PATIENT-SPECIFIC DOSE ESTIMATES IN DYNAMIC COMPUTED TOMOGRAPHY MYOCARDIAL PERFUSION EXAMINATION.

The study aimed to implement realistic source models of a computed tomography (CT) scanner and Monte Carlo simulations to actual patient data and to calculate patient-specific organ and effective dose estimates for patients undergoing dynamic CT myocardial perfusion examinations. Source models including bowtie filter, tube output and x-ray spectra were determined for a dual-source Siemens Somatom Definition Flash scanner. Twenty CT angiography patient datasets were merged with a scaled International Commission on Radiological Protection (ICRP) 110 voxel phantom. Dose simulations were conducted with ImpactMC software. Effective dose estimates varied from 5.0 to 14.6 mSv for the 80 kV spectrum and from 8.9 to 24.7 mSv for the 100 kV spectrum. Significant differences in organ doses and effective doses between patients emphasise the need to use actual patient data merged with matched anthropomorphic anatomy in the dose simulations to achieve a reasonable level of accuracy in the dose estimation procedure.

CT beam dosimetric characterization procedure for personalized dosimetry.

Personalized dosimetry in computed tomography (CT) can be realized by a full Monte Carlo (MC) simulation of the scan procedure. Essential input data needed for the simulation are appropriate CT x-ray source models and a model of the patient's body which is based on the CT image. The purpose of this work is to develop comprehensive procedures for the determination of CT x-ray source models and their verification by comparison of calculated and measured dose distributions in physical phantoms. Mobile equipment together with customized software was developed and used for non-invasive determination of equivalent source models of CT scanners under clinical conditions. Standard and physical anthropomorphic CT dose phantoms equipped with real-time CT dose probes at five representative positions were scanned. The accumulated dose was measured during the scan at the five positions. ImpactMC, an MC-based CT dose software program, was used to simulate the scan. The necessary inputs were obtained from the scan parameters, from the equivalent source models and from the material-segmented CT images of the phantoms. 3D dose distributions in the phantoms were simulated and the dose values calculated at the five positions inside the phantom were compared to measured dose values. Initial results were obtained by means of a General Electric Optima CT 660 and a Toshiba (Canon) Aquilion ONE. In general, the measured and calculated dose values were within relative uncertainties that had been estimated to be less than 10%. The procedures developed were found to be viable and rapid. The procedures are applicable to any scanner type under clinical conditions without making use of the service mode with stationary x-ray tube position. Results show that the procedures are well suited for determining and verifying the equivalent source models needed for personalized CT dosimetry based on post-scan MC calculations.

Relative response of the alanine dosimeter to medium energy x-rays.

The response of the alanine dosimeter to kilovoltage x-rays with respect to the dose to water was measured, relative to the response to Co-60 radiation.Two series of x-ray qualities were investigated, one ranging from 30 kV to 100 kV tube voltage (TW series), the other one ranging from 70 kV to 280 kV (TH series). Due to the use of the water calorimeter as a primary standard, the uncertainty of the delivered dose is significantly lower than for other published data. The alanine response was measured as described in a previous publication (Anton et al 2013 Phys. Med. Biol. 58 3259-82). The uncertainty component due to the alanine measurement and analysis is ⩽0.4%, the major part of the combined uncertainty of the relative response originates from the uncertainty of the delivered dose. The relative uncertainties of the relative response vary from ⩽2% for the TW series to ⩽1.1% for the TH series.Different from the behaviour of the alanine dosimeter for megavoltage x-rays or electrons, the relative response drops significantly from unity for Co-60 radiation to less than 64% for the TW quality with a tube voltage of 30 kV. In order to reproduce this behaviour through Monte Carlo simulations, not only the ratio of the absorbed dose to alanine to the absorbed dose to water has to be known, but also the intrinsic efficiency, i.e. the dependence of the number of free radicals generated per unit of absorbed dose on the photon energy. This quantity is not yet accessible for the TW series.For a possible use of the alanine dosimeter for kilovoltage x-rays, for example in electronic brachytherapy, users should rely on the measured data for the relative response which have become available with this publication.

Measurement of the mass energy-absorption coefficient of air for x-rays in the range from 3 to 60 keV.

For the first time the absolute photon mass energy-absorption coefficient of air in the energy range of 10 to 60 keV has been measured with relative standard uncertainties below 1%, considerably smaller than those of up to 2% assumed for calculated data. For monochromatized synchrotron radiation from the electron storage ring BESSY II both the radiant power and the fraction of power deposited in dry air were measured using a cryogenic electrical substitution radiometer and a free air ionization chamber, respectively. The measured absorption coefficients were compared with state-of-the art calculations and showed an average deviation of 2% from calculations by Seltzer. However, they agree within 1% with data calculated earlier by Hubbell. In the course of this work, an improvement of the data analysis of a previous experimental determination of the mass energy-absorption coefficient of air in the range of 3 to 10 keV was found to be possible and corrected values of this preceding study are given.

Calorimetric determination of the absorbed dose to water for medium-energy x-rays with generating voltages from 70 to 280 kV.

