一种半导体探测器在乳腺AEC中应用的初步研究

目的:研究一种有效面积为1 cm×1 cm的半导体探测器对钼靶X射线的响应情况、探测器的输出与胶片达到质控密度时所需曝光量的函数关系,以期将此探测器实际应用于高频乳腺X线摄影AEC控制系统中.方法:将探测器置于暗盒下部,焦片距63 cm,利用高频乳腺X线机分别在28 kV和35 kV管电压情况下对不同厚度组体模照射,测量探测器输出,分析探测器对经体模衰减后的软X射线响应情况;对不同厚度组体模阶梯状排列以不同摄影条件拍摄胶片、测量各阶梯对应密度值,分析在胶片密度为1.0和1.25时,体模厚度与所需曝光量的函数关系,再进一步分析设定密度时探测器输出值与所需曝光量的函数关系.结果:探测器输出与体模厚度之间符合V=V0e-cx函数关系;设定胶片密度时,探测器输出值与所需曝光量之间符合J=J0(V0)k/cV-k/c函数关系.结论:进行相应的电路和控制程序设计,可将此探测器应用于实际的高频乳腺X线摄影自动曝光控制系统中,实现管电压和mAs的自动控制.     

X射线诊断所致受检者辐射剂量的表征与评估研究进展

目的：为正确评价医用X射线诊断所致受检者的辐射剂量，探讨科学且实用的测量、估算与评价各类诊断所致受检者剂量的相应方法。方法：从便于电离辐射剂量学分析角度出发。将各种医用X射线诊断分类为普通X射线检查、数字X射线摄影、乳腺X射线摄影和X射线计算机断层扫描。对比分析各类X射线诊断所致受检者剂量的各种表征量及其相应的直接测量或利用相应模式来推算的方法。结果：各类医用X射线诊断所致受检者剂量的表征量目前大都可以通过直接测量来得到，但即便辅助以各种模体，也只能准确测量出特定条件下的表征量，另外直接测量工作费时且费用高；利用有关参数建立的数理模式不仅可较方便推算各种诊断类型的辐射表征量，同时它们还可用于估算与辐射风险直接相关的受检者的有效剂量；后者更适于用来开展大规模调查和评价群体剂量及其相应的辐射风险。结论：准确评价X射线诊断所致受检者辐射剂量是医学物理领域颇为重要的课题，研究建立科学合理的辐射剂量评价模式具有重要的实用价值。     

数字化X射线摄影图像显示器配置对X射线摄影剂量的影响

目的:研究数字化X射线摄影系统图像获取工作站显示器配置不同对图像质量的影响及对被检者照射剂量的影响.材料与方法:应用对比度细节体模CDRAD2.0影像,以图像质量因子IQF作为图像质量评价标准,计算不同照射剂量下两种图像显示条件下图像质量及照射剂量的差别.结果:所研究的普通显示器与高分辨率、高亮度显示器在不同照射剂量条件下显示的图像质量因子显著不同(p＜0.000).结论:应用高亮度、高分辨率显示器作为图像获取工作站显示器可显著降低体模照射剂量.     

工频X线机和中频X线机在胸部计算机X线摄影中应用分析

目的分析工频X线机和中频X线机在胸部计算机X线摄影(CR)中的图像质量,监测相应辐射剂量,比较两种X线机在CR摄影中的适用性。方法使用工频X线机和中频X线机摄取2～3岁小儿胸片共28例,分析图像质量,监测辐射剂量;并对两种X线机高压输出及IP对X线吸收特点进行分析。结果同工频X线机相比,中频X线机更易获得优质图像,且降低了辐射剂量。结论在CR应用中,中频X线机比工频X线机有明显优势。     

