TLD occupational dose distribution study in nuclear medicine

The large and growing number of patients undergoing nuclear medicine procedures and workers involved in this practice requires continued efforts to improve the quality of diagnosis and to reduce the radiological risk associated. In Brazil, external individual monitoring with a dosemeter located on the thorax is compulsory for all workers in controlled areas. Extremity dosemeters are recommended in activities where hand dose can be much higher than on the thorax. This is typically the case for nuclear medicine procedures, but extremity dosemeters are not regularly used in Brazil. With the aim to study the occupational dose distribution in the nuclear medicine staff during their tasks of preparation and injection of radionuclides, Harshaw TLD chips of LiF:Mg,Cu,P (TLD-100H) were used for individual monitoring on different parts of the worker body. As expected, all doses measured on the thorax were much lower than on the hands. For both Single Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET), the dose to the fingers during preparation is about two orders of magnitude higher than in the thorax, and in the injection procedure, one order higher. The doses received by the workers' fingers varied widely depending on how they hold the syringe, but fingertips always received higher doses. The dose values measured in the eye lens were 200% higher than the one measured on the thorax.     

Organ dose and scattering dose for CT coronary angiography and calcium scoring using automatic tube current modulation

Noninvasive coronary angiography and calcium scoring with the use of multi-detector computed tomography scanners are feasible for reliably detecting coronary artery disease. The purpose of this study is to investigate organ dose and scattering dose for CT coronary angiography and calcium scoring using automatic tube current modulation. Organ doses of an anthropomorphic phantom were estimated using LiF:Mg,Cu,P thermoluminescent dosimeter (TLD) chips. The dose profiles inside and outside the scanning regions were measured. Effective doses for coronary angiography and calcium scoring without using automatic tube current modulation are respectively 12.72 ± 2.06 and 1.69 ± 0.30 mSv. Using automatic tube current modulation can reduce effective dose by 43% for coronary angiography, and 24–32% for calcium scoring. Scatter doses at the point of 10 cm away from the margin of scanning region decreased to 5–9% of in-plane doses. Using automatic tube current modulation can effectively reduce radiation doses inside the CT scanning region.     

Organ point dose measurements in clinical multi slice computed tomography (MSCT) examinations with the MOSkin™ radiation dosimeter

This study reports on the application of the MOSkin™ dosimeter in MSCT imaging for the real-time measurement of absorbed organ point doses in a tissue-equivalent female anthropomorphic phantom. MOSkin™ dosimeters were placed within the phantom to measure absorbed point organ doses for 2 commonly applied clinical scan protocols, namely the renal calculus scan and the pulmonary embolus scan. Measured organ doses in the imaged field of view were found to be in the dose range 4.7–9.5 mGy and 16.2–27.4 mGy for the renal calculus scan and pulmonary scan protocols respectively. For the derivation of effective dose, using the more recent ICRP 103 tissue weighting factors (w_T) compared to that of the ICRP 60 w_T resulted in a difference in the derived effective dose by up to 0.8 mSv (−20%) in the renal calculus protocol and up to 1.8 mSv (18%) in the pulmonary embolus protocol. This difference is attributed to the reduced radiosensitivity of the gonads and the increased radiosensitivity of breast tissue in the latest ICRP 103 assigned w_T. The results of this study show that the MOSkin™ dosimeter is a useful real-time tool for the direct assessment of organ doses in clinical MSCT examinations.     

A study of the dose distribution in the region of the eye lens and extremities for staff working in interventional cardiology

