Background: The present study investigated the radiation dose distribution of balloon kyphoplasty (BKP) among surgeons and medical staff, and this is the first research to observe such exposure in Japan. Materials and Methods: The study subjects were an orthopedic surgeon (n = 1) and surgical staff (n = 9) who intervened in BKP surgery performed at the National Hospital Organization Disaster Medical Center (Tokyo, Japan) between March 2019 and October 2019. Only disposable protective gloves (0.022 mmPb equivalent thickness or less) and trunk protectors were used, and no protective glasses or thyroid drapes were used. Results and Discussion: The surgery time per vertebral body was 36.2 minutes, and the fluoroscopic time was 6.8 minutes. The average exposure dose per vertebral body was 1.46 mSv for the finger (70 ㎛ dose equivalent), 0.24 mSv for the lens of the eye (3 mm dose equivalent), 0.11 mSv for the neck (10 mm dose equivalent), and 0.03 mSv for the chest (10 mm dose equivalent) under the protective suit.The estimated cumulative radiation exposure dose of 23 cases of BKP was calculated to be 50.37 mSv for the fingers, 8.27 mSv for the lens, 3.91 mSv for the neck, and 1.15 mSv for the chest. Conclusion: It is important to know the exposure dose of orthopedic surgeons, implement measures for exposure reduction, and verify the safety of daily use of radiation during surgery and examination.
Recently pediatric CT has been performed by reduced dose according to tube current modulation이라고, this fact has a possibility more reduce a dose because of strong affect depend on tube current modulation. Almost all MDCT snow show and allow storage of the volume CT dose index (CTDIvol), dose length product (DLP), and effective dose estimations on dose reports, which are essential to assess patient radiation exposure and risks. To decrease these radiation exposure risks, the principles of justification and optimization should be followed. justification means that the examination must be medically indicated and useful. Results is using tube current modulation이라고 tend to the lower kV, the lower effective dose. In case of use a low dose CT protocol, we found a relatively lower effective dose than using tube current modulation. Average effective dose of our studies(brain, chest, abdomen-pelvis) less than 47%, 13.8%, 25.7% of germany reference dose, and 55.7%, 10.2%, 43.6% of UK(United Kingdom) reference dose respectively. when performed examination for reduced dose, we must use tube current modulation and low dose CT protocol including body-weight based tube current adaption.
Background: Radiotherapy is an important treatment of choice for breast cancer patients after breast-conserving surgery, and we compare the feasibility of using dual arc volumetric modulated arc therapy (VMAT2), single arc volumetric modulated arc therapy (VMAT1) and Multi-beam Intensity Modulated Radiotherapy (M-IMRT) on patients after breast-conserving surgery. Materials and Methods: Thirty patients with breast cancer (half right-sided and half left-sided) treated by conservative lumpectomy and requiring whole breast radiotherapy with tumor bed boost were planned with three different radiotherapy techniques: 1) VMAT1; 2) VMAT2; 3) M-IMRT. The distributions for the planning target volume (PTV) and organs at risk (OARs) were compared. Dosimetries for all the techniques were compared. Results: All three techniques satisfied the dose constraint well. VMAT2 showed no obvious difference in the homogeneity index (HI) and conformity index (CI) of the PTV with respect to M-IMRT and VMAT1. VMAT2 clearly improved the treatment efficiency and can also decrease the mean dose and V5Gy of the contralateral lung. The mean dose and maximum dose of the spinal cord and contralateral breast were lower for VMAT2 than the other two techniques. The very low dose distribution (V1Gy) of the contralateral breast also showed great reduction in VMAT2 compared with the other two techniques. For the ipsilateral lung of right-sided breast cancer, the mean dose was decreased significantly in VMAT2 compared with VMAT1 and M-IMRT. The V20Gy and V30Gy of the ipsilateral lung of the left-sided breast cancer for VMAT2 showed obvious reduction compared with the other two techniques. The heart statistics of VMAT2 also decreased considerably compared to VMAT1 and M-IMRT. Conclusions: Compared to the other two techniques, the dual arc volumetric modulated arc therapy technique reduced radiation dose exposure to the organs at risk and maintained a reasonable target dose distribution.
CT scan is reported to have a high risk of cancer due to a relatively high dose among medical radiological examinations. In particular, exposure to radiation to the breast, which is sensitive to radiation, is inevitable during a chest CT scan for female patient. In this study, the dose reduction effect of wearing a compression band during chest CT scans in women was evaluated, and the lifetime attributable risk due to the effective dose exposed during the CT scan was estimated. As a result, when the compression band was used, the effective tube current decreased as the outer perimeter of the chest became smaller, and it was analyzed that the CT dose index and effective dose were also reduced. In addition, the lifetime attributable risk by chest CT scan was found to reduce the cancer risk by 3.2 per 100,000 for all cancers, 0.2 per 100,000 for solid cancer, and 0.8 per 100,000 for breast cancer, based on women in their 30s when using a compression band. It is judged that the risk of cancer can be reduced through the use of appropriate scan parameters and dose optimization measures such as compression bands for future CT examinations.
