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At least 703 records · Page 39Linked to original sources
PubMed2004

Skin permeation of propranolol from polymeric film containing terpene enhancers for transdermal use.

To develop the suitable film formulations of propranolol hydrochloride (PPL) containing enhancers for transdermal use, polymeric film formulations were prepared by employing ethyl cellulose (EC) and polyvinyl pyrrolidone (PVP) as a film former, and dibutyl phthalate (DBP) as a plasticizer. Terpenes such as menthol and cineole, and propylene glycol (PG) were also employed as a chemical enhancer to improve the skin penetration of PPL. The film preparations were characterized in physical properties such as uniformity of drug content, thickness and moisture uptake capacity. Release and skin permeation kinetics of PPL from film preparations were examined in the in vitro studies using a Franz-type diffusion cell. The uniformity of drug content was evidenced by the low S.D. values for each film preparation. The moisture uptake capacity and drug release rate increased with the increase of PVP in each preparation. Enhancers examined in the present study also increased the moisture uptake capacity and release rate of PPL from the film preparations. Increasing the concentration of PPL from 1 to 2 mg/cm2 in the film enhanced the release rate of PPL, while no effect of enhancer concentrations on the release rate from the film preparations was observed. In vitro skin permeation study showed that cineole was the most promising enhancer among the enhancers examined in the present study and suggested that the suitable compositions of film preparation would be EC:PVP:PPL=6:3:4 with 10% (w/w) cineole and 7:2:4 with 10% (w/w) PG and cineole, which provided high skin permeation rates at 93.81+/-11.56 and 54.51+/-0.52 microg/cm2/h, respectively.

Administration, Cutaneous↗
PubMed2006

Effects of incorporated drugs on degradation of novel 2,2'-bis(2-oxazoline) linked poly(lactic acid) films.

Earlier studies have indicated that the degradation rate of poly(lactic acid) (PDLLA) can be modified by using 2,2'-bis(2-oxazoline) as a chain extender in polymer synthesis to form a lactic acid-based poly(ester-amide) (PEA). In the present study, the effect of an incorporated drug on the degradation rate of the PEA was evaluated. The model drugs, neutral guaifenesin, acidic sodium salicylate (pK(a) 3.0) and basic timolol (pK(a) 9.2), were incorporated into solvent cast PDLLA and PEA films. The drug content in the films was 2% (w/w). The degradation studies were carried out in PBS (pH 7.4, 37 degrees C); the resulting decrease in molecular weight of polymers was determined by size exclusion chromatography and the weight loss of films was measured. In addition, the drug release from the films in PBS (pH 7.4, 37 degrees C) was studied. The model drugs were released from the PDLLA and PEA films in a biphasic or triphasic manner. The final fast release phase of the drugs from both PDLLA and PEA films started when the molecular weight (M(n)) of the polymer had decreased close to 15,000 g/mol. The degradation rate of the PDLLA films was clearly enhanced by incorporated sodium salicylate or timolol. Whereas, the degradation rate of the PEA film was not enhanced by the incorporated drugs. The present results indicate that when compared to the PDLLA film, degradation rate of the PEA film in the presence of the drug is more predictable.

Drug Delivery Systems↗
PubMed2006

A novel gel formation method, microstructure and mechanical properties of calcium polysaccharide gel films.

