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At least 595 records · Page 33Linked to original sources
PubMed1991

Synergistic inhibition of human immunodeficiency virus type 1 replication in vitro by two-drug and three-drug combinations of 3'-azido-3'-deoxythymidine, phosphonoformate, and 2',3'-dideoxythymidine.

The effects of 3'-azido-3'-deoxythymidine (AZT), phosphonoformate (PFA), and 2',3'-dideoxythymidine (ddT) and their combination on human immunodeficiency type 1 (HIV-1) replication were studied by measuring the HIV-1 p24 antigen expression and reverse transcriptase (RT) release in HIV-1-infected MT4 cells in vitro. RT activity was also measured in a cell-free system by using poly(rA)-oligo(dT) as the primer-template, and cell growth inhibition was measured in noninfected MT4 cells. The interactions of these two- and three-drug combinations were evaluated by the combination index (CI) method and isobologram techniques. The 50% effective concentrations (EC50s) of AZT, PFA, and ddT were 0.014 to 0.005, 9.4 to 8.8, and 8.4 to 2.5 microM, respectively, for p24 enzyme-linked immunosorbent assays (ELISAs) and 0.005 to 0.0034, 1.43 to 1.37, and 2.87 to 2.83 microM, respectively, for RT activity in vitro; for RT activity in the cell-free system, the EC50s were 0.00019 to 0.00024, 0.012 to 0.02, and 0.00074 to 0.0005 microM, for AZT-5'-triphosphate, PFA, and ddT-5'-triphosphate, respectively. AZT in combination with PFA (1:200) or ddT (1:5) as well as the combination of these three drugs (1:200:5) synergistically inhibited HIV-1 replication and RT activity in the cell-free system over a wide range of drug concentrations, with the CIs ranging from 0.5 to 0.09, in which CIs of less than 1, 1, and greater than 1 indicate synergism, additive effect, and antagonism, respectively. Three- and two-drug combinations of AZT, PFA, and ddT showed similar degrees of synergism against HIV-1 replication in p24 assays and RT release assays, whereas the combination of AZT and ddT was found to be the most selective in terms of its anti-HIV-1 effect versus cytotoxicity. Dose reduction indices calculated from both HIV-1 replication inhibition, as measured by p24 ELISA and by RT activity in the cell-free system, indicated that two- and three-drug combinations at high effect levels and the selected combination ratios allow 2- to 240-fold dose reduction over the single drug alone in terms of their anti-HIV-1 effects. The three-drug combination showed the highest dose reduction index. These finding suggest that increased efficacy and reduced toxicity may be achieved in AIDS therapy by using AZT, PFA, and ddT in two- or three-drug combinations.

Antiviral Agents↗
PubMed2000

A systematic evaluation of air cavity dose perturbation in megavoltage x-ray beams.

The EGS4 Monte Carlo radiation transport code was used to systematically study the dose perturbation near planar and cylindrical air cavities in a water medium irradiated by megavoltage x-ray beams. The variables of the problem included x-ray energy, cavity shape and dimension, and depth of the cavity in water. The Monte Carlo code was initially validated against published measurements and its results were found to agree within 2% with the published measurements. The study results indicate that the dose perturbation is strongly dependent on x-ray energy, field size, depth, and size of cavity in water. For example, the Monte Carlo calculations show dose reductions of 42% and 18% at 0.05 and 2 mm, respectively, beyond the air-water interface distal to the radiation source for a 3 cm thick air slab irradiated by a single 5x5 cm2 15 MV beam. The dose reductions are smaller for a parallel-opposed pair of 5x5 cm2 15 MV x-ray beams, being 21% and 11% for the same depths. The combined set of Monte Carlo calculations showed that the dose reduction near an air cavity is greater for: (a) Smaller x-ray field size, (b) higher x-ray energy, (c) larger air-cavity size, and (d) smaller depth in water where the air cavity is situated. A potential clinical application of these results to the treatment of prostate cancer is discussed.

Air↗
PubMed1993

Clinical recognition and management of depression in node negative breast cancer patients treated with tamoxifen.

