Gudrun Alm Carlsson

Bone mineral density and bone structure parameters as predictors of bone strength: an analysis using computerized microtomography and gastrectomy-induced osteopenia in the rat.

In this study the relationships of bone mineral density (BMD) and bone structure parameters calculated from 2D microtomography images to bone strength were investigated. Femurs from 21 male Sprague Dawley rats were subjected to dual-energy X-ray absorptiometry, computerized microtomography (CmicroT) and either three-point cantilever bending (femoral shaft) or two-point bending compression (femoral neck). Gastrectomy was performed on 12 animals and 9 were sham operated. From the tomograms bone structure analysis was performed using a software routine based on grey level run-length method. Correlations of BMD and bone structure parameters to mechanical parameters were investigated as were differences between the gastrectomized and the control samples. The reductions of BMD between the groups were 21 and 27% in the femoral neck and shaft, respectively. For the shaft, the correlations of BMD to all mechanical parameters were significant and BMD was a consistent predictor of bone strength for cortical bone. However, in the femoral neck where cancellous bone predominates, BMD was weakly correlated only to deflection. A significant correlation between trabecular thickness and neck bone strength was found. Hence, compared to trabecular thickness, BMD was of limited value in predicting bone strength in the femoral neck.

Monte Carlo-aided dosimetry of the symmetra model I25.S06 125I, interstitial brachytherapy seed

A dosimetric study of a new 125I seed for permanent prostate implant, the Symmetra 1251 Seed model I25.S06, has been undertaken utilizing Monte Carlo photon transport calculations. All dosimetric quantities recommended by the AAPM Task Group 43 (TG-43) report have been calculated. Quantities determined are dose rate constant, radial dose function, anisotropy function, anisotropy factor, and anisotropy constant. The recently (January 1999) revised NIST (National Institute of Standards and Technology) 1251 standard for air kerma strength calibration was taken into account as well as updated interaction cross-section data. Calculations were done for the competing model 6702 source for the purpose of comparison. The calculated dose-rate constants for the two seeds are 1.010 and 1.016 cGyh(-1)U(-1) for the Symmetra and model 6702 seeds, respectively. The latter value deviates from the value, 1.039 cGyh(-1)U(-1), recommended in the TG-43 report. The calculated radial dose function for the Symmetra new seed is more penetrating than that of the model 6711 seed (by 20% at 5 cm distance) but agrees closely (within statistical errors) with that of the model 6702 seed up to distances of 10 cm. The anisotropy function for the seed is also close to that for the 6702 seed with a tendency of somewhat more pronounced anisotropy (lower values at small angles from the longitudinal axis). Compared to the model 6711 seed, the Symmetra new seed is more isotropic. The anisotropy constants (the anisotropy function averaged with respect to angle and distance) for the three seed models are within 2%.

Influence on X-ray energy spectrum, contrasting detail and detector on the signal-to-noise ratio (SNR) and detective quantum efficiency (DQE) in projection radiography

A lower limit to patient irradiation in diagnostic radiology is set by the fundamental stochastics of the energy imparted to the image receptor (quantum noise). Image quality is investigated and expressed in terms of the signal-to-noise ratio due to quantum noise. The Monte Carlo method is used to calculate signal-to-noise ratios (SNRDelta S) and detective quantum efficiencies (DQEDelta S) in imaging thin contrasting details of air, fat, bone and iodine within a water phantom using X-ray spectra (40-140 kV) and detectors of CsI, BaFCl and Gd2O2S. The atomic composition of the contrasting detail influences considerably the values of SNRDelta S due to the different modulations of the energy spectra of primary photons passing beside and through the contrasting detail. By matching the absorption edges of the contrasting detail and the detector, a partially absorbing detector may be more efficient (yield higher SNRDelta S) than a totally absorbing one; this is demonstrated for the case of detecting an iodine detail using a CsI detector. The degradation of SNRDelta S and DQEDelta S due to scatter is larger when the detector is operated in the photon counting compared to in the energy integrating mode and for partially absorbing compared to totally absorbing detectors.