数字X线摄影中原发射线和散射线的实验研究

目的：探索数字X线摄影中散射线对图像质量的影响，确定散射线影响最小、图像边界清晰的窄束X射线的线束直径。方法：在2mm厚的铅板上钻0．8mm-10．0mm不同直径的小孔，获取不同直径的X射线束。以80kV管电压、50mA管电流、15em厚的有机玻璃体模，模拟临床成像条件，获取不同直径的圆形X线束图像，并在相同条件下获取不用铅板的X射线束的图像（开放野）；由ImageJ 1．36b图象处理软件获取沿圆形图像直径方向上的像素值，绘制像素值曲线图，分析X线束图像特征。结果：经2．0mm小孔准直后，散射线对X射线束图像质量的影响几可忽略，可认为X射线束图像全是由原发射线形成的的窄束X射线，图像的像素值与空气间隙大小无关。结论：根据开放野测得的总信号和2．Omm小孔测得的原发射线信号可以计算出散射线的强度，从而将散射线分离出来。     

CR静脉肾盂造影图像质量与X射线剂量的探讨

目的探讨计算机X射线摄影（CR）在静脉肾盂造影应用中以满足图像诊断质量和X射线曝光参数（kVp、mAs）的优化组合,使X射线剂量控制在最低,降低被检者的有害X射线辐射量。方法对3组不同体型厚度（18cm、22cm、26cm）的被检者,对每组分别以常规摄影条件,增加kVp、降低mAs进行摄影。以kVp与mAs组合图像质量完全满足诊断要求,剂量最低的参数作为最优参考曝光参数。用体模替代3种被检者体型厚度,用同样摄影曝光参数,分别测量体表、体后及有关被检者器官组织的吸收X射线剂量。结果与常规摄影相比,被检者的X射线吸收剂量平均降低了31.97%,面积乘积剂量平均降低了34.57%,有效剂量降低了33.98%。结论在静脉肾盂造影中用CR成像技术与投照参数优化组合,对降低被检者的X射线吸收剂量是行之有效的,为其他投照部位用CR或数字X射线摄影（DR）数字成像参数优化组合研究提供了指导性的方法,有一定的临床应用价值。     

DAP电离室的研制及其特性研究

目的：研制适用于医学诊断X线摄影被检者照射量监测的电离室，并对其各种输出特性进行实验测量研究。材料与方法：整个电离室采用平行板电极，收集电极采用静电喷涂石墨电极，即不会在胶片上形成影像又不增加电离室对射线采吸收。结果与结论：所研制的电离室对有用X线束吸收少，其信号输出与输入线量强度及照射野面积呈良好线性，且线质响应均匀。     

Optical Surface Monitoring系统跟踪运动靶区的位置精度和剂量精度验证

目的:评估Optical Surface Monitoring System(OSMS)测量靶区运动的几何精度和使用OSMS跟踪运动靶区放疗时的剂量精度。方法:①分别使用OSMS与锥形束CT监测腹部模体的位置,通过移动治疗床使模体产生位移和旋转,对比二者对模体位置的测量结果;②用呼吸运动平台搭载MatriXX二维电离室阵列,测量不同跟踪阈值时模体内相对剂量,分别与计划剂量分布对比,分析不同跟踪阈值时计划验证的gamma通过率。结果:OSMS和锥形束CT系统对模体平移和旋转预设偏移的测量结果差异很小,使用OSMS门控技术时OSMS的阈值越小gamma通过率越高,相对剂量分布与计划剂量的一致性也越好。结论:OSMS系统对模体表面位置监测精度高,可以应用到实际放射治疗的辅助摆位。使用OSMS门控技术跟踪运动靶区可以提高靶区的剂量精度,而且对患者不附加任何电离辐射,适合应用于分次间的辅助摆位和分次内的靶区跟踪。     

线扫描直接数字化X线摄影原理与应用

目的 探讨线扫描直接数字化X线摄影的工作原理与实用价值。方法 以多丝正比室线扫描X线摄影系统为基础，分析线扫描直接数字化X线摄影的适用性。结果 线扫描成像技术克服了散射线造成的干扰，且探测灵敏度和精密度分辨率高。结论 线扫描成像技术适合于除了动态摄影以外的各种数字X线摄影，对我国常规X线摄影逐步实现数字化开辟了美好的前景。     

