Optimal dose levels in screening chest CT for unimpaired detection and volumetry of lung nodules, with and without computer assisted detection at minimal patient radiation

OBJECTIVES The aim of this phantom study was to minimize the radiation dose by finding the best combination of low tube current and low voltage that would result in accurate volume measurements when compared to standard CT imaging without significantly decreasing the sensitivity of detecting lung nodules both with and without the assistance of CAD. METHODS An anthropomorphic chest phantom containing artificial solid and ground glass nodules (GGNs, 5-12 mm) was examined with a 64-row multi-detector CT scanner with three tube currents of 100, 50 and 25 mAs in combination with three tube voltages of 120, 100 and 80 kVp. This resulted in eight different protocols that were then compared to standard CT sensitivity (100 mAs/120 kVp). For each protocol, at least 127 different nodules were scanned in 21-25 phantoms. The nodules were analyzed in two separate sessions by three independent, blinded radiologists and computer-aided detection (CAD) software. RESULTS The mean sensitivity of the radiologists for identifying solid lung nodules on a standard CT was 89.7% ± 4.9%. The sensitivity was not significantly impaired when the tube and current voltage were lowered at the same time, except at the lowest exposure level of 25 mAs/80 kVp [80.6% ± 4.3% (p = 0.031)]. Compared to the standard CT, the sensitivity for detecting GGNs was significantly lower at all dose levels when the voltage was 80 kVp; this result was independent of the tube current. The CAD significantly increased the radiologists' sensitivity for detecting solid nodules at all dose levels (5-11%). No significant volume measurement errors (VMEs) were documented for the radiologists or the CAD software at any dose level. CONCLUSIONS Our results suggest a CT protocol with 25 mAs and 100 kVp is optimal for detecting solid and ground glass nodules in lung cancer screening. The use of CAD software is highly recommended at all dose levels.

