PubMed · 3828728
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A Stacey-Clear, C W Jamieson. 1987. Omnitract retractor.. https://doi.org/10.1002/bjs.1800740107
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PURPOSE: The creation of the first large-area, amorphous silicon megavoltage imager is reported. The imager is an engineering prototype built to serve as a stepping stone toward the creation of a future clinical prototype. The engineering prototype is described and various images demonstrating its properties are shown including the first reported patient image acquired with such an amorphous silicon imaging device. Specific limitations in the engineering prototype are reviewed and potential advantages of future, more optimized imagers of this type are presented. METHODS AND MATERIALS: The imager is based on a two-dimensional, pixelated array containing amorphous silicon field-effect transistors and photodiode sensors which are deposited on a thin glass substrate. The array has a 512 x 560-pixel format and a pixel pitch of 450 microns giving an imaging area of approximately 23 x 25 cm2. The array is used in conjunction with an overlying metal plate/phosphor screen converter as well as an electronic acquisition system. Images were acquired fluoroscopically using a megavoltage treatment machine. RESULTS: Array and digitized film images of a variety of anthropomorphic phantoms and of a human subject are presented and compared. The information content of the array images generally appears to be at least as great as that of the digitized film images. CONCLUSION: Despite a variety of severe limitations in the engineering prototype, including many array defects, a relatively slow and noisy acquisition system, and the lack of a means to generate images in a radiographic manner, the prototype nevertheless generated clinically useful information. The general properties of these amorphous silicon arrays, along with the quality of the images provided by the engineering prototype, strongly suggest that such arrays could eventually form the basis of a new imaging technology for radiotherapy localization and verification. The development of a clinically useful prototype offering high-quality images, ultimately with an approximately 52 x 52-cm2 detection surface, is anticipated.
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PURPOSE: The purpose of this study is to report that commercially available eye shields (designed for orthovoltage x-rays) are inadequate to protect the ocular structures from penetrating electrons for electron beam energies equal to or greater than 6 MeV. Therefore, a prototype medium size tungsten eye shield was designed and fabricated. The advantages of the tungsten eye shield over lead are discussed. METHODS AND MATERIALS: Electron beams (6-9 MeV) are often used to irradiate eyelid tumors to curative doses. Eye shields can be placed under the eyelids to protect the globe. Film and thermoluminescent dosimeters (TLDs) were used within a specially constructed polystyrene eye phantom to determine the effectiveness of various commercially available internal eye shields (designed for orthovoltage x-rays). The same procedures were used to evaluate a prototype medium size tungsten eye shield (2.8 mm thick), which was designed and fabricated for protection of the globe from penetrating electrons for electron beam energy equal to 9 MeV. A mini-TLD was used to measure the dose enhancement due to electrons backscattered off the tungsten eye shield, both with or without a dental acrylic coating that is required to reduce discomfort, permit sterilization of the shield, and reduce the dose contribution from backscattered electrons. RESULTS: Transmission of a 6 MeV electron beam through a 1.7 mm thick lead eye shield was found to be 50% on the surface (cornea) of the phantom and 27% at a depth of 6 mm (lens). The thickness of lead required to stop 6-9 MeV electron beams is impractical. In place of lead, a prototype medium size tungsten eye shield was made. For 6 to 9 MeV electrons, the doses measured on the surface (cornea) and at 6 mm (lens) and 21 mm (retina) depths were all less than 5% of the maximum dose of the open field (4 x 4 cm). Electrons backscattered off a tungsten eye shield without acrylic coating increased the lid dose from 85 to 123% at 6 MeV and 87 to 119% at 9 MeV. For the tungsten eye shield coated with 2-3 mm of dental acrylic, the lid dose was increased from 85 to 98.5% at 6 MeV and 86 to 106% at 9 MeV. CONCLUSION: Commercially available eye shields were evaluated and found to be clearly inadequate to protect the ocular structures for electron beam energies equal to or greater than 6 MeV. A tungsten eye shield has been found to provide adequate protection for electrons up to 9 MeV. The increase in lid dose due to electrons backscattered off the tungsten eye shield should be considered in the dose prescription. A minimum thickness of 2 mm dental acrylic on the beam entrance surface of the tungsten eye shield was found to reduce the backscattered electron effect to acceptable levels.