Volumen 25 (2019): Edición 1 (March 2019)

The behaviour of light interaction with biological tissue is determined by micro-optical parameters: refractive index (n), absorption coefficient (µ_a), scattering coefficient (µ_s), and anisotropy (g). The goal of this study is to measure the optical properties of normal whole blood using He-Ne laser (wavelength 632.8 nm).

The refractive index is measured using the traveller microscope. The integrating sphere method is used to measure the macro-optical parameters: total diffusive reflectance, transmittance, and collimated transmittance at wavelength 632.8 nm. The macro-optical parameters are fed to Inverse Adding Doubling (IAD) theoretical technique, to estimate the micro-optical parameters (µ_s, µ_a, g). An alternative practical method is used to measure the g value based on utilising the goniometric table. The study reveals that the refractive index (n) equals 1.395±0.0547, absorption coefficient (µ_a) equals 2.37 mm⁻¹, scattering coefficient (µ_s) equals 55.69 mm⁻¹, and anisotropy (g) equals 0.82.

In conclusion, these findings approved, in general, the applicability of the suggested experimental set up. The set up depend on using three devices: the integrating sphere method to estimate (µ_s, µ_a, g), traveller microscope (n) and goniometer (g).

We used GATE simulation to study the effect of the coincidence time window (CTW) along with the block gap and the intercrystal gap on the count rate performance and the spatial resolution of the Biograph^™ mCT 20 Excel. We ran simulations on our local cluster to reduce computation time. The task was split into several jobs that were then triggered simultaneously on the cluster nodes. The Biograph^TM mCT 20 Excel was validated using the NEMA NU 2-2012 protocol. Our results showed good agreement with experimental data. The simulated sensitivity, peak true count rate, peak noise equivalent count rate (NECR), and scatter fraction showed agreement within 3.62%, 5.77%, 0.6%, and 2.69%, respectively. In addition, the spatial resolution agreed within <0.51 mm. The results showed that a decrease in the coincidence time window and the block gap and an increase in the intercrystal gap increase the count rate performance and improve the spatial resolution. The results also showed that decreasing the coincidence time window increased the NECR by 27.37%. Changing the intercrystal gap from 0 to 0.2 mm and the block gap and from 4 to 0.4 mm increased the NECR by 5.53% and improved the spatial resolution at 1 cm by 2.91% and that at 10 cm by 3.85%. The coincidence time window, crystal gap, and block gap are important parameters with respect to improving the spatial resolution.

Permanent and temporary implantation of I-125 brachytherapy sources has become an official method for the treatment of different cancers. In this technique, it is essential to determine dose distribution around the brachytherapy source to choose the optimal treatment plan. In this study, the dosimetric parameters for a new interstitial brachytherapy source I-125 (IrSeed-125) were calculated with GATE/GEANT4 Monte Carlo code. Dose rate constant, radial dose function and 2D anisotropy function were calculated inside a water phantom (based on the recommendations of TG-43U1 protocol), and inside several tissue phantoms around the IrSeed-125 capsule. Acquired results were compared with MCNP simulation and experimental data. The dose rate constant of IrSeed-125 in the water phantom was about 1.038 cGy·h⁻¹U⁻¹ that shows good consistency with the experimental data. The radial dose function at 0.5, 0.9, 1.8, 3 and 7 cm radial distances were obtained as 1.095, 1.019, 0.826, 0.605, and 0.188, respectively. The results of the IrSeed-125 is not only in good agreement with those calculated by other simulation with MCNP code but also are closer to the experimental results. Discrepancies in the estimation of dose around IrSeed-125 capsule in the muscle and fat tissue phantoms are greater than the breast and lung phantoms in comparison with the water phantom. Results show that GATE/GEANT4 Monte Carlo code produces accurate results for dosimetric parameters of the IrSeed-125 LDR brachytherapy source with choosing the appropriate physics list. There are some differences in the dose calculation in the tissue phantoms in comparison with water phantom, especially in long distances from the source center, which may cause errors in the estimation of dose around brachytherapy sources that are not taken account by the TG43-U1 formalism.

This study aims to investigate and evaluate the secondary photons characterizations under flattening filter (FF) for high radiotherapy quality in terms of fluence, energy fluence, energy fluence distribution, spectral distribution and angular spread distribution of secondary photons, which are mainly coming from primary collimator originated in the whole Linac head. However, the flattening filter illuminates the photons of low energy. After this component, the secondary photons of low energy are coming from flattening filter and secondary collimators that contaminate the dosimetry for deep tumor treatment.

Fluence profile, energy profile and angular spread of secondary photons decreased with FF volume reduction percent but energy distribution and spectral distribution kept almost constant with FF volume reduction. The FF volume reduction allows reducing the secondary photons emergent from FF in number and in energy and it permits to increase the radiotherapy efficiency by decreasing the photons contamination when the cancer is treating.

Aim: To estimate the Gross Tumor Volume (GTV) using different modes (axial, helical, slow, KV-CBCT & 4D-CT) of computed tomography (CT) in pulmonary tumors.

Materials & Methods: We have retrospectively included ten previously treated case of carcinoma of primary lung or metastatic lung using Stereotactic Body Radiation Therapy (SBRT) in this study. All the patients underwent 4 modes of CT scan Axial, Helical, Slow & 4D-CT using GE discovery 16 Slice PET-CT scanner and daily KV-CBCT for the daily treatment verification. For standardization, all the patients underwent different modes of scan using 2.5 mm slice thickness, 16 detectors rows and field of view of 400mm. Slow CT was performed using axial mode scan by increasing the CT tube rotation time (typically 3 – 4 sec.) as per the breathing period of the patients. 4D-CT scans were performed and the entire respiratory cycle was divided into ten phases. Maximum Intensity Projections (MIP), Minimum Intensity Projections (MinIP) and Average Intensity Projections (AvIP) were derived from the 10 phases. GTV volumes were delineated for all the patients in all the scanning modes (GTV_AX - Axial, GTV_HL - Helical, GTV_SL – Slow, GTV_MIP -4DCT and GTV_CB – KV-CBCT) in the Eclipse treatment planning system version 11.0 (M/S Varian Medical System, USA). GTV volumes were measured, documented and compared with the different modes of CT scans.

