DQE values were computed for each applied filtration and compared to the reference case of inherent beam-hardening filtration only. Results showed that the NPS values were reduced between 5 and 12% compared to inherent filtration case. Additionally, CTDIvol values were reduced between 15 and 27% depending on the composition of filtration applied. However, no noticeable changes in image contrast-to-noise ratios were noted. Conclusion: The reduction in the quanta noise section of the NPS profile found in this phantom-based study is encouraging. The reduction in both noise and dose through the application of beam-hardening filters is reflected in our phantom image quality. However, further investigation is needed to ascertain the applicability of this approach to reducing patient dose while maintaining diagnostically acceptable image qualities in a

  18. Defining the Optimal Selenium Dose for Prostate Cancer Risk Reduction: Insights from the U-Shaped Relationship Between Selenium Status, DNA Damage, and Apoptosis

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Our work in dogs has revealed a U-shaped dose response between selenium status and prostatic DNA damage that remarkably parallels the relationship between dietary selenium and prostate cancer risk in men, suggesting that more selenium is not necessarily better. Herein, we extend this canine work to ...

  19. Exposure to Non-Therapeutic INR in a High Risk Cardiovascular Patient: Potential Hazard Reduction with Genotype-guided Warfarin (Coumadin®) Dosing

    PubMed Central

    Rodríguez-Vélez, Rosángela; Ortiz-Rivera, Oscar J.; Bower, Bruce; Gorowski, Krystyna; Windemuth, Andreas; Villagra, David; Kocherla, Mohan; Seip, Richard L; D'Agostino, Darrin; Vergara, Cunegundo; Ruaño, Gualberto; Duconge, Jorge

    2013-01-01

    A case to illustrate the utility of genetic screening in warfarin (Coumadin®) management is reported. A 45 year-old woman of Puerto Rican ancestry was admitted to the emergency room twice within one month with chest pain. She was diagnosed with congestive heart failure, which was stabilized both times. At her second release, warfarin therapy was initiated at 5 mg/day to prevent thrombus formation and was lowered to 3.75 mg/day at day 7 by her primary physician. International Normalized Ratio (INR) test results in the follow-up period at days 1, 7, and 10 of warfarin therapy were 4.5, 6.5, and 7.3, respectively—far in excess of the therapeutic range, despite the lower dosage in effect from day 7 onward. the patient achieved target INR over the next 43 days after downward adjustment of the dose to a dose of 1.5 mg/day by trial and error. DNA-typing specific for the CYP2C9*2, *3, *4, *5, *6 alleles and seven variants in the VKORC1 gene, including the VKORC1-1639 G>A polymorphism, revealed the presence of combinatorial CYP2C9*2/*3 and VKORC1-1639 G/A genotypes in this patient. Entering the patient's demographic and genotype status data into independent algorithms available in the public domain to predict effective warfarin dose yielded predicted doses which ranged from 1.5 to 1.8 mg/day. Notably, the prediction of 1.5 mg/day, which was generated by the online resource www.warfarindosing.org, coincided with the patient's actual effective warfarin dose. We conclude that the rapid rise in INR observed upon the initiation of warfarin therapy and the final effective warfarin dose of 1.5 mg/day, are attributable in some part to the presence of two minor alleles in CYP2C9, which together significantly reduce warfarin metabolism. Warfarin genotyping can therefore inform the clinician of the predicted effective warfarin dose. the results highlight the potential for warfarin genetic testing to improve patient care. PMID:21261182

  20. SU-E-T-13: A Comparative Dosimetric Study On Radio-Dynamic Therapy for Pelvic Cancer Treatment: Strategies for Bone Marrow Dose and Volume Reduction

    SciTech Connect

    Li, C; Wang, B; Dong, Z; Ma, C; Ge, W; Xu, L

    2015-06-15

    Purpose: Radio-dynamic therapy (RDT) is a potentially effective modality for local and systemic cancer treatment. Using RDT, the administration of a radio-sensitizer enhances the biological effect of high-energy photons. Although the sensitizer uptake ratio of tumor to normal tissue is normally high, one cannot simply neglect its effect on critical structures. In this study, we aim to explore planning strategies to improve bone marrow sparing without compromising the plan quality for RDT treatment of pelvic cancers. Methods: Ten cervical and ten prostate cancer patients who previously received radiotherapy at our institution were selected for this study. For each patient, nine plans were created using the Varian Eclipse treatmentplanning-system (TPS) with 3D-CRT, IMRT, and VMAT delivery techniques containing various gantry angle combinations and optimization parameters (dose constraints to the bone marrow). To evaluate the plans for bone marrow sparing, the dose-volume parameters V5, V10, V15, V20, V30, and V40 for bone marrow were examined. Effective doseenhancement factors for the sensitizer were used to weigh the dose-volume histograms for various tissues from individual fractions. Results: The planning strategies had different impacts on bone marrow sparing for the cervical and prostate cases. For the cervical cases, provided the bone marrow constraints were properly set during optimization, the dose to bone marrow sparing was found to be comparable between different IMRT and VMAT plans regardless of the gantry angle selection. For the prostate cases, however, careful selection of gantry angles could dramatically improve the bone marrow sparing, although the dose distribution in bone marrow was clinically acceptable for all prostate plans that we created. Conclusion: For intensity-modulated RDT planning for cervical cancer, planners should set bone marrow constraints properly to avoid any adverse damage, while for prostate cancer one can carefully select gantry

  1. Ibandronate dose response is associated with increases in bone mineral density and reductions in clinical fractures: results of a meta-analysis.

    PubMed

    Sebba, Anthony I; Emkey, Ronald D; Kohles, Joseph D; Sambrook, Philip N

    2009-03-01

    This meta-analysis pooled data from the four phase III clinical trials of ibandronate to assess the relationship between ibandronate dose, changes in bone mineral density, and rates of both clinical and non-vertebral fractures. Individual patient data from the intent-to-treat population of the BONE, IV fracture prevention, MOBILE, and DIVA studies were included for analysis. The relationship between ibandronate dose and bone mineral density at both the lumbar spine and at the total hip was assessed qualitatively. The relationship between lumbar spine bone mineral density and clinical fracture rate, and the relationship between total hip bone mineral density and non-vertebral fracture rate, were assessed both qualitatively and using mathematical models. A total of 8710 patients were included in this analysis. Both lumbar spine and total hip bone mineral density were observed to increase with increasing ibandronate dose. The incidence of all clinical fractures was observed to decrease as lumbar spine bone mineral density increased. A statistically significant inverse linear relationship was observed between percent change in lumbar spine bone mineral density and the rate of clinical fractures (P=0.005). A non-significant curvilinear relationship was observed between percent change in total hip bone mineral density and non-vertebral fracture rate. Increased ibandronate exposure is associated with increasing gains in the lumbar spine bone mineral density and decreasing clinical fracture rates. A non-linear relationship may exist between increases in the total hip bone mineral density and non-vertebral fracture rate.

  2. Dose reduction technique using a combination of a region of interest (ROI) material x-ray attenuator and spatially different temporal filtering for fluoroscopic interventions

    NASA Astrophysics Data System (ADS)

    Swetadri Vasan, S. N.; Panse, A.; Jain, A.; Sharma, P.; Ionita, Ciprian N.; Titus, A. H.; Cartwright, A. N.; Bednarek, D. R.; Rudin, S.

    2012-03-01

    We demonstrate a novel approach for achieving patient dose savings during image-guided neurovascular interventions, involving a combination of a material x-ray region of interest (ROI) attenuator and a spatially different ROI temporal filtering technique. The part of the image under the attenuator is reduced in dose but noisy and less bright due to fewer x-ray quanta reaching the detector, as compared to the non-attenuating (or less attenuating) region. First the brightness is equalized throughout the image by post processing and then a temporal filter with higher weights is applied to the high attenuating region to reduce the noise, at the cost of increased lag; however, in the regions where less attenuation is present, a lower temporal weight is needed and is applied to preserve temporal resolution. A simulation of the technique is first presented on an actual image sequence obtained from an endovascular image guided interventional (EIGI) procedure. Then the actual implementation of the technique with a physical ROI attenuator is presented. Quantitative analysis including noise analysis and integral dose calculations are presented to validate the proposed technique.

  3. Dose addition models based on biologically-relevant reductions in fetal testosterone accurately predict postnatal reproductive tract alterations by a phthalate mixture in rats

    EPA Science Inventory

    Challenges in cumulative risk assessment of anti-androgenic phthalate mixtures include a lack of data on all the individual phthalates and difficulty determining the biological relevance of reduction in fetal testosterone (T) on postnatal development. The objectives of the curren...

  4. Evaluation of blood pressure reduction response and responder characteristics to fixed-dose combination treatment of amlodipine and losartan: a post hoc analysis of pooled clinical trials.

    PubMed

    Unniachan, Sreevalsa; Wu, David; Rajagopalan, Srinivasan; Hanson, Mary E; Fujita, Kenji P

    2014-09-01

    Data from four clinical trials compared reductions in systolic blood pressure (SBP) and diastolic blood pressure (DBP) among patients treated with amlodipine/losartan 5/50 mg vs 5/100 mg and amlodipine/losartan 5/50 mg vs amlodipine 5 mg and 10 mg. Response rate was assessed as reduction in SBP or DBP (>20/10 mm Hg) and proportion of patients achieving SBP <140 mm Hg or DBP <90 mm Hg. Patients were grouped into quartiles based on baseline SBP and DBP. Mean SBP and DBP were reduced in amlodipine/losartan 5/50 mg (n=182) and amlodipine/losartan 5/100 mg (n=95) users across all baseline quartiles. Patients using amlodipine/losartan 5/50 mg had significantly greater SBP and DBP reductions vs amlodipine 5 mg (P=.001 and P=.02, respectively). Amlodipine/losartan 5/50 mg users had significantly greater SBP reduction vs amlodipine 10 mg (SBP P=.02; DBP P=not significant). The odds of responding to therapy were significantly greater with amlodipine/losartan 5/50 mg vs amlodipine 5 mg (odds ratio, 5.33; 95% confidence interval, 1.42-25.5) and were similar vs amlodipine 10 mg (odds ratio, 0.67; 95% confidence interval, 0.017-9.51). These results support the use of combination therapy early in the treatment of hypertension.

  5. Nutritional Status, Body Surface, and Low Lean Body Mass/Body Mass Index Are Related to Dose Reduction and Severe Gastrointestinal Toxicity Induced by Afatinib in Patients With Non-Small Cell Lung Cancer

    PubMed Central

    De la Torre-Vallejo, Martha; López-Macías, Diego; Orta, David; Turcott, Jenny; Macedo-Pérez, Eleazar-Omar; Sánchez-Lara, Karla; Ramírez-Tirado, Laura-Alejandra; Baracos, Vickie E.

    2015-01-01

    Background. The main reason for dose reduction of afatinib is gastrointestinal toxicity (GT). In a phase II study, we analyzed anthropometrical, nutritional, and biochemical factors associated with GT induced by afatinib. Materials and Methods. Patients diagnosed with non-small cell lung cancer who progressed to prior chemotherapy received 40 mg of afatinib. Malnutrition was determined by Subjective Global Assessment, and lean body mass (LBM) was determined by computed tomography scan analysis using a pre-established Hounsfield unit threshold. Toxicity was obtained during four cycles by Common Terminology Criteria for Adverse Events. Results. Eighty-four patients were enrolled. Afatinib was administered as the second, third, and fourth line of treatment in 54.8%, 38.1%, and 7.12% of patients, respectively. Severe diarrhea, mucositis, and overall severe GT were present in 38.9%, 28.8%, and 57.5%, respectively. Of the patients, 50% developed dose-limiting toxicity (DLT). Patients with malnutrition have higher risk for severe GT. Patients with lower LBM and body mass index developed more DLT (71.4% vs. 18.8%). Conclusion. Malnutrition is associated with a higher risk of severe GT induced by afatinib. Determination of nutritional status and body composition are helpful in identifying patients at higher risk of severe GT and could allow initiating treatment with lower doses according to tolerance. Implications for Practice: Body composition analysis, specifically lean body mass quantification, and nutritional status assessment are significant clinical variables to take into account when assessing oncological patients. This study on patients with non-small cell lung cancer treated with afatinib showed the important impact that malnutrition and low lean body mass have on the risk for developing dose-limiting toxicity and severe gastrointestinal toxicity. Still more research needs to be done to explore dose adjustment according to lean body mass, especially in drugs that

  6. Penalized weighted least-squares approach to sinogram noise reduction and image reconstruction for low-dose X-ray computed tomography.

    PubMed

    Wang, Jing; Li, Tianfang; Lu, Hongbing; Liang, Zhengrong

    2006-10-01

    Reconstructing low-dose X-ray computed tomography (CT) images is a noise problem. This work investigated a penalized weighted least-squares (PWLS) approach to address this problem in two dimensions, where the WLS considers first- and second-order noise moments and the penalty models signal spatial correlations. Three different implementations were studied for the PWLS minimization. One utilizes a Markov random field (MRF) Gibbs functional to consider spatial correlations among nearby detector bins and projection views in sinogram space and minimizes the PWLS cost function by iterative Gauss-Seidel algorithm. Another employs Karhunen-Loève (KL) transform to de-correlate data signals among nearby views and minimizes the PWLS adaptively to each KL component by analytical calculation, where the spatial correlation among nearby bins is modeled by the same Gibbs functional. The third one models the spatial correlations among image pixels in image domain also by a MRF Gibbs functional and minimizes the PWLS by iterative successive over-relaxation algorithm. In these three implementations, a quadratic functional regularization was chosen for the MRF model. Phantom experiments showed a comparable performance of these three PWLS-based methods in terms of suppressing noise-induced streak artifacts and preserving resolution in the reconstructed images. Computer simulations concurred with the phantom experiments in terms of noise-resolution tradeoff and detectability in low contrast environment. The KL-PWLS implementation may have the advantage in terms of computation for high-resolution dynamic low-dose CT imaging.

  7. A patient-specific therapeutic approach for tumour cell population extinction and drug toxicity reduction using control systems-based dose-profile design

    PubMed Central

    2013-01-01

    Background When anti-tumour therapy is administered to a tumour-host environment, an asymptotic tapering extremity of the tumour cell distribution is noticed. This extremity harbors a small number of residual tumour cells that later lead to secondary malignances. Thus, a method is needed that would enable the malignant population to be completely eliminated within a desired time-frame, negating the possibility of recurrence and drug-induced toxicity. Methods In this study, we delineate a computational procedure using the inverse input-reconstruction approach to calculate the unknown drug stimulus input, when one desires a known output tissue-response (full tumour cell elimination, no excess toxicity). The asymptotic extremity is taken care of using a bias shift of tumour-cell distribution and guided control of drug administration, with toxicity limits enforced, during mutually-synchronized chemotherapy (as Temozolomide) and immunotherapy (Interleukin-2 and Cytotoxic T-lymphocyte). Results Quantitative modeling is done using representative characteristics of rapidly and slowly-growing tumours. Both were fully eliminated within 2 months with checks for recurrence and toxicity over a two-year time-line. The dose-time profile of the therapeutic agents has similar features across tumours: biphasic (lymphocytes), monophasic (chemotherapy) and stationary (interleukin), with terminal pulses of the three agents together ensuring elimination of all malignant cells. The model is then justified with clinical case studies and animal models of different neurooncological tumours like glioma, meningioma and glioblastoma. Conclusion The conflicting oncological objectives of tumour-cell extinction and host protection can be simultaneously accommodated using the techniques of drug input reconstruction by enforcing a bias shift and guided control over the drug dose-time profile. For translational applicability, the procedure can be adapted to accommodate varying patient parameters

  8. Serum PCSK9 Levels Distinguish Individuals Who Do Not Respond to High-Dose Statin Therapy with the Expected Reduction in LDL-C

    PubMed Central

    Taylor, Beth A.; Panza, Gregory; Pescatello, Linda S.; Chipkin, Stuart; Gipe, Daniel; Shao, Weiping; White, C. Michael; Thompson, Paul D.

    2014-01-01

    The purpose of the present report was to examine whether proprotein convertase subtilisin/kexin type 9 (PCSK9) levels differ in individuals who do not exhibit expected reductions in low density lipoprotein cholesterol (LDL-C) with statin therapy. Eighteen nonresponder subjects treated with 80 mg atorvastatin treatment for 6 months without substantial reductions in LDL-C (ΔLDL-C: 2.6 ± 11.4%) were compared to age- and gender-matched atorvastatin responders (ΔLDL-C: 50.7 ± 8.5%) and placebo-treated subjects (ΔLDL-C: 9.9 ± 21.5%). Free PCSK9 was marginally higher in nonresponders at baseline (P = 0.07) and significantly higher in atorvastatin responders after 6 months of treatment (P = 0.04). The change in free PCSK9 over 6 months with statin treatment was higher (P < 0.01) in atorvastatin responders (134.2 ± 131.5 ng/mL post- versus prestudy) than in either the nonresponders (39.9 ± 87.8 ng/mL) or placebo subjects (27.8 ± 97.6 ng/mL). Drug compliance was not lower in the nonresponders as assessed by pill counts and poststudy plasma atorvastatin levels. Serum PCSK9 levels, both at baseline and in response to statin therapy, may differentiate individuals who do versus those who do not respond to statin treatment. PMID:25136459

  9. Legal, ethical, and economic implications of breaking down once-daily fixed-dose antiretroviral combinations into their single components for cost reduction.

    PubMed

    Ramiro, Miguel A; Llibre, Josep M

    2014-11-01

    The availability of generic lamivudine in the context of the current economic crisis has raised a new issue in some European countries: breaking up the once-daily fixed-dose antiretroviral combinations (FDAC) of efavirenz/tenofovir/emtricitabine, tenofovir/emtricitabine, or abacavir/lamivudine, in order to administer their components separately, thereby allowing the use of generic lamivudine instead of branded emtricitabine or lamivudine. The legal, ethical, and economic implications of this potential strategy are reviewed, particularly in those patients receiving a once-daily single-tablet regimen. An unfamiliar change in antiretroviral treatment from a successful patient-friendly FDAC into a more complex regimen including separately the components to allow the substitution of one (or some) of them for generic surrogates (in the absence of a generic bioequivalent FDAC) could be discriminatory because it does not guarantee access to equal excellence in healthcare to all citizens. Furthermore, it could violate the principle of non-maleficence by potentially causing harm both at the individual level (hindering adherence and favouring treatment failure and resistance), and at the community level (hampering control of disease transmission and transmission of HIV-1 resistance). Replacing a FDAC with the individual components of that combination should only be permitted when the substituting medication has the same qualitative and quantitative composition of active ingredients, pharmaceutical form, method of administration, dosage and presentation as the medication being replaced, and a randomized study has demonstrated its non-inferiority. Finally, a strict pharma-economic study supporting this change, comparing the effectiveness and the cost of a specific intervention with the best available alternative, should be undertaken before its potential implementation.

  10. Repression of Gurken translation by a meiotic checkpoint in Drosophila oogenesis is suppressed by a reduction in the dose of eIF1A.

    PubMed

    Li, Wei; Klovstad, Martha; Schüpbach, Trudi

    2014-10-01

    In Drosophila melanogaster, the anteroposterior (AP) and dorsoventral (DV) axes of the oocyte and future embryo are established through the localization and translational regulation of gurken (grk) mRNA. This process involves binding of specific factors to the RNA during transport and a dynamic remodeling of the grk-containing ribonucleoprotein (RNP) complexes once they have reached their destination within the oocyte. In ovaries of spindle-class females, an activated DNA damage checkpoint causes inefficient Grk translation and ventralization of the oocyte. In a screen for modifiers of the oocyte DV patterning defects, we identified a mutation in the eIF1A gene as a dominant suppressor. We show that reducing the function of eIF1A in spnB ovaries suppresses the ventralized eggshell phenotype by restoring Grk expression. This suppression is not the result of more efficient DNA damage repair or of disrupted checkpoint activation, but is coupled to an increase in the amount of grk mRNA associated with polysomes. In spnB ovaries, the activated meiotic checkpoint blocks Grk translation by disrupting the accumulation of grk mRNA in a translationally competent RNP complex that contains the translational activator Oo18 RNA-binding protein (Orb); this regulation involves the translational repressor Squid (Sqd). We further propose that reduction of eIF1A allows more efficient Grk translation possibly because of the presence of specific structural features in the grk 5'UTR.

  11. Objective and Longitudinal Assessment of Dermatitis After Postoperative Accelerated Partial Breast Irradiation Using High-Dose-Rate Interstitial Brachytherapy in Patients With Breast Cancer Treated With Breast Conserving Therapy: Reduction of Moisture Deterioration by APBI

    SciTech Connect

    Tanaka, Eiichi; Yamazaki, Hideya; Yoshida, Ken; Takenaka, Tadashi; Masuda, Norikazu; Kotsuma, Tadayuki; Yoshioka, Yasuo; Inoue, Takehiro

    2011-11-15

    Purpose: To objectively evaluate the radiation dermatitis caused by accelerated partial breast irradiation (APBI) using high-dose-rate interstitial brachytherapy. Patients and Methods: The skin color and moisture changes were examined using a newly installed spectrophotometer and corneometer in 22 patients who had undergone APBI using open cavity implant high-dose-rate interstitial brachytherapy (36 Gy in six fractions) and compared with the corresponding values for 44 patients in an external beam radiotherapy (EBRT) control group (50-60 Gy in 25-30 fractions within 5-6 weeks) after breast conserving surgery. Results: All values changed significantly as a result of APBI. The extent of elevation in a Asterisk-Operator (reddish) and reduction in L Asterisk-Operator (black) values caused by APBI were similar to those for EBRT, with slightly delayed recovery for 6-12 months after treatment owing to the surgical procedure. In contrast, only APBI caused a change in the b Asterisk-Operator values, and EBRT did not, demonstrating that the reduction in b Asterisk-Operator values (yellowish) depends largely on the surgical procedure. The changes in moisture were less severe after APBI than after EBRT, and the recovery was more rapid. The toxicity assessment using the Common Toxicity Criteria, version 3, showed that all dermatitis caused by APBI was Grade 2 or less. Conclusion: An objective analysis can quantify the effects of APBI procedures on color and moisture cosmesis. The radiation dermatitis caused by APBI using the present schedule showed an equivalent effect on skin color and a less severe effect on moisture than the effects caused by standard EBRT.

  12. A comparative study of seed localization and dose calculation on pre- and post-implantation ultrasound and CT images for low-dose-rate prostate brachytherapy

    NASA Astrophysics Data System (ADS)

    Ali, Imad; Algan, Ozer; Thompson, Spencer; Sindhwani, Puneet; Herman, Terence; Cheng, Chih-Yao; Ahmad, Salahuddin

    2009-09-01

    This work investigates variation in the volume of the prostate measured at different stages through the prostate brachytherapy procedure for 30 patients treated with I-125 radioactive seeds. The implanted seeds were localized on post-implantation ultrasound (US) images and the effect of prostate enlargement due to edema on dose coverage for 15 patients was studied. The volume of the prostate was measured at four stages as follows: (a) 2-3 weeks prior to implantation using US imaging, (b) then at the start of the intra-operative prostate brachytherapy procedure on the day of the implant, (c) immediately post-implantation using US imaging in the operating room and (d) finally by CT imaging at nearly 4 weeks post-implantation. Comparative prostate volume studies were performed using US imaging stepper and twister modes. For the purpose of this study, the implanted seeds were localized successfully on post-implant ultrasound twister images, retrospectively. The plans using post-implant US imaging were compared with intra-operative plans on US and plans created on CT images. The prostate volume increases about 10 cm3 on average due to edema induced by needle insertion and seed loading during implantation. The visibility of the implanted seeds on US twister images acquired post-implantation is as good as those on CT images and can be localized and used for dose calculation. The dose coverage represented by parameters such as D90 (dose covering 90% of the volume) and V100 (volume covered by 100% dose) is poorer on plans performed on post-implantation twister US studies than on the intra-operative live plan or the CT scan performed 4 weeks post-operatively. For example, the mean D90 difference on post-implantation US is lower by more than 15% than that on pre-implantation US. The volume enlargement of the prostate due to edema induced by needle insertion and seed placement has a significant effect on the quality of dosimetric coverage in brachytherapy prostate seed

  13. Corneal edema induced by cold in trigeminal nerve palsy

    SciTech Connect

    Thorgaard, G.L.; Holland, E.J.; Krachmer, J.H.

    1987-05-15

    We examined a 34-year-old man who complained of decreased visual acuity in the right eye when exposed to cold environmental temperatures. Although examination at room temperature was unremarkable, he developed prominent unilateral corneal edema of the right eye when placed in a cold room at 4 C. Corneal thickness increased from 525 to 789 microns in the affected eye. Further examination disclosed a right-sided trigeminal nerve palsy. He was eventually found to have a 3 X 2-cm tentorial ridge meningioma on the right.

  14. Effect of a small number of training cases on the performance of massive training artificial neural network (MTANN) for reduction of false positives in computerized detection of lung nodules in low-dose CT

    NASA Astrophysics Data System (ADS)

    Suzuki, Kenji; Armato, Samuel G., III; Li, Feng; Sone, Shusuke; Doi, Kunio

    2003-05-01

    In this study, we investigated a pattern-classification technique which can be trained with a small number of cases with a massive training artificial neural network (MTANN) for reduction of false positives in computerized detection of lung nodules in low-dose CT (LDCT). The MTANN consists of a modified multilayer artificial neural network (ANN), which is capable of operating on image data directly. The MTANN is trained by use of a large number of sub-regions extracted from input images together with the teacher images containing the distribution for the "likelihood of being a nodule." The output image is obtained by scanning of an input image with the MTANN. In the MTANN, the distinction between nodules and non-nodules is treated as an image-processing task, in other words, as a highly nonlinear filter that performs both nodule enhancement and non-nodule suppression. This allows us to train the MTANN not on a case basis, but on a sub-region basis. Therefore, the MTANN can be trained with a very small number of cases. Our database consisted of 101 LDCT scans acquired from 71 patients in a lung cancer screening program. The scans consisted of 2,822 sections, and contained 121 nodules including 104 nodules representing confirmed primary cancers. With our current CAD scheme, a sensitivity of 81.0% (98/121 nodules) with 0.99 false positives per section (2,804/2,822) was achieved. By use of the MTANN trained with a small number of training cases (n=10), i.e., five pairs of nodules and non-nodules, we were able to remove 55.8% of false positives without a reduction in the number of true positives, i.e., a classification sensitivity of 100%. Thus, the false-positive rate of our current CAD scheme was reduced from 0.99 to 0.44 false positive per section, while the current sensitivity (81.0%) was maintained.

  15. RTOG 0529: A Phase 2 Evaluation of Dose-Painted Intensity Modulated Radiation Therapy in Combination With 5-Fluorouracil and Mitomycin-C for the Reduction of Acute Morbidity in Carcinoma of the Anal Canal

    SciTech Connect

    Kachnic, Lisa A.; Winter, Kathryn; Myerson, Robert J.; Goodyear, Michael D.; Willins, John; Esthappan, Jacqueline; Haddock, Michael G.; Rotman, Marvin; Parikh, Parag J.; Safran, Howard; Willett, Christopher G.

    2013-05-01

    Purpose: A multi-institutional phase 2 trial assessed the utility of dose-painted intensity modulated radiation therapy (DP-IMRT) in reducing grade 2+ combined acute gastrointestinal and genitourinary adverse events (AEs) of 5-fluorouracil (5FU) and mitomycin-C (MMC) chemoradiation for anal cancer by at least 15% compared with the conventional radiation/5FU/MMC arm from RTOG 9811. Methods and Materials: T2-4N0-3M0 anal cancer patients received 5FU and MMC on days 1 and 29 of DP-IMRT, prescribed per stage: T2N0, 42 Gy elective nodal and 50.4 Gy anal tumor planning target volumes (PTVs) in 28 fractions; T3-4N0-3, 45 Gy elective nodal, 50.4 Gy ≤3 cm or 54 Gy >3 cm metastatic nodal and 54 Gy anal tumor PTVs in 30 fractions. The primary endpoint is described above. Planned secondary endpoints assessed all AEs and the investigator’s ability to perform DP-IMRT. Results: Of 63 accrued patients, 52 were evaluable. Tumor stage included 54% II, 25% IIIA, and 21% IIIB. In primary endpoint analysis, 77% experienced grade 2+ gastrointestinal/genitourinary acute AEs (9811 77%). There was, however, a significant reduction in acute grade 2+ hematologic, 73% (9811 85%, P=.032), grade 3+ gastrointestinal, 21% (9811 36%, P=.0082), and grade 3+ dermatologic AEs 23% (9811 49%, P<.0001) with DP-IMRT. On initial pretreatment review, 81% required DP-IMRT replanning, and final review revealed only 3 cases with normal tissue major deviations. Conclusions: Although the primary endpoint was not met, DP-IMRT was associated with significant sparing of acute grade 2+ hematologic and grade 3+ dermatologic and gastrointestinal toxicity. Although DP-IMRT proved feasible, the high pretreatment planning revision rate emphasizes the importance of real-time radiation quality assurance for IMRT trials.

  16. TU-EF-204-03: Task-Based KV and MAs Optimization for Radiation Dose Reduction in CT: From FBP to Statistical Model-Based Iterative Reconstruction (MBIR)

    SciTech Connect

    Gomez-Cardona, D; Li, K; Lubner, M G; Pickhardt, P J; Chen, G-H

    2015-06-15

    Purpose: The introduction of the highly nonlinear MBIR algorithm to clinical CT systems has made CNR an invalid metric for kV optimization. The purpose of this work was to develop a task-based framework to unify kV and mAs optimization for both FBP- and MBIR-based CT systems. Methods: The kV-mAs optimization was formulated as a constrained minimization problem: to select kV and mAs to minimize dose under the constraint of maintaining the detection performance as clinically prescribed. To experimentally solve this optimization problem, exhaustive measurements of detectability index (d’) for a hepatic lesion detection task were performed at 15 different mA levels and 4 kV levels using an anthropomorphic phantom. The measured d’ values were used to generate an iso-detectability map; similarly, dose levels recorded at different kV-mAs combinations were used to generate an iso-dose map. The iso-detectability map was overlaid on top of the iso-dose map so that for a prescribed detectability level d’, the optimal kV-mA can be determined from the crossing between the d’ contour and the dose contour that corresponds to the minimum dose. Results: Taking d’=16 as an example: the kV-mAs combinations on the measured iso-d’ line of MBIR are 80–150 (3.8), 100–140 (6.6), 120–150 (11.3), and 140–160 (17.2), where values in the parentheses are measured dose values. As a Result, the optimal kV was 80 and optimal mA was 150. In comparison, the optimal kV and mA for FBP were 100 and 500, which corresponded to a dose level of 24 mGy. Results of in vivo animal experiments were consistent with the phantom results. Conclusion: A new method to optimize kV and mAs selection has been developed. This method is applicable to both linear and nonlinear CT systems such as those using MBIR. Additional dose savings can be achieved by combining MBIR with this method. This work was partially supported by an NIH grant R01CA169331 and GE Healthcare. K. Li, D. Gomez-Cardona, M. G

  17. Imaging task-based optimal kV and mA selection for CT radiation dose reduction: from filtered backprojection (FBP) to statistical model based iterative reconstruction (MBIR)

    NASA Astrophysics Data System (ADS)

    Li, Ke; Gomez-Cardona, Daniel; Lubner, Meghan G.; Pickhardt, Perry J.; Chen, Guang-Hong

    2015-03-01

    Optimal selections of tube potential (kV) and tube current (mA) are essential in maximizing the diagnostic potential of a given CT technology while minimizing radiation dose. The use of a lower tube potential may improve image contrast, but may also require a significantly higher tube current to compensate for the rapid decrease of tube output at lower tube potentials. Therefore, the selection of kV and mA should take those kinds of constraints as well as the specific diagnostic imaging task in to consideration. For conventional quasi-linear CT systems employing linear filtered back-projection (FBP) image reconstruction algorithm, the optimization of kV-mA combinations are relatively straightforward, as neither spatial resolution nor noise texture has significant dependence on kV and mA settings. In these cases, zero-frequency analysis such as contrast-to-noise ratio (CNR) or normalized CNR by dose (CNRD) can be used for optimal kV-mA selection. The recently introduced statistical model-based iterative reconstruction (MBIR) method, however, has introduced new challenges to optimal kV and mA selection, as both spatial resolution and noise texture become closely correlated with kV and mA. In this work, a task-based approach based on modern signal detection theory and the corresponding frequency-dependent analysis has been proposed to perform the kV and mA optimization for both FBP and MBIR. By performing exhaustive measurements of task-based detectability index through the technically accessible kV-mA parameter space, iso-detectability contours were generated and overlaid on top of iso-dose contours, from which the kV-mA pair that minimize dose yet still achieving the desired detectability level can be identified.

  18. ORGAN DOSES AND EFFECTIVE DOSE FOR FIVE PET RADIOPHARMACEUTICALS.

    PubMed

    Andersson, Martin; Johansson, Lennart; Mattsson, Sören; Minarik, David; Leide-Svegborn, Sigrid

    2016-06-01

    Diagnostic investigations with positron-emitting radiopharmaceuticals are dominated by (18)F-fluorodeoxyglucose ((18)F-FDG), but other radiopharmaceuticals are also commercially available or under development. Five of them, which are all clinically important, are (18)F-fluoride, (18)F-fluoroethyltyrosine ((18)F-FET), (18)F-deoxyfluorothymidine ((18)F-FLT), (18)F-fluorocholine ((18)F-choline) and (11)C-raclopride. To estimate the potential risk of stochastic effects (mainly lethal cancer) to a population, organ doses and effective dose values were updated for all five radiopharmaceuticals. Dose calculations were performed using the computer program IDAC2.0, which bases its calculations on the ICRP/ICRU adult reference voxel phantoms and the tissue weighting factors from ICRP publication 103. The biokinetic models were taken from ICRP publication 128. For organ doses, there are substantial changes. The only significant change in effective dose compared with previous estimations was a 46 % reduction for (18)F-fluoride. The estimated effective dose in mSv MBq(-1) was 1.5E-02 for (18)F-FET, 1.5E-02 for (18)F-FLT, 2.0E-02 for (18)F-choline, 9.0E-03 for (18)F-fluoride and 4.4E-03 for (11)C-raclopride.