Depression is not an uncommon complaint of women with breast cancer and is usually assumed to be related to the cancer diagnosis itself or its treatment. As part of a prospective clinical trial of adjuvant therapy of node negative breast cancer, 301 patients treated and assessed by one oncologist (SEJ) were serially questioned for symptoms of depression in the first 6-12 months after completing initial treatment (surgery, radiation therapy, and/or chemotherapy). Two hundred and fifty-seven patients were evaluable for assessment of depression; 155 were receiving tamoxifen and 102 were not. Twenty-six patients had symptoms of depression including 23 (15%) treated with tamoxifen compared to 3 (3%) in the group not placed on tamoxifen (p < 0.005). Of the 23 patients with depression in the tamoxifen group, symptoms were temporally related to the initiation of therapy and occurred generally in the first 2 months of treatment. Eight patients had mild symptoms not requiring a dose reduction, 8 had significant depression requiring a dose reduction to relieve symptoms, and 7 required discontinuation of tamoxifen. We conclude that clinical depression as a side effect of tamoxifen therapy may be more common than previously believed and should be further rigorously investigated to confirm or deny our clinical impressions.

Adult↗
PubMed2001

Radiation dose optimization in coronary angiography and percutaneous coronary intervention (PCI). II. Clinical evaluation.

In a previous part of this study, the fluoroscopy dose rate was reduced in a cardiac catheterization laboratory. The objectives of the present study were to evaluate the effects in a clinical population undergoing percutaneous coronary intervention (PCI) of the dose-reducing measures detailed previously. Kerma area-product (KAP) values were first recorded for 154 patients undergoing PCI. Then, the fluoroscopy KAP rate was reduced from 44 to 16 mGy cm(2)/s by increasing filtration and reducing the image intensifier dose request. After this optimization, KAP was recorded for another 138 PCI procedures. After adjustment for differing proportions of combined procedures (coronary angiography+PCI), the total KAP was reduced to 67% of the original value with a 95% confidence interval from 57 to 78%, statistically significant. The mean total KAP values were 93.6 Gy cm(2) before and 69.1 Gy cm(2) after optimization. The KAP for digital acquisition did not change significantly. It is possible to make a large dose reduction in PCI by reducing the fluoroscopy dose rate. This dose reduction is beneficial for both patients and staff.

Cardiac Catheterization↗
PubMed1982

Phase II trial of 13-cis-retinoic acid in metastatic breast cancer.

Studies have suggested that both natural and synthetic retinoids have extensive chemopreventive activity against a variety of carcinogens in vivo and in vitro. We have previously shown that growth of human breast cancer cells can be inhibited by retinoids, and retinoic acid-binding proteins have been demonstrated in these cell lines and tumor biopsies. We studied the activity of 13-cis-retinoic acid in the treatment of 18 patients with advanced breast cancer refractory to standard cytotoxic and/or endocrine therapy. Patients began on 0.5 mg/kg and escalated to 8 mg/kg over a one-month period unless toxicity (dry skin, dry mucosa, cheilitis, conjunctivitis) forced dose reduction. All these toxicities responded promptly to dose reduction. Four patients exhibited drug related hypercalcemia, 2 complained of severe earache and several had nausea, vomiting and abdominal cramping. There were no objective responses as defined by standard criteria. One patient with thrombocytopenia secondary to documented marrow involvement demonstrated a recovery of platelet count from 9000 to 110,000. 13-cis-Retinoic acid is not of apparent value in women with heavily pretreated breast cancer.

Breast Neoplasms↗
PubMedDate not supplied

Phase II trial of capecitabine and rHu-interferon-alpha-2a in patients with metastatic renal cell carcinoma, limited efficacy, and moderate toxicity.

BACKGROUND: Capecitabine is an orally administered fluoropyrimidine that is converted to 5-fluorouracil by thymidine phosphorylase. In view of the recognized synergism of fluoropyrimidines with interferon-alpha (IFNalpha), a Phase II study to characterize the toxicity and efficacy of the combination of capecitabine and rHuIFNalpha-2a for the treatment of patients with renal cell carcinoma (RCC) was conducted. PATIENTS AND METHODS: Eligible patients had metastatic RCC, measurable disease, and no prior systemic therapy. A total of 32 patients were entered into the study. Histologic subtypes included clear cell (n = 28) and nonclear cell (n = 2). Histology was unknown for 2 patients. The first 14 patients were treated with capecitabine 1,000 mg/m(2) twice daily on days 1-14 and 22-36, combined with IFNalpha-2a 3.0 MU/m(2) subcutaneously 3 times weekly. Because of toxicity requiring dose reductions during the first cycle, the capecitabine dose was reduced to 825 mg/m(2) twice daily on days 1-14 and 22-36 in the subsequent 18 patients. RESULTS: Responses were seen in 4 of 32 patients (12%) (95% confidence interval 4% to 29%), with 1 complete response and 3 partial responses. There were 3 responses that occurred at the higher capecitabine starting dose level. Median response duration was 12 months (range 4.6-15.0). There were 12 patients (38%) who had stable disease for at least 2 cycles (duration 2.9 to 33.6+ months). One-year survival was 63%. Toxicity was moderate to severe and required dose reductions in 88% of patients. There were 23 patients who had grade > or =3 toxicity. CONCLUSION: The combination of capecitabine and IFNalpha-2a has limited activity in metastatic RCC and is associated with moderate-to-severe toxicity.