The dose distributions at the region of eye lens and extremities of staff working in interventional cardiology were analyzed. The doses to physicians and nurses from three hospitals in Poland were measured with TL dosimeters (MCP-N) located on various places near eyebrows, on both fingers, wrists, knees and on the ankle. The procedures under investigation were coronary angiography (CA) and percutaneous coronary intervention (PCI), peacemaker and defibrillator implantations (PM/ICDs), cardiac resynchronization therapy with or without defibrillator implantations (CRT-D or CRT) and radiofrequency ablations (RFA). The study aimed at analyzing the distribution of radiation in selected anatomic regions, determining the typical locations of highest doses and estimating the dose ranges for selected types of procedures.The maximum registered doses per procedure to eye lens and ankle were 1.21 mSv and 1.46 mSv for CA PCI procedures, 0.02 mSv and 0.05 mSv for RFA and 0.13 mSv and 0.51 mSv for PM/ICDs, respectively. The maximum doses to fingers, wrists and knees were, accordingly, 2.11 mSv, 1.07 mSv and 0.77 mSv for CA PCI procedures, 0.38 mSv, 0.20 mSv and 0.04 mSv for RFA ones, 0.50 mSv, 0.25 mSv and 0.01 mSv for PM/ICDs procedures and 2.25 mSv, 1.12 mSv and 0.58 mSv for CRT and CRT-D ones. The factors which might influence the dose like utilized radiation, availability of additional protective equipment and position of the staff with respect to X-ray source were also analyzed.The annual doses for eye lens and extremities were estimated on the basis of individual annual workloads of the physicians participating in the study. The highest annual doses were revealed for physicians performing CA PCI procedures. Annual eye lens doses range up to 247 mSv indicating that the occupational limit for eye lens 150 mSv has been surpassed. In case of extremities the maximal estimated annual doses were 355 mSv, 136 mSv, 55 mSv and 328 mSv, for fingers, wrists, knees and for ankle, respectively. Moreover, in the light of ICRP new Statement on Tissue Reactions raising the possibility of lowering the annual limit for the lens of the eye the annual doses estimated in our paper indicate that for some procedures the monitoring of eye lens doses should be considered. On the other hand, it is important to note that most of high occupational doses can be easily avoided if radiation protection tools are used and, moreover, used properly.The present survey is a part of ORAMED project concerning the determination of doses to extremities (fingers, wrists and knees) and eye lens during interventional procedures and includes the detailed analyses of results of Polish partner. They are, however, presented in wider context. The study is additionally extended by the investigation of the dose distribution at the eyebrows and ankle level.     

Scatter radiation dose at the height of the operator's eye in interventional cardiology

This paper presents the first experimental result for scatter dose at the height of the operator's eye measured for a Polymethyl methacrylate (PMMA) phantom simulating an adult patient in an interventional laboratory at Belo Horizonte, Brazil. Values for scattered radiation doses at the height of the operator's eye are reported for procedures performed with and without a ceiling-suspended screen. Correlations between scatter radiation doses and different angiographic projections, phantom entrance dose and kerma area product, were obtained.Experimental measurements were made in an angiography X-ray system equipped with flat-panel detector. A cine and three fluoroscopy modes: low, medium and high dose were available. Scattered radiation doses were measured at three angiographic projections: anterior-posterior (AP), left anterior oblique 90° and left anterior oblique 45° with cranial 30° (spider) angulations. The detector measuring scatter radiation was positioned at the usual distance of the cardiologist's eye and the detector measuring phantom entrance dose was positioned at the bottom of the PMMA phantom.The phantom entrance dose for fluoroscopy low, medium, high and cine were 15, 29, 36 ± 4 and 184 ± 18 mGy/min, respectively to AP projection. A good linear correlation exists between phantom entrance doses rate and scatter dose rate to AP projection. There is a good linear correlation between the kerma-area product and scatter dose at the height of the operator's eye, coefficient of determination R² were 0.9728 and 0.9913 with and without ceiling-suspended screen. An experimental correlation factor of 0.1 and 3.5 μSv/Gy*cm2 has been found for the AP projection with and without ceiling-suspended screen, respectively. Scatter dose at the eyes cardiologist position depends on the C-arm angulation an increase of the scatter radiation dose by a factor of 5 was found.The highest dose rate in the lens was 19.74 ± 1.97 mSv/h without ceiling-suspended screen in cine mode for “spider” projection. For lateral projection in cine mode, the ceiling-suspended screen reduced dose by a factor 0.01. Interventional operator may therefore easily exceed the lens dose limit if ceiling-suspended screen is not used.     

Ultraviolet-Cathodoluminescent 330 nm light source from a 2-inch wide CNT electron-beam emission under DC electric field

We report a 2-inch wide-area AlGaN-based ultraviolet (UV) – cathodoluminescence (CL) light source emission using electron beam (EB) pumped source under DC electric field from an AlGaN/GaN multi-quantum-well grown on a sapphire substrate. The EB-pumping is achieved by wide-area carbon nanotubes (CNT) based field emitters and is arranged via a metal mesh, thereby acting as a gate to pump the electron flow. We have carried out UV–CL measurements with a turn-on field emission in the anode voltage ranging between 5 kV and 9 kV at anode current up to 1 mA. The best results are obtained at the low consumption energy of 7 W (anode current 1 mA; anode voltage 7 kV). The 330 nm UV–CL emission shows an output power of ~225 mW, with an as-calculated power efficiency of ~3.6%. The CL measurements show (5–8) % defect luminescence in the visible region.     

