The UF family of hybrid phantoms of the developing human fetus for computational radiation dosimetry

Fetal atomic bomb survivor dosimetry using the J45 series of pregnant female phantoms with realistic survivor exposure scenarios: comparisons to dose estimates in the DS02 system

A significant source of information on radiation-induced biological effects following in-utero irradiation stems from studies of atomic bomb survivors who were pregnant at the time of exposure in Hiroshima, and to a lesser extent, from survivors in Nagasaki. Dose estimates to the developing fetus for these survivors have been assigned in prior dosimetry systems of the Radiation Effects Research Foundation as the dose to the uterine wall within the non-pregnant adult stylized phantom, originally designed for the dosimetry system DS86 and then carried forward in DS02. In a prior study, a new J45 (Japanese 1945) series of high-resolution phantoms of the adult pregnant female at 8 weeks, 15 weeks, 25 weeks, and 38-weeks post-conception was presented. Fetal and maternal organ doses were estimated by computationally exposing the pregnant female phantom series to DS02 free-in-air cumulative photon and neutron fluences at three distances from the hypocenter at both Hiroshima and Nagasaki under idealized frontal (AP) and isotropic (ISO) particle incidence. In this present study, this work was extended using realistic angular fluences (480 directions) from the DS02 system for seven radiation source terms, nine different radiation dose components, and five shielding conditions. In addition, to explore the effects of fetal position within the womb, four new phantoms were created and the same irradiation scenarios were performed. General findings are that the current DS02 fetal dose surrogate overestimates values of fetal organ dose seen in the J45 phantoms towards the cranial end of the fetus, especially in the later stages of pregnancy. For example, for in-open exposures at 1000 m in Hiroshima, the ratio of J45 fetal brain dose to DS02 uterine wall dose is 0.90, 0.82, and 0.70 at 15 weeks, 25 weeks, and 38-weeks, respectively, for total gamma exposures, and are 0.64, 0.44, and 0.37 at these same gestational ages for total neutron exposures. For organs in the abdominal and pelvic regions of the fetus, dose gradients across gestational age flatten and later reverse, so that DS02 fetal dosimetry begins to underestimate values of fetal organ dose as seen in the J45 phantoms. For example, for the same exposure scenario, the ratios of J45 fetal kidney dose to DS02 uterine wall dose are about 1.09 from 15 to 38 weeks for total gamma dose, and are 1.30, 1.56, and 1.75 at 15 weeks, 25 weeks, and 38 weeks, respectively, for the total neutron dose. Results using the new fetal positioning phantoms show this trend reversing for a head-up, breach fetal position. This work supports previous findings that the J45 pregnant female phantom series offers significant opportunities for gestational age-dependent assessment of fetal organ dose without the need to invoke the uterine wall as a fetal organ surrogate.

Patient-specific fetal radiation dosimetry for pregnant patients undergoing abdominal and pelvic CT imaging

BACKGROUND

Accurate estimation of fetal radiation dose is crucial for risk-benefit analysis of radiological imaging, while the radiation dosimetry studies based on individual pregnant patient are highly desired.

PURPOSE

To use Monte Carlo calculations for estimation of fetal radiation dose from abdominal and pelvic computed tomography (CT) examinations for a population of patients with a range of variations in patients' anatomy, abdominal circumference, gestational age (GA), fetal depth (FD), and fetal development.

METHODS

Forty-four patient-specific pregnant female models were constructed based on CT imaging data of pregnant patients, with gestational ages ranging from 8 to 35 weeks. The simulation of abdominal and pelvic helical CT examinations was performed on three validated commercial scanner systems to calculate organ-level fetal radiation dose.

RESULTS

The absorbed radiation dose to the fetus ranged between 0.97 and 2.24 mGy, with an average of 1.63 ± 0.33 mGy. The CTDI_vol -normalized fetal dose ranged between 0.56 and 1.30, with an average of 0.94 ± 0.25. The normalized fetal organ dose showed significant correlations with gestational age, maternal abdominal circumference (MAC), and fetal depth. The use of ATCM technique increased the fetal radiation dose in some patients.

