Adult female voxel models of different stature and photon conversion coefficients for radiation protection

Standardization of patient modeling in hyperthermia simulation studies: introducing the Erasmus Virtual Patient Repository

Purpose: Thermal dose-effect relations have demonstrated that clinical effectiveness of hyperthermia would benefit from more controlled heating of the tumor. Hyperthermia treatment planning (HTP) is a potent tool to study strategies enabling target conformal heating, but its accuracy is affected by patient modeling approximations. Homogeneous phantoms models are being used that do not match the body shape of patients in treatment position and often have unrealistic target volumes. As a consequence, simulation accuracy is affected, and performance comparisons are difficult. The aim of this study is to provide the first step toward standardization of HTP simulation studies in terms of patient modeling by introducing the Erasmus Virtual Patient Repository (EVPR): a virtual patient model database.Methods: Four patients with a tumor in the head and neck or the pelvis region were selected, and corresponding models were created using a clinical segmentation procedure. Using the Erasmus University Medical Center standard procedure, HTP was applied to these models and compared to HTP for commonly used surrogate models.Results: Although this study was aimed at presenting the EVPR database, our study illustrates that there is a non-negligible difference in the predicted SAR patterns between patient models and homogeneous phantom-based surrogate models. We further demonstrate the difference between actual and simplified target volumes being used today.Conclusion: Our study describes the EVPR for the research community as a first step toward standardization of hyperthermia simulation studies.

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.

Advances in Computational Human Phantoms and Their Applications in Biomedical Engineering - A Topical Review

Over the past decades, significant improvements have been made in the field of computational human phantoms (CHPs) and their applications in biomedical engineering. Their sophistication has dramatically increased. The very first CHPs were composed of simple geometric volumes, e.g., cylinders and spheres, while current CHPs have a high resolution, cover a substantial range of the patient population, have high anatomical accuracy, are poseable, morphable, and are augmented with various details to perform functionalized computations. Advances in imaging techniques and semi-automated segmentation tools allow fast and personalized development of CHPs. These advances open the door to quickly develop personalized CHPs, inherently including the disease of the patient. Because many of these CHPs are increasingly providing data for regulatory submissions of various medical devices, the validity, anatomical accuracy, and availability to cover the entire patient population is of utmost importance. The article is organized into two main sections: the first section reviews the different modeling techniques used to create CHPs, whereas the second section discusses various applications of CHPs in biomedical engineering. Each topic gives an overview, a brief history, recent developments, and an outlook into the future.

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.

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

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

A feasibility study on the use of phantoms with statistical lung masses for determining the uncertainty in the dose absorbed by the lung from broad beams of incident photons and neutrons

Computational models of the human body have gradually become crucial in the evaluation of doses absorbed by organs. However, individuals may differ considerably in terms of organ size and shape. In this study, the authors sought to determine the energy-dependent standard deviations due to lung size of the dose absorbed by the lung during external photon and neutron beam exposures. One hundred lungs with different masses were prepared and located in an adult male International Commission on Radiological Protection (ICRP) reference phantom. Calculations were performed using the Monte Carlo N-particle code version 5 (MCNP5). Variation in the lung mass caused great uncertainty: ~90% for low-energy broad parallel photon beams. However, for high-energy photons, the lung-absorbed dose dependency on the anatomical variation was reduced to <1%. In addition, the results obtained indicated that the discrepancy in the lung-absorbed dose varied from 0.6% to 8% for neutron beam exposure. Consequently, the relationship between absorbed dose and organ volume was found to be significant for low-energy photon sources, whereas for higher energy photon sources the organ-absorbed dose was independent of the organ volume. In the case of neutron beam exposure, the maximum discrepancy (of 8%) occurred in the energy range between 0.1 and 5 MeV.

MIDA: A Multimodal Imaging-Based Detailed Anatomical Model of the Human Head and Neck

Computational modeling and simulations are increasingly being used to complement experimental testing for analysis of safety and efficacy of medical devices. Multiple voxel- and surface-based whole- and partial-body models have been proposed in the literature, typically with spatial resolution in the range of 1-2 mm and with 10-50 different tissue types resolved. We have developed a multimodal imaging-based detailed anatomical model of the human head and neck, named "MIDA". The model was obtained by integrating three different magnetic resonance imaging (MRI) modalities, the parameters of which were tailored to enhance the signals of specific tissues: i) structural T1- and T2-weighted MRIs; a specific heavily T2-weighted MRI slab with high nerve contrast optimized to enhance the structures of the ear and eye; ii) magnetic resonance angiography (MRA) data to image the vasculature, and iii) diffusion tensor imaging (DTI) to obtain information on anisotropy and fiber orientation. The unique multimodal high-resolution approach allowed resolving 153 structures, including several distinct muscles, bones and skull layers, arteries and veins, nerves, as well as salivary glands. The model offers also a detailed characterization of eyes, ears, and deep brain structures. A special automatic atlas-based segmentation procedure was adopted to include a detailed map of the nuclei of the thalamus and midbrain into the head model. The suitability of the model to simulations involving different numerical methods, discretization approaches, as well as DTI-based tensorial electrical conductivity, was examined in a case-study, in which the electric field was generated by transcranial alternating current stimulation. The voxel- and the surface-based versions of the models are freely available to the scientific community.

Fluence-to-effective dose conversion coefficients from a Saudi population based phantom for monoenergetic photon beams from 10 keV to 20 MeV

Fluence-to-dose conversion coefficients are important quantities for radiation protection, derived from Monte Carlo simulations of the radiation particles through a stylised phantom or voxel based phantoms. The voxel phantoms have been developed for many ethnic groups for their accurate reflection of the anatomy. In this study, we used the Monte Carlo code MCNPX to calculate the photon fluence-to-effective dose conversion coefficients with a voxel phantom based on the Saudi Arabian male population. Six irradiation geometries, anterior-posterior (AP), posterior-anterior (PA), left lateral (LLAT), right lateral (RLAT), rotational (ROT) and isotropic (ISO) were simulated for monoenergetic photon beams from 10 keV to 20 MeV. We compared the coefficients with the reference values in ICRP Publication 116. The coefficients in the AP and PA geometries match the reference values to 9% and 12% on average as measured by root mean square while those in the LLAT, RLAT ROT and ISO geometries differ, mostly below, from the reference by 23, 22, 15 and 16%, respectively. The torso of the Saudi phantom is wider than the ICRP reference male phantom and likely to cause more attenuation to the lateral beam. The ICRP reference coefficients serve well for the Saudi male population as conservative estimations for the purpose of radiation protection.

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).

