Anatomical Model Uncertainty for RF Safety Evaluation of Metallic Implants Under MRI Exposure

The Virtual Population (ViP) phantoms have been used in many dosimetry studies, yet, to date, anatomical phantom uncertainty in radiofrequency (RF) research has largely been neglected. The objective of this study is to gain insight, for the first time, regarding the uncertainty in RF‐induced fields during magnetic resonance imaging associated with tissue assignment and segmentation quality and consistency in anatomical phantoms by evaluating the differences between two generations of ViP phantoms, ViP1.x and ViP3.0. The RF‐induced 10g‐average electric (E‐) fields, tangential E‐fields distribution along active implantable medical devices (AIMD) routings, and estimated AIMD heating were compared for five phantoms that are part of both ViP1.x and ViP3.0. The results demonstrated that differences exceeded 3 dB (?29%, +41%) for local quantities and 1 dB (±12% for field, ±25% for power) for integrated and volume‐averaged quantities (e.g., estimated AIMD‐heating and 10 g‐average E‐fields), while the variation across different ViP phantoms of the same generation can exceed 10 dB (?68% and +217% for field, ?90% and +900% for power). In conclusion, the anatomical phantom uncertainty associated with tissue assignment and segmentation quality/consistency is larger than previously assumed, i.e., 0.6 dB or ±15% (k = 1) for AIMD heating. Further, multiple phantoms based on different volunteers covering the target population are required for quantitative analysis of dosimetric endpoints, e.g., AIMD heating, which depend on patient anatomy. Phantoms with the highest fidelity in tissue assignment and segmentation should be used, as these ensure the lowest uncertainty and possible underestimation of exposure. To verify that the uncertainty decreases monotonically with improved phantom quality, the evaluation of differences between phantom generations should be repeated for any improvement in segmentation. Bioelectromagnetics. 2019;40:458–471. © 2019 Bioelectromagnetics Society     

Feasibility of reducing differences in estimated doses in nuclear medicine between a patient-specific and a reference phantom

The feasibility of reducing the differences between patient-specific internal doses and doses estimated using reference phantoms was evaluated. Relatively simple adjustments to a polygon-surface ICRP adult male reference phantom were applied to fit selected individual dimensions using the software Rhinoceros®4.0. We tested this approach on two patient-specific phantoms: the biggest and the smallest phantoms from the Helmholtz Zentrum München library. These phantoms have unrelated anatomy and large differences in body-mass-index. Three models approximating each patient’s anatomy were considered: the voxel and the polygon-surface ICRP adult male reference phantoms and the adjusted polygon-surface reference phantom. The Specific Absorbed Fractions (SAFs) for internal photon and electron sources were calculated with the Monte Carlo code EGSnrc. Employing the time-integrated activity coefficients of a radiopharmaceutical (S)-4-(3-¹⁸F-fluoropropyl)-l-glutamic acid and the calculated SAFs, organ absorbed-dose coefficients were computed following the formalism promulgated by the Committee on Medical Internal Radiation Dose. We compared the absorbed-dose coefficients between each patient-specific phantom and other models considered with emphasis on the cross-fire component. The corresponding differences for most organs were notably lower for the adjusted reference models compared to the case when reference models were employed. Overall, the proposed approach provided reliable dose estimates for both tested patient-specific models despite the pronounced differences in their anatomy. To capture the full range of inter-individual anatomic variability more patient-specific phantoms are required. The results of this test study suggest a feasibility of estimating patient-specific doses within a relative uncertainty of 25% or less using adjusted reference models, when only simple phantom scaling is applied.     

The construction of computer tomographic phantoms and their application in radiology and radiation protection

Summary In order to assess human organ doses for risk estimates under natural and man made radiation exposure conditions, human phantoms have to be used. As an improvement to the mathematical anthropomorphic phantoms, a new family of phantoms is proposed, constructed from computer tomographic (CT) data. A technique is developed which allows any physical phantom to be converted into computer files to be used for several applications. The new human phantoms present advantages towards the location and shape of the organs, in particular the hard bone and bone marrow. The CT phantoms were used to construct three dimensional images of high resolution; some examples are given and their potential is discussed. The use of CT phantoms is also demonstrated to assess accurately the proportion of bone marrow in the skeleton. Finally, the use of CT phantoms for Monte Carlo (MC) calculations of doses resulting from various photon exposures in radiology and radiation protection is discussed.Dedicated to Prof. W. Jacobi on the occasion of his 60th birthday     

