Tissue-equivalent materials for construction of tomographic dosimetry phantoms in pediatric radiology

Photon Interaction Coefficients for the Colorectal Cancer Tissue

Purpose

The application of radiotherapy to the treatment of cancer requires the knowledge of photon interaction coefficients such as mass attenuation (μm) and mass energy-absorption coefficients (μen/ρ). Although these coefficients have been determined for different tissues, it is lacking for the colorectal cancer (CRC) tissue in the literature. This study determines the μm and μen/ρ for the CRC tissue within the radiotherapy energy range.

Materials and Methods

The CRC tissue from autopsy patients was freeze-dried, grounded into a fine powder, and made into pellets of 1 cm thickness. The elements detected in the CRC tissue using Rutherford backscattering spectrometry were used in XCOM to determine the theoretical values of μm and μen/ρ. The CRC tissue was again exposed to X-rays of energies of 6 and 15MV, respectively, to determine its experimental values of μm and μen/ρ.

Results

Elements detected included carbon, oxygen and nitrogen making up 96.67%, high atomic number and trace elements making up the remaining 3.33% fraction of the CRC tissue.

Conclusion

The theoretical and experimental μm and μen/ρ values showed a good agreement of about 2% difference between them. These values can be used to simulate the CRC tissue with respect to μm and μen/ρ.

Simple beam hardening correction method (2DCalBH) based on 2D linearization

Objective. The polychromatic nature of the x-ray spectrum in computed tomography leads to two types of artifacts in the reconstructed image: cupping in homogeneous areas and dark bands between dense parts, such as bones. This fact, together with the energy dependence of the mass attenuation coefficients of the tissues, results in erroneous values in the reconstructed image. Many post-processing correction schemes previously proposed require either knowledge of the x-ray spectrum or the heuristic selection of some parameters that have been shown to be suboptimal for correcting different slices in heterogeneous studies. In this study, we propose and validate a method to correct the beam hardening artifacts that avoids such restrictions and restores the quantitative character of the image. Approach. Our approach extends the idea of the water-linearization method. It uses a simple calibration phantom to characterize the attenuation for different soft tissue and bone combinations of the x-ray source polychromatic beam. The correction is based on the bone thickness traversed, obtained from a preliminary reconstruction. We evaluate the proposed method with simulations and real data using a phantom composed of PMMA and aluminum 6082 as materials equivalent to water and bone. Main results. Evaluation with simulated data showed a correction of the artifacts and a recovery of monochromatic values similar to that of the post-processing techniques used for comparison, while it outperformed them on real data. Significance. The proposed method corrects beam hardening artifacts and restores monochromatic attenuation values with no need of spectrum knowledge or heuristic parameter tuning, based on the previous acquisition of a very simple calibration phantom.

Direct measurement of radiation exposure dose to individual organs during diagnostic computed tomography examination

Ionizing radiation from Computed tomography (CT) examinations and the associated health risks are growing concerns. The purpose of this study was to directly measure individual organ doses during routine clinical CT scanning protocols and to evaluate how these measurements vary with scanning conditions. Optically stimulated luminescence (OSL) dosimeters were surgically implanted into individual organs of fresh non-embalmed whole-body cadavers. Whole-body, head, chest, and abdomen CT scans were taken of 6 cadavers by simulating common clinical methods. The dosimeters were extracted and the radiation exposure doses for each organ were calculated. Average values were used for analysis. Measured individual organ doses for whole-body routine CT protocol were less than 20 mGy for all organs. The measured doses of surface/shallow organs were higher than those of deep organs under the same irradiation conditions. At the same tube voltage and tube current, all internal organ doses were significantly higher for whole-body scans compared with abdominal scans. This study could provide valuable information on individual organ doses and their trends under various scanning conditions. These data could be referenced and used when considering CT examination in daily clinical situations.

Optimization of a calibration phantom for quantitative radiography

OBJECTIVE

Dual energy radiography (DER) makes it possible to obtain separate images for soft-tissue and bony structures (tissue maps) based on the acquisition of two radiographs at different source peak-kilovoltage values. Current DER studies are based on the weighted subtraction method, which requires either manual tuning or the use of precomputed tables, or on decomposition methods, which make use of a calibration to model soft-tissue and bone components. In this study, we examined in depth the optimum method to perform this calibration.

METHODS

We used simulations to optimize the calibration protocol and evaluated the effect of the material and size of a calibration phantom composed of two wedges and its positioning in the system. Evaluated materials were water, PMMA and A-150 as soft-tissue equivalent, and Teflon, B-100 and aluminum as bone equivalent, with sizes from 5 to 30 cm. Each material combination was compared with an ideal phantom composed of soft tissue and bone. Our simulation results enabled us to propose four designs that were tested with the NOVA FA X-ray system with a realistic thorax phantom.

RESULTS

Calibration based on a very simple and inexpensive phantom with no strict requirements in its placement results in appropriate separation of the spine (a common focus in densitometry studies) and the identification of nodules as small as 6 mm, which have been reported to have a low rate of detection in radiography.

