Search

The radiotherapy is performed with the aim of delivering the optimal dose to the target volume with minimal side effect of surrounding normal tissue. For this purpose, quality assurance is essential to ensure that the target volume is correctly irradiated in the optimal geometrical arrangement, and the absorbed dose evaluation is essential to ensure that the prescribed dose is correctly delivered. The absorbed doses are generally evaluated using a small cavity ionization chamber that utilizes gas ionization. For the evaluation of absorbed dose to water using ionization chambers, the national dose and charge standards, ionization chambers and electrometer calibration systems are required. And it is also required standard dosimetry protocol that recommend conditions such as fields, depths, and optimal ionization chambers for the measurement, as well as reliable physical data. This manuscript reviews the transition of standard dosimetry of absorbed dose to water in external beam radiotherapy, including the background of dose standards, ionization chamber calibration systems, units, and physical constants.

Neuropathic pain associated with cancer, diabetic neuropathy, and postherpetic neuralgia is a type of intractable chronic pain characterized by mechanical allodynia and abnormal pain hypersensitivity evoked by innocuous stimuli. However, this disorder has no specific treatment. We previously showed that the purinergic receptor P2X4 (P2X4R), a subtype of ATP-gated nonselective cation channels, is highly upregulated in spinal microglia after peripheral nerve injury, and blocking the function of P2X4R reverses mechanical allodynia. In the present study, we screened a chemical library of 1979 clinically approved compounds (a gift from the Drug Discovery Initiative at the University of Tokyo) aimed at achieving "Eco-Pharma," which refers to seeking new effects of existing drugs. We demonstrated that duloxetine, a serotonin and noradrenaline reuptake inhibitor, has an inhibitory effect on rat and human P2X4R. In rat primary cultured microglial cells, duloxetine also inhibited P2X4R-mediated responses. Moreover, intrathecal administration of duloxetine in a model of neuropathic pain reversed nerve injury-induced mechanical allodynia. Based on those results, we suggest that the inhibition of P2X4R expressed in microglial cells may be involved in the antiallodynic effect of duloxetine in neuropathic pain. Furthermore, in this review, we discuss a new strategy for drug discovery called "Green Pharma" (a merger of "Eco-Pharma" and "Green chemistry" and referring to the development of eco-friendly pharmaceuticals).

In Japan and North America, different dosimetry protocols have been implemented to determine the absorbed dose to water: JSMP Standard Dosimetry 12 and AAPM TG-51 addendum. In this study, Japanese and Canadian reference dosimetries for high energy photon beams were compared theoretically, and then they were verified experimentally. We estimated the theoretical differences of the ion recombination correction factors, the leakage correction factors, the radial dose distribution correction factors, the calibration factors, the beam quality correction factors and the absorbed dose to water. When an influence of the radial dose distribution is negligible, the ratios of Canadian to Japanese absorbed dose in reference dosimetries ranged from 0.995 to 1.007 for all the reference-class-Farmer-type ionization chambers. This discrepancy was mainly caused by the wall correction factor included in the beam quality correction factor. Subsequently, to verify the theoretical approaches, we calibrated the same ionization chamber in 60 Co gamma ray of Japanese primary and secondary standard dosimetry laboratories (PSDL and SSDL) and measured the absorbed dose of a clinical linear accelerator. It followed that the ratios of Canadian to Japanese absorbed dose in reference dosimetries increased up to 1.015 for PTW 30013 reference-class-Farmer-type ionization chamber. This increase was mainly caused by a discrepancy in the calibration factors (N D,w ) observed between Japanese PSDL and SSDL. In conclusion, in order to improve the international consistency of the absorbed dose to water determined by JSMP Standard Dosimetry 12, we should reevaluate the accuracy of the wall correction factors and implement a periodic comparative test of the N D,w between Japanese PSDL and SSDL.

