Real-time estimation of surface dose based on incident air kerma in diagnostic radiology

PurposeTo estimate the surface dose in diagnostic radiology in real time based on the relationship between the incident air kerma and the surface dose.MethodsThe air kerma for 20 X-ray beams with tube voltages of 50–140 kV and a half-value layer (HVL) of 2.27–9.65 mm Al was measured using an ionization chamber. The beam quality was classified based on the quality indexes (QIs) of 0.4, 0.5, and 0.6, which are defined as the ratio of the effective energy to the maximum energy corresponding to the tube potential. The surface dose for 20 X-ray beams was evaluated based on the measured air kerma, backscatter factor, and ratio of the mass–energy absorption coefficients of water to air, which were calculated using the Monte Carlo method. Finally, the relationship between the air kerma and the surface dose was investigated for X-ray beams with the specific QI values.ResultsThe surface dose at a water phantom was represented by a linear approximation of R² > 0.98, with the air kerma, regardless of the X-ray beam quality. The surface dose estimated based on a linear approximation with the air kerma indicated an agreement within 8% with that evaluated by the chamber measurements at HVL > 3.4 mm Al.ConclusionIt is possible to estimate the surface dose in real time using the linear relationship between the incident air kerma and the surface dose regardless of the X-ray beam quality by accepting ±10% uncertainty in the surface dose estimation.     

Determination of the surface dose of a water phantom using a semiconductor detector for diagnostic kilovoltage x-ray beams

PurposeTo determine the surface dose of a water phantom using a semiconductor detector for diagnostic kilovoltage x-ray beams.MethodsAn AGMS-DM+ semiconductor detector was calibrated in terms of air kerma measured with an ionization chamber. Air kerma was measured for 20 x-ray beams with tube voltages of 50–140 kVp and a half-value layer (HVL) of 2.2–9.7 mm Al for given quality index (QI) values of 0.4, 0.5, and 0.6, and converted to the surface dose. Finally, the air kerma and HVL measured by the AGMS-DM+ detector were expressed as a ratio of the surface dose for 10 × 10 and 20 × 20 cm² fields. The ratio of both was represented as a function of HVL for the given QI values and verified by comparing it with that calculated using the Monte Carlo method.ResultsThe air kerma calibration factor, CF, for the AGMS-DM+ detector ranged from 0.986 to 1.016 (0.9% in k = 1). The CF values were almost independent of the x-ray fluence spectra for the given QI values. The ratio of the surface dose to the air kerma determined by the PTW 30,013 chamber and the AGMS-DM+ detector was less than 1.8% for the values calculated using the Monte Carlo method, and showed a good correlation with the HVL for the given QI values.ConclusionIt is possible to determine the surface dose of a water phantom from the air kerma and HVL measured by a semiconductor detector for given QI values.     

EGS_cbct: Simulation of a fan beam CT and RMI phantom for measured HU verification

IntroductionA mathematical 3D model of an existing computed tomography (CT) scanner was created and used in the EGSnrc-based BEAMnrc and egs_cbct Monte Carlo codes. Simulated transmission dose profiles of a RMI-465 phantom were analysed to verify Hounsfield numbers against measured data obtained from the CT scanner.Methods and materialsThe modelled CT unit is based on the design of a Toshiba Aquilion 16 LB CT scanner. As a first step, BEAMnrc simulated the X-ray tube, filters, and secondary collimation to obtain phase space data of the X-ray beam. A bowtie filter was included to create a more uniform beam intensity and to remove the beam hardening effects. In a second step the Interactive Data Language (IDL) code was used to build an EGSPHANT file that contained the RMI phantom which was used in egs_cbct simulations. After simulation a series of profiles were sampled from the detector model and the Feldkamp-Davis-Kress (FDK) algorithm was used to reconstruct transversal images. The results were tested against measured data obtained from CT scans.ResultsThe egs_cbct code can be used for the simulation of a fan beam CT unit. The calculated bowtie filter ensured a uniform flux on the detectors. Good correlation between measured and simulated CT numbers was obtained.ConclusionsIn principle, Monte Carlo codes such as egs_cbct can model a fan beam CT unit. After reconstruction, the images contained Hounsfield values comparable to measured data.     