  19. Case Example of Dose Optimization Using Data From Bortezomib Dose-Finding Clinical Trials

    PubMed Central

    Backenroth, Daniel; Cheung, Ying Kuen Ken; Hershman, Dawn L.; Vulih, Diana; Anderson, Barry; Ivy, Percy; Minasian, Lori

    2016-01-01

    Purpose The current dose-finding methodology for estimating the maximum tolerated dose of investigational anticancer agents is based on the cytotoxic chemotherapy paradigm. Molecularly targeted agents (MTAs) have different toxicity profiles, which may lead to more long-lasting mild or moderate toxicities as well as to late-onset and cumulative toxicities. Several approved MTAs have been poorly tolerated during long-term administration, leading to postmarketing dose optimization studies to re-evaluate the optimal treatment dose. Using data from completed bortezomib dose-finding trials, we explore its toxicity profile, optimize its dose, and examine the appropriateness of current designs for identifying an optimal dose. Patients and Methods We classified the toxicities captured from 481 patients in 14 bortezomib dose-finding studies conducted through the National Cancer Institute Cancer Therapy Evaluation Program, computed the incidence of late-onset toxicities, and compared the incidence of dose-limiting toxicities (DLTs) among groups of patients receiving different doses of bortezomib. Results A total of 13,008 toxicities were captured: 46% of patients’ first DLTs and 88% of dose reductions or discontinuations of treatment because of toxicity were observed after the first cycle. Moreover, for the approved dose of 1.3 mg/m2, the estimated cumulative incidence of DLT was > 50%, and the estimated cumulative incidence of dose reduction or treatment discontinuation because of toxicity was nearly 40%. Conclusions When considering the entire course of treatment, the approved bortezomib dose exceeds the conventional ceiling DLT rate of 20% to 33%. Retrospective analysis of trial data provides an opportunity for dose optimization of MTAs. Future dose-finding studies of MTAs should take into account late-onset toxicities to ensure that a tolerable dose is identified for future efficacy and comparative trials. PMID:26926682

  20. Harm reduction

    PubMed Central

    Normand, Jacques; Li, Jih-Heng; Thomson, Nicholas; Jarlais, Don Des

    2014-01-01

    The “Harm Reduction” session was chaired by Dr. Jacques Normand, Director of the AIDS Research Program of the U.S. National Institute on Drug Abuse. The three presenters (and their presentation topics) were: Dr. Don Des Jarlais (High Coverage Needle/Syringe Programs for People Who Inject Drugs in Low and Middle Income Countries: A Systematic Review), Dr. Nicholas Thomson (Harm Reduction History, Response, and Current Trends in Asia), and Dr. Jih-Heng Li (Harm Reduction Strategies in Taiwan). PMID:25278732

  1. Acoustic dose and acoustic dose-rate.

    PubMed

    Duck, Francis

    2009-10-01

    Acoustic dose is defined as the energy deposited by absorption of an acoustic wave per unit mass of the medium supporting the wave. Expressions for acoustic dose and acoustic dose-rate are given for plane-wave conditions, including temporal and frequency dependencies of energy deposition. The relationship between the acoustic dose-rate and the resulting temperature increase is explored, as is the relationship between acoustic dose-rate and radiation force. Energy transfer from the wave to the medium by means of acoustic cavitation is considered, and an approach is proposed in principle that could allow cavitation to be included within the proposed definitions of acoustic dose and acoustic dose-rate.

  2. Waste Reduction.

    ERIC Educational Resources Information Center

    Bray, Marilyn; And Others

    1996-01-01

    Presents activities that focus on waste reduction in the school and community. The ideas are divided into grade level categories. Sample activities include Techno-Trash, where children use tools to take apart broken appliances or car parts, then reassemble them or build new creations. Activities are suggested for areas including language arts and…

  3. Absorbed Dose and Dose Equivalent Calculations for Modeling Effective Dose

    NASA Technical Reports Server (NTRS)

    Welton, Andrew; Lee, Kerry

    2010-01-01

    While in orbit, Astronauts are exposed to a much higher dose of ionizing radiation than when on the ground. It is important to model how shielding designs on spacecraft reduce radiation effective dose pre-flight, and determine whether or not a danger to humans is presented. However, in order to calculate effective dose, dose equivalent calculations are needed. Dose equivalent takes into account an absorbed dose of radiation and the biological effectiveness of ionizing radiation. This is important in preventing long-term, stochastic radiation effects in humans spending time in space. Monte carlo simulations run with the particle transport code FLUKA, give absorbed and equivalent dose data for relevant shielding. The shielding geometry used in the dose calculations is a layered slab design, consisting of aluminum, polyethylene, and water. Water is used to simulate the soft tissues that compose the human body. The results obtained will provide information on how the shielding performs with many thicknesses of each material in the slab. This allows them to be directly applicable to modern spacecraft shielding geometries.

  4. Reduction Corporoplasty

    PubMed Central

    Hakky, Tariq S.; Martinez, Daniel; Yang, Christopher; Carrion, Rafael E.

    2015-01-01

    Objective Here we present the first video demonstration of reduction corporoplasty in the management of phallic disfigurement in a 17 year old man with a history sickle cell disease and priapism. Introduction Surgical management of aneurysmal dilation of the corpora has yet to be defined in the literature. Materials and Methods: We preformed bilateral elliptical incisions over the lateral corpora as management of aneurysmal dilation of the corpora to correct phallic disfigurement. Results The patient tolerated the procedure well and has resolution of his corporal disfigurement. Conclusions Reduction corporoplasty using bilateral lateral elliptical incisions in the management of aneurysmal dilation of the corpora is a safe an feasible operation in the management of phallic disfigurement. PMID:26005988

  5. Nitrate reduction

    DOEpatents

    Dziewinski, Jacek J.; Marczak, Stanislaw

    2000-01-01

    Nitrates are reduced to nitrogen gas by contacting the nitrates with a metal to reduce the nitrates to nitrites which are then contacted with an amide to produce nitrogen and carbon dioxide or acid anions which can be released to the atmosphere. Minor amounts of metal catalysts can be useful in the reduction of the nitrates to nitrites. Metal salts which are formed can be treated electrochemically to recover the metals.

  6. Radiation dose optimization in thoracic imaging.

    PubMed

    Tack, D

    2010-01-01

    Guidelines for reduction of CT radiation dose were introduced in 1997 and are now more than 12 years old. The process initiated by the European Regulatory authorities to reduce the excess of radiation from CT has however not produced the expected results. Reference diagnostic levels (DRL) from surveys are still twice as high as needed in most European countries and were not significantly reduced as compared to the initial European ones. Many factors may at least explain partially the lack of dose reduction. One of them is the complexity of the dose optimization process while maintaining image quality at a diagnostically acceptable level. Chest is an anatomical region where radiation dose could be substantially reduced because of high natural contrasts between structures, such as air in the lungs and fat in the mediastinum. In this article, the concept of CT radiation dose optimization and the factors that contribute to maintain global excess in radiation dose are reviewed and a brief summary of results from research in the field of chest CT radiation dose is given.

  7. Dose optimization tool

    NASA Astrophysics Data System (ADS)

    Amir, Ornit; Braunstein, David; Altman, Ami

    2003-05-01

    A dose optimization tool for CT scanners is presented using patient raw data to calculate noise. The tool uses a single patient image which is modified for various lower doses. Dose optimization is carried out without extra measurements by interactively visualizing the dose-induced changes in this image. This tool can be used either off line, on existing image(s) or, as a pre - requisite for dose optimization for the specific patient, during the patient clinical study. The algorithm of low-dose simulation consists of reconstruction of two images from a single measurement and uses those images to create the various lower dose images. This algorithm enables fast simulation of various low dose (mAs) images on a real patient image.

  8. SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT.

    PubMed

    Halliburton, Sandra S; Abbara, Suhny; Chen, Marcus Y; Gentry, Ralph; Mahesh, Mahadevappa; Raff, Gilbert L; Shaw, Leslee J; Hausleiter, Jörg

    2011-01-01

    Over the last few years, computed tomography (CT) has developed into a standard clinical test for a variety of cardiovascular conditions. The emergence of cardiovascular CT during a period of dramatic increase in radiation exposure to the population from medical procedures and heightened concern about the subsequent potential cancer risk has led to intense scrutiny of the radiation burden of this new technique. This has hastened the development and implementation of dose reduction tools and prompted closer monitoring of patient dose. In an effort to aid the cardiovascular CT community in incorporating patient-centered radiation dose optimization and monitoring strategies into standard practice, the Society of Cardiovascular Computed Tomography has produced a guideline document to review available data and provide recommendations regarding interpretation of radiation dose indices and predictors of risk, appropriate use of scanner acquisition modes and settings, development of algorithms for dose optimization, and establishment of procedures for dose monitoring.

  9. SCCT guidelines on radiation dose and dose-optimization strategies in cardiovascular CT

    PubMed Central

    Halliburton, Sandra S.; Abbara, Suhny; Chen, Marcus Y.; Gentry, Ralph; Mahesh, Mahadevappa; Raff, Gilbert L.; Shaw, Leslee J.; Hausleiter, Jörg

    2012-01-01

    Over the last few years, computed tomography (CT) has developed into a standard clinical test for a variety of cardiovascular conditions. The emergence of cardiovascular CT during a period of dramatic increase in radiation exposure to the population from medical procedures and heightened concern about the subsequent potential cancer risk has led to intense scrutiny of the radiation burden of this new technique. This has hastened the development and implementation of dose reduction tools and prompted closer monitoring of patient dose. In an effort to aid the cardiovascular CT community in incorporating patient-centered radiation dose optimization and monitoring strategies into standard practice, the Society of Cardiovascular Computed Tomography has produced a guideline document to review available data and provide recommendations regarding interpretation of radiation dose indices and predictors of risk, appropriate use of scanner acquisition modes and settings, development of algorithms for dose optimization, and establishment of procedures for dose monitoring. PMID:21723512

  10. Neutron dose equivalent meter

    DOEpatents

    Olsher, Richard H.; Hsu, Hsiao-Hua; Casson, William H.; Vasilik, Dennis G.; Kleck, Jeffrey H.; Beverding, Anthony

    1996-01-01

    A neutron dose equivalent detector for measuring neutron dose capable of accurately responding to neutron energies according to published fluence to dose curves. The neutron dose equivalent meter has an inner sphere of polyethylene, with a middle shell overlying the inner sphere, the middle shell comprising RTV.RTM. silicone (organosiloxane) loaded with boron. An outer shell overlies the middle shell and comprises polyethylene loaded with tungsten. The neutron dose equivalent meter defines a channel through the outer shell, the middle shell, and the inner sphere for accepting a neutron counter tube. The outer shell is loaded with tungsten to provide neutron generation, increasing the neutron dose equivalent meter's response sensitivity above 8 MeV.

  11. Low-dose digital urography in the pregnant patient

    SciTech Connect

    Albert, S.A.; Richter, J.O.; Rosenfield, A.T.

    1987-04-01

    In the pregnant patient when visualization of the ureters is requested, excretory urography is often ordered. We propose the use of digital radiography using single exposure as an alternative to conventional urography. This technique allows significant dose reduction while visualizing the entire urinary tract. It can be performed on most current-generation computerized tomographic scanners. In addition to dose reduction, the ability to manipulate, magnify, and avoid repeat exposures makes this an attractive alternative to the conventional film-screen technique.

  12. Equivalent dose and effective dose from stray radiation during passively scattered proton radiotherapy for prostate cancer

    NASA Astrophysics Data System (ADS)

    Fontenot, Jonas; Taddei, Phillip; Zheng, Yuanshui; Mirkovic, Dragan; Jordan, Thomas; Newhauser, Wayne

    2008-03-01

    Proton therapy reduces the integral therapeutic dose required for local control in prostate patients compared to intensity-modulated radiotherapy. One proposed benefit of this reduction is an associated decrease in the incidence of radiogenic secondary cancers. However, patients are also exposed to stray radiation during the course of treatment. The purpose of this study was to quantify the stray radiation dose received by patients during proton therapy for prostate cancer. Using a Monte Carlo model of a proton therapy nozzle and a computerized anthropomorphic phantom, we determined that the effective dose from stray radiation per therapeutic dose (E/D) for a typical prostate patient was approximately 5.5 mSv Gy-1. Sensitivity analysis revealed that E/D varied by ±30% over the interval of treatment parameter values used for proton therapy of the prostate. Equivalent doses per therapeutic dose (HT/D) in specific organs at risk were found to decrease with distance from the isocenter, with a maximum of 12 mSv Gy-1 in the organ closest to the treatment volume (bladder) and 1.9 mSv Gy-1 in the furthest (esophagus). Neutrons created in the nozzle predominated effective dose, though neutrons created in the patient contributed substantially to the equivalent dose in organs near the proton field. Photons contributed less than 15% to equivalent doses.

  13. Patient Dose Management: Focus on Practical Actions

    PubMed Central

    2016-01-01

    Medical radiation is a very important part of modern medicine, and should be only used when needed and optimized. Justification and optimization of radiation examinations must be performed. The first step of reduction of medical exposure is to know the radiation dose in currently performed examinations. This review covers radiation units, how various imaging modalities report dose, and the current status of radiation dose reports and legislation. Also, practical tips that can be applied to clinical practice are introduced. Afterwards, the importance of radiology exposure related education is emphasized and the current status of education for medical personal and the public is explained, and appropriate education strategies are suggested. Commonly asked radiation dose related example questions and answers are provided in detail to allow medical personnel to answer patients. Lastly, we talk about computerized programs that can be used in medical facilities for managing patient dose. While patient dose monitoring and management should be used to decrease and optimize overall radiation dose, it should not be used to assess individual cancer risk. One must always remember that medically justified examinations should always be performed, and unneeded examinations should be avoided in the first place. PMID:26908988

  14. Calculation of effective dose.

    PubMed

    McCollough, C H; Schueler, B A

    2000-05-01

    The concept of "effective dose" was introduced in 1975 to provide a mechanism for assessing the radiation detriment from partial body irradiations in terms of data derived from whole body irradiations. The effective dose is the mean absorbed dose from a uniform whole-body irradiation that results in the same total radiation detriment as from the nonuniform, partial-body irradiation in question. The effective dose is calculated as the weighted average of the mean absorbed dose to the various body organs and tissues, where the weighting factor is the radiation detriment for a given organ (from a whole-body irradiation) as a fraction of the total radiation detriment. In this review, effective dose equivalent and effective dose, as established by the International Commission on Radiological Protection in 1977 and 1990, respectively, are defined and various methods of calculating these quantities are presented for radionuclides, radiography, fluoroscopy, computed tomography and mammography. In order to calculate either quantity, it is first necessary to estimate the radiation dose to individual organs. One common method of determining organ doses is through Monte Carlo simulations of photon interactions within a simplified mathematical model of the human body. Several groups have performed these calculations and published their results in the form of data tables of organ dose per unit activity or exposure. These data tables are specified according to particular examination parameters, such as radiopharmaceutical, x-ray projection, x-ray beam energy spectra or patient size. Sources of these organ dose conversion coefficients are presented and differences between them are examined. The estimates of effective dose equivalent or effective dose calculated using these data, although not intended to describe the dose to an individual, can be used as a relative measure of stochastic radiation detriment. The calculated values, in units of sievert (or rem), indicate the amount of

  15. Optimizing CT radiation dose based on patient size and image quality: the size-specific dose estimate method.

    PubMed

    Larson, David B

    2014-10-01

    The principle of ALARA (dose as low as reasonably achievable) calls for dose optimization rather than dose reduction, per se. Optimization of CT radiation dose is accomplished by producing images of acceptable diagnostic image quality using the lowest dose method available. Because it is image quality that constrains the dose, CT dose optimization is primarily a problem of image quality rather than radiation dose. Therefore, the primary focus in CT radiation dose optimization should be on image quality. However, no reliable direct measure of image quality has been developed for routine clinical practice. Until such measures become available, size-specific dose estimates (SSDE) can be used as a reasonable image-quality estimate. The SSDE method of radiation dose optimization for CT abdomen and pelvis consists of plotting SSDE for a sample of examinations as a function of patient size, establishing an SSDE threshold curve based on radiologists' assessment of image quality, and modifying protocols to consistently produce doses that are slightly above the threshold SSDE curve. Challenges in operationalizing CT radiation dose optimization include data gathering and monitoring, managing the complexities of the numerous protocols, scanners and operators, and understanding the relationship of the automated tube current modulation (ATCM) parameters to image quality. Because CT manufacturers currently maintain their ATCM algorithms as secret for proprietary reasons, prospective modeling of SSDE for patient populations is not possible without reverse engineering the ATCM algorithm and, hence, optimization by this method requires a trial-and-error approach.

  16. Eye lens dose in interventional cardiology.

    PubMed

    Principi, S; Delgado Soler, C; Ginjaume, M; Beltran Vilagrasa, M; Rovira Escutia, J J; Duch, M A

    2015-07-01

    The ICRP has recently recommended reducing the occupational exposure dose limit for the lens of the eye to 20 mSv y(-1), averaged over a period of 5 y, with no year exceeding 50 mSv, instead of the current 150 mSv y(-1). This reduction will have important implications for interventional cardiology and radiology (IC/IR) personnel. In this work, lens dose received by a staff working in IC is studied in order to determine whether eye lens dose monitoring or/and additional radiological protection measures are required. Eye lens dose exposure was monitored in 10 physicians and 6 nurses. The major IC procedures performed were coronary angiography and percutaneous transluminal coronary angioplasty. The personnel were provided with two thermoluminescent dosemeters (TLDs): one calibrated in terms of Hp(3) located close to the left ear of the operator and a whole-body dosemeter calibrated in terms of Hp(10) and Hp(0.07) positioned on the lead apron. The estimated annual eye lens dose for physicians ranged between 8 and 60 mSv, for a workload of 200 procedures y(-1). Lower doses were collected for nurses, with estimated annual Hp(3) between 2 and 4 mSv y(-1). It was observed that for nurses the Hp(0.07) measurement on the lead apron is a good estimate of eye lens dose. This is not the case for physicians, where the influence of both the position and use of protective devices such as the ceiling shield is very important and produces large differences among doses both at the eyes and on the thorax. For physicians, a good correlation between Hp(3) and dose area product is shown.

  17. Radiotherapy dose calculations in the presence of hip prostheses

    SciTech Connect

    Keall, Paul J.; Siebers, Jeffrey V.; Jeraj, Robert; Mohan, Radhe

    2003-06-30

    The high density and atomic number of hip prostheses for patients undergoing pelvic radiotherapy challenge our ability to accurately calculate dose. A new clinical dose calculation algorithm, Monte Carlo, will allow accurate calculation of the radiation transport both within and beyond hip prostheses. The aim of this research was to investigate, for both phantom and patient geometries, the capability of various dose calculation algorithms to yield accurate treatment plans. Dose distributions in phantom and patient geometries with high atomic number prostheses were calculated using Monte Carlo, superposition, pencil beam, and no-heterogeneity correction algorithms. The phantom dose distributions were analyzed by depth dose and dose profile curves. The patient dose distributions were analyzed by isodose curves, dose-volume histograms (DVHs) and tumor control probability/normal tissue complication probability (TCP/NTCP) calculations. Monte Carlo calculations predicted the dose enhancement and reduction at the proximal and distal prosthesis interfaces respectively, whereas superposition and pencil beam calculations did not. However, further from the prosthesis, the differences between the dose calculation algorithms diminished. Treatment plans calculated with superposition showed similar isodose curves, DVHs, and TCP/NTCP as the Monte Carlo plans, except in the bladder, where Monte Carlo predicted a slightly lower dose. Treatment plans calculated with either the pencil beam method or with no heterogeneity correction differed significantly from the Monte Carlo plans.

  18. Automated size-specific CT dose monitoring program: Assessing variability in CT dose

    SciTech Connect

    Christianson, Olav; Li Xiang; Frush, Donald; Samei, Ehsan

    2012-11-15

    that were not adjusted by patient size. Additionally, considerable differences were noted in ED{sub adj} distributions between scanners, with scanners employing iterative reconstruction exhibiting significantly lower ED{sub adj} (range: 9%-64%). Finally, a significant difference (up to 59%) in ED{sub adj} distributions was observed between institutions, indicating the potential for dose reduction. Conclusions: The authors developed a robust automated size-specific radiation dose monitoring program for CT. Using this program, significant differences in ED{sub adj} were observed between scanner models and across institutions. This new dose monitoring program offers a unique tool for improving quality assurance and standardization both within and across institutions.

  19. Low-dose CT via convolutional neural network

    PubMed Central

    Chen, Hu; Zhang, Yi; Zhang, Weihua; Liao, Peixi; Li, Ke; Zhou, Jiliu; Wang, Ge

    2017-01-01

    In order to reduce the potential radiation risk, low-dose CT has attracted an increasing attention. However, simply lowering the radiation dose will significantly degrade the image quality. In this paper, we propose a new noise reduction method for low-dose CT via deep learning without accessing original projection data. A deep convolutional neural network is here used to map low-dose CT images towards its corresponding normal-dose counterparts in a patch-by-patch fashion. Qualitative results demonstrate a great potential of the proposed method on artifact reduction and structure preservation. In terms of the quantitative metrics, the proposed method has showed a substantial improvement on PSNR, RMSE and SSIM than the competing state-of-art methods. Furthermore, the speed of our method is one order of magnitude faster than the iterative reconstruction and patch-based image denoising methods. PMID:28270976

  20. Electron beam dose calculations.

    PubMed

    Hogstrom, K R; Mills, M D; Almond, P R

    1981-05-01

    Electron beam dose distributions in the presence of inhomogeneous tissue are calculated by an algorithm that sums the dose distribution of individual pencil beams. The off-axis dependence of the pencil beam dose distribution is described by the Fermi-Eyges theory of thick-target multiple Coulomb scattering. Measured square-field depth-dose data serve as input for the calculations. Air gap corrections are incorporated and use data from'in-air' measurements in the penumbra of the beam. The effective depth, used to evaluate depth-dose, and the sigma of the off-axis Gaussian spread against depth are calculated by recursion relations from a CT data matrix for the material underlying individual pencil beams. The correlation of CT number with relative linear stopping power and relative linear scattering power for various tissues is shown. The results of calculations are verified by comparison with measurements in a 17 MeV electron beam from the Therac 20 linear accelerator. Calculated isodose lines agree nominally to within 2 mm of measurements in a water phantom. Similar agreement is observed in cork slabs simulating lung. Calculations beneath a bone substitute illustrate a weakness in the calculation. Finally a case of carcinoma in the maxillary antrum is studied. The theory suggests an alternative method for the calculation of depth-dose of rectangular fields.

  1. Breast Reduction Surgery

    MedlinePlus

    ... considering breast reduction surgery, consult a board-certified plastic surgeon. It's important to understand what breast reduction ... risk of complications from breast reduction surgery. Your plastic surgeon will likely: Evaluate your medical history and ...

  2. Lymphedema Risk Reduction Practices

    MedlinePlus

    ... now! Position Paper: Lymphedema Risk Reduction Practices Category: Position Papers Tags: Risks Archives Treatment risk reduction garments surgery obesity infection blood pressure trauma morbid obesity body weight ...

  3. CT Radiation Dose Management: A Comprehensive Optimization Process for Improving Patient Safety.

    PubMed

    Parakh, Anushri; Kortesniemi, Mika; Schindera, Sebastian T

    2016-09-01

    Rising concerns of radiation exposure from computed tomography have caused various advances in dose reduction technologies. While proper justification and optimization of scans has been the main focus to address increasing doses, the value of dose management has been largely overlooked. The purpose of this article is to explain the importance of dose management, provide an overview of the available options for dose tracking, and discuss the importance of a dedicated dose team. The authors also describe how a digital radiation tracking software can be used for analyzing the big data on doses for auditing patient safety, scanner utilization, and productivity, all of which have enormous personal and institutional implications. (©) RSNA, 2016.

  4. Utirik Atoll Dose Assessment

    SciTech Connect

    Robison, W.L.; Conrado, C.L.; Bogen, K.T

    1999-10-06

    On March 1, 1954, radioactive fallout from the nuclear test at Bikini Atoll code-named BRAVO was deposited on Utirik Atoll which lies about 187 km (300 miles) east of Bikini Atoll. The residents of Utirik were evacuated three days after the fallout started and returned to their atoll in May 1954. In this report we provide a final dose assessment for current conditions at the atoll based on extensive data generated from samples collected in 1993 and 1994. The estimated population average maximum annual effective dose using a diet including imported foods is 0.037 mSv y{sup -1} (3.7 mrem y{sup -1}). The 95% confidence limits are within a factor of three of their population average value. The population average integrated effective dose over 30-, 50-, and 70-y is 0.84 mSv (84, mrem), 1.2 mSv (120 mrem), and 1.4 mSv (140 mrem), respectively. The 95% confidence limits on the population-average value post 1998, i.e., the 30-, 50-, and 70-y integral doses, are within a factor of two of the mean value and are independent of time, t, for t > 5 y. Cesium-137 ({sup 137}Cs) is the radionuclide that contributes most of this dose, mostly through the terrestrial food chain and secondarily from external gamma exposure. The dose from weapons-related radionuclides is very low and of no consequence to the health of the population. The annual background doses in the U. S. and Europe are 3.0 mSv (300 mrem), and 2.4 mSv (240 mrem), respectively. The annual background dose in the Marshall Islands is estimated to be 1.4 mSv (140 mrem). The total estimated combined Marshall Islands background dose plus the weapons-related dose is about 1.5 mSv y{sup -1} (150 mrem y{sup -1}) which can be directly compared to the annual background effective dose of 3.0 mSv y{sup -1} (300 mrem y{sup -1}) for the U. S. and 2.4 mSv y{sup -1} (240 mrem y{sup -1}) for Europe. Moreover, the doses listed in this report are based only on the radiological decay of {sup 137}Cs (30.1 y half-life) and other

  5. [Unilateral cystoid macular edema induced by citalopram--a case report].

    PubMed

    Alexík, M

    2011-10-01

    Citamopram is an antidepressant drug with fatigue, sleep disorders, appetite changes and visual impairment being the most common side effects. We are not aware of any published cases of cystoid macular edema following medication of this drug. We present a case of 55 year old woman with medical history of depression placed on Citalopram medication who noticed deterioration of right eye vision. Best corrected visual acuity was 20/120, ophthalmic coherence tomography and fluorescein angiography revealed cystoid macular edema. Two months following drug withdrawal edema disappeared and best corrected visual acuity improved to 20/32. Due to lack of other probable causes of edema and quick disappearance following drug withdrawal it is plausible to think of Citalopram as causative factor of cystoid macular edema in this patient.

  6. In vivo photoacoustic tomography of mouse cerebral edema induced by cold injury

    NASA Astrophysics Data System (ADS)

    Xu, Zhun; Zhu, Quing; Wang, Lihong V.

    2011-06-01

    For the first time, we have implemented photoacoustic tomography (PAT) to image the water content of an edema in vivo. We produced and imaged a cold-induced cerebral edema transcranially, then obtained blood vessel and water accumulation images at 610 and 975 nm, respectively. We tracked the changes at 12, 24, and 36 h after the cold injury. The blood volume decreased after the cold injury, and the maximum area of edema was observed 24 h after the cold injury. We validated PAT of the water content of the edema through magnetic Resonance Imaging and the water spectrum from the spectrophotometric measurement.

  7. Comparison of the efficacy and safety of intensive-dose and standard-dose statin treatment for stroke prevention

    PubMed Central

    Wang, Juan; Chen, Dan; Li, Da-Bing; Yu, Xin; Shi, Guo-Bing

    2016-01-01

    Abstract Background: Previous study indicated that high-dose statin treatment might increase the risk of hemorrhagic stroke and adverse reactions. We aim to compare the efficacy and safety of intensive-dose and standard-dose statin treatment for preventing stroke in high-risk patients. Methods: A thorough search was performed of multiple databases for publications from 1990 to June 2015. We selected the randomized clinical trials comparing standard-dose statin with placebo and intensive-dose statin with standard-dose statin or placebo for the prevention of stroke events in patients. Duplicate independent data extraction and bias assessments were performed. Data were pooled using a fixed-effects model or a random-effects model if significant heterogeneity was present. Results: For the all stroke incidences, intensive-dose statin treatment compared with placebo treatment and standard-dose statin treatment compared with placebo treatment showed a significant 21% reduction in relative risk (RR) (RR 0.79, 95% confidence interval (CI) [0.71, 0.87], P < 0.00001) and an 18% reduction in RR (RR 0.82, 95% CI [0.73, 0.93], P = 0.002) in the subgroup without renal transplant recipients and patients undergoing regular hemodialysis separately. For the fatal stroke incidences, intensive-dose statin treatment compared with standard dose or placebo was effective reducing fatal stroke (RR 0.61, 95% CI [0.39, 0.96], P = 0.03) and the RR was 1.01 (95% CI [0.85, 1.20], P = 0.90) in standard-dose statin treatment compared with placebo. Conclusion: The results of this meta-analysis suggest that intensive-dose statin treatment might be more favorable for reducing the incidences of all strokes than standard-dose statin treatment, especially for patients older than 65 years in reducing the incidences of all stroke incidences. PMID:27684837

  8. Dose calculation for permanent prostate implants incorporating spatially anisotropic linearly time-resolving edema

    SciTech Connect

    Monajemi, T. T.; Clements, Charles M.; Sloboda, Ron S.

    2011-04-15

    Purpose: The objectives of this study were (i) to develop a dose calculation method for permanent prostate implants that incorporates a clinically motivated model for edema and (ii) to illustrate the use of the method by calculating the preimplant dosimetry error for a reference configuration of {sup 125}I, {sup 103}Pd, and {sup 137}Cs seeds subject to edema-induced motions corresponding to a variety of model parameters. Methods: A model for spatially anisotropic edema that resolves linearly with time was developed based on serial magnetic resonance imaging measurements made previously at our center to characterize the edema for a group of n=40 prostate implant patients [R. S. Sloboda et al., ''Time course of prostatic edema post permanent seed implant determined by magnetic resonance imaging,'' Brachytherapy 9, 354-361 (2010)]. Model parameters consisted of edema magnitude, {Delta}, and period, T. The TG-43 dose calculation formalism for a point source was extended to incorporate the edema model, thus enabling calculation via numerical integration of the cumulative dose around an individual seed in the presence of edema. Using an even power piecewise-continuous polynomial representation for the radial dose function, the cumulative dose was also expressed in closed analytical form. Application of the method was illustrated by calculating the preimplant dosimetry error, RE{sub preplan}, in a 5x5x5 cm{sup 3} volume for {sup 125}I (Oncura 6711), {sup 103}Pd (Theragenics 200), and {sup 131}Cs (IsoRay CS-1) seeds arranged in the Radiological Physics Center test case 2 configuration for a range of edema relative magnitudes ({Delta}=[0.1,0.2,0.4,0.6,1.0]) and periods (T=[28,56,84] d). Results were compared to preimplant dosimetry errors calculated using a variation of the isotropic edema model developed by Chen et al. [''Dosimetric effects of edema in permanent prostate seed implants: A rigorous solution,'' Int. J. Radiat. Oncol., Biol., Phys. 47, 1405-1419 (2000

  9. Dose Calculation Spreadsheet

    SciTech Connect

    Simpkins, Ali

    1997-06-10

    VENTSAR XL is an EXCEL Spreadsheet that can be used to calculate downwind doses as a result of a hypothetical atmospheric release. Both building effects and plume rise may be considered. VENTSAR XL will run using any version of Microsoft EXCEL version 4.0 or later. Macros (the programming language of EXCEL) was used to automate the calculations. The user enters a minimal amount of input and the code calculates the resulting concentrations and doses at various downwind distances as specified by the user.

  10. NOTE: Validation of blood product irradiation doses

    NASA Astrophysics Data System (ADS)

    Cheung, T.; Butson, M.; Yu, P. K. N.

    2001-10-01

    Dosimetry of blood irradiation using x-ray beams on a medical linear accelerator has been studied to evaluate the accuracy of a diode detector and the delivery achievable. Variations in applied doses for a standard dual field 6 MV x-ray are measured with a commercial diode detector. Results show that the diode detector measured applied in vitro doses to within 5.4% (2 standard deviations (2 SD)) of those calculated with a collapsed-cone convolution treatment-planning computer for a sample of 100 blood irradiations. Experiments involving the packing procedure of the blood products in the blood box were performed. It was found that a large proportion of the variation in the predicted and measured dose was due to the compacting of the scatter material at the base of the blood box (over a 6 month period) producing a higher density below the blood than originally scanned; hence an overall reduction of delivered dose was observed. The diode measurements (which provide an immediate printout) are recommended in conjunction with a film dosimeter such as radiochromic film, which still provides a back-up dose monitor and a visual reminder that the blood has been irradiated. It is also recommended that the blood box be completely evacuated of all scatter material every month and the base be carefully repacked to provide uniform scatter material.

  11. Validation of blood product irradiation doses.

    PubMed

    Cheung, T; Butson, M; Yu, P K

    2001-10-01

    Dosimetry of blood irradiation using x-ray beams on a medical linear accelerator has been studied to evaluate the accuracy of a diode detector and the delivery achievable. Variations in applied doses for a standard dual field 6 MV x-ray are measured with a commercial diode detector. Results show that the diode detector measured applied in vitro doses to within 5.4% (2 standard deviations (2 SD)) of those calculated with a collapsed-cone convolution treatment-planning computer for a sample of 100 blood irradiations. Experiments involving the packing procedure of the blood products in the blood box were performed. It was found that a large proportion of the variation in the predicted and measured dose was due to the compacting of the scatter material at the base of the blood box (over a 6 month period) producing a higher density below the blood than originally scanned; hence an overall reduction of delivered dose was observed. The diode measurements (which provide an immediate printout) are recommended in conjunction with a film dosimeter such as radiochromic film, which still provides a back-up dose monitor and a visual reminder that the blood has been irradiated. It is also recommended that the blood box be completely evacuated of all scatter material every month and the base be carefully repacked to provide uniform scatter material.

