Kijung Ahn

The Effect of Probiotics for Preventing Radiation-Induced Morphological Changes in Intestinal Mucosa of Rats

Radiation therapy is an important treatment modality for abdominal or pelvic cancer, but there is a common and serious complication such as radiation-induced enteritis. Probiotics is reported to have positive effects against radiation-induced enteropathy. In this study, morphological changes of bowel mucosa were analyzed in rats to presume the effect of probiotics on radiation-induced enteritis and its correlation with radiation dose. A total of 48 adult male Sprague-Dawley rats were randomly assigned to two groups and received a solution containing 1.0×108 colony-forming units of Lactiobacillus acidophilus or water once daily for 10 days. Each of two groups was divided into three subgroups and abdomino-pelvic area of each subgroup was irradiated with 10, 15, and 20 Gy, respectively on the seventh day of feeding the solutions. All rats were sacrificed 3 days after irradiation and the mucosal thickness and villus height of jejunum, ileum and colon were measured. The morphological parameters of the small intestine represented significant differences between two solution groups irradiated 10 or 15 Gy, except for villus height of jejunum in 15 Gy-subgroup (P=0.065). There was no significant morphometric difference between two groups irradiated with 20 Gy of radiation. Probiotics appear to be effective for the morphological shortening of small intestinal mucosa damaged by radiation less than or equal to 15 Gy. Graphical Abstract

Study on the feasibility of the HgI2 dosimeter for quality assurance of radiotherapy

In radiotherapy, a variety of detectors such as ionization chambers, films, TLDs, diodes, and OSL, are being used for quality assurance (QA). Owing to its high sensitivity and feasibility to operate at low voltages, silicon (Si) photoconductors, which are used as detection material of a diode, are currently being used as relative dosimeters. In addition, other materials such as amorphous selenium (a-Se), cadmium telluride (CdTe), lead iodide (PbI2), and mercury iodide (HgI2) were also being investigated for their feasibility as diagnostic radiation detector. Among these materials, HgI2 has been reported to show remarkable properties including high spatial resolution and high stopping power. Hence In this study, we have verified the feasibility of HgI2 dosimeter for quality assurance of radiotherapy. In order to fabricate the detector, HgI2 was mixed with TiO2 to minimize the signal reduction. Following this, the resulting mixture was deposited onto indium tin oxide (ITO) coated glass by particle-in binder (PIB) method. Finally, the top ITO electrode was coated by magnetron sputterring system. Subsequently, we measured the electrical properties generated by high-energy radiation from linear accelerator (LINAC), and analyzed the reproducibility, linearity, and percent depth dose (PDD) of the fabricated detoctor. In addition, we have determined the build-up materials in experimental setup, since the thickness of build-up region, where the secondary electron emission equilibrium occurs, changes depending on radiation energy. It was observed that the relative variations measured as standard deviation divided by the average value among repeated measurements was approximately 1%. Deviations from linearity are smaller than 5%. Finally, we compared the experimental data of the detector fabricated in this study with those of the farmer-type ionization chamber. Base on the results obtained from this study, it could be realized that HgI2 could be used as dosimeter for QA of radiotherapy.

Evaluation of radiotherapy setup accuracy for head and neck cancer using a 3-D surface imaging system

The purpose of this study was to measure the accuracy of a three-dimensional surface imaging system (3-D SIS) in comparison to a 3-laser system by analyzing the setup errors obtained from a RANDO Phantom and head and neck cancer patients. The 3-D SIS used for the evaluation of the setup errors was a C-RAD Sentinel. In the phantom study, the OBI setup errors without the thermoplastic mask of the 3-laser system vs. the 3-D SIS were measured. Furthermore, the setup errors with the thermoplastic mask of the 3-laser system vs. the 3-D SIS were measured. After comparison of the CBCT, setup correction about 1 mm was performed in a few cases. The probability of the error without the thermoplastic mask exceeding 1 mm in the 3-laser system vs. the 3-D SIS was 75.00% vs. 35.00% on the X-axis, 80.00% vs. 40.00% on the Y-axis, and 80.00% vs. 65.00% on the Z-axis. Moreover, the probability of the error with the thermoplastic mask exceeding 1 mm in the 3-laser system vs. the 3-D SIS was 70.00% vs. 15.00% on the X-axis, 75.00% vs. 25.00% on the Y-axis, and 70.00% vs. 35.00% on the Z-axis. These results showed that the 3-D SIS has a lower probability of setup error than the 3-laser system for the phantom. For the patients, the setup errors of the 3-laser system vs. the 3-D SIS were measured. The probability of the error exceeding more than 1 mm in the 3-laser system vs. the 3-D SIS was shown to be 81.82% vs. 36.36% on the X-axis, 81.82% vs. 45.45% on the Y-axis, and 86.36% vs. 72.73% on the Z-axis. As a result, the 3-D SIS also exhibited a lower probability of setup error for the cancer patients. Therefore, this study confirmed that the 3-D SIS is a promising method for setup verification.