CONCLUSION

The proposed method is completely automatic, avoiding the need for a radiology technician with expert knowledge of the protocol, as is the case in densitometry exams. The method provides real mass thickness values, enabling quantitative planar studies instead of relative comparisons.

Automated determination of chest characteristics of Indonesians as the basis of chest dosimetrical phantom design

Purpose: The purpose of this study was to develop software to automatically measure the main areas of the chest, i.e. soft tissue, bone, and air and to implement it in Kraton Regional General Hospital for designing a specific dosimetrical phantom for chest digital radiography (DR) examination.

Methods: This study was a retrospective study on all DR images from 2015 to 2019, and computed tomography (CT) images of 102 patients in Digital Imaging and Communications in Medicine (DICOM) format files scanned from January-December 2019 at the Kraton Regional General Hospital. We evaluated the number of basic DR chest examinations compared to all DR radiological examinations. We developed a MatLab graphical user interface (GUI) for automated measurement of the areas of the main chest components (soft tissue, bone, and air). We computed the areas of the main components of the chest in order to develop a specific chest phantom for DR in the hospital. In order to compute the areas of the main components, we used chest CT images of patients with clinical indications of chest tumors.

Results: The basic DR chest examination comprised 59.5% of all DR examinations in the hospital during 2015-2019. The average areas of soft tissue, bone, and air within the chest in all patients were 331, 20, and 125 cm2, respectively, with values of 345, 23, and 139 cm2 for males, and 309, 15, and 103 cm2 for females. The areas were also dependent on age with values of 121, 10, 55 cm2 for patients aged 5-11 years, 371, 27, and 88 cm2 for patients aged 12-25 years, 322, 22, and 131 cm2 for patients aged 26-45 years, and 334, 19, and 126 cm2 for patients > 45 years old.

Conclusion: A GUI for computing the main composition of the chest was successfully developed. The areas of chest male patients were greater than female patients. The areas of soft tissue, bone, and air were dependent on the patient’s age. Therefore, the design of dosimetrical DR phantom must consider the gender and age of the patient.

Synthetic polymer hydrogels as potential tissue phantoms in radiation therapy and dosimetry

The efficacy of synthetic polymers as hydrogel phantoms for radiation therapy and dosimetry has been investigated for photon and charged particle (electron, proton and alpha particle) interactions. Tissue equivalence has been studied in terms of photon mass energy-absorption coefficients, KERMA (kinetic energy released per unit mass), equivalent atomic number and energy absorption build-up factors, relative to human tissues (skin, soft tissue, cortical bone and skeletal muscle), in the energy range 0.015-15 MeV. For charged particle interactions, ratio of effective atomic number is examined for tissue-equivalence in the energy region of 10 keV-1 GeV. Well established theoretical formulations are used for computation of photon mass-energy absorption effective atomic number, electron density and KERMA. Five-parameter geometric progression (G-P) fitting approximation is used to compute the values of energy absorption build-up factors. Effective atomic number for charged particle interaction is determined using logarithmic interpolation method. Using the analytical methodology, it has been revealed that all the selected synthetic polymers have good tissue-equivalence relative to all tissue except cortical bone. In particular, polyglycolic acid (PGA) and poly-lactic-co-glycolic acid (PLGA) prove to be best substitute material for photon interactions. On the other hand, % difference between effective atomic number for charged particle relative to human tissues is found least for polyethylene glycol (PEG) demonstrating adequate tissue-equivalence. Therefore, the present study is expected to be useful to choose most appropriate phantom material for radiation therapy.

Development of a head CT dose index (CTDI) phantom based on polyester resin and methyl ethyl ketone peroxide (MEKP): a preliminary study

This paper aims to develop phantoms for measurement of computed tomography dose index (CTDI) based on a polyester resin mixed with methyl ethyl ketone peroxide (MEKP) as catalyst. CT number and CTDI values of the polyester resin phantoms were compared with a standard polymethyl methacrylate (PMMA) phantom as reference. The percentage of MEKP was varied from 0.3 to 0.6 wt%. The polyester resin phantoms had diameter of 160 mm, length of 150 mm and five cylindrical holes with diameter of 13.5 mm. One hole was positioned at the centre of the phantom and the other four near its periphery, 10 mm from the edge. The results show that the CT number of the polyester resin phantom was about 1%-9% higher than that of the standard PMMA phantom. Among the polyester resin phantoms, the one with 0.3 wt% MEKP is closest to the standard PMMA phantom in terms of CT number. In addition, the difference in weighted CTDI value between the 0.3 wt% polyester resin phantom and the PMMA is less than 5%. Thus, the 0.3 wt% polyester resin is potentially used as an alternative to the standard PMMA, with the advantage of a lower cost.

Synthesis, characterization and low energy photon attenuation studies of bone tissue substitutes

Epoxy composites with different weight percentages of calcium carbonate and calcium phosphate were synthesized as bone tissue substitutes (BTS) for internal dosimetry. The Fourier-transform infrared spectroscopy analysis confirmed that no chemical reaction occurred between the polymer and the fillers. Thermogravimetric analysis also showed improvement in the thermal properties of the composites due to the fillers. The uniform distribution of fillers in the epoxy matrix was established by X-ray radiography. The attenuation behavior of BTS was probed for low energy γ source 241Am (59.5 keV) using planar HPGe detector. The measured mass attenuation coefficients of BTS were found to match with the values calculated using XCOM software. The radiological properties derived for these composites were found to be on par with those of ICRU-44 cortical bone and B-100 bone equivalent plastic.

