Nico Lanconelli

A free database of radionuclide voxel S values for the dosimetry of nonuniform activity distributions.

The increasing availability of SPECT/CT devices with advanced technology offers the opportunity for the accurate assessment of the radiation dose to the biological target volume during radionuclide therapy. Voxel dosimetry can be performed employing direct Monte Carlo radiation transport simulations, based on both morphological and functional images of the patient. On the other hand, for voxel dosimetry calculations the voxel S value method can be considered an easier approach than patient-specific Monte Carlo simulations, ensuring a good dosimetric accuracy at least for anatomic regions which are characterized by uniform density tissue. However, this approach has been limited because of the lack of tabulated S values for different voxel dimensions and radionuclides. The aim of this work is to provide a free dataset of values which can be used for voxel dosimetry in targeted radionuclide studies. Seven different radionuclides (89Sr, 90Y, 131I, 153Sm, 177Lu, 186Re, 188Re), and 13 different voxel sizes (2.21, 2.33, 2.4, 3, 3.59, 3.9, 4, 4.42, 4.8, 5, 6, 6.8 and 9.28 mm) are considered. Voxel S values are calculated performing simulations of monochromatic photon and electron sources in two different homogeneous tissues (soft tissue and bone) with DOSXYZnrc code, and weighting the contributions on the basis of the radionuclide emission spectra. The outcomes are validated by comparison with Monte Carlo simulations obtained with other codes (PENELOPE and MCNP4c) performing direct simulation of the radionuclide emission spectra. The differences among the different Monte Carlo codes are of the order of a few per cent when considering the source voxel and the bremsstrahlung tail, whereas the highest differences are observed at a distance close to the maximum continuous slowing down approximation range of electrons. These discrepancies would negligibly affect dosimetric assessments. The dataset of voxel S values can be freely downloaded from the website www.medphys.it.

On the beam direction search space in computerized non-coplanar beam angle optimization for IMRT—prostate SBRT

In a recent paper, we have published a new algorithm, designated iCycle, for fully automated multi-criterial optimization of beam angles and intensity profiles. In this study, we have used this algorithm to investigate the relationship between plan quality and the extent of the beam direction search space, i.e. the set of candidate beam directions that may be selected for generating an optimal plan. For a group of ten prostate cancer patients, optimal IMRT plans were made for stereotactic body radiation therapy (SBRT), mimicking high dose rate brachytherapy dosimetry. Plans were generated for five different beam direction input sets: a coplanar (CP) set and four non-coplanar (NCP) sets. For CP treatments, the search space consisted of 72 orientations (5° separations). The NCP CyberKnife (CK) space contained all directions available in the robotic CK treatment unit. The fully non-coplanar (F-NCP) set facilitated the highest possible degree of freedom in selecting optimal directions. CK(+) and CK(++) were subsets of F-NCP to investigate some aspects of the CK space. For each input set, plans were generated with up to 30 selected beam directions. Generated plans were clinically acceptable, according to an assessment of our clinicians. Convergence in plan quality occurred only after around 20 included beams. For individual patients, variations in PTV dose delivery between the five generated plans were minimal, as aimed for (average spread in V(95): 0.4%). This allowed plan comparisons based on organ at risk (OAR) doses, with the rectum considered most important. Plans generated with the NCP search spaces had improved OAR sparing compared to the CP search space, especially for the rectum. OAR sparing was best with the F-NCP, with reductions in rectum D(Mean), V(40Gy), V(60Gy) and D(2%) compared to CP of 25%, 35%, 37% and 8%, respectively. Reduced rectum sparing with the CK search space compared to F-NCP could be largely compensated by expanding CK with beams with relatively large direction components along the superior-inferior axis (CK(++)). Addition of posterior beams (CK(++) → F-NCP) did not lead to further improvements in OAR sparing. Plans with 25 beams clearly performed better than 11-beam plans. For CP plans, an increase from 11 to 25 involved beams resulted in reductions in rectum D(Mean), V(40Gy), V(60Gy) and D(2%) of 39%, 57%, 64% and 13%, respectively.

