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The aim of this study is the evaluation of electron dose enhancement and photon contamination production by various nanoparticles in the electron mode of a medical linac. MCNPX Monte Carlo code was used for simulation of Siemens Primus linac as well as a phantom and a tumor loaded with nanoparticles. Electron dose enhancement by Au, Ag, I and Fe2O3 nanoparticles of 7, 18 and 30 mg/ml concentrations for 8, 12 and 14 MeV electrons was calculated. The increase in photon contamination due to the presence of the nanoparticles was evaluated as well. The above effects were evaluated for 500 keV and 10 keV energy cut-offs defined for electrons and photons. For 500 keV energy cut-off, there was no significant electron dose enhancement. However, for 10 keV energy cut-off, a maximum electron dose enhancement factor of 1.08 was observed for 30 mg/ml of gold nanoparticles with 8 MeV electrons. An increase in photon contamination due to nanoparticles was also observed which existed mainly inside the tumor. A maximum photon dose increase factor of 1.07 was observed inside the tumor with Au nanoparticles. Nanoparticles can be used for the enhancement of electron dose in the electron mode of a linac. Lower energy electron beams, and nanoparticles with higher atomic number, can be of greater benefit in this field. Photons originating from nanoparticles will increase the photon dose inside the tumor, and will be an additional advantage of the use of nanoparticles in radiotherapy with electron beams.

Introduction: Cone-beam computed tomography is used for specialized imaging of dental and maxillofacial structures. CBCTs capabilities and facilities for dental and maxillofacial imaging have resulted in their increasing clinical use. Although the dose of CBCT tests is low, its widespread use increases the cumulative dose. This study was conducted to evaluate head and neck effective dose and image quality in different organs for various exposure techniques in CBCT imaging. Material and Methods: This study was performed on various CBCT imaging examinations. Head and neck parts of anthropomorphic male Rando® Alderson Phantom and thermoluminescent dosimeters were used for organ dosimetry. Contrast to noise ratio and signal to noise ratio were evaluated for image quality assessments. For this purpose, the region of the tooth and soft tissue images were randomly used as the basis. Results: Mean effective dose for face and paranasal sinuses imaging in three modes (standard, low-dose, ultra-low dose), temporomandibular imaging in two modes(standard & low dose), and dental imaging in implant and endo imaging modes was equal to 382.17, 193.97, 79.96, 262.6, 135.67, 53.93, 682.83, 335.75, 184.18, and 234.57 µSv, respectively. Signal -to -noise ratio (SNR) for the above-mentioned procedures was equal to 6.04, 5.73, 3.71, 6.3, 6.00, 4.08, 14.2, 12.3, 7.51, and 6.97, respectively. Conclusion: The present study showed, when low dose and ultra-low-dose modes are chosen, the patient's dose will be severely reduced in most CBCT procedures. Contrast-to-noise ratio (CNR) and SNR will diminish too, but they are sufficient for some diagnostic purposes. [ABSTRACT FROM AUTHOR]

Background: Skin is a sensitive organ and should be spared in radiotherapy and irradiation of skin in radiotherapy can cause to acute and late skin effects such as erythema, desquamation, epilation, color change, or even necrosis. Objective: The aim of the present study is to do skin dosimetry in radiotherapy of parotid cancer using Gafchromic EBT3 radiochromic film. EBT3 radiochromic films were calibrated in 0.2-5 Gy dose range. Material and Methods: This is an experimental study in the field of radiotherapy physics. Treatment planning was performed on a RANDO phantom for treatment of parotid cancer by a clinical oncologist. Based on the treatment planning, the skin dose at various points in the overlapping region of right anterior-oblique and right posterior-oblique fields were measured using EBT3 radiochromic film. Results: The minimum and maximum skin doses in a fraction (with 2.0 Gy prescribed dose) were 0.50 Gy and 0.97 Gy, respectively. Based on these values, the total skin dose in 30 treatment fractions (for removed tumor) or in 35 treatment fractions (for unremoved tumor) was in the range of 15-33 Gy. Conclusion: Based on the skin dosimetry results of parotid cancer radiotherapy using EBT3 films, it is predicted that there will occur mild skin reactions and these reactions can be neglected due to being mild. [ABSTRACT FROM AUTHOR]

Background: The importance of cellular dosimetry in both diagnostic and radiation therapy is becoming increasingly recognized. Objective: This study aims to compare surviving fractions, which were predicted using Geant4 and contained three types of cancer cell lines exposed to 188Re with the experimentally surviving fraction determined by MTT assay. Material and Methods: In this comparative study, Geant4 was used to simulate the transport of electrons emitted by 188Re from the cell surface, cytoplasm, nucleus or medium around the cells. The nucleus dose per decay (S-value) was computed for models of single cell and random monolayer cell. Geant4-computed survival fraction (SF) of cancer cells exposed to 188Re was compared with the experimental SF values of MTT assay. Results: For single cell model, Geant4 S-values of nucleus-to-nucleus were consistent with values reported by Goddu et al. (ratio of S-values by analytical techniques vs. Geant4 = 0.811-0.975). Geant4 S-values of cytoplasm and cell surface to nucleus were relatively comparable to the reported values (ratio =0.914-1.21). For monolayer model, the values of SCy→N and SCS→N, were greater compared to those for model of single cell (2%-25% and 4%-38% were larger than single cell, respectively). The Geant4 predicted SF for monolayer MCF7, HeLa and A549 cells was in agreement with the experimental data in 10 μCi activity (relative error of 2.29%, 2.69% and 2.99%, respectively). Conclusion: Geant4 simulation with monolayer cell model showed the highest accuracy in predicting the SF of cancer cells exposed to homogeneous distribution of 188Re in the medium. [ABSTRACT FROM AUTHOR]

