Air Kerma Rate Measurements Research Articles

Establishment of an absolute measurement of the reference air kerma rate for HDR 192Ir brachytherapy sources

Before this study, no institution in China had undertaken the calculation and official establishment of reference values for the reference air kerma rate associated with high-dose rate 192Ir sources used in brachytherapy. This research, carried out at the National Institute of Metrology (NIM) in China, has successfully established an 192Ir reference radiation facility. Consequently, it has achieved the absolute measurement of the reference air kerma rate for high-dose rate brachytherapy using 192Ir sources. For this study, a medical afterloader machine was acquired. The radiation source employed was a high-dose rate 192Ir source for brachytherapy, produced by HTA Co., Ltd. A reference graphite cavity ionization chamber with a volume of 100 cm3 was designed to serve as the ionization chamber for absolute measurements. The determination of various correction factors and physical constants was achieved through a method that combines Monte Carlo simulations with experimental techniques. The study successfully accomplished the absolute measurement of the reference air kerma rate for the high-dose rate brachytherapy 192Ir radiation source. The expanded uncertainty of the measurement results was 0.72% (k = 2). The relative standard deviation for the RAKR of the same 192Ir radiation source was 0.073%. This study marks a significant advancement in the field of radiation therapy in China, particularly in the accurate dosimetry for brachytherapy using high-dose rate 192Ir sources. The study will contribute to the BIPM.RI(I)-K8 international comparison, organized by the Bureau International des Poids et Mesures (BIPM), thus facilitating the international recognition of the measurement values.

Characterization of X-ray Beams: Determination of K\(_{a,e}\) for Comparison with DRLs

Aims: The aim of this experimental study was to quantify the entrance surface air kerma (Ka,e) of X-ray beams in radiographic examinations, and the obtained values were compared with national and international Diagnostic Reference Levels (DRLs). Place and Duration of Study: Sample: Department of Medical Physics and Radiology, Franciscan University (UFN), between June 2023 and August 2024. Methodology: Initially, the main quality control (QC) tests were applied to characterize the radiographic equipment. During the evaluation of the X-ray beam, a dosimetric set was used, and for the same QC geometry, Air Kerma Rate (KAIR) measurements were obtained to determine the output of the X-ray tube. Under the same conditions, a phantom without water and the same filled with water were used to determine the backscatter factor (BSF), which was then used to estimate the Ka,e for the main radiographic examinations. Results: The results of this study are consistent with other studies and identified the region/anatomy with the highest radiation exposure, highlighting the importance of its optimization and verifying that continued professional training should be integrated into best practices to ensure greater safety in procedures. The results obtained evidence the necessity for adjustments in image acquisition protocols, as the Ka,e values found in this study, although within the limits established by the national DRLs, exceed the reference values of countries such as the United Kingdom and Japan in the areas of the skull, abdomen, and lumbar spine. This discrepancy highlights the importance of the periodic review and update of DRLs, in accordance with international recommendations and the technological evolution of equipment. Dose optimization is an ongoing process that involves the evaluation of image quality, the appropriate selection of technical parameters, and the implementation of specific dose protocols. The continuous training of radiology professionals is essential to ensure the correct application of imaging techniques and the minimization of patient exposure to ionizing radiation. Conclusion: This study shows the importance of evaluating radiation dose in diagnostic imaging and the need for a multidisciplinary approach to dose optimization. Implementing quality assurance programs, updating DRLs, and providing ongoing training for professionals are essential to ensure patient safety and high-quality diagnostic imaging. The methodology adopted in this study can contribute to the ongoing education of radiology professionals, promoting the correct application of imaging techniques and reducing patient exposure to ionizing radiation.

