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Open access

Behrouz Rasuli, Naser Tabkhi, Ebrahim Kalantar, Vahid Zarezade and Mohammad Bagher shiran

Abstract

The aim of this work was to investigate the potential of high frequency ultrasound for the cleaning of a Polysulfone (PSU) ultrafiltration membrane used in hemodialysis. The blood substitute solution flowing through the hollow fiber membrane used in the High Flux F60 dialyzers has been sonicated by ultrasonic (US) waves with 1 MHz frequency and 2 W/cm2 in situ intensity. The solution was comprised of toxic compounds such as Urea, Creatinine, Vitamin B12 and Inulin. The effect of US was represented by comparison of the clearance in both OFF and ON ultrasound conditions. The results of these studies have been demonstrated that US can enhance the permeability of the PSU dialyzer membrane. Results revealed that US had significant effect (p-value ˂ 0.05) on the clearance of Inulin as a large molecule (5200 D) and accelerated its filtration by 28%. The proposed dialysis method can be used alongside the existing dialysis machine.

Open access

Osamu Tanaka, Hisao Komeda, Shigeki Hirose, Takuya Taniguchi, Kousei Ono, Eiichi Yama and Masayuki Matsuo

Abstract

Gold markers (GM) are increasingly used for CT and MRI registration during in intensity-modulated radiation therapy for prostate cancer. Additionally, diffusion-weighted imaging has been adopted to measure the effects of radiotherapy for prostate cancer, similar to tests of blood prostate-specific antigen levels. As diffusion-weighted imaging (DWI) is often affected by a magnetic component, we evaluated the influence of GM on the Diffusion weighted images in three cases. We found that the size range of signal void of GM in MRI was 2–5 mm. We conclude that a GM would not affect the quality of DWI in daily practice.

Open access

Gowri Balan, Anu Radha Chandrasekaran, Ramasubramanian Velayudham, Gopiraj Annamalai and Mohan Ramachandran

Abstract

Purpose: To estimate the midpoint dose delivered to cervical cancer patients treated by conventional technique using Electronic Portal Imaging Device (EPID).

Materials and Methods: Clinac 2100 equipped with aS500 EPID was used in this study. A methodology was developed to generate a Gy/Calibration Unit (CU) look up table for the determination of midpoint dose of patients. 25 patients of cervical cancer were included in this study and the delivered dose to the midpoint of the patients was estimated using EPID. The deviation between the prescribed and the measured dose was calculated and analysed.

Results: EPID showed a linear response with increase in Monitor unit and the Gy/CU look up table was validated for different field sizes and depth. 250 fields were measured for 25 patients, 10 measurements per patient, weekly once and for 5 weeks. The results show that out of 250 measurements, 98% of the measurements are within ±5% and 83.2% are within ±3% for with a standard deviation of 1.66%.

Conclusion: The outcome of this study proves the efficacy of this methodology for the estimation of midpoint dose using EPID with minimal effort, time and without any inconvenience to the patients unlike other in-vivo dosimeters.

Open access

Elias Alibeyki, Saeid Karimkhani, Sepide Saadatmand and Parvaneh Shokrani

Abstract

Purpose: Hodgkin lymphoma (HL) is one of the most frequent malignancies among pediatric patients. One of the common causes of death in HL survivors after radiation therapy (RT), is radiation-induced heart disease (RIHD). The aim of this study was to compare several dosimetric parameters for two methods of early stage Hodgkin lymphoma radiotherapy with reference to potential risk of RIHD.

Materials and Methods: Using a series of computed tomography slices of 40 young patients, treatment planning was done in two methods of HL RT, including involved field (IFRT) and involved site (ISRT) in doses of 20, 30, and 35 Gy. Contouring of clinical target volume as well as the organs at risk, including the heart, was performed by a radiation oncologist. The mean and maximum dose of heart (Dheart-mean and Dheart-max), the volume of heart receiving a dose more than 25 Gy (V25), and the standard deviation of dose as a dose homogeneity index in heart, were used to compare the RIHD risk.

Results: The mean value for Dheart-mean in ISRT method in all doses was less compare to IFRT. Maximum reduction in mean value of Dheart-mean occurred at moving from 30 Gy IFRT to ISRT by 9.53 Gy (p < 0.001) and minimum was between 35 Gy IFRT and ISRT. The mean value for Dheart-max was fewer in IFRT rather than ISRT and the maximum difference was between 35 Gy IFRT and ISRT (1.35 Gy). The mean of V25 of heart was 26.66% and 23.74% in 35 Gy IFRT and ISRT, respectively, and dose distribution was more homogeneous in IFRT.

