Directional dependence in film dosimetry: radiographic and radiochromic film

The trend towards conformal, intensity modulated radiotherapy treatments has established the need for a true integrating dosimeter. In traditional radiotherapy, radiographic film dosimetry is commonly used. The accuracy and reproducibility of film optical density as an indicator of dose is influenced by several variables, including the chemical processing conditions. As a result radiochromic film, with all the advantages of radiographic film but without the need for chemical processing, has increased in popularity, although the low-dose sensitivity of radiochromic film does remain a disadvantage for some experiments. Several studies have investigated the reproducibility of radiochromic film results, but none have specifically addressed the well-known directional dependence seen with traditional radiographic film. In this study, the directional dependence of radiographic (Kodak X-omat V) and radiochromic (Gafchromic) films were measured. It was found that both films over responded when exposed parallel to the central axis of the beam as opposed to perpendicular exposure. An attempt is made to explain the reason for the responses of both films in terms of spectral effects and the air gap between the phantom segments. Although radiographic film exposed parallel rather than perpendicular to the central axis of the beam exhibits a measured difference in film response at depth, this over response does not occur when the extent of the film is restricted to a small region at the centre of the phantom (in this case an air gap is not introduced across the phantom). This suggests that it is the air gap rather than the orientation of the film that is the cause of the over response. Furthermore, when film occupies a slice through the entire phantom an over response occurs for both radiographic and radiochromic film, indicating that spectral effects are not the cause.     

Contrast enhancement of noisy images by windowing: limitations due to the finite dynamic range of the display system

A theoretical model has been developed to explain the effects of simple linear windowing on the apparent contrasts of signals in displayed digital images. The model predicts, and experimental results demonstrate, that the effective displayed contrast of a digital radiographic signal depends in a complex way upon interactions among the endpoints of the display scale, the signal contrast and noise level of the original data, the window center and display center selected, and the contrast enhancement factor applied. The results obtained from this work apply quantitatively to the highly idealized situation in which (i) a uniform signal is superimposed on a uniform background containing Gaussian pixel-value noise, and (ii) a linear (or exponential) relationship exists between the optical density of a film display (or the light intensity of a luminous display) and pixel value in some finite range. However, the qualitative effects demonstrated here may be expected to arise in a broad variety of situations involving strong digital contrast enhancement.     

High sensitivity radiochromic film dosimetry using an optical common-mode rejection and a reflective-mode flatbed color scanner

A novel method that can greatly improve the dosimetric sensitivity limit of a radiochromic film (RCF) through use of a set of color components, e.g., red and green, outputs from a RGB color scanner has been developed. RCFs are known to have microscopic and macroscopic nonuniformities, which come from the thickness variations in the film's active radiochromic layer and coating. These variations in the response make the optical signal-to-noise ratio lower, resulting in lower film sensitivity. To mitigate the effects of RCF nonuniform response, an optical common-mode rejection (CMR) was developed. The CMR compensates nonuniform response by creating a ratio of the two signals where the factors common to both numerator and denominator cancel out. The CMR scheme was applied to the mathematical operation of creating a ratio using two components, red and green outputs from a scanner. The two light component lights are neighboring wavebands about 100 nm apart and suffer a common fate, with the exception of wavelength-dependent events, having passed together along common attenuation paths. Two types of dose-response curves as a function of delivered dose ranging from 3.7 mGy to 8.1 Gy for 100 kV x-ray beams were obtained with the optical CMR scheme and the conventional analysis method using red component, respectively. In the range of 3.7 mGy to 81 mGy, the optical densities obtained with the optical CMR showed a good consistency among eight measured samples and an improved consistency with a linear fit within 1 standard deviation of each measured optical densities, while those with the conventional analysis exhibited a large discrepancy among eight samples and did not show a consistency with a linear fit.     