Results: The mean ± standard deviation (range) for MIP, slow, axial, helical & CBCT were 36.5 ± 40.5 (2.29 – 87.0), 35.38 ± 39.52 (2.1 – 82), 31.95 ± 37.29 (1.32 – 66.9), 28.98 ± 33.36 (1.01 – 65.9) & 37.16 ± 42.23 (2.29 – 92). Overall underestimation of helical scan and axial scan compared to MIP is 21% and 12.5%. CBCT and slow CT volume has a good correlation with the MIP volume.

Conclusion: For SBRT in lung tumors better to avoid axial and helical scan for target delineation. MIP is a still a golden standard for the ITV delineation, but in the absence of 4DCT scanner, Slow CT and KV-CBCT data may be considered for ITV delineation with caution.

Background: The relationship between the prostate IMRT techniques and patients anatomical parameters has been rarely investigated.

Objective: to evaluate various prostate IMRT techniques based on tumor control and normal tissue complication probability (TCP and NTCP) values and also the correlation of such techniques with patients anatomical parameters. Methods: Four IMRT techniques (9, 7 and 5 fields and also automatic) were planned on the CT scans of 63 prostate cancer patients. The sum of distances between the organs at risk (OARs) and target tissue and also their average joint volumes were measured and assumed as anatomical parameters. Selected dosimetric and radiobiological parameters (TCP and NTCP) values were compared among various techniques and the correlation with the above anatomical parameters were assessed using Pearsons’ correlation.

Results: High correlations were found between the dosimetric/radiobiological parameters of OARs with the joint volumes and with the distances between the OARs and target tissue in all the techniques. The TCP and complication free tumor control probability (P₊) values were decreased with increasing the joint volume and decreasing the distances between the OARs and target tissue (as poly-nominal functions). The NTCP values were increased with increasing the joint volumes and decreasing the distances (3-degree poly-nominal functions). For the low percent joint volumes (<20%) and high distances (>7 cm), The TCP, NTCP and P₊ showed no statistical differences between various techniques (P-value>0.07). However, 9 and 7 fields techniques indicated better radiobiological results (P-value<0.05) in almost other ranges (>20% joint volumes and <7 cm distances).

Conclusion: Based on our results, it would be possible to compare radiobiological effects of various common IMRT techniques and choose the best one regarding to patients anatomical parameters derived from the CT scans.

Introduction: Since the CT operators play an important role in the diagnosis and treatment of diseases and exposing the patients to radiation exposure, they must be aware of all CT parameters which affect the image quality and patient dose and update their knowledge in parallel with the progresses in CT technology. Therefore, the knowledge of radiographers and CT technologists regarding the CT parameters was assessed in this study to identify and resolve any potential deficiencies.

Material and methods: This study was conducted in 2018 among 113 radiographers and 103 CT technologists in Khuzestan province using a three-part questionnaire containing demographic characteristics, general opinion on CT scan dose and questions assessing technologists’ knowledge of CT exposure parameters. Data were analyzed using SPSS software.

Results: Total knowledge scores of radiographers and CT technologists about CT exposure parameters were 36 and 42, respectively. The highest knowledge score among technologist was the knowledge of changing parameters based on patient characteristics and the lowest was in the field of awareness of noise index and diagnostic reference levels.

Conclusion: Total knowledge scores of radiographers and CT technologists about different scan parameters affecting dose and image quality was very low. Reviewing and updating the content of academic education and holding retraining courses are suggested.

Objective: The literature has approved that the use of the concept of diagnostic reference level (DRL) as a part of an optimization process could help to reduce patient doses in diagnostic radiology comprising the Computed Tomography (CT) examinations. There are four public/governmental CT centers in the province (Semnan, Iran) and, to our knowledge, after about 12 years since the launch of the first CT scanner in the province there is no dosimetry information on those CT scanners. The aim of this study was to evaluate CT dose indices with the aim of the establishment of the DRL for head, chest, cervical spine, and abdomen-pelvis examinations.

Methods: Scan parameters of 381 patients were collected during two months from 4 CT scanners. The CT dose index (CTDI) was measured using a calibrated ionization chamber on two cylindrical poly methyl methacrylate (PMMA) phantoms. For each sequences, weighted CTDI (CTDIw), volumetric CTDI (CTDIv) and dose length product (DLP) were calculated. The 75th percentile was proposed as the criterion for DRL values.

Results: Proposed DRL (CTDIw, CTDIv, DLP) for the head, chest, cervical spine, and abdomen-pelvis were (46.1 mGy, 46.1 mGy, 723 mGy × cm), (13.8 mGy, 12.0 mGy, 377 mGy × cm), (40.0 mGy, 40.0 mGy, 572 mGy × cm) and (14.9 mGy, 12.1 mGy, 524 mGy × cm), respectively.

Conclusion: Comparison with the others results from the other countries indicates that the head, chest and abdomen-pelvis scans in our region are lower or in the range of the other studies investigated in terms of dose. In the case of cervical spine scanning it’s necessary to review and regulate scan protocols to reach acceptable dose levels.