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Piai A, Loria A, Tiberio P, Magnino S, Campoleoni M, Sconfienza LM, del Vecchio A. ASSESSMENT OF PCXMC MONTE CARLO SIMULATIONS IN SLOT-SCANNING-BASED EXAMINATIONS: COMPARISON WITH IN-PHANTOM THERMOLUMINESCENT DOSIMETRY. RADIATION PROTECTION DOSIMETRY 2023; 199:ncac273-234. [PMID: 36583519 PMCID: PMC9985171 DOI: 10.1093/rpd/ncac273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 10/07/2022] [Accepted: 11/19/2022] [Indexed: 06/17/2023]
Abstract
Slot-scanning technology is nowadays a valid solution for the follow-up of chronic musculoskeletal disorders on children and adolescent patients, but there is no commercial software designed for simulating this X-ray beam geometry. PC Program for X-ray Monte Carlo (PCXMC) is a widespread Monte Carlo software developed for dose computation in projection radiography. In this study, experimental measurements were performed to evaluate its applicability in examinations with a slit-beam device. Physical phantoms corresponding to an adult and a 5-y-old child with calibrated thermoluminescent dosemeters were used for experiments. Different simulation approaches were investigated. Differences between measured and calculated organ doses ranged from -95 to 67% and were statistically significant for almost all organs. For both patients, PCXMC underestimated the effective dose of about 25%. This study suggests that PCXMC is not suited for organ dose evaluation in examinations with slot-scanning devices. It is still a useful tool for effective dose estimation when a proper correction factor is applied.
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Affiliation(s)
| | - A Loria
- Medical Physics Department, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - P Tiberio
- Medical Physics Department, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - S Magnino
- Postgraduate School of Medical Physics, Università degli Studi di Milano, 20133 Milan, Italy
| | - M Campoleoni
- Medical Physics Unit, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - L M Sconfienza
- Unit of Diagnostic and Interventional Radiology, IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, 20123 Milan, Italy
| | - A del Vecchio
- Medical Physics Department, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
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Hamzian N, Roozmand Z, Abrisham SMJ, Abdollahi-Dehkordi S, Afereydoon S, Ghorbani M, Deevband MR. Monte Carlo evaluation of effective dose and risk of exposure induced cancer death (REID) for common examinations in stereo radiography (EOS) imaging: Considering age and gender. J Med Imaging Radiat Sci 2022; 53:283-290. [DOI: 10.1016/j.jmir.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 02/26/2022] [Accepted: 03/04/2022] [Indexed: 11/25/2022]
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Kelly C, Delakis I. Technical evaluation of a clinical, bi-planar, digital and upright X-ray imaging unit. J Med Radiat Sci 2021; 68:475-481. [PMID: 34096199 PMCID: PMC8655884 DOI: 10.1002/jmrs.519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 05/04/2021] [Accepted: 05/22/2021] [Indexed: 11/07/2022] Open
Abstract
We describe the technical evaluation of the commercially available, clinical, bi-planar, low dose, digital X-ray system (EOS System, EOS imaging, France). The unit is used for upright, weight-bearing musculoskeletal pathologies, in particular, in the spine and lower limbs. The evaluation incorporated tests on the X-ray generator performance, radiation/imaging field alignment, dose area product accuracy and image quality. The assessment methodology was based on objective parameters and required equipment readily available for technical evaluation of other radiological equipment. Results demonstrated that the system performs well within acceptable performance criteria with regard to X-ray generator performance, radiation/imaging field alignment and dose area product accuracy. In addition, results from the image-quality assessment were aligned with previously published work. The work presented in this article can be used for the technical evaluation of the EOS System at other clinical sites.
