Multi-institution consensus paper for acquisition of portable chest radiographs through glass barriers.
Journal of applied clinical medical physics
BACKGROUND: To conserve personal protective equipment (PPE) and reduce exposure to potentially infected COVID-19 patients, several Californian facilities independently implemented a method of acquiring portable chest radiographs through glass barriers that was originally developed by the University of Washington.METHODS: This work quantifies the transmission of radiation through a glass barrier using six radiographic systems at five facilities. Patient entrance air kerma (EAK) and effective dose were estimated both with and without the glass barrier. Beam penetrability and resulting exposure index (EI) and deviation index (DI) were measured and used to adjust the tube current-time product (mAs) for glass barriers. Because of beam hardening, the contrast-to-noise ratio (CNR) was measured with image quality phantoms to ensure diagnostic integrity. Finally, scatter surveys were performed to assess staff radiation exposure both inside and outside the exam room.RESULTS: The glass barriers attenuated a mean of 61% of the normal X-ray beams. When the mAs was increased to match EI values, there was no discernible degradation of image quality as determined by the CNR. This was corroborated with subjective assessments of image quality by chest radiologists. The glass-hardened beams acted as a filter for low energy X-rays, and some facilities observed slight changes in patient effective doses. There was scattering from both the phantoms and the glass barriers within the room.CONCLUSIONS: Glass barriers require an approximate 2.5 times increase in beam intensity, with all other technique factors held constant. Further refinements are necessary for increased source-to-image distance and beam quality in order to adequately match EI values. This does not result in a significant increase in the radiation dose delivered to the patient. The use of lead aprons, mobile shields, and increased distance from scattering sources should be employed where practicable in order to keep staff radiation doses as low as reasonably achievable.
View details for DOI 10.1002/acm2.13330
View details for PubMedID 34216091
- "Leaping" Toward the Bottom. Journal of the American College of Radiology : JACR 2019
Mini EXPLORER II: a prototype high-sensitivity PET/CT scanner for companion animal whole body and human brain scanning
PHYSICS IN MEDICINE AND BIOLOGY
2019; 64 (7): 075004
As part of the EXPLORER total-body positron emission tomography (PET) project, we have designed and built a high-resolution, high-sensitivity PET/CT scanner, which is expected to have excellent performance for companion animal whole body and human brain imaging. The PET component has a ring diameter of 52 cm and an axial field of view of 48.3 cm. The detector modules are composed of arrays of lutetium (yttrium) oxyorthosilicate (LYSO) crystals of dimensions 2.76 × 2.76 × 18.1 mm3 coupled to silicon photomultipliers (SiPMs) for read-out. The CT component is a 24 detector row CT scanner with a 50 kW x-ray tube. PET system time-of-flight resolution was measured to be 409 ± 39 ps and average system energy resolution was 11.7% ± 1.5% at 511 keV. The NEMA NU2-2012 system sensitivity was found to be 52-54 kcps MBq-1. Spatial resolution was 2.6 mm at 10 mm from the center of the FOV and 2.0 mm rods were clearly resolved on a mini-Derenzo phantom. Peak noise-equivalent count (NEC) rate, using the NEMA NU 2-2012 phantom, was measured to be 314 kcps at 9.2 kBq cc-1. The CT scanner passed the technical components of the American College of Radiology (ACR) accreditation tests. We have also performed scans of a Hoffman brain phantom and we show images from the first canine patient imaged on this device.
View details for DOI 10.1088/1361-6560/aafc6c
View details for Web of Science ID 000462050200004
View details for PubMedID 30620929
- Gonadal shielding should be discontinued for most diagnostic imaging exams MEDICAL PHYSICS 2019; 46 (3): 1111–14
- Improved Estimates of Trunk and Head CT Radiation Dose: Development of Size-Specific Dose Estimate. Journal of the American College of Radiology : JACR 2019
- Pediatric CT Protocols From the American Association of Physicists in Medicine Alliance for Quality CT JOURNAL OF THE AMERICAN COLLEGE OF RADIOLOGY 2018; 15 (10): 1448–49
Lead Apron Inspection Using Infrared Light: A Model Validation Study
JOURNAL OF THE AMERICAN COLLEGE OF RADIOLOGY
2018; 15 (2): 313–18
To evaluate defect detection in radiation protective apparel, typically called lead aprons, using infrared (IR) thermal imaging. The use of IR lighting eliminates the need for access to x-ray-emitting equipment and radiation dose to the inspector.The performance of radiation workers was prospectively assessed using both a tactile inspection and the IR inspection with a lead apron phantom over a 2-month period. The phantom was a modified lead apron with a series of nine holes of increasing diameter ranging from 2 to 35 mm in accordance with typical rejection criteria. Using the tactile method, a radiation worker would feel for the defects in the lead apron. For the IR inspection, a 250-W IR light source was used to illuminate the lead apron phantom; an IR camera detected the transmitted radiation. The radiation workers evaluated two stills from the IR camera.From the 31 participants inspecting the lead apron phantom with the tactile method, only 2 participants (6%) correctly discovered all 9 holes and 1 participant reported a defect that was not there; 10 of the 20 participants (50%) correctly identified all 9 holes using the IR method. Using a weighted average, 5.4 defects were detected with the tactile method and 7.5 defects were detected with the IR method.IR light can penetrate an apron's protective outer fabric and illuminate defects below the current standard rejection size criteria. The IR method improves defect detectability as compared with the tactile method.
