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Purpose: To propose new dose point measurement-based metrics to characterize the dose distributions and the mean dose from a single partial rotation of an automatic exposure control-enabled, C-arm-based, wide cone angle computed tomography system over a stationary, large, body-shaped phantom., Methods: A small 0.6 cm(3) ion chamber (IC) was used to measure the radiation dose in an elliptical body-shaped phantom made of tissue-equivalent material. The IC was placed at 23 well-distributed holes in the central and peripheral regions of the phantom and dose was recorded for six acquisition protocols with different combinations of minimum kVp (109 and 125 kVp) and z-collimator aperture (full: 22.2 cm; medium: 14.0 cm; small: 8.4 cm). Monte Carlo (MC) simulations were carried out to generate complete 2D dose distributions in the central plane (z = 0). The MC model was validated at the 23 dose points against IC experimental data. The planar dose distributions were then estimated using subsets of the point dose measurements using two proposed methods: (1) the proximity-based weighting method (method 1) and (2) the dose point surface fitting method (method 2). Twenty-eight different dose point distributions with six different point number cases (4, 5, 6, 7, 14, and 23 dose points) were evaluated to determine the optimal number of dose points and their placement in the phantom. The performances of the methods were determined by comparing their results with those of the validated MC simulations. The performances of the methods in the presence of measurement uncertainties were evaluated., Results: The 5-, 6-, and 7-point cases had differences below 2%, ranging from 1.0% to 1.7% for both methods, which is a performance comparable to that of the methods with a relatively large number of points, i.e., the 14- and 23-point cases. However, with the 4-point case, the performances of the two methods decreased sharply. Among the 4-, 5-, 6-, and 7-point cases, the 7-point case (1.0% [±0.6%] difference) and the 6-point case (0.7% [±0.6%] difference) performed best for method 1 and method 2, respectively. Moreover, method 2 demonstrated high-fidelity surface reconstruction with as few as 5 points, showing pixelwise absolute differences of 3.80 mGy (±0.32 mGy). Although the performance was shown to be sensitive to the phantom displacement from the isocenter, the performance changed by less than 2% for shifts up to 2 cm in the x- and y-axes in the central phantom plane., Conclusions: With as few as five points, method 1 and method 2 were able to compute the mean dose with reasonable accuracy, demonstrating differences of 1.7% (±1.2%) and 1.3% (±1.0%), respectively. A larger number of points do not necessarily guarantee better performance of the methods; optimal choice of point placement is necessary. The performance of the methods is sensitive to the alignment of the center of the body phantom relative to the isocenter. In body applications where dose distributions are important, method 2 is a better choice than method 1, as it reconstructs the dose surface with high fidelity, using as few as five points.

Purpose: With the increasing clinical use of shift-variant CT protocols involving tube current modulation (TCM), variable pitch or pitch modulation (PM), and variable aperture a(t), the interpretation of the scanner-reported CTDI(vol) is called into question. This was addressed for TCM in their previous paper published by Dixon and Boone [Med. Phys. 40, 111920 (14pp.) (2013)] and is extended to PM and concurrent TCM/PM as well as variable aperture in this work., Methods: Rigorous convolution equations are derived to describe the accumulated dose distributions for TCM, PM, and concurrent TCM/PM. A comparison with scanner-reported CTDI(vol) formulae clearly identifies the source of their differences with the traditional CTDI(vol). Dose distribution simulations using the convolution are provided for a variety of TCM and PM scenarios including a helical shuttle used for perfusion studies (as well as constant mA)-all having the same scanner-reported CTDI(vol). These new convolution simulations for TCM are validated by comparison with their previous discrete summations., Results: These equations show that PM is equivalent to TCM if the pitch variation p(z) is proportional to 1/i(z), where i(z) is the local tube current. The simulations show that the local dose at z depends only weakly on the local tube current i(z) or local pitch p(z) due to scatter from all other locations along z, and that the "local CTDI(vol)(z)" or "CTDI(vol) per slice" do not represent a local dose but rather only a relative i(z) or p(z). The CTDI-paradigm does not apply to shift-variant techniques and the scanner-reported CTDI(vol) for the same lacks physical significance and relevance., Conclusions: While the traditional CTDI(vol) at constant tube current and pitch conveys useful information (the peak dose at the center of the scan length), CTDI(vol) for shift-variant techniques (TCM or PM) conveys no useful information about the associated dose distribution it purportedly represents. On the other hand, the total energy absorbed E ("integral dose") as well as its surrogate DLP remain robust (invariant) with respect to shift-variance, depending only on the total mAs = 〈i〉t0 accumulated during the total beam-on time t0 and aperture a, where 〈i〉 is the average current.