Hydrophilic gels, formed by the interaction of calcium ions with either sodium alginate or potassium pectinate, can be deposited as a wet coating on to the surface of drug loaded pellets. If the coated pellets are dried, they could be dispensed to a patient in a capsule for oral delivery of the active drug. In contact with the aqueous fluids of the gastrointestinal tract, the gel coat will rehydrate, swell and will sustain the release of active drug from the core. In order to facilitate the development and refinement of this novel coated system, it is beneficial to have a method that can produce free gel films in a manner that closely mimics the way the gel coat is formed and deposited on the pellet surface. Traditional film producing methods would involve the spraying or depositing (by evaporation) the gel forming polysaccharide on to an inert surface, drying it and then exposing the dry film to a solution containing calcium ions. Because the film is dry before it is gelled, it is fundamentally different to the wet gel coats that are deposited on to the pellets. We have developed a method to produce wet gel films and have evaluated different manufacturing conditions in order to optimize the quality of the completed gel film. Additionally, we have used these films to assess the effect that the type of polysaccharide and the environmental conditions experienced during rehydration (pH and ionic strength) has on the mechanical properties and the microscopic morphology of the gel. Irrespective of the rehydration medium, the calcium pectinate gel films were softer, weaker and more porous, than the calcium alginate films. Although calcium alginate gels that were rehydrated in 0.1M NaCl were porous, the same films rehydrated in either water, simulated gastric fluid USP (without pepsin) or 0.1M HCl were stronger and much more dense microscopically. Furthermore, of the four different alginates that were evaluated, those with a high content of guluronic acid saccharides were the strongest but most brittle when rehydrated in water.

Alginates↗
PubMed2004

Luminescence quenching of tris(2,2'-bipyridine)ruthenium(II) by 2,6-dimethylphenol and 4-bromo-2,6-dimethylphenol in sol-gel-processed silicate thin films.

The luminescence properties of tris(1,2-bipyridine)ruthenium(II) (Ru(bpy)(3)(2+)), included in different organically modified silicate gel matrixes were investigated. Spin and dip-coated thin films were prepared from methyltrimethoxysilane (MTMOS) and methyltriethoxysilane (MTEOS). A blue shift in the emission spectrum of the MLCT excited state of Ru(bpy)(3)(2+) with respect to the aqueous solution was observed in all the films, practically independent of the reaction pH used to prepare the "sol," silane-derived precursor, and procedure used (dip-coating or spin-coating) to obtain the film. A bimodal distribution of probe sites in the films was obtained from modeling of the emission decays by a double exponential and from application of the exponential series method. The parameters of the decay components depended principally on the thermal treatment used in the processing of the films. The lifetimes decreased with the increase in the drying temperature of the films; at the same time, the emission spectra showed a red shift and the luminescence efficiency decreased. A luminescence quenching of the ruthenium complex in the films by 4-bromo-2,6-dimethylphenol and 2,6-dimethylphenol in aerated aqueous solution at pH 12 in contact with the film was also observed. The quenching plots obtained from luminescence intensities or luminescence intensity decay measurements showed a downward curvature. These plots could be fitted satisfactorily by a sum of two Stern-Volmer terms with quenching constants K(SV1) and K(SV2) associated with two different binding sites of the ruthenium complex. This result is indicative of the matrix microheterogeneity in the films and is fully consistent with the biexponential nature of the luminescence intensity decay profiles. The Stern-Volmer parameter values for both sites in the films suggest that only a low percentage of the probe is accessible to the quencher and its respective constant K(SV1) is lower than in water.

2,2'-Dipyridyl↗
PubMed2004

Motion of foam films in diverging-converging channels.

Existing theories of the motion of foam films in capillaries often assimilate the pressure drop over the foam films to the static capillary pressure obtained from the Young-Laplace equation. Hence, they ignore the contribution of dynamic effects associated with the rapid stretching and contraction of the foam films to the overall viscous dissipation. This paper reports an investigation of the motion of foam films in axisymmetric diverging-converging channels, taking into account surface viscosity and elasticity. First, a phenomenological theory for the motion of the foam films is developed using simple physical arguments. We show that the displacement of the film obeys a nonlinear second-order differential equation, which can be solved numerically for the (dimensionless) distance from the inlet and the pressure drop as a function of time. Experiments with foam film motion, conducted using glass diverging-converging channels (minimum radius = 3.00 +/- 0,01 mm, maximum diameter = 7,98 +/- 0,01 mm) and nitrogen foam stabilized with sodium dodecyl sulfate (SDS) in brine, are discussed. For a single film motion in the diverging channel, we find that (a) the static pressure drop is a concave-upward function of distance and decreases from 1.0 to about 0.3, whereas (b) the dynamic pressure drop is concave downward and increases from 1 to a maximum of 1.3 and then decreases to 0.7. In the converging channel both the static and dynamic pressure drops are concave-downward functions, but the dynamic pressure drop values are always higher than the static ones. For two films the motions were found to be rather sensitive to the initial arrangement in the channel. The experiments are found to be in excellent agreement with the theoretical predictions. These observations imply that the large flow resistance obtained during foam flow in granular porous media, where converging-diverging channels are abundant, is largely due to the surface elasticity and viscosity of the films.

