Image quantification for radiation dose calculations--limitations and uncertainties.

Radiation dose calculations in nuclear medicine depend on quantification of activity via planar and/or tomographic imaging methods. However, both methods have inherent limitations, and the accuracy of activity estimates varies with object size, background levels, and other variables. The goal of this study was to evaluate the limitations of quantitative imaging with planar and single photon emission computed tomography (SPECT) approaches, with a focus on activity quantification for use in calculating absorbed dose estimates for normal organs and tumors. To do this we studied a series of phantoms of varying complexity of geometry, with three radionuclides whose decay schemes varied from simple to complex. Four aqueous concentrations of 99mTc, ¹³¹I, and ¹¹¹In (74, 185, 370, and 740 kBq mL⁻¹) were placed in spheres of four different sizes in a water-filled phantom, with three different levels of activity in the surrounding water. Planar and SPECT images of the phantoms were obtained on a modern SPECT/computed tomography (CT) system. These radionuclides and concentration/background studies were repeated using a cardiac phantom and a modified torso phantom with liver and "tumor" regions containing the radionuclide concentrations and with the same varying background levels. Planar quantification was performed using the geometric mean approach, with attenuation correction (AC), and with and without scatter corrections (SC and NSC). SPECT images were reconstructed using attenuation maps (AM) for AC; scatter windows were used to perform SC during image reconstruction. For spherical sources with corrected data, good accuracy was observed (generally within ±10% of known values) for the largest sphere (11.5 mL) and for both planar and SPECT methods with 99mTc and ¹³¹I, but were poorest and deviated from known values for smaller objects, most notably for ¹¹¹In. SPECT quantification was affected by the partial volume effect in smaller objects and generally showed larger errors than the planar results in these cases for all radionuclides. For the cardiac phantom, results were the most accurate of all of the experiments for all radionuclides. Background subtraction was an important factor influencing these results. The contribution of scattered photons was important in quantification with ¹³¹I; if scatter was not accounted for, activity tended to be overestimated using planar quantification methods. For the torso phantom experiments, results show a clear underestimation of activity when compared to previous experiment with spherical sources for all radionuclides. Despite some variations that were observed as the level of background increased, the SPECT results were more consistent across different activity concentrations. Planar or SPECT quantification on state-of-the-art gamma cameras with appropriate quantitative processing can provide accuracies of better than 10% for large objects and modest target-to-background concentrations; however when smaller objects are used, in the presence of higher background, and for nuclides with more complex decay schemes, SPECT quantification methods generally produce better results.

A software to digital image processing to be used in the voxel phantom development.

Anthropomorphic models used in computational dosimetry, also denominated phantoms, are based on digital images recorded from scanning of real people by Computed Tomography (CT) or Magnetic Resonance Imaging (MRI). The voxel phantom construction requests computational processing for transformations of image formats, to compact two-dimensional (2-D) images forming of three-dimensional (3-D) matrices, image sampling and quantization, image enhancement, restoration and segmentation, among others. Hardly the researcher of computational dosimetry will find all these available abilities in single software, and almost always this difficulty presents as a result the decrease of the rhythm of his researches or the use, sometimes inadequate, of alternative tools. The need to integrate the several tasks mentioned above to obtain an image that can be used in an exposure computational model motivated the development of the Digital Image Processing (DIP) software, mainly to solve particular problems in Dissertations and Thesis developed by members of the Grupo de Pesquisa em Dosimetria Numérica (GDN/CNPq). Because of this particular objective, the software uses the Portuguese idiom in their implementations and interfaces. This paper presents the second version of the DIP, whose main changes are the more formal organization on menus and menu items, and menu for digital image segmentation. Currently, the DIP contains the menus Fundamentos, Visualizações, Domínio Espacial, Domínio de Frequências, Segmentações and Estudos. Each menu contains items and sub-items with functionalities that, usually, request an image as input and produce an image or an attribute in the output. The DIP reads edits and writes binary files containing the 3-D matrix corresponding to a stack of axial images from a given geometry that can be a human body or other volume of interest. It also can read any type of computational image and to make conversions. When the task involves only an output image, this is saved as a JPEG file in the Windows default; when it involves an image stack, the output binary file is denominated SGI (Simulações Gráficas Interativas (Interactive Graphic Simulations), an acronym already used in other publications of the GDN/CNPq.

Photon and electron absorbed fractions calculated from a new tomographic rat model.

This paper describes the development of a tomographic model of a rat developed using CT images of an adult male Wistar rat for radiation transport studies. It also presents calculations of absorbed fractions (AFs) under internal photon and electron sources using this rat model and the Monte Carlo code MCNP. All data related to the developed phantom were made available for the scientific community as well as the MCNP inputs prepared for AF calculations in that phantom and also all estimated AF values, which could be used to obtain absorbed dose estimates--following the MIRD methodology--in rats similar in size to the presently developed model. Comparison between the rat model developed in this study and that published by Stabin et al (2006 J. Nucl. Med. 47 655) for a 248 g Sprague-Dawley rat, as well as between the estimated AF values for both models, has been presented.

Application of the MAX/EGS4 exposure model to the dosimetry of the Yanango radiation accident.

