Journal of Biomedical Physics & Engineering
Volume:7 Issue: 3, May-Jun 2017

Jaw bone quality plays an essential role in treatment planning and prognosis of dental implants. Regarding several available methods for bone density measurements, they are not routinely used before implant surgery due to hard accessibility.
An in vitro investigation of correlation between average gray scale in direct digital radiographs and Hounsfield units in CT-Scan provides a feasible method for evaluating alveolar bone quality prior to implant surgery.
26 sheep’s mandibles in which a square shape ROI marked by gutta percha, were prepared. Three direct digital radiographs (CCD sensor) from every specimen were taken using 80, 100 and 200 milli-seconds. Then, the average gray levels for ROIs were calculated using a costume-made software. Next, the specimens were scanned using a 16-slice spiral CT and the Hounsfield Unit of each ROI was calculated. Pearson analysis measured the correlation between Hounsfield units and average gray levels.
There was a positive correlation between Hounsfield unit and average gray level in the radiographs and the correlation was better in higher exposure times.
It is possible to estimate Hounsfield unit and bone density in the jaw bones using average gray scale in a digital radiograph. This approach is easy, simple and available and also results in lower patient exposure comparing other bone densitometric analysis methods.

A new treatment approach for most patients who have undergone early stage non-small-cell lung carcinoma (NSCLC), is wedge resection plus permanent implant brachytherapy. However, the specification of dose to medium at low energies especially in heterogeneous lung is unclear yet.
The present study aims to modify source strength for different configurations of 125I and 103Pd seeds used in lung permanent implant brachytherapy.
Different arrays of 125I and 103Pd seeds were simulated by MCNPX code in protocol-based water vs. actual 3D lung environments. Absorbed dose was, then, scored in both mediums. Dose differences between both environments were calculated and source strength was modified for the prescription point. In addition, lung-to-water absorbed dose ratio was obtained and presented by precise equations.
Due to significant differences in prescription dose, source strength was modified 16%-19% and 37%-43% for different configurations of 125I and 103Pd seeds, respectively. In addition, depth-dependent dose differences were observed between the actual lung and protocol-based water mediums (dose difference as a function of depth).
Modification of source strength is essential for different arrangements of 125I and 103Pd seeds in lung implantation. Modified source strength and presented equations are recommended to be considered in future studies based on lung brachytherapy.

Stereotactic body radiotherapy delivers hypofractionated irradiation with high dose per fraction through complex treatment techniques. The increased complexity leads to longer dose delivery times for each fraction. The purpose of this study is to investigate the impact of prolonged fraction delivery time with high-dose hypofractionation on the killing of cultured ACHN cells.
Methods and Materials: The radiobiological characteristics and repair half-time of human ACHN renal cell carcinoma cell line were studied with clonogenic assays. A total dose of 20 Gy was administered in 1, 2 or 3 fractions over 15, 30 or 45 min to investigate the biological effectiveness of radiation delivery time and hypofractionation. Cell cycle and apoptosis analysis was performed after 3-fraction irradiation over 30 and 45 min.
The α/β and repair half-time were 5.2 Gy and 19 min, respectively. The surviving fractions increased with increase in the fraction delivery time and decreased more pronouncedly with increase in the fraction number over a treatment period of 30 to 45 min. With increase in the total radiation time to 30 and 45 min, it was found that with the same total dose, 2- and 3-fraction irradiation led to more cell killing than 1-fraction irradiation. 3-fraction radiation induced G2/M arrest, and the percentage of apoptotic cells decreased when the fraction delivery time increased from 30 min to 45 min.
Our findings revealed that sublethal damage repair and redistribution of the cell cycle were predominant factors affecting cell response in the prolonged and hypofractionated irradiation regimes, respectively.

Chest CT is a commonly used examination for the diagnosis of lung diseases, but a breast within the scanned field is nearly never the organ of interest.
The purpose of this study is to compare the female breast and lung doses using split and standard protocols in chest CT scanning.
The sliced chest and breast female phantoms were used. CT exams were performed using a single-slice (SS)- and a 16 multi-slice (MS)- CT scanner at 100 kVp and 120 kVp. Two different protocols, including standard and split protocols, were selected for scanning. The breast and lung doses were measured using thermo-luminescence dosimeters which were inserted into different layers of the chest and breast phantoms. The differences in breast and lung radiation doses in two protocols were studied in two scanners, analyzed by SPSS software and compared by t-test.
Breast dose by split scanning technique reduced 11% and 31% in SS- and MS- CT. Also, the radiation dose of lung tissue in this method decreased 18% and 54% in SS- and MS- CT, respectively. Moreover, there was a significant difference (p The application of a split scan technique instead of standard protocol has a considerable potential to reduce breast and lung doses in SS- and MS- CT scanners. If split scanning protocol is associated with an optimum kV and MSCT, the maximum dose decline will be provided.