For medium energy x-rays produced with tube voltages from 70 to 280 kV, the absorbed dose to water, D(w), has been determined by means of water calorimetry with relative standard uncertainties ranging from 0.45% to 0.98% at 280 and 70 kV. The results were confirmed by Monte Carlo calculations, in which the ratios of D(w) at 5 cm depth in a reference water phantom to the air kerma free in air, K(a), at the same point in space were compared to the corresponding ratios determined experimentally. The general agreement between measurement and calculation was better than 1%. These results confirm earlier investigations in which the absorbed dose to graphite was determined by means of a graphite extrapolation chamber. For the Monte Carlo calculations, an attempt was made to present a complete uncertainty budget, taking into account type B contributions also.

Measurement of the x-ray mass energy-absorption coefficient of air using 3 keV to 10 keV synchrotron radiation.

For the first time absolute photon mass energy-absorption coefficients of air in the energy range 3 keV to 10 keV have been measured with relative standard uncertainties less than 1%, significantly smaller than those of up to 5% assumed hitherto for calculated data. Monochromatized synchrotron radiation was used to measure both the total radiant energy by means of silicon photodiodes calibrated against a cryogenic radiometer and the fraction of radiant energy that is deposited in dry air by means of a free air ionization chamber. The measured ionization charge was converted into energy absorbed in air by calculated effective W values of photons as a function of their energy based on new measurements of the W values in dry air for electron kinetic energies between 1 keV and 7 keV, also presented in this work. The measured absorption coefficients were compared with state-of-the art calculations and found to agree within 0.7% with data calculated earlier by Hubbell at energies above 4 keV but were found to differ by values up to 2.1% at 10 keV from more recent calculations of Seltzer.

Is there reliable experimental evidence for different dicentric yields in human lymphocytes produced by mammography X-rays free-in-air and within a phantom?

We examined the production of dicentrics in human lymphocytes irradiated with 29 kV X-rays to a depth of 13.5 mm in a PMMA phantom. For these irradiation conditions, which are appropriate for the diagnostic application of mammography X-rays, a coefficient alpha of (5.88+/-0.66) x 10(-2) Gy(-1) of the linear quadratic dose-response relationship was determined. This value does not differ significantly from the coefficient alpha of (6.55+/-0.97) x 10(-2) Gy(-1) obtained earlier for a free-in-air set-up using blood of the same donor. The results are interpreted in terms of both the energy distributions of the photon fluence of mammography X-rays free-in-air and those in the PMMA phantom. Based on earlier results of experiments with monochromatic X-rays in the energy range 1.83-40 keV (completed here by an additional measurement at 25 keV), a fit function alpha(E) to the measured alpha coefficients as a function of the energy E of monochromatic X-rays was used to calculate weighted mean values alpha for both the mammography X-ray spectra free-in-air and in the phantom. As a result, weighted mean values of (4.9+/-1.0) x 10(-2) Gy(-1) and (4.5+/-1.0) x 10(-2) Gy(-1) were obtained, respectively. Although the measured alpha coefficients for mammography X-rays appear to be systematically higher than those calculated as weighted mean values alpha, it can be concluded that the modification of the mammography X-ray spectrum to a depth of 13.5 mm in a PMMA phantom compared with the free-in-air spectrum has no significant influence on the dicentric yields in human lymphocytes.

Results supporting calculated wall correction factors for cavity chambers.

Thick walled cavity ionization chambers are used by primary standard laboratories as primary air kerma standards in 137Cs and 60Co gamma-rays. Application of the cavity theory requires correction for the effects of photon attenuation and scattering in the chamber walls. For more than a decade there have been intensive discussions about the validity of wall correction factors determined by more traditional extrapolation methods versus those calculated by Monte Carlo methods. For existing primary standards the alternative methods lead to results that differ by up to 50% of the correction itself. This report presents both experimental and theoretical results which strongly support the validity of calculated wall correction factors. Moreover, it is demonstrated that, in selected cases, the application of a linear extrapolation method leads to errors in the determination of the air kerma reaching up to 13%.

Mixed high energy photon and electron radiation fields for calibrating radiation protection dosemeters.

According to ISO 4037-3, calibrations of radiation protection dosemeters with photon radiation of energies above 3 MeV are performed under conditions of charged particle equilibrium. No information is provided concerning how to determine the response of dosemeters to radiation fields in the more general case when these conditions are not fulfilled. This paper deals with the production of mixed high energy photon and electron fields characterised by a lack or an excess of charged particles relative to conditions of equilibrium and describes a new procedure for the dosimetry in such fields. Through variation of the charged particle fluence fraction with respect to a nearly constant photon fluence, Hp(10) and H'(10) values varied by up to a factor of 1.74. The above mentioned basic study was utilised in the recent IAEA intercomparison (Co-ordinated Research Project 1996-1998) and EURADOS 'trial performance test' (1996-1998) for individual monitoring of photon radiation in testing response characteristics of individual dosemeters in non-charged particle equilibrium conditions.

Response of radiation protection dosemeters in mixed high-energy photon and electron radiation fields.

The response of radiation protection dosemeters in terms of the phantom-related operational quantities Hp(10) and H'(10.0 degrees) was measured for personal and area monitoring systems in mixed high-energy electron and photon radiation fields with energies up to 7 MeV. Using mixed radiation fields composed of different fractions of charged particle and photon fluence, three conditions were produced at the point of measurement: charged particle equilibrium (CPE) (a), a lack (b) and an excess (c) of charged particles relative to the conditions of CPE. Personal and area dosemeters of different types were investigated under conditions (a)-(c). A large variability of the response of the different dosemeter types was observed. The results are presented and discussed.