Studies of the radiation chemistry and grafting of a fluoropolymer

The radiation chemistry and the grafting of a fluoropolymer, poly(tetrafluoroethylene-coperfluoropropyl vinyl ether) (PFA), was investigated with the aim of developing a highly stable grafted support for use in solid phase organic chemistry (SPOC). A radiation-induced grafting method was used whereby the PFA was exposed to ionizing radiation to form free radicals capable of initiating graft copolymerization of styrene. To fully investigate this process, both the radiation chemistry of PFA and the grafting of styrene to PFA were examined. Radiation alone was found to have a detrimental effect on PFA when irradiated at 303 K. This was evident from the loss in the mechanical properties due to chain scission reactions. This meant that when radiation was used for the grafting reactions, the total radiation dose needed to be kept as low as possible. The radicals produced when PFA was exposed to radiation were examined using electron spin resonance spectroscopy. Both main-chain (–CF2–C.F–CF2-) and end-chain (–CF2–C.F2) radicals were identified. The stability of the majority of the main-chain radicals when the polymer was heated above the glass transition temperature suggested that they were present mainly in the crystalline regions of the polymer, while the end-chain radicals were predominately located in the amorphous regions. The radical yield at 77 K was lower than the radical yield at 303 K suggesting that cage recombination at low temperatures inhibited free radicals from stabilizing. High-speed MAS 19F NMR was used to identify the non-volatile products after irradiation of PFA over a wide temperature range. The major products observed over the irradiation temperature 303 to 633 K included new saturated chain ends, short fluoromethyl side chains in both the amorphous and crystalline regions, and long branch points. The proportion of the radiolytic products shifted from mainly chain scission products at low irradiation temperatures to extensive branching at higher irradiation temperatures. Calculations of G values revealed that net crosslinking only occurred when PFA was irradiated in the melt. Minor products after irradiation at elevated temperatures included internal and terminal double bonds and CF3 groups adjacent to double bonds. The volatile products after irradiation at 303 K included tetrafluoromethane (CF4) and oxygen-containing species from loss of the perfluoropropyl ether side chains of PFA as identified by mass spectrometry and FTIR spectroscopy. The chemical changes induced by radiation exposure were accompanied by changes in the thermal properties of the polymer. Changes in the crystallinity and thermal stability of PFA after irradiation were examined using DSC and TGA techniques. The equilibrium melting temperature of untreated PFA was 599 K as determined using a method of extrapolation of the melting temperatures of imperfectly formed crystals. After low temperature irradiation, radiation- induced crystallization was prevalent due to scission of strained tie molecules, loss of perfluoropropyl ether side chains, and lowering of the molecular weight which promoted chain alignment and hence higher crystallinity. After irradiation at high temperatures, the presence of short and long branches hindered crystallization, lowering the overall crystallinity. The thermal stability of the PFA decreased with increasing radiation dose and temperature due to the introduction of defect groups. Styrene was graft copolymerized to PFA using -radiation as the initiation source with the aim of preparing a graft copolymer suitable as a support for SPOC. Various grafting conditions were studied, such as the total dose, dose rate, solvent effects and addition of nitroxides to create “living” graft chains. The effect of dose rate was examined when grafting styrene vapour to PFA using the simultaneous grafting method. The initial rate of grafting was found to be independent of the dose rate which implied that the reaction was diffusion controlled. When the styrene was dissolved in various solvents for the grafting reaction, the graft yield was strongly dependent of the type and concentration of the solvent used. The greatest graft yield was observed when the solvent swelled the grafted layers and the substrate. Microprobe Raman spectroscopy was used to map the penetration of the graft into the substrate. The grafted layer was found to contain both poly(styrene) (PS) and PFA and became thicker with increasing radiation dose and graft yield which showed that grafting began at the surface and progressively penetrated the substrate as the grafted layer was swollen. The molecular weight of the grafted PS was estimated by measuring the molecular weight of the non-covalently bonded homopolymer formed in the grafted layers using SEC. The molecular weight of the occluded homopolymer was an order of magnitude greater than the free homopolymer formed in the surrounding solution suggesting that the high viscosity in the grafted regions led to long PS grafts. When a nitroxide mediated free radical polymerization was used, grafting occurred within the substrate and not on the surface due to diffusion of styrene into the substrate at the high temperatures needed for the reaction to proceed. Loading tests were used to measure the capacity of the PS graft to be functionialized with aminomethyl groups then further derivatized. These loading tests showed that samples grafted in a solution of styrene and methanol had superior loading capacity over samples graft using other solvents due to the shallow penetration and hence better accessibility of the graft when methanol was used as a solvent.

Evaluation of coronary angiographic projections to balance the clinical yield with the radiation risk

Objective: Radiation safety principles dictate that imaging procedures should minimise the radiation risks involved, without compromising diagnostic performance. This study aims to define a core set of views that maximises clinical information yield for minimum radiation risk. Angiographers would supplement these views as clinically indicated. Methods: An algorithm was developed to combine published data detailing the quality of information derived for the major coronary artery segments through the use of a common set of views in angiography with data relating to the dose–area product and scatter radiation associated with these views. Results: The optimum view set for the left coronary system comprised four views: left anterior oblique (LAO) with cranial (Cr) tilt, shallow right anterior oblique (AP-RAO) with caudal (Ca) tilt, RAO with Ca tilt and AP-RAO with Cr tilt. For the right coronary system three views were identified: LAO with Cr tilt, RAO and AP-RAO with Cr tilt. An alternative left coronary view set including a left lateral achieved minimally superior efficiency (,5%), but with an ,8% higher radiation dose to the patient and 40% higher cardiologist dose. Conclusion: This algorithm identifies a core set of angiographic views that optimises the information yield and minimises radiation risk. This basic data set would be supplemented by additional clinically determined views selected by the angiographer for each case. The decision to use additional views for diagnostic angiography and interventions would be assisted by referencing a table of relative radiation doses for the views being considered.

