Quality assurance of carbon ion and proton beams: A feasibility study for using the 2D MatriXX detector

PurposeThe quality assurance (QA) procedures in particle therapy centers with active beam scanning make extensive use of films, which do not provide immediate results. The purpose of this work is to verify whether the 2D MatriXX detector by IBA Dosimetry has enough sensitivity to replace films in some of the measurements.MethodsMatriXX is a commercial detector composed of 32 × 32 parallel plate ionization chambers designed for pre-treatment dose verification in conventional radiation therapy. The detector and GAFCHROMIC® films were exposed simultaneously to a 131.44 MeV proton and a 221.45 MeV/u carbon-ion therapeutic beam at the CNAO therapy center of Pavia – Italy, and the results were analyzed and compared.ResultsThe sensitivity MatriXX on the beam position, beam width and field flatness was investigated. For the first two quantities, a method for correcting systematic uncertainties, dependent on the beam size, was developed allowing to achieve a position resolution equal to 230 μm for carbon ions and less than 100 μm for protons. The beam size and the field flatness measured using MatriXX were compared with the same quantities measured with the irradiated film, showing a good agreement.ConclusionsThe results indicate that a 2D detector such as MatriXX can be used to measure several parameters of a scanned ion beam quickly and precisely and suggest that the QA would benefit from a new protocol where the MatriXX detector is added to the existing systems.     

An investigation of the IQM signal variation and error detection sensitivity for patient specific pre-treatment QA

PurposeTo evaluate the Integral Quality Monitor (IQM) as a clinical dosimetry device for detecting photon beam delivery errors in clinically relevant conditions.Materials and methodsThe IQM’s ability to detect delivery errors introduced into clinical VMAT plans for two different treatment sites was assessed. This included measuring 103 nasopharynx VMAT plans and 78 lung SBRT VMAT plans with introduced errors in gantry angle (1–5°) and in MLC-defined field size and field shift (1–5 mm). The IQM sensitivity was compared to ArcCheck detector performance. Signal dependence on field position for on-axis and asymmetrically offset square field sizes from 1 × 1 cm² to 30 × 30 cm² was also investigated.ResultsThe IQM detected almost all introduced clinically-significant MLC field size errors, but not some small gantry angle errors or most MLC field shift errors. The IQM sensitivity was comparable to the ArcCheck for lung SBRT, but worse for the nasopharynx plans. Differences between IQM calculated/predicted and measured signals were within ± 2% for all on-axis square fields, but up to 60% for the smallest asymmetrically offset fields at large offsets.Conclusion The IQM performance was consistent and reproducible. It showed highest sensitivity to the field size errors for these plans, but did not detect some clinically-significant introduced gantry angle errors or most MLC field shift errors. The IQM calculation model is still being developed, which should improve small offset-field performance. Care is required in IQM use for plan verification or online monitoring, especially for small fields that are off-axis in the detector gradient direction.     

拟南芥IQM2 cDNA 的克隆与生物信息学分析

拟南芥IQM2由At3g13600编码,是IQM家族的第二个成员,但在各种分子生物学相关的文献和数据库中都找不到其cDNA序列。本研究采用RACE和RT-PCR技术,克隆得到拟南芥IQM2基因的全长cDNA序列。该cDNA长2245 bp,其开放阅读框长1818 bp,编码1个由605个氨基酸残基组成的多肽链。生物信息学分析表明,IQM2蛋白含有一个IQ基序,属于钙不依赖性钙调素结合蛋白;其N端与豌豆重金属诱导蛋白6（HMIP6）有较高的同源性,而IQ基序则分布在HMIP6结构域内部;其C端与栝楼天花粉蛋白（trichosanthin）N端具有较高的同源性。     

拟南芥IQM3基因的表达分析及其突变体的鉴定

对拟南芥(Arabidopsis thaliana)IQM3基因的功能进行了分析.结果表明,推定IQM3的启动子中存在多种光、非生物胁迫和植物激素反应的顺式作用元件,可能参与植物对环境变化的反应.RT-PCR分析表明,IQM3在拟南芥莲座叶、花序叶、茎、花和根中的表达较强,但在荚果中的表达很弱;IQM3基因的T-DNA插入突变体iqm3-1和iqm3-2分别是功能缺失和超表达突变体,对这些突变体的表型分析表明,IQM3基因与种子萌发及幼苗子叶膨大有密切关系.     

