Radiographic Film Research Articles

Assessment of Rejected Radiographs during planar imaging procedures

Radiographic Imaging represents the largest source of exposure to ionizing radiation humans from artificial sources. The estimated annual radiation exposure per individual in the United States is 6.20 mSv. This study aims to evaluate the rejection rate at King Khalid Hospital-Al-Kharj retrospectively and to identify the causes of rejection to radiographic technique. This study was carried out at King Khalid Hospital (KKH) and Prince Sultan center for health services (PSCHS) in Al-Kharj City, Saudi Arabia. The radiographs were retrospectively analyzed for seven digital X-ray machines for three consecutive months. Reject rates per technologist and cause for rejection were analyzed. In total, 22552 radiographic images were acquired for 11134 patients (15363 radiographs) obtained over a period of three months. 67.1% (7544 patients) of the patients are males. Two thousand two hundred five patients were pediatric, representing 19.8% of the all-patients group. In total, 50 technologists are working in the radiology departments with different levels of qualification (Diploma, and Bachelor of Science) and experience. 27 (54%) radiography technologist are working at the planar radiography departments. The overall average positioning error is 34.26%, while the anatomical cut-off is 13.37%. Therefore, staff training is recommended to ensure that patients are well positioned regarding patient setup and body positioning with the proper exposure setting. The study showed no significant difference between image receptors in reject analysis, suggesting that operator performance and professional experience are more important factor than type of image receptor. The study showed that screen film radiography (SFR) is still used in many African countries, while computed radiography (CR) and digital radiography (DR) are dominant in Gulf, Europe, and the United States.

Lesions of the visceral mediastinum

The visceral or middle mediastinum contains nonvascular (trachea, carina, esophagus, and lymph nodes) and vascular structures (heart, ascending aorta, aortic arch, descending aorta, superior vena cava, intrapericardial pulmonary arteries, thoracic duct). The various pathologies of the visceral mediastinum and imaging features are presented. Plain film radiography shows the gross anatomy and allows visualization of larger pathologies. However, for detailed anatomic and structural classification more sophisticated imaging techniques are required. Especially computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) are well suited for structural and functional assessment of mediastinal lesions. This article summarizes the major pathologies of the visceral mediastinum.

Maintenance of curve correction and unplanned return to the operating room with magnetically controlled growing rods: a cohort of 24 patients with follow-up between 2 and 7 years.

Early onset scoliosis (EOS) is defined as spinal curvature affecting children below 10years of age. Non-operative treatment can consist of casting and bracing. When curvature progresses despite these treatments, operative intervention is indicated. Traditional growing rods (TGR) have been a mainstay of treatment. Unfortunately, TGR's require planned return to the operating room every 6-9months. Magnetic controlled growing rods (MCGR) ideally provide curve correction and allow the spine to grow without frequent surgeries. However, the ability to correct and maintain correction after MCGR has not been well-characterized. The purpose of this study is to evaluate maintenance of curve correction in patients treated primarily with MCGR and analyze the rate of complications including unplanned return to the operating room (UPROR). 24 patients with EOS were retrospectively reviewed. These patients were subdivided into 4 subcategories: congenital, idiopathic, neuromuscular (NMS), and syndromic. The major curve correction (%) and T1-S1 distance were assessed utilizing scoliosis plain film radiographs over time. Complications and return to the operating room for any reason were recorded. Patients were followed until conversion to posterior spinal fusion (PSF) or most recent lengthening of MCGR. There were 11 male and 13 female patients averaging 8 years at the time of index surgery. The average preoperative curve angle was 61.1°. Initial curve correction with MCGR obtained at the index procedure was 46.2%, reducing the mean curve angle to 32.7° (p < 0.05). Curve correction at a mean 6.2years (2.4-7.4) follow-up was 36.1°, 40.9% curve correction. 75% of patients underwent conversion to PSF during the study period 4.8years (2.4-7.0) after initial MCGR surgery. 15% of patients were still undergoing MCGR lengthening after 6.1years. 54.2% of patients had at least one UPROR. For patients with EOS with curve progression, MCGRs can maintain curve correction well after 2years. Furthermore, MCGR allowed patients to grow over time to safely delay timing to definitive fusion. On average, patients underwent conversion to PSF after 4.7years at an average age of 13.5. Although the complication rate in the first 2years is relatively low, 54.2% of patients underwent an UPROR. As the use of MCGR increases, surgeons should be aware of possible complications associated with this technology and counsel patients accordingly. Further research is needed to continue to evaluate the efficacy and safety of MCGR in this challenging patient population.

