Polish Journal of Medical Physics and Engineering Feed

Optimizing Isocenter Accuracy in ExacTrac Dynamic®: Daily Verification and Quality Assurance for Reliable Patient Positioning

Tue, 17 Mar 2026 00:00:00 GMT

Introduction Advances in teleradiotherapy, such as SRS and SBRT, have improved treatment by delivering higher doses in fewer sessions, reducing duration, and sparing healthy tissue. These techniques require precise patient positioning, achieved through systems like SGRT (surface tracking) and IGRT (X-ray imaging). The ExacTrac Dynamic system (Brainlab AG, Germany) combines both, offering submillimetric accuracy for cranial radiotherapy. This study evaluates its quality assurance (QA) protocols, focusing on calibration, accuracy, and clinical performance. Background and Purpose SRS and SBRT allow targeted treatment with minimal margins, reducing complications. Precise alignment is essential, particularly for cranial cases. The study assesses the QA processes of the ExacTrac Dynamic system and evaluates its accuracy and reliability. Results Daily logs revealed differences between Surface Tracking and X-ray imaging. X-ray was more reliable, especially for longitudinal translational deviations, while Surface Tracking was affected by thermal artifacts. Rotational deviations remained within tolerance, with the largest shifts in yaw. Histogram analysis showed skewed distributions, underscoring the importance of combining both methods and regular QA. Conclusion Regular QA and recalibration of the ExacTrac Dynamic system are essential to address discrepancies between SGRT and X-ray methods. X-ray offers greater precision, while Surface Tracking is prone to environmental artifacts. Combining SGRT and IGRT ensures accuracy but requires consistent QA to maintain treatment precision.

The Utility of the TKEO Parameter in the assessment of thoracic respiratory movements

Tue, 17 Mar 2026 00:00:00 GMT

Introduction Chronic obstructive pulmonary disease (COPD) and dysphonia are prevalent disorders associated with altered respiratory patterns, posing significant diagnostic and therapeutic challenges. Accurate and efficient assessment of thoracic respiratory movements is essential for individualized therapy and monitoring. The Teager-Kaiser Energy Operator (TKEO), originally developed for speech analysis, offers a single-parameter approach to evaluate both amplitude and frequency characteristics of biosignals. This study aimed to determine the utility of TKEO in assessing thoracic respiratory patterns in healthy individuals, COPD patients, and those with dysphonia. Material and methods Sixty-one participants were enrolled: 30 healthy controls, 16 with COPD, and 15 with dysphonia. Thoracic and abdominal respiratory movements were recorded using Respiratory Inductive Plethysmography (RIP) in both standing and seated positions. The TKEO parameter was calculated from the displacement signals, and its values were compared with conventional respiratory parameters (inspiratory and expiratory depths) obtained via RIP. Statistical analysis included the Kruskal-Wallis test and Spearman’s rank correlation to assess group differences and parameter relationships. Results In the seated position, TKEO values and conventional respiratory parameters significantly differentiated between healthy subjects, COPD, and dysphonia groups (p < 0.01). Healthy and COPD subjects exhibited higher diaphragmatic activity, while dysphonia patients showed a dominant upper rib pattern. TKEO values closely paralleled traditional respiratory measures, with strong to very strong positive correlations observed across all groups and positions (Spearman’s ρ, p < 0.001). In the standing position, group differences were less pronounced, but TKEO still reflected underlying respiratory patterns. Conclusions TKEO is a sensitive and efficient parameter for assessing thoracic respiratory movements, correlating strongly with established respiratory metrics. Its application may accelerate and refine the diagnosis of respiratory pattern disorders in clinical practice. Further research should explore TKEO’s integration with artificial intelligence-based diagnostic tools and its utility in larger, age-matched cohorts.