Flattening filter-free (FFF) beams generated by linear accelerators have been widely adopted in many hospitals recently for radiation therapy. FFF technology can provide higher dose rates so that shortening of the treatment time and less intra-fraction motion error are expected.In Japan, the current way of determining absorbed dose to water for FFF beams is to follow the Standard Dosimetry 12 protocol which was developed for flattened beams. Since it has been reported that the flattened beams and FFF beams have different beam properties, it is necessary to evaluate the usefulness of Standard Dosimetry 12 protocol for FFF beam dosimetry.This report reviews physical and dosimetric properties of FFF beams especially in terms of the effect on absorbed dose to water dosimetry using an ionization chamber. From the review, it became evident that the absorbed dose to water is underestimated by volume averaging effect of the ionization chamber. On the other hand, the absorbed dose to water is overestimated by using the beam-quality specifier TPR 20,10 to predict the restricted mass collision stopping power ratio for FFF beams. Therefore, an alternative method was proposed for absorbed dose to water dosimetry of FFF beams based on Standard Dosimetry 12.

In this report, history of the dose standard system, calibration of ionization chamber and standard dosimetry protocol to assure dose traceability was interpreted. The water absorbed dose standard is newly established in Japan and calibration service and dosimetry protocol based on the water absorbed dose has been provided. A lot of uncertainties exist in current complicated radiation therapy. However, uncertainty of dose delivery will be reduced and further progress of quality assurance is expected by shift to the absorbed dose calibration system in radiation therapy field.

Neuropathic pain is often a consequence of nerve injury due to surgery, cancer, bone compression, diabetes, or infection. This type of pain can be so severe that even the slightest touch can cause intense pain in the affected area. Neuropathic pain is generally resistant to currently available treatments. Abundant evidence in the literature suggests that activated microglia and astrocytes are key players in neuropathic pain and that ATP receptors expressed in the glia have an important role in pain signaling. In this review, we summarize the roles of the microglia in the functioning of ATP receptors and of the astrocytes in neuropathic pain. Understanding the key functions of the microglia and astrocytes may lead to the development of new strategies for the management of intractable chronic pain.

To establish traceability of absorbed dose to water, a cobalt calibration coefficient is transferred to a reference ionization chamber by the standard dosimetry laboratory in the radiotherapy field. In Japan, the calibration is done against a set of an ionization chamber and an electrometer as a system. Nowadays, solely electrometer calibration is desirable to measure absorbed dose with more than one combination of ionization chamber and electrometer. Unfortunately, there is no domestic electrometer calibration service for nano-ampere range appropriate for ionization current measurement in the radiotherapy field. In this report, a relative electrometer calibration factor was determined by comparison between a calibrated combination and a non-calibrated electrometer under identical irradiation conditions at the user site. To estimate uncertainties of user electrometer calibration, comparison was made between calibration factors obtained by ionization current under a linac photon beam and DC current with a precision DC source instrument. It was found that the variation of electrometer readings to pulse ionization current is negligible under the steady photon beam output and dose monitor system. Therefore relative electrometer calibration under identical irradiation conditions at the user site was judged valid until a domestic nano-ampere electrometer calibration service becomes available.

Plane-parallel ionization chambers that exhibit polar effects with low energy electron beams are recommended for therapeutic electron dosimetry. In this study, the polarity effects of a C-134A ionization chamber, a major commercially available plane-parallel ionization chamber in Japan, were characterized as a function of mean energy at various depths. Polarity effects were measured at representative depths along depth dose curves of nominal 4, 6, 9, 12 and 15 MeV electron beams, and were compared with previously reported results. Polarity errors for the ionization chamber studied were shown to monotonically increase with decreasing mean energy at a given depth and were maximal at about 1-2 MeV. It was also shown that polarity errors depended on the energy of the incident electron beam. The polarity error of the C-134A ionization chamber was larger than that of other previously investigated plane-parallel ionization chambers. Because the magnitude of polarity effects should be determined throughout the depth dose curve in therapeutic electron dosimetry, it is always necessary to measure ionization readings taken at both polarities.

Recently, a few types of step-wedges for bootstrap sensitometry with a mammographic screen-film system have been proposed. In this study, the bootstrap sensitometry with the mammographic screen-film system was studied for two types of aluminum step-wedges. Characteristic X-ray energy curves were determined using mammographic and general radiographic aluminum step-wedges devised to prevent scattered X-rays generated from one step penetrating into the region of another one, and dependence of the characteristic curves on the wedges was also discussed. No difference was found in the characteristic curves due to the difference in the step-wedges for mammography and general radiography although there was a slight difference in shape at the shoulder portion for the two types of step-wedges. Therefore, it was concluded that aluminum step-wedges for mammography and general radiography could be employed in bootstrap sensitometry with the mammographic screen-film system.