CT图像质量和辐射剂量的影响因素研究

目的对自动曝光技术性能进行定量评价。方法①在自动曝光方式下,检测肩部体模偏离扫描野中心时,噪声和有效mAs的变化。②在自动曝光和手动固定曝光方式下,对圆锥体模用头部和腹部方案分别进行螺旋扫描,比较2种曝光方式噪声和有效mAs随体模直径的变化。结果体模偏离扫描野中心25mm及以上时,图像的噪声在统计学上有显著差异．辐射剂量降低幅度依赖体模直径,体模位置明显影响图像质量和辐射剂量。结论在自动曝光方式下,体模位置明显影响图像质量和辐射剂量,辐射剂量降低幅度与体模的结构和大小有关。     

The influence of patient centering on CT dose and image noise

Although x-ray intensity shaping filters (bowtie filters) have been used since the introduction of some of the earliest CT scanner models, the clinical implications on dose and noise are not well understood. To achieve the intended dose and noise advantage requires the patient to be centered in the scan field of view. In this study we explore the implications of patient centering in clinical practice. We scanned various size and shape phantoms on a GE LightSpeed VCT scanner using each available source filter with the phantom centers positioned at 0, 3, and 6 cm below the center of rotation (isocenter). Surface doses were measured along with image noise over a large image region. Regression models of surface dose and noise were generated as a function of phantom size and centering error. Methods were also developed to determine the amount of miscentering using a scout scan projection radiograph (SPR). These models were then used to retrospectively evaluate 273 adult body patients for clinical implications. When miscentered by 3 and 6 cm, the surface dose on a 32 cm CTDI phantom increased by 18% and 41% while image noise also increased by 6% and 22%. The retrospective analysis of adult body scout SPR scans shows that 46% of patients were miscentered in elevation by 20-60 mm with a mean position 23 mm below the center of rotation (isocenter). The analysis indicated a surface dose penalty of up to 140% with a mean dose penalty of 33% assuming that tube current is increased to compensate for the increased noise due to miscentering. Clinical image quality and dose efficiency can be improved on scanners with bowtie filters if care is exercised when positioning patients. Automatically providing patient specific centering and scan parameter selection information can help the technologist improve workflow, achieve more consistent image quality and reduce patient dose.     

Filter materials for dose reduction in screen-film radiography

A computer program was developed to calculate both integral absorbed dose in a water phantom and entrance exposure, for the imaging of iodine contrast with x-ray intensifying screens. The effect of filtration of the x-ray beam on integral absorbed dose and entrance exposure was studied for 27 different filter materials and four types of intensifying screens. The dose and exposure were calculated, keeping the image contrast and energy absorption in the screens constant. To check the validity of the calculations, a number of measurements were performed, the results of which agreed well with our calculations. A remarkable result is that dose and exposure reduction can be achieved almost equally well with conventional filters (aluminum and copper) as with a number of K-edge filters. This was found for situations commonly encountered in diagnostic radiology (60-80 kV, 20 cm water). This finding is in contrast to a number of earlier studies, in which K-edge filters were found to be superior to conventional filters.     

Design and evaluation of a HDR skin applicator with flattening filter

The purposes of this study are: (i) to design field flattening filters for the Leipzig applicators of 2 and 3 cm of inner diameter with the source traveling parallel to the applicator contact surface, which are accessories of the microSelectron-HDR afterloader (Nucletron, Veenendaal, The Netherlands). These filters, made of tungsten, aim to flatten the heterogeneous dose distribution obtained with the Leipzig applicators. (ii) To estimate the dose rate distributions for these Leipzig+filter applicators by means of the Monte Carlo (MC) method. (iii) To experimentally verify these distributions for prototypes of these new applicators, and (iv) to obtain the correspondence factors to measure the output of the applicators by the user using an insert into a well chamber. The MC GEANT4 code has been used to design the filters and to obtain the dose rate distributions in liquid water for the two Leipzig+filter applicators. In order to validate this specific application and to guarantee that realistic source-applicator geometry has been considered, an experimental verification procedure was implemented in this study, in accordance with the updated recommendations of the American Association of Physicists in Medicine Task Group No. 43 U1 Report. Thermoluminescent dosimeters, radiochromic film, and a pin-point ionization chamber in a plastic [polymethylmethacrylate (PMMA)] phantom were used to verify the MC results for the two applicators of a microSelectron-HDR afterloader with the mHDR-v2 source. To verify the output of the Leipzig +filter applicators, correspondence factors were deduced for the well chambers HDR100-plus (Standard Imaging, Inc., Middleton, WI) and TM33004 (PTW, Freiburg, Germany) using a specific insert for both applicators. The doses measured in the PMMA phantom agree within experimental uncertainties with the dose obtained by the MC calculations. Percentage depth dose and off-axis profiles were obtained normalized at a depth of 3 mm along the central applicator axis in a cylindrical 20 x 20 cm water phantom. A table of output factors, normalized to 1 U of source air kerma strength at this depth, is presented. Correspondence factors were obtained for the two well chambers considered. The matrix data obtained in the MC simulation with a grid separation of 0.5 mm has been used to build a data set in a convenient format to model these distributions for routine use with a brachytherapy treatment planning system.     