Effect of Clinical Acquisition Parameters to Dose Distribution Adaptive Radiotherapy in Two Institutions

Tue, 17 Mar 2026 00:00:00 GMT

Introduction This work aims to examine image quality and dose based on Cone Beam Computed Tomography using phantoms in the two institutions Materials and methods The Rando and Catphan Phantoms were scanned using identical image acquisition and reconstruction settings with Cone Beam Computed Tomography (CBCT). The calibration curve was obtained based on the Hounsfiled Unit (HU) values on the Gammex 467 Phantom.. This study was performed at two institutions equipped with the same CBCT and CT Simulator. The acquisition with CBCT HU values that closely matched CT HU values employed a protocol of 120 kVp, Bowtie Filter (F1), and 80 mA for 10 ms within a Small Field of View (FOV). For the Medium FOV, the closest protocol also used 120 kVp, a Bowtie Filter, and 64 mA for 32 ms, while for the Large FOV, it was set at 120 kVp, F1, and 50 mA for 40 ms. The parameters chosen from each reconstructed FOV served as calibration curves for planning head and neck and pelvic treatments. Planning followed the Task Group 119 recommendations incorporating IMRT techniques. Result The best acquisition protocol for accurate dose calculations in head and neck cases is Field of View Small with 20 collimation using bowtie filter with 120 kVp and 80 mA for 10 ms/frame, while for Pelvic cases, it is FOVMedium with 20 collimation using bowtie filter with 120 kVp and 64 mA for 32 ms/frame. In image quality assessments, the lowest contrast visibility and uniformity scores were observed with FOV Small with 20 collimation using bowtie filter with 120 kVp and 80 mA for 10 ms/frame, using the reconstruction parameters Quality Image (QI) of 0.65% and 1%. Conclusion Selecting the appropriate CBCT acquisition protocol can lead to favorable outcomes in both dose calculation and image quality.

Biomaterials for hip joint implants with particular emphasis on titanium and its alloys

Tue, 17 Mar 2026 00:00:00 GMT

Introduction The primary objectives of replacing a natural hip joint with a prosthesis are to restore the function of a joint damaged by degenerative disease, advanced rheumatoid conditions, or mechanical injury, to eliminate pain caused by pathological joint changes, and to re-establish proper load transfer. Additionally, the procedure aims to restore motor functions, enabling the patient to move and perform essential daily activities such as walking, lifting, and carrying objects. Material and methods This article outlines the requirements for biomaterials used in the components of hip joint prostheses, presents various groups of titanium alloys, and describes their properties in detail. Special attention is paid to titanium and titanium alloys, including their mechanical and physical characteristics. The influence of Young’s modulus on fretting and fatigue cracking in metallic alloys used in modular prosthetic components is also examined. Results Titanium alloys are generally not used for femoral heads due to their poor tribological performance. Without appropriate surface modification, titanium alloys are unsuitable for use in articulating components such as heads and acetabular cups, as they exhibit low abrasion resistance. They also demonstrate limited resistance to fretting damage, particularly at the junctions between the stem neck and head in modular prostheses. Conclusions To improve abrasion resistance, diffusion-based thermochemical surface treatments can be employed to harden the material’s outer layer. However, the issue of fretting-induced damage at the neck region of hip endopros-theses remains unresolved. This problem is critical, as it often leads to corrosion and fatigue cracking of the stem neck, ultimately requiring prosthesis revision and incurring significant clinical and economic consequences. Plasma (ionic) nitriding has been shown to enhance surface properties such as hardness, wear resistance, resistance to fretting damage, fretting corrosion, and fretting fatigue, as well as overall fatigue cracking resistance.

Breast Density Patterns and Their Association with BI-RADS Categories among a Large Cohort of Ghanaian Women