Adult↗
PubMed2002

Peginterferon-alpha-2a (40kD) and ribavirin in patients with chronic hepatitis C: a phase II open-label study.

BACKGROUND AND AIMS: Addition of a 40kD polyethylene glycol moiety to interferon-alpha-2a [peginterferon-alpha-2a (40kD)] improves pharmacokinetic properties over those of standard interferon. We conducted a phase II study to assess the safety and initial efficacy of peginterferon-alpha-2a (40kD) plus ribavirin combination therapy in patients with chronic hepatitis C (CHC). METHODS: Twenty patients received open-label 180 microg peginterferon-alpha-2a (40kD) subcutaneously once weekly and oral ribavirin 1000 or 1200mg daily for patients weighing <75 or > or =75kg, respectively, for a period of 24 weeks. Patients with hepatitis C virus (HCV) genotype 1 and a virological response at week 24 received study drugs for an additional 24 weeks. RESULTS: A sustained virological response, defined as undetectable HCV RNA 24 (i.e. <100 copies/ml) weeks after completing the therapy, was achieved in 50% of patients in an intent-to-treat analysis (6/16 genotype 1 and 4/4 genotype non-1). Adverse events were similar to those reported with unmodified interferon plus ribavirin combination therapy. Anaemia led to ribavirin dose reduction in five patients. Neutropenia led to dose reduction in three patients treated with peginterferon-alpha-2a (40kD). CONCLUSIONS: The addition of ribavirin to a once-weekly peginterferon-alpha-2a (40kD) regimen should be investigated in larger clinical trials.

Adult↗
PubMed1992

The role of autologous bone marrow transplantation in the treatment of solid tumors.

Until effective new agents can be developed, increasing dose intensity may be the best way to improve therapy for patients who fail conventional treatment. Alkylating agents, including radiation, are likely candidates for use in dose-intensive combinations. Past phase I clinical trials of single agents have redefined the maximum tolerated doses when marrow transplantation attenuates the myelosuppression. High-dose combinations of more than two agents are only possible with significant dose reductions from single-agent maximum tolerated doses. Multiple courses of therapy might permit the use of more than two agents without dose reduction. A multidrug and/or multicourse approach will probably be needed to effect curative therapy.

Antineoplastic Agents↗
PubMed2004

Results of a multicenter randomized phase II trial of thalidomide and prednisone maintenance therapy for multiple myeloma after autologous stem cell transplant.

We report a multicenter, randomized phase II trial conducted to assess the tolerability of combined thalidomide and prednisone maintenance in multiple myeloma. Eligibility required administration of melphalan (200 mg/m2) with blood stem cell support within 1 year of treatment onset and initiation of maintenance within 60 to 100 days after stem cell infusion. All patients received 50 mg of prednisone by mouth on alternate days and thalidomide at a starting dose of either 200 or 400 mg daily by mouth. The primary end point was the incidence of dropout or dose reduction due to treatment toxicity within 6 months. Sixty-seven patients were enrolled. Median follow-up is 36.8 months. The primary end point was reached by 31% of patients on the 200 mg of thalidomide arm and 64% of patients on the 400 mg of thalidomide arm. Allowing for dose reduction, 76% of patients assigned to the 200 mg of thalidomide arm and 41% of patients assigned to the 400 mg of thalidomide arm remained on any maintenance therapy 18 months after registration. Eighty-eight percent of all patients dose-reduced thalidomide and 72% of all patients dose-reduced prednisone within 2 years of beginning maintenance. The median progression-free survival post-transplant is 32.3 months, or 42.2 months from diagnosis. Only the 200 mg of thalidomide arm of this trial met our definition of a tolerable maintenance therapy, defined as no dose reductions or discontinuation due to toxicity in at least 65% of patients for a minimum of 6 months, thus establishing a dosing schedule for phase III trials.

Aged↗
PubMed1983

Radiation shielding in dental radiography.