Ammonium tartrate as an ESR dosimeter material

ESR dosimetry with L-α-alanine as a dosimeter material is a well known and frequently used method for measuring high absorbed doses, for example at sterilisation and food irradiation. The increased sensitivity of modem spectrometers and an increased knowledge of the radiochemical properties of alanine have lowered the detection limit of ESR/alanine dosimetry to the dose range relevant for radiation therapy. The aim of this thesis is to contribute to an extended use of ESR dosimetry in radiation therapy, including development of an alanine-based gel dosimeter and investigation of alternative dosimeter materials.The dosimeter material is often a polycrystalline powder, which can be mixed with a binder and formed to solid dosimeters in the shape of tablets, rods or films. It can also be distributed in a gel, to serve as both dosimeter material and phantom material. Thus, problems caused by the detector displacing the medium are avoided. The gel developed in this thesis is based on polycrystalline alanine, distributed in an agarose gel. It was tested for calibrated measurements in a brachytherapy situation. With further development, the alanine/agarose gel was found to have potential as a tool for verification of treatment plans, also at complicated dose distributions. One problem to be solved before the gel can be used at an arbitrary irradiation geometry is the low sensitivity of the gel. At present, the sensitivity puts a limit on the spatial resolution at low doses because of the high demands on measurement precision in radiation therapy.The low sensitivity of the alanine/agarose gel, and also the need for a high precision at low doses together with a small dosimeter size when using traditional solid dosimeters, have raised the need for alternative, more sensitive, dosimeter materials than alanine. Such a material should form only one radiation induced radical, giving an ESR spectrum with few and narrow lines for easy evaluation. It should also be possible to increase the microwave power and the field modulation amplitude without severe distortion of the spectrum shape. Other important criteria are a low effective atomic number, a signal that is stable over time and, preferably, a linear dose response.Two compounds are presented; ammonium tartrate and 2-methylalanine. Both are more sensitive than alanine at low settings of microwave power and modulation amplitude, and fulfil the criteria of a low effective atomic number and a linear dose response. Ammonium tartrate is saturated already at low microwave power levels whereas the modulation amplitude can be increased to very high levels without saturation. However, the spectrum shape is then distorted. The signal-changes over time are rapid during the first hours after irradiation, but are then stabilised and can be corrected for.The other investigated substance, 2-methylalanine, is more similar to alanine regarding signal stability over time and dependency of microwave power and field modulation amplitude. However, irradiation of 2-methylalanine results in only one detectable radical, where the alanine spectrum is composed of at least two radicals. The less complicated spectrum of 2-methylalanine makes it more safe to increase the microwave power and the modulation amplitude to their saturation levels.

Calculation of scattering cross sections for increased accuracy in diagnostic radiology. I. Energy broadening of Compton‐scattered photons

In this work, scattering cross sections differential with respect to both the scattering angle and the energy of the scattered photon are derived in the relativistic impulse approximation for the light elements H, Be, and Al, and photon energies between 30 and 200 keV. The energy broadening of the scattered photons reflects the momentum distribution of the target electrons. It increases with both increasing atomic number of the scatterer and with scattering angle. Even in light elements, the energy broadening is comparable with the intrinsic energy resolution of modern Ge spectrometers. In reconstructing primary photon energy spectra by means of a Ge spectrometer and Compton scattering techniques, i.e., by measuring the photons incoherently scattered at a given angle, the energy resolution is markedly impaired compared to direct measurements in the primary beam. This is usually explained as an effect of the nonzero acceptance angle of the detector. It is shown, however, that the fundamental energy broadening of the scattered photons is alone sufficient as an explanation. The Compton scattering technique is valuable in determining energy spectra in clinical situations. Aspects of its optimal performance are discussed. The commonly used scattering angle of 90 degrees seems adequate. At small scattering angles, the incoherent-scattering cross section is badly known due to electron-electron interactions and, for photon energies less than 100 keV, coherent scattering contributes appreciably to the total scattering even in media of low atomic number. In cases where coherent scattering dominates and where the energy degradation of the incoherently scattered photons is small compared to the energy resolution of the spectrometer, the reconstruction is simplified. The double-differential cross sections derived can be used to simplify calculations of the Compton component of the mass-energy absorption coefficient.

A Monte Carlo program for the calculation of contrast, noise and absorbed dose in diagnostic radiology.

A Monte Carlo computer program has been developed for the simulation of X-ray photon transport in diagnostic X-ray examinations. The simulation takes account of the incident photon energy spectrum and includes a phantom (representing the patient), an anti-scatter grid and an image receptor. The primary objective for developing the program was to study and optimise the design of anti-scatter grids. The program estimates image quality in terms of contrast and signal-to-noise ratio, and radiation risk in terms of mean absorbed dose in the patient. It therefore serves as a tool for the optimisation of the radiographic procedure. A description is given of the program and the variance-reduction techniques used. The computational method was validated by comparison with measurements and other Monte Carlo simulations.

Compton spectroscopy in the diagnostic x-ray energy range. II. Effects of scattering material and energy resolution.

The overall performance of a Compton spectrometer and, in particular, its energy resolution are investigated both experimentally and theoretically for different scattering materials. Using low-Z (less than or equal to 8) scatterers of moderate sizes (scatterer diameter d less than or equal to 5 mm), there are negligible disturbances due to coherent and/or multiple scattering at 90 degrees scattering angle and photon energies above 20 keV. Two factors contribute to decreasing the energy resolution compared with that in direct measurements: (i) the velocity distribution of the electrons in the scatterer and (ii) the scattering geometry. Of these, (i) is dominant for photon energies less than or equal to 100 keV. The optimal scattering material is a metal of as low Z as possible, i.e. beryllium. However, polyethylene and lucite are normally sufficiently good scatterers. The scattering geometry may become the dominating factor decreasing energy resolution at high photon energies hv greater than or equal to 150 keV.

