Assessment of safety culture in radiotherapy facilities using safety performance indicators.

This paper describes the development of the Safety Performance Indicators (SPIs), the methodology for assessment of the safety culture of radiotherapy institutions using SPIs and common strengths and common areas for improvement. SPIs were categorized into eight sections which all together contain 23 attributes and each attribute has scoring criteria from 0 to 2 (in steps of 0.5).

Multi-institutional dose audit in radiotherapy facilities using in-house developed optically stimulated luminescence disc dosimeters.

Aim: The aim of this study was to carried out the audit of radiotherapy centers practicing conformal radiotherapy techniques and demonstrate the suitability of this indigenous optically stimulated luminescence (OSL) disc dosimeters in beam quality audit and verification of patient-specific dosimetry in conventional and conformal treatments in radiotherapy.

Materials And Methods: Dose audit in conventional and conformal (intensity-modulated radiotherapy and volumetric-modulated arc therapy) radiotherapy techniques was conducted using in-house developed Al2O3:C-based OSL disc dosimeter and commercially available Gafchromic EBT3 film in 6 MV (flat and unflat) photon and 6 and 15 MeV electron beams. OSL disc dosimeter and Gafchromic EBT3 film measured dose values were verified using the ionization chamber measurements.

Evaluating the Impact of Ionization Chamber-Specific Beam Quality Correction Factor in Dosimetry of Filtered and Unfiltered Photon Beams.

Aim: The response of ionization chamber changes when used at beam quality Q which is different from beam quality Q (usually Co) that was used at the time of its calibration. Hence, one needs to apply beam quality correction factor (k) during dosimetric measurements. However, k data are unavailable for novel ion chambers in the literature.

Assessment of Regional Diagnostic Reference Levels in Dental Radiography in Tamil Nadu.

Aim: The aim of this article is to assess Tamil Nadu adult diagnostic reference levels (DRLs) by collecting radiation dose data from the four different dental modalities.

Materials And Methods: The study was carried out using routine adult exposure settings in 131 intraoral, 75 panoramic, 35 cephalometric, and 10 dental cone beam computed tomography (CBCT) X-ray devices. DRLs were assessed for intraoral and extraoral (panoramic, cephalometric, and CBCT) examinations in terms of incident air kerma (K) and kerma area product (P), respectively.

Sinogenic Intracranial Suppuration in Children: Systematic Review and Meta-analysis.

Objective: To evaluate temporal trends in the management of sinogenic intracranial suppuration and its outcomes in children.

Data Sources: A systematic search of databases was performed (Medline, Embase, Cochrane, ClinicalTrials.gov).

Survey of the Use of Diffusion-Weighted Imaging for Cholesteatoma in the United Kingdom.

Background: Non-echoplanar diffusion-weighted MRI (DWMRI) has a role in the surgical planning for cholesteatoma.

Aims/objectives: The aim of the study was to assess the use of DWMRI in the management of cholesteatoma across the UK, and measure clinicians' confidence in the use of DWMRI.

Materials And Methods: Telephone survey in 139 Otolaryngology Departments in the United Kingdom between March 2017 and July 2017, and asking radiology delegates at the British Society of Head and Neck Imaging 2017 meeting.

In-vivo dose measurements with MOSFET dosimeters during MV portal imaging.

Background: The purpose of this study was to investigate the feasibility of MOSFET dosimeter in measuring eye dose during 2D MV portal imaging for setup verification in radiotherapy.

Materials And Methods: The in-vivo dose measurements were performed by placing the dosimeters over the eyes of 30 brain patients during the acquisition of portal images in linear accelerator by delivering 1 MU with the field sizes of 10 × 10 cm and 15 × 15 cm.

Results: The mean doses received by the left and right eyes of 10 out of 30 patients when both eyes were completely inside the anterior portal field were found to be 2.

Non-classical lipoid adrenal hyperplasia presenting as hypoglycemic seizures.

