Peter F. Caracappa

The development, validation and application of a multi-detector CT (MDCT) scanner model for assessing organ doses to the pregnant patient and the fetus using Monte Carlo simulations

The latest multiple-detector technologies have further increased the popularity of x-ray CT as a diagnostic imaging modality. There is a continuing need to assess the potential radiation risk associated with such rapidly evolving multi-detector CT (MDCT) modalities and scanning protocols. This need can be met by the use of CT source models that are integrated with patient computational phantoms for organ dose calculations. Based on this purpose, this work developed and validated an MDCT scanner using the Monte Carlo method, and meanwhile the pregnant patient phantoms were integrated into the MDCT scanner model for assessment of the dose to the fetus as well as doses to the organs or tissues of the pregnant patient phantom. A Monte Carlo code, MCNPX, was used to simulate the x-ray source including the energy spectrum, filter and scan trajectory. Detailed CT scanner components were specified using an iterative trial-and-error procedure for a GE LightSpeed CT scanner. The scanner model was validated by comparing simulated results against measured CTDI values and dose profiles reported in the literature. The source movement along the helical trajectory was simulated using the pitch of 0.9375 and 1.375, respectively. The validated scanner model was then integrated with phantoms of a pregnant patient in three different gestational periods to calculate organ doses. It was found that the dose to the fetus of the 3 month pregnant patient phantom was 0.13 mGy/100 mAs and 0.57 mGy/100 mAs from the chest and kidney scan, respectively. For the chest scan of the 6 month patient phantom and the 9 month patient phantom, the fetal doses were 0.21 mGy/100 mAs and 0.26 mGy/100 mAs, respectively. The paper also discusses how these fetal dose values can be used to evaluate imaging procedures and to assess risk using recommendations of the report from AAPM Task Group 36. This work demonstrates the ability of modeling and validating an MDCT scanner by the Monte Carlo method, as well as assessing fetal and organ doses by combining the MDCT scanner model and the pregnant patient phantom.

RPI-AM and RPI-AF, a pair of mesh-based, size-adjustable adult male and female computational phantoms using ICRP-89 parameters and their calculations for organ doses from monoenergetic photon beams

This paper describes the development of a pair of adult male and adult female computational phantoms that are compatible with anatomical parameters for the 50th percentile population as specified by the International Commission on Radiological Protection (ICRP). The phantoms were designed entirely using polygonal mesh surfaces--a Boundary REPresentation (BREP) geometry that affords the ability to efficiently deform the shape and size of individual organs, as well as the body posture. A set of surface mesh models, from Anatomium 3D P1 V2.0, including 140 organs (out of 500 available) was adopted to supply the basic anatomical representation at the organ level. The organ masses were carefully adjusted to agree within 0.5% relative error with the reference values provided in the ICRP Publication 89. The finalized phantoms have been designated the RPI adult male (RPI-AM) and adult female (RPI-AF) phantoms. For the purposes of organ dose calculations using the MCNPX Monte Carlo code, these phantoms were subsequently converted to voxel formats. Monoenergetic photons between 10 keV and 10 MeV in six standard external photon source geometries were considered in this study: four parallel beams (anterior-posterior, posterior-anterior, left lateral and right lateral), one rotational and one isotropic. The results are tabulated as fluence-to-organ-absorbed-dose conversion coefficients and fluence-to-effective-dose conversion coefficients and compared against those derived from the ICRP computational phantoms, REX and REGINA. A general agreement was found for the effective dose from these two sets of phantoms for photon energies greater than about 300 keV. However, for low-energy photons and certain individual organs, the absorbed doses exhibit profound differences due to specific anatomical features. For example, the position of the arms affects the dose to the lung by more than 20% below 300 keV in the lateral source directions, and the vertical position of the testes affects the dose by more than 80% below 150 keV in the PA source direction. The deformability and adjustability of organs and posture in the RPI adult phantoms may prove useful not only for average workers or patients for radiation protection purposes, but also in studies involving anatomical and posture variability that is important in future radiation protection dosimetry.