Study of the counting efficiency of a WBC setup by using a computational 3D human body library in sitting position based on polygonal mesh surfaces

A realistic computational 3D human body library, called MaMP and FeMP (Male and Female Mesh Phantoms), based on polygonal mesh surface geometry, has been created to be used for numerical calibration of the whole body counter (WBC) system of the nuclear power plant (NPP) in Doel, Belgium. The main objective was to create flexible computational models varying in gender, body height, and mass for studying the morphology-induced variation of the detector counting efficiency (CE) and reducing the measurement uncertainties. First, the counting room and an HPGe detector were modeled using MCNPX (Monte Carlo radiation transport code). The validation of the model was carried out for different sample-detector geometries with point sources and a physical phantom. Second, CE values were calculated for a total of 36 different mesh phantoms in a seated position using the validated Monte Carlo model. This paper reports on the validation process of the in vivo whole body system and the CE calculated for different body heights and weights. The results reveal that the CE is strongly dependent on the individual body shape, size, and gender and may vary by a factor of 1.5 to 3 depending on the morphology aspects of the individual to be measured.

Dosimetry and Therapeutic Ratios for Rhenium-186 HEDP

Rhenium-186 (Re-186) is a β-emitting radionuclide. Emitted β-particles have ranges up to 4.5 mm in tissue, capable of delivering high doses to skeletal regions of high Re-186 concentrations while sparing adjacent radiosensitive regions and thus making the irradiation well tolerated for the patient. Along with the β-emissions, γ-rays are emitted having an adequate energy for imaging during therapy and biodistribution assessment for patient-specific dosimetry calculations. The relatively short physical half-life combined with the β-emissions allows the delivery of relatively high activity rate for a short period of time in areas of concentration. This study is a short review concerning the palliative treatment of skeletal metastases using 186Re-HEDP. After presenting the dominant ways of 186Re production, special emphasis is given to dosimetry issues while the effect of palliation therapy can be evaluated through the comparison of the absorbed dose in metastatic lesion relatively to the normal bone region. Accurate dose estimation is required taking into account the anatomic individual difference of each patient. For this purpose a patient specific dosimetric model considering metastatic lesions as spherical nodules is introduced. In order to quantify in a representative way the results of palliation treatment, the concept of therapeutic ratios is analyzed.

Organ doses from environmental exposures calculated using voxel phantoms of adults and children

This paper presents effective and organ dose conversion coefficients for members of the public due to environmental external exposures, calculated using the ICRP adult male and female reference computational phantoms as well as voxel phantoms of a baby, two children and four adult individual phantoms--one male and three female, one of them pregnant. Dose conversion coefficients are given for source geometries representing environmental radiation exposures, i.e. whole body irradiations from a volume source in air, representing a radioactive cloud, a plane source in the ground at a depth of 0.5 g cm⁻², representing ground contamination by radioactive fall-out, and uniformly distributed natural sources in the ground. The organ dose conversion coefficients were calculated employing the Monte Carlo code EGSnrc simulating the photon transport in the voxel phantoms, and are given as effective and equivalent doses normalized to air kerma free-in-air at height 1 m above the ground in Sv Gy(-1). The findings showed that, in general, the smaller the body mass of the phantom, the higher the dose. The difference in effective dose between an adult and an infant is 80-90% at 50 keV and less than 40% above 100 keV. Furthermore, dose equivalent rates for photon exposures of several radionuclides for the above environmental exposures were calculated with the most recent nuclear decay data. Data are shown for effective dose, thyroid, colon and red bone marrow. The results are expected to facilitate regulation of exposure to radiation, relating activities of radionuclides distributed in air and ground to dose of the public due to external radiation as well as the investigation of the radiological effects of major radiation accidents such as the recent one in Fukushima and the decision making of several committees.

Neutron dosimetry in organs of an adult human phantom using linacs with multileaf collimator in radiotherapy treatments

PURPOSE

To calculate absorbed doses due to neutrons in 87 organs/tissues for anthropomorphic phantoms, irradiated in position supine (head first into the gantry) with orientations anteroposterior (AP) and right-left (RLAT) with a 18 MV accelerator. Conversion factors from monitor units to μGy per neutron in organs, equivalent doses in organs/tissues, and effective doses, which permit to quantify stochastic risks, are estimated.

METHODS

MAX06 and FAX06 phantoms were modeled with MCNPX and irradiated with a 18 MV Varian Clinac 2100C/D accelerator whose geometry included a multileaf collimator. Two actual fields of a pelvic treatment were simulated using electron-photon-neutron coupled transport. Absorbed doses due to neutrons were estimated from kerma. Equivalent doses were estimated using the radiation weighting factor corresponding to an average incident neutron energy 0.47 MeV. Statistical uncertainties associated to absorbed doses, as calculated by MCNPX, were also obtained.

RESULTS

Largest doses were absorbed in shallowest (with respect to the neutron pathway) organs. In μGyMU(-1), values of 2.66 (for penis) and 2.33 (for testes) were found in MAX06, and 1.68 (for breasts), 1.05 (for lenses of eyes), and 0.94 (for sublingual salivary glands) in FAX06, in AP orientation. In RLAT, the largest doses were found for bone tissues (leg) just at the entrance of the beam in the body (right side in our case). Values, in μGyMU(-1), of 1.09 in upper leg bone right spongiosa, for MAX06, and 0.63 in mandible spongiosa, for FAX06, were found. Except for gonads, liver, and stomach wall, equivalent doses found for FAX06 were, in both orientations, higher than for MAX06. Equivalent doses in AP are higher than in RLAT for all organs/tissues other than brain and liver. Effective doses of 12.6 and 4.1 μSvMU(-1) were found for AP and RLAT, respectively. The organs/tissues with larger relative contributions to the effective dose were testes and breasts, in AP, and breasts and red marrow, in RLAT. Equivalent and effective doses obtained for MAX06/FAX06 were smaller (between 2 and 20 times) than those quoted for the mathematical phantoms ADAM/EVA in ICRP-74.

CONCLUSIONS

The new calculations of conversion coefficients for neutron irradiation in AP and RLAT irradiation geometries show a reduction in the values of effective dose by factors 7 (AP) and 6 (RLAT) with respect to the old data obtained with mathematical phantoms. The existence of tissues or anatomical regions with maximum absorbed doses, such as penis, lens of eyes, fascia (part of connective tissue), etc., organs/tissues that classic mathematical phantoms did not include because they were not considered for the study of stochastic effects, has been revealed. Absorbed doses due to photons, obtained following the same simulation methodology, are larger than those due to neutrons, reaching values 100 times larger as the primary beam is approached. However, for organs far from the treated volume, absorbed photon doses can be up to three times smaller than neutron ones. Calculations using voxel phantoms permitted to know the organ dose conversion coefficients per MU due to secondary neutrons in the complete anatomy of a patient.

Construction of an extended library of adult male 3D models: rationale and results

In order to best cover the possible extent of heights and weights of male adults the construction of 25 whole body 3D models has been undertaken. Such a library is thought to be useful to specify the uncertainties and relevance of dosimetry calculations carried out with models representing individuals of average body heights and weights. Representative 3D models of Caucasian body types are selected in a commercial database according to their height and weight, and 3D models of the skeleton and internal organs are designed using another commercial dataset. A review of the literature enabled one to fix volume or mass target values for the skeleton, soft organs, skin and fat content of the selected individuals. The composition of the remainder tissue is fixed so that the weight of the voxel models equals the weight of the selected individuals. After mesh and NURBS modelling, volume adjustment of the selected body shapes and additional voxel-based work, 25 voxel models with 109 identified organs or tissue are obtained. Radiation transport calculations are carried out with some of the developed models to illustrate potential uses. The following points are discussed throughout this paper: justification of the fixed or obtained models’ features regarding available and relevant literature data; workflow and strategy for major modelling steps; advantages and drawbacks of the obtained library as compared with other works. The construction hypotheses are explained and justified in detail since future calculation results obtained with this library will depend on them.

