Radiation dose reduction during hysterosalpingography: an application of scanning-beam digital radiography

Hysterosalpingography was performed in 31 patients by means of a low-dose scanning-beam digital radiographic system. The technique permits adequate evaluation of gynecologic abnormalities while allowing significant reduction in radiation: 2.4-mR (6.1 X 10(-7) C/kg) exposure to the skin and 0.7-mrad (7 X 10(-6) Gy) mean dose to the ovaries per image obtained. Sixteen patients demonstrated readily recognizable and documented abnormalities, corroborated by laparoscopy, laparotomy, or other supportive evidence.     

Influence of complement on sperm motility

Isolated sperm from normo-, oligo- and astheno-spermic men were incubated for 20 h in medium supplemented with 8% heat-inactivated or untreated human serum, and in medium with heated or untreated serum deficient in complement factor C3. Before and after incubation, sperm motility was assessed by means of a computer-assisted semen analyser. The results did not show significant differences between the motility of sperm incubated in heated or untreated serum. It is concluded that heating of homologous serum is not necessary for preserving sperm motility and in some cases may even be disadvantageous.     

Image-directed percutaneous biopsies with a biopsy gun

Core tissue for histologic study is believed by many pathologists to be more diagnostic than material from needle aspiration. Recently, a biopsy "gun" has been introduced, which simplifies core biopsies. With this device, 182 biopsies of multiple anatomic sites were performed with ultrasonic, computed tomographic, and fluoroscopic guidance and 18-gauge needles. High-quality histopathologic specimens were obtained in 177 of the biopsies, and diagnostic target tissue was obtained in 167. Only three significant complications occurred: one bleeding complication that required transfusion and two cases of pneumothorax that necessitated placement of chest tubes. The biopsy gun eliminated the disjointed movements of conventional "skinny" needle biopsies, and none of the samples demonstrated significant "crush" artifact or obscuring blood, problems that are commonly associated with manual biopsy techniques. Patient discomfort was decreased with this system compared with that of manual biopsies, and the total procedure time was reduced. Because of these distinct advantages, the authors now use the biopsy gun exclusively for all percutaneous biopsies and recommend that other institutions consider the use of this biopsy method.     

Dosimetry comparison of 192Ir sources

192Ir sources besides being widely utilized in the field of conventional brachytherapy also find use in contemporary peripheral and coronal intravascular applications. In this study, the same Monte Carlo simulation code and input data were used to investigate differences between the dose rate distributions of the most commonly used 192Ir sources in the cm and mm distance range. Findings are discussed in view of differences in source and encapsulation dimensions as well as structural details. Results are presented in the AAPM TG-43 formalism, as generalized by AAPM TG-60, for five 192Ir HDR source designs as well as an LDR seed and an LDR wire source. Dose rate constants of the sources at r0 = 1 cm and r0 = 2 mm were found proportional to the corresponding geometry factors along the transverse source bisectors and an equation of the form lambda r0(cGyh(-1) U(-1)) = 1.12 x G(r0,90 degrees) provides results within clinical accuracy (less than 2%) for any 192Ir source. Radial dose functions do not depend significantly on source and encapsulation geometry and agree within 2% with that of a point 192Ir source. Anisotropy is of importance for accurate dosimetry at the cm distance range but it does not affect dose rate in the mm distance range significantly. At such short radial distances the source geometry factor defines the shape of isodose lines. Dose uniformity at given distances from the sources is strongly dependent on source dimensions as indicated by dose rate profiles in polar and Cartesian coordinates.     

Wide dynamic dose range of VIPAR polymer gel dosimetry

In this work the extent of the linear dose response and the dynamic dose range of N-vinylpyrrolidone-argon based (VIPAR) polymer gels were investigated. VIPAR gels were irradiated using a 6 MV linear accelerator up to 60 Gy and a Nucletron microSelectron 192Ir HDR brachytherapy source to much higher doses to cover a dose range of two orders of magnitude. They were then MR scanned at 1.5 T to obtain T2-maps. VIPAR gel measurements obtained from the two irradiation regimes were calibrated against ion chamber measurements and dose calculations derived using the AAPM TG-43 protocol respectively. A satisfying agreement between the calibration results derived using the 6 MV x-rays and the 192Ir source was found for doses up to 60 Gy, implying that the response of the VIPAR gels is independent of photon energy and dose rate. A linear R2 dose response up to approximately 40 Gy and a dynamic dose range up to at least approximately 250 Gy were observed. VIPAR gel dose measurements derived using the monoexponentially fitted brachytherapy calibration data were found to be quite accurate.     