Monte Carlo determination of a nanoDot OSLD response using quality index for diagnostic kilovoltage X-ray beams

PurposeThis study aims to investigate the energy response of an optically stimulated luminescent dosimeter known as nanoDot for diagnostic kilovoltage X-ray beams via Monte Carlo calculations.MethodsThe nanoDot response is calculated as a function of X-ray beam quality in free air and on a water phantom surface using Monte Carlo simulations. The X-ray fluence spectra are classified using the quality index (QI), which is defined as the ratio of the effective energy to the maximum energy of the photons. The response is calculated for X-ray fluence spectra with QIs of 0.4, 0.5, and 0.6 with tube voltages of 50–137.6 kVp and monoenergetic photon beams. The surface dose estimated using the calculated response is verified by comparing it with that measured using an ionization chamber.ResultsThe nanoDot response in free air for monoenergetic photon beams (QI = 1.0) varies significantly at photon energies below 100 keV and reaches a factor of 3.6 at 25–30 keV. The response differs by up to approximately 6% between QIs of 0.4 and 0.6 for the same half-value layer (HVL). The response at the phantom surface decreases slightly owing to the backscatter effect, and it is almost independent of the field size. The agreement between the surface dose estimated using the nanoDot and that measured using the ionization chamber for assessing X-ray beam qualities is less than 2%.ConclusionsThe nanoDot response is indicated as a function of HVL for the specified QIs, and it enables the direct surface dose measurement.     

Monte Carlo-based assessment of the trade-off between spatial resolution,field-of-view and scattered radiation in the variable resolution X-ray CT scanner

ObjectiveThe purpose of this work is to evaluate the impact of optimization of magnification on performance parameters of the variable resolution X-ray (VRX) CT scanner.MethodsA realistic model based on an actual VRX CT scanner was implemented in the GATE Monte Carlo simulation platform. To evaluate the influence of system magnification, spatial resolution, field-of-view (FOV) and scatter-to-primary ratio of the scanner were estimated for both fixed and optimum object magnification at each detector rotation angle. Comparison and inference between these performance parameters were performed angle by angle to determine appropriate object position at each opening half angle.ResultsOptimization of magnification resulted in a trade-off between spatial resolution and FOV of the scanner at opening half angles of 90°–12°, where the spatial resolution increased up to 50% and the scatter-to-primary ratio decreased from 4.8% to 3.8% at a detector angle of about 90° for the same FOV and X-ray energy spectrum. The disadvantage of magnification optimization at these angles is the significant reduction of the FOV (up to 50%). Moreover, magnification optimization was definitely beneficial for opening half angles below 12° improving the spatial resolution from 7.5 cy/mm to 20 cy/mm. Meanwhile, the FOV increased by more than 50% at these angles.ConclusionIt can be concluded that optimization of magnification is essential for opening half angles below 12°. For opening half angles between 90° and 12°, the VRX CT scanner magnification should be set according to the desired spatial resolution and FOV.     

Experimental implementation of a polyenergetic statistical reconstruction algorithm for a commercial fan-beam CT scanner

PurposeTo present a framework for characterizing the data needed to implement a polyenergetic model-based statistical reconstruction algorithm, Alternating Minimization (AM), on a commercial fan-beam CT scanner and a novel method for assessing the accuracy of the commissioned data model.MethodsThe X-ray spectra for three tube potentials on the Philips Brilliance CT scanner were estimated by fitting a semi-empirical X-ray spectrum model to transmission measurements. Spectral variations due to the bowtie filter were computationally modeled. Eight homogeneous cylinders of PMMA, Teflon and water with varying diameters were scanned at each energy. Central-axis scatter was measured for each cylinder using a beam-stop technique. AM reconstruction with a single-basis object-model matched to the scanned cylinder's composition allows assessment of the accuracy of the AM algorithm's polyenergetic data model. Filtered-backprojection (FBP) was also performed to compare consistency metrics such as uniformity and object-size dependence.ResultsThe spectrum model fit measured transmission curves with residual root-mean-square-error of 1.20%–1.34% for the three scanning energies. The estimated spectrum and scatter data supported polyenergetic AM reconstruction of the test cylinders to within 0.5% of expected in the matched object-model reconstruction test. In comparison to FBP, polyenergetic AM exhibited better uniformity and less object-size dependence.ConclusionsReconstruction using a matched object-model illustrate that the polyenergetic AM algorithm's data model was commissioned to within 0.5% of an expected ground truth. These results support ongoing and future research with polyenergetic AM reconstruction of commercial fan-beam CT data for quantitative CT applications.     