Journal Article↗
PubMed2004

Phase diagrams of nonionic foam films: construction by means of disjoining pressure versus thickness curves.

The thickness h of foam films can be measured as a function of the disjoining pressure Pi using a thin film pressure balance. Experimental Pi-h curves of foam films stabilized with nonionic surfactants measured at various concentrations resemble the p-V(m) isotherms of real gases measured at various temperatures (p is the pressure and V(m) is the molar volume of the gas). This observation led us to adopt the van der Waals approach for describing real gases to thin foam films, where the thickness h takes the role of V(m) and the disjoining pressure Pi replaces the ordinary pressure p. Our analysis results in a phase diagram for a thin foam film with spinodal, binodal as well as a critical point. The thicker common black film corresponds to the gas phase and the compact Newton black film for which the two surfaces are in direct contact corresponds to the dense liquid. We show that the tuning parameter for the phase behavior of the film is the surface charge density, which means that Pi-h curves should not be referred to as isotherms. In addition to the equilibrium properties the driving force for the phase transition from a common black film to a Newton black film or vice versa is calculated. We discuss how this transition can be controlled experimentally.

Journal Article↗
PubMed2005

Spectroscopic and optical characterization of porphyrin chromophores incorporated into ultrathin polyimide films.

Polyamic acid (PAA) containing free-base porphyrin and zinc(II) porphyrin chromophores was synthesized by copolymerization of diphenylether-type tetracarboxylic dianhydride and diamines. The monolayer of the alkylamine salts of PAA (PAASs) at the air/water interface was deposited on solid substrates by the Langmuir-Blodgett (LB) technique. The PAAS LB films thus obtained were converted to polyimide (PI) LB films by chemical treatment. The fluorescence of porphyrin moieties in the PI LB film was observed, because of the weak electron-accepting properties of the diphenylether unit. Therefore, the photophysically important processes, such as photoinduced electron transfer, excitation energy transfer, and excitation energy migration could be investigated in relation to the layered nanostructures of the ultrathin PI films. The fluorescence spectrum suggested that the aggregation of porphyrin moieties in the PI LB films was effectively prevented by the use of polymeric films. The surface plasmon (SP) measurement showed that the thickness of the monolayers was 0.9-1.0 nm for PAAS films and 0.32-0.40 nm on average for PI LB films. The absorption dichroism of the Soret band of porphyrin indicated that porphyrin moieties in the PAAS and PI LB films are oriented in parallel with the substrate. These results showed that the orientation and the spatial distribution of porphyrin units can be efficiently regulated in the PI LB films in a nanometer dimension.

Journal Article↗
PubMed2005

Foams and foam films stabilized by CnTAB: influence of the chain length and of impurities.