Comparisons of focal-spot size measurements with a direct-exposure X-ray film, screen-film (S/F) system, and imaging plate (IP) were carried out for slit and star resolution pattern camera techniques. The focal-spot measurements of X-ray units with the nominal size of 0.1-1 mm were performed, and measurement using the computed radiography (CR) system was investigated. Compared with the direct-exposure X-ray film method, the measurements of focal-spot size by the S/F system were slightly small for all focal spots. The measurements obtained with IP were slightly large for large and small focal spots, although the measurement of micro focal-spot size was overestimated, extending the tolerance level owing to the sampling. With the star pattern camera technique, differences between the three kinds of detectors were minimal. Therefore, it was thought that measurement of focal-spot size using the CR system would be practical for both large and small focal spots if this method were used for quality control in medical facilities.

The Japan Society of Medical Physics (JSMP) has published a new dosimetry protocol "JSMP-01" (standard dosimetry of absorbed dose in external beam radiotherapy) which conforms to the recommendations of the International Atomic Energy Agency (IAEA TRS-398) and the American Association of Physicists in Medicine (AAPM TG-51) protocols for the calibration of radiotherapy beams. Since the new protocol offers the physical data for the Famer-type ionization chambers of the various wall materials, the user can measure the absorbed dose at reference point (D(r)) using most of the commercially available Famer-type ionization chambers. In this paper, the six Famer-type ionization chambers of the various wall materials are examined for photon beam by two ways. To verify the JSMP-01 protocol as the first way, D(r) was cross-measured based on the JSMP-01 protocol using a Farmer-type ionization chamber of the acrylic wall material which is called "JARP-chamber" and the Farmer-type ionization chambers of the various wall materials, and compared. To compare the basic data in previous and new protocols as the second way, D(r) was measured based on the previous protocol (JSMP-86) and the JSMP-01 protocol using the Farmer-type ionization chambers of the various wall materials. Dose calculation was made using common exposure calibration factor for (60)Co gamma-rays (Nc) for each of the Farmer-type ionization chambers. Measurement was made with each ionization chamber for 6 and 10 MV photon beams in two facilities. D(r) were found to agree to that of JARP-chamber within about +/- 1% despite significant differences of ratio of calibration factor (k(D,X)) and beam quality conversion factor (k(Q)) for photon beams. The ratios JSMP-01/JSMP-86 of the reference dose were found to lie on between 0.999 and 1.004 for 6 MV and on between 0.999 and 1.005 for 10 MV depending upon the Farmer-type ionization chambers used. The largest discrepancies between the previous and new protocols arise from the use of different data of k(D,x) x k(Q) and C(lambda) for the absorbed dose conversion factors of each ionization chamber.

We have produced a novel water substitute phantom suitable for film dosimetry, while retaining the radiological property of a conventional water substitute phantom. The novel phantom excludes the effect of light, which is known to affect the accuracy of results on conventional phantoms. The effect of light was eliminated by appropriately adjusting the quantum of the carbon black to that of a conventional phantom material. Through comparison of the novel phantom with a conventional phantom it was shown that the absorbed dose determined by conventional phantom was 15% higher for 10 MV X-rays and 18% higher for an 18 MeV electron beam, attributable to the contamination of Cerenkov light. Although the net optical density of the film increased with time owing to the optical permeability of the phantom, that of the novel phantom did not vary with time. The novel phantom was therefore shown to be unaffected by such local light and by the optical transmission of the phantom.

Dry-processing leaser imager systems have become popular due to the advantages such as the elimination of the cost and labor associated with the wet chemical processing. In this paper, the stability of a dry-processing imager system Drypro 722/SD-P was studied using SMPTE pattern films processed by a dry-processing imager Drypro 722 and a wet-processing imager Li-8/SRX-502 at three different times of the day over a period of five consecutive working days. The dry system is inferior to the wet system on the stability and the spatial uniformity, so that the problems assess the necessity of QC for Drypro 722 Laser Imagers. The instability of the post-processing dry and wet films is also studied. The dry film is very instable compared with the wet film. Accordingly the wet film must be handled with the care.