The protective effect in the thyroid region from different types of radiation shielding at intraoral radiography has been studied as well as the reduction of the absorbed dose to the sternal and the gonadal regions. The shielding tested were the different types of leaded aprons, of which three had an attached leaded collar and the other two were used in combination with separate soft leaded collars. Furthermore one of the soft leaded collars and an unflexible horizontal leaded shield were tested separately. Two dental x-ray machines of 60 and 65 kVp with rectangular and circular tube collimators were used. The exposure times corresponded to speed group E film. The absorbed doses were measured with two ionization chambers. No significant difference in the protective effect in the thyroid gland could be found between the different types of radiation shieldings. There was a dose reduction by approximately a factor of 2 to the thyroid region down to 0.08 mGy per full survey using parallelling technique, and below 0.001 mGy per single bitewing exposure. The shielding reduced the thyroid dose using bisecting-angle technique by a factor of 5 down to 0.15 mGy per full survey (20 exposures). In the sternal region the combinations of apron and collar reduced the absorbed dose from a full survey to below 2 microGy compared with 18 microGy (parallelling) and 31 microGy (bisecting-angle) without any shielding. With the horizontal leaded shield a reduction by a factor of 6 was obtained, but no significant sternal dose reduction could be detected from the soft collar alone. The gonadal dose could be reduced by a factor of 10 with the horizontal leaded shield, parallelling technique and circular collimator. Using leaded aprons the gonadal was approximately one per cent of the dose without any shielding, i.e. below 0.01 microGy per single intraoral exposure.

Humans↗
PubMed2001

Characteristics of sirolimus-associated interstitial pneumonitis in renal transplant patients.

BACKGROUND: Sirolimus, a promising new immunosuppressive drug for organ transplantation, is currently associated with side effects, such as thrombocytopenia and hyperlipidemia. METHODS: Eight renal transplant recipients, who developed unexplained interstitial pneumonitis during sirolimus therapy, were extensively re-screened for all causes of pneumonitis. RESULTS: Interstitial pneumonitis was constantly characterized by bilateral interstitial infiltrates on chest x-rays and lung computed tomography scans, with marked general symptoms in all patients but one. Bronchoalveolar lavage (BAL) disclosed lymphocytic alveolitis (mainly of the CD4 type) in seven patients and alveolar hemorrhage in one. Transbronchial lung biopsies, performed in two patients, showed bronchiolitis obliterans with organizing pneumonia combined with lymphocytic interstitial pneumonitis. Pulmonary infections were ruled out by specific stainings and cultures of BAL, bronchial aspirates, and blood cultures. After the elimination of all possible causes, sirolimus-induced pneumonitis was considered probable. Discontinuation of sirolimus in seven cases and dose reduction in the remaining case dramatically improved clinical and radiological status within a few weeks and led to complete resolution within 3 months. CONCLUSIONS: Sirolimus is very probably responsible for interstitial pneumonitis on the following grounds: (a) occurrence of pneumonitis during sirolimus therapy; (b) absence of any other causes; and (c) resolution within 3 months of sirolimus discontinuation or dose reduction. Sirolimus should now be added to the list of possible causes of pulmonary complications after renal transplantation. Discontinuation or dose reduction of sirolimus led to complete and lasting resolution of symptoms.

Aged↗
PubMed2004

Oral dexamethasone attenuates Doxil-induced palmar-plantar erythrodysesthesias in patients with recurrent gynecologic malignancies.

OBJECTIVE: The aim of this study is to evaluate the effect of oral dexamethasone in attenuating palmar-plantar erythrodysesthesias (PPE) in Doxil-treated patients for gynecologic malignancies. METHODS: An IRB-approved prospective case study was conducted in patients with recurrent gynecologic malignancies who were treated with Doxil (50 mg/m(2)) on a 28-day cycle. Patients experiencing grades II-IV PPE were delayed until resolution then retreated without dose reduction and with a tapering oral dexamethasone regimen (8 mg BID days -1 to 4; 4 mg BID day 5; 4 mg day 6). Standard treatment for grades II-IV PPE in those not receiving dexamethasone was weekly dose delay until resolution of symptoms up to 2 weeks. If resolution occurred within 3 weeks of delay, a 25% dose reduction was made. Persistent grades III/IV PPE resulted in withdrawal of Doxil. RESULTS: Twenty-three patients (ovarian-16, uterine-7) were treated between January 1998 and December 2000. The median number of cycles administered was 5 (range 1-20). Nine patients (39%) developed grades II-IV PPE. All nine patients received more than five cycles of Doxil. The median time to PPE was 3 cycles (range 2-5). Six out of nine PPE patients received scheduled dose dexamethasone. All six had complete or near complete resolution of PPE and all continued treatment without subsequent dose modification. All three of the nine PPE patients not receiving dexamethasone required treatment delays and were dose reduced. CONCLUSION: Oral dexamethasone is effective in attenuating or eliminating Doxil-induced PPE. The use of the dexamethasone regimen prevents treatment delay and dose reduction.