Quantitative comparison of foam films and the corresponding foams is very demanding. One problem is the fact that investigations of foam films are usually performed at constant capillary pressures P, whereas in foams P is a function of the height of the foam column. A way out of this dilemma is to examine films and foams at the same P. The method of choice for the foam films is the thin film pressure balance (TFPB), whereas the corresponding investigation of foams is based on the foam pressure drop technique (FPDT). An extensive TFPB study on foam films stabilized by the cationic alkyltrimethylammonium bromides C(n)TAB with n=10, 12, 14, and 16 was performed by Bergeron. For this series a steep increase of the foam film stability was observed when the chain length was increased from n=12 to n=14. Moreover, the influence of impurities was found to be limited to the films stabilized by C(12)TAB. In order to study the correlation between the properties of films and foams, the present study deals with the respective foam properties investigated with the FPDT. It was found that both the steep increase in the film stability and the influence of impurities are also reflected in the properties of the foam.

Journal Article↗
PubMed2005

Rupture of thin stagnant films on a solid surface due to random thermal and mechanical perturbations.

A generalized formalism for the rupture of a nondraining thin film on a solid support due to imposed random thermal and mechanical perturbations, modeled as a Gaussian white noise, is presented. The evolution of amplitude of perturbation is described by a stochastic differential equation. The average film rupture time is the average time for the amplitude of perturbation to equal to the film thickness and is calculated by employing a first passage time analysis for different amplitudes of imposed perturbations, wavenumbers, film thickness, van der Waals and electrostatic interactions and surface tensions. The results indicate the existence of an optimum wavenumber at which the rupture time is minimum. A critical film thickness is identified based on the sign of the disjoining pressure gradient, below which the film is unstable in that the rupture time is very small. The calculated values of rupture time as well as the optimum wavenumber in the present analysis agree well with the results of linear stability analysis for immobile as well as completely mobile gas-liquid film interfaces. For stable films, the rupture time is found to increase dramatically with film thickness near the critical film thickness. As expected, the average rupture time was found to be higher for smaller amplitudes of imposed perturbations, larger surface potentials, larger surface tensions and smaller Hamaker constants.

Algorithms↗
PubMed2005

Facile formation of water-insoluble cyclodextrin/Nafion composite films on solid surfaces.

The water-insoluble poly-beta-cyclodextrin (poly-CD)/Nafion composite film was easily prepared by casting a mixed solution of poly-CD and Nafion onto substrate plates. FT-IR measurements showed that the 50/50 wt% poly-CD/Nafion composite film remained stable on the glass and quartz substrates after immersion in water for more than 3 h, while a pure poly-CD film was almost completely dissolved by immersion within 1 h. The film stability was also evaluated from the amount of p-nitrophenol (p-NP) inclusion in the film, which was determined from the decrease in UV-vis absorbance of the p-NP solution into which the film was immersed. The composition dependence of the inclusion amount showed that the film was stable up to 50 wt% CD, but became less stable with further increase in the CD concentration in the film. From the isotherms for the inclusion of p-NP and 1-naphthoate (1-Naph) into the film, the inclusion (stability) constants were determined to be 3.7x10(3) M(-1) and 1.9x10(2) M(-1), respectively. These results show that the selective inclusion of CD is retained after preparation of the composite film.

Journal Article↗
PubMed2006

Thinning of drying latex films due to surfactant.

Lateral non-uniformities in surfactant distribution in drying latex films induce surface tension gradients at the film surface and lead to film thinning through surfactant spreading. Here we investigate the influence of the surfactant driven to the air-water interface, during the early stages of latex film drying, on the film thinning process which could possibly lead to film rupture. A film height evolution equation is coupled with conservation equations for particles and surfactant, within the lubrication approximation, and solved numerically, to obtain the film height, particle volume fraction, and surfactant concentration profiles. Parametric analysis identifies the effect of drying rate, dispersion viscosity and initial particle volume fraction on film thinning and reveals the conditions under which films could rupture. The results from surface profilometry conform qualitatively to the model predictions.

Journal Article↗
PubMed2004

Sequential changes of lipid tear film after the instillation of a single drop of a new emulsion eye drop in dry eye patients.