Introduction Primary adrenal insufficiency is a potentially life-threatening condition that can have many underlying causes. Mutations in the steroidogenic acute regulatory protein (StAR) gene produce lipoid congenital adrenal hyperplasia (LCAH) which usually presents in the infantile period with severe symptoms of adrenal insufficiency. Less commonly, a non-classical form is identified which may present at a later age in affected individuals.

Demineralization of tooth enamel following radiation therapy; An microstructure and microhardness analysis.

Objective: The objective of this study is to evaluate the effects of radiotherapy doses on mineral density and percentage mineral volume of human permanent tooth enamel.

Materials And Methods: Synchrotron radiation Xray microcomputed tomography (SRμCT) and microhardness testing were carried out on 8 and 20 tooth samples, respectively. Enamel mineral density was derived from SRμCT technique using ImageJ software.

Relative energy response of indigenously developed optically stimulated luminescence dosimeters Al O :C, LiMgPO :B and LiCaAlF :Eu,Y in therapeutic photon and electron beams.

The relative energy responses of three indigenously developed optically stimulated luminescence (OSL) phosphors in the disc form were studied in therapeutic photon and electron beams. Calibration in terms of absorbed dose was carried out in the dose range 5-500 cGy in Co gamma rays, high energy X-rays, and electron beams used in radiotherapy. The combined standard uncertainty in the estimation of absorbed dose using these OSL discs (OSLDs) was 3.

PATIENT-SPECIFIC DOSIMETRY USING IN-HOUSE DEVELOPED OSL DISC DOSEMETERS.

Circular discs of diameter 5 mm were made from three indigenously developed optically stimulated luminescent (OSL) phosphors for medical dosimetry. Dosimetric characteristics of these discs were evaluated for their use in machine and patient-specific dosimetry in radiotherapy. Uncertainty in dosimetric measurements using these discs was also estimated, and combined standard uncertainty in measurement of absorbed dose was found to be 3.

Surgical mapping of middle ear cholesteatoma with fusion of computed tomography and diffusion-weighted magnetic resonance images: Diagnostic performance and interobserver agreement.

Objective: To assess the diagnostic performance in detecting primary cholesteatoma at various anatomical subsites using Computed Tomography (CT), Diffusion-weighted Magnetic Resonance Imaging (DWMRI) and Fusion of CT and DWMRI (Fusion CT-MRI) images.

Study Design: A retrospective study of 22 children identified from a prospective database of surgically treated cholesteatoma cases over a five year period. All cases underwent pre-operative CT, non-echo planar DWMRI and Fusion CT-DWMRI, and with clearly documented surgical findings.

Radiation dose measurements in a dental orthopantogram unit using indigenously developed optically stimulated luminescence dosimeters.

Dental orthopantogram (OPG)/cone beam computed tomography (CBCT) scanners are gaining popularity due to their 3D imaging with multiplanar view that provides clinical benefits over conventional dental radiography systems. Dental OPG/CBCT provides optimal visualization of adjacent overlaying anatomical structures that will be superpositioned in any single projection. The characteristics of indigenously developed optically stimulated luminescence dosimeters, namely, aluminium oxide doped with carbon (Al O :C), lithium magnesium phosphate doped with terbium and boron (LiMgPO :Tb,B) and lithium calcium aluminium fluoride doped with europium and yttrium (LiCaAlF :Eu,Y) were evaluated for their use in dental dosimetry.

Pretreatment Dose Verification in Volumetric Modulated Arc Therapy Using Liquid Ionization Chamber.

Purpose: The purpose of the present study was to evaluate the practicability of liquid ionization chamber (LIC) for pretreatment dose verification of the advanced radiotherapy techniques such as volumetric modulated arc therapy (VMAT).

Materials And Methods: The dosimetric characteristics of LIC such as repeatability, sensitivity, monitor unit linearity, dose rate dependence, angular dependence, voltage-current response, and output factors were investigated in 6 MV therapeutic X-ray beams. The LIC was cross-calibrated against 0.