  12. When is a dose not a dose

    SciTech Connect

    Bond, V.P.

    1991-01-01

    Although an enormous amount of progress has been made in the fields of radiation protection and risk assessment, a number of significant problems remain. The one problem which transcends all the rest, and which has been subject to considerable misunderstanding, involves what has come to be known as the 'linear non-threshold hypothesis', or 'linear hypothesis'. Particularly troublesome has been the interpretation that any amount of radiation can cause an increase in the excess incidence of cancer. The linear hypothesis has dominated radiation protection philosophy for more than three decades, with enormous financial, societal and political impacts and has engendered an almost morbid fear of low-level exposure to ionizing radiation in large segments of the population. This document presents a different interpretation of the linear hypothesis. The basis for this view lies in the evolution of dose-response functions, particularly with respect to their use initially in the context of early acute effects, and then for the late effects, carcinogenesis and mutagenesis. 11 refs., 4 figs. (MHB)

  13. Low-Dose Carcinogenicity Studies

    EPA Science Inventory

    One of the major deficiencies of cancer risk assessments is the lack of low-dose carcinogenicity data. Most assessments require extrapolation from high to low doses, which is subject to various uncertainties. Only 4 low-dose carcinogenicity studies and 5 low-dose biomarker/pre-n...

  14. Local reduction in physics

    NASA Astrophysics Data System (ADS)

    Rosaler, Joshua

    2015-05-01

    A conventional wisdom about the progress of physics holds that successive theories wholly encompass the domains of their predecessors through a process that is often called "reduction." While certain influential accounts of inter-theory reduction in physics take reduction to require a single "global" derivation of one theory's laws from those of another, I show that global reductions are not available in all cases where the conventional wisdom requires reduction to hold. However, I argue that a weaker "local" form of reduction, which defines reduction between theories in terms of a more fundamental notion of reduction between models of a single fixed system, is available in such cases and moreover suffices to uphold the conventional wisdom. To illustrate the sort of fixed-system, inter-model reduction that grounds inter-theoretic reduction on this picture, I specialize to a particular class of cases in which both models are dynamical systems. I show that reduction in these cases is underwritten by a mathematical relationship that follows a certain liberalized construal of Nagel/Schaffner reduction, and support this claim with several examples. Moreover, I show that this broadly Nagelian analysis of inter-model reduction encompasses several cases that are sometimes cited as instances of the "physicist's" limit-based notion of reduction.

  15. Patient-specific dose calculation methods for high-dose-rate iridium-192 brachytherapy

    NASA Astrophysics Data System (ADS)

    Poon, Emily S.

    In high-dose-rate 192Ir brachytherapy, the radiation dose received by the patient is calculated according to the AAPM Task Group 43 (TG-43) formalism. This table-based dose superposition method uses dosimetry parameters derived with the radioactive 192Ir source centered in a water phantom. It neglects the dose perturbations caused by inhomogeneities, such as the patient anatomy, applicators, shielding, and radiographic contrast solution. In this work, we evaluated the dosimetric characteristics of a shielded rectal applicator with an endocavitary balloon injected with contrast solution. The dose distributions around this applicator were calculated by the GEANT4 Monte Carlo (MC) code and measured by ionization chamber and GAFCHROMIC EBT film. A patient-specific dose calculation study was then carried out for 40 rectal treatment plans. The PTRAN_CT MC code was used to calculate the dose based on computed tomography (CT) images. This study involved the development of BrachyGUI, an integrated treatment planning tool that can process DICOM-RT data and create PTRAN_CT input initialization files. BrachyGUI also comes with dose calculation and evaluation capabilities. We proposed a novel scatter correction method to account for the reduction in backscatter radiation near tissue-air interfaces. The first step requires calculating the doses contributed by primary and scattered photons separately, assuming a full scatter environment. The scatter dose in the patient is subsequently adjusted using a factor derived by MC calculations, which depends on the distances between the point of interest, the 192Ir source, and the body contour. The method was validated for multicatheter breast brachytherapy, in which the target and skin doses for 18 patient plans agreed with PTRAN_CT calculations better than 1%. Finally, we developed a CT-based analytical dose calculation method. It corrects for the photon attenuation and scatter based upon the radiological paths determined by ray tracing

  16. Management of pediatric radiation dose using GE fluoroscopic equipment.

    PubMed

    Belanger, Barry; Boudry, John

    2006-09-01

    In this article, we present GE Healthcare's design philosophy and implementation of X-ray imaging systems with dose management for pediatric patients, as embodied in its current radiography and fluoroscopy and interventional cardiovascular X-ray product offerings. First, we present a basic framework of image quality and dose in the context of a cost-benefit trade-off, with the development of the concept of imaging dose efficiency. A set of key metrics of image quality and dose efficiency is presented, including X-ray source efficiency, detector quantum efficiency (DQE), detector dynamic range, and temporal response, with an explanation of the clinical relevance of each. Second, we present design methods for automatically selecting optimal X-ray technique parameters (kVp, mA, pulse width, and spectral filtration) in real time for various clinical applications. These methods are based on an optimization scheme where patient skin dose is minimized for a target desired image contrast-to-noise ratio. Operator display of skin dose and Dose-Area Product (DAP) is covered, as well. Third, system controls and predefined protocols available to the operator are explained in the context of dose management and the need to meet varying clinical procedure imaging demands. For example, fluoroscopic dose rate is adjustable over a range of 20:1 to adapt to different procedure requirements. Fourth, we discuss the impact of image processing techniques upon dose minimization. In particular, two such techniques, dynamic range compression through adaptive multiband spectral filtering and fluoroscopic noise reduction, are explored in some detail. Fifth, we review a list of system dose-reduction features, including automatic spectral filtration, virtual collimation, variable-rate pulsed fluoroscopic, grid and no-grid techniques, and fluoroscopic loop replay with store. In addition, we describe a new feature that automatically minimizes the patient-to-detector distance, along with an

  17. Intensity-modulated radiosurgery: improving dose gradients and maximum dose using post inverse-optimization interactive dose shaping.

    PubMed

    Fuss, Martin; Salter, Bill J

    2007-06-01

    dose gradient, and increased maximum and mean target doses compared to clinically delivered plans that were already considered excellent. Gains were especially pronounced in the reduction of normal brain tissue included into the 90%, and 50% isodose lines. We have since made this process part of the clinical routine for all cranial IMRS procedures.

  18. Comparison of planned and measured rectal dose in-vivo during high dose rate Cobalt-60 brachytherapy of cervical cancer.

    PubMed

    Zaman, Z K; Ung, N M; Malik, R A; Ho, G F; Phua, V C E; Jamalludin, Z; Baharuldin, M T H; Ng, K H

    2014-12-01

    Cobalt-60 (Co-60) is a relatively new source for the application of high-dose rate (HDR) brachytherapy. Radiation dose to the rectum is often a limiting factor in achieving the full prescribed dose to the target during brachytherapy of cervical cancer. The aim of this study was to measure radiation doses to the rectum in-vivo during HDR Co-60 brachytherapy. A total of eleven HDR brachytherapy treatments of cervical cancer were recruited in this study. A series of diodes incorporated in a rectal probe was inserted into the patient's rectum during each brachytherapy procedure. Real-time measured rectal doses were compared to calculated doses by the treatment planning system (TPS). The differences between calculated and measured dose ranged from 8.5% to 41.2%. This corresponds to absolute dose differences ranging from 0.3 Gy to 1.5 Gy. A linear relationship was observed between calculated and measured doses with linear regression R(2) value of 0.88, indicating close association between the measured and calculated doses. In general, absorbed doses for the rectum as calculated by TPS were observed to be higher than the doses measured using the diode probe. In-vivo dosimetry is an important quality assurance method for HDR brachytherapy of cervical cancer. It provides information that can contribute to the reduction of errors and discrepancies in dose delivery. Our study has shown that in-vivo dosimetry is feasible and can be performed to estimate the dose to the rectum during HDR brachytherapy using Co-60.

  19. Solving Problems Reductively

    ERIC Educational Resources Information Center

    Armoni, Michal; Gal-Ezer, Judith; Tirosh, Dina

    2005-01-01

    Solving problems by reduction is an important issue in mathematics and science education in general (both in high school and in college or university) and particularly in computer science education. Developing reductive thinking patterns is an important goal in any scientific discipline, yet reduction is not an easy subject to cope with. Still,…

  20. Estimation of the Dose and Dose Rate Effectiveness Factor

    NASA Technical Reports Server (NTRS)

    Chappell, L.; Cucinotta, F. A.

    2013-01-01

    Current models to estimate radiation risk use the Life Span Study (LSS) cohort that received high doses and high dose rates of radiation. Transferring risks from these high dose rates to the low doses and dose rates received by astronauts in space is a source of uncertainty in our risk calculations. The solid cancer models recommended by BEIR VII [1], UNSCEAR [2], and Preston et al [3] is fitted adequately by a linear dose response model, which implies that low doses and dose rates would be estimated the same as high doses and dose rates. However animal and cell experiments imply there should be curvature in the dose response curve for tumor induction. Furthermore animal experiments that directly compare acute to chronic exposures show lower increases in tumor induction than acute exposures. A dose and dose rate effectiveness factor (DDREF) has been estimated and applied to transfer risks from the high doses and dose rates of the LSS cohort to low doses and dose rates such as from missions in space. The BEIR VII committee [1] combined DDREF estimates using the LSS cohort and animal experiments using Bayesian methods for their recommendation for a DDREF value of 1.5 with uncertainty. We reexamined the animal data considered by BEIR VII and included more animal data and human chromosome aberration data to improve the estimate for DDREF. Several experiments chosen by BEIR VII were deemed inappropriate for application to human risk models of solid cancer risk. Animal tumor experiments performed by Ullrich et al [4], Alpen et al [5], and Grahn et al [6] were analyzed to estimate the DDREF. Human chromosome aberration experiments performed on a sample of astronauts within NASA were also available to estimate the DDREF. The LSS cohort results reported by BEIR VII were combined with the new radiobiology results using Bayesian methods.

  1. Dose esclation in radioimmunotherapy based on projected whole body dose

    SciTech Connect

    Wahl, R.L.; Kaminski, M.S.; Regan, D.

    1994-05-01

    A variety of approaches have been utilized in conducting phase I radioimmunotherapy dose-escalation trials. Escalation of dose has been based on graded increases in administered mCi; mCi/kg; or mCi/m2. It is also possible to escalate dose based on tracer-projected marrow, blood or whole body radiation dose. We describe our results in performing a dose-escalation trial in patients with non-Hodgkin lymphoma based on escalating administered whole-body radiation dose. The mCi dose administered was based on a patient-individualized tracer projected whole-body dose. 25 patients were entered on the study. RIT with 131 I anti-B-1 was administered to 19 patients. The administered dose was prescribed based on the projected whole body dose, determined from patient-individualized tracer studies performed prior to RIT. Whole body dose estimates were based on the assumption that the patient was an ellipsoid, with 131 antibody kinetics determined using a whole-body probe device acquiring daily conjugate views of 1 minute duration/view. Dose escalation levels proceeded with 10 cGy increments from 25 cGy whole-body and continues, now at 75 cGy. The correlation among potential methods of dose escalation and toxicity was assessed. Whole body radiation dose by probe was strongly correlated with the blood radiation dose determined from sequential blood sampling during tracer studies (r=.87). Blood radiation dose was very weakly correlated with mCi dose (r=.4) and mCi/kg (r=.45). Whole body radiation dose appeared less well-correlated with injected dose in mCi (r=.6), or mCi/kg (r=.64). Toxicity has been infrequent in these patients, but appears related to increasing whole body dose. Non-invasive determination of whole-body radiation dose by gamma probe represents a non-invasive method of estimating blood radiation dose, and thus of estimating bone marrow radiation dose.

  2. Endothelial Effect of Statin Therapy at a High Dose Versus Low Dose Associated with Ezetimibe

    PubMed Central

    Garcia, Maristela Magnavita Oliveira; Varela, Carolina Garcez; Silva, Patricia Fontes; Lima, Paulo Roberto Passos; Góes, Paulo Meira; Rodrigues, Marilia Galeffi; Silva, Maria de Lourdes Lima Souza e; Ladeia, Ana Marice Teixeira; Guimarães, Armênio Costa; Correia, Luis Claudio Lemos

    2016-01-01

    Background The effect of statins on the endothelial function in humans remains under discussion. Particularly, it is still unclear if the improvement in endothelial function is due to a reduction in LDL-cholesterol or to an arterial pleiotropic effect. Objective To test the hypothesis that modulation of the endothelial function promoted by statins is primarily mediated by the degree of reduction in LDL-cholesterol, independent of the dose of statin administered. Methods Randomized clinical trial with two groups of lipid-lowering treatment (16 patients/each) and one placebo group (14 patients). The two active groups were designed to promote a similar degree of reduction in LDL-cholesterol: the first used statin at a high dose (80 mg, simvastatin 80 group) and the second used statin at a low dose (10 mg) associated with ezetimibe (10 mg, simvastatin 10/ezetimibe group) to optimize the hypolipidemic effect. The endothelial function was assessed by flow-mediated vasodilation (FMV) before and 8 weeks after treatment. Results The decrease in LDL-cholesterol was similar between the groups simvastatin 80 and simvastatin 10/ezetimibe (27% ± 31% and 30% ± 29%, respectively, p = 0.75). The simvastatin 80 group presented an increase in FMV from 8.4% ± 4.3% at baseline to 11% ± 4.2% after 8 weeks (p = 0.02). Similarly, the group simvastatin 10/ezetimibe showed improvement in FMV from 7.3% ± 3.9% to 12% ± 4.4% (p = 0.001). The placebo group showed no variation in LDL-cholesterol level or endothelial function. Conclusion The improvement in endothelial function with statin seems to depend more on a reduction in LDL-cholesterol levels, independent of the dose of statin administered, than on pleiotropic mechanisms. PMID:27142792

  3. Organ equivalent doses of patients undergoing chest computed tomography: measurements with TL dosimeters in an anthropomorphic phantom.

    PubMed

    Gonzaga, N B; Mourão, A P; Magalhães, M J; da Silva, T A

    2014-01-01

    Dose reduction in patients undergoing computed tomography (CT) examinations has become a concern in many countries. CT dosimetric quantities were defined aiming optimization of CT procedures, organ absorbed doses and effective doses have been calculated for radiation risk assessments in patients. In this work, an experimental methodology was established for measuring organ doses with thermoluminescent (TL) dosimeters in an anthropomorphic phantom for routine CT chest examinations. Results may be useful for validating computational software used for CT dose calculations.

  4. Computed tomography dose optimisation in cystic fibrosis: A review

    PubMed Central

    Ferris, Helena; Twomey, Maria; Moloney, Fiachra; O’Neill, Siobhan B; Murphy, Kevin; O’Connor, Owen J; Maher, Michael

    2016-01-01

    Cystic fibrosis (CF) is the most common autosomal recessive disease of the Caucasian population worldwide, with respiratory disease remaining the most relevant source of morbidity and mortality. Computed tomography (CT) is frequently used for monitoring disease complications and progression. Over the last fifteen years there has been a six-fold increase in the use of CT, which has lead to a growing concern in relation to cumulative radiation exposure. The challenge to the medical profession is to identify dose reduction strategies that meet acceptable image quality, but fulfil the requirements of a diagnostic quality CT. Dose-optimisation, particularly in CT, is essential as it reduces the chances of patients receiving cumulative radiation doses in excess of 100 mSv, a dose deemed significant by the United Nations Scientific Committee on the Effects of Atomic Radiation. This review article explores the current trends in imaging in CF with particular emphasis on new developments in dose optimisation. PMID:27158420

  5. SU-E-T-315: The Change of Optically Stimulated Luminescent Dosimeters (OSLDs) Sensitivity by Accumulated Dose and High Dose

    SciTech Connect

    Han, S; Jung, H; Kim, M; Ji, Y; Kim, K; Choi, S; Park, S; Yoo, H; Yi, C

    2014-06-01

    Purpose: The objective of this study is to evaluate radiation sensitivity of optical stimulated luminance dosimeters (OSLDs) by accumulated dose and high dose. Methods: This study was carried out in Co-60 unit (Theratron 780, AECL, and Canada) and used InLight MicroStar reader (Landauer, Inc., Glenwood, IL) for reading. We annealed for 30 min using optical annealing system which contained fluorescent lamps (Osram lumilux, 24 W, 280 ∼780 nm). To evaluate change of OSLDs sensitivity by repeated irradiation, the dosimeters were repeatedly irradiated with 1 Gy. And whenever a repeated irradiation, we evaluated OSLDs sensitivity. To evaluate OSLDs sensitivity after accumulated dose with 5 Gy, We irradiated dose accumulatively (from 1 Gy to 5 Gy) without annealing. And OSLDs was also irradiated with 15, 20, 30 Gy to certify change of OSLDs sensitivity after high dose irradiation. After annealing them, they were irradiated with 1Gy, repeatedly. Results: The OSLDs sensitivity increased up to 3% during irradiating seven times and decreased continuously above 8 times. That dropped by about 0.35 Gy per an irradiation. Finally, after 30 times irradiation, OSLDs sensitivity decreased by about 7%. For accumulated dose from 1 Gy to 5 Gy, OSLDs sensitivity about 1 Gy increased until 4.4% after second times accumulated dose compared with before that. OSLDs sensitivity about 1 Gy decreased by 1.6% in five times irradiation. When OSLDs were irradiated ten times with 1Gy after irradiating high dose (10, 15, 20 Gy), OSLDs sensitivity decreased until 6%, 9%, 12% compared with it before high dose irradiation, respectively. Conclusion: This study certified OSLDs sensitivity by accumulated dose and high dose. When irradiated with 1Gy, repeatedly, OSLDs sensitivity decreased linearly and the reduction rate of OSLDs sensitivity after high dose irradiation had dependence on irradiated dose.

  6. Analysis of radiation doses from operation of postulated commercial spent fuel transportation systems: Main report

    SciTech Connect

    Schneider, K.J.; Hostick, C.J.; Ross, W.A.; Peterson, R.W.; Smith, R.I.; Stiles, D.L.; Daling, P.M.; Weakley, S.A.; Grinde, R.B.; Young, J.R.

    1987-11-01

    This report contains a system study of estimated radiation doses to the public and workers resulting from the transport of spent fuel from commercial nuclear power reactors to a geologic repository. The report contains a detailed breakdown of activities and a description of time/distance/dose-rate estimates for each activity within the system. Collective doses are estimated for each of the major activities at the reactor site, in transit, and at the repository receiving facility. Annual individual doses to the maximally exposed individuals or groups of individuals are also estimated. A total of 17 alternatives and subalternatives to the postulated reference transportation system are identified, conceptualized, and their dose-reduction potentials and costs estimated. Resulting ratios of ..delta..cost/..delta..collective system dose for each alternative relative to the postulated reference transportation system are given. Most of the alternatives evaluated are estimated to provide both cost and dose reductions. Major reductions in transportation system dose and cost are estimated to result from using higher-capacity rail and truck casks, and particularly when replacing legalweight truck casks with ''advanced design'' overweight truck casks. The greatest annual dose reduction to the highest exposed individual workers (i.e., at the repository) is estimated to be achieved by using remote handling equipment for the cask handling operations at the repository. Additional shielding is also effective in reducing doses to both radiation workers at the reactor and repository and to transport workers. 69 refs., 36 figs., 156 tabs.

  7. Ultralow dose computed tomography attenuation correction for pediatric PET CT using adaptive statistical iterative reconstruction

    SciTech Connect

    Brady, Samuel L.; Shulkin, Barry L.

    2015-02-15

    Purpose: To develop ultralow dose computed tomography (CT) attenuation correction (CTAC) acquisition protocols for pediatric positron emission tomography CT (PET CT). Methods: A GE Discovery 690 PET CT hybrid scanner was used to investigate the change to quantitative PET and CT measurements when operated at ultralow doses (10–35 mA s). CT quantitation: noise, low-contrast resolution, and CT numbers for 11 tissue substitutes were analyzed in-phantom. CT quantitation was analyzed to a reduction of 90% volume computed tomography dose index (0.39/3.64; mGy) from baseline. To minimize noise infiltration, 100% adaptive statistical iterative reconstruction (ASiR) was used for CT reconstruction. PET images were reconstructed with the lower-dose CTAC iterations and analyzed for: maximum body weight standardized uptake value (SUV{sub bw}) of various diameter targets (range 8–37 mm), background uniformity, and spatial resolution. Radiation dose and CTAC noise magnitude were compared for 140 patient examinations (76 post-ASiR implementation) to determine relative dose reduction and noise control. Results: CT numbers were constant to within 10% from the nondose reduced CTAC image for 90% dose reduction. No change in SUV{sub bw}, background percent uniformity, or spatial resolution for PET images reconstructed with CTAC protocols was found down to 90% dose reduction. Patient population effective dose analysis demonstrated relative CTAC dose reductions between 62% and 86% (3.2/8.3–0.9/6.2). Noise magnitude in dose-reduced patient images increased but was not statistically different from predose-reduced patient images. Conclusions: Using ASiR allowed for aggressive reduction in CT dose with no change in PET reconstructed images while maintaining sufficient image quality for colocalization of hybrid CT anatomy and PET radioisotope uptake.

  8. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S.M.; McMakin, A.H.

    1992-01-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (dose estimates): Source Terms, Environmental Transport, Environmental Monitoring Data, Demography, Food Consumption, and Agriculture, and Environmental Pathways and Dose Estimates.

  9. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S.M.; McMakin, A.H.

    1991-01-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (dose estimates): Source terms; environmental transport environmental monitoring data; demographics, agriculture, food habits; environmental pathways and dose estimates.

  10. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S.M.; McMakin, A.H.

    1992-02-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (dose estimates): source terms; environmental transport; environmental monitoring data; demography, food consumption, and agriculture; environmental pathways and dose estimates.

  11. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Cannon, S.D.; Finch, S.M.

    1992-10-01

    The objective of the Hanford Environmental Dose Reconstruction (HEDR) Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The independent Technical Steering Panel (TSP) provides technical direction. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed from release to impact on humans (dose estimates):Source Terms, Environmental Transport, Environmental Monitoring Data, Demography, Food Consumption, and Agriculture, and Environmental Pathways and Dose Estimates.

  12. Thyroid Dose During Neurointerventional Procedures: Does Lead Shielding Reduce the Dose?

    SciTech Connect

    Shortt, C. P.; Fanning, N. F.; Malone, L.; Thornton, J.; Brennan, P.; Lee, M. J.

    2007-09-15

    Purpose. To assess radiation dose to the thyroid in patients undergoing neurointerventional procedures and to evaluate dose reduction to the thyroid by lead shielding. Methods and Materials. A randomized patient study was undertaken to evaluate the dose reduction by thyroid lead shields and assess their practicality in a clinical setting. Sixty-five patients attending for endovascular treatment of arteriovenous malformations (AVMs) and aneurysms were randomized into one of 2 groups a) No Thyroid Shield and b) Thyroid Lead Shield. Two thermoluminescent dosimeters (TLDs) were placed over the thyroid gland (1 on each side) at constant positions on each patient in both groups. A thyroid lead shield (Pb eq. 0.5 mm) was placed around the neck of patients in the thyroid lead shield group after the neurointerventional radiologist had obtained satisfactory working access above the neck. The total dose-area-product (DAP) value, number and type of digital subtraction angiography (DSA) runs and fluoroscopy time were recorded for all patients. Results. Of the 72 patients who initially attended for neurointerventional procedures, 7 were excluded due to failure to consent or because of procedures involving access to the external carotid circulation. Of the remaining 65 who were randomized, a further 9 were excluded due to; procedureabandonment, unfeasible shield placement or shield interference with the procedure. Patient demographics included mean age of 47.9 yrs (15-74), F:M=1.4:1. Mean fluoroscopy time was 25.9 min. Mean DAP value was 13,134.8 cGy.cm{sup 2} and mean number of DSA runs was 13.4. The mean relative thyroid doses were significantly different (p< 0.001) between the unshielded (7.23 mSv/cGy2 x 105) and shielded groups (3.77 mSv/cGy2 x 105). A mean thyroid dose reduction of 48% was seen in the shielded group versus the unshielded group. Conclusion. Considerable doses to the thyroid are incurred during neurointerventional procedures, highlighting the need for

  13. CARBON DIOXIDE REDUCTION SYSTEM.

    DTIC Science & Technology

    CARBON DIOXIDE , *SPACE FLIGHT, RESPIRATION, REDUCTION(CHEMISTRY), RESPIRATION, AEROSPACE MEDICINE, ELECTROLYSIS, INSTRUMENTATION, ELECTROLYTES, VOLTAGE, MANNED, YTTRIUM COMPOUNDS, ZIRCONIUM COMPOUNDS, NICKEL.

  14. Drag reduction in nature

    NASA Technical Reports Server (NTRS)

    Bushnell, D. M.; Moore, K. J.

    1991-01-01

    Recent studies on the drag-reducing shapes, structures, and behaviors of swimming and flying animals are reviewed, with an emphasis on potential analogs in vehicle design. Consideration is given to form drag reduction (turbulent flow, vortex generation, mass transfer, and adaptations for body-intersection regions), skin-friction drag reduction (polymers, surfactants, and bubbles as surface 'additives'), reduction of the drag due to lift, drag-reduction studies on porpoises, and drag-reducing animal behavior (e.g., leaping out of the water by porpoises). The need for further research is stressed.

  15. Evaluation of effective dose in region-of-interest neuroimaging

    NASA Astrophysics Data System (ADS)

    Gill, Kamaljit K.

    We used small field-of-view (FOV) region-of-interest (ROI) imaging for integral dose reduction and to improve image quality by reducing scatter and providing increased resolution. We quantify the reduction of effective dose (ED) realized when using ROI techniques in neuroimaging. Microangiographic fluoroscopic (MAF) detector being used to provide improved visualization of fine detail in the treatment volume during neurointerventional procedures and in ROI cone-beam CT. Using PCXMC (STUK, Helsinki, Finland), the ED was calculated for the 3.6x3.6-cm FOV of the MAF, for the 20x20-cm FOV of the Varian PaxScan 2020 FPD and for a 20x3.6-cm FOV as used in dual detector ROI CBCT for circle of Willis. Substantial reduction in effective dose per detector exposure is realized using ROI techniques in neuroimaging. This reduction would allow the dose in the ROI to be increased over an order of magnitude to provide increased contrast resolution without increasing the stochastic risk to the patient compared to full-FOV imaging.

  16. Survey of computed tomography scanners in Taiwan: Dose descriptors, dose guidance levels, and effective doses

    SciTech Connect

    Tsai, H. Y.; Tung, C. J.; Yu, C. C.; Tyan, Y. S.

    2007-04-15

    The IAEA and the ICRP recommended dose guidance levels for the most frequent computed tomography (CT) examinations to promote strategies for the optimization of radiation dose to CT patients. A national survey, including on-site measurements and questionnaires, was conducted in Taiwan in order to establish dose guidance levels and evaluate effective doses for CT. The beam quality and output and the phantom doses were measured for nine representative CT scanners. Questionnaire forms were completed by respondents from facilities of 146 CT scanners out of 285 total scanners. Information on patient, procedure, scanner, and technique for the head and body examinations was provided. The weighted computed tomography dose index (CTDI{sub w}), the dose length product (DLP), organ doses and effective dose were calculated using measured data, questionnaire information and Monte Carlo simulation results. A cost-effective analysis was applied to derive the dose guidance levels on CTDI{sub w} and DLP for several CT examinations. The mean effective dose{+-}standard deviation distributes from 1.6{+-}0.9 mSv for the routine head examination to 13{+-}11 mSv for the examination of liver, spleen, and pancreas. The surveyed results and the dose guidance levels were provided to the national authorities to develop quality control standards and protocols for CT examinations.

  17. Collective dose-practical ways to estimate a dose matrix.

    PubMed

    Simmonds, Jane; Sihra, Kamaljit; Bexon, Antony

    2006-06-01

    It has been suggested that collective doses should be presented in the form of a 'dose matrix' giving information on the breakdown of collective dose in space and time and by population group. This paper is an initial attempt to provide such a breakdown by geographic region and time, and to give an idea of associated individual doses for routine discharges to atmosphere. This is done through the use of representative per-caput individual doses but these need to be supplemented by information on the individual doses received by the critical group for a full radiological impact assessment. The results show that it is important to distinguish between the different population groups for up to a few hundred years following the discharge. However, beyond this time the main contribution is from global circulation and this distinction is less important. The majority of the collective dose was found to be delivered at low levels of individual doses; the estimated per-caput dose rates were significantly less than 10(-5) Sv y(-1), a level of dose felt to give rise to a trivial risk to the exposed individual.

  18. AAPM/RSNA Physics Tutorial for Residents: Topics in CT. Radiation dose in CT.

    PubMed

    McNitt-Gray, Michael F

    2002-01-01

    This article describes basic radiation dose concepts as well as those specifically developed to describe the radiation dose from computed tomography (CT). Basic concepts of radiation dose are reviewed, including exposure, absorbed dose, and effective dose. Radiation dose from CT demonstrates variations within the scan plane and along the z axis because of its unique geometry and usage. Several CT-specific dose descriptors have been developed: the Multiple Scan Average Dose descriptor, the Computed Tomography Dose Index (CTDI) and its variations (CTDI(100), CTDI(w), CTDI(vol)), and the dose-length product. Factors that affect radiation dose from CT include the beam energy, tube current-time product, pitch, collimation, patient size, and dose reduction options. Methods of reducing the radiation dose to a patient from CT include reducing the milliampere-seconds value, increasing the pitch, varying the milliampere-seconds value according to patient size, and reducing the beam energy. The effective dose from CT can be estimated by using Monte Carlo methods to simulate CT of a mathematical patient model, by estimating the energy imparted to the body region being scanned, or by using conversion factors for general anatomic regions. Issues related to radiation dose from CT are being addressed by the Society for Pediatric Radiology, the American Association of Physicists in Medicine, the American College of Radiology, and the Center for Devices and Radiological Health of the Food and Drug Administration.

  19. Escalation to High-Dose Defibrotide in Patients with Hepatic Veno-Occlusive Disease.

    PubMed

    Triplett, Brandon M; Kuttab, Hani I; Kang, Guolian; Leung, Wing

    2015-12-01

    Hepatic veno-occlusive disease (VOD) is a serious complication of high-dose chemotherapy regimens, such as those used in hematopoietic cell transplantation recipients. Defibrotide is considered a safe and effective treatment when dosed at 25 mg/kg/day. However, patients who develop VOD still have increased mortality despite the use of defibrotide. Data are limited on the use of doses above 60 mg/kg/day for persistent VOD. In this prospective clinical trial 34 patients received escalating doses of defibrotide. For patients with persistent VOD despite doses of 60 mg/kg/day, doses were increased to a maximum of 110 mg/kg/day. Increased toxicity was not observed until doses rose beyond 100 mg/kg/day. Patients receiving doses between 10 and 100 mg/kg/day experienced an average of 3 bleeding episodes per 100 days of treatment, whereas those receiving doses >100 mg/kg/day experienced 13.2 bleeding episodes per 100 days (P = .008). Moreover, dose reductions due to toxicity were needed at doses of 110 mg/kg/day more often than at lower doses. Defibrotide may be safely escalated to doses well above the current standard without an increase in bleeding risk. However, the efficacy of this dose-escalation strategy remains unclear, because outcomes were similar to published cohorts of patients receiving standard doses of defibrotide for VOD.

  20. Standardized radiological dose evaluations

    SciTech Connect

    Peterson, V.L.; Stahlnecker, E.

    1996-05-01

    Following the end of the Cold War, the mission of Rocky Flats Environmental Technology Site changed from production of nuclear weapons to cleanup. Authorization baseis documents for the facilities, primarily the Final Safety Analysis Reports, are being replaced with new ones in which accident scenarios are sorted into coarse bins of consequence and frequency, similar to the approach of DOE-STD-3011-94. Because this binning does not require high precision, a standardized approach for radiological dose evaluations is taken for all the facilities at the site. This is done through a standard calculation ``template`` for use by all safety analysts preparing the new documents. This report describes this template and its use.

  1. beta- and gamma-Comparative dose estimates on Enewetak Atoll.

    PubMed

    Crase, K W; Gudiksen, P H; Robison, W L

    1982-05-01

    Enewetak Atoll is one of the Pacific atolls used for atmospheric testing of U.S. nuclear weapons. Beta dose and gamma-ray exposure measurements were made on two islands of the Enewetak Atoll during July-August 1976 to determine the beta and low energy gamma-contribution to the total external radiation doses to the returning Marshallese. Measurements were made at numerous locations with thermoluminescent dosimeters (TLD), pressurized ionization chambers, portable NaI detectors, and thin-window pancake GM probes. Results of the TLD measurements with and without a beta-attenuator indicate that approx. 29% of the total dose rate at 1 m in air is due to beta- or low energy gamma-contribution. The contribution at any particular site, however, is somewhat dependent on ground cover, since a minimal amount of vegetation will reduce it significantly from that over bare soil, but thick stands of vegetation have little effect on any further reductions. Integral 30-yr external shallow dose estimates for future inhabitants were made and compared with external dose estimates of a previous large scale radiological survey (En73). Integral 30-yr shallow external dose estimates are 25-50% higher than whole body estimates. Due to the low penetrating ability of the beta's or low energy gamma's, however, several remedial actions can be taken to reduce the shallow dose contribution to the total external dose.

  2. Effectiveness of an Increased Dose of Bovamine Compared to a Lower Dose to Reduce Salmonella in Fed Cattle

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Category: Pre-harvest pathogen reduction Published: unpublished to date Objective: To examine the effect of increasing the probiotic dose from Bovamine® to Bovamine® Defend™ on the prevalence of Salmonella in pen environments, fecal samples and subiliac lymph nodes of fed cattle. Experimental ...