MAKING A SIMPLE TAM-EM BOARD TO ASSIST RADIOLOGICAL EXAMINATION IN BABIES USING ACRYLIC

Repetition on radiographic films due to object movement that often occurs in uncooperative patients, especially occurs in infants or toddlers, examinations that are often performed on infants or toddlers are examinations of the thorax and abdomen. At the time the examination was carried out, then the patient was uncooperative, it would produce an unclear picture caused by the patient's movement, so that the picture was not suitable for reading and resulted in the repetition of the resulting radiographic film. At the time of examination, the baby is often held or assisted by the patient's family or the mother of the baby, so that the family or mother of the baby is exposed to scattered radiation, so that the principle of radiation protection does not work properly, so a tool is needed, namely the manufacture of a Tam-Em device. A simple board to help radiological examinations in infants using Acrylic. To find out the effectiveness of making Tam Em Board Aids on baby examination using acrylic. This type of research is qualitative with experimental methods. Testing the Tam Em-Board tool at Pariaman Hospital by involving a radiographer as an assessor in testing a device with infant patients by assessing several components including the reliability of the tool when used, the safety of a tool during the inspection process, the quality of the radiograph produced when using the tool, the aesthetics of a device. tools and whether there are repeated examinations when using the Tam Em-Board tool, after testing with several assessment components and an assessment questionnaire of a tool assessed by the accompanying radiographer, it can be concluded that the tool works well and there are no repetitions during the examination.

Avascular Necrosis and Posttraumatic Arthritis After Proximal Humerus Fracture Internal Fixation: Evaluation and Management.

Avascular necrosis (AVN) and posttraumatic arthritis (PTA) are common complications following both conservative treatment and open reduction and internal fixation (ORIF) of proximal humerus fractures (PHFs). Despite the frequent utilization of ORIF, information regarding these leading causes of failure is limited. This review includes a discussion of incidence, risk factors, and evaluation of AVN and PTA following PHF. The mechanisms of treatment options and associated outcomes are also reviewed. Recent best available evidence demonstrates significant rates of AVN and PTA following ORIF of PHF. This is particularly true of complex fracture patterns. A thorough workup is required in the setting of failure caused by AVN and PTA. This includes a careful patient history, clinical exam, plain film radiographs, and CT scans. EMG and/or aspiration may also be indicated. Special consideration is given to the examination of the deltoid muscle, neurovascular status, rotator cuff function, and the possibility of infection. Biological supplementation, anatomic total shoulder replacement (aTSA), and fusion are rarely employed in the treatment of AVN and/or PTA. Due to satisfactory patient outcomes, reverse total shoulder replacement (rTSA) has increased in popularity for the elderly population, while hemiarthroplasty (HA) may be appropriate for some young, active patients. With careful patient selection and meticulous surgical technique, AVN and PTA can be mitigated. Careful indications for ORIF may decrease the frequency of these complications. For most patients, rTSA is the optimal treatment option. Given the frequent utilization of ORIF and the higher than acceptable complication and failure rates, AVN and PTA warrant our attention.

