A pilot study has been conducted in which coronary arteries subject to re-stenosis after angioplasty and stenting have been irradiated following further angioplasty. The method of irradiation has been to use radioactive 188Re in an angioplasty balloon. This paper considers all aspects of the procedure including elution of the rhenium from a tungsten/rhenium generator, its concentration, dispensing and safe delivery to the patient using specially designed equipment to reduce staff doses and radioactive spills. In the pilot study of 28 lesions in 26 patients only 1 was recorded as having angiographic re-stenosis in the treated region at 6 months although 4 other patients had edge re-stenosis. This represents less than 18% re-stenosis in a population that would have been expected to exhibit at least 50% re-stenosis at 6 months. A total of 72 patients have been treated either in the pilot study or a subsequent trial. In only one case has a minor spill of radioactivity occurred and in no case has the balloon burst. Radiation doses to staff are approximately 20 microSv per procedure and are therefore not of serious consequence. It is concluded that this procedure is safe, feasible and effective in reducing in-stent re-stenosis.

Radiation dose distributions have been calculated for 188Re and 32P activity on a coronary artery stent. The doses have been calculated both as a function of position along the stent and of depth into the artery wall. Comparisons of the dose from identical activities of 188Re and 32P on the stent show that the major differences arise from the different half-lives of the two activities. Coating the activity onto three surfaces of the stent rather than just the outside surface is found to reduce the dose by approximately 8 to 9%. Similarly, the effect of ignoring the attenuation in the stainless steel of the stent is to increase doses by 11 to 17%. Consideration is also given to the effect of the prolonged treatment times associated with a radioactive stent compared with the more common treatment over several minutes. It is shown that extended treatment may require between two and eight times the single dose to achieve the same effect depending on factors such as the radionuclide used, the dose required and the assumed cell survival curve. On the assumption that an instantaneous dose of 18 Gy at a depth of 1 mm into the artery would be required for successful prevention of neointimal hyperplasia, activities required for a stent coated with 188Re and 32P are tabulated.

The radiation dosimetry associated with the use of the beta particle emitter 188Re in an angioplasty balloon is investigated for the case when the balloon has an elliptical rather than circular cross section and when iodinated x-ray contrast medium is included inside the balloon. It is found that the elliptical cross section introduces significant dose corrections when the eccentricity of the ellipse is equal to or greater than 0.7. However, for cases where the artery is nearly circular in cross section, the corrections are likely to be small. As expected, the dose is reduced along the major axis of the ellipse and increased along the minor axis. The corrections are greatest at larger distances from the surface of the balloon. The effect on dose of contrast in the balloon is significant for 33% Omnipaque in saline. Since this is a typical concentration of contrast that is used for imaging the radiation-filled balloon, correction for the effects of contrast medium in the balloon should in general be applied. To enable corrections to be readily applied for other types and concentrations of contrast media, formulas have been derived that allow the dose correction to be calculated for a range of balloon diameters and at various distances from the surface of the balloon. To undertake this calculation, the elemental composition and density of the material in the balloon needs to be known.

A surgical light source has been examined to determine the potential for retinal damage to staff in the operating theatre. It has been shown that under certain circumstances the light source examined can give an irradiance at the cornea which is well in excess of accepted safety standards. Calculation using data on the retinal irradiance required to produce retinal damage indicates that for an accidental exposure at a distance of 500 mm there is a significant possibility of retinal damage. At closer distances the probability of retinal damage is even higher. It is possible that other surgical light sources produce a similar degree of hazard and hospitals should establish suitable safety measures where necessary.

A CT scanner has been used to measure the electron density of a range of bone types in vivo. It is shown that there is a linear relationship between the CT number of bone and its electron density, which is expected theoretically if different bone types are treated as a variable mixture of osseous material and marrow. A method of calibrating any CT scanner using a simply prepared solution is proposed, which should enable electron densities of bone to be estimated from CT numbers with an accuracy of 5%.

Achromatic combinations of a diffractive phase Fresnel lens and a refractive correcting element have been proposed for x-ray and gamma-ray astronomy and for microlithography, but considerations of absorption often dictate that the refractive component be given a stepped profile, resulting in a double Fresnel lens. The imaging performance of corrected Fresnel lenses, with and without stepping, is investigated, and the trade-off between resolution and useful bandwidth in different circumstances is discussed. Provided that the focal ratio is large, correction lenses made from low atomic number materials can be used with x rays in the range of approximately 10-100 keV without stepping. The use of stepping extends the possibility of correction to higher-aperture systems, to energies as low as a few kilo electron volts, and to gamma rays of mega electron volt energy.

