Search

Abstract Purpose To develop a model of the internal vasculature of the adult liver and demonstrate its application to the differentiation of radiopharmaceutical decay sites within liver parenchyma from those within organ blood. Method Computer-generated models of hepatic arterial (HA), hepatic venous (HV), and hepatic portal venous (HPV) vascular trees were algorithmically created within individual lobes of the ICRP adult female and male livers (AFL/AML). For each iteration of the algorithm, pressure, blood flow, and vessel radii within each tree were updated as each new vessel was created and connected to a viable bifurcation site. The vascular networks created inside the AFL/AML were then tetrahedralized for coupling to the PHITS radiation transport code. Specific absorbed fractions (SAF) were computed for monoenergetic alpha particles, electrons, positrons, and photons. Dual-region liver models of the AFL/AML were proposed, and particle-specific SAF values were computed assuming radionuclide decays in blood within two locations: (1) sites within explicitly modeled hepatic vessels, and (2) sites within the hepatic blood pool residing outside these vessels to include the capillaries and blood sinuses. S values for 22 and 10 radionuclides commonly used in radiopharmaceutical therapy and imaging, respectively, were computed using the dual-region liver models and compared to those obtained in the existing single-region liver model. Results Liver models with virtual vasculatures of ~ 6000 non-intersecting straight cylinders representing the HA, HPV, and HV circulations were created for the ICRP reference. For alpha emitters and for beta and auger-electron emitters, S values using the single-region models were approximately 11% (AML) to 14% (AFL) and 11% (AML) to 13% (AFL) higher than the S values obtained using the dual-region models, respectively. Conclusions The methodology employed in this study has shown improvements in organ parenchymal dosimetry through explicit consideration of blood self-dose for alpha particles (all energies) and for electrons at energies below ~ 100 keV.

Abstract 99mTc-DMSA is one of the most commonly used pediatric nuclear medicine imaging agents. Nevertheless, there are no pharmacokinetic (PK) models for 99mTc-DMSA in children, and currently available pediatric dose estimates for 99mTc-DMSA use pediatric S values with PK data derived from adults. Furthermore, the adult PK data were collected in the mid-70’s using quantification techniques and instrumentation available at the time. Using pediatric imaging data for DMSA, we have obtained kinetic parameters for DMSA that differ from those applicable to adults. Methods We obtained patient data from a retrospective re-evaluation of clinically collected pediatric SPECT images of 99mTc-DMSA in 54 pediatric patients from Boston’s Children Hospital (BCH), ranging in age from 1 to 16 years old. These were supplemented by prospective data from twenty-three pediatric patients (age range: 4 months to 6 years old). Results In pediatric patients, the plateau phase in fractional kidney uptake occurs at a fractional uptake value closer to 0.3 than the value of 0.5 reported by the International Commission on Radiological Protection (ICRP) for adult patients. This leads to a 27% lower time-integrated activity coefficient in pediatric patients than in adults. Over the age range examined, no age dependency in uptake fraction at the clinical imaging time was observed. Female pediatric patients had a 17% higher fractional kidney uptake at the clinical imaging time than males (P < 0.001). Conclusions Pediatric 99mTc-DMSA kinetics differ from those reported for adults and should be considered in pediatric patient dosimetry. Alternatively, the differences obtained in this study could reflect improved quantification methods and the need to re-examine DMSA kinetics in adults.

Abstract Background Dosimetry for diagnostic agents is performed to assess the risk of radiation detriment (e.g., cancer) associated with the imaging agent and the risk is assessed by computing the effective dose coefficient, e. Stylized phantoms created by the MIRD Committee and updated by work performed by Cristy-Eckerman (CE) have been the standard in diagnostic dosimetry. Recently, the ICRP developed voxelized phantoms, which are described in ICRP Publication 110. These voxelized phantoms are more realistic and detailed in describing human anatomy compared with the CE stylized phantoms. Ideally, all tissues should be represented and their pharmacokinetics collected for an as accurate a dosimetric calculation as possible. As the number of source tissues included increases, the calculated e becomes more accurate. There is, however, a trade-off between the number of source tissues considered, and the time and effort required to measure the time-activity curve for each tissue needed for the calculations. In this study, we used a previously published 68Ga-DOTA-TATE data set to examine how the number of source tissues included for both the ICRP voxelized and CE stylized phantoms affected e. Results Depending upon the number of source tissues included e varied between 14.0–23.5 μSv/MBq for the ICRP voxelized and 12.4–27.7 μSv/MBq for the CE stylized phantoms. Furthermore, stability in e, defined as a < 10% difference between e obtained using all source tissues compared to one using fewer source tissues, was obtained after including 5 (36%) of the 14 source tissues for the ICRP voxelized, and after including 3 (25%) of the 12 source tissues for the CE stylized phantoms. In addition, a 2-fold increase in e was obtained when all source tissues where included in the calculation compared to when the TIAC distribution was lumped into a single reminder-of-body source term. Conclusions This study shows the importance of including the larger tissues like the muscles and remainder-of-body in the dosimetric calculations. The range of e based on the included tissues were less for the ICRP voxelized phantoms using tissue weighting factors from ICRP Publication 103 compared to CE stylized phantoms using tissue weighting factors from ICRP Publication 60.

