Ashland, KY, United States
Ashland, KY, United States

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Gossman M.S.,Regulation Directive Medical Physics | Gossman M.S.,Tri State Regional Cancer Center
Neuromodulation | Year: 2015

Objective This testing was conducted to determine if exposure from a particle accelerator used to treat cancer patients would alter the performance of the EndoStim® neurostimulator when programmed either passively or actively and while being irradiated. Methods A total of 12 EndoStim Lower Esophageal Sphincter (LES) Stimulation System implantable neurostimulators were investigated in this research. Included were six each of the EndoStim I and EndoStim II. Half were used for passive testing, with the remaining half for active testing. Bremsstrahlung x-rays were delivered having a nominal energy of 18 MV at a rate of 6 Gy/min. A total dose of 80 Gy was achieved in testing minimally. Results Monitoring of stimulation frequency, amplitude, pulse width, stimulation time, and voltage was conducted using software developed by EndoStim along with an oscilloscope. No observed changes to the intended stimulation were noted and all scheduled parameter magnitudes were achieved with device operation. All functional parameter changes were within ±10% from baseline. Conclusions EndoStim I and EndoStim II implant pulse generators appear to be immune to x-ray radiation from the particle accelerator at energies up to 18 MV, at dose rates of up to 6 Gy/min, and up to cumulative doses of minimally 80 Gy. As there were no observable effects on neurostimulation requirements, the EndoStim LES Stimulation System implantable neurostimulators are capable of withstanding direct radiation. The recommendations of the manufacturer should be followed further regarding the labeling requirements for insured safety to patients. © 2015 International Neuromodulation Society.


Gossman M.S.,Tri State Regional Cancer Center | Graves-Calhoun A.R.,Medtronic | Wilkinson J.D.,Medtronic
Journal of Applied Clinical Medical Physics | Year: 2010

Recent improvements to the functionality and stability of implantable pacemakers and cardioverter-defibrillators involve changes that include efficient battery power consumption and radiation hardened electrical circuits. Manufacturers have also pursued MRI-compatibility for these devices. While such newer models of pacemakers and cardioverter-defibrillators are similar in construction to previously marketed devices - even for the recent MRI-compatible designs currently in clinical trials - there is increased interest now with regard to radiation therapy dose effects when a device is near or directly in the field of radiation. Specifically, the limitation on dose to the device from therapeutic radiation beams is being investigated for a possible elevation in limiting dose above 200 cGy. We present here the first-ever study that evaluates dosimetric effects from implantable pacemakers and implantable cardioverter-defibrillators in high energy X-ray beams from a medical accelerator. Treatment plan simulations were analyzed for four different pacemakers and five different implantable cardioverter-defibrillators and intercompared with direct measurements from a miniature ionization chamber in water. All defibrillators exhibited the same results and all pacemakers were seen to display the same consequences, within only a ± 1.8% deviation for all X-ray energies studied. Attenuation, backscatter, and lateral scatter were determined to be -13.4%, 2.1% and 1.5% at 6 MV, and -6.1%, 3.1% and 5.1% at 18 MV for the defibrillator group. For the pacemaker group, this research showed results of -15.9%, 2.8% and 2.5% at 6 MV, and -9.4%, 3.4% and 5.7% at 18 MV, respectively. Limited results were discovered from scattering processes through computer modeling. Strong verification from measurements was concluded with respect to simulating attenuation characteristics. For IP and ICD leads, measured dose changes were less than 4%, existing as attenuation processes only, and invariant with regard to X-ray energy.