Measuring skin dose in CT examinations under complex geometries: Instruments,methods and considerations

ObjectiveTo investigate skin dose in Computed Tomography (CT) and its dependence on scanning geometry.Materials and methodsMeasurements of entrance surface air kerma (ESAK) in free air and entrance skin dose (ESD) on an anthropomorphic phantom were performed in a 64-slice CT scanner, using two different instruments: the Dose Profiler (DP) and the QED skin diode (QEDSD). Using DP and QEDSD, the ESAK rate profiles at the isocenter and at different distances from it, were measured using axial scans. Using DP and helical scans the ESAK rate profile in the Z-axis was acquired. The same profile was acquired with the QEDSD also, using many axial scans and manual table translation. ESD measurements were performed with the DP and QEDSD, in axial and helical scan mode.ResultsESAK measurements with DP and QEDSD were in good agreement, for both point dose and profile measurements. The agreement was also good for ESD measurements but not for helical scans, due to variable X-ray beam overlapping and different tube angular positions at each scan start. It was observed that the ESD values at different Y-axis offsets were comparable to the respective ESAK values recorded at the same Y-axis offset distances without the phantom.ConclusionsBoth DP and QEDSD were proven suitable for performing point ESD measurements. However, calculating the skin dose distribution in CT examinations is a very challenging task. A practical approach would be for CT scanners to provide a conservative estimate of the peak skin dose using the isocenter ESAK value.     

CT dosimetry considerations in non typical conditions: The effect of scan field of view and table height selection

PurposeTo experimentally investigate the effect of the scan field of view (SFOV) selection and table height settings on the Computed Tomography Dose Index (CTDI) and the implications concerning patient effective and skin dose.MethodsAir-kerma length product (AKLP) measurements were carried out in a helical CT scanner using a pencil type dosimeter positioned in air and inside the holes of a head and a body phantom, using all available SFOV selections and different table height settings. Furthermore, using radiotherapy verification films placed on the CT table surface, the entrance surface air kerma (ESAK) profiles were derived with different SFOV and table height selections, both with and without a phantom on top of the films.ResultsThe AKLP is strongly dependent on the SFOV selection and the table height settings. Different SFOV selections correspond to the selection of different bowtie filters that shape the X-ray beam intensity, resulting in different ESAK values at the isocenter and at the other points within the scanning plane. With the off-center positioning the calculated CTDI values within the center and the periphery of the phantom change also, as a result of the different intensity and width of the X-ray beam to which are exposed to.ConclusionsThe existing protocols for calculating effective dose are limited to only two patient anatomy-SFOV combinations and cannot account for off-center positioning. Therefore, more work will be required to estimate the effective and skin dose for non-standard SFOV-patient anatomy combinations and off-center patient positioning.     

Dual-energy contrast-enhanced digital mammography: Glandular dose estimation using a Monte Carlo code and voxel phantom

PurposeTo estimate the mean glandular dose of contrast enhanced digital mammography, using the EGSnrc Monte Carlo code and female adult voxel phantom.MethodsAutomatic exposure control of full field digital mammography system was used for the selection of the X-ray spectrum and the exposure settings for dual energy imaging. Measurements of the air-kerma and of the half value layers were performed and a Monte Carlo simulation of the digital mammography system was used to compute the mean glandular dose, for breast phantoms of various thicknesses, glandularities and for different X-ray spectra (low and high energy).ResultsFor breast phantoms of 2.0–8.0 cm thick and 0.1–100% glandular fraction, CC view acquisition, from AEC settings, can result in a mean glandular dose of 0.450 ± 0.022 mGy −2.575 ± 0.033 mGy for low energy images and 0.061 ± 0.021 mGy – 0.232 ± 0.033 mGy for high energy images. In MLO view acquisition mean glandular dose values ranged between 0.488 ± 0.007 mGy – 2.080 ± 0.021 mGy for low energy images and 0.065 ± 0.012 mGy – 0.215 ± 0.010 mGy for high energy images.ConclusionThe low kV part of contrast enhanced digital mammography is the main contributor to total mean glandular breast dose. The results of this study can be used to provide an estimated mean glandular dose for individual cases.     

