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The aim of this study was to assess the dosimetric characteristics of a state-of-the-art C-arm cone beam computed tomography (CBCT) system using the methodology proposed by the American Association of Physicists in Medicine (AAPM) Task Group (TG) 111. The dose measurement methodology described in AAPM TG 111 for wide cone beam acquisitions without table translation was employed to estimate equilibrium beam length (αeq‾) and equilibrium dose (feq‾) in various interventional task-specific protocols with different tube arc projection geometries. Dose profiles were derived from point dose measurements in the centre and peripheral locations of the ICRU/AAPM and standard polymethyl methacrylate (PMMA) body phantom. Dose measurements were performed in phantom and free-in-air using a solid-state point detector. Monte Carlo (MC) based simulation dosimetry was performed to quantify the inhomogeneous dose patterns imparted in the phantoms. Estimatedαeq‾andfeq‾on the ICRU/AAPM phantom was up to 49.4 cm and 6.17 mGy/100 mAs, respectively. Corresponding values determined on the PMMA phantom were 139 cm and 8.8 mGy/100 mAs, respectively. Free-in-air dose measurement ranged from 1.43 mGy/100 mAs to 5.93 mGy/100 mAs. Per cent difference inαeq‾andfeq‾between MC simulation and solid-state point detector measurement methods in the ICRU/AAPM phantom were within 16% and 18%, respectively. Manufacturers can use the presented methodology to characterize the dosimetric properties of C-arm CBCT systems. Clinical medical physicists may follow this methodology to verify corresponding data provided by the manufacturer and check for C-arm CBCT system performance dosimetric consistency., (© 2023 Society for Radiological Protection. Published on behalf of SRP by IOP Publishing Limited. All rights reserved.)

Purpose: The aim of this study was to investigate the effect of varying arc exposure trajectory on radiation dose to radiosensitive organs and to assess image quality in abdominal C-arm cone beam computed tomography (CBCT) interventional procedures using a latest generation system., Methods: An anthropomorphic phantom that simulates the average adult individual was used. Individual-specific Monte Carlo (MC) simulation dosimetry was performed to estimate organ doses (OD) in abdominal C-arm CBCT. Seven examination protocols prescribed by the system for vascular and soft tissue CBCT, were simulated. These protocols are differentiated in the range of the arc exposure trajectory and the level of radiation dose delivered to the patient. OD was estimated for liver, adrenals, kidneys, pancreas, stomach, gall bladder, spleen, bone and skin. Image noise, signal to noise ratio (SNR), contrast to noise ratio (CNR) and in-plane spatial resolution were assessed using CT-specific image quality assessment phantoms., Results: OD was found to depend on the range of arc trajectory and was higher for posterior located organs. In vascular protocols OD ranged from 4.75 mGy for skin to 0.60 mGy for bone. Image noise was higher in vascular protocols than in soft tissue ones. SNR and CNR were significantly modified among different soft tissue protocols (P < 0.05). In-plane spatial resolution was found 0.80 lp/mm in vascular as opposed to 0.41 lp/mm in soft tissue protocols., Conclusions: The current results may be used to estimate OD for different examination protocols and enable operators choose the appropriate acquisition protocol on the preprogrammed interventional task., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Associazione Italiana di Fisica Medica e Sanitaria. Published by Elsevier Ltd. All rights reserved.)