Gossman M.S.,Tri State Regional Cancer Center | McGinley P.H.,685 Tahoe Circle | Rising M.B.,University of Louisville
Journal of Applied Clinical Medical Physics | Year: 2010

This study assesses the dose level from skyshine produced by a 6 MeV medical accelerator. The analysis of data collected on skyshine yields professional guidance for future investigators as they attempt to quantify and qualify radiation protection concerns in shielding therapy vaults. Survey measurements using various field sizes and at varying distances from a primary barrier have enabled us to identify unique skyshine behavior in comparison to other energies already seen in literature. In order to correctly quantify such measurements outside a shielded barrier, one must take into consideration the fact that a skyshine maximum may not be observed at the same distance for all field sizes. A physical attribute of the skyshine scatter component was shown to increase to a maximum value at 4.6 m from the barrier for the largest field size used. We recommend that the largest field sizes be used in the field for the determination of skyshine effect and that the peak value be further analyzed specifically when considering shielding designs.


Gossman M.S.,Tri State Regional Cancer Center | Gossman M.S.,Regulation Directive Medical Physics LLC | Ketkar A.,Cyberonics | Liu A.K.,Aurora University | Olin B.,Cyberonics
Physics in Medicine and Biology | Year: 2012

Five different models of Cyberonics, Inc. vagus nerve stimulation (VNS) therapy pulse generators were investigated for their stability under radiation and their ability to change the absorbed dose from incident radiation. X-ray beams of 6 MV and 18 MV were used to quantify these results up to clinical doses of 68-78 Gy delivered in a single fraction. In the first part, the effect on electronic stimulation signaling of each pulse generator was monitored during and immediately afterwards with computer interrogation. In the second part, the effects of having the pulse generators scatter or attenuate the x-ray beam was also characterized from dose calculations on a treatment planning system as well as from actual radiation measurements. Some device models were found to be susceptible to radiation interference when placed directly in the beam of high energy therapeutic x-ray radiation. While some models exhibited no effect at all, others showed an apparent loss of stimulation output immediately after radiation was experienced. Still, other models were observed to have a cumulative dose effect with a reduced output signal, followed by battery depletion above 49Gy. Absorbed dose changes on computer underestimated attenuation by nearly half for both energies amongst all pulse generators, although the computer did depict the proper shape of the changed distribution of dose around the device. Measured attenuation ranged from 7.0% to 11.0% at 6 MV and 4.2% to 5.2% at 18 MV for x-rays. Processes of back-scatter and side-scatter were deemed negligible although recorded. Identical results from 6 MV and 18 MV x-ray beams conclude no neutron effect was induced for the 18 MV beam. As there were documented effects identified in this research regarding pulse generation, it emphasizes the importance of caution when considering radiation therapy on patients with implanted VNS devices with observed malfunctions consequential. © 2012 Institute of Physics and Engineering in Medicine.


Gossman M.S.,Tri State Regional Cancer Center | Treaba C.G.,Denver Research and Technology Labs | Kirk J.R.,Denver Research and Technology Labs
Otology and Neurotology | Year: 2011

Hypothesis: Processes of scattering and attenuation were investigated to determine the consequence on dose distributions by having a cochlear implant in the field of therapeutic radiation. Background: Radiation oncology medical accelerator beams of 6- and 18-MV x-ray energy were used. Five cochlear implants were investigated. Methods: Each implant model was individually studied using computer dose modeling and through exercises in radiation measurement during live delivery. Results: No side scatter was detected, and negligible backscattering was observed for the primary device housing and electrodes. Attenuation consequences were found to be dependent on the model of cochlear implant studied and specifically dependent on the material composition of each device. Conclusion: The maximum attenuated dose change for the study was found to be -8.8% for 6 MV and -6.6% for 18 MV. This study presents the first comparison of therapeutic radiation delivery versus computerized treatment simulation involving cochlear implants. Copyright © 2011 Otology & Neurotology, Inc. Unauthorized reproduction of this article is prohibited.


