Development of a motorized system for the characterization of the RQR reference x-ray beams at the KFSHRC's SSDL using an extrapolation chamber.

An extrapolation chamber of type Böhm 23392, used for the dosimetry of RQR beam qualities at the Secondary Standard Dosimetry Laboratory of King Faisal Specialist Hospital, is presented. A computer-based motorized system consisting of a stepping motor coupled to the chamber's built-in micrometer screw was designed to expedite the measurements process, giving a linear relationship between the number of motor steps and the chamber depth with a Coefficient of Determination (COD) equal to 0.9990. The extrapolation chamber along with the motorized system was used to determine the extrapolation curves. The slope of the extrapolation curves, measured for the eight RQR beam qualities with a relative uncertainty between 0.17% and 0.58%, varies linearly with the beam quality expressed in terms of HVL, with a COD between 0.9995 and 1.0000.

The Effects of Different Spectrophotometric Modes on Colour Measurement of Resin Composite and Porcelain Materials.

OBJECTIVES: To investigate the influence of a number of controlled modes on the spectrophotometric analysis of the colour of resin composite and porcelain materials. METHODS: A total of 20 samples of commercially available resin composite, and 20 samples of commercially available porcelain materials in four different shades were produced (five samples for each shade). Colour was measured using a spectrophotometer (CM2600-d, Minolta Konica) set with different colour measuring modes namely, small aperture size (SAV) or large aperture size (MAV); specular component included (SCI), or excluded (SCE); 0% (UV-) or 100% UV illumination (UV+). Colour data were then compared using paired T-test. RESULTS: Colour coordinates measured with spectrophotometric modes set as 2° observation angle, SAV, SCI, and UV- were significantly different from those measured with 10° observation angle, MAV, SCE, and UV+ respectively in most cases for both materials. CONCLUSION: Different spectrophotometric modes (2 or 10 degrees observation angle, SAV or MAV aperture size, 0% or 100% UV, and SCI or SCE) significantly influenced the absolute colour measurements of resin composite and porcelain samples. CLINICAL SIGNIFICANCE: Measuring modes should be taken into consideration when comparing the results of absolute colour measurements of resin composite and dental porcelain materials.

The Effect of Try-In Paste and Resin Cement Shade on Colour Properties of Dental Veneers.

OBJECTIVES: The purpose of this study was to investigate how different shades of try-in pastes, uncured and cured resin cements affect the overall colour of porcelain veneer restorations. METHODS: A total of 90 porcelain veneers of shade Vita 1M1 VM7 and 0.6 mm thick were applied to bovine teeth using 3 shades of resin cement and their try-in paste produced by 3 manufacturers. RESULTS: Colour differences produced between the try-in pastes and the corresponding shades of cured resin cements ranged from (ΔE* 1.18-3.1). The colour differences between uncured and cured resins of the same shade ranged from (ΔE* 0.78 - 1.41). CONCLUSIONS: Different shades of try-in pastes and resin cements produced colour changes which are clinically useful in changing the colour of veneer restorations and therefore assist in colour matching to adjacent teeth. Clinically significant differences were noticed between try-in pastes and the cured resin of the same shade, however, there were relatively small changes measured between un-cured and cured resins. The colour match obtained by the try-in paste has to be treated with caution and further evaluation of the restoration made with the resin in place before curing is recommended.

Comparison of clinical and radiographic status around immediately loaded versus conventional loaded implants placed in patients with type 2 diabetes: 12- and 24-month follow-up results.

There are no studies that have compared the clinical and radiographic status around immediately loaded (IL) and conventional loaded (CL) implants placed in patients with type 2 diabetes mellitus (T2DM). The aim was to compare the clinical and radiographic status around IL and CL implants placed in T2DM patients. One hundred and eight diabetic patients [55 with IL implants (Group 1) and 53 with CL implants (Group 2)] were included in this cross-sectional study. All implants were placed in healed sites in the maxillary and mandibular premolar and molar regions and supported single restorations. All patients underwent full mouth mechanical debridement biannually. Haemoglobin A1c (HbA1c) levels, clinical [bleeding on probing (BOP) and probing depth (PD) ≥ 4 mm] and radiographic [crestal bone loss (CBL)] peri-implant parameters were measured for both groups at 12- and 24-month follow-up. Group comparisons were performed using the Mann-Whitney U-test (P < 0·05). The mean age and duration of T2DM in groups 1 and 2 were 50·6 ± 2·2 and 51·8 ± 1·7 years, and 9·2 ± 2·4 and 8·5 ± 0·4 years, respectively. At 12- and 24-month follow-up, the mean HbA1c levels in groups 1 and 2 were 5·4% (4·8-5·5%) and 5·1% (4·7-5·4%) and 5·1% (4·7-5·2%) and 4·9% (4·5-5·2%), respectively. At 12- and 24-month follow-up, there was no statistically significant difference in peri-implant BOP, PD and CBL in both groups. It was concluded that clinical and radiographic status is comparable around IL and CL implants placed in patients with T2DM. The contribution of careful case selection, oral hygiene maintenance and glycaemic control is emphasised.