Characterization of Nylon-12 as a water-equivalent solid phantom material for dosimetric measurements in therapeutic photon and electron beams

The tissue- or water-equivalence of dosimetry phantoms used as substitutes for water is essential for absorbed dose measurements in radiotherapy. At our institution, a heterogeneous pelvic phantom that consists of stacked Nylon-12 layers has recently been manufactured for Gafchromic film dosimetry. However, data on the use of Nylon as tissue-mimicking media for dosimetric applications are scarce. This study characterizes the water-equivalence of Nylon-12 for dosimetric measurements in therapeutic photon and electron beams. Employing an Elekta Synergy and SL25 linear accelerator (Linac), photon beam transmission measurements for 6 MV and 15 MV, acquired in narrow beam geometry with a 0.6 cm³ Farmer-type ion chamber showed that the mass attenuation coefficient μ_m of Nylon-12 agrees with the values of water, water-equivalent RW3 and Perspex phantom materials within 3%. For 6 MV, the μ_m values were 0.0477 ± 0.002 cm²/g, 0.0490 ± 0.003 cm²/g, 0.0482 ± 0.001 cm²/g and 0.0479 ± 0.002cm²/g for Nylon-12, water, RW3, and Perspex, respectively. Differences within 2% were attained between depth dose data measured in Nylon-12 slabs with Gafchromic EBT3 films and in water with a Roos ion chamber for 10 × 10 cm² 6, 12 and 20 MeV electron beams produced by the Elekta Synergy and SL25 Linacs. Also, a good agreement within 2% was obtained between percent depth doses computed by DOSXYZnrc Monte Carlo simulations in water, Nylon-12 and RW3 materials for photon spectra between 250 kV and 15 MV. The discrepancies between the ratios of average, restricted stopping powers of Nylon to air and water to air for photon spectra ranging from 2 to 45 MV are typically within 1% signifying that Nylon and water have equivalent stopping power characteristics. This study highlights that Nylon-12 can be used as a tissue-mimicking phantom material for dosimetric measurements in clinical megavoltage photon and electron beams as it exhibits good water-equivalence.

Fabrication and characterization of polymeric cellular foams for low-density computed tomography phantom applications

Computed tomography imaging phantom devices have proven to be beneficial in improving computed tomography diagnostic techniques. Though commercial phantoms are available with tissue mimicking properties, there is a lack of low-density tissue specificity and variety. This study proposes a method for the fabrication of various low-density tissue mimicking computed tomography imaging phantoms. By illustrating the fabrication technique, material properties can be shown to be controlled and assessed against characteristic computed tomography imaging properties, most particularly, the computed tomography number in Hounsfield Units. A batch cellular foaming technique was utilized on thermoplastic polyurethane with ranging heated water bath foaming times from 0.5 to 10 min to fabricate polymeric computed tomography phantoms of controlled foam material properties. Computed tomography number values were experimentally measured. Additionally, separate experimental measurements were made on the foam characteristic properties of fabricated thermoplastic polyurethane foams. A relative decreasing trend was exhibited between the foam characteristic properties of cell density, average cell size, and material density to computed tomography number.

Three-dimensional printing CT-derived objects with controllable radiopacity

Purpose

The goal of this work was to develop phantoms for the optimization of pre‐operative computed tomography (CT) scans of the prostate artery, which are used for embolization planning.

Methods

Acrylonitrile butadiene styrene (ABS) pellets were doped with barium sulfate and extruded into filaments suitable for 3D printing on a fused deposition modeling (FDM) printer. Cylinder phantoms were created to evaluate radiopacity as a function of doping percentage. Small‐diameter tree phantoms were created to assess their composition and dimensional accuracy. A half‐pelvis phantom was created using clinical CT images, to assess the printer's control over cortical bone thickness and cancellous bone attenuation. CT‐derived prostate artery phantoms were created to simulate complex, contrast‐filled arteries.

Results

A linear relationship (R = 0.998) was observed between barium sulfate added (0%–10% by weight), and radiopacity (−31 to 1454 Hounsfield Units [HU]). Micro‐CT scans showed even distribution of the particles, with air pockets comprising 0.36% by volume. The small vessels were found to be oversized by a consistent amount of 0.08 mm. Micro‐CT scans revealed that the phantoms' interiors were completely filled in. The maximum HU values of cortical bone in the phantom were lower than that of the filament, a result of CT image reconstruction. Creation of cancellous bone regions with lower HU values, using the printer's infill parameter, was successful. Direct volume renderings of the pelvis and prostate artery were similar to the clinical CT, with the exception that the surfaces of the phantom objects were not as smooth.

Conclusions

It is possible to reliably create FDM 3D printer filaments with predictable radiopacity in a wide range of attenuation values, which can be used to print dimensionally accurate radiopaque objects derived from CT data. Phantoms of this type can be quickly and inexpensively developed to assess and optimize CT protocols for specific clinical applications.