Purpose: Anomalous, scanner-reported values of CTDIvol for stationary phantom/table protocols (having elevated values of CTDIvol over 300% higher than the actual dose to the phantom) have been observed; which are well-beyond the typical accuracy expected of CTDIvol as a phantom dose. Recognition of these outliers as "bad data" is important to users of CT dose index tracking systems (e.g., ACR DIR), and a method for recognition and correction is provided., Methods: Rigorous methods and equations are presented which describe the dose distributions for stationary-table CT. A comparison with formulae for scanner-reported values of CTDIvol clearly identifies the source of these anomalies., Results: For the stationary table, use of the CTDI100 formula (applicable to a moving phantom only) overestimates the dose due to extra scatter and also includes an overbeaming correction, both of which are nonexistent when the phantom (or patient) is held stationary. The reported DLP remains robust for the stationary phantom., Conclusions: The CTDI-paradigm does not apply in the case of a stationary phantom and simpler nonintegral equations suffice. A method of correction of the currently reported CTDIvol using the approach-to-equilibrium formula H(a) and an overbeaming correction factor serves to scale the reported CTDIvol values to more accurate levels for stationary-table CT, as well as serving as an indicator in the detection of "bad data."

Purpose: The scanner-reported CTDI(vol) for automatic tube current modulation (TCM) has a different physical meaning from the traditional CTDI(vol) at constant mA, resulting in the dichotomy "CTDI(vol) of the first and second kinds" for which a physical interpretation is sought in hopes of establishing some commonality between the two., Methods: Rigorous equations are derived to describe the accumulated dose distributions for TCM. A comparison with formulae for scanner-reported CTDI(vol) clearly identifies the source of their differences. Graphical dose simulations are also provided for a variety of TCM tube current distributions (including constant mA), all having the same scanner-reported CTDI(vol)., Results: These convolution equations and simulations show that the local dose at z depends only weakly on the local tube current i(z) due to the strong influence of scatter from all other locations along z, and that the "local CTDI(vol)(z)" does not represent a local dose but rather only a relative i(z) ≡ mA(z). TCM is a shift-variant technique to which the CTDI-paradigm does not apply and its application to TCM leads to a CTDI(vol) of the second kind which lacks relevance., Conclusions: While the traditional CTDI(vol) at constant mA conveys useful information (the peak dose at the center of the scan length), CTDI(vol) of the second kind conveys no useful information about the associated TCM dose distribution it purportedly represents and its physical interpretation remains elusive. On the other hand, the total energy absorbed E ("integral dose") as well as its surrogate DLP remain robust between variable i(z) TCM and constant current i0 techniques, both depending only on the total mAs = {i}t0 = i0t0 during the beam-on time t0.

Purpose: Knowledge of the complete axial dose profile f(z), including its long scatter tails, provides the most complete (and flexible) description of the accumulated dose in CT scanning. The CTDI paradigm (including CTDIvol) requires shift-invariance along z (identical dose profiles spaced Sat equal intervals), and is therefore inapplicable to many of the new and complex shift-variant scan protocols, e.g., high dose perfusion studies using variable (or zero) pitch. In this work, a convolustion-based beam model developed by Dixon et al. [Med. Phys. 32, 3712-3728, (2005)] updated with a scatter LSF kernel (or DSF) derived from a Monte Carlo simulation by Boone [Med. Phys. 36, 4547-4554 (2009)] is used to create an analytical equation for the axial dose profile f(z) in a cylindrical phantom. Using f(z), equations are derived which provide the analytical description of Sconventional (axial and helical) dose, demonstrating its physical underpinnings; and likewise for the peak axial dose f(0) appropriate to stationary phantom cone beam CT, (SCBCT). The methodology can also be applied to dose calculations in shift-variant scan protocols. This paper is an extension of our recent work Dixon and Boone [Med. Phys. 37, 2703-2718 (2010)], which dealt only with the properties of the peak dose f(0), its relationship to CTDI, and its appropriateness to SCBCT., Methods: The experimental beam profile data f(z) of Mori et al. [Med. Phys. 32, 1061-1069 (2005)] from a 256 channel prototype cone beam scanner for beam widths (apertures) ranging from a = 28 to 138 mm are used to corroborate the theoretical axial profiles in a 32 cm PMMA body phantom., Results: The theoretical functions f(z) closely-matched the central axis experimental profile data for all apertures (a = 28 -138 mm). Integration of f(z) likewise yields analytical equations for all the (CTDI-based) dosimetric quantities of conventional CT (including CTDIL itself) in addition to the peak dose f(0) relevant to SCBCT (allowing direct cross-comparison between CT scan modes and mathematical proofs of several hypotheses of practical utility in CT dosimetry). A fast, analytical dose simulator6 is also demonstrated-successfully matching complex dose distributions measured using OSL and film dosimetry., Conclusions: The model described allows one to obtain analytical functions describing both the primary and scatter components of the axial dose profile. This model (using no empirical functions or adjustable fit parameters) provides a good match to the experimental data, as well as a complete analytical description of dose for both conventional (axial and helical) CT and cone beam CT. An efficient method whereby the complete data set for both modalities can be obtained from a single measurement of either CTDI100 or f(0) is illustrated. This method is also flexible--allowing calculation of heretofore unattainable doses for recently-introduced shift-variant protocols [e.g., variable pitch (irregular scan spacing), variable aperture, shuttle mode acquisition, and mA modulation schemes].