Introduction: In various radiotherapy techniques for breast cancer, the inclusion of internal mammary nodes (IMNs) in the target volume is important for selecting the most appropriate technique. This study aimed to compare three radiotherapy techniques with the inclusion of IMNs regarding the dose homogeneity index (DHI) of regional lymph nodes and the chest wall, besides the dose received by the heart and the left lung. Material and Methods: Three radiotherapy techniques were planned for CT imaging of the RANDO phantom, including the wide tangent (WT); oblique parasternal photon (OPP); and oblique parasternal electron (OPE) techniques. The doses reaching the contoured organs were compared between the three techniques, using the data gathered from the thermoluminescent dosimetry and treatment planning system. Results: The OPE technique produced a lower absorbed dose for the left IMNs, compared to the other two techniques. In the OPP technique, the dose received by the left lung was higher than its tolerance, while the lung dose in the OPE technique was slightly lower than the WT technique. The absorbed dose by the heart was the lowest in the WT technique; also, the DHI value was better for this technique than the other two techniques. Conclusion: The WT technique showed better results regarding the dose homogeneity distribution of IMNs and the chest wall, as well as protection of organs at risk. [ABSTRACT FROM AUTHOR]

Introduction: Radiation-induced bystander effects (RIBE) is the radiobiological effects detected in nonirradiated cells that have received signals from neighboring irradiated cells. In some studies, there are observations that RIBE unexpectedly reduces at high doses. In this study, the expression of two selected apoptotic and repair genes and their possible role in the formation of this unexpected reduction is examined.Materials and Methods: The QU-DB cells were irradiated with gamma rays of a60 Co teletherapy unit at doses of 2, 4, 6, and 8 Gy. One hour following irradiation, their culture media were transferred to bystander cells to induced RIBE. After 24 h incubation, the RNA of cells was isolated and cDNA synthesized. Expression levels of BAX, XPA, and XPA/BAX ratio were examined by relative quantitative reverse transcription-polymerase chain reaction.Results: In target cells, up-regulation of both genes was observed at all doses. In bystander cells, at the low dose (2 Gy), the expression of BAX was more than XPA; at 4 Gy, the ratio was balanced. A significant correlation was found between the XPA/BAX ratio and the dose, at high doses pattern of gene expression dominated by DNA repair gene.Conclusion: Gene expression profile was distinctive in bystander cells compared to target cells. The observed linear increasing of the ratio of XPA/BAX could support the hypothesis that the DNA repair system is stimulated and causes a reduction in RIBE at high doses. [ABSTRACT FROM AUTHOR]

These procedures have a significant contribution to medical exposure to the general population. Exposure of patients to high doses of x-rays could cause deterministic effects on the skin. Therefore, the assessment of radiation doses of patients is of great importance. This study aimed to assess maximum entrance skin dose (MESD) of patients who underwent interventional cardiology procedures. Moreover, it was attempted to determine the correlation between MESD and other relevant dosimetric parameters. Material and Methods: The MESDs of 32 patients who underwent CA procedures were measured by an array of thermoluminescence dosimeters (TLDs). In this study, a Perspex tray consisting of 5 rows and 6 columns was used to hold the TLDs. Its long axis was perpendicular to the long axis of the table, and the top edges of the tray were approximately equal to the patient's shoulders. Results: The results revealed a linear relationship between dose area product (DAP) values and MESDs (R2=0.89; P=0.00). In addition, there was a significant association between MESD and fluoroscopy time (R2=0.89). Moreover, a weak correlation was observed between MESD and the number of frames per second (R2=0.23). Conclusion: According to the results, the recorded DAP values and fluoroscopy time can be used to estimate the MESDs of patients undergoing coronary fluoroscopy procedures. [ABSTRACT FROM AUTHOR]

Introduction: The effects of the low dose of ionizing radiation are not thoroughly evident due to an unavoidable increase of occupational exposure and the widespread application of ionizing radiation in medical and industrial fields. The aim of this study was to investigate immune system responses following the low doses of ionizing radiation. Material and Methods: BALB/c mice were exposed to Whole Body Irradiation of 20, 50, and 100 mGy through a 60Co source. Lymphocytes extraction were operated 24 h after irradiation. Afterwards, gene expression analysis was performed with relative quantitative Real-Time polymerase chain reaction to IL-4, IFN-γ, and TGF-β expression levels. Moreover, IFN-γ/IL-4 ratio was computed, and the independent sample t-test was performed for the statistical analysis. Results: Whereas IL-4, IFN-γ, and TGF-β expression levels decrease after the radiation of the low doses of gamma rays, the IFN-γ/IL-4 ratio increased significantly after irradiation of 20 mGy (P-Value<0.05). However, this ratio did not vary following the gamma irradiation of 50 and 100 mGy. Conclusion: The positive effects of the low dose of ionizing radiation can be observed through significant alterations in gene expression and the activation of protection mechanisms. This process was caused by the modulation of cellular immune responses after the exposure to 20 mGy. Although the irradiation of higher doses (50 and 100 mGy) induced alterations in the IFN- γ/IL-4 ratio was insignificant. These findings did not confirm the linear no-threshold model theory, and demonstrated that the low dose of ionizing radiation could be the cause of the hormesis phenomenon. [ABSTRACT FROM AUTHOR]

