S-values calculated from a tomographic head/brain model for brain imaging

Methods of improving brain dose estimates for internally deposited radionuclides. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2022;42:033001. [PMID: 35785774 DOI: 10.1088/1361-6498/ac7e02]

The US National Council on Radiation Protection and Measurements (NCRP) convened Scientific Committee 6-12 (SC 6-12) to examine methods for improving dose estimates for brain tissue for internally deposited radionuclides, with emphasis on alpha emitters. This Memorandum summarises the main findings of SC 6-12 described in the recently published NCRP Commentary No. 31, 'Development of Kinetic and Anatomical Models for Brain Dosimetry for Internally Deposited Radionuclides'. The Commentary examines the extent to which dose estimates for the brain could be improved through increased realism in the biokinetic and dosimetric models currently used in radiation protection and epidemiology. A limitation of most of the current element-specific systemic biokinetic models is the absence of brain as an explicitly identified source region with its unique rate(s) of exchange of the element with blood. The brain is usually included in a large source region calledOtherthat contains all tissues not considered major repositories for the element. In effect, all tissues inOtherare assigned a common set of exchange rates with blood. A limitation of current dosimetric models for internal emitters is that activity in the brain is treated as a well-mixed pool, although more sophisticated models allowing consideration of different activity concentrations in different regions of the brain have been proposed. Case studies for 18 internal emitters indicate that brain dose estimates using current dosimetric models may change substantially (by a factor of 5 or more), or may change only modestly, by addition of a sub-model of the brain in the biokinetic model, with transfer rates based on results of published biokinetic studies and autopsy data for the element of interest. As a starting place for improving brain dose estimates, development of biokinetic models with explicit sub-models of the brain (when sufficient biokinetic data are available) is underway for radionuclides frequently encountered in radiation epidemiology. A longer-term goal is development of coordinated biokinetic and dosimetric models that address the distribution of major radioelements among radiosensitive brain tissues.

S VALUES FOR NEUROIMAGING PROCEDURES ON KOREAN PEDIATRIC AND ADULT HEAD COMPUTATIONAL PHANTOMS

Over the past decades, the application of single-photon emission computed tomography and positron emission tomography in neuroimaging has markedly increased. In the current study, we used a series of Korean computational head phantoms with detailed cranial structures for 6-, 9-, 12-, 15-y-old children and adult and a Monte Carlo transport code, MCNPX, to calculate age-dependent specific absorbed fraction (SAF) for mono-energetic electrons ranging from 0.01 to 4 MeV and S values for seven radionuclides widely used in nuclear medicine neuroimaging for the combination of ten source and target regions. Compared to the adult phantom, the 6-y phantom showed up to 1.7-fold greater SAF (cerebellum < cerebellum) and up to 1.4-fold greater S values (vitreous body < lens) for 123I. The electron SAF data, combined with our previous photon SAF data, will facilitate absorbed dose calculations for various cranial structures in patients undergoing neuroimaging procedures.

Estimating the Absorbed Dose of Organs in Pediatric Imaging of 99mTc-DTPATc-DTPA Radiopharmaceutical using MIRDOSE Software

Introduction:

In this study, organ radiation doses were calculated for the renal agent ^99mTc-DTPATc-DTPA in children. Bio-kinetic energy of ^99mTc-DTPATc-DTPA was evaluated by scintigraphy and estimates for absorbed radiation dose were provided using standard medical internal radiation dosimetry (MIRD) techniques.

Material and Methods:

In this applied research, fourteen children patients (6 males and 8 females) were imaged using a series of planar and SPECT images after injecting with technetium-^99mTc-DTPA diethylenetriaminepentaacetic acid (^99mTc-DTPATc-DTPA). A hybrid planar/SPECT method was used to plot time-activity curves to obtain the residence time of the source organs and also MIRDOSE software was used to calculate the absorbed dose of every organ. P-values were calculated using t-tests in order to make a comparison between the adsorbed doses of male and female groups.

Results:

Mean absorbed doses (µGy/MBq) for urinary bladder wall, kidneys, gonads, liver and adrenals were 213.5±47.8, 12.97±6.23, 12.0±2.5, 4.29±1.47, and 3.31±0.96, respectively. Furthermore, the mean effective dose was 17.5±3.7 µSv/MBq. There was not any significant difference in the mean absorbed dose of the two groups.

Conclusion:

Bladder cumulated activity was the most contribution in the effective dose of patients scanned with ^99mTc-DTPATc-DTPA. Using a hybrid planar/SPECT method can cause an increase in accumulated activity accuracy for the region of interest. Moreover, patient-specified internal dosimetry is recommended.

