Dental enamel as an in vivo radiation dosimeter

The determination of the radiation exposure history of the population has become increasingly important in the study of the effects of low-level radiation. The present work was started to try to obtain an in vivo dosimeter that could give an indication of radiation exposure. Dental enamel is the only living tissue which retains indefinitely its radiation history, and electron spin resonance measurements have shown that the radiation signal can be resolved down to about 10 cGy. Measurements on samples from the general population give radiation exposure estimates that are reasonable, and one measurement on a patient who had radiotherapy to the mouth area showed a good correlation with tumor dose. We believe that this is an important new indicator of radiation dose and taken together with exposure histories should provide important data for epidemiological studies as well as accidental exposures.     

The micronucleus assay as a biological dosimeter of in vivo ionising radiation exposure

Biological dosimetry, based on the analysis of micronuclei (MN) in the cytokinesis-block micronucleus (CBMN) assay can be used as an alternative method for scoring dicentric chromosomes in the field of radiation protection. Biological dosimetry or Biodosimetry, is mainly performed, in addition to physical dosimetry, with the aim of individual dose assessment. Many studies have shown that the number of radiation-induced MN is strongly correlated with dose and quality of radiation. The CBMN assay has become, in the last years, a thoroughly validated and standardised technique to evaluate in vivo radiation exposure of occupational, medical and accidentally exposed individuals. Compared to the gold standard, the dicentric assay, the CBMN assay has the important advantage of allowing economical, easy and quick analysis. The main disadvantage of the CBMN assay is related to the variable micronucleus (MN) background frequency, by which only in vivo exposures in excess of 0.2-0.3 Gy X-rays can be detected. In the last years, several improvements have been achieved, with the ultimate goals (i) of further increasing the sensitivity of the CBMN assay for low-dose detection by combining the assay with a fluorescence in situ hybridisation centromere staining technique, (ii) of increasing the specificity of the test for radiation by scoring nucleoplasmic bridges in binucleated cells and (iii) of making the assay optimally suitable for rapid automated analysis of a large number of samples, viz. in case of a large-scale radiation accident. The development of a combined automated MN-centromere scoring procedure remains a challenge for the future, as it will allow systematic biomonitoring of radiation workers exposed to low-dose radiation.     

MgO:Fe as an absolute radiation dosimeter

Iron impurities can take the 1+, 2+, or 3+ valence state in substitutional lattice sites in MgO. Virtually no Fe3+ remains after annealing in a reducing atmosphere. Upon irradiation with x rays or electrons, holes are trapped at Fe2+ sites. The resulting Fe3+ ion absorbs ultraviolet photons at 285 nm. Monitoring the radiation-induced growth of the Fe3+ optical absorption band provides the basis of using MgO:Fe as a solid-state dosimeter analogous to the ferrous sulfate chemical dosimeter.     

An implantable radiation dosimeter for use in external beam radiation therapy

An implantable radiation dosimeter for use with external beam therapy has been developed and tested both in vitro and in canines. The device uses a MOSFET dosimeter and is polled telemetrically every day during the course of therapy. The device is designed for permanent implantation and also acts as a radiographic fiducial marker. Ten dogs (companion animals) that presented with spontaneous, malignant tumors were enrolled in the study and received an implant in the tumor CTV. Three dogs received an additional implant in collateral normal tissue. Radiation therapy plans were created for the animals and they were treated with roughly 300 cGy daily fractions until completion of the prescribed cumulative dose. The primary endpoints of the study were to record any adverse events due to sensor placement and to monitor any movement away from the point of placement. No adverse events were recorded. Unacceptable device migration was experienced in two subjects and a retention mechanism was developed to prevent movement in the future. Daily dose readings were successfully acquired in all subjects. A rigorous in vitro calibration methodology has been developed to ensure that the implanted devices maintain an accuracy of +/-3.5% relative to an ionization chamber standard. The authors believe that an implantable radiation dosimeter is a practical and powerful tool that fosters individualized patient QA on a daily basis.     

Evaluation of polymer gels and MRI as a 3-D dosimeter for intensity-modulated radiation therapy.