Schemes for the optimization of chest radiography using a computer model of the patient and x-ray imaging system.

A computer program has been developed to model chest radiography. It incorporates a voxel phantom of an adult and includes antiscatter grid, radiographic screen, and film. Image quality is quantified by calculating the contrast (deltaOD) and the ideal observer signal-to-noise ratio (SNR(I)) for a number of relevant anatomical details at various positions in the anatomy. Detector noise and system unsharpness are modeled and their influence on image quality is considered. A measure of useful dynamic range is computed and defined as the fraction of the image that is reproduced at an optical density such that the film gradient exceeds a preset value. The effective dose is used as a measure of the radiation risk for the patient. A novel approach to patient dose and image quality optimization has been developed and implemented. It is based on a reference system acknowledged to yield acceptable image quality in a clinical trial. Two optimizations schemes have been studied, the first including the contrast of vessels as measure of image quality and the second scheme using also the signal-to-noise ratio of calcifications. Both schemes make use of our measure of useful dynamic range as a key quantity. A large variety of imaging conditions was simulated by varying the tube voltage, antiscatter device, screen-film system, and maximum optical density in the computed image. It was found that the optical density is crucial in screen-film chest radiography. Significant dose savings (30%-50%) can be accomplished without sacrificing image quality by using low-atomic-number grids with a low grid ratio or an air gap and more sensitive screen-film system. Dose-efficient configurations proposed by the model agree well with the example of good radiographic technique suggested by the European Commission.

Calculation of the small-angle distribution of scattered photons in diagnostic radiology using a Monte Carlo collision density estimator

Calculations of various physical quantities pertaining to scattered photons in diagnostic radiology are conveniently carried out using the Monte Carlo technique. Some quantities, e.g., the small-angle distribution of scattered photons transmitted through the patient, are difficult to obtain with sufficient precision using straightforward simulation of physical experiments. By mixing the simulation of random trajectories with analytical calculations, the efficiency of deriving values for a particular field quantity may be drastically improved. This work describes a Monte Carlo collision density estimator that increases the efficiency of calculating the small-angle distribution of transmitted scattered photons by a factor of more than 50. Examples of such distributions outside laterally infinite water slabs are given for x rays generated at 40-70 kV and for various slab thicknesses (10-200 mm). Comparison with experimental results from the literature shows that cross sections for coherent scattering which take diffraction phenomena in liquid water into account must be used to get accurate results. A discrepancy between the experimental and calculated distributions of photons transmitted at very small (less than 3 degrees) angles to the normal to the slab may be interpreted in terms of experimental difficulties or insufficient accuracy in the differential scattering cross sections used in the calculations.

A search for optimal x-ray spectra in iodine contrast media mammography

The aim of this work was to search for the optimal x-ray tube voltage and anode-filter combination in digital iodine contrast media mammography. In the optimization, two entities were of interest: the average glandular dose, AGD, and the signal-to-noise ratio, SNR, for detection of diluted iodine contrast medium. The optimum is defined as the technique maximizing the figure of merit, SNR2/AGD. A Monte Carlo computer program was used which simulates the transport of photons from the x-ray tube through the compression plate, breast, breast support plate, anti-scatter grid and image detector. It computes the AGD and the SNR of an iodine detail inside the compressed breast. The breast thickness was varied between 2 and 8 cm with 10-90% glandularity. The tube voltage was varied between 20 and 55 kV for each anode material (Rh, Mo and W) in combination with either 25 microm Rh or 0.05-0.5 mm Cu added filtration. The x-ray spectra were calculated with MCNP4C (Monte Carlo N-Particle Transport Code System, version 4C). A CsI scintillator was used as the image detector. The results for Rh/0.3 mmCu, Mo/0.3 mmCu and W/0.3 mmCu were similar. For all breast thicknesses, a maximum in the figure of merit was found at approximately 45 kV for the Rh/Cu, Mo/Cu and W/Cu combinations. The corresponding results for the Rh/Rh combination gave a figure of merit that was typically lower and more slowly varying with tube voltage. For a 4 cm breast at 45 kV, the SNR2/AGD was 3.5 times higher for the Rh/0.3 mmCu combination compared with the Rh/Rh combination. The difference is even larger for thicker breasts. The SNR2/AGD increases slowly with increasing Cu-filter thickness. We conclude that tube voltages between 41 and 55 kV and added Cu-filtration will result in significant dose advantage in digital iodine contrast media mammography compared to using the Rh/Rh anode/filter combination at 25-32 kV.