Tue, 17 Mar 2026 00:00:00 GMT

Introduction Breast cancer remains a major global health challenge, with Africa and other developing countries experiencing its greatest impact. Knowledge of breast density (an independent risk factor) is essential for early breast cancer diagnosis. However, such data is scarce across Africa and absent in Ghana. The aim of this work was to investigate the association between mammographic breast density patterns and BI-RADS assessment categories among women in Ghana. Material and methods A retrospective cross-sectional study was conducted on 2,108 women who underwent mammography between October 2011 and December 2022. Breast density was visually assessed by radiologists using the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS). Associations between breast density, age, and BI-RADS assessment categories were analysed using Fisher’s Exact Test. Results Breast density category B (scattered fibroglandular tissue) was most common (44%, n = 935), followed by category A (almost entirely fatty; 39%, n = 821), category C (heterogeneously dense; 16%, n = 397), and category D (extremely dense; 1%, n = 23). More than 50% of all categories received benign diagnoses (BI-RADS 2), while less than 10% recorded negative diagnoses (BI-RADS 1). Higher-density categories demonstrated a greater proportion of suspicious and malignant findings: in category D, 17% were BI-RADS 3, 17% BI-RADS 4, and 13% BI-RADS 5, compared to lower proportions in categories A and B. Confirmed malignancies (BI-RADS 6) were observed across categories A–C (1% each). A significant association was found between breast density and cancer diagnoses (p < 0.05), as well as between age and breast density (p < 0.05). Conclusion There is a significant association between breast density and BI-RADS assessment categories, with lower breast density observed in older women, a finding consistent with published literature. These results highlight the need for tailored breast cancer screening strategies in Ghana.

Implementation and Application of the IORT INTRABEAM 600 System – Commissioning Measurements and Independent Treatment Verification

Tue, 17 Mar 2026 00:00:00 GMT

Introduction Intraoperative radiotherapy (IORT) delivers a single high-dose radiation fraction directly to the tumor or tumor bed during surgery, minimizing exposure to healthy tissue. The INTRABEAM 600 system, with its compact design and low-energy X-rays, requires thorough commissioning and quality assurance. This study performs dosimetric measurements, establishes an independent verification method, and compares Calibration v4.0 and TARGIT approaches to ensure accurate, safe, and reliable IORT delivery, supporting improved clinical outcomes. Materials and Methods The INTRABEAM 600 system delivers low-energy X-rays via a XRS generator for precise intraoperative radiotherapy. Commissioning involved depth dose rate measurements in a water phantom using ionization chambers, with probe tip positioned along X, Y, and Z axes. Dose rates were determined using Calibration v4.0 and TARGIT methods, correlated via a conversion function. QA checks included PAICH output, IRM baseline, and isotropy verification, ensuring accurate, reproducible treatment delivery. Results Dynamic offset analysis showed minimal deviations, confirming accurate beam targeting. The Output Check confirmed stable system performance. Depth dose rate curve measurements revealed a mean difference of -1.3 ± 1% from certification data. Treatment time calculations using spherical applicators showed minor differences between INTRABEAM600 and radiance, with the largest at -1.9 ± 1.1% for the 20 mm applicator. TARGIT results were similar, with the largest differences at -1.8 ± 0.6% for the 15 mm and 20 mm applicators. Conclusion Comprehensive commissioning and QA confirmed that the INTRABEAM 600 system is stable, precise, and clinically reliable. Dynamic offsets showed minimal deviations, verifying correct beam alignment, while Output Check tests confirmed XRS generator stability. Depth dose rate measurements agreed closely with certification data −1.3 ± 1.0%. Treatment time comparisons using Calibration v4.0 and TARGIT showed minor discrepancies, largest for small applicators (15–20 mm). Independent verification and radiance simulations support accurate dose delivery.

Proposal of method dosimetry to realize in-vivo measurements in skin surface brachytherapy