Dosimetric feasibility study for an extracorporeal BNCT application on liver metastases at the TRIGA Mainz

This study investigates the dosimetric feasibility of Boron Neutron Capture Therapy (BNCT) of explanted livers in the thermal column of the research reactor in Mainz. The Monte Carlo code MCNP5 is used to calculate the biologically weighted dose for different ratios of the (10)B-concentration in tumour to normal liver tissue. The simulation results show that dosimetric goals are only partially met. To guarantee effective BNCT treatment the organ has to be better shielded from all gamma radiation.

Organ-specific external dose coefficients and protective apron transmission factors for historical dose reconstruction for medical personnel

While radiation absorbed dose (Gy) to the skin or other organs is sometimes estimated for patients from diagnostic radiologic examinations or therapeutic procedures, rarely is occupationally-received radiation absorbed dose to individual organs/tissues estimated for medical personnel; e.g., radiologic technologists or radiologists. Generally, for medical personnel, equivalent or effective radiation doses are estimated for compliance purposes. In the very few cases when organ doses to medical personnel are reconstructed, the data is usually for the purpose of epidemiologic studies; e.g., a study of historical doses and risks to a cohort of about 110,000 radiologic technologists presently underway at the U.S. National Cancer Institute. While ICRP and ICRU have published organ-specific external dose conversion coefficients (DCCs) (i.e., absorbed dose to organs and tissues per unit air kerma and dose equivalent per unit air kerma), those factors have been published primarily for mono-energetic photons at selected energies. This presents two related problems for historical dose reconstruction, both of which are addressed here. It is necessary to derive conversion factor values for (1) continuous distributions of energy typical of diagnostic medical x-rays (bremsstrahlung radiation), and (2) energies of particular radioisotopes used in medical procedures, neither of which are presented in published tables. For derivation of DCCs for bremsstrahlung radiation, combinations of x-ray tube potentials and filtrations were derived for different time periods based on a review of relevant literature. Three peak tube potentials (70 kV, 80 kV, and 90 kV) with four different amounts of beam filtration were determined to be applicable for historic dose reconstruction. The probabilities of these machine settings were assigned to each of the four time periods (earlier than 1949, 1949-1954, 1955-1968, and after 1968). Continuous functions were fit to each set of discrete values of the ICRP/ICRU mono-energetic DCCs and the functions integrated over the air-kerma weighted photon fluence of the 12 defined x-ray spectra. The air kerma-weighted DCCs in this work were developed specifically for an irradiation geometry of anterior to posterior (AP) and for the following tissues: thyroid, breast, ovary, lens of eye, lung, colon, testes, heart, skin (anterior side only), red bone marrow (RBM), and brain. In addition, a series of functional relationships to predict DT Ka-1 values for RBM dependent on body mass index [BMI (kg m-2) ≡ weight per height] and average photon energy were derived from a published analysis. Factors to account for attenuation of radiation by protective lead aprons were also developed. Because lead protective aprons often worn by radiology personnel not only reduce the intensity of x-ray exposure but also appreciably harden the transmitted fluence of bremsstrahlung x-rays, DCCs were separately calculated for organs possibly protected by lead aprons by considering three cases: no apron, 0.25 mm Pb apron, and 0.5 mm Pb apron. For estimation of organ doses from conducting procedures with radioisotopes, continuous functions of the reported mono-energetic values were developed, and DCCs were derived by estimation of the function at relevant energies. By considering the temporal changes in primary exposure-related parameters (e.g., energy distribution), the derived DCCs and transmission factors presented here allow for more realistic historical dose reconstructions for medical personnel when monitoring badge readings are the primary data on which estimation of an individual's organ doses are based.

The feasibility of patient size-corrected, scanner-independent organ dose estimates for abdominal CT exams

PURPOSE

A recent work has demonstrated the feasibility of estimating the dose to individual organs from multidetector CT exams using patient-specific, scanner-independent CTDIvol-to-organ-dose conversion coefficients. However, the previous study only investigated organ dose to a single patient model from a full-body helical CT scan. The purpose of this work was to extend the validity of this dose estimation technique to patients of any size undergoing a common clinical exam. This was done by determining the influence of patient size on organ dose conversion coefficients generated for typical abdominal CT exams.

METHODS

Monte Carlo simulations of abdominal exams were performed using models of 64-slice MDCT scanners from each of the four major manufacturers to obtain dose to radiosensitive organs for eight patient models of varying size, age, and gender. The scanner-specific organ doses were normalized by corresponding CTDIvol values and averaged across scanners to obtain scanner-independent CTDIvol-to-organ-dose conversion coefficients for each patient model. In order to obtain a metric for patient size, the outer perimeter of each patient was measured at the central slice of the abdominal scan region. Then, the relationship between CTDIvol-to-organ-dose conversion coefficients and patient perimeter was investigated for organs that were directly irradiated by the abdominal scan. These included organs that were either completely ("fully irradiated") or partly ("partially irradiated") contained within the abdominal exam region. Finally, dose to organs that were not at all contained within the scan region ("nonirradiated") were compared to the doses delivered to fully irradiated organs.

RESULTS

CTDIvol-to-organ-dose conversion coefficients for fully irradiated abdominal organs had a strong exponential correlation with patient perimeter. Conversely, partially irradiated organs did not have a strong dependence on patient perimeter. In almost all cases, the doses delivered to nonirradiated organs were less than 5%, on average across patient models, of the mean dose of the fully irradiated organs.

CONCLUSIONS

This work demonstrates the feasibility of calculating patient-specific, scanner-independent CTDIvol-to-organ-dose conversion coefficients for fully irradiated organs in patients undergoing typical abdominal CT exams. A method to calculate patient-specific, scanner-specific, and exam-specific organ dose estimates that requires only knowledge of the CTDIvol for the scan protocol and the patient's perimeter is thus possible. This method will have to be extended in future studies to include organs that are partially irradiated. Finally, it was shown that, in most cases, the doses to nonirradiated organs were small compared to the dose to fully irradiated organs.

Dose conversion coefficients for CT examinations of adults with automatic tube current modulation

Automatic tube current modulation (TCM) is used in modern CT devices. This is implemented in the numerical calculation of dose conversion coefficients for CT examinations. For four models of adults, the female and male reference models of ICRP and ICRU and a lighter and a heavier female model, dose conversion coefficients normalized to CTDI(vol) (DCC(CT)) have been computed with a Monte Carlo transport code for CT scans with and without TCM. It could be shown for both cases that reliable values for spiral CT scans are obtained when combining the results from an appropriate set of axial scans. The largest organ DCC(CT) are presented for typical CT examinations for all four models. The impact of TCM is greatest for chest, pelvis and whole-trunk CT examinations, where with TCM the effective DCC(CT) can be 20-25% lower than without TCM. Typical organs with strong dependence on TCM are thyroid, urinary bladder, lungs and oesophagus. While the DCC(CT) of thyroid and urinary bladder are mainly sensitive to angular TCM, the DCC(CT) of lungs and oesophagus are influenced primarily by longitudinal TCM. The impact of the body stature on the effective DCC(CT) is of the same order as the effect of TCM. Thus, for CT scans in the trunk region, accurate dose values can only be obtained when different sets of DCC(CT) are employed that are appropriate for the patient's sex and stature and the actual TCM settings.