Correcting radiation survey data to account for increased leakage during intensity modulated radiotherapy treatments

Purpose Intensity modulated radiotherapy (IMRT) treatments require more beam-on time and produce more linac head leakage to deliver similar doses to conventional, unmodulated, radiotherapy treatments. It is necessary to take this increased leakage into account when evaluating the results of radiation surveys around bunkers that are, or will be, used for IMRT. The recommended procedure of 15 applying a monitor-unit based workload correction factor to secondary barrier survey measurements, to account for this increased leakage when evaluating radiation survey measurements around IMRT bunkers, can lead to potentially-costly over estimation of the required barrier thickness. This study aims to provide initial guidance on the validity of reducing the value of the correction factor when applied to different radiation barriers (primary barriers, doors, maze walls and other walls) by 20 evaluating three different bunker designs. Methods Radiation survey measurements of primary, scattered and leakage radiation were obtained at each of five survey points around each of three different radiotherapy bunkers and the contribution of leakage to the total measured radiation dose at each point was evaluated. Measurements at each survey point were made with the linac gantry set to 12 equidistant positions from 0 to 330o, to 25 assess the effects of radiation beam direction on the results. Results For all three bunker designs, less than 0.5% of dose measured at and alongside the primary barriers, less than 25% of the dose measured outside the bunker doors and up to 100% of the dose measured outside other secondary barriers was found to be caused by linac head leakage. Conclusions Results of this study suggest that IMRT workload corrections are unnecessary, for 30 survey measurements made at and alongside primary barriers. Use of reduced IMRT workload correction factors is recommended when evaluating survey measurements around a bunker door, provided that a subset of the measurements used in this study are repeated for the bunker in question. Reduction of the correction factor for other secondary barrier survey measurements is not recommended unless the contribution from leakage is separetely evaluated.

Radiosensitizing effect of electrochemotherapy in a fractionated radiation regimen in radiosensitive murine sarcoma and radioresistant adenocarcinoma tumor model

Radiosensitizing Effect of Electrochemotherapy in a Fractionated Radiation Regimen in Radiosensitive Murine Sarcoma and Radioresistant Adenocarcinoma Tumor Model. Electrochemotherapy can potentiate the radiosensitizing effect of bleomycin, as shown in our previous studies. To bring this treatment closer to use in clinical practice, we evaluated the interaction between electrochemotherapy with bleomycin and single-dose or fractionated radiation in two murine tumor models with different histology and radiosensitivity. Radiosensitive sarcoma SA-1 and radioresistant adenocarcinoma CaNT subcutaneous tumors grown in A/J and CBA mice, respectively, were used. The anti-tumor effect and skin damage around the treated tumors were evaluated after electrochemotherapy with bleomycin alone or combined with single-dose radiation or a fractionated radiation regimen. The anti-tumor effectiveness of electrochemotherapy was more pronounced in SA-1 than CaNT tumors. In both tumor models, the tumor response to radiation was not significantly influenced by bleomycin alone or by electroporation alone. However, electrochemotherapy before the first tumor irradiation potentiated the response to a single-dose or fractionated radiation regimen in both tumors. For the fractionated radiation regimen, normal skin around the treated tumors was damaged fourfold less than for the single-dose regimen. Electrochemotherapy prior to single-dose irradiation induced more damage to the skin around the treated tumors and greater loss of body weight compared to other irradiated groups, whereas electrochemotherapy combined with the fractionated radiation regimen did not. Electrochemotherapy with low doses of bleomycin can also be used safely for radiosensitization of different types of tumors in a fractionated radiation regimen, resulting in a good anti-tumor effect and no major potentiating effect on radiation-induced skin damage. © 2009 by Radiation Research Society.

Investigation of the relationship between BMI and prostate motion in radiation therapy treatment for prostate cancer

This thesis studied the influence of patient obesity on prostate motion during radiation therapy treatment delivery, an important consideration in the accurate treatment of prostate cancer. The study highlighted the importance of daily image guidance to correct for prostate motion, increasing radiation dose to the prostate while decreasing radiation dose to surrounding healthy tissues, thereby increasing patient quality of life.

