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Inverse planning for four-dimensional (4D) volumetric modulated arc therapy
 
" Purpose: To develop a 4D volumetric modulated arc therapy (VMAT) inverse planning framework. Methods: 4D VMAT inverse planning aims to derive an aperture and weight modulated arc therapy treatment plan that optimizes the accumulated dose distribution from all gantry angles and breathing phases. Under an assumption that the gantry rotation and patient breathing are synchronized (i.e., there is a functional relationship between the phase of the patient breathing cycle and the beam angle), the authors compute the contribution from different respiration phases through the registration of the phased CT images. The accumulative dose distribution is optimized by iteratively adjusting the aperture shape and weight of each beam through the minimization of the planning objective function. For comparison, traditional 3D VMAT plans are also performed for the two cases and the performance of the proposed technique is demonstrated. Results: A framework for 4D VMAT inverse planning has been proposed. With the consideration of the extra dimension of time in VMAT, a tighter target margin can be achieved with a full duty cycle, which is otherwise not achievable simultaneously by either 3D VMAT optimization or gated VMAT. Conclusions: The 4D VMAT planning formulism proposed here provides useful insight on how the “time” dimension can be exploited in rotational arc therapy to maximally compensate for the intrafraction organ motion. © 2010 American Association of Physicists in Medicine " [+ leia mais]
Colaborador: Laura Natal
Fonte: Medical Physics
 
 
Guia de Seguridad del OIEA
 
"Creación de competencia en materia de protección radiológica y uso seguro de las fuentes de radiación" [+ leia mais]
Colaborador: Laura Natal
Fonte: Pub.IAEA
 
 
Spectral perturbations from silicon diode detector encapsulation and shielding in photon fields
 
" Purpose: Silicon diodes are widely used as detectors for relative dose measurements in radiotherapy. The common manufacturing practice is to encapsulate the diodes in plastic for protection and to facilitate mounting in scanning devices. Diodes intended for use in photon fields commonly also have a shield of a high atomic number material (usually tungsten) integrated into the encapsulation to selectively absorb low-energy photons to which silicon diodes would otherwise over-response. However, new response models based on cavity theories and spectra calculations have been proposed for direct correction of the readout from unshielded (e.g., “electron”) diodes used in photon fields. This raises the question whether it is correct to assume that the spectrum in a water phantom at the location of the detector cavity is not perturbed by the detector encapsulation materials. The aim of this work is to investigate the spectral effects of typical encapsulations, including shielding, used for clinical diodes. Methods: The effects of detector encapsulation of an unshielded and a shielded commercial diode on the spectra at the detector cavity location are studied through Monte Carlo simulations with PENELOPE-2005. Variance reduction based on correlated sampling is applied to reduce the CPU time needed for the simulations. Results: The use of correlated sampling is found to be efficient and to not introduce any significant bias to the results. Compared to reference spectra calculated in water, the encapsulation for an unshielded diode is demonstrated to not perturb the spectrum, while a tungsten shielded diode caused not only the desired decrease in low-energy scattered photons but also a large increase of the primary electron fluence. Measurements with a shielded diode in a 6 MV photon beam proved that the shielding does not completely remove the field-size dependence of the detector response caused by the over-response from low-energy photons. Response factors of a properly corrected unshielded diode were shown to give comparable, or better, results than the traditionally used shielded diode. Conclusions: Spectra calculated for photon fields in water can be directly used for modeling the response of unshielded silicon diodes with plastic encapsulations. Unshielded diodes used together with appropriate corrections can replace shielded diodes in photon dose measurements. © 2010 American Association of Physicists in Medicine " [+ leia mais]
Colaborador: Laura Natal
Fonte: Medical Physics
 