Comparison of two types of adult phantoms in terms of organ doses from diagnostic CT procedures

The rapidly increasing number of diagnostic computed tomography (CT) procedures in the recent decades has spurred heightened concern over the potential risk to patients. Although an accurate organ dose assessment tool has now become highly desirable, existing software packages depend on stylized computational phantoms that were originally developed more than 40 years ago, exhibiting very large discrepancies when compared with phantoms that are anatomically realistic. However, past comparative studies did not focus on CT protocols for adult patients. This study was designed to quantitatively compare two types of phantoms, the stylized phantoms and a pair of recently developed RPI-adult male and adult female (RPI-AM and RPI-AF) phantoms, for various CT scanning protocols involving the chest, abdomen-pelvis and chest-abdomen-pelvis. Organ doses were based on Monte Carlo simulations using the MCNPX code and a detailed CT scanner model for the GE LightSpeed 16. Results are presented as ratios of organ doses from the stylized phantoms to those from the RPI phantoms. It is found that, for most organs contained in the scan volume, the ratios were within the range of 0.75-1.16. However, the stomach doses are significantly different and the ratio is found to be up to 1.86 in male phantoms and 2.29 in the female phantoms due to the anatomical differences between the two types of phantoms. Organs that lie near a scan boundary also exhibit a significant relative difference in organ doses between the two types of phantoms. This study concludes that, due to relatively low x-ray energies, CT doses are very sensitive to organ shape, size and position, and thus anatomically realistic phantoms should be used to avoid the dose uncertainties caused by the lack of anatomical realism. The new phantoms, such as the RPI-AM and AF phantoms that are designed using advanced surface meshes, are deformable and will make it possible to match the anatomy of a specific patient leading to further improvement in dose and risk assessments for patients undergoing CT examinations.

Fetal doses to pregnant patients from CT with tube current modulation calculated using Monte Carlo simulations and realistic phantoms

To investigate the radiation dose to the fetus using retrospective tube current modulation (TCM) data selected from archived clinical records. This paper describes the calculation of fetal doses using retrospective TCM data and Monte Carlo (MC) simulations. Three TCM schemes were adopted for use with three pregnant patient phantoms. MC simulations were used to model CT scanners, TCM schemes and pregnant patients. Comparisons between organ doses from TCM schemes and those from non-TCM schemes show that these three TCM schemes reduced fetal doses by 14, 18 and 25 %, respectively. These organ doses were also compared with those from ImPACT calculation. It is found that the difference between the calculated fetal dose and the ImPACT reported dose is as high as 46 %. This work demonstrates methods to study organ doses from various TCM protocols and potential ways to improve the accuracy of CT dose calculation for pregnant patients.

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.

Multi-resolution voxel phantom modeling: a high-resolution eye model for computational dosimetry

Voxel models of the human body are commonly used for simulating radiation dose with a Monte Carlo radiation transport code. Due to memory limitations, the voxel resolution of these computational phantoms is typically too large to accurately represent the dimensions of small features such as the eye. Recently reduced recommended dose limits to the lens of the eye, which is a radiosensitive tissue with a significant concern for cataract formation, has lent increased importance to understanding the dose to this tissue. A high-resolution eye model is constructed using physiological data for the dimensions of radiosensitive tissues, and combined with an existing set of whole-body models to form a multi-resolution voxel phantom, which is used with the MCNPX code to calculate radiation dose from various exposure types. This phantom provides an accurate representation of the radiation transport through the structures of the eye. Two alternate methods of including a high-resolution eye model within an existing whole-body model are developed. The accuracy and performance of each method is compared against existing computational phantoms.

Modelling and Monte Carlo organ dose calculations for workers walking on ground contaminated with Cs-137 and Co-60 gamma sources

A pair of walking phantoms was developed from deformable mesh phantoms to represent individuals walking on contaminated ground. The Monte Carlo N-particle extended version code was used to calculate organ doses from ground contamination scenarios involving parallel and isotropic planar sources of Cs-137 and Co-60 with concentrations of 30 kBqm(-2). For the parallel plane source case, the organ doses were up to 78 % greater for walking phantoms than those for the standing phantoms. The dose difference is because the widely open legs during walking provide less shielding to several organs, especially the kidneys, ovaries and liver, from parallel sources. The effective doses of the walking phantoms were on average 15 % higher than the standing phantoms. On the other hand, when isotropic planar sources were considered, no significant dose difference was observed. This study demonstrated the feasibility of using deformable phantoms to represent realistic postures for organ dose calculations in environmental dosimetry studies.

Development of posture-specific computational phantoms using motion capture technology and application to radiation dose-reconstruction for the 1999 Tokai-Mura nuclear criticality accident.