Conclusions: If Dheart-max and V25 of heart or homogeneity of dose distribution in heart are considered as determining factors in RIHD, then IFRT can be considered optimum, especially in 35 Gy IFRT; while, assuming the Dheart-mean as the most important factor in RIHD, superiority of ISRT over IFRT is observed.

Open access

Mohammed El Adnani Krabch, Abdelouahed Chetaine, Abdelati Nourreddine, Fatim Zohra Er-Radi and Laila Baddouh

Abstract

The aim of this study was to investigate the impact of heterogeneity on the dose calculation for two algorithms implemented in the TPS “Analytical Anisotropic Algorithm (AAA) and Acuros XB” and validated the use of Acuros XB algorithm in clinical routine. First, we compare the dose calculated by these algorithms and the dose measured at the given point P, which is found after heterogeneity insert. Second, we extend our work on clinical cases that present a complex heterogeneity. By evaluating the impact of the choice of the algorithm on the dose coverage of the tumor, and the dose received by the organs at risk for 20 patients affected by lung cancer.

The result of our phantom study showed a good agreement with several studies that showed the superiority of the Acuros XB over the AAA in predicting dose when it concerns heterogeneous media. The treatment plans for 20 lung cancers were calculated by two algorithms AAA and Acuros XB, the results show a statistical significant difference between algorithms for Homogeneity Index and the maximum dose of planning target volume (HI: 0.11±0.01 vs 0.05±0.01 p = 0.04; Dmax: 69.30±3.12 vs 68.51±2.64 p = 0.02). Instead, no statistically significant difference was observed for conformity index CI and mean dose (CI: 0.98±0.18 vs 0.99±0.14 p = 0.33; Dmean: 66.3±0.65 vs 66.10 ±0.61 p = 0.54). For organs at risk, the maximum dose for spinal cord, mean dose and D37 % of lung minus GTV (dose receiving 37% of lung volume) were found to be lower for AAA plans than Acuros XB and the differences were statistically significant (p<0.05). For the heart D33% and D67% were found to be higher for AAA plans than Acuros XB and the differences were statistically significant (p<0.05), but No difference was observed for D100% of the heart.

The use of the AXB algorithm is suitable in the case of presence of heterogeneity, because it allows to have a better accuracy close to the Monte Carlo calculation.

Open access

Duraisamy Velmurugan, Masilamany Santha Alphin and Benedict Jain AR Tony

Abstract

Background: Implant thread profile plays a vital role in magnitude and distribution of contact stresses at the implant-bone interface. The main goal of this study was to evaluate the biomechanical effects of four distinct thread profiles of a dental implant in the mandibular premolar region.

Methods: The dental implant represented the biocompatible Zirconia material and the bone block was modelled as transversely isotropic and elastic material. Three-dimensional finite element simulations were conducted for four distinct thread profiles of a dental implant at 50%, 75%, and 100% osseointegration. An axial static load of 500 N was applied on the abutment surface to estimate the stresses acting within the bones surrounding the implant.

Results: Regions of stress concentration were seen mostly along the mesiodistal direction compared to that in the buccolingual direction. The cortical bone close to the cervical region of the implant and the cortical bone next to the first thread of the implant experienced peak stress concentration. Increasing the degree of osseointegration resulted in increased von-Mises stresses on the implant-cortical transition region, the implant-cancellous transition region, the cortical bone, and the cancellous bone.

Conclusion: The results show that the application of distinct thread profiles at different degrees of osseointegration had significant effect on the stresses distribution contours in the surrounding bony structure. Comparing all four thread profiles, a dental implant with V-thread profile induced lower values of von-Mises stresses and shear stresses on the implant-cortical transition region, implant-cancellous transition region, cortical bone, and cancellous bone.

Open access

Karthick Raj Mani, Md Anisuzzaman Bhuiyan, Md. Shakilur Rahman and S. M. Azharur Islam

Abstract

True Beam medical linear accelerator is capable of delivering flattening filter free (FFF) and with flattening filter (WFF) photon beams. True Beam linear accelerator is equipped with five photon beam energies (6 FFF, 6 WFF, 10 FFF, 10 WFF and 15 WFF) as well as six electron beam energies (6 MeV, 9 MeV, 12 MeV, 15 MeV and 18 MeV). The maximum dose rate for the 6 WFF, 10 WFF and 15 WFF is 600 MU/min, whereas 6 FFF has a maximum dose rate of 1400 MU/min and 10 FFF with a maximum dose rate of 2400 MU/min. In this report we discussed the open beam dosimetric characteristics of True Beam medical linear accelerator with FFF and WFF beam. All the dosimetric data (i.e. depth dose, cross-line profiles, diagonal profiles, output factors, MLC transmission, etc.) for 6 MV, 6 FFF, 10 MV, 10 FFF and 15 MV were measured and compared with the published data of the True Beam. Multiple detectors were used in order to obtain a consistent dataset. The measured data has a good consistency with the reference golden beam data. The measured beam quality index for all the beams are in good agreement with the published data. The percentage depth dose at 10 cm depth of all the available photon beams was within the tolerance of the Varian acceptance specification. The dosimetric data shows consistent and comparable results with the published data of other True Beam linear accelerators. The dosimetric data provide us an appreciated perception and consistent among the published data and may be used for future references.