Matchline dosimetry in step and shoot IMRT fields: a film study

The Varian millennium 120 multileaf collimator has curved leaf ends. Transmission through the leaf ends generates a small asymmetric penumbral dose effect. This design can lead to hot spots between neighbouring beam segments during step and shoot IMRT dose delivery. We have observed some matchlines with film for clinical beams optimized using the pinnacle radiotherapy treatment planning system; hence we sought to verify the optimum leaf offset required to minimize the matchline effect. An in-house program was created to control the MLC leaf banks in 2 cm steps with a 2 cm gap. The gap was varied by the following offset values from 0.0 to 0.1 cm. Two types of radiographic films (Kodak EDR and XV films) and a radiochromic film (Gafchromic MD-55-2) were used to measure the optical density maps. The films were positioned in a solid water phantom perpendicular to the beam axis and irradiated at d(max) using a 6 MV photon beam. An ion chamber (IC4) was used to measure point doses for normalization in a beam umbral minima position. The relative mean peak to valley dose ratios measured with no leaf offset were 1.31, 1.30 and 1.31 for the XV, EDR2 and Gafchromic films, respectively. For a 0.07 cm gap per leaf and a performance of end leaf repeatability of 0.01 cm, the central matchline was reduced to about 1.0 for all dosimeters, with two mini-peaks measured as 1.05, 1.05 and 1.08 each side of the matchline, for XV, EDR2 and Gafchromic, respectively. The average relative dose across the umbra for this offset was XO-mat V = 1.01, EDR = 1.01 and radiochromic film = 1.02, respectively. While we expected the beam penumbral tails from segment neighbours to cause overprediction of the dose in the central valley regions due to the energy response of radiographic films, by normalizing all dosimeters to an ion chamber reading in the minimum we could not observe any major shape distortion between the radiographic film and radiochromic film results. In conclusion, relative doses measured by radiographic and radiochromic films agree well with IC4 within +/-2%.     

Dependence of radiochromic film optical density post-exposure kinetics on dose and dose fractionation

Radiochromic film (RCF) has been shown to be a precise and accurate secondary planar dosimeter for acute exposure radiation fields. However, its application to low dose-rate brachytherapy has been questioned because of possible dose-rate effects. To address this concern, we have measured the optical density (OD) of Model 55-2 RCF as a function of time (interval between the completion of irradiation and densitometry using a 633 nm laser scanner) following exposure (from less than 1 hour to 90 days) for single and split doses from 1 Gy to 100 Gy. Our work demonstrates that film darkening as a function of post-irradiation time depends significantly on total dose, with films exposed to lower doses developing faster than films given higher doses. At 1 Gy, the OD 90 days after exposure is 200% larger than that measured 1 h after exposure compared to a 20% increase over 90 days for doses larger than 20 Gy. An empirical model with time-independent, fast and slow growth terms was used to fit single exposure data. The dependence of the resulting best-fit parameters on dose was investigated. Splitting the dose into two fractions (20 Gy followed by doses of 1-80 Gy 24 h later) results in modest post-irradiation time-dependent changes in the total optical density (at most 15% at small doses), which dissipates within 20 hours following the second exposure. This experimental finding is consistent with the predictions of a simple cumulative dose superposition model. Overall, both experimental and empirical modeling suggest that dose-rate effects may be relatively small despite the strong dependence of film darkening kinetics on total dose. However, more experimental evaluation of radiochromic film response dependence on dose rate and dose-time-fractionation patterns is needed.     

Portal dosimetry using x-ray film: an experimental and computational study

To evaluate the accuracy and precision of relative portal dosimetry using x-ray film, we compared the radiation doses measured by x-ray film and by an ion chamber at various portal planes that were 0 to 50 cm behind an 18 cm thick phantom. In addition, we calculated photon spectra at the measurement planes by using the Monte Carlo particle transport technique. The experiments showed that the film usually measured relative doses to within 5% of the measurements by the ion chamber and that the errors were associated with the changes in the spectra of photon energy fluence at portal planes. The relative magnitude of low-energy fluence in the photon fluence spectrum and its variance across the portal plane caused the film response to differ from the ion-chamber response especially with lead screen on top of film in the film cassette. Relative film dosimetry may be improved to accuracy of better than 2% by using solid water or other tissue equivalent cassettes.     