Statistical construction of a Japanese male liver phantom for internal radionuclide dosimetry

A computational framework is presented, based on statistical shape modelling, for construction of race-specific organ models for internal radionuclide dosimetry and other nuclear-medicine applications. This approach was applied to the construction of a Japanese liver phantom, using the liver of the digital Zubal phantom as the template and 35 liver computed tomography (CT) scans of male Japanese individuals as a training set. The first step was the automated object-space registration (to align all the liver surfaces in one orientation), using a coherent-point-drift maximum-likelihood alignment algorithm, of each CT scan-derived manually contoured liver surface and the template Zubal liver phantom. Six landmark points, corresponding to the intersection of the contours of the maximum-area sagittal, transaxial and coronal liver sections were employed to perform the above task. To find correspondence points in livers (i.e. 2000 points for each liver), each liver surface was transformed into a mesh, was mapped for the parameter space of a sphere (parameterisation), yielding spherical harmonics (SPHARMs) shape descriptors. The resulting spherical transforms were then registered by minimising the root-mean-square distance among the SPHARMs coefficients. A mean shape (i.e. liver) and its dispersion (i.e. covariance matrix) were next calculated and analysed by principal components. Leave-one-out-tests using 5-35 principal components (or modes) demonstrated the fidelity of the foregoing statistical analysis. Finally, a voxelisation algorithm and a point-based registration is utilised to convert the SPHARM surfaces into its corresponding voxelised and adjusted the Zubal phantom data, respectively. The proposed technique used to create the race-specific statistical phantom maintains anatomic realism and provides the statistical parameters for application to radionuclide dosimetry.

The feasibility of a scanner-independent technique to estimate organ dose from MDCT scans: using CTDIvol to account for differences between scanners

PURPOSE

Monte Carlo radiation transport techniques have made it possible to accurately estimate the radiation dose to radiosensitive organs in patient models from scans performed with modern multidetector row computed tomography (MDCT) scanners. However, there is considerable variation in organ doses across scanners, even when similar acquisition conditions are used. The purpose of this study was to investigate the feasibility of a technique to estimate organ doses that would be scanner independent. This was accomplished by assessing the ability of CTDIvol measurements to account for differences in MDCT scanners that lead to organ dose differences.

METHODS

Monte Carlo simulations of 64-slice MDCT scanners from each of the four major manufacturers were performed. An adult female patient model from the GSF family of voxelized phantoms was used in which all ICRP Publication 103 radiosensitive organs were identified. A 120 kVp, full-body helical scan with a pitch of 1 was simulated for each scanner using similar scan protocols across scanners. From each simulated scan, the radiation dose to each organ was obtained on a per mA s basis (mGy/mA s). In addition, CTDIvol values were obtained from each scanner for the selected scan parameters. Then, to demonstrate the feasibility of generating organ dose estimates from scanner-independent coefficients, the simulated organ dose values resulting from each scanner were normalized by the CTDIvol value for those acquisition conditions.

RESULTS

CTDIvol values across scanners showed considerable variation as the coefficient of variation (CoV) across scanners was 34.1%. The simulated patient scans also demonstrated considerable differences in organ dose values, which varied by up to a factor of approximately 2 between some of the scanners. The CoV across scanners for the simulated organ doses ranged from 26.7% (for the adrenals) to 37.7% (for the thyroid), with a mean CoV of 31.5% across all organs. However, when organ doses are normalized by CTDIvoI values, the differences across scanners become very small. For the CTDIvol, normalized dose values the CoVs across scanners for different organs ranged from a minimum of 2.4% (for skin tissue) to a maximum of 8.5% (for the adrenals) with a mean of 5.2%.

CONCLUSIONS

This work has revealed that there is considerable variation among modern MDCT scanners in both CTDIvol and organ dose values. Because these variations are similar, CTDIvol can be used as a normalization factor with excellent results. This demonstrates the feasibility of establishing scanner-independent organ dose estimates by using CTDIvol to account for the differences between scanners.

FASH and MASH: female and male adult human phantoms based on polygon mesh surfaces: I. Development of the anatomy

Among computational models, voxel phantoms based on computer tomographic (CT), nuclear magnetic resonance (NMR) or colour photographic images of patients, volunteers or cadavers have become popular in recent years. Although being true to nature representations of scanned individuals, voxel phantoms have limitations, especially when walled organs have to be segmented or when volumes of organs or body tissues, like adipose, have to be changed. Additionally, the scanning of patients or volunteers is usually made in supine position, which causes a shift of internal organs towards the ribcage, a compression of the lungs and a reduction of the sagittal diameter especially in the abdominal region compared to the regular anatomy of a person in the upright position, which in turn can influence organ and tissue absorbed or equivalent dose estimates. This study applies tools developed recently in the areas of computer graphics and animated films to the creation and modelling of 3D human organs, tissues, skeletons and bodies based on polygon mesh surfaces. Female and male adult human phantoms, called FASH (Female Adult meSH) and MASH (Male Adult meSH), have been designed using software, such as MakeHuman, Blender, Binvox and ImageJ, based on anatomical atlases, observing at the same time organ masses recommended by the International Commission on Radiological Protection for the male and female reference adult in report no 89. 113 organs, bones and tissues have been modelled in the FASH and the MASH phantoms representing locations for adults in standing posture. Most organ and tissue masses of the voxelized versions agree with corresponding data from ICRP89 within a margin of 2.6%. Comparison with the mesh-based male RPI_AM and female RPI_AF phantoms shows differences with respect to the material used, to the software and concepts applied, and to the anatomies created.

Tools for creating and manipulating voxel phantoms

The National Internal Radiation Assessment Section's Human Monitoring Laboratory (HML) has purchased and developed a number of in-house tools to create and edit voxel phantoms. This paper describes the methodology developed in the HML using those tools to prepare input files for Monte Carlo simulations using voxel phantoms. Three examples are given. The in-house tools described in this paper, and the phantoms that have been created using them, are all publically available upon request from the corresponding author.