  3. Does Source Reduction Work?

    ERIC Educational Resources Information Center

    Allaway, David

    1992-01-01

    Suggests that quantification is essential to establish the cost-effectiveness of source reduction (SR). Presents case studies of monitoring methods for seven different kinds of SR efforts: (1) packaging changes, (2) SR businesses, (3) waste exchanges, (4) individual nonresidential efforts, (5) variable garbage rates, (6) yard waste reduction, and…

  4. Managing Faculty Reductions

    ERIC Educational Resources Information Center

    Alm, Kent F.; And Others

    1977-01-01

    A process for the management of reductions in the number of faculty positions available to a university is described. It considers staffing by projections, the evolution of personnel planning, and the balance of reductions in faculty and administration, along with coping strategies and advice growing out of five years of enrollment decline…

  5. Microbial reductive dehalogenation.

    PubMed Central

    Mohn, W W; Tiedje, J M

    1992-01-01

    A wide variety of compounds can be biodegraded via reductive removal of halogen substituents. This process can degrade toxic pollutants, some of which are not known to be biodegraded by any other means. Reductive dehalogenation of aromatic compounds has been found primarily in undefined, syntrophic anaerobic communities. We discuss ecological and physiological principles which appear to be important in these communities and evaluate how widely applicable these principles are. Anaerobic communities that catalyze reductive dehalogenation appear to differ in many respects. A large number of pure cultures which catalyze reductive dehalogenation of aliphatic compounds are known, in contrast to only a few organisms which catalyze reductive dehalogenation of aromatic compounds. Desulfomonile tiedjei DCB-1 is an anaerobe which dehalogenates aromatic compounds and is physiologically and morphologically unusual in a number of respects, including the ability to exploit reductive dehalogenation for energy metabolism. When possible, we use D. tiedjei as a model to understand dehalogenating organisms in the above-mentioned undefined systems. Aerobes use reductive dehalogenation for substrates which are resistant to known mechanisms of oxidative attack. Reductive dehalogenation, especially of aliphatic compounds, has recently been found in cell-free systems. These systems give us an insight into how and why microorganisms catalyze this activity. In some cases transition metal complexes serve as catalysts, whereas in other cases, particularly with aromatic substrates, the catalysts appear to be enzymes. Images PMID:1406492

  6. Method to monitor HC-SCR catalyst NOx reduction performance for lean exhaust applications

    DOEpatents

    Viola, Michael B [Macomb Township, MI; Schmieg, Steven J [Troy, MI; Sloane, Thompson M [Oxford, MI; Hilden, David L [Shelby Township, MI; Mulawa, Patricia A [Clinton Township, MI; Lee, Jong H [Rochester Hills, MI; Cheng, Shi-Wai S [Troy, MI

    2012-05-29

    A method for initiating a regeneration mode in selective catalytic reduction device utilizing hydrocarbons as a reductant includes monitoring a temperature within the aftertreatment system, monitoring a fuel dosing rate to the selective catalytic reduction device, monitoring an initial conversion efficiency, selecting a determined equation to estimate changes in a conversion efficiency of the selective catalytic reduction device based upon the monitored temperature and the monitored fuel dosing rate, estimating changes in the conversion efficiency based upon the determined equation and the initial conversion efficiency, and initiating a regeneration mode for the selective catalytic reduction device based upon the estimated changes in conversion efficiency.

  7. Bayesian supervised dimensionality reduction.

    PubMed

    Gönen, Mehmet

    2013-12-01

    Dimensionality reduction is commonly used as a preprocessing step before training a supervised learner. However, coupled training of dimensionality reduction and supervised learning steps may improve the prediction performance. In this paper, we introduce a simple and novel Bayesian supervised dimensionality reduction method that combines linear dimensionality reduction and linear supervised learning in a principled way. We present both Gibbs sampling and variational approximation approaches to learn the proposed probabilistic model for multiclass classification. We also extend our formulation toward model selection using automatic relevance determination in order to find the intrinsic dimensionality. Classification experiments on three benchmark data sets show that the new model significantly outperforms seven baseline linear dimensionality reduction algorithms on very low dimensions in terms of generalization performance on test data. The proposed model also obtains the best results on an image recognition task in terms of classification and retrieval performances.

  8. Assessment of out-of-field absorbed dose and equivalent dose in proton fields

    SciTech Connect

    Clasie, Ben; Wroe, Andrew; Kooy, Hanne; Depauw, Nicolas; Flanz, Jay; Paganetti, Harald; Rosenfeld, Anatoly

    2010-01-15

    . Conclusions: The dose deposited immediately downstream of the primary field, in these cases, is dominated by internally produced neutrons; therefore, scattered and scanned fields may have similar risk of second cancer in this region. The authors confirm that there is a reduction in the out-of-field dose in active scanning but the effect decreases with depth. GEANT4 is suitable for simulating the dose deposited outside the primary field. The agreement with measurements is comparable to or better than the agreement reported for other implementations of Monte Carlo models. Depending on the position, the absorbed dose outside the primary field is dominated by contributions from primary protons that may or may not have scattered in the brass collimating devices. This is noteworthy as the quality factor of the low LET protons is well known and the relative dose risk in this region can thus be assessed accurately.

  9. Intrathyroidal iodide binding rates and plasma methimazole concentrations in hyperthyroid patients on small doses of carbimazole.

    PubMed Central

    Low, L C; McCruden, D C; Alexander, W D; Hilditch, T E; Skellern, G G; Knight, B I

    1981-01-01

    1 The effect of small doses of carbimazole on the binding rate constant of intrathyroidal iodide, plasma methimazole concentrations and circulating thyroid hormone concentrations in five hyperthyroid patients is presented. 2 In all patients there was a marked reduction in iodide binding with carbimazole doses as low as 5 to 10 mg daily. 3 In three patients little further reduction in the observed binding rate occurred with daily doses in excess of 10 mg despite progressive increases in plasma methimazole concentrations. 4 At the end of 4 weeks' treatment with 10 mg carbimazole daily, the reduction in thyroid hormone concentrations and clinical improvement were such as to suggest that this dose may be an effective starting dose in many patients. PMID:7295461

  10. Phage therapy pharmacology: calculating phage dosing.

    PubMed

    Abedon, Stephen

    2011-01-01

    Phage therapy, which can be described as a phage-mediated biocontrol of bacteria (or, simply, biocontrol), is the application of bacterial viruses-also bacteriophages or phages-to reduce densities of nuisance or pathogenic bacteria. Predictive calculations for phage therapy dosing should be useful toward rational development of therapeutic as well as biocontrol products. Here, I consider the theoretical basis of a number of concepts relevant to phage dosing for phage therapy including minimum inhibitory concentration (but also "inundation threshold"), minimum bactericidal concentration (but also "clearance threshold"), decimal reduction time (D value), time until bacterial eradication, threshold bacterial density necessary to support phage population growth ("proliferation threshold"), and bacterial density supporting half-maximal phage population growth rates (K(B)). I also address the concepts of phage killing titers, multiplicity of infection, and phage peak densities. Though many of the presented ideas are not unique to this chapter, I nonetheless provide variations on derivations and resulting formulae, plus as appropriate discuss relative importance. The overriding goal is to present a variety of calculations that are useful toward phage therapy dosing so that they may be found in one location and presented in a manner that allows facile appreciation, comparison, and implementation. The importance of phage density as a key determinant of the phage potential to eradicate bacterial targets is stressed throughout the chapter.

  11. Gold Nanoparticle Hyperthermia Reduces Radiotherapy Dose

    PubMed Central

    Lin, Lynn; Slatkin, Daniel N.; Dilmanian, F. Avraham; Vadas, Timothy M.; Smilowitz, Henry M.

    2014-01-01

    Gold nanoparticles can absorb near infrared light, resulting in heating and ablation of tumors. Gold nanoparticles have also been used for enhancing the dose of X-rays in tumors during radiotherapy. The combination of hyperthermia and radiotherapy is synergistic, importantly allowing a reduction in X-ray dose with improved therapeutic results. Here we intratumorally infused small 15 nm gold nanoparticles engineered to be transformed from infrared-transparent to infrared-absorptive by the tumor, which were then heated by infrared followed by X-ray treatment. Synergy was studied using a very radioresistant subcutaneous squamous cell carcinoma (SCCVII) in mice. It was found that the dose required to control 50% of the tumors, normally 55 Gy, could be reduced to <15 Gy (a factor of >3.7). Gold nanoparticles therefore provide a method to combine hyperthermia and radiotherapy to drastically reduce the X-ray radiation needed, thus sparing normal tissue, reducing the side effects, and making radiotherapy more effective. PMID:24990355

  12. Dose refinement. ARAC's role

    SciTech Connect

    Ellis, J. S.; Sullivan, T. J.; Baskett, R. L.

    1998-06-01

    The Atmospheric Release Advisory Capability (ARAC), located at the Lawrence Livermore National Laboratory, since the late 1970's has been involved in assessing consequences from nuclear and other hazardous material releases into the atmosphere. ARAC's primary role has been emergency response. However, after the emergency phase, there is still a significant role for dispersion modeling. This work usually involves refining the source term and, hence, the dose to the populations affected as additional information becomes available in the form of source term estimates release rates, mix of material, and release geometry and any measurements from passage of the plume and deposition on the ground. Many of the ARAC responses have been documented elsewhere. 1 Some of the more notable radiological releases that ARAC has participated in the post-emergency phase have been the 1979 Three Mile Island nuclear power plant (NPP) accident outside Harrisburg, PA, the 1986 Chernobyl NPP accident in the Ukraine, and the 1996 Japan Tokai nuclear processing plant explosion. ARAC has also done post-emergency phase analyses for the 1978 Russian satellite COSMOS 954 reentry and subsequent partial burn up of its on board nuclear reactor depositing radioactive materials on the ground in Canada, the 1986 uranium hexafluoride spill in Gore, OK, the 1993 Russian Tomsk-7 nuclear waste tank explosion, and lesser releases of mostly tritium. In addition, ARAC has performed a key role in the contingency planning for possible accidental releases during the launch of spacecraft with radioisotope thermoelectric generators (RTGs) on board (i.e. Galileo, Ulysses, Mars-Pathfinder, and Cassini), and routinely exercises with the Federal Radiological Monitoring and Assessment Center (FRMAC) in preparation for offsite consequences of radiological releases from NPPs and nuclear weapon accidents or incidents. Several accident post-emergency phase assessments are discussed in this paper in order to illustrate

  13. Kilovoltage Imaging Doses in the Radiotherapy of Pediatric Cancer Patients

    SciTech Connect

    Deng Jun; Chen Zhe; Roberts, Kenneth B.; Nath, Ravinder

    2012-04-01

    Purpose: To investigate doses induced by kilovoltage cone-beam computed tomography (kVCBCT) to pediatric cancer patients undergoing radiotherapy, as well as strategies for dose reduction. Methods and Materials: An EGS4 Monte Carlo code was used to calculate three-dimensional dose deposition due to kVCBCT on 4 pediatric cancer patients. Absorbed doses to various organs were analyzed for both half-fan and full-fan modes. Clinical conditions, such as distance from organ at risk (OAR) to CBCT field border, kV peak energy, and testicular shielding, were studied. Results: The mean doses induced by one CBCT scan operated at 125 kV in half-fan mode to testes, liver, kidneys, femoral heads, spinal cord, brain, eyes, lens, and optical nerves were 2.9, 4.7, 7.7, 10.5, 8.8, 7.6, 7.7, 7.8, and 7.2 cGy, respectively. Increasing the distances from OARs to CBCT field border greatly reduced the doses to OARs, ranging from 33% reduction for spinal cord to 2300% reduction for testes. As photon beam energy increased from 60 to 125 kV, the dose increase due to kVCBCT ranged from 170% for lens to 460% for brain and spinal cord. A testicular shielding made of 1-cm cerrobend could reduce CBCT doses down to 31%, 51%, 68%, and 82%, respectively, for 60, 80, 100, and 125 kV when the testes lay within the CBCT field. Conclusions: Generally speaking, kVCBCT deposits much larger doses to critical structures in children than in adults, usually by a factor of 2 to 3. Increasing the distances from OARs to CBCT field border greatly reduces doses to OARs. Depending on OARs, kVCBCT-induced doses increase linearly or exponentially with photon beam energy. Testicular shielding works more efficiently at lower kV energies. On the basis of our study, it is essential to choose an appropriate scanning protocol when kVCBCT is applied to pediatric cancer patients routinely.

  14. A comprehensive study on the relationship between the image quality and imaging dose in low-dose cone beam CT

    NASA Astrophysics Data System (ADS)

    Yan, Hao; Cervino, Laura; Jia, Xun; Jiang, Steve B.

    2012-04-01

    While compressed sensing (CS)-based algorithms have been developed for the low-dose cone beam CT (CBCT) reconstruction, a clear understanding of the relationship between the image quality and imaging dose at low-dose levels is needed. In this paper, we qualitatively investigate this subject in a comprehensive manner with extensive experimental and simulation studies. The basic idea is to plot both the image quality and imaging dose together as functions of the number of projections and mAs per projection over the whole clinically relevant range. On this basis, a clear understanding of the tradeoff between the image quality and imaging dose can be achieved and optimal low-dose CBCT scan protocols can be developed to maximize the dose reduction while minimizing the image quality loss for various imaging tasks in image-guided radiation therapy (IGRT). Main findings of this work include (1) under the CS-based reconstruction framework, image quality has little degradation over a large range of dose variation. Image quality degradation becomes evident when the imaging dose (approximated with the x-ray tube load) is decreased below 100 total mAs. An imaging dose lower than 40 total mAs leads to a dramatic image degradation, and thus should be used cautiously. Optimal low-dose CBCT scan protocols likely fall in the dose range of 40-100 total mAs, depending on the specific IGRT applications. (2) Among different scan protocols at a constant low-dose level, the super sparse-view reconstruction with the projection number less than 50 is the most challenging case, even with strong regularization. Better image quality can be acquired with low mAs protocols. (3) The optimal scan protocol is the combination of a medium number of projections and a medium level of mAs/view. This is more evident when the dose is around 72.8 total mAs or below and when the ROI is a low-contrast or high-resolution object. Based on our results, the optimal number of projections is around 90 to 120. (4

  15. A comprehensive study on the relationship between the image quality and imaging dose in low-dose cone beam CT.

    PubMed

    Yan, Hao; Cervino, Laura; Jia, Xun; Jiang, Steve B

    2012-04-07

    While compressed sensing (CS)-based algorithms have been developed for the low-dose cone beam CT (CBCT) reconstruction, a clear understanding of the relationship between the image quality and imaging dose at low-dose levels is needed. In this paper, we qualitatively investigate this subject in a comprehensive manner with extensive experimental and simulation studies. The basic idea is to plot both the image quality and imaging dose together as functions of the number of projections and mAs per projection over the whole clinically relevant range. On this basis, a clear understanding of the tradeoff between the image quality and imaging dose can be achieved and optimal low-dose CBCT scan protocols can be developed to maximize the dose reduction while minimizing the image quality loss for various imaging tasks in image-guided radiation therapy (IGRT). Main findings of this work include (1) under the CS-based reconstruction framework, image quality has little degradation over a large range of dose variation. Image quality degradation becomes evident when the imaging dose (approximated with the x-ray tube load) is decreased below 100 total mAs. An imaging dose lower than 40 total mAs leads to a dramatic image degradation, and thus should be used cautiously. Optimal low-dose CBCT scan protocols likely fall in the dose range of 40-100 total mAs, depending on the specific IGRT applications. (2) Among different scan protocols at a constant low-dose level, the super sparse-view reconstruction with the projection number less than 50 is the most challenging case, even with strong regularization. Better image quality can be acquired with low mAs protocols. (3) The optimal scan protocol is the combination of a medium number of projections and a medium level of mAs/view. This is more evident when the dose is around 72.8 total mAs or below and when the ROI is a low-contrast or high-resolution object. Based on our results, the optimal number of projections is around 90 to 120. (4

  16. A comprehensive study on the relationship between image quality and imaging dose in low-dose cone beam CT

    PubMed Central

    Yan, Hao; Cervino, Laura; Jia, Xun; Jiang, Steve B.

    2012-01-01

    While compressed sensing (CS) based algorithms have been developed for low-dose cone beam CT (CBCT) reconstruction, a clear understanding on the relationship between the image quality and imaging dose at low dose levels is needed. In this paper, we qualitatively investigate this subject in a comprehensive manner with extensive experimental and simulation studies. The basic idea is to plot both the image quality and imaging dose together as functions of number of projections and mAs per projection over the whole clinically relevant range. On this basis, a clear understanding on the tradeoff between image quality and imaging dose can be achieved and optimal low-dose CBCT scan protocols can be developed to maximize the dose reduction while minimizing the image quality loss for various imaging tasks in image guided radiation therapy (IGRT). Main findings of this work include: 1) Under the CS-based reconstruction framework, image quality has little degradation over a large range of dose variation. Image quality degradation becomes evident when the imaging dose (approximated with the x-ray tube load) is decreased below 100 total mAs. An imaging dose lower than 40 total mAs leads to a dramatic image degradation, and thus should be used cautiously. Optimal low-dose CBCT scan protocols likely fall in the dose range of 40–100 total mAs, depending on the specific IGRT applications. 2) Among different scan protocols at a constant low-dose level, the super sparse-view reconstruction with projection number less than 50 is the most challenging case, even with strong regularization. Better image quality can be acquired with low mAs protocols. 3) The optimal scan protocol is the combination of a medium number of projections and a medium level of mAs/view. This is more evident when the dose is around 72.8 total mAs or below and when the ROI is a low-contrast or high-resolution object. Based on our results, the optimal number of projections is around 90 to 120. 4) The clinically

  17. In defence of collective dose.

    PubMed

    Fairlie, I; Sumner, D

    2000-03-01

    Recent proposals for a new scheme of radiation protection leave little room for collective dose estimations. This article discusses the history and present use of collective doses for occupational, ALARA, EIS and other purposes with reference to practical industry papers and government reports. The linear no-threshold (LNT) hypothesis suggests that collective doses which consist of very small doses added together should be used. Moral and ethical questions are discussed, particularly the emphasis on individual doses to the exclusion of societal risks, uncertainty over effects into the distant future and hesitation over calculating collective detriments. It is concluded that for moral, practical and legal reasons, collective dose is a valid parameter which should continue to be used.

  18. Dose from slow negative muons.

    PubMed

    Siiskonen, T

    2008-01-01

    Conversion coefficients from fluence to ambient dose equivalent, from fluence to maximum dose equivalent and quality factors for slow negative muons are examined in detail. Negative muons, when stopped, produce energetic photons, electrons and a variety of high-LET particles. Contribution from each particle type to the dose equivalent is calculated. The results show that for the high-LET particles the details of energy spectra and decay yields are important for accurate dose estimates. For slow negative muons the ambient dose equivalent does not always yield a conservative estimate for the protection quantities. Especially, the skin equivalent dose is strongly underestimated if the radiation-weighting factor of unity for slow muons is used. Comparisons to earlier studies are presented.

  19. Real-Time Patient Radiation Dose Monitoring System Used in a Large University Hospital.

    PubMed

    Kim, Jungsu; Yoon, Yongsu; Seo, Deoknam; Kwon, Soonmu; Shim, Jina; Kim, Jungmin

    2016-10-01

    Radiation dose monitoring in medical imaging examination areas is mandatory for the reduction of patient radiation exposure. Recently, dose monitoring techniques that use digital imaging and communications in medicine (DICOM) dose structured reports (SR) have been introduced. The present paper discusses the setup of a radiation dose monitoring system based on DICOM data from university hospitals in Korea. This system utilizes the radiation dose data-archiving method of standard DICOM dose SR combined with a DICOM modality performed procedure step (MPPS). The analysis of dose data based on a method utilizing DICOM tag information is proposed herein. This method supports the display of dose data from non-dosimeter-attached X-ray equipment. This system tracks data from 62 pieces of equipment to analyze digital radiographic, mammographic, mobile radiographic, CT, PET-CT, angiographic, and fluorographic modalities.

  20. Microbial reduction of uranium

    USGS Publications Warehouse

    Lovley, D.R.; Phillips, E.J.P.; Gorby, Y.A.; Landa, E.R.

    1991-01-01

    REDUCTION of the soluble, oxidized form of uranium, U(VI), to insoluble U(IV) is an important mechanism for the immobilization of uranium in aquatic sediments and for the formation of some uranium ores1-10. U(VI) reduction has generally been regarded as an abiological reaction in which sulphide, molecular hydrogen or organic compounds function as the reductant1,2,5,11. Microbial involvement in U(VI) reduction has been considered to be limited to indirect effects, such as microbial metabolism providing the reduced compounds for abiological U(VI) reduction and microbial cell walls providing a surface to stimulate abiological U(VI) reduction1,12,13. We report here, however, that dissimilatory Fe(III)-reducing microorganisms can obtain energy for growth by electron transport to U(VI). This novel form of microbial metabolism can be much faster than commonly cited abiological mechanisms for U(VI) reduction. Not only do these findings expand the known potential terminal electron acceptors for microbial energy transduction, they offer a likely explanation for the deposition of uranium in aquatic sediments and aquifers, and suggest a method for biological remediation of environments contaminated with uranium.

  1. Low dose ionizing radiation detection using conjugated polymers

    SciTech Connect

    Silva, E.A.B.; Borin, J.F.; Nicolucci, P.; Graeff, C.F.O.; Netto, T. Ghilardi; Bianchi, R.F.

    2005-03-28

    In this work, the effect of gamma radiation on the optical properties of poly[2-methoxy-5-(2{sup '}-ethylhexyloxy)-p-phenylenevinylene] (MEH-PPV) is studied. The samples were irradiated at room temperature with different doses from 0 Gy to 152 Gy using a {sup 60}Co gamma ray source. For thin films, significant changes in the UV-visible spectra were only observed at high doses (>1 kGy). In solution, shifts in absorption peaks are observed at low doses (<10 Gy), linearly dependent on dose. The shifts are explained by conjugation reduction, and possible causes are discussed. Our results indicate that MEH-PPV solution can be used as a dosimeter adequate for medical applications.

  2. Dose to medium versus dose to water as an estimator of dose to sensitive skeletal tissue

    NASA Astrophysics Data System (ADS)

    Walters, B. R. B.; Kramer, R.; Kawrakow, I.

    2010-08-01

    The purpose of this study is to determine whether dose to medium, Dm, or dose to water, Dw, provides a better estimate of the dose to the radiosensitive red bone marrow (RBM) and bone surface cells (BSC) in spongiosa, or cancellous bone. This is addressed in the larger context of the ongoing debate over whether Dm or Dw should be specified in Monte Carlo calculated radiotherapy treatment plans. The study uses voxelized, virtual human phantoms, FAX06/MAX06 (female/male), incorporated into an EGSnrc Monte Carlo code to perform Monte Carlo dose calculations during simulated irradiation by a 6 MV photon beam from an Elekta SL25 accelerator. Head and neck, chest and pelvis irradiations are studied. FAX06/MAX06 include precise modelling of spongiosa based on µCT images, allowing dose to RBM and BSC to be resolved from the dose to bone. Modifications to the FAX06/MAX06 user codes are required to score Dw and Dm in spongiosa. Dose uncertainties of ~1% (BSC, RBM) or ~0.5% (Dm, Dw) are obtained after up to 5 days of simulations on 88 CPUs. Clinically significant differences (>5%) between Dm and Dw are found only in cranial spongiosa, where the volume fraction of trabecular bone (TBVF) is high (55%). However, for spongiosa locations where there is any significant difference between Dm and Dw, comparisons of differential dose volume histograms (DVHs) and average doses show that Dw provides a better overall estimate of dose to RBM and BSC. For example, in cranial spongiosa the average Dm underestimates the average dose to sensitive tissue by at least 5%, while average Dw is within ~1% of the average dose to sensitive tissue. Thus, it is better to specify Dw than Dm in Monte Carlo treatment plans, since Dw provides a better estimate of dose to sensitive tissue in bone, the only location where the difference is likely to be clinically significant.

  3. REMEDIATION FACILITY WORKER DOSE ASSESSMENT

    SciTech Connect

    V. Arakali; E. Faillace

    2004-02-27

    The purpose of this design calculation is to estimate radiation doses received by personnel in the Remediation Facility performing operations to receive, prepare, open, repair, recover, disposition, and correct off-normal and non-standard conditions with casks, canisters, spent nuclear fuel (SNF) assemblies, and waste packages (WP). The specific scope of work contained in this calculation covers both collective doses and individual worker group doses on an annual basis, and includes the contributions due to external and internal radiation. The results of this calculation will be used to support the design of the Remediation Facility and provide occupational dose estimates for the License Application.

  4. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S.M.; McMakin, A.H.

    1992-06-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is being managed and conducted by the Battelle Pacific Northwest Laboratories under contract with the Centers for Disease Control. The independent Technical Steering Panel (TSP) provides technical direction. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (dose estimates): source terms; environmental transport; environmental monitoring data; demography, food consumption, and agriculture; environmental pathways and dose estimates.

  5. Psychotropic dose equivalence in Japan.

    PubMed

    Inada, Toshiya; Inagaki, Ataru

    2015-08-01

    Psychotropic dose equivalence is an important concept when estimating the approximate psychotropic doses patients receive, and deciding on the approximate titration dose when switching from one psychotropic agent to another. It is also useful from a research viewpoint when defining and extracting specific subgroups of subjects. Unification of various agents into a single standard agent facilitates easier analytical comparisons. On the basis of differences in psychopharmacological prescription features, those of available psychotropic agents and their approved doses, and racial differences between Japan and other countries, psychotropic dose equivalency tables designed specifically for Japanese patients have been widely used in Japan since 1998. Here we introduce dose equivalency tables for: (i) antipsychotics; (ii) antiparkinsonian agents; (iii) antidepressants; and (iv) anxiolytics, sedatives and hypnotics available in Japan. Equivalent doses for the therapeutic effects of individual psychotropic compounds were determined principally on the basis of randomized controlled trials conducted in Japan and consensus among dose equivalency tables reported previously by psychopharmacological experts. As these tables are intended to merely suggest approximate standard values, physicians should use them with discretion. Updated information of psychotropic dose equivalence in Japan is available at http://www.jsprs.org/en/equivalence.tables/. [Correction added on 8 July 2015, after first online publication: A link to the updated information has been added.].

  6. Accelerated heavy particles and the lens. III. Cataract enhancement by dose fractionation

    SciTech Connect

    Worgul, B.V.; Merriam, G.R. Jr.; Medvedovsky, C.; Brenner, D.J.

    1989-04-01

    For a number of biological end points it has been shown that, in contrast to low linear energy transfer (LET) radiation, dose fractionation of high-LET radiation does not result in a reduction in overall effectiveness. Studies were conducted to determine the effect of fractionating the exposures to heavy ion doses on the development of cataracts. Rat eyes were exposed to single doses of 1, 5, and 25 cGy of 570 MeV/amu40Ar ions and to 2, 4, and 10 Gy of 250 kVp X rays. These were compared to unirradiated controls and eyes which were exposed to the same total dose delivered in four fractions over 12 h. While in all cases fractionation of the exposure to X rays produced significant reduction in cataractogenic potential, fractionating doses of 40Ar ions caused a dose- and stage-dependent enhancement in the development of cataracts.

  7. Monte Carlo dose calculations in advanced radiotherapy

    NASA Astrophysics Data System (ADS)

    Bush, Karl Kenneth

    this dissertation the design, implementation and evaluation of a technique for reducing a latent variance inherent from the recycling of phase space particle tracks in a simulation is presented. In the technique a random azimuthal rotation about the beam's central axis is applied to each recycled particle, achieving a significant reduction of the latent variance. In a third component, the dissertation presents the first MC modeling of Varian's new RapidArc delivery system and a comparison of dose calculations with the Eclipse treatment planning system. A total of four arc plans are compared including an oropharynx patient phantom containing tissue inhomogeneities. Finally, in a step toward introducing MC dose calculation into the planning of treatments such as RapidArc, a technique is presented to feasibly generate and store a large set of MC calculated dose distributions. A novel 3-D dyadic multi-resolution (MR) decomposition algorithm is presented and the compressibility of the dose data using this algorithm is investigated. The presented MC beamlet generation method, in conjunction with the presented 3-D data MR decomposition, represents a viable means to introduce MC dose calculation in the planning and optimization stages of advanced radiotherapy.

  8. Esophageal Cancer Dose Escalation Using a Simultaneous Integrated Boost Technique

    SciTech Connect

    Welsh, James; Palmer, Matthew B.; Ajani, Jaffer A.; Liao Zhongxing; Swisher, Steven G.; Hofstetter, Wayne L.; Allen, Pamela K.; Settle, Steven H.; Gomez, Daniel; Likhacheva, Anna; Cox, James D.; Komaki, Ritsuko

    2012-01-01

    Purpose: We previously showed that 75% of radiation therapy (RT) failures in patients with unresectable esophageal cancer are in the gross tumor volume (GTV). We performed a planning study to evaluate if a simultaneous integrated boost (SIB) technique could selectively deliver a boost dose of radiation to the GTV in patients with esophageal cancer. Methods and Materials: Treatment plans were generated using four different approaches (two-dimensional conformal radiotherapy [2D-CRT] to 50.4 Gy, 2D-CRT to 64.8 Gy, intensity-modulated RT [IMRT] to 50.4 Gy, and SIB-IMRT to 64.8 Gy) and optimized for 10 patients with distal esophageal cancer. All plans were constructed to deliver the target dose in 28 fractions using heterogeneity corrections. Isodose distributions were evaluated for target coverage and normal tissue exposure. Results: The 50.4 Gy IMRT plan was associated with significant reductions in mean cardiac, pulmonary, and hepatic doses relative to the 50.4 Gy 2D-CRT plan. The 64.8 Gy SIB-IMRT plan produced a 28% increase in GTV dose and comparable normal tissue doses as the 50.4 Gy IMRT plan; compared with the 50.4 Gy 2D-CRT plan, the 64.8 Gy SIB-IMRT produced significant dose reductions to all critical structures (heart, lung, liver, and spinal cord). Conclusions: The use of SIB-IMRT allowed us to selectively increase the dose to the GTV, the area at highest risk of failure, while simultaneously reducing the dose to the normal heart, lung, and liver. Clinical implications warrant systematic evaluation.

  9. Steroid dose sparing: pharmacodynamic responses to single versus divided doses of methylprednisolone in man.

    PubMed

    Reiss, W G; Slaughter, R L; Ludwig, E A; Middleton, E; Jusko, W J

    1990-06-01

    Inhibitory drug interactions affecting the metabolism of methylprednisolone (MP) may produce either steroid sparing or adverse effects partly by increasing the exposure time to the steroid. This phenomenon can be mimicked by administering MP in divided doses. Two types of responses were compared after a single MP dose (40 mg bolus) and a divided regimen (20 mg bolus and a 5 mg bolus 8 hours later) in six healthy male volunteers. The suppression of basophils measured as whole blood histamine and plasma cortisol concentrations was assessed during 32 hours. The 37.5% reduction in dose produced a 23% overall decreased blood histamine response. A pharmacodynamic model for basophil cell distribution to and from an extravascular compartment describes the effects of MP after both regimens. A slower initial decline in blood histamine after the divided regimen may be related to incomplete suppression of basophil cell return to blood. The 50% inhibitory concentrations of MP of about 5 ng/ml were similar for both regimens. The decline and return of cortisol concentrations were similar between MP treatments with suppression continuing for 24 hours. The 50% inhibitory concentrations of MP values for adrenal suppression were about 1 ng/ml. Pharmacodynamic modeling is useful in quantitating corticosteroid responses and generally predicted the "dose-sparing" effects that were achieved by prolonging MP plasma concentrations. This study supports previous clinical observations that patients may require morning through evening exposure to MP to optimize efficacy while adrenal suppression is being minimized.

  10. A dose error evaluation study for 4D dose calculations

    NASA Astrophysics Data System (ADS)

    Milz, Stefan; Wilkens, Jan J.; Ullrich, Wolfgang

    2014-10-01

    Previous studies have shown that respiration induced motion is not negligible for Stereotactic Body Radiation Therapy. The intrafractional breathing induced motion influences the delivered dose distribution on the underlying patient geometry such as the lung or the abdomen. If a static geometry is used, a planning process for these indications does not represent the entire dynamic process. The quality of a full 4D dose calculation approach depends on the dose coordinate transformation process between deformable geometries. This article provides an evaluation study that introduces an advanced method to verify the quality of numerical dose transformation generated by four different algorithms. The used transformation metric value is based on the deviation of the dose mass histogram (DMH) and the mean dose throughout dose transformation. The study compares the results of four algorithms. In general, two elementary approaches are used: dose mapping and energy transformation. Dose interpolation (DIM) and an advanced concept, so called divergent dose mapping model (dDMM), are used for dose mapping. The algorithms are compared to the basic energy transformation model (bETM) and the energy mass congruent mapping (EMCM). For evaluation 900 small sample regions of interest (ROI) are generated inside an exemplary lung geometry (4DCT). A homogeneous fluence distribution is assumed for dose calculation inside the ROIs. The dose transformations are performed with the four different algorithms. The study investigates the DMH-metric and the mean dose metric for different scenarios (voxel sizes: 8 mm, 4 mm, 2 mm, 1 mm 9 different breathing phases). dDMM achieves the best transformation accuracy in all measured test cases with 3-5% lower errors than the other models. The results of dDMM are reasonable and most efficient in this study, although the model is simple and easy to implement. The EMCM model also achieved suitable results, but the approach requires a more complex

  11. Randomised crossover trial of tripotassium dicitrato bismuthate versus high dose cimetidine for duodenal ulcers resistant to standard dose of cimetidine.