Abstract Background Computed Tomography (CT) contributes up to 50% of the medical exposure to the United States population. Children are considered to be at higher risk of developing radiation-induced tumors due to the young age of exposure and increased tissue radiosensitivity. Organ dose estimation is essential for pediatric and adult patient cancer risk assessment. The objective of this study is to validate the VirtualDose software in comparison to currently available software and methods for pediatric and adult CT organ dose estimation. Methods Five age groups of pediatric patients and adult patients were simulated by three organ dose estimators. Head, chest, abdomen-pelvis, and chest-abdomen-pelvis CT scans were simulated, and doses to organs both inside and outside the scan range were compared. For adults, VirtualDose was compared against ImPACT and CT-Expo. For pediatric patients, VirtualDose was compared to CT-Expo and compared to size-based methods from literature. Pediatric to adult effective dose ratios were also calculated with VirtualDose, and were compared with the ranges of effective dose ratios provided in ImPACT. Results In-field organs see less than 60% difference in dose between dose estimators. For organs outside scan range or distributed organs, a five times’ difference can occur. VirtualDose agrees with the size-based methods within 20% difference for the organs investigated. Between VirtualDose and ImPACT, the pediatric to adult ratios for effective dose are compared, and less than 21% difference is observed for chest scan while more than 40% difference is observed for head-neck scan and abdomen-pelvis scan. For pediatric patients, 2 cm scan range change can lead to a five times dose difference in partially scanned organs. Conclusions VirtualDose is validated against CT-Expo and ImPACT with relatively small discrepancies in dose for organs inside scan range, while large discrepancies in dose are observed for organs outside scan range. Patient-specific organ dose estimation is possible using the size-based methods, and VirtualDose agrees with size-based method for the organs investigated. Careful range selection for CT protocols is necessary for organ dose optimization for pediatric and adult patients.

A comprehensive set of photon fluence-to-dose response functions (DRFs) is presented for two radiosensitive skeletal tissues--active and total shallow marrow--within 15 and 32 bone sites, respectively, of the ICRP reference adult male. The functions were developed using fractional skeletal masses and associated electron-absorbed fractions as reported for the UF hybrid adult male phantom, which in turn is based upon micro-CT images of trabecular spongiosa taken from a 40 year male cadaver. The new DRFs expand upon both the original set of seven functions produced in 1985, and a 2007 update calculated under the assumption of secondary electron escape from spongiosa. In this study, it is assumed that photon irradiation of the skeleton will yield charged particle equilibrium across all spongiosa regions at energies exceeding 200 keV. Kerma coefficients for active marrow, inactive marrow, trabecular bone and spongiosa at higher energies are calculated using the DRF algorithm setting the electron-absorbed fraction for self-irradiation to unity. By comparing kerma coefficients and DRF functions, dose enhancement factors and mass energy-absorption coefficient (MEAC) ratios for active marrow to spongiosa were derived. These MEAC ratios compared well with those provided by the NIST Physical Reference Data Library (mean difference of 0.8%), and the dose enhancement factors for active marrow compared favorably with values calculated in the well-known study published by King and Spiers (1985 Br. J. Radiol. 58 345-56) (mean absolute difference of 1.9 percentage points). Additionally, dose enhancement factors for active marrow were shown to correlate well with the shallow marrow volume fraction (R2 = 0.91). Dose enhancement factors for the total shallow marrow were also calculated for 32 bone sites representing the first such derivation for this target tissue. [ABSTRACT FROM AUTHOR]

Bone-seeking alpha-particle emitting radionuclides are common health physics hazards. Additionally, they are under consideration as an option for therapeutic molecular radiotherapy applications. Current dose models do not account for energy or bone-site dependence as shown by alpha-particle absorbed fractions given in ICRP Publication 30. Energy-dependent, yet bone-site independent, alpha-particle absorbed fractions have been presented by the models of Stabin and Siegel (2003 Health Phys. 85 294-310). In this work, a chord-based computational model of alpha-particle transport in cortical bone has been developed that explicitly accounts for both the bone-site and particle-energy dependence of alpha-particle absorbed fractions in this region of the skeleton. The model accounts for energy deposition to three targets: cortical endosteum, haversian space tissues and cortical bone. Path length distributions for cortical bone given in Beddoe (1977 Phys. Med. Biol. 22 298-308) provided additional transport regions in the absorbed fraction calculation. Significant variations in absorbed fractions between different skeletal sites were observed. Differences were observed between this model and the absorbed fractions given in ICRP Publication 30, which varied by as much as a factor of 2.1 for a cortical bone surface source irradiating cortical endosteum. [ABSTRACT FROM AUTHOR]

Current efforts to reconstruct organ doses in children undergoing diagnostic imaging or therapeutic interventions using ionizing radiation typically rely upon the use of reference anthropomorphic computational phantoms coupled to Monte Carlo radiation transport codes. These phantoms are generally matched to individual patients based upon nearest age or sometimes total body mass. In this study, we explore alternative methods of phantom-to-patient matching with the goal of identifying those methods which yield the lowest residual errors in internal organ volumes. Various thoracic and abdominal organs were segmented and organ volumes obtained from chest-abdominal-pelvic (CAP) computed tomography (CT) image sets from 38 pediatric patients ranging in age from 2 months to 15 years. The organs segmented included the skeleton, heart, kidneys, liver, lungs and spleen. For each organ, least-squared regression lines, 95th percentile confidence intervals and 95th percentile prediction intervals were established as a function of patient age, trunk volume, estimated trunk mass, trunk height, and three estimates of the ventral body cavity volume based on trunk height alone, or in combination with circumferential, width and/or breadth measurements in the mid-chest of the patient. When matching phantom to patient based upon age, residual uncertainties in organ volumes ranged from 53% (lungs) to 33% (kidneys), and when trunk mass was used (surrogate for total body mass as we did not have images of patient head, arms or legs), these uncertainties ranged from 56% (spleen) to 32% (liver). When trunk height is used as the matching parameter, residual uncertainties in organ volumes were reduced to between 21 and 29% for all organs except the spleen (40%). In the case of the lungs and skeleton, the two-fold reduction in organ volume uncertainties was seen in moving from patient age to trunk height--a parameter easily measured in the clinic. When ventral body cavity volumes were used, residual uncertainties were lowered even further to a range of between 14 and 20% for all organs except the spleen, which continued to remain at around 40%. The results of this study suggest that a more anthropometric pairing of computational phantom to individual patient based on simple measurements of trunk height and possibly mid-chest circumference or thickness (where influences of subcutaneous fat are minimized) can lead to significant reductions in organ volume uncertainties: ranges of 40-50% (based on patient age) to between 15 and 20% (based on body cavity volumes tied to trunk height). An expanded series of non-uniform rational B-spine (NURBS) pediatric phantoms are being created at the University of Florida to allow the full application of this new approach in pediatric medical imaging studies. [ABSTRACT FROM AUTHOR]