 
Monte Carlo calculations of kQ, the beam quality conversion factor
 
" Purpose: To use EGSnrc Monte Carlo simulations to directly calculate beam quality conversion factors, kQ, for 32 cylindrical ionization chambers over a range of beam qualities and to quantify the effect of systematic uncertainties on Monte Carlo calculations of kQ. These factors are required to use the TG-51 or TRS-398 clinical dosimetry protocols for calibrating external radiotherapy beams. Methods: Ionization chambers are modeled either from blueprints or manufacturers’ user’s manuals. The dose-to-air in the chamber is calculated using the EGSnrc user-code egs_chamber using 11 different tabulated clinical photon spectra for the incident beams. The dose to a small volume of water is also calculated in the absence of the chamber at the midpoint of the chamber on its central axis. Using a simple equation, kQ is calculated from these quantities under the assumption that W/e is constant with energy and compared to TG-51 protocol and measured values. Results: Polynomial fits to the Monte Carlo calculated kQ factors as a function of beam quality expressed as %dd(10)x and TPR1020 are given for each ionization chamber. Differences are explained between Monte Carlo calculated values and values from the TG-51 protocol or calculated using the computer program used for TG-51 calculations. Systematic uncertainties in calculated kQ values are analyzed and amount to a maximum of one standard deviation uncertainty of 0.99% if one assumes that photon cross-section uncertainties are uncorrelated and 0.63% if they are assumed correlated. The largest components of the uncertainty are the constancy of W/e and the uncertainty in the cross-section for photons in water. Conclusions: It is now possible to calculate kQ directly using Monte Carlo simulations. Monte Carlo calculations for most ionization chambers give results which are comparable to TG-51 values. Discrepancies can be explained using individual Monte Carlo calculations of various correction factors which are more accurate than previously used values. For small ionization chambers with central electrodes composed of high-Z materials, the effect of the central electrode is much larger than that for the aluminum electrodes in Farmer chambers. © 2010 American Association of Physicists in Medicine ACKNOWLEDGMENTS The authors thank Joerg Wulff for making the egs_chamber user-code available before it was distributed with EGSnrc code system. The authors thank Brian Hooten of Standard Imaging for providing blueprints of Exradin ion chambers and Igor Gomola of IBA for providing technical drawings of the CC01 ion chamber. The authors thank Iwan Kawrakow for useful discussions about correlated uncertainties and Roberto Capote for useful discussions about correlated dose ratios. Thanks to Elsayed Ali, Rowan Thomson, and Justin Sutherland of the CLRP for helpful comments on the manuscript. This work is supported by an OGSST scholarship held by B.R. Muir, by NSERC, CRC program, CFI, and OIT. " [+ leia mais]
Colaborador: Laura Natal
Fonte: Medical Physics
 
 
Safeguards Symposium opens in Vienna, Austria
 
"Vienna, 1 November 2010 |The future challenges facing the IAEA in its efforts to prevent nuclear materials from being used to produce weapons are being discussed from 1-5 November in Vienna, Austria. Over 700 experts are meeting for a symposium on international Safeguards at the IAEA headquarters. The event brings together representatives of the IAEA|s Member States, the nuclear industry and members of the broader nuclear non-proliferation community. It provides an opportunity for the participants to jointly explore possible solutions to the various challenges of the future, in support of the IAEA|s nuclear verification mission. Most countries around the world use nuclear techniques for a variety of peaceful purposes. To ensure that these nuclear programmes are not misused the IAEA has developed a system of Safeguards Agreements. Around 170 states have entered into such agreements with the IAEA, submitting nuclear materials, facilities and activities to the scrutiny of the IAEA|s inspectors. The IAEA currently inspects over 900 nuclear facilities and in 2009 around 2000 inspections were performed. The nuclear landscape is constantly evolving. With global interest in nuclear power generation increasing, the demands on the IAEA look set to rise. This offers both challenges and opportunities to the IAEA and its Member States. Topics to be addressed during the 2010 Symposium include supporting the global nuclear non-proliferation regime, building support for strengthening international safeguards, the role of Non-State actors and covert trade networks, and the globalisation of nuclear information and technology. IAEA Deputy Director General and head of the Department of Safeguards, Herman Nackaerts, discusses the symposium and the work of his department: video and audio More information on: Safeguards Symposium For more information on Herman Nackaerts " [+ leia mais]
Colaborador: Laura Natal
Fonte: IAEA
 
 
VII Curso de Física, Técnica e Aplicações de Tomografia Computadorizada - HMV
 
"Venho por meio deste informar que realizaremos, nos dias 26, 27 e 28 de Novembro de 2010, o VII Curso de Física, Técnica e Aplicações de Tomografia Computadorizada no Auditório do IEP do Hospital Moinhos de Vento de Porto Alegre. Segue em anexo informações sobre o curso e a forma de inscrição. As inscrições permanecerão abertas até o dia 24/11. Ficamos a disposição para contato e esclarecimentos. " [+ leia mais]
Colaborador: Alessandro A. Mazzola
Fonte: Phymed
 
