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T Kron

Publications and source records attributed to T Kron.

At least 55 records · Page 3Linked to original sources
PubMed1996

TLD extrapolation for skin dose determination in vivo.

Prediction of skin reactions requires knowledge of the dose at various depths in the human skin. Using thermoluminescence dosimeters of three different thicknesses, the dose can be extrapolated to the surface and interpolated between the different depths. A TLD holder was designed for these TLD extrapolation measurements on patients during treatment which allowed measurements of entrance and exit skin dose with a day to day variability of +/-7% (S.D. of mean reading). In a pilot study on 18 patients undergoing breast irradiation, it was found that the angle of incidence of the radiation beam is the most significant factor influencing skin entrance dose. In most of these measurements the beam exit dose contributed 50% more to the surface dose than the entrance dose.

Breast Neoplasms↗
PubMed1996

Variation in calculated effective source-surface distances with depth.

Effective source-surface distances (ESSD) are assessed at the depth of maximum dose in electron beams. This study investigated the variation of the ESSD with the depth of measurement. The dose was measured with the range of SSDs 100-130 cm, using a water-equivalent parallel-plate ion chamber in solid water. ESSDs were calculated for electron beams in the energy range 4-20 MeV and were found to vary with depth. The surface ESSD varied from 68 cm for 4 MeV to 82 cm for 16 MeV, but increased with depth to a maximum value, which was found at approximately half the practical range (Rp), at 0.3Rp for 4 MeV and at 0.6Rp for 20 MeV. Beyond this depth the ESSD decreased towards the end of the practical range. Without an electron applicator, the ESSD was higher at the surface. For smaller field sizes, the depth of the maximum ESSD increased towards Rp, and ESSD values increased. The 20 MeV beam in the 6 cm x 6 cm2 field showed a difference of 31 cm between the surface ESSD and the maximum ESSD. The ESSD calculated at the maximum dose depth (Dmax) may be used with reasonable accuracy for calculation of the dose in the therapeutic range, except at larger SSDs or when high-energy beams are used in small fields Depth-dose distributions under these conditions should be compared with measured results.

Electrons↗
PubMed1996

Surface dose measurements for highly oblique electron beams.

Clinical applications of electrons may involve oblique incidence of beams, and although dose variations for angles up to 60 degrees from normal incidence are well documented, no results are available for highly oblique beams. Surface dose measurements in highly oblique beams were made using parallel-plate ion chambers and both standard LiF:Mg, Ti and carbon-loaded LiF Thermoluminescent Dosimeters (TLD). Obliquity factors (OBF) or surface dose at an oblique angle divided by the surface dose at perpendicular incidence, were obtained for electron energies between 4 and 20 MeV. Measurements were performed on a flat solid water phantom without a collimator at 100 cm SSD. Comparisons were also made to collimated beams. The OBFs of surface doses plotted against the angle of incidence increased to a maximum dose followed by a rapid dropoff in dose. The increase in OBF was more rapid for higher energies. The maximum OBF occurred at larger angles for higher-energy beams and ranged from 73 degrees for 4 MeV to 84 degrees for 20 MeV. At the dose maximum, OBFs were between 130% and 160% of direct beam doses, yielding surface doses of up to 150% of Dmax for the 20 MeV beam. At 2 mm depth the dose ratio was found to increase initially with angle and then decrease as Dmax moved closer to the surface. A higher maximum dose was measured at 2 mm depth than at the surface. A comparison of ion chamber types showed that a chamber with a small electrode spacing and large guard ring is required for oblique dose measurement. A semiempirical equation was used to model the dose increase at the surface with different energy electron beams.

Colloids↗
PubMed1996

Evaluation of rectal shielding in a Henschke system applicator.