Purpose: This article describes a common methodology and measurement technique, encompassing both conventional (helical and axial) CT scanning using phantom translation and cone beam (or narrow fan beam) CT scans about a stationary phantom. Cone beam CT systems having beam widths along the z-axis wide enough to cover a significant anatomical length (50-160 mm) in a single axial rotation (e.g., in cardiac CT) are rapidly proliferating in the clinic, referred to herein as stationary cone beam CT (SCBCT). The integral format of the CTDI paradigm is not appropriate for a stationary phantom, and is not useful for predicting the dose in SCBCT, nor for perfusion studies or CT fluoroscopy. Likewise, the pencil chamber has limited utility in this domain (even one of extended length)., Methods: By demonstrating, both experimentally and theoretically, the match between the dose distribution f(z) for a wide cone beam and that due to an axial scan series D(z), it is shown that the dose on the central ray of the cone beam f(0) is both spatially colocated and numerically equal to the dose predicted by CTDI for the axial series; and thus f(0) is the logical (and unique) choice for a SCBCT dose-descriptor consistent with the CTDI-based dose of conventional CT. This dose f(0) can be readily measured using a conventional (short) ionization chamber. Additionally, Monte Carlo simulations of Boone [J. M. Boone, "Dose spread functions in computed tomography: A Monte Carlo study," Med. Phys. 36, 4547-4554 (2009)], expressed as a scatter LSF (or DSF), allow the application of a convolution-based model [R. L. Dixon, M. T. Munley, and E. Bayram, "An improved analytical model for CT dose simulation with a new look at the theory of CT dose," Med. Phys. 32, 3712-3728 (2005)] of the axial dose profile f(z) for any primary beam width a (any n x T), fan beam and cone beam alike, from a single LSF kernel; its simple form allows the results to be expressed as simple analytical equations. The experimental data of Mori et al. [S. Mori, M. Endo, K. Nishizawa, T. Tsunoo, T. Aoyama, H. Fujiwara, and K. Murase, "Enlarged longitudinal dose profiles in cone-beam CT and the need for modified dosimetry," Med. Phys. 32, 1061-1069 (2005)] from a 256 channel cone beam scanner for a variety of beam widths (28-138 mm) are used to corroborate the theory., Results: Useful commonalities between SCBCT and conventional CT dose are revealed, including a common equilibrium dose parameter A(eq), which is independent of z-collimator aperture a (or n x T), and a common analytical (exponential growth) function H(lambda) describing the relative approach to scatter equilibrium at z = 0 for both modalities (with lambda = a or lambda = scan length L). This function exhibits good agreement with the above-mentioned cone beam data of Mori et al. for H(a) as well as with data H(L) obtained from conventional CT scanning [R. L. Dixon and A. C. Ballard, "Experimental validation of a versatile system of CT dosimetry using a conventional ion chamber: Beyond CTDI100," Med. Phys. 34(8), 3399-3413 (2007)] for the same directly irradiated, phantom length L = a., Conclusions: This methodology and associated mathematical theory provide a physically self-consistent description of dose between stationary phantom CT and conventional CT, and has predictive capabilities which can be used to effect a substantial reduction in data collection; provide a bridge between modalities; and predict the relevant peak doses f(0) for perfusion studies.

