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High sensitivity radiochromic film dose comparisons.

This short note investigates the dose characteristics of a relatively new high sensitivity radiochromic film (Gafchromic HS) and compares dose and energy response to various Gafchromic film types and radiographic (EDR-2) film. The original MD-55-1 and two improved sensitivity films, MD-55-2 and HS film, were investigated for energy and dose response. Results show that the energy response of the new HS film is relatively the same as the original MD-55-1 and MD-55-2 films with a decrease in sensitivity at lower x-ray energies, with response decreasing down to approximately 0.64 (normalized to 1 for a 6 MV beam) for a 28 keV effective energy beam. This is compared to an over response of 9.2 at the same energy for EDR-2 film. The dose response at the maximum absorption peak was found to be approximately 3.8 and 1.9 times more sensitive than MD-55-1 and MD-55-2 films, respectively. At the absorption peak yielding the maximum optical density change, HS was found to be approximately 0.2 to 0.25 times the sensitivity of EDR-2.

Dose-Response Relationship, Radiation↗

Rounded end multi-leaf penumbral measurements with radiochromic film.

Multi-leaf penumbral doses have been investigated for 6 MV x-rays and a Varian millennium multi-leaf collimator (MLC) using Gafchromic MD-55-2, radiochromic film and X-omat V radiographic film. An advantage of Gafchromic film for multi-leaf penumbral dose measurement is the relatively low energy dependence of the film. A comparison of penumbral dose measurements has also ascertained the effects of energy response on radiographic film in this region. Similar 80%/20% penumbral doses have been measured with both types of films. Thus there is a relatively low energy effect on penumbral dose measurements in film dosimetry. The 80%/20% dose penumbral distances for rounded leaf end multi-leafs for a 10 cm x 10 cm field at Dmax were found to be 4.6 mm and 4.3 mm for radiochromic and radiographic film respectively. This is compared to 2.6 mm and 2.6 mm for the leaf edge penumbra. Radiochromic film also measured leaf end/interleaf leakage doses in the penumbral region, which was shown to produce approximately 4% of maximum dose wave across the penumbral region with maximum doses delivered at the MLC leaf interfaces.

Equipment Failure Analysis↗

Dosimetry of ultrasoft x-rays (1.5 keV Al(Kalpha)) using radiochromatic films and colour scanners.

This work explores the possibility of measuring the absorbed dose of ultrasoft x-rays (USX, 1.5 keV Al(Kalpha)) with GAFCHROMIC HD-810 radiochromatic dosimetry films (HD-810 films) and colour scanners. HD-810 films were exposed to USX, soft x-rays (14.8 keV) and gamma-rays (60Co) for various times. The response of HD-810 films to absorbed doses of gamma-rays in water was calibrated with Fricke dosimetry and used for the calibration of USX. The optical density of the HD-810 films was quantified with an HP ScanJet 6100C scanner and Corel Picture Paint 7. The choice of the reading channel and colour adjustment settings were optimized to either improve sensitivity or expand the measurable dose range. The response of the HD-810 films to the absorbed dose in water decreased by 50% when the effective photon energy decreased from 1.25 MeV to 14.8 keV. The ratio of the mass energy absorption coefficient of the active layer of HD-810 films to that of water was found to play a major role in this decrease. The mean absorbed doses of the active layer of the HD-810 films exposed to USX were derived. The calculation of the initial photon fluence rate and the mean absorbed doses of USX to biological samples such as plasmid DNA is discussed. This study suggests that radiochromatic dosimetry films are promising secondary dosimeters for measuring the absorbed dose of USX.

Color↗

Absorption spectra variations of EBT radiochromic film from radiation exposure.