Shaping X-ray spectra with filters in X-ray diagnostics

The influence on image contrast, tube load and patient mean absorbed dose of different ways of shaping diagnostic X-ray spectra by placing filters in the beam is derived for two radiographic models (abdominal screen-film radiography and intra-oral, dental radiography) using a computational model. The filters are compared at either equal tube load (keeping tube potential constant) or equal contrast (adjusting the tube potential with the different filters), but always at equal energy imparted per unit area to the image receptor. Compared at equal tube load and relative to standard aluminium filtration, reductions in the mean absorbed dose in the patient of 15–25% can be achieved using filters of Cu, Ti, W and Au (increasing the tube load by 30–40% compared with standard aluminium filtration). However, contrast is also reduced by 7%. Compared at equal contrast, the dose reductions are smaller, about 10%. Filters of copper are generally recommended, as are filters of aluminium. The use of bandpass filters (K-edge filters) should be restricted to examinations where the need for substantial variation in tube potential from patient to patient is small. The benefit of using thicker filters than those commonly used today (increasing tube load by factors of 1.4–2.0 compared with no added filter) is small as the dose reduction is most rapid for small initial values of added filters, and the increase in tube load increases steadily with increasing filter thickness.     

A method of using noise as a test pattern for determining image enhancement filters

Many digitally based medical imaging systems include both reconstruction algorithms and additional image filters designed to enhance certain image features. However, the manufacturers usually consider these algorithms and filters to be proprietory information. The purpose of this note is to describe a simple procedure for determining the spatial frequency response of these proprietary enhancement filters. The technique uses image noise as a test pattern. The procedure consists of acquiring a small number of noise-only data sets (say 10) of a uniform phantom and reconstructing the images using the different filters with repeated use of the noise data sets. A straightforward analysis then yields the enhancement filter frequency responses.     

不同算法所得IMRT计划的剂量学验证评估

目的:评估分别采用AAA(Analytic Anisotropic Algorithm)算法和PBC(Pencil Beam Convolution)算法所制订的IMRT计划在质量学验证方面的差异。方法:选取20例肺部肿瘤患者,对每个病例分别用AAA和PBC两种算法进行剂量计算得到2个IMRT计划,将病人的IMRT计划移植至模体生成QA(quality assurance)计划,使用Mapcheck工具对QA计划分别进行剂量学验证,并对结果进行比较和分析。结果:采用AAA算法进行肺部肿痛的剂量运算时,其所得到的治疗计划在剂量验证的结果方面要明显优于PBC算法所得到的治疗计划,值得注意的是,在其中进一步选取7例靶区位置和形态较为复杂的病例,出现以上结果的现象会更加明显。结论:从剂量学验证的角度来看,对于类似于肺部肿瘤这种靶区周围存在明显密度差异的肿瘤,在选取IMRT计划中剂量运算法则时,AAA算法剂量学验证的γ通过率更高,运算更加准确,尤其是如果靶区较为复杂时,这种表现更加显著。     