View details for DOI 10.1016/j.jacr.2017.09.014
View details for Web of Science ID 000425839800017
View details for PubMedID 29128502
Radiation dose management for pediatric cardiac computed tomography: a report from the Image Gently 'Have-A-Heart' campaign
2018; 48 (1): 5–20
Children with congenital or acquired heart disease can be exposed to relatively high lifetime cumulative doses of ionizing radiation from necessary medical imaging procedures including radiography, fluoroscopic procedures including diagnostic and interventional cardiac catheterizations, electrophysiology examinations, cardiac computed tomography (CT) studies, and nuclear cardiology examinations. Despite the clinical necessity of these imaging studies, the related ionizing radiation exposure could pose an increased lifetime attributable cancer risk. The Image Gently "Have-A-Heart" campaign is promoting the appropriate use of medical imaging studies in children with congenital or acquired heart disease while minimizing radiation exposure. The focus of this manuscript is to provide a comprehensive review of radiation dose management and CT performance in children with congenital or acquired heart disease.
View details for DOI 10.1007/s00247-017-3991-x
View details for Web of Science ID 000419128500002
View details for PubMedID 29292481
View details for PubMedCentralID PMC6230472
Methods for CT Automatic Exposure Control Protocol Translation Between Scanner Platforms
JOURNAL OF THE AMERICAN COLLEGE OF RADIOLOGY
2014; 11 (3): 285–91
An imaging facility with a diverse fleet of CT scanners faces considerable challenges when propagating CT protocols with consistent image quality and patient dose across scanner makes and models. Although some protocol parameters can comfortably remain constant among scanners (eg, tube voltage, gantry rotation time), the automatic exposure control (AEC) parameter, which selects the overall mA level during tube current modulation, is difficult to match among scanners, especially from different CT manufacturers.Objective methods for converting tube current modulation protocols among CT scanners were developed. Three CT scanners were investigated, a GE LightSpeed 16 scanner, a GE VCT scanner, and a Siemens Definition AS+ scanner. Translation of the AEC parameters such as noise index and quality reference mAs across CT scanners was specifically investigated. A variable-diameter poly(methyl methacrylate) phantom was imaged on the 3 scanners using a range of AEC parameters for each scanner. The phantom consisted of 5 cylindrical sections with diameters of 13, 16, 20, 25, and 32 cm. The protocol translation scheme was based on matching either the volumetric CT dose index or image noise (in Hounsfield units) between two different CT scanners. A series of analytic fit functions, corresponding to different patient sizes (phantom diameters), were developed from the measured CT data. These functions relate the AEC metric of the reference scanner, the GE LightSpeed 16 in this case, to the AEC metric of a secondary scanner.When translating protocols between different models of CT scanners (from the GE LightSpeed 16 reference scanner to the GE VCT system), the translation functions were linear. However, a power-law function was necessary to convert the AEC functions of the GE LightSpeed 16 reference scanner to the Siemens Definition AS+ secondary scanner, because of differences in the AEC functionality designed by these two companies.Protocol translation on the basis of quantitative metrics (volumetric CT dose index or measured image noise) is feasible. Protocol translation has a dependency on patient size, especially between the GE and Siemens systems. Translation schemes that preserve dose levels may not produce identical image quality.