Determining The Accuracy of Dwell Position by Using Electron Energy with Gafchromic Film in High Dose Rate Brachytherapy Systems

Due to the general lack of darkroom and film processing equipment in many clinics, it is no longer possible to use radiation sensitive Xomat V radiographic film for High Dose Rate brachytherapy quality assurance. An alternative is to use radio chromic film that does not require processing. The aim of this study is to develop and clinically test the GafChromic film-based brachytherapy Quality Assurance (QA) system using different electron energies. As an electron source (6 MeV-9 MeV-12 MeV -15 MeV -18 MeV) (Elekta Synergy® Platform linear accelerator, Varian GM plus IX (Varian Medical Systems, Inc.USA), Varian brand cylinder, ring and tandem double ovoid applicators, RTQA2 and EBT3 GafChromic film were used. In RTQA2 films, images are obtained at high electron energies (12 MeV and above) at 300 Monitor Unit (MU), while images are obtained at all energies at 700 MU in irradiation using different electron energies and MUs. For the desired image quality depending on the material of the applicator used, it was determined that the image clarity increased as the energy, field size and MUs increased. In EBT3, the desired image could be obtained at 18 MeV and 2500 MU. It is possible to obtain the desired image quality by using high-energy electrons, especially RTQA2 Gafchromic film, in determining the accuracy of the dwell position in brachytherapy. Since it has been determined that this method can be used easily in quality control tests, we think that this method is suitable for clinical use when necessary.

Ratio of Vascular Pedicle Width and Thoracic Diameter to Differentiate Cardiogenic and Non-Cardiogenic Pulmonary Edema

Background: Excess intravascular volume evaluation is essential in the intensive care unit (ICU); however, clinical information to differentiate cardiogenic and non-cardiogenic pulmonary edema has been proven ineffective. Thus, this study aimed to distinguish cardiogenic from non-cardiogenic pulmonary edema using the ratio of vascular pedicle width (VPW) to thoracic diameter (VPTR). Methods: This cross-sectional study was conducted based on secondary data from chest radiographs of 100 patients with clinical symptoms of pulmonary edema in the ICU from January 2013 to December 2015. Cardiogenic and non-cardiogenic pulmonary edema were distinguished using VPW and cardiothoracic ratio measurements (CTR). VPTR was measured to differentiate between the two types of pulmonary edema, and the cut-off value was obtained using a receiver operating characteristic curve. Results: This study revealed a prevalence of 21% and 79% for cardiogenic and non-cardiogenic pulmonary edema, respectively. A VPTR cut-off value of 25.1% with a sensitivity of 90% and specificity of 86%, may distinguish cardiogenic from non-cardiogenic pulmonary edema. Conclusions: VPTR is an alternative method to differentiate between cardiogenic and non-cardiogenic pulmonary edema, and this ratio measurement is useful in cases where radiograph films are not standardized.

КОНЦЕПЦИЯ МЕДИЦИНСКОЙ ИНФОРМАЦИОННОЙ СИСТЕМЫ ДЛЯ РЕШЕНИЯ ЗАДАЧ ДИАГНОСТИКИ ЗАБОЛЕВАНИЙ НА ОСНОВЕ ВЕРИФИКАЦИИ ФРАГМЕНТОВ МЕДИЦИНСКИХ БИОЛОГИЧЕСКИХ ОБЪЕКТОВ

This article offers one of the variants of the concept of developing and implementing the synthesisof MIS from the perspective of a systematic approach, which is designed to solve the problems of diagnosingdiseases through the application and development of a methodology for verifying the state offragments of biological objects using computed tomographic images and using statistical parameters forthis (expectation, variance, histogram, coefficient of variation, autocorrelation matrix, correlation coefficient) for quantitative assessment of the conditions of the frontal or maxillary sinus inotolaryngological diseases, chest organs in bronchopulmonary diseases, bone tissues and their identificationin accordance with the class of pathologies in the diagnosis of the patient in automatic mode byradiographic (tomographic) images. A variant of the implementation of MIS for the diagnosis and evaluationof the results of medical research is proposed, built on a modular principle based on the technologiesof Intranet and Internet networks using standard data transmission protocols, audio-video information,graphic information of a medical nature and including a subsystem of technical support, a subsystemof mathematical support, a subsystem of software, a subsystem of information support, a subsystemof organizational support, information security subsystem, subsystem of methodological supportand support. It is pointed out the current state of development of medical diagnostic equipment, theequipment of which medical institutions of the country and its non-operational accessibility to the populationcontributed to and led to the emergence and active development of new directions in the field ofradiation diagnostics, which include: digital and film radiography, computed tomography, magneticresonance imaging. A brief analysis of the implementation of mathematical models of diagnostic methodsimplemented by software for the functioning of the decision support subsystem of the medicalautomated information system is given. Examples of practical implementation of software and informationsupport for verification methods of medical objects in the form of screen forms for workingwith fragments of the object under study and the results of the analysis of radiographic images areshown. This makes it possible to increase the efficiency, accuracy of verification of the state of medicalbiological objects, the reliability of the disease diagnosis process. The scientific novelty, the resultsof the approbation of the material presented in the article at international, All-Russian conferences,scientific journals are shown.

