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In the timeframe following the September 11th attacks on the United States, increased emphasis has been placed on Chemical, Biological, Radiological and Nuclear (CBRN) preparedness. Of prime importance is rapid field assessment of potential radiation exposure to Canadian Forces field personnel. This work set up a framework for generating an 'expert' computer system for aiding and assisting field personnel in determining the extent of radiation insult to military personnel. Data was gathered by review of the available literature, discussions with medical and health physics personnel having hands-on experience dealing with radiation accident victims, and from experience of the principal investigator. Flow charts and generic data fusion algorithms were developed. Relationships between known exposure parameters, patient interview and history, clinical symptoms, clinical work-ups, physical dosimetry, biological dosimetry, and dose reconstruction as critical data indicators were investigated. The data obtained was examined in terms of information theory. A main goal was to determine how best to generate an adaptive model (i.e. when more data becomes available, how is the prediction improved). Consideration was given to determination of predictive algorithms for health outcome. In addition. the concept of coding an expert medical treatment advisor system was developed (U)
The first purpose of this study was to illustrate the contribution of statistical process control for a better security in intensity modulated radiotherapy (IMRT) treatments. This improvement is possible by controlling the dose delivery process, characterized by pretreatment quality control results. So, it is necessary to put under control portal dosimetry measurements (currently, the ionisation chamber measurements were already monitored by statistical process control thanks to statistical process control tools). The second objective was to state whether it is possible to substitute ionisation chamber with portal dosimetry in order to optimize time devoted to pretreatment quality control. At Alexis-Vautrin center, pretreatment quality controls in IMRT for prostate and head and neck treatments were performed for each beam of each patient. These controls were made with an ionisation chamber, which is the reference detector for the absolute dose measurement, and with portal dosimetry for the verification of dose distribution. Statistical process control is a statistical analysis method, coming from industry, used to control and improve the studied process quality. It uses graphic tools as control maps to follow-up process, warning the operator in case of failure, and quantitative tools to evaluate the process toward its ability to respect guidelines: this is the capability study. The study was performed on 450 head and neck beams and on 100 prostate beams. Control charts, showing drifts, both slow and weak, and also both strong and fast, of mean and standard deviation have been established and have shown special cause introduced (manual shift of the leaf gap of the multileaf collimator). Correlation between dose measured at one point, given with the EPID and the ionisation chamber has been evaluated at more than 97% and disagreement cases between the two measurements were identified. The study allowed to demonstrate the feasibility to reduce the time devoted to
In-vivo light dosimetry for patients undergoing photodynamic therapy (PDT) is critical for predicting PDT outcome. Patients in this study are enrolled in a Phase I clinical trial of HPPH-mediated PDT for the treatment of non-small cell lung cancer with pleural effusion. They are administered 4mg per kg body weight HPPH 48 hours before the surgery and receive light therapy with a fluence of 15-45 J/cm2 at 661 and 665nm. Fluence rate (mW/cm2) and cumulative fluence (J/cm2) are monitored at 7 sites during the light treatment delivery using isotropic detectors. Light fluence (rate) delivered to patients is exa