A proposed enhancement to the in air sensitivity test for ultrasound quality assurance

PurposeA number of guidelines for ultrasound quality assurance recommend the use of the in air reverberation depth as a proxy measure for sensitivity. The test is quantised, i.e. it depends on the brightness of the deepest in air reverberation. The aim of this study was to investigate a possible enhancement to the test, where the gain is reduced to determine the “reverberation threshold”.MethodsThe test was introduced in several ultrasound departments. Results were audited to determine agreement with annual tests of sensitivity using a tissue mimicking test object.ResultsThe new test was performed on 100 probes. A change in reverberation threshold was demonstrated in 9 probes; 8 of these also had changes in penetration and/or grey level in a tissue mimicking test object. Reduced penetration but no change in reverberation threshold was seen in 2 probes.ConclusionsThe reverberation threshold provides a simple enhancement to the in air sensitivity test. Periodic sensitivity testing with a tissue mimicking test object remains important.     

On the evaluation of edgeless diode detectors for patient-specific QA in high-dose stereotactic radiosurgery

PurposeIn this work, the potential of an innovative “edgeless” silicon diode was evaluated as a response to the still unmet need of a reliable tool for plan dosimetry verification of very high dose, non-coplanar, patient-specific radiosurgery treatments. In order to prove the effectiveness of the proposed technology, we focused on radiosurgical treatments for functional disease like tremor or pain.MethodsThe edgeless diodes response has been validated with respect to clinical practice standard detectors by reproducing the reference dosimetry data adopted for the Treatment Planning System. In order to evaluate the potential for radiosurgery patient-specific treatment plan verification, the anthropomorphic phantom Alderson RANDO has been adopted along with three edgeless sensors, one placed in the centre of the Planning Target Volume, one superiorly and one inferiorly.ResultsThe reference dosimetry data obtained from the edgeless detectors are within 2.6% for output factor, off-axis ratio and well within 2% for tissue phantom ratio when compared to PTW 60,018 diode. The edgeless detectors measure a dose discrepancy of approximately 3.6% from the mean value calculated by the TPS. Larger discrepancies are obtained in very steep gradient dose regions when the sensors are placed outside the PTV.ConclusionsThe angular independent edgeless diode is proposed as an innovative dosimeter for patient quality assurance of brain functional disorders and other radiosurgery treatments. The comparison of the diode measurements with TPS calculations confirms that edgeless diodes are suitable candidates for patient-specific dosimetric verification in very high dose ranges delivered by non-isocentric stereotactic radiosurgery modalities.     

Evaluation of the effects of implementing a diode transmission device into the clinical workflow

PurposeThis work investigated effects of implementing the Delta⁴ Discover diode transmission detector into the clinical workflow.MethodsPDD and profile scans were completed with and without the Discover for a number of photon beam energies. Transmission factors were determined for all beam energies and included in Eclipse TPS to account for the attenuation of the Discover. A variety of IMRT plans were delivered to a Delta⁴ Phantom+ with and without the Discover to evaluate the Discover’s effects on IMRT QA. An imaging QA phantom was used to assess the detector’s effects on MV image quality. OSLDs placed on the Phantom+ were used to determine the detector’s effects on superficial dose.ResultsThe largest effect on PDDs after d_max was 0.5%. The largest change in beam profile symmetry and flatness was 0.2% and 0.1%, respectively. An average difference in gamma passing rates (2%/2 mm) of 0.2% was observed between plans that did not include the Discover in the measurement and calculation to plans that did include the Discover in the measurement and calculation. The Discover did not significantly change the MV image quality, and the largest observed increase in the relative superficial dose when the Discover was present was 1%.ConclusionsThe effects the Discover has on the linac beam were found to be minimal. The device can be implemented into the clinic without the need to alter the TPS beam modeling, other than accounting for the device’s attenuation. However, a careful workflow review to implement the Discover should be completed.     

Use of PTW-microDiamond for relative dosimetry of unflattened photon beams

PurposeThe increasing interest in SBRT treatments encourages the use of flattening filter free (FFF) beams. Aim of this work was to evaluate the performance of the PTW60019 microDiamond detector under 6 MV and 10MVFFF beams delivered with the EDGE accelerator (Varian Medical System, Palo Alto, USA). A flattened 6 MV beam was also considered for comparison.MethodsShort term stability, dose linearity and dose rate dependence were evaluated. Dose per pulse dependence was investigated in the range 0.2–2.2 mGy/pulse. MicroDiamond profiles and output factors (OFs) were compared to those obtained with other detectors for field sizes ranging from 40 × 40 cm² to 0.6 × 0.6 cm². In small fields, volume averaging effects were evaluated and the relevant correction factors were applied for each detector.ResultsMicroDiamond short term stability, dose linearity and dependence on monitor unit rate were less than 0.8% for all energies. Response variations with dose per pulse were found within 1.8%. MicroDiamond output factors (OF) values differed from those measured with the reference ion-chamber for less than 1% up to 40 × 40 cm² fields where silicon diodes overestimate the dose of ≈3%. For small fields (<3 × 3 cm²) microDiamond and the unshielded silicon diode were in good agreement.ConclusionsMicroDiamond showed optimal characteristics for relative dosimetry even under high dose rate beams. The effects due to dose per pulse dependence up to 2.2 mGy/pulse are negligible. Compared to other detectors, microDiamond provides accurate OF measurements in the whole range of field sizes. For fields <1 cm correction factors accounting for fluence perturbation and volume averaging could be required.     