The water equivalence and stable relative energy response of polymer gel dosimeters are usually taken for granted in the relatively high x-ray energy range of external beam radiotherapy based on qualitative indices such as mass and electron density and effective atomic number. However, these favourable dosimetric characteristics are questionable in the energy range of interest to brachytherapy especially in the case of lower energy photon sources such as 103Pd and 125I that are currently utilized. In this work, six representative polymer gel formulations as well as the most commonly used experimental set-up of a LiF TLD detector-solid water phantom are discussed on the basis of mass attenuation and energy absorption coefficients calculated in the energy range of 10 keV-10 MeV with regard to their water equivalence as a phantom and detector material. The discussion is also supported by Monte Carlo simulation results. It is found that water equivalence of polymer gel dosimeters is sustained for photon energies down to about 60 keV and no corrections are needed for polymer gel dosimetry of 169Yb or 192Ir sources. For 125I and 103Pd sources, however, a correction that is source-distance dependent is required. Appropriate Monte Carlo results show that at the dosimetric reference distance of 1 cm from a source, these corrections are of the order of 3% for 125I and 2% for 103Pd. These have to be compared with corresponding corrections of up to 35% for 125I and 103Pd and up to 15% even for the 169Yb energies for the experimental set-up of the LiF TLD detector-solid water phantom.

A novel parameterization of x-ray interaction cross-sections is developed, and employed to describe the x-ray linear attenuation coefficient and mass energy absorption coefficient for both elements and mixtures. The new parameterization scheme addresses the Z-dependence of elemental cross-sections (per electron) using a simple function of atomic number, Z. This obviates the need for a complicated mathematical formalism. Energy dependent coefficients describe the Z-direction curvature of the cross-sections. The composition dependent quantities are the electron density and statistical moments describing the elemental distribution. We show that it is possible to describe elemental cross-sections for the entire periodic table and at energies above the K-edge (from 6 keV to 125 MeV), with an accuracy of better than 2% using a parameterization containing not more than five coefficients. For the biologically important elements 1 < or = Z < or = 20, and the energy range 30-150 keV, the parameterization utilizes four coefficients. At higher energies, the parameterization uses fewer coefficients with only two coefficients needed at megavoltage energies.

The expanding clinical use of low-energy photon emitting 125I and 103Pd seeds in recent years has led to renewed interest in their dosimetric properties. Numerous papers pointed out that higher accuracy could be obtained in Monte Carlo simulations by utilizing newer libraries for the low-energy photon cross-sections, such as XCOM and EPDL97. The recently developed PENELOPE 2001 Monte Carlo code is user friendly and incorporates photon cross-section data from the EPDL97. The code has been verified for clinical dosimetry of high-energy electron and photon beams, but has not yet been tested at low energies. In the present work, we have benchmarked the PENELOPE code for 10-150 keV photons. We computed radial dose distributions from 0 to 10 cm in water at photon energies of 10-150 keV using both PENELOPE and MCNP4C with either DLC-146 or DLC-200 cross-section libraries, assuming a point source located at the centre of a 30 cm diameter and 20 cm length cylinder. Throughout the energy range of simulated photons (except for 10 keV), PENELOPE agreed within statistical uncertainties (at worst +/- 5%) with MCNP/DLC-146 in the entire region of 1-10 cm and with published EGS4 data up to 5 cm. The dose at 1 cm (or dose rate constant) of PENELOPE agreed with MCNP/DLC-146 and EGS4 data within approximately +/- 2% in the range of 20-150 keV, while MCNP/DLC-200 produced values up to 9% lower in the range of 20-100 keV than PENELOPE or the other codes. However, the differences among the four datasets became negligible above 100 keV.