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Affiliation(s)
- Charlotte Kelly
- Radiology DepartmentSidra Medical and Research CenterDohaQatar
| | - Ioannis Delakis
- Radiology DepartmentSidra Medical and Research CenterDohaQatar
- Radiology DepartmentWeill Cornell Medical CollegeNYUSA
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Hamzian N, Afereydoon S, Ghorbani M, Abrisham SMJ, Roozmand Z, Abdollahi-Dehkordi S, Sepehr Javan M, Reza Deevband M. Equivalent Dose and Risk of Exposure Induced Cancer Death of Different Organs due to Various Image Techniques of EOS Imaging System. J Biomed Phys Eng 2021; 11:289-296. [PMID: 34189117 PMCID: PMC8236105 DOI: 10.31661/jbpe.v0i0.2012-1242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 01/26/2021] [Indexed: 11/16/2022]
Abstract
Background: Euronext Paris Advanced Orthopedic Solutions (EOS) system is a new radiography system, capable of obtaining two-dimensional and three-dimensional images from bony structures in the body. Objective: The aim of this study is to estimate equivalent dose and the risk of exposure induced cancer death (REID) in different organs of body due to EOS imaging system. Material and Methods: In this experimental study, totally 120 patients were evaluated for various imaging techniques of lower limb, full spine and whole body. Equivalent dose and REID for colon, liver, lung, stomach, breast, bladder, ovary, blood cells (leukemia) and other organs were calculated using PCXMC software (version 2.0.1.2) based on Monte Carlo simulation of X-ray and human phantoms. The data on imaging technique, including age, sex, kVp, dose area product (DAP), mA, focal to detector distance were introduced as the input of PCXMC. Results: The maximum equivalent dose (mSv) due to EOS imaging system, was estimated for the bladder 0.240±0.066 for the full body technique and 0.240±0.093 for the lower limb technique, respectively, in both males and females. The maximum organ REID (incidence per million) due to EOS imaging system was estimated for lungs as 2.59±1.0 and 2.53±0.9, for the full body technique in both males and females, respectively. Conclusion: Generally, the equivalent dose and REID by EOS imaging system in different organs of body is low due to the low radiation dose received by the body in different techniques and views.
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Affiliation(s)
- Nima Hamzian
- PhD, Department of Medical Physics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Saeid Afereydoon
- MSc, Department of Medical Physics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahdi Ghorbani
- PhD, Department of Biomedical Engineering and Medical Physics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Jalil Abrisham
- MD, Department of EOS Imaging, Shahid Sadoughi General Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Zahra Roozmand
- BSc, Department of Medical Physics, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sepideh Abdollahi-Dehkordi
- MSc, Department of Medical Physics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Morteza Sepehr Javan
- BSc, Department of EOS Imaging, Shahid Sadoughi General Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Reza Deevband
- PhD, Department of Biomedical Engineering and Medical Physics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Pedersen PH, Petersen AG, Ostgaard SE, Tvedebrink T, Eiskjær SP. HOW MANY DOSEMETERS ARE NEEDED FOR CORRECT MEAN ORGAN DOSE ASSESSMENT WHEN PERFOMING PHANTOM DOSIMETRY? A PHANTOM STUDY EVALUATING LIVER ORGAN DOSE AND INVESTIGATING TLD NUMBERS AND WAYS OF DOSEMETER PLACEMENT. RADIATION PROTECTION DOSIMETRY 2020; 189:475-488. [PMID: 32424427 DOI: 10.1093/rpd/ncaa062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 03/28/2020] [Accepted: 04/15/2020] [Indexed: 06/11/2023]
Abstract
This study evaluated repeated mean organ dose measurements of the liver by phantom dosimetry and statistical modelling in order to find a way to reduce the number of dosemeters needed for precise organ dose measurements. Thermoluminescent dosemeters were used in an adult female phantom exposed to a biplanar x-ray source at three different axial phantom rotations. Generalised mixed linear effect modelling was used for statistical analysis. A subgroup of five to six organ-specific locations out of 28 yielded mean liver organ doses within 95% confidence intervals of measurements based on all 28 liver-specific dosemeter locations. No statistical difference of mean liver dose was observed with rotation of the phantom either 10° clockwise or counter-clockwise as opposed to the coronal plane. Phantom dosimetry handling time during organ dose measurements can be markedly reduced, in this case the liver, by 79% (22/28), while still providing precise mean organ dose measurements.