PURPOSE: The lipid tear film stabilizes the tears by lowering the surface tension and preventing aqueous tear evaporation and may be analyzed by kinetic analysis of the tear interference images. This study investigated changes in the lipid film after application of a new emulsion-based eye drop of Refresh Endura (Allergan, Irvine, CA) in normal subjects and patients with dry eyes. DESIGN: Comparative, nonrandomized interventional study. PARTICIPANTS: Five normal subjects and 10 aqueous tear deficiency (ATD) patients with or without lipid tear deficiency were enrolled prospectively. METHODS: A complete eye examination was performed, including symptom score, tear break-up time, dye staining, and fluorescein clearance test. One eye received a single dose of emulsion eye drop (EED), whereas the other eye received nonpreserved saline as a control. Kinetic analysis of tear interference images taken by DR-1 (Kowa, Japan) was performed before and at various times after instillation of the drops. MAIN OUTCOME MEASURES: Symptoms, pattern, thickness, and spread time of the tear film. RESULTS: Compared with the control, all eyes receiving EED showed rapid restructuring of the preexisting lipid film. In normal persons, restructuring resulted in a thick lipid band across the cornea and a significant increase of the lipid film thickness. For ATD patients, EED application resulted in either a scant, irregular tear film, which became covered by the lipid film, or a modified lipid film changed without forming a band or irregularities. Emulsion eye drops tended to be more comfortable in patients with more severe ATD. Kinetic analysis showed that the mean spread time improved for all patients after EED when compared with baseline or with controls (P<0.05). CONCLUSIONS: Emulsion eye drop produces significant changes in the tear film of normal and dry eye patients. Further investigation with a prolonged period of treatment is warranted to establish whether EED may help improve the spread and thickness of the lipid tear film in moderate and severe dry eyes.

Adult↗
PubMed2002

Electrochemistry and electrocatalysis with heme proteins in chitosan biopolymer films.

Protein-chitosan (CS) films were made by casting a solution of proteins and CS on pyrolytic graphite electrodes. Myoglobin (Mb), hemoglobin (Hb), and horseradish peroxidase (HRP) incorporated in CS films gave a pair of stable, well-defined, and quasi-reversible cyclic voltammetric peaks at about -0.33V vs saturated calomel electrode in pH 7 buffers, respectively, while catalase (Ct) in CS films showed a peak pair at about -0.46V which was not stable. All these peaks are located at the potentials characteristic of heme Fe(III)/Fe(II) redox couples of the proteins. The electrochemical parameters such as formal potentials (E degrees (')) and apparent heterogeneous electron-transfer rate constants (k(s)) were estimated by square-wave voltammetry with nonlinear regression analysis. Chitosan films contained considerable water and formed hydrogel in aqueous solution. Positions of the Soret absorbance band suggest that Mb and Hb in CS films keep their secondary structure similar to the native states in the medium pH range, while HRP and Ct retain their native conformation at least in the dry CS films. Scanning electron microscopy of the films demonstrated that interaction between the proteins and CS would make the morphology of dry protein-CS films very different from the CS films alone. Oxygen, trichloroacetic acid, nitrite, and hydrogen peroxide were catalytically reduced by all four proteins in CS films.

Animals↗
PubMed2000

Palmitoylation of a pulmonary surfactant protein C analogue affects the surface associated lipid reservoir and film stability.

