P. Dimitriou

Doses to operators during interventional radiology procedures: focus on eye lens and extremity dosimetry

The present study is focused on the personnel doses during several types of interventional radiology procedures. Apart from the use of the official whole body dosemeters (thermoluminescence dosemeter type), measurements were performed to the extremities and the eyes using thermoluminescent loose pellets. The mean doses per kerma area product were calculated for the monitored anatomic regions and for the most frequent types of procedures. Higher dose values were measured during therapeutic procedures, especially embolisations. The maximum recorded doses during a single procedure were 1.8 mSv to the finger (nephrostomy), 2.1 mSv to the wrist (liver chemoembolisation), 0.6 mSv to the leg (brain embolisation) and 2.4 mSv to the eye (brain embolisation). The annual doses estimated for the operator with the highest workload according to the measurements and the systems log book were 90.4 mSv to the finger, 107.9 mSv to the wrist, 21.6 mSv to the leg and 49.3 mSv to the eye. Finally, the effect of the beam angulation (i.e. projection) and shielding equipment on the personnel doses was evaluated. The measurements were performed within the framework of the ORAMED (Optimization of RAdiation Protection for MEDical staff) project.

Anatomy- vs. fluence-based planning for prostate cancer treatments using VMAT

The purpose of this study was to compare the planning approaches used in two treatment planning systems (TPS) provided by Elekta for VMAT treatments. Ten prostate patients were studied retrospectively. Plan comparison was performed in terms of delivery efficiency and accuracy, as well as in terms of target coverage and critical organ protection by utilizing physical and radiobiological indices. These include: DVH (dose volume histogram) values, CI (conformity index), HI(%) (homogeneity index) and TCP (tumor control probability) for target coverage; mean doses, DVH values, dose to the normal non-target tissue, NTCP (normal tissue complication probability) and GI (gradient index) for critical organ sparing; MU/fraction and treatment time for delivery efficiency. The comparisons were performed using the two-sided Wilcoxon matched-pair signed rank test. Plans generated using the anatomy-based approach in ERGO++ and fluence-based approach in Monaco were found similar in terms of target coverage and TCP values, as well as in terms of rectum protection and corresponding NTCP values. The former exhibited increased delivery efficiency (comparable to that of 3D conformal radiotherapy) due to the relatively larger segments used. On the other hand advantages of the fluence-based approach in Monaco include increased conformity, better target dose homogeneity and higher dose gradient (lower dose to normal non-target-tissue) mainly due to the higher degree of modulation offered by the fluence-based approach, while the Monte Carlo algorithm used for dose calculation provides plans with increased accuracy despite the relatively small segments used.

Kinetics of heat-damaged homologous erythrocytes. A five-compartmental analysis.

A new theoretical five-compartmental model (5CM) was developed for analysis of the clearance of heat-damaged erythroctes (HDE) labelled with chromium 51. Besides the HDE-spleen interaction, this new model also takes into account the interaction between extrasplenic reticuloendothelial (RES) sites and HDE, i.e. the hepatic clearance of fragmented erythrocytes (FE). Accordingly, HIDE clearance curves are analysed into three exponential components, the fastest of which describes the RES-FE interaction, whereas the others describe the splenic clearance of spherocytes. Therefore, an estimation of the effective liver blood flow for HDE (ELBF) was achieved, along with a series of parameters describing splenic function. The 5CM proved to be more efficient than a previously proposed three-compartmental model (3CM) in the mathematical description of HDE clearance. Comparison was made by applying both models to 37 experimental curves obtained from 20 patients with congenital hemolytic anemias. The values for the splenic function parameters calculated by 5CM analysis and the strong correlations observed among them offer evidence that this model provides an adequate approximation to the real conditions under which HDE clearance takes place. Furthermore, a detailed quantitative analysis of the pooling of spherocytes within the spleen was attempted in this work, and this phenomenon was found to compete with splenic irreversible spherocyte trapping. The ELBF proved to be closely correlated with the hemodynamic splenic parameters, following first-order kinetics, as do low-dose colloids.

Image quality and patient dose in computed tomography examinations in Greece

The purpose of this study is to evaluate image quality of various computed tomography (CT) scanners installed in Greece, as well as to investigate patient doses from common CT examinations. An image quality survey was performed in 44 CT scanners countrywide. The imaging performance of the systems was evaluated by measurements of certain parameters, such as image noise, spatial uniformity, high- and low-contrast resolution and slice thickness accuracy. Moreover, preliminary results of patient dose survey are presented. Concerning image quality, 80 % of the scanners were found to be in compliance with the national legislation and relative international guidelines for all the examined parameters. Weighted CT dose index and dose-length product values for chest and abdomen routine examinations were generally below the dose reference levels (DRLs) suggested by the European Commission. However, some scanners were found to deliver significantly higher doses than the suggested DRL for head routine examinations. Finally, differences in the performance among scanners of the same type and similar age were observed, pointing out the importance of frequent calibration, routine quality control and proper maintenance.

EDUCATIONAL AND TRAINING ACTIVITIES IN PERSONAL DOSIMETRY IN GREECE

An individual monitoring programme is one of the main components of any radiation protection programme since it constitutes the mean for assessing and thus optimising the doses of occupationally exposed workers. The Greek Atomic Energy Commission (GAEC) is the competent authority for radiation protection and nuclear safety in Greece. GAECs educational and training activities in the field of occupational radiation protection at the national and regional (Eastern Europe) level are presented, along with the relevant activities of the University of Ioannina in the region of North-West Greece, as an example of a local education and training programme. The curricula of two postgraduate courses addressed to qualified experts and medical physics experts and mainly the modules dedicated to individual monitoring are discussed as well.

Effect of hydration and continuous urinary drainage on urine production in children

Objective. Although urine production depends on numerous physiological variables there are no quantitative data regarding the effect of bladder decompression, by means of continuous catheter drainage, on urine production. The aim of this study was to investigate this effect. Material and methods. The study was carried out in two stages, each consisting of two phases. The effect of two distinct orally administered amounts of water was recorded in relation to continuous bladder decompression on the changes with time of urine volume and the urine production rate. In the first stage, 35 children were randomly divided into two groups and two different hydration schemes (290 and 580 ml of water/m2) were used. After the second urination of Phase 1, continuous drainage was employed in the phase that followed (Phase 2). In the second stage, a group of 10 children participated and Phase 2 was carried out 1 day after the completion of Phase 1. Results. It was shown that the amount of urine produced increased in accordance with the degree of hydration and doubled or tripled with continual urine drainage by catheter for the same degree of hydration and within the same time interval. This was also true for Stage 2, in which Phase 2 was performed 24 h after Phase 1, indicating that diuresis during Phase 2 (as a result of Phase 1) was negligible. Conclusion. It was shown that during continuous drainage of urine with bladder catheterization there is an increased need for fluids, which should be administered early.