Administration, Oral↗
PubMed1999

Gradual withdrawal of long-term anticholinergic antiparkinson medication in Chinese patients with chronic schizophrenia.

Previous antiparkinson drug withdrawal studies involving white subjects have yielded inconclusive findings, whereas there is a paucity of data concerning Asian patients. A double-blind, placebo-controlled, randomized trial using gradual withdrawal of antiparkinson medication was conducted to evaluate the need for maintenance antiparkinson therapy for clinically stable Chinese patients with chronic schizophrenia. Seventy-five schizophrenic subjects who had received a diagnosis according to DSM-IV who had been ill for at least 5 years and on antipsychotic and antiparkinson medication for a minimum of 2 years entered the study. After baseline assessment, 58 subjects were matched according to age, sex, age at onset, length of illness, dose and length of antipsychotic and antiparkinson medication, and the presence of various extrapyramidal side effects. Randomly assigned dose-reduction and control groups were formed consisting of 29 subjects each. Trihexyphenidyl (THP), the only oral antiparkinson drug used in the study, was reduced by 1 mg every 2 weeks, whereas other psychotropic medication remained unchanged. Monthly assessment was performed using the Brief Psychiatric Rating Scale, Hamilton Rating Scale for Depression, Abnormal Involuntary Movement Scale, Simpson-Angus Scale, Barnes Akathisia Rating Scale, and the Nursing Observation Scale for Inpatient Evaluation-30. Complete withdrawal of THP was possible in 25 (90%) of the 28 subjects who completed the study, whereas considerable dose reduction was achieved in the remaining 3 subjects. There were no significant differences between dose reduction and control groups on any of the rating scales at the completion of the study. Our results suggest that long-term prophylactic administration of antiparkinson medication is unnecessary in the treatment of the majority of Chinese patients with chronic schizophrenia because withdrawal was accomplished without adverse mental or motor effects.

Adult↗
PubMed1995

Feasibility of reducing L-thyroxine dose in patients with a suppressed serum TSH.

A total of 748 patients on L-thyroxine with a suppressed serum TSH were requested to reduce their dose and this was achieved in 601 patients. Thyroxine dosage was reduced by 25 or 50 micrograms of L-thyroxine and patients were reviewed six months later. Of all 601 patients, 54.4% remained with a suppressed serum TSH despite dose reduction and in 5.8% an elevated serum TSH resulted. 25 micrograms reductions and 50 micrograms reductions were equally likely to result in an detectable but non-elevated serum TSH (42.8% vs 34.1% ns) but 25 micrograms reductions were less likely to result in an elevated serum TSH (3.8% vs 10.0% p < 0.01). Only 7/601 patients in the study (1.2%) appeared to require a dose of over 150 micrograms. If dose reduction is thought to be necessary for patients with a suppressed serum TSH, we would recommend 50 micrograms reductions if the original dose is 200 micrograms or more, and 25 micrograms reductions if the original dose is 175 micrograms or less.

Feasibility Studies↗
PubMed1996

125I eye plaque dose distribution including penumbra characteristics.

The two main purposes of this work are (1) to determine the penumbra characteristics for 125I eye plaque and the relative influence of the plaque and eye-air interface on the dose distribution, and (2) to initiate development of a treatment planning algorithm for clinical dose calculations. Dose was measured in a newly designed solid water eye phantom for an 125I (6711) seed at the center of a 20 mm COMS eye plaque using thermoluminescent dosimeter (TLD) "cubes" and "minichips" inside and outside the eye, in the longitudinal and transverse central planes. TLD cubes were used in most locations, except for short distances from the seed and in the penumbra region. In the presence of both the plaque and the eye-air interface, the dose along the central axis was found to be reduced by 10% at 1 cm and up to 20% at 2.5 cm, relative to the bulk homogeneous phantom case. In addition, the overall dose reduction was greater for larger off-axis coordinates at a given depth. The penumbra characteristics due to the lip collimation were quantified, particularly the dependence of penumbra center and width on depth. Only small differences were observed between the profiles in the transverse and longitudinal planes. In the bulk geometry (without the eye-air interface), the dose reduction due to the presence of the plaque alone was found to be 7% at a depth of 2.5 cm. The additional reduction of 13% observed, with the presence of eye-air interface (20% combined), can be attributed to the lack of backscattering from the air in front of the eye. The dose-reduction effect due to the anterior air interface alone became unnoticeable at a depth of 1.1 cm (1.5 cm from the eye-air interface). An analytic fit to measured data was developed for clinical dose calculations for a centrally loaded seed. The central axis values of the dose rates multiplied by distance squared, Dr2, were fitted with a double exponential function of depth. The off-axis profile of Dr2, at a given depth, was parametrized by a modified Fermi-Dirac function to model both the penumbra characteristics due the plaque lip collimation and the effect of oblique filtration by silastic.