Objectives: To estimate organ dose to major radiosensitive organs during pediatric body C-arm CBCT and determine normalized organ doses using a state-of-the-art equipment., Methods: This is a study performed utilizing physical anthropomorphic phantoms. Four anthropomorphic phantoms that simulate the average individual as a neonate, 1-year-old, 5-year-old, and 10-year-old child were used. Personalized Monte Carlo (MC)-based dosimetry was performed to estimate organ doses in children referred to thorax and abdomen C-arm CBCT acquisitions on a recently released latest generation C-arm CBCT system. Age-specific normalized organ doses were generated and organ dose was estimated for skin, bone, breast, lungs, esophagus, thymus, and heart, in the thorax, and liver, adrenals, kidneys, pancreas, stomach, gall bladder, and spleen in the abdomen. Estimated doses were compared to corresponding values obtained with physical measurements performed using thermoluminescent dosimeters (TLD)., Results: The results consist of organ doses for thorax and abdomen acquisition protocols. The majority of organs received a dose below 1 mSv. For all ages, the normalized organ doses decreased from neonate to 10-year-old. The difference between the organ doses obtained with MC and TLDs was less than 8%., Conclusions: Normalized organ doses in pediatric C-arm CBCT varied with age. Pediatric C-arm CBCT with latest-generation systems may be performed with sub mGy dose for most organs., Key Points: • The dose to the majority of organs from pediatric C-arm CBCT is in the sub mSv level. • The normalized organ doses decreased from neonate to 10-year-old. • Reported normalized organ doses may be used to estimate organ dose in pediatric C-arm cone-beam CT on modern equipment., (© 2022. The Author(s), under exclusive licence to European Society of Radiology.)

Purpose: To assess the utility of the standard body CTDI phantom in characterizing the operation scheme of tube current modulation (TCM) systems in CT., Methods: The body CDTI phantom was used to characterize two TCM systems: TCM 1 and TCM 2 , implemented in scanners from different vendors. The phantom was aligned at the gantry isocenter in two configurations. In configuration A, the facet planes of the phantom were parallel to the patient table, while in configuration B they were vertical to the patient table and parallel to the patient's long axis. Acquisitions were performed using the routine abdominal examination protocol. mA(z) profiles were recorded from images' DICOM header. The water equivalent diameter (d w ) and oval ratio (OR) were calculated as a function of z-axis location. Image noise was defined as the standard deviation (SD) of the mean Hounsfield unit value measured in a region of interest at the center of the phantom's image. Regression analysis was performed to modulated mA and SD vs d w and OR. The spatial concordance between the change in phantom size and change in mA (SC mA ) was calculated as the percent difference in the slope of mA(z) change between the 1st and 2nd half of the phantom. The corresponding spatial concordance between the change in phantom size and change in image noise (SC noise ) was calculated., Results: Modulated mA(z) along the z-axis did not substantially differentiate between configurations A and B. Correlation between ln(mA) and OR was found to be higher compared to correlation between ln(mA) and d w . SC mA was 48% for TCM 1 and 33% for TCM 2 . The corresponding SC noise was 29% for TCM 1 and 16% for TCM 2 ., Conclusion: Apart from routine CT dosimetry evaluations, the standard CTDI phantom positioned in configuration A or B may additionally be used by medical physicists to evaluate the performance of TCM operational characteristics., (© 2020 American Association of Physicists in Medicine.)

Objectives: To investigate the effect of iodine uptake on tissue/organ absorbed doses from CT exposure and its implications in CT dosimetry., Methods: The contrast-induced CT number increase of several radiosensitive tissues was retrospectively determined in 120 CT examinations involving both non-enhanced and contrast-enhanced CT imaging. CT images of a phantom containing aqueous solutions of varying iodine concentration were obtained. Plots of the CT number increase against iodine concentration were produced. The clinically occurring iodine tissue uptake was quantified by attributing recorded CT number increase to a certain concentration of aqueous iodine solution. Clinically occurring iodine uptake was represented in mathematical anthropomorphic phantoms. Standard 120 kV CT exposures were simulated using Monte Carlo methods and resulting organ doses were derived for non-enhanced and iodine contrast-enhanced CT imaging., Results: The mean iodine uptake range during contrast-enhanced CT imaging was found to be 0.02-0.46% w/w for the investigated tissues, while the maximum value recorded was 0.82% w/w. For the same CT exposure, iodinated tissues were found to receive higher radiation dose than non-iodinated tissues, with dose increase exceeding 100% for tissues with high iodine uptake., Conclusions: Administration of iodinated contrast medium considerably increases radiation dose to tissues from CT exposure., Key-Points: • Radiation absorption ability of organs/tissues is considerably affected by iodine uptake • Iodinated organ/tissues may absorb up to 100 % higher radiation dose • Compared to non-enhanced, contrast-enhanced CT may deliver higher dose to patient tissues • CT dosimetry of contrast-enhanced CT imaging should encounter tissue iodine uptake.