This article is an experimental demonstration and authentication of a new method of computed tomography dosimetry [R. L. Dixon, Med. Phys. 30, 1272-1280 (2003)], which utilizes a short, conventional ion chamber rather than a pencil chamber, and which is more versatile than the latter. The value of CTDI100 correctly predicts the accumulated dose only for a total scan length L equal to 100 mm and underestimates the limiting equilibrium dose approached for longer, clinically relevant body scan lengths [R. L. Dixon, Med. Phys. 30, 1272-1280 (2003); K. D. Nakonechny, B. G. Fallone, and S. Rathee, Med. Phys. 32, 98-109 (2005); S. Mori, M. Endo, K. Nishizawa, T. Tsunoo, T. Aoyama, H. Fujiwara, and K. Murase, Med. Phys. 32, 1061-1069 (2005); R. L. Dixon, M. T. Munley, and E. Bayram, Med. Phys. 32, 3712-3728 (2005); R. L. Dixon, Med. Phys. 33, 3973-3976 (2006)]. Dixon [Med. Phys. 30, 1272-1280 (2003)] originally proposed an alternative using a short ion chamber and a helical scan acquisition to collect the same integral for any scan length L (and not limited 100 mm). The primary purpose of this work is to demonstrate experimentally the implementation, robustness, and versatility of this small ion chamber method in measuring the accumulated dose in the body phantom for any desired scan length L (up to the available phantom length) including the limiting equilibrium dose (symbolically CTDIinfinity), and validation of the method against the pencil chamber methodology. Additionally, a simple and robust method for independently verifying the active length of a pencil chamber is described. The results of measurements made in a 400 mm long, 32 cm diameter polymethylmethacrylate body phantom using a small Farmer-type ion chamber and two pencil chambers of lengths l=100 and 150 mm confirm that the two methodologies provide the same dose values at the corresponding scan lengths L=l. The measured equilibrium doses obtained for GE MDCT scanners at 120 kVp are CTDIinfinity = 1.75 CTDI100 on the central axis and 1.22 CTDI100 on the peripheral axes, illustrating a nontrivial shortfall of CTDI100 in that regard and in good agreement with comparable data [S. Mori, M. Endo, K. Nishizawa, T. Tsunoo, T. Aoyama, H. Fujiwara, and K. Murase, Med. Phys. 32, 1061-1069 (2005); J. M. Boone, Med. Phys. 34, 1364-1371 (2007)].

Gagne [Med. Phys. 16, 29-37 (1989)] has previously described a model for predicting the sensitivity and dose profiles in the slice-width (z) direction for CT scanners. The model, developed prior to the advent of multidetector CT scanners, is still widely used; however, it does not account for the effect of anode tilt on the penumbra or include the heel effect, both of which are increasingly important for the wider beams (up to 40 mm) of contemporary, multidetector scanners. Additionally, it applied only on (or near) the axis of rotation, and did not incorporate the photon energy spectrum. The improved model described herein transcends all of the aforementioned limitations of the Gagne model, including extension to the peripheral phantom axes. Comparison of simulated and measured dose data provides experimental validation of the model, including verification of the superior match to the penumbra provided by the tilted-anode model, as well as the observable effects on the cumulative dose distribution. The initial motivation for the model was to simulate the quasiperiodic dose distribution on the peripheral, phantom axes resulting from a helical scan series in order to facilitate the implementation of an improved method of CT dose measurement utilizing a short ion chamber, as proposed by Dixon [Med. Phys. 30, 1272-1280 (2003)]. A more detailed set of guidelines for implementing such measurements is also presented in this paper. In addition, some fundamental principles governing CT dose which have not previously been clearly enunciated follow from the model, and a fundamental (energy-based) quantity dubbed "CTDI-aperture" is introduced.

Equations are derived for generating accumulated dose distributions and the dose line integral in a cylindrical dosimetry phantom for a helical CT scan series from the single slice dose profiles using convolution methods. This exposition will better clarify the nature of the dose distribution in helical CT, as well as providing the medical physicist with a better understanding of the physics involved in dose delivery and the measurement process. Also addressed is the concern that as radiation beam widths for multi-slice scanners get wider, the current methodology based on the measurement of the integral of the single slice profile using a 10 cm long ion chamber (CTDI100) may no longer be adequate. It is shown that this measurement would underestimate the equilibrium dose and dose line integral by about 20% in the center of the body phantom, and by about 10% in the center of the head phantom for a 20 mm nominal beam width in a multi-slice scanner. Rather than making the ion chamber even longer to collect the broad scatter tails of the single slice profile, an alternative to the CTDI method is suggested which involves using a small volume ion chamber, and scanning a length of phantom long enough to establish dose equilibrium at the location of the chamber. With a modern CT scanner, such a scan length can be covered in 15 s or less with a helical or axial series, so this method is not significantly more time-consuming than the long chamber method. The method is demonstrated experimentally herein.