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Affiliation(s)
- Peter H Pedersen
- Department of Orthopaedic Surgery, Aalborg Universitetshospital, Syd, Hobrovej 18-22, 9000 Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Fredrik Bajers Vej 5, 9100 Aalborg, Denmark
| | - Asger G Petersen
- Region Nordjylland, Røntgenfysik, Merkurvej 13, 9700 Brønderslev, Denmark
| | - Svend E Ostgaard
- Department of Orthopaedic Surgery, Aalborg Universitetshospital, Syd, Hobrovej 18-22, 9000 Aalborg, Denmark
| | - Torben Tvedebrink
- Department of Mathematical Sciences, Aalborg University, Skjernvej 4A, 9220 Aalborg Øst, Denmark
| | - Søren P Eiskjær
- Department of Orthopaedic Surgery, Aalborg Universitetshospital, Syd, Hobrovej 18-22, 9000 Aalborg, Denmark
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Oakley PA, Harrison DE. Are Restrictive Medical Radiation Imaging Campaigns Misguided? It Seems So: A Case Example of the American Chiropractic Association's Adoption of "Choosing Wisely". Dose Response 2020; 18:1559325820919321. [PMID: 32425722 PMCID: PMC7218311 DOI: 10.1177/1559325820919321] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 03/12/2020] [Accepted: 03/20/2020] [Indexed: 12/18/2022] Open
Abstract
Since the 1980s, increased utilization of medical radiology, primarily computed tomography, has doubled medically sourced radiation exposures. Ensuing fear-mongering media headlines of iatrogenic cancers from these essential medical diagnostic tools has led the public and medical professionals alike to display escalating radiophobia. Problematically, several campaigns including Image Gently, Image Wisely, and facets of Choosing Wisely propagate fears of all medical radiation, which is necessary for the delivery of effective and efficient health care. Since there are no sound data supporting the alleged risks from low-dose radiation and since there is abundant evidence of health benefits from low-doses, these imaging campaigns seem misguided. Further, thresholds for cancer are 100 to 1000-fold greater than X-rays, which are within the realm of natural background radiation where no harm has ever been validated. Here, we focus on radiographic imaging for use in spinal rehabilitation by manual therapists, chiropractors, and physiotherapists as spinal X-rays represent the lowest levels of radiation imaging and are critical in the diagnosis and management of spine-related disorders. Using a case example of a chiropractic association adopting "Choosing Wisely," we argue that these campaigns only fuel the pervasive radiophobia and continue to constrain medical professionals, attempting to deliver quality care to patients.
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Ben-Sira L, Shiran SI, Pratt LT, Precel R, Ovadia D, Constantini S, Roth J. Use of EOS Low-Dose Biplanar X-Ray for Shunt Series in Children with Hydrocephalus: A Preliminary Study. World Neurosurg 2018; 116:e273-e277. [PMID: 29730101 DOI: 10.1016/j.wneu.2018.04.187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Revised: 04/24/2018] [Accepted: 04/25/2018] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Shunt series (SS) are a common diagnostic tool used to verify shunt integrity. SS include X-ray films of the skull, chest, and abdomen and often are performed either when a shunted patient presents with suspected shunt malfunction or as a screening test to identify shunt disconnections or dislodgment. EOS low-dose biplanar X-rays are associated with significantly reduced radiation doses compared with ordinary X-rays and are used for various indications. This is the first publication on the use of EOS as a SS technique. METHODS Over a period of 6 months, EOS were performed at our center for various orthopedic indications, mostly for scoliosis evaluation. Nine children (<20 years of age) had a ventriculoperitoneal shunt and served as the study group. We retrospectively reviewed shunt visibility and integrity in the EOS scans as well as regular SS or plain spinal X-rays. RESULTS Three patients had bilateral shunts, and 8 had previous X-rays for comparison. In all patients, the shunt integrity was easily demonstrated on the EOS images. Two patients had an identified shunt disconnection confirmed on the EOS images. No shunt-related information was missed on the EOS compared with the other X-ray images. CONCLUSIONS These preliminary results suggest that EOS may be used as an alternative technology to demonstrate shunt integrity instead of regular X-ray SS. Favorable shunt visibility without the need for multiple radiation exposures and image processing (such as stitching) results in a significantly shorter examination time and significant less radiation.
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Affiliation(s)
- Liat Ben-Sira
- Division of Pediatric Radiology, Department of Radiology, Dana Children's Hospital, Tel-Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Shelly I Shiran
- Division of Pediatric Radiology, Department of Radiology, Dana Children's Hospital, Tel-Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Li-Tal Pratt
- Division of Pediatric Radiology, Department of Radiology, Dana Children's Hospital, Tel-Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Ronit Precel
- Division of Pediatric Radiology, Department of Radiology, Dana Children's Hospital, Tel-Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Dror Ovadia
- Department of Pediatric Orthopedics, Dana Children's Hospital, Tel-Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Shlomi Constantini
- Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Jonathan Roth
- Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel.
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Morel B, Moueddeb S, Blondiaux E, Richard S, Bachy M, Vialle R, Ducou Le Pointe H. Dose, image quality and spine modeling assessment of biplanar EOS micro-dose radiographs for the follow-up of in-brace adolescent idiopathic scoliosis patients. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 27:1082-1088. [DOI: 10.1007/s00586-018-5464-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 12/15/2017] [Accepted: 01/04/2018] [Indexed: 11/28/2022]
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