ISO 4037 narrow spectrum X-ray reference field: Simulation and measurement

The paper presents the characteristics of the ISO-4037 narrow spectrum X-ray reference fields in 02 different manners: simulation using the SpekPy and measurement using a calibrated ionization chamber. The physical (air Kerma rate) and radiation (X-ray fluence-spectrum-averaged energy, the first and the second half value layers, as well as the beam homogeneity coefficient) quantities were simulated using the SpekPy web-based simulation toolkit. In addition, air Kerma rates were measured by the ionization chamber. The characteristics of the ISO-4037 narrow spectrum X-ray reference fields were determined for various X-ray beam qualities (i.e., N-40, 60, 80, 100, 120, and 150) at 250 cm from the X-ray focal spot. The air Kerma rate tendency was deduced by comparing simulation and measurement data. The combined standard uncertainty of measured air Kerma rate was investigated and presented.

Determination of an air kerma-rate correction factor for the S7600 Xoft AxxentⓇ source model

PurposeThe purpose of this work was to provide guidance for the lack of an air-kerma rate standard for the S7600 Xoft Axxent® source by providing a correction factor to apply to the National Institute of Standards and Technology (NIST) traceable S7500 well chamber (WC) calibration coefficient before the development of an S7600 standard at NIST. METHODS AND MATERIALSThe Attix free air chamber (FAC) at the University of Wisconsin Medical Radiation Research Center was used to measure the air-kerma rate at 50 cm for six S7500 and six S7600 sources. These same sources were then measured using five standard imaging HDR1000+ WCs. The measurements made with the FAC were used to calculate source-specific WC calibration coefficients for the S7500 and S7600 source. These results were compared to the NIST traceable calibration coefficients for the S7500 source. The average results for each WC were then averaged together, and a ratio of the S7600 to S7500 WC calibration coefficients was determined. ResultsThe average S7600 air-kerma rate measurement with the FAC was 7% lower than the average air-kerma rate measurements of the S7500 source. On average, the S7500 determined WC calibration coefficients agreed within ±1% of the NIST traceable S7500 values. The S7600 WC calibration coefficients were up to 16% less than the NIST traceable S7500 values. The final correction factor determined to be applied to the NIST traceable S7500 value was 0.8415 with an associated uncertainty of ±8.1% at k = 2. ConclusionsThis work provides a suggested correction factor for the S7600 Xoft Axxent source such that the sources can be accurately implemented in the clinical setting.

Monte Carlo calculation of the TG-43 dosimetry parameters for the INTRABEAM source with spherical applicators

Objective: The relative TG-43 dosimetry parameters of the INTRABEAM (Carl Zeiss Meditec AG, Jena, Germany) bare probe were recently reported by Ayala Alvarez et al (2020 Phys. Med. Biol. 65 245041). The current study focuses on the dosimetry characterization of the INTRABEAM source with the eight available spherical applicators according to the TG-43 formalism using Monte Carlo (MC) simulations. Approach: This report includes the calculated dose-rate conversion coefficients that determine the absolute dose rate to water at a reference point of 10 mm from the applicator surface, based on calibration air-kerma rate measurements at 50 cm from the source on its transverse plane. Since the air-kerma rate measurements are not yet provided from a standards laboratory for the INTRABEAM, the values in the present study were calculated with MC. This approach is aligned with other works in the search for standardization of the dosimetry of electronic brachytherapy sources. As a validation of the MC model, depth dose calculations along the source axis were compared with calibration data from the source manufacturer. Main results: The calculated dose-rate conversion coefficients were 434.0 for the bare probe, and 683.5, 548.3, 449.9, 376.5, 251.0, 225.6, 202.8, and 182.6 for the source with applicators of increasing diameter from 15 to 50 mm, respectively. The radial dose and the 2D anisotropy functions of the TG-43 formalism were also obtained and tabulated in this document. Significance: This work presents the data required by a treatment planning system for the characterization of the INTRABEAM system in the context of intraoperative radiotherapy applications.