Wed, 17 Dec 2025 00:00:00 GMT

Introduction Skin surface brachytherapy is a highly targeted radiation therapy used for treating superficial malignancies, offering precise dose delivery with minimal impact on surrounding healthy tissues. However, in-vivo dose verification remains a critical challenge in brachytherapy. Thermoluminescent dosimeters (TLDs) provide a promising solution for increased precision of dose delivery to cancer patients. This study proposes a TLD-based method to assess radiation exposure during skin surface brachytherapy, with a particular focus on TLDs calibration process and validation leading to the opportunity to reduce dose of radiosensitive structures such as the lens of the eye. Materials and Methods TL detectors were calibrated using both an Iridium-192 (¹⁹²Ir) source and a 6 MV photon beam, incorporating correction factors to enhance measurement accuracy. During measurements, TLDs were positioned on the skin surface of the anthropomorphic head phantom to absolute point dose measurements. The measured TLD doses were compared with treatment planning system (TPS) calculations to validate the proposed method. Additionally a specific analysis was conducted to compare the radiation exposure of the eye lens with and without the use of a protective eye shield with use of the anthropomorphic head phantom. Results TLDs response to a uniform radiation dose were within the range of ±10% of the mean. For the method of calibration used 6MV photons from medical linear accelerator, a value 3% for the energy correction factor was applied to account for the difference in sensitivity of the TLDs in 192Ir and 6MV. For both calibration methods, with used appropriate calibration factors, obtained dose values for the anthropomorphic head phantom were within ±5% of the TPS dose values. The use of a lead shield placed in the phantom’s eye socket reduced the dose to the eye lens by up to 20%. Conclusions The developed TLD dosimetry method provides a precise and reliable approach for in-vivo dose verification in skin surface brachytherapy. By integrating calibrated TLD-based measurements, the correct implementation of radiotherapy plans can be verified. The study also confirms the protective efficacy of an eye shield in minimizing radiation exposure to the lens, reinforcing the importance of shielding strategies in clinical practice. Further validation and clinical implementation will contribute to improved patient safety and therapeutic outcomes in brachytherapy.

Tailored software for post-radiotherapy lung radiomics analysis

Wed, 17 Dec 2025 00:00:00 GMT

Introduction Radiotherapy is a crucial method of treating lung cancer. However, potential toxicity such as radiation-induced lung injury (RILI) must be considered. In order to quantitatively describe different forms of RILI, a next generation of a previously discussed system has been developed to analyse the subsequent series of CT scans performed by patients during radiation therapy and post-RT follow-up. Materials and methods A 3D CT scan registration module has been developed as part of the system. The analysis management module has been expanded compared to previous versions of the system. The environment has been prepared and the system has been deployed. In order to determine the effectiveness of the system, 1598 analyses, based on automated image pre-processing (registration and segmentation) and first-order delta-radiomics features, have been performed on a data set from 50 Patients. Results The efficiency of the execution of the analysis was evaluated in terms of time, including a breakdown into individual stages of the pipeline. The results of the analyses were visualised and exported to a CSV file, then evaluated from a clinical perspective. Conclusions The system allows, thanks to the use of a 3D registration algorithm, to analyse changes more accurately than before, and thanks to the use of a more flexible architecture, to introduce subsequent registration and calculation algorithms more easily. The current main research and development areas of the system include the extension of the analytical capabilities of the system in the field of radiomics and the expansion of the number of image analysis algorithms used within the system.

A novel agar-based phantom for quality control of medical ultrasound devices

Wed, 17 Dec 2025 00:00:00 GMT

Introduction Regular quality control and verification of medical ultrasound systems are essential for maintaining high diagnostic accuracy. However, the high cost of commercial phantoms often limits their use, particularly in smaller healthcare facilities. This study aimed to develop a low-cost agar-based phantom and evaluate its suitability for ultra-sound quality control. Material and methods The phantom was constructed using a plexiglass container filled with a 30 g/L agar solution. Test structures of different sizes were incorporated using nylon threads, small wooden pieces, and agar mixed with graphite. Measurements were performed with Voluson 730 Expert and GE Healthcare LOGIQ α 100 systems. Results Quality control tests included assessments of image uniformity, contrast resolution, spatial resolution, dead zone, maximum penetration depth, and geometric accuracy. The presence of targets of varying sizes enabled evaluations consistent with international quality assurance guidelines. During testing, several image artifacts and minor malfunctions were observed, likely resulting from trapped air bubbles or transducer imperfections, which could influence image interpretation. Nevertheless, the results indicate that the developed phantom performs reliably for key ultrasound quality control procedures. Conclusions Its simple design, inexpensive materials, and adaptability make it particularly suitable for routine checks and training applications. Furthermore, its easy reproducibility allows customization for different clinical needs and equipment types. Overall, this study demonstrates that an agar-based phantom can serve as an effective, low-cost alternative to commercial models, supporting systematic quality control in ultrasound imaging. Such accessible solutions may help standardize testing procedures, enhance diagnostic consistency, and ultimately improve patient safety.