Angular independent silicon detector for dosimetry in external beam radiotherapy.

PURPOSE: In this work, the "edgeless" silicon detector technology is investigated, in combination with an innovative packaging solution, to manufacture silicon detectors with negligible angular response. The new diode is also characterized as a dosimeter for radiotherapy with the aim to verify its suitability as a single detector for in vivo dosimetry as well as large area 2D array that does not require angular correction to their response. METHODS: For the characterisation of the "edgeless-drop-in" detector technology, a set of samples have been manufactured with different sensitive areas (1 × 1 and 0.5 × 0.5 mm(2)) and different thicknesses (0.1 and 0.5 mm) in four different combinations of top and peripheral p-n junction fabricated on p-type and n-type silicon substrates. The diode probes were tested in terms of percentage depth dose (PDD), dose rate, and linearity and compared to ion chambers. Measurements of the output factor have been compared to film. The angular response of the diodes probes has been tested in a cylindrical PMMA phantom, rotated with bidirectional accuracy of 0.25° under 10 × 10 cm(2) 6 MV Linac photon beam. The radiation hardness has been investigated as well as the effect of radiation damage on the angular and dose rate response of the diode probes when irradiated with photons from a Co-60 gamma source up to dose of 40 kGy. RESULTS: The PDDs measured by the edgeless detectors show an agreement with the data obtained using ion chambers within ±2%. The output factor measured with the smallest area edgeless diodes (0.5 × 0.5 mm(2)-0.1 and 0.5 mm thick) matches EBT3 film to within 2% for square field size from 10 to 0.5 cm side equivalent distance. The dose rate dependence in a dose per pulse range of 0.9 × 10(-5)-2.7 × 10(-4) Gy/pulse was less than -7% and +300% for diodes fabricated on p-type and n-type substrates, respectively. The edgeless diodes fabricated on the p-type substrate demonstrated degradation of the response as a function of the irradiation dose within 5%-15%, while diodes on the n-type substrate show a variation of approximately 30% after 40 kGy. The angular response of all probes is minimal (within 2%) but the N on N and P on P configurations show the best performances with an angular dependence of ±1.0% between 0° and 180° in the transversal direction. In this configuration, the space charge region of the passive diode extends from the behind and sidewall toward the anode on the top providing beneficial electric field distribution in the peripheral area of the diode. Such performance has also been tested after irradiation by Co-60 up to 40 kGy with no measurable change in angular response. CONCLUSIONS: A new edgeless-drop-in silicon diode fabrication and packaging technology has been used to develop detectors that show no significant angular dependence in their response for dosimetry in radiation therapy. From the characterisation of the diodes, proposed in a wide range of different geometries and configurations, the authors recommend the P-on-P detectors in conjunction with "drop in" packaging technology as the candidate for further development as single diode probe or 2D diode array for dosimetry in radiotherapy.

MagicPlate-512: A 2D silicon detector array for quality assurance of stereotactic motion adaptive radiotherapy.

PURPOSE: Spatial and temporal resolutions are two of the most important features for quality assurance instrumentation of motion adaptive radiotherapy modalities. The goal of this work is to characterize the performance of the 2D high spatial resolution monolithic silicon diode array named "MagicPlate-512" for quality assurance of stereotactic body radiation therapy (SBRT) and stereotactic radiosurgery (SRS) combined with a dynamic multileaf collimator (MLC) tracking technique for motion compensation. METHODS: MagicPlate-512 is used in combination with the movable platform HexaMotion and a research version of radiofrequency tracking system Calypso driving MLC tracking software. The authors reconstruct 2D dose distributions of small field square beams in three modalities: in static conditions, mimicking the temporal movement pattern of a lung tumor and tracking the moving target while the MLC compensates almost instantaneously for the tumor displacement. Use of Calypso in combination with MagicPlate-512 requires a proper radiofrequency interference shielding. Impact of the shielding on dosimetry has been simulated by (GEANT)4 and verified experimentally. Temporal and spatial resolutions of the dosimetry system allow also for accurate verification of segments of complex stereotactic radiotherapy plans with identification of the instant and location where a certain dose is delivered. This feature allows for retrospective temporal reconstruction of the delivery process and easy identification of error in the tracking or the multileaf collimator driving systems. A sliding MLC wedge combined with the lung motion pattern has been measured. The ability of the MagicPlate-512 (MP512) in 2D dose mapping in all three modes of operation was benchmarked by EBT3 film. RESULTS: Full width at half maximum and penumbra of the moving and stationary dose profiles measured by EBT3 film and MagicPlate-512 confirm that motion has a significant impact on the dose distribution. Motion, no motion, and motion with MLC tracking profiles agreed within 1 and 0.4 mm, respectively, for all field sizes tested. Use of electromagnetic tracking system generates a fluctuation of the detector baseline up to 10% of the full scale signal requiring a proper shielding strategy. MagicPlate-512 is also able to reconstruct the dose variation pulse-by-pulse in each pixel of the detector. An analysis of the dose transients with motion and motion with tracking shows that the tracking feedback algorithm used for this experiment can compensate effectively only the effect of the slower transient components. The fast changing components of the organ motion can contribute only to discrepancy of the order of 15% in penumbral region while the slower components can change the dose profile up to 75% of the expected dose. CONCLUSIONS: MagicPlate-512 is shown to be, potentially, a valid alternative to film or 2D ionizing chambers for quality assurance dosimetry in SRS or SBRT. Its high spatial and temporal resolutions allow for accurate reconstruction of the profile in any conditions with motion and with tracking of the motion. It shows excellent performance to reconstruct the dose deposition in real time or retrospectively as a function of time for detailed analysis of the effect of motion in a specific pixel or area of interest.