Introduction: Ionizing radiation is widely used in industry and medicine; however, it causes a significant health hazard by making microscopic damage to living tissue. Various biological parameters, including cell survival fraction and relative biological effectiveness, are taken into account to assess the severity and extent of biological damages. Microdosimetry suffers from various shortcomings and limitations, but the development of some powerful simulation software has paved the way to resolve these problems in recent years. Material and Methods: In this study, the authors were looked for two keywords (Geant4 and radiobiology) in the title, abstracts, and keywords of Scopus and PubMed database articles. Results: More than 100 articles were found. The researchers extracted the articles that were devoted to the construction of different geometries for DNA, nucleus, and cells as simulate the parameters, such as relative biological effectiveness, SF, linear energy transfer, and single-strand breaks/double-strand breaks in the present study. Conclusion: Geant4 is one of the software commonly used to simulate biological factors. It has many properties, such as the ability to follow up physical processes in very low energy, open source code, and flexibility in complex geometries. In this paper, we reviewed some of the radiobiological parameters simulated with Geant4. [ABSTRACT FROM AUTHOR]

Introduction: International Commission on Radiological Protection introduced three basic principles of radiation protection, namely justification, optimization, and dose limit. Medical exposure has no dose limits, and generally, diagnostic reference levels are used as a tool for optimization of patient protection. Material and Methods: Dosimetry was performed on 20 CT scanners located in 14 cities in 12 provinces of Iran. A calibrated pencil-shaped ionization chamber, standard head and body CT dosimetry phantoms and a radiation monitor were used to determine and calculate Computed Tomography Dose Index (CTDI) and Dose Length Product (DLP). The DLP-based estimates of effective dose were derived using effective dose conversion coefficients. Results: The nCTDIw values for head phantoms fell within the range of 22.05-168.38 and 43.77-426.69 μGy/mAs for 5 and 10mm slice thicknesses, respectively. These values for body phantom were 4.65-146.39 and 9.43-308.92 μGy/mAs for 5 and 10mm slice thicknesses, respectively. The third quartile of CTDIvol and DLP values for head CT examinations were 49.85 mGy and 1161.00 mGy-cm, respectively. The body CT examinations had the values of 8.89 mGy and 370.97 mGy-cm, respectively. The findings of this study revealed that the above-mentioned values can be considered as national diagnostic reference levels for head and body CT examinations in Iran. Conclusion: The results of the current study suggested that there is a need to re-assess DRLs for CT examinations at regular time intervals by the appropriate regulatory authority which can improve the continuous performance of CT scanners in Iran. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to assess the accuracy of electron dose calculations of Prowess Panther treatment planning system (TPS) for abutting photon-electron (PE) technique. In this work, we have assessed the accuracy of electron dose calculations in a simulated internal mammary field because this field is irradiated with electron in PE technique.Materials and Methods: In this study, regions of in-field, under electron shield, and outside the internal mammary field were evaluated. Thermoluminescent dosimeter (TLD-700) chips were used within RANDO phantom for dose measurement. Prowess Panther TPS was also applied for dose calculation. Finally, confidence limit values were obtained to quantify the TPS electron dose calculation accuracy of an internal mammary field.Results: The results show that for outside of field and under shield regions, Prowess Panther TPS underestimated the dose compared to the measured doses by TLD-700, whereas for in-field regions, the calculated doses by Prowess Panther TPS compared to the measured doses by TLD-700, for some points are overestimated and other points are underestimated. Finally, the confidence limit values were obtained for various regions of the internal mammary field. Confidence limits for in-field, outside of field, and under shield regions were 54.23, 108.19, and 80.51, respectively.Conclusions: It is concluded that the accuracy of electron dose calculations of Prowess Panther TPS is not adequate for internal mammary field treatment. Therefore, it is recommended that for fields with electron beams Prowess Panther TPS calculations should not be entirely relied upon. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to measure entrance skin dose (ESD) on the breast of patients who had undergone radiotherapy following surgery, in the presence and absence of bolus.Materials and Methods: In this study, the ESD on the breast of 22 female patients was measured using thermoluminescent dosimeter-100 chips. For each patient, the ESD was measured 3 times (once without bolus and twice using bolus). The bolus types used in this study include super flab and wax.Results: The average ESDs on the breast of patients (from both medial and lateral tangential fields) in the presence of the super flab bolus and absence of bolus were 225.8 and 148.17 cGy, respectively, that when using the bolus, around 52% increasing in ESD was observed. The results showed a significant relationship between the ESD on the breast of patients and bolus types (P = 0.002); in addition, correlation coefficient between the two boluses (super flab and wax) was 0.615 (r = 0.615).Conclusion: When using the bolus in postmastectomy irradiation, it is noted that in dose delivery to the chest wall, surgical scar or skin of the treated region should be considered. The use of the bolus as a substance that increases of the skin dose can sometimes cause an excessive increase in skin dose that may cause severe skin reactions and underdosing of underlying tissues. Furthermore, using wax bolus in regions that do not require a lot of shaping of bolus is affordable. [ABSTRACT FROM AUTHOR]