Analysis of daily changes in volume and predicted doses for critical organs and the prostate during radiotherapy

Wed, 17 Dec 2025 00:00:00 GMT

Introduction The analysis of the differences in the daily volumes and the predicted dose to the actual dose in the bladder, rectum, and targets in prostate radiotherapy is presented. Material and methods The analysis was performed for 30 patients treated with prostate cancer. Precision treatment planning system was used to calculate the dose distribution. Patients were set up on the treatment table in the treatment position every day. kVCT images were acquired. kVCT images were imported into the PreciseART module. Organs at Risk and the prostate (PTV) volumes were copied onto these daily actual CT images and then automatically deformed to their current shapes. They were used to recalculate the updated therapeutic treatment plan. 726 CT examinations were analyzed. The volumes and dose values from clinical treatment plan have been used as reference values for the PTV, bladder, and rectum. Changes in volumes and doses for reference values and daily CT images were analyzed. Results The average daily changes in PTV, bladder and rectum volumes ranged from -0.3% to 14.4%, -21.7% to 32.5% and -10.5% to 32.5%, respectively. Corresponding standard deviations ranged from 1.0% to 5.5%, 4.9% to 35.5% and 5.8% to 25.2%, respectively. Corresponding median values ranged from -0.2% to 14.1%, -22.0% to 37.8% and -10.9 to 32.8, respectively. The average daily changes in PTV, bladder and rectum projected doses ranged from -1.4% to 2.9%, -9.0% to 24.8% and -25.4% to 15.9%, respectively. Corresponding standard deviations ranged from -1.4% to 2.6%, 0.0% to 14.8% and 0,0% to 17,2%, respectively. Corresponding median values ranged from -1.5% to 2.7%, -8.8% to 28.7% and -25.9% to 17.2%, respectively. Conclusions Qualitative data analysis showed that the greatest differences in volumes and doses occurred for these structures. For the prostate, these changes were lower than for other organs.

Investigating the Dose Parameters of Low-Level Laser Therapy to Optimize Therapeutic Efficacy

Mon, 01 Dec 2025 00:00:00 GMT

Introduction Low-level laser therapy (LLLT), also known as photobiomodulation, has emerged as a promising therapeutic option for various medical applications, including pain management and wound healing. This study aims to investigate the dose parameters of LLLT to optimize therapeutic efficacy. Materials and Methods We utilized Finite Element Analysis within the COMSOL Multiphysics software package to model light-tissue interactions and refine dosing protocols. Lasers with wavelengths of 660 nm, 780 nm, and 808 nm were selected due to their widespread use in therapy. Additionally, we examined several factors that impact the effectiveness of the treatment. Key parameters considered include energy, energy density, power, power density, irradiation time, and tissue penetration depth. Results The recommended stimulation time should not exceed six minutes (480 seconds) at a power density of 15.62 mW/cm². However, if the power density is reduced to a maximum of 3.10 mW/cm2, the stimulation time can be safely extended to 10 minutes (600 seconds) without causing undesirable thermal effects, as long as the tissue temperature does not exceed 40°C during the extended stimulation. It is important to note that the dose applied to the surface of the tissue significantly decreases as it penetrates deeper. The average energy loss is approximately 11% per millimetre of tissue. Our simulations indicate that effective doses range from 0.38 J/cm² to 9.37 J/cm² while maintaining safe tissue temperatures, which are consistent with WALT recommendations. Conclusion Our findings help identify factors influencing stimulation, guiding therapists to standardize treatment parameters such as wavelength, exposure time, and dosages measured in joules, watts, W/cm², and J/cm² for consistency and safety across studies.

