Percutaneous image-guided needle biopsy is typically performed in highly vascular organs or in tumours with rich macroscopic and microscopic blood supply. The main risks related to this procedure are haemorrhage and implantation of tumour cells in the needle tract after the biopsy needle is withdrawn. From numerous conducted studies, it was found that heating the needle tract using alternating current in radiofrequency (RF) range has a potential to minimize these effects. However, this solution requires the use of specially designed needles, which would make the procedure relatively expensive and complicated. Thus, we propose a simple solution by using readily available coaxial core biopsy needles connected to a radiofrequency ablation (RFA) generator. In order to do so, we have designed and developed an adapter to interface between these two devices. For evaluation purpose, we used a bovine liver as a sample tissue. The experimental procedure was done to study the effect of different parameter settings on the size of coagulation necrosis caused by the RF current heating on the subject. The delivery of the RF energy was varied by changing the values for delivered power, power delivery duration, and insertion depth. The results showed that the size of the coagulation necrosis is affected by all of the parameters tested. In general, the size of the region is enlarged with higher delivery of RF power, longer duration of power delivery, and shallower needle insertion and become relatively constant after a certain value. We also found that the solution proposed provides a low cost and practical way to minimizes unwanted post-biopsy effects.
Development of computer-based medical inference systems is always confronted with some difficulties. In this paper, difficulties of designing an inference system for the diagnosis of arthritic diseases are described, including variations of disease manifestations under various situations and conditions. Furthermore, the need for a huge knowledge base would result in low efficiency of the inference system. We proposed a hierarchical model of the fuzzy inference system as a possible solution. With such a model, the diagnostic process is divided into two levels. The first level of the diagnosis reduces the scope of diagnosis to be processed by the second level. This will reduce the amount of input and mapping for the whole diagnostic process. Fuzzy relational theory is the core of this system and it is used in both levels to improve the accuracy.
This is a study using LiF:Mg;Ti thermoluminescent dosimeter (TLD) rods in phantoms to investigate the effect of lack of backscatter on exit dose. Comparing the measured dose with anticipated dose calculated using tissue maximum ratio (TMR) or percentage depth dose (PDD) gives rise to a correction factor. This correction factor may be applied to in-vivo dosimetry results to derive true dose to a point within the patient. Measurements in a specially designed humanoid breast phantom as well as patients undergoing radiotherapy treatment were also been done. TLDs with reproducibility of within +/- 3% (1 SD) are irradiated in a series of measurements for 6 and 10 MV photon beams from a medical linear accelerator. The measured exit doses for the different phantom thickness for 6 MV beams are found to be lowered by 10.9 to 14.0% compared to the dose derived from theoretical estimation (normalized dose at dmax). The same measurements for 10 MV beams are lowered by 9.0 to 13.5%. The variations of measured exit dose for different field sizes are found to be within 2.5%. The exit doses with added backscatter material from 2 mm up to 15 cm, shows gradual increase and the saturated values agreed within 1.5% with the expected results for both beams. The measured exit doses in humanoid breast phantom as well as in the clinical trial on patients undergoing radiotherapy also agreed with the predicted results based on phantom measurements. The authors' viewpoint is that this technique provides sufficient information to design exit surface bolus to restore build down effect in cases where part of the exit surface is being considered as a target volume. It indicates that the technique could be translated for in vivo dose measurements, which may be a conspicuous step of quality assurance in clinical practice.