Comparison of Radiation Doses for Catheter Ablation Procedures for Atrial Fibrillation with Percutaneous Coronary Intervention Cases

Background: Catheter ablation procedures for atrial fibrillation (AF) may frequently require long fluoroscopic times. We sought to undertake a review of radiation safety practice in our Cardiac Electrophysiology Laboratory and implement changes to minimize fluoroscopic doses. We also sought to compare the results with radiation doses for percutaneous coronary intervention (PCI) cases performed in our hospital. Methods: Fluoroscopic times and doses for AF ablation procedures performed by a single operator on a Philips Integris H3000 image-intensifier were analysed for 11-month period. Results were compared with all PCI procedures performed over a similar period by multiple operators on a Philips Integris Allura FD system. Comprehensive review of radiation practice in the Electrophysiology laboratory identified the potential to reduce pulse frame rates and doses, and to narrow the field of interest without impacting the performance of the procedure. These changes were implemented and results analysed after a further 11 months. Results: In the pre-intervention period 50 AF catheter ablations had a mean fluoroscopic time of 86.4 min and mean fluoroscopic dose 68.4 Gy/cm2. Post-intervention 75 procedures had a mean fluorosocopic time of 68.9 min (p < 0.0001) and mean dose of 14.3 Gy/cm2 (p < 0.0001) 128 PCI procedures had a mean combined fluoroscopic and image acquisition time of 10.0 min and mean total dose 38.8 Gy/cm2. Conclusions: Catheter ablation procedures for AF may require lengthy use of fluoroscopy but simple modifications to radiation practice can result in marked reductions in radiation dose that compare favourably with PCI case doses

Dose rate dependence of electrical characteristics of lead zirconate titanate capacitors

The influence of gamma-radiation dose rate on the electrical properties of lead zirconate titanate capacitors was investigated. More severe degradations in dielectric constant, coercive field, remanent polarization and capacitance-voltage (C-V) curves occurred with increasing radiation dose at lower dose rates. The electrical properties exhibited distinct radiation dose rate dependence and the worst-case degradation occurred at the lowest dose rate. The radiation-induced degradation of parameters such as the coercive field drift and distortion of the C-V curve can be recovered partly through post-irradiation annealing.

Effect of gamma-ray radiation on physiological, morphological characters and chromosome aberrations of minitubers in Solanum tuberosum L.

Purpose: To investigate the effects of gamma-ray radiation on the physiological, morphological characters and chromosome aberrations of minitubers. Materials and methods: Minitubers of one potato cultivar, 'Shepody', were irradiated with 8 doses of gamma-rays (0, 10, 20, 30, 40, 50, 60, 70 and 80 Gy [Gray]) to investigate the effects of radiation on emergence ability, plant height and root length, morphological variations, chromosome aberrations, M-1 (first generation mutants) tuber number and size of minituber plants. Results: Compared with the non-irradiated controls, the whole period of emergence was prolonged by 10-15 days for minitubers treated with gamma-ray radiation, but low doses of radiation (10, 20 and 30 Gy) promoted the emergence percentage of minitubers. With an increase in radiation dose, the emergence percentage, plant height and root length of minituber plants were significantly inhibited at 40 and 50 Gy. No emergence occurred at 60 Gy and higher doses. After radiation, a series of morphological variations and chromosome aberrations appeared in minituber plants. Radiation with 20 Gy promoted tuber formation, and the average number and diameter of M-1 tubers per plant were significantly increased over the control by 71% and 34%, respectively. Conclusion: Low doses of radiation (10-30 Gy) might be used as a valuable parameter to study the improvement of minitubers by gamma-ray radiation treatment.

Effect of gamma-radiation on the thermal and mechanical properties of a commercial poly(butylene adipate-co-terephthalate)

BACKGROUND: Poly(butylene adipate-co-terephthalate) (PBAT) has attracted wide interest as a biodegradable polymer. However, its use is restricted in certain applications due to its low melting point.RESULTS: PBAT was treated using gamma-radiation. The radiation features were analyzed using Soxhlet extraction, and the ratio of chain scission and crosslinking and gelation dose were determined using the classical Charlesby-Pinner equation. The results showed that PBAT is a radiation-crosslinkable polymer. The degree of crosslinking increased with increasing radiation dose; the relation between sol fraction and dose followed the Charlesby-Pinner equation. Differential scanning calorimetry analyses showed that the melting temperature (T-m) and the heat of fusion (Delta H-m) of PBAT exhibited almost no change in the first scan. The second scan, however, showed a decrease in T-m and Delta H-m. The glass transition temperature of irradiated PBAT increased with increasing radiation dose.