With the recent prevalence of helical CT and multi-slice CT, which deliver higher radiation dose than conventional CT due to overbeaming effect in X-ray exposure and interpolation technique in image reconstruction. Although multi-detector and helical CT scanner provide a variety of opportunities for patient dose reduction, the potential risk for high radiation levels in CT examination can't be overemphasized in spite of acquiring more diagnostic information. So much more concerns is necessary about dose characteristics of CT scanner, especially dose efficient design as well as dose modulation software, because dose efficiency built into the scanner's design is probably the most important aspect of successful low dose clinical performance. This study was conducted to evaluate z-axis geometric dose efficiency in single detector CT and each level multi-detector CT, as well as to compare z-axis dose efficiency with change of technical scan parameters such as focal spot size of tube, beam collimation, detector combination, scan mode, pitch size, slice width and interval. The results obtained were as follows ; 1. SDCT was most highest and 4 MDCT was most lowest in z-axis geometric dose efficiency among SDCT, 4, 8, 16, 64 slice MDCT made by GE manufacture. 2. Small focal spot was 0.67-13.62% higher than large focal spot in z-axis geometric dose efficiency at MDCT. 3. Large beam collimation was 3.13-51.52% higher than small beam collimation in z-axis geometric dose efficiency at MDCT. 4. Z-axis geometric dose efficiency was same at 4 slice MDCT in all condition and 8 slice MDCT of large beam collimation with change of detector combination, but was changed irregularly at 8 slice MDCT of small beam collimation and 16 slice MDCT in all condition with change of detector combination. 5. There was no significant difference for z-axis geometric dose efficiency between conventional scan and helical scan, and with change of pitch factor, as well as change of slice width or interval for image reconstruction. As a conclusion, for reduction of patient radiation dose delivered from CT examination we are particularly concerned with dose efficiency of equipment and have to select proper scanning parameters which increase z-axis geometric dose efficiency within the range of preserving optimum clinical information in MDCT examination.
Proceedings of the Korean Society of Medical Physics Conference
/
2003.09a
/
pp.63-63
/
2003
Purpose: Planning target volume (PTV) for tumors in abdomen or thorax includes enough margin for breathing-related movement of tumor volumes during treatment. We developed a simple and handy method, which can reduce PTV margins in patients with moving tumors, respiratory motion reduction device system (RMRDs). Materials and Methods: The patients clinical database was structured for moving tumor patients and patient setup error measurement and immobilization device effects were investigated. The system is composed of the respiratory motion reduction device utilized in prone position and abdominal presser (strip device) utilized in the supine position, moving phantom and the analysis program, which enables the analysis on patients setup reproducibility. It was tested for analyzing the diaphragm movement and CT volume differences from patients with RMRDs, the magnitude of PTV margin was determined and dose volume histogram (DVH) was computed using a treatment planning software. Dose to normal tissue between patients with RMRDs and without RMRDs was analyzed by comparing the fraction of the normal liver receiving to 50% of the isocenter dose(TD50). Results: In case of utilizing RMRDs, which was personally developed in our hospital, the value was reduced to $5pm1.4 mm$, and in case of which the belt immobilization device was utilized, the value was reduced to 3$pm$0.9 mm. Also in case of which the strip device was utilized, the value was proven to reduce to $4pm.3 mm$0. As a result of analyzing the TD50 is irradiated in DVH according to the radiation treatment planning, the usage of the respiratory motion reduction device can create the reduce of 30% to the maximum. Also by obtaining the digital image, the function of comparison between the standard image, automated external contour subtraction, and etc were utilized to develop patients setup reproducibility analysis program that can evaluate the change in the patients setup. Conclusion: Internal organ motion due to breathing can be reduced using RMRDs, which is simple and easy to use in clinical setting. It can reduce the organ motion-related PTV margin, thereby decrease volume of the irradiated normal tissue.