Neuroscientists have investigated the functionality of the brain in detail and achieved remarkable results but this area still need further research. Functional magnetic resonance imaging (fMRI) is considered as the most reliable and accurate technique to decode the human brain activity, on the other hand electroencephalography (EEG) is a portable and low cost solution in brain research. The purpose of this study is to find whether EEG can be used to decode the brain activity patterns like fMRI. In fMRI, data from a very specific brain region is enough to decode the brain activity patterns due to the quality of data. On the other hand, EEG can measure the rapid changes in neuronal activity patterns due to its higher temporal resolution i.e., in msec. These rapid changes mostly occur in different brain regions. In this study, multivariate pattern analysis (MVPA) is used both for EEG and fMRI data analysis and the information is extracted from distributed activation patterns of the brain. The significant information among different classes is extracted using two sample t test in both data sets. Finally, the classification analysis is done using the support vector machine. A fair comparison of both data sets is done using the same analysis techniques, moreover simultaneously collected data of EEG and fMRI is used for this comparison. The final analysis is done with the data of eight participants; the average result of all conditions are found which is 65.7% for EEG data set and 64.1% for fMRI data set. It concludes that EEG is capable of doing brain decoding with the data from multiple brain regions. In other words, decoding accuracy with EEG MVPA is as good as fMRI MVPA and is above chance level.
A thermoluminescent dosimetry (TLD) postal dose inter-comparison was carried out amongst radiotherapy centres in Malaysia. The aim of this TLD inter-comparison was to compare the uniformity involved in the measurement of absorbed dose among the participating centres. A set of 5 TLD chips placed within acrylic trays were mailed to all participating centres for irradiation to an absorbed dose to water of 2 Gy. Measurements were made for 6 MV and 60Co photon beams. Results show an agreement of +/- 5% for all but three radiotherapy centres. The ratios of the TLD readings to that of the reference centre are comparable with other national/regional dose inter-comparisons. The importance of a proper ongoing quality assurance program is essential in maintaining the consistency and uniformity of doses delivered.
This policy statement, which is the sixth of a series of documents prepared by the Asia-Oceania Federation of Organizations for Medical Physics (AFOMP) Professional Development Committee, gives guidance on how medical physicists in AFOMP countries should conduct themselves in an ethical manner in their professional practice (Ng et al. in Australas Phys Eng Sci Med 32:175-179, 2009; Round et al. in Australas Phys Eng Sci Med 33:7-10, 2010; Round et al. in Australas Phys Eng Sci Med 34:303-307, 2011; Round et al. in Australas Phys Eng Sci Med 35:393-398, 2012; Round et al. in Australas Phys Eng Sci Med 38:217-221, 2015). It was developed after the ethics policies and codes of conducts of several medical physics societies and other professional organisations were studied. The policy was adopted at the Annual General Meeting of AFOMP held in Jaipur, India, in November 2017.
Illuminance level in the softcopy image viewing room is a very important factor to optimize productivity in radiological diagnosis. In today's radiological environment, the illuminance measurements are normally done during the quality control procedure and performed annually. Although the room is equipped with dimmer switches, radiologists are not able to decide the level of illuminance according to the standards. The aim of this study is to develop a simple real-time illuminance detector system to assist the radiologists in deciding an adequate illuminance level during radiological image viewing. The system indicates illuminance in a very simple visual form by using light emitting diodes. By employing the device in the viewing room, illuminance level can be monitored and adjusted effectively.
The history of medical physics in Asia-Oceania goes back to the late nineteenth century when X-ray imaging was introduced, although medical physicists were not appointed until much later. Medical physics developed very quickly in some countries, but in others the socio-economic situation as such prevented it being established for many years. In others, the political situation and war has impeded its development. In many countries their medical physics history has not been well recorded and there is a danger that it will be lost to future generations. In this paper, brief histories of the development of medical physics in most countries in Asia-Oceania are presented by a large number of authors to serve as a record. The histories are necessarily brief; otherwise the paper would quickly turn into a book of hundreds of pages. The emphasis in each history as recorded here varies as the focus and culture of the countries as well as the length of their histories varies considerably.