Comparison of different computed radiography systems: Physical characterization and contrast detail analysis

PURPOSEnIn this study, five different units based on three different technologies-traditional computed radiography (CR) units with granular phosphor and single-side reading, granular phosphor and dual-side reading, and columnar phosphor and line-scanning reading-are compared in terms of physical characterization and contrast detail analysis.nnnMETHODSnThe physical characterization of the five systems was obtained with the standard beam condition RQA5. Three of the units have been developed by FUJIFILM (FCR ST-VI, FCR ST-BD, and FCR Velocity U), one by Kodak (Direct View CR 975), and one by Agfa (DX-S). The quantitative comparison is based on the calculation of the modulation transfer function (MTF), noise power spectrum (NPS), and detective quantum efficiency (DQE). Noise investigation was also achieved by using a relative standard deviation analysis. Psychophysical characterization is assessed by performing a contrast detail analysis with an automatic reading of CDRAD images.nnnRESULTSnThe most advanced units based on columnar phosphors provide MTF values in line or better than those from conventional CR systems. The greater thickness of the columnar phosphor improves the efficiency, allowing for enhanced noise properties. In fact, NPS values for standard CR systems are remarkably higher for all the investigated exposures and especially for frequencies up to 3.5 lp/mm. As a consequence, DQE values for the three units based on columnar phosphors and line-scanning reading, or granular phosphor and dual-side reading, are neatly better than those from conventional CR systems. Actually, DQE values of about 40% are easily achievable for all the investigated exposures.nnnCONCLUSIONSnThis study suggests that systems based on the dual-side reading or line-scanning reading with columnar phosphors provide a remarkable improvement when compared to conventional CR units and yield results in line with those obtained from most digital detectors for radiography.

A PET Prototype for “In-Beam” Monitoring of Proton Therapy

The in-beam PET is a novel PET application to image the beta+ activity induced in biological tissues by hadronic therapeutic beams. Thanks to the correlation existing between beam-delivered dose profiles and beam-induced activity profiles, in vivo information about the effective ion paths can be extracted from the in-beam pet image. in situ measurements, immediately after patient irradiation, are recommended in order to exploit the maximum statistics, by also detecting the contribution provided by the very short lived isotopes, e.g. 15O. A compact, dedicated tomograph should then be developed for such an application, so as to be used in the treatment room. We developed a small PET prototype in order to demonstrate the feasibility of such a technique for the monitoring of proton therapy of ocular tumors at the CATANA facility (Catania, Italy). The prototype consists of two planar heads with an active area of about 5 cm times 5 cm. Each head is made up of a square position sensitive photomultiplier (Hamamatsu H8500) coupled to a matrix of the same size of LYSO scintillating crystals (2 mm times 2 mm times 18 mm pixel dimensions). Dedicated, compact electronic boards are used for the signal multiplexing, amplification and digitization. The distance between the pair can be varied from 10 cm up to a maximum of about 20 cm. The validation of the prototype was performed on plastic phantoms using 62 MeV protons at the CATANA beam line. Different dose distributions were delivered and a good correlation between the distal fall-off of the activity profiles and of the dose profiles was found, i.e., better than 2 mm along the beam direction.

Computer-aided mass detection in mammography: False positive reduction via gray-scale invariant ranklet texture features

In this work, gray-scale invariant ranklet texture features are proposed for false positive reduction (FPR) in computer-aided detection (CAD) of breast masses. Two main considerations are at the basis of this proposal. First, false positive (FP) marks surviving our previous CAD system seem to be characterized by specific texture properties that can be used to discriminate them from masses. Second, our previous CAD system achieves invariance to linear/nonlinear monotonic gray-scale transformations by encoding regions of interest into ranklet images through the ranklet transform, an image transformation similar to the wavelet transform, yet dealing with pixels ranks rather than with their gray-scale values. Therefore, the new FPR approach proposed herein defines a set of texture features which are calculated directly from the ranklet images corresponding to the regions of interest surviving our previous CAD system, hence, ranklet texture features; then, a support vector machine (SVM) classifier is used for discrimination. As a result of this approach, texture-based information is used to discriminate FP marks surviving our previous CAD system; at the same time, invariance to linear/nonlinear monotonic gray-scale transformations of the new CAD system is guaranteed, as ranklet texture features are calculated from ranklet images that have this property themselves by construction. To emphasize the gray-scale invariance of both the previous and new CAD systems, training and testing are carried out without any in-between parameters adjustment on mammograms having different gray-scale dynamics; in particular, training is carried out on analog digitized mammograms taken from a publicly available digital database, whereas testing is performed on full-field digital mammograms taken from an in-house database. Free-response receiver operating characteristic (FROC) curve analysis of the two CAD systems demonstrates that the new approach achieves a higher reduction of FP marks when compared to the previous one. Specifically, at 60%, 65%, and 70% per-mammogram sensitivity, the new CAD system achieves 0.50, 0.68, and 0.92 FP marks per mammogram, whereas at 70%, 75%, and 80% per-case sensitivity it achieves 0.37, 0.48, and 0.71 FP marks per mammogram, respectively. Conversely, at the same sensitivities, the previous CAD system reached 0.71, 0.87, and 1.15 FP marks per mammogram, and 0.57, 0.73, and 0.92 FPs per mammogram. Also, statistical significance of the difference between the two per-mammogram and per-case FROC curves is demonstrated by the p-value < 0.001 returned by jackknife FROC analysis performed on the two CAD systems.