Extension of the NCAT phantom for the investigation of intra-fraction respiratory motion in IMRT using 4D Monte Carlo

The purpose of this work was to create a computational platform for studying motion in intensity modulated radiotherapy (IMRT). Specifically, the non-uniform rational B-spline (NURB) cardiac and torso (NCAT) phantom was modified for use in a four-dimensional Monte Carlo (4D-MC) simulation system to investigate the effect of respiratory-induced intra-fraction organ motion on IMRT dose distributions as a function of diaphragm motion, lesion size and lung density. Treatment plans for four clinical scenarios were designed: diaphragm peak-to-peak amplitude of 1 cm and 3 cm, and two lesion sizes--2 cm and 4 cm diameter placed in the lower lobe of the right lung. Lung density was changed for each phase using a conservation of mass calculation. Further, a new heterogeneous lung model was implemented and tested. Each lesion had an internal target volume (ITV) subsequently expanded by 15 mm isotropically to give the planning target volume (PTV). The PTV was prescribed to receive 72 Gy in 40 fractions. The MLC leaf sequence defined by the planning system for each patient was exported and used as input into the MC system. MC simulations using the dose planning method (DPM) code together with deformable image registration based on the NCAT deformation field were used to find a composite dose distribution for each phantom. These composite distributions were subsequently analyzed using information from the dose volume histograms (DVH). Lesion motion amplitude has the largest effect on the dose distribution. Tumor size was found to have a smaller effect and can be mitigated by ensuring the planning constraints are optimized for the tumor size. The use of a dynamic or heterogeneous lung density model over a respiratory cycle does not appear to be an important factor with a <or=0.6% change in the mean dose received by the ITV, PTV and right lung. The heterogeneous model increases the realism of the NCAT phantom and may provide more accurate simulations in radiation therapy investigations that use the phantom. This work further evaluates the NCAT phantom for use as a tool in radiation therapy research in addition to its extensive use in diagnostic imaging and nuclear medicine research. Our results indicate that the NCAT phantom, combined with 4D-MC simulations, is a useful tool in radiation therapy investigations and may allow the study of relative effects in many clinically relevant situations.

Doses and risks from tritiated water and environmental organically bound tritium

This short review provides an explanation of the calculation and use of the ICRP protection quantities, equivalent and effective dose, including the simplifications introduced by using radiation and tissue weighting factors. It discusses the dose coefficients (Sv Bq(-1) intake) provided by ICRP for intakes of tritiated water (HTO) and organically bound tritium (OBT) and considers uncertainties in the human and animal data on which they are based, including information on the relative biological effectiveness (RBE) of tritium beta particles compared to gamma and x-rays. The review also addresses the specific issue of dose coefficients for ingestion of OBT in Cardiff Bay fish. A distinction is drawn between the adequacy of the ICRP calculation of effective dose to a reference person for the purposes of planning and regulatory control, and the calculation of best estimates of dose and risk to individuals. ICRP will continue to use a radiation weighting factor of 1 for all low LET radiations in the calculation of effective dose, but specific RBE data should be used in risk estimates. Uncertainties in dose coefficients are small for HTO but greater for OBT. The generic consideration of OBT provided by ICRP may not be appropriate for specific organic forms such as OBT in fish.

Organ dose conversion coefficients for external photon irradiation using the Chinese voxel phantom (CVP)

A set of conversion coefficients from kerma free-in-air to the organ absorbed dose are presented for external monoenergetic photon beams from 10 keV to 10 MeV based on a whole-body, Chinese adult male voxel phantom. This computational phantom, called the Chinese voxel phantom (CVP), including totally 23 organs, was developed from magnetic resonance imaging of a young healthy Chinese man at a resolution of 2 x 2 mm. Compared with the ICRP Reference Man, more than half of the organs or tissues in the CVP show mass differences of more than 20. Monte Carlo simulations with MCNP code were carried out to calculate the organ dose conversion coefficients. Irradiation conditions include anterior-posterior, posterior-anterior (PA), right-lateral, left-lateral, rotational and isotropic geometries. Organ dose conversion coefficients from this study are compared with the data from the Asian voxel phantoms Visible Chinese Human and KORMAN. These data sets agree with each other within 10% for photon energy >5 MeV. However, discrepancies of 34-63% were observed for organs of the alimentary tract, such as the oesophagus and stomach, those of the urinary system, such as the bladder wall and thyroid, especially at low photon energy range and PA geometry. These results suggest that the anatomical variation within the Chinese population, as represented by these adult male voxel phantoms, can lead to uncertainties when a standard phantom is used for the entire population.

Biokinetic and dosimetric modelling in the estimation of radiation risks from internal emitters

The International Commission on Radiological Protection (ICRP) has developed biokinetic and dosimetric models that enable the calculation of organ and tissue doses for a wide range of radionuclides. These are used to calculate equivalent and effective dose coefficients (dose in Sv Bq(-1) intake), considering occupational and environmental exposures. Dose coefficients have also been given for a range of radiopharmaceuticals used in diagnostic medicine. Using equivalent and effective dose, exposures from external sources and from different radionuclides can be summed for comparison with dose limits, constraints and reference levels that relate to risks from whole-body radiation exposure. Risk estimates are derived largely from follow-up studies of the survivors of the atomic bombings at Hiroshima and Nagasaki in 1945. New dose coefficients will be required following the publication in 2007 of new ICRP recommendations. ICRP biokinetic and dosimetric models are subject to continuing review and improvement, although it is arguable that the degree of sophistication of some of the most recent models is greater than required for the calculation of effective dose to a reference person for the purposes of regulatory control. However, the models are also used in the calculation of best estimates of doses and risks to individuals, in epidemiological studies and to determine probability of cancer causation. Models are then adjusted to best fit the characteristics of the individuals and population under consideration. For example, doses resulting from massive discharges of strontium-90 and other radionuclides to the Techa River from the Russian Mayak plutonium plant in the early years of its operation are being estimated using models adapted to take account of measurements on local residents and other population-specific data. Best estimates of doses to haemopoietic bone marrow, in utero and postnatally, are being used in epidemiological studies of radiation-induced leukaemia. Radon-222 is the one internal emitter for which control of exposure is based on direct information on cancer risks, with extensive information available on lung cancer induction by radon progeny in mines and consistent data on risks in homes. The dose per unit (222)Rn exposure can be calculated by comparing lung cancer risk estimates derived for (222)Rn exposure and for external exposure of the Japanese survivors. Remarkably similar values are obtained by this method and by calculations using the ICRP model of the respiratory tract, providing good support for model assumptions. Other informative comparisons with risks from external exposure can be made for Thorotrast-induced liver cancer and leukaemia, and radium-induced bone cancer. The bone-seeking alpha emitters, plutonium-239 and radium isotopes, are poorer leukaemogens than predicted by models. ICRP dose coefficients are published as single values without consideration of uncertainties. However, it is clear that full consideration of uncertainties is appropriate when considering best estimates of doses and risks to individuals or specific population groups. An understanding of the component uncertainties in the calculation of dose coefficients can be seen as an important goal and should help inform judgements on the control of exposures. The routine consideration of uncertainties in dose assessments, if achievable, would be of questionable value when doses are generally maintained at small fractions of limits.