The oxidation of ferrous to ferric ions due to ionizing radiation has been used for chemical dosimetry since 1927. The introduction of metal indicator dye xylenol orange (XO) sensitises the measurement of ferric ion yield. A ferrous sulphate- agarose- xylenol orange (FAX) gel was prepared and the gel then exposed to dose ranging from 0.2 to 10 Gy using various high energy photon and electron beams from a linear accelerator. Some general characteristics of FAX such as energy dependence, optical density (OD)-dose relationship, reproducibility and auto-oxidation of ferrous ions were analysed. The radiation yield G of the gel was calculated for gels prepared in oxygen and in air and the values were 46.3 +/- 2.1 and 40.9 +/- 1.4 Fe3+ per 100 eV for photons respectively. However for stock gel which was kept for 5 days pre-irradiation the G value decreased to 36.6 +/- 1.1. The gel shows linearity in OD-dose relationship, energy independence and reproducibility over the dose range investigated. Auto-oxidation of ferrous ions resulted in optical density changes of less than 1.5% per day.
Surface electromyography (SEMG) signals can provide important information for prosthetic hand control application. In this study, time domain (TD) features were used in extracting information from the SEMG signal in determining hand motions and stages of contraction (start, middle and end). Data were collected from ten healthy subjects. Two muscles, which are flexor carpi ulnaris (FCU) and extensor carpi radialis (ECR) were assessed during three hand motions of wrist flexion (WF), wrist extension (WE) and co-contraction (CC). The SEMG signals were first segmented into 132.5 ms windows, full wave rectified and filtered with a 6 Hz low pass Butterworth filter. Five TD features of mean absolute value, variance, root mean square, integrated absolute value and waveform length were used for feature extraction and subsequently patterns were determined. It is concluded that the TD features that were used are able to differentiate hand motions. However, for the stages of contraction determination, although there were patterns observed, it is determined that the stages could not be properly be differentiated due to the variability of signal strengths between subjects.
Second cancer induction in the contralateral breast (CB) is an issue of some concern in breast radiotherapy especially for women under the age of 45 years at the time of treatment. The CB dose from 2-field and 3-field techniques in post-mastectomy chest wall irradiations in an anthropomorphic phantom as well as in patients were measured using thermoluminescent dosimeters (TLDs) at the local radiotherapy center. Breast and chest wall radiotherapy treatments were planned conformally (3D-CRT) and delivered using 6-MV photons. The measured CB dose at the surface fell sharply with distance from the field edge. However, the average ratio of the measured to the calculated CB dose using the pencil beam algorithm at the surface was approximately 53%. The mean and median measured internal dose at the posterior border of CB in a phantom was 5.47+/-0.22 cGy and 5.44 cGy, respectively. The internal CB dose was relatively independent of depth. In the present study the internal CB dose is 2.1-4.1% of the prescribed dose which is comparable to the values reported by other authors.
This study investigates the characteristics and application of the optically-stimulated luminescence dosimeter (OSLD) in cobalt-60 high dose rate (HDR) brachytherapy, and compares the results with the dosage produced by the treatment planning system (TPS). The OSLD characteristics comprised linearity, reproducibility, angular dependence, depth dependence, signal depletion, bleaching rate and cumulative dose measurement. A phantom verification exercise was also conducted using the Farmer ionisation chamber and in vivo diodes. The OSLD signal indicated a supralinear response (R2 = 0.9998). It exhibited a depth-independent trend after a steep dose gradient region. The signal depletion per readout was negligible (0.02%), with expected deviation for angular dependence due to off-axis sensitive volume, ranging from 1 to 16%. The residual signal of the OSLDs after 1 day bleached was within 1.5%. The accumulated and bleached OSLD signals had a standard deviation of ± 0.78 and ± 0.18 Gy, respectively. The TPS was found to underestimate the measured doses with deviations of 5% in OSLD, 17% in the Farmer ionisation chamber, and 7 and 8% for bladder and rectal diode probes. Discrepancies can be due to the positional uncertainty in the high-dose gradient. This demonstrates a slight displacement of the organ at risk near the steep dose gradient region will result in a large dose uncertainty. This justifies the importance of in vivo measurements in cobalt-60 HDR brachytherapy.
