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Yoshida T, Sasaki K, Hayakawa T, Kawadai T, Shibasaki T, Kawasaki Y. Recommendation for reducing the crystalline lens exposure dose by reducing imaging field width in cone-beam computed tomography for image-guided radiation therapy: an anthropomorphic phantom study. Radiol Phys Technol 2024:10.1007/s12194-024-00810-0. [PMID: 38691308 DOI: 10.1007/s12194-024-00810-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/23/2024] [Accepted: 04/26/2024] [Indexed: 05/03/2024]
Abstract
In cone-beam computed tomography (CBCT) for image-guided radiation therapy (IGRT) of the head, we evaluated the exposure dose reduction effect to the crystalline lens and position-matching accuracy by narrowing one side (X2) of the X-ray aperture (blade) in the X-direction. We defined the ocular surface dose of the head phantom as the crystalline lens exposure dose and measured using a radiophotoluminescence dosimeter (RPLD, GD-352 M) in the preset field (13.6 cm) and in each of the fields when blade X2 aperture was reduced in 0.5 cm increments from 10.0 to 5.0 cm. Auto-bone matching was performed on CBCT images acquired five times with blade X2 aperture set to 13.6 cm and 5.0 cm at each position when the head phantom was moved from - 5.0 to + 5.0 mm in 1.0 mm increment. The maximum reduction rate in the crystalline lens exposure dose was - 38.7% for the right lens and - 13.2% for the left lens when blade X2 aperture was 5.0 cm. The maximum difference in the amount of position correction between blade X2 aperture of 13.6 cm and 5.0 cm was 1 mm, and the accuracy of auto-bone matching was similar. In CBCT of the head, reduced blade X2 aperture is a useful technique for reducing the crystalline lens exposure dose while ensuring the accuracy of position matching.
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Affiliation(s)
- Tatsuya Yoshida
- Department of Radiology, Koritsu Tatebayashi Kosei General Hospital, Gunma, Japan.
- Graduate School of Radiological Technology, Gunma Prefectural College of Health Sciences, Gunma, Japan.
| | - Koji Sasaki
- Graduate School of Radiological Technology, Gunma Prefectural College of Health Sciences, Gunma, Japan
| | - Tomoki Hayakawa
- Department of Radiology, Koritsu Tatebayashi Kosei General Hospital, Gunma, Japan
| | - Toshiyuki Kawadai
- Department of Radiology, Koritsu Tatebayashi Kosei General Hospital, Gunma, Japan
| | - Takako Shibasaki
- Department of Radiology, Koritsu Tatebayashi Kosei General Hospital, Gunma, Japan
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Xu Q, Vinogradskiy Y, Grimm J, Nie W, Dupre P, Chawla AK, Bajaj G, Yang H, LaCouture T, Fan J. Evaluation of a novel patient-specific quality assurance phantom for robotic single-isocentre, multiple-target stereotactic radiosurgery, and stereotactic radiotherapy. Br J Radiol 2024; 97:660-667. [PMID: 38401536 PMCID: PMC11027335 DOI: 10.1093/bjr/tqae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/26/2023] [Accepted: 01/11/2024] [Indexed: 02/26/2024] Open
Abstract
OBJECTIVES To evaluate patient-specific quality assurance (PSQA) of 3 targets in a single delivery using a novel film-based phantom. METHODS The phantom was designed to rotate freely as a sphere and could measure 3 targets with film in a single delivery. After identifying the coordinates of 3 targets in the skull, the rotation angles about the equator and meridian were computed for optimal phantom setup, ensuring the film plane intersected the 3 targets. The plans were delivered on the CyberKnife system using fiducial tracking. The irradiated films were scanned and processed. All films were analysed using 3 gamma criteria. RESULTS Fifteen CyberKnife test plans with 3 different modalities were delivered on the phantom. Both automatic and marker-based registration methods were applied when registering the irradiated film and dose plane. Gamma analysis was performed using a 3%/1 mm, 2%/1 mm, and 1%/1 mm criteria with a 10% threshold. For the automatic registration method, the passing rates were 98.2% ± 1.9%, 94.2% ± 3.7%, and 80.9% ± 6.3%, respectively. For the marker-based registration approach, the passing rates were 96.4% ± 2.7%, 91.7% ± 4.3%, and 78.4% ± 6.2%, respectively. CONCLUSIONS A novel spherical phantom was evaluated for the CyberKnife system and achieved acceptable PSQA passing rates using TG218 recommendations. The phantom can measure true-composite dose and offers high-resolution results for PSQA, making it a valuable device for robotic radiosurgery. ADVANCES IN KNOWLEDGE This is the first study on PSQA of 3 targets concurrently on the CyberKnife system.