The calculation of absorbed dose to the radiosensitive tissues of the skeleton is routinely performed using reference masses provided in publications from the International Commission on Radiological Protection (ICRP). These values typically include total skeleton tissue masses by reference subject age, but not by individual bone site at a given age. Site-specific variations in absorbed fractions are known to occur for internal alpha-particle and beta-particle emitters, and in certain medical dose reconstructions, site-specific estimates of marrow dose may be desirable. Furthermore, bone-site-specific tissue masses are required to properly estimate skeletal-averaged absorbed fractions and, more importantly, specific absorbed fractions for internalized radionuclides and radiopharmaceuticals. Reference masses by skeletal site are also needed in the development of ICRP compliant tomographic phantoms, as this organ system is initially segmented from medical images only as a homogeneous tissue region. ICRP reference skeletal masses are assigned based upon several independent data sources, many of which may not be entirely consistent with one another. In this study, a methodology is presented, using data from the various ICRP publications, to derive site-specific skeletal tissue masses for each member of the ICRP age series. Active marrow masses are calculated and differences are shown with respect to ICRP Publications 70 and 89 values. New data for a revised surrogate tissue region for the osteoprogenitor cells within bone marrow is presented with estimates of its total mass throughout the skeleton and for different subject ages. [ABSTRACT FROM AUTHOR]

The effective dose recommended by the International Commission on Radiological Protection (ICRP) is the sum of organ equivalent doses weighted by corresponding tissue weighting factors, wT. ICRP is in the process of revising its 1990 recommendations on the effective dose where new values of organs and tissue weighting factors have been proposed and published in draft form for consultation by the radiological protection community. In its 5 June 2006 draft recommendations, new organs and tissues have been introduced in the effective dose which do not exist within the 1987 Oak Ridge National Laboratory (ORNL) phantom series (e.g., salivary glands). Recently, the investigators at University of Florida have updated the series of ORNL phantoms by implementing new organ models and adopting organ-specific elemental composition and densities. In this study, the effective dose changes caused by the transition from the current recommendation of ICRP Publication 60 to the 2006 draft recommendations were investigated for external photon irradiation across the range of ICRP reference ages (newborn, 1-year, 5-year, 10-year, 15-year and adult) and for six idealized irradiation geometries: anterior-posterior (AP), posterior-anterior (PA), left-lateral (LLAT), right-lateral (RLAT), rotational (ROT) and isotropic (ISO). Organ-absorbed doses were calculated by implementing the revised ORNL phantoms in the Monte Carlo radiation transport code, MCNPX2.5, after which effective doses were calculated under the 1990 and draft 2006 evaluation schemes of the ICRP. Effective doses calculated under the 2006 draft scheme were slightly higher than estimated under ICRP Publication 60 methods for all irradiation geometries exclusive of the AP geometry where an opposite trend was observed. The effective doses of the adult phantom were more greatly affected by the change in tissue weighting factors than that seen within the paediatric members of the phantom series. Additionally, dose conversion coefficients for newly identified radiosensitive organs-salivary glands, gall bladder, heart and prostate-were reported, as well as the brain, which was originally considered in ICRP Publication 60 as a member of the remainder category of the effective dose. [ABSTRACT FROM AUTHOR]

The dosimetric dependence of ocular structures on eye size and shape was investigated within the standard ICRP Publication 116 irradiation geometries. A realistic transport geometry was constructed by inserting a scalable and deformable stylised eye model developed in our previous study within the head of the ICRP Publication 110 adult male reference computational phantom. Beam irradiations of external electrons, photons, and neutrons on this phantom were simulated using the Monte Carlo radiation transport code PHITS in the geometries of AP, RLAT, PA and ROT. Absorbed doses in ocular structures such as ciliary body, retina, and optic nerves were computed as well as that in lens. A clear dosimetric dependence of ocular structures on eye size and shape was observed for external electrons while only a small dependence was seen for external photons and neutrons. Difference of the tendency was attributed to their depth-dose distributions where spread dose distributions were created by photons and neutrons while more concentrated distributions were created by external electrons. [ABSTRACT FROM AUTHOR]

Of all the medical imaging modalities that utilize ionizing radiation, fluoroscopy proves to be the most difficult to assess values of patient organ dose owing to the dynamic and patient-specific nature of the irradiation geometry and its associated x-ray beam characteristics. With the introduction of the radiation dose structured report (RDSR) in the mid-2000s, however, computational tools have been developed to extract patient and procedure-specific data for each irradiation event of the study, and when coupled to a computational phantom of the patient, values of skin and internal organ dose may be assessed. Unfortunately, many legacy and even current diagnostic fluoroscopy units do not have RDSR reporting capabilities, thus limiting these dosimetry reporting advances. Nevertheless, knowledge of patient organ doses for patient care, as well as for radiation epidemiology studies, remains a research and regulatory priority. In this study, we created procedural outlines which document all radiation exposure information required for organ dose assessment, akin to a reference RDSR, for six common diagnostic fluoroscopy procedures performed at the University of Florida (UF) Shands Pediatric Hospital. These procedures include the voiding cystourethrogram, the gastrostomy-tube placement, the lower gastrointestinal study, the rehabilitation swallow, the upper gastrointestinal study, and the upper gastrointestinal study with follow through. These procedural outlines were used to develop an extensive database of organ doses for the 162-member UF/NCI (National Cancer Institute) library of pediatric hybrid phantoms, with each member varying combinations of sex, height, and weight. The organ dose assessment accounts for the varying x-ray fields, fluoroscopy time, relative concentration of x-ray contrast in the organs, and changes in the fluoroscope output due to patient size. Furthermore, we are also reporting organ doses normalized to total fluoroscopy time, reference point air kerma, and kerma-area product, effectively providing procedure dose coefficients. The extensive organ dose library produced in this study may be used prospectively for patient organ dose reporting or retrospectively in epidemiological studies of radiation-associated health risks. [ABSTRACT FROM AUTHOR]