Driver drowsiness has been one of the major causes of road accidents that lead to severe trauma, such as physical injury, death, and economic loss, which highlights the need to develop a system that can alert drivers of their drowsy state prior to accidents. Researchers have therefore attempted to develop systems that can determine driver drowsiness using the following four measures: (1) subjective ratings from drivers, (2) vehicle-based measures, (3) behavioral measures and (4) physiological measures. In this study, we analyzed the various factors that contribute towards drowsiness. A total of 15 male subjects were asked to drive for 2 h at three different times of the day (00:00-02:00, 03:00-05:00 and 15:00-17:00 h) when the circadian rhythm is low. The less intrusive physiological signal measurements, ECG and EMG, are analyzed during this driving task. Statistically significant differences in the features of ECG and sEMG signals were observed between the alert and drowsy states of the drivers during different times of day. In the future, these physiological measures can be fused with vision-based measures for the development of an efficient drowsiness detection system.
Human brain generates electromagnetic signals during certain activation inside the brain. The localization of the active sources which are responsible for such activation is termed as brain source localization. This process of source estimation with the help of EEG which is also known as EEG inverse problem is helpful to understand physiological, pathological, mental, functional abnormalities and cognitive behaviour of the brain. This understanding leads for the specification for diagnoses of various brain disorders such as epilepsy and tumour. Different approaches are devised to exactly localize the active sources with minimum localization error, less complexity and more validation which include minimum norm, low resolution brain electromagnetic tomography (LORETA), standardized LORETA, exact LORETA, Multiple Signal classifier, focal under determined system solution etc. This paper discusses and compares the ability of localizing the sources for two low resolution methods i.e., sLORETA and eLORETA respectively. The ERP data with visual stimulus is used for comparison at four different time instants for both methods (sLORETA and eLORETA) and then corresponding activation in terms of scalp map, slice view and cortex map is discussed.
The aim of this paper is to develop a preliminary neurofeedback system to improve the mood of the subjects using audio signals by enhancing their alpha brainwaves. Assessment of the effect of music on the human subjects is performed using three methods; subjective assessment of mood with the help of a questionnaire, the effect on brain by analysing EEG signals, and the effect on body by physiological assessment. In this study, two experiments have been designed. The first experiment was to determine the short-term effect of music on soothing human subjects, whereas the second experiment was to determine its long-term effect. Two types of music were used in the first experiment, the favourite music selected by the participants and a relaxing music with alpha wave binaural beats. The research findings showed that the relaxing music has a better soothing effect on the participants psychologically and physiologically. However, the one-way analysis of variance (ANOVA) results showed that the short-term soothing effect of both favourite music and relaxing music was not significant in changing the mean alpha absolute power and mean physiological measures (blood pressure and heart rate) at the significance level of 0.05. The second experiment was somewhat similar to an alpha neurofeedback training whereby the participants trained their brains to produce more alpha brainwaves by listening to the relaxing music with alpha wave binaural beats for a duration of 30 min daily. The results showed that the relaxing music has a long-term psychological and physiological effect on soothing the participants, as can be observed from the increase in alpha power and decrease in physiological measures after each session of training. The training was found to be effective in increasing the alpha power significantly [F(2,12) = 11.5458 and p = 0.0016], but no significant reduction in physiological measures was observed at the significance level of 0.05.
This paper describes a discrete wavelet transform-based feature extraction scheme for the classification of EEG signals. In this scheme, the discrete wavelet transform is applied on EEG signals and the relative wavelet energy is calculated in terms of detailed coefficients and the approximation coefficients of the last decomposition level. The extracted relative wavelet energy features are passed to classifiers for the classification purpose. The EEG dataset employed for the validation of the proposed method consisted of two classes: (1) the EEG signals recorded during the complex cognitive task--Raven's advance progressive metric test and (2) the EEG signals recorded in rest condition--eyes open. The performance of four different classifiers was evaluated with four performance measures, i.e., accuracy, sensitivity, specificity and precision values. The accuracy was achieved above 98 % by the support vector machine, multi-layer perceptron and the K-nearest neighbor classifiers with approximation (A4) and detailed coefficients (D4), which represent the frequency range of 0.53-3.06 and 3.06-6.12 Hz, respectively. The findings of this study demonstrated that the proposed feature extraction approach has the potential to classify the EEG signals recorded during a complex cognitive task by achieving a high accuracy rate.