Average glandular doses in contrast-enhanced spectral mammography (CEM)

Mon, 01 Dec 2025 00:00:00 GMT

Introduction Contrast-enhanced spectral mammography (CEM) is based on dual-energy breast exposure following intravenous administration of an iodinated contrast agent. Our study quantitatively assessed radiation dose from CEM for different breast thicknesses and compared it with doses from full-field digital mammography (FFDM) and with the dose limits set in the European Guidelines. Materials and Methods We studied 200,976 exposures from 59,438 examinations performed between January 2019 and December 2023 at the National Research Institute of Oncology, using a GE Healthcare Pristina Senographe mammography unit. Radiation exposure–related data, including average glandular dose (AGD) values, were obtained from the GE DoseWatch monitoring system. Doses for CEM exposure pairs (low- and high-energy exposure) were summed. Results Out of 176,700 FFDM exposures, the acceptable dose level was exceeded only in 11 cases (less than 0.01%). For combined CEM exposures, the acceptable dose level was exceeded in 965 out of 5481 cases (17.6%). The doses in FFDM exposures and low-energy CEM exposures are similar. Average glandular dose for FFDM exposures and low-energy CEM exposures is clearly dependent on the breast thickness. In contrast, the dose for a single high-energy CEM exposure is about 0.7 mGy and shows no clear dependency on breast thickness. Acceptable dose levels for combined CEM exposures were exceeded primarily with breasts with small thicknesses, most often (70% of cases) in patients whose breasts were less than 4 cm thick. For breasts from 6 cm and larger, no CEM exposures exceeded acceptable dose levels. Conclusions Although CEM exposures are a combination of two exposures (low- and high-energy), in most cases, the doses associated with CEM exposure do not exceed limits that were originally set for single FFDM exposures.

Letter to the Editor: Why continuing education matters for X-ray technicians

Mon, 01 Dec 2025 00:00:00 GMT

Estimation of the radiation damage in CA1, CA2 and CA3 pyramidal and dentate granule cell neurons during proton and carbon-ion irradiation: A study with the Geant4 toolkit

Mon, 01 Dec 2025 00:00:00 GMT

Introduction Radiation damage to the central nervous system (CNS) has been a persistent problem for decades, owing to difficulties such as brain radiotherapy and astronaut radiation protection during space flight. Hippocampus is the most radiation-sensitive structure of the central nervous system. The present study aims to investigate damage induced by 12C ions and proton radiation in pyramidal neurons of cornu ammonis regions and dentate granule neurons using Geant4 toolkit. Materials and Methods The Geant4/Geant4-DNA Monte Carlo toolkits were used to simulate the neuron shape and particle track structures. The computations were done for various energy proton beams and 12C particles with different linear energy transfers from a few to hundreds of keV/µm. Damage to pyramidal and dentate granule neurons of hippocampus as well as length reduction of the dendrites were studied by the dose absorbed in dendrite and DTH (dendrites threshold dose). Also, in the present study, using Spearman’s correlation test, we examined the correlation between the morphological characteristics of neurons and the reduction in the length of their dendrites. Results According to the results obtained in this study, the apical dendrites of CA3 and the basal dendrites of CA1 were more vulnerable following proton irradiation and carbon ions with different energies under proton and carbon radiation. But, the pyramidal neurons of CA2 were more resistant to radiation than those of CA1and CA3 regions. Furthermore, the dentate granule neurons were more resistant to radiation than the pyramidal neurons. According to the results of Spearman’s correlation test, there was a statistical significance correlation (p-value< 0.05) between some of the morphological characteristics of neurons and the reduction in the length of their dendrites. Conclusion The results indicate that the neuron morphology is an important factor determining the accumulation of absorbed dose and length reduction of neurons. By evaluating the neurons with different morphology from the hippocampus, it was found that the dentate granule and pyramidal neurons had different vulnerabilities to radiation. The pyramidal neurons with less densely packed are more resistant to radiation.