CONCLUSION

A technique enabling the calculation of organ-level radiation dose to the fetus was developed from models of actual anatomy representing a range of gestational age, maternal size, and fetal position. The developed maternal and fetal models provide a basis for reliable and accurate radiation dose estimation to fetal organs.

Breast Shielding Combined With an Optimized Computed Tomography Pulmonary Angiography Pregnancy Protocol: A Special Use-Case for Shielding?

OBJECTIVES

To determine the impact of breast shields on breast dose and image quality when combined with a low-dose computed tomography pulmonary angiography (CTPA) protocol for pregnancy.

METHODS

A low-dose CTPA protocol, with and without breast shields, was evaluated by anthropomorphic phantom and 20 prospectively recruited pregnant participants from January to October 2019. Thermoluminescent dosimeters measured surface and absorbed breast dose in the phantom and surface breast dose in participants. The Monte-Carlo method estimated the absorbed breast dose in participants. Image quality was assessed quantitatively by regions of interest analysis and subjectively by the Likert scale. Doses and image quality for CTPA alone were compared with CTPA with breast shields.

RESULTS

Mean surface and absorbed breast dose for CTPA alone were 1.3±0.4 and 2.8±1.5 mGy in participants, and 1.5±0.7 and 1.6±0.6 mGy in the phantom. Shielding reduced surface breast dose to 0.5±0.3 and 0.7±0.2 mGy in the phantom (66%) and study participants (48%), respectively. Absorbed breast dose reduced to 0.9±0.5 mGy (46%) in the phantom.Noise increased with breast shields at lower kV settings (80 to 100 kV) in the phantom; however, in study participants there was no significant difference between shield and no-shield groups for main pulmonary artery noise (no-shield: 34±9.8, shield: 36.3±7.2, P =0.56), SNR (no-shield: 11.2±3.7, shield: 10.8±2.6, P =0.74) or contrast-to-noise ratio (no-shield: 10.0±3.3, shield: 9.3±2.4, P =0.6). Median subjective image quality scores were comparable (no-shield: 4.0, interquartile range: 3.5 to 4.4, shield: 4.3, interquartile range: 4.0 to 4.5).

CONCLUSION

Combining low-dose CTPA with breast shields confers additional breast-dose savings without impacting image quality and yields breast doses approaching those of low-dose scintigraphy, suggesting breast shields play a role in protocol optimization for select groups.

Assessment of Twin Fetal Exposure to Environmental Magnetic and Electromagnetic Fields

Fetal development is vital in the human lifespan. Therefore, it is essential to characterize exposure by a series of typical environmental magnetic and electromagnetic fields. In particular, there has recently been a sharp increase in the twin birth rate. However, lack of appropriate models has prohibited dosimetric evaluation, restricting characterization of the impact of these environmental factors on twins. The present study developed two whole-body pregnant models of 31 and 32 weeks of gestation with twin fetuses and explored several typical exposure scenarios, including 50-Hz uniform magnetic field exposure, local 125-kHz magnetic field (MF), and 13.56-MHz electromagnetic field exposure, as well as wideband planewave radiofrequency (RF) exposure from 20 to 6000 MHz. Finally, dosimetric results were derived. Compared to the singleton pregnancy with similar weeks of gestation, twin fetuses were overexposed at 50-Hz uniform MF, but they were probably underexposed in the RF scenarios with frequencies for wireless communications. Furthermore, the twin fetuses manifested large dosimetric variability compared to the singleton, which was attributed to the incident direction and fetal position. Based on the analysis, the dosimetric results over the entire gestation period were estimated. The results can be helpful to estimate the risk of twin-fetal exposure to electromagnetic fields and examine the conservativeness of the international guidelines.© 2022 Bioelectromagnetics Society.

Quantifying cancer risk from exposures to medical imaging in the Risk of Pediatric and Adolescent Cancer Associated with Medical Imaging (RIC) Study: research methods and cohort profile

PURPOSE

The Risk of Pediatric and Adolescent Cancer Associated with Medical Imaging (RIC) Study is quantifying the association between cumulative radiation exposure from fetal and/or childhood medical imaging and subsequent cancer risk. This manuscript describes the study cohorts and research methods.