Study on the lower absolute measurement limit of air kerma from 137Cs source using a large-size cavity chamber

For the purpose of obtaining the lower absolute measurement limit of the air kerma in 137Cs γ-ray reference fields, a cavity chamber with a volume of 301.936(19) cm3 was designed and fabricated. The absolute measurement of the air kerma was performed at the minimum effective dose rate of the large-size cavity chamber in our 137Cs γ-ray reference field. With the help of the detailed Monte-Carlo (MC) simulations of the large-size cavity chamber and our 137Cs irradiation facility, the conversion coefficient from the cavity dose to the reference air kerma was calculated. And the obtained air kerma rate with the MC simulation method was 1.429(13) mGy/h. At the same condition, the measured air kerma rates with the cavity theory method and the substitute method were 1.428(13) mGy/h and 1.419(53) mGy/h, respectively. The measurement result with the full MC simulation method agrees with the other two measurement results within 0.07% and 0.70%, respectively. The combination of the large-size chamber and the full MC simulation method can help calibration laboratories achieve the absolute measurement of the low air kerma rate (such as 1.5 mGy/h) in the 137Cs γ-ray reference field.

Geometrical model for calculating the effect of surface morphology on total x-ray output of medical x-ray tubes.

PurposeCorrelation of characteristic surface appearance and surface roughness with measured air kerma (kinetic energy released in air) reduction of tungsten‐rhenium (WRe) stationary anode surfaces.MethodsA stationary anode test system was developed and used to alter nine initially ground sample surfaces through thermal cycling at high temperatures. A geometrical model based on high resolution surface data was implemented to correlate the measured reduction of the air kerma rate with the changing surface appearance of the samples. In addition to the nine thermally cycled samples, three samples received synthetic surface structuring to prove the applicability of the model to nonconventional surface alterations. Representative surface data and surface roughness values were acquired by laser scanning confocal microscopy.ResultsAfter thermal cycling in the stationary anode test system, the samples showed surface features comparable to rotating anodes after long‐time operation. The established model enables the appearance of characteristic surface features like crack networks, pitting, and local melting to be linked to the local x‐ray output at 100 kV tube voltage ,10° anode take off angle and 2 mm of added Al filtration. The results from the conducted air kerma measurements were compared to the predicted total x‐ray output reduction from the geometrical model and show, on average, less than 10 % error within the 12 tested samples. In certain boundaries, the calculated surface roughness Ra showed a linear correlation with the measured air kerma reduction when samples were having comparable damaging characteristics and similar operation parameters. The orientation of the surface features had a strong impact on the measured air kerma rate which was shown by testing synthetically structured surfaces.ConclusionsThe geometrical model used herein considers and describes the effect of individual surface features on the x‐ray output. In close boundaries arithmetic surface roughness Ra was found to be a useful characteristic value on estimating the effect of surface damage on total x‐ray output.

Analysis of Long-Term Quality Control Data for a 137Cs Dosimetry Calibration Source.

Strict quality assurance programs are required for many radiological applications, but these seldom exist for verifying dosimetry calibration sources. After initial characterization of a dosimetry calibration facility, quality control procedures are recommended to ensure the early detection of any changes or malfunctions. These also result in refined knowledge about average dose rate and experimental variations in dose delivery. This paper describes the implementation of a phase I quality control protocol for a 137Cs dosimetry calibration source and includes an analysis of the resulting data collected over a 24-mo period. During this time, substantial data was collected to establish trial control limits. Air kerma rate measurements were obtained using an ion chamber and were adjusted for decay, corrected for ambient temperature, pressure and humidity, and then analyzed using quality control charts. Three variations of rational subgrouping methods were used in order to find assignable causes of error, and Nelson's Rules were followed to detect any non-random statistical variations. Measurements were subgrouped according to same-day measurements in order to detect positional errors as well as atmospheric correction errors. Additionally, measurements were subgrouped according to analogous experimental setups in order to detect failure in equipment or incorrect settings. Both were analyzed using the X-bar and R chart method. Similarly, individuals and moving ranges charts were used to carefully examine each position in order to observe any situational errors that may occur which include timing, positional, or interference errors. Each method was successful in identifying unique out-of-control data points that occurred during the phase I application of forming control limits. Over the 24-mo period, enough data points were deemed in-control to establish reliable trial limits. Future experiments will include the phase II application of gaining more reliable measurements in order to fine-tune the limits, as well as performing a designed experiment, where variables are purposefully changed in order to test the variation of the data.