Gossman M.S.,Tri State Regional Cancer Center
Journal of applied clinical medical physics / American College of Medical Physics | Year: 2010

This study assesses the dose level from skyshine produced by a 6 MeV medical accelerator. The analysis of data collected on skyshine yields professional guidance for future investigators as they attempt to quantify and qualify radiation protection concerns in shielding therapy vaults. Survey measurements using various field sizes and at varying distances from a primary barrier have enabled us to identify unique skyshine behavior in comparison to other energies already seen in literature. In order to correctly quantify such measurements outside a shielded barrier, one must take into consideration the fact that a skyshine maximum may not be observed at the same distance for all field sizes. A physical attribute of the skyshine scatter component was shown to increase to a maximum value at 4.6 m from the barrier for the largest field size used. We recommend that the largest field sizes be used in the field for the determination of skyshine effect and that the peak value be further analyzed specifically when considering shielding designs.


Gossman M.S.,Tri State Regional Cancer Center
Journal of applied clinical medical physics / American College of Medical Physics | Year: 2010

Recent improvements to the functionality and stability of implantable pacemakers and cardioverter-defibrillators involve changes that include efficient battery power consumption and radiation hardened electrical circuits. Manufacturers have also pursued MRI-compatibility for these devices. While such newer models of pacemakers and cardioverter-defibrillators are similar in construction to previously marketed devices - even for the recent MRI-compatible designs currently in clinical trials - there is increased interest now with regard to radiation therapy dose effects when a device is near or directly in the field of radiation. Specifically, the limitation on dose to the device from therapeutic radiation beams is being investigated for a possible elevation in limiting dose above 200 cGy. We present here the first-ever study that evaluates dosimetric effects from implantable pacemakers and implantable cardioverter-defibrillators in high energy X-ray beams from a medical accelerator. Treatment plan simulations were analyzed for four different pacemakers and five different implantable cardioverter-defibrillators and intercompared with direct measurements from a miniature ionization chamber in water. All defibrillators exhibited the same results and all pacemakers were seen to display the same consequences, within only a +/- 1.8% deviation for all X-ray energies studied. Attenuation, backscatter, and lateral scatter were determined to be -13.4%, 2.1% and 1.5% at 6 MV, and -6.1%, 3.1% and 5.1% at 18 MV for the defibrillator group. For the pacemaker group, this research showed results of -15.9%, 2.8% and 2.5% at 6 MV, and -9.4%, 3.4% and 5.7% at 18 MV, respectively. Limited results were discovered from scattering processes through computer modeling. Strong verification from measurements was concluded with respect to simulating attenuation characteristics. For IP and ICD leads, measured dose changes were less than 4%, existing as attenuation processes only, and invariant with regard to X-ray energy.


Gossman M.S.,Tri State Regional Cancer Center
Journal of applied clinical medical physics / American College of Medical Physics | Year: 2010

We detail, derive and correct the technical use of the solid angle variable identified in formal guidance that relates skyshine calculations to dose-equivalent rate. We further recommend it for use with all National Council on Radiation Protection and Measurements (NCRP), Institute of Physics and Engineering in Medicine (IPEM) and similar reports documented. In general, for beams of identical width which have different resulting areas, within ± 1.0 % maximum deviation the analytical pyramidal solution is 1.27 times greater than a misapplied analytical conical solution through all field sizes up to 40 × 40 cm2. Therefore, we recommend determining the exact results with the analytical pyramidal solution for square beams and the analytical conical solution for circular beams.


Gossman M.S.,Tri State Regional Cancer Center
Journal of the American College of Radiology | Year: 2011

This research focuses on morbidity-mortality reviews and internal outcome focus studies. Definitions are provided as well as a complete discussion of the ideal parameters to consider when constructing each of these. The implementation of the design characteristics used may be of assistance to a center pursuing achievement of these requirements toward accreditation to exemplify continuous quality improvement in external-beam radiation therapy. The article further provides the educational tools necessary for readers to mature expanded studies from it for advanced site-specific clinical analyses. © 2011 American College of Radiology.