METHODS

The RIC Study is a longitudinal study of children in two retrospective cohorts from 6 U.S. healthcare systems and from Ontario, Canada over the period 1995-2017. The fetal-exposure cohort includes children whose mothers were enrolled in the healthcare system during their entire pregnancy and followed to age 20. The childhood-exposure cohort includes children born into the system and followed while continuously enrolled. Imaging utilization was determined using administrative data. Computed tomography (CT) parameters were collected to estimate individualized patient organ dosimetry. Organ dose libraries for average exposures were constructed for radiography, fluoroscopy, and angiography, while diagnostic radiopharmaceutical biokinetic models were applied to estimate organ doses received in nuclear medicine procedures. Cancers were ascertained from local and state/provincial cancer registry linkages.

RESULTS

The fetal-exposure cohort includes 3,474,000 children among whom 6,606 cancers (2394 leukemias) were diagnosed over 37,659,582 person-years; 0.5% had in utero exposure to CT, 4.0% radiography, 0.5% fluoroscopy, 0.04% angiography, 0.2% nuclear medicine. The childhood-exposure cohort includes 3,724,632 children in whom 6,358 cancers (2,372 leukemias) were diagnosed over 36,190,027 person-years; 5.9% were exposed to CT, 61.1% radiography, 6.0% fluoroscopy, 0.4% angiography, 1.5% nuclear medicine.

CONCLUSION

The RIC Study is poised to be the largest study addressing risk of childhood and adolescent cancer associated with ionizing radiation from medical imaging, estimated with individualized patient organ dosimetry.

Fetal dose from proton pencil beam scanning craniospinal irradiation during pregnancy: a Monte Carlo study

Objective. We conducted a Monte Carlo study to comprehensively investigate the fetal dose resulting from proton pencil beam scanning (PBS) craniospinal irradiation (CSI) during pregnancy.Approach. The gestational-age dependent pregnant phantom series developed at the University of Florida (UF) were converted into DICOM-RT format (CT images and structures) and imported into a treatment planning system (TPS) (Eclipse v15.6) commissioned to a IBA PBS nozzle. A proton PBS CSI plan (prescribed dose: 36 Gy) was created on the phantoms. The TOPAS MC code was used to simulate the proton PBS CSI on the phantoms, for which MC beam properties at the nozzle exit (spot size, spot divergence, mean energy, and energy spread) were matched to IBA PBS nozzle beam measurement data. We calculated mean absorbed doses for 28 organs and tissues and whole body of the fetus at eight gestational ages (8, 10, 15, 20, 25, 30, 35, and 38 weeks). For contextual purposes, the fetal organ/tissue doses from the treatment planning CT scan of the mother's head and torso were estimated using the National Cancer Institute dosimetry system for CT (NCICT, Version 3) considering a low-dose CT protocol (CTDIvol: 8.97 mGy).Main results. The majority of the fetal organ/tissue doses from the proton PBS CSI treatment fell within a range of 3-6 mGy. The fetal organ/tissue doses for the 38 week phantom showed the largest variation with the doses ranging from 2.9 mGy (adrenals) to 8.2 mGy (eye lenses) while the smallest variation ranging from 3.2 mGy (oesophagus) to 4.4 mGy (brain) was observed for the doses for the 20 week phantom. The fetal whole-body dose ranged from 3.7 mGy (25 weeks) to 5.8 mGy (8 weeks). Most of the fetal doses from the planning CT scan fell within a range of 7-13 mGy, approximately 2-to-9 times lower than the fetal dose equivalents of the proton PBS CSI treatment (assuming a quality factor of 7).Significance. The fetal organ/tissue doses observed in the present work will be useful for one of the first clinically informative predictions on the magnitude of fetal dose during proton PBS CSI during pregnancy.