Occupational doses of medical staff and their relation to patient exposure incurred in coronary angiography and intervention

Patient kerma–area product P_KA, cumulative kerma in the air K_IRP, fluoroscopic time t, personal dose equivalent (in terms of Hp(10), Hp(0.07) and Hp(3)) for most common interventional cardiology procedures were measured. P_KA and K_IRP measurements were used for patients and thermoluminescent dosimetry for the personnel. Dosemeters for personal doses measurements containing MCP-N (LiF: Mg, Cu, P) type thermoluminescence detectors (TLDs), were read out at the Institute of Nuclear Physics Polish Academy of Science (IFJ PAN) dosimetry service.The patient and personal doses were similar to those reported by other authors. The mean values of total kerma–area product (P_KA) were 22.7 (7.3–50.9) Gy·cm² for coronary angiography (CA) and 43.1 (3.2–86.4) Gy·cm² for percutaneous coronary intervention (PCI). In general, doses received by the staff performing PCI procedures were found to be systematically higher than those after CA procedures, by some 30% or more. Within the medical team, operators always received the highest doses, followed by nurses and technicians. Maximum eye lens doses, skin doses and whole body doses were 165 μSv, 962 μSv and 30 μSv per procedure, respectively. Annual eye lens doses received by the operators, especially in PCI procedures, may well exceed the value of the recently recommended annual dose limit of 20 mSv and should be monitored.No meaningful correlation could be established between occupational doses and patient exposure, however some degree of correlation was observed between values of dose to the eye lens and whole body dose.     

Investigations into the reliability of SAR-OSL equivalent doses obtained for quartz samples displaying dose response curves with more than one component

Fast component dominated quartz single aliquot regenerative dose optically stimulated luminescence (SAR-OSL) dose response curves that display continuing growth at high doses are increasingly reported in literature. This behaviour would result in higher equivalent doses being obtained. Here we document the characteristics of OSL signals from fine (4–11 μm) and coarse (63–90 μm) quartz extracted from Romanian loess that display such behaviour. For very high doses (>1 kGy up to 5–15 kGy) the data could be closely fitted to a double saturating exponential regression model. Nonetheless, the saturation charcteristics of these fine and coarse quartz grains are very different, with average saturation chracteristic doses of D₀₁ ≈ 175 Gy and D₀₂ ≈ 1800 Gy in the case of the fine material, while in the case of the coarse material values of D₀₁ ≈ 55 Gy and D₀₂ ≈ 600 Gy have been obtained. Our results imply a hitherto unexplained mechanism in OSL production at high doses and question the reliability of obtaining SAR-OSL equivalent doses in the high dose region when a second function is needed to describe the dose response.     

Reliability of single aliquot regenerative protocol (SAR) for dose estimation in quartz at different burial temperatures: A simulation study

The single aliquot regenerative protocol (SAR) is a well-established technique for estimating naturally acquired radiation doses in quartz. This simulation work examines the reliability of SAR protocol for samples which experienced different ambient temperatures in nature in the range of −10 to 40 °C. The contribution of various experimental variables used in SAR protocols to the accuracy and precision of the method is simulated for different ambient temperatures. Specifically the effects of paleo-dose, test dose, pre-heating temperature and cut-heat temperature on the accuracy of equivalent dose (ED) estimation are simulated by using random combinations of the concentrations of traps and centers using a previously published comprehensive quartz model. The findings suggest that the ambient temperature has a significant bearing on the reliability of natural dose estimation using SAR protocol, especially for ambient temperatures above 0 °C. The main source of these inaccuracies seems to be thermal sensitization of the quartz samples caused by the well-known thermal transfer of holes between luminescence centers in quartz. The simulations suggest that most of this inaccuracy in the dose estimation can be removed by delivering the laboratory doses in pulses (pulsed irradiation procedures).     