This research proposes an exploratory study of a simple, accurate, and computationally efficient movement classification technique for prosthetic hand application. Surface myoelectric signals were acquired from the four muscles, namely, flexor carpi ulnaris, extensor carpi radialis, biceps brachii, and triceps brachii, of four normal-limb subjects. The signals were segmented, and the features were extracted with a new combined time-domain feature extraction method. Fuzzy C-means clustering method and scatter plot were used to evaluate the performance of the proposed multi-feature versus Hudgins' multi-feature. The movements were classified with a hybrid Adaptive Resonance Theory-based neural network. Comparative results indicate that the proposed hybrid classifier not only has good classification accuracy (89.09%) but also a significantly improved computation time.
Homogenous strain analysis (HSA) was developed to evaluate regional cardiac function using tagged cine magnetic resonance images of heart. Current cardiac applications of HSA are however limited in accurately detecting tag intersections within the myocardial wall, producing consistent triangulation of tag cells throughout the image series and achieving optimal spatial resolution due to the large size of the triangles. To address these issues, this article introduces a harmonic phase (HARP) interference method. In principle, as in the standard HARP analysis, the method uses harmonic phases associated with the two of the four fundamental peaks in the spectrum of a tagged image. However, the phase associated with each peak is wrapped when estimated digitally. This article shows that special combination of wrapped phases results in an image with unique intensity pattern that can be exploited to automatically detect tag intersections and to produce reliable triangulation with regularly organized partitioning of the mesh for HSA. In addition, the method offers new opportunities and freedom for evaluating myocardial function when the power and angle of the complex filtered spectra are mathematically modified prior to computing the phase. For example, the triangular elements can be shifted spatially by changing the angle and/or their sizes can be reduced by changing the power. Interference patterns obtained under a variety of power and angle conditions were presented and specific features observed in the results were explained. Together, the advanced processing capabilities increase the power of HSA by making the analysis less prone to errors from human interactions. It also allows strain measurements at higher spatial resolution and multi-scale, thereby improving the display methods for better interpretation of the analysis results.
The MOSkin, a metal-oxide semiconductor field-effect transistor based detector, is suitable for evaluating skin dose due to its water equivalent depth (WED) of 0.07 mm. This study evaluates doses received by target area and unavoidable normal skin during a the case of skin brachytherapy. The MOSkin was evaluated for its feasibility as detector of choice for in vivo dosimetry during skin brachytherapy. A high-dose rate Cobalt-60 brachytherapy source was administered to the tumour located at the medial aspect of the right arm, complicated with huge lymphedema thus limiting the arm motion. The source was positioned in the middle of patients' right arm with supine, hands down position. A 5 mm lead and 5 mm bolus were sandwiched between the medial aspect of the arm and lateral chest to reduce skin dose to the chest. Two calibrated MOSkin detectors were placed on the target and normal skin area for five treatment sessions for in vivo dose monitoring. The mean dose to the target area ranged between 19.9 and 21.1 Gy and was higher in comparison with the calculated dose due to contribution of backscattered dose from lead. The mean measured dose at normal skin chest area was 1.6 Gy (1.3-1.9 Gy), less than 2 Gy per fraction. Total dose in EQD2 received by chest skin was much lower than the recommended skin tolerance. The MOSkin detector presents a reliable real-time dose measurement. This study has confirmed the applicability of the MOSkin detector in monitoring skin dose during brachytherapy treatment due to its small sensitive volume and WED 0.07 mm.