Organ doses of the fetus from external environmental exposures

This article presents nuclide-specific organ dose rate coefficients for environmental external exposures due to soil contamination assumed as a planar source at a depth of 0.5 g cm-2 in the soil and submersion to contaminated air, for a pregnant female and its fetus at the 24th week of gestation. Furthermore, air kerma free-in-air coefficient rates are listed. The coefficients relate the organ equivalent dose rates (Sv s-1) to the activity concentration of environmental sources, in Bq m-2 or Bq m-3, allowing to time-integrate over a particular exposure period. The environmental radiation fields were simulated with the Monte Carlo radiation transport codes PHITS and YURI. Monoenergetic organ dose rate coefficients were calculated employing the Monte Carlo code EGSnrc simulating the photon transport in the voxel phantom of a pregnant female and fetus. Photons of initial energies of 0.015-10 MeV were considered including bremsstrahlung. By folding the monoenergetic dose coefficients with the nuclide decay data, nuclide-specific organ doses were obtained. The results of this work can be employed for estimating the doses from external exposures to pregnant women and their fetus, until more precise data are available which include coefficients obtained for phantoms at different stages of pregnancy.

Dosimetric Impact of a New Computational Voxel Phantom Series for the Japanese Atomic Bomb Survivors: Pregnant Females

An important cohort of the atomic bomb survivors are women who were pregnant when exposed to the photon and neutron fields at both Hiroshima and Nagasaki, as well as their children who were exposed in utero. Estimates of organ dose to the developing fetus allow for the development of dose-dependent and gestational age-dependent models of deterministic (e.g., organ malformation) and stochastic (e.g., leukemia) risk of in utero exposure. To date, both the 1986 and 2002 dosimetry systems at the Radiation Effects Research Foundation have utilized the uterine wall in the non-pregnant adult female as a dose surrogate for individual fetal organs and tissues. Here we present a new J45 (Japanese 1945) series of high-resolution phantoms of the adult pregnant female at 8-, 15-, 25- and 38-weeks post-conception. These models, which were derived from the University of Florida (UF) series of ICRP Publication 89 compliant reference phantoms, have been rescaled to approximate the pregnant mother using 1945 Japanese morphometry data. Fetal and maternal organ doses were estimated by computationally exposing the pregnant female phantom series to DS02 free-in-air photon and neutron fluences at three distances from the hypocenter at both Hiroshima and Nagasaki under frontal (AP) and isotropic (ISO) particle incidence. As for the fetal organ doses, our results indicate that the uterine wall of the non-pregnant female generally underestimates fetal organ dose within the pregnant female. The magnitude of these differences varies with both radiation type and irradiation geometry, with the smallest differences (5-7%) seen for ISO photon fields and the largest differences (20-30%) seen for AP neutron fields. Significant discrepancies were seen in fetal brain dose and its uterine wall surrogate, particularly for photon AP fields (ratio of uterine wall to brain dose varied from 0.9 to 1.3) and neutron AP fields (dose ratios from 0.75 to 2.0). As for the maternal organ doses, the use of organ doses in a non-pregnant female was shown, in general, to overestimate the corresponding organ doses in the pregnant female, with greater deviations seen at later stages of pregnancy (12-16% for AP photons and 44-53% for AP neutrons). The one exception was the uterine wall dose in pregnancy which was seen to be underestimated by that in the non-pregnant female phantom, particularly for ISO and AP neutron fields. These results demonstrate that the J45 pregnant female phantom series offers the opportunity for significant improvements in both fetal and maternal organ dose assessment within this unique cohort of the atomic bomb survivors.

Estimating fetal dose from tube current-modulated (TCM) and fixed tube current (FTC) abdominal/pelvis CT examinations

PURPOSE

The purpose of this work was to estimate scanner-independent CTDI_vol -to-fetal-dose coefficients for tube current-modulated (TCM) and fixed tube current (FTC) computed tomography (CT) examinations of pregnant patients of various gestational ages undergoing abdominal/pelvic CT examinations.