    PubMed

    Lam, S K; Lee, N W; Koo, J; Hui, W M; Fok, K H; Ng, M

    1984-07-01

    Of 212 patients with duodenal ulcer treated with four weeks of one gram daily cimetidine, 25 had ulcers which underwent no reduction in size despite treatment. The effects of tripotassium dicitrato bismuthate (TDB) tablet four times a day or cimetidine 1.6 g daily on the healing of these cimetidine resistant ulcers were compared in a randomised crossover trial. Ten of 12 patients on tripotassium dicitrato bismuthate and five of 13 patients on high dose cimetidine had complete healing (p less than 0.02). On crossing over, seven of the eight ulcers not healed by high dose cimetidine completely healed with TDB in another four weeks, and one of the two ulcers not healed by TDB healed with high dose cimetidine. Overall, TDB healed 85% of cimetidine resistant ulcers, whereas high dose cimetidine healed 40% (p less than 0.006). Tripotassium dicitrato bismuthate is recommended for cimetidine resistant duodenal ulcers.

  12. Waste Reduction Model

    EPA Pesticide Factsheets

    To help solid waste planners and organizations track/report GHG emissions reductions from various waste management practices. To assist in calculating GHG emissions of baseline and alternative waste management practices and provide the history of WARM.

  13. Reduction of astrometric plates

    NASA Technical Reports Server (NTRS)

    Stock, J.

    1984-01-01

    A rapid and accurate method for the reduction of comet or asteroid plates is described. Projection equations, scale length correction, rotation of coordinates, linearization, the search for additional reference stars, and the final solution are examined.

  14. Reduction of bone strength

    NASA Technical Reports Server (NTRS)

    Bingham, Cindy

    1990-01-01

    Viewgraphs on reduction of bone strength are presented. WEHI 231 B growth rates, experimental chambers used to apply the electric field to the cell cultures, and a mouse suspended by rotating cuff in electromagnetic field are shown.

  15. Estimated ultraviolet radiation doses in wetlands in six national parks

    USGS Publications Warehouse

    Diamond, S.A.; Trenham, P.C.; Adams, Michael J.; Hossack, B.R.; Knapp, R.A.; Stark, L.; Bradford, D.; Corn, P.S.; Czarnowski, K.; Brooks, P.D.; Fagre, D.B.; Breen, B.; Dentenbeck, N.E.; Tonnessen, K.

    2005-01-01

    Ultraviolet-B radiation (UV-B, 280–320-nm wavelengths) doses were estimated for 1024 wetlands in six national parks: Acadia (Acadia), Glacier (Glacier), Great Smoky Mountains (Smoky), Olympic (Olympic), Rocky Mountain (Rocky), and Sequoia/Kings Canyon (Sequoia). Estimates were made using ground-based UV-B data (Brewer spectrophotometers), solar radiation models, GIS tools, field characterization of vegetative features, and quantification of DOC concentration and spectral absorbance. UV-B dose estimates were made for the summer solstice, at a depth of 1 cm in each wetland. The mean dose across all wetlands and parks was 19.3 W-h m−2 (range of 3.4–32.1 W-h m−2). The mean dose was lowest in Acadia (13.7 W-h m−2) and highest in Rocky (24.4 W-h m−2). Doses were significantly different among all parks. These wetland doses correspond to UV-B flux of 125.0 μW cm−2 (range 21.4–194.7 μW cm−2) based on a day length, averaged among all parks, of 15.5 h. Dissolved organic carbon (DOC), a key determinant of water-column UV-B flux, ranged from 0.6 (analytical detection limit) to 36.7 mg C L−1 over all wetlands and parks, and reduced potential maximal UV-B doses at 1-cm depth by 1%–87 %. DOC concentration, as well as its effect on dose, was lowest in Sequoia and highest in Acadia (DOC was equivalent in Acadia, Glacier, and Rocky). Landscape reduction of potential maximal UV-B doses ranged from zero to 77% and was lowest in Sequoia. These regional differences in UV-B wetland dose illustrate the importance of considering all aspects of exposure in evaluating the potential impact of UV-B on aquatic organisms.

  16. Helical tomotherapy superficial dose measurements

    SciTech Connect

    Ramsey, Chester R.; Seibert, Rebecca M.; Robison, Benjamin; Mitchell, Martha

    2007-08-15

    Helical tomotherapy is a treatment technique that is delivered from a 6 MV fan beam that traces a helical path while the couch moves linearly into the bore. In order to increase the treatment delivery dose rate, helical tomotherapy systems do not have a flattening filter. As such, the dose distributions near the surface of the patient may be considerably different from other forms of intensity-modulated delivery. The purpose of this study was to measure the dose distributions near the surface for helical tomotherapy plans with a varying separation between the target volume and the surface of an anthropomorphic phantom. A hypothetical planning target volume (PTV) was defined on an anthropomorphic head phantom to simulate a 2.0 Gy per fraction IMRT parotid-sparing head and neck treatment of the upper neck nodes. A total of six target volumes were created with 0, 1, 2, 3, 4, and 5 mm of separation between the surface of the phantom and the outer edge of the PTV. Superficial doses were measured for each of the treatment deliveries using film placed in the head phantom and thermoluminescent dosimeters (TLDs) placed on the phantom's surface underneath an immobilization mask. In the 0 mm test case where the PTV extends to the phantom surface, the mean TLD dose was 1.73{+-}0.10 Gy (or 86.6{+-}5.1% of the prescribed dose). The measured superficial dose decreases to 1.23{+-}0.10 Gy (61.5{+-}5.1% of the prescribed dose) for a PTV-surface separation of 5 mm. The doses measured by the TLDs indicated that the tomotherapy treatment planning system overestimates superficial doses by 8.9{+-}3.2%. The radiographic film dose for the 0 mm test case was 1.73{+-}0.07 Gy, as compared to the calculated dose of 1.78{+-}0.05 Gy. Given the results of the TLD and film measurements, the superficial calculated doses are overestimated between 3% and 13%. Without the use of bolus, tumor volumes that extend to the surface may be underdosed. As such, it is recommended that bolus be added for these

  17. Effect of ROI filtering in 3D cone-beam rotational angiography on organ dose and effective dose in cerebral investigations.

    PubMed

    Göpfert, Fabian; Schmidt, Ralph; Wulff, Jörg; Zink, Klemens

    2015-03-08

    The assessment of intracranial aneurysms is increasingly performed using three-dimensional cone-beam rotational angiography (3D CBRA). To reduce the dose to the patient during 3D CBRA procedures, filtered region-of-interest imaging (FROI) is presented in literature to be an effective technique as the dose in regions of low interest is reduced, while high image quality is preserved in the ROI. The purpose of this study was to quantify the benefit of FROI imaging during a typical 3D CBRA procedure in a patient's head region. A cone-beam rotational angiography unit (Infinix) was modeled in GMctdospp, an EGSnrc-based Monte Carlo software, which calculates patient dose distributions in rotational computed tomography. Kodak Lanex, a gadolinium compound, was chosen to be the ROI filter material. The adult female ICRP reference phantom was integrated in GMctdospp to calculate organ and effective doses in simulations of FROI-CBRA examinations. During the Monte Carlo simulations, different parameters as the ROI filter thickness, the ROI opening size, the tube voltage, and the isocenter position were varied. The results showed that the reduction in dose clearly depends on these parameters. Comparing the reduction in organ dose in standard 3D CBRA and FROI-CBRA, a maximum reduction of about 60%-80% could be achieved with a small sized ROI filter and about 40%-70% of the dose could be saved using a ROI filter with a large opening. Further we could show that dose reduction strongly depends on filter thickness, the location of the organ in the radiated area, and the position of the isocenter. As a consequence, dose reduction partially differs from theoretically calculated values by a factor up to 1.6. The effective dose could be reduced to a minimum of about 40%. Due to the fact that standard 3D CBRA is only used for the assessment of aneurysms at present and, thus, most of the patient dose originates from the aneurysm treatment (with 2D techniques) itself, the dose reduction

  18. Single daily dosing of aminoglycosides.

    PubMed

    Preston, S L; Briceland, L L

    1995-01-01

    To evaluate the rationale behind dosing aminoglycosides as a single daily dose versus traditional dosing approaches, we conducted a MEDLINE search to identify all pertinent articles, and also reviewed the references of all articles. Single daily dosing of aminoglycosides is not a new concept, having been examined since 1974. The advantages of this regimen include optimum concentration-dependent bactericidal activity, longer dosing intervals due to the postantibiotic effect (PAE), and prevention of bacterial adaptive resistance. Because of longer dosing intervals, toxicity may also be delayed or reduced. Costs may be reduced due to decreased monitoring and administration. Clinically, the regimen has been implemented in various patient populations with reported success. Questions remain, however, about optimum dose, peak and trough serum concentrations, and dose adjustment in patients with renal impairment or neutropenia. More clinical experience with this method in large numbers of patients has to be published. Pharmacists can be instrumental in monitoring patients receiving once-daily therapy and by educating health care professionals as to the rationale behind the therapy.

  19. Bayesian estimation of dose thresholds

    NASA Technical Reports Server (NTRS)

    Groer, P. G.; Carnes, B. A.

    2003-01-01

    An example is described of Bayesian estimation of radiation absorbed dose thresholds (subsequently simply referred to as dose thresholds) using a specific parametric model applied to a data set on mice exposed to 60Co gamma rays and fission neutrons. A Weibull based relative risk model with a dose threshold parameter was used to analyse, as an example, lung cancer mortality and determine the posterior density for the threshold dose after single exposures to 60Co gamma rays or fission neutrons from the JANUS reactor at Argonne National Laboratory. The data consisted of survival, censoring times and cause of death information for male B6CF1 unexposed and exposed mice. The 60Co gamma whole-body doses for the two exposed groups were 0.86 and 1.37 Gy. The neutron whole-body doses were 0.19 and 0.38 Gy. Marginal posterior densities for the dose thresholds for neutron and gamma radiation were calculated with numerical integration and found to have quite different shapes. The density of the threshold for 60Co is unimodal with a mode at about 0.50 Gy. The threshold density for fission neutrons declines monotonically from a maximum value at zero with increasing doses. The posterior densities for all other parameters were similar for the two radiation types.

  20. A comparison of Monte Carlo dose calculation denoising techniques

    NASA Astrophysics Data System (ADS)

    El Naqa, I.; Kawrakow, I.; Fippel, M.; Siebers, J. V.; Lindsay, P. E.; Wickerhauser, M. V.; Vicic, M.; Zakarian, K.; Kauffmann, N.; Deasy, J. O.

    2005-03-01

    Recent studies have demonstrated that Monte Carlo (MC) denoising techniques can reduce MC radiotherapy dose computation time significantly by preferentially eliminating statistical fluctuations ('noise') through smoothing. In this study, we compare new and previously published approaches to MC denoising, including 3D wavelet threshold denoising with sub-band adaptive thresholding, content adaptive mean-median-hybrid (CAMH) filtering, locally adaptive Savitzky-Golay curve-fitting (LASG), anisotropic diffusion (AD) and an iterative reduction of noise (IRON) method formulated as an optimization problem. Several challenging phantom and computed-tomography-based MC dose distributions with varying levels of noise formed the test set. Denoising effectiveness was measured in three ways: by improvements in the mean-square-error (MSE) with respect to a reference (low noise) dose distribution; by the maximum difference from the reference distribution and by the 'Van Dyk' pass/fail criteria of either adequate agreement with the reference image in low-gradient regions (within 2% in our case) or, in high-gradient regions, a distance-to-agreement-within-2% of less than 2 mm. Results varied significantly based on the dose test case: greater reductions in MSE were observed for the relatively smoother phantom-based dose distribution (up to a factor of 16 for the LASG algorithm); smaller reductions were seen for an intensity modulated radiation therapy (IMRT) head and neck case (typically, factors of 2-4). Although several algorithms reduced statistical noise for all test geometries, the LASG method had the best MSE reduction for three of the four test geometries, and performed the best for the Van Dyk criteria. However, the wavelet thresholding method performed better for the head and neck IMRT geometry and also decreased the maximum error more effectively than LASG. In almost all cases, the evaluated methods provided acceleration of MC results towards statistically more accurate

  1. Dose-shaping using targeted sparse optimization

    SciTech Connect

    Sayre, George A.; Ruan, Dan

    2013-07-15

    }{sup sparse} improves tradeoff between planning goals by 'sacrificing' voxels that have already been violated to improve PTV coverage, PTV homogeneity, and/or OAR-sparing. In doing so, overall plan quality is increased since these large violations only arise if a net reduction in E{sub tot}{sup sparse} occurs as a result. For example, large violations to dose prescription in the PTV in E{sub tot}{sup sparse}-optimized plans will naturally localize to voxels in and around PTV-OAR overlaps where OAR-sparing may be increased without compromising target coverage. The authors compared the results of our method and the corresponding clinical plans using analyses of DVH plots, dose maps, and two quantitative metrics that quantify PTV homogeneity and overdose. These metrics do not penalize underdose since E{sub tot}{sup sparse}-optimized plans were planned such that their target coverage was similar or better than that of the clinical plans. Finally, plan deliverability was assessed with the 2D modulation index.Results: The proposed method was implemented using IBM's CPLEX optimization package (ILOG CPLEX, Sunnyvale, CA) and required 1-4 min to solve with a 12-core Intel i7 processor. In the testing procedure, the authors optimized for several points on the Pareto surface of four 7-field 6MV prostate cases that were optimized for different levels of PTV homogeneity and OAR-sparing. The generated results were compared against each other and the clinical plan by analyzing their DVH plots and dose maps. After developing intuition by planning the four prostate cases, which had relatively few tradeoffs, the authors applied our method to a 7-field 6 MV pancreas case and a 9-field 6MV head-and-neck case to test the potential impact of our method on more challenging cases. The authors found that our formulation: (1) provided excellent flexibility for balancing OAR-sparing with PTV homogeneity; and (2) permitted the dose planner more control over the evolution of the PTV's spatial dose

  2. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S.M.

    1990-09-01

    This monthly report summarizes the technical progress and project status for the Hanford Environmental Dose Reconstruction (HEDR) Project being conducted at the Pacific Northwest Laboratory (PNL) under the direction of a Technical Steering Panel (TSP). The TSP is composed of experts in numerous technical fields related to this project and represents the interests of the public. The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that populations could have received from nuclear operations at Hanford since 1944. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (dose estimates): source terms, environmental transport, environmental monitoring data, demographics, agriculture, food habits, environmental pathways and dose estimates. 3 figs.

  3. Exercise Dose in Clinical Practice.

    PubMed

    Wasfy, Meagan M; Baggish, Aaron L

    2016-06-07

    There is wide variability in the physical activity patterns of the patients in contemporary clinical cardiovascular practice. This review is designed to address the impact of exercise dose on key cardiovascular risk factors and on mortality. We begin by examining the body of literature that supports a dose-response relationship between exercise and cardiovascular disease risk factors, including plasma lipids, hypertension, diabetes mellitus, and obesity. We next explore the relationship between exercise dose and mortality by reviewing the relevant epidemiological literature underlying current physical activity guideline recommendations. We then expand this discussion to critically examine recent data pertaining to the impact of exercise dose at the lowest and highest ends of the spectrum. Finally, we provide a framework for how the key concepts of exercise dose can be integrated into clinical practice.

  4. Implementation of spot scanning dose optimization and dose calculation for helium ions in Hyperion

    SciTech Connect

    Fuchs, Hermann; Schreiner, Thomas; Georg, Dietmar

    2015-09-15

    OAR doses were within tolerances specified in the QUANTEC report. Conclusions: The biological {sup 4}He model proposed above is a first approach matching biological data published so far. The advantage of {sup 4}He seems to lie in the reduction of dose to surrounding tissue and to OARs. Nevertheless, additional biological experiments and treatment planning studies with larger patient numbers and more tumor indications are necessary to study the possible benefits of helium ion beam therapy in detail.

  5. Optimization of dosing regimens and dosing in special populations.

    PubMed

    Sime, F B; Roberts, M S; Roberts, J A

    2015-10-01

    Treatment of infectious diseases is becoming increasingly challenging with the emergence of less-susceptible organisms that are poorly responsive to existing antibiotic therapies, and the unpredictable pharmacokinetic alterations arising from complex pathophysiologic changes in some patient populations. In view of this fact, there has been a progressive work on novel dose optimization strategies to renew the utility of forgotten old antibiotics and to improve the efficacy of those currently in use. This review summarizes the different approaches of optimization of antibiotic dosing regimens and the special patient populations which may benefit most from these approaches. The existing methods are based on monitoring of antibiotic concentrations and/or use of clinical covariates. Measured concentrations can be correlated with predefined pharmacokinetic/pharmacodynamic targets to guide clinicians in predicting the necessary dose adjustment. Dosing nomograms are also available to relate observed concentrations or clinical covariates (e.g. creatinine clearance) with optimal dosing. More precise dose prediction based on observed covariates is possible through the application of population pharmacokinetic models. However, the most accurate estimation of individualized dosing requirements is achieved through Bayesian forecasting which utilizes both measured concentration and clinical covariates. Various software programs are emerging to ease clinical application. Whilst more studies are warranted to clarify the clinical outcomes associated with the different dose optimization approaches, severely ill patients in the course of marked infections and/or inflammation including those with sepsis, septic shock, severe trauma, burns injury, major surgery, febrile neutropenia, cystic fibrosis, organ dysfunction and obesity are those groups which may benefit most from individualized dosing.

  6. Dose rate effects in the radiation damage of the plastic scintillators of the CMS hadron endcap calorimeter

    DOE PAGES

    Khachatryan, V.; Sirunyan, A. M.; Tumasyan, A.; ...

    2016-10-07

    We present measurements of the reduction of light output by plastic scintillators irradiated in the CMS detector during the 8 TeV run of the Large Hadron Collider and show that they indicate a strong dose rate effect. The damage for a given dose is larger for lower dose rate exposures. The results agree with previous measurements of dose rate effects, but are stronger due to the very low dose rates probed. Here, we show that the scaling with dose rate is consistent with that expected from diffusion effects.

  7. Dose rate effects in the radiation damage of the plastic scintillators of the CMS hadron endcap calorimeter

    NASA Astrophysics Data System (ADS)

    Khachatryan, V.; Sirunyan, A. M.; Tumasyan, A.; Litomin, A.; Mossolov, V.; Shumeiko, N.; Van De Klundert, M.; Van Haevermaet, H.; Van Mechelen, P.; Van Spilbeeck, A.; Alves, G. A.; Aldá Júnior, W. L.; Hensel, C.; Carvalho, W.; Chinellato, J.; De Oliveira Martins, C.; Matos Figueiredo, D.; Mora Herrera, C.; Nogima, H.; Prado Da Silva, W. L.; Tonelli Manganote, E. J.; Vilela Pereira, A.; Finger, M.; Finger, M., Jr.; Jain, S.; Khurana, R.; Adamov, G.; Tsamalaidze, Z.; Behrens, U.; Borras, K.; Campbell, A.; Costanza, F.; Gunnellini, P.; Lobanov, A.; Melzer-Pellmann, I.-A.; Muhl, C.; Roland, B.; Sahin, M.; Saxena, P.; Hegde, V.; Kothekar, K.; Pandey, S.; Sharma, S.; Beri, S. B.; Bhawandeep, B.; Chawla, R.; Kalsi, A.; Kaur, A.; Kaur, M.; Walia, G.; Bhattacharya, S.; Ghosh, S.; Nandan, S.; Purohit, A.; Sharan, M.; Banerjee, S.; Bhattacharya, S.; Bhowmik, S.; Chatterjee, S.; Das, P.; Dewanjee, R. K.; Jain, S.; Kumar, S.; Maity, M.; Majumder, G.; Mandakini, P.; Patil, M.; Sarkar, T.; Saikh, A.; Sezen, S.; Juodagalvis, A.; Afanasiev, S.; Bunin, P.; Ershov, Y.; Golutvin, I.; Malakhov, A.; Moisenz, P.; Smirnov, V.; Zarubin, A.; Chadeeva, M.; Chistov, R.; Danilov, M.; Popova, E.; Rusinov, V.; Andreev, Yu.; Dermenev, A.; Karneyeu, A.; Krasnikov, N.; Tlisov, D.; Toropin, A.; Epshteyn, V.; Gavrilov, V.; Lychkovskaya, N.; Popov, V.; Pozdnyakov, I.; Safronov, G.; Toms, M.; Zhokin, A.; Flacher, H.; Baskakov, A.; Belyaev, A.; Boos, E.; Dubinin, M.; Dudko, L.; Ershov, A.; Gribushin, A.; Kaminskiy, A.; Klyukhin, V.; Kodolova, O.; Lokhtin, I.; Miagkov, I.; Obraztsov, S.; Petrushanko, S.; Savrin, V.; Snigirev, A.; Andreev, V.; Azarkin, M.; Dremin, I.; Kirakosyan, M.; Leonidov, A.; Terkulov, A.; Bitioukov, S.; Elumakhov, D.; Kalinin, A.; Krychkine, V.; Mandrik, P.; Petrov, V.; Ryutin, R.; Sobol, A.; Troshin, S.; Volkov, A.; Adiguzel, A.; Bakirci, N.; Cerci, S.; Damarseckin, S.; Demiroglu, Z. S.; Dozen, C.; Dumanoglu, I.; Eskut, E.; Girgis, S.; Gokbulut, G.; Guler, Y.; Hos, I.; Kangal, E. E.; Kara, O.; Kayis Topaksu, A.; Kiminsu, U.; Oglakci, M.; Onengut, G.; Ozdemir, K.; Ozturk, S.; Polatoz, A.; Sunar Cerci, D.; Tali, B.; Topakli, H.; Turkcapar, S.; Zorbakir, I. S.; Zorbilmez, C.; Bilin, B.; Isildak, B.; Karapinar, G.; Murat Guler, A.; Ocalan, K.; Yalvac, M.; Zeyrek, M.; Gülmez, E.; Kaya, M.; Kaya, O.; Yetkin, E. A.; Yetkin, T.; Cankocak, K.; Sen, S.; Boyarintsev, A.; Grynyov, B.; Levchuk, L.; Popov, V.; Sorokin, P.; Borzou, A.; Call, K.; Dittmann, J.; Hatakeyama, K.; Liu, H.; Pastika, N.; Charaf, O.; Cooper, S. I.; Henderson, C.; Rumerio, P.; West, C.; Arcaro, D.; Gastler, D.; Hazen, E.; Rohlf, J.; Sulak, L.; Wu, S.; Zou, D.; Hakala, J.; Heintz, U.; Kwok, K. H. M.; Laird, E.; Landsberg, G.; Mao, Z.; Gary, J. W.; Ghiasi Shirazi, S. M.; Lacroix, F.; Long, O. R.; Wei, H.; Bhandari, R.; Heller, R.; Stuart, D.; Yoo, J. H.; Apresyan, A.; Chen, Y.; Duarte, J.; Spiropulu, M.; Winn, D.; Abdullin, S.; Banerjee, S.; Chlebana, F.; Freeman, J.; Green, D.; Hare, D.; Hirschauer, J.; Joshi, U.; Lincoln, D.; Los, S.; Pedro, K.; Spalding, W. J.; Strobbe, N.; Tkaczyk, S.; Whitbeck, A.; Linn, S.; Markowitz, P.; Martinez, G.; Bertoldi, M.; Hagopian, S.; Hagopian, V.; Kolberg, T.; Baarmand, M. M.; Noonan, D.; Roy, T.; Yumiceva, F.; Bilki, B.; Clarida, W.; Debbins, P.; Dilsiz, K.; Durgut, S.; Gandrajula, R. P.; Haytmyradov, M.; Khristenko, V.; Merlo, J.-P.; Mermerkaya, H.; Mestvirishvili, A.; Miller, M.; Moeller, A.; Nachtman, J.; Ogul, H.; Onel, Y.; Ozok, F.; Penzo, A.; Schmidt, I.; Snyder, C.; Southwick, D.; Tiras, E.; Yi, K.; Al-bataineh, A.; Bowen, J.; Castle, J.; McBrayer, W.; Murray, M.; Wang, Q.; Kaadze, K.; Maravin, Y.; Mohammadi, A.; Saini, L. K.; Baden, A.; Belloni, A.; Eno, S. C.; Ferraioli, C.; Grassi, T.; Hadley, N. J.; Jeng, G.-Y.; Kellogg, R. G.; Kunkle, J.; Mignerey, A.; Ricci-Tam, F.; Shin, Y. H.; Skuja, A.; Tonjes, M. B.; Yang, Z. S.; Apyan, A.; Bierwagen, K.; Brandt, S.; Klute, M.; Niu, X.; Chatterjee, R. M.; Evans, A.; Frahm, E.; Kubota, Y.; Lesko, Z.; Mans, J.; Ruckstuhl, N.; Heering, A.; Karmgard, D. J.; Musienko, Y.; Ruchti, R.; Wayne, M.; Benaglia, A. D.; Medvedeva, T.; Mei, K.; Tully, C.; Bodek, A.; de Barbaro, P.; Galanti, M.; Garcia-Bellido, A.; Khukhunaishvili, A.; Lo, K. H.; Vishnevskiy, D.; Zielinski, M.; Agapitos, A.; Chou, J. P.; Hughes, E.; Saka, H.; Sheffield, D.; Akchurin, N.; Damgov, J.; De Guio, F.; Dudero, P. R.; Faulkner, J.; Gurpinar, E.; Kunori, S.; Lamichhane, K.; Lee, S. W.; Libeiro, T.; Undleeb, S.; Volobouev, I.; Wang, Z.; Goadhouse, S.; Hirosky, R.; Wang, Y.; CMS-HCAL Collaboration

    2016-10-01

    We present measurements of the reduction of light output by plastic scintillators irradiated in the CMS detector during the 8 TeV run of the Large Hadron Collider and show that they indicate a strong dose rate effect. The damage for a given dose is larger for lower dose rate exposures. The results agree with previous measurements of dose rate effects, but are stronger due to the very low dose rates probed. We show that the scaling with dose rate is consistent with that expected from diffusion effects.

  8. A radiobiological model of metastatic burden reduction for molecular radiotherapy: application to patients with bone metastases

    NASA Astrophysics Data System (ADS)

    Denis-Bacelar, Ana M.; Chittenden, Sarah J.; Murray, Iain; Divoli, Antigoni; McCready, V. Ralph; Dearnaley, David P.; O’Sullivan, Joe M.; Johnson, Bernadette; Flux, Glenn D.

    2017-04-01

    Skeletal tumour burden is a biomarker of prognosis and survival in cancer patients. This study proposes a novel method based on the linear quadratic model to predict the reduction in metastatic tumour burden as a function of the absorbed doses delivered from molecular radiotherapy treatments. The range of absorbed doses necessary to eradicate all the bone lesions and to reduce the metastatic burden was investigated in a cohort of 22 patients with bone metastases from castration-resistant prostate cancer. A metastatic burden reduction curve was generated for each patient, which predicts the reduction in metastatic burden as a function of the patient mean absorbed dose, defined as the mean of all the lesion absorbed doses in any given patient. In the patient cohort studied, the median of the patient mean absorbed dose predicted to reduce the metastatic burden by 50% was 89 Gy (interquartile range: 83–105 Gy), whilst a median of 183 Gy (interquartile range: 107–247 Gy) was found necessary to eradicate all metastases in a given patient. The absorbed dose required to eradicate all the lesions was strongly correlated with the variability of the absorbed doses delivered to multiple lesions in a given patient (r  =  0.98, P  <  0.0001). The metastatic burden reduction curves showed a potential large reduction in metastatic burden for a small increase in absorbed dose in 91% of patients. The results indicate the range of absorbed doses required to potentially obtain a significant survival benefit. The metastatic burden reduction method provides a simple tool that could be used in routine clinical practice for patient selection and to indicate the required administered activity to achieve a predicted patient mean absorbed dose and reduction in metastatic tumour burden.

  9. A radiobiological model of metastatic burden reduction for molecular radiotherapy: application to patients with bone metastases.

    PubMed

    Denis-Bacelar, Ana M; Chittenden, Sarah J; Murray, Iain; Divoli, Antigoni; Ralph McCready, V; Dearnaley, David P; O'Sullivan, Joe M; Johnson, Bernadette; Flux, Glenn D

    2017-04-07

    Skeletal tumour burden is a biomarker of prognosis and survival in cancer patients. This study proposes a novel method based on the linear quadratic model to predict the reduction in metastatic tumour burden as a function of the absorbed doses delivered from molecular radiotherapy treatments. The range of absorbed doses necessary to eradicate all the bone lesions and to reduce the metastatic burden was investigated in a cohort of 22 patients with bone metastases from castration-resistant prostate cancer. A metastatic burden reduction curve was generated for each patient, which predicts the reduction in metastatic burden as a function of the patient mean absorbed dose, defined as the mean of all the lesion absorbed doses in any given patient. In the patient cohort studied, the median of the patient mean absorbed dose predicted to reduce the metastatic burden by 50% was 89 Gy (interquartile range: 83-105 Gy), whilst a median of 183 Gy (interquartile range: 107-247 Gy) was found necessary to eradicate all metastases in a given patient. The absorbed dose required to eradicate all the lesions was strongly correlated with the variability of the absorbed doses delivered to multiple lesions in a given patient (r  =  0.98, P  <  0.0001). The metastatic burden reduction curves showed a potential large reduction in metastatic burden for a small increase in absorbed dose in 91% of patients. The results indicate the range of absorbed doses required to potentially obtain a significant survival benefit. The metastatic burden reduction method provides a simple tool that could be used in routine clinical practice for patient selection and to indicate the required administered activity to achieve a predicted patient mean absorbed dose and reduction in metastatic tumour burden.

  10. Effect of radiation-induced reduction of nitroimidazoles on biologically active DNA

    SciTech Connect

    Lafleur, M.V.; Pluijmackers-Westmijze, E.J.; Loman, H.

    1986-07-01

    Radiation-chemical reductions have been carried out with several nitroimidazoles. Reduction of these drugs in the presence of single-stranded phi chi 174 DNA causes extensive lethal damage. However, relatively stable (end) products, do not contribute to the damage, although glyoxal is potentially toxic. This demonstrates that a short-lived intermediate in the reduction process is responsible. Further, the quantity of damage in the DNA depends on both dose (reduction)-rate and also the nature of the drug.

  11. Dose reconstruction for real-time patient-specific dose estimation in CT

    SciTech Connect

    De Man, Bruno Yin, Zhye; Wu, Mingye; FitzGerald, Paul; Kalra, Mannudeep

    2015-05-15

    Purpose: Many recent computed tomography (CT) dose reduction approaches belong to one of three categories: statistical reconstruction algorithms, efficient x-ray detectors, and optimized CT acquisition schemes with precise control over the x-ray distribution. The latter category could greatly benefit from fast and accurate methods for dose estimation, which would enable real-time patient-specific protocol optimization. Methods: The authors present a new method for volumetrically reconstructing absorbed dose on a per-voxel basis, directly from the actual CT images. The authors’ specific implementation combines a distance-driven pencil-beam approach to model the first-order x-ray interactions with a set of Gaussian convolution kernels to model the higher-order x-ray interactions. The authors performed a number of 3D simulation experiments comparing the proposed method to a Monte Carlo based ground truth. Results: The authors’ results indicate that the proposed approach offers a good trade-off between accuracy and computational efficiency. The images show a good qualitative correspondence to Monte Carlo estimates. Preliminary quantitative results show errors below 10%, except in bone regions, where the authors see a bigger model mismatch. The computational complexity is similar to that of a low-resolution filtered-backprojection algorithm. Conclusions: The authors present a method for analytic dose reconstruction in CT, similar to the techniques used in radiation therapy planning with megavoltage energies. Future work will include refinements of the proposed method to improve the accuracy as well as a more extensive validation study. The proposed method is not intended to replace methods that track individual x-ray photons, but the authors expect that it may prove useful in applications where real-time patient-specific dose estimation is required.

  12. Reporting small bowel dose in cervix cancer high-dose-rate brachytherapy.

    PubMed

    Liao, Yixiang; Dandekar, Virag; Chu, James C H; Turian, Julius; Bernard, Damian; Kiel, Krystyna

    2016-01-01

    Small bowel (SB) is an organ at risk (OAR) that may potentially develop toxicity after radiotherapy for cervix cancer. However, its dose from brachytherapy (BT) is not systematically reported as in other OARs, even with image-guided brachytherapy (IGBT). This study aims to introduce consideration of quantified objectives for SB in BT plan optimization and to evaluate the feasibility of sparing SB while maintaining adequate target coverage. In all, 13 patients were included in this retrospective study. All patients were treated with external beam radiotherapy (EBRT) 45Gy in 25 fractions followed by high dose rate (HDR)-BT boost of 28Gy in 4 fractions using tandem/ring applicator. Magnetic resonance imaging (MRI) and computed tomographic (CT) images were obtained to define the gross tumor volume (GTV), high-risk clinical target volume (HR-CTV) and OARs (rectum, bladder, sigmoid colon, and SB). Treatment plans were generated for each patient using GEC-ESTRO recommendations based on the first CT/MRI. Treatment plans were revised to reduce SB dose when the [Formula: see text] dose to SB was > 5Gy, while maintaining other OAR constraints. For the 7 patients with 2 sets of CT and MRI studies, the interfraction variation of the most exposed SB was analyzed. Plan revisions were done in 6 of 13 cases owing to high [Formula: see text] of SB. An average reduction of 19% in [Formula: see text] was achieved. Meeting SB and other OAR constraints resulted in less than optimal target coverage in 2 patients (D90 of HR-CTV < 77Gyαβ10). The highest interfraction variation was observed for SB at 16 ± 59%, as opposed to 28 ± 27% for rectum and 21 ± 16% for bladder. Prospective reporting of SB dose could provide data required to establish a potential correlation with radiation-induced late complication for SB.