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Affiliation(s)
- Qianyi Xu
- Department of Advanced Radiation Oncology and Proton Therapy, Inova Schar Cancer Institute, Fairfax, VA 22031, United States
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA 19107, United States
| | - Yevgeniy Vinogradskiy
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA 19107, United States
| | - Jimm Grimm
- Department of Radiation Oncology, Wellstar Health System, Marietta, GA 30060, United States
| | - Wei Nie
- Department of Advanced Radiation Oncology and Proton Therapy, Inova Schar Cancer Institute, Fairfax, VA 22031, United States
| | - Pamela Dupre
- Department of Advanced Radiation Oncology and Proton Therapy, Inova Schar Cancer Institute, Fairfax, VA 22031, United States
| | - Ashish K Chawla
- Department of Advanced Radiation Oncology and Proton Therapy, Inova Schar Cancer Institute, Fairfax, VA 22031, United States
| | - Gopal Bajaj
- Department of Advanced Radiation Oncology and Proton Therapy, Inova Schar Cancer Institute, Fairfax, VA 22031, United States
| | - Haihua Yang
- Department of Radiation Oncology, Taizhou Hospital, Zhejiang 317000, China
| | - Tamara LaCouture
- Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, PA 19107, United States
| | - Jiajin Fan
- Department of Advanced Radiation Oncology and Proton Therapy, Inova Schar Cancer Institute, Fairfax, VA 22031, United States
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Ryu JC, Yoon JT, Kim BJ, Kim MH, Moon EJ, Suh PS, Roh YH, Moon HH, Kwon B, Lee DH, Song Y. Impact of a selective lens dose reduction protocol in 3D rotational angiography on radiation exposure to the eye lens during cerebral angiography: a randomized controlled trial. J Neurointerv Surg 2023:jnis-2023-020730. [PMID: 37739793 DOI: 10.1136/jnis-2023-020730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/29/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND We aimed to investigate the radiation dose to the eye lens (lens dose) during cerebral angiography and to evaluate the effectiveness of the lens dose reduction protocol for 3-dimensional rotational angiography (3D-RA) in reducing overall lens dose exposure. METHODS We conducted a randomized, controlled clinical trial at a tertiary hospital with patients undergoing cerebral angiography. The lens dose reduction protocol in 3D-RA involved raising the table to position the patient's eye lens away from the rotation axis. The lens dose was estimated by measuring the entrance surface air kerma using a photoluminescent glass dosimeter. The lens doses of 3D-RA, overall examination, and image quality were analyzed and compared between the two groups. RESULTS A total of 20 participants (mean age, 58±9.4 years; including 12 men [60%]) were enrolled and randomly assigned to either the conventional group or the dose reduction group. The median lens dose in 3D-RA was significantly lower in the dose reduction group compared with the conventional group (1.1 mGy vs 4.5 mGy, p<0.001). The total dose was significantly lower in the dose reduction group (median of 7.5 mGy vs 10.2 mGy, p=0.003). In the conventional group, 3D-RA accounted for 46% of the total lens dose, while in the dose reduction group, its proportion decreased to 16%. No significant differences were observed in the image quality between the groups. CONCLUSION The lens dose reduction protocol resulted in a significant reduction in the lens dose of the 3D-RA as well as entire cerebral angiography, while maintaining the image quality.
