PERFORMANCE OF HANDHELD NAI(TL) SPECTROMETERS AS DOSIMETERS BY LABORATORY AND FIELD DOSE RATE MEASUREMENTS.

In the framework of the IAEA Coordinated Research Project (CRP) J02012 on 'Advancing Radiation Detection Equipment for Detecting Nuclear and Other Radioactive Material Out of Regulatory Control', the properties of two commercial instruments (1) InSpector 1000 analyzer (Canberra), with a 2″ × 2″ NaI(Tl) scintillator and (2) RIIDEYE M-G3 analyzer (Thermo Scientific), with a 3″ × 3″ NaI(Tl) scintillator, were evaluated as dosimeters by laboratory and field measurements. In the Ionizing Radiation Calibration Laboratory (IRCL) of the Greek Atomic Energy Commission, the NaI(Tl) spectrometers were tested in order to measure Ambient gamma Dose Equivalent Rate (ADER). The NaI(Tl) scintillators were irradiated in a homogeneous field with 662 keV photons with different ADER values from 0.17 to 100 µSv h-1 at 0° incidence (irradiation field perpendicular to the detector's front window) and at 90° incidence. For each irradiation, the measured ADER by the spectrometers and the 'true' ADER values (provided by the IRCL) were compared. In addition, the angular dependence (0-359°) of the ADER response of the spectrometers was studied with a 152Eu source placed at 1, 2 and 3 m from the spectrometers. The ADER dependence as function of the distance from the 152Eu source (at 0° incidence) measured by the two detectors was compared with the theoretical one. In the field studies, ADER was measured by the spectrometers at seven locations belonging to the Greek Early Warning System Network (which is based on Reuter-Stokes ionization chambers). These locations have different ADER values ranging from 20 to 120 nSv h-1. In these locations, gamma ADER were also deduced (1) by in situ gamma spectrometry measurements with portable Germanium HPGe detectors and (2) by the Reuter-Stokes ionization chambers (by subtraction of the cosmic radiation). Gamma dose measurements were also performed with the InSpector 1000 and RIIDEYE M-G3 detectors in 25 locations (beaches) of Northern Greece and compared with the ADER values deduced by sand sample analysis with gamma spectroscopy. Beaches with sand are good candidates for such type of measurements since they are commonly flat and in principle the natural radionuclides are homogenously distributed.

PROCEDURES TO MEASURE MEAN AMBIENT DOSE EQUIVALENT RATES USING ELECTRET ION CHAMBERS.

The capabilities of electret ion chambers (EICs) to measure mean ambient dose equivalent rates were investigated by performing both laboratory and field studies of their properties. First, EICs were 'calibrated' to measure ambient gamma dose equivalent in the Ionizing Calibration Laboratory of the Greek Atomic Energy Commission. The EICs were irradiated with different gamma photon energies and from different angles. Calibration factors were deduced (electret's voltage drop due to irradiation in terms of ambient dose equivalent). In the field studies, EICs were installed at eight locations belonging to the Greek Early Warning System Network (which is based on Reuter-Stokes ionization chambers) for three periods, averaging 5 months each. In the same locations, in situ gamma spectrometry measurements were performed with portable germanium detectors. Gamma ambient dose equivalent rates were deduced by the in situ gamma spectrometry measurements and by soil sample analysis. The mean daily electret potential drop (in Volts) was compared with the mean daily ambient dose equivalent, measured with a portable HPGe detector and Reuter-Stokes high-pressure ionization chambers. From these measurements, 'field' calibration factors (electret's voltage drop due to gamma radiation in terms of ambient dose equivalent) were deduced and found in very good agreement with the values deduced in Laboratory. The influence of cosmic radiation and the intrinsic voltage loss when performing long-term environmental gamma measurements with EICs, was estimated.

A Holistic Approach to Assessment of Population Exposure to Radiation: Challenges and Initiatives of a Regulatory Authority.