View details for DOI 10.1016/j.jacr.2013.10.014
View details for Web of Science ID 000332354800020
View details for PubMedID 24589404
View details for PubMedCentralID PMC3942665
Real-time dosimeter employed to evaluate the half-value layer in CT
PHYSICS IN MEDICINE AND BIOLOGY
2014; 59 (2): 363–77
Half-value layer (HVL) measurements on commercial whole body computer tomography (CT) scanners require serial measurements and, in many institutions, the presence of a service engineer. An assembly of aluminum filters (AAF), designed to be used in conjunction with a real-time dosimeter, was developed to provide estimates of the HVL using clinical protocols. Two real-time dose probes, a solid-state and air ionization chamber, were examined. The AAF consisted of eight rectangular filters of high-purity aluminum (Type 1100), symmetrically positioned to form a cylindrical 'cage' around the probe's detective volume. The incident x-ray beam was attenuated by varying thicknesses of aluminum filters as the gantry completed a minimum of one rotation. Measurements employing real-time chambers were conducted both in service mode and with a routine abdomen/pelvis protocol for several combinations of x-ray tube potentials and bow tie filters. These measurements were validated against conventional serial HVL measurements. The average relative difference between the HVL measurements using the two methods was less than 5% when using a 122 mm diameter AAF; relative differences were reduced to 1.1% when the diameter was increased to 505 mm, possibly due to reduced scatter contamination. Use of a real-time dose probe and the AAF allowed for time-efficient measurements of beam quality on a clinical CT scanner using clinical protocols.
View details for DOI 10.1088/0031-9155/59/2/363
View details for Web of Science ID 000332842000008
View details for PubMedID 24351935
View details for PubMedCentralID PMC4369799
Kilovoltage Rotational External Beam Radiotherapy on a Breast Computed Tomography Platform: A Feasibility Study
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
2012; 84 (2): 533-539
To demonstrate the feasibility of a dedicated breast computed tomography (bCT) platform to deliver rotational kilovoltage (kV) external beam radiotherapy (RT) for partial breast irradiation, whole breast irradiation, and dose painting.Rotational kV-external beam RT using the geometry of a prototype bCT platform was evaluated using a Monte Carlo simulator. A point source emitting 178 keV photons (approximating a 320-kVp spectrum with 4-mm copper filtration) was rotated around a 14-cm voxelized polyethylene disk (0.1 cm tall) or cylinder (9 cm tall) to simulate primary and primary plus scattered photon interactions, respectively. Simulations were also performed using voxelized bCT patient images. Beam collimation was varied in the x-y plane (1-14 cm) and in the z-direction (0.1-10 cm). Dose painting for multiple foci, line, and ring distributions was demonstrated using multiple rotations with varying beam collimation. Simulations using the scanner's native hardware (120 kVp filtered by 0.2-mm copper) were validated experimentally.As the x-y collimator was narrowed, the two-dimensional dose profiles shifted from a cupped profile with a high edge dose to an increasingly peaked central dose distribution with a sharp dose falloff. Using a 1-cm beam, the cylinder edge dose was <7% of the dose deposition at the cylinder center. Simulations using 120-kVp X-rays showed distributions similar to the experimental measurements. A homogeneous dose distribution (<2.5% dose fluctuation) with a 20% decrease in dose deposition at the cylinder edge (i.e., skin sparing) was demonstrated by weighted summation of four dose profiles using different collimation widths. Simulations using patient bCT images demonstrated the potential for treatment planning and image-guided RT.Rotational kV-external beam RT for partial breast irradiation, dose painting, and whole breast irradiation with skin sparing is feasible on a bCT platform with the potential for high-resolution image-guided RT.
View details for DOI 10.1016/j.ijrobp.2011.12.042
View details for Web of Science ID 000308062700064
View details for PubMedID 22436786
View details for PubMedCentralID PMC3397279
Development of a patient-specific two-compartment anthropomorphic breast phantom
PHYSICS IN MEDICINE AND BIOLOGY
2012; 57 (13): 4293-4307
The purpose of this paper is to develop a technique for the construction of a two-compartment anthropomorphic breast phantom specific to an individual patient's pendant breast anatomy. Three-dimensional breast images were acquired on a prototype dedicated breast computed tomography (bCT) scanner as part of an ongoing IRB-approved clinical trial of bCT. The images from the breast of a patient were segmented into adipose and glandular tissue regions and divided into 1.59 mm thick breast sections to correspond to the thickness of polyethylene stock. A computer-controlled water-jet cutting machine was used to cut the outer breast edge and the internal regions corresponding to glandular tissue from the polyethylene. The stack of polyethylene breast segments was encased in a thermoplastic 'skin' and filled with water. Water-filled spaces modeled glandular tissue structures and the surrounding polyethylene modeled the adipose tissue compartment. Utility of the phantom was demonstrated by inserting 200 µm microcalcifications as well as by measuring point dose deposition during bCT scanning. Affine registration of the original patient images with bCT images of the phantom showed similar tissue distribution. Linear profiles through the registered images demonstrated a mean coefficient of determination (r(2)) between grayscale profiles of 0.881. The exponent of the power law describing the anatomical noise power spectrum was identical in the coronal images of the patient's breast and the phantom. Microcalcifications were visualized in the phantom at bCT scanning. The real-time air kerma rate was measured during bCT scanning and fluctuated with breast anatomy. On average, point dose deposition was 7.1% greater than the mean glandular dose. A technique to generate a two-compartment anthropomorphic breast phantom from bCT images has been demonstrated. The phantom is the first, to our knowledge, to accurately model the uncompressed pendant breast and the glandular tissue distribution for a specific patient. The modular design of the phantom allows for studies of a single breast segment and the entire breast volume. Insertion of other devices, materials and tissues of interest into the phantom provide a robust platform for future breast imaging and dosimetry studies.