A study of predicted bone marrow distribution on calculated marrow dose from external radiation exposures using two sets of image data for the same individual

Red bone marrow is among the tissues of the human body that are most sensitive to ionizing radiation, but red bone marrow cannot be distinguished from yellow bone marrow by normal radiographic means. When using a computational model of the body constructed from computed tomography (CT) images for radiation dose, assumptions must be applied to calculate the dose to the red bone marrow. This paper presents an analysis of two methods of calculating red bone marrow distribution: 1) a homogeneous mixture of red and yellow bone marrow throughout the skeleton, and 2) International Commission on Radiological Protection cellularity factors applied to each bone segment. A computational dose model was constructed from the CT image set of the Visible Human Project and compared to the VIP-Man model, which was derived from color photographs of the same individual. These two data sets for the same individual provide the unique opportunity to compare the methods applied to the CT-based model against the observed distribution of red bone marrow for that individual. The mass of red bone marrow in each bone segment was calculated using both methods. The effect of the different red bone marrow distributions was analyzed by calculating the red bone marrow dose using the EGS4 Monte Carlo code for parallel beams of monoenergetic photons over an energy range of 30 keV to 6 MeV, cylindrical (simplified CT) sources centered about the head and abdomen over an energy range of 30 keV to 1 MeV, and a whole-body electron irradiation treatment protocol for 3.9 MeV electrons. Applying the method with cellularity factors improves the average difference in the estimation of mass in each bone segment as compared to the mass in VIP-Man by 45% over the homogenous mixture method. Red bone marrow doses calculated by the two methods are similar for parallel photon beams at high energy (above about 200 keV), but differ by as much as 40% at lower energies. The calculated red bone marrow doses differ significantly for simplified CT and electron beam irradiation, since the computed red bone marrow dose is a strong function of the cellularity factor applied to bone segments within the primary radiation beam. These results demonstrate the importance of properly applying realistic cellularity factors to computation dose models of the human body.

Estimation of patients' organ doses and conceptus doses from selected X-ray examinations in two Nigeria X-ray centres

In this study, organ and conceptus doses of patients undergoing chest, abdomen and skull radiograph examinations at two Nigeria X-ray centres, Niger State General Hospital (NGH) and Two-Tees (TTX), are reported. Air kerma was measured, and entrance surface dose (ESD) and half-value layer estimated for each set of tube potential (kV(p)), focus to skin distance and current-time product (mAs) used for each of the patients included in this study. Results show that the mean air kerma in the two centres are similar for the three projections considered in this study. Organ doses ranged from <0.01 to 2.18 mGy in NGH and from <0.01 to 1.29 mGy in TTX for examinations of the abdomen, from <0.01 to 0.20 mGy in NGH and from <0.01 to 0.13 mGy in TTX for examinations of the skull and from <0.01 to 3.90 mGy in NGH and from <0.01 to 1.96 mGy in TTX for examinations of the chest. Generally, no significant difference is seen between the organ doses of male and female patients. In NGH, organ doses are generally greater than those from TTX for the three examinations. The mean ESDs for examinations of the chest postero-anterior, abdomen antero-posterior (AP) and skull AP are, respectively, 5.37, 6.28 and 4.24 mGy in NGH, and 5.82, 5.33 and 4.76 mGy in TTX. The ESDs reported in this study, except for examinations of the chest, are generally lower than comparable values published in the literature. Conceptus doses were also estimated for female patients using normalised published conceptus dose data for abdomen examinations. The estimated conceptus doses were >1 mGy even when the conceptus was located 12 cm below the surface of the abdomen.

Diversification of existing reference phantoms in nuclear medicine: Calculation of specific absorbed fractions for 21 mathematical phantoms and validation through dose estimates resulting from the administration of (18)F-FDG

Current dose assessment in nuclear medicine patient studies relies on published S-values, which are, in turn, based on calculated specific absorbed fractions (SAFs) available for a limited number of anthro-pomorphic computational phantoms. In order to take the individual physiognomy of patients more into account, this study aimed to broaden the supply of phantoms and their respective SAFs. An ensemble of 21 mathematical phantoms was submitted to the Monte Carlo Code MCNP4c2 for the purpose of calculation of SAFs for annihilation radiation. These values were incorporated into an internal dose assessment following the Medical Internal Radiation Dose (MIRD) schema and relying on published biokinetic data for intravenous administration of (18)F-FDG. The results were compared with data from the ICRP, MIRD reports and concurrent calculations with OLINDA/EXM. A very good agreement with sources relying on the SAFs of Cristy and Eckerman (i.e., the ICRP and OLINDA/EXM) was observed, with the absorbed dose in lung being the only exception. In the case of dose to red marrow, the King Spiers factors were omitted in the three-factor approximation, which led to a precise accordance with the Cristy/Eckerman values. Summarizing, one can say that the coincidence with published data justifies the method chosen and demonstrates successfully the expansion of available reference phantoms for dose assessment in nuclear medicine.

Radiation doses and risks from internal emitters

This review updates material prepared for the UK Government Committee Examining Radiation Risks from Internal Emitters (CERRIE) and also refers to the new recommendations of the International Commission on Radiological Protection (ICRP) and other recent developments. Two conclusions from CERRIE were that ICRP should clarify and elaborate its advice on the use of its dose quantities, equivalent and effective dose, and that more attention should be paid to uncertainties in dose and risk estimates and their implications. The new ICRP recommendations provide explanations of the calculation and intended purpose of the protection quantities, but further advice on their use would be helpful. The new recommendations refer to the importance of understanding uncertainties in estimates of dose and risk, although methods for doing this are not suggested. Dose coefficients (Sv per Bq intake) for the inhalation or ingestion of radionuclides are published as reference values without uncertainty. The primary purpose of equivalent and effective dose is to enable the summation of doses from different radionuclides and from external sources for comparison with dose limits, constraints and reference levels that relate to stochastic risks of whole-body radiation exposure. Doses are calculated using defined biokinetic and dosimetric models, including reference anatomical data for the organs and tissues of the human body. Radiation weighting factors are used to adjust for the different effectiveness of different radiation types, per unit absorbed dose (Gy), in causing stochastic effects at low doses and dose rates. Tissue weighting factors are used to take account of the contribution of individual organs and tissues to overall detriment from cancer and hereditary effects, providing a simple set of rounded values chosen on the basis of age- and sex-averaged values of relative detriment. While the definition of absorbed dose has the scientific rigour required of a basic physical quantity, the same is not true of the ICRP protection quantities equivalent and effective dose (i.e. those measured in sieverts). The ICRP quantities are intended for practical application in radiological protection and the choice of radiation and tissue weighting factors used in their calculation involves simplifying assumptions regarded as acceptable for this purpose. Best estimates of doses and risks to individuals and specific population groups may be calculated using ICRP biokinetic and dosimetric approaches, but would require the use of best available information on RBE and age-, sex- and population-specific risk factors. Consideration of uncertainties is important in applications such as the assessment of the probability of cancer causation for an individual and in estimating doses in epidemiological studies. While the ICRP system of protection does not take explicit account of uncertainties, an understanding of the various contributions to uncertainty can be seen to be of value when making judgments on the optimisation of protection.

The NORMAN phantom vs. the BOMAB phantom: are they different?

