Lars René Lindvold

Characterizing a pulse-resolved dosimetry system for complex radiotherapy beams using organic scintillators

A fast-readout dosimetry system based on fibre-coupled organic scintillators has been developed for the purpose of conducting point measurements of absorbed dose in radiotherapy beams involving high spatial and temporal dose gradients. The system measures the dose for each linac radiation pulse with millimetre spatial resolution. To demonstrate the applicability of the system in complex radiotherapy fields, output factors and per cent depth dose measurements were performed in solid water for a 6 MV photon beam and compared with Monte Carlo simulated doses for square fields down to 0.6 cm × 0.6 cm size. No significant differences between measurements and simulations were observed. The temporal resolution of the system was demonstrated by measuring dose per pulse, beam start-up transients and the quality factor for 6 MV. The precision of dose per pulse measurements was within 2.7% (1 SD) for a 10 cm × 10 cm field at 10 cm depth. The dose per pulse behaviour compared well with linac target current measurements and accumulated dose measurements, and the system was able to resolve transient dose delivery differences between two Varian linac builds. The system therefore shows promise for reference dosimetry and quality assurance of complex radiotherapy treatments.

UV-assisted rotational moulding of microstructures using a conventional flexographic printing machine

This paper pertains to the development of a system for micro replication that has been successfully implemented on a conventional flexographic printing machine. The core technology in the system is UV assisted rotational moulding using an elastomer as the micro mould and UV curable polymers as the casting material.

Office-based transurethral devascularisation of low grade non-invasive urothelial cancer using diode laser. A feasibility study

Frequent recurrence of non‐muscle invasive bladder tumours (NMIBC) requiring transurethral resection of bladder tumour (TUR‐BT) and lifelong monitoring makes the lifetime cost per patient the highest of all cancers. A new method is proposed for the removal of low grade NMIBCs in an office‐based setting, without the need for sedation and pain control and where the patient can leave immediately after treatment.

An optical method for reducing green fluorescence from urine during fluorescence-guided cystoscopy

Photodynamic diagnosis (PDD) of bladder tumour tissue significantly improves endoscopic diagnosis and treatment of bladder cancer in rigid cystoscopes in the operating theatre and thus reduces tumour recurrence. PDD comprises the use of blue light, which unfortunately excites green fluorescence from urine. As this green fluorescence confounds the desired red fluorescence of the PDD, methods for avoiding this situation particularly in cystoscopy using flexible cystoscopes are desirable. In this paper we demonstrate how a tailor made high power LED light source at 525 nm can be used for fluorescence assisted tumour detection using both a flexible and rigid cystoscope used in the outpatient department (OPD) and operating room (OR) respectively. It is demonstrated both in vitro and in vivo how this light source can significantly reduce the green fluorescence problem with urine. At the same time this light source also is useful for exciting autofluorescence in healthy bladder mucosa. This autofluorescence then provides a contrast to the sensitized fluorescence (PDD) of tumours in the bladder.

Method for improving photodynamic diagnosis and surgery of bladder tumours using cystoscopes

We present a new concept on how to remove unwanted green fluorescence from urine during Photodynamic Diagnostics of tumours in the bladder using cystoscopy. A high power LED based light source (525 nm) has been made in our laboratory. This light source is tailored to match most commercially available rigid cystoscopes. A suitable spectral filter and adapter, for the eyepiece of the cystoscope, has been selected which allows the urologist to observe both red fluorescence from tumours and autofluorescence from healthy tissue at the same time.