Comparison of dose measurements in CT using a photodiode and a small ion chamber

Owing to the advance of multislice computed tomography (CT), the dosimetric protocol currently used in CT has become inadequate. Instead of dosimetry based on the measurement of the Computed Tomography Dosimetry Index (CTDI) using a pencil ion chamber (IC) 100 mm in length, the use of a short IC and the calculation of the dose equilibrium (D_eq) at the location of the chamber are proposed. The objective of this work was to compare the performance of a short IC and a commercial photodiode (BPW34FS) to measure the accumulated dose at the center of the scan length L, D_L(0), and to obtain the equilibrium dose D_eq using the two detectors. The result for L = 100 mm was compared with the result of the pencil chamber. The results indicate that the commercial photodiode is suitable to measure the accumulated dose at the center of the scan length L as compared with the ICs. This methodology allows measurements of the accumulated dose for any desired scan length, allowing measurement of the equilibrium dose D_eq if the phantom is long enough to allow it.     

Dosimetric evaluation of alanine-in-glass dosimeters at clinical dose levels using high-energy X-rays from a linear accelerator

This study presents the first dosimetric evaluation of the alanine-in-glass dosimeter in radiation therapy. The dosimeter is composed of a Pyrex glass tube filled with pure polycrystalline alanine. 6 MV X-ray beams from a linear accelerator were used to irradiate the dosimeter in a solid water phantom to therapy-level doses ranging from 0 to 30 Gy. An X-band electron paramagnetic resonance (EPR) spectrometer was utilized to measure the absorbed dose of the dosimeter. The doses measured by the dosimeter were compared to those from ion chamber dosimetry. It was found that the dosimeter exhibited a linear response in the dose range from 0.1 to 30 Gy. The deviation between measured and delivered doses was 0.11% over the 0.5–30 Gy range, whereas the deviation increased to about 25% at 0.1 Gy. The lowest detectable dose with an acceptable deviation limit of 5% or less was found to be 0.3 Gy. The inaccuracy in measurements at low doses can be attributed to background signals and instrument noise. The accuracy can be improved by proper selection of measurement conditions and better optimization of equipment. The findings of this study show that the alanine-in-glass dosimeter is suitable for dose measurements with acceptable accuracy down to 0.3 Gy. The dosimeter is therefore has the potential to be employed in radiotherapy applications and quality control procedures.     

Developing a single-aliquot protocol for measuring equivalent dose in biogenic carbonates

Exploiting biogenic carbonates as thermoluminescence dosimeters requires an understanding of trap kinetics and an appropriate sequence with which to measure equivalent dose. The trap kinetics of two high temperature peaks (peaks II and III) from calcitic snail opercula have been investigated resulting in the calculation of lifetimes of 7.4 × 10⁷ and 1.4 × 10¹¹ years for the two peaks respectively. Two measurement sequences, based upon changes in the application and measurement of a test dose, have been applied to peaks II and III, and though both methods were equally successful in dose recovery and production of a dose response curve some differences were observed. Primarily, the use of method 1 lead to dose dependant sensitivity change implying competition effects occurring during irradiation; method 2 did not experience this phenomenon. As a consequence method 2 was chosen as the most appropriate protocol for single-aliquot dating of this material.When assessing the TL behaviour of the two peaks, peak II performed poorly in dose recovery experiments recovering a dose 60–100% larger than that applied. Disproportionate growth of peak II in response to a beta dose applied prior to measurement, compared to growth following regeneration doses indicated that peak II was not suitable for use in single-aliquot protocols. However, dose recovery results for peak III were all within errors of unity of the given dose, and peak III was therefore chosen as the most appropriate peak for TL dosimetry in these single-aliquot procedures. The lifetime of charge in peak III is sufficient to date over many millions of years, and furthermore using the chosen method 2 the dose response curve has a D₀ of 3,250 ± 163 Gy allowing dating to over 3 million years.     