 
13th European ALARA Network Workshop, 7-10 June 2011
 
"The workshop will cover topics covered by following working groups * Challenges for the optimisation of patient and staff radiation protection in the medical sector * Policy and tools for implementing the ALARA principle in the medical sector * Education, training and communication to improve ALARA in the medical sector * Technical developments and quality assurance in the implementation of the ALARA principle in the medical sector Event website: http://conferences.nrpa.no/_images/EAN_Workshop_2011.pdf" [+ leia mais]
Colaborador: Laura Natal
Fonte: IOMP
 
 
ALARA-CT meeting, Dallas, Texas, 5-6 March 2011
 
"The Society for Paediatric Radiology is holding an ALARA-CT meeting. The objectives of the activity are to: 1. Describe the important changes, advances and educational efforts in CT dose reduction over the past decade. 2. Describe the fundamental concepts of CT physics, technological advances in MDCT, as well as practical methods of CT dose reduction. 3. Discuss controversial dose-related issues in paediatric CT imaging practice. 4. Propose ideas and establish initiatives for cooperative planning for future educational, accreditation and research initiatives in paediatric CT imaging. " [+ leia mais]
Colaborador: Laura Natal
Fonte: IOMP
 
 
International Workshop ORAMED 2011, Barcelona 20-22 January 2011
 
"ORAMED, Optimization of RAdiation protection for MEDical staff is a collaborative project funded in 2008 within the 7th EU Framework Programme, Euratom Programme for Nuclear Research and training. The scope of the workshop is: - to present new methodologies for improving dose assessment in interventional radiology and nuclear medicine, - to present the ORAMED developed prototypes. - to introduce training material in order to facilitate the understanding of the proposed recommendations, - to highlight the best practices for reducing occupational doses Event website: http://www.euradnews.org/fullstory.php?storyid=23037" [+ leia mais]
Colaborador: Laura Natal
Fonte: IOMP
 
 
IAEA to establish a network of medical professionals on "radiation protection of children" for Asian region, 15-17 December 2010
 
In keeping with the emphasis on radiation protection of children, the IAEA is going to have a meeting in Bangkok on 15-17 December 2010 under the technical cooperation project RAS 9055 to establish the above network. Participants from 15 countries of Asian and Pacific region will participate. The purpose of the meeting are, to: a) create awareness on ongoing work of the IAEA on radiation protection of children b) assess the work undertaken by Member States in recent years in this field and c) create network with specific tasks. A similar network has just been established for participants from European countries in September 2010. [+ leia mais]
Colaborador: Laura Natal
Fonte: IOMP
 