A regulatory authority for radiation safety should continuously evaluate and improve the national safety framework, in line with current requirements and standards. In this context, the Greek Atomic Energy Commission initiated a series of concerted actions. The radiation dose to the population due to public and medical exposures was assessed. The assessment of dose due to public exposure was based on measurements of radon concentrations in dwellings, radionuclide concentrations in environmental samples, and air dose rates; the assessment of dose due to medical exposure was based on dose measurements for typical examinations or procedures and data on their frequency. The mean effective dose to a member of the population was found to be 4.5 mSv (1.8 mSv and 2.7 mSv from medical and public exposures, respectively). Regarding occupational exposure, aircrew dose assessment, eye lens monitoring, and the national dose registry were significantly improved. With respect to artificial tanning (sun beds), the ultraviolet radiation produced was assessed and the practices followed were observed. Results demonstrated exceedance of the 0.3 W m erythema effective irradiance limit set in European Union standards by 63.5% of the sun beds measured, along with general noncompliance with standards. An overarching activity was the upgrade of the Greek Atomic Energy Commission information system in order to collect and disseminate radiation data electronically, launch a networking strategy for interaction with stakeholders, and facilitate the process of regulatory control. In response to the above findings, regulatory actions have been initiated.

The use of active personal dosemeters as a personal monitoring device: comparison with TL dosimetry.

The use of active personal dosemeters (APDs) not only as a warning device but also, in some cases, as an official and hence stand-alone dosemeter is rapidly increasing. A comparison in terms of dose, energy and angle dependence, among different types of APD and a routinely used whole-body thermoluminescence dosemeter (TLD) has been performed. Significant differences were found between the TLD readings and mainly some not commonly used APDs. The importance of choosing the best adapted APD according to the radiation field characteristics is pointed out.

The effect of a compression paddle on energy response, calibration and measurement with mammographic dosimeters using ionization chambers and solid-state detectors.

A compression paddle is always used in mammography x-ray examinations, in order to improve image quality and reduce patient doses. Although clinical dose measurements should be performed with the paddle to interfere with the x-ray beam, calibration of mammography dosimeters is performed free in air without the presence of the paddle. The paddle hardens the x-ray beam, which has an impact on a dosimeter performance, particularly on high-energy-dependent detectors. Due to the paddle, clinical mammography x-ray systems may exhibit beams with HVL values exceeding those of the IEC 61267 RQR-M series qualities at which dosimeters are usually calibrated. In this study, the influence of the paddle in mammography dosimetry is examined, in Mo/Mo anode/filter x-ray qualities. PMMA slabs of 1, 2 and 3 mm thickness and Al foils of 0.05, 0.10 and 0.15 mm thicknesses were used to simulate the paddles, producing beams with HVL values from 0.28 up to 0.43 mmAl. In these qualities, four solid-state (ST) detectors and three ionizations chambers (IC) were calibrated in terms of Kair and N(K) and k(Q) were deduced. The results showed that all IC and two modern-type ST dosimeters have a flat energy response in the above HVL range (less than 3%), so their calibration factor at RQR-M2 quality could be safely used for clinical measurements. Two other ST dosimeters exhibit up to 20% energy response, so differences up to 15% in dose measurement may be observed if the effect of paddle on their performance is ignored. Finally, the need of additional mammographic calibration qualities to the existing IEC 61267 RQR-M series is examined and discussed.

Dosimetry quality audit of high energy photon beams in greek radiotherapy centers.

BACKGROUND AND PURPOSE: Dosimetry quality audits and intercomparisons in radiotherapy centers is a useful tool in order to enhance the confidence for an accurate therapy and to explore and dissolve discrepancies in dose delivery. This is the first national comprehensive study that has been carried out in Greece. During 2002--2006 the Greek Atomic Energy Commission performed a dosimetry quality audit of high energy external photon beams in all (23) Greek radiotherapy centers, where 31 linacs and 13 Co-60 teletherapy units were assessed in terms of their mechanical performance characteristics and relative and absolute dosimetry. MATERIALS AND METHODS: The quality audit in dosimetry of external photon beams took place by means of on-site visits, where certain parameters of the photon beams were measured, calculated and assessed according to a specific protocol and the IAEA TRS 398 dosimetry code of practice. In each radiotherapy unit (Linac or Co-60), certain functional parameters were measured and the results were compared to tolerance values and limits. Doses in water under reference and non reference conditions were measured and compared to the stated values. Also, the treatment planning systems (TPS) were evaluated with respect to irradiation time calculations. RESULTS: The results of the mechanical tests, dosimetry measurements and TPS evaluation have been presented in this work and discussed in detail. This study showed that Co-60 units had worse performance mechanical characteristics than linacs. 28% of all irradiation units (23% of linacs and 42% of Co-60 units) exceeded the acceptance limit at least in one mechanical parameter. Dosimetry accuracy was much worse in Co60 units than in linacs. 61% of the Co60 units exhibited deviations outside +/-3% and 31% outside +/-5%. The relevant percentages for the linacs were 24% and 7% respectively. The results were grouped for each hospital and the sources of errors (functional and human) have been investigated and discussed in details. CONCLUSION: This quality audit proved to be a useful tool for the improvement of quality in radiotherapy. It succeeded to disseminate the IAEA TRS-398 protocol in nearly all radiotherapy centers achieving homogenization and consistency of dosimetry within the country. Also, it detected discrepancies in dosimetry and provided guidance and recommendations to eliminate sources of errors. Finally, it proved that quality assurance programs, periodic quality control tests, maintenance and service play an important role for achieving accuracy and safe operation in radiotherapy.

