An Electron Gamma Shower version 4 (EGS4) based user code was developed to simulate the absorbed dose in humans during routine diagnostic radiological procedures. Measurements of absorbed dose using thermoluminescent dosimeters (TLDs) were compared directly with EGS4 simulations of absorbed dose in homogeneous, heterogeneous and anthropomorphic phantoms. Realistic voxel-based models characterizing the geometry of the phantoms were used as input to the EGS4 code. The voxel geometry of the anthropomorphic Rando phantom was derived from a CT scan of Rando. The 100 kVp diagnostic energy x-ray spectra of the apparatus used to irradiate the phantoms were measured, and provided as input to the EGS4 code. The TLDs were placed at evenly spaced points symmetrically about the central beam axis, which was perpendicular to the cathode-anode x-ray axis at a number of depths. The TLD measurements in the homogeneous and heterogenous phantoms were on average within 7% of the values calculated by EGS4. Estimates of effective dose with errors less than 10% required fewer numbers of photon histories (1 x 10(7)) than required for the calculation of dose profiles (1 x 10(9)). The EGS4 code was able to satisfactorily predict and thereby provide an instrument for reducing patient and staff effective dose imparted during radiological investigations.
The impact of a formal compliance testing program has been evaluated three years post-implementation on a major teaching hospital (Sir Charles Gairdner Hospital) with 46 x-ray tubes located throughout 37 rooms. The mandatory program, implemented by the statutory authority in January 1997, called for all medical (including chiropractic and dental) equipment used in human diagnosis to be tested at prescribed frequencies using established protocols. The application of the required test methods demonstrated various non-compliance issues. Notices of non-compliance were received for approximately 60% of the equipment in the hospital following the equipment's first annual test. The reasons for, and the significance of, failure varied according to equipment category, test category, equipment use and equipment age. However, at the end of the third year of testing, approximately 75% of the tested x-ray units satisfied the compliance criteria. The main reasons for non-compliance were found to be design limitations of old technology and the current radiation legislation that makes it difficult for some older equipment to meet the relatively stringent criteria.
A phosphor opto-coupled monochrome CMOS image sensor with a slit diaphragm was used to investigate focal spot characteristics. Images were captured during x-ray exposure with a triggered frame grabber and subsequently enhanced. Dimensions of the focal spot width (1.39mm) and length (1.92mm) were determined from the focal spot intensity profiles and their corresponding Full Width at Half Maxima (FWHM) in two orthogonal orientations. The CMOS image sensor measurements demonstrated differences in the measured width and length dimensions when compared to film measurements. The obtained nominal focal spot values however showed that image-sensor determined focal spot dimensions agreed with the direct film and film-screen methods when based on the AS/NZS defined nominal focal spot values. The CMOS image sensor tested appears to lack the measurement accuracy required for the measurement of small focal spot sizes due in part to its limited camera sensitivity.
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