3D printing from a biocompatible material for a new design of electron applicators of the intraoperative accelerator

Mon, 01 Dec 2025 00:00:00 GMT

Introduction A special type of radiotherapy is Intraoperative Electron Radiation Therapy (IOERT). The electron applicator is the element forming the final shape of the electron beam delivered to the postoperative bed. This work presents the new design of an electron applicator made from the biocompatible material MED610. The applicators will form an electron beam in the AQURE intraoperative accelerator. Material and methods The main problem to be solved during the construction work was to propose a design solution for the electron applicator that would be light, transparent, and made of a biocompatible material, and at the same time sufficiently shield the patient against radiation scattered outside its walls. Moreover, the applicator used in intraoperative therapy should have the thinnest possible walls. Results The calculations and design work performed allowed the lower part of the applicator to be made of a biocompatible, material. This element allows the beam to be formed in accordance with the normative recommendations, it is light and transparent. In this case, PolyJet 3D printing was selected as the most appropriate method. Conclusions Thanks to the use of a new solution for the shape of the walls, the applicator limits the leakage radiation by the standard, without the need for thicker outer walls. This material is light, thanks to which the doctor keeps this part of the applicator in the right position until it is fastened with the part on the head that does not require additional, dedicated fastening. The resin MED610 is suitable for 3D printing, it can be easily used to create any shape, and thus the possibilities of forming the lower part of the applicator are not limited. In the future, for individual purposes, the shape of the beam formed by the lower part of the applicator may be dedicated to special applications.

Comparative Evaluation of Metal Artifact Reduction Algorithms in Computed Tomography: Siemens iMAR vs. GE MARS for Improved Radiotherapy Planning

Thu, 28 Aug 2025 00:00:00 GMT

Introduction In this article, the effectiveness of two commercial metal artifact reduction algorithms, Siemens iMAR and GE MARS, in computed tomography (CT) imaging is evaluated. Metal artifacts, which arise primarily due to the presence of high atomic number metals in clinical imaging, significantly degrade image quality and impede accurate diagnostics. Material and methods The study compares monoenergetic and dual-energy CT reconstruction algorithms by examining their performance on phantom models, including a Gammex Tissue Characterization Phantom and a custom-made spine stabilization system phantom. Quantitative assessments, such as Hounsfield unit analysis were performed. Results The results show that the iterative reconstruction algorithm (iMAR) from Siemens offers superior artifact suppression and image clarity compared to GE’s dual-energy algorithm (MARS), particularly in cases involving titanium implants. Quantitative assessments, such as Hounsfield unit measurements and visual image analysis, confirm that iMAR produces images with reduced artifacts and more consistent tissue characterization. Conclusions These findings suggest that the choice of artifact reduction algorithm has a profound impact on the diagnostic and planning accuracy of CT scans in patients with metal implants.

Thermal evaluation of TECAR used in the treatment of active myofascial trigger point

Thu, 28 Aug 2025 00:00:00 GMT

Introduction This study aimed to evaluate the efficacy of TECAR therapy in treating MTrP using thermographic imaging as a diagnostic tool. Material and methods The study was conducted on a group of 13 volunteers aged 25 to 45 years (mean age 34.3 ± 6.4 years) who were diagnosed with active MTrP in the UT muscle. Thermography measured skin temperature changes in the treated areas before and after TECAR therapy. Results The study revealed a correlation between changes in skin temperature and clinical pain indicators, as measured by the NRS and PPT. Initial results showed no significant correlations between temperature parameters and pain scales. However, after seven days of TECAR therapy, a strong, positive correlation was observed between temperature and NRS scores (p = 0.004, r = 0.8), suggesting that TECAR therapy affects temperature in the MTrP area, resulting in a pain decrease. Conclusions The results obtained over 30 days of therapy showed variability in thermal response, indicating the need for further research to fully understand the mechanisms of action of TECAR therapy in the treatment of MTrP. Nevertheless, the observed strong correlation after seven days of therapy suggests promising possibilities for using thermography to monitor treatment effects.