A PRELIMINARY STUDY OF RADIATION QUALITY CORRECTION FACTOR (KQ) DETERMINATION FOR WELL-TYPE IONIZATION CHAMBER

This paper deals with the determination of the radiation quality correction factor (kQ) well-type ionization chamber for the measurement of Co-60 brachytherapy. The measurement of the brachytherapy source has been done in the hospital brachytherapy facilities. The measurement of air Kerma has been done using three different ionization chambers 0.6 cm3, 30 cm3, 80 cm3, which have calibration factor traceability for Co-60 and one well-type ionization chamber which calibrated for Ir-192. The determination of the radiation quality correction factor (kQ) was determined based on the results of the air Kerma ratio between measurements using ionization chambers, which have traceability to Co-60 and Ir-192 sources. The results of the measurement of the reference air Kerma rate (RAKR) obtained from the three chambers were 21.36, 19.87, 19.34 mGy.m2.h-1, while the results of measurements with ionization chambers get a value of 19.01 mGy.m2.h-1. The kQCal results from 0.6 cm3 ionization chamber get a value of 1.07. The kQCal value was compared with the value of Andreas Schuller’s et al. kQreff of 1.05 and get a deviation of 2.2%. Implementation of the booth kQ value on the results of the RAKR from the HDR1000Plus well-type ionization chamber in the measurement of brachytherapy in two different facilities gets maximal deviation 1.7% with dose value from Treatment Planning System (TPS). The deviation was in the acceptable range of ±5%. Based on this, the use of radiation quality correction factor (kQ) value can be implemented as one method if it does not have the traceability factor calibration of the Co-60 brachytherapy source.

Study the Calibration of the High Dose Rate Brachytherapy Radioactive Source 60Co

Aim of this work is to calibrate the high dose rate (HDR) brachytherapy source 60Co. The radioactive source calibration is a very important part of the quality assurance program for dosimetry of brachytherapy source. The goal of this project is the calibration of HDR Brachytherapy source in radiation therapy is the measurement of the air kerma rate which required actual dose to deliver. The source calibration is an essential part of the quality assurance program for dosimetry of brachytherapy source. This research will help the patient who is involving brachytherapy treatment. HDR brachytherapy source 60Co is inserted directly or in close to the tumor. Most commonly using method for calibration of HDR brachytherapy source 60CO is well type ionization chamber. Calibration of the radioactive source 60Co brachytherapy source is very important for the treatment of cancer patient. We have got the variation between RAKR from TPS and measured Air Kerma Rate of 60Co brachytherapy source are 3.2% and 3.04% and which give very good agreement with the Air Kerma Rate (RAKR) is 5% (from BEBIG protocol, Germany). So, our results were satisfied for brachytherapy treatment. From these results, it must be concluded that, 60Co brachytherapy source is suitable for brachytherapy cancer treatment. It is very difficult to calculate treatment deliver dose without calibrating AKR of HDR brachytherapy source. It is very important to verify the calculated Air Kerma Rate by TPS Air Kerma Rate.

Radiometric Survey in Mammography: Review of regulations, recommendations, field and laboratories practices and first tests.

A review about Radiometric Survey in Mammography (RSM) in terms of regulatory documents, recommendations, radiation meters, besides field and laboratories practices shows that there is not many specific information about how these radiation area monitoring tests shall be performed. A search on the website of the most known manufacturers of radiation meters was made, but only one fully comply the requirements for RSM application. Tests with four laboratorial reference chambers, but none specific to RSM, were made submitting them to ISO N 20, 25 and 30 calibration setup (Based on document ISO 4037-1:1996) and their behavior in terms of HVL’s and air kerma rate measurements was compared to endorse some evaluations. The result of this work suggests that some RSM performed in Brazil, with nonspecific chambers and calibration can have underestimation of until 60% in those measurements, once a lack of specific information and specific calibration services in this country contributes for this scenario.