 
Momentum catching with radiation protection in cardiology
 
"This week is bubbling with activity on radiation issues in particular in cardiac imaging. The International Society for Computed Tomography is holding its regular International Symposium on Multidetector Row CT from May 18-21, 2010, in San Francisco, USA, and the May issue of the Journal of American College Cardiovascular Imaging has a series of articles including a number of Editorials on radiation risks. Cardiologists have been at the forefront in the use of fluoroscopy in catheterization laboratories for decades, but the new momentum comes from imaging modalities such as CT, SPECT and PET. Grappling with the core issue of risk-benefit evaluation of different imaging modalities in different clinical situations involving graded severity of disease at different age settings and patient’s gender, all confounding factors make the situation very challenging. It is clear that simple criteria of appropriateness are not sufficient. The risk-benefits equation becomes simple when one is dealing with high risk of death or disability where benefits can indisputably overweigh minor radiation risks; they are also easier to infer in patients with age above 50 years where radiation risk diminishes; but the situation gets complicated with low and medium risk, with younger age and in asymptomatic patients. It is clear that there are large challenges ahead and it will take years for a successful and acceptable situation to emerge. Even though one can always debate about radiation risks at lower doses and the applicability of linear-non-threshold (LNT) hypothesis, one cannot deny that almost all major international organizations have agreed to LNT, to risk coefficients for carcinogenic effects and have a similar voice concerning validity and constraints in the use of radiation risk quantities. There is much more data, knowledge and experience in radiation risk than many other risks in the medical arena. Perfection is utopian. There are no doubts about the radiation risks involved in imaging studies that involve 100 mGy or more organ dose. One can debate about single CT scans, but risks are clear with tens of CT scans for a patient, and not so blurred with half a dozen CT scans and other imaging modalities that involve similar levels of radiation dose. We are in an era where patients are receiving multiple high-dose imaging examinations. The purpose of this is not to focus attention on radiation risk but to state that one should not handle this risk with doubt and move ahead in including the risk with other parameters to arrive at a rational risk-benefit equation. There are no doubts that not performing a radiological examination may entail a much higher level of risk in many situations, and this is what informed decision-making is all about. Radiation protection does not imply avoiding radiation, but, rather, avoiding unnecessary radiation. The information to the patients on this website has been prepared with this pragmatic approach in mind. Realising the importance of radiation protection in interventional cardiology, The IAEA had taken the lead to start training courses in 2004 and has trained cardiologists from more than 55 countries. A set of extensive training material containing power point slides on the subject was prepared in cooperation with Society of Cardiovascular Angiography and Interventions (SCAI) and WHO and the material has been made available for FREE download. A network of Asian Cardiologists in Radiation Protection was created that is spearheading the campaign and has established a newsletter. This website has material in form of simple questions and answers. A publication on Radiation Protection in Cardiac CT was released in 2009. Patient information pages released earlier this year contain guidance for the patient." [+ leia mais]
Colaborador: Laura Natal
Fonte: IOMP
 
 
IAEA enhances public focus to radiation protection of patients
 
"A significant portion of the activities of the IAEA is directed towards promoting the safe and peaceful uses of nuclear technology. Nevertheless, the IAEA is still largely perceived as the nuclear watchdog organization in the public’s mind, despite awareness of the important uses radiation applications in areas such as agriculture and human health. This month the main web site of IAEA is being dedicated to the theme, “Radiation Protection of Patients”, to place more emphasis on this important aspect of the IAEA’s work. The theme includes several multimedia elements, including a number of video and audio interviews and also links to a focus page and an interactive quiz. After remaining on Home page of www.iaea.org, the theme is available now at focus page at http://www.iaea.org/NewsCenter/Focus/RadiationProtection/index.html" [+ leia mais]
Colaborador: Laura Natal
Fonte: IOMP
 
 
Summary Report of the Fourth Meeting of the Steering Panel on The International Action Plan for the Radiation Protection of Patients
 
"The Steering Panel of the International Action Plan for the Radiation Protection of Patients keeps under review the implementation of the activities listed in the plan, with a view to providing guidance – on a periodic basis – on the overall approach to the implementation of the Action Plan and to make proposals for adjustments, as may appear necessary. At its fourth meeting, the Steering Panel reviewed and evaluated the developments that have taken place since the third meeting in February 2008, and recommended future actions addressing emerging trends. " [+ leia mais]
Colaborador: Laura Natal
Fonte: IOMP
 
 
New Era in CT scanning
 
"More than 400 cases of radiation overexposure from CT scan in 8 hospitals, many suffering hair loss and skin injuries including as well a child of less than 2 years getting 150 times more radiation dose- these are newest situations never encountered before even though CT has been around since 1972 and the technology has been considered safe. Manufacturers, radiologists and radiographers never imagined that software problems that keep on getting reported from time to time with high tech radiotherapy machines resulting in serious incidents could ever occur with very well behaved CT machines. Six years ago it was not easy to spot a case of either accidental exposure to patient in CT scan or a patient having skin injury from CT scans. With almost 115 years gone by, after the discovery of X rays by Roentgen, the current interest in radiation protection seems to be what it would have been about a century ago. This follows a period of almost half century (from 1930’s to 1980’s) when X rays started to be considered safe enough, making some health professionals rather complacent. The recent spurt in interest comes from visible effects of radiation (skin injuries), but CT has also been much in news during the current decade for potential long term effects predominantly cancer. It must be emphasized that the benefits of use of X rays including CT are enormous and overall outweigh the risks. Unfortunately, complacency that sets in on safety without accidental events needs to be corrected and that will bring back the public confidence. The manufacturers have been much aware about the need to contribute their bit and have been competing with each other to produce CT machines that have better and better dose management features each year. While this is a good sign, the recent events of CT equipment not behaving the way it is supposed to and leading to events as stated above requires immediate and urgent attention on their part. The manufacturers have responded to call by FDA and have committed to provide new radiation dose check features that will alert CT machine operators when radiation dose levels – as determined by hospitals and imaging centers will be exceeded. The radiation dose upper-limit alert (or warning) will notify operators when an error may have occurred in setting parameters. This feature can be configured to prevent a CT scan from occurring." [+ leia mais]
Colaborador: Laura Natal
Fonte: IOMP
 