  13. Effectiveness of the Medical Emergency Team: the importance of dose.

    PubMed

    Jones, Daryl; Bellomo, Rinaldo; DeVita, Michael A

    2009-01-01

    Up to 17% of hospital admissions are complicated by serious adverse events unrelated to the patients presenting medical condition. Rapid Response Teams (RRTs) review patients during early phase of deterioration to reduce patient morbidity and mortality. However, reports of the efficacy of these teams are varied. The aims of this article were to explore the concept of RRT dose, to assess whether RRT dose improves patient outcomes, and to assess whether there is evidence that inclusion of a physician in the team impacts on the effectiveness of the team. A review of available literature suggested that the method of reporting RRT utilization rate, (RRT dose) is calls per 1,000 admissions. Hospitals with mature RRTs that report improved patient outcome following RRT introduction have a RRT dose between 25.8 and 56.4 calls per 1,000 admissions. Four studies report an association between increasing RRT dose and reduced in-hospital cardiac arrest rates. Another reported that increasing RRT dose reduced in-hospital mortality for surgical but not medical patients. The MERIT study investigators reported a negative relationship between MET-like activity and the incidence of serious adverse events. Fourteen studies reported improved patient outcome in association with the introduction of a RRT, and 13/14 involved a Physician-led MET. These findings suggest that if the RRT is the major method for reviewing serious adverse events, the dose of RRT activation must be sufficient for the frequency and severity of the problem it is intended to treat. If the RRT dose is too low then it is unlikely to improve patient outcomes. Increasing RRT dose appears to be associated with reduction in cardiac arrests. The majority of studies reporting improved patient outcome in association with the introduction of an RRT involve a MET, suggesting that inclusion of a physician in the team is an important determinant of its effectiveness.

  14. Radiation dose estimates for radiopharmaceuticals

    SciTech Connect

    Stabin, M.G.; Stubbs, J.B.; Toohey, R.E.

    1996-04-01

    Tables of radiation dose estimates based on the Cristy-Eckerman adult male phantom are provided for a number of radiopharmaceuticals commonly used in nuclear medicine. Radiation dose estimates are listed for all major source organs, and several other organs of interest. The dose estimates were calculated using the MIRD Technique as implemented in the MIRDOSE3 computer code, developed by the Oak Ridge Institute for Science and Education, Radiation Internal Dose Information Center. In this code, residence times for source organs are used with decay data from the MIRD Radionuclide Data and Decay Schemes to produce estimates of radiation dose to organs of standardized phantoms representing individuals of different ages. The adult male phantom of the Cristy-Eckerman phantom series is different from the MIRD 5, or Reference Man phantom in several aspects, the most important of which is the difference in the masses and absorbed fractions for the active (red) marrow. The absorbed fractions for flow energy photons striking the marrow are also different. Other minor differences exist, but are not likely to significantly affect dose estimates calculated with the two phantoms. Assumptions which support each of the dose estimates appears at the bottom of the table of estimates for a given radiopharmaceutical. In most cases, the model kinetics or organ residence times are explicitly given. The results presented here can easily be extended to include other radiopharmaceuticals or phantoms.

  15. Time, Chance, and Reduction

    NASA Astrophysics Data System (ADS)

    Ernst, Gerhard; Hüttemann, Andreas

    2010-01-01

    List of contributors; 1. Introduction Gerhard Ernst and Andreas Hütteman; Part I. The Arrows of Time: 2. Does a low-entropy constraint prevent us from influencing the past? Mathias Frisch; 3. The part hypothesis meets gravity Craig Callender; 4. Quantum gravity and the arrow of time Claus Kiefer; Part II. Probability and Chance: 5. The natural-range conception of probability Jacob Rosenthal; 6. Probability in Boltzmannian statistical mechanics Roman Frigg; 7. Humean mechanics versus a metaphysics of powers Michael Esfeld; Part III. Reduction: 8. The crystallisation of Clausius's phenomenological thermodynamics C. Ulises Moulines; 9. Reduction and renormalization Robert W. Batterman; 10. Irreversibility in stochastic dynamics Jos Uffink; Index.

  16. REDUCTIONS WITHOUT REGRET: SUMMARY

    SciTech Connect

    Swegle, J.; Tincher, D.

    2013-09-16

    This paper briefly summarizes the series in which we consider the possibilities for losing, or compromising, key capabilities of the U.S. nuclear force in the face of modernization and reductions. The first of the three papers takes an historical perspective, considering capabilities that were eliminated in past force reductions. The second paper is our attempt to define the needed capabilities looking forward in the context of the current framework for force modernization and the current picture of the evolving challenges of deterrence and assurance. The third paper then provides an example for each of our undesirable outcomes: the creation of roach motels, box canyons, and wrong turns.

  17. Monitoring of radiation dose rates around a clinical nuclear medicine site

    NASA Astrophysics Data System (ADS)

    Shao, Chia-Ho; Lu, Cheng-Chang; Chen, Tou-Rong; Weng, Jui-Hung; Kao, Pan-Fu; Dong, Shang-Lung; Chou, Ming-Jen

    2014-11-01

    The monitoring of radiation dose around the nuclear medicine site is an important study issue. In this study, TLD-100H radiation dosimeters were used to measure the ambient radiation dose rates around a clinical nuclear medicine site in order to investigate the latent hot zones of radiation exposure. Results of this study showed that the radiation doses measured from all piping and storage systems were comparable to the background dose. A relatively high dose was observed at the single bend point of waste water piping of the PET/CT. Another important finding was the unexpected high dose rates observed at the non-restricted waiting area (NRWA) of SPECT. To conclude, this study provides useful information for further determination of an appropriate dose reduction strategy to achieve the ALARA principle in a clinical nuclear medicine site.

  18. Interstitial pneumonitis following bone marrow transplantation after low dose rate total body irradiation

    SciTech Connect

    Barrett, A.; Depledge, M.H.; Powles, R.L.

    1983-07-01

    Idiopathic and infective interstitial pneumonitis (IPn) is a common complication after bone marrow transplantation (BMT) in many centers and carries a high mortality. We report here a series of 107 patients with acute leukemia grafted at the Royal Marsden Hospital in which only 11 (10.3%) developed IPn and only 5 died (5%). Only one case of idiopathic IPn was seen. Factors which may account for this low incidence are discussed. Sixty of 107 patients were transplanted in first remission of acute myeloid leukemia (AML) and were therefore in good general condition. Lung radiation doses were carefully monitored and doses of 10.5 Gy were not exceeded except in a group of 16 patients in whom a study of escalating doses of TBI (up to 13 Gy) was undertaken. The dose rate used for total body irradiation (TBI) was lower than that used in other centers and as demonstrated elsewhere by ourselves and others, reduction of dose rate to <0.05 Gy/min may be expected to lead to substantial reduction in lung damage. Threshold doses of approximately 8 Gy for IPn have been reported, but within the dose range of 8 to 10.5 Gy we suggest that dose rate may significantly affect the incidence. Data so far available suggest a true improvement in therapeutic ratio for low dose rate single fraction TBI compared with high dose rate.

  19. Patient-specific dose estimation for pediatric chest CT

    SciTech Connect

    Li Xiang; Samei, Ehsan; Segars, W. Paul; Sturgeon, Gregory M.; Colsher, James G.; Frush, Donald P.

    2008-12-15

    any other patient in the same size/protocol group who undergoes the chest scan. In summary, this work reported the first assessment of dose variations across pediatric CT patients in the same size/protocol group due to the variability of patient anatomy and body habitus and provided a previously unavailable method for patient-specific organ dose estimation, which will help in assessing patient risk and optimizing dose reduction strategies, including the development of scan protocols.

  20. Chemoradiation of Hepatic Malignancies: Prospective, Phase 1 Study of Full-Dose Capecitabine With Escalating Doses of Yttrium-90 Radioembolization

    SciTech Connect

    Hickey, Ryan; Mulcahy, Mary F.; Lewandowski, Robert J.; Gates, Vanessa L.; Vouche, Michael; Habib, Ali; Kircher, Sheetal; Newman, Steven; Nimeiri, Halla; Benson, Al B.; Salem, Riad

    2014-04-01

    Purpose: Radiosensitizing chemotherapy improves the outcomes in comparison with radiation alone for gastrointestinal cancers. The delivery of radiation therapy with yttrium90 ({sup 90}Y) radioembolization, in combination with the radiosensitizing chemotherapeutic agent capecitabine, provides the opportunity to enhance the effects of radiation on hepatic malignancies. This phase 1 study sought to determine the maximum tolerated dose (MTD) of {sup 90}Y plus capecitabine in patients with cholangiocarcinoma or liver metastases confined to the liver. Methods and Materials: Patients were given initial treatment at full-dose capecitabine during days 1 to 14 of a 21-day cycle. At days 1 to 7 of the second cycle, whole-liver {sup 90}Y was given at the test dose, after which time capecitabine was continued. Dose-limiting toxicity (DLT) was determined 6 weeks after {sup 90}Y infusion. If a DLT was not observed, the {sup 90}Y dose was escalated. The planned dose cohorts were 110, 130, 150, and 170 Gy. The primary endpoint was to determine the MTD of {sup 90}Y with full-dose capecitabine. Results: Sixteen patients were treated according to the study protocol. Two patients experienced DLTs. Nine patients required capecitabine dose reduction as a result of toxicities attributable to capecitabine alone. The criteria for establishing {sup 90}Y MTD were not met, indicating an MTD of >170 Gy. Conclusion: The MTD of {sup 90}Y delivered in conjunction with capecitabine in the setting of intrahepatic cholangiocarcinoma or metastatic disease confined to the liver exceeds 170 Gy. This is the highest {sup 90}Y dose reported to date and has important implications on combined therapy with the radiosensitizing oral chemotherapeutic capecitabine. Further studies are under way.

  1. Dose and dose rate effects of whole-body proton irradiation on leukocyte populations and lymphoid organs: part I

    NASA Technical Reports Server (NTRS)

    Gridley, Daila S.; Pecaut, Michael J.; Dutta-Roy, Radha; Nelson, Gregory A.

    2002-01-01

    The goal of part I of this study was to evaluate the effects of whole-body proton irradiation on lymphoid organs and specific leukocyte populations. C57BL/6 mice were exposed to the entry region of the proton Bragg curve to total doses of 0.5 gray (Gy), 1.5 Gy, and 3.0 Gy, each delivered at a low dose rate (LDR) of 1 cGy/min and high dose rate (HDR) of 80 cGy/min. Non-irradiated and 3 Gy HDR gamma-irradiated groups were included as controls. At 4 days post-irradiation, highly significant radiation dose-dependent reductions were observed in the mass of both lymphoid organs and the numbers of leukocytes and T (CD3(+)), T helper (CD3(+)/CD4(+)), T cytotoxic (CD3(+)/CD8(+)), and B (CD19(+)) cells in both blood and spleen. A less pronounced dose effect was noted for natural killer (NK1.1(+) NK) cells in spleen. Monocyte, but not granulocyte, counts in blood were highly dose-dependent. The numbers for each population generally tended to be lower with HDR than with LDR radiation; a significant dose rate effect was found in the percentages of T and B cells, monocytes, and granulocytes and in CD4(+):CD8(+) ratios. These data indicate that mononuclear cell response to the entry region of the proton Bragg curve is highly dependent upon the total dose and that dose rate effects are evident with some cell types. Results from gamma- and proton-irradiated groups (both at 3 Gy HDR) were similar, although proton-irradiation gave consistently lower values in some measurements.

  2. A reductive dissolution study of magnetite

    SciTech Connect

    Hui-Jun Won; Jung-Soon Park; Chong-Hun Jung; Sang-Yoon Park; Wang-Kyu Choi; Jei-Kwon Moon

    2013-07-01

    Magnetite dissolution tests using a hydrazine base solution were performed at a temperature range of 90 to 150 deg. C. The dissolution rate of magnetite increased with [N{sub 2}H{sub 4}], time, and temperature. The optimum solution pH in the experimental range was 3. The addition of copper ion to the hydrazine base solution greatly increased the magnetite dissolution rate. This was explained by the complex formation between N{sub 2}H{sub 4} and Cu ions, and the reducing power of the hydrazine-Cu complex to the ferric ions of magnetite. The reductive decontamination solution can be applied below 100 deg. C by the addition of copper ions. The chemical decontamination of a Type 304 stainless steel specimen using a hydrazine base reductive decontamination solution was also performed. The contact dose rate was greatly decreased by the repetitive application of NP and the hydrazine base solution. (authors)

  3. Magnitudes of biomarker reductions in response to controlled reductions in cigarettes smoked per day: a one-week clinical confinement study.

    PubMed

    Theophilus, Eugenia H; Coggins, Christopher R E; Chen, Peter; Schmidt, Eckhardt; Borgerding, Michael F

    2015-03-01

    Tobacco toxicant-related exposure reduction is an important tool in harm reduction. Cigarette per day reduction (CPDR) occurs as smokers migrate from smoking cigarettes to using alternative tobacco/nicotine products, or quit smoking. Few reports characterize the dose-response relationships between CPDR and effects on exposure biomarkers, especially at the low end of CPD exposure (e.g., 5 CPD). We present data on CPDR by characterizing magnitudes of biomarker reductions. We present data from a well-controlled, one-week clinical confinement study in healthy smokers who were switched from smoking 19-25 CPD to smoking 20, 10, 5 or 0 CPD. Biomarkers were measured in blood, plasma, urine, and breath, and included smoke-related toxicants, urine mutagenicity, smoked cigarette filter analyses (mouth level exposure), and vital signs. Many of the biomarkers (e.g., plasma nicotine) showed strong CPDR dose-response reductions, while others (e.g., plasma thiocyanate) showed weaker dose-response reductions. Factors that lead to lower biomarker reductions include non-CPD related contributors to the measured response (e.g., other exposure sources from environment, life style, occupation; inter-individual variability). This study confirms CPDR dose-responsive biomarkers and suggests that a one-week design is appropriate for characterizing exposure reductions when smokers switch from cigarettes to new tobacco products.

  4. Exercise and Fat Reduction.

    ERIC Educational Resources Information Center

    Clarke, H. Harrison, Ed.

    1975-01-01

    This document analyzes the problems encountered by the obese individual and the effects of regular exercise on weight loss and fat reduction. Part one compares the psychological traits of obese children with age groups of normal weight and discusses the organic disorders and social attitudes which plague the overweight individual. Part two states…

  5. Financing Class Size Reduction

    ERIC Educational Resources Information Center

    Achilles, C. M.

    2005-01-01

    Class size reduction has been shown to, among other things, improve academic achievement for all students and particularly for low-income and minority students. With the No Child Left Behind Act's heavy emphasis on scientifically based research, adequate yearly progress, and disaggregated results, one wonders why all children aren't enrolled in…

  6. Reduction in Force.

    ERIC Educational Resources Information Center

    Phay, Robert

    Chapter 2 in a book on school law discusses the reasons for reduction in force (RIF) and presents a set of model regulations for school districts as the best means of minimizing legal problems resulting from RIF. The reasons for RIF include declining student enrollments; reduced turnover among teachers; changes in programs; and more constrained…

  7. UCAC3: Astrometric Reductions

    DTIC Science & Technology

    2010-06-01

    Number of Number of Number of Calibration Frames Survey Frames Minor Planet Frames Pluto Frames CTIO east 1582 5 14 0 0 3 14 0 CTIO west 1583 163460 828...reduction steps to derive corrections to systematic errors. A summary of the CCD observations is given in Table 1. The frames taken along the path of Pluto

  8. Breast reduction (mammoplasty) - slideshow

    MedlinePlus

    ... Indications URL of this page: //medlineplus.gov/ency/presentations/100189.htm Breast reduction (mammoplasty) - series—Indications To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 4 Go to slide 2 ...

  9. Nagel on reduction.

    PubMed

    Sarkar, Sahotra

    2015-10-01

    This paper attempts a critical reappraisal of Nagel's (1961, 1970) model of reduction taking into account both traditional criticisms and recent defenses. This model treats reduction as a type of explanation in which a reduced theory is explained by a reducing theory after their relevant representational items have been suitably connected. In accordance with the deductive-nomological model, the explanation is supposed to consist of a logical deduction. Nagel was a pluralist about both the logical form of the connections between the reduced and reducing theories (which could be conditionals or biconditionals) and their epistemological status (as analytic connections, conventions, or synthetic claims). This paper defends Nagel's pluralism on both counts and, in the process, argues that the multiple realizability objection to reductionism is misplaced. It also argues that the Nagel model correctly characterizes reduction as a type of explanation. However, it notes that logical deduction must be replaced by a broader class of inferential techniques that allow for different types of approximation. Whereas Nagel (1970), in contrast to his earlier position (1961), recognized the relevance of approximation, he did not realize its full import for the model. Throughout the paper two case studies are used to illustrate the arguments: the putative reduction of classical thermodynamics to the kinetic theory of matter and that of classical genetics to molecular biology.

  10. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    McMakin, A.H.; Cannon, S.D.; Finch, S.M.

    1992-07-01

    The objective of the Hanford Environmental Dose Reconstruction (HEDR) Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The TSP consists of experts in environmental pathways, epidemiology, surface-water transport, ground-water transport, statistics, demography, agriculture, meteorology, nuclear engineering, radiation dosimetry, and cultural anthropology. Included are appointed technical members representing the states of Oregon, Washington, and Idaho, a representative of Native American tribes, and an individual representing the public. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed from release to impact on humans (dose estimates): Source terms, environmental transport, environmental monitoring data, demography, food consumption, and agriculture, and environmental pathways and dose estimates. Progress is discussed.

  11. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S.M.; McMakin, A.H.

    1991-01-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is being managed and conducted by the Pacific Northwest Laboratory (PNL) under the direction of an independent Technical Steering Panel (TSP). The TSP consists of experts in environmental pathways, epidemiology, surface-water transport, ground-water transport, statistics, demography, agriculture, meteorology, nuclear engineering, radiation dosimetry, and cultural anthropology. Included are appointed technical members representing the states of Oregon and Washington, a representative of Native American tribes, and an individual representing the public. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on human (dose estimates): Source Terms; Environmental Transport; Environmental Monitoring Data; Demographics, Agriculture, Food Habits and; Environmental Pathways and Dose Estimates.

  12. Gamma Radiation Doses In Sweden

    SciTech Connect

    Almgren, Sara; Isaksson, Mats; Barregaard, Lars

    2008-08-07

    Gamma dose rate measurements were performed in one urban and one rural area using thermoluminescence dosimeters (TLD) worn by 46 participants and placed in their dwellings. The personal effective dose rates were 0.096{+-}0.019(1 SD) and 0.092{+-}0.016(1 SD){mu}Sv/h in the urban and rural area, respectively. The corresponding dose rates in the dwellings were 0.11{+-}0.042(1 SD) and 0.091{+-}0.026(1 SD){mu}Sv/h. However, the differences between the areas were not significant. The values were higher in buildings made of concrete than of wood and higher in apartments than in detached houses. Also, {sup 222}Rn measurements were performed in each dwelling, which showed no correlation with the gamma dose rates in the dwellings.

  13. A simplified technique for delivering total body irradiation (TBI) with improved dose homogeneity

    SciTech Connect

    Yao Rui; Bernard, Damian; Turian, Julius; Abrams, Ross A.; Sensakovic, William; Fung, Henry C.; Chu, James C. H.

    2012-04-15

    Purpose: Total body irradiation (TBI) with megavoltage photon beams has been accepted as an important component of management for a number of hematologic malignancies, generally as part of bone marrow conditioning regimens. The purpose of this paper is to present and discuss the authors' TBI technique, which both simplifies the treatment process and improves the treatment quality. Methods: An AP/PA TBI treatment technique to produce uniform dose distributions using sequential collimator reductions during each fraction was implemented, and a sample calculation worksheet is presented. Using this methodology, the dosimetric characteristics of both 6 and 18 MV photon beams, including lung dose under cerrobend blocks was investigated. A method of estimating midplane lung doses based on measured entrance and exit doses was proposed, and the estimated results were compared with measurements. Results: Whole body midplane dose uniformity of {+-}10% was achieved with no more than two collimator-based beam modulations. The proposed model predicted midplane lung doses 5% to 10% higher than the measured doses for 6 and 18 MV beams. The estimated total midplane doses were within {+-}5% of the prescribed midplane dose on average except for the lungs where the doses were 6% to 10% lower than the prescribed dose on average. Conclusions: The proposed TBI technique can achieve dose uniformity within {+-}10%. This technique is easy to implement and does not require complicated dosimetry and/or compensators.

  14. SU-F-BRF-11: Dose Rearrangement in High Dose Locally Advanced Lung Patients Based On Perfusion Imaging

    SciTech Connect

    Matrosic, C; Jarema, D; Kong, F; McShan, D; Stenmark, M; Owen, D; Ten Haken, R; Matuszak, M

    2014-06-15

    Purpose: The use of mean lung dose (MLD) limits allows individualization of lung patient tumor doses at safe levels. However, MLD does not account for local lung function differences between patients, leading to toxicity variability at the same MLD. We investigated dose rearrangement to minimize dose to functional lung, as measured by perfusion SPECT, while maintaining target coverage and conventional MLD limits. Methods: Retrospective plans were optimized for 15 locally advanced NSCLC patients enrolled in a prospective imaging trial. A priority-based optimization system was used. The baseline priorities were (1) meet OAR dose constraints, (2) maximize target gEUD, and (3) minimize physical MLD. As a final step, normal tissue doses were minimized. To determine the benefit of rearranging dose using perfusion SPECT, plans were reoptimized to minimize functional lung gEUD as the 4th priority. Results: When only minimizing physical MLD, the functional lung gEUD was 10.8+/−5.0 Gy (4.3–19.8 Gy). Only 3/15 cases showed a decrease in functional lung gEUD of ≥4% when rearranging dose to minimize functional gEUD in the cost function (10.5+/−5.0 Gy range 4.3−19.7). Although OAR constraints were respected, the dose rearrangement resulted in ≥10% increases in gEUD to an OAR in 4/15 cases. Only slight reductions in functional lung gEUD were noted when omitting the minimization of physical MLD, suggesting that constraining the target gEUD minimizes the potential to redistribute dose. Conclusion: Prioritydriven optimization permits the generation of plans that respect traditional OAR limits and target coverage, but with the ability to rearrange dose based on functional imaging. The latter appears to be limited due to the decreased solution space when constraining target coverage. Since dose rearrangement may increase dose to other OARs, it is also worthwhile to investigate global biomarkers of lung toxicity to further individualize treatment in this population

  15. Methods for variance reduction in Monte Carlo simulations

    NASA Astrophysics Data System (ADS)

    Bixler, Joel N.; Hokr, Brett H.; Winblad, Aidan; Elpers, Gabriel; Zollars, Byron; Thomas, Robert J.

    2016-03-01

    Monte Carlo simulations are widely considered to be the gold standard for studying the propagation of light in turbid media. However, due to the probabilistic nature of these simulations, large numbers of photons are often required in order to generate relevant results. Here, we present methods for reduction in the variance of dose distribution in a computational volume. Dose distribution is computed via tracing of a large number of rays, and tracking the absorption and scattering of the rays within discrete voxels that comprise the volume. Variance reduction is shown here using quasi-random sampling, interaction forcing for weakly scattering media, and dose smoothing via bi-lateral filtering. These methods, along with the corresponding performance enhancements are detailed here.

  16. Weldon Spring historical dose estimate

    SciTech Connect

    Meshkov, N.; Benioff, P.; Wang, J.; Yuan, Y.

    1986-07-01

    This study was conducted to determine the estimated radiation doses that individuals in five nearby population groups and the general population in the surrounding area may have received as a consequence of activities at a uranium processing plant in Weldon Spring, Missouri. The study is retrospective and encompasses plant operations (1957-1966), cleanup (1967-1969), and maintenance (1969-1982). The dose estimates for members of the nearby population groups are as follows. Of the three periods considered, the largest doses to the general population in the surrounding area would have occurred during the plant operations period (1957-1966). Dose estimates for the cleanup (1967-1969) and maintenance (1969-1982) periods are negligible in comparison. Based on the monitoring data, if there was a person residing continually in a dwelling 1.2 km (0.75 mi) north of the plant, this person is estimated to have received an average of about 96 mrem/yr (ranging from 50 to 160 mrem/yr) above background during plant operations, whereas the dose to a nearby resident during later years is estimated to have been about 0.4 mrem/yr during cleanup and about 0.2 mrem/yr during the maintenance period. These values may be compared with the background dose in Missouri of 120 mrem/yr.

  17. Technical basis for dose reconstruction

    SciTech Connect

    Anspaugh, L.R.

    1996-01-31

    The purpose of this paper is to consider two general topics: technical considerations of why dose-reconstruction studies should or should not be performed and methods of dose reconstruction. The first topic is of general and growing interest as the number of dose-reconstruction studies increases, and one asks the question whether it is necessary to perform a dose reconstruction for virtually every site at which, for example, the Department of Energy (DOE) has operated a nuclear-related facility. And there is the broader question of how one might logically draw the line at performing or not performing dose-reconstruction (radiological and chemical) studies for virtually every industrial complex in the entire country. The second question is also of general interest. There is no single correct way to perform a dose-reconstruction study, and it is important not to follow blindly a single method to the point that cheaper, faster, more accurate, and more transparent methods might not be developed and applied.

  18. BENCHMARK DOSE TECHNICAL GUIDANCE DOCUMENT ...

    EPA Pesticide Factsheets

    The U.S. EPA conducts risk assessments for an array of health effects that may result from exposure to environmental agents, and that require an analysis of the relationship between exposure and health-related outcomes. The dose-response assessment is essentially a two-step process, the first being the definition of a point of departure (POD), and the second extrapolation from the POD to low environmentally-relevant exposure levels. The benchmark dose (BMD) approach provides a more quantitative alternative to the first step in the dose-response assessment than the current NOAEL/LOAEL process for noncancer health effects, and is similar to that for determining the POD proposed for cancer endpoints. As the Agency moves toward harmonization of approaches for human health risk assessment, the dichotomy between cancer and noncancer health effects is being replaced by consideration of mode of action and whether the effects of concern are likely to be linear or nonlinear at low doses. Thus, the purpose of this project is to provide guidance for the Agency and the outside community on the application of the BMD approach in determining the POD for all types of health effects data, whether a linear or nonlinear low dose extrapolation is used. A guidance document is being developed under the auspices of EPA's Risk Assessment Forum. The purpose of this project is to provide guidance for the Agency and the outside community on the application of the benchmark dose (BMD) appr

  19. Improving pediatric radiation dose management using Agfa digital radiography DICOM header information.

    PubMed

    Juste, B; Villaescusa, N; Granero, D; Verdú, G

    2007-01-01

    Dose reduction in pediatric explorations is especially important because of children radiation sensitivity. According to this, with the aim of saving radiation exposure in future clinical practice, we have developed a technique to control delivered dose in pediatric radiographic exams. To that, a computer science program has been developed to calculate entrance skin dose (ESD) provided by AGFA radiology digital system, using the "lgM" parameter exported from Dicom files. ESD values are compared with dose limits established in regulations to detect if children are being exposed to excessive amounts of radiation during their explorations.

  20. Collection of DICOM RDSR (Digital Imaging and Communication in Medicine, Radiation Dose Structured Report) Information Aimed at Reducing Patient Exposure Dose.

    PubMed

    Morota, Koichi; Moritake, Takashi; Sun, Lue; Ishihara, Takahiro; Kuma, Natsuyo; Murata, Satomi; Yamada, Takahiro; Okazaki, Ryuji

    2016-01-01

    The recent progress in angiography technology bestows benefits on patients for minimally invasive than surgery, while there has been an increase in the number of cases involving stochastic effects, such as radiation dermatitis, resulting from upgrading of the procedure because of an extension of the time for fluoroscopy and the number of shots. Recent CT equipment saves the dose data along with image data about the information management for patient exposure dose, which is used for management of individual cumulative dose and the presumed effective dose, using digital imaging and communication in medicine (DICOM). We extracted detailed information about shooting conditions and dose from the DICOM radiation dose structured report (DICOM RDSR) in the angiography area, and evaluated the trend of patient exposure dose in each procedure. As a result, we found that cases exceeding 3 Gy which needed observation in the head region were 16.7% and in the heart region were 27.3%. We also found that angiography had a higher dose of shooting than did fluoroscopy, and that the diagnosis and treatment with tumor involvement required a exposure dose than did vascular lesion. In this paper, we review the shooting conditions as a root of DICOM RDSR information and consider the possibility of planning for further reduction of the exposure dose.

  1. Low dose dynamic myocardial CT perfusion using advanced iterative reconstruction

    NASA Astrophysics Data System (ADS)

    Eck, Brendan L.; Fahmi, Rachid; Fuqua, Christopher; Vembar, Mani; Dhanantwari, Amar; Bezerra, Hiram G.; Wilson, David L.

    2015-03-01

    Dynamic myocardial CT perfusion (CTP) can provide quantitative functional information for the assessment of coronary artery disease. However, x-ray dose in dynamic CTP is high, typically from 10mSv to >20mSv. We compared the dose reduction potential of advanced iterative reconstruction, Iterative Model Reconstruction (IMR, Philips Healthcare, Cleveland, Ohio) to hybrid iterative reconstruction (iDose4) and filtered back projection (FBP). Dynamic CTP scans were obtained using a porcine model with balloon-induced ischemia in the left anterior descending coronary artery to prescribed fractional flow reserve values. High dose dynamic CTP scans were acquired at 100kVp/100mAs with effective dose of 23mSv. Low dose scans at 75mAs, 50mAs, and 25mAs were simulated by adding x-ray quantum noise and detector electronic noise to the projection space data. Images were reconstructed with FBP, iDose4, and IMR at each dose level. Image quality in static CTP images was assessed by SNR and CNR. Blood flow was obtained using a dynamic CTP analysis pipeline and blood flow image quality was assessed using flow-SNR and flow-CNR. IMR showed highest static image quality according to SNR and CNR. Blood flow in FBP was increasingly over-estimated at reduced dose. Flow was more consistent for iDose4 from 100mAs to 50mAs, but was over-estimated at 25mAs. IMR was most consistent from 100mAs to 25mAs. Static images and flow maps for 100mAs FBP, 50mAs iDose4, and 25mAs IMR showed comparable, clear ischemia, CNR, and flow-CNR values. These results suggest that IMR can enable dynamic CTP at significantly reduced dose, at 5.8mSv or 25% of the comparable 23mSv FBP protocol.

  2. The Monte Carlo calculation of integral radiation dose in xeromammography.

    PubMed

    Dance, D R

    1980-01-01

    A Monte Carlo computer program has been developed for the computation of integral radiation dose to the breast in xeromammography. The results are given in terms of the integral dose per unit area of the breast per unit incident exposure. The calculations have been made for monoenergetic incident photons and the results integrated over a variety of X-ray spectra from both tungsten and molybdenum targets. This range incorporates qualities used in conventional and xeromammography. The program includes the selenium plate used in xeroradiography; the energy absorbed in this detector has also been investigated. The latter calculations have been used to predict relative values of exposure and of integral dose to the breast for xeromammograms taken at various radiation qualities. The results have been applied to recent work on the reduction of patient exposure in xeromammography by the addition of aluminium filters to the X-ray beam.

  3. Sulfide elimination by intermittent nitrate dosing in sewer sediments.

    PubMed

    Liu, Yanchen; Wu, Chen; Zhou, Xiaohong; Zhu, David Z; Shi, Hanchang

    2015-01-01

    The formation of hydrogen sulfide in biofilms and sediments in sewer systems can cause severe pipe corrosions and health hazards, and requires expensive programs for its prevention. The aim of this study is to propose a new control strategy and the optimal condition for sulfide elimination by intermittent nitrate dosing in sewer sediments. The study was carried out based on lab-scale experiments and batch tests using real sewer sediments. The intermittent nitrate dosing mode and the optimal control condition were investigated. The results indicated that the sulfide-intermittent-elimination strategy by nitrate dosing is advantageous for controlling sulfide accumulation in sewer sediment. The oxidation-reduction potential is a sensitive indicator parameter that can reflect the control effect and the minimum N/S (nitrate/sulfide) ratio with slight excess nitrate is necessary for optimal conditions of efficient sulfide control with lower carbon source loss. The optimal control condition is feasible for the sulfide elimination in sewer systems.

  4. Confusion: acetaminophen dosing changes based on NO evidence in adults.

    PubMed

    Krenzelok, Edward P; Royal, Mike A

    2012-06-01

    Acetaminophen (paracetamol) plays a vital role in American health care, with in excess of 25 billion doses being used annually as a nonprescription medication. Over 200 million acetaminophen-containing prescriptions, usually in combination with an opioid, are dispensed annually. While acetaminophen is recognized as a safe and effective analgesic and antipyretic, it is also associated with significant morbidity and mortality (hepatotoxicity) if doses in excess of the therapeutic amount are ingested inappropriately. The maximum daily therapeutic dose of 3900-4000 mg was established in separate actions in 1977 and 1988, respectively, via the Food and Drug Administration (FDA) monograph process for nonprescription medications. The FDA has conducted multiple advisory committee meetings to evaluate acetaminophen and its safety profile, and has suggested (but not mandated) a reduction in the maximum daily dosage from 3900-4000 mg to 3000-3250 mg. In 2011, McNeil, the producer of the Tylenol® brand of acetaminophen, voluntarily reduced the maximum daily dose of its 500 mg tablet product to 3000 mg/day, and it has pledged to change the labeling of its 325 mg/tablet product to reflect a maximum of 3250 mg/day. Generic manufacturers have not changed their dosing regimens and they have remained consistent with the established monograph dose. Therefore, confusion will be inevitable as both consumers and health care professionals try to determine the proper therapeutic dose of acetaminophen. Which is the correct dose of acetaminophen: 3000 mg if 500 mg tablets are used, 3250 mg with 325 mg tablets, or 3900 mg when 650 mg arthritis-strength products are used?

  5. Injury reduction at Fermilab

    SciTech Connect

    Griffing, Bill; /Fermilab

    2005-06-01

    In a recent DOE Program Review, Fermilab's director presented results of the laboratory's effort to reduce the injury rate over the last decade. The results, shown in the figure below, reveal a consistent and dramatic downward trend in OSHA recordable injuries at Fermilab. The High Energy Physics Program Office has asked Fermilab to report in detail on how the laboratory has achieved the reduction. In fact, the reduction in the injury rate reflects a change in safety culture at Fermilab, which has evolved slowly over this period, due to a series of events, both planned and unplanned. This paper attempts to describe those significant events and analyze how each of them has shaped the safety culture that, in turn, has reduced the rate of injury at Fermilab to its current value.