The density of growth cartilage evaluation due to epiphysiodesis procedure

Thu, 28 Aug 2025 00:00:00 GMT

Introduction Proper prediction of remaining lower limbs growth is crucial for determining the optimal timing of epiphysiodesis in patients with limb length discrepancies or the curvature occurred in knee joint occurred in children during rapid growth period. Several methods are commonly used in correction of such orthopedic problem. One of them is procedure of epiphysiodesis. The main goal of the study was to evaluate changes in the density of growth cartilage at the distal end of the thigh bone following epiphysiodesis, and to compare it with the cartilage density on the side without screw placement in the same limb, as well as with the contralateral side. Material and methods The clinical study included 9 patients of both sexes (5 females and 4 males) who were treated at the Department and Clinic of Orthopedic Surgery, Medical University of Silesia in Katowice. Results The regions of interest marked on the X-ray images from which the average pixel value have been derived. Conclusions The conducted study demonstrated a statistically significant difference of over 50% the average pixel value between preoperative and postoperative measurements on the side where screws were placed (p = 0.01). Additionally, a significant difference of 50% was observed between the preoperative pixel value on the side designated for screw placement and the postoperative pixel value on the contralateral, non-operated side.

Evaluating scintigraphic dyssynchrony as radiomic parameters for dynamic laminar and turbulent fluids in compartmental phantom systems: A signal processing study

Thu, 28 Aug 2025 00:00:00 GMT

Introduction: Radiomics quantify radiological data to correlate with clinical findings. Dyssynchrony, a proposed radiomic parameter measured via phase images, reflects the temporal discoordination of ventricular contraction, which can impair overall cardiac efficiency. This study assessed the consistency and reliability of dyssynchrony in laminar and turbulent flow compartments under varying image acquisition. It also evaluated the relationship between dyssynchrony and fluid dynamics alterations. Methods: The dataset included 64 dynamic images using gamma camera (128,000 frames) generated using an in-home phantom, representing combinations of flow velocity, count, and frame rates. Phase and amplitude images were generated and analyzed to calculate synchrony, entropy, approximate entropy (ApEn), and bounded-ApEn for different rotation directions. Entropy values were examined under parameter changes, with comparisons using Pearson’s test, ANOVA, logistic regression, and receiver operating characteristic (ROC) analysis. Results: Images were categorized by activity concentrations: Group 1 (37 MBq), Group 2 (29.5 MBq), and Group 3 (18.5 MBq). Group 1 showed a strong negative correlation between entropy and frame rates (r = −0.991, p < 0.001), while Group 3 displayed positive correlations between frame rate, ApEn, gray count, and pixel count. Logistic regression predicted turbulence (AUC = 0.93) and direction (AUC = 0.96) using bounded-ApEn. Regression analysis indicated ApEn and bounded-ApEn significantly predicted vortex parameters (R² = 93%). Conclusion: Dyssynchrony metrics, including entropy, ApEn, and bounded-ApEn, demonstrated consistent measurements across varying conditions. These findings highlight their potential for enhancing diagnostic accuracy and guiding personalized therapeutic strategies for conditions influenced by blood flow patterns

Diagnostic reference levels (DRLs) in digital mammography in the European context – a systematic review

Thu, 28 Aug 2025 00:00:00 GMT

This systematic review examines the establishment of Diagnostic Reference Levels (DRLs) in digital mammography across 18 European countries, based on studies from 2005-2025. A total of 353 articles were identified through the comprehensive search of academic networks: Google Scholar, PubMed, Research Gate, Academia. Only 18 peer-reviewed studies met inclusion criteria – reporting Mean Glandular Dose (MGD)-based DRLs from Finland to Malta. Eight studies used patient data, four used phantom measurements, and six used both. To overcome the challenging comparison of the variety of reported parameters, we undertook some data harmonisation procedures, focusing on a common Compressed Breast Thickness (CBT) range of 50-59 mm. The DRLs varied notably by country, with 75th percentile MGDs ranging from 1.1 to 2.6 mGy and 95th percentile from 1.6 to 2.9 mGy, averaging to 1.44 mGy, which is lower than the achievable European level (2 mGy). The harmonisation approach enabled the derivation of a comparable dataset of average MGDs, facilitating cross-country comparisons and insights into radiation dose optimisation in digital mammography across Europe.