An exponential growth of computational phantom research in radiation protection, imaging, and radiotherapy: a review of the fifty-year history

Radiation dose calculation using models of the human anatomy has been a subject of great interest to radiation protection, medical imaging, and radiotherapy. However, early pioneers of this field did not foresee the exponential growth of research activity as observed today. This review article walks the reader through the history of the research and development in this field of study which started some 50 years ago. This review identifies a clear progression of computational phantom complexity which can be denoted by three distinct generations. The first generation of stylized phantoms, representing a grouping of less than dozen models, was initially developed in the 1960s at Oak Ridge National Laboratory to calculate internal doses from nuclear medicine procedures. Despite their anatomical simplicity, these computational phantoms were the best tools available at the time for internal/external dosimetry, image evaluation, and treatment dose evaluations. A second generation of a large number of voxelized phantoms arose rapidly in the late 1980s as a result of the increased availability of tomographic medical imaging and computers. Surprisingly, the last decade saw the emergence of the third generation of phantoms which are based on advanced geometries called boundary representation (BREP) in the form of Non-Uniform Rational B-Splines (NURBS) or polygonal meshes. This new class of phantoms now consists of over 287 models including those used for non-ionizing radiation applications. This review article aims to provide the reader with a general understanding of how the field of computational phantoms came about and the technical challenges it faced at different times. This goal is achieved by defining basic geometry modeling techniques and by analyzing selected phantoms in terms of geometrical features and dosimetric problems to be solved. The rich historical information is summarized in four tables that are aided by highlights in the text on how some of the most well-known phantoms were developed and used in practice. Some of the information covered in this review has not been previously reported, for example, the CAM and CAF phantoms developed in 1970s for space radiation applications. The author also clarifies confusion about 'population-average' prospective dosimetry needed for radiological protection under the current ICRP radiation protection system and 'individualized' retrospective dosimetry often performed for medical physics studies. To illustrate the impact of computational phantoms, a section of this article is devoted to examples from the author's own research group. Finally the author explains an unexpected finding during the course of preparing for this article that the phantoms from the past 50 years followed a pattern of exponential growth. The review ends on a brief discussion of future research needs (a supplementary file '3DPhantoms.pdf' to figure 15 is available for download that will allow a reader to interactively visualize the phantoms in 3D).

Paired organs-should they be treated jointly or separately in internal dosimetry?

PURPOSE

Size, shape, and the position of paired organs are different in abdomen. However, the counterpart organs are conventionally treated jointly together in internal dosimetry. This study was performed to quantify the difference of specific absorbed fraction of organs in considering paired organs jointly like single organs or as two separate organs.

METHODS

Zubal phantom and GATE Monte Carlo package were used to calculate the SAF for the self-absorption and cross-irradiation of the lungs, kidneys, adrenal glands (paired organs), liver, spleen, stomach, and pancreas (single organs). The activity was assumed uniformly distributed in the organs, and simulation was performed for monoenergetic photons of 10, 50, 100, 500, 1000 keV and mono-energetic electrons of 350, 500, 690, 935, 1200 keV.

RESULTS

The results demonstrated that self-absorption of left and right counterpart organs may be different depending upon the differences in their masses. The cross-irradiations between left-to-right and right-to-left counterpart organs are always equal irrespective of difference in their masses. Cross-irradiation from the left and right counterpart organs to other organs are different (4-24 times in Zubal phantom) depending on the photon energy and organs. The irradiation from a single source organ to the left and right counterpart paired organs is always different irrespective of activity concentration.

CONCLUSIONS

Left and right counterpart organs always receive different absorbed doses from target organs and deliver different absorbed doses to target organs. Therefore, in application of radiopharmaceuticals in which the dose to the organs plays a role, counterpart organs should be treated separately as two separate organs.© 2011 American Association of Physicists in Medicine.

Comparison of internal dosimetry factors for three classes of adult computational phantoms with emphasis on I-131 in the thyroid