PURPOSE: To assess the effectiveness of avoid shielding in the Henschke intracavitary gynaecologic 3-channel applicator. MATERIAL AND METHODS: An acrylic phantom was used with our locally modified 3-channel Henschke applicator so that standard treatments with caesium-137 sources could be simulated. Thermoluminescent dosimeters were used to measure point A and rectal doses with and without ovoid shielding to assess the benefits of this shielding. Unshielded measurements were also compared to our planning computer calculations to assess its accuracy. The thermoluminescent dosimeters were calibrated against a caesium teletherapy unit. An estimate of shielding effect produced by the ovoid shielding when using iridium-192 wire was also determined. RESULTS: Doses received at points in the plane containing the rectal point as defined by the ICRU in its report 38 [4] show a reduction ranging from 5% to 15% over the area measured due to the ovoid shielding. As expected this benefit is more pronounced when using iridium-192 sources. Given the steep dose gradients, good agreement is found between computed and measured values of point A doses. CONCLUSION: While ovoid shielding will never provide a large reduction in rectal dose using caesium-137 sources, our results indicate that it can be a worthwhile option when using the Henschke applicator.

Brachytherapy↗
PubMed1996

Radiotherapy treatment checking procedures throughout Australasia: results of a survey.

In July 1995, a questionnaire was forwarded to thirty two physicists overseeing Radiation Oncology Departments and brachytherapy in hospitals throughout Australia and New Zealand. From the thirty seven hospitals reached by this survey, details were gathered on thirty hospitals, including the Newcastle Mater Hospital. In most radiotherapy centres where treatment planning is performed by radiation therapists, at least some of the treatment sheets and their calculations are double checked by radiotherapy physicists. While 23% checked the treatment sheets of all patients, in the majority of centres physicists were found to check only a minor selection, that is, less than 20% of all treatment sheets. Only in six centres physicists were not involved.

Australia↗
PubMed1996

Evaluation of P-type semiconductor diodes for in-vivo dosimetry in a 6MV x-ray beam.

The importance of dose verification in radiotherapy has long been recognised. Semiconductor diodes used for in-vivo dosimetry are well suited for this purpose. It was the aim of the present study to investigate the performance of a commercially available set of diodes (Rainbow diodes by Nuclear Associates) which had been in use for two years in our department. The reading of the diodes proved to be reproducible within +/- 0.5% and recalibration was necessary approximately every month. While no marked influence of field size or beam modifiers was found, SSD proved to be a significant factor influencing diode response. Using various radiation qualities in air and phantom experiments, it could be shown that dose rate was not the contributing factor to the SSD dependence of the diode reading, as has been reported by some authors. The results reinforce the need to thoroughly assess diode response prior to clinical use. Using a correction for SSD this work has resulted in the implementation of an accurate and reliable system for diode entrance dose measurements in our 6MV x-ray beams, allowing an action level of +/- 4% to be set in patient measurements.

Biophysical Phenomena↗
PubMed1996

Synchrotron radiation in the study of the variation of dose response in thermoluminescence dosimeters with radiation energy.

Thermoluminescence dosimetry (TLD) is a versatile technique with many applications for dosimetry of ionising radiation. However, in the range of kilovoltage x-rays which is widely used for diagnostic and therapeutic medical applications, problems arise from the differing dose response of most TL dosimeters with the radiation energy. The dose response of various TL detector types was investigated in mono-energetic x-ray beams of 26.8, 33.2, 40, 80.4 and 99.6keV from a synchrotron radiation source at the National Laboratory for High Energy Physics in Japan. This response was studied as a function of TL material (LiF:Mg,Ti, LiF:Mg,Cu,P and Al2O3), the detector geometry and size, and their thermal history. Due to the asymmetric diffraction from a Si crystal employed to produce monoenergetic photons there was more than 50% dose inhomogeneity in some of radiation fields used. Therefore, the different TL dosimeter types were rotated around and the results related to the reading of a set of "standard" LiF:Mg,Ti ribbons which were included in all experiments as reference detectors. No significant influence of the detector shape (physical size, thickness) on the dose response with energy could be found. However, the pre-irradiation thermal history influences the dose response with radiation energy: a fast cool down of LiF:Mg,Ti after a high temperature anneal will increase the sensitivity by more than a factor of two. The relatively new TLD material LiF:Mg,Cu,P (GR-200, obtained from Solid Dosimeter & Detector Laboratories, Beijing) was found to be approximately 100 times more sensitive than the standard LiF:Mg,Ti. In addition it proved to be more tissue equivalent for photon radiation between 27keV and 40keV. The performance of LiF:Mg,Cu,P makes it a very interesting TL material deserving further evaluation for applications in diagnostic and therapeutic x-rays.

