Satish C. Prasad

Laser-based microfocused x-ray source for mammography: feasibility study.

A laser-produced plasma (LPP) x-ray source with possible application in mammography was created by focusing a laser beam on a Mo target. A Table-Top-Terawatt (TTT) laser operating at 1 J energy per pulse was employed. A dual pulse technique was used. Maximum energy transfer (approximately 10%) from laser light to hot electrons was reached at a 150 ps delay between pulses and the conversion efficiency (hard x-ray yield/laser energy input) was approximately 2 x 10(-4). The created LPP x-ray source is characterized by a very small focal spot size (tens of microns), Gaussian brightness distribution, and a very short pulse duration (a few ps). The spectral distribution of the generated x rays was measured. Images of the focal spot, using a pinhole camera, and images of a resolution pattern and a mammographic phantom were obtained. The LPP focal spot modulation transfer function for different magnification factors was calculated. We have shown that the LPP source in conjunction with a spherically bent, high throughput, crystal monochromator in a fixed-exit Rowland circle configuration can be used to created a narrow band tunable mammography system. Tunability to a specific patient breast tissue thickness and density would allow one to significantly improve contrast and resolution (exceeding 20 lp/mm) while lowering the exposure up to 50% for thicker breasts. The prospects for the LPP x-ray source for mammographic application are discussed.

Scatter reduction in mammography with air gap

Scatter reduction by air gaps in mammography was investigated. We have experimentally demonstrated that, independently of the imaging geometry, scatter in air-gap mammography can be well described by a virtual source of scatter (VSS) model. This model postulates that scatter radiation originates from a virtual point source of scatter placed on the central axis between the x-ray source and the exit surface of a patient at distance delta and utilizes only two parameters: delta and (S/P)0. The (S/P)0 parameter represents scatter-to-primary ratio without an air gap and delta is the distance from the exit surface of a patient to the virtual source of scatter. We have experimentally determined the analytical form of the two independent parameters of the VSS model; delta exhibits a linear increase proportional to the radiation field size, does not depend on patient thickness, and is in the 10-30 cm range, while (S/P)0 increases with the field size as a power function and is in the 0.4-1.3 range. In the framework of the VSS model the selectivity, the contrast improvement factor, and the signal-to-noise improvement factor were employed to evaluate performance of air-gap mammography systems. We have demonstrated that selectivity of an air gap rapidly deteriorates at some well-defined critical value of scatter fraction that has profound consequences on air-gap performance. Assuming fixed patient exposure, the results shows that, if a contrast limited detection system (such as film/screen mammography) is used, an air gap system can outperform a grid system only if a very large source-to-patient (SPD) distance is utilized, which might be possible with new laser-based x-ray sources. For the noise limited detection systems (such as digital mammography) even a small SPD (70 cm) and a small air-gap (20 cm) system will outperform a grid system.

Dosimetry of I-125 seeds implanted on the surface of a cavity

Dosimetry of a new implant technique to treat brain tumors is presented. High grade gliomas or astrocytomas are surgically removed, and radioactive I-125 seeds are implanted on the surface of the cavity. A computational model is presented to determine the number of seeds and the activity of the seeds for a given dose and cavity size.

Radiation protection considerations for endocavitary x ray units

Application of a contact X ray therapy unit for endocavitary irradiation of selected rectal carcinomas is gaining acceptance as a treatment of choice. The patient is placed on a proctoscopic table in the surgical suite and the anus is anesthetized and dilated to allow insertion of a 3 cm diameter proctoscope designed to admit the X ray tube. The measured half-value layer for 50 kVp X rays filtered by 1.0 mm of aluminum was determined to be 0.65 mm of aluminium. The dose rate at the end of the 4.0 cm source-skin-distance (SSD) cone was measured to be on the order of 1000 rad/minute. Radiation surveys performed for several treatment geometries indicate that exposure rate levels in the environs immediately around the patient can be quite high. Radiation measurements were made for the following locations: where the radiotherapist stands holding the X ray tube; at the side of the patient where the technologist or any supporting personnel might stand; and at the patients posterior surface in the direction where the anesthesiologist might stand. Radiation levels ranged from 0.001 to 1.0 roentgen (R) per hour and depend primarily on the depth and angle of the X ray tube inserted into the rectum.