The S values for 11 major target organs for I-131 in the thyroid were compared for three classes of adult computational human phantoms: stylized, voxel and hybrid phantoms. In addition, we compared specific absorbed fractions (SAFs) with the thyroid as a source region over a broader photon energy range than the x- and gamma-rays of I-131. The S and SAF values were calculated for the International Commission on Radiological Protection (ICRP) reference voxel phantoms and the University of Florida (UF) hybrid phantoms by using the Monte Carlo transport method, while the S and SAF values for the Oak Ridge National Laboratory (ORNL) stylized phantoms were obtained from earlier publications. Phantoms in our calculations were for adults of both genders. The 11 target organs and tissues that were selected for the comparison of S values are brain, breast, stomach wall, small intestine wall, colon wall, heart wall, pancreas, salivary glands, thyroid, lungs and active marrow for I-131 and thyroid as a source region. The comparisons showed, in general, an underestimation of S values reported for the stylized phantoms compared to the values based on the ICRP voxel and UF hybrid phantoms and relatively good agreement between the S values obtained for the ICRP and UF phantoms. Substantial differences were observed for some organs between the three types of phantoms. For example, the small intestine wall of ICRP male phantom and heart wall of ICRP female phantom showed up to eightfold and fourfold greater S values, respectively, compared to the reported values for the ORNL phantoms. UF male and female phantoms also showed significant differences compared to the ORNL phantom, 4.0-fold greater for the small intestine wall and 3.3-fold greater for the heart wall. In our method, we directly calculated the S values without using the SAFs as commonly done. Hence, we sought to confirm the differences observed in our S values by comparing the SAFs among the phantoms with the thyroid as a source region for selected target organs--small intestine wall, lungs, pancreas and breast--as well as illustrate differences in energy deposition across the energy range (12 photon energies from 0.01 to 4 MeV). Differences were found in the SAFs between phantoms in a similar manner as the differences observed in S values but with larger differences at lower photon energies. To investigate the differences observed in the S and SAF values, the chord length distributions (CLDs) were computed for the selected source--target pairs and compared across the phantoms. As demonstrated by the CLDs, we found that the differences between phantoms in those factors used in internal dosimetry were governed to a significant degree by inter-organ distances which are a function of organ shape as well as organ location.

Assessment of MIRD data for internal dosimetry using the GATE Monte Carlo code

GATE/GEANT is a Monte Carlo code dedicated to nuclear medicine that allows calculation of the dose to organs of voxel phantoms. On the other hand, MIRD is a well-developed system for estimation of the dose to human organs. In this study, results obtained from GATE/GEANT using Snyder phantom are compared to published MIRD data. For this, the mathematical Snyder phantom was discretized and converted to a digital phantom of 100 × 200 × 360 voxels. The activity was considered uniformly distributed within kidneys, liver, lungs, pancreas, spleen, and adrenals. The GATE/GEANT Monte Carlo code was used to calculate the dose to the organs of the phantom from mono-energetic photons of 10, 15, 20, 30, 50, 100, 200, 500, and 1000 keV. The dose was converted into specific absorbed fraction (SAF) and the results were compared to the corresponding published MIRD data. On average, there was a good correlation (r (2)>0.99) between the two series of data. However, the GATE/GEANT data were on average -0.16 ± 6.22% lower than the corresponding MIRD data for self-absorption. Self-absorption in the lungs was considerably higher in the MIRD compared to the GATE/GEANT data, for photon energies of 10-20 keV. As for cross-irradiation to other organs, the GATE/GEANT data were on average +1.5 ± 8.1% higher than the MIRD data, for photon energies of 50-1000 keV. For photon energies of 10-30 keV, the relative difference was +7.5 ± 67%. It turned out that the agreement between the GATE/GEANT and the MIRD data depended upon absolute SAF values and photon energy. For 10-30 keV photons, where the absolute SAF values were small, the uncertainty was high and the effect of cross-section prominent, and there was no agreement between the GATE/GEANT results and the MIRD data. However, for photons of 50-1,000 keV, the bias was negligible and the agreement was acceptable.

Development of a geometry-based respiratory motion-simulating patient model for radiation treatment dosimetry

Temporal and spatial anatomic changes caused by respiration during radiation treatment delivery can lead to discrepancies between prescribed and actual radiation doses. The present paper documents a study to construct a respiratory‐motion‐simulating, four‐dimensional (4D) anatomic and dosimetry model for the study of the dosimetric effects of organ motion for various radiation treatment plans and delivery strategies. The non‐uniform rational B‐splines (NURBS) method has already been used to reconstruct a three‐dimensional (3D) VIP‐Man (“visible photographic man”) model that can reflect the deformation of organs during respiration by using time‐dependent equations to manipulate surface control points. The EGS4 (Electron Gamma Shower, version 4) Monte Carlo code is then used to apply the 4D model to dose simulation. We simulated two radiation therapy delivery scenarios: gating treatment and 4D image‐guided treatment. For each delivery scenario, we developed one conformal plan and one intensity‐modulated radiation therapy plan. A lesion in the left lung was modeled to investigate the effect of respiratory motion on radiation dose distributions. Based on target dose–volume histograms, the importance of using accurate gating to improve the dose distribution is demonstrated. The results also suggest that, during 4D image‐guided treatment delivery, monitoring of the patient's breathing pattern is critical. This study demonstrates the potential of using a “standard” motion‐simulating patient model for 4D treatment planning and motion management.