The traditional approach to shielding design for diagnostic x-ray facilities has been to designate as primary barriers the floor and those walls on which the useful beam may impinge, and to ignore the attenuation provided by the patient, grid, cassette, cassette holder, and x-ray table in computing the required thickness of these barriers. The degree of attenuation provided by the aforementioned materials has been measured on three-phase x-ray equipment including a variety of modern x-ray tables, grids, and cassettes. The primary beam is shown to be attenuated by more than two orders of magnitude at 100 kVp by the x-ray tables tested prior to impinging on the floor (ignoring patient attenuation). If patient attenuation is included, the attenuation is more than three orders of magnitude. Transmission factors as well as lead and concrete equivalencies for the various attenuating materials have been determined and included in tabular form. Example calculations for a heavy work load show that only a modest amount of concrete is required in the floor as a primary barrier if attenuation by these materials is taken into consideration (less than 2.5 cm at 80 kVp and less than 4 cm at 100 kVp) and the required secondary barrier may be thicker than the primary barrier.(ABSTRACT TRUNCATED AT 250 WORDS)

The performance of a new quality control dose monitor for radiation therapy with respect to precision, stability, temperature coefficient, and radiation damage has been extensively evaluated. The results of routine use at several centers are reported.

A systematic survey of the thermoluminescence (TL) of rare earth activated sulfates of the form MeSO4:RE was made, where Me denotes a divalent metal and RE the rare earth. SrSO4:Tb(3+) and BaSO4:Eu(2+) exhibit very high TL efficiency following gamma irradiation, comparable to that of the most sensitive phosphors currently available for TL dosimetry. Due to their relatively high Z, these phosphors could prove useful as quality indicators for personnel dosimetry or for detecting very small exposures of low-energy X rays of a known quality.

The physics of pulse NMR which is pertinent to an understanding of proton NMR imaging has been condensed and directed toward the medical physicist. The basic physical principals of spin manipulations using rf pulses are presented, and the relation between the quantum mechanical and the classical descriptions is covered in a rigorous fashion. The physics of relaxation is described and the relaxation times T1 and T2 are explained in some detail. Application of these spin manipulation techniques is illustrated by showing how they may be used in creating an image.

Oblique incidence of an electron beam can alter the central axis depth dose. The incident beam can be considered to be an integration of many pencil beams or slit beams. Depending on the depth in the phantom, neighboring pencil beams may have a greater or lesser contribution to the dose at a point on the central axis compared to the contribution under normal incidence. The effect has been studied experimentally and theoretically. For 6- and 9-MeV electron beans, oblique incidence is found to produce an increased dose at shallow depths and a decreased dose at normal treatment depths.

A calibration monitor has been designed for measuring the constancy of linear accelerator or cobalt unit output between full calibrations. This monitor is battery operated, light-weight and slides into the shadow tray attachment on a linear accelerator or cobalt unit for easy setup. It provides a digital readout of the dose delivered, and a consistency check can be made in less than two minutes. The precision of the monitor, determined by cobalt-60 irradiations over a 2 1/2 period, is +/- 0.6% (standard deviation). The monitor also retains the dose reading in a CMOS digital counter indefinitely, hence it can be used in the same fashion as mailed thermoluminescent dosimeters (TLD) for calibration checks at remote facilities without the complicated readout procedures associated with TLD. The monitor can be mailed to a remote facility, positioned without ambiguity, and irradiated; and the reading can be verified on return to the originating center simply by pressing a switch. The monitor can easily be set up to carry out a "blind" check in which the reading obtained is not known to the remote facility.

The nuclear magnetic resonance (NMR) spin-lattice relaxation time (T1) of samples taken from human tumors was measured in vitro at Larmor frequencies of 24 and 6.25 MHz. It was found that on the average T1 at 6.25 MHz was linearly related to T1 at 24 MHz. An analogous set of measurements was performed on pieces of normal rat tissue. In this case, the relationship between T1 at the two frequencies was similar to that found for the human tumor tissue.

A simple, heuristic model of a photographic emulsion is described for the purpose of illustrating the fundamental physical processes and emulsion properties which determine the characteristics of an x-ray film (viz., the shape of the H - D curve, film gamma, and film speed). By means of this model, it is shown that the contrast multiplication afforded by an x-ray film (i.e., a film gamma greater than unity) is a direct result of the exponential attenuation of the viewing light by the developed film, and that film gamma is proportional to grain size, grain density, and emulsion thickness. The difference in the H - D curve that is observed when the same film is exposed to light from an intensifying screen or directly to x rays is also predicted by the model.