Effects of collimator jaw setting on dose output for treatments with multileaf collimator

The variations in dose output with collimator jaw setting have been investigated for treatment fields shaped by a multileaf collimator. Measurements have been made for 6 and 15 MV x-ray beams on a Varian Clinac 2100C machine. The results of our study show that the collimator jaw settings can affect the dose by about 5% for a small field shaped by a multileaf collimator. The effect is smaller for larger fields.

Buildup factors and dose around a 137Cs source in the presence of inhomogeneities

The effect of inhomogeneities on dose near a gamma-ray source has been investigated. Experimental measurements were made with a 137Cs source in a polystyrene phantom at a distance of 5 cm from the source. Inhomogeneities consisted of 2-cm-thick slabs interposed between the source and the plane of measurement. Dose correction factors (DCF) for 2-cm-thick aluminum, bone, lung, and air have been determined. Our results show that for 137Cs source the dose correction factors are of the order of 3% to 8%. A theoretical model for calculation of dose correction factor in brachytherapy in the presence of inhomogeneities has been developed. The model calculates DCF using buildup factors for the water-equivalent path between the source and the point of calculation. Good agreement was found between calculations and experimental measurements.

Comparison of measured and calculated dose for asymmetric x-ray beams defined by independently movable collimators

Linear accelerators with x-ray collimators that move independently are becoming increasingly common for treatment with asymmetric fields. In an asymmetric field, the center of the treatment field is away from the true central axis where dosimetric data are normally obtained. In this paper we present a simplified approach to the calculation of dose for asymmetric fields. We use central axis tissue-maximum ratio, off-axis factor in phantom and relative field-size factor in phantom to calculate dose. The accuracy of our calculations has been compared with ion-chamber measurements for 6 and 15 MV x-ray beams. Measurements were made at 5, 10, and 15 cm off-axis for a 20 cm x 20 cm asymmetric field at dmax and 6 cm depths in a solid-water phantom using a 0.6 cc Farmer chamber. Agreement within 3% was found at the measurement points.

Linear quadratic model and biologically equivalent dose for single fraction treatments.

The linear quadratic model has been used to calculate the biologically equivalent dose for single fraction treatments. Our calculations suggest that for late reacting tissue, such as the brain, a single fraction of 1440 cGy is equivalent to a conventional treatment of 5000 cGy in 25 fractions.

Comparison of Absorbed Doses in Water and Solid Water for Electron Beams

Solid water, as a substitute for water, has become commercially available for dosimetry measurements. A study was undertaken to compare the dose in water and solid water respectively for 6, 9, 12, 16 and 20 MeV electron beams. Measurements using ion chamber show that the dose in water is higher than the dose in solid water by 1% for 6, 9, and 12 MeV electrons. For 16 and 20 MeV electrons, the dose in water and solid water are the same within the uncertainty of our measurements.

Calculation of dose in off‐central axis planes using off‐axis ratios

Accuracy of dose calculation for regular fields in off-central axis planes was investigated on a RAD-8 treatment planning computer for 4- and 10-MV x-ray beams produced by Varian Clinac -4 and Clinac -18 linear accelerators. These calculations, which are based on central axis depth dose and off-axis ratios in the principal planes, can be in error by as much as 25%-30% at locations well within the irradiated volume for the 4-MV x-ray beam. These large errors for the Clinac -4 beam result from the falloff in dose beyond the peak dose along a diagonal of a large field at distances greater than 14 cm from the central axis due to the lead flattening filter. The profile data stored in the computer along the principal planes cannot be used to calculate the dose accurately in such a situation. Computed doses for the 10-MV x-ray beam agreed with the measured doses within 4%-6% at all locations.