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Affiliation(s)
- Jae-Chan Ryu
- Neurology, Korea University Ansan Hospital, Ansan, Korea (the Republic of)
| | - Jong-Tae Yoon
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Byung Jun Kim
- Advanced Therapies, Siemens Healthineers Co Ltd, Seoul, Korea (the Republic of)
| | - Mi Hyeon Kim
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Eun Ji Moon
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Pae Sun Suh
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Yun Hwa Roh
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Hye Hyeon Moon
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Boseong Kwon
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Deok Hee Lee
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
| | - Yunsun Song
- Radiology, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
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Ryu JC, Yoon JT, Kim BJ, Kim MH, Moon EJ, Suh PS, Roh YH, Moon HH, Kwon B, Lee DH, Song Y. Reduction of Radiation Dose to Eye Lens in Cerebral 3D Rotational Angiography Using Head Off-Centering by Table Height Adjustment: A Prospective Study. Korean J Radiol 2023; 24:681-689. [PMID: 37404110 DOI: 10.3348/kjr.2023.0169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/29/2023] [Accepted: 04/24/2023] [Indexed: 07/06/2023] Open
Abstract
OBJECTIVE Three-dimensional rotational angiography (3D-RA) is increasingly used for the evaluation of intracranial aneurysms (IAs); however, radiation exposure to the lens is a concern. We investigated the effect of head off-centering by adjusting table height on the lens dose during 3D-RA and its feasibility in patient examination. MATERIALS AND METHODS The effect of head off-centering during 3D-RA on the lens radiation dose at various table heights was investigated using a RANDO head phantom (Alderson Research Labs). We prospectively enrolled 20 patients (58.0 ± 9.4 years) with IAs who were scheduled to undergo bilateral 3D-RA. In all patients' 3D-RA, the lens dose-reduction protocol involving elevation of the examination table was applied to one internal carotid artery, and the conventional protocol was applied to the other. The lens dose was measured using photoluminescent glass dosimeters (GD-352M, AGC Techno Glass Co., LTD), and radiation dose metrics were compared between the two protocols. Image quality was quantitatively analyzed using source images for image noise, signal-to-noise ratio, and contrast-to-noise ratio. Additionally, three reviewers qualitatively assessed the image quality using a five-point Likert scale. RESULTS The phantom study showed that the lens dose was reduced by an average of 38% per 1 cm increase in table height. In the patient study, the dose-reduction protocol (elevating the table height by an average of 2.3 cm) led to an 83% reduction in the median dose from 4.65 mGy to 0.79 mGy (P < 0.001). There were no significant differences between dose-reduction and conventional protocols in the kerma area product (7.34 vs. 7.40 Gy·cm², P = 0.892), air kerma (75.7 vs. 75.1 mGy, P = 0.872), and image quality. CONCLUSION The lens radiation dose was significantly affected by table height adjustment during 3D-RA. Intentional head off-centering by elevation of the table is a simple and effective way to reduce the lens dose in clinical practice.
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Affiliation(s)
- Jae-Chan Ryu
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong-Tae Yoon
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - Byung Jun Kim
- Advanced Therapies, Siemens Healthineers Ltd., Seoul, Korea
| | - Mi Hyeon Kim
- Biomedical Engineering Research Center, Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - Eun Ji Moon
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Pae Sun Suh
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yun Hwa Roh
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hye Hyeon Moon
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Boseong Kwon
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Deok Hee Lee
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yunsun Song
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Fingernail electron paramagnetic resonance dosimetry protocol for localized hand exposure accident. NUCLEAR ENGINEERING AND TECHNOLOGY 2022. [DOI: 10.1016/j.net.2022.08.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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