Current investigative modalities for detecting and staging lung cancers: a comprehensive summary.

This narrative review compares the advantages and drawbacks of imaging and other investigation modalities which currently assist with lung cancer diagnosis and staging, as well as those which are not routinely indicated for this. We examine plain film radiography, computed tomography (CT) (alone, as well as in conjunction with positron emission tomography (PET)), magnetic resonance imaging (MRI), ultrasound, and newer techniques such as image-guided bronchoscopy (IGB) and robotic bronchoscopy (RB). While a chest X-ray is the first-line imaging investigation in patients presenting with symptoms suggestive of lung cancer, it has a high positive predictive value (PPV) even after negative X-ray findings, which calls into question its value as part of a potential national screening programme. CT lowers the mortality for high-risk patients when compared to X-ray and certain scoring systems, such as the Brock model can guide the need for further imaging, like PET-CT, which has high sensitivity and specificity for diagnosing solitary pulmonary nodules as malignant, as well as for assessing small cell lung cancer spread. In practice, PET-CT is offered to everyone whose lung cancer is to be treated with a curative intent. In contrast, MRI is only recommended for isolated distant metastases. Similarly, ultrasound imaging is not used for diagnosis of lung cancer but can be useful when there is suspicion of intrathoracic lymph node involvement. Ultrasound imaging in the form of endobronchial ultrasonography (EBUS) is often used to aid tissue sampling, yet the diagnostic value of this technique varies widely between studies. RB is another novel technique that offers an alternative way to biopsy lesions, but further research on it is necessary. Lastly, thoracic surgical biopsies, particularly minimally invasive video-assisted techniques, have been used increasingly to aid in diagnosis and staging.

Inspection of Pipe Welds Using the Radiogrphy Method with the Double Wall Double Image Technique

Inspection of 900 angle pipe welds using the Radiography method with an Ir.192 source with a capacity of 150 Curie while operating 56 curies using the Double Wall Double Image Technique Case study at (PT. Sinar Mas, Riau). Errors and inaccuracies in timing result in the resulting image being damaged, not meeting radiographic film acceptance quality standards. irradiation (exposure time). The purpose of this paper is to be able to calculate the exposure time using computation, and to know the type of defects in the welding and there are significant undercutting defects that require repair or re-welding and are declared rejected by the radiographer. The results of the exposure time calculation between the calculations of several processes have a relatively large time difference, this is because they do not follow the curve value. In the end it can be concluded from the results of the film is very influential on the exposure time. Based on this, the resulting software can be declared in accordance with field conditions

Lower extremity puncture wound.