Development of a high resolution voxelised head phantom for medical physics applications

Computational anthropomorphic phantoms have become an important investigation tool for medical imaging and dosimetry for radiotherapy and radiation protection. The development of computational phantoms with realistic anatomical features contribute significantly to the development of novel methods in medical physics. For many applications, it is desirable that such computational phantoms have a real-world physical counterpart in order to verify the obtained results.In this work, we report the development of a voxelised phantom, the HIGH_RES_HEAD, modelling a paediatric head based on the commercial phantom 715-HN (CIRS). HIGH_RES_HEAD is unique for its anatomical details and high spatial resolution (0.18 × 0.18 mm² pixel size). The development of such a phantom was required to investigate the performance of a new proton computed tomography (pCT) system, in terms of detector technology and image reconstruction algorithms.The HIGH_RES_HEAD was used in an ad-hoc Geant4 simulation modelling the pCT system. The simulation application was previously validated with respect to experimental results. When compared to a standard spatial resolution voxelised phantom of the same paediatric head, it was shown that in pCT reconstruction studies, the use of the HIGH_RES_HEAD translates into a reduction from 2% to 0.7% of the average relative stopping power difference between experimental and simulated results thus improving the overall quality of the head phantom simulation.The HIGH_RES_HEAD can also be used for other medical physics applications such as treatment planning studies.A second version of the voxelised phantom was created that contains a prototypic base of skull tumour and surrounding organs at risk.     

Dose coefficients of percentile-specific computational phantoms for photon external exposures

The use of dose coefficients (DCs) based on the reference phantoms recommended by the International Commission on Radiological Protection (ICRP) with a fixed body size may produce errors to the estimated organ/tissue doses to be used, for example, for epidemiologic studies depending on the body size of cohort members. A set of percentile-specific computational phantoms that represent 10th, 50th, and 90th percentile standing heights and body masses in adult male and female Caucasian populations were recently developed by modifying the mesh-type ICRP reference computational phantoms (MRCPs). In the present study, these percentile-specific phantoms were used to calculate a comprehensive dataset of body-size-dependent DCs for photon external exposures by performing Monte Carlo dose calculations with the Geant4 code. The dataset includes the DCs of absorbed doses for 29 individual organs/tissues from 0.01 to 104 MeV photon energy, in the antero-posterior, postero-anterior, right lateral, left lateral, rotational, and isotropic geometries. The body-size-dependent DCs were compared with the DCs of the MRCPs in the reference body size, showing that the DCs of the MRCPs are generally similar to those of the 50th percentile standing height and body mass phantoms over the entire photon energy region except for low energies (≤ 0.03 MeV); the differences are mostly less than 10%. In contrast, there are significant differences in the DCs between the MRCPs and the 10th and 90th percentile standing height and body mass phantoms (i.e., H10M10 and H90M90). At energies of less than about 10 MeV, the MRCPs tended to under- and over-estimate the organ/tissue doses of the H10M10 and H90M90 phantoms, respectively. This tendency was revised at higher energies. The DCs of the percentile-specific phantoms were also compared with the previously published values of another phantom sets with similar body sizes, showing significant differences particularly at energies below about 0.1 MeV, which is mainly due to the different locations and depths of organs/tissues between the different phantom libraries. The DCs established in the present study should be useful to improve the dosimetric accuracy in the reconstructions of organ/tissue doses for individuals in risk assessment for epidemiologic investigations taking body sizes into account.     