Open access

Déte van Eeden and Freek C.P. du Plessis

Abstract

Monte Carlo (MC) simulation is the gold standard for dose calculation. An accurate mathematical source model can be used for the radiation beams. Source models can consist of sub-sources or fewer sources with data that need to be measured. This can speed up treatment plan verification without the need for a full simulation of the radiation treatment machine.

Aims: This study aimed to construct a novel hybrid source model for 6 MV photon beams for an Elekta Synergy accelerator and to commission it against measured beam data and treatments plans.

Methods and Material: The model comprised of a circular photon and planar electron contamination source. The modified Schiff formula provided off-axis variable bremsstrahlung spectra. Collimation and scatter were modelled with error functions. An exponential function modelled the transmitted fluence through the collimators. The source model was commissioned by comparing simulated and measured MC data. Dose data included profiles, depth dose and film measurements in a Rando phantom. Field sizes ranged from 1 × 1 cm2 to 40 × 40 cm2.

Results: Regular, wedged and asymmetrical fields could be modelled within 1.5% or 1.5 mm. More than 95% of all points lie within 3% or 3 mm for the multi-leaf collimators contours data. A gamma criterion of 3% or 3 mm was met for a complex treatment case.

Conclusions: The two sub-source model replicated clinical 6 MV Elekta Synergy photons beams and could calculate the dose accurately for conformal treatments in complex geometries such as a head-and-neck case.

Open access

Duong Thanh Tai, Luong Thi Oanh, Nguyen Dong Son and Truong Thi Hong Loan

Abstract

Introduction: Jaws-Only Intensity modulated radiation therapy (JO-IMRT) is a technique uses the collimator jaws of the linear accelerator (LINAC) to delivery of complex intensity patterns. In previous studies, pretreatment patient specific quality assurance for those JO-IMRT were also performed using ionization chamber, MapCHECK2, and Octavius 4D and good agreements were shown. The aim of this study is to further verify JO-IMRT plans in 2 different cases: one with the gantry angle set equal to beam angle as in the plans and the other with gantry angle set to zero degree.

Materials and Methods: Twenty-five JO-IMRT, previously verified, were executed twice for each plan. The first one used a real gantry angle, and the second one used a 0° gantry angle. Measurements were performed using Octavius 4D 1500.

Results: The results were analyzed using Verisoft software. The results show that the Gamma average was 97.32 ± 2.21% for IMRT with a 0° gantry angle and 94.72 ± 2.67% for IMRT with a true gantry angle.

Conclusion: In both cases, gamma index of more than 90% were found for all of our 25 JO-IMRT treatment plans.

Open access

Abed Al Nasser Assi

Abstract

Reduction of the patient’s received radiation dose to as low as reasonably achievable (ALARA) is based on recommendations of radiation protection organizations such as the International Commission on Radiological Protection (ICRP) and the National Radiological Protection Board (NRPB). The aim of this study was to explore the frequency and characteristics of rejected / repeated radiographic films in governmental and private centers in Jenin city. The radiological centers were chosen based on their high volume of radiographic studies. The evaluation was carried out over a period of four months. The collected data were compiled at the end of each week and entered into a computer for analysis at the end of study. Overall 5000 films (images) were performed in four months, The average repeat rate of radiographic images was 10% (500 films). Repetition rate was the same for both thoracic and abdominal images (42%). The main reason for repeating imaging was inadequate imaging quality (58.2%) and poor film processing (38%). Human error was the most likely reason necessitating the repetition of the radiographs (48 %). Infant and children groups comprised 85% of the patient population that required repetition of the radiographic studies. In conclusion, we have a higher repetition rate of imaging studies compared to the international standards (10% vs. 4-6%, respectively). This is especially noticeable in infants and children, and mainly attributed to human error in obtaining and processing images. This is an important issue that needs to be addressed on a national level due to the ill effects associated with excessive exposure to radiation especially in children, and to reduce cost of the care delivered.