Surfactant protein C (SP-C) is a lipopeptide that contains two thioester-linked palmitoyl groups and is considered to be important for formation of the alveolar surface active lipid film. Here, a non- or dipalmitoylated SP-C analogue (SP-C(Leu)), in which all helical Val residues were replaced with Leu and Cys-5 and Cys-6 were replaced with Ser, was tested for surface activity in a captive bubble system (CBS). SP-C(Leu), either palmitoylated at Ser-5 and Ser-6 or non-palmitoylated, was added to mixtures of 1, 2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC)/phosphatidyl glycerol (PG)/palmitic acid (PA), 68:22:9, (by mass) at a concentration of 2 and 5%. With 2% peptide, surface film formation was rapid, reaching a surface tension below 25 mN/m within 5 s, but the samples with 5% SP-C(Leu) required more than 20 s to reach values below 25 mN/m. Minimum surface tension for the samples with dipalmitoylated SP-C(Leu) was below 1.5 mN/m and very stable, as the surface tension increased by less than 0.5 mN/m within 10 min at constant bubble volume. Minimum surface tension for the non-palmitoylated SP-C(Leu) was approximately 2 and 5 mN/m for 2 and 5% peptide, respectively, but the films were less stable as seen by frequent bubble clicking at low surface tensions. Films with dipalmitoylated SP-C(Leu) that were dynamically cycled at 20-30 cycles/min were substantially less compressible at a surface tension of 20 mN/m (0.007 m/mN) than those that contained the non-palmitoylated peptide (0.02 m/mN). After subphase depletion, the incorporation of lipids into the surface active film during initial bubble expansion occurred at a relatively low surface tension (about 35 mN/m) for the samples with dipalmitoylated SP-C(Leu) compared to approximately 45 mN/m for those containing the non-palmitoylated peptide. Furthermore, for samples that contained non-palmitoylated SP-C(Leu), the ability to reach near zero stable surface tension was lost after a few adsorption steps, whereas with the dipalmitoylated peptide the film quality did not deteriorate even after more than 10 expansion steps and the incorporation of reservoir material equivalent to more than two monolayers. It appears that the covalently linked palmitoyl groups of the SP-C analogue studied are important for the mechanical stability of the lipid film, for the capacity to incorporate material from the reservoir into the surface active film upon area expansion, and for the low film compressibility of dynamically cycled films.

1,2-Dipalmitoylphosphatidylcholine↗
PubMed2000

The role of surfactant proteins in DPPC enrichment of surface films.

A pressure-driven captive bubble surfactometer was used to determine the role of surfactant proteins in refinement of the surface film. The advantage of this apparatus is that surface films can be spread at the interface of an air bubble with a different lipid/protein composition than the subphase vesicles. Using different combinations of subphase vesicles and spread surface films a clear correlation between dipalmitoylphosphatidylcholine (DPPC) content and minimum surface tension was observed. Spread phospholipid films containing 50% DPPC over a subphase containing 50% DPPC vesicles did not form stable surface films with a low minimum surface tension. Addition of surfactant protein B (SP-B) to the surface film led to a progressive decrease in minimum surface tension toward 1 mN/m upon cycling, indicating an enrichment in DPPC. Surfactant protein C (SP-C) had no such detectable refining effect on the film. Surfactant protein A (SP-A) had a positive effect on refinement when it was present in the subphase. However, this effect was only observed when SP-A was combined with SP-B and incubated with subphase vesicles before addition to the air bubble containing sample chamber. Comparison of spread films with adsorbed films indicated that refinement induced by SP-B occurs by selective removal of non-DPPC lipids upon cycling. SP-A, combined with SP-B, induces a selective adsorption of DPPC from subphase vesicles into the surface film. This is achieved by formation of large lipid structures which might resemble tubular myelin.

1,2-Dipalmitoylphosphatidylcholine↗
PubMed2001

Release of PEGylated granulocyte-macrophage colony-stimulating factor from chitosan/glycerol films.

