Comparison of five methods for the derivation of spectra for a constant potential dental X-ray unit.

OBJECTIVES: To compare the diagnostic X-ray spectra derived by different methods for a constant potential dental X-ray unit. MATERIALS AND METHODS: Five methods of deriving X-ray spectra for a constant potential dental X-ray unit were compared: measurement by spectrometer using cadmium-zinc-telluride (CZT) detector, calculation by Monte Carlo simulation, calculation by two different, semi-empirical methods and estimation from transmission data. The dental X-ray set was a Heliodent MD unit (Sirona, Charlotte, NC, USA) operable at 60 or 70 kV. A semiconductor detector was used in the spectrometer measurements and an ionization chamber dosimeter in the transmission measurements. From the five methods, photon-fluence spectra were derived. Based on the photon-fluence spectra, average energies and transmission curves in aluminum were calculated. RESULTS: For all five methods, the average energies were within 2.4% of one another. Comparison of the transmission curves showed an average difference in the range of 1 to 6%. CONCLUSION: All of the five methods of deriving spectra are in extremely good agreement with each other.

X-ray spectra estimation using attenuation measurements from 25 kVp to 18 MV.

Attenuation measurements for primary x-ray spectra from 25 kVp to 18 MV were made using aluminum filters for all energies except for orthovoltage where copper filters were used. An iterative perturbation method, which utilized these measurements, was employed to derive the apparent x-ray spectrum. An initial spectrum or pre-spectrum was used to start the process. Each energy value of the pre-spectrum was perturbed positively and negatively, and an attenuation curve was calculated using the perturbed values. The value of x-rays in the given energy bin was chosen to minimize the difference between the measured and calculated transmission curves. The goal was to derive the minimum difference between the measured transmission curve and the calculated transmission curve using the derived x-ray spectrum. The method was found to yield useful information concerning the lower photon energy and the actual operating potential versus the nominal potential. Mammographic, diagnostic, orthovoltage, and megavoltage x-ray spectra up to 18 MV nominal were derived using this method. The method was validated using attenuation curves from published literature. The method was also validated using attenuation curves calculated from published spectra. The attenuation curves were then used to derive the x-ray spectra.

Measured water transmission curves and calculated zero field size tumor maximum ratios for 4, 6, and 15 MV x-rays.

A multihole diverging Cerrobend plug for megavoltage energies was used to measure water transmission values at different locations in a 20 x 20 cm field at 100 cm source-to-axis distance (SAD) for 4, 6, and 15 MV therapy photon beams. The transmission curves in water were measured at 25 locations across the 20 x 20 field, and each location was separated by 5 cm at the isocenter. Each transmission value was made using a 0.3175 cm diameter (0.079 cm2 area) hole of 20 cm length at the central axis (CAX). The small field measured transmission curve in water was used to derive the zero field size tumor maximum ratio (TMR) and the primary photon exposure spectrum as a function of energy at depth. The exposure spectrum was used to find an effective photon energy and linear attenuation coefficient at depth and at different locations in the field. These values were found to vary with location in the field.

Half-value layer and intensity variations as a function of position in the radiation field for film-screen mammography.

Differences in half-value layer (HVL) and radiation intensity are investigated as a function of position in the mammographic radiation field. Sources of systematic variation include the heel effect, the inverse square law, and differential photon path lengths through thicknesses of inherent and added filtration. The combination of these effects can increase the HVL by as much as 9% and reduce intensity by as much as 40% along the cathode-anode axis. To the left and right of the x-ray field central axis, reductions in radiation intensity of up to 9% and minor increases in HVL are noted as well. Optical density variations as a function of position in the field correlate well with the measured radiation intensity changes.

Calculated mammographic spectra confirmed with attenuation curves for molybdenum, rhodium, and tungsten targets.

A model for calculating mammographic spectra independent of measured data and fitting parameters is presented. This model is based on first principles. Spectra were calculated using various target and filter combinations such as molybdenum/molybdenum, molybdenum/rhodium, rhodium/rhodium, and tungsten/aluminum. Once the spectra were calculated, attenuation curves were calculated and compared to measured attenuation curves. The attenuation curves were calculated and measured using aluminum alloy 1100 or high purity aluminum filtration. Percent differences were computed between the measured and calculated attenuation curves resulting in an average of 5.21% difference for tungsten/aluminum, 2.26% for molybdenum/molybdenum, 3.35% for rhodium/rhodium, and 3.18% for molybdenum/rhodium. Calculated spectra were also compared to measured spectra from the Food and Drug Administration [Fewell and Shuping, Handbook of Mammographic X-ray Spectra (U.S. Government Printing Office, Washington, D.C., 1979)] and a comparison will also be presented.