This paper describes the implementation of the NORMAN phantom with the Human Monitoring Laboratory's Monte Carlo simulator, the problems that were encountered, and their solution. The NORMAN phantom has been compared with the reference man BOMAB phantom in three different whole body counting geometries: a scanning detector system (WBC1), and two stand-up whole body counters (WBC2, WBC3) that have different reference points for their counting geometry. The average agreement (taken over all energies) of the two phantoms is approximately a factor of 1.15 on any given counting system. For the first two systems (WBC1, WBC2) the BOMAB has the highest counting efficiency, whereas it is reversed on the third system (WBC3). Considering the differences between the two phantoms, the agreement is good.

The LLNL voxel phantom: comparison with the physical phantom and previous virtual phantoms

The Human Monitoring Laboratory has created a voxel phantom from computer tomography scans of the Lawrence Livermore National Laboratory (LLNL) torso phantom for use in Monte Carlo simulations. The voxel phantom has been compared to the previously developed mathematical phantom using Monte Carlo simulations and both virtual phantoms have been compared to physical measurement of the LLNL phantom. The voxel phantom agreed well with the others, except at very low photon energies (i.e., 17.5 keV), with predicted counting efficiencies being within 2% of the counting efficiencies from the other two phantoms at 59.5 keV and above. The mathematical phantom performs similarly to the voxel phantom, but much faster, so it is an excellent alternative if computer power is lacking. The voxel phantom of the LLNL phantom is available from the authors, on request.

Computational Anthropomorphic Models of the Human Anatomy: The Path to Realistic Monte Carlo Modeling in Radiological Sciences

The widespread availability of high-performance computing and popularity of simulations stimulated the development of computational anthropomorphic models of the human anatomy for medical imaging modalities and dosimetry calculations. The widespread interest in molecular imaging spurred the development of more realistic three- to five-dimensional computational models based on the actual anatomy and physiology of individual humans and small animals. These can be defined by either mathematical (analytical) functions or digital (voxel-based) volume arrays (or a combination of both), thus allowing the simulation of medical imaging data that are ever closer to actual patient data. The paradigm shift away from the stylized human models is imminent with the development of more than 30 voxel-based tomographic models in recent years based on anatomical medical images. We review the fundamental and technical challenges of designing computational models of the human anatomy, and focus particularly on the latest developments and future directions of their application in the simulation of radiological imaging systems and dosimetry calculations.

Hybrid computational phantoms of the male and female newborn patient: NURBS-based whole-body models

Anthropomorphic computational phantoms are computer models of the human body for use in the evaluation of dose distributions resulting from either internal or external radiation sources. Currently, two classes of computational phantoms have been developed and widely utilized for organ dose assessment: (1) stylized phantoms and (2) voxel phantoms which describe the human anatomy via mathematical surface equations or 3D voxel matrices, respectively. Although stylized phantoms based on mathematical equations can be very flexible in regard to making changes in organ position and geometrical shape, they are limited in their ability to fully capture the anatomic complexities of human internal anatomy. In turn, voxel phantoms have been developed through image-based segmentation and correspondingly provide much better anatomical realism in comparison to simpler stylized phantoms. However, they themselves are limited in defining organs presented in low contrast within either magnetic resonance or computed tomography images-the two major sources in voxel phantom construction. By definition, voxel phantoms are typically constructed via segmentation of transaxial images, and thus while fine anatomic features are seen in this viewing plane, slice-to-slice discontinuities become apparent in viewing the anatomy of voxel phantoms in the sagittal or coronal planes. This study introduces the concept of a hybrid computational newborn phantom that takes full advantage of the best features of both its stylized and voxel counterparts: flexibility in phantom alterations and anatomic realism. Non-uniform rational B-spline (NURBS) surfaces, a mathematical modeling tool traditionally applied to graphical animation studies, was adopted to replace the limited mathematical surface equations of stylized phantoms. A previously developed whole-body voxel phantom of the newborn female was utilized as a realistic anatomical framework for hybrid phantom construction. The construction of a hybrid phantom is performed in three steps: polygonization of the voxel phantom, organ modeling via NURBS surfaces and phantom voxelization. Two 3D graphic tools, 3D-DOCTOR and Rhinoceros, were utilized to polygonize the newborn voxel phantom and generate NURBS surfaces, while an in-house MATLAB code was used to voxelize the resulting NURBS model into a final computational phantom ready for use in Monte Carlo radiation transport calculations. A total of 126 anatomical organ and tissue models, including 38 skeletal sites and 31 cartilage sites, were described within the hybrid phantom using either NURBS or polygon surfaces. A male hybrid newborn phantom was constructed following the development of the female phantom through the replacement of female-specific organs with male-specific organs. The outer body contour and internal anatomy of the NURBS-based phantoms were adjusted to match anthropometric and reference newborn data reported by the International Commission on Radiological Protection in their Publication 89. The voxelization process was designed to accurately convert NURBS models to a voxel phantom with minimum volumetric change. A sensitivity study was additionally performed to better understand how the meshing tolerance and voxel resolution would affect volumetric changes between the hybrid-NURBS and hybrid-voxel phantoms. The male and female hybrid-NURBS phantoms were constructed in a manner so that all internal organs approached their ICRP reference masses to within 1%, with the exception of the skin (-6.5% relative error) and brain (-15.4% relative error). Both hybrid-voxel phantoms were constructed with an isotropic voxel resolution of 0.663 mm--equivalent to the ICRP 89 reference thickness of the newborn skin (dermis and epidermis). Hybrid-NURBS phantoms used to create their voxel counterpart retain the non-uniform scalability of stylized phantoms, while maintaining the anatomic realism of segmented voxel phantoms with respect to organ shape, depth and inter-organ positioning.

Treating voxel geometries in radiation protection dosimetry with a patched version of the Monte Carlo codes MCNP and MCNPX

The question of Monte Carlo simulation of radiation transport in voxel geometries is addressed. Patched versions of the MCNP and MCNPX codes are developed aimed at transporting radiation both in the standard geometry mode and in the voxel geometry treatment. The patched code reads an unformatted FORTRAN file derived from DICOM format data and uses special subroutines to handle voxel-to-voxel radiation transport. The various phases of the development of the methodology are discussed together with the new input options. Examples are given of employment of the code in internal and external dosimetry and comparisons with results from other groups are reported.

Japanese adult male voxel phantom constructed on the basis of CT images

A Japanese adult male voxel (volume pixel) phantom (hereinafter referred to as the JM phantom) was constructed on the basis of CT images of a healthy Japanese adult male volunteer. Body characteristics of the JM phantom were compared with those of a voxelised MIRD5 type phantom and a Japanese adult male voxel phantom which was previously developed. The voxel size of the JM phantom is 0.98 x 0.98 x 1 mm(3). The shapes of the organs of the JM phantom, even for small or complicated organs, such as thyroid and stomach, are more realistically reproduced as compared with the previous Japanese voxel phantom (voxel size: 0.98 x 0.98 x 10 mm(3)). Photon self-absorbed fractions (self-AFs) for brain, kidneys, spleen, pancreas, thyroid and urinary bladder wall of JM were evaluated and were compared with those of the other phantoms. In consequence, it was suggested that the mass, shape and thickness of organs are important factors for the determination of self-AFs.