Image quality evaluation and patient dose assessment of medical fluoroscopic X-ray systems: a national study.

This study presents the results from a survey conducted by the Greek Atomic Energy Commission (GAEC), during the period 1998-2003, in 530 public and private owned fluoroscopic X-ray systems in Greece. Certain operational parameters for conventional and remote control systems were assessed, according to a quality control protocol developed by GAEC on the basis of the current literature. Public (91.5%) and private (81.5%) owned fluoroscopic units exhibit high-contrast resolution values over 1 lp mm(-1). Moreover, 88.5 and 87.1% of the fluoroscopic units installed in the public and private sector, respectively, present Maximum Patient Entrance Kerma Rate values lower than 100 mGy min(-1). Additionally, 68.3% of the units assessed were found to perform within the acceptance limits. Finally, the third quartile of the Entrance Surface Dose Rate distribution was estimated according to the Dose Reference Level definition and found equal to 35 mGy min(-1).

Performance of medical radiographic X-ray systems in Greece for the time period 1998-2004.

This study presents the results of the on-site inspections performed by the Greek Atomic Energy Commission (GAEC) on conventional X-ray systems, both in public and private medical radiology departments. A part of the inspection concerns the assessment of important radiographic parameters obtained according to a specified quality control protocol and the comparison of the measured parameter values with the corresponding acceptance limits. A total number of 1011 radiographic systems were inspected by the GAEC during the period 1998-2004, with 63.4% of them being privately owned. Analysis of 8 different operational parameters is carried out providing information on the overall performance, as well as on each parameter of the inspected X-ray systems. Tube voltage reproducibility values show the highest percentage of acceptability (98.9%, 99.5% for private and public owned radiographic systems respectively), while linearity of radiation output for private systems (72.5%) and time accuracy for public ones (72.7%) show the worst results. The comparison of the results for the private sector to those of a similar study carried out during the period 1995-1997 indicates a substantial improvement in X-ray systems performance. Higher level of improvement shows exposure time accuracy (12.2% percentile increase) and linearity of radiation output (12.5% percentile increase). Nevertheless, the situation can be further optimized if maintenance and quality control of the radiographic systems are carried out on a more regular basis.

Calibration, performance and type testing of personal dosemeters used in ionising-radiation applications in Greece.

Active Personal Dosemeters (APDs) are widely used in real-time personal dosimetry. Their performance, operational characteristics and limitations, as well as their calibration should be routinely checked to assure satisfactory operation and safe use. This study summarises the results of such type tests and calibrations performed in almost 4750 dosemeters at Ionising Radiation Calibration Laboratory (HIRCL) of Greek Atomic Energy Commission (GAEC). About 13.8% of the pencil type and 4.3% of the electronic dosemeters were found to be out of limits of acceptable performance. For the pencil type dosemeters, the mean calibration factor (CF+/-SD) for high- and low-dose categories was found to be 1.014+/-0.102 (range 0.793-1.458) and 0.995+/-0.059 (range 0.794-1.311), respectively. Of these >85% of them had reproducibility better than 90%, while <1% showed remarkable non-linearity and approximately 10% of them failed to retain the dose reading within the limits after 24 h. For the electronic dosemeters, the mean CF was 1.034+/-0.046 (range 0.967-1.238). The majority of them showed good reproducibility and linearity results while, after irradiation, the dose readings were not shifted through time. The energy response varies with the dosemeter type, reaching in one dosemeter type down to 50%. Both electronic and pencil did not showed electronic equilibrium problems.