Gafchromic EBT radiochromic film is one of the newest radiation-induced auto-developing x-ray analysis films available for therapeutic radiation dosimetry in radiotherapy applications. The spectral absorption properties in the visible wavelengths have been investigated and results show two main peaks in absorption located at 636 nm and 585 nm. These absorption peaks are different to many other radiochromic film products such as Gafchromic MD-55 and HS film where two peaks were located at 676 nm and 617 nm respectively. The general shape of the absorption spectra is similar to older designs. A much higher sensitivity is found at high-energy x-rays with an average 0.6 OD per Gy variation in OD seen within the first Gy measured at 636 nm using 6 MV x-rays. This is compared to approximately 0.09 OD units for the first Gy at the 676 nm absorption peak for HS film at 6 MV x-ray energy. The film's blue colour is visually different from older varieties of Gafchromic film with a higher intensity of mid-range blue within the film. The film provides adequate relative absorbed dose measurement for clinical radiotherapy x-ray assessment in the 1-2 Gy dose range which with further investigation may be useful for fractionated radiotherapy dose assessment.

Dose-Response Relationship, Radiation↗

XR type-R radiochromic film x-ray energy response.

Gafchromic XR type-R radiochromic film is a relatively new product designed for use at clinical diagnostic x-ray energies both qualitatively and quantitatively. This short note investigates the energy response characteristics of this high-sensitivity radiochromic film for both diagnostic and therapeutic x-ray energies. Results are also compared to conventional silver halide x-ray film for energy response. Results show that the energy response of the new XR type-R film is minimal over the 75-125 kVp range (9% variation with +/-3% error in measurement to 1 SD). This is compared to a 27% variation for X-Omat V radiographic film for the same energy range. XR type-R film does, however, produce a larger energy response variation when compared over a larger therapeutic x-ray range (50 kVp superficial to 10 MV megavoltage) with a relative response of 10.4 at 125 kVp compared to 1 at 6 MV. This is significantly different to MD-55-2 and HS Gafchromic film which has a lower energy response at lower energies. XR type-R film is ideal for a quantitative dosimeter in the low energy range due to its relative energy independence and high sensitivity compared to conventional radiochromic film.

Dose-Response Relationship, Radiation↗

Comparison of light and x-ray sensitometric responses of double-emulsion films for different processing conditions.

The effects of different film processing conditions on light and x-ray sensitometric responses were compared for a variety of double-emulsion x-ray films. The processing conditions were altered by changes of the developer temperature. Three different exposure variants were applied: x-ray sensitometry using two stepped neutral density attenuators between film and screens, simultaneous double-sided light sensitometry, and single-sided light sensitometry. 13 different types of double-emulsion x-ray films were investigated, among them three asymmetric films. In the special case of exposing the asymmetric films with the single-sided light sensitometer, a method was investigated where each side of the film is exposed at different locations and the sum effect is analyzed. From each sensitometric curve shape two parameters, the logarithmic speed (logS) and the average gradient (G), were evaluated. The results of this study can be summarized as follows: (1) Single-sided and double-sided light sensitometers revealed almost equal changes of logS when the processing conditions are altered. Thus, single-sided light sensitometers can serve as a substitute for double-sided light sensitometers provided that suited exposure methods are used and appropriate sensitometric parameters are evaluated. (2) Light sensitometry quantitatively indicated changes of the film processing that affect the x-ray speed. Hence, light sensitometry is a useful method to monitor changes in film processing.

Biophysical Phenomena↗

EDR2 film dosimetry for IMRT verification using low-energy photon filters.

Recently the EDR2 (extended dose range) film has been introduced commercially for applications in radiation therapy dosimetry. In addition to characterizing the wide dynamic range, several authors have reported a reduced energy dependence of this film compared to that of X-Omatic Verification (XV) films for megavoltage photon beams. However, those investigations were performed under limited geometrical conditions. We have investigated the dosimetric performance of EDR2 film for the verification of IMRT fields at more clinically relevant conditions by comparing the film doses with the doses measured with an ion chamber and XV films. The effects of using a low energy scattered photon filter on EDR2 film dosimetry was also studied. In contrast to previous reports our results show that EDR2 film still exhibits considerable energy dependence (a maximum discrepancy of 9%, compared with an ion chamber) at clinically relevant conditions (10 cm depth for IMRT fields). However, by using the low-energy filters the discrepancy is reduced to within 3%. Therefore, EDR2 film, in combination with the filters, is found to be a promising two-dimensional dosimeter for verification of IMRT treatment fields.