Measurement of air kerma rate and ambient dose equivalent rate using the G(E) function with hemispherical CdZnTe detector

Since the room-temperature detector CdZnTe (CZT) has advantages in terms of detection efficiency, energy resolution, and size, it has been extensively used to detect X-rays and gamma-rays. So far, nuclear radiation detectors such as cerium chloride doped with lanthanum bromide (LaBr $$_3$$ (Ce)), thallium doped with cesium iodide (CsI (Tl)), thallium doped with sodium iodide (NaI (Tl)), and high-purity germanium (HPGe) primarily use the spectroscopy-dose rate function (G(E)) to achieve the accurate measurement of air kerma rate ( $$\dot{K}_{a}$$ ) and ambient dose equivalent rate ( $$\dot{H}^*(10)$$ ). However, the spectroscopy-dose rate function has been rarely measured for a CZT detector. In this study, we performed spectrum measurement using a hemispherical CZT detector in a radiation protection standards laboratory. The spectroscopy-dose rate function G(E) of the CZT detector was calculated using the least-squares method combined with the standard dose rate at the measurement position. The results showed that the hemispherical CZT detector could complete the measurement of air kerma rate ( $$\dot{K}_{a}$$ ) and ambient dose equivalent rate ( $$\dot{H}^*$$ (10)) by using the G(E) function at energies between 48 keV and 1.25 MeV, and the relative intrinsic errors were, respectively, controlled within ± 2. 3 and ± 2. 1%.

METROLOGICAL SUPPORT OF DOSIMETRY GAMMA-RAY WITH ENERGY TO 10 MEV FOR RADIATION PROTECTION DEVICES

The field of high-energy gamma-ray for the calibration of radiation protection devices can be obtained by capturing thermal neutrons from titanium target (to 7 MeV) and nickel target (to 10 MeV). The aim of this work was to determine the metrological characteristics of capture gamma-ray fields from titanium target and nickel target obtained at the AT140 Neutron Calibration Facility to provide dosimetry up to 10 MeV.We have chosen energy intervals in which we can calibrate dosimetry devices taking into account the accompanying generation of gamma-ray neutrons by the fast neutron source 238PuBe, the capture radiation of collimator materials and capture radiation from targets.We measured air kerma rate with the aid of the reference AT5350 dosimeter with the ionization chamber TM32002. Using the Monte-Carlo simulation, we obtained the energy distribution of the air kerma rate for targets. We determined the geometric dimensions of the uniform field and the interval of operating distances of the facility.We investigated the metrological characteristics of capture gamma-ray fields from titanium target and nickel target obtained at the AT140 Neutron Calibration Facility for dosimetric radiation protection devices. We showed that in such fields it is possible to calibrate dosimetry devices in the extended energy range up to 10 MeV.

Is lead shielding of patients necessary during fluoroscopic procedures? A study based on kyphoplasty.

To determine the benefits, risks, and limitations associated with wrapping a patient with lead shielding during fluoroscopy-guided kyphoplasty procedures as a way to reduce operator radiation exposure. An anthropomorphic phantom was used to mimic a patient undergoing a kyphoplasty procedure under fluoroscopic guidance. Radiation measurements of the air kerma rate (AKR) were made at several locations and under various experimental conditions. First, AKR was measured at various angles along the horizontal plane of the phantom and at varying distances from the phantom, both with and without a lead apron wrapped around the lower portion of the phantom (referred to here as phantom shielding). Second, the effect of an operator's apron was simulated by suspending a lead apron between the phantom and the measurement device. AKR was measured for the four shielding conditions-phantom shielding only, operator apron only, both phantom shielding and operator apron, and no shielding. Third, AKR measurements were made at various heights and with varying C-arm angle. At all locations, the phantom shielding provided no substantial protection beyond that provided by an operator's own lead apron. Phantom shielding did not reduce AKR at a height comparable to that of an operator's head. Previous reports of using patient shielding to reduce operator exposure fail to consider the role of an operator's own lead apron in radiation protection. For an operator wearing appropriate personal lead apparel, patient shielding provides no substantial reduction in operator dose.