CT reconstruction algorithm for a dental panoramic x-ray unit.

A variable Jacobian and weighted backprojection algorithm, used for medical CT, was adapted to perform CT reconstructions on data obtained with a dental panoramic x-ray unit. A detector array, fitted to the unit for the purpose of acquiring digital panoramic radiographs, was used to collect the data. Compensations were made for the incomplete (230 degrees) rotation of the panoramic x-ray unit, the non-fixed centre of rotation, the irregular rotation of the x-ray target and detector, and the resulting variances in magnification. The algorithm was tested on mathematically simulated phantoms and on acquired data. Reconstruction of simulated data proved the success of the algorithm. Real data reconstructions showed some defects as a result of inaccuracies in quantifying the experimental panoramic device.

Comparison of x-radiation doses between conventional and rare earth panoramic radiographic techniques.

The radiation dose to radiobiologically critical organs at various anatomic sites in a phantom was compared with the use of rare earth screen/film combinations and calcium tungstate screen/film combinations. Rare earth screens and films produced a reduction in dose up to 40% to 50% depending on the anatomic site.

Spatial resolution requirements for digitizing dental radiographs.

A study was performed to determine the appropriate spatial resolution for digitizing and transmitting dental radiographs with the KODAK EKTASCAN, a computer-based digital enhancement and transmission system. Periapical, bitewing, and panoramic radiographs were digitized in three formats representing varying spatial resolution parameters. Eight viewers used a 5-point rating scale to evaluate the detectability of periapical pathosis on the periapical images, of proximal surface caries on the bitewing images, and of various bony abnormalities on the panoramic images. Receiver operating characteristic curves were generated, and the results of the periapical, bitewing and panoramic experiments were presented as trapezoidal and maximum likelihood receiver operating characteristic curve areas. The results of this study indicate that digital images of dental radiographs provide adequate diagnostic accuracy for evaluating the presence of periapical pathosis, proximal surface caries, and specified bony abnormalities. The digitization parameters established for the KODAK EKTASCAN provide a guide for digitizing dental radiographs on other commercially available digital image-processing systems.

Electron beam depth dose scaling by means of effective atomic number reconstructed from CT scans.

A method is developed by which the computed tomography scans of a medium carried out at a number of diagnostic energies can be utilized to obtain the in situ "Effective Atomic Number" and "Effective Density". The electron depth dose curves in water when scaled by these factors estimate the actual electron depth dose distribution in that medium. It appears that the use of CT scans for electron beam treatment planning, in the management of cancer, is quite promising.

Extraction of information from CT scans at different energies.

The image displayed in computed tomography is a scaled representation of attenuation coefficients within the patient's body. A number of authors have presented methods by which additional information (such as electron density, effective atomic number, and extrapolated attenuation coefficients for therapy applications) can be extracted from CT scans carried out at different energies. In the present paper, the dual-energy method described by Rutherford has been used to produce complete images of effective atomic number and electron density of a known phantom (the AAPM phantom) in order to investigate the usefulness of applying this method to current commercial scanners.

Determination of effective energies in CT calibration.

The effective energy of a polychromatic beam for a Computed Tomography (CT) scanner can be measured directly only with difficulty. However, a linear relationship exists between the measured CT numbers and corresponding attenuation coefficients of known materials at the effective energy of the x-ray beam. The effective energy can then be determined by searching all energies for the best linear correlation between the CT numbers and the attenuation coefficients. This can be performed by two methods: graphically, by means of choosing visually the straightest of the fitted lines or, mathematically, by maximizing the correlation coefficient. The energy corresponding to the optimal fit is therefore selected as the effective energy. The latter method was implemented by computer and demonstrated by scanning the AAPM phantom, which contained known materials, and determining the effective energies and the relationship between the linear attenuation coefficients and CT numbers for three commercial units.

A method for rapid determination of the energy of electron beams from medical linear accelerators.