Purpose: To develop a method for estimating doses to primarily exposed organs in pediatric CT by taking into account patient size and automatic tube current modulation (ATCM)., Methods: A Monte Carlo CT dosimetry software package, which creates patient-specific voxelized phantoms, accurately simulates CT exposures, and generates dose images depicting the energy imparted on the exposed volume, was used. Routine head, thorax, and abdomen/pelvis CT examinations in 92 pediatric patients, ranging from 1-month to 14-yr-old (49 boys and 43 girls), were simulated on a 64-slice CT scanner. Two sets of simulations were performed in each patient using (i) a fixed tube current (FTC) value over the entire examination length and (ii) the ATCM profile extracted from the DICOM header of the reconstructed images. Normalized to CTDIvol organ dose was derived for all primary irradiated radiosensitive organs. Normalized dose data were correlated to patient's water equivalent diameter using log-transformed linear regression analysis., Results: The maximum percent difference in normalized organ dose between FTC and ATCM acquisitions was 10% for eyes in head, 26% for thymus in thorax, and 76% for kidneys in abdomen/pelvis. In most of the organs, the correlation between dose and water equivalent diameter was significantly improved in ATCM compared to FTC acquisitions (P < 0.001)., Conclusions: The proposed method employs size specific CTDIvol-normalized organ dose coefficients for ATCM-activated and FTC acquisitions in pediatric CT. These coefficients are substantially different between ATCM and FTC modes of operation and enable a more accurate assessment of patient-specific organ dose in the clinical setting.

The aim of this study is to dosimetrically characterize a new MRI based polymer gel system and to evaluate its usefulness in clinical practice just in terms of beam profile measurements. Normoxic N-vinylpyrrolidone based polymer gel (VIPET) phantoms were produced and used in order to perform three main sets of experiments: a) dose-response evaluation and reproducibility experiments, b) experiments for the evaluation of sensitivity of dose characteristics on 'gel manufacture - irradiation' time interval and c) experiments for the evaluation of sensitivity of dose characteristics on 'irradiation - MRscanning' time interval. It has been shown that this gel system can be used in a wide dose-range of 0-60 Gy. It exhibits a linear dose-response in the dose-range of 2-35 Gy. Following the proposed manufacturing method the dose-response characteristics are reproducible. Moreover, it seems that the optimum 'gel manufacturing - irradiation' time interval is 1 day. However, a 'gel manufacturing - irradiation' time interval up to ∼1 week can be safely used. The optimum 'irradiation - MRscanning' time interval in terms of dose-response sensitivity and dose resolution can be reliably ranged from 1 day to 3 weeks. Finally, X-ray beam profile gel-measurements were performed and found to be in satisfying agreement with corresponding small sensitive volume ion chamber measurements. VIPET gel dosimeters preserved the spatial integrity of the dose distribution during a time period of 50 days post-irradiation. The studied gel system can be safely used in clinical practice within the practical limitations found and described in this work., (Copyright © 2013 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.)