High dose rate brachytherapy source measurement intercomparison.

This work presents a comparison of air kerma rate (AKR) measurements performed by multiple radiotherapy centres for a single HDR 192Ir source. Two separate groups (consisting of 15 centres) performed AKR measurements at one of two host centres in Australia. Each group travelled to one of the host centres and measured the AKR of a single 192Ir source using their own equipment and local protocols. Results were compared to the 192Ir source calibration certificate provided by the manufacturer by means of a ratio of measured to certified AKR. The comparisons showed remarkably consistent results with the maximum deviation in measurement from the decay-corrected source certificate value being 1.1%. The maximum percentage difference between any two measurements was less than 2%. The comparisons demonstrated the consistency of well-chambers used for 192Ir AKR measurements in Australia, despite the lack of a local calibration service, and served as a valuable focal point for the exchange of ideas and dosimetry methods.

Characterization of a scintillating fibre detector for small animal imaging and irradiation dosimetry.

Small animal image-guided irradiators have recently been developed to mimic the delivery techniques of clinical radiotherapy. A dosemeter adapted to millimetric beams of medium-energy X-rays is then required. This work presents the characterization of a dosemeter prototype for this particular application. A scintillating optical fibre dosemeter (called DosiRat) has been implemented to perform real-time dose measurements with the dedicated small animal X-RAD® 225Cx (Precision X-Ray, Inc., North Branford, CT) irradiator. Its sensitivity, stem effect, stability, linearity and measurement precision were determined in large field conditions for three different beam qualities, consistent with small animal irradiation and imaging parameters. DosiRat demonstrates good sensitivity and stability; excellent air kerma and air kerma rate linearity; and a good repeatability for air kerma rates >1 mGy s-1. The stem effect was found to be negligible. DosiRat showed limited precision for low air kerma rate measurements (<1 mGy s-1), typically for imaging protocols. A positive energy dependence was found that can be accounted for by calibrating the dosemeter at the needed beam qualities. The dosimetric performances of DosiRat are very promising. Extensive studies of DosiRat energy dependence are still required. Further developments will allow to reduce the dosemeter size to ensure millimetric beams dosimetry and perform small animal in vivo dosimetry. Advances in knowledge: Among existing point dosemeters, very few are dedicated to both medium-energy X-rays and millimetric beams. Our work demonstrated that scintillating fibre dosemeters are suitable and promising tools for real-time dose measurements in the small animal field of interest.

Poster ‐ 15: Air kerma rate measurements using a cylindrical free‐air ionization chamber on the 05B1‐1 beamline at the Canadian Light Source

Purpose:The BioMedical Imaging and Therapy (BMIT) beamlines at the Canadian Light Source offer the opportunity for investigating novel imaging and therapy applications of synchrotron radiation. A necessary component in advancing this research, and in progressing toward clinical applications, is the availability of accurate dosimetry that is traceable to a standards institution. However, dosimetry in this setting is challenging. These beams are typically small, non‐uniform, and highly intense. This work describes air kerma rate measurements on a BMIT beamline using a free‐air ionization chamber (FAC).Methods:The measurements were taken at the 05B1‐1 beamline (∼8 – 100 keV) for several beam qualities with mean energies between 20.0 and 84.0 keV. The Victoreen Model 480 cylindrical FAC, with a specially fabricated 0.52 mm diameter aperture, was used to measure air kerma rates. The required correction factors were determined using a variety of methods: tabulated data, measurements, theoretical calculations and Monte Carlo simulations (EGSnrc user code egs_fac).Results:The experimental air kerma rates measured between 0.270 ± 13.6% and 312 ± 2.7% Gy/min. At lower energies (low filtration), the most impactful correction factors were those for ion recombination and for x‐ray attenuation.Conclusions:These measurements marked the first absolute dosimetry performed at the BMIT beamlines. The experimental and Monte Carlo methods developed will allow air kerma rates to be measured under other experimental conditions, provide a benchmark to which other dosimeters will be compared, and provide a reference for imaging and therapy research programs on this beamline.