Equipment Failure Analysis↗

Dosimetric properties of improved GafChromic films for seven different digitizers.

Two recently introduced GafChromic film models, HS and XR-T, have been developed as more sensitive and uniform alternatives to GafChromic MD-55-2 film. The HS model has been specifically designed for measurement of absorbed dose in high-energy photon beams (above 1 MeV), while the XR-T model has been introduced for dose measurements of low energy (0.1 MeV) photons. The goal of this study is to compare the sensitometric curves and estimated dosimetric uncertainties associated with seven different GafChromic film dosimetry systems for the two new film models. The densitometers tested are: LKB Pharmacia UltroScan XL, Molecular Dynamics Personal Densitometer, Nuclear Associates Radiochromic Densitometer Model 37-443, Photoelectron Corporation CMR-604, Laser Pro 16, Vidar VXR-16, and AGFA Arcus II document scanner. Pieces of film were exposed to different doses in a dose range from 0.5 to 50 Gy using 6 MV photon beam. Functional forms for dose vs net optical density have been determined for each of the GafChromic film-dosimetry systems used in this comparison. Two sources of uncertainties in dose measurements, governed by the experimental measurement and calibration curve fit procedure, have been compared for the densitometers used. Among the densitometers tested, it is found that for the HS film type the uncertainty caused by the experimental measurement varies from 1% to 3% while the calibration fit uncertainty ranges from 2% to 4% for doses above 5 Gy. Corresponding uncertainties for XR-T film model are somewhat higher and range from 1% to 5% for experimental and from 2% to 7% for the fit uncertainty estimates. Notwithstanding the significant variations in sensitivity, the studied densitometers exhibit very similar precision for GafChromic film based dose measurements above 5 Gy.

Equipment Failure Analysis↗

Problems associated with simulated light sensitometry for low-crossover medical x-ray films.

Over the past ten years the evolution of medical x-ray films has been toward films with reduced intensifying-screen light crossover in order to reduce blur and obtain higher spatial resolution. For films with very low crossover, misleading and incorrect sensitometric data may be obtained for film contrast evaluation and processor control if a simulated light sensitometer with a single-sided, light-exposing device is used. Screen light exposures were made using an inverse square, intensity-scale sensitometer. Simulated light exposures were made using a widely used single-sided, simulated-light sensitometer commonly used for film processor quality control, and a new simulated-light sensitometer capable of producing either single- or double-sided sensitometric exposures. The films used included one single-emulsion film and three double-emulsion medical x-ray films with light-crossover values ranging from approximately 3% to 30%. Sensitometric data showed a significant distortion (bump) in the characteristic curve for the 3% light-crossover film exposed with the single-sided, simulated-light sensitometer.

Light↗

Method of simulated screen sensitometry for asymmetric, low crossover medical x-ray films.

Recognition of the importance of performing simulated screen-light sensitometry of medical x-ray films for the purpose of processor quality control has increased over the past several years. As a result there is a greater need to provide new techniques for performing simulated screen-light sensitometry. Medical films with reduced intensifying screen-light crossover intended to achieve reduced blur and higher spatial resolution pose particular problems in doing simulated screen-light sensitometry if care is not taken to choose a proper simulated light sensitometer with the capability of simultaneous double-sided exposures. Misleading and incorrect sensitometric data can be obtained for film contrast evaluation if a single side exposure is used. Asymmetric, near-zero crossover films pose even greater problems as proper orientation of the film and proper degree of light output asymmetry need be achieved in order to obtain correct sensitometry. The films used in this study were three double emulsion films varying in crossover from 3% to 24%. Of the two very-low-crossover films, one had symmetric emulsion layers while the second featured emulsion layers which were asymmetric in terms of contrast and speed. Sensitometric data show several curve shapes with significant distortions, depending on orientation, for the asymmetric, low-crossover film when exposed using a single-sided exposure. Only by using a double-sided exposure and an appropriate neutral density filter to simulate the degree of screen-light asymmetry in this system could one achieve a characteristic curve comparable to that achieved by inverse square sensitometry.