Buildup/surface dose and exit dose measurements for a 6-MV linear accelerator

The central axis dose distribution in the buildup region for the Varian Clinac 6/100 6-MV x-ray beam was measured in a polystyrene phantom using a fixed volume (0.5 cm3) parallel-plate ionization chamber (2.4-mm plate separation). Results for the surface dose measurements ranged from approximately 8% of the maximum dose for a 5 X 5 cm field, up to 36% for a 40 X 40 cm field, 100-cm source-skin distance. The effect of a 0.6-cm-thick polycarbonate blocking tray and metal filters on the surface and buildup dose is also reported. In addition, ionization measurements were made to document the dose perturbations caused by the absence of backscattering material at the exit surface of a polystyrene phantom. Exit dose measurements showed a 15% reduction in dose with essentially no scattering material beyond the measurement point. Near full scatter condition could be restored by placing 5-10 mm (depending on field size) of unit density material directly behind the ion chamber's distal surface.     

An investigation of flat panel equipment variables on image quality with a dedicated cardiac phantom

Image quality (IQ) evaluation plays a key role in the process of optimization of new x-ray systems. Ideally, this process should be supported by real clinical images, but ethical issues and differences in anatomy and pathology of patients make it impossible. Phantom studies might overcome these issues. This paper presents the IQ evaluation of 30 cineangiographic films acquired with a cardiac flat panel system. The phantom used simulates the anatomy of the heart and allows the circulation of contrast agent boluses through coronary arteries. Variables investigated with influence on IQ and radiation dose are: tube potential, detector dose, added Copper filters, dynamic density optimization (DDO) and viewing angle. The IQ evaluation consisted of scoring 4 simulated calcified lesions located on different coronary artery segments in terms of degree of visualization. Eight cardiologists rated the lesions using a five-point scale ((1) lesion not visible to (5) very good visibility). Radiation doses associated to the angiograms are expressed in terms of incident air kerma (IAK) and effective dose that has been calculated with PCXMX software (STUK, Finland) from the exposure settings assuming a standard sized patient of 70 Kg. Mean IQ scores ranged from 1.68 to 4.88. The highest IQ scores were obtained for the angiograms acquired with tube potential 80 kVp, no added Cu filters, DDO 60%, RAO and LAO views and the highest entrance detector dose that has been used in the present study, namely 0.17 muGy/im. Radiation doses (IAK approximately 40 mGy and effective dose of 1 mSv) were estimated for angiograms acquired at 15 frames s(-1), detector field-of-view 20 cm, and a length of 5 s. The following parameters improved the IQ factor significantly: a change in tube potential from 96 to 80 kVp, detector dose from 0.10 muGy/im to 0.17 muGy/im, the absence of Copper filtration. DDO variable which is a post-processing parameter should be carefully evaluated because it alters the quality of the images independently of radiation exposure settings. The SAM anthropomorphic phantom has the advantage of visualization of stenotic lesions during the injection of a contrast agent and using an anatomical background. In the future, this phantom could potentially bridge the gap between physics tests and the clinical reality in the catheterization laboratory.     

Field size dependence of wedge factors

The radiation output in the presence of wedge filters is characterized by the wedge transmission factor and open beam field size factors. Conventionally, the wedge factor for high-energy photons is measured in a water phantom at depth of maximum dose for a reference field size. Experimental measurements on different wedges indicate that the wedge factors are a function of field size. An analysis of these data show that this is primarily caused by the change in scattered radiation from the treatment head in the presence of wedge filters. The change in phantom scatter and radiation backscattered to the monitor chamber are minimal. For 4- or 6-MV x rays with a 60 degrees wedge, the use of a single wedge factor measured for 10 cm X 10 cm field introduces errors of up to 3.5%, for a 16-cm-wide field. For a 20-cm-wide field with this wedge, the error is 7%. Thinner wedges exhibit less differences.     

面膜及床单对皮肤剂量的影响

目的：观测面膜和治疗床床单对皮肤剂量的影响。方法：我们用DPD510多通道剂量监测仪及其配套的EDD2型半导体探头分别在水箱上及在患者治疗中对皮肤剂量进行了测定。结果：在水箱上测定结果显示面膜增加8.4%左右，双层床单影响4.8%，双层床单加网格状治疗床板影响14.7%。患者身上实测的结果显示面膜使皮肤剂量增加了4.5%。结论：使用面膜及床单增加了皮肤剂量，临床上需注意这一问题。