Monte Carlo evaluation of glandular dose in cone-beam X-ray computed tomography dedicated to the breast: Homogeneous and heterogeneous breast models

PurposeIn cone-beam computed tomography dedicated to the breast (BCT), the mean glandular dose (MGD) is the dose metric of reference, evaluated from the measured air kerma by means of normalized glandular dose coefficients (DgN_CT). This work aimed at computing, for a simple breast model, a set of DgN_CT values for monoenergetic and polyenergetic X-ray beams, and at validating the results vs. those for patient specific digital phantoms from BCT scans.MethodsWe developed a Monte Carlo code for calculation of monoenergetic DgN_CT coefficients (energy range 4.25–82.25 keV). The pendant breast was modelled as a cylinder of a homogeneous mixture of adipose and glandular tissue with glandular fractions by mass of 0.1%, 14.3%, 25%, 50% or 100%, enveloped by a 1.45 mm-thick skin layer. The breast diameter ranged between 8 cm and 18 cm. Then, polyenergetic DgN_CT coefficients were analytically derived for 49-kVp W-anode spectra (half value layer 1.25–1.50 mm Al), as in a commercial BCT scanner. We compared the homogeneous models to 20 digital phantoms produced from classified 3D breast images.ResultsPolyenergetic DgN_CT resulted 13% lower than most recent published data. The comparison vs. patient specific breast phantoms showed that the homogeneous cylindrical model leads to a DgN_CT percentage difference between −15% and +27%, with an average overestimation of 8%.ConclusionsA dataset of monoenergetic and polyenergetic DgN_CT coefficients for BCT was provided. Patient specific breast models showed a different volume distribution of glandular dose and determined a DgN_CT 8% lower, on average, than homogeneous breast model.     

Impact of spherical applicator diameter on relative biologic effectiveness of low energy IORT X-rays: A hybrid Monte Carlo study

IntroductionLow-kV IORT (Low kilovoltage intraoperative radiotherapy) using INTRABEAM machine and dedicated spherical applicators is a candidate modality for breast cancer treatment. The current study aims to quantify the RBE (relative biologic effectiveness) variations of emitted X-rays from the surface of different spherical applicators and bare probe through a hybrid Monte Carlo (MC) simulation approach.Materials and methodsA validated MC model of INTRABEAM machine and different applicator diameters, based on GEANT4 Toolkit, was employed for RBE evaluation. To doing so, scored X-ray energy spectra at the surface of each applicator diameter/bare probe were used to calculate the corresponding secondary electron energy spectra at various distances inside the water and breast tissue. Then, MCDS (Monte Carlo damage simulation) code was used to calculate the RBE values according to the calculated electron spectra.ResultsPresence of spherical applicators can increase the RBE of emitted X-rays from the bare probe by about 22.3%. In return, changing the applicator diameter has a minimal impact (about 3.2%) on RBE variation of emitted X-rays from each applicator surface. By increasing the distance from applicator surface, the RBE increments too, so that its value enhances by about 10% with moving from 2 to 10 mm distance. Calculated RBE values within the breast tissue were higher than those of water by about 4% maximum value.ConclusionBall section of spherical IORT applicators can affect the RBE value of the emitted X-rays from INTRABEAM machine. Increased RBE of breast tissue can reduce the prescribed dose for breast irradiation if INTRABEAM machine has been calibrated inside the water.     

Investigation of the dose distribution for a cone beam CT system dedicated to breast imaging