  6. Aluminum reduction cell electrode

    DOEpatents

    Goodnow, W.H.; Payne, J.R.

    1982-09-14

    The invention is directed to cathode modules comprised of refractory hard metal materials, such as TiB[sub 2], for an electrolytic cell for the reduction of alumina wherein the modules may be installed and replaced during operation of the cell and wherein the structure of the cathode modules is such that the refractory hard metal materials are not subjected to externally applied forces or rigid constraints. 9 figs.

  7. Oxidation, Reduction, and Deoxygenation

    NASA Astrophysics Data System (ADS)

    Madsen, Robert

    In this chapter, methods for oxidation, reduction, and deoxygenation of carbohydrates are presented. In most cases, the reactions have been used on aldoses and their derivatives including glycosides, uronic acids, glycals, and other unsaturated monosaccharides. A number of reactions have also been applied to aldonolactones. The methods include both chemical and enzymatic procedures and some of these can be applied for regioselective transformation of unprotected or partially protected carbohydrates.

  8. Reduction of astrographic catalogues

    NASA Technical Reports Server (NTRS)

    Stock, J.; Prugna, F. D.; Cova, J.

    1984-01-01

    An automatic program for the reduction of overlapping Carte du Ciel plates is described. The projection and transformation equations are given and the RAA subprogram flow is outlined. The program was applied to two different sets of data, namely to nine overlapping plates of the Cape Zone of the CdC, and to fifteen plates taken with the CIDA-refractor of the open cluster Tr10.

  9. Aluminum reduction cell electrode

    DOEpatents

    Goodnow, Warren H.; Payne, John R.

    1982-01-01

    The invention is directed to cathode modules comprised of refractory hard metal materials, such as TiB.sub.2, for an electrolytic cell for the reduction of alumina wherein the modules may be installed and replaced during operation of the cell and wherein the structure of the cathode modules is such that the refractory hard metal materials are not subjected to externally applied forces or rigid constraints.

  10. Somatic reduction in cycads.

    PubMed

    Storey, W B

    1968-02-09

    Recurrent somatic reduction is a normal ontogenetic process in apogeotropic roots of cycads, which develop into dichotomously branching coralloid masses. The reduced cells make up part of a ring of differentiated cortical tissue lying midway between the pericycle and the epidermis; they serve as fillers among the large cells and become charged with slime. The differentiated tissue is colonized by a species of blue-green algae.

  11. Television noise reduction device

    NASA Technical Reports Server (NTRS)

    Gordon, B. L.; Stamps, J. C. (Inventor)

    1975-01-01

    A noise reduction system that divides the color video signal into its luminance and chrominance components is reported. The luminance component of a given frame is summed with the luminance component of at least one preceding frame which was stored on a disc recorder. The summation is carried out so as to achieve a signal amplitude equivalent to that of the original signal. The averaged luminance signal is then recombined with the chrominance signal to achieve a noise-reduced television signal.

  12. Comparative transcriptome analysis of rice seedlings induced by different doses of heavy ion radiation

    NASA Astrophysics Data System (ADS)

    Zhao, Qian; Sun, Yeqing; Wang, Wei

    2016-07-01

    Highly ionizing radiation (HZE) in space is considered as a main factor causing biological effects on plant seeds. To investigate the different effects on genome-wide gene expression of low-dose and high-dose ion radiation, we carried out ground-base carbon particle HZE experiments with different cumulative doses (0Gy, 0.2Gy, 2Gy) to rice seeds and then performed comparative transcriptome analysis of the rice seedlings. We identified a total of 2551 and 1464 differentially expressed genes (DEGs) in low-dose and high-dose radiation groups, respectively. Gene ontology analyses indicated that low-dose and high-dose ion radiation both led to multiple physiological and biochemical activities changes in rice. By Gene Ontology analyses, the results showed that only one process-oxidation reduction process was enriched in the biological process category after high-dose ion radiation, while more processes such as response to biotic stimulus, heme binding, tetrapyrrole binding, oxidoreductase activity, catalytic activity and oxidoreductase activity were significantly enriched after low-dose ion radiation. The results indicated that the rice plants only focused on the process of oxidation reduction to response to high-dose ion radiation, whereas it was a coordination of multiple biological processes to response to low-dose ion radiation. To elucidate the transcriptional regulation of radiation stress-responsive genes, we identified several DEGs-encoding TFs. AP2/EREBP, bHLH, C2H2, MYB and WRKY TF families were altered significantly in response to ion radiation. Mapman analysis speculated that the biological effects on rice seedlings caused by the radiation stress might share similar mechanisms with the biotic stress. Our findings highlight important alterations in the expression of radiation response genes, metabolic pathways, and TF-encoding genes in rice seedlings exposed to low-dose and high-dose ion radiation.

  13. Uranium Reduction by Clostridia

    SciTech Connect

    Francis, A.J.; Dodge, Cleveland J.; Gillow, Jeffrey B.

    2006-04-05

    The FRC groundwater and sediment contain significant concentrations of U and Tc and are dominated by low pH, and high nitrate and Al concentrations where dissimilatory metal reducing bacterial activity may be limited. The presence of Clostridia in Area 3 at the FRC site has been confirmed and their ability to reduce uranium under site conditions will be determined. Although the phenomenon of uranium reduction by Clostridia has been firmly established, the molecular mechanisms underlying such a reaction are not very clear. The authors are exploring the hypothesis that U(VI) reduction occurs through hydrogenases and other enzymes (Matin and Francis). Fundamental knowledge of metal reduction using Clostridia will allow us to exploit naturally occurring processes to attenuate radionuclide and metal contaminants in situ in the subsurface. The outline for this report are as follows: (1) Growth of Clostridium sp. under normal culture conditions; (2) Fate of metals and radionuclides in the presence of Clostridia; (3) Bioreduction of uranium associated with nitrate, citrate, and lepidocrocite; and (4) Utilization of Clostridium sp. for immobilization of uranium at the FRC Area 3 site.

  14. Thermochemical nitrate reduction

    SciTech Connect

    Cox, J.L.; Lilga, M.A.; Hallen, R.T.

    1992-09-01

    A series of preliminary experiments was conducted directed at thermochemically converting nitrate to nitrogen and water. Nitrates are a major constituent of the waste stored in the underground tanks on the Hanford Site, and the characteristics and effects of nitrate compounds on stabilization techniques must be considered before permanent disposal operations begin. For the thermochemical reduction experiments, six reducing agents (ammonia, formate, urea, glucose, methane, and hydrogen) were mixed separately with {approximately}3 wt% NO{sub 3}{sup {minus}} solutions in a buffered aqueous solution at high pH (13); ammonia and formate were also mixed at low pH (4). Reactions were conducted in an aqueous solution in a batch reactor at temperatures of 200{degrees}C to 350{degrees}C and pressures of 600 to 2800 psig. Both gas and liquid samples were analyzed. The specific components analyzed were nitrate, nitrite, nitrous oxide, nitrogen, and ammonia. Results of experimental runs showed the following order of nitrate reduction of the six reducing agents in basic solution: formate > glucose > urea > hydrogen > ammonia {approx} methane. Airnmonia was more effective under acidic conditions than basic conditions. Formate was also effective under acidic conditions. A more thorough, fundamental study appears warranted to provide additional data on the mechanism of nitrate reduction. Furthermore, an expanded data base and engineering feasibility study could be used to evaluate conversion conditions for promising reducing agents in more detail and identify new reducing agents with improved performance characteristics.

  15. Dose evaluation of selective collimation effect in cephalography by measurement and Monte Carlo simulation.

    PubMed

    Lee, Boram; Shin, Gwisoon; Kang, Sunjung; Shin, Boram; Back, Ilhong; Park, Hyok; Park, Changseo; Lee, Jeongwoo; Lee, Wonho; Choi, Jonghak; Park, Ryeonghwang; Kim, Youhyun

    2012-01-01

    Recently, simulations based on the Monte Carlo code have been increasingly applied for physics phenomena, patient dose and quality assurance of radiation systems. The objective of this study was to use Monte Carlo simulation and measurement to verify dose and dose reduction in cephalography. The collimator was constructed with 3-mm thick lead plate, and attached to the tube head to remove regions of disinterest in the radiation field. A digital phantom patient was constructed to evaluate patient dose. In addition, detectors of pixel size 1×1 cm² and 0.1×0.1 cm² were constructed to check collimator location. The effective dose according to International Commission on Radiological Protection 103 was calculated with and without collimation. The effective doses for simulation with and without collimation were 5.09 and 11.32 µSv, respectively. The results of the calculated effective dose show 61.7 % reduction of field area and 55 % of effective dose. The Monte Carlo simulation is a good evaluation tool for patient dose.

  16. Induction of reciprocal translocations in rhesus monkey stem-cell spermatogonia: effects of low doses and low dose rates

    SciTech Connect

    van Buul, P.P.; Richardson, J.F. Jr.; Goudzwaard, J.H.

    1986-01-01

    The induction of reciprocal translocation in rhesus monkey spermatogonial stem cells was studied following exposure to low doses of acute X rays (0.25 Gy, 300 mGy/min) or to low-dose-rate X rays (1 Gy, 2 mGy/min) and gamma rays (1 Gy, 0.2 mGy/min). The results obtained at 0.25 Gy of X rays fitted exactly the linear extrapolation down from the 0.5 and 1.0 Gy points obtained earlier. Extension of X-ray exposure reduced the yield of translocations similar to that in the mouse by about 50%. The reduction to 40% of translocation rate after chronic gamma exposure was clearly less than the value of about 80% reported for the mouse over the same range of dose rates. Differential cell killing with ensuing differential elimination of aberration-carrying cells is the most likely explanation for the differences between mouse and monkey.

  17. Peripheral doses from pediatric IMRT

    SciTech Connect

    Klein, Eric E.; Maserang, Beth; Wood, Roy; Mansur, David

    2006-07-15

    Peripheral dose (PD) data exist for conventional fields ({>=}10 cm) and intensity-modulated radiotherapy (IMRT) delivery to standard adult-sized phantoms. Pediatric peripheral dose reports are limited to conventional therapy and are model based. Our goal was to ascertain whether data acquired from full phantom studies and/or pediatric models, with IMRT treatment times, could predict Organ at Risk (OAR) dose for pediatric IMRT. As monitor units (MUs) are greater for IMRT, it is expected IMRT PD will be higher; potentially compounded by decreased patient size (absorption). Baseline slab phantom peripheral dose measurements were conducted for very small field sizes (from 2 to 10 cm). Data were collected at distances ranging from 5 to 72 cm away from the field edges. Collimation was either with the collimating jaws or the multileaf collimator (MLC) oriented either perpendicular or along the peripheral dose measurement plane. For the clinical tests, five patients with intracranial or base of skull lesions were chosen. IMRT and conventional three-dimensional (3D) plans for the same patient/target/dose (180 cGy), were optimized without limitation to the number of fields or wedge use. Six MV, 120-leaf MLC Varian axial beams were used. A phantom mimicking a 3-year-old was configured per Center for Disease Control data. Micro (0.125 cc) and cylindrical (0.6 cc) ionization chambers were appropriated for the thyroid, breast, ovaries, and testes. The PD was recorded by electrometers set to the 10{sup -10} scale. Each system set was uniquely calibrated. For the slab phantom studies, close peripheral points were found to have a higher dose for low energy and larger field size and when MLC was not deployed. For points more distant from the field edge, the PD was higher for high-energy beams. MLC orientation was found to be inconsequential for the small fields tested. The thyroid dose was lower for IMRT delivery than that predicted for conventional (ratio of IMRT/cnventional ranged

  18. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S.M.

    1990-01-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that populations could have received from nuclear operations at Hanford since 1944. The project is being managed and conducted by the Pacific Northwest Laboratory (PNL) under the direction of an independent Technical Steering Panel (TSP). The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (dose estimates). The Source Terms Task develops estimates of radioactive emissions from Hanford facilities since 1944. The Environmental Transport Task reconstructs the movement of radioactive materials from the areas of release to populations. The Environmental Monitoring Data Task assembles, evaluates, and reports historical environmental monitoring data. The Demographics, Agriculture, Food Habits Task develops the data needed to identify the populations that could have been affected by the releases. In addition to population and demographic data, the food and water resources and consumption patterns for populations are estimated because they provide a primary pathway for the intake of radionuclides. The Environmental Pathways and Dose Estimates Task use the information produced by the other tasks to estimate the radiation doses populations could have received from Hanford radiation. Project progress is documented in this monthly report, which is available to the public. 3 figs., 3 tabs.

  19. AGING FACILITY WORKER DOSE ASSESSMENT

    SciTech Connect

    R.L. Thacker

    2005-03-24

    The purpose of this calculation is to estimate radiation doses received by personnel working in the Aging Facility performing operations to transfer aging casks to the aging pads for thermal and logistical management, stage empty aging casks, and retrieve aging casks from the aging pads for further processing in other site facilities. Doses received by workers due to aging cask surveillance and maintenance operations are also included. The specific scope of work contained in this calculation covers both collective doses and individual worker group doses on an annual basis, and includes the contributions due to external and internal radiation from normal operation. There are no Category 1 event sequences associated with the Aging Facility (BSC 2004 [DIRS 167268], Section 7.2.1). The results of this calculation will be used to support the design of the Aging Facility and to provide occupational dose estimates for the License Application. The calculations contained in this document were developed by Environmental and Nuclear Engineering of the Design and Engineering Organization and are intended solely for the use of the Design and Engineering Organization in its work regarding facility operation. Yucca Mountain Project personnel from the Environmental and Nuclear Engineering should be consulted before use of the calculations for purposes other than those stated herein or use by individuals other than authorized personnel in Environmental and Nuclear Engineering.

  20. Hanford Environmental Dose Reconstruction Project

    SciTech Connect

    Finch, S. M.; McMakin, A. H.

    1991-09-01

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation dose that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is divided into five technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (i.e., dose estimates). The Source Terms Task develops estimates of radioactive emissions from Hanford facilities since 1944. The Environmental Transport Task reconstructs the movements of radioactive particles from the areas of release to populations. The Environmental Monitoring Data Task assemblies, evaluates and reports historical environmental monitoring data. The Demographics, Agriculture and Food Habits Task develops the data needed to identify the populations that could have been affected by the releases. The Environmental Pathways and Dose Estimates Task used the information derived from the other Tasks to estimate the radiation doses individuals could have received from Hanford radiation. This document lists the progress on this project as of September 1991. 3 figs., 2 tabs.

  1. Sci—Thur AM: YIS - 05: 10X-FFF VMAT for Lung SABR: an Investigation of Peripheral Dose

    SciTech Connect

    Mader, J; Mestrovic, A

    2014-08-15

    Flattening Filter Free (FFF) beams exhibit high dose rates, reduced head scatter, leaf transmission and leakage radiation. For VMAT lung SABR, treatment time can be significantly reduced using high dose rate FFF beams while maintaining plan quality and accuracy. Another possible advantage offered by FFF beams for VMAT lung SABR is the reduction in peripheral dose. The focus of this study was to investigate and quantify the reduction of peripheral dose offered by FFF beams for VMAT lung SABR. The peripheral doses delivered by VMAT Lung SABR treatments using FFF and flattened beams were investigated for the Varian Truebeam linac. This study was conducted in three stages, (1): ion chamber measurement of peripheral dose for various plans, (2): validation of AAA, Acuros XB and Monte Carlo for peripheral dose using measured data, and (3): using the validated Monte Carlo model to evaluate peripheral doses for 6 VMAT lung SABR treatments. Three energies, 6X, 10X, and 10X-FFF were used for all stages. Measured data indicates that 10X-FFF delivers the lowest peripheral dose of the three energies studied. AAA and Acuros XB dose calculation algorithms were identified as inadequate, and Monte Carlo was validated for accurate peripheral dose prediction. The Monte Carlo-calculated VMAT lung SABR plans show a significant reduction in peripheral dose for 10X-FFF plans compared to the standard 6X plans, while no significant reduction was showed when compared to 10X. This reduction combined with shorter treatment time makes 10X-FFF beams the optimal choice for superior VMAT lung SABR treatments.

  2. Pharmacodynamic imaging guides dosing of a selective estrogen receptor degrader

    PubMed Central

    Heidari, Pedram; Deng, Francis; Esfahani, Shadi A.; Leece, Alicia K.; Shoup, Timothy M.; Vasdev, Neil; Mahmood, Umar

    2015-01-01

    Purpose Estrogen receptor (ER) targeting is key in management of receptor-positive breast cancer (BrCa). Currently, there are no methods to optimize anti-ER therapy dosing. This study assesses the utility of 16α-18F-fluoroestradiol (18F-FES) PET for fulvestrant dose optimization in a preclinical ER+ BrCa model. Experimental Design In vitro, 18F-FES retention was compared to ERα protein expression (ELISA) and ESR1 mRNA transcription (qPCR) in MCF7 cells (ER+) after treatment with different fulvestrant doses. MCF7 xenografts were grown in ovariectomized nude mice and assigned to vehicle, low- (0.05mg), medium- (0.5mg) or high-dose (5mg) fulvestrant treatment groups (5–7 per group). Two and three days after fulvestrant treatment, PET/CT was performed using 18F-FES and 18F-FDG, respectively. ER expression was assessed by immunohistochemistry, ELISA, and qPCR on xenografts. Tumor proliferation was assessed using Ki-67 immunohistochemistry. Results In vitro, we observed a parallel graded reduction in 18F-FES uptake and ER expression with increased fulvestrant doses, despite enhancement of ER mRNA transcription. In xenografts, ER expression significantly decreased with increased fulvestrant dose, despite similar mRNA expression and Ki-67 staining among the treatment groups. We observed a significant dose-dependent reduction of 18F-FES PET mean standardized uptake value (SUVmean) with fulvestrant treatment, but no significant difference among the treatment groups in 18F-FDG PET SUVmean.. Conclusion We demonstrated that 18F-FES uptake mirrors the dose-dependent changes in functional ER expression with fulvestrant resulting in ER degradation and/or blockade; these precede changes in tumor metabolism and proliferation. Quantitative 18F-FES PET may be useful for tracking early efficacy of ER blockade/degradation and guiding ER-targeted therapy dosing in BrCa patients. PMID:25609068

  3. Zuclopenthixol decanoate in maintenance treatment of schizophrenic outpatients. Minimum effective dose and corresponding serum levels.

    PubMed

    Solgaard, T; Kistrup, K; Aaes-Jørgensen, T; Gerlach, J

    1994-05-01

    23 schizophrenic outpatients in maintenance treatment with zuclopenthixol decanoate were included in a study aimed at finding the minimum effective dose and corresponding serum concentration of zuclopenthixol. Every three months the dose was gradually reduced until prodromal symptoms appeared, indicative of an incipient relapse. A slightly higher dose was then promptly reinstituted (the minimum effective dose). At each dose level, two blood samples were drawn to determine the serum concentration. This dose reduction principles proved feasible. Only one patient had a clear-cut relapse. The condition of the remaining patients was acceptably maintained by a dose increase. The minimum effective dose of zuclopenthixol was 200 mg/2 weeks (range 60-400), with a serum concentration of 22 nmol/l (7.1-69.7). There was a significant correlation between the administered dose and the corresponding serum level of the drug (r = 0.66, P < 0.01). A trend towards a positive correlation was found between the serum level at the minimum effective dose and the BPRS score (r = 0.42, P < 0.1). No correlation was found between the serum level and the side-effects or length of neuroleptic treatment. It is concluded that routine serum drug monitoring is hardly indicated in the long-term depot-neuroleptic treatment of schizophrenic patients. A strategy aiming at continually seeking the lowest effective dose on the basis of clinical parameters appears more appropriate, especially in case of depot-neuroleptic treatment.

  4. Tools for Optimal Waste and Exposure Reduction

    SciTech Connect

    Tripp, J. L.

    2002-02-26

    The INEEL has developed a software called TOWER (Tools for Optimal Waste and Exposure Reduction) to provide a new way to visualize and safely interact with hazardous facilities and equipment. This gives workers a comprehensive tool for planning and executing work in hazardous areas and the dismantling of complex and often dangerous sites. TOWER incorporates innovative technologies that can significantly reduce worker hazardous material doses and decrease the volume of waste going to disposal sites compared with currently used approaches. TOWER creates a 3-dimensional simulation of a facility that reveals in detail its solid components (pipes, valves, and pumps) as well as its invisible hazards (radiation, chemical, gas, and electric fields). Suggested segmentation can be shown on the facility model. TOWER also lets operators move simulated workers through the work site while monitoring their instantaneous and cumulative hazardous materials doses to help plan the best operational strategies. Because of its ability to visualize complex facilities, chart optimal dismantling and packaging steps, and track worker hazardous material dose, TOWER is a significant new way to plan and document work in hazardous areas including D&D projects, train workers, reduce worker exposure to hazardous materials, and lower project and waste disposal costs.

  5. Radiation Dose from Reentrant Electrons

    NASA Technical Reports Server (NTRS)

    Badhwar, G.D.; Cleghorn, T. E.; Watts, J.

    2003-01-01

    In estimating the crew exposures during an EVA, the contribution of reentrant electrons has always been neglected. Although the flux of these electrons is small compared to the flux of trapped electrons, their energy spectrum extends to several GeV compared to about 7 MeV for trapped electrons. This is also true of splash electrons. Using the measured reentrant electron energy spectra, it is shown that the dose contribution of these electrons to the blood forming organs (BFO) is more than 10 times greater than that from the trapped electrons. The calculations also show that the dose-depth response is a very slowly changing function of depth, and thus adding reasonable amounts of additional shielding would not significantly lower the dose to BFO.

  6. Parameterization of solar flare dose

    SciTech Connect

    Lamarche, A.H.; Poston, J.W.

    1996-12-31

    A critical aspect of missions to the moon or Mars will be the safety and health of the crew. Radiation in space is a hazard for astronauts, especially high-energy radiation following certain types of solar flares. A solar flare event can be very dangerous if astronauts are not adequately shielded because flares can deliver a very high dose in a short period of time. The goal of this research was to parameterize solar flare dose as a function of time to see if it was possible to predict solar flare occurrence, thus providing a warning time. This would allow astronauts to take corrective action and avoid receiving a dose greater than the recommended limit set by the National Council on Radiation Protection and Measurements (NCRP).

  7. Automated Gamma Knife dose planning

    NASA Astrophysics Data System (ADS)

    Leichtman, Gregg S.; Aita, Anthony L.; Goldman, H. W.

    1998-06-01

    The Gamma Knife (Elekta Instruments, Inc., Atlanta, GA), a neurosurgical, highly focused radiation delivery device, is used to eradicate deep-seated anomalous tissue within the human brain by delivering a lethal dose of radiation to target tissue. This dose is the accumulated result of delivering sequential `shots' of radiation to the target where each shot is approximately 3D Gaussian in shape. The size and intensity of each shot can be adjusted by varying the time of radiation exposure and by using one of four collimator sizes ranging from 4 - 18 mm. Current dose planning requires that the dose plan be developed manually to cover the target, and only the target, with a desired minimum radiation intensity using a minimum number of shots. This is a laborious and subjective process which typically leads to suboptimal conformal target coverage by the dose. We have used adaptive simulated annealing/quenching followed by Nelder-Mead simplex optimization to automate the selection and placement of Gaussian-based `shots' to form a simulated dose plane. In order to make the computation of the problem tractable, the algorithm, based upon contouring and polygon clipping, takes a 2 1/2-D approach to defining the cost function. Several experiments have been performed where the optimizers have been given the freedom to vary the number of shots and the weight, collimator size, and 3D location of each shot. To data best results have been obtained by forcing the optimizers to use a fixed number of unweighted shots with each optimizer set free to vary the 3D location and collimator size of each shot. Our preliminary results indicate that this technology will radically decrease planning time while significantly increasing accuracy of conformal target coverage and reproducibility over current manual methods.

  8. Radiation doses of employees of a Nuclear Medicine Department after implementation of more rigorous radiation protection methods.

    PubMed

    Piwowarska-Bilska, Hanna; Supinska, Aleksandra; Listewnik, Maria H; Zorga, Piotr; Birkenfeld, Bozena

    2013-11-01

    The appropriate radiation protection measures applied in departments of nuclear medicine should lead to a reduction in doses received by the employees. During 1991-2007, at the Department of Nuclear Medicine of Pomeranian Medical University (Szczecin, Poland), nurses received on average two-times higher (4.6 mSv) annual doses to the whole body than those received by radiopharmacy technicians. The purpose of this work was to examine whether implementation of changes in the radiation protection protocol will considerably influence the reduction in whole-body doses received by the staff that are the most exposed. A reduction in nurses' exposure by ~63 % took place in 2008-11, whereas the exposure of radiopharmacy technicians grew by no more than 22 % in comparison with that in the period 1991-2007. Proper reorganisation of the work in departments of nuclear medicine can considerably affect dose reduction and bring about equal distribution of the exposure.

  9. Reduction of turbomachinery noise

    NASA Technical Reports Server (NTRS)

    Waitz, Ian A. (Inventor); Brookfield, John M. (Inventor); Sell, Julian (Inventor); Hayden, Belva J. (Inventor); Ingard, K. Uno (Inventor)

    1999-01-01

    In the invention, propagating broad band and tonal acoustic components of noise characteristic of interaction of a turbomachine blade wake, produced by a turbomachine blade as the blade rotates, with a turbomachine component downstream of the rotating blade, are reduced. This is accomplished by injection of fluid into the blade wake through a port in the rotor blade. The mass flow rate of the fluid injected into the blade wake is selected to reduce the momentum deficit of the wake to correspondingly increase the time-mean velocity of the wake and decrease the turbulent velocity fluctuations of the wake. With this fluid injection, reduction of both propagating broad band and tonal acoustic components of noise produced by interaction of the blade wake with a turbomachine component downstream of the rotating blade is achieved. In a further noise reduction technique, boundary layer fluid is suctioned into the turbomachine blade through a suction port on the side of the blade that is characterized as the relatively low-pressure blade side. As with the fluid injection technique, the mass flow rate of the fluid suctioned into the blade is here selected to reduce the momentum deficit of the wake to correspondingly increase the time-mean velocity of the wake and decrease the turbulent velocity fluctuations of the wake; reduction of both propagating broad band and tonal acoustic components of noise produced by interaction of the blade wake with a turbomachine component downstream of the rotating blade is achieved with this suction technique. Blowing and suction techniques are also provided in the invention for reducing noise associated with the wake produced by fluid flow around a stationary blade upstream of a rotating turbomachine.

  10. Dose-volume histogram parameters of high-dose-rate brachytherapy for Stage I-II cervical cancer (≤4cm) arising from a small-sized uterus treated with a point A dose-reduced plan.

    PubMed

    Nakagawa, Akiko; Ohno, Tatsuya; Noda, Shin-ei; Kubo, Nobuteru; Kuwako, Keiko; Saitoh, Jun-Ichi; Nakano, Takashi

    2014-07-01

    We investigated the rectal dose-sparing effect and tumor control of a point A dose-reduced plan in patients with Stage I-II cervical cancer (≤4 cm) arising from a small-sized uterus. Between October 2008 and August 2011, 19 patients with Stage I-II cervical cancer (≤4 cm) were treated with external beam radiotherapy (EBRT) for the pelvis and CT-guided brachytherapy. Seven patients were treated with brachytherapy with standard loading of source-dwell positions and a fraction dose of 6 Gy at point A (conventional brachy-plan). The other 12 patients with a small uterus close to the rectum or small intestine were treated with brachytherapy with a point A dose-reduction to match D2cc of the rectum and <6 Gy as the dose constraint ('point A dose-reduced plan') instead of the 6-Gy plan at point A ('tentative 6-Gy plan'). The total doses from EBRT and brachytherapy were added up and normalized to a biological equivalent dose of 2 Gy per fraction (EQD2). The median doses to the high-risk clinical target volume (HR-CTV) D90 in the conventional brachy-plan, tentative 6-Gy plan and point A dose-reduced plan were 62 GyEQD2, 80 GyEQD2 and 64 GyEQD2, respectively. The median doses of rectal D2cc in the corresponding three plans were 42 GyEQD2, 62 GyEQD2 and 51 GyEQD2, respectively. With a median follow-up period of 35 months, three patients developed Grade-1 late rectal complications and no patients developed local recurrence. Our preliminary results suggested that CT-guided brachytherapy using an individualized point A dose-reduced plan might be useful for reducing late rectal complications while maintaining primary tumor control.

  11. Cone beam CT for dental and maxillofacial imaging: dose matters.

    PubMed

    Pauwels, Ruben

    2015-07-01

    The widespread use of cone-beam CT (CBCT) in dentistry has led to increasing concern regarding justification and optimisation of CBCT exposures. When used as a substitute to multidetector CT (MDCT), CBCT can lead to significant dose reduction; however, low-dose protocols of current-generation MDCTs show that there is an overlap between CBCT and MDCT doses. More importantly, although the 3D information provided by CBCT can often lead to improved diagnosis and treatment compared with 2D radiographs, a routine or excessive use of CBCT would lead to a substantial increase of the collective patient dose. The potential use of CBCT for paediatric patients (e.g. developmental disorders, trauma and orthodontic treatment planning) further increases concern regarding its proper application. This paper provides an overview of justification and optimisation issues in dental and maxillofacial CBCT. The radiation dose in CBCT will be briefly reviewed. The European Commission's Evidence Based Guidelines prepared by the SEDENTEXCT Project Consortium will be summarised, and (in)appropriate use of CBCT will be illustrated for various dental applications.

  12. Electrolytic oxide reduction system

    DOEpatents

    Wiedmeyer, Stanley G; Barnes, Laurel A; Williamson, Mark A; Willit, James L; Berger, John F

    2015-04-28

    An electrolytic oxide reduction system according to a non-limiting embodiment of the present invention may include a plurality of anode assemblies, a plurality of cathode assemblies, and a lift system configured to engage the anode and cathode assemblies. The cathode assemblies may be alternately arranged with the anode assemblies such that each cathode assembly is flanked by two anode assemblies. The lift system may be configured to selectively engage the anode and cathode assemblies so as to allow the simultaneous lifting of any combination of the anode and cathode assemblies (whether adjacent or non-adjacent).

  13. Aluminum reduction cell electrode

    DOEpatents

    Payne, John R.

    1983-09-20

    The invention is directed to an anode-cathode structure for an electrolytic cell for the reduction of alumina wherein the structure is comprised of a carbon anode assembly which straddles a wedge-shaped refractory hard metal cathode assembly having steeply sloped cathodic surfaces, each cathodic surface being paired in essentially parallel planar relationship with an anode surface. The anode-cathode structure not only takes into account the structural weakness of refractory hard metal materials but also permits the changing of the RHM assembly during operation of the cell. Further, the anode-cathode structure enhances the removal of anode gas from the interpolar gap between the anode and cathode surfaces.

  14. Aircraft engine pollution reduction

    NASA Technical Reports Server (NTRS)

    Rudey, R. A.

    1972-01-01

    The effect of engine operation on the types and levels of the major aircraft engine pollutants is described and the major factors governing the formation of these pollutants during the burning of hydrocarbon fuel are discussed. Methods which are being explored to reduce these pollutants are discussed and their application to several experimental research programs are pointed out. Results showing significant reductions in the levels of carbon monoxide, unburned hydrocarbons, and oxides of nitrogen obtained from experimental combustion research programs are presented and discussed to point out potential application to aircraft engines.

  15. NSF grant reductions

    NASA Astrophysics Data System (ADS)

    Jones, R.

    Many National Science Foundation grants will be reduced this year as a result of a provision in H.R. 3299. The provision stems from disagreement between the Congress and the administration on how to make budget deficit cuts required by the Gramm-Rudman-Hollings budget law. An agreement was made to cut $4.55 billion through a reduction in discretionary spending, by what amounts to 1.4% across-the-board. The cuts will affect all discretionary federal domestic and defense programs.

  16. Meta-analysis of the impact of thioprine S-methyltransferase polymorphisms on the tolerable 6-mercaptopurine dose considering initial dose and ethnic difference

    PubMed Central

    Kim, Myeong Gyu; Ko, Minoh; Kim, In-Wha; Oh, Jung Mi

    2016-01-01

    A meta-analysis was conducted to decide whether to reduce an initial 6-mercaptopurine (6-MP) dose in TPMT heterozygote in the case of an initial 6-MP dose of <75 mg/m2/d and to compare the tolerable 6-MP dose among different ethnic groups. The study was undertaken according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The differences in mean values of the tolerable 6-MP dose were calculated by using Comprehensive Meta-Analysis version 3. The results of the meta-analysis indicated that the tolerable 6-MP dose was significantly lower in the TPMT heterozygote group (difference in mean values =11.729, 95% confidence interval =7.617–15.842, P<0.001) even when the initial 6-MP dose was <75 mg/m2/d. The TPMT*3C allele-dominant ethnic group (Asian) needed less reduction in mean 6-MP dose in comparison to the TPMT*3A allele-dominant ethnic group (Caucasian, Mediterranean, South American) (difference in mean values =8.884 vs 15.324). In conclusion, the initial 6-MP dose needs to be reduced in TPMT heterozygote when compared to the wild-type, and ethnic difference might influence the tolerable 6-MP dose in TPMT heterozygotes. PMID:27920553

  17. Reduction operators of Burgers equation.

    PubMed

    Pocheketa, Oleksandr A; Popovych, Roman O

    2013-02-01

    The solution of the problem on reduction operators and nonclassical reductions of the Burgers equation is systematically treated and completed. A new proof of the theorem on the special "no-go" case of regular reduction operators is presented, and the representation of the coefficients of operators in terms of solutions of the initial equation is constructed for this case. All possible nonclassical reductions of the Burgers equation to single ordinary differential equations are exhaustively described. Any Lie reduction of the Burgers equation proves to be equivalent via the Hopf-Cole transformation to a parameterized family of Lie reductions of the linear heat equation.

  18. Reduction operators of Burgers equation

    PubMed Central

    Pocheketa, Oleksandr A.; Popovych, Roman O.

