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Long-term stability of beam quality and output of conventional X-ray units
Abstract
Conventional diagnostic X-ray units are used for radiographic imaging in many countries. For obtaining entrance surface doses, a numerical dose determination method has been applied in Japan. Although this technique is effective, it has to account for errors, particularly fluctuations, due to the beam quality and output of X-ray tubes. As a part of our quality control procedures, we recorded the entrance surface air kerma, tube voltage, and half-value layer measurements made for four diagnostic X-ray tubes over a 103-week period. The entrance surface air kerma for one of the four X-ray tubes had increased significantly by 11.4 % over 1 year from its initial setting, whereas the tube voltages and half-value layers did not deviate significantly from their initial values. Medical physicists and radiological technologists should be aware of this fluctuation for diagnostic X-ray tubes and take it into consideration when calculating the entrance surface air kerma.
... By contrast, the focal spot position can take a few hours to stabilise [11, 46]. Over longer times Fukuda et al [47] found that the half-value layer (the thickness of material required to reduce the x-ray flux by half, and is dependent on the x-ray spectrum) varied for a particular x-ray source by ±2% over a 103 week period, while for another source the entrance air kerma increased by ~11%. Similarly, the output of x-ray detectors can vary over a range of timescales [48]. ...
Tomographic imaging modalities are being increasingly used to quantify internal characteristics of objects for a wide range of applications, from medical imaging to materials science research. However, such measurements are typically presented without an assessment being made of their associated variance or confidence interval. In particular, noise in raw scan data places a fundamental lower limit on the variance and bias of measurements made on the reconstructed 3D volumes. In this paper, the simulation-extrapolation technique, which was originally developed for statistical regression, is adapted to estimate the bias and variance for measurements made from a single scan. The application to x-ray tomography is considered in detail and it is demonstrated that the technique can also allow the robustness of automatic segmentation strategies to be compared.
The optimum X-ray tube voltage for chest radiographic examinations remains unclear; hence, the tube voltage varies between medical facilities. An exposure index (EI) was proposed to standardize the parameters for radiographic examinations. However, even if identical EI values are used to examine the same person, organ doses may vary due to differences in tube voltages. In this study, the variation in organ doses between different beam qualities under identical EI values for chest radiographic examinations was investigated using Monte Carlo simulations. A focused anti-scatter grid as well as standard and larger physique-type medical internal radiation dose (MIRD) phantoms were studied under tube voltages of 90, 100, 110, and 120 kVp. The organ doses in the MIRD phantom increased as the X-ray tube voltage decreased, even with identical EI values. The absorbed doses in the lungs of standard and large-sized MIRD phantoms at 90 kVp were 23% and 35% higher than those at 120 kVp, respectively. The doses to organs other than the lung at 90 kVp were also higher than those at 120 kVp. From the perspective of reducing radiation doses, a tube voltage of 120 kVp is considered better for chest examinations compared with a tube voltage of 90 kVp under identical EI values.
This study aimed to develop an energy-based Hp(3) measurement method using a solid-state detector (SSD). Incident and entrance surface air kerma were measured using an ionization chamber placed free-in-air and in front of an anthropomorphic or slab phantom. Subsequently, three SSDs were placed free-in-air, and half-value layer and readings were obtained. After measurements, an X-ray beam quality correction factor $\left ({{k}}_{{Q},{{Q}}_{\mathbf{0}}}^{{SSD}}\right)$, backscatter factor (BSF) and conversion factor from incident air kerma to Hp(3) (C3) were determined. Then, the incident air kerma by SSD $\left ({{K}}_{{a},{i}}^{{SSD}}\right )$, Hp(3) and Hp(3)/${{K}}_{{a},{i}}^{{SSD}}$ were calculated. The ${{k}}_{{Q},{{Q}}_{\mathbf{0}}}^{{SSD}}$ was almost consistent for all SSDs. The C3 and BSF were found to increase as tube potential increased. The Hp(3)/${{K}}_{{a},{i}}^{{SSD}}$ calculated with the anthropomorphic and slab phantoms were consistent within 2.1% and 2.6% for all SSDs, respectively. This method improves the energy dependence of Hp(3) measurement and can estimate the Hp(3) measurement error for dedicated Hp(3) dosemeters.