Purpose: To introduce a novel laser-based optical-CT scanner for the readout of three-dimensional (3D) radiation dosimeters., Methods: The scanner employs a diode laser, a cylindrical lens, a motorized linear rail, a rotation stage, and a charge-coupled device camera. The scanner operates in a translate-rotate fashion and may be set up in two configurations depending on the orientation of the cylindrical lens. The attenuation coefficient versus dose response was determined for a normoxic N-vinylpyrrolidone based polymer gel dosimeter. Cylindrical dosimeters, 2 cm diameter, were homogenously irradiated to known doses up to 60 Gy using a 6 MV linear accelerator. For a test irradiation, a 5 cm diameter dosimeter was irradiated along its cylindrical axis using a rectangular 1 cm x 1 cm irradiation beam. The dose readout of this scanner was compared to the corresponding readout of a common wide illumination and area detector optical-CT scanner., Results: The attenuation coefficient versus dose response of the laser-based system was found to be linear up to 60 Gy (r2 = 0.997) compared to the wide field illumination based optical-CT scanner, which exhibits linearity up to 32 Gy (r2 = 0.996). The noise in the reconstructed attenuation coefficient maps was +/- 7.2 x 10(-2) mm(-1) versus +/- 9.5 x 10(-3) mm(-1) for the laser-based system and the wide field illumination system, respectively., Conclusions: We have developed a novel laser-based optical-CT scanner, which is capable of generating fast 3D dosimetric data using a scattering polymer gel dosimeter. Our data demonstrate that the dose readout of this scanner preserves the advantage of existing laser-based optical-CT scanners in providing measurements, which are minimally affected by scattered light. For accurate reconstruction of the attenuation coefficients, noise reduction techniques need to be applied.

This study has the following objectives: To measure the geometric efficiency (GE) of a multidetector CT (MDCT) system and investigate its dependence on several exposure parameters and to correlate GE with radiation dose burden of patients undergoing MDCT imaging. Dose profiles for all available beam collimations, tube voltage values, focal spot sizes, and modes of operation were determined for a modern MDCT scanner using an array of thermoluminescent chip dosimeters positioned side by side. Dose profiles measured free-in-air and at the center and periphery of the standard polymethyl methacrylate (PMMA) phantoms were used to estimate GE. The standard free-in-air and a new measure of GE determined using the standard PMMA phantoms were correlated with volume computed tomography dose index normalized to the z-axis coverage per rotation which is directly related to patient radiation dose burden. GE was found to be from 30% to 88% as beam collimation was changed from 1.2 to 24 mm, with thin beam collimations corresponding to higher "wasted" dose. For the same tube voltage and beam collimation, the use of small focal spot was associated with higher GE compared to the large focal spot. Besides, beam quality was found to have a much weaker effect on the GE value. In comparison to free-in-air, a weighted GE determined using the standard PMMA phantoms was found to have significantly better correlation with patient radiation burden (p < 0.05). Overbeaming strongly depends on the beam collimation and focal spot size, while the impact of beam quality on GE is less pronounced. Thin beam collimations are associated with a GE of as low as 30%.

The aim of this work was to investigate the dosimetric performance properties of the N-vinylpyrrolidone argon (VIPAR) based polymer gel as a dosimetric tool in clinical radiotherapy. VIPAR gels with a larger concentration of gelatin than the standard recipe were manufactured and irradiated up to 68 Gy using a 6 and 18 MV linear accelerator. Using MRI, the R2-dose response was recorded at different imaging sessions within a 34 day time period post-irradiation. The R2-dose response was found to be linear between 5 and 68 Gy. Although dose sensitivity did not show significant variation with time, the measured R2-dose values showed an increasing trend, which was less evident beyond 17 days. At one day post-irradiation, calculated dose standard uncertainties at 20 Gy and 56 Gy were 2.2% and 1.7%, providing a dose resolution of 0.45 Gy and 0.97 Gy, respectively. Although these values fulfilled the 2% limit of ICRU, when gels were imaged at one day post-irradiation, it was shown that the temporal evolution of the R2 values deteriorated the per cent standard uncertainty and the dose resolution by approximately 57%, when imaged 17 days post-irradiation. Variation in the coagulation temperature of the gels did not impact the R2-dose sensitivity. This study has shown that the VIPAR gel has the properties of a dosimetric tool required in clinical radiotherapy, especially in applications where a wide dose dynamic range is employed. For results with the lowest per cent uncertainty and the optimum dose resolution, the dosimetry gels used in this work should be MR scanned at one day post-irradiation. Furthermore, a preliminary study on the R2-dose response of a new normoxic N-vinylpyrrolidone-based polymer gel showed that it could potentially replace the traditional VIPAR gel formulation, while preserving the wide dynamic dose response inherent to that monomer.