The majority of existing computational phantoms are designed to represent workers in typical standing anatomical postures with fixed arm and leg positions. However, workers found in accident-related scenarios often assume varied postures. This paper describes the development and application of two phantoms with adjusted postures specified by data acquired from a motion capture system to simulate unique human postures found in a 1999 criticality accident that took place at a JCO facility in Tokai-Mura, Japan. In the course of this accident, two workers were fatally exposed to extremely high levels of radiation. Implementation of the emergent techniques discussed produced more accurate and more detailed dose estimates for the two workers than were reported in previous studies. A total-body dose of 6.43 and 26.38 Gy was estimated for the two workers, who assumed a crouching and a standing posture, respectively. Additionally, organ-specific dose estimates were determined, including a 7.93 Gy dose to the thyroid and 6.11 Gy dose to the stomach for the crouching worker and a 41.71 Gy dose to the liver and a 37.26 Gy dose to the stomach for the standing worker. Implications for the medical prognosis of the workers are discussed, and the results of this study were found to correlate better with the patient outcome than previous estimates, suggesting potential future applications of such methods for improved epidemiological studies involving next-generation computational phantom tools.

TH‐C‐201B‐10: Development and Testing of a CT Dose Software “VirtualDose” Using Anatomically Realistic Patient Phantoms: Preliminary Results for the Phase I of the Project

Purpose: To demonstrate the need and feasibility for developing a new software for reporting patient imaging dose who undergoing CT or PET/CT examinations. Method and Materials: Existing CT dose reporting software do not meet the need because of the simplified anatomical phantoms updated ICRP data and scanner information. A new software is being designed with original dose data derived from Monte Carlo simulations involving CTscannermodels and anatomically realistic phantoms. Specified scanning protocols and CT sources are modeled. Dosimetry capabilities for tube current modulation (TCM) and PET/CT protocols are currently under development. The RPI Pregnant Women series RPI Adult Male and Adult Female phantoms are used in the dose calculation. Organ doses and effective doses are computed using ICRP Publication 60 and 103. The software framework is developed using the Visual C#.NET. Results: VirtualDose offers a modern graphical user interface (GUI) designed to allow interactive 3D phantom display and user‐selectable scanning parameters. Standard scanning ranges can be selected from a pull‐down menu or manually specified on the displayed phantom. When compared with data reported by existing software using stylized MIRD‐type phantoms the organ dose estimates have been found to differ by a ratio ranging from 0.77 to 1.24 for organs or tissues covered in the scan range and a ratio as small as 0.13 for organs outside of the scan region. The TCM technique can reduce the dose by around 20% for pregnant patient phantoms. Conclusion: It is clear that existing software do not meet the need for accurate and state‐of‐the‐art CT dose reporting. The preliminary GUI design and reporting features of VirtualDose improve upon existing tools by considering the latest CTscanners new ICRP recommendations and anatomically realistic patient phantoms. VirtualDose is expected to improve both the accuracy and usability in reporting CT doses in the future.

A dose-reconstruction study of the 1997 Sarov criticality accident using animated dosimetry techniques.

AbstractMost computational human phantoms are static, representing a standing individual. There are, however, cases when these phantoms fail to represent accurately the detailed effects on dose that result from considering varying human posture and even whole sequences of motion. In this study, the feasibility of a dynamic and deformable phantom is demonstrated with the development of the Computational Human for Animated Dosimetry (CHAD) phantom. Based on modifications to the limb structure of the previously developed RPI Adult Male, CHAD’s posture is adjustable using an optical motion capture system that records real-life human movement. To demonstrate its ability to produce dose results that reflect the changes brought about by posture-deformation, CHAD is employed to perform a dose-reconstruction analysis of the 1997 Sarov criticality accident, and a simulated total body dose of 13.3 Gy is observed, with the total body dose rate dropping from 1.4 Gy s−1 to 0.25 Gy s−1 over the first 4 s of retreat time. Additionally, dose measurements are calculated for individual organs and body regions, including a 36.8-Gy dose to the breast tissue, a 3.8-Gy dose to the bladder, and a 31.1-Gy dose to the thyroid, as well as the changes in dose rates for the individual organs over the course of the accident sequence. Comparison of results obtained using CHAD in an animated dosimetry simulation with reported information on dose and the medical outcome of the case shows that the consideration of posture and movement in dosimetry simulation allows for more detailed and precise analysis of dosimetry information, consideration of the evolution of the dose profile over time in the course of a given scenario, and a better understanding of the physiological impacts of radiation exposure for a given set of circumstances.