Peripheral doses in radiotherapy: A comparison between IMRT,VMAT and Tomotherapy

The goal of this intercomparison is to determine the peripheral doses during treatment of prostate and head and neck (H&N) cancers. In the case of prostate cancer, two different treatment techniques are compared: intensity-modulated radiation therapy (IMRT – 10 MV and 18 MV), on a Varian Clinac 2100 C/D and Tomotherapy. VMAT (also on a Varian Clinac 2100 C/D) was compared to Tomotherapy, for H&N cancer. The treatment devices are located at the university hospitals of Leuven and Brussels, respectively. A common treatment protocol was agreed between the two clinical centers and this same protocol was used by each partner. For the higher energy modalities (10 MV and 18 MV) we also assessed the neutron contribution to the total dose, by using bubble detectors. In this way, the performance (in terms of peripheral doses) of the different treatment techniques, when faced with the same dose distribution constraints, was evaluated. The doses were evaluated with an anthropomorphic phantom loaded with TLD detectors. Summarizing our results, we can conclude that low energy radiation techniques, namely VMAT and Tomotherapy, have more interesting performances when compared to IMRT at energies of 10 MV and 18 MV, with respect to peripheral dose. On the one hand the former are associated with lower photon doses and, on the other hand, there is no contribution from neutrons to the total dose.     

Development of new chemical dosimeter for low dose range

Accurate measurement of low dose radiation in complex systems is of utmost importance in radiation biology and related areas. Ferrous Benzoic acid Xylenol orange (FBX) system is being widely used for measurement of low dose gamma radiation because of its reproducibility and precision. However, an additional step, i.e., dissolution of benzoic acid in water at higher temperature followed by cooling at room temperature is involved for the preparation of this dosimeter. This makes it inconvenient as a ready to use dosimeter. In the present work, the organic molecule, sorbitol has been used for measurement of low doses of radiation. The advantages of using sorbitol are its ready availability and instantaneous water solubility. Owing to its dissolution at room temperature, possible errors those are involved in calculation of dose due to thermal oxidation of ferrous ions during preparation of the FBX dosimetric solution could be made insignificant in the proposed dosimeter. In the present system, sorbitol acts as radiolytic sensitizer for the oxidation of ferrous ion, and xylenol orange forms a 1:1 complex specifically with ferric ions. Thus, the analytical detection limit of ferric ions is enhanced compared to other systems. Final composition of the dosimetric solution is; 0.5 mol/m³ xylenol orange, 10 mol/m³ sorbitol and 0.2 mol/m³ ferrous ion in 50 mol/m³ sulfuric acid. Radiolytic sensitization in combination with analytical enhancement of the ferrous based system, allows us to measure radiation dose in the range of 0.05 Gy–12 Gy with ease and high reproducibility.     

Low energy ion beams by laser interaction

We developed an ion accelerator with a double accelerating gap system supplied by two power generators of different polarity. The ions were generated by laser ion source technique. The laser plasma induced by an excimer KrF laser, freely expanded before the action of accelerating fields. After the first gap action, the ions were again accelerated by a second gap. The total acceleration can imprint a maximum ion energy up to 160 keV per charge state. We analysed the extracted charge from a Cu target as a function of the accelerating voltage at laser energy of 9, 11 and 17 mJ deposited on a spot of 0.005 cm². The peak of current density was 3.9 and 5.3 mA for the lower and medium laser energy at 60 kV. At the highest laser energy, the maximum output current was 11.7 mA with an accelerating voltage of 50 kV. The maximum ion dose was estimated to be 10¹² ions/cm². Under the condition of 60 kV accelerating voltage and 5.3 mA output current the normalized emittance of the beam measured by pepper pot method was 0.22 π mm mrad.     

Emergency EPR dosimetry technique using vacuum-stored dry nails

Human finger- and toenails have been tested with an X-band EPR technique for different conditions of nail storage. The main radiation-induced signal at g = 2.005 demonstrated good stability if the samples were stored in a vacuum at room temperature after nail harvesting and irradiation. On the basis of this phenomenon, a new protocol is proposed to use the nails as possible emergency EPR dosimeters. The dosimetry protocol was tested on laboratory-exposed samples and demonstrated the ability to recover doses in the region 0–10 Gy with an estimated uncertainty of approximately 0.3–0.4 Gy for doses in the range <2 Gy, increasing to 0.6–0.7 Gy for doses in the range 5–10 Gy.     