Underdosing of the maxillary sinus for small fields used in newer radiotherapy techniques: Comparison of thermoluminescent dosimeter and Monte Carlo data.

Aims: To evaluate the underdosing of the maxillary sinus at its distal end produced by air cavity in the path of the 6 MV photon beam.

Materials And Methods: A cubic solid water slab phantom of dimensions 18 cm × 18 cm × 18 cm with 4 cm × 4 cm × 4 cm air cavity 3 cm away from its anterior surface was used in this study. The percentage depth dose (PDD) for 6 MV X-rays along the central axis of the cubical air cavity was measured using thermoluminescent dosimeter-100 chips.

CT- and MRI-based gross target volume comparison in vestibular schwannomas.

Aim: This study represents an enumeration and comparison of gross target volumes (GTV) as delineated independently on contrast-enhanced computed tomography (CT) and T1 and T2 weighted magnetic resonance imaging (MRI) in vestibular schwannomas (VS).

Background: Multiple imaging in radiotherapy improves target localization.

Methods And Materials: 42 patients of VS were considered for this prospective study with one patient showing bilateral tumor.

Radiological safety features of indigenously developed radiotherapy simulator.

Objective: To study the radiological safety feature of indigenously developed radiotherapy simulator.

Materials And Methods: A comprehensive study for radiological safety features of the unit were carried out as per the standard protocol/guidelines. NERO mAx X-ray test device was used for KVp, mA, mAs, and X-rays output related test of the units along with other required test device.

Radiation dose measurements during kilovoltage-cone beam computed tomography imaging in radiotherapy.

Objective: The use of image guidance during radiotherapy for accurate localization and setup has become the standard care of practice in radiotherapy. This mostly involves the use of kilovoltage-cone beam computed tomography (kV-CBCT) for verification of patient setup on the first few days and on a weekly basis. Some protocols require this to be performed daily and also before and after the treatment.

Hyperthyroidism in patients with thyroid cancer.

We present a retrospective case series of patients with hyperthyroidism and thyroid cancer. Our goal was to look at their clinical characteristics and outcomes to determine which patients would require further investigation. We reviewed the case notes of all patients with a histopathologic diagnosis of thyroid cancer and biochemical evidence of hyperthyroidism who had been treated at a thyroid cancer center from January 2006 through October 2013.

Radiation dose to patients from X-ray radiographic examinations using computed radiography imaging system.

The screen-film system is replaced by computed radiography system for recording the images of the patients during X-ray radiography examinations. The change in imaging system requires the re-establishment of the institutional diagnostic reference levels (DRLs) for different types of X-ray examinations conducted at the hospital. For this purpose, patient specific parameters [age, height, weight, body mass index (BMI), object to image distance (OID)] and machine specific parameters (kVp, mAs, distance and field sizes) of 1875 patients during 21 different types of X-ray examinations were recorded for estimating the entrance skin dose (ESD).

Dose enhancement in gold nanoparticle-aided radiotherapy for the therapeutic photon beams using Monte Carlo technique.

Background: Gold nanoparticle (GNP)-aided radiation therapy (RT) is useful to make the tumor more sensitive to radiation damage because of the enhancement in the dose inside the tumor region. Polymer gel dosimeter (PGD) can be a good choice for the physical measurement of dose enhancement produced by GNP inside the gel.

Materials And Methods: The present study uses EGSnrc Monte Carlo code to estimate dose enhancement factor (DEF) due to the introduction of GNPs inside the PGD at different concentrations (7 and 18 mg Au/g of gel) when irradiated by therapeutic X-rays of energy 100 kVp, 150 kVp, 6 MV, and 15 MV.

Do immediate cytology and specialist radiologists improve the adequacy of ultrasound-guided fine-needle aspiration cytology?

Objective: To assess whether a dedicated "1-stop" neck lump clinic has improved the percentage of adequate fine-needle aspiration cytology (FNAC) samples and reduced the need for repeat FNAC.

Study Design: Retrospective review.

Setting: District General Hospital in the United Kingdom.