Introduction: In recent years, the number of computed tomography (CT) scans, which is a high-dose technique, has increased significantly. Head and neck CT is performed frequently and thyroid, particularly in children, has always been considered a sensitive organ. In recent years, radiobiologists and health physicists have been more concerned about the safety of lenses of the eyes, as cataract is no longer considered a deterministic effect. Material and Methods: In the present study, incurred doses to the thyroid and lens of the eye of 140 patients who underwent common head and neck CT at five hospitals were measured by thermoluminescent dosimeters (TLD-100). The patients were divided into two age groups of pediatrics and adults. TLD chips were placed on the patient's skin surface. For each patient, scan parameters, sex and age were recorded. Exposed TLDs were read by a manual TLD reader. Results: The average absorbed dose of the thyroid, as well as the lenses of the left and right eyes were 5.89±1.74, 15.84±2.81 and 16.25±2.57, respectively, for the pediatric patients and 5.00±1.17, 17.64±1.69 and 24.41±1.89 for adults. Patient-specific organ doses were influenced by the scanned region, scan protocol and patient's age. Conclusion: In the present study, the mean eye dose was much lower than the 500 mGy threshold recommended by International Commission on Radiological Protection (ICRP) for lens of the eye damage, thus, it appears to be clinically safe. While CT scan remains a crucial tool, further dose reduction can be achieved by controlling different factors affecting patient doses. [ABSTRACT FROM AUTHOR]

Objective(s): Radiotherapy is one of the most effective modalities of cancer therapy, but clinical responses of individual patients varies considerably. To enhance treatment efficiency it is essential to implement an individual-based treatment. The aim of present study was to identify the mechanism of intrinsic apoptosis pathway on radiosensitivity and normal tissue complications caused by the radiotherapy. Materials and Methods: Peripheral blood mononuclear cells from ten breast cancer patients were exposed to 6MV X-rays to deliver 1 and 2 Gy. Expression levels of Bax, Bcl-2, and Bax/Bcl-2 ratio were examined by relative quantitative RT-PCR. All the patients received similar tangential irradiation of the whole breast and conventional fractionation. Skin dosimetry was done by GAFChromic EBT-3 film and clinical radiosensitivity was determined using the acute reactions to radiotherapy of the skin according to Radiation Therapy Oncology Group score. All statistical analyses were performed using GraphPad Prism, version 7.01. Results: In the in-vitro experiment, Bax and Bax/Bcl-2 ratios were significantly increased with 1 and 2 Gy doses (P<0.001 and P<0.0001, respectively). Herein, the notable result was a significant correlation between dose-response curve slope (as an in-vitro radiosensitivity index) and acute skin toxicity score following irradiation (as a clinical radiosensitivity index). There was no significant relationship between skin dose and reactions (P>0.05 for all patients). Conclusion: Significant correlation between Bax/Bcl-2 ratio determined before radiation therapy and clinical response in the patients, can be used as a biomarker to identify radiosensitive individuals. However, further studies are required to validate radiation-induced apoptotic biomarkers. [ABSTRACT FROM AUTHOR]

Introduction: Diagnostic reference level (DRL) is a useful tool for the promotion of optimization. The national DRLs (NDRLs) are useful, brief, and robust guidelines for optimizing radiation protection in a country. The aim of this study was to extract the local DRLs (LDRLs) for some common radiologic examination in Sabzevar county. Materials and Methods: There are eight radiology departments in Sabzevar County, Iran. The entrance skin dose (ESD) distributions were determined by use of thermoluminescence dosimeter (TLD) chips for 10 standard projections (i.e., anterioposterior [AP] abdomen, AP and posteroanterior [PA] chest, AP and lateral [LAT] lumbar spine, AP pelvis, cervical AP, cervical LAT, as well as AP and LAT skull). The third quartiles of the measured ESDs were compared with the previously published data. Results: In the present study, the third quartile of the measured ESDs for the patients undergoing specific examination were selected as LDRLs. The calculated LDRLs for the chest PA, chest AP, lumbar spine PA, lumbar spine LAT, pelvis AP, abdomen AP, cervical AP, cervical LAT, skull PA, and skull LAT were 0.54, 0.64, 1.99, 3.83, 1.47, 2.15, 0.54, 0.78, 1.22, and 1.01 mGy, respectively. Conclusion: Our results were compared with the DRLs reported in Iran, UK, and Japan as well as those reported by the National Radiological Protection Board (NPRB) for the UK. The ESDs obtained in this study for the chest PA, cervical AP, cervical LAT, AP and LAT skull, abdomen AP, pelvis AP, lumbar PA, and lumbar LAT examinations did not exceed the DRL values reported by NPRB. [ABSTRACT FROM AUTHOR]