Algorithms↗
PubMed2006

Mycophenolate mofetil tolerability and dose changes in tacrolimus-treated renal allograft recipients.

Mycophenolate mofetil (MMF) reduces acute rejection episodes (AREs) and may be associated with better renal graft survival than azathioprine. However, MMF-related adverse events are frequent; dose reduction or even withdrawal are quite common. Between 1999 and 2003, 115 renal transplantation patients were treated with tacrolimus, MMF, and steroids. An observational study was undertaken until graft loss (n = 7), death with a functioning graft (n = 2), or October 31, 2005 (mean follow-up-50 months). We assessed MMF dose reductions due to adverse events with the possible consequences on AREs and graft function. Treated acute ARE occurred in 11.3% of recipients, all of which were steroid-responsive. The median MMF initial daily dose was 1000 mg. In 44 patients (38.3%), the MMF dose was not changed; in 48 (41.7%) it was reduced; and in 23 (20%), withdrawn. The causes for dose modification were diarrhea (n = 33, 28.7% of all patients), leukopenia (n = 22, 19.1%), both of these (n = 7, 6.1%), or other events (n = 9, 7.8%). No AREs were attributed to MMF dose changes. Tacrolimus blood levels were higher at 3 years and serum creatinine values at 4 years among patients with dose changes (8.43 +/- 2.42 vs 7.37 +/- 2.23 ng/mL; P = .051 and 1.75 +/- 0.71 vs 1.48 +/- 0.38 mg/dL; P = .038, respectively). The need for MMF dose reduction or withdrawal was frequent in our patients with diarrhea or leukopenia during treatment with tacrolimus, MMF, and steroids. These adverse event-related changes were not associated with AREs, but produced deleterious effects on long-term graft function.

Creatinine↗
PubMed1995

Rechallenge with lamotrigine after initial rash.

Eight patients rechallenged with lamotrigine after initial exposure which resulted in a skin rash are reported. On reintroduction of the lamotrigine, six of the patients had no recurrence of the rash. Of the other two patients, one had the occurrence of a mild fluctuating and qualitatively different skin rash on rechallenge. The other patient had developed a dose-related rash on initial challenge resulting in a dose reduction. The first attempt to re-increase the dose resulted in reappearance of the rash which again disappeared on dose reduction. However a further attempt to re-increase the dose did not result in reappearance of a rash. It is suggested that patients who experience a rash but good therapeutic response to lamotrigine might be considered for re-dosing.

Adolescent↗
PubMed1999

[Digital flat image detector technique based on cesium iodide and amorphous silicon: experimental studies and initial clinical results].

PURPOSE: Experimental and clinical evaluation of a digital flat-panel X-ray system based on cesium iodide (CsI) and amorphous silicon (a-Si). METHODS: Performance of a prototype detector was compared with conventional screen-film radiography (SFR) using several phantom studies. Foreign bodies, fractures, osteolyses, and pulmonary lesions were analyzed. Additionally, 120 patients were studied prospectively, resulting in 400 comparative X-ray studies. The flat-panel detector was exposed with standard dose and with a dose reduction of up to 75%. Detector size was 15 x 15 cm, pixel matrix was 1 x 1 k with a pixel size of 143 microns. Modulation-transfer function was determined to be 18% at the maximum spatial resolution of 3.5 lp/mm. RESULTS: The diagnostic results achieved with the digital detector were similar to those of conventional SFR, even at reduced radiation exposure. A potential for dose reduction was observed: 50% with respect to osteoarthrosis and fractures, and 75% for determining bony alignment. DISCUSSION: This new technology can be used in thoracic and skeletal radiography. A significant dose reduction is possible, depending on the suspected disease.

Animals↗