METHODS

For 24 pregnant patients of gestational age from <5 to 36 weeks who underwent clinically indicated CT examinations, voxelized models of maternal and fetal (or embryo) anatomy were created from abdominal/pelvic image data. Absolute fetal dose (D_fetus ) was estimated using Monte Carlo (MC) simulations of helical scans covering the abdomen and pelvis for TCM and FTC scans. Estimated TCM schemes were generated for each patient model using a validated method that accounts for patient attenuation and scanner output limits for one scanner model and were incorporated into MC simulations. FTC scans were also simulated for each patient model with multidetector row CT scanners from four manufacturers. Normalized fetal dose estimates, nD_fetus , was obtained by dividing D_fetus from the MC simulations by CTDI_vol . Patient size was described using water equivalent diameter (D_w ) measured at the three-dimensional geometric centroid of the fetus. Fetal depth (DE_f ) was measured from the anterior skin surface to the anterior part of the fetus. nD_fetus and D_w were correlated using an exponential model to develop equations for fetal dose conversion coefficients for TCM and FTC abdominal/pelvic CT examinations. Additionally, bivariate linear regression was performed to analyze the correlation of nD_fetus with D_w and fetal depth (DE_f ). For one scanner model, nD_fetus from TCM was compared to FTC and the size-specific dose estimate (SSDE) conversion coefficients (f-factors) from American Association of Physicists in Medicine (AAPM) Report 204. nD_fetus from FTC simulations was averaged across all scanners for each patient ( n D fetus ¯ ) . n D fetus ¯ was then compared with SSDE f-factors and correlated with D_w using an exponential model and with D_w and DE_f using a bivariate linear model.

RESULTS

For TCM, the coefficient of determination (R² ) of nD_fetus and D_w was observed to be 0.73 using an exponential model. Using the bivariate linear model with D_w and DE_f , an R² of 0.78 was observed. For the TCM technology modeled, TCM yielded nD_fetus values that were on average 6% and 17% higher relative to FTC and SSDE f-factors, respectively. For FTC, the R² of n D fetus ¯ with respect to D_w was observed to be 0.64 using an exponential model. Using the bivariate linear model, an R² of 0.75 was observed for n D fetus ¯ with respect to D_w and DE_f . A mean difference of 0.4% was observed between n D fetus ¯ and SSDE f-factors.

CONCLUSION

Good correlations were observed for nD_fetus from TCM and FTC scans using either an exponential model with D_w or a bivariate linear model with both D_w and DE_f . These results indicate that fetal dose from abdomen/pelvis CT examinations of pregnant patients of various gestational ages may be reasonably estimated with models that include (a) scanner-reported CTDI_vol and (b) D_w as a patient size metric, in addition to (c) DE_f if available. These results also suggest that SSDE f-factors may provide a reasonable (within ±25%) estimate of nD_fetus for TCM and FTC abdomen/pelvis CT exams.

Innovations in Computer Technologies Have Impacted Radiation Dosimetry Through Anatomically Realistic Phantoms and Fast Monte Carlo Simulations

Radiological physics principles have not changed in the past 60 y when computer technologies advanced exponentially. The research field of anatomical modeling for the purpose of radiation dose calculations has experienced an explosion in activity in the past two decades. Such an exciting advancement is due to the feasibility of creating three-dimensional geometric details of the human anatomy from tomographic imaging and of performing Monte Carlo radiation transport simulations on increasingly fast and cheap personal computers. The advent of a new type of high-performance computing hardware in recent years-graphics processing units-has made it feasible to carry out time-consuming Monte Carlo calculations at near real-time speeds. This paper introduces the history of three generations of computational human phantoms (the stylized medical internal radiation dosimetry-type phantoms, the voxelized tomographic phantoms, and the boundary representation deformable phantoms) and new development of the graphics processing unit-based Monte Carlo radiation dose calculations. Examples are given for research projects performed by my students in applying computational phantoms and a new Monte Carlo code, ARCHER, to problems in radiation protection, imaging, and radiotherapy. Finally, the paper discusses challenges and future opportunities for research.

Computational phantoms, ICRP/ICRU, and further developments

Phantoms simulating the human body play a central role in radiation dosimetry. The first computational body phantoms were based upon mathematical expressions describing idealised body organs. With the advent of more powerful computers in the 1980s, voxel phantoms have been developed. Being based on three-dimensional images of individuals, they offer a more realistic anatomy. Hence, the International Commission on Radiological Protection (ICRP) decided to construct voxel phantoms representative of the adult Reference Male and Reference Female for the update of organ dose coefficients. Further work on phantom development has focused on phantoms that combine the realism of patient-based voxel phantoms with the flexibility of mathematical phantoms, so-called 'boundary representation' (BREP) phantoms. This phantom type has been chosen for the ICRP family of paediatric reference phantoms. Due to the limited voxel resolution of the adult reference computational phantoms, smaller tissues, such as the lens of the eye, skin, and micron-thick target tissues in the respiratory and alimentary tract regions, could not be segmented properly. In this context, ICRP Committee 2 initiated a research project with the goal of producing replicas of the ICRP Publication 110 phantoms in polygon mesh format, including all source and target regions, even those with micron resolution. BREP phantoms of the fetus and the pregnant female at various stages of gestation complete the phantoms available for radiation protection computations.