SU‐F‐I‐72: Evaluation of the Ancillary Lead Shielding for Optimizing Radiation Protection in the Interventional Radiology Department

Purpose:The rising complexity of interventional fluoroscopic procedures has resulted in an increase of occupational radiation exposures in the interventional radiology (IR) department. This study assessed the impact of ancillary shielding on optimizing radiation protection for the IR staff.Methods:Scattered radiation measurements were performed in two IR suites equipped with Axiom Artis systems (Siemens Healthcare, Erlangen, Germany) installed in 2006 and 2010. Both rooms had suspended ceiling‐mounted lead‐acrylic shields of 75×60 cm (Mavig, Munich, Germany) with lead equivalency of 0.5 mm, and under‐table drapes of 70×116 cm and 65×70 cm in the newer and the older room respectively. The larger skirt can be wrapped around the table's corner and in addition the newer suite had two upper shields of 25×55 cm and 25×35 cm. The patient was simulated by 30 cm of acrylic, air kerma rate (AKR) was measured with the 180cc ionization chamber (AccuPro Radcal Corporation, Monrovia, CA, USA) at different positions. The ancillary shields, x‐ray tube, image detector, and table height were adjusted by the IR radiologist to simulate various clinical setups. The same exposure parameters were used for all acquisitions. AKR measurements were made at different positions relative to the operator.Results:The AKR measurements demonstrated 91–99% x‐ray attenuation by the drapes in both suites. The smaller size of the under‐table skirt and absence of the side‐drapes in the older room resulted in a 20–50 fold increase of scattered radiation to the operator. The mobile suspended lead‐acrylic shield reduced AKR by 90–94% measured at 150–170 cm height. The recommendations were made to replace the smaller under‐table skirt and to use the ceiling‐mounted shields for all IR procedures.Conclusion:The ancillary shielding may significantly affect radiation exposure to the IR staff. The use of suspended ceiling‐mounted shields is especially important for reduction of interventional radiologists’ cranial radiation.

Significant radiation reduction in interventional fluoroscopy using a novel eye controlled movable region of interest.

This paper reports the first results obtained using a novel technology called eye controlled region of interest (ECR) that substantially reduces both staff and patient irradiation during an interventional fluoroscopy procedure without interfering with workflow. Its collimator includes a partially x-ray attenuating plate with a nonattenuating aperture. An eye tracker follows the operator's gaze to automatically position the aperture to the clinical region of interest (CROI) anywhere in the image in real-time. Experiments were performed in a swine model using a mobile fluoroscope with a 30 cm image intensifier and manual control of fluoroscopic factors. The factory collimator and image display monitor were replaced with different components for this study. The full 30 cm field-of-view (FOV) of the image intensifier was irradiated at normal levels, and served as a baseline, when ECR was disengaged. With ECR engaged, most of the 30 cm FOV was irradiated to less than 20% of normal levels while the CROI was normally irradiated. Animal irradiation was determined by physical KAP (kerma area product) measurements. Operator irradiation was characterized by air kerma and air kerma rate measurements near the operator. Data were collected from three pairs of interventions in each of five swine models. When ECR was engaged, KAP was reduced to 0.22 (p < 0.001) of baseline and operator irradiation to 0.27 (p < 0.001) of baseline. Overall procedure time had a borderline increase (p = 0.07) but fluoroscopy time was unchanged (p = 0.36) (Wilcoxon signed rank). Measured staff and patient radiation reductions are consistent with this collimator's design. Subjective impressions of imaging improvements are consistent with less scatter reaching the CROI. Engaging ECR reduced irradiation without subjectively or objectively increasing operator workload. The first in vivo evaluation of ECR demonstrated that this technology has objectively reduced KAP and operator irradiation by approximately 75% without interfering with the performance of fluoroscopically guided interventional procedures. In addition, reduced scatter production subjectively improved device visualization. These findings indicate the practicability of achieving better radiation optimization.