A method has been developed using a Varian Clinac-18 LINAC for the rapid determination of electron beam energy for clinically used linear accelerators. The method involves measuring the ionization values in a water or polystyrene phantom with an ion chamber at two predetermined depths. Then with predetermined Bremsstrahlung "tail" values which are presented here or which can be developed by the user, the practical range, Rp can be measured. With the Rp, the effective surface energy Eo of the electron beam can be determined by the Markus range-energy formula. Thus, by measuring just two depth ionization values, one is quickly able to determine the Eo of an electron beam without plotting a full depth ionization curve.

Treatment planning in Cobalt-60 radiotherapy using computerized tomography techniques.

Cobalt-60 transmission measurements were made through an Alderson phantom utilizing a transverse axial tomographic device and a NaI (Tl) detector. Measurements were made on different sections of the phantom for as many as 162 angles and 120 linear increments. The attenuation coefficients were reconstructed using both convolution and algebraic reconstruction techniques. Three-dimensional isodose distributions were obtained using the reconstructed attenuation coefficients. Comparison with standard treatment plans and measured isodose distribution using TLD techniques suggest that a more accurate isodose distribution may be obtained using the reconstructed attenuation coefficients, particularly in regions involving tissue heterogeneities.

Extrapolation of linear attenuation coefficients of biological materials from diagnostic-energy x-ray levels to the megavoltage range.

A dual-energy algorithm is used in determining the effective atomic number, atomic density, and electron density of biological substances. These quantities are then used to calculate linear attenuation coefficients at the megavolttage level. The validity of this method is checked several ways, including a comparison of extrapolated values with experimental data reported by Rao and Gregg where linear attenuation coefficients at 60 and 122 keV are used to extrapolate coefficients at 662 keV. Except for a few instances, the extrapolated values agree quite well with the reported experimental values. This method is also used to calculate coefficients at the 60Co range, and these are compared with experimental values measured in water and various types of tissue-equivalent materials. An additional algorithm is developed to extrapolate coefficients in water and bone up to 10 MeV. These quantities are compared with accepted values previously reported in the literature.

Estimation of chemical composition and density from computed tomography carried out at a number of energies.

A method is presented by whichcomputed tomography scans carried out at a number of energies may be utilized to obtain cross-sectional images of density and atomic number in addition to the conventional array of linear attenuation coefficients. This type of analysis has been carried out for various substances of biological relevance. Computer simulated reconstructions of clinical situations suggest that the method shows promise for providing additional diagnostic information and might dispense to some extent with the necessity of injecting contrast agents into the patient.

Correction for spectral artifacts in cross-sectional reconstruction from x rays.

A monoenergetic response correction is described which, along with adequate filtration, may be used to remove the spectral shift artifact encountered in three-dimensional reconstruction from x rays. Reconstructions were carried out by means of a convolution algorithm for simulated data using this method. These are compared with reconstructions obtained using fixed-length water-bath scans as a remedy for the special artifact. These studies suggest that the spectral artifact can be successfully eliminated from computerized cross-sectional scans without resorting to the use of the water bath while, at the same time, improving quantum statistics and/or permitting operation at a lower tube current.

Measurement of primary bremsstrahlung spectrum from an 8-MeV linear accelerator.

The bremsstrahlung spectrum from an 8-MeV linear accelerator has been measured using a NaI(T1) spectrometer system. The spectrum shows a low-energy cutoff at 0.4 MeV and the maximum photon energy to be approximately 6% greater than the nominal energy. The maximum emission of energy fluence was 1.6 and 1.8 MeV for measured and calculated values, respectively. The fast neutron dose in the photon beam was approximately 0.09% of the x-ray dose. The weighted mean energy was 2.3 MeV, measured value, and 2.4 MeV, calculated value.

Spectral effects on three-dimensional reconstruction from rays.

Continuous bremsstrahlung spectra were calculated for 120 kVp for constant and sinusoidal potentials. Fluorescent radiation for the tungsten target was added to the bremsstrahlung, and the spectra were attenuated through various filter materials. A drawing of an object to be scanned was divided into an array of small squares in which the composition was assumed to be constant. Transmission data for 120 rays at each of 120 angles spanning a range of 180 degrees were calculated. Two algorithms for the reconstruction of attenuation coefficients from projection data, an algebraic reconstruction technique (ART) and the convolution method, were utilized to reconstruct effective coefficients. The effect of spectral filtration on the quality of the reconstruction was evaluated. Lightly filtered x-ray beams give rise to severe distortions in image quality, with values of the reconstructed coefficients rising toward the periphery of the object. Highly filtered beams give rise to images with less pronounced distortion.