Feasibility Study of Phosphor Screen Containing Nano-Scale Anti-Reflection Layer for Improved Optical Properties in Indirect X-ray Detector

With increasingly strict regulations regarding patient exposure, research on digital radiography technology has recently focused on indirect methods that can produce high-quality images for a low radiation dose. In particular, medical imaging systems based on indirect methods universally use rare-earth metal phosphors, because of their high atomic number and excellent luminescence efficiency. Thus, various studies aiming to improve the luminescence efficiency of phosphors have been conducted. Despite this research, however, the current luminescence efficiencies are insufficient. Here, we report a basic study aiming to develop a phosphor screen containing a three-quarter-wave optical-thickness layer to improve the light transmission efficiency. Specifically, the fabrication and measurement of a Gd2O2S:Tb phosphor screen containing a single three-quarter-wave optical-thickness layer is presented. The screen is fabricated via a screen-printing and spin-coating method. Based on histograms of the degree of luminescence and the pixel values, we demonstrate that the light transmission efficiency is improved by the three-quarter-wave optical-thickness layer. Note that analysis of the full width at half maximum of the pixel value distribution reveals the possibility of resolution loss when obtaining medical images. Overall, the results of this study confirm that the light transmission efficiency can be improved through use of a single-layer anti-reflection coating. However, because the emission spectrum of the Gd2O2S:Tb screen is in the 480-600-nm band, it is necessary to expand the areas exhibiting the lowest reflectance to the wavelengths at the edge of this band. Thus, further study should be conducted to optimize the optical thickness.

Feasibility study of a photoconductor based dosimeter for quality assurance in radiotherapy

With the recent market entries of new types of linear accelerators (LINACs) with a multi leaf collimator (MLC) mounted on them, high-precision radiosurgery applying a LINAC to measure high-dose radiation on the target region has been gaining popularity. Systematic and accurate quality assurance (QA) is of vital important for high-precision radiosurgery because of its increased risk of side effects including life-threatening ones such as overexposure of healthy tissues to high-dose radiation beams concentrated on small areas. Therefore, accurate dose and dose-distribution measurements are crucial in the treatment procedure. The accurate measurement of the properties of beams concentrated on small areas requires high-precision dosimeters capable of high-resolution output and dose mapping as well as accurate dosimetry in penumbra regions. In general, the properties of beams concentrated on small areas are measured using thermos luminescent dosimeters (TLD), diode detectors, ion chambers, diamond detectors, or films, and many papers have presented the advantages and disadvantages of each of these detectors for dosimetry. In this study, a solid-state photoconductor dosimeter was developed, and its clinical usability was tested by comparing its relative dosimetric performance with that of a conventional ion chamber. As materials best-suited for radiation dosimeters, four candidates namely lead (II) iodide (PbI2), lead (II) oxide (PbO), mercury (II) iodide (HgI2), and HgI2/ titanium dioxide (TiO2) composite, the performances of which were proved in previous studies, were used. The electrical properties of each candidate material were examined using the sedimentation method, one of the particle-in-binder (PIB) methods, and unit-cell-type prototypes were fabricated. The unit-cell samples thus prepared were cut into specimens of area 1 × 1 cm2 with 400-μ m thickness. The electrical properties of each sample, such as sensitivity, dark current, output current, rising time, falling time, and response delay, were then measured, in addition to the consistency, reproducibility and linearity of each unit-cell. According to the measurement results, HgI2/TiO2 composite outperformed the other candidate materials. A radiation dosimeter with a chamber-type structure was fabricated in this study using a LINAC under accelerating voltages of 6, and 15 MV and compared with a commercial ion chamber. Percent depth dose (PDD) and beam profile were measured on a water phantom at a fixed area of 10 × 10 cm2 by using the fabricated chamber-type dosimeter, and the values were compared with those measured by a commercial ion chamber. Additionally, a homogeneous phantom was fabricated, and the exposure doses of the center points were measured according to a real treatment plan, followed by a comparison of the measured values as relative values. In this paper, we report that the manufactured dosimeter shows similar characteristics in terms of PDD and beam profile and results for the conventional ion chamber. Based on these results, it is demonstrated that the HgI2/TiO2-based dosimeter complies with radiotherapy QA requirements, namely Superior detection characteristics, consistency, dose linearity, reproducibility. Thus, we expect the HgI2/TiO2-based dosimeter to be used commercially in the future.

Feasibility study of a lead(II) iodide-based dosimeter for quality assurance in therapeutic radiology

The most widely used form of radiotherapy to treat tumors uses a linear accelerator, and the apparatus requires regular quality assurance (QA). QA for a linear accelerator demands accuracy throughout, from mock treatment and treatment planning, up to treatment itself. Therefore, verifying a radiation dose is essential to ensure that the radiation is being applied as planned. In current clinical practice, ionization chambers and diodes are used for QA. However, using conventional gaseous ionization chambers presents drawbacks such as complex analytical procedures, difficult measurement procedures, and slow response time. In this study, we discuss the potential of a lead(II) iodide (PbI2)-based radiation dosimeter for radiotherapy QA. PbI2 is a semiconductor material suited to measurements of X-rays and gamma rays, because of its excellent response properties to radiation signals. Our results show that the PbI2-based dosimeter offers outstanding linearity and reproducibility, as well as dose-independent characteristics. In addition, percentage depth dose (PDD) measurements indicate that the error at a fixed reference depth Dmax was 0.3%, very similar to the measurement results obtained using ionization chambers. Based on these results, we confirm that the PbI2-based dosimeter has all the properties required for radiotherapy: stable dose detection, dose linearity, and rapid response time. Based on the evidence of this experimental verification, we believe that the PbI2-based dosimeter could be used commercially in various fields for precise measurements of radiation doses in the human body and for measuring the dose required for stereotactic radiosurgery or localized radiosurgery.