In this study, a method for linear attenuation coefficient calculation was introduced.
Linear attenuation coefficient was calculated with a new method that base on the physics of interaction of photon with matter, mathematical calculation and x-ray spectrum consideration. The calculation was done for Cerrobend as a common radiotherapy modifier and Mercury.
The values of calculated linear attenuation coefficient with this new method are in acceptable range. Also, the linear attenuation coefficient decreases slightly as the thickness of attenuating filter (Cerrobend or mercury) increased, so the procedure of linear attenuation coefficient variation is in agreement with other documents. The results showed that the attenuation ability of mercury was about 1.44 times more than Cerrobend.
The method that was introduced in this study for linear attenuation coefficient calculation is general enough to treat beam modifiers with any shape or material by using the same formalism; however, calculating was made only for mercury and Cerrobend attenuator. On the other hand, it seems that this method is suitable for high energy shields or protector designing.

Angiogenesis initiated by cancerous cells is the process by which new blood vessels are formed to enhance oxygenation and growth of tumor.
In this paper, we present a new multiscale mathematical model for the formation of a vascular network in tumor angiogenesis process.
Our model couples an improved sprout spacing model as a stochastic mathematical model of sprouting along an existing parent blood vessel, with a mathematical model of sprout progression in the extracellular matrix (ECM) in response to some tumor angiogenic factors (TAFs). We perform simulations of the siting of capillary sprouts on an existing blood vessel using finite difference approximation of the dynamic equations of some angiogenesis activators and inhibitors. Angiogenesis activators are chemicals secreted by hypoxic tumor cells for initiating angiogenesis, and inhibitors of the angiogenesis are chemicals that are produced around every new sprout during tumor angiogenesis to inhibit the formation of further sprouts as a feedback of sprouting in angiogenesis. Moreover, for modelling sprout progression in ECM, we use three equations for the motility of endothelial cells at the tip of the activated sprouts, the consumption of TAF and the production and uptake of Fibronectin by endothelial cells.
Coupling these two basic models not only does provide a better time estimation of angiogenesis process, but also it is more compatible with reality.
This model can be used to provide basic information for angiogenesis in the related studies. Related simulations can estimate the position and number of sprouts along parent blood vessel during the initial steps of angiogenesis and models the process of sprout progression in ECM until they vascularize a tumor.

Radiation therapy is among the most conventional cancer therapeutic modalities with effective local tumor control. However, due to the development of radio-resistance, tumor recurrence and metastasis often occur following radiation therapy. In recent years, combination of radiotherapy and gene therapy has been suggested to overcome this problem. The aim of the current study was to explore the potential synergistic effects of N-Myc Downstream-Regulated Gene 2 (NDRG2) overexpression, a newly identified candidate tumor suppressor gene, with radiotherapy against proliferation of prostate LNCaP cell line.
In this study, LNCaP cells were exposed to X-ray radiation in the presence or absence of NDRG2 overexpression using plasmid PSES- pAdenoVator-PSA-NDRG2-IRES-GFP. The effects of NDRG2 overexpression, X-ray radiation or combination of both on the cell proliferation and apoptosis of LNCaP cells were then analyzed using MTT assay and flow cytometery, respectively.
Results of MTT assay showed that NDRG2 overexpression and X-ray radiation had a synergistic effect against proliferation of LNCaP cells. Moreover, NDRG2 overexpression increased apoptotic effect of X-ray radiation in LNCaP cells synergistically.
Our findings suggested that NDRG2 overexpression in combination with radiotherapy may be an effective therapeutic option against prostate cancer.

Magnetic resonance imaging (MRI) is the most sensitive technique to detect multiple sclerosis (MS) plaques in central nervous system. In some cases, the patients who were suspected to MS, Whereas MRI images are normal, but whether patients don’t have MS plaques or MRI images are not enough optimized enough in order to show MS plaques? The aim of the current study is evaluating the efficiency of different MRI sequences in order to better detection of MS plaques.
In this cross-sectional study which was performed at Shohada-E Tajrish in Tehran - Iran hospital between October, 2011 to April, 2012, included 20 patients who suspected to MS disease were selected by the method of random sampling and underwent routine brain Pulse sequences (Axial T2w, Axial T1w, Coronal T2w, Sagittal T1w, Axial FLAIR) by Siemens, Avanto, 1.5 Tesla system. If any lesion which is suspected to the MS disease was observed, additional sequences such as: Sagittal FLAIR Fat Sat, Sagittal PDw-fat Sat, Sagittal PDw-water sat was also performed.
This study was performed in about 52 lesions and the results in more than 19 lesions showed that, for the Subcortical and Infratentorial areas, PDWw sequence with fat suppression is the best choice, And in nearly 33 plaques located in Periventricular area, FLAIR Fat Sat was the most effective sequence than both PDw fat and water suppression pulse sequences.
Although large plaques may visible in all images, but important problem in patients with suspected MS is screening the tiny MS plaques. This study showed that for revealing the MS plaques located in the Subcortical and Infratentorial areas, PDw-fat sat is the most effective sequence, and for MS plaques in the periventricular area, FLAIR fat Sat is the best choice.