 
IAEA Cataract studies published
 
"IAEA studies on Retrospective Evaluation of Lens Injuries and Dose (RELID) that were started in 2008 covering staff working in interventional cardiology have reached the stage of publication in reputed journals. The study involving testing of eyes of interventional cardiologists and nurses as organized by the IAEA in cooperation with National Heart Association of Malaysia (NHAM) and conducted in April 2009 has just been published in Catheterization and Cardiovascular Interventions [CIRAJ-BJELAC, O., et al., 2010] Another study organized by the IAEA in cooperation with Latin American Society of Interventional Cardiology (SOLACI) and conduced in Bogota, Colombia in Sept.2008 and in Montevideo, Uruguay in April 2009 has been published in Radiation Research. [VANO, E., 2010]. These are the first published reports of cataract among this group, that is, staff in interventional cardiology. A review of findings in other groups is available at » These findings demonstrate a dose dependent increased risk of posterior lens opacities for interventional cardiologists and nurses when radiation protection tools are not used. While study of a larger cohort is needed to confirm these findings, the results suggest ocular radio-protection should be utilized and indicate an urgent need to educate professionals in radiation protection to reduce the likelihood of cataract. CIRAJ-BJELAC, O., REHANI, M.M., SIM, K.H., LIEW, H.B., VANO, E., KLEIMAN, N.J., Risk for radiation induced cataract for staff in interventional cardiology: Is there reason for concern? Catheter. Cardiovasc. Interv. (Jun. 2010). VANO, E., KLEIMAN, N.J., DURAN, A., REHANI, M.M., ECHEVERRI, D., CABRERA, M., Radiation Cataract Risk in Interventional Cardiology Personnel. Radiat. Res. (Jun. 2010)." [+ leia mais]
Colaborador: Laura Natal
Fonte: IOMP
 
 
Radiographer Society institutes award for Dosewise radiographer of the year
 
In keeping with the momentum to keep radiation dose to the patient as low as reasonably achievable, without affecting image quality, the International Society of Radiographers and Radiological Technologists (ISRRT) has instituted an award for Dosewise radiographer of the year. Further details can be found at the website of the ISRRT (http://www.isrrt.org/isrrt/Default_EN.asp). This is a very timely initiative that will have impact on reducing unnecessary radiation doses to patients. Radiographers are on fore-front to operate x-ray machines. Also the organization is celebrating the World Radiography day on 8th November 2010 to commemorate the discovery of X ray by Roentgen. [+ leia mais]
Colaborador: Laura Natal
Fonte: IOMP
 
 
Patient radiation exposure tracking published in The Lancet
 
"The Lancet has published the article on tracking of radiation exposure of patients that deals with the concept of the IAEA Smart Car/SmartRadTrack project. As per the article: The well established principles of radiation protection are justification and optimisation. The physician’s role is paramount in justification and the radiology facility has a major role to optimise the technique to do the examination with the minimum possible radiation dose without hampering the diagnostic purpose. The approach towards justification so far has been to promote use of appropriateness criteria developed by professional societies. Obviously the current situation with arguably unjustified CT scans ranging from 3% to 77% for certain indications and patients subjected to multiple radiological examinations shows that this approach is insufficient. A compelling answer is to track lifetime radiation exposure (radiation history, which should work efficiently to improve justification)." [+ leia mais]
Colaborador: Laura Natal
Fonte: IOMP
 