External beam irradiation in angioplasted arteries of hypercholesterolemic rabbits. The dose and time effect.

PURPOSE: To study the dose and time effect of external beam irradiation on the morphometry of both angioplasted and nonangioplasted arteries in a hypercholesterolemic rabbit model. METHODS AND MATERIALS: Eight groups of rabbit femoral arteries were studied: arteries (a) with no intervention, (b) irradiated with a 12-Gy 6 MV X-ray dose, (c) with a 18-Gy, (d) treated with balloon angioplasty, (e) dosed with 12-Gy half an hour post-angioplasty, (f) dosed with 18-Gy half an hour post-angioplasty, (g) dosed with 12-Gy 48 h post angioplasty, (g) dosed with 18-Gy 48 h post angioplasty. RESULTS: External irradiation at either 12 or 18 Gy was not found to change vessel morphometry in noninjured arteries. The 12-Gy dose given soon after angioplasty further increased percentage stenosis (63% on the average), despite the preservation of the lumen cross-sectional area. Positive remodeling was not observed in arteries given 18-Gy half an hour post angioplasty to counterbalance the increased neointimal formation. Therefore, this treatment resulted in a drastic reduction in lumen area and in enhancement of percentage stenosis (84% on the average). On the contrary, the delayed irradiation of the angioplasted arteries at either 12 or 18 Gy was not found to influence any of the studied morphometric parameters 5 weeks after angioplasty. CONCLUSIONS: Uniform external beam irradiation up to 18 Gy was well tolerated by intact femoral arteries. Prompt 12- or 18-Gy irradiations accentuated percentage stenosis. However the lumen cross-sectional area was preserved only at the lower dose point. Delayed irradiation at any dose did not influence the restenosis process.

Thermoluminescence dosimetry for quality assurance in radiation therapy.

A methodology based on thermoluminescence dosimetry was developed to check the output of teletherapy units and the given doses. It was applied in a hospital as a part of an extemal quality audit programme. Over a 7 year period the mean ratios of the output doses measured by TLDs calibrated free-in-air to the doses measured at the hospital in a 6 MV X ray and in a 60Co unit were 1.000 +/- 0.024 (n = 86) and 0.997 +/- 0.027 (n=61), respectively. TLDs in capsules were attached to the patient's body or to a phantom to assess entrance, exit and midline doses and transmission. Factors were determined experimentally to relate the doses measured with TLDs in capsules and inside the body. The accuracy in given doses with pelvic and tangential breast fields and assessed via 752 in vivo measurements, was considered to be adequately good, taking into account the limitations of the equipment available in the hospital.

External beam irradiation following balloon angioplasty in an atherosclerotic rabbit model.

PURPOSE: To study the effect of external beam irradiation on the morphometry of both angioplasted and nonangioplasted arteries in a hypercholesterolemic rabbit model. METHODS AND MATERIALS: Four groups of rabbit femoral arteries were studied: arteries (a) with no intervention, (b) irradiated with a 12-Gy x-ray dose, (c) treated with balloon angioplasty, and (d) dosed with 12 Gy 30 min after balloon angioplasty. RESULTS: External irradiation did not change vessel morphometry in nonangioplasted arteries. On the contrary, it induced neointimal formation and decreased luminal area, without causing any vessel remodeling in arteries treated with balloon angioplasty. CONCLUSION: External irradiation at 12 Gy given 30 min after angioplasty in the studied model accentuated the neointimal response to vascular injury, without causing any vessel remodeling.

Electron density of tissues and breast cancer radiotherapy: a quantitative CT study.

PURPOSE: To obtain more accurate data on the electron density of tissues to be used in the treatment planning of breast cancer patients. METHODS AND MATERIALS: Single kVp quantitative computed tomography was applied in 70 women, 20 to 77 years old, to study the electron density of the breast, the thoracic wall close and parallel to the breast, and the lung parenchyma. RESULTS: The electron density of the entire breast decreases with increasing age in premenopausal women and remains practically constant in postmenopausal women (8% less than that of water). No difference was found in the electron densities of the right and left breast. The electron density of the lung parenchyma in proximity to the breast is lower than the density in the entire lung parenchyma. CONCLUSIONS: Whenever no accurate data is available on individual patients, the electron density values to be used in treatment planning for breast and thoracic wall have to take into account both age and menstrual status. The regional differences in electron density of the lung also have to be considered.