PACS numbers: 87.53.Bn, 87.53.Kn, 87.53.Tf, 87.53.Wz, 87.57.Gg, 89.80.+h

Current status and new horizons in Monte Carlo simulation of X-ray CT scanners

With the advent of powerful computers and parallel processing including Grid technology, the use of Monte Carlo (MC) techniques for radiation transport simulation has become the most popular method for modeling radiological imaging systems and particularly X-ray computed tomography (CT). The stochastic nature of involved processes such as X-ray photons generation, interaction with matter and detection makes MC the ideal tool for accurate modeling. MC calculations can be used to assess the impact of different physical design parameters on overall scanner performance, clinical image quality and absorbed dose assessment in CT examinations, which can be difficult or even impossible to estimate by experimental measurements and theoretical analysis. Simulations can also be used to develop and assess correction methods and reconstruction algorithms aiming at improving image quality and quantitative procedures. This paper focuses mainly on recent developments and future trends in X-ray CT MC modeling tools and their areas of application. An overview of existing programs and their useful features will be given together with recent developments in the design of computational anthropomorphic models of the human anatomy. It should be noted that due to limited space, the references contained herein are for illustrative purposes and are not inclusive; no implication that those chosen are better than others not mentioned is intended.

Strategies for attenuation compensation in neurological PET studies

Molecular brain imaging using positron emission tomography (PET) has evolved into a vigorous academic field and is progressively gaining importance in the clinical arena. Significant progress has been made in the design of high-resolution three-dimensional (3-D) PET units dedicated to brain research and the development of quantitative imaging protocols incorporating accurate image correction techniques and sophisticated image reconstruction algorithms. However, emerging clinical and research applications of molecular brain imaging demand even greater levels of accuracy and precision and therefore impose more constraints with respect to the quantitative capability of PET. It has long been recognized that photon attenuation in tissues is the most important physical factor degrading PET image quality and quantitative accuracy. Quantitative PET image reconstruction requires an accurate attenuation map of the object under study for the purpose of attenuation compensation. Several methods have been devised to correct for photon attenuation in neurological PET studies. Significant attention has been devoted to optimizing computational performance and to balancing conflicting requirements. Approximate methods suitable for clinical routine applications and more complicated approaches for research applications, where there is greater emphasis on accurate quantitative measurements, have been proposed. The number of scientific contributions related to this subject has been increasing steadily, which motivated the writing of this review as a snapshot of the dynamically changing field of attenuation correction in cerebral 3D PET. This paper presents the physical and methodological basis of photon attenuation and summarizes state of the art developments in algorithms used to derive the attenuation map aiming at accurate attenuation compensation of brain PET data. Future prospects, research trends and challenges are identified and directions for future research are discussed.

Specific absorbed fraction for Korean adult voxel phantom from internal photon source

Absorbed fraction (AF) and specific absorbed fraction (SAF) are crucial values for the calculation of radionuclide S-values and consequently for internal dose estimates. The formalism of the Medical Internal Radiation Dose (MIRD) committee of the Society of Nuclear Medicine (SNM) has been utilised as a standard in the calculation of individual organ doses for biologically distributed radionuclides and for different types of radiation. Although those quantities are highly sensitive to individual anatomical difference, the SAF dataset calculated by Caucasian-based stylised phantoms have been applied to Korean population until now. This study was intended to calculate the SAFs by using realistic Korean voxel phantom and Monte Carlo transport technique for the first time and compare the results with those of the existing Caucasian-based data and the Korean stylised phantom published recently. The up-to-date realistic Korean voxel phantom, KTMAN-2, which was developed from computed tomography (CT) images of an average Korean adult male, was employed for Monte Carlo calculation using EGSnrc user-code, developed for the purpose of this study. The SAFs for 32 target organs and tissues from the photon source, uniformly deposited in a total of 37 source organs and tissues, were calculated from KTMAN-2. The results were compared with those for an adult phantom of Oak Ridge National Laboratory (ORNL) and Korean adult stylised phantom. Two major reasons of discrepancy were analysed: (1) racial difference between the Korean and the Caucasian and (2) anatomical difference between stylised and voxel phantoms. When the source organ was identical to the target organ, difference in SAF caused by the difference in target-organ mass between the Korean and the Caucasian phantoms was mainly observed. When the source and target organs were not identical, significant difference in SAF was observed which was mainly attributed to the difference in inter-organ distance and organ shape between voxel and stylised phantoms.