Aluminum Oxide↗
PubMed1995

Clinical use of carbon-loaded thermoluminescent dosimeters for skin dose determination.

PURPOSE: Carbon-loaded thermoluminescent dosimeters (TLDs) are designed for surface/skin dose measurements. Following 4 years in clinical use at the Mater Hospital, the accuracy and clinical usefulness of the carbon-loaded TLDs was assessed. METHODS AND MATERIALS: Teflon-based carbon-loaded lithium fluoride (LiF) disks with a diameter of 13 mm were used in the present study. The TLDs were compared with ion chamber readings and TLD extrapolation to determine the effective depth of the TLD measurement. In vivo measurements were made on patients receiving open-field treatments to the chest, abdomen, and groin. Skin entry dose or entry and exit dose were assessed in comparison with doses estimated from phantom measurements. RESULTS: The effective depth of measurement in a 6 MV therapeutic x-ray beam was found to be about 0.10 mm using TLD extrapolation as a comparison. Entrance surface dose measurements made on a solid water phantom agreed well with ion chamber and TLD extrapolation measurements, and black TLDs provide a more accurate exit dose than the other methods. Under clinical conditions, the black TLDs have an accuracy of +/- 5% (+/- 2 SD). The dose predicted from black TLD readings correlate with observed skin reactions as assessed with reflectance spectroscopy. CONCLUSION: In vivo dosimetry with carbon-loaded TLDs proved to be a useful tool in assessing the dose delivered to the basal cell layer in the skin of patients undergoing radiotherapy.

Carbon↗
PubMed1995

Acute reaction parameters for human oropharyngeal mucosa.

The purpose of this study was to determine the influence of changes in dose rate over the range 0.8-240 Gy/h on acute oropharyngeal mucosal reactions in human subjects, and to estimate the values of the important parameters that influence these reactions. Sixty-one patients requiring radiotherapy to palliate incurable head and neck cancer were treated on a telecaesium unit, using opposing lateral portals to total midline doses, varying between 30 and 42 Gy in 10 daily fractions over 2 weeks, at dose rates of 0.8, 1.8, 3.0 and 240 Gy/h according to a central composite study design. The severity and time course of reactions were charted at least twice weekly for each patient, using the EORTC/RTOG acute mucosal reaction grading system. Duration of reaction at each grade was observed to provide a more sensitive reflection of effect than the proportion of patients reaching any particular reaction grade. Analysis of duration by direct and indirect methods suggest alpha/beta ratios in the range 7-10 Gy and half-time (t1/2) values in the range 0.27-0.5 h, if mono-exponential repair kinetics are assumed. The t1/2 values are short and raise the question as to whether the repair kinetics of this tissue are well described by a mono-exponential function. Further prospective studies involving multiple daily fraction treatment regimes delivered at high dose rate, in which interfraction interval is deliberately varied, are needed to find out whether the parameters derived from this project are applicable to fractionated treatment courses at high dose rate.

Carcinoma, Squamous Cell↗
PubMed1995

Factors influencing the degree of erythematous skin reactions in humans.