According to the International Atomic Energy Agency (IAEA), industrial radiography accounts for approximately half of all reported accidents for the nuclear related industry. Detailed information about these accidents have been published by the IAEA in its Safety Report Series, one of which describes the radiological accident which happened in 1999 in Yanango/Peru. Under unsettled circumstances an 192Ir source was lost from an industrial radiographic camera and later picked up by a welder, who normally had nothing to do with the radiographic work. The man put the source into the right back pocket of his jeans and continued working for at least another 6.5 h. This study uses the MAX/EGS4 exposure model in order to determine absorbed dose distributions in the right thigh of the MAX phantom, as well as average absorbed doses to radiosensitive organs and tissues. For this purpose, the Monte Carlo code for standard exposure situations has been modified in order to match the irradiation conditions of the accident as closely as possible. The results present the maximum voxel absorbed dose, voxel depth absorbed dose and voxel surface absorbed dose distributions, average organ and tissue doses and a maximum surface absorbed dose for zero depth.

All about FAX: a Female Adult voXel phantom for Monte Carlo calculation in radiation protection dosimetry.

The International Commission on Radiological Protection (ICRP) has created a task group on dose calculations, which, among other objectives, should replace the currently used mathematical MIRD phantoms by voxel phantoms. Voxel phantoms are based on digital images recorded from scanning of real persons by computed tomography or magnetic resonance imaging (MRI). Compared to the mathematical MIRD phantoms, voxel phantoms are true to the natural representations of a human body. Connected to a radiation transport code, voxel phantoms serve as virtual humans for which equivalent dose to organs and tissues from exposure to ionizing radiation can be calculated. The principal database for the construction of the FAX (Female Adult voXel) phantom consisted of 151 CT images recorded from scanning of trunk and head of a female patient, whose body weight and height were close to the corresponding data recommended by the ICRP in Publication 89. All 22 organs and tissues at risk, except for the red bone marrow and the osteogenic cells on the endosteal surface of bone ('bone surface'), have been segmented manually with a technique recently developed at the Departamento de Energia Nuclear of the UFPE in Recife, Brazil. After segmentation the volumes of the organs and tissues have been adjusted to agree with the organ and tissue masses recommended by ICRP for the Reference Adult Female in Publication 89. Comparisons have been made with the organ and tissue masses of the mathematical EVA phantom, as well as with the corresponding data for other female voxel phantoms. The three-dimensional matrix of the segmented images has eventually been connected to the EGS4 Monte Carlo code. Effective dose conversion coefficients have been calculated for exposures to photons, and compared to data determined for the mathematical MIRD-type phantoms, as well as for other voxel phantoms.

All about MAX: a male adult voxel phantom for Monte Carlo calculations in radiation protection dosimetry.

The MAX (Male Adult voXel) phantom has been developed from existing segmented images of a male adult body, in order to achieve a representation as close as possible to the anatomical properties of the reference adult male specified by the ICRP. The study describes the adjustments of the soft-tissue organ masses, a new dosimetric model for the skin, a new model for skeletal dosimetry and a computational exposure model based on coupling the MAX phantom with the EGS4 Monte Carlo code. Conversion coefficients between equivalent dose to the red bone marrow as well as effective MAX dose and air-kerma free in air for external photon irradiation from the front and from the back, respectively, are presented and compared with similar data from other human phantoms.

A Monte Carlo approach to calculate dose distribution around the lineal brachytherapy sources.

Monte Carlo means the statistical methods used to solve stochastic or deterministic physical or mathematical problems. The use of this technique for solving deterministic problems is indicated whenever there is no analytical solution for the problem or when this solution is very difficult or when the use of numerical methods requires an excessive amount of CPU-time. This paper describes the application of Monte Carlo methods using a computer program, called ISODOSE, which calculates isodose curves around linear radioactive sources to be used in brachytherapy treatment-planning. Brachytherapy is a special form of cancer treatment in which the radioactive source is placed near or inside the tumor, in order to produce cancer tissue necrosis. The program is written in C language, and the results will be compared to similar data obtained from a commercially available program at Hospital do Cancer de Recife (Brazil), radiation therapy institute. The use of Monte Carlo techniques in the ISODOSE program allows for plotting isodose curves around linear sources, and it is especially more precise near the borders of the source (singularities), taking less time than it would be possible by using deterministic methods. The ISODOSE program can be used for brachytherapy planning in small clinics in Recife and adjacent areas.

A voxel-based head-and-neck phantom built from tomographic colored images.

Recent progress in computer speed and medical imaging has made possible the development of a new family of anthropomorphic models, based on a volume elements (voxels) approach to phantom design. Such phantoms can represent details of the anatomical structures of the human body more realistically. Tomographic images (CT or MRI) contain the basic information for the construction of voxel-based phantoms. Use of voxel-based phantoms has its most significant application in the planning of individual patients therapy. To be implemented, results must be obtained in a reasonably short period of time. The segmentation of organs and tissues is a critical step in this process. This article presents a new approach in the construction of voxel-based phantoms that was implemented to simplify the segmentation process of organs and tissues, reducing the time used in this procedure. A voxel-based head and neck phantom, called MCvoxEL, was built using this new approach. The volumes and masses of the segmented organs and tissues were compared with data published by other investigators.

An EGS4 based Monte Carlo code for the calculation of organ equivalent dose to a modified Yale voxel phantom.

Organ or tissue equivalent dose, the most important quantity in radiation protection, cannot be measured directly. Therefore it became common practice to calculate the quantity of interest with Monte Carlo methods applied to so-called human phantoms, which are virtual representations of the human body. The Monte Carlo computer code determines conversion coefficients, which are ratios between organ or tissue equivalent dose and measurable quantities. Conversion coefficients have been published by the ICRP (Report No. 74) for various types of radiation, energies and fields, which have been calculated, among others, with the mathematical phantoms ADAM and EVA. Since then progress of image processing, and of clock speed