A new clinical unit for digital radiography based on a thick amorphous Selenium plate: Physical and psychophysical characterization

PURPOSEnHere, we present a physical and psychophysical characterization of a new clinical unit (named AcSelerate) for digital radiography based on a thick a-Se layer. We also compared images acquired with and without a software filter (named CRF) developed for reducing sharpness and noise of the images and making them similar to images coming from traditional computed radiography systems.nnnMETHODSnThe characterization was achieved in terms of physical figures of merit [modulation transfer function (MTF), noise power spectra (NPS), detective quantum efficiency (DQE)], and psychophysical parameters (contrast-detail analysis with an automatic reading of CDRAD images). We accomplished measurements with four standard beam conditions: RAQ3, RQA5, RQA7, and RQA9.nnnRESULTSnThe system shows an excellent MTF (about 50% at the Nyquist frequency). The DQE is about 55% at 0.5 lp/mm and above 20% at the Nyquist frequency and is almost independent from exposure. The contrast-detail curves are comparable to some of the best published data for other systems devoted to imaging in general radiography. The CRF filter influences both the MTF and NPS, but it does lead to very small changes on DQE. Also the visibility of CDRAD details is basically unaltered, when the filter is activated.nnnCONCLUSIONSnAs normally happens with detector based on direct conversion, the system presents an excellent MTF. The improved efficiency caused by the thick layer allows getting good noise characteristics and DQE results better (about 10% on average) than many of the computed radiography (CR) systems and comparable to those obtained by the best systems for digital radiography available on the market.

Cone‐beam breast computed tomography with a displaced flat panel detector array

PURPOSEnIn cone-beam computed tomography (CBCT), and in particular in cone-beam breast computed tomography (CBBCT), an important issue is the reduction of the image artifacts produced by photon scatter and the reduction of patient dose. In this work, the authors propose to apply the detector displacement technique (also known as asymmetric detector or extended view geometry) to approach this goal. Potentially, this type of geometry, and the accompanying use of a beam collimator to mask the unirradiated half-object in each projection, permits some reduction of radiation dose with respect to conventional CBBCT and a sizeable reduction of the overall amount of scatter in the object, for a fixed contrast-to-noise ratio (CNR).nnnMETHODSnThe authors consider a scan configuration in which the projection data are acquired from an asymmetrically positioned detector that covers only one half of the scan field of view. Monte Carlo simulations and measurements, with their CBBCT laboratory scanner, were performed using PMMA phantoms of cylindrical (70-mm diameter) and hemiellipsoidal (140-mm diameter) shape simulating the average pendant breast, at 80 kVp. Image quality was evaluated in terms of contrast, noise, CNR, contrast-to-noise ratio per unit of dose (CNRD), and spatial resolution as width of line spread function for high contrast details.nnnRESULTSnReconstructed images with the asymmetric detector technique deviate less than 1% from reconstruction with a conventional symmetric detector (detector view) and indicate a reduction of the cupping artifact in CT slices. The maximum scatter-to-primary ratio at the center of the phantom decreases by about 50% for both small and large diameter phantoms (e.g., from 0.75 in detector view to 0.40 in extended view geometry at the central axis of the 140-mm diameter PMMA phantom). Less cupping produces an increase of the CT number accuracy and an improved image detail contrast, but the associated increase of noise observed may produce a decrease of detail CNR. By simulating the energy deposited inside the phantoms, the authors evaluated a maximum 50% reduction of the absorbed dose at the expense of a decrease of CNR, for the half beam irradiation of the object performed with the displaced detector technique with respect to full beam irradiation. The decrease in CNR, and in absorbed dose as well, translates into a detail CNRD showing values comparable to or higher than the ones obtained for a conventional symmetric detector technique, attributed to the effect of decreased scatter in particular at the axis of the irradiated object. An estimate is provided (about 12%) for the average dose reduction possible in CBBCT at constant CNR for the average uncompressed breast (14 cm diameter, 50% glandularity), in case of minimum image overlapping in extended view.nnnCONCLUSIONSnSimulations and experiments show that CBCT reconstructions with the displaced detector technique and with a half beam collimator are less affected by scatter artifacts, which could lead to some decrease of the radiation dose to the irradiated object with respect to a conventional reconstruction. This dose reduction is associated with increase of noise, decrease of CNR, but equal or improved CNRD values. The use of a small area detector would allow also to reduce the apparatus cost and to improve the data transfer speed with a corresponding increment of frame rate.