Characterization of a commercial scintillation detector for 2-D dosimetry in scanned proton and carbon ion beams

IntroductionPencil beam scanning technique used at CNAO requires beam characteristics to be carefully assessed and periodically checked to guarantee patient safety. This study aimed at characterizing the Lynx® detector (IBA Dosimetry) for commissioning and periodic quality assurance (QA) for proton and carbon ion beams, as compared to EBT3 films, currently used for QA checks.Methods and materialsThe Lynx® is a 2-D high-resolution dosimetry system consisting of a scintillating screen coupled with a CCD camera, in a compact light-tight box. The scintillator was preliminarily characterized in terms of short-term stability, linearity with number of particles, image quality and response dependence on iris setting and beam current; Lynx® was then systematically tested against EBT3 films. The detector response dependence on radiation LET was also assessed.ResultsPreliminary results have shown that Lynx is suitable to be used for commissioning and QA checks for proton and carbon ion scanning beams; the cross-check with EBT3 films showed a good agreement between the two detectors, for both single spot and scanned field measurements. The strong LET dependence of the scintillator due to quenching effect makes Lynx® suitable only for relative 2-D dosimetry measurements.ConclusionLynx® appears as a promising tool for commissioning and periodic QA checks for both protons and carbon ion beams. This detector can be used as an alternative of EBT3 films, allowing real-time measurements and analysis, with a significant time sparing.     

An institutional experience of quality assurance of a treatment planning system on photon beam

Aim

The purpose of the present study is to show the application of the IAEA TRS-430 QA procedures of Eclipse™v7.5 TPS for photon energies. In addition, the trends of the deviations found in the conducted tests were determined.

Background

In the past, the lack of complete TPS QA procedures led to some serious accidents. So, QA in the radiotherapy treatment planning process is essential for determination of accuracy in the radiotherapy process and avoidance of treatment errors.

Materials and methods

The calculations of TPS and measurements of irradiations of the treatment device were compared in the study. As a result, the local dose deviation values (δ₁: central beam axis, δ₂: penumbra and build up region, δ₃: inside field, δ₄: outside beam edges, δ_50–90: beam fringe, RW₅₀: radiological width) and their confidence limit values (including systematic and random errors) were obtained.

Results

The confidence limit values of δ₄ were detected to increase with expanding field size. The values of δ₁ and δ₃ of hard wedge were larger than open fields. The values of δ₂ and δ_50–90 of the inhomogeneity effect test were larger, especially than other tests of this study. The average deviation was showed to increase with the rise of the wedge angle. The values of δ₃ and δ₄ of lung irradiation were outside tolerance.

Conclusions

The QA of TPS was done and it was found that there were no reservations in its use in patient treatment. The trend of the deviations is shown.     

Determination of the surface dose of a water phantom using a semiconductor detector for diagnostic kilovoltage x-ray beams

PurposeTo determine the surface dose of a water phantom using a semiconductor detector for diagnostic kilovoltage x-ray beams.MethodsAn AGMS-DM+ semiconductor detector was calibrated in terms of air kerma measured with an ionization chamber. Air kerma was measured for 20 x-ray beams with tube voltages of 50–140 kVp and a half-value layer (HVL) of 2.2–9.7 mm Al for given quality index (QI) values of 0.4, 0.5, and 0.6, and converted to the surface dose. Finally, the air kerma and HVL measured by the AGMS-DM+ detector were expressed as a ratio of the surface dose for 10 × 10 and 20 × 20 cm² fields. The ratio of both was represented as a function of HVL for the given QI values and verified by comparing it with that calculated using the Monte Carlo method.ResultsThe air kerma calibration factor, CF, for the AGMS-DM+ detector ranged from 0.986 to 1.016 (0.9% in k = 1). The CF values were almost independent of the x-ray fluence spectra for the given QI values. The ratio of the surface dose to the air kerma determined by the PTW 30,013 chamber and the AGMS-DM+ detector was less than 1.8% for the values calculated using the Monte Carlo method, and showed a good correlation with the HVL for the given QI values.ConclusionIt is possible to determine the surface dose of a water phantom from the air kerma and HVL measured by a semiconductor detector for given QI values.     