Schmid et al. recently reported on the maximum low-dose RBE for mammography X rays (29 kV) for the induction of dicentrics in human lymphocytes. To obtain additional information on the RBE for this radiation quality, experiments with monochromatized synchrotron radiation were performed. Monochromatic 17.4 keV X rays were chosen for comparison with the diagnostic mammography X-ray spectrum to evaluate the spectral influence, while monochromatic 40 keV X rays represent a higher-energy reference radiation, within the experiment. The induction of dicentric chromosomes in human lymphocytes from one blood donor irradiated in vitro with 17.4 keV and 40 keV monochromatic X rays resulted in alpha coefficients of (3.44 +/- 0.87) x 10(-2) Gy(-1) and (2.37 +/- 0.93) x 10(-2) Gy(-1), respectively. These biological effects are only about half of the alpha coefficients reported earlier for exposure of blood from the same donor with the broad energy spectra of 29 kV X rays (mean energy of 17.4 keV) and 60 kV X rays (mean energy of 48 keV). A similar behavior is evident in terms of RBEM. Relative to weakly filtered 220 kV X rays, the RBEM for 17.4 and 40 keV monochromatic X rays is 0.86 +/- 0.23 and 0.59 +/- 0.24, respectively, which is in contrast to the RBEM of 1.64 +/- 0.27 for 29 kV X rays and 1.10 +/- 0.19 for 60 kV X rays. It is evident that the monochromatic radiations are less effective in inducing dicentric chromosomes than broad-spectrum X rays with the corresponding mean energy value. Therefore, it can be assumed that, for these X-ray qualities with broad energy spectra, a large fraction of the effects should be attributed predominantly to photons with energies well below the mean energy.

High-resolution backscatter electron (BSE) imaging of colloidal gold can be accomplished at low voltage using in-lens or below-the-lens FESEMs equipped with either Autrata-modified yttrium aluminium garnet (YAG) scintillators doped with cerium, or with BSE to secondary electron (SE) conversion plates. The threshold for BSE detection of colloidal gold was 1.8 keV for the YAG detector, and the BSE/SE conversion was sensitive down to 1 keV. Gold particles (6, 12 and 18 nm) have an atomic number of 79 and were clearly distinguished at 500,000x by materials contrast and easily discriminated from cell surfaces coated with platinum with an atomic number of 78. BSE imaging was relatively insensitive to charging, and build up of carbon contamination on the specimen was transparent to the higher energy BSE.

Total linear attenuation coefficients of three tissue equivalent materials differing in their fat contents were experimentally determined for low energy photons in the range 13-51 keV. It is found that their variations with photon energy for each of these materials are describable by two distinct power functions with the validity ranges being (13-23 keV) and (32-51 keV), respectively. Therefore, to adequately represent the variation of total linear attenuation coefficients over the full photon energy range i.e., 13-51 keV, a sum of two power functions is needed. Least squares fitted equations to the entire experimental data are thus included. For muscle, the experimental data show a reasonably good agreement with the theoretically computed values that are available in literature.

We compare new experimental x-ray total mass attenuation coefficients of silicon obtained with the x-ray extended-range technique (XERT) from 5 to 20 keV with theoretical calculations and earlier experimental measurements over a 5 to 50 keV energy range. The accuracy of between 0.27% and 0.5% of the XERT data allows us to probe alternate atomic and solid state wave function calculations and to test dominant scattering mechanisms. Discrepancies between experimental results and theoretical computations of the order of 5% are discussed in detail. No single theoretical computation is currently able to reproduce the experimental results over the entire 5 to 50 keV energy range investigated.

Monochromatic x-ray computed tomography (CT) at two different energies provides information about electron density of human tissue without ambiguity due to the beam hardening effect. This information makes the treatment planning for proton and heavy-ion radiotherapy more precise. We have started a feasibility study on dual energy x-ray CT by using synchrotron radiation. A translation-rotation scanning CT system was developed for quantitative measurement in order to clarify what precision in the measurement was achieved. Liquid samples of solutions of K2HPO4 and solid samples of tissue equivalent materials were used to simulate human tissue. The experiments were carried out using monochromatic x-rays with energies of 40, 70 and 80 keV produced by monochromatizing synchrotron radiation. The solid samples were also measured in a complementary method using high-energy carbon beams to evaluate the electron densities. The measured electron densities were compared with the theoretical values or the values measured in the complementary method. It was found that these values were in agreement in 0.9% on average. Effective atomic numbers were obtained as well from dual-energy x-ray CT. The tomographic image based on each of the electron densities and the effective atomic number presents a different feature of the material, and its contrast drastically differs from that in a conventional CT image.