BANG gel (MGS Research, Inc., Guilford, CT) has been evaluated for measuring intensity-modulated radiation therapy (IMRT) dose distributions. Treatment plans with target doses of 1500 cGy were generated by the Peacock IMRT system (NOMOS Corp., Sewickley, PA) using test target volumes. The gels were enclosed in 13 cm outer diameter cylindrical glass vessels. Dose calibration was conducted using seven smaller (4 cm diameter) cylindrical glass vessels irradiated to 0-1800 cGy in 300 cGy increments. Three-dimensional maps of the proton relaxation rate R2 were obtained using a 1.5 T magnetic resonance imaging (MRI) system (Siemens Medical Systems, Erlangen, Germany) and correlated with dose. A Hahn spin echo sequence was used with TR = 3 s, TE = 20 and 100 ms, NEX = 1, using 1 x 1 x 3 mm3 voxels. The MRI measurements were repeated weekly to identify the gel-aging characteristics. Ionization chamber, thermoluminescent dosimetry (TLD), and film dosimetry measurements of the IMRT dose distributions were obtained to compare against the gel results. The other dosimeters were used in a phantom with the same external cross-section as the gel phantom. The irradiated R2 values of the large vessels did not precisely track the smaller vessels, so the ionization chamber measurements were used to normalize the gel dose distributions. The point-to-point standard deviation of the gel dose measurements was 7.0 cGy. When compared with the ionization chamber measurements averaged over the chamber volume, 1% agreement was obtained. Comparisons against radiographic film dose distribution measurements and the treatment planning dose distribution calculation were used to determine the spatial localization accuracy of the gel and MRI. Spatial localization was better than 2 mm, and the dose was accurately determined by the gel both within and outside the target. The TLD chips were placed throughout the phantom to determine gel measurement precision in high- and low-dose regions. A multidimensional dose comparison tool that simultaneously examines the dose-difference and distance-to-agreement was used to evaluate the gel in both low-and high-dose gradient regions. When 3% and 3 mm criteria were used for the comparisons, more than 90% of the TLD measurements agreed with the gel, with the worst of 309 TLD chip measurements disagreeing by 40% of the criteria. All four MRI measurement session gel-measured dose distributions were compared to evaluate the time behavior of the gel. The low-dose regions were evaluated by comparison with TLD measurements at selected points, while high-dose regions were evaluated by directly comparing measured dose distributions. Tests using the multidimensional comparison tool showed detectable degradation beyond one week postirradiation, but all low-dose measurements passed relative to the test criteria and the dose distributions showed few regions that failed.     

Use of radiation induced chromosomal damage in human lymphocytes as a biological dosimeter is questionable

Using dicentric chromosomes and acentric fragments as indicators of radiation sensitivity, a study has been performed on human lymphocyte chromosomes by irradiating peripheral blood cells at G0. Donor-to-donor variation has been noticed regarding radiation sensitivity even when metaphase spreads were scored at the first cell cycle. Thus, it appears that, at the present state, use of chromosomal damage in peripheral blood cell cultures as an effective biological dosimeter for effects of radiation is questionable.     

Performance characteristics of an orthovoltage x-ray therapy machine

Performance characteristics sufficient to provide physical data base specific to the Siemen's Stabilipan 2 orthovoltage x-ray therapy machine are presented. Operating conditions covering the working range of the unit from 100 to 300 kVp are selected. Beam quality, output, the central axis depth dose, relative output factors, field flatness, uniformity index, and filtration characteristics of the beams are studied. Selected results are reported.     

Relaxation therapy as an adjunct in radiation oncology.

Stress, anxiety, and depression in patients who are undergoing treatment of cancer significantly compromise the quality of their lives. The impact of stress reduction by relaxation training and imagery was studied in 82 out-patients who were undergoing curative (73 patients) or palliative (9 patients) radiotherapy. Fifty-two females and 30 males were assigned randomly to a relaxation training condition (34 patients) as an adjunct to radiation or a control condition (29 patients), which entailed education and counseling along with the RT. Using pre- and posttests of the Profile of Mood States, significant (p less than .01) reductions were noted in the treatment group in tension, depression, anger, and fatigue. The results suggest that relaxation training substantially improves several psychological parameters associated with quality of life in ambulatory patients who are undergoing radiation therapy.     

A new radiation dosimeter using a pyroelectric detector

We describe a new type of radiation dosimeter, for the diagnostic x-ray region, using a pyroelectric detector. It consists of a PZT ceramic crystal thick enough to absorb all the incident radiation at 33 keV. This pyroelectric radiation dosimeter (PERD) produces an electrical signal when exposed to a chopped beam of x-ray photons. The PERD is basically a microcalorimeter. It has the following characteristics: (1) it responds linearly to the energy fluence rate of the radiation; (2) it responds linearly to the radiation intensity for a given radiation spectrum; (3) it has excellent stability; (4) it is simple to construct and inexpensive; and (5) it is rugged.     