Functional near-infrared optical imaging: utility and limitations in human brain mapping

Although near-infrared spectroscopy (NIRS) was developed as a tool for clinical monitoring of tissue oxygenation, it also has potential for neuroimaging. A wide range of different NIRS instruments have been developed, and instruments for continuous intensity measurements with fixed spacing [continuous wave (CW)-type instruments], which are most readily available commercially, allow us to see dynamic changes in regional cerebral blood flow in real time. However, quantification, which is necessary for imaging of brain functions, is impossible with these CW-type instruments. Over the past 20 years, many different approaches to quantification have been tried, and several multichannel time-resolved and frequency-domain instruments are now in common use for imaging. Although there are still many problems with this technique, such as incomplete knowledge of how light propagates through the head, NIRS will not only open a window on brain physiology for subjects who have rarely been examined until now, but also provide a new direction for functional mapping studies.     

Comparison of the epson expression 1680 flatbed and the vidar VXR-16 dosimetry PRO film scanners for use in IMRT dosimetry using gafchromic and radiographic film

Intensity-modulated radiotherapy (IMRT) treatment plan verification is often done using Kodak EDR2 film and a Vidar Dosimetry PRO film digitizer. However, since many hospitals are moving towards a filmless environment, access to a film processor may not be available. Therefore, we have investigated a newly available Gafchromic EBT film for IMRT dosimetry. Planar IMRT dose distributions are delivered to both EBT and EDR2 film and scanned with the Vidar VXR-16 as well as an Epson Expression 1680 flatbed scanner. The measured dose distributions are then compared to those calculated with a Pinnacle treatment planning system. The IMRT treatments consisted of 7-9 6 MV beams for treatment of prostate, head and neck, and a few other sites. The films were analyzed using FilmQATM (3cognition LLC) software. Comparisons between measured and calculated dose distributions are reported as dose difference (DD) (pixels within +/-5%), distance to agreement (DTA) (3 mm), as well as gamma values (y) (dose= +/-3%, dist. =2 mm). Using EDR2 with the Vidar scanner is an established technique and agreement between calculated and measured dose distributions was better than 90% in all indices (DD, DTA, and gamma). However, agreement with calculations deteriorated reaching the lower 80% for EBT film scans with the Vidar scanner in logarithmic mode. The EBT Vidar scans obtained in linear mode showed an improved agreement to the upper 80% range, but artifacts were still observed across the scan. These artifacts were very distinct in all EBT scans and can be attributed to the way the film is transported through the scanner. In the Epson scanner both films are rigidly immobilized and the light source scans over the film. It was found that the Epson scanner performed equally well with both types of film giving agreement to better than 90% in all indices.     

Human finger independence: limitations due to passive mechanical coupling versus active neuromuscular control

We studied the extent to which mechanical coupling and neuromuscular control limit finger independence by studying passive and active individuated finger movements in healthy adults. For passive movements, subjects relaxed while each finger was rotated into flexion and extension by a custom-built device. For active movements, subjects moved each finger into flexion and extension while attempting to keep the other, noninstructed fingers still. Active movements were performed through approximately the same joint excursions and at approximately the same speeds as the passive movements. We quantified how mechanical coupling limited finger independence from the passive movements, and quantified how neuromuscular control limited finger independence using an analysis that subtracted the indices obtained in the passive condition from those obtained in the active condition. Finger independence was generally similar during passive and active movements, but showed a trend toward less independence in the middle, ring, and little fingers during active, large-arc movements. Mechanical coupling limited the independence of the index, middle, and ring fingers to the greatest degree, followed by the little finger, and placed only negligible limitations on the independence of the thumb. In contrast, neuromuscular control primarily limited the independence of the ring, and little fingers during large-arc movements, and had minimal effects on the other fingers, especially during small-arc movements. For the movement conditions tested here, mechanical coupling between the fingers appears to be a major factor limiting the complete independence of finger movement.     

Responsiveness of human lung diploid fibroblast ageing in vitro to epidermal growth factor: saturation density and lifespan

Epidermal growth factor (EGF) in culture medium increased the saturation density of human diploid fibroblasts. In the first half of their in vitro lifespan the magnitude of the EGF-induced augmentation increased and in the second half, decreased. Their lifespan was not extended by continuous exposure to EGF.     