Dose-response relationships have been studied using an ordinal visual scale and reflectance spectrophotometry data from 123 treatment sites on 110 patients treated with 10 dose fractions over 12-14 days. Dose rates varied between 3 and 240 Gy/h and total doses of between 25 and 41 Gy were given using teletherapy apparatus. We found qualitative scoring of erythematous skin reactions to be subject to considerable inter- and intra-observer variation. Reflectance spectrophotometry provided more reproducible information, some of which was undetectable by naked eye. Baseline erythema readings were significantly higher in male patients and at anatomical sites of previous heavy UV exposure. In addition, a pronounced decline in erythema readings during the second week of therapy and 'reciprocal vicinity' (abscopal) effects adjacent to the field, undetected by the eye, were observed in a subset of patients. Meaningful dose-response relationships could be derived only from reflectance data with peak change from the pretreatment baseline measure providing the best discrimination. Peak erythema measures following treatment were found to depend on the age and gender of the patient as well as the treatment site and its baseline erythema measurement. This was independent of the total dose administered or the instantaneous dose rate at which it was delivered. The rate of erythema development was also dose rate dependent but only weakly dependent on the biological dose intensity (Gy equiv./day) of the treatment course. The data raise the question of whether irradiation-induced erythema is exclusively a secondary phenomenon occurring as a result of basal cell killing. The short repair half time value of 0.06 h obtained by direct analysis is perplexing and may reflect a dose rate-dependent physiological vasodilatory response to irradiation and/or a multi-component cellular repair process.

Aged↗
PubMed1995

Verification of surface dose on patients undergoing low to medium energy X-ray therapy.

About 5% of patients still undergo cancer treatment with superficial (peak energy < or = 120 kVp) X-ray radiation. Dosimetry of these beams is difficult since the maximum dose is delivered at the surface and backscatter contributes significantly to the dose. This is particularly a problem in the difficult geometries encountered in superficial treatments in the head and neck area. It has recently been shown that surface dose measurements in mega-voltage X-ray beams can be performed using TLD (Thermoluminescence Dosimetry) extrapolation. In this technique, LiF TLD chips with a surface area of 3.15 x 3.15 cm2 and three different thicknesses (0.230, 0.099, and 0.038 g/cm2) are used together in the same radiation beam which allows the extrapolation of the measured dose back to the true surface. The energy response curve of the three thicknesses of LiF chips was measured for the energy range of 60kVp, HVL 1.6 mm Al to 300kVp, 4 mm Cu. LiF was found to over respond by a factor of 1.7 at 60kVp HVL 1.6 mm Al with respect to a 6MV photon beam. A feasibility study was carried out on three patients undergoing treatment at 120kVp. Because of the small field sizes involved it was necessary to limit irradiation to one or two chips at a time. The dose fall off in the first millimetre of tissue could be clearly detected. TLD extrapolation, in low to medium energy beams, was found to be useful to assess the dose of patients undergoing treatment for superficial lesions.

Feasibility Studies↗
PubMed1995

Workload and use factor of medical linear accelerators in radiotherapy.

An important factor in the design of primary protective barriers is the use factor. The present study was aimed at obtaining historical data on the use factor of two dual modality linear accelerators in a radiotherapy department. Gantry angle, field size, and beam modifiers were recorded for all radiation qualities in use at two medical linear accelerators with 6 MV and 18 MV x-rays and multiple electron energies ranging from 4 MeV to 20 MeV. The data for one year of clinical use was extracted from a record and verifying system and an estimate of the physics workload on the machines was obtained by going through the quality assurance records and machine log books. Of the total dose of approximately 37,000 Gy delivered in one year at isocenter on each unit 80% was given as 6 MV x-rays. As can be expected, most x-ray beams were directed at the four cardinal gantry angles with the angular distribution for 6 MV and 18 MV x-rays being very similar. Electron fields were broadly distributed around the gantry pointing down position. Less than 25% of all clinical x-ray treatment fields extended beyond a field size of 200 cm2.

Blood Component Transfusion↗
PubMed1995

Thermoluminescence dosimetry and its applications in medicine--Part 2: History and applications.