Comparison of photon organ and effective dose coefficients for PIMAL stylized phantom in bent positions in standard irradiation geometries

Computational phantoms with articulated arms and legs have been constructed to enable the estimation of radiation dose in different postures. Through a graphical user interface, the Phantom wIth Moving Arms and Legs (PIMAL) version 4.1.0 software can be employed to articulate the posture of a phantom and generate a corresponding input deck for the Monte Carlo N-Particle (MCNP) radiation transport code. In this work, photon fluence-to-dose coefficients were computed using PIMAL to compare organ and effective doses for a stylized phantom in the standard upright position with those for phantoms in realistic work postures. The articulated phantoms represent working positions including fully and half bent torsos with extended arms for both the male and female reference adults. Dose coefficients are compared for both the upright and bent positions across monoenergetic photon energies: 0.05, 0.1, 0.5, 1.0, and 5.0 MeV. Additionally, the organ doses are compared across the International Commission on Radiological Protection’s standard external radiation exposure geometries: antero-posterior, postero-anterior, left and right lateral, and isotropic (AP, PA, LLAT, RLAT, and ISO). For the AP and PA irradiation geometries, differences in organ doses compared to the upright phantom become more profound with increasing bending angles and have doses largely overestimated for all organs except the brain in AP and bladder in PA. In LLAT and RLAT irradiation geometries, energy deposition for organs is more likely to be underestimated compared to the upright phantom, with no overall change despite increased bending angle. The ISO source geometry did not cause a significant difference in absorbed organ dose between the different phantoms, regardless of position. Organ and effective fluence-to-dose coefficients are tabulated. In the AP geometry, the effective dose at the 45° bent position is overestimated compared to the upright phantom below 1 MeV by as much as 27% and 82% in the 90° position. The effective dose in the 45° bent position was comparable to that in the 90° bent position for the LLAT and RLAT irradiation geometries. However, the upright phantom underestimates the effective dose to PIMAL in the LLAT and RLAT geometries by as much as 30% at 50 keV.     

Comparison of specific absorbed fractions (SAF) in the Brazilian adult male and the reference man phantoms.

The mathematical phantom of the Brazilian man was developed because many anatomical differences exist between South Americans, Europeans and North Americans. The objective of this work was to compare specific absorbed fractions (SAF) obtained for a model of the Brazilian adult male with those for the reference adult calculated by Snyder et al. in 1974 and to evaluate the importance of these new values in calculating radiation doses in diagnosis and therapy. The length and mass of the total body for the Brazilian man phantom were obtained from tables provided by the Brazilian government (IBGE) in which the masses of organs were measured atautopsy. Monte Carlo methods (using the ALGAM-97 computer code) were applied to calculate SAF for internal organs and the total body. The mathematical phantom designed by Snyder et al. represents very closely Reference Man, as defined in ICRP publication 23. SAF for the whole body were not more than 15% different between the two phantoms. The differences between both models are more significant for individual organs. When the source organ is the lung and red marrow is the target, for initial photon energy of 10 keV, the results obtained indicate that marrow receives 64% more dose in Brazilian model than in the Reference Man model. Eighty tables were made for 97 distinct organs (target-source) and the comparison made between the, Brazilian man and Reference man.     

Posterior kV-CBCT scanning of the head and neck region minimizes doses to critical organs with sustained image quality

We evaluated the absorbed dose to critical organs, as well as the image quality, at different partial angles in kV-CBCT (Cone Beam Computed Tomography) scanning of the head and neck region. CBCT images of phantom from a 200° rotation were performed by using three different scanning paths, anterior, posterior, and right lateral with Catphan504 and RANDO phantoms. Critical organ dose was measured using TLD 100H in the RANDO phantom. The image quality of those phantoms was evaluated, using HU uniformity, HU linearity, contrast-to-noise ratio, low contrast visibility and spatial resolution with the Catphan504 dataset; and 5-point grading scales for the RANDO phantom dataset by five radiation oncologists. The image qualities from Catphan504 and RANDO phantom of every scanning path were comparable, with no statistically significant difference (p ≥ 0.05). However, there was a significant difference in the critical organ dose in all paths (p < 0.05), depending on the critical organ location and the scanning direction. Scanning directions show no effects on the image quality. Differences in absorbed dose to critical organs should were evaluated. The posterior scanning path for the CBCT was deemed preferable due because of considerably lower doses to several critical organs of the head and neck region.     