A posteriori quality control for the curation and reuse of public proteomics data

Proteomics is a rapidly expanding field encompassing a multitude of complex techniques and data types. To date much effort has been devoted to achieving the highest possible coverage of proteomes with the aim to inform future developments in basic biology as well as in clinical settings. As a result, growing amounts of data have been deposited in publicly available proteomics databases. These data are in turn increasingly reused for orthogonal downstream purposes such as data mining and machine learning. These downstream uses however, need ways to a posteriori validate whether a particular data set is suitable for the envisioned purpose. Furthermore, the (semi-)automatic curation of repository data is dependent on analyses that can highlight misannotation and edge conditions for data sets. Such curation is an important prerequisite for efficient proteomics data reuse in the life sciences in general. We therefore present here a selection of quality control metrics and approaches for the a posteriori detection of potential issues encountered in typical proteomics data sets. We illustrate our metrics by relying on publicly available data from the Proteomics Identifications Database (PRIDE), and simultaneously show the usefulness of the large body of PRIDE data as a means to derive empirical background distributions for relevant metrics.     

Comparative evaluation of photoionization and flame ionization detectors for ethylene analysis

Abstract. This paper compares the use of photoionization and flame ionization detectors (PID and FID. respectively) for the analysis of ethylene in plant physiological studies. It is shown that PID has the capability to analyse ethylene levels in the order of 1 mm³ m⁻³. This represents an increase in sensitivity over FID of several-fold. Evidence is presented that this enhanced sensitivity allows for measurement of the rate of ethylene production from plants in continuous-flow systems by taking air samples directly from the air stream, thus eliminating the need for selective collection and concentration of ethylene.     

ERIC-PCR在人工混合菌体系中的检出灵敏度

提取大肠杆菌DHSα和阴沟肠杆菌(E-26R)的基因组DNA,进行ERIC-PCR,可以分别得到稳定而独特的DNA指纹图谱;模板量的变动范围从10～100ng都不会影响其图谱的稳定性;在图谱中DHSa和E-26R各自均有一条含量最大的特征带,其不易受实验环境和实验条件的干扰而发生变化。把DHSa和E-26R按比例混合,提取混合菌基因组DNA,进行ERIC-PCR,结果表明：混合菌的DNA指纹图谱为各纯菌图谱的叠加,亦具有稳定性;通过对凝胶电泳图谱中特征带的分析,可以看出：当DHSα的菌含量达到总菌量的0．5％时,可被ERIC-PCR方法清楚地检测出来。为ERIC-PCR用于土壤微生物和环境微生物的研究,特别是用于发酵工业中杂菌污染的检测与鉴定提供了一定的依据。     

An adaptation of the ultrasound transducer element test for multi-row arrays

PurposeA simple “paperclip test” for the function of individual elements in a diagnostic ultrasound transducer array is widely performed and has been adapted for phased arrays. The aim of this study was to adapt the test further for multi-row transducer arrays.MethodsAn embossing tool was used in place of the usual paperclip or metal rod and was slowly moved along the transducer array, attempting to isolate the signal from each row in turn. Phased array transducers were operated in M-mode. Non-functioning elements were identified by a reduction in amplitude of the reverberation line. The test was repeated several times for each transducer, ensuring that all non-functioning elements were identified and looking for consistency of results. 28 phased arrays and 5 linear/curvi-linear arrays in clinical use and 1 phased array and 1 linear array already identified as faulty by electronic transducer testing, and not in clinical service, were available for testing.Results8 of the clinical phased arrays were found to have 1 or more faulty elements; 3 had only minor defects and 5 were replaced under warranty or service contract. The linear/curvi-linear arrays showed no fault. The adapted test showed the failed elements in the known faulty phased array, except at the end of the array, but weak elements were not detected. The faulty linear array had a block of failed outer elements which was identified by the test.ConclusionsThe adapted test is capable of detecting non-functioning elements in multi-row arrays, but weak elements were not detected.     