Estimates of regional blood volumes (BVs) in humans are needed in dosimetric models of radionuclides and radiopharmaceuticals that decay in the circulation to a significant extent. These values are also needed to refine models of tissue elemental composition in computational human phantoms of both patients and exposed members of the general public. The International Commission on Radiological Protection (ICRP) in its Publication 89 provides reference values for total blood content in the full series of their reference individuals, to include the male and female newborn, 1 year-old, 5 year-old, 10 year-old, 15 year-old, and adult. Furthermore, Publication 89 provides reference values for the percentage distribution of total blood volume in 27 different blood-filled organs and tissues of the reference adult male and adult female. However, no similar distribution values are provided for non-adults. The goal of the present study is to present a volumetric scaling methodology to derive these values for the same organs and tissues at ages younger than the reference adult. Literature data on organ-specific vascular growth in the brain, kidneys, and skeletal tissues are also considered. [ABSTRACT FROM AUTHOR]

Balancing the tradeoff between radiation dose, acquisition duration and diagnostic image quality is essential for medical imaging modalities involving ionizing radiation. Lower administered activities to the patient can reduce absorbed dose, but can result in reduced diagnostic image quality or require longer acquisition durations. In pediatric nuclear medicine, it is desirable to use the lowest amount of administered radiopharmaceutical activity and the shortest acquisition duration that gives sufficient image quality for clinical diagnosis. However, diagnostic image quality is a complex function of patient factors including body morphometry. In this study, we present a digital population of 90 computational anatomic phantoms that model realistic variations in body morphometry and internal anatomy. These phantoms were used to generate a large database of projection images modeling pediatric SPECT imaging using a 99mTc-DMSA tracer. We used an analytic projection code that models attenuation, spatially varying collimator-detector response, and object-dependent scatter to generate the projections. The projections for each organ were generated separately and can be subsequently scaled by parameters extracted from a pharmacokinetics model to simulate realistic tracer biodistribution, including variations in uptake, inside each relevant organ or tissue structure for a given tracer. Noise-free projection images can be obtained by summing these individual organ projections and scaling by the system sensitivity and acquisition duration. We applied this database in the context of 99mTc-DMSA renal SPECT, the most common nuclear medicine imaging procedure in pediatric patients. Organ uptake fractions based on literature values and patient studies were used. Patient SPECT images were used to verify that the sum of counts in the simulated projection images was clinically realistic. For each phantom, 384 uptake realizations, modeling random variations in the uptakes of organs of interest, were generated, producing 34 560 noise-free projection datasets (384 uptake realizations times 90 phantoms). Noisy images modeling various count levels (corresponding to different products of acquisition duration and administered activity) were generated by appropriately scaling these images and simulating Poisson noise. Acquisition duration was fixed; six count levels were simulated corresponding to projection images acquired using 25%, 50%, 75%, 100%, 125%, and 150% of the original weight-based administrated activity as computed using the North American Guidelines (Gelfand et al 2011 J. Nucl. Med. 52 318–22). Combined, a total number of 207 360 noisy projection images were generated, creating a realistic projection database for use in renal pediatric SPECT imaging research. The phantoms and projection datasets were used to calculate three surrogate indices for factors affecting image quality: renal count density, average radius of rotation, and scatter-to-primary ratio. Differences in these indices were seen across the phantoms for dosing based on current guidelines, and especially for the phantom modeling the newborn. We also performed an image quality study using an anthropomorphic model observer that demonstrates that the weight-based dose scaling does not equalize image quality as measured by the area under the receiver-operating characteristics curve. These studies suggest that a dosing procedure beyond weight-based scaling of administered activities is required to equalize image quality in pediatric renal SPECT. [ABSTRACT FROM AUTHOR]

With recent changes in the recommended annual limit on eye lens exposures to ionizing radiation, there is considerable interest in predictive computational dosimetry models of the human eye and its various ocular structures including the crystalline lens, ciliary body, cornea, retina, optic nerve, and central retinal artery. Computational eye models to date have been constructed as stylized models, high-resolution voxel models, and polygon mesh models. Their common feature, however, is that they are typically constructed of nominal size and of a roughly spherical shape associated with the emmetropic eye. In this study, we present a geometric eye model that is both scalable (allowing for changes in eye size) and deformable (allowing for changes in eye shape), and that is suitable for use in radiation transport studies of ocular exposures and radiation treatments of eye disease. The model allows continuous and variable changes in eye size (axial lengths from 20 to 26 mm) and eye shape (diopters from  −12 to  +6). As an explanatory example of its use, five models (emmetropic eyes of small, average, and large size, as well as average size eyes of  −12D and  +6D) were constructed and subjected to normally incident beams of monoenergetic electrons and photons, with resultant energy-dependent dose coefficients presented for both anterior and posterior eye structures. Electron dose coefficients were found to vary with changes to both eye size and shape for the posterior eye structures, while their values for the crystalline lens were found to be sensitive to changes in only eye size. No dependence upon eye size or eye shape was found for photon dose coefficients at energies below 2 MeV. Future applications of the model can include more extensive tabulations of dose coefficients to all ocular structures (not only the lens) as a function of eye size and shape, as well as the assessment of x-ray therapies for ocular disease for patients with non-emmetropic eyes. [ABSTRACT FROM AUTHOR]