Light dosimetry in optical phantoms and in tissues: I. Multiple flux and transport theory

This is the first of two papers on the quantitative measurement of light energy fluence rates in optical phantoms and in tissues, in vitro and in vivo. The theory discussed in the present paper will be used in a forthcoming experimental paper to quantitatively check measurements of light energy fluence rates. A simple multiple flux model, which is equivalent to the diffusion approximation, is derived from the equation of transfer in a plane as well as in a spherical geometry. The equations obtained are similar to those of the Kubelka-Munk and related heuristic models. This permits conclusions regarding the limitations of these models and the values of their constants. The heuristic models are equivalent to diffusion theory for diffuse incident light, but not for collimated incident light. We also present a simple calculation of the radiance as a function of direction in the diffusion domain. This, together with the effective attenuation coefficient, permits indirect experimental determination of both the albedo and the anisotropy factor (g) of the scattering function. Similarity relations are discussed, as they result from the so called delta-Eddington approximation, leading to the conclusion that far from boundaries and sources light propagation characteristics do not change very much when g and omega s are varied, provided omega s (1-g) is kept constant (omega s = scattering coefficient). Therefore, only two optical constants are required to approximately describe light propagation in homogeneous and isotropic media in the diffusion approximation.     

Precautions and strategies in using a commercial flatbed scanner for radiochromic film dosimetry

The purpose of this study was to investigate the value of a commercially available flatbed scanner for film dosimetry with radiochromic film for external radiotherapy. The EPSON Pro 1680 Expression scanner was examined as a densitometer for two-dimensional film dosimetry with Gafchromic EBT film. An accurate and efficient scanning procedure was established. Possible drift and warm-up effects of the scanner were studied and the direct physical influence of the scanner light on the radiochromic film was assessed. Next, we investigated the scan field uniformity. Also, we examined if the accuracy of radiochromic film was improved by subtracting the optical density of the unirradiated blank film from the optical density of the irradiated film. To assess the accuracy of Gafchromic EBT film when the EPSON scanner was used as a densitometer, the depth dose of a 2 x 15 cm(2) field and the in-plane and cross-plane profiles of a 15 x 15 cm(2) field were measured and compared with diamond detector measurements. When taking consecutive scans, we found that the optical density taken from the first scan was about 1% higher than the optical density taken from subsequent scans. We attribute this to the warming up of the lamp of the scanner. Longer-term drift of the scanner was found to be absent. We found that the use of a correction matrix was necessary to correct for the non-uniform scanner response over the scan field. Subtracting the optical density of the unirradiated blank film from the irradiated film improves the precision of the Gafchromic EBT film. Depth dose and profile measurements with Gafchromic EBT film and the diamond detector are in agreement within 2.5%. The EPSON Pro 1680 Expression scanner is an excellent tool for accurate two-dimensional film dosimetry with Gafchromic EBT film provided that some precautions and corrections are taken into account.     

Radiochromic film dosimetry with flatbed scanners: a fast and accurate method for dose calibration and uniformity correction with single film exposure

Film dosimetry is an attractive tool for dose distribution verification in intensity modulated radiotherapy (IMRT). A critical aspect of radiochromic film dosimetry is the scanner used for the readout of the film: the output needs to be calibrated in dose response and corrected for pixel value and spatial dependent nonuniformity caused by light scattering; these procedures can take a long time. A method for a fast and accurate calibration and uniformity correction for radiochromic film dosimetry is presented: a single film exposure is used to do both calibration and correction. Gafchromic EBT films were read with two flatbed charge coupled device scanners (Epson V750 and 1680Pro). The accuracy of the method is investigated with specific dose patterns and an IMRT beam. The comparisons with a two-dimensional array of ionization chambers using a 18 x 18 cm2 open field and an inverse pyramid dose pattern show an increment in the percentage of points which pass the gamma analysis (tolerance parameters of 3% and 3 mm), passing from 55% and 64% for the 1680Pro and V750 scanners, respectively, to 94% for both scanners for the 18 x 18 open field, and from 76% and 75% to 91% for the inverse pyramid pattern. Application to an IMRT beam also shows better gamma index results, passing from 88% and 86% for the two scanners, respectively, to 94% for both. The number of points and dose range considered for correction and calibration appears to be appropriate for use in IMRT verification. The method showed to be fast and to correct properly the nonuniformity and has been adopted for routine clinical IMRT dose verification.     