Thermoluminescence dosimetry (TLD) has been available for dosimetry of ionising radiation for nearly 100 years. The variety of materials and their different physical forms allow the determination of different radiation qualities over a wide range of absorbed dose. This makes TL dosimeters useful in radiation protection where dose levels of microGy are monitored as well as in radiotherapy where doses up to several Gray are to be measured. The major advantages of TL detectors are their small physical size and that no cables or auxiliary equipment is required during the dose assessment. Therefore TLD is a good method for point dose measurements in phantoms as well as for in vivo dosimetry on patients during radiotherapy treatment. As an integrative dosimetric technique, it can be applied to personal dosimetry and it lends itself to the determination of dose distributions due to multiple or moving radiation sources (e.g. conformal and dynamic radiotherapy, computed tomography). In addition, TL dosimeters are easy to transport, and they can be mailed. This makes them well suited for intercomparison of doses delivered in different institutions. The present article aims at describing the various applications TLD has found in medicine by taking into consideration the physics and practice of TLD measurements which have been discussed in the first part of this review (Australas. Phys. Eng. Sci. Med. 17: 175-199, 1994).

Equipment Design↗
PubMed1995

A perspex flattening filter for a 300k Vp orthovoltage X-ray beam.

For economic reasons modern equipment which produces low to medium energy X-rays covers the whole range of beam qualities from traditional superficial to orthovoltage radiation qualities. A recent trend shows an increasing number of installations of orthovoltage units in the cancer therapy community in the last five years. The use of a single anode for accelerating voltages between 60 and 300 kVp leads to compromises with regards to beam flatness and symmetry in the anode/cathode direction of the Siemens Stabilipan II radiation beam. A perspex flattening filter was designed to improve these beam parameters of the 300 kVp radiation beam (HVT 4mm Cu) at 50 cm and 60 cm FSD using a diaphragm-mounted field defining device. The filter design correlates with focal spot characteristics of the beam. The use of the filter improves flatness and symmetry for all measured field sizes from 6 x 6 cm2 to 18 x 18 cm2 by up to 8% (flatness) and 7% (symmetry) respectively. No significant difference in the depth dose characteristic of the 300 kVp beam was found with and without the filter. The only modification in the planning procedures required is the use of an attenuation factor of 0.89 for the filter. The use of the filter improves the dose distribution in treatment of patients undergoing orthovoltage radiotherapy--in particular treatments with large field sizes such as for metastases in the spinal column.

Radiographic Image Enhancement↗
PubMed1994

Dose distribution measurements in superficial x-ray beams using NMR dosimetry.

The conversion of Fe2+ to Fe3+ in a Fricke solution due to ionizing radiation can be detected using nuclear magnetic resonance (NMR) imaging. The aim of the present study was to develop a suitable system for the study of dose distributions in superficial radiation beams making use of the water equivalence of the dosimetric gel system. Agarose gels (1.5%) doped with 0.5 mM ammonium ferrous sulphate and 125 mM sulphuric acid were exposed to x-rays from a superficial radiotherapy treatment unit (HVT 1.4, 2.4 and 7.25 mm A1). In the experiments doses between 10 Gy and 20 Gy were given, and the gel surface was in direct contact with the lead glass cone applicators (diameters 1 cm and 2.5 cm) at an FSD of 10 cm. Images were obtained within 4 h after irradiation in the head coil of a 1.5 T clinical MR scanner. Using spin-echo sequences with seven different repetition times between 120 ms and 4 s, the spin-lattice relaxation time (T1) was calculated for specified regions of interest with about 1 mm spacing. The inverse of T1 was shown to be proportional to the given dose and 1/T1 maps were obtained for all three superficial radiation qualities. The depth-dose curves determined with NMR dosimetry compare well with those obtained with a thin-window parallel plate ion chamber and thermoluminescence dosimetry in the same radiation beams.

Dose-Response Relationship, Radiation↗