    2013-01-01

    The solution of the problem on reduction operators and nonclassical reductions of the Burgers equation is systematically treated and completed. A new proof of the theorem on the special “no-go” case of regular reduction operators is presented, and the representation of the coefficients of operators in terms of solutions of the initial equation is constructed for this case. All possible nonclassical reductions of the Burgers equation to single ordinary differential equations are exhaustively described. Any Lie reduction of the Burgers equation proves to be equivalent via the Hopf–Cole transformation to a parameterized family of Lie reductions of the linear heat equation. PMID:23576819

  19. MO-PIS-Exhibit Hall-01: Imaging: CT Dose Optimization Technologies I

    SciTech Connect

    Denison, K; Smith, S

    2014-06-15

    Partners in Solutions is an exciting new program in which AAPM partners with our vendors to present practical “hands-on” information about the equipment and software systems that we use in our clinics. The imaging topic this year is CT scanner dose optimization capabilities. Note that the sessions are being held in a special purpose room built on the Exhibit Hall Floor, to encourage further interaction with the vendors. Dose Optimization Capabilities of GE Computed Tomography Scanners Presentation Time: 11:15 – 11:45 AM GE Healthcare is dedicated to the delivery of high quality clinical images through the development of technologies, which optimize the application of ionizing radiation. In computed tomography, dose management solutions fall into four categories: employs projection data and statistical modeling to decrease noise in the reconstructed image - creating an opportunity for mA reduction in the acquisition of diagnostic images. Veo represents true Model Based Iterative Reconstruction (MBiR). Using high-level algorithms in tandem with advanced computing power, Veo enables lower pixel noise standard deviation and improved spatial resolution within a single image. Advanced Adaptive Image Filters allow for maintenance of spatial resolution while reducing image noise. Examples of adaptive image space filters include Neuro 3-D filters and Cardiac Noise Reduction Filters. AutomA adjusts mA along the z-axis and is the CT equivalent of auto exposure control in conventional x-ray systems. Dynamic Z-axis Tracking offers an additional opportunity for dose reduction in helical acquisitions while SmartTrack Z-axis Tracking serves to ensure beam, collimator and detector alignment during tube rotation. SmartmA provides angular mA modulation. ECG Helical Modulation reduces mA during the systolic phase of the heart cycle. SmartBeam optimization uses bowtie beam-shaping hardware and software to filter off-axis x-rays - minimizing dose and reducing x-ray scatter. The

  20. Does administering iodine in radiological procedures increase patient doses?

    SciTech Connect

    He, Wenjun; Yao, Hai; Huda, Walter; Mah, Eugene

    2014-11-01

    Purpose: The authors investigated the changes in the pattern of energy deposition in tissue equivalent phantoms following the introduction of iodinated contrast media. Methods: The phantom consisted of a small “contrast sphere,” filled with water or iodinated contrast, located at the center of a 28 cm diameter water sphere. Monte Carlo simulations were performed using MCNP5 codes, validated by simulating irradiations with analytical solutions. Monoenergetic x-rays ranging from 35 to 150 keV were used to simulate exposures to spheres containing contrast agent with iodine concentrations ranging from 1 to 100 mg/ml. Relative values of energy imparted to the contrast sphere, as well as to the whole phantom, were calculated. Changes in patterns of energy deposition around the contrast sphere were also investigated. Results: Small contrast spheres can increase local absorbed dose by a factor of 13, but the corresponding increase in total energy absorbed was negligible (<1%). The highest localized dose increases were found to occur at incident photon energies of about 60 keV. For a concentration of about 10 mg/ml, typical of clinical practice, localized absorbed doses were generally increased by about a factor of two. At this concentration of 10 mg/ml, the maximum increase in total energy deposition in the phantom was only 6%. These simulations demonstrated that increases in contrast sphere doses were offset by corresponding dose reductions at distal and posterior locations. Conclusions: Adding iodine can result in values of localized absorbed dose increasing by more than an order of magnitude, but the total energy deposition is generally very modest (i.e., <10%). Their data show that adding iodine primarily changes the pattern of energy deposition in the irradiated region, rather than increasing patient doses per se.

  1. Islam and harm reduction.

    PubMed

    Kamarulzaman, A; Saifuddeen, S M

    2010-03-01

    Although drugs are haram and therefore prohibited in Islam, illicit drug use is widespread in many Islamic countries throughout the world. In the last several years increased prevalence of this problem has been observed in many of these countries which has in turn led to increasing injecting drug use driven HIV/AIDS epidemic across the Islamic world. Whilst some countries have recently responded to the threat through the implementation of harm reduction programmes, many others have been slow to respond. In Islam, The Quran and the Prophetic traditions or the Sunnah are the central sources of references for the laws and principles that guide the Muslims' way of life and by which policies and guidelines for responses including that of contemporary social and health problems can be derived. The preservation and protection of the dignity of man, and steering mankind away from harm and destruction are central to the teachings of Islam. When viewed through the Islamic principles of the preservation and protection of the faith, life, intellect, progeny and wealth, harm reduction programmes are permissible and in fact provide a practical solution to a problem that could result in far greater damage to the society at large if left unaddressed.

  2. Core Noise Reduction

    NASA Technical Reports Server (NTRS)

    Hultgren, Lennart S.

    2011-01-01

    This presentation is a technical summary of and outlook for NASA-internal and NASA-sponsored external research on core (combustor and turbine) noise funded by the Fundamental Aeronautics Program Subsonic Fixed Wing (SFW) Project. Sections of the presentation cover: the SFW system-level noise metrics for the 2015, 2020, and 2025 timeframes; turbofan design trends and their aeroacoustic implications; the emerging importance of core noise and its relevance to the SFW Reduce-Perceived-Noise Technical Challenge; and the current research activities in the core noise area. Recent work1 on the turbine-transmission loss of combustor noise is briefly described, two2,3 new NRA efforts in the core-noise area are outlined, and an effort to develop CMC-based acoustic liners for broadband noise reduction suitable for turbofan-core application is delineated. The NASA Fundamental Aeronautics Program has the principal objective of overcoming today's national challenges in air transportation. The reduction of aircraft noise is critical to enabling the anticipated large increase in future air traffic. The Subsonic Fixed Wing Project's Reduce-Perceived-Noise Technical Challenge aims to develop concepts and technologies to dramatically reduce the perceived aircraft noise outside of airport boundaries.

  3. Microbial reduction of iodate

    USGS Publications Warehouse

    Councell, T.B.; Landa, E.R.; Lovley, D.R.

    1997-01-01

    The different oxidation species of iodine have markedly different sorption properties. Hence, changes in iodine redox states can greatly affect the mobility of iodine in the environment. Although a major microbial role has been suggested in the past to account for these redox changes, little has been done to elucidate the responsible microorganisms or the mechanisms involved. In the work presented here, direct microbial reduction of iodate was demonstrated with anaerobic cell suspensions of the sulfate reducing bacterium Desulfovibrio desulfuricans which reduced 96% of an initial 100 ??M iodate to iodide at pH 7 in 30 mM NaHCO3 buffer, whereas anaerobic cell suspensions of the dissimilatory Fe(III)-reducing bacterium Shewanella putrefaciens were unable to reduce iodate in 30 mM NaHCO3 buffer (pH 7). Both D. desulfuricans and S. putrefaciens were able to reduce iodate at pH 7 in 10 mM HEPES buffer. Both soluble ferrous iron and sulfide, as well as iron monosulfide (FeS) were shown to abiologically reduce iodate to iodide. These results indicate that ferric iron and/or sulfate reducing bacteria are capable of mediating both direct, enzymatic, as well as abiotic reduction of iodate in natural anaerobic environments. These microbially mediated reactions may be important factors in the fate and transport of 129I in natural systems.

  4. Harm Reduction From Below

    PubMed Central

    Van Schipstal, Inge; Berning, Moritz; Murray, Hayley

    2016-01-01

    This article focuses on how recreational drug users in the Netherlands and in online communities navigate the risks and reduce the harms they associate with psychoactive drug use. To do so, we examined the protective practices they invent, use, and share with their immediate peers and with larger drug experimenting communities online. The labor involved in protective practices and that which ultimately informs harm reduction from below follows three interrelated trajectories: (1) the handling and sharing of drugs to facilitate hassle-free drug use, (2) creating pleasant and friendly spaces that we highlight under the practices of drug use attunements, and (3) the seeking and sharing of information in practices to spread the good high. We focus not only on users’ concerns but also on how these concerns shape their approach to drugs, what young people do to navigate uncertainties, and how they reach out to and create different sources of knowledge to minimize adversities and to improve highs. Harm reduction from below, we argue, can best be seen in the practices of sharing around drug use and in the caring for the larger community of drug-using peers. PMID:27721525

  5. The Dose Makes the Poison.

    ERIC Educational Resources Information Center

    Ottoboni, Alice

    1992-01-01

    A Toxicologist discusses common misconception that all chemicals are poisonous to people and the environment and how these misconceptions are perpetuated. Describes what makes a chemical toxic. Defines related concepts including dose, acute and chronic toxicity, and natural verses synthetic chemicals. (MCO)

  6. The air dose rate around the Fukushima Dai-ichi Nuclear Power Plant: its spatial characteristics and temporal changes until December 2012.

    PubMed

    Mikami, Satoshi; Maeyama, Takeshi; Hoshide, Yoshifumi; Sakamoto, Ryuichi; Sato, Shoji; Okuda, Naotoshi; Sato, Tetsuro; Takemiya, Hiroshi; Saito, Kimiaki

    2015-01-01

    Distribution maps of air dose rates around the Fukushima Dai-ichi Nuclear Power Plant were constructed using the results of measurement obtained from approximately 6500 locations (at most) per measurement period. The measurements were conducted 1 m above the ground using survey meters in flat and spatially open locations. Spatial distribution and temporal change of the air dose rate in the area were revealed by examining the resultant distribution maps. The observed reduction rate of the air dose rate over the 18 months between June 2011 and December 2012 was greater than that calculated from radioactive decay of radiocesium by 10% in relative percentage except decontaminated sites. This 10% difference in the reduction of the air dose rate can be explained by the mobility of radiocesium in the depth direction. In the region where the air dose rate was lower than 0.25 μSv h(-1) on June 2011, the reduction of the air dose rate was observed to be smaller than that of the other dose rate regions, and it was in fact smaller than the reduction rate caused by radioactive decay alone. In contrast, the reduction rate was larger in regions with higher air dose rates. In flat and spatially open locations, no significant difference in the reduction tendency of air dose rates was observed among different land use classifications (rice fields, farmland, forests, and building sites).

  7. [Side effects of postoperative irradiation of uterine cancer with high dose rate iridium and low dose rate radium].

    PubMed

    Kucera, H; Unel, N; Weghaupt, K

    1986-02-01

    A report is given about reversible and irreversible complications following postoperative irradiation in cases of endometrial carcinoma. Intravaginal brachytherapy was performed. In advanced cases or in cases with poor prognosis (tumor grading) percutaneous irradiation was added (Co60). In 156 cases low-dose-rate irradiation (Ra226) and in 143 cases high-dose-rate irradiation (Ir192) was applied intravaginally. Reversible complications (cystitis, proctitis) could be observed following Radium in 7%, following Iridium in 14%. Irreversible complications (fistulas, stenoses): 1.9% following Radium and 3.5% following Iridium. When high-dose-rate irradiation was combined with percutaneous Co60 therapy, reversible complications occurred in 22.8%. After changing the Iridium-therapy scheme (reduction of dose from 10 to 7 Gy and irradiation only of the upper two thirds of the vagina) complications only could be observed in the same level as in Radium-therapy. High-dose-rate irradiation does not need hospitalization of the patients.

  8. Heart rate reduction and longevity in mice.

    PubMed

    Gent, Sabine; Kleinbongard, Petra; Dammann, Philip; Neuhäuser, Markus; Heusch, Gerd

    2015-03-01

    Heart rate correlates inversely with life span across all species, including humans. In patients with cardiovascular disease, higher heart rate is associated with increased mortality, and such patients benefit from pharmacological heart rate reduction. However, cause-and-effect relationships between heart rate and longevity, notably in healthy individuals, are not established. We therefore prospectively studied the effects of a life-long pharmacological heart rate reduction on longevity in mice. We hypothesized, that the total number of cardiac cycles is constant, and that a 15% heart rate reduction might translate into a 15% increase in life span. C57BL6/J mice received either placebo or ivabradine at a dose of 50 mg/kg/day in drinking water from 12 weeks to death. Heart rate and body weight were monitored. Autopsy was performed on all non-autolytic cadavers, and parenchymal organs were evaluated macroscopically. Ivabradine reduced heart rate by 14% (median, interquartile range 12-15%) throughout life, and median life span was increased by 6.2% (p = 0.01). Body weight and macroscopic findings were not different between placebo and ivabradine. Life span was not increased to the same extent as heart rate was reduced, but nevertheless significantly prolonged by 6.2%.

  9. EXOMARS IRAS (DOSE) radiation measurements.

    NASA Astrophysics Data System (ADS)

    Federico, C.; Di Lellis, A. M.; Fonte, S.; Pauselli, C.; Reitz, G.; Beaujean, R.

    The characterization and the study of the radiations on their interaction with organic matter is of great interest in view of the human exploration on Mars. The Ionizing RAdiation Sensor (IRAS) selected in the frame of the ExoMars/Pasteur ESA mission is a lightweight particle spectrometer combining various techniques of radiation detection in space. It characterizes the first time the radiation environment on the Mars surface, and provide dose and dose equivalent rates as precursor information absolutely necessary to develop ways to mitigate the radiation risks for future human exploration on Mars. The Martian radiation levels are much higher than those found on Earth and they are relatively low for space. Measurements on the surface will show if they are similar or not to those seen in orbit (modified by the presence of ``albedo'' neutrons produced in the regolith and by the thin Martian atmosphere). IRAS consists of a telescope based on segmented silicon detectors of about 40\\userk\\milli\\metre\\user;k diameter and 300\\user;k\\micro\\metre\\user;k thickness, a segmented organic scintillator, and of a thermoluminescence dosimeter. The telescope will continuously monitor temporal variation of the particle count rate, the dose rate, particle and LET (Linear Energy Transfer) spectra. Tissue equivalent BC430 scintillator material will be used to measure the neutron dose. Neutrons are selected by a criteria requiring no signal in the anti-coincidence. Last, the passive thermoluminescence dosimeter, based on LiF:Mg detectors, regardless the on board operation timing, will measure the total dose accumulated during the exposure period and due to beta and gamma radiation, with a responsivity very close to that of a human tissue.

  10. [Absorbed doses in dental radiology].

    PubMed

    Bianchi, S D; Roccuzzo, M; Albrito, F; Ragona, R; Anglesio, S

    1996-01-01

    The growing use of dento-maxillo-facial radiographic examinations has been accompanied by the publication of a large number of studies on dosimetry. A thorough review of the literature is presented in this article. Most studies were carried out on tissue equivalent skull phantoms, while only a few were in vivo. The aim of the present study was to evaluate in vivo absorbed doses during Orthopantomography (OPT). Full Mouth Periapical Examination (FMPE) and Intraoral Tube Panoramic Radiography (ITPR). Measurements were made on 30 patients, reproducing clinical conditions, in 46 anatomical sites, with 24 intra- and 22 extra-oral thermoluminiscent dosimeters (TLDS). The highest doses were measured, in orthopantomography, at the right mandibular angle (1899 mu Gy) in FMPE on the right naso-labial fold (5640 mu Gy and in ITPR on the palatal surface of the left second upper molar (1936 mu Gy). Intraoral doses ranged from 21 mu Gy, in orthopantomography, to 4494 mu Gy in FMPE. Standard errors ranged from 142% in ITPR to 5% in orthopantomography. The highest rate of standard errors was found in FMPE and ITPR. The data collected in this trial are in agreement with others in major literature reports. Disagreements are probably due to different exam acquisition and data collections. Such differences, presented comparison in several sites, justify lower doses in FMPE and ITPR. Advantages and disadvantages of in vivo dosimetry of the maxillary region are discussed, the former being a close resemblance to clinical conditions of examination and the latter the impossibility of collecting values in depth of tissues. Finally, both ITPR and FMPE required lower doses than expected, and can be therefore reconsidered relative to their radiation risk.

  11. A MULTIMODEL APPROACH FOR CALCULATING BENCHMARK DOSE

    EPA Science Inventory


    A Multimodel Approach for Calculating Benchmark Dose
    Ramon I. Garcia and R. Woodrow Setzer

    In the assessment of dose response, a number of plausible dose- response models may give fits that are consistent with the data. If no dose response formulation had been speci...

  12. Human Collagen Injections to Reduce Rectal Dose During Radiotherapy

    SciTech Connect

    Noyes, William R.; Hosford, Charles C.; Schultz, Steven E.

    2012-04-01

    Objectives: The continuing search for interventions, which address the incidence and grade of rectal toxicities associated with radiation treatment of prostate cancer, is a major concern. We are reporting an investigational trial using human collagen to increase the distance between the prostate and anterior rectal wall, thereby decreasing the radiation dose to the rectum. Methods: This is a pilot study evaluating the use of human collagen as a displacing agent for the rectal wall injected before starting a course of intensity-modulated radiotherapy (IMRT) for prostate cancer. Using a transperineal approach, 20 mL of human collagen was injected into the perirectal space in an outpatient setting. Computerized IMRT plans were performed pre- and postcollagen injection, and after a patient completed their radiotherapy, to determine radiation dose reduction to the rectum associated with the collagen injection. Computed tomography scans were performed 6 months and 12 months after completing their radiotherapy to evaluate absorption rate of the collagen. All patients were treated with IMRT to a dose of 75.6 Gy to the prostate. Results: Eleven patients were enrolled into the study. The injection of human collagen in the outpatient setting was well tolerated. The mean separation between the prostate and anterior rectum was 12.7 mm. The mean reduction in dose to the anterior rectal wall was 50%. All men denied any rectal symptoms during the study. Conclusions: The transperineal injection of human collagen for the purpose of tissue displacement is well tolerated in the outpatient setting. The increased separation between the prostate and rectum resulted in a significant decrease in radiation dose to the rectum while receiving IMRT and was associated with no rectal toxicities.

  13. Evaluation of a low-dose neonatal chest radiographic system

    SciTech Connect

    Burton, E.M.; Kirks, D.R.; Strife, J.L.; Henry, G.C.; Kereiakes, J.G.

    1988-11-01

    A new low-dose chest radiographic system for use in the neonatal nursery was evaluated. This test system, composed of a Du Pont Kevlar fiber-front cassette, Quanta fast-detail screen, Cronex 4L film (wide latitude), and additional yttrium filtration (0.1 mm), reduced the radiation dose in neonatal chest radiography by 69% (0.9 vs 2.9 mrad (0.009 vs 0.029 mGy)) as compared with a conventional system without added yttrium filtration; the thyroid dose was reduced by 76% (0.9 vs 3.7 mrad (0.009 vs 0.037 mGy)). The cumulative dose reduction was achieved through a combination of factors, including (1) beam hardening by the added yttrium filter, (2) increased X-ray transmission through the Kevlar cassette, and (3) a fast film-screen combination. Scatter radiation at distances of 1 and 6 ft. (0.3 and 1.8 m) was negligible for both systems. Image sharpness was compared for the conventional system with and without added yttrium filtration and for the Kevlar system with yttrium. Although sharpness of bony detail was unchanged by adding yttrium filtration to the conventional system, a decrease in sharpness was noted with the Kevlar system. Because image sharpness was affected in the test system, we are not using the Kevlar-Cronex 4L system for mobile chest radiography in the neonatal intensive care unit, despite dose reductions. However, further study is recommended to determine if there is a slower film-screen combination with yttrium filtration that will not degrade image sharpness.

  14. Filtration to reduce paediatric dose for a linear slot-scanning digital X-ray machine.

    PubMed

    Perks, T D; Dendere, R; Irving, B; Hartley, T; Scholtz, P; Lawson, A; Trauernicht, C; Steiner, S; Douglas, T S

    2015-12-01

    This paper describes modelling, application and validation of a filtration technique for a linear slot-scanning digital X-ray system to reduce radiation dose to paediatric patients while preserving diagnostic image quality. A dose prediction model was implemented, which calculates patient entrance doses using variable input parameters. Effective dose is calculated using a Monte Carlo simulation. An added filter of 1.8-mm aluminium was predicted to lower the radiation dose significantly. An objective image quality study was conducted using detective quantum efficiency (DQE). The PTW Normi 4FLU test phantom was used for quantitative assessment, showing that image contrast and spatial resolution were maintained with the proposed filter. A paediatric cadaver full-body imaging trial assessed the diagnostic quality of the images and measured the dose reduction using a 1.8-mm aluminium filter. Assessment by radiologists indicated that diagnostic quality was maintained with the added filtration, despite a reduction in DQE. A new filtration technique for full-body paediatric scanning on the Lodox Statscan has been validated, reducing entrance dose for paediatric patients by 36 % on average and effective dose by 27 % on average, while maintaining image quality.

  15. Peripheral dose measurement for CyberKnife radiosurgery with upgraded linac shielding

    SciTech Connect

    Chuang, Cynthia F.; Larson, David A.; Zytkovicz, Andrea; Smith, Vernon; Petti, Paula L.

    2008-04-15

    The authors investigated the peripheral dose reduction for CyberKnife radiosurgery treatments after the installation of a linac shielding upgrade. As in a previous investigation, the authors considered two treatment plans, one for a hypothetical target in the brain and another for a target in the thorax, delivered to an anthropomorphic phantom. The results of the prior investigation showed that the CyberKnife delivered significantly higher peripheral doses than comparable model C Gamma Knife or IMRT treatments. Current measurements, after the linac shielding upgrade, demonstrate that the additional shielding decreased the peripheral dose, expressed as a percentage of the delivered monitor units (MU), by a maximum of 59%. The dose reduction was greatest for cranial-caudal distances from the field edge less than 30 cm, and at these distances, the CyberKnife peripheral dose, expressed as a percentage of the delivered MU, is now comparable to that measured for the other treatment modalities in our previous investigation. For distances between 30 and 70 cm from the field edge, the additional shielding reduced the peripheral dose by between 20% and 55%. At these distances, the CyberKnife peripheral dose remains higher than doses measured in our previous study for the model C Gamma Knife and IMRT.

  16. Joint Minimization of Uplink and Downlink Whole-Body Exposure Dose in Indoor Wireless Networks

    PubMed Central

    Plets, D.; Joseph, W.; Vanhecke, K.; Vermeeren, G.; Wiart, J.; Aerts, S.; Varsier, N.; Martens, L.

    2015-01-01

    The total whole-body exposure dose in indoor wireless networks is minimized. For the first time, indoor wireless networks are designed and simulated for a minimal exposure dose, where both uplink and downlink are considered. The impact of the minimization is numerically assessed for four scenarios: two WiFi configurations with different throughputs, a Universal Mobile Telecommunications System (UMTS) configuration for phone call traffic, and a Long-Term Evolution (LTE) configuration with a high data rate. Also, the influence of the uplink usage on the total absorbed dose is characterized. Downlink dose reductions of at least 75% are observed when adding more base stations with a lower transmit power. Total dose reductions decrease with increasing uplink usage for WiFi due to the lack of uplink power control but are maintained for LTE and UMTS. Uplink doses become dominant over downlink doses for usages of only a few seconds for WiFi. For UMTS and LTE, an almost continuous uplink usage is required to have a significant effect on the total dose, thanks to the power control mechanism. PMID:25793213

  17. Joint minimization of uplink and downlink whole-body exposure dose in indoor wireless networks.

    PubMed

    Plets, D; Joseph, W; Vanhecke, K; Vermeeren, G; Wiart, J; Aerts, S; Varsier, N; Martens, L

    2015-01-01

    The total whole-body exposure dose in indoor wireless networks is minimized. For the first time, indoor wireless networks are designed and simulated for a minimal exposure dose, where both uplink and downlink are considered. The impact of the minimization is numerically assessed for four scenarios: two WiFi configurations with different throughputs, a Universal Mobile Telecommunications System (UMTS) configuration for phone call traffic, and a Long-Term Evolution (LTE) configuration with a high data rate. Also, the influence of the uplink usage on the total absorbed dose is characterized. Downlink dose reductions of at least 75% are observed when adding more base stations with a lower transmit power. Total dose reductions decrease with increasing uplink usage for WiFi due to the lack of uplink power control but are maintained for LTE and UMTS. Uplink doses become dominant over downlink doses for usages of only a few seconds for WiFi. For UMTS and LTE, an almost continuous uplink usage is required to have a significant effect on the total dose, thanks to the power control mechanism.

  18. Sonoassisted microbial reduction of chromium.

    PubMed

    Kathiravan, Mathur Nadarajan; Karthick, Ramalingam; Muthu, Naggapan; Muthukumar, Karuppan; Velan, Manickam

    2010-04-01

    This study presents sonoassisted microbial reduction of hexavalent chromium (Cr(VI)) using Bacillus sp. isolated from tannery effluent contaminated site. The experiments were carried out with free cells in the presence and absence of ultrasound. The optimum pH and temperature for the reduction of Cr(VI) by Bacillus sp. were found to be 7.0 and 37 degrees C, respectively. The Cr(VI) reduction was significantly influenced by the electron donors and among the various electron donors studied, glucose offered maximum reduction. The ultrasound-irradiated reduction of Cr(VI) with Bacillus sp. showed efficient Cr(VI) reduction. The percent reduction was found to increase with an increase in biomass concentration and decrease with an increase in initial concentration. The changes in the functional groups of Bacillus sp., before and after chromium reduction were observed with FTIR spectra. Microbial growth was described with Monod and Andrews model and best fit was observed with Andrews model.

  19. Tank Z-361 dose rate calculations

    SciTech Connect

    Richard, R.F.

    1998-09-30

    Neutron and gamma ray dose rates were calculated above and around the 6-inch riser of tank Z-361 located at the Plutonium Finishing Plant. Dose rates were also determined off of one side of the tank. The largest dose rate 0.029 mrem/h was a gamma ray dose and occurred 76.2 cm (30 in.) directly above the open riser. All other dose rates were negligible. The ANSI/ANS 1991 flux to dose conversion factor for neutrons and photons were used in this analysis. Dose rates are reported in units of mrem/h with the calculated uncertainty shown within the parentheses.

  20. Online measurement of dose and dose distribution at bremsstrahlung facilities

    NASA Astrophysics Data System (ADS)

    Auslender, V. L.; Bryazgin, A. A.; Bukin, A. D.; Voronin, L. A.; Lukin, A. N.; Sidorov, A. V.

    2004-09-01

    A real-time measurement system of the spatial dose distribution is developed and realized for monitoring the bremsstrahlung flow generated on X-ray target by 5 MeV 50 kW electron accelerator. The sensors of the system consist of semiconductor diodes. The beam target and electron accelerator (ILU-10) are briefly described. The practice of using the system in the experimental and start-up procedure is included.

  1. Experimental benchmarking of a Monte Carlo dose simulation code for pediatric CT

    NASA Astrophysics Data System (ADS)

    Li, Xiang; Samei, Ehsan; Yoshizumi, Terry; Colsher, James G.; Jones, Robert P.; Frush, Donald P.

    2007-03-01

    In recent years, there has been a desire to reduce CT radiation dose to children because of their susceptibility and prolonged risk for cancer induction. Concerns arise, however, as to the impact of dose reduction on image quality and thus potentially on diagnostic accuracy. To study the dose and image quality relationship, we are developing a simulation code to calculate organ dose in pediatric CT patients. To benchmark this code, a cylindrical phantom was built to represent a pediatric torso, which allows measurements of dose distributions from its center to its periphery. Dose distributions for axial CT scans were measured on a 64-slice multidetector CT (MDCT) scanner (GE Healthcare, Chalfont St. Giles, UK). The same measurements were simulated using a Monte Carlo code (PENELOPE, Universitat de Barcelona) with the applicable CT geometry including bowtie filter. The deviations between simulated and measured dose values were generally within 5%. To our knowledge, this work is one of the first attempts to compare measured radial dose distributions on a cylindrical phantom with Monte Carlo simulated results. It provides a simple and effective method for benchmarking organ dose simulation codes and demonstrates the potential of Monte Carlo simulation for investigating the relationship between dose and image quality for pediatric CT patients.

  2. In vivo dosimetry for estimation of effective doses in multislice CT coronary angiography

    SciTech Connect

    De Denaro, M.; Bregant, P.; Severgnini, M.; De Guarrini, F.

    2007-10-15

    In vivo dosimetry represents a technique that has been widely employed to evaluate the dose to the patient mainly in radiotherapy. Considering the increment in dose to the population due to new high-dose multislice CT examinations, such as coronary angiography, it is becoming important to more accurately know the dose to the patient. The desire to know patient dose extends even to radiological examinations. Thermoluminescent dosimeters are considered the gold standard for in vivo dosimetry, but their use is time consuming. A rapid, less labor-intensive method has been developed to perform in vivo dosimetry using radiochromic film positioned next to the patient's skin. Multislice CT scanners allow the estimation of the effective dose to the patient from the dose length product (DLP) parameter, the value of which is displayed on the acquisition console, simply multiplying the DLP by published conversion factors. The method represents only an approximation based on standard size circular phantoms and neglects the actual size of the patient. More accurate evaluations can be carried out using software-based Monte Carlo simulations. However, these methods do not consider possible dose reduction techniques, such as automatic tube-current modulation. For 22 patients effective doses measured by in vivo dosimetry and calculated by software were compared. The technique of using in vivo dosimetry measured with radiochromic film appears a promising procedure for improving the assessment of the effective dose to the patient.

  3. Analysis of dose rates received around the storage pool for irradiated control rods in a BWR nuclear power plant.

    PubMed

    Ródenas, J; Abarca, A; Gallardo, S

    2011-08-01

    BWR control rods are activated by neutron reactions in the reactor. The dose produced by this activity can affect workers in the area surrounding the storage pool, where activated rods are stored. Monte Carlo (MC) models for neutron activation and dose assessment around the storage pool have been developed and validated. In this work, the MC models are applied to verify the expected reduction of dose when the irradiated control rod is hanged in an inverted position into the pool.

  4. [Effectiveness of various dopamine doses in acute myocardial ischemia complicated by cardiogenic shock (an experimental study)].

    PubMed

    Kipshidze, N N; Korotkov, A A; Marsagishvili, L A; Prigolashvili, T Sh; Bokhua, M R

    1981-06-01

    The effect of various doses of dopamine on the values of cardiac contractile and hemodynamic function under conditions of acute two-hour ischemia complicated by cardiogenic shock was studied in 27 experiments on dogs. In a dose of 5 microgram/kg/min dopamine caused an optimum increase in cardiac productive capacity, reduction of peripheral resistance, adequate increase in coronary circulation and decrease in ST segment depression on the ECG. Infusion of 10 microgram/kg/min dopamine usually caused myocardial hyperfunction with an increase in total peripheral resistance and cardiac performance. Maximum dopamine doses (10 microgram/kg/min and more) were effective in the areactive form of cardiogenic shock. In longterm dopamine infusion it is necessary to establish continuous control over the hemodynamic parameters and the ECG to prevent aggravation of ischemia and for stage-by-stage reduction of the drug concentration and determination of the minimum maintenance dose.

  5. Oral microflora and selection of resistance after a single dose of amoxicillin.

    PubMed

    Khalil, D; Hultin, M; Rashid, M U; Lund, B

    2016-11-01

    The study aimed to determine the effects of a single-dose antibiotic prophylaxis on normal oral microflora. A single dose of 2 g amoxicillin was given to 29 healthy volunteers. Saliva was collected before antibiotic administration (day 1), and again on days 2, 5, 10, 17 and 24 and subjected to culturing and antibiotic sensitivity analysis. Twenty-one per cent (6/29) of the individuals carried penicillin-V- and amoxicillin-resistant viridans streptococci before antibiotic administration. After a single dose of amoxicillin there was a significant reduction in Streptococcus salivarius on days 2 and 5, a significant reduction in other viridans streptococci on day 2 and the proportion of viridans streptococci with reduced susceptibility to amoxicillin was significantly increased on days 2 and 5. A single dose of amoxicillin can cause an ecological disturbance and induce selection of resistant strains in the oral microflora.

  6. A multi-phased study of optimisation methodologies and radiation dose savings for head CT examinations.

    PubMed

    Zarb, Francis; McEntee, Mark F; Rainford, Louise

    2015-03-01

    The impact of optimisation methods on dose reductions for head computerised tomography was undertaken in three phases for two manufacturer models. Phase 1: a Catphan(®)600 was employed to evaluate protocols where the impact of parameter manipulation on dose and image quality was gauged by psychophysical measurements of contrast and spatial resolution in terms of contrast discs and line pairs. mA, kV and pitch were systematically altered until the optimisation threshold was identified. Phantom studies provide dose comparisons during optimisation but lack anatomical detail. Phase 2: optimised protocols were tested on a porcine model permitting further dose reductions over phantom findings providing anatomical structures for image quality evaluation using relative visual grading analysis of anatomical criteria. Phase 3: patient images using pre- and post-optimised protocols were clinically audited using visual grading characteristic analysis and ordinal regression analysis providing a robust analysis of image quality data prior to clinical implementation.

  7. Serum phosphorus reduction in dialysis patients treated with cinacalcet for secondary hyperparathyroidism results mainly from parathyroid hormone reduction

    PubMed Central

    Zitt, Emanuel; Fouque, Denis; Jacobson, Stefan H.; Malberti, Fabio; Ryba, Miroslav; Ureña, Pablo; Rix, Marianne; Dehmel, Bastian; Manamley, Nick; Vervloet, Marc

    2013-01-01

    Background The calcimimetic cinacalcet lowers parathyroid hormone (PTH), calcium (Ca) and phosphorus (P) in dialysis patients with secondary hyperparathyroidism (SHPT). We explored serum P changes in dialysis patients treated with cinacalcet, while controlling for vitamin D sterol and phosphate binder (PB) changes, based on data from the pan-European observational study ECHO. Methods Patients were categorized by serum P change (decreased/unchanged/increased) at 12 months after starting cinacalcet and subcategorized by vitamin D sterol and PB dose changes (decreased/unchanged/increased). The impact of P