Internal radiation dose estimates for diagnostic nuclear medicine procedures are typically calculated for a reference individual. Resultantly, there is uncertainty when determining the organ doses to patients who are not at 50th percentile on either height or weight. This study aims to better personalize internal radiation dose estimates for individual patients by modifying the dose estimates calculated for reference individuals based on easily obtainable morphometric characteristics of the patient. Phantoms of different sitting heights and waist circumferences were constructed based on computational reference phantoms for the newborn, 10 year-old, and adult. Monoenergetic photons and electrons were then simulated separately at 15 energies. Photon and electron specific absorbed fractions (SAFs) were computed for the newly constructed non-reference phantoms and compared to SAFs previously generated for the age-matched reference phantoms. Differences in SAFs were correlated to changes in sitting height and waist circumference to develop scaling factors that could be applied to reference SAFs as morphometry corrections. A further set of arbitrary non-reference phantoms were then constructed and used in validation studies for the SAF scaling factors. Both photon and electron dose scaling methods were found to increase average accuracy when sitting height was used as the scaling parameter (~11%). Photon waist circumference-based scaling factors showed modest increases in average accuracy (~7%) for underweight individuals, but not for overweight individuals. Electron waist circumference-based scaling factors did not show increases in average accuracy. When sitting height and waist circumference scaling factors were combined, modest average gains in accuracy were observed for photons (~6%), but not for electrons. Both photon and electron absorbed doses are more reliably scaled using scaling factors computed in this study. They can be effectively scaled using sitting height alone as patient-specific morphometric parameter. [ABSTRACT FROM AUTHOR]

Various computational tools are currently available that facilitate patient organ dosimetry in diagnostic nuclear medicine, yet they are typically restricted to reporting organ doses to ICRP-defined reference phantoms. The present study, while remaining computational phantom based, provides straightforward tools to adjust reference phantom organ dose for both internal photon and electron sources. A wide variety of monoenergetic specific absorbed fractions were computed using radiation transport simulations for tissue spheres of varying size and separation distance. Scaling methods were then constructed for both photon and electron self-dose and cross-dose, with data validation provided from patient-specific voxel phantom simulations, as well as via comparison to the scaling methodology given in MIRD Pamphlet No. 11. Photon and electron self-dose was found to be dependent on both radiation energy and sphere size. Photon cross-dose was found to be mostly independent of sphere size. Electron cross-dose was found to be dependent on sphere size when the spheres were in close proximity, owing to differences in electron range. The validation studies showed that this dataset was more effective than the MIRD 11 method at predicting patient-specific photon doses for at both high and low energies, but gave similar results at photon energies between 100 keV and 1 MeV. The MIRD 11 method for electron self-dose scaling was accurate for lower energies but began to break down at higher energies. The photon cross-dose scaling methodology developed in this study showed gains in accuracy of up to 9% for actual patient studies, and the electron cross-dose scaling methodology showed gains in accuracy up to 9% as well when only the bremsstrahlung component of the cross-dose was scaled. These dose scaling methods are readily available for incorporation into internal dosimetry software for diagnostic phantom-based organ dosimetry. [ABSTRACT FROM AUTHOR]

Epidemiologic data demonstrate that pediatric patients face a higher relative risk of radiation induced cancers than their adult counterparts at equivalent exposures. Infants and children with congenital heart defects are a critical patient population exposed to ionizing radiation during life-saving procedures. These patients will likely incur numerous procedures throughout their lifespan, each time increasing their cumulative radiation absorbed dose. As continued improvements in long-term prognosis of congenital heart defect patients is achieved, a better understanding of organ radiation dose following treatment becomes increasingly vital. Dosimetry of these patients can be accomplished using Monte Carlo radiation transport simulations, coupled with modern anatomical patient models. The aim of this study was to evaluate the performance of the University of Florida/National Cancer Institute (UF/NCI) pediatric hybrid computational phantom library for organ dose assessment of patients that have undergone fluoroscopically guided cardiac catheterizations. In this study, two types of simulations were modeled. A dose assessment was performed on 29 patient-specific voxel phantoms (taken as representing the patient’s true anatomy), height/weight-matched hybrid library phantoms, and age-matched reference phantoms. Two exposure studies were conducted for each phantom type. First, a parametric study was constructed by the attending pediatric interventional cardiologist at the University of Florida to model the range of parameters seen clinically. Second, four clinical cardiac procedures were simulated based upon internal logfiles captured by a Toshiba Infinix-i Cardiac Bi-Plane fluoroscopic unit. Performance of the phantom library was quantified by computing both the percent difference in individual organ doses, as well as the organ dose root mean square values for overall phantom assessment between the matched phantoms (UF/NCI library or reference) and the patient-specific phantoms. The UF/NCI hybrid phantoms performed at percent differences of between 15% and 30% for the parametric set of irradiation events. Among internal logfile reconstructed procedures, the UF/NCI hybrid phantoms performed with RMS organ dose values between 7% and 29%. Percent improvement in organ dosimetry via the use of hybrid library phantoms over the reference phantoms ranged from 6.6% to 93%. The use of a hybrid phantom library, Monte Carlo radiation transport methods, and clinical information on irradiation events provide a means for tracking organ dose in these radiosensitive patients undergoing fluoroscopically guided cardiac procedures. [ABSTRACT FROM AUTHOR]