Cone-beam breast Computed Tomography (bCT) is an X-ray imaging technique for breast cancer diagnosis, in principle capable of delivering a much more homogeneous dose spatial pattern to the breast volume than conventional mammography, at dose levels comparable to two-view mammography. We present an investigation of the three-dimensional dose distribution for a cone-beam CT system dedicated to breast imaging. We employed Monte Carlo simulations for estimating the dose deposited within a breast phantom having a hemiellipsoidal shape placed on a cylinder of 3.5 cm thickness that simulates the chest wall. This phantom represents a pendulant breast in a bCT exam with the average diameter at chest wall, assumed to correspond to a 5-cm-thick compressed breast in mammography. The phantom is irradiated in a circular orbit with an X-ray cone beam selected from four different techniques: 50, 60, 70, and 80 kVp from a tube with tungsten anode, 1.8 mm Al inherent filtration and additional filtration of 0.2 mm Cu. Using the Monte Carlo code GEANT4 we simulated a system similar to the experimental apparatus available in our lab. Simulations were performed at a constant free-in-air air kerma at the isocenter (1 μGy); the corresponding total number of photon histories per scan was 288 million at 80 kVp. We found that the more energetic beams provide a more uniform dose distribution than at low energy: the 50 kVp beam presents a frequency distribution of absorbed dose values with a coefficient of variation almost double than that for the 80 kVp beam. This is confirmed by the analysis of the relative dose profiles along the radial (i.e. parallel to the “chest wall”) and longitudinal (i.e. from “chest wall” to “nipple”) directions. Maximum radial deviations are on the order of 25% for the 80 kVp beam, whereas for the 50 kVp beam variations around 43% were observed, with the lowest dose values being found along the central longitudinal axis of the phantom.     

An in-silico method to predict and quantify the effect of gold nanoparticles in X-ray imaging

PurposeOver the last few years studies are conducted, highlighting the feasibility of Gold Nanoparticles (GNPs) to be used in clinical CT imaging and as an efficient contrast agent for cancer research. After ensuring that GNPs formulations are appropriate for in vivo or clinical use, the next step is to determine the parameters for an X-ray system’s optimal contrast for applications and to extract quantitative information. There is currently a gap and need to exploit new X-ray imaging protocols and processing algorithms, through specific models avoiding trial-and-error procedures and provide an imaging prognosis tool. Such a model can be used to confirm the accumulation of GNPs in target organs before radiotherapy treatments with a system easily available in hospitals, as low energy X-rays.MethodsIn this study a complete, easy-to-use, simulation platform is designed and built, where simple parameters, as the X-ray’s specifications and experimentally defined biodistributions of specific GNPs are imported. The induced contrast and images can be exported, and accurate quantification can be performed. This platform is based on the GATE Monte Carlo simulation toolkit, based on the GEANT4 toolkit and the MOBY phantom, a realistic 4D digital mouse.ResultsWe have validated this simulation platform to predict the contrast induction and minimum detectable concentration of GNPs on any given X-ray system. The study was applied to preclinical studies but is also expandable to clinical studies.ConclusionsAccording to our knowledge, no other such validated simulation model currently exists, and this model could help radiology imaging with GNPs to be truly deployed.     

Radiation dose around a PET scanner installation: Comparison of Monte Carlo simulations,analytical calculations and experimental results

PurposeMonte Carlo study of radiation transmission around areas surrounding a PET room.MethodsAn extended population of patients administered with ¹⁸F-FDG for PET-CT investigations was studied, collecting air kerma rate and gamma ray spectra measurements at a reference distance. An MC model of the diagnostic room was developed, including the scanner and walls with variable material and thickness. MC simulations were carried out with the widely used code GEANT4.ResultsThe model was validated by comparing simulated radiation dose values and gamma ray spectra produced by a volumetric source with experimental measurements; ambient doses in the surrounding areas were assessed for different combinations of wall materials and shielding and compared with analytical calculations, based on the AAPM Report 108.In the range 1.5–3.0 times of the product between the linear attenuation coefficient and thickness of an absorber (μ x), it was observed that the effectiveness of different combinations of shielding is roughly equivalent. An extensive tabulation of results is given in the text.ConclusionsThe validation tests performed showed a satisfactory agreement between the simulated and expected results. The simulated dose rates incident on, and transmitted by the walls in our model of PET scanner room, are generally in good agreement with analytical estimates performed using the AAPM Publication No. 108 method. This provides an independent confirmation of AAPM's approach. Even in this specific field of application, GEANT4 proved to be a relevant and accurate tool for dosimetry estimates, shielding evaluation and for general radiation protection use.     