Dose comparison between Gafchromic film, XiO, and Monaco treatment planning systems in a novel pelvic phantom that contains a titanium hip prosthesis

The presence of metallic prostheses during external beam radiotherapy of malignancies in the pelvic region has the potential to strongly influence the dose distribution to the target and to tissue surrounded by the prostheses. This study systematically investigates the perturbation effects of unilateral titanium prosthesis on 6 and 15 MV photon beam dose distributions using Gafchromic EBT2 film measurements in a novel pelvic phantom made out of a stack of nylon slices. Comparisons were also made between the film data and dose calculations made on XiO and Monaco treatment planning systems. The collapsed cone algorithm was chosen for the XiO and the Monte Carlo algorithm used on Monaco is XVMC. Transmission measurements were taken using a narrow‐beam geometry to determine the mass attenuation coefficient of nylon = 0.0458 cm²/g and for a water‐equivalent RW3 phantom, it was 0.0465 cm²/g. The perturbation effects of the prosthesis on dose distributions were investigated by measuring and comparing dose maps and profiles. The magnitude of dose perturbations was quantified by calculating dose enhancement and reduction factors using field sizes of 3 × 3, 5 × 5, 10 × 10, and 15 × 15 cm². For the studied beams and field sizes, dose enhancements between 21 and 30% and dose reductions between 15 and 21% were observed at the nylon‐prosthesis interface on the proximal and distal sides of the prosthesis for film measurements. The dose escalation increases with beam energy, and the dose reduction due to attenuation decreases with increasing beam energy when compared to unattenuated beam data. A comparison of film and XiO depth doses for the studied fields gave relative errors between 1.1 and 23.2% at the proximal and distal interfaces of the Ti prosthesis. Also, relative errors < 4.0% were obtained between film and Monaco dose data outside the prosthesis for 6 and 15 MV lateral opposing fields.

Design and implementation of a prototype head and neck phantom for the performance evaluation of gamma imaging systems

Background

A prototype anthropomorphic head and neck phantom has been designed to simulate the adult head and neck anatomy including some internal organs and tissues of interest, such as thyroid gland and sentinel lymph nodes (SLNs). The design of the head and neck phantom includes an inner jig holding the simulated SLNs and thyroid gland. The thyroid gland structure was manufactured using three-dimensional (3D) printing taking into consideration the morphology and shape of a healthy adult thyroid gland.

Result

The head and neck phantom was employed to simulate a situation where there are four SLNs distributed at two different vertical levels and at two depths within the neck. Contrast to noise ratio (CNR) calculations were performed for the detected SLNs at an 80 mm distance between both pinhole collimators (0.5 and 1.0 mm diameters) and the surface of the head and neck phantom with a 100 s acquisition time. The recorded CNR values for the simulated SLNs are higher when the hybrid gamma camera (HGC) was fitted with the 1.0 mm diameter pinhole collimator. For instance, the recorded CNR values for the superficially simulated SLN (15 mm depth) containing 0.1 MBq of ^99mTc using 0.5 and 1.0 mm diameter pinhole collimators are 6.48 and 16.42, respectively (~87% difference).

Gamma and hybrid optical images were acquired using the HGC for the simulated thyroid gland. The count profiles through the middle of the simulated thyroid gland images provided by both pinhole collimators were obtained. The HGC could clearly differentiate the individual peaks of both thyroid lobes in the gamma image produced by the 0.5-mm pinhole collimator. In contrast, the recorded count profile for the acquired image using the 1.0-mm-diameter pinhole collimator showed broader peaks for both lobes, reflecting the degradation of the spatial resolution with increasing the diameter of the pinhole collimator.

Conclusions

This anthropomorphic head and neck phantom provides a valuable tool for assessing the imaging ability of gamma cameras used for imaging the head and neck region. The standardisation of test phantoms for SFOV gamma systems will provide an opportunity to collect data across various medical centres. The phantom described is cost effective, reproducible, flexible and anatomically representative.

Scattered Dose Calculations and Measurements in a Life-Like Mouse Phantom

Anatomically accurate phantoms are useful tools for radiation dosimetry studies. In this work, we demonstrate the construction of a new generation of life-like mouse phantoms in which the methods have been generalized to be applicable to the fabrication of any small animal. The mouse phantoms, with built-in density inhomogeneity, exhibit different scattering behavior dependent on where the radiation is delivered. Computer models of the mouse phantoms and a small animal irradiation platform were devised in Monte Carlo N-Particle code (MCNP). A baseline test replicating the irradiation system in a computational model shows minimal differences from experimental results from 50 Gy down to 0.1 Gy. We observe excellent agreement between scattered dose measurements and simulation results from X-ray irradiations focused at either the lung or the abdomen within our phantoms. This study demonstrates the utility of our mouse phantoms as measurement tools with the goal of using our phantoms to verify complex computational models.