Calculation of the Photon Dose Conversion Coefficient Based on Boundary Representation Phantoms of Different Postures

Based on the hybrid Chinese reference adult female phantom, the Chinese reference female boundary representation (BREP) phantoms involving sitting, walking, and squatting postures were established. The photon effective dose conversion coefficient (ECCK) and some organ absorbed dose conversion coefficients (DCCK) were calculated under six standard irradiation geometries, and the irradiation source included 20 monoenergetic photon energies ranging from 0.01 MeV to 10 MeV. The results indicate that the postures, location of the organs, and irradiation geometries have an impact on the dose conversion coefficients. With the same irradiation geometry, the DCCKs of different organs are different; when the photon energy is from 0.02 MeV to 0.1 MeV, significant differences exist in the DCCK of phantoms of various postures, and the maximum relative deviation is 80%. For the ECCKs, there are greater differences among phantoms of various postures with the same irradiation geometry when the photon energy is from 0.02 MeV to 0.05 MeV, and the maximum relative deviation is about 20%.

Organ Doses to Airline Passengers Screened by X-Ray Backscatter Imaging Systems

Advanced imaging technologies (AIT) are being developed for passenger airline transportation. They are designed to provide enhanced security benefits by identifying objects on passengers that would not be detected by methodologies now used for routine surveillance. X-ray backscatter imaging is one AIT system being considered. Since this technology is based on scanning passengers with ionizing radiation, concern has been raised relating to the health risks associated with these exposures. Recommendations for standards of radiation safety have been proposed by the American National Standards Institute published in ANSI/HPS N43.17-2009. A Monte Carlo based methodology for estimating organ doses received from an X-ray backscatter AIT system is presented. Radiological properties of a reference scanner including beam intensity, geometry and energy spectra were modeled based on previous studies and physical measurements. These parameters were incorporated into a Monte Carlo source subroutine and validated with comparison of simulated versus measured data. One extension of this study was to calculate organ and effective dose on a wide range of potential passengers. Computational phantoms with realistic morphologies were used including adults of 5th, 25th, 50th, 75th and 95th percentile weight, children of 5th, 50th and 95th percentile weight, and the developing fetus of 15, 25, and 38 weeks after conception. Additional sensitivity studies were performed to evaluate effects of passenger positioning within the scanner, energy spectrum and beam geometry, as well as failure mode analyses. Results for routine operations yielded a maximum effective dose to the adult and pediatric passengers of 15 and 25 nSv per screen, respectively. The developing fetus received a maximum organ dose and whole body dose of 16 nGy and 8.5 nGy per screen, respectively. The sensitivity analyses indicated that variations in positioning, energy spectra, and beam geometry yielded a range of effective doses per screen that were an order of magnitude below the ANSI recommendation.

New small-intestine modeling method for surface-based computational human phantoms

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.

ICRP dose coefficients: computational development and current status

Major current efforts within Committee 2 of the International Commission on Radiological Protection (ICRP) involve the development of dose coefficients for inhalation and ingestion of radionuclides, and those for exposure to environmental radiation fields. These efforts build upon changes in radiation and tissue weighting factors (Publication 103), radionuclide decay schemes (Publication 107), computational phantoms of the adult reference male and female (Publication 110), external dose coefficients for adult reference workers for idealised radiation fields (Publication 116), models of radionuclide intake (Publications 66, 100 and 130), and models of radionuclide systemic biokinetics (Publication 130). This paper will review the overall computational framework for both internal and external dose coefficients. For internal exposures, the work entails assessment of organ self-dose and cross-dose from monoenergetic particle emissions (specific absorbed fraction), absorbed dose per nuclear transformation (S value), time-integrated activity of the radionuclide in source tissues (inhalation, ingestion, and systemic biokinetic models), and their numerical combination to yield the organ equivalent dose or effective dose per activity inhaled or ingested. Various challenges are reviewed that were not included in the development of Publication 30 dose coefficients, which were based upon much more simplified biokinetic models and computational phantoms. For external exposures, the computations entail the characterisation of environmental radionuclide distributions, the transport of radiation particles through that environment, and the tracking of energy deposition to the organs of the exposed individual. Progress towards the development of dose coefficients to members of the general public (adolescents, children, infants and fetuses) are also reviewed.