Age-dependent organ and effective dose coefficients for external photons: a comparison of stylized and voxel-based paediatric phantoms

This present study investigates the anatomical realism of conventional stylized models of children by comparing organ dose conversion coefficients for the ORNL paediatric phantom series with those determined in the UF (University of Florida) voxel paediatric phantoms. The latter includes whole-body models of a 9 month male, 4 year female, 8 year female, 11 year male and a 14 year male. Of these phantoms, the 1 year, 5 year and 10 year ORNL phantoms, and 9 month male, 4 year female and 11 year male UF voxel phantoms were selected for side-by-side comparisons under idealized external photon irradiation. Organ absorbed dose per unit air kerma (Gy/Gy) for various radiosensitive organs and tissues were calculated for monoenergetic photons over the energy range of 15 keV to 10 MeV and for six irradiation geometries: anterior-posterior (AP), posterior-anterior (PA), right lateral (RLAT), left lateral (LLAT), rotational (ROT) and isotropic (ISO). Differences in organ dose conversion coefficients for the gonads, bone marrow, colon, lung and stomach, to which prominent tissue weighting factors are assigned, were depicted and analysed. Two major causes of observed differences were suggested: differences in organ shape and position and the differences in tissue shielding by overlying tissue regions within the phantoms. Significant discrepancies caused by anatomical differences between the two types of phantoms are also reported for several organs, and in particular, the thyroid and urinary bladder. The results of this study suggest that the paediatric series of ORNL phantoms also have less realistic internal organ and body anatomy and that dose conversion coefficients from these stylized phantoms should be re-evaluated using paediatric voxel phantoms.

Development of pregnant female, hybrid voxel-mathematical models and their application to the dosimetry of applied magnetic and electric fields at 50 Hz

This paper describes the development of 2 mm resolution hybrid voxel-mathematical models of the pregnant female. Mathematical models of the developing foetus at 8-, 13-, 26- and 38-weeks of gestation were converted into voxels and combined with the adult female model, NAOMI. This set of models was used to calculate induced current densities and electric fields in the foetus from applied 50 Hz magnetic and electric fields. The influence of foetal tissue conductivities was investigated and implications for electromagnetic field guidelines discussed.

Development of the two Korean adult tomographic computational phantoms for organ dosimetry

Following the previously developed Korean tomographic phantom, KORMAN, two additional whole-body tomographic phantoms of Korean adult males were developed from magnetic resonance (MR) and computed tomography (CT) images, respectively. Two healthy male volunteers, whose body dimensions were fairly representative of the average Korean adult male, were recruited and scanned for phantom development. Contiguous whole body MR images were obtained from one subject exclusive of the arms, while whole-body CT images were acquired from the second individual. A total of 29 organs and tissues and 19 skeletal sites were segmented via image manipulation techniques such as gray-level thresholding, region growing, and manual drawing, in which each of segmented image slice was subsequently reviewed by an experienced radiologist for anatomical accuracy. The resulting phantoms, the MR-based KTMAN-1 (Korean Typical MAN-1) and the CT-based KTMAN-2 (Korean Typical MAN-2), consist of 300 X 150 X 344 voxels with a voxel resolution of 2 X 2 X 5 mm3 for both phantoms. Masses of segmented organs and tissues were calculated as the product of a nominal reference density, the prevoxel volume, and the cumulative number of voxels defining each organs or tissue. These organs masses were then compared with those of both the Asian and the ICRP reference adult male. Organ masses within both KTMAN-1 and KTMAN-2 showed differences within 40% of Asian and ICRP reference values, with the exception of the skin, gall bladder, and pancreas which displayed larger differences. The resulting three-dimensional binary file was ported to the Monte Carlo code MCNPX2.4 to calculate organ doses following external irradiation for illustrative purposes. Colon, lung, liver, and stomach absorbed doses, as well as the effective dose, for idealized photon irradiation geometries (anterior-posterior and right lateral) were determined, and then compared with data from two other tomographic phantoms (Asian and Caucasian), and stylized ORNL phantom. The armless KTMAN-1 can be applied to dosimetry for computed tomography or lateral x-ray examination, while the whole body KTMAN-2 can be used for radiation protection dosimetry.

Development of a Korean adult male computational phantom for internal dosimetry calculation

A Korean adult male computational phantom was constructed based on the current anthropometric and organ volume data of Korean average adult male, and was applied to calculate internal photon dosimetry data. The stylised models of external body, skeleton, and a total of 13 internal organs (brain, gall bladder, heart, kidneys, liver, lungs, pancreas, spleen, stomach, testes, thymus, thyroid and urinary bladder) were redesigned based on the Oak Ridge National Laboratory (ORNL) adult phantom. The height of trunk of the Korean phantom was 8.6% less than that of the ORNL adult phantom, and the volumes of all organs decreased up to 65% (pancreas) except for brain, gall bladder wall and thymus. Specific absorbed fraction (SAF) was calculated using the Korean phantom and Monte Carlo code, and compared with those from the ORNL adult phantom. The SAF of organs in the Korean phantom was overall higher than that from the ORNL adult phantom. This was caused by the smaller organ volume and the shorter inter-organ distance in the Korean phantom. The self SAF was dominantly affected by the difference in organ volume, and the SAF for different source and target organs was more affected by the inter-organ distance than by the organ volume difference. The SAFs of the Korean stylised phantom differ from those of the ORNL phantom by 10-180%. The comparison study of internal dosimetry will be extended to tomographic phantom and electron source in the future.

Parameters affecting EPR dose reconstruction in teeth

The aim of this paper is to analyze the lower limit of detection (LLD), linearity of dose response, variation of radiation sensitivity between different tooth enamel samples, and time/temperature stability of EPR biodosimetry in tooth enamel. The theoretical LLD is shown to be 0.46 mGy, which is far lower than the measured value of about 30 mGy. The main issues to lowering LLD are the differentiation of the radiation-induced component against the total EPR spectrum and the complex nature of the dose dependence of the EPR signal. The following questions are also discussed in detail: need for exfoliated or extracted teeth from persons of interest, accounting for background radiation contribution; conversion of tooth enamel absorbed dose to effective dose; accounting for internal exposure specifically from bone-seeking radionuclides. Conclusions on future development of EPR retrospective biodosimetry are made.

Development of the female voxel phantom, NAOMI, and its application to calculations of induced current densities and electric fields from applied low frequency magnetic and electric fields

This paper outlines the development of a 2 mm resolution voxel model, NAOMI (aNAtOMIcal model), designed to be representative of the average adult female. The primary medical imaging data were derived from a high-resolution MRI scan of a 1.65 m tall, 23 year old female subject with a mass of 58 kg. The model was rescaled to a height of 1.63 m and a mass of 60 kg, the dimensions of the International Commission on Radiological Protection reference adult female. There are 41 tissue types in the model. The application of NAOMI to the calculations of induced current densities and electric fields from applied low frequency magnetic and electric fields is described. Comparisons are made with values from the male voxel model, NORMAN. The calculations were extended from 50 Hz up to 10 MHz. External field reference levels are compared with the ICNIRP guidelines.