Strategies towards rapid generation of forefoot model incorporating realistic geometry of metatarsals encapsulated into lumped soft tissues for personalized finite element analysis

Use of finite element (FE) foot model as a clinical diagnostics tool is likely to improve the specificity of foot injury predictions in the diabetic population. Here we proposed a novel workflow for rapid construction of foot FE model incorporating realistic geometry of metatarsals encapsulated into lumped forefoot’s soft tissues. Custom algorithms were implemented to perform unsupervised segmentation and mesh generation to directly convert CT data into a usable FE model. The automatically generated model provided higher efficiency and comparable numerical accuracy when compared to the model constructed using a traditional solid-based mesh process. The entire procedure uses MATLAB as the main platform, and makes the present approach attractive for creating personalized foot models to be used in clinical studies.     

Evaluation of conversion coefficients from measurable to risk quantities for external exposure over contaminated soil by use of physical human phantoms

Conversion coefficients from measurable quantities such as air kerma free-in-air or personal dose equivalent to effective dose were determined by phantom experiments. Heterogenic anthropomorphic phantoms representing children of one and five years age, and a Rando phantom representing an adult were exposed in the open field contaminated by different levels of radiocesium in the upper soil layer, in a forest site and inside a wooden house. LiF thermoluminescent (TL) detectors were used inside the phantoms for the estimation of organ doses and effective dose. Personal dosimeters similar to those used in radiation protection for individual dose measurements were placed onto the phantom surface (chest area). The ratios of dose values in separate organs to air kerma free-in-air varied from 0.69 to 1.15 for the children phantoms, and from 0.55 to 0.94 for the adult phantom, respectively, when irradiated in the open field. Body size (weight) was found to be the most important factor influencing the values of the conversion coefficients. The differences observed can reach approximately 40% when comparing conversion factors from air kerma free-in-air to effective dose for adults and newborns. For conversion coefficients from personal dose to effective dose, these differences can reach approximately 15%. The dependences of the various conversion coefficients on body mass were quantified by regression analysis. The results were compared with those calculated for a plane mono-energetic photon source having an energy of 700 keV and being located in the ground at a depth of 0.5 g cm⁻². Calculated and measured conversion coefficients from air kerma free-in-air to effective dose agreed within 12%.     

An accurate and effective FMM-based approach for freehand 3D ultrasound reconstruction

Freehand three-dimensional ultrasound imaging is a highly attractive research area because it is capable of volumetric visualization and analysis of tissues and organs. The reconstruction algorithm plays a key role to the construction of three-dimensional ultrasound volume data with higher image quality and faster reconstruction speed. However, a systematic approach to such problem is still missing. A new fast marching method (FMM) for three-dimensional ultrasound volume reconstruction using the tracked and hand-held probe is proposed in this paper. Our reconstruction approach consists of two stages: bin-filling stage and hole-filling stage. Each pixel in the B-scan images is traversed and its intensity value is assigned to its nearest voxel in the bin-filling stage. For the efficient and accurate reconstruction, we present a new hole-filling algorithm based on the fast marching method. Our algorithm advances the interpolation boundary along its normal direction and fills the area closest to known voxel points in first, which ensure that the structural details of image can be preserved. Experimental results on both ultrasonic abdominal phantom and in vivo urinary bladder of human subject and comparisons with some popular algorithms are used to demonstrate its improvement in both reconstruction accuracy and efficiency.     

Focused hyperthermia with a magnetic resonance imaging (MRI) unit and an interstitial grounded probe

The feasibility of using a commercial magnetic resonance imaging (MRI) scanner to do either imaging or hyperthermic treatment was demonstrated. Radiofrequency (RF) induced focal heating of phantoms and animal tissues was performed using a MRI scanner as the RF power source and a grounded interstitial probe as a device to produce hyperthermia via eddy current convergence. In the therapeutic mode, a pulse width of 900 microseconds and interval of 50 ms were used to give 2% duty cycle (closest simulation to continuous wave (CW) mode without bypassing imaging filters). Temperature in the vicinity of the grounded probe was measured with a field nonperturbing fluoroptic probe. Temperatures increased 4.5 degrees C in 5 minutes in a dielectrically uniform phantom, 3.1 degrees C in 6.7 minutes in rats' leg muscles, and 5.0 degrees C in 6.0 minutes in rats' peritoneum. The MRI of the phantom with the grounded probe and the fluoroptic probe was obtained using spin echo sequences. The potential advantage of this approach is visualization of deep-seated tumors and hyperthermic treatment with minimal modification of the MRI scanner.     