A Monte Carlo-based radiation safety assessment for astronauts in an environment with confined magnetic field shielding

The active shielding technique has great potential for radiation protection in space exploration because it has the advantage of a significant mass saving compared with the passive shielding technique. This paper demonstrates a Monte Carlo-based approach to evaluating the shielding effectiveness of the active shielding technique using confined magnetic fields (CMFs). The International Commission on Radiological Protection reference anthropomorphic phantom, as well as the toroidal CMF, was modeled using the Monte Carlo toolkit Geant4. The penetrating primary particle fluence, organ-specific dose equivalent, and male effective dose were calculated for particles in galactic cosmic radiation (GCR) and solar particle events (SPEs). Results show that the SPE protons can be easily shielded against, even almost completely deflected, by the toroidal magnetic field. GCR particles can also be more effectively shielded against by increasing the magnetic field strength. Our results also show that the introduction of a structural Al wall in the CMF did not provide additional shielding for GCR; in fact it can weaken the total shielding effect of the CMF. This study demonstrated the feasibility of accurately determining the radiation field inside the environment and evaluating the organ dose equivalents for astronauts under active shielding using the CMF.

Fetal organ dosimetry for the Techa River and Ozyorsk Offspring Cohorts, part 2: radionuclide S values for fetal self-dose and maternal cross-dose

One of the many objectives of the European Union's SOLO (Epidemiological Studies of Exposed Southern Urals Populations) project is to quantify the radiation dose-response following chronic in utero exposures to ionizing radiation. The project is presently conducting a pooled analysis of two cohorts of individuals born to exposed mothers-the Techa River Offspring Cohort (TROC) and the Ozyorsk Offspring Cohort (OOC). The TROC includes the offspring of mothers with external exposures to contaminated riverbanks and internal ingestions of (89)Sr, (90)Sr/(90)Y, and (137)Cs/(137m)Ba, while the OOC includes the offspring of mothers with external exposures seen within the Mayak plutonium production facilities and internal inhalation of (239)Pu and possibly (131)I. In the present study, a newly created Urals-based series of fetal and maternal models is employed to assess S values for all seven radionuclides. Among all fetal ages, S values ranged in magnitude from 10(-14) to 10(-10) Gy per Bq-s for fetal source organs and from 10(-18) to 10(-14) Gy per Bq-s from maternal source organs, depending upon particle type, particle energy, and fetal age. For a given radionuclide and fetal age, S values for fetal source organs were approximately two orders of magnitude higher than for maternal source organs. Little variation in S values was observed among fetal source organs, while variations of over 100 % with respect to the mean were observed for maternal source organs near the fetus. S value variations from maternal cross-fire were highly dependent on fetal position and separation distance from the maternal source organ. These radionuclide S values have been coupled with biokinetic models for use in cohort dose assessment within the SOLO project.

Fetal organ dosimetry for the Techa River and Ozyorsk offspring cohorts, part 1: a Urals-based series of fetal computational phantoms

The European Union's SOLO (Epidemiological Studies of Exposed Southern Urals Populations) project aims to improve understanding of cancer risks associated with chronic in utero radiation exposure. A comprehensive series of hybrid computational fetal phantoms was previously developed at the University of Florida in order to provide the SOLO project with the capability of computationally simulating and quantifying radiation exposures to individual fetal bones and soft tissue organs. To improve harmonization between the SOLO fetal biokinetic models and the computational phantoms, a subset of those phantoms was systematically modified to create a novel series of phantoms matching anatomical data representing Russian fetal biometry in the Southern Urals. Using previously established modeling techniques, eight computational Urals-based phantoms aged 8, 12, 18, 22, 26, 30, 34, and 38 weeks post-conception were constructed to match appropriate age-dependent femur lengths, biparietal diameters, individual bone masses and whole-body masses. Bone and soft tissue organ mass differences between the common ages of the subset of UF phantom series and the Urals-based phantom series illustrated the need for improved understanding of fetal bone densities as a critical parameter of computational phantom development. In anticipation for SOLO radiation dosimetry studies involving the developing fetus and pregnant female, the completed phantom series was successfully converted to a cuboidal voxel format easily interpreted by radiation transport software.