PubMed | Tri State Regional Cancer Center
Type: Journal Article | Journal: Medical physics | Year: 2017

William D. Coolidge, Inventor of the Modern X-ray Tube David J. Allard, M.S., CHP - Director, PA DEP Bureau of Radiation Protection William David Coolidge 1873-1975 was a research scientist and inventor of the modern X-ray tube. Besides Roentgen, with his 1895 discovery and subsequent studies of X-rays, perhaps no other individual contributed more to the advancement of X-ray technology than did Coolidge. He was born in Hudson, MA and received his Bachelor of Science degree from MIT in 1896. That same year he went to Europe to study under renowned physicists of the time. Coolidge received his Ph.D. summa cum laude from the University of Leipzig in 1899 and soon after joined the staff of MIT. While studying at Leipzig, he met Roentgen. In 1905 he was asked to join the newly established General Electric Research Laboratory in Schenectady, NY. He promptly began fundamental work on the production of ductile tungsten filaments as a replacement for fragile carbon filaments used in incandescent light bulbs. This improved light bulb was brought to market by GE in 1911. It was subsequent application of his tungsten work that led Coolidge to his studies in X ray production. Circa 1910, the state-of-the-art X-ray tube was a gas tube or cold cathode type tube. These crude X-ray tubes relied on residual gas molecules as a source of electrons for bombardment of low to medium atomic number metal targets. In 1912 Coolidge described the use of tungsten as an improved anode target material for X-ray tubes. Shortly after in 1913 he published a paper in Physical Review describing A Powerful Roentgen Ray Tube With a Pure Electron Discharge. This tube used a tungsten filament as a thermionic source of electrons under high vacuum to bombard a tungsten anode target. Great improvements in X-ray tube stability, output and performance were obtained with the hot cathode or Coolidge tube. With some variation in filament and target geometry, this 100 year old invention is the same basic X-ray tube used today in medicine, research and industry. In 1932 Coolidge became Director of the GE Laboratory, then in 1940 Vice-President and Director of Research. In 1941 he was a member of a small committee, appointed by President Franklin D. Roosevelt, to evaluate the military importance of research on uranium. This committees report led to the establishment of the Manhattan Engineering District for nuclear weapons development during WWII. Coolidge lived to be over 100 years old, he had 83 patents to his credit, numerous awards and honorary degrees, and in 1975 was elected to the National Inventors Hall of Fame. At the time he was the only inventor to receive this honor in his lifetime. Dr. Coolidge was also the first recipient of the AAPMs highest science award - named in his honor. From notes of a day-long interview with Coolidges son Lawrence in the mid-1990s, previous biographies, publications, books, GE literature, historic photographs, e.g., a wonderful 1874 photo stereoview card with 1 year old baby Willie Coolidge, and other artifacts in the authors collection, this presentation will review Dr. Coolidges amazing life, work, accomplishments and awards. History and Archives Resources at AIP for AAPM and its Members Gregory A. Good, Ph.D. - Director, AIP Center for History of Physics Melanie J. Mueller, MLIS - Acting Director, AIP Niels Bohr Library & Archives The American Institute of Physics established the Center for History of Physics and the Niels Bohr Library & Archives in the 1960s. Our shared mission is: To preserve and make known the history of the physical sciences. This talk will explore the many ways that AIPs two history programs support the historical and archival activities of AAPM. Topics will include our ongoing oral history program, web outreach through exhibits and teaching guides, and archiving for AAPM and other Member Societies. We will focus in particular on materials in our collections related to the history of medical physics and to the history of AAPM. We will unveil and demonstrate a new Archives Portal that we are designing specifically to be useful to AAPM and its members.1. Study the background of the medical physicist - William David Coolidge 2. Examine the time-line for his success 3. Review the publications conceptualizing his works and progressions 4. Realize what he invented 5. Evaluate the importance of the invention 6. Relate the success to national prominence 7. Uncover how he influenced medical physicists today 8. Find out how he was celebrated by the AAPM 9. View the AIP established Center for History of Physics 10. Consider the significant efforts and vision to preserve the history of medical physics 11. Learn about the Niels Bohr Library & Archives 12. Look back in time at medical physics in the 1960s 13. Unveil and demonstrate a new Archives Portal that will be useful to AAPM.

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