A new function to treat tetrahedral-mesh geometry was implemented in the particle and heavy ion transport code systems. To accelerate the computational speed in the transport process, an original algorithm was introduced to initially prepare decomposition maps for the container box of the tetrahedral-mesh geometry. The computational performance was tested by conducting radiation transport simulations of 100 MeV protons and 1 MeV photons in a water phantom represented by tetrahedral mesh. The simulation was repeated with varying number of meshes and the required computational times were then compared with those of the conventional voxel representation. Our results show that the computational costs for each boundary crossing of the region mesh are essentially equivalent for both representations. This study suggests that the tetrahedral-mesh representation offers not only a flexible description of the transport geometry but also improvement of computational efficiency for the radiation transport. Due to the adaptability of tetrahedrons in both size and shape, dosimetrically equivalent objects can be represented by tetrahedrons with a much fewer number of meshes as compared its voxelized representation. Our study additionally included dosimetric calculations using a computational human phantom. A significant acceleration of the computational speed, about 4 times, was confirmed by the adoption of a tetrahedral mesh over the traditional voxel mesh geometry. [ABSTRACT FROM AUTHOR]

It is not feasible to define very small or complex organs and tissues in the current voxel-type adult reference computational phantoms of the International Commission on Radiological Protection (ICRP), which limit dose coefficients for weakly penetrating radiations. To address the problem, the ICRP is converting the voxel-type reference phantoms into mesh-type phantoms. In the present study, as a part of the conversion project, the micrometer-thick target and source regions in the alimentary and respiratory tract systems as described in ICRP Publications 100 and 66 were included in the mesh-type ICRP reference adult male and female phantoms. In addition, realistic lung airway models were simulated to represent the bronchial (BB) and bronchiolar (bb) regions. The electron specific absorbed fraction (SAF) values for the alimentary and respiratory tract systems were then calculated and compared with the values calculated with the stylized models of ICRP Publications 100 and 66. The comparisons show generally good agreement for the oral cavity, oesophagus, and BB, whereas for the stomach, small intestine, large intestine, extrathoracic region, and bb, there are some differences (e.g. up to ~9 times in the large intestine). The difference is mainly due to anatomical difference in these organs between the realistic mesh-type phantoms and the simplified stylized models. The new alimentary and respiratory tract models in the mesh-type ICRP reference phantoms preserve the topology and dimensions of the voxel-type ICRP phantoms and provide more reliable SAF values than the simplified models adopted in previous ICRP Publications. [ABSTRACT FROM AUTHOR]

An image-based skeletal dosimetry model for internal electron sources was created for the ICRP-defined reference adult female. Many previous skeletal dosimetry models, which are still employed in commonly used internal dosimetry software, do not properly account for electron escape from trabecular spongiosa, electron cross-fire from cortical bone, and the impact of marrow cellularity on active marrow self-irradiation. Furthermore, these existing models do not employ the current ICRP definition of a 50 µm bone endosteum (or shallow marrow). Each of these limitations was addressed in the present study. Electron transport was completed to determine specific absorbed fractions to both active and shallow marrow of the skeletal regions of the University of Florida reference adult female. The skeletal macrostructure and microstructure were modeled separately. The bone macrostructure was based on the whole-body hybrid computational phantom of the UF series of reference models, while the bone microstructure was derived from microCT images of skeletal region samples taken from a 45 years-old female cadaver. The active and shallow marrow are typically adopted as surrogate tissue regions for the hematopoietic stem cells and osteoprogenitor cells, respectively. Source tissues included active marrow, inactive marrow, trabecular bone volume, trabecular bone surfaces, cortical bone volume, and cortical bone surfaces. Marrow cellularity was varied from 10 to 100 percent for active marrow self-irradiation. All other sources were run at the defined ICRP Publication 70 cellularity for each bone site. A total of 33 discrete electron energies, ranging from 1 keV to 10 MeV, were either simulated or analytically modeled. The method of combining skeletal macrostructure and microstructure absorbed fractions assessed using MCNPX electron transport was found to yield results similar to those determined with the PIRT model applied to the UF adult male skeletal dosimetry model. Calculated skeletal averaged absorbed fractions for each source-target combination were found to follow similar trends of more recent dosimetry models (image-based models) but did not follow results from skeletal models based upon assumptions of an infinite expanse of trabecular spongiosa. [ABSTRACT FROM AUTHOR]

Aircraft crew members are occupationally exposed to considerable levels of cosmic radiation at flight altitudes. Since aircrew (pilots and passengers) are in the sitting posture for most of the time during flight, and up to now there has been no data on the effective dose rate calculated for aircrew dosimetry in flight altitude using a sitting phantom, we therefore calculated the effective dose rate using a phantom in the sitting and standing postures in order to compare the influence of the posture on the radiation protection of aircrew members. We found that although the better description of the posture in which the aircrews are exposed, the results of the effective dose rate calculated with the phantom in the sitting posture were very similar to the results of the phantom in the standing posture. In fact we observed only a 1% difference. These findings indicate the adequacy of the use of dose conversion coefficients for the phantom in the standing posture in aircrew dosimetry. We also validated our results comparing the effective dose rate obtained using the standing phantom with values reported in the literature. It was observed that the results presented in this study are in good agreement with other authors (the differences are below 30%) who have measured and calculated effective dose rates using different phantoms. [ABSTRACT FROM AUTHOR]