Evaluation of Scattering in Cone-Beam Breast Computed Tomography: A Monte Carlo and Experimental Phantom Study

In this paper Monte Carlo simulations were performed for X-ray irradiations of breast phantoms of various sizes such as PMMA cylinders of different diameters and a hemi-ellipsoidal PMMA phantom. The aim was the evaluation of the 2D distribution of primary and scattered photons and Scatter-to-Primary Ratio (SPR) in projection images in cone-beam breast Computed Tomography (CT). Irradiation geometry and technique factors reproduce the experimental conditions used for validation measurements with a prototype CT breast scanner. Simulations were performed with GEANT4 software. We varied the phantom diameter and shape, the X-ray tube voltage and added filtration. Magnification was 1.31. SPR increases from 0.4 (at 8 cm cylinder diameter) up to 1.5 (14 cm cylinder diameter) at the centre of the phantom. In the same phantom, SPR has lower values toward the bases of the cylinder than at its centre. The scatter component increases by adopting a 50 kVp or higher tube voltages, up to 80 kVp, and by increasing the added filtration. Simulated and measured lateral profiles across a 14 cm cylinder diameter in projection images show a relative deviation of 4%. Simulations show a different distribution of scatter and SPR in a 14 cm diameter cylinder and 14 cm hemi-ellipsoidal phantom, so questioning the use of simple cylindrical geometries when simulating the attenuation of the pendant breast for scatter correction procedures. The strength and the non-uniformity of the SPR inside the cylindrical phantom decrease as the size of the air gap between object and detector increases.

Characterization of an In-Beam PET Prototype for Proton Therapy With Different Target Compositions

At the University of Pisa, the DoPET (Dosimetry with a Positron Emission Tomograph) project has focused on the development and characterization of an ad hoc, scalable, dual-head PET prototype for in-beam treatment planning verification of the proton therapy. In this paper we report the first results obtained with our current prototype, consisting of two opposing lutetium yttrium orthosilicate (LYSO) detectors, each one covering an area of 4.5 × 4.5 cm2. We measured the β+-activation induced by 62 MeV proton beams at Catana facility (LNS, Catania, Italy) in several plastic phantoms. Experiments were performed to evaluate the possibility to extract accurate phantom geometrical information from the reconstructed PET images. The PET prototype proved its capability of locating small air cavities in homogeneous PMMA phantoms with a submillimetric accuracy and of distinguishing materials with different 16O and 12C content by back mapping phantom geometry through the separation of the isotope contributions. This could be very useful in the clinical practice as a tool to highlight anatomical or physiological organ variations among different treatment sessions and to discriminate different tissue types, thus providing feedbacks for the accuracy of dose deposition.

The importance of Monte Carlo simulations in modeling detectors for Nuclear Medicine

Nowadays, Monte Carlo techniques are very common for the development of Nuclear Medicine systems. Simulations can be very helpful for the optimization of SPECT and PET cameras, and for investigating the importance of several physical effects involved in image formation. In this paper, a simulation study for evaluating various aspects inuencing image formation in detectors for Nuclear Medicine is presented. To this end, the EGSnrc Monte Carlo code has been used, which transports photons and electrons in any material and handling various physical phenomena. Here, some detector systems are simulated, consisting of a parallel-hole collimator and a pixellated scintillator. Various effects are investigated, such as electron transport, uorescence photons, collimator septa penetration. Results are evaluated by means of energy spectra, photon uxes, uniformity of response, SNR and spatial resolution.