A 58-year-old woman presented with pain after sustaining a right foot wound from a damaged wooden floor. Physical examination was remarkable for a 0.3-cm puncture wound between the first webspace on the plantar aspect of the foot with tenderness to palpation, but no visible or palpable foreign body. Plain radiographs were negative, and computed tomography of the foot noted the small puncture wound with a proximally extending linear tract. Orthopedic surgery was consulted but did not appreciate any foreign body and thus recommended conservative management without wound exploration in the emergency department (ED). Bedside ultrasound was then performed by emergency physicians that visualized a linear 4-cm hyperechoic foreign body with posterior acoustic shadowing (Figure 1, Video 1). Ultrasound-guided deep peroneal and posterior tibial nerve blocks were performed for anesthesia (Video 2). Under ultrasound guidance, curved forceps were used to grasp and remove a large wooden fragment (Figure 2, Video 3). The patient was discharged with oral antibiotics. Traumatic wounds are responsible for 11 million ED visits annually, and foreign bodies are involved in 7% to 15%.1 Many foreign bodies are missed on initial evaluation, and because of their risk for complications, they are frequently implicated in malpractice litigation.2 Plain film radiographs are considered first line and detect 80% of all foreign bodies but have a mere sensitivity of 15% for radiolucent objects, such as wood or other vegetative material.1, 3 Therefore, multimodal imaging is frequently necessary. Ultrasonography, performed in the ED setting, has an overall sensitivity and specificity of 91% for identifying foreign bodies.2 These will appear hyperechoic and may have additional clues, such as posterior acoustic shadowing, reverberation artifact, or hypoechoic halo. Using ultrasound to guide percutaneous foreign body removal can increase success in the ED to nearly 100%.4 Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.

Knowledge level on imaging exams protocols in pediatric dentistry: a cross-sectional study with questionnaire

This study aimed to evaluate the knowledge level of Dentistry students, who have already taken the Dental Radiology and Maternal Child 1 courses at the University of Caxias do Sul in May 2020, on the appropriate prescriptions and protocols of different imaging exams in their daily clinical practice. Materials and Methods: A questionnaire was developed using the Google Forms online platform and divided into different sessions: a) personal information; b) prescription of CBCT; c) students' specific knowledge regarding CBCT images; d) prescription of dental radiography techniques; e) imaging diagnostics; f) exposure dose; g) care with the radiation protection of both the professional and the patient during processing time for conventional radiographs. Fifty-six participants received the form by email. Results: Regarding CBCT, 66.6% of the respondents have already used it, and 91.6% believe that it is essential to have easy access to this technology. Whereas 37.5% declared thorough knowledge of the main terminologies, 66.67% stated that they rarely prescribe CBCT. Regarding radiation protection, 97.92% of the respondents said they wear a lead apron to ensure patients' protection; however, 23% of the aprons do not include a thyroid gland shield. As for the sensitivity of radiographic films, 50% of the respondents use radiographic film F. Conclusion:Thus, we found that a lack of specific knowledge on CBCT examinations and on conventional radiographic films exists among dental surgeo.

Man With Right Hand Pain

A 41-year-old man was involved in a scooter collision accident that resulted in right hand pain. Physical examination revealed dorsal-side swelling and ulnar aspect tenderness in the injured hand. The motions of the right finger and wrist were preserved. Plain film radiography (Figure 1) and point-of-care ultrasonography (Figure 2) indicated a possible diagnosis.

Assessing Clinical Feasibility of a LINAC-Based Electron FLASH Radiotherapy System Using an Anthropomorphic Phantom under Realistic Clinical Conditions