The cytokinesis-block micronucleus assay as a biological dosimeter for targeted alpha therapy

Ionizing radiation causes structural chromosomal aberrations, a proportion of which give rise to chromosome fragments without spindle attachment organelles. When a cell divides, some of these fragments are excluded from the main daughter nuclei and form small nuclei within the cytoplasm. The cytokinesis-block micronucleus assay allows these micronuclei (MN) to be counted, providing an in situ biological dosimeter. In this study, we evaluated the micronucleus frequency in peripheral blood lymphocytes after in vitro incubation with the alpha conjugates (213)BiI(3) and (213)Bi-9.2.27 (AIC). Lymphocytes were inoculated in vitro AIC for 3 h. Further, we report the first MN measurements in melanoma patients after targeted alpha therapy (TAT) with (213)Bi-9.2.27. Patients were injected with 260-360 MBq of AIC, and blood samples taken at 3 h, 2 weeks and 4 weeks post-treatment. Absorbed dose (MIRD) and effective total body dose (PED) were calculated. The MN frequency in lymphocytes was similar for equal in vitro incubation activities of (213)BiI(3) and (213)Bi-9.2.27 (P=0.5), indicating that there is no selective targeting of lymphocytes by the alpha conjugates. After inoculation with 10-1200 kBq mL-1 of AIC, there was a substantial activity-related increase in MN. The number of MN in the blood of treated patients peaked at 3 h post-TAT, slowly returning to baseline levels by 4 weeks. The mean photon equivalent dose (PED) is 0.43 Gy (SD 0.15) and the mean MIRD calculated absorbed dose is 0.11 Gy (SD 0.03), giving an RBE=4+/-0.4 for this study.     

Dosimetric evaluation of a new design MOSFET in vivo dosimeter

A single-use dosimeter, designed for in vivo patient dosimetry, has been evaluated. Key dosimetric characteristics of the dosimetry system have been measured for high-energy photon and electron beams commonly used in external beam therapy. Under the measurement conditions utilized, dose accuracy was within 5% for all data points, and inter-batch uniformity was acceptable, with a standard deviation of 1.7%. Dose linearity was confirmed for doses ranging from 2 to 400 cGy. The dosimeter readings were independent of dose rate for rates ranging from 80 to 480 cGy/min. When used as instructed, the dosimeter readings were accurate across the tested range of energy and modality. These measurements show that the dosimetry system's performance may be acceptable for in vivo dosimetry of entrance d(max) doses.     

Synthetic diamonds as in vivo radiation detectors

Synthetic diamonds with controlled amounts of impurity atoms can be manufactured so that, as thermoluminescent dosimeters, they can be made to have sensitivities at least as good as presently available commercial thermoluminescent dosimeters. They also exhibit, for radiations normally found in therapy situations, a linearity of response that extends from less than 0.01 Gy (1 rad) to over 10 Gy (1000 rad). Their physical size and form, crystals which can have volumes of less than 1 mm3, make them ideal candidates for in vivo monitoring of radiation fields, particularly electron fields where high-resolution measurements are essential for accurate isodose line determinations. Aspects of dose response from gamma-ray beams in relation to the type and concentrations of the impurity atoms within the diamond are discussed, and some experimental values for gamma, x-ray, and electron beams are presented.     

Magnetic resonance imaging of radiation dose distributions using a polymer-gel dosimeter

A new formulation of a tissue-equivalent polymer-gel dosimeter for the measurement of three-dimensional dose distributions of ionizing radiation has been developed. It is composed of aqueous gelatin infused with acrylamide and N, N'-methylene-bisacrylamide monomers, and made hypoxic by nitrogen saturation. Irradiation of the gel, referred to as BANG, causes localized polymerization of the monomers, which, in turn, reduces the transverse NMR relaxation times of water protons. The dose dependence of the NMR transverse relaxation rate, R2, is reproducible (less than 2% variation) and is linear up to about 8 Gy, with a slope of 0.25 s(-1)Gy(-1) at 1.5 T. Magnetic resonance imaging may be used to obtain accurate three-dimensional dose distributions with high spatial resolution. Since the radiation-induced polymers do not diffuse through the gelatin matrix, the dose distributions recorded by BANG gels are stable for long periods of time, and may be used to measure low-activity radioactive sources. Since the light-scattering properties of the polymerized regions are different from those of the clear, non-irradiated regions, the dose distributions are visible, and their optical densities are dependent on dose.     

Intraoperative radiation therapy as an adjunctive therapy for huge and highly vascular parasagittal meningiomas

This case presents a 34-year-old man who had a huge parasagittal meningioma. Initial treatment consisted of preoperative external carotid artery embolization and partial tumor resection. During the resection, we found that the tumor invaded the adjacent calvarium, and due to massive hemorrhage, total removal of the tumor was impossible. The patient was treated with intraoperative radiation therapy (IORT) (25 Gy via 16 MeV) as an adjunctive therapy. Eight months after IORT, we were able to remove the tumor completely without surgical difficulties. IORT can be considered an useful adjunctive therapy for the superficially located, huge, and highly vascular meningioma.     

Performance characteristics of a widely used orthovoltage x-ray therapy machine

Experimental results sufficient to provide a data base for the Philips RT 250 x-ray machine are presented. A representative selection of operating conditions covering the working range of the machine from 75 to 250 kVp, were used. Beam quality, depth dose data, field flatness, and filtration characteristics were studied, and selected results are reported.