A numerical and experimental comparison of human head phantoms for compliance testing of mobile telephone equipment

A new human head phantom has been proposed by CENELEC/IEEE, based on a large scale anthropometric survey. This phantom is compared to a homogeneous Generic Head Phantom and three high resolution anatomical head models with respect to specific absorption rate (SAR) assessment. The head phantoms are exposed to the radiation of a generic mobile phone (GMP) with different antenna types and a commercial mobile phone. The phones are placed in the standardized testing positions and operate at 900 and 1800 MHz. The average peak SAR is evaluated using both experimental (DASY3 near field scanner) and numerical (FDTD simulations) techniques. The numerical and experimental results compare well and confirm that the applied SAR assessment methods constitute a conservative approach.     

A mechanical model to compute elastic modulus of tissues for harmonic motion imaging

Numerous experimental and computational methods have been developed to estimate tissue elasticity. The existing testing techniques are generally classified into in vitro, invasive in vivo and non-invasive in vivo. For each experimental method, a computational scheme is accordingly proposed to calculate mechanical properties of soft biological tissues. Harmonic motion imaging (HMI) is a new technique that performs radio frequency (RF) signal tracking to estimate the localized oscillatory motion resulting from a radiation force produced by focused ultrasound. A mechanical model and computational scheme based on the superposition principle are developed in this paper to estimate the Young's modulus of a tissue mimicking phantom and bovine liver in vitro tissue from the harmonic displacement measured by HMI. The simulation results are verified by two groups of measurement data, and good agreement is shown in each comparison. Furthermore, an inverse function is observed to correlate the elastic modulus of uniform phantoms with amplitude of displacement measured in HMI. The computational scheme is also implemented to estimate 3D elastic modulus of bovine liver in vitro.     

Chirp phantom for MTF calculations. A study of its precision in noisy environments

Bar pattern phantoms are used to determine the maximum number of line-pairs per mm that an imaging system can resolve. In some cases, a numerical determination of the modulation transfer function (MTF) can also be carried out. However, calculations can only be performed in a relatively small number of frequencies because of the small number of bar groups in the phantom. In this work, a new bar pattern phantom has been simulated. This phantom consists of 66 pairs of lines of different periods and these periods vary exponentially with spatial position, like in a chirp wave. An oversampling procedure has been implemented to obtain the pre-sampled MTF of the system and the results obtained have been compared with those obtained with the edge method, recommended by the IEC. Monte Carlo simulations were carried out for three different levels of noise aimed at investigating the effect of noise on the uncertainties of the MTF determination. In addition, using the analytic expressions for the MTF calculation, statistical fluctuations of noise in phantom images were propagated to MTF values. Despite the smaller size of the chirp phantom, uncertainties in the chirp method are smaller than those of the edge method. For the edge image, the standard deviation of the MTF is proportional to the frequency f, whereas for the chirp method it is proportional to its square root. It is shown that applying an oversampling method allows the use of a single line pair per period without compromising the precision in noisy environments.     

Three-dimensional printer-generated patient-specific phantom for artificial in vivo dosimetry in radiotherapy quality assurance

Pretreatment intensity-modulated radiotherapy quality assurance is performed using simple rectangular or cylindrical phantoms; thus, the dosimetric errors caused by complex patient-specific anatomy are absent in the evaluation objects. In this study, we construct a system for generating patient-specific three-dimensional (3D)-printed phantoms for radiotherapy dosimetry. An anthropomorphic head phantom containing the bone and hollow of the paranasal sinus is scanned by computed tomography (CT). Based on surface rendering data, a patient-specific phantom is formed using a fused-deposition-modeling-based 3D printer, with a polylactic acid filament as the printing material. Radiophotoluminescence glass dosimeters can be inserted in the 3D-printed phantom. The phantom shape, CT value, and absorbed doses are compared between the actual and 3D-printed phantoms. The shape difference between the actual and printed phantoms is less than 1 mm except in the bottom surface region. The average CT value of the infill region in the 3D-printed phantom is −6 ± 18 Hounsfield units (HU) and that of the vertical shell region is 126 ± 18 HU. When the same plans were irradiated, the dose differences were generally less than 2%. These results demonstrate the feasibility of the 3D-printed phantom for artificial in vivo dosimetry in radiotherapy quality assurance.     