<h3>Purpose/Objective(s)</h3> Ultra-high dose rate (UHDR) radiotherapy (RT) at ≥40 Gy/s has been shown preclinically to reduce toxicity with similar tumor control compared to conventional RT, a phenomenon known as the FLASH effect. We previously described a configuration of a clinical-use LINAC that can output ∼17 MeV electron UHDR RT at 45-80 Gy/s with clinically feasible beam profiles, field sizes (3-20 cm), and SSDs (70-90 cm). Safe and effective clinical trials are needed to advance translation of FLASH treatment in humans, such as one proposed at our institution for cutaneous lymphomas. This study characterizes the beam output of our electron UHDR RT set-up under realistic clinical conditions for common anatomic sites using an anthropomorphic phantom, to assess its feasibility for clinical translation. <h3>Materials/Methods</h3> Our electron UHDR RT set-up utilizes a treatment delivery system with a configured program board of a decommissioned electron energy to adjust the beam output and control, without hardware modification. The electron cone is replaced with a flat applicator with custom cut-outs that lies in the accessory mount. We tested this set-up under realistic clinical conditions on a RANDO phantom for treatment of the chest/breast, leg, and scalp. We used 3 cm and 10 cm circular field sizes at 80 cm SSD with the gantry angled en-face to the targets. Tissue-equivalent bolus and flexible tungsten-silicone skin collimators (made from silicone sheets with tungsten powder cut into donut shapes of varying diameters) were used to mimic clinical treatment standards. Measurements were done using radiographic film and we evaluated the beam width, percent depth dose, and penumbra width. <h3>Results</h3> All results reported include 1 cm bolus and skin collimators unless otherwise specified. The values for R80 (depth at 80% dose), beam width of 80% dose (at R95), and penumbra width (at R85) for the 10 cm chest/breast field are 5.2, 8.7, and 0.9 cm, respectively. Without skin collimators, the values are 5.4, 9.0, and 1.2 cm, respectively. The values for the 3 cm chest/breast field are 2.9, 1.9, and 0.6 cm, respectively. Without skin collimators, the values are 3.2, 1.9, and 0.7 cm, respectively. The values for the 10 cm leg field are 4.0, 6.6, and 0.9 cm, respectively. The values for the 3 cm scalp field (with 4 cm bolus to minimize dose penetration to the brain) are 1.1, 1.6, and 0.9 cm, respectively. The steep curvature of the leg and scalp sites led to expected decrease in beam flatness but retained a treatment area that allows for a reasonable range of tumor sizes and depths. <h3>Conclusion</h3> Our configuration is able to deliver electron UHDR RT with clinically applicable beam profiles to various anatomic sites under realistic clinical conditions. Tungsten-silicone skin collimators are an easy-to-use tool to narrow the penumbra. Overall, these results show potential for treatment of superficial indications, including cutaneous lymphoma, extremity sarcoma, and partial breast irradiation, and place us one step closer toward the clinical translation of FLASH.

BgRT Motion Management Maintains Target Dose Coverage for Respiratory and Non-Respiratory Motion

<h3>Purpose/Objective(s)</h3> Biology-guided radiotherapy (BgRT) uses outgoing emissions after administration of an injected radiotracer to dynamically guide the delivery of radiation treatment to PET-avid targets. In this study, we evaluated the tracking performance of FDG-guided BGRT for two potential types of motion management (respiratory and non-respiratory (gastrointestinal)) while exploring different target shapes: spherical and non-spherical. BgRT is designed to ensure target coverage while keeping organ-at-risk (OAR) doses low. <h3>Materials/Methods</h3> A large custom anthropomorphic phantom with 2 robotic articulating arms was used to place a target and organ-at-risk inside a 27-liter water filled cavity. The targets consisted of an integrated ion chamber inside a 3D printed 22 mm sphere or a small non-spherical ovoid shape filled with FDG. The hot FDG-filled OAR consisted of either a 3D printed large C-shape annulus (mimicking a heart), large ovoid (mimicking a kidney), or a 30 mm sphere, all with integrated ion chambers. Both the 3D printed target and the OAR were filled with an 8:1 concentration ratio versus the water background. Three different 10 Gy/fraction treatment plans with two different target shapes and realistic nearby OARs were created with a 5 mm margin added to the CTV to generate the PTV. 3D printed targets and OARs were loaded with EBT-XD radiographic film. A 3D elliptical motion trajectory with breathing induced hysteresis with a maximum amplitude of +/- 12 mm was used for the respiratory motion model. An asymmetric slow-moving drift waveform with long-step shifts of +13/-5mm mm was used for the non-respiratory (gastrointestinal) motion model. Dosimetric results were evaluated based on 2-dimensional comparisons between measured film and planned dose distributions for the target and OAR. BgRT must maintain a prescription dose margin greater than 2 mm on the CTV for the three different motion experiments. Also, ion-chamber point dose and maximum film dose on the OAR must be within bounds predicted by the treatment planning system. <h3>Results</h3> BgRT was able to meet minimum margin requirements (a margin loss < 3mm) and meet prescription dose coverage in both motion management scenarios while maintaining OAR dose limits within the plan predicted bounds (see Table 1). <h3>Conclusion</h3> BgRT is able to provide motion management in complex cases that is agnostic to the type of motion. BgRT is able to maintain the PTV coverage with less than 3 mm reduction from the original 5mm margin.