Aim: Our objective is to quantify dose calculation accuracy in the build-up region using TiGRT and Prowess Panther treatment planning systems (TPSs).Materials and Methods: Thermoluminescent dosimeter-100 chips were used in a phantom for dose measurement. TiGRT Version 1.2 (LinaTech, Sunnyvale, CA, USA) and Prowess Panther version 5.1 (Prowess Inc., Concord, CA, USA) TPSs were also used for dose calculations. Finally, the confidence limit values obtained to quantify dose calculation accuracy of the TPSs at build-up region for different field sizes and various gantry angles.Results: For 8 cm × 10 cm, 10 cm × 10 cm, and 15 cm × 10 cm field sizes, the confidence limit values for TiGRT TPS were 16.64, 16.56, and 25.85; for Prowess TPS with fast photon effective (FPE) algorithm were 15.17, 14.22, and 9.73; and for Prowess TPS with collapsed cone convolution superposition (CCCS) algorithm were 10.53, 9.97, and 9.76, respectively. For wedged field with gantry angles of 15°, 30°, and 60°, the confidence limit values for TiGRT TPS were 12.11, 12.96, and 22.69 and for Prowess TPS with FPE algorithm were 24.50, 22.07, and 7.82, respectively.Conclusions: It is concluded that for open field sizes without gantry angulation, dose calculation accuracy in Prowess TPS with CCCS algorithm is better than TiGRT and Prowess TPSs with FPE algorithm. Furthermore, it is concluded that for wedged field with large gantry angle, dose calculation accuracy of Prowess TPS with FPE algorithm is better than TiGRT TPS while, for medium and small gantry angles, dose calculation accuracy of TiGRT TPS is better than Prowess TPS with FPE algorithm. [ABSTRACT FROM AUTHOR]

Objective:The dose-response relationship of radiation-induced bystander effect (RIBE) is controversial at high dose levels. The aim of the present study is to assess RIBE at high dose levels by examination of different endpoints. Materials and Methods: This experimental study used the medium transfer technique to induce RIBE. The cells were divided into two main groups: QU-DB cells which received medium from autologous irradiated cells and MRC5 cells which received medium from irradiated QU-DB cells. Colony, MTT, and micronucleus assays were performed to quantify bystander responses. The medium was diluted and transferred to bystander cells to investigate whether medium dilution could revive the RIBE response that disappeared at a high dose. Results: The RIBE level in QU-DB bystander cells increased in the dose range of 0.5 to 4 Gy, but decreased at 6 and 8 Gy. The Micronucleated cells per 1000 binucleated cells (MNBN) frequency of QU-DB bystander cells which received the most diluted medium from 6 and 8 Gy QU-DB irradiated cells reached the maximum level compared to the MNBN frequency of the cells that received complete medium (P<0.0001). MNBN frequency of MRC5 cells which received the most diluted medium from 4 Gy QU-DB irradiated cells reached the maximum level compared to MNBN frequency of cells that received complete medium (P<0.0001). Conclusion: Our results showed that RIBE levels decreased at doses above 4 Gy; however, RIBE increased when diluted conditioned medium was transferred to bystander cells. This finding confirmed that a negative feedback mechanism was responsible for the decrease in RIBE response at high doses. Decrease of RIBE at high doses might be used to predict that in radiosurgery, brachytherapy and grid therapy, in which high dose per fraction is applied, normal tissue damage owing to RIBE may decrease. [ABSTRACT FROM AUTHOR]

Introduction Quality control (QC) techniques are used in monitoring and maintenance of the components of an x-ray system. QC of radiology devices plays a significant role in reduction of medication dose and optimization of image quality. This study aimed to conduct QC tests on randomly selected radiology devices, installed in diagnostic imaging departments of Iran. Materials and Methods In total, quality control tests were conducted on 51 conventional radiology devices installed in 20 cities of Iran in order to assess the accuracy of peak kilovoltage (kVp), exposure time, exposure linearity and reciprocity, reproducibility of exposure and determination of half-value layer (HVL) using a calibrated Mult-O-Meter. Results In this study, 38.6% of devices had intolerable variance of kVp accuracy. The results of 34.5% of devices were out of the acceptable limits in exposure time accuracy test. In 46.7% and 53.1% of devices, variance was greater than the acceptable range for exposure linearity and exposure reciprocity, respectively. In terms of reproducibility of exposure test, the reproducibility variance and percentage of tube output variations in 19.4% of devices exceeded the limits. Moreover, the thickness of first HVL was lower than the acceptable limit in 14.7% of devices. Conclusion According to the results of this study, there were wide variations in QC test results, perhaps mainly due to the fact that it is not an obligation to implement QC programs in Iran. The most important problems were non-reciprocity of exposure, nonlinearity of exposure with milliampere-second (mAs), kVp and timer inaccuracy. Involvement of medical physicists, radiologists and radiographers in the implementation of QC programs at various stages of development, installation and use of equipment should enable the gradual improvement in equipment performance. [ABSTRACT FROM AUTHOR]

Introduction Wedge modifiers are commonly applied in external beam radiotherapy to change the dose distribution corresponding to the body contour and to obtain a uniform dose distribution within the target volume. Since the radiation dose delivered to the target must be within ±5% of the prescribed dose, accurate dose calculation by a treatment planning system (TPS) is important. The objective of the present study was to quantify the dose calculation accuracy of TiGRT TPS for physical wedged fields in radiotherapy. Materials and Methods A Semiflex™ ionization chamber was used for dose measurements in a water phantom; TiGRT TPS was also applied for dose calculations. The central axis (i.e., high dose-small dose gradient), build-up (i.e., high doselarge dose gradient), off-axis (i.e., high dose-small dose gradient), and out-of-field (i.e., low dose-small dose gradient) regions were evaluated in this study. Finally, the confidence limit values were obtained to quantify the dose calculation accuracy of TPS in these regions. Results The confidence limit values for the central axis, build-up, off-axis, and out-of-field regions were 1.01, 8.62, 1.79, and 55.24, respectively. Furthermore, the results showed that TiGRT TPS underestimated the dose of build-up and out-of-field regions for most points. Conclusion According to the results of the present study, it can be concluded that the dose calculation accuracy of TiGRT TPS for physical wedged fields in the central axis, build-up, and off-axis regions is adequate, while it is insufficient for out-of-field regions. [ABSTRACT FROM AUTHOR]