Monte Carlo simulation of the dose distribution of ICRP adult reference computational phantoms for acquisitions with a 320 detector-row cone-beam CT scanner

PurposeThe purpose of this study was to develop and validate a Monte Carlo (MC) simulation tool for patient dose assessment for a 320 detector-row CT scanner, based on the recommendations of International Commission on Radiological Protection (ICRP). Additionally, the simulation was applied on four clinical acquisition protocols, with and without automatic tube current modulation (TCM).MethodsThe MC simulation was based on EGS4 code and was developed specifically for a 320 detector-row cone-beam CT scanner. The ICRP adult reference phantoms were used as patient models. Dose measurements were performed free-in-air and also in four CTDI phantoms: 150 mm and 350 mm long CT head and CT body phantoms. The MC program was validated by comparing simulations results with these actual measurements acquired under the same conditions. The measurements agreed with the simulations across all conditions within 5%. Patient dose assessment was performed for four clinical axial acquisitions using the ICRP adult reference phantoms, one of them using TCM.ResultsThe results were nearly always lower than those obtained from other dose calculator tools or published in other studies, which were obtained using mathematical phantoms in different CT systems. For the protocol with TCM organ doses were reduced by between 28 and 36%, compared to the results obtained using a fixed mA value.ConclusionsThe developed simulation program provides a useful tool for assessing doses in a 320 detector-row cone-beam CT scanner using ICRP adult reference computational phantoms and is ready to be applied to more complex protocols.     

A patient-centric approach to quality control and dosimetry in CT including CBCT

One measurement and an algebraic formula are used to calculate the incident air kerma (K_a,i) at the skin after any CT examination, including cone-beam CT (CBCT) and multi-slice CT (MSCT).Empty scans were performed with X-ray CBCT systems (dental, C-arm and linac guidance scanners) as well as two MSCT scanners. The accumulated K_a,i at the flat panel (in CBCT) or the maximum incident air kerma at the isocentre (in MSCT) were measured using a solid-state probe. The average K_a,i(skin), at the skin of a hypothetical patient, was calculated using the proposed formula. Additional measurements of dose at the isocentre (D_FOV) and kerma-area product (KAP), as well as K_a,i(skin) from thermoluminiscence dosimeters (TLDs) and size-specific dose estimates are presented for comparison.The K_a,i(skin) for the standard head size in the dental scanner, the C-arm (high dose head protocol) and the linac (head protocol) were respectively 3.33 ± 0.19 mGy, 15.15 ± 0.76 mGy and 3.23 ± 0.16 mGy. For the first MSCT, the calculated K_a,i(skin) was 13.1 ± 0.7 mGy and the TLDs provided a K_a,i(skin) between 10.3 ± 1.1 mGy and 13.8 ± 1.4 mGy.Estimation of patient air kerma in tomography with an uncertainty below 7% is thus feasible using an empty scan and conventional measurement tools. The provided equations and website can be applied to a standard size for the sake of quality control or to several sizes for the definition of diagnostic reference levels (DRLs). The obtained incident air kerma can be directly compared to the K_a,i from other X-ray modalities as recommended by ICRU and IAEA.     

Clinical implementation of a Monte Carlo based treatment plan QA platform for validation of Cyberknife and Tomotherapy treatments

PurposeThe main focus of the current paper is the clinical implementation of a Monte Carlo based platform for treatment plan validation for Tomotherapy and Cyberknife, without adding additional tasks to the dosimetry department.MethodsThe Monte Carlo platform consists of C++ classes for the actual functionality and a web based GUI that allows accessing the system using a web browser. Calculations are based on BEAMnrc/DOSXYZnrc and/or GATE and are performed automatically after exporting the dicom data from the treatment planning system. For Cyberknife treatments of moving targets, the log files saved during the treatment (position of robot, internal fiducials and external markers) can be used in combination with the 4D planning CT to reconstruct the actually delivered dose. The Monte Carlo platform is also used for calculation on MRI images, using pseudo-CT conversion.ResultsFor Tomotherapy treatments we obtain an excellent agreement (within 2%) for almost all cases. However, we have been able to detect a problem regarding the CT Hounsfield units definition of the Toshiba Large Bore CT when using a large reconstruction diameter. For Cyberknife treatments we obtain an excellent agreement with the Monte Carlo algorithm of the treatment planning system. For some extreme cases, when treating small lung lesions in low density lung tissue, small differences are obtained due to the different cut-off energy of the secondary electrons.ConclusionsA Monte Carlo based treatment plan validation tool has successfully been implemented in clinical routine and is used to systematically validate all Cyberknife and Tomotherapy plans.     