A Study on Image Interpretations of Computed Radiography for Iron Samples Using Image Evaluation Techniques

In the non-destructive radiographic testing methods used for specimens with cultural heritage, analog film radiography is being replaced with digital radiography by the introduction of an imaging plate computed radiography system. Adoption of the computed radiography system has helped standardize digital image quality.&lt;/br&gt;This study analyzed the X-ray transmission characteristics and evaluated image quality according to image developing time for iron, the most important metal in cultural heritage. Computed radiography images were acquired. The transmittance of the images was determined based on Gray Scale and Duplex-wire Image Quality Indicator data. In addition, the change in images with the image developing time was compared and analyzed using the Structural Similarity Index Measure, mean square error, and peak signal-to-noise ratio.

Comparison of X-ray films in term of kVp, mA, exposure time and distance using Radiographic Chest Phantom as a radiation quality

Chest X-rays are one of the most commonly performed procedures for diagnosing conditions affecting the chest and its contents. It's also represents the change of actual human body to compare the image produced by using different parameters. And comparing the image characteristics of a particular x-ray system with different techniques. The aim of this experiment is to obtain the best quality radiograph by evaluating the optimum parameters such as kVp, mA, exposure time, and distance associated with the film characteristic and to find the difference in optical density (OD) of air stepwedge with different thicknesses. The comparison of the image produced in terms of exposure assessment was made by using the Toshiba KXO 50R X-ray Machine. The RMI Radiographic Chest Phantom, Model 170B, was used as the subject matter in this experiment. Radiographic film KONICA MG-SR PLUS, which is green-sensitive film, was used and inserted into a cassette. It was placed right below the RMI Radiographic Chest Phantom, Model 170B and then was exposed by using different kVp, which were 60, 70, and 80 kVp with 2, 2.5, 3.2, and 4 mAs for each kVp. The source-to-image distance, which was 183 cm, was kept constant in this study. The film was then processed by using an automatic processor in the darkroom. From the observations, 80 kVp with 2 mAs provides a better image quality as compared to others, and the optical density (OD) of air stepwedge increases with increasing thickness.

Endoscopic-assisted approaches for enucleation of invaded sinonasal region by benign odontogenic cysts: a case series study

BackgroundDuring surgical planning for the excision of odontogenic cysts and tumors, surgeons should consider choosing the appropriate endoscopic approach to reach all parts of the maxillary sinus and cyst walls during its enucleation. Using the endoscopic trans-nasal approaches results in less than one-third of the maxillary sinus being reached regardless of antrostomy or angled instruments used. Also, the expansion process and involvement of maxillary sinuses in odontogenic cysts and tumors are variable, adding more difficulties during excision. This study aimed to assess the expansion process of large benign odontogenic cysts and tumors involving nasoantral regions and adaptability to different endoscopic approaches for enucleation. Six patients were included in this case series study. Preoperative panoramic views plain film radiography, and computed tomography scans were obtained. Lesion characteristics, relation to teeth origin, the nose, and maxillary sinus wall displacement, location of lesions about typical vertical and horizontal nasomaxillary constructions, and associated inflammation of the paranasal sinuses were evaluated. Three surgical approaches were tailored, allowing viewing and endoscopic enucleation.ResultsFour periapical (radicular) cysts, one ameloblastoma, and one calcifying epithelial odontogenic tumor, ranging in size from 3 to 5 cm, were enucleated endoscopically in patients aged 15–40 years. Intra-sinus expansion of the cyst and lesion level above the nasal floor allowed endoscopic enucleation using wide middle meatal antrostomy in 1 (17%). Lesions localized to the anterior wall and the nasal process of the maxilla permitted endonasal minimal rhinotomy approach in 1 (17%). Central lesions, cyst extension below the level of the nasal floor, and lateral wall expansion with or without anterior maxillary wall scalloping had adequate exposure using a minimal sublabial approach in four patients (67%). Together with its role in complete enucleation, endoscopy allowed associated rhinosinusitis surgical treatment in five patients (83%).ConclusionTailoring surgical approaches to the expansion process allowed endoscopic enucleation of large odontogenic cysts/tumors without wall remnants. The integrity of the Schneiderian membrane was preserved, protecting the critical surrounding structures.

