This study aimed to evaluate the influence of change in respiratory motion on matchline (ML) and reduction of the effect by increasing ML levels of field matching technique in passive scattering proton therapy for esophageal cancer. To evaluate the influence of respiratory motion in terms of stability, we measured relative dose around ML using a respiratory motion phantom. The relative error was −0.5% when the respiratory motion phantom worked stable, whereas there was obvious change that the relative error was −25.5% when the difference of amplitude between upper field and lower field was one side 3 mm on each cranially and caudally direction. In clinical case of the seven esophageal cancer patients simulated by the treatment planning system, assuming the difference of amplitude was 3 mm, the relative error of maximum (minimum) dose in clinical target volume around ML against the original treatment plan were 5.8±1.2% (−6.0±2.7%), 3.3±0.9% (−3.8±1.0%), and 2.4±0.5% (2.6±0.8%) on average (±SD) when ML levels were 2, 4, and 6, respectively. Increasing ML levels can reduce the influence of respiratory motion.

In image guided radiation therapy (IGRT) using implanted fiducial marker by two-dimensional radiography for prostate cancer, temporal positional relationship during treatment between the isocenter and the prostate is changed by respiratory phase at the time of image acquisition. We examined influence of the respiratory phase in the IGRT on dose variation by interplay effect. Intra-fractional prostate motions of patients who were implanted fiducial marker were measured using fluoroscopy, then we reconstructed plans considering for the respiratory phase in IGRT and the respiratory motion during volumetric modulated arc therapy. Averages of the intra-fractional prostate motion in left-right, anterior-posterior and superior-inferior direction were 0.039, 0.49 and 1.6 mm respectively. There was a patient whose intra-fractional prostate motion was larger than 4 mm that was planning target volume margin. By changing the respiratory phase like inspiration, exhalation and dispersing respiratory phase in each fraction, dose variation from original plan became smaller in order of the inspiration, exhalation and dispersion. The largest variations of dose indices in clinical target volume, bladder and rectum were 8.0%, 4.5% and 9.1% respectively when IGRT was done in inspiration. When the IGRT is performed by the same respiratory phase in each fraction, systematic dose variations may occur even if the respiratory phase at the timing of irradiation is changed. By dispersing the respiratory phase in each fraction, the variations in all dose indices were<1% from original plan. We realized that dispersing the respiratory phase in IGRT by each fraction is effective to reduce the dose variation caused by the respiratory phase in IGRT.

This research measured the radiation exposure of the computed tomography(CT) localizer radiograph of the trunk of the body. The entrance surface dose for CT localizer radiograph was measured using radiophotoluminescent glass dosimeter(RPLD) on four points of measurement, including the center of the phantom, on the surface of a phantom placed in the center of a CT bed, assuming that the subject has a thickness of 20 cm. The entrance surface dose of the localizer radiograph under the chest CT protocol manufacturer’s initial setting conditions of 120 kV 35 mA was 0.80 mGy at the center and 0.53 for the 4-location average for the upper X-ray tube (excluding the CT bed), and 0.74 mGy at the center and 0.48 mGy for the 4-location average for the lower X-ray tube (including the CT bed). Compared to the Japan DRLs 2015 chest X-ray (P→A), the entrance surface dose was 2.67 times at the center and 1.77 times for the 4-location average for the upper X-ray tube and 2.47 times at the center and 1.60 times for the 4-location average for the lower X-ray tube. The CT radiation dose also cannot be ignored for the localizer radiograph entrance surface dose.

We determined the procedure to reduce arrhythmia-related ghosting artifacts in the late gadolinium enhancement (LGE) imaging of cardiovascular magnetic resonance (CMR) in patients with arrhythmia by examining the causing factors using phantoms. Inversion recovery gradient echo and phase-sensitive inversion recovery (PSIR) sequences were compared under normal sinus rhythm and premature ventricular contraction (PVC) conditions. Under the PVC condition, trigger interval irregularly performed induced ghosting artifacts. A phase-corrected real image in PSIR, however; demonstrated an accurately positive contrast of pale LGE area indicative of mild fibrosis with minimal ghosting artifacts. The study results indicate that PSIR has an advantage for LGE CMR in patients with arrhythmia. Even without having PSIR method, the 2R-R method ensures consistency of contrast and enables reduction of ghost artifacts.

In radiography with anti-scatter grid, it is important to make sure that the X-ray beam direct exactly perpendicular to the grid plane. However, it is so difficult to ensure in mobile radiography. An optical sight to ensure X-ray alignment in mobile radiography with anti-scatter grid was devised. The device measures the X-ray beam angle respect to the grid plane by utilizing collimator-lamp. Computed radiography of water phantom on inclined bedding with anti-scatter grid (6 : 1) were done by aid of devised optical sight 20 times. The result showed that the average alignment error of the radiographies by aid of devised optical sight was within 1°, and the maximum error was<2°.