A two dimensional silicon detectors array for quality assurance in stereotactic radiotherapy: MagicPlate-512.

PURPOSE: Silicon diode arrays are commonly implemented in radiation therapy quality assurance applications as they have a number of advantages including: real time operation (compared to the film) and high spatial resolution, large dynamic range and small size (compared to ionizing chambers). Most diode arrays have detector pitch that is too coarse for routine use in small field applications. The goal of this work is to characterize the two-dimensional monolithic silicon diode array named "MagicPlate-512" (MP512) designed for QA in stereotactic body radiation therapy (SBRT) and stereotactic radio surgery (SRS). METHODS: MP512 is a silicon monolithic detector manufactured on ap-type substrate. An array contains of 512 pixels with size 0.5×0.5 mm2 and pitch 2 mm with an overall dimension of 52×52 mm2. The MP512 monolithic detector is wire bonded on a printed circuit board 0.5 mm thick and covered by a thin layer of raisin to preserve the silicon detector from moisture and chemical contamination and to protect the bonding wires. Characterization of the silicon monolithic diode array response was performed, and included pixels response uniformity, dose linearity, percent depth dose, output factor, and beam profiling for beam sizes relevant to SBRT and SRS and depth dose response in comparison with ionization chamber. RESULTS: MP512 shows a good dose linearity (R2=0.998) and repeatability within 0.2%. The measured depth dose response for field size of 10×10 cm2 agreed to within 1.3%, when compared to a CC13 ionization chamber for depths in PMMA up to 30 cm. The output factor of a 6 MV Varian 2100EX medical linac beam measured by MP512 at the isocenter agrees to within 2% when compared to PTW diamond, Scanditronix point EDD-2 diode and MOSkin detectors for field sizes down to 1×1 cm2. An over response of 4% was observed for square beam size smaller than 1 cm when compared to EBT3 films, while the beam profiles (FWHM) of MP512 match to within 2% the data measured by radiochromic film. CONCLUSIONS: The response of the 2D detector array, MP512, has been evaluated. The properties of the array demonstrated suitability for use as in phantom dosimeter for QA in SRS and SBRT. Although MP512 matches film measurements down to 1×1 cm2 well, it showed a discrepancy of 4% in the determination of output factors of beams smaller than 0.5×0.5 cm2 due to the field perturbation generated by the large amount of silicon surrounding the central diode. MP512 is highly capable of measuring beam size (FWHM) and has a discrepancy of less than 1.3% when compared to EBT3 film. A reduction in the detector pitch to less than 2 mm would improve the penumbra reconstruction accuracy at the cost readout electronics complexity.

Influence of benzylisothiocyanate and 13-cis-retinoic acid on micronucleus formation induced by benzo[a]pyrene.

The purpose of this study was to investigate the influence of benzylisothiocyanate (BIT) and 13-cis-retinoic acid (RA) upon the genotoxic potential of benzo[a]pyrene (BaP) to induce micronucleus formation in the bone marrow of mice. Eighty-two male mice were divided into 10 groups. One group served as a negative control (olive oil intubation). Four groups received an oral intubation of various concentrations of BIT (15 to 120 mg/kg) and i.p. injections of BaP (185 mg/kg). Another four groups were treated identically, but received RA (20 to 150 mg/kg) in place of BIT. Finally, one group received only i.p. injection of BaP (185 mg/kg). The results showed that both BIT and RA significantly reduced the frequency of micronucleus formation in the bone marrow of the BaP treated animals. BIT was found to be effective at all the tested concentrations. RA was effective only at three of the four tested concentrations (40, 75 and 150 mg/kg). These findings indicate that both BIT and RA may reduce the genotoxic effects of benzo[a]pyrene in the mice under the test conditions utilized.