Biophysical Phenomena↗

Evaluation of an asymmetric screen-film system for chest radiography.

To evaluate the potential utility of an asymmetric screen-film system for chest radiography, its image quality and detail visibility compared with a conventional screen-film system are investigated. The basic imaging properties were evaluated by measuring Hurter and Driffield curves, resolution properties, and noise Wiener spectra. The visibility of simulated anatomical and pathological details in radiographs of a chest phantom and normal anatomy in chest radiographs of patients were evaluated subjectively. The dynamic range of each system is comparable, though the asymmetric screen-film system can provide an advantage over the conventional system due to a relative dose reduction of approximately 35% and higher resolution properties at high optical densities. The noise level of the asymmetric screen-film system is slightly greater at low optical densities and much greater at high optical densities. However, the visibility of lung details with the asymmetric screen-film system is slightly superior to the conventional screen-film system despite the increase in noise. Mediastinal and retrodiaphragmatic details are similar, though marginally superior with the asymmetric screen-film system. It is concluded that the asymmetric screen-film system provided slightly superior image quality to the conventional screen-film system for chest radiography, provided the average lung density is maintained at a higher level than is customary with conventional systems.

Biophysical Phenomena↗

A new approach to film dosimetry for high energy photon beams: lateral scatter filtering.

A method of film dosimetry for high energy photon beams is proposed which reduces the required film calibration exposures to a set of films obtained for a small radiation field size and shallow depth (6 cm x 6 cm at 5 cm depth). It involves modification of a compression type polystyrene film phantom to include thin lead foils parallel to the vertical film plane at approximately 1 cm from both sides of the film emulsion. The foils act as high atomic number filters which remove low energy Compton scatter photons that otherwise would cause the film sensitivity to change with field size and depth. The proposed method is best described as "lateral scatter filtering." To validate the proposed method, central axis depth doses and isodose curves for a 4 MV photon beam were determined from films exposed within the modified phantom and the results compared with ionization chamber measurements. When no lateral filtering was used, for field sizes of 6 cm x 6 cm and 25 cm x 25 cm, this comparison demonstrated up to a 65% difference between film and ionization chamber central axis depth dose measurements. When using the lateral scatter filtering technique, less than a 4% difference was observed for these field sizes.

Evaluation Studies as Topic↗

Mammography film processor replenishment rate: bromide level monitoring.

The effects of the mammography film processing replenishment rate on contrast and speed are studied sensitometrically. Two experiments studied decreasing replenishment rates in the Kodak RP developer and quantified changes in the developer by measuring bromide ion concentrations. First, values of NaBr concentration from 1.7 to 8.4 g/L, achieved by reducing the replenishment rate, were tested with sensitometry strips. Second, the developer replenishment rate of a high volume dedicated mammography processor was reduced by one-third, to 20 cm3/1560 cm2, so that the NaBr concentration rose from 2.0 to 12.36. Sensitometric results for four film types and patient films were tested for changes from standard values as NaBr concentration was restored to 3.31 g/L. Fifty-five clinical images obtained at 7.3-9.3 NaBr g/L were compared to their matching previous films, with NaBr levels of 2-3 g/L, for contrast and visibility of the skin line. For the range of the NaBr ion from 1.7 to 7 g/L, no significant sensitometric differences were found. Above 7 g/L, different film types had different sensitometric results. From 7.3 to 9.3 NaBr g/L, 47.5% of the clinical films reviewed by four radiologists had less contrast compared to previous films. Dedicated mammography processors with high film volume (i.e., those that do not have excessive oxidation or foreign dye problems) can operate at lower replenishment rates than are currently employed. All common mammography film types are stable at these lower replenishment rates up to 7.0 NaBr g/L.