View details for DOI 10.1088/0031-9155/57/13/4293
View details for Web of Science ID 000305803600015
View details for PubMedID 22705748
View details for PubMedCentralID PMC3404613
The characterization of breast anatomical metrics using dedicated breast CT
2011; 38 (4): 2180-2191
Accurate anatomical characterization of the breast is useful in breast phantom development and computer modeling of breast imaging technologies. Capitalizing on the three-dimensional capabilities of dedicated breast CT (bCT), a number of parameters which describe breast shape and fibroglandular distribution are defined.Among 219 bCT data sets, the effective diameter and length of the pendant breast as well as the breast volume were measured and characterized for each bra cup size. The volume glandular fraction (VGF) was determined as a function of patient age, BIRADS density, bra cup size, and breast diameter. The glandular fraction was examined in coronal and sagittal planes of the breast, and the radial distribution of breast glandular fraction within a coronal bCT image was examined for three breast regions. The areal glandular fraction (AGF) was estimated from two-dimensional projections of the breast (simulated by projecting bCT data sets) and was compared to the corresponding VGF.The effective breast diameter and length increase with increasing bra cup size. The mean breast diameters (+/- standard error) of bra cup sizes A/AA, B, C, and D/DD were 11.1 +/- 0.5, 11.4 +/- 0.3, 13.0 +/- 0.2, and 13.7 +/- 0.2 cm, respectively. VGF was lower among older women and those with larger breast diameter and larger bra cup size. VGF increased as a function of the reported BIRADS density. AGF increased with VGF. Fibroglandular tissue was distributed primarily in the central portion of the breast.Breast metrics were examined and a number of parameters were defined which may be useful for breast modeling. The reported data may provide researchers with useful information for characterizing the breast for various imaging or dosimetry tasks.
View details for DOI 10.1118/1.3567147
View details for Web of Science ID 000289153500046
View details for PubMedID 21626952
View details for PubMedCentralID PMC3081868
Experimental validation of a method characterizing bow tie filters in CT scanners using a real-time dose probe
2011; 38 (3): 1406–15
Beam-shaping or "bow tie" (BT) filters are used to spatially modulate the x-ray beam in a CT scanner, but the conventional method of step-and-shoot measurement to characterize a beam's profile is tedious and time-consuming. The theory for characterization of bow tie relative attenuation (COBRA) method, which relies on a real-time dosimeter to address the issues of conventional measurement techniques, was previously demonstrated using computer simulations. In this study the feasibility of the COBRA theory is further validated experimentally through the employment of a prototype real-time radiation meter and a known BT filter.The COBRA method consisted of four basic steps: (1) The probe was placed at the edge of a scanner's field of view; (2) a real-time signal train was collected as the scanner's gantry rotated with the x-ray beam on; (3) the signal train, without a BT filter, was modeled using peak values measured in the signal train of step 2; and (4) the relative attenuation of the BT filter was estimated from filtered and unfiltered data sets. The prototype probe was first verified to have an isotropic and linear response to incident x-rays. The COBRA method was then tested on a dedicated breast CT scanner with a custom-designed BT filter and compared to the conventional step-and-shoot characterization of the BT filter. Using basis decomposition of dual energy signal data, the thickness of the filter was estimated and compared to the BT filter's manufacturing specifications. The COBRA method was also demonstrated with a clinical whole body CT scanner using the body BT filter. The relative attenuation was calculated at four discrete x-ray tube potentials and used to estimate the thickness of the BT filter.The prototype probe was found to have a linear and isotropic response to x-rays. The relative attenuation produced from the COBRA method fell within the error of the relative attenuation measured with the step-and-shoot method. The BT filter thickness estimates resulting from the dual energy scans on the breast CT system were equivalent to the manufacturing specifications. The clinical CT evaluation produced data conceptually similar to previous computer simulations and plausible relative attenuation profiles were observed.The COBRA method is a fast and accurate method for BT filter characterization, which requires a simple experimental setup in a clinical environment. Because of the ease of data acquisition, multienergy scans can be acquired which allow characterization of the BT filter thickness.
View details for DOI 10.1118/1.3551990
View details for Web of Science ID 000287879400029
View details for PubMedID 21520852
View details for PubMedCentralID PMC3055909