Simulation evaluation of NIST air-kerma rate calibration standard for electronic brachytherapy.

Dosimetry for the model S700 50 kV electronic brachytherapy (eBT) source (Xoft, Inc., a subsidiary of iCAD, San Jose, CA) was simulated using Monte Carlo (MC) methods by Rivard et al. ["Calculated and measured brachytherapy dosimetry parameters in water for the Xoft Axxent x-ray source: An electronic brachytherapy source," Med. Phys. 33, 4020-4032 (2006)] and recently by Hiatt et al. ["A revised dosimetric characterization of the model S700 electronic brachytherapy source containing an anode-centering plastic insert and other components not included in the 2006 model," Med. Phys. 42, 2764-2776 (2015)] with improved geometric characterization. While these studies examined the dose distribution in water, there have not previously been reports of the eBT source calibration methods beyond that recently reported by Seltzer et al. ["New national air-kerma standard for low-energy electronic brachytherapy sources," J. Res. Natl. Inst. Stand. Technol. 119, 554-574 (2014)]. Therefore, the motivation for the current study was to provide an independent determination of air-kerma rate at 50 cm in air K̇air(d=50 cm) using MC methods for the model S700 eBT source. Using CAD information provided by the vendor and disassembled sources, an MC model was created for the S700 eBT source. Simulations were run using the mcnp6 radiation transport code for the NIST Lamperti air ionization chamber according to specifications by Boutillon et al. ["Comparison of exposure standards in the 10-50 kV x-ray region," Metrologia 5, 1-11 (1969)], in air without the Lamperti chamber, and in vacuum without the Lamperti chamber. K̇air(d=50 cm) was determined using the *F4 tally with NIST values for the mass energy-absorption coefficients for air. Photon spectra were evaluated over 2 π azimuthal sampling for polar angles of 0° ≤ θ ≤ 180° every 1°. Volume averaging was averted through tight radial binning. Photon energy spectra were determined over all polar angles in both air and vacuum using the F4 tally with 0.1 keV resolution. A total of 10(11) simulated histories were run for the Lamperti chamber geometry (statistical uncertainty of 0.14%), with 10(10) histories for the in-air and in-vacuum simulations (statistical uncertainty of 0.04%). The total standard uncertainty in the calculated air-kerma rate determination amounted to 6.8%. MC simulations determined the air-kerma rate at 50 cm from the source with the modeled Lamperti chamber to be (1.850 ± 0.126) × 10(-4) Gy/s, which was within the range of K̇air(d=50 cm) values (1.67-2.11) × 10(-4) Gy/s measured by NIST. The ratio of the photon spectra in air and in vacuum were in good agreement above 13 keV, and for θ < 150° where the influence of the Kovar sleeve and the Ag epoxy components caused increased scatter in air. Below 13 keV, the ratio of the photon spectra in air to vacuum exhibited a decrease that was attributed to increased attenuation of the photons in air. Across most of the energy range on the source transverse plane, there was good agreement between the authors' simulated spectra and that measured by NIST. Discrepancies were observed above 40 keV where the NIST spectrum had a steeper fall-off towards 50 keV. Through MC simulations of radiation transport, this study provided an independent validation of the measured air-kerma rate at 50 cm in air at NIST for the model S700 eBT source, with mean results in agreement within 3.3%. This difference was smaller than the range (i.e., 23%) of the measured values.