Biophysical Phenomena↗

A generalized film technique for the verification of vertex fields used in the treatment of brain tumors.

With the availability of commercial three-dimensional (3D)-treatment planning systems, more and more treatment plans call for the use of noncoplanar conformal beams for the treatment of brain tumors. However, techniques for the verification of many noncoplaner beams, such as vertex fields which involve any combination of gantry, collimator, and table angles, do not exist. The purpose of this work is to report on the results of an algorithm and a technique that have been developed for the verification of noncoplanar vertex fields used in the treatment of brain tumors. This technique is applicable to any geometric orientation of the beam, i.e., a beam orientation that consists of any combination of gantry, table, and collimator rotations. The method consists of superimposing a central plane image of a correctly magnified vertex field on a lateral or oblique field port film. To achieve this, the 3D coordinates of the projection of the isocenter onto the film for lateral (or oblique) as well as the vertex fields are determined and then appropriately matched. Coordinate transformation equations have been developed that enable this matching precisely. A film holder has been designed such that a film cassette can be secured rigidly along the side rails of the treatment table. The technique for taking a patient treatment setup verification film consists of two steps. In the first step, the gantry, table, and collimator angles for the lateral (or oblique) field are set and the usual double exposures are made; the first exposure corresponds to that of the treatment portal with the isocenter clearly identified and the second one a larger radiation field so that the peripheral anatomy is visible on the film. In the next step, the gantry, table, and collimator angles are positioned for the vertex field and the table is moved laterally and vertically and the film longitudinally to a position that will enable precise matching of the isocenter on the film. A third exposure is then taken with the vertex portal. What is seen on the film is a superposition of a central plane image of the vertex field onto the image of the lateral or oblique field. This technique has been used on 60 patients treated with noncoplanar fields for brain tumors. In all of these cases, the coincidence of the projection of the isocenter for the lateral (or oblique) and the vertex fields was found to be within 3 mm.

Algorithms↗

Sensitometric responses of selected medical radiographic films.

Radiographic films produce different densities and contrast when processor changes occur, and the magnitude and rate of change vary with film type. The ability to detect and interpret the clinical importance of film density changes may depend on the method of sensitometry used. The characteristics of several medical radiographic films and various sensitometers were examined under three sensitometric variations and five processing variations. Of all variations used, only exposure with a single-versus a double-sided sensitometer caused a film type to have a marked different response. The results indicate that mismatching the sensitometer spectral output with the spectral sensitivity of the film in most cases does not affect the density changes of the film. The fact that a few films may be sensitive to differences in spectral content of the exposing light and dual- versus single-sided exposure and that only a limited number of film types were tested, however, leads to the prudent conclusion that the exposure conditions for quality control purposes should match clinical exposure conditions as closely as possible.

Technology, Radiologic↗

Approximal caries depth assessment with storage phosphor versus film radiography. Evaluation of the caries-specific Oslo enhancement procedure.

