Influence of Backscatter Radiation on Cranial Bone Fixation Devices.

Postoperative radiation can cause ulcer formation, leading to the denudation of skin over alloplastic materials. The influence of backscatter radiation from fixation devices has not been investigated. The aim of this study is to evaluate backscatter dose variations for different cranial bone fixation devices in an experimental model designed to simulate postoperative radiotherapy. The authors assessed the radiation backscatter doses associated with resorbable (PLLA-PGA) and titanium plates. The samples were irradiated with 6 and 10 MV photon beams from a linear accelerator. Measurements were obtained using an ionization chamber and radiochromic films cut from the same batch. As a result, the backscatter radiation of water and PLLA-PGA proportionally decreased as the depth increased. However, the backscatter radiation of the titanium plate increased just above the plate. This depth lies in the region of the scalp. Each material showed a dose of radioactivity that was higher at 10 MV than that at 6 MV. These devices showed a significant difference, which suggested that these materials amplified the dose compared with water at 6 MV. In conclusion, it is supposed that PLLA-PGA should be used to fix the cranium to decrease the potential for radiation ulcers.

Influence of backscatter radiation on cranial reconstruction implants.

OBJECTIVE: We aimed to evaluate backscatter dose variations in different cranial bone implant materials in an experimental model designed to simulate post-operative radiotherapy. METHODS: We assessed the radiation backscatter doses associated with sheet- and mesh-type titanium plates and hydroxyapatite (HAP) samples (porosity: 35%, 50% and 85%). The samples were irradiated with 6- and 10-MV photon beams from a linear accelerator. Measurements were obtained using an ionization chamber and radiochromic films cut from the same batch. RESULTS: At 6 MV, the titanium sheet showed the highest peak for backscattered radiation, followed by (in decreasing order) HAP30%, HAP50%, titanium mesh and HAP85%. At 10 MV, HAP30% showed the highest peak, followed by HAP50%, titanium sheet, titanium mesh and HAP85%. The peaks were at different depths in the titanium and HAP samples. The thickness of the human scalp is approximately 7 mm; therefore, measurements were obtained 0-7 mm above the implants to assess the likely dose on the scalp. A comparison of the maximum dose on the scalp showed the titanium sheet had the highest dose at both 6 and 10 MV. CONCLUSION: The backscatter dose differed with the density of the material and the backscatter depth was different for each material. Advances in knowledge: Ulcer formation due to radiotherapy after brain tumour depends on not only radiation but also the implant material. Therefore, the density and type of implant material should be considered when planning radiotherapy and selecting bone reconstruction materials.

Surface dose measurement in patients and physicians and effective dose estimation in patients during uterine artery embolisation.

Surface dose monitoring in patients and physicians during 29 uterine artery embolisation (UAE) procedures was performed using photoluminescence dosemeters and thermo-luminescence dosemeters. Organ or tissue doses were measured with an anthropomorphic phantom using UAE exposure conditions averaged from the 29 cases, and effective doses were estimated for the patient. Entrance surface dose of the patients at the maximum dose position ranged from 121.5 to 1650 mGy. Estimated doses ranged from 3.16 to 43 mGy for the ovary and from 3.8 to 51.8 mGy for the uterus. The effective dose was 1.09-14.8 mSv. Monitored doses on the body surface of physicians were relatively high in the upper arm (5.41+/-1.52 to 163+/-17.25 microGy) and the hand and fingers (0.85+/-1.18 to 222+/-16.4 microGy).

Effective doses in subjects undergoing computed tomography cardiac imaging with the 256-multislice CT scanner.

BACKGROUND: The 256-multislice CT (256MSCT) obtains volumetric data with 128-mm coverage in a single rotation. This coverage allows satisfactory visualization of the whole heart, allowing the 256MSCT to visualize the cardiac chambers and coronary arteries by cine scan without ECG gating. These characteristics provide a solution to the problems of MSCT. Although a wider beam width provides more efficient imaging over a wider coverage area, patient doses with the 256MSCT are of considerable concern. OBJECTIVE: We assessed potential radiation exposure with the 256MSCT in a cardiac CT protocol and compared the results to those with 16- and 64MSCT (collimated 64x0.5mm using 256MSCT). METHODS: Organ or tissue doses were measured in an anthropomorphic phantom under a coronary artery imaging protocol with the 256MSCT in cine scan mode without ECG gating, and with the 16- and 64MSCT in helical scan mode with ECG gating. RESULTS: Average effective doses were 22.8mSv for the 16MSCT, 27.8mSv for the 64MSCT and 14.1mSv for the 256MSCT. The 16- and 64MSCT doses were thus approximately 1.6- and 2.0-fold higher than those of the 256MSCT. CONCLUSIONS: Use of the 256MSCT in cardiac volumetric cine imaging offers lower radiation exposure than 16- and 64MSCT, and suggests the potential of this equipment in single-beat cardiac imaging without ECG gating. This effective dose is acceptable for routine cardiac imaging.

Patient dose estimation for multi-detector-row CT examinations.

The spread of Multi-detector-row computed tomography (MDCT) has been remarkable. Here, various organ and tissue doses were evaluated with six types of MDCT scanners in common use in Japan; using thermoluminescence dosimeters and anthropomorphic phantoms under condition of routine clinical examinations of the chest in adult and child, of the head in child and of the abdomen-pelvis in adult. Estimated lung doses and averaged effective dose in chest examinations were 19.2 +/- 2.03 mGy and 9.54 +/- 0.90 mSv for the adult and 15.7 +/- 1.88 mGy and 7.42 +/- 0.82 mSv for the child phantom, respectively. The numerical difference between effective dose and organ or tissue doses was about 2-2.5 times. For the adult abdomen-pelvis examinations, averaged effective dose was 13.0 +/- 3.72 mSv. Averaged effective dose for the child head examinations was 2.6 +/- 1.32 mSv. In one case, the dose approached 80 mGy for the brain in the head examination, giving a difference from the effective dose of 10 times or more.

Prototype heel effect compensation filter for cone-beam CT.

The prototype cone-beam CT (CBCT) has a larger beam width than the conventional multi-detector row CT (MDCT). This causes a non-uniform angular distribution of the x-ray beam intensity known as the heel effect. Scan conditions for CBCT tube current are adjusted on the anode side to obtain an acceptable clinical image quality. However, as the dose is greater on the cathode side than on the anode side, the signal-to-noise ratio on the cathode side is excessively high, resulting in an unnecessary dose amount. To compensate for the heel effect, we developed a heel effect compensation (HEC) filter. The HEC filter rendered the dose distribution uniform and reduced the dose by an average of 25% for free air and by 20% for CTDI phantoms compared to doses with the conventional filter. In addition, its effect in rendering the effective energy uniform resulted in an improvement in image quality. This new HEC filter may be useful in cone-beam CT studies.