Determination of the radiation dose scattered outside the target volume treated with IMRT technique

Intensity Modulated Radiation Therapy (IMRT) is an advanced mode of high precision radiation therapy that uses computer controlled linear accelerators to deliver precise radiation doses to a malignant tumor or specific areas within the tumor. This is achieved using a more precise adjustment of the beam to the three dimensional shape of the tumor by modulating or controlling the intensity of the radiation beam in multiple small volumes. IMRT also allows higher radiation doses to be focused to regions within the tumor while minimizing the dose to surrounding normal critical structures. This work aims at determining the radiation dose in two target volumes (tumors) treated at same time and the scattered dose distribution in organs at risk using thermoluminescent dosimeters of LiF:Mg,Ti for IMRT treatment technique and a polymethylmethacrylate (PMMA) phantom. The shortest distance between the cavities 1 and 2 that simulate tumors is 1.5 cm and the shortest distances from the cavity 1 to the cavities 3, 4 and 5 are, respectively, 1.9 cm, 2.2 cm and 2.65 cm. The shortest distance from the cavity 2 to cavities 3, 4 and 5 are, respectively, 5.4 cm; 5.7 cm and 1.5 cm. The relative difference for the doses measured by TLD-100 and provided by the TPS were +3.7% and −1.38%. The out-of-target doses received by cavities 3, 4 and 5 corresponded on average to 19.36, 17.84% and 6.72% of the highest dose received by the cavity 1 and the doses received by cavities 3, 4 and 5 corresponded on average to 29.51%, 27.20% and 10.24% of the dose received by cavity 2.     

Entrance surface dose in cerebral interventional radiology procedures

During interventional radiology procedures patients receive doses which exceed thresholds for non-stochastic effects on the skin, such as erythema (2 Gy) and epilation (3 Gy), so the entrance surface dose imparted during these proceedings should be monitored. The aim of this work was to determine the entrance surface dose (ESD) in patients who undergo diagnostic or therapeutic procedures at the Instituto Nacional de Neurología y Neurocirugía (INNN). The procedures were performed using two systems for neuroradiology, an Axiom Artis and an Artis Zeego from Siemens. The ESD was measured, for diagnostic and therapeutic procedures, using 15 × 15 cm² of Gafchromic XR-RV3 film and/or 25 TLD-100 chips that were attached in a holder of 15 × 15 cm² in the posteroanterior and left and right lateral positions during all the procedures. The results show that the maximum ESD measured was lower than 1 Gy for the nine diagnostic procedures evaluated whereas four of the ten therapeutic procedures were greater than 2 Gy in at least one position. Seven patients were monitored, three of which have presented epilation and one erythema.     

Low dose TL characteristics of Nigerian fluorite

Nigerian fluorite has been characterized by β-irradiation for thermoluminescence in the low dose range (40 μGy–72 mGy). The glow curves exhibit 3 peaks recorded at 111 ± 11 °C, 196 ± 2 °C and 282 ± 4 °C at the heating rate of 5 °C s^?1. The two high temperature peaks exhibit a linear response over the range of study. The minimum detectable dose for each of the observed peaks has been determined and the lowest detection limit of fluorite was also determined. A complex fading pattern was observed for the phosphor and the possible source of the TL buildup has been discussed.     

Assessment of undesirable dose to eye-melanoma patients after proton radiotherapy

Radiotherapy with a proton beam of initial energy 55–80 MeV is presently the clinically recommended therapy for some cases of intraocular melanoma such as large melanomas or tumours adjacent to critical organs. Evaluation and optimization of radiation doses outside the treatment volume may contribute to reducing undesirable side-effects and decreasing the risk of occurrence of secondary cancers, particularly for paediatric patients. In this work the undesired doses to organs were assessed basing on Monte Carlo calculation of secondary radiation transport and on results of measurements of neutron and γ-ray doses at the proton therapy facility of the Institute of Nuclear Physics at Kraków. Dosimetry was performed using a He-3-based FHT 762 neutron monitor (Wendi II), a FH40G proportional counter (for γ-rays), and MTS-7 (LiF:Mg,Ti) thermoluminescence detectors (TLDs). Organ doses were calculated in the ADAM anthropomorphic phantom using the MCNPX Monte Carlo transport code and partly verified, for γ-ray doses, with TLD measurements in the RANDO Anderson anthropomorphic phantom. The effective dose due to undesired radiation, including exposure from scattered radiation during the entire process of proton radiotherapy and patient positioning using X-rays, does not exceed 1 mSv.