LDPE/carbon black conductive composites: Influence of radiation crosslinking on PTC and NTC properties

The electrical resistivity of low-density polyethylene/carbon black composites irradiated by Co-60 gamma-rays was investigated as a function of temperature. The experimental results obtained by scanning electron microscopy, solvent extraction techniques, and pressure-specific volume-temperature analysis techniques showed that the positive temperature coefficient (PTC) and negative temperature coefficient (NTC) effects of the composites were influenced by the irradiation dose, network forming (gel), and soluble fractions (Sol). The NTC effect was effectively eliminated when the radiation dose reached 400 kGy. The results showed that the elimination of the NTC effect was related to the difference in the thermal expansion of the gel and Sol regions. The thermal expansion of the sol played an important role in both increasing the PTC intensity and decreasing the NTC intensity at 400 kGy.

Advanced research work on radiation cross-linking of polymers in CIAC

Recent research carried out at the Chinese Institute of Applied Chemistry has contributed significantly to the understanding of the radiation chemistry of polymers. High energy radiation has been successfully used to cross-link fluoropolymers and polyimides. Here chain flexibility has been shown to play an important role, and T-type structures were found to exist in the cross-linked fluoropolymers. A modified Charlesby-Pinner equation, based upon the importance of chain flexibility, was developed to account for the sol-radiation dose relationship in systems of this type. An XPS method has been developed to measure the cross-linking yields in aromatic polymers and fluoropolymers, based upon the dose dependence of the aromatic shake-up peaks and the F/C ratios, respectively. Methods for radiation cross-linking degrading polymers in polymer blends have also been developed, as have methods for improving the radiation resistance of polymers through radiation cross-linking.

Influence of interface on radiation effects of crystalline polymer - radiation effects on polyamide-1010 containing BMI

Aimed at saving the radiation dose required to crosslinking the polyamid-1010, BMI/PA1010 systems containing different amounts of difunctional crosslinking agent N,N'-bis-maleimide-4,4'-biphenyl methane (BMI) were prepared and the structure changes at the crystallographic and supermolecular levels before and after irradiation were studied by using WAXD, SAXS, and DSC techniques. It was found that by incorporation of BMI the microcrystal size L-100 is lowered due to the formation of hydrogen bond between the carbonyl oxygen of BMI and the amide hydrogen of PA1010 in the hydrogen bonded plane, and the overall crystallinity W-c is also decreased. The presence of BMI causes the crystal lamella thickness d(c) to decrease and greatly thickens the transition zone d(tr) between the crystalline and amorphous regions. As for the irradiated specimen, the maximum increments in the L-100 and W-c against dose curves decrease with BMI content, and the interception point D-i, at which the L-100 and W-c curves intercept their respective horizontal line of L-100/L-100(0) and W-c/W-c(0)=1, shift to lower dose with an increase in BMI concentration. In addition. the mechanism of the radiation chemical reactions in the three different phases under the action of BMI are discussed with special focus on the interface region. (C) 1999 Published by Elsevier Science Ltd. All rights reserved.

WAXD and SAXS study on gamma-radiation damage to polyamide-1010 crystal structure

In the present work we attempt to settle the controversy on the district wherein the radiation induced reaction preferentially occurs through examining the structural changes of the irradiated polyamide-1010 specimens on both the crystallographic and the supermolecular level by using WAXD and SAXS techniques. Experimental results indicated that the chain crosslinking and scission of the irradiated specimens occur mainly in the amorphous region and on the crystal surface (or interphase), and extend into the inner portion of the crystal with increasing radiation dose.