A Monte Carlo simulation for the estimation of patient dose in rest and stress cardiac computed tomography with a 320-detector row CT scanner

PurposeTo estimate organ dose and effective dose for patients for cardiac CT as applied in an international multicenter study (CORE320) with a 320-Detector row CT scanner using Monte Carlo (MC) simulations and voxelized phantoms. The effect of positioning of the arms, off-centering the patient and heart rate on patient dose was analyzed.MethodsA MC code was tailored to simulate the geometry and characteristics of the CT scanner. The phantoms representing the adult reference male and female were implemented according to ICRP 110. Effective dose and organ doses were obtained for CT acquisition protocols for calcium scoring, coronary angiography and myocardial perfusion.ResultsFor low heart rate, the normalized effective dose (E) for cardiac CT was higher for female (5.6 mSv/100 mAs) compared to male (2.2 mSv/100 mAs) due to the contribution of female breast tissue. Averaged E for female and male was 11.3 mSv for the comprehensive cardiac protocol consisting of calcium scoring (1.9 mSv); coronary angiography including rest cardiac perfusion (5.1 mSv) and stress cardiac perfusion (4.3 mSv). These values almost doubled at higher heart rates (20.1 mSv). Excluding the arms increased effective dose by 6–8%, centering the patient showed no significant effect. The k-factor (0.028 mSv/mGy.cm) derived from this study leads to effective doses up to 2–3 times higher than the values obtained using now outdated methodologies.ConclusionMC modeling of cardiac CT examinations on realistic voxelized phantoms allowed us to assess patient doses accurately and we derived k-factors that are well above those published previously.     

GEANT4 Monte Carlo simulations for virtual clinical trials in breast X-ray imaging: Proof of concept

Virtual clinical trials (VCT) are in-silico reproductions of medical examinations, which adopt digital models of patients and simulated devices. They are intended to produce clinically equivalent outcome data avoiding long execution times, ethical issues related to radiation induced risks and huge costs related to real clinical trials with a patient population. In this work, we present a platform for VCT in 2D and 3D X-ray breast imaging. The VCT platform uses Monte Carlo simulations based on the Geant4 toolkit and patient breast models derived from a cohort of high resolution dedicated breast CT (BCT) volume data sets. Projection images of the breast and three-dimensional glandular dose maps are generated for a given breast model, by simulating both 2D full-field digital mammography (DM) and 3D BCT examinations. Uncompressed voxelized breast models were derived from segmented patient images. Compressed versions of the digital breast phantoms for DM were generated using a previously published digital compression algorithm. The Monte Carlo simulation framework has the capability of generating and tracking ~10⁵ photons/s using a server equipped with 16-cores and 3.0 GHz clock speed. The VCT platform will provide a framework for scanner design optimization, comparison between different scanner designs and between different modalities or protocols on computational breast models, without the need for scanning actual patients as in conventional clinical trials.     

Air kerma strength characterization of a GZP6 Cobalt-60 brachytherapy source

Background

Task group number 40 (TG-40) of the American Association of Physicists in Medicine (AAPM) has recommended calibration of any brachytherapy source before its clinical use. GZP6 afterloading brachytherapy unit is a ⁶⁰Co high dose rate (HDR) system recently being used in some of the Iranian radiotherapy centers.

Aim

In this study air kerma strength (AKS) of ⁶⁰Co source number three of this unit was estimated by Monte Carlo simulation and in air measurements.

Materials and methods

Simulation was performed by employing the MCNP-4C Monte Carlo code. Self-absorption of the source core and its capsule were taken into account when calculating air kerma strength. In-air measurements were performed according to the multiple distance method; where a specially designed jig and a 0.6 cm³ Farmer type ionization chamber were used for the measurements. Monte Carlo simulation, in air measurement and GZP6 treatment planning results were compared for primary air kerma strength (as for November 8th 2005).

Results

Monte Carlo calculated and in air measured air kerma strength were respectively equal to 17240.01 μGym² h⁻¹ and 16991.83 μGym² h⁻¹. The value provided by the GZP6 treatment planning system (TPS) was “15355 μGym² h⁻¹”.

Conclusion

The calculated and measured AKS values are in good agreement. Calculated-TPS and measured-TPS AKS values are also in agreement within the uncertainties related to our calculation, measurements and those certified by the GZP6 manufacturer. Considering the uncertainties, the TPS value for AKS is validated by our calculations and measurements, however, it is incorporated with a large uncertainty.