In monitor unit (MU) independent verification by calculation for irregular field (MLC field) using multileaf collimator in X-ray therapy, it has become common to use collimator scatter factor (S_c) and phantom scatter factor (S_p) instead of total scatter factor (S_{c, p}). It is usually expressed as S_{c, p} (A)=S_c (A)×S_p (A), and the field size A is considered but the depth d is not. S_c is data of in-air output, and measure with a mini-phantom at constant depth to remove electron contamination. On the other hand, S_p is obtained from measurement data of S_{c, p} and S_c, and can be expressed as S_{c, p} (d, A)=S_c (constant depth, A)×S_p (d, A) at an arbitrary depth d, thus S_p depends on the depth of S_{c, p}. Therefore, S_p needs to consider depth. In addition, a linear accelerator equipped with the tertiary MLC has two field sizes, that are collimator field by upper and lower collimators and MLC field by tertiary MLC below them. In MU independent verification by calculation, it is often used that the estimated value of S_p obtained by converting MLC field to equivalent square field and referring to data of S_p in square field. To convert the MLC field to equivalent square field, a conversion formula from sector radius r to equivalent square field L by Clarkson’s sector integration (Clarkson method) is used. In this study, using 24 types of MLC fields to evaluate estimation accuracy due to the difference of conversion formula in Clarkson method, we estimated value of S_p using r=0.5611L of B-Clarkson method and using r=0.5580L of A-Clarkson method. And the difference with the measured value of S_p obtained by measuring S_{c, p} and S_c in the same MLC fields was compared. While, to evaluate estimation accuracy due to the different depths using these Clarkson methods, the difference between estimated value and measured value of S_p similarly obtained at depth of 5, 10 and 15 cm was compared. As results, estimated value of S_p using A-Clarkson method than using B-Clarkson method was close to measured value, and it was the same trend at depth of 5, 10 and 15 cm. Therefore, it was suggested that estimation accuracy of S_p by A-Clarkson method is higher than B-Clarkson method when verifying beams with different depths in MU independent verification by calculation for MLC field.

The imaging parameters of non-contrast three-dimensional time-of-flight magnetic resonance angiography (3D TOF-MRA) were optimized to improve the image quality for patients treated using stent-assisted coiling. A simulated blood flow phantom with three types of stents (Enterprise 2, Neuroform Atlas, and LVIS) was imaged by changing echo time (TE), band width (BW), flip angle (FA), and matrix (phase, frequency). The difference between the signal intensity in the simulated vessel and the background was measured at each imaging condition. The ratio of this difference with and without the stent was evaluated as the relative in-stent signal (RIS). In addition, the error ratio of the stent lumen diameter was assessed by comparing the full width at half maximum (FWHM) to that measured by 3D X-ray angiography. The RIS was higher in order of LVIS, Neuroform Atlas, and Enterprise 2 in all conditions. The RIS was higher in imaging conditions with short TE, narrow BW, high FA, and large phase matrix. The highest RIS was seen with a frequency matrix of 320 in the Enterprise 2 and 256 in the others. FWHM error ratio was smaller in the same order as the RIS. FWHM error ratio was smaller in imaging conditions with short TE, large frequency matrix (>384), large phase matrix (>224), and high FA (>20°). Imaging conditions of 3D TOF-MRA that were effective to improve the image quality for stent lumen evaluation were short TE and high spatial resolution.

Generally, the imaging range of the brain magnetic resonance angiography (MRA) is determined in the subjectivity by the operator used by the plan image that a blood vessel is not depicted. However, a necessary blood vessel may not be often depicted by an error of the setting of the imaging area. Therefore, optimal slab angle, thickness, distance, and image contrast for depiction of the unruptured cerebral aneurysm were examined. The brain MRA of 14 subjects was imaged in a wide area parallel to an orbitomeatal line (OM) line. The line which linked the arteria vertebral (the first cervical vertebrae curved section) to anterior cerebral artery (A3) was determined with an optimal slab base line, and the angle with the OM line was evaluated. Moreover, slavic range including the unruptured aneurysm was calculated. In addition, the distance from the inferior margin of pons to the slavic bottom end was measured. Furthermore, the cerebrovascular contrast by the slave angle was compared. As a result, the slave setting of the range was recommended in brain-MRA as an angle was 34.3 degrees, and the thickness was 56.4 mm, and, as the distance from the inferior margin of pons was 27.6 mm. The cerebrovascular contrast of the optimal slab base line angle did not have a significant difference for an OM line.