Comparison of computed tomography dose index in polymethyl methacrylate and nylon dosimetry phantoms

The use of computed tomography (CT) scanning has been growing steadily. Therefore, CT dose measurement is becoming increasingly important for patient protection and optimization. A phantom is an important tool for dose measurement. This paper focuses on the evaluation of a CT dosimetry phantom made from nylon, instead of the standard polymethyl methacrylate (PMMA), which is not readily available or is too expensive in some countries. Comparison between phantoms made from the two materials is made in terms of measurements of the CT dose indices (CTDI). These were measured for four different beam widths and kVp settings at the center and periphery in head and body phantoms made from both materials and weighted CTDIs (CTDIw) were calculated. CT numbers along the z-axis of the phantom were also measured at the center and four peripheral positions of each scanned slice to check phantom homogeneity. Results showed that values for the CTDIw measured in the nylon phantoms were slightly higher than those from the PMMA while CT numbers for nylon were lower than those of PMMA. This is because the mass attenuation coefficient of the nylon is higher. Nylon could be used as a substitute material for CT dosimetry phantom to enable measurements and adjustment factors are given which could be used to estimate PMMA values for making comparisons with displayed values.

Efficiency corrections in determining the (137)Cs inventory of environmental soil samples by using relative measurement method and GEANT4 simulations

The determination of (137)Cs inventory is widely used to estimate the soil erosion or deposition rate. The generally used method to determine the activity of volumetric samples is the relative measurement method, which employs a calibration standard sample with accurately known activity. This method has great advantages in accuracy and operation only when there is a small difference in elemental composition, sample density and geometry between measuring samples and the calibration standard. Otherwise it needs additional efficiency corrections in the calculating process. The Monte Carlo simulations can handle these correction problems easily with lower financial cost and higher accuracy. This work presents a detailed description to the simulation and calibration procedure for a conventionally used commercial P-type coaxial HPGe detector with cylindrical sample geometry. The effects of sample elemental composition, density and geometry were discussed in detail and calculated in terms of efficiency correction factors. The effect of sample placement was also analyzed, the results indicate that the radioactive nuclides and sample density are not absolutely uniform distributed along the axial direction. At last, a unified binary quadratic functional relationship of efficiency correction factors as a function of sample density and height was obtained by the least square fitting method. This function covers the sample density and height range of 0.8-1.8 g/cm(3) and 3.0-7.25 cm, respectively. The efficiency correction factors calculated by the fitted function are in good agreement with those obtained by the GEANT4 simulations with the determination coefficient value greater than 0.9999. The results obtained in this paper make the above-mentioned relative measurements more accurate and efficient in the routine radioactive analysis of environmental cylindrical soil samples.

Construction of mouse phantoms from segmented CT scan data for radiation dosimetry studies

We present the complete construction methodology for an anatomically accurate mouse phantom made using materials which mimic the characteristics of tissue, lung, and bone for radiation dosimetry studies. Phantoms were constructed using 2 mm thick slices of tissue equivalent material which was precision machined to clear regions for insertion of lung and bone equivalent material where appropriate. Images obtained using a 3D computed tomography (CT) scan clearly indicate regions of tissue, lung, and bone that match their position within the original mouse CT scan. Additionally, radiographic films are used with the phantom to demonstrate dose mapping capabilities. The construction methodology presented here can be quickly and easily adapted to create a phantom of any specific small animal given a segmented CT scan of the animal. These physical phantoms are a useful tool to examine individual organ dose and dosimetry within mouse systems that are complicated by density inhomogeneity due to bone and lung regions.

Monte Carlo simulations of adult and pediatric computed tomography exams: validation studies of organ doses with physical phantoms

PURPOSE

To validate the accuracy of a Monte Carlo source model of the Siemens SOMATOM Sensation 16 CT scanner using organ doses measured in physical anthropomorphic phantoms.

METHODS

The x-ray output of the Siemens SOMATOM Sensation 16 multidetector CT scanner was simulated within the Monte Carlo radiation transport code, MCNPX version 2.6. The resulting source model was able to perform various simulated axial and helical computed tomographic (CT) scans of varying scan parameters, including beam energy, filtration, pitch, and beam collimation. Two custom-built anthropomorphic phantoms were used to take dose measurements on the CT scanner: an adult male and a 9-month-old. The adult male is a physical replica of the University of Florida reference adult male hybrid computational phantom, while the 9-month-old is a replica of the University of Florida Series B 9-month-old voxel computational phantom. Each phantom underwent a series of axial and helical CT scans, during which organ doses were measured using fiber-optic coupled plastic scintillator dosimeters developed at the University of Florida. The physical setup was reproduced and simulated in MCNPX using the CT source model and the computational phantoms upon which the anthropomorphic phantoms were constructed. Average organ doses were then calculated based upon these MCNPX results.

RESULTS

For all CT scans, good agreement was seen between measured and simulated organ doses. For the adult male, the percent differences were within 16% for axial scans, and within 18% for helical scans. For the 9-month-old, the percent differences were all within 15% for both the axial and helical scans. These results are comparable to previously published validation studies using GE scanners and commercially available anthropomorphic phantoms.

CONCLUSIONS

Overall results of this study show that the Monte Carlo source model can be used to accurately and reliably calculate organ doses for patients undergoing a variety of axial or helical CT examinations on the Siemens SOMATOM Sensation 16 scanner.