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).

A comprehensive tool for image-based generation of fetus and pregnant women mesh models for numerical dosimetry studies

Fetal dosimetry studies require the development of accurate numerical 3D models of the pregnant woman and the fetus. This paper proposes a 3D articulated fetal growth model covering the main phases of pregnancy and a pregnant woman model combining the utero-fetal structures and a deformable non-pregnant woman body envelope. The structures of interest were automatically or semi-automatically (depending on the stage of pregnancy) segmented from a database of images and surface meshes were generated. By interpolating linearly between fetal structures, each one can be generated at any age and in any position. A method is also described to insert the utero-fetal structures in the maternal body. A validation of the fetal models is proposed, comparing a set of biometric measurements to medical reference charts. The usability of the pregnant woman model in dosimetry studies is also investigated, with respect to the influence of the abdominal fat layer.

The UF Family of hybrid phantoms of the pregnant female for computational radiation dosimetry

Efforts to assess in utero radiation doses and related quantities to the developing fetus should account for the presence of the surrounding maternal tissues. Maternal tissues can provide varying levels of protection to the fetus by shielding externally-emitted radiation or, alternatively, can become sources of internally-emitted radiation following the biokinetic uptake of medically-administered radiopharmaceuticals or radionuclides located in the surrounding environment--as in the case of the European Union's SOLO project (Epidemiological Studies of Exposed Southern Urals Populations). The University of Florida had previously addressed limitations in available computational phantom representation of the developing fetus by constructing a series of hybrid computational fetal phantoms at eight different ages and three weight percentiles. Using CT image sets of pregnant patients contoured using 3D-DOCTOR(TM), the eight 50th percentile fetal phantoms from that study were systematically combined in Rhinoceros(TM) with the UF adult non-pregnant female to yield a series of reference pregnant female phantoms at fetal ages 8, 10, 15, 20, 25, 30, 35 and 38 weeks post-conception. Deformable, non-uniform rational B-spline surfaces were utilized to alter contoured maternal anatomy in order to (1) accurately position and orient each fetus and surrounding maternal tissues and (2) match target masses of maternal soft tissue organs to reference data reported in the literature.

Development of a 9-months pregnant hybrid phantom and its internal dosimetry for thyroid agents

As a consequence of fetal radiosensitivity, the estimation of internal dose received by a fetus from radiopharmaceuticals applied to the mother is often important in nuclear medicine. A new 9-months pregnant phantom based on magnetic resonance (MR) images tied to the International Commission on Radiological Protection (ICRP) reference voxel phantom has been developed. Maternal and fetal organs were segmented from a set of pelvic MR images of a 9-months pregnant subject using 3D-DOCTOR(TM) and then imported into the 3D modeling software package Rhinoceros(TM) for combining with the adult female ICRP voxel phantom and further modeling. Next, the phantom organs were rescaled to match with reference masses described in ICRP Publications. The internal anatomy of previous pregnant phantom models had been limited to the fetal brain and skeleton only, but the fetus model developed in this study incorporates 20 different organs. The current reference phantom has been developed for application in comprehensive dosimetric study in nuclear medicine. The internal dosimetry calculations were performed for thyroid agents using the Monte Carlo transport method. Biokinetic data for these radiopharmaceuticals were used to estimate cumulated activity during pregnancy and maternal and fetal organ doses at seven different maximum thyroid uptake levels. Calculating the dose distribution was also presented in a sagittal view of the pregnant model utilizing the mesh tally function. The comparisons showed, in general, an overestimation of the absorbed dose to the fetus and an underestimation of the fetal thyroid dose in previous studies compared with the values based on the current hybrid phantom.