Dosimetry close to an 192Ir HDR source using N-vinylpyrrolidone based polymer gels and magnetic resonance imaging

In this work, the utilization of polymer gel-MRI dosimetry for measurements at distances relevant to clinical brachytherapy and intravascular applications [i.e., in the mm range, where steep three-dimensional (3-D) dose gradients exist] is investigated using N-vinylpyrrolidone-based gels. Transverse axis radial dose distributions, dose distributions parallel to the source axis, and 2-D dose distributions around the commonly used microSelectron 192Ir HDR source are measured for single source dwell position irradiations. Experimental results are found in good agreement with verified Monte Carlo calculations, even for distances less than 3 mm from the source. The effect of various MRI parameters, such as slice thickness, slice mispositioning, and in-plane resolution, on the accuracy of the method is also investigated. Possible limitations of the method are discussed, and its' overall potential in brachytherapy dosimetry is evaluated. Experimental 2-D dose distributions for an intravascular application following the Paris irradiation protocol are compared to corresponding commercial treatment planning system calculations. Results suggest that polymer gel-MRI dosimetry is capable of experimentally verifying dose distributions in relevant clinical intravascular applications.     

Thermoluminescent dosimetry of the selectseed 125I interstitial brachytherapy seed

This work presents experimental dosimetry results for the new selectSeed 125I prostate seed design for use with the seedSelectron afterloading device, in accordance with the AAPM advisory that all new low energy interstitial brachytherapy seeds should undergo one Monte Carlo (MC) and at least one experimental dosimetry characterization. TLD dosimetry was performed using 120 cylindrical LiF TLD type-100 rods calibrated using a 6 MV photon beam. They were irradiated in solid water phantoms for the experimental determination of the seed dose rate constant, radial dose functions and anisotropy functions. MC simulations were performed for the determination of the TLDs relative energy response that was found position independent and equal to 1.40+/-0.03, and for the calculation of the ratio of dose in liquid water to dose in solid water that was found to be well described by Dliquidwater/Dsolidwater= 1.013*r+0.030 presenting only a minor dependence on polar angle. The selectSeed dose rate constant in liquid water was found equal to 0.938+/-0.065 cGy h(-1) U(-1), which agrees within experimental uncertainties with corresponding MC results of lambdaselect Seed=0.954+/-0.005 cGy h(-1) U(-1). The experimental radial dose and anisotropy function results were also found in good agreement with corresponding MC calculations.     

Monte Carlo dosimetry of the selectSeed 125I interstitial brachytherapy seed

This work provides full dosimetric data for the new selectSeed 125I prostate seed source to be distributed by Nucletron B.V. The AAPM TG-43 dosimetric formalism and the new 1999 NIST air kerma strength calibration standard have been followed. Air kerma strength, dose rate constant, radial dose functions, anisotropy functions, and anisotropy factors were calculated using Monte Carlo simulation. Corresponding calculations were also performed for the commercially available 6711 seed source, which is of similar design, for reasons of comparison. The calculated dose rate constant of the selectSeed was 0.954+/-0.005 cGy h(-1) U(-1) compared to 0.953+/-0.005 cGy h(-1) U(-1) for the 6711 source design. The latter value for the 6711 source suggests that the correction factor proposed by NIST for conversion of dose rate constants to the new 1999 NIST calibration standard may be overestimated by 2-3%. Radial dose functions of the two sources were found in good agreement for radial distances up to 4 cm, the selectSeed being less penetrating at greater radial distances (approximately 4% at 10 cm). The selectSeed source presents similar anisotropy characteristics with the 6711 source design. For both source designs, a distance and polar angle dependent discontinuity of anisotropy function values was observed owing to the dose contribution of radioactivity distributed on the ends of the cylindrical source cores. Variation of dosimetric parameters with possible variation in radioactive silver halide coating thickness of the silver source core of the new source was also investigated.