浙江省热原检查用兔敏感性状况调查

目的调查浙江省热原检查用兔对细菌内毒素的敏感性情况,为提高热原检查结果的准确性和可靠性提供参考。方法对全省所有取得生产许可证单位的家兔,用国家颁发的细菌内毒素标准品,＂热原检查法＂进行检查,剂量分别为5EU/Kg和10EU/Kg,记录并比较各单位家兔的平均升温值和升温率。结果对细菌内毒素,各兔场家兔的敏感性有一定的差异。静脉注射5EU/kg,平均升温值为0.40℃～0.87℃,升温率为35%～83%;静脉注射10EU/kg,平均升温值为0.74℃～1.16℃,升温率为70%～94%。结论不同生产单位的家兔对细菌内毒素的敏感性不同,有必要对热原检查用家兔进行细菌内毒素敏感性检查。     

Body temperature measurements in the clinic; evaluation of practice in a Norwegian hospital

(1) The aim of this study was to determine the degree of agreement between the requirements of medical staff for body temperature measurements for clinical use, as defined in a previous study, and current practice in two departments in a Norwegian university hospital.

(2) The results showed that few of the highest-ranked requirements for body temperature measurements were regarded by health personnel as having been fulfilled.

(3) It will be necessary to change current practice in order to obtain agreements between these requirements and the performance of temperature measurements. This will help to improve the basis for diagnosis and treatment and provide more efficient body temperature measurement.

How to measure CT image quality: Variations in CT-numbers,uniformity and low contrast resolution for a CT quality assurance phantom

PurposeQuality assurance (QA) phantoms for testing different image quality parameters in computed tomography (CT) are commercially available. Such phantoms are also used as reference for acceptance in the specifications of CT-scanners. The aim of this study was to analyze the characteristics of the most commonly used QA phantom in CT: Catphan 500/504/600.MethodsNine different phantoms were scanned on the same day, on one CT-scanner with the same parameter settings. Interphantom variations in CT-number values, image uniformity and low contrast resolution were evaluated for the phantoms. Comparisons between manual image analysis and results obtained from the automatic evaluation software QAlite were performed.ResultsSome interphantom variations were observed in the low contrast resolution and the CT-number modules of the phantoms. Depending on the chosen regulatory framework, the variations in CT-numbers can be interpreted as substantial. The homogenous modules were found more invariable. However, the automatic image analysis software QAlite measures image uniformity differently than recommended in international standards, and will not necessarily give results in agreement with these standards.ConclusionsIt is important to consider the interphantom variations in relation to ones framework, and to be aware of which phantom is used to study CT-numbers and low contrast resolution for a specific scanner. Comparisons with predicted values from manual and acceptance values should be performed with care and consideration. If automatic software-based evaluations are to be used, users should be aware that large differences can exist for the image uniformity testing.     

支原体对抗生素的体外敏感性研究

目的研究非淋菌性尿道(宫颈)炎(NGU)患者支原体对12种抗生素敏感性,指导临床治疗。方法男性标本取尿道拭子．女性标本取宫颈拭子,采用支原体培养鉴定及药敏试剂盒进行体外药敏测定。结果126株解脲支原体(Uu)对12种抗生素敏感性从高至低依次为交沙霉素、强力霉素、美满霉素、克拉霉素、四环素、阿奇霉素、罗红霉素、司帕沙星、甲砜霉素、红霉素、可乐必妥和壮观霉素。12株人型支原体(Mh)对12种抗生素敏感性从高至低依次为交沙霉素、强力霉素、美满霉素、司帕沙星、四环素、壮观霉素、可乐必妥、甲砜霉素、红霉素、阿奇霉素、克拉霉素和罗红霉素。结论支原体耐药情况相当普遍。Uu、Mh对相同抗生素具有不同的敏感性。治疗时可依据药敏结果选择用药。     

Electron-counting MicroED data with the K2 and K3 direct electron detectors

Microcrystal electron diffraction (MicroED) uses electron cryo-microscopy (cryo-EM) to collect diffraction data from small crystals during continuous rotation of the sample. As a result of advances in hardware as well as methods development, the data quality has continuously improved over the past decade, to the point where even macromolecular structures can be determined ab initio. Detectors suitable for electron diffraction should ideally have fast readout to record data in movie mode, and high sensitivity at low exposure rates to accurately report the intensities. Direct electron detectors are commonly used in cryo-EM imaging for their sensitivity and speed, but despite their availability are generally not used in diffraction. Primary concerns with diffraction experiments are the dynamic range and coincidence loss, which will corrupt the measurement if the flux exceeds the count rate of the detector. Here, we describe instrument setup and low-exposure MicroED data collection in electron-counting mode using K2 and K3 direct electron detectors and show that the integrated intensities can be effectively used to solve structures of two macromolecules between 1.2 Å and 2.8 Å resolution. Even though a beam stop was not used with the K3 studies we did not observe damage to the camera. As these cameras are already available in many cryo-EM facilities, this provides opportunities for users who do not have access to dedicated facilities for MicroED.