We have prepared a new formulation for mucosal delivery of GM-CSF or PEGylated GM-CSF based on a chitosan carrier plus added glycerol to control the rate of release of the protein. Thin dry films comprised of various weight ratios of chitosan to glycerol and containing either granulocyte-macrophage colony-stimulating factor (GM-CSF) or PEGylated GM-CSF, PEG-(GM-CSF), were prepared. The amount of GM-CSF or PEG-(GM-CSF) released from the chitosan/glycerol films was determined using size exclusion high performance liquid chromatography (HPLC-SEC). The amount of PEG-(GM-CSF) released from the films decreased with an increase in the amount of glycerol present in the film. In parallel with this, films with higher glycerol content exhibited a lower degree of equilibrium swelling when immersed in release media. pH measurements of the release media and analysis of the dried films by Fourier-transform infrared spectroscopy (FTIR) suggested that the amount of residual acetic acid in the dry films decreased as the glycerol content increased. This indicates that glycerol may act by displacing and releasing bound acetic acid from the chitosan molecules, resulting in chitosan--glycerol hydrogen bond formation as the film dries. Further, it was found that the release rate and the amount of PEG-(GM-CSF) released decreased with increasing molecular weight of the conjugated PEG. This effect was not observed with films containing physical mixtures of PEG and GM-CSF. The decrease in the fraction of PEG-(GM-CSF) released with increasing PEG molecular weight is believed to be due to the increased steric hindrance of the PEGylated protein molecule during its diffusion out of the swollen chitosan/glycerol film.

Biocompatible Materials↗
PubMed1984

Aortic injury: comparison of supine and upright portable chest films to evaluate the widened mediastinum.

Despite many reports of radiologic findings that may be suggestive of aortic injury, most authors believe the recognition of a widened mediastinum on chest film remains the sine qua non. Few studies have confirmed the widely held belief that the supine AP chest film is inaccurate in assessing the width of the mediastinal structures, and that one should use only the upright or sitting chest films. This study was undertaken to assess the accuracy of both upright and supine chest films in the evaluation of mediastinal widening after blunt deceleration chest injury. Both supine and upright sitting chest films were obtained immediately on arrival in the resuscitation areas for 55 patients. Twenty-one (38%) exhibited a mediastinum that appeared wide on supine view but within normal limits on the upright view, as attested by two radiologists. Aortography was not performed on any of these patients. Daily upright chest films, repeated until discharge, failed to demonstrate any change in mediastinal anatomy, and all patients recovered without incident. Twelve patients' films (22%) demonstrated widened mediastinum on both views, and these 12 patients underwent immediate aortography. Aortic rupture was revealed in four (33%). This study clarifies the diagnostic value of the upright chest film in assessing the mediastinum after blunt injury. It confirms the belief that supine films are not accurate, and that they may lead to numerous false positives and unnecessary aortograms. The initial upright or sitting chest film is accurate, and its use is cost-effective and time-saving for patient and physician.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta↗
PubMed1999

Subjectivity in interpretation of portal films.

PURPOSE: We have measured the variability in identifying geometric errors and the variability in clinical decision making when using portal films. METHODS AND MATERIALS: Eight observers (four radiation oncologists and four radiation therapists) viewed 40 film pairs from 40 different patients. All films, which were acquired using conventional simulator and portal film cassettes, were selected retrospectively from a large clinical database. The observers compared the simulator and portal films under standard conditions, identified the field placement errors, and decided whether adjustments in treatment were required. In addition, all films were digitized and the field placement errors were measured objectively using image registration software. RESULTS: There was much variability in identifying field placement errors and even more variability in the number of recommended adjustments. The field placement errors identified by the different observers differed by up to 50 mm for the same film pair. The number of adjustments of treatment or block position recommended by the observers also varied between 8 and 25 for the same set of films. The average field placement error, before correction, for AP lung, AP pelvis, and lateral pelvis films was 5.7 mm, 6.3 mm, and 8.9 mm, while the average error after correction (i.e., correcting all errors identified by the observers) was 5.5 mm, 4.9 mm, and 5.7 mm, respectively. Thus, for lateral pelvis films, where the initial errors were larger, the observers were able to make an improvement in patient setup. CONCLUSIONS: The results suggest that human observers have difficulty identifying field placement errors accurately when the errors are around 5 mm or smaller. Although there is some evidence that experience influenced the performance of the observers, the effect of experience is not large. In routine clinical environments, the use of visual inspection will detect large field placement errors. However, tools other than visual inspection will be required if field placement errors 5 mm or smaller are to be identified accurately.

Decision Making↗