OBJECTIVES: To study whether caries-specific enhancement of storage phosphor images might improve the observer performance of approximal caries depth assessments compared with film radiography. MATERIALS AND METHODS: 120 exposures were made of 120 extracted human teeth. To obtain geometrically identical images, Ektaspeed Plus films and storage phosphor plates were exposed simultaneously. The imaging plates were scanned in a Digora scanner and the files transferred to a different platform for image enhancement. Nine observers viewed films and storage phosphor images without provisions for adjustment of image intensity and contrast. For each imaging modality, 240 approximal surfaces were rated for caries on a 5-point confidence scale. Definite and probable caries lesions were also rated for lesion depth, and all ratings were compared with the histological state. Diagnostic accuracy was expressed as the area under the ROC curve (A(z) value). Paired t tests were used to compare the imaging modalities for diagnostic accuracy and F tests to compare observer variances. RESULTS: Enhanced storage phosphor images demonstrated significantly higher mean A(z) values than film (p = 0.0066). Significantly higher mean A(z) values were demonstrated in the outer half of enamel (p = 0.01), but no significant differences were found between the modalities for caries lesions penetrating beyond the outer half of the enamel. The number of correctly diagnosed true-positive surfaces with caries in outer enamel was significantly higher with storage phosphor images than with film (p = 0.00014). False-positive surfaces were most frequently registered in the outer enamel with both modalities, but in this region the number of false-positive surfaces was significantly higher with storage phosphor images than with film (p = 0.0038). Pooled sensitivity and specificity values were 0.48/0.94 and 0.61/0.86 for film and storage phosphor images, respectively. The interobserver variability was significantly lower for storage phosphor images than for film. CONCLUSION: Enhancement of storage phosphor images with a caries-specific procedure significantly improved the accuracy of caries depth assessments in the outer half of the enamel compared with film radiography and reduced observer variability.

Adult↗

Variation of the sensitometric characteristics of seven mammographic films with processing conditions.

The effect of different processing conditions on the sensitometric characteristics of mammographic films was investigated and the implications of this effect on clinical practice are discussed. Three Agfa (MR5-II, HDR and HT), two Kodak (MinR-M, MinR-2000), one Fuji (AD-M) and one Konica (CM-H) single emulsion mammographic films were used. For each film type a 21-step sensitometric strip was developed in seven different processing conditions involving the use of four processors, five developing times and four chemistries. The different processing conditions produced a variable effect on the sensitometric characteristics of the mammographic films. While some films seemed relatively insensitive, others were greatly affected. Furthermore, not all the sensitometric parameters of a film were affected in the same way. For example, a change of processing conditions in some cases increased speed and decreased contrast but in some other cases increased both speed and contrast. Different mammographic films present different sensitometric characteristics that can be altered by processing conditions. Thus, in a mammographic facility any change in film processor/processing cycle or chemistry should be carefully investigated before mammograms of patients are acquired. Furthermore, the results of film comparisons under certain processing conditions should not be generalized to other processing conditions.

Female↗

Comparative image quality of 105 mm and conventional spot films.

The image qualities of 105 mm film (Cronex MRF-21) and a conventional screen-film (Hi-Plus/Cronex 4) were compared for gastrointestinal studies, a high-contrast-resolution procedure, using a General Electric MPX 100/Fluoricon 300 x-ray system. The high contrast resolution was determined at a location approximating the midplane of an average-sized patient (20 cm). Films were made for each image-intensifier mode (9, 6, and 4.5 inch [22.9, 15.2, and 11.4 cm]) and compared with the conventional screen-film for contrast transfer (modulation-transfer function) and maximum cutoff frequency. The effects of unsharpness caused by patient motion were included in the analysis. The patient entrance exposure was measured for each technique. In the absence of patient motion, the cutoff frequencies for the spot films in the 9, 6, and 4.5 inch (22.9, 15.2, and 11.4 cm) modes were 2.1, 2.3, and 2.4 line pairs/mm, respectively. The cutoff frequency for the conventional spot-film was 2.0 line pairs/mm. The modulation-transfer functions for the 105 mm films in the 9, 6, and 4.5 inch (22.9, 15.2, and 11.4 cm) modes were found to be equal to or superior to those of the conventional screen-film for all degrees of patient motion. The 6 inch (15.2 cm), 105 mm films were found to have the best overall performance. These results were achieved with a reduction in radiation dose of 55%.

Digestive System↗