New head equivalent phantom for task and image performance evaluation representative for neurovascular procedures occurring in the Circle of Willis

Phantom equivalents of different human anatomical parts are routinely used for imaging system evaluation or dose calculations. The various recommendations on the generic phantom structure given by organizations such as the AAPM, are not always accurate when evaluating a very specific task. When we compared the AAPM head phantom containing 3 mm of aluminum to actual neuro-endovascular image guided interventions (neuro-EIGI) occurring in the Circle of Willis, we found that the system automatic exposure rate control (AERC) significantly underestimated the x-ray parameter selection. To build a more accurate phantom for neuro-EIGI, we reevaluated the amount of aluminum which must be included in the phantom. Human skulls were imaged at different angles, using various angiographic exposures, at kV's relevant to neuro-angiography. An aluminum step wedge was also imaged under identical conditions, and a correlation between the gray values of the imaged skulls and those of the aluminum step thicknesses was established. The average equivalent aluminum thickness for the skull samples for frontal projections in the Circle of Willis region was found to be about 13 mm. The results showed no significant changes in the average equivalent aluminum thickness with kV or mAs variation. When a uniform phantom using 13 mm aluminum and 15 cm acrylic was compared with an anthropomorphic head phantom the x-ray parameters selected by the AERC system were practically identical. These new findings indicate that for this specific task, the amount of aluminum included in the head equivalent must be increased substantially from 3 mm to a value of 13 mm.

Verification of dosimetric materials to be used as tissue-substitutes in radiological diagnosis

Dosimetric materials have been investigated in terms of calculated mass energy absorption coefficient, equivalent atomic number and KERMA (kinetic energy released per unit mass) in the energy range 0.015-15 MeV. Using analytical methodology it has verified that nylon is the best substitute dosimetric material for skin, muscle, bone and soft-tissues. Relative energy absorption buildup factors calculated by G-P fitting method confirm the findings. Nylon has been found to be good tissue substitute material for making tissue-phantoms of the biological tissues investigated.

Construction of anthropomorphic phantoms for use in dosimetry studies

This paper reports on the methodology and materials used to construct anthropomorphic phantoms for use in dosimetry studies, improving on methods and materials previously described by Jones et al. [Med Phys. 2006;33(9):3274-82]. To date, the methodology described has been successfully used to create a series of three different adult phantoms at the University of Florida (UF). All phantoms were constructed in 5 mm transverse slices using materials designed to mimic human tissue at diagnostic photon energies: soft tissue-equivalent substitute (STES), lung tissue-equivalent substitute (LTES), and bone tissue-equivalent substitute (BTES). While the formulation for BTES remains unchanged from the previous epoxy resin compound developed by Jones et al. [Med Phys. 2003;30(8):2072-81], both the STES and LTES were redesigned utilizing a urethane based compound which forms a pliable tissue-equivalent material. These urethane based materials were chosen in part for improved phantom durability and easier accommodation of real-time dosimeters. The production process has also been streamlined with the use of an automated machining system to create molds for the phantom slices from bitmap images based on the original segmented computed tomography (CT) datasets. Information regarding the new tissue-equivalent materials as well as images of the construction process and completed phantom are included.

A low-cost density reference phantom for computed tomography

The authors characterized a commercially available foam composed of polyurethane and polyisocyanurate which is marketed for modeling parts in the aircraft, automotive, and related industries. The authors found that the foam may be suitable for use as a density reference standard in the range below -400 Hounsfield units. This range is coincident with the density of lung tissue. The foam may be helpful in making the diagnosis of lung disease more systematic.

Parameters and computer software for the evaluation of mass attenuation and mass energy-absorption coefficients for body tissues and substitutes

The mass attenuation and energy-absorption coefficients (radiation interaction data), which are widely used in the shielding and dosimetry of X-rays used for medical diagnostic and orthovoltage therapeutic procedures, are strongly dependent on the energy of photons, elements and percentage by weight of elements in body tissues and substitutes. Significant disparities exist in the values of percentage by weight of elements reported in literature for body tissues and substitutes for individuals of different ages, genders and states of health. Often, interested parties are in need of these radiation interaction data for body tissues or substitutes with percentage by weight of elements and intermediate energies that are not tabulated in literature. To provide for the use of more precise values of these radiation interaction data, parameters and computer programs, MUA_T and MUEN_T are presented for the computation of mass attenuation and energy-absorption coefficients for body tissues and substitutes of arbitrary percentage-by-weight elemental composition and photon energy ranging between 1 keV (or k-edge) and 400 keV. Results are presented, which show that the values of mass attenuation and energy-absorption coefficients obtained from computer programs are in good agreement with those reported in literature.