Rapid goal-directed elbow flexion movements: limitations of the speed control system due to neural constraints

Summary In rapid goal-directed elbow flexion movements the influence of both movement amplitude and inertial load on the three-burst pattern and the consequences on movement time were studied. Subjects performed visually guided, self-paced movements as rapidly and as accurately as possible. An increase of both the movement amplitude and the inertial load were found to be interacting factors for the modulation of the three-burst-pattern and movement time. The first biceps burst progressively increased in duration and amplitude for larger movements, resulting in prolonged movement times. Surplus inertial loads further prolonged the agonist burst for large, but not for small movement amplitudes. The activity of the antagonist burst, in contrast, was largest in small movements and successively decreased at increasing movement amplitudes. Its duration, however, remained fairly constant. As was similarly observed for the agonist burst, surplus inertial loads lead to a prolongation of antagonist burst duration and an increase of the activity integral for large, but not for small movement amplitudes. It is suggested that in elbow flexion movements the programming of fastest goal-directed movements must take into account neural constraints and biomechanical characteristics of the agonist muscle and the antagonist muscle. Due to neural constraints of the biceps muscle, in contrast to finger movements, the concept of movement time invariance does not hold for elbow movements. Furthermore, neural constraints of the antagonist muscle lead to a limited force production of the agonist muscle at small movement amplitudes in order to avoid an overload of the braking process. The complexity of the relationship between neural and mechanical factors indicate that the size and timing of the three-burst-pattern has to be subtly adjusted to the precise nature of the task and its biomechanical characteristics.Supported by the Deutsche Forschungsgemeinschaft (SFB 33)     

Evaluation of film and thermoluminescent dosimetry of high-energy electron beams in heterogeneous phantoms.

Film and thermoluminescent dosimetry (TLD) are investigated in heterogeneous phantoms irradiated by high-energy electron beams. Both film and TLD are practical dosimeters for multiple and moving beam radiotherapy. The accuracy and precision of these dosimeters for radiation dose measurements in homogeneous water-equivalent phantoms has been discussed in the literature. However, film and TLD are often used for dose measurements in heterogeneous phantoms. In those situations perturbations are produced which are related to the density and atomic number of the phantom material and the physical size and orientation of the dosimeter. In our experiments the relative dose measurements in homogeneous phantoms were the same regardless of dosimeter or dosimeter orientation. However, significant differences were observed between the dose measurements within the inhomogeneity. These differences were influenced by the type and orientation of the dosimeter in addition to the properties of the heterogeneity. These differences could be reproduced with Monte Carlo calculations and modeling of the experimental conditions.     

The value of radiochromic film dosimetry around air cavities: experimental results and Monte Carlo simulations

In this study we investigate radiochromic film dosimetry around air cavities with particular focus on the perturbation of the dose distribution by the film when the film is parallel to the beam axis. We considered a layered polystyrene phantom containing an air cavity as a model for the air-soft tissue geometry that may occur after surgical resection of a paranasal sinus tumour. A radiochromic film type MD-55 was positioned within the phantom so that it intersected the cavity. Two phantom set-ups were examined. In the first case, the air cavity is at the centre of the phantom, thus the film is lying along the central beam axis. In the second case, the cavity and film are located 2 cm offset from the phantom centre and the central beam axis. In order to examine the influence of the film on the dose distribution and to interpret the film-measured results, Monte Carlo simulations were performed. The film was modelled rigorously to incorporate the composition and structure of the film. Two field configurations, a 1 x 10 cm2 field and a 10 x 10 cm2 field, were examined. The dose behind the air cavity is reduced by 6 to 7% for both field configurations when a film that intersects the cavity contains the central beam axis. This is due to the attenuation exerted by the film when photons cross the cavity. Offsetting the beam to the cavity and the film by 2 cm removes the dose reduction behind the air cavity completely. Another result was that the rebuild-up behind the cavity for the 10 x 10 cm2 field, albeit less significant than for the 1 x 10 cm2 field, could only be measured by the film that was placed offset with respect to the central beam axis. Although radiochromic film is approximately soft-tissue equivalent and energy independent as compared to radiographic films, care should be taken in the case of inhomogeneous phantoms when the film intersects air cavities and contains the beam central axis. Errors in dose measurement can be expected distal to the air cavity due to attenuation in the film itself. This attenuation would not occur in the absence of the film. Both experiments and Monte Carlo computations support this conclusion.