Radiation control of blanks manufactured using additive technology by digital radiography

Additive technologies, namely selective laser melting (SLM), are often used in manufacturing products of critical duty. At the same time, the SLM process may be accompanied by the appearance of specific defects in the product. We present the results of radiation monitoring of aviation blanks manufactures using addi­tive technology by digital radiography. A digital detector system was used as an X-ray converter. It is shown that the methods of film radiography traditionally used for control in the case of aircraft objects are not always effective. The method of digital radiography, on the contrary, is the most adequate. Comparison of the results of digital radiography with data of traditional radiography revealed that the time spent on radiation monitoring when using an automated manipulator is significantly reduced, while the monitor­ing performance increases dramatically. The results obtained can be used to improve the methods of radia­tion monitoring of aircraft objects manufactured using additive technologies.

Comparison of Two Modified Linear Accelerators for Use in FLASH Clinical Trials

<h3>Purpose/Objective(s)</h3> This study is the first direct comparison of two converted clinical linear accelerators producing ultra-high dose rate electron beams in the same way. It sought to quantify the differences in the spatial and temporal properties of the beams in relation to potential clinical impacts. <h3>Materials/Methods</h3> FLASH beams were produced on Varian Trilogy and 21EX linear accelerators by selecting the 10MV photon mode, retracting the target and setting the carousel to an empty port to give access to the pristine electron beam. Lateral profiles of an open beam with no accessories were measured by radiographic film (depth = 2cm, SSD = 100cm) in Solid Water. Percent depth dose (PDD) was measured along the central axis with radiographic film placed at varying depths in Solid Water. The temporal pulse structure and per-pulse output was recorded with a photomultiplier tube that amplified the signal from an optical fiber placed outside the beam with film providing cumulative absolute dosimetry. Pulse-to-pulse dosimetry was further confirmed with a diode detector centered in the beam under 1cm buildup. The practical range was calculated using PDD data. Beam width was reported as the FWHM of a Gaussian fit to the profile. Dose per-pulse (DPP) was calculated using film and the number of pulses detected with the PMT. Mean dose rate was calculated using the DPP and the accelerator rep rate. <h3>Results</h3> As reported in the included table, spatial beam characteristics were similar between the machines with the Trilogy showing a slightly wider profile in inline and crossline directions. The DPP on the Trilogy was 19.6% higher than the 21EX at 0.90 Gy/pulse with a mean dose rate of 322 Gy/s, compared to the 270 Gy/s on the 21EX. The Trilogy accelerator exhibited more stability during the initial pulses as indicated by the higher 25% quartile dose per-pulse. The difference between the 25% and 75% quartiles was 0.25 and 0.02 Gy/pulse on the 21EX and Trilogy, respectively. The 21EX exhibited additional low-dose outliers in the initial pulses and showed significant ramp-up and variability during the first 20 pulses of a 36-pulse delivery. The Trilogy was nearly stable after the first pulse. <h3>Conclusion</h3> For clinically relevant doses, the entire FLASH treatment may consist of only a few initial pulses. Stability across these initial pulses with high dose rates from the start are key to ensure the quality, repeatability, and safety of UHDR deliveries. Although significant variabilities have been observed between the two FLASH Linacs, the Trilogy demonstrated potential superiority in stability, which particularly matters for the clinical translation of FLASH-RT.