 
Increasing focus on radiation protection in CT is unabated
 
"Regular developments continue to keep radiation protection in CT in the news, be it publication of papers in peer reviewed journals, or actions by professional societies, regulators and, more recently, by governments. The American Association of Physicists in Medicine (AAPM) has begun to post on its website scan protocols for frequently performed CT examinations. These protocols will summarize the basic requirements of the exams, and provide several model-specific examples of scan and reconstruction parameters that are considered by the Working Group to be reasonable and appropriate to the specified diagnostic task. A sample of adult CT brain perfusion has just been released. CT has entered into the arena of signing bills into law. In October, the California Governor has signed a bill which would, commencing July 1, 2012, require hospitals and clinics, that use computed tomography (CT) X-ray systems for human use to record, if the CT systems are capable, the dose of radiation on every CT study produced during the administration of a CT examination, as specified. The bill would require the dose to be verified annually by a medical physicist, as specified, unless the facility is accredited." [+ leia mais]
Colaborador: Laura Natal
Fonte: IOMP
 
 
Radiation dose optimization in nuclear medicine
 
"While there has been continuing and increasing interest in patient radiation dose reduction in X-ray procedures, predominantly in CT, there has not been relative matching of momentum with nuclear medicine procedures. This is despite the fact that a number of nuclear medicine examinations deliver patient effective dose in the range of 5 to 20 mSv per study, which is similar to that in CT. One of the main reasons has been relatively limited possibilities. When it comes to opportunities in the hands of users, the predominant controllable factor is administered radioactivity with some options on the choice of equipment parameters. Unlike CT technological innovations and advances have also not been such as to result in increasing dose and frequency of use. However, the Society of Nuclear Medicine has recently made available on its website North American Consensus Guidelines For Administered Radiopharmaceutical Activities in Children And Adolescents. The consensus includes doses for 11 commonly used radiopharmaceuticals, in terms of (1) administered activity/kg, and (2) minimum administered radiopharmaceutical doses for the smallest patients. The consensus guidelines differ significantly from the European Association for Nuclear Medicine (EANM) Paediatric Dose Card in several important respects: 1. The administered activities in the consensus guidelines are slightly lower for infants and small children. 2. Administered activities for 99mTc-DMSA and 18F-fluoride are considerably lower in the consensus guidelines. 3. Administered activities for orally administered 99mTc-labeled radiopharmaceuticals and for radionuclide cystography provide a range of administered activities for each type of study rather than an administered activity/kg. 4. The consensus guidelines more closely represent clinical practice in North American paediatric centres. " [+ leia mais]
Colaborador: Laura Natal
Fonte: IOMP
 
 
MODIFIED COMS PLAQUES FOR 125I AND 103PD IRIS
 
"Purpose: Novel plaques are used to treat iris melanoma at the Mayo Clinic Rochester. The plaques are a modification of the Collaborative Ocular Melanoma Study (COMS) 22 mm plaque design with a gold alloy backing, outer lip, and silicone polymer insert. An inner lip surrounds a 10 mm diameter cutout region at the plaque center. Plaques span 360, 270, and 180 arcs. This article describes dosimetry for these plaques and others used in the treatment of anterior eye melanomas. Methods and Materials: The EGSnrc user-code BrachyDose is used to perform Monte Carlo simulations. Plaques and seeds are fully modeled. Three-dimensional dose distributions for different plaque models, TG-43 calculations, and 125I (model 6711) and 103Pd (model 200) seeds are compared via depth–dose curves, tabulation of doses at points of interest, and isodose contours. Results: Doses at points of interest differ by up to 70% from TG-43 calculations. The inner lip reduces corneal doses. Matching plaque arc length to tumor extent reduces doses to eye regions outside the treatment area. Maintaining the same prescription dose, 103Pd offers lower doses to critical structures than 125I, with the exception of the sclera adjacent to the plaque. Conclusion: The Mayo Clinic plaques offer several advantages for anterior eye tumor treatments. Doses to regions outside the treatment area are significantly reduced. Doses differ considerably from TG-43 predictions, illustrating the importance of complete Monte Carlo simulations. Calculations take a few minutes on a single CPU, making BrachyDose sufficiently fast for routine clinical treatment planning." [+ leia mais]
Fonte: Int. J. Radiation Oncology Biol. Phys
 
 
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