The reference adult computational phantoms of the international commission on radiological protection (ICRP) described in Publication 110 are voxel-type computational phantoms based on whole-body computed tomography (CT) images of adult male and female patients. The voxel resolutions of these phantoms are in the order of a few millimeters and smaller tissues such as the eye lens, the skin, and the walls of some organs cannot be properly defined in the phantoms, resulting in limitations in dose coefficient calculations for weakly penetrating radiations. In order to address the limitations of the ICRP-110 phantoms, an ICRP Task Group has been recently formulated and the voxel phantoms are now being converted to a high-quality mesh format. As a part of the conversion project, in the present study, the skeleton models, one of the most important and complex organs of the body, were constructed. The constructed skeleton models were then tested by calculating red bone marrow (RBM) and endosteum dose coefficients (DCs) for broad parallel beams of photons and electrons and comparing the calculated values with those of the original ICRP-110 phantoms. The results show that for the photon exposures, there is a generally good agreement in the DCs between the mesh-type phantoms and the original voxel-type ICRP-110 phantoms; that is, the dose discrepancies were less than 7% in all cases except for the 0.03 MeV cases, for which the maximum difference was 14%. On the other hand, for the electron exposures (⩽4 MeV), the DCs of the mesh-type phantoms deviate from those of the ICRP-110 phantoms by up to ~1600 times at 0.03 MeV, which is indeed due to the improvement of the skeletal anatomy of the developed skeleton mesh models. [ABSTRACT FROM AUTHOR]

When converting voxel phantoms to a surface format, the small intestine (SI), which is usually not accurately represented in a voxel phantom due to its complex and irregular shape on one hand and the limited voxel resolutions on the other, cannot be directly converted to a high-quality surface model. Currently, stylized pipe models are used instead, but they are strongly influenced by developer’s subjectivity, resulting in unacceptable geometric and dosimetric inconsistencies. In this paper, we propose a new method for the construction of SI models based on the Monte Carlo approach. In the present study, the proposed method was tested by constructing the SI model for the polygon-mesh version of the ICRP reference male phantom currently under development. We believe that the new SI model is anatomically more realistic than the stylized SI models. Furthermore, our simulation results show that the new SI model, for both external and internal photon exposures, leads to dose values that are more similar to those of the original ICRP male voxel phantom than does the previously constructed stylized SI model. [ABSTRACT FROM AUTHOR]

Published guidelines for administered activity to pediatric patients undergoing diagnostic nuclear medicine imaging are currently obtained through expert consensus of the minimum values as a function of body weight as required to yield diagnostic quality images. We have previously shown that consideration of body habitus is also important in obtaining diagnostic quality images at the lowest administered activity. The objective of this study was to create a series of computational phantoms that realistically portray the anatomy of the pediatric patient population which can be used to develop and validate techniques to minimize radiation dose while maintaining adequate image quality. To achieve this objective, we have defined an imaging risk index that may be used in future studies to develop pediatric patient dosing guidelines. A population of 48 hybrid phantoms consisting of non-uniform B-spline surfaces and polygon meshes was generated. The representative ages included the newborn, 1 year, 5 year, 10 year and 15 year male and female. For each age, the phantoms were modeled at their 10th, 50th, and 90th height percentile each at a constant 50th weight percentile. To test the impact of kidney size, the newborn phantoms were modeled with the following three kidney volumes:  −15%, average, and  +15%. To illustrate the impact of different morphologies on dose optimization, we calculated the effective dose for each phantom using weight-based 99mTc-DMSA activity administration. For a given patient weight, body habitus had a considerable effect on effective dose. Substantial variations were observed in the risk index between the 10th and 90th percentile height phantoms from the 50th percentile phantoms for a given age, with the greatest difference being 18%. There was a dependence found between kidney size and risk of radiation induced kidney cancer, with the highest risk indices observed in newborns with the smallest kidneys. Overall, the phantoms and techniques in this study can be used to provide data to refine dosing guidelines for pediatric nuclear imaging studies while taking into account the effects on both radiation dose and image quality. [ABSTRACT FROM AUTHOR]

We developed computational methods and tools to assess organ doses for pediatric and adult patients undergoing computed tomography (CT) examinations. We used the International Commission on Radiological Protection (ICRP) reference pediatric and adult phantoms combined with the Monte Carlo simulation of a reference CT scanner to establish comprehensive organ dose coefficients (DC), organ absorbed dose per unit volumetric CT Dose Index (CTDIvol) (mGy/mGy). We also developed methods to estimate organ doses with tube current modulation techniques and size specific dose estimates. A graphical user interface was designed to obtain user input of patient- and scan-specific parameters, and to calculate and display organ doses. A batch calculation routine was also integrated into the program to automatically calculate organ doses for a large number of patients. We entitled the computer program, National Cancer Institute dosimetry system for CT(NCICT). We compared our dose coefficients with those from CT-Expo, and evaluated the performance of our program using CT patient data. Our pediatric DCs show good agreements of organ dose estimation with those from CT-Expo except for thyroid. Our results support that the adult phantom in CT-Expo seems to represent a pediatric individual between 10 and 15 years rather than an adult. The comparison of CTDIvol values between NCICT and dose pages from 10 selected CT scans shows good agreements less than 12% except for two cases (up to 20%). The organ dose comparison between mean and modulated mAs shows that mean mAs-based calculation significantly overestimates dose (up to 2.4-fold) to the organs in close proximity to lungs in chest and chest–abdomen–pelvis scans. Our program provides more realistic anatomy based on the ICRP reference phantoms, higher age resolution, the most up-to-date bone marrow dosimetry, and several convenient features compared to previous tools. The NCICT will be available for research purpose in the near future. [ABSTRACT FROM AUTHOR]

The dose coefficients for the eye lens reported in ICRP 2010 Publication 116 were calculated using both a stylized model and the ICRP-110 reference phantoms, according to the type of radiation, energy, and irradiation geometry. To maintain consistency of lens dose assessment, in the present study we incorporated the ICRP-116 detailed eye model into the converted polygon-mesh (PM) version of the ICRP-110 reference phantoms. After the incorporation, the dose coefficients for the eye lens were calculated and compared with those of the ICRP-116 data. The results showed generally a good agreement between the newly calculated lens dose coefficients and the values of ICRP 2010 Publication 116. Significant differences were found for some irradiation cases due mainly to the use of different types of phantoms. Considering that the PM version of the ICRP-110 reference phantoms preserve the original topology of the ICRP-110 reference phantoms, it is believed that the PM version phantoms, along with the detailed eye model, provide more reliable and consistent dose coefficients for the eye lens. [ABSTRACT FROM AUTHOR]