Introduction The purpose of this study was to estimate organ and effective doses in patients undergoing some common Xray examinations in Sabzevar, Iran. The effective dose is one of the best parameters for describing the amount of radiation dose received by a patient undergoing any diagnostic X-ray examination. The public dose from X-ray examinations depends on various factors, and its contribution to the overall public dose from medical applications widely varies in different societies; however, in Iran, limited data is available on this subject. Materials and Methods In the present study, we aimed to estimate organ and effective doses arising from some common X-ray examinations on patients. Organ and effective doses were calculated by employing PCXMC program, based on Monte Carlo method. Results The mean effective doses in this study were compared with similar findings reported in previous research. The applied methods in different studies are the main factors, which influence the effective dose values. Conclusion Radiation doses to radiosensitive organs such as the ovaries, testicles, and thyroid may induce harmful effects, e.g., cancer and genetic effects. Therefore, we should try to maintain the organ doses as low as possible. [ABSTRACT FROM AUTHOR]

Introduction: The increasing practice of interventional fluoroscopy in diagnosis and treatment of cardiovascular disease has risen attention to improve radiation protection of patients and cardiologists in these relatively high dose techniques. Therefore, nowadays there is an emphasis on the measurement of radiation dose received by patients and cardiologists arising from the relevant procedures. Materials and Methods: Maximum skin dose of 90 patients in two hospitals in Mashhad have been measured by a grid of 30 thermoluminescent dosimeters (TLDs). The X-ray units were Axiom Artis Siemens in both hospitals which were equipped with integrated dose area product (DAP) meters. The procedures were divided into two groups: diagnostic procedures (angiography and angiography with measurement of left or right ventricle and pulmonary artery) and therapeutic procedures (angioplasty with or without dilatation or stent and angiography with angioplasty). DAP value, fluoro time, and cumulative dose at Interventional Reference Point (CDIRP) were also registered for each procedure. Results: The mean values of maximum skin dose (MSD) and DAP for diagnostic procedures were 68.51 mGy and 20.96 Gy.cm², respectively and for therapeutic procedures 344.18 mGy and 70.94 Gy.cm², respectively. A good correlation was found between MSD and DAP (R=0.88) but correlation between MSD and CDIRP was stronger (R=0.90). Conclusion: MSD values did not exceed the 2000 mGy dose threshold for deterministic effects. The highest MSD obtained for diagnostic procedures was 229.40 mGy and for therapeutic procedures it was 820.50 mGy. The results show that CDIRP can be a fairly good estimate of MSD. [ABSTRACT FROM AUTHOR]

Introduction: SPECT projections are contaminated by scatter radiation, resulting in reduced image contrast and quantitative errors. Backscatter constitutes a major part of the scatter contamination in lower energy windows. The current study is an evaluation of the effect of backscatter material on FWHM and image quality investigated by Monte Carlo simulation. Materials and Methods: SIMIND program was used for simulation of a Siemen's dual-head variable angle scintillation gamma camera. Planar and SPECT scanning of a 99mTc source and a Jaszczak phantom for varying thicknesses of Perspex slabs, as a backscatter media, were analyzed using the photopeak and scatter windows. Simulated planar images and reconstructed tomographic images were evaluated qualitatively, by two nuclear medicine specialists, and quantitatively, by Structural Similarity (SSIM) Index. Results: In the 99mTc photopeak window, no significant change in total counts due to backscatter material was measured. In the scatter windows, scattering was overestimated compared with a simulated backscatter free SPECT system. For instance, at a thickness of 10 cm, total counts of a 99mTc source detected in the 72 keV windows eventually doubled with increasing backscatter material, compared with the situation without backscatter material. The backscatter contribution plateaued when more than 7 cm of scatter material was placed but there were optimized results for a backscatter thickness of 4.5 cm. Better image quality for the thickness was confirmed by the results of eye interpretation and also by SSIM algorithm. Conclusion: Backscatter should be taken into account, particularly in model-based scatter correction methods in SPECT for an accurate simulation system optimization. [ABSTRACT FROM AUTHOR]

Nowadays, radiography is a necessary procedure in diagnosis and treatment of patients with dental problems. According to the ALARA (as low as reasonably achievable) principle, dentists must take radiographs of sufficient quality at the lowest possible radiation dose to the patients. The assessment of patient dose on panoramic radiography is difficult because of dynamic nature of the imaging process and the narrow width of the x-ray beam. The present work describes an experiment undertaken using thermoluminescence dosimeters (TLD-100) to obtain the absorbed dose in organs and sensitive tissues in head and neck region during panoramic radiography, based on patient measurement. The overall mean entrance surface dose on thyroid, right and left lens of eyes, parotid glands (right and left) and occipital region in panoramic were 38, negligible, negligible, 367, 319 and 262 μGy, respectively. The results show that there are differences between patient doses examined by different panoramic systems. There is a tendency for lower organ doses for digital compared with analogue panoramic units. [ABSTRACT FROM AUTHOR]