Occupational exposures during abdominal fluoroscopically guided interventional procedures for different patient sizes — A Monte Carlo approach

In this study we evaluated the occupational exposures during an abdominal fluoroscopically guided interventional radiology procedure. We investigated the relation between the Body Mass Index (BMI), of the patient, and the conversion coefficient values (CC) for a set of dosimetric quantities, used to assess the exposure risks of medical radiation workers. The study was performed using a set of male and female virtual anthropomorphic phantoms, of different body weights and sizes. In addition to these phantoms, a female and a male phantom, named FASH3 and MASH3 (reference virtual anthropomorphic phantoms), were also used to represent the medical radiation workers. The CC values, obtained as a function of the dose area product, were calculated for 87 exposure scenarios. In each exposure scenario, three phantoms, implemented in the MCNPX 2.7.0 code, were simultaneously used. These phantoms were utilized to represent a patient and medical radiation workers. The results showed that increasing the BMI of the patient, adjusted for each patient protocol, the CC values for medical radiation workers decrease. It is important to note that these results were obtained with fixed exposure parameters.     

Identification process based on shear wave propagation within a phantom using finite element modelling and magnetic resonance elastography

Magnetic resonance elastography (MRE), based on shear wave propagation generated by a specific driver, is a non-invasive exam performed in clinical practice to improve the liver diagnosis. The purpose was to develop a finite element (FE) identification method for the mechanical characterisation of phantom mimicking soft tissues investigated with MRE technique. Thus, a 3D FE phantom model, composed of the realistic MRE liver boundary conditions, was developed to simulate the shear wave propagation with the software ABAQUS. The assumptions of homogeneity and elasticity were applied to the FE phantom model. Different ranges of mesh size, density and Poisson's ratio were tested in order to develop the most representative FE phantom model. The simulated wave displacement was visualised with a dynamic implicit analysis. Subsequently, an identification process was performed with a cost function and an optimisation loop provided the optimal elastic properties of the phantom. The present identification process was validated on a phantom model, and the perspective will be to apply this method on abdominal tissues for the set-up of new clinical MRE protocols that could be applied for the follow-up of the effects of treatments.     

联合细胞培养在组织工程血管化中的应用

自从1987年正式提出组织工程这一概念来以来,培养具有生物学活性组织器官替代物始终是组织工程学的发展方向。目前,虽然一些工程化组织如皮肤、软骨等已被成功构建,并应用于临床,但其他工程化组织如心脏、骨骼肌、肝脏等体积大、功能复杂,移植后难以及时建立血液供应。而及时建立的血管网络对组织器官的存活与功能实现至关重要。为此,国内外一些实验室采用联合细胞培养的方法,观察不同细胞间的相互作用对血管形成的影响。结果表明,联合细胞培养在血管的形成、稳定和成熟方面起着重要作用。     

Magnetoacoustic imaging of electrical conductivity of biological tissues at a spatial resolution better than 2 mm

Magnetoacoustic tomography with magnetic induction (MAT-MI) is an emerging approach for noninvasively imaging electrical impedance properties of biological tissues. The MAT-MI imaging system measures ultrasound waves generated by the Lorentz force, having been induced by magnetic stimulation, which is related to the electrical conductivity distribution in tissue samples. MAT-MI promises to provide fine spatial resolution for biological tissue imaging as compared to ultrasound resolution. In the present study, we first estimated the imaging spatial resolution by calculating the full width at half maximum (FWHM) of the system point spread function (PSF). The actual spatial resolution of our MAT-MI system was experimentally determined to be 1.51 mm by a parallel-line-source phantom with Rayleigh criterion. Reconstructed images made from tissue-mimicking gel phantoms, as well as animal tissue samples, were consistent with the morphological structures of the samples. The electrical conductivity value of the samples was determined directly by a calibrated four-electrode system. It has been demonstrated that MAT-MI is able to image the electrical impedance properties of biological tissues with better than 2 mm spatial resolution. These results suggest the potential of MAT-MI for application to early detection of small-size diseased tissues (e.g. small breast cancer).