Tomographic physical phantom of the newborn child with real-time dosimetry I. Methods and techniques for construction

A tomographic phantom representing a newborn female patient was constructed using tissue-equivalent materials previously developed at the University of Florida. This phantom was constructed using contoured images from an actual patient data set, a whole-body computed tomography of a newborn cadaver previously described by Nipper et al. [Phys. Med. Biol. 47, 3143-1364 (2002)]. Four types of material are incorporated in the phantom: soft tissue, bone tissue, lung tissue, and air. The phantom was constructed on a slice-by-slice basis with a z-axis resolution of 5 mm, channels for dosimeters (thermoluminescent dosimeter (TLD), metal-oxide-semiconductor field-effect transistor, or gated fiber-optic-coupled dosimeter (GFOC)) were machined into slices prior to assembly, and the slices were then fixed together to form the complete phantom. The phantom will be used in conjunction with an incorporated dosimetry system to calculate individual organ and effective doses delivered to newborn patients during various diagnostic procedures, including, but not limited to, projection radiography and computed tomography. Included in this paper are images detailing the construction process, and images of the completed phantom.

Whole-body voxel phantoms of paediatric patients--UF Series B

Following the previous development of the head and torso voxel phantoms of paediatric patients for use in medical radiation protection (UF Series A), a set of whole-body voxel phantoms of paediatric patients (9-month male, 4-year female, 8-year female, 11-year male and 14-year male) has been developed through the attachment of arms and legs from segmented CT images of a healthy Korean adult (UF Series B). Even though partial-body phantoms (head-torso) may be used in a variety of medical dose reconstruction studies where the extremities are out-of-field or receive only very low levels of scatter radiation, whole-body phantoms play important roles in general radiation protection and in nuclear medicine dosimetry. Inclusion of the arms and legs is critical for dosimetry studies of paediatric patients due to the presence of active bone marrow within the extremities of children. While the UF Series A phantoms preserved the body dimensions and organ masses as seen in the original patients who were scanned, comprehensive adjustments were made for the Series B phantoms to better match International Commission on Radiological Protection (ICRP) age-interpolated reference body masses, body heights, sitting heights and internal organ masses. The CT images of arms and legs of a Korean adult were digitally rescaled and attached to each phantom of the UF series. After completion, the resolutions of the phantoms for the 9-month, 4-year, 8-year, 11-year and 14-year were set at 0.86 mm x 0.86 mm x 3.0 mm, 0.90 mm x 0.90 mm x 5.0 mm, 1.16 mm x 1.16 mm x 6.0 mm, 0.94 mm x 0.94 mm x 6.00 mm and 1.18 mm x 1.18 mm x 6.72 mm, respectively.

Physical phantom of typical Korean male for radiation protection purpose

Dose distribution within a human body can be measured using physical anthropomorphic phantoms. In an effort to establish reference Korean physical model, the first Korean physical phantom of average Korean adult male was constructed using computed tomography (CT) images of a healthy volunteer. The body dimension of the subject was close to that of average Korean male. The source images were obtained using fusion positron emission tomography machine at Radiation Health Research Institute in Korea, and ported into rapid prototyping process. The physical phantom was composed of three tissue-equivalent materials: epoxy resin, urethane foam and polyurethane representing bone, lungs and soft tissues, respectively. The densities of the tissue-equivalent materials were close to those recommended by the International Commission on Radiation Units and measurements. To facilitate dose mapping, the phantom was sliced into 2 cm sections. Hole grids for thermoluminescence (TL) dosemeter chips were drilled. To verify the appropriateness of the physical phantom, organ doses of selected organs were measured for reference photon beam, and compared with those computed by tomographic model constructed from the same CT images. Absorbed doses converted from TL relative response showed good agreement within 7% with those calculated.

MOSFET dosimeter depth-dose measurements in heterogeneous tissue-equivalent phantoms at diagnostic x-ray energies

The objective of the present study was to explore the use of the TN-1002RD metal-oxide-semiconductor field effect transistor (MOSFET) dosimeter for measuring tissue depth dose at diagnostic photon energies in both homogeneous and heterogeneous tissue-equivalent materials. Three cylindrical phantoms were constructed and utilized as a prelude to more complex measurements within tomographic physical phantoms of pediatric patients. Each cylindrical phantom was constructed as a stack of seven 5-cm-diameter and 1-cm-thick discs of materials radiographically representative of either soft tissue (S), bone (B), or lung tissue (L) at diagnostic photon energies. In addition to a homogeneous phantom of soft tissue (SSSSSSS), two heterogeneous phantoms were constructed: SSBBSSS and SBLLBSS. MOSFET dosimeters were then positioned at the interface of each disc, and the phantoms were then irradiated at 66 kVp and 200 mAs. Measured values of absorbed dose at depth were then compared to predicated values of point tissue dose as determined via Monte Carlo radiation transport modeling. At depths exceeding 2 cm, experimental results matched the computed values of dose with high accuracy regardless of the dosimeter orientation (epoxy bubble facing toward or away from the x-ray beam). Discrepancies were noted, however, between measured and calculated point doses near the surface of the phantom (surface to 2 cm depth) when the dosimeters were oriented with the epoxy bubble facing the x-ray beam. These discrepancies were largely eliminated when the dosimeters were placed with the flat side facing the x-ray beam. It is therefore recommended that the MOSFET dosimeters be oriented with their flat sides facing the beam when they are used at shallow depths or on the surface of either phantoms or patients.