Complex procedures for interventional radiology can result in high radiation doses to patients and physicians. A spectral shaping filter (SSF) has recently been developed and equipped with angiographic systems to modulate the X-ray beam spectrum. In our feasibility study, the radiation doses to patients and physicians, air kerma rate at image receptor, and image quality were evaluated when SSF was applied in fluoroscopy. Polymethyl methacrylate (PMMA) phantom, a catheter attached on the bottom was placed on the examination table. The entrance air kerma rate at patient entrance reference point, H* (10) rate at a distance of 100 cm from the center of PMMA, air kerma rate at image receptor and the fluoroscopic catheter images were recorded as a function of PMMA thickness. Contrast-to-noise ratio (CNR) was used for the objective image quality. As a subjective image quality evaluation, three physicians (cardiologist, neurologist, and radiologist) rated the catheter images by a Likert scale. With SSF, the entrance air kerma rate and H* (10) rate reduced by about 34 and 21%, respectively. The air kerma rate at image receptor in conventional filter mode increased when the PMMA was up to 10 cm and then CNR was also improved. However, no significant differences were found in the subjective image qualities. In conclusion, SSF was contributed to the reduction of the radiation doses to patients and physicians while the subjective image quality was not affected.
Conventional diagnostic X-ray units are used for radiographic imaging in several countries. As a part of our quality control procedures, we recorded entrance surface air kerma, tube voltage, and half-value layer measurements for four diagnostic X-ray tubes over a 108 week course. The entrance surface air kerma for one of the X-ray tubes suddenly declined in the 107th week, and the filament burned out 1 week later. We retrospectively reviewed these data and observed that the entrance surface air kerma of the failing tube had increased as a function of elapsed time. The slopes for these four X-ray units were calculated, and we observed that the slope of the failing tube was higher than that of the other three tubes (P < 0.001). Monitoring of the fluctuation in the entrance surface air kerma would be valuable for predicting the residual life expectancy of X-ray tubes.
In Japan, the entrance air kerma rate (EAKR) to a patient cannot exceed 50 mGy/min in conventional fluoroscopy. However, it is unclear where the EAKR should be measured. We obtained the tube potential and tube current as a function of polymethylmethacrylate (PMMA) thickness, and the EAKR at the interventional reference point (IRP) was measured from the trajectory. The EAKR at the point established by the U.S. Food and Drug Administration (FDA) was calculated from EAKR at the IRP. The EAKR at the IRP exceeded the limit at a PMMA thickness of 22-28 cm. However, the EAKR did not exceed the limit at the FDA point. If the EAKR to a patient is being verified to meet the recent Japanese ruling, the EAKR should be measured at the FDA point, and if the EAKR is being evaluated for determination of the skin dose, it should be monitored at the IRP.
The purpose of this work was to propose guidance levels of entrance surface doses for radiographic examinations of Japanese patients based on a nationwide survey. Questionnaires asking about the technical conditions of radiography were sent to 2,000 hospitals in Japan. The entrance doses (1st quartile, median, 3rd quartile, and mean) were calculated by the Numerical Dose Determination (NDD) method described in this paper and by using the conditions reported in the questionnaires. Our results for all types of examinations showed that the median was lower than the mean, whereas the median was higher than the mean in the results reported in the British NRPB 21. The median of our results was lower than that in the NRPB in England (Present work/NRPB in England = 0.27-0.74). We propose guidance levels of entrance surface doses for examinations carried out in Japanese institutions as the 3rd quartile of the dose distributions. The present proposed levels are lower than those described by IAEA. The calculated entrance surface doses exceeded the guidance levels set by IAEA in less than 10% of the institutions surveyed.
Reference values (RVs) are recommended by the American Association of Physicists in Medicine for four radiographic projections, computed tomography, fluoroscopy, and dental radiography. RVs are used to compare radiation doses from individual pieces of radiographic equipment with doses from similar equipment assessed in national surveys. RVs recommended by the American Association of Physicists in Medicine have been developed from the Nationwide Evaluation of X-ray Trends survey performed by the state radiation protection agencies with the cooperation and support of the U.S. Food and Drug Administration, the Conference of Radiation Control Program Directors, and the American College of Radiology. The RVs selected by the American Association of Physicists in Medicine represent, approximately, the 80th percentile of the survey distributions. Consequently, equipment exceeding the RVs is using higher radiation doses than is 80% of the equipment in the surveys. Radiation doses for specific projections, with standard phantoms, should be measured annually, as recommended by the American College of Radiology. When the RVs are exceeded, the medical physicist should investigate the cause and determine, in cooperation with the responsible radiologist, whether these doses are justified or the imaging system should be optimized to reduce patient radiation doses. RVs are a useful tool for comparing patient radiation doses at institutions throughout the United States and for providing information about radiographic equipment performance.