This paper describes the development and testing of VirtualDose—a software for reporting organ doses for adult and pediatric patients who undergo x-ray computed tomography (CT) examinations. The software is based on a comprehensive database of organ doses derived from Monte Carlo (MC) simulations involving a library of 25 anatomically realistic phantoms that represent patients of different ages, body sizes, body masses, and pregnant stages. Models of GE Lightspeed Pro 16 and Siemens SOMATOM Sensation 16 scanners were carefully validated for use in MC dose calculations. The software framework is designed with the ‘software as a service (SaaS)’ delivery concept under which multiple clients can access the web-based interface simultaneously from any computer without having to install software locally. The RESTful web service API also allows a third-party picture archiving and communication system software package to seamlessly integrate with VirtualDose’s functions. Software testing showed that VirtualDose was compatible with numerous operating systems including Windows, Linux, Apple OS X, and mobile and portable devices. The organ doses from VirtualDose were compared against those reported by CT-Expo and ImPACT—two dosimetry tools that were based on the stylized pediatric and adult patient models that were known to be anatomically simple. The organ doses reported by VirtualDose differed from those reported by CT-Expo and ImPACT by as much as 300% in some of the patient models. These results confirm the conclusion from past studies that differences in anatomical realism offered by stylized and voxel phantoms have caused significant discrepancies in CT dose estimations. [ABSTRACT FROM AUTHOR]

After an incident of radiological dispersal devices (RDD), health care providers will be exposed to the contaminated patients in the extended medical treatments. Assessment of potential radiation dose to the health care providers will be crucial to minimize their health risk. In this study, we compiled a set of conversion coefficients (mSv MBq−1 s−1) to readily estimate the effective dose from the time-integrated activity for the health care providers while they deal with internally contaminated patients at different ages. We selected Co-60, Ir-192, Am-241, Cs-137, and I-131 as the major radionuclides that may be used for RDD. We obtained the age-specific organ burdens after the inhalation of those radionuclides from the Dose and Risk Calculation Software (DCAL) program. A series of hybrid computational phantoms (1-, 5-, 10-, and 15 year-old, and adult males) were implemented in a general purpose Monte Carlo (MC) transport code, MCNPX v 2.7, to simulate an adult male health care provider exposed to contaminated patients at different ages. Two exposure scenarios were taken into account: a health care provider (a) standing at the side of patients lying in bed and (b) sitting face to face with patients. The conversion coefficients overall depended on radionuclides, the age of the patients, and the orientation of the patients. The conversion coefficient was greatest for Co-60 and smallest for Am-241. The dose from the 1 year-old patient phantom was up to three times greater than that from the adult patient phantom. The conversion coefficients were less dependent on the age of the patients in the scenario of a health care provider sitting face to face with patients. The dose conversion coefficients established in this study will be useful to readily estimate the effective dose to the health care providers in RDD events. [ABSTRACT FROM AUTHOR]

ICRP Publication 116 on ‘Conversion coefficients for radiological protection quantities for external radiation exposures’, provides fluence-to-dose conversion coefficients for organ-absorbed doses and effective dose for various types of external exposures (ICRP 2010 ICRP Publication 116). The publication supersedes the ICRP Publication 74 (ICRP 1996 ICRP Publication 74, ICRU 1998 ICRU Report 57), including new particle types and expanding the energy ranges considered. The coefficients were calculated using the ICRP/ICRU computational phantoms (ICRP 2009 ICRP Publication 110) representing the reference adult male and reference adult female (ICRP 2002 ICRP Publication 89), together with a variety of Monte Carlo codes simulating the radiation transport in the body. Idealized whole-body irradiation from unidirectional and rotational parallel beams as well as isotropic irradiation was considered for a large variety of incident radiations and energy ranges. Comparison of the effective doses with operational quantities revealed that the latter quantities continue to provide a good approximation of effective dose for photons, neutrons and electrons for the ‘conventional’ energy ranges considered previously (ICRP 1996, ICRU 1998), but not at the higher energies of ICRP Publication 116. [ABSTRACT FROM AUTHOR]

Substantial increases in pediatric and adult obesity in the US have prompted a major revision to the current UF/NCI (University of Florida/National Cancer Institute) family of hybrid computational phantoms to more accurately reflect current trends in larger body morphometry. A decision was made to construct the new library in a gridded fashion by height/weight without further reference to age-dependent weight/height percentiles as these become quickly outdated. At each height/weight combination, circumferential parameters were defined and used for phantom construction. All morphometric data for the new library were taken from the CDC NHANES survey data over the time period 1999–2006, the most recent reported survey period. A subset of the phantom library was then used in a CT organ dose sensitivity study to examine the degree to which body morphometry influences the magnitude of organ doses for patients that are underweight to morbidly obese in body size. Using primary and secondary morphometric parameters, grids containing 100 adult male height/weight bins, 93 adult female height/weight bins, 85 pediatric male height/weight bins and 73 pediatric female height/weight bins were constructed. These grids served as the blueprints for construction of a comprehensive library of patient-dependent phantoms containing 351 computational phantoms. At a given phantom standing height, normalized CT organ doses were shown to linearly decrease with increasing phantom BMI for pediatric males, while curvilinear decreases in organ dose were shown with increasing phantom BMI for adult females. These results suggest that one very useful application of the phantom library would be the construction of a pre-computed dose library for CT imaging as needed for patient dose-tracking. [ABSTRACT FROM AUTHOR]