Background: Treatment planning systems (TPSs) are used for dose calculations in dose delivery by afterloading brachytherapy machines. Such planning systems usually use simplified algorithms in their dose calculations. Verification of dose distributions produced by TPS is of clinical importance and is part of a quality assurance program. In this study, the dose distributions generated by GZP6 TPS for two GZP6 sources were verified. Methods: The evaluation was based on the inter comparisons between the isodose curves obtained through Monte Carlo simulations, radiochromic film measurements, and GZP6 treatment planning system. MCNPX Monte Carlo code was used to simulate the sources. Dose measurements were performed in a perspex phantom using Gafchromic® EBT radiochromic films. Comparisons between the results obtained from MC, RCF, and TPS were performed by gamma function calculations with 5% dose/2 mm distance criterion. Results: Based on gamma calculations our results showed that there was good agreement between the dose distributions obtained by the three aforementioned methods in both transverse and longitudinal planes for the GZP6 source No.2. However, for source No. 5, the agreement was good in the transverse plane but it was low in the longitudinal plane. Conclusion: The results showed that dose distributions certified by the GZP6 TPS for the GZP6 source No. 2 were validated. However, for source No. 5 some discrepancies were observed. Accurate knowledge of the activity of each active pellet in the source No. 5 can clarify the cause of the discrepancies. [ABSTRACT FROM AUTHOR]

Introduction: The present work describes a study in which, based on patient dose measurements, thermoluminescent dosimeters were used to obtain the diagnostic reference level arising from panoramic radiography. Materials and Methods: Ten panoramic units and a sample of 15 patients per X-ray unit were studied. Two thermoluminescent dosimeter chips were placed on the skin surface of selected organs. Mean value of two ESDs was taken as the measured representation dose at the point of interest. Results: Mean ESD on parotid glands derived from panoramic radiography was equal to 369.2 µGy. Individual patients' dose value varied from 180.1 to 470.3 µGy. Conclusion: Third quartile of mean absorbed dose distribution arising from a particular examination has been adopted as diagnostic reference level. Based on this definition, local diagnostic reference level arising from panoramic radiography of the greater Khorasan province is equal to 400 µG. [ABSTRACT FROM AUTHOR]

Background. Dosimetric characteristics of a high dose rate (HDR) GZP6 Co-60 brachytherapy source have been evaluated following American Association of Physicists in MedicineTask Group 43U1 (AAPM TG-43U1) recommendations for their clinical applications. Materials and methods. MCNP-4C and MCNPX Monte Carlo codes were utilized to calculate dose rate constant, two dimensional (2D) dose distribution, radial dose function and 2D anisotropy function of the source. These parameters of this source are compared with the available data for Ralstron 60Co and microSelectron192Ir sources. Besides, a superimposition method was developed to extend the obtained results for the GZP6 source No. 3 to other GZP6 sources. Results. The simulated value for dose rate constant for GZP6 source was 1.104±0.03 cGyh-1U -1. The graphical and tabulated radial dose function and 2D anisotropy function of this source are presented here. The results of these investigations show that the dosimetric parameters of GZP6 source are comparable to those for the Ralstron source. While dose rate constant for the two 60Co sources are similar to that for the microSelectron192Ir source, there are differences between radial dose function and anisotropy functions. Radial dose function of the 192Ir source is less steep than both 60Co source models. In addition, the 60Co sources are showing more isotropic dose distribution than the 192Ir source. Conclusions. The superimposition method is applicable to produce dose distributions for other source arrangements from the dose distribution of a single source. The calculated dosimetric quantities of this new source can be introduced as input data to the GZP6 treatment planning system (TPS) and to validate the performance of the TPS. [ABSTRACT FROM AUTHOR]

In single photon emission computed tomography (SPECT), the collimator is a crucial element of the imaging chain and controls the noise resolution tradeoff of the collected data. The current study is an evaluation of the effects of different thicknesses of a low-energy high-resolution (LEHR) collimator on tomographic spatial resolution in SPECT. In the present study, the SIMIND Monte Carlo program was used to simulate a SPECT equipped with an LEHR collimator. A point source of 99mTc and an acrylic cylindrical Jaszczak phantom, with cold spheres and rods, and a human anthropomorphic torso phantom (4D-NCAT phantom) were used. Simulated planar images and reconstructed tomographic images were evaluated both qualitatively and quantitatively. According to the tabulated calculated detector parameters, contribution of Compton scattering, photoelectric reactions, and also peak to Compton (P/C) area in the obtained energy spectrums (from scanning of the sources with 11 collimator thicknesses, ranging from 2.400 to 2.410 cm), we concluded the thickness of 2.405 cm as the proper LEHR parallel hole collimator thickness. The image quality analyses by structural similarity index (SSIM) algorithm and also by visual inspection showed suitable quality images obtained with a collimator thickness of 2.405 cm. There was a suitable quality and also performance parameters' analysis results for the projections and reconstructed images prepared with a 2.405 cm LEHR collimator thickness compared with the other collimator thicknesses. [ABSTRACT FROM AUTHOR]