Journal of the Korea Academia-Industrial cooperation Society
/
v.12
no.7
/
pp.3117-3122
/
2011
Skull A-P projections are the bi-product where the ESD (Entrance Surface Dose) for digital radiography is much higher than that conventional screen-film radiography. Therefore, the aim of this study was to reduce radiation doses to patients by using an added filter. This research focuses on the identification of the reduction of exposure to radiation based on the thickness of an added filter when applying the 'Skull A-P Projection' by using the 'Skull Phantom'. Also, an experiment was conducted to evaluate the qualitative decline of images through filtration. The measurement of one's exposed dose to radiation was executed by locating the 'Skull Phantom' on the position of the 'Skull AP,' while changing 16 kinds of added filters from 0.1 mmAl to 0.5 mmCu + 2.0 mmAl in terms of incident and penetrating doses. For the qualitative evaluation of images, a total number of 17 images have been acquired in the 'Skull Phantom' under the same conditions as those for the measurement of one's exposed dose. The acquired images have been evaluated by a radiological specialist. As a result, the images with a diagnostic value have been obtained by using such added filters as the compound filter of 0.2 mmCu +1.0 mmAl. The exposed dose absorbed on the 'Skull Phantom' is about 0.6 mGy. The value is only 12% of 5 mGy, the ESD value acquired on the 'Skull P-A Projection', which is recommended by the International Atomic Energy Agency (IAEA). As a result, depending on the parts of inspection, it is possible to reduce the patient's exposed dosage of radiation considerably by using an appropriate added filter.
This study was performed to obtain optimal conditions for reduction of color in dye wastewaters using coagulation-sedimentation processes with redox reactions. The reduction of color as well as organic matters variation was observed after coagulation-sedimentation processes using FeSO$_4$ $\cdot$ 7H$_2$O and NaOCl. Coagulation-redox reaction was done with the dose of Coagulant and oxidant at various pH values. Redox reaction was done through jar-mixing and aeration. The results of study were as follows: 1. In the coagulation-sedimentation processes using FeSO$_4$ $\cdot$ 7H$_2$O, color reduction was heigher at pH 3. With variance of dosage of FeSO$_4$ $\cdot$ 7H$_2$O, color reduction was higher at 250 mg/l. When coagulation-sedimentation using FeSO$_4$ $\cdot$ 7H$_2$O 250 mg/l was added at pH 3, the reduction of color, COD$_{Mn}$, and COD$_{Cr}$ showed 47.6%, 21.3% and 22.1%, respectively. 2. When NaOCI was added at level of 100 ppm in raw wastewater at pH 3, the reduction of color, COD$_{Mn}$, and COD$_{Cr}$ showed 30.2%, 5.5% and 6.2%, respectively. 3. After coagulation-sedimentation processes by addition of FeSO$_4$ $\cdot$ 7H$_2$O, when NaOCl was added at level of 250 mg/l in supernant, color reduction was 47.8% in aeration and 37.5% in jar-mixing. 4. Color reduction by aeration was higher than that by jar-mixing.
The treatment of tumors along curved surfaces with stationary electron beams using cone collimation may lead to non-uniform dose distributions due to a varying air gap between the cone surface and patient. For large tumors, more than one port may have to be used in irradiation of the chest wall, often leading to regions of high or low dose at the junction of the adjacent ports. Electron-beam arc therapy may elimination many of these fixed port problems. When treating breast tumors with electrons, the energy of the internal mammary port is usually higher than that of the chest wall port. Bolus is used to increase the skin dose or limit the range of the electrons. We invertiaged the effect of various arc beam parameters in the isodose distributions, and combined into a single arc port for adjacent fixed ports of different electron beam eneries. The higher fixed port energy would be used as the arc beam energy while the beam penetration in the lower energy region would be controlled by a proper thickness of bolus. We obtained the results of following: 1. It is more uniform dose distribution of electron to use rotation than stationary irradiation. 2. Increasing isocenter depth on arc irradiation, increased depth of maximum dose, reduction in surface dose and an increasing penetration of the linear portion of the curve. 3. The deeper penetration of the depth dose curve and higher X-ray background for the smaller field sized. 4. If the isocenter depth increase, the field effect is small. 5. The decreasing arc beam penetration with decreasing isocenter depth and the isocenter depth effect appears at a greater depth as the energy increases. 6. The addition of bolus produces a shift in the penetration that is the same for all depths leaving the shape of the curves unchanged. 7. Lead strips 5 mm thick were placed at both ends of the arc to produce a rapid dose drop-off.
The present work is determine to the dose distribution reduced by the insertion of a shielded into a vaginal cylinder around a $\^$60/CO source in brachytherapy, and to the source calibration. It was investigated by measuring the relative dose around a 2.5cm diameter shielded vaginal cylinder in a polystyrene phantom by use of a ionization chamber. Measurements were made with the cylinder unshielded and 0.55cm thick 90$^{\circ}C$ lead shields inserted. Also, the dose distribution compared measurement value with calculation value according to the device manufacturer and the multiple-divided dose tables. A reduction in dose was observed on the unshielded side of the cylinder which increased with distance from the source and it does 4.4% within 1cm from the surface of the cylinder. On the shielded side of the cylinder, the dose at the surface is reduced to about 20.4% of its value without the shield. The effective attenuation factor entered for the 90$^{\circ}C$ lead shielded cylinder was average 0.2 in a $\^$60/CO moving source. In comparision with the dose calculation mathods, the multiple-divided dose tables are difference less than ${\pm}$4.1% with measured data in a $\^$60/Co source.
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