Little information is available concerning the radiation exposure of anesthesiologists, and no such data have previously been collected in Iran. This prospective study was performed to determine the amount of radiation exposure of anesthesiologists for the purpose of assessing whether or not dangerous levels of radiation exposures were being reached, and to identify factors that correlate with excessive risk.
Participants and The radiation exposure of all anesthesiology residents and the attending of Shiraz University of Medical Sciences during a 3-month period (from June to August 2016) was measured using a film badge with monthly readings. Physicians were divided into two groups: group 1 (the ones assigned to ORs with radiation exposure), and group 2 (the ones assigned to ORs with no or minimal radiation exposure).
A total number of 10744 procedures were performed in 3 major university hospitals including 353 cases of pediatric angiography, 251 cases of percutaneous nephrolithotomy, 43 cases of chronic pain palliation and 672 cases of orthopedic surgeries with C-arm application. In all 3 months, there were statistically significant differences in the amount of radiation exposure between the two groups.
Anesthesiologists working in the cardiac catheterization laboratory, pain treatment service, orthopedic and urologic ORs are exposed to statistically significantly higher radiation levels compared to their colleagues in other ORs. The radiation exposure to anesthesiologists can rise to high levels; therefore, they should get proper teaching, shielding and periodic evaluations.

Fiber carbon is the most common material used in treating couch as it causes less beam attenuation than other materials. Beam attenuation replaces build-up region, reduces skin-sparing effect and causes target volume under dosage. In this study, we aimed to evaluate beam attenuation and variation of build-up region in 550 TxT radiotherapy couch.
In this study, we utilized cylindrical PMMA Farmer chamber, DOSE-1 electrometer and set PMMA phantom in isocenter of gantry and the Farmer chamber on the phantom. Afterwards, the gantry rotated 10°, and attenuation was assessed. To measure build-up region, we used Markus chamber, Solid water phantom and DOSE-1 electrometer. Doing so, we set Solid water phantom on isocenter of gantry and placed Markus chamber in it, then we quantified the build-up region at 0° and 180° gantry angels and compared the obtained values.
Notable attenuation and build-up region variation were observed in 550 TxT treatment table. The maximum rate of attenuation was 5.95% for 6 MV photon beam, at 5×5 cm2 field size and 130° gantry angle, while the maximum variation was 7 mm for 6 MV photon beam at 10×10 cm2 field size.
Fiber carbon caused beam attenuation and variation in the build-up region. Therefore, the application of fiber carbon is recommended for planning radiotherapy to prevent skin side effects and to decrease the risk of cancer recurrence.

Polymer gel dosimeters combined with magnetic resonance imaging (MRI) can be used for dose verification of advanced radiation therapy techniques. However, the uncertainty of dose map measured by gel dosimeter should be known. The purpose of this study is to investigate the uncertainty related to calibration curve and MRI protocol for MAGIC (Methacrylic and Ascorbic acid in Gelatin Initiated by Copper) gel and finally ways of optimization MRI protocol is introduced.
MAGIC gel was prepared by the Fong et al. instruction. The gels were poured into calibration vials and irradiated by 18 MV photons. 1.5 Tesla MRI was used for reading out information. Finally, uncertainty of measured dose was calculated.
Results show that for MAGIC polymer gel dosimeter, at low doses, the estimated uncertainty is high (≈ 18.96% for 1 Gy) but it reduces to approximately 4.17% for 10 Gy. Also, with increasing dose, the uncertainty for the measured dose decreases non-linearly. For low doses, the most significant uncertainties are σR0 (uncertainty of intercept) and σa (uncertainty of slope) for high doses. MRI protocol parameters influence signal-to-noise ratio (SNR).
The most important source of uncertainty is uncertainty of R2. Hence, MRI protocol and parameters therein should be optimized. At low doses, the estimated uncertainty is high and reduces by increasing dose. It is suggested that in relative dosimetry, gels are irradiated by high doses in linear range of given gel dosimeter and then scaled down to the desired dose range.

Estimating the elbow angle using shoulder data is very important and valuable in Functional Electrical Stimulation (FES) systems which can be useful in assisting C5/C6 SCI patients. Much research has been conducted based on the elbow-shoulder synergies.
The aim of this study was the online estimation of elbow flexion/extension angle from the upper arm acceleration signals during ADLs. For this, a three-level hierarchical structure was proposed based on a new approach, i.e. ‘the movement phases’. These levels include Clustering, Recognition using HMMs and Angle estimation using neural networks. ADLs were partitioned to the movement phases in order to obtain a structured and efficient method. It was an online structure that was very useful in the FES control systems. Different initial locations for the objects were considered in recording the data to increase the richness of the database and to improve the neural networks generalization.
The cross correlation coefficient (K) and Normalized Root Mean Squared Error (NRMSE) between the estimated and actual angles, were obtained at 90.25% and 13.64%, respectively. A post-processing method was proposed to modify the discontinuity intervals of the estimated angles. Using the post-processing, K and NRMSE were obtained at 91.19% and 12.83%, respectively.