The UF series of tomographic computational phantoms of pediatric patients

Two classes of anthropomorphic computational phantoms exist for use in Monte Carlo radiation transport simulations: tomographic voxel phantoms based upon three-dimensional (3D) medical images, and stylized mathematical phantoms based upon 3D surface equations for internal organ definition. Tomographic phantoms have shown distinct advantages over the stylized phantoms regarding their similarity to real human anatomy. However, while a number of adult tomographic phantoms have been developed since the early 1990s, very few pediatric tomographic phantoms are presently available to support dosimetry in pediatric diagnostic and therapy examinations. As part of a larger effort to construct a series of tomographic phantoms of pediatric patients, five phantoms of different ages (9-month male, 4-year female, 8-year female, 11-year male, and 14-year male) have been constructed from computed tomography (CT) image data of live patients using an IDL-based image segmentation tool. Lungs, bones, and adipose tissue were automatically segmented through use of window leveling of the original CT numbers. Additional organs were segmented either semiautomatically or manually with the aid of both anatomical knowledge and available image-processing techniques. Layers of skin were created by adding voxels along the exterior contour of the bodies. The phantoms were created from fused images taken from head and chest-abdomen-pelvis CT exams of the same individuals (9-month and 4-year phantoms) or of two different individuals of the same sex and similar age (8-year, 11-year, and 14-year phantoms). For each model, the resolution and slice positions of the image sets were adjusted based upon their anatomical coverage and then fused to a single head-torso image set. The resolutions of the phantoms for the 9-month, 4-year, 8-year, 11-year, and 14-year are 0.43 x 0.43 x 3.0 mm, 0.45 x 0.45 x 5.0 mm, 0.58 x 0.58 x 6.0 mm, 0.47 X 0.47 x 6.00 mm, and 0.625 x 0.625 x 6.0 mm, respectively. While organ masses can be matched to reference values in both stylized and tomographic phantoms, side-by-side comparisons of organ doses in both phantom classes indicate that organ shape and positioning are equally important parameters to consider in accurate determinations of organ absorbed dose from external photon irradiation. Preliminary studies of external photon irradiation of the 11-year phantom indicate significant departures of organ dose coefficients from that predicted by the existing stylized phantom series. Notable differences between pediatric stylized and tomographic phantoms include anterior-posterior (AP) and right lateral (RLAT) irradiation of the stomach wall, left lateral (LLAT) and right lateral (RLAT) irradiation of the thyroid, and AP and posterior-anterior (PA) irradiation of the urinary bladder.

Development of lung and soft tissue substitutes for photons

The use of solid tissue substitutes is a well-accepted and common practice in dosimetric studies and in the production of counting standards for radiological protection. However, only a few solid tissue substitutes simulating a particular body tissue with respect to a set of physical characteristics are commercially available. Hence, we have developed polyurethane-based tissue substitutes simulating soft tissue, muscle, muscle-adipose mixture tissue (90% muscle + 10% adipose), brain, cartilage, larynx, thyroid, trachea, liver, kidney, skin and lungs. Tissue substitutes for photons were formulated using the basic data method together with an equation for calculating the optimum relative mass of corrective additives. The tissue substitutes were formulated to be phantom materials in the photon energy range of at least 8 keV-10 MeV. In particular, they were designed to match the body tissues with linear attenuation coefficients for low photon energy (13.6, 17.2 and 20.2 keV from 239Pu) and to have the same mass densities as the tissues. The tissue substitutes developed in the present study were examined for the photon transmissions using 16.6 keV KX rays from 93Nb(m). The experimental transmission curves of the tissue substitutes were found to be consistent with those derived from data on the body tissues in ICRP Publication 23. It was found that the developed tissue substitutes are suitable to the corresponding body tissues defined by ICRP.

Polymer gel water equivalence and relative energy response with emphasis on low photon energy dosimetry in brachytherapy

The water equivalence and stable relative energy response of polymer gel dosimeters are usually taken for granted in the relatively high x-ray energy range of external beam radiotherapy based on qualitative indices such as mass and electron density and effective atomic number. However, these favourable dosimetric characteristics are questionable in the energy range of interest to brachytherapy especially in the case of lower energy photon sources such as 103Pd and 125I that are currently utilized. In this work, six representative polymer gel formulations as well as the most commonly used experimental set-up of a LiF TLD detector-solid water phantom are discussed on the basis of mass attenuation and energy absorption coefficients calculated in the energy range of 10 keV-10 MeV with regard to their water equivalence as a phantom and detector material. The discussion is also supported by Monte Carlo simulation results. It is found that water equivalence of polymer gel dosimeters is sustained for photon energies down to about 60 keV and no corrections are needed for polymer gel dosimetry of 169Yb or 192Ir sources. For 125I and 103Pd sources, however, a correction that is source-distance dependent is required. Appropriate Monte Carlo results show that at the dosimetric reference distance of 1 cm from a source, these corrections are of the order of 3% for 125I and 2% for 103Pd. These have to be compared with corresponding corrections of up to 35% for 125I and 103Pd and up to 15% even for the 169Yb energies for the experimental set-up of the LiF TLD detector-solid water phantom.