A new optical method improves fluorescence guided diagnosis of bladder tumor in the outpatient department and reveals significant photo bleaching problems in established inpatients PDD techniques

Photo dynamic diagnosis (PDD) is a convenient and well-documented procedure for diagnosis of bladder cancer and tumours using endoscopic techniques. At present, this procedure is available only for routine use in an operating room (OR) and often with substantial photobleaching effects of the photosensitizer. We present a novel optical design of the endoscopic PDD procedure that allows the procedure to be performed in the outpatient department (OPD) and not only in the OR. Thereby, inpatient procedures lasting 1-2 days may be replaced by a few hours lasting procedure in the OPD. Urine blurs the fluorescence during PDD used in the OPD. Urine contains fluorescent metabolites that are excited by blue light giving an opaque green fluorescence confounding the desired red fluorescence (PDD) from the tumour tissue. Measurements from the clinical situation has shown that some systems for PPD based on blue light illumination (PDD mode) and white light illumination used for bladder tumour diagnosis and surgery suffers some inherent disadvantages, i.e., photo bleaching in white light that impairs the possibility for PDD as white light usually is used before the blue light for PDD. Based on spectroscopic observations of urine and the photoactive dye Protoporphyrin IX used in PDD a novel optical system for use with the cystoscope has been devised that solves the problem of green fluorescence from urine. This and the knowledge of photo-bleaching pitfalls in established systems make it possible to perform PDD of bladder tumours in the OPD and to improve PDD in the OR.

A method for tuning the excitation wavelength of an LED light source during fluorescence-based cystoscopy (Conference Presentation)

In clinical applications of fluorescence-guided endoscopy of the bladder (cystoscopy) it can be observed that the contrast in light from autofluorescence and from photodynamic diagnosis (PDD) varies from patient to patient. To compensate for this effect, a new method is presented for tuning the wavelength of a LED-based light source during fluorescence guided endoscopy of the bladder i.e. photodynamic diagnosis of bladder tumours. In the present embodiment, the wavelength of the LED source, developed in our laboratory, can be tuned to vary the excitation wavelength of both the sensitised fluorescence in the tumours (PDD) as well as the native fluorescence of the bladder mucosa and blood vessels. The contrast of the image observed through the CCD-camera attached to the cystoscope is thereby increased. In this way, patient to patient variations in autofluorescence and in sensitised fluorescence of tumours can be compensated for during fluorescence-guided cystoscopy in the clinic.

A platform for lab and industrial scale replication of phase optics and microfluidics

A platform for lab-scale replication of phase optics and microfluidics is presented in this paper. The platform is based on the use of a rotational micro-moulding technique using light-curable polymers as the media for holding the phase optics or microfluidics. As the moulding technique essentially can be repeated in sequential steps, the method can be used for more complex combinations of micro- and nanostructures than a simple moulding process would permit. Furthermore, the use of light-curable polymers makes it possible to use materials with a refractive index ranging from 1.4 to 1.6 allowing for precise control of the phase shift in the replicated optical components. The use of light-curable polymers also paves the way for subsequent modification of the surface chemistry e.g. the replicated microfluidic structure. Such a modality is high desirable in the making of e.g. lab-on-a-chip system. The paper will address on how to use the technology on lab-scale but also how it can be scaled to high-volume production if needed.

Fiber-coupled organic plastic scintillator for on-line dose rate monitoring in 6 MV X-ray beam for external radiotherapy

Fiber-coupled organic plastic scintillators enable on-line dose rate monitoring in conjunction with pulsed radiation sources like linear medical accelerators (linacs). The accelerator, however, generates a significant amount of stray ionizing radiation. This radiation excites the long optical fiber (15-20 m), connecting the scintillator, typically with a diameter of 1 mm and 5 mm in length, with the optical detector circuit, causing parasitic luminescence in the optical fiber. In this paper we propose a method for circumventing this problem. The method is based on the use of an organic scintillator, 2-Naphthoic acid, doped in an optical polymer. The organic scintillator possesses a long luminescent lifetime (room temperature phosphorescence). The scintillator is molded onto the distal end of a polymer optical fiber. The luminescent signal from the scintillator is detected by a PMT in photon-counting mode. The long lifetime of the scintillator signal facilitates a temporal gating of the dose rate signal with respect to the parasitic luminescence from the optical fiber. We will present data obtained using a solid water phantom irradiated with 6 MV Xrays from a medical linac at the Copenhagen University Hospital. Also issues pertaining to the selection of proper matrix as well as phosphorescent dye will be presented in this paper.