Abstract: Background: As a routine method for stepping source simulation, a Monte Carlo program is run according to the number of steps and then the summation of dose from each run is taken to obtain total dose distribution. This method is time consuming. Aim: As an alternative method, a matrix shift based technique was applied to simulate a stepping source for brachytherapy. Materials and methods: The stepping source of GZP6 brachytherapy unit was simulated. In a matrix shift method, it is assumed that a radiation source is stationary and instead the data matrix is shifted based on the number of steps. In this study, by running MCNPX program for one point and calculation of the dose matrix using the matrix shift method, the isodose curves for the esophageal cancer tumor lengths of 4 and 6cm were obtained and compared with the isodose curves obtained by running MCNPX programs in each step position separately (15 and 23 steps for esophageal cancer tumor lengths of 4 and 6cm, respectively). Results: The difference between the two dose matrixes for the stepping and matrix shift methods based on the average dose differences are 3.85×10−4 Gy and 5.19×10−4 Gy for treatment length of 4cm and 6cm, respectively. Dose differences are insignificant and these two methods are equally valid. Conclusions: The matrix shift method presented in this study can be used for calculation of dose distribution for a brachytherapy stepping source as a quicker tool compared to other routine Monte Carlo based methods. [Copyright &y& Elsevier]

The national diagnostic reference levels (NDRLs) form an efficient, concise and powerful standard for optimising the radiation protection of a patient. With an aim to establish the first Iranian NDRLs, the nationwide survey of the frequency of medical X-ray examinations and entrance surface doses received by the patients during the most typical X-ray examinations has been performed. Seven most common X-ray examinations in 14 projections were included in the list of procedures under consideration. Hospitals of different sizes and levels using different X-ray machines were represented in (he survey. The standard thermoluminescence dosemeters were applied to measure entrance surface dose (ESD). A total of 1601 patients were included in this study. The data were analysed statistically, and the minimum, median, mean, maximum, first and third quartile values of ESDs are reported. Finally, the proposed Iranian DRLs are compared with the international reference dose values reported by the European Commission, the International Atomic Energy Agency and the National Radiological Protection Board. [ABSTRACT FROM AUTHOR]

Introduction: Organ dose distribution calculation in radiotherapy and knowledge about its side effects in cancer etiology is the most concern for medical physicists. Calculation of organ dose distribution for breast cancer treatment plans with Monte Carlo (MC) simulation is the main goal of this study., Materials and Methods: Elekta Precise linear accelerator (LINAC) photon mode was simulated and verified using the GEANT4 application for tomographic emission. Eight different radiotherapy treatment plans on RANDO's phantom left breast were produced with the ISOgray treatment planning system (TPS). The simulated plans verified photon dose distribution in clinical tumor volume (CTV) with TPS dose volume histogram (DVH) and gamma index tools. To verify photon dose distribution in out-of-field organs, the point dose measurement results were compared with the same point doses in the MC simulation. Eventually, the DVHs for out-of-field organs that were extracted from the TPS and MC simulation were compared., Results: Based on the implementation of gamma index tools with 2%/2 mm criteria, the simulated LINAC output demonstrated high agreement with the experimental measurements. Plan simulation for in-field and out-of-field organs had an acceptable agreement with TPS and experimental measurement, respectively. There was a difference between DVHs extracted from the TPS and MC simulation for out-of-field organs in low-dose parts. This difference is due to the inability of the TPS to calculate dose distribution in out-of-field organs., Conclusion and Discussion: Based on the results, it was concluded that the treatment plans with the MC simulation have a high accuracy for the calculation of out-of-field dose distribution and could play a significant role in evaluating the important role of dose distribution for second primary cancer estimation., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Medical Signals & Sensors.)

Aim of the Study: The (57)Co radioisotope has recently been proposed as a hypothetical brachytherapy source due to its high specific activity, appropriate half-life (272 days) and medium energy photons (114.17 keV on average). In this study, Task Group No. 43 dosimetric parameters were calculated and reported for a hypothetical (57)Co source., Material and Methods: A hypothetical (57)Co source was simulated in MCNPX, consisting of an active cylinder with 3.5 mm length and 0.6 mm radius encapsulated in a stainless steel capsule. Three photon energies were utilized (136 keV [10.68%], 122 keV [85.60%], 14 keV [9.16%]) for the (57)Co source. Air kerma strength, dose rate constant, radial dose function, anisotropy function, and isodose curves for the source were calculated and compared to the corresponding data for a (192)Ir source., Results: The results are presented as tables and figures. Air kerma strength per 1 mCi activity for the (57)Co source was 0.46 cGyh(-1) cm 2 mCi(-1). The dose rate constant for the (57)Co source was determined to be 1.215 cGyh(-1)U(-1). The radial dose function for the (57)Co source has an increasing trend due to multiple scattering of low energy photons. The anisotropy function for the (57)Co source at various distances from the source is more isotropic than the (192)Ir source., Conclusions: The (57)Co source has advantages over (192)Ir due to its lower energy photons, longer half-life, higher dose rate constant and more isotropic anisotropic function. However, the (192)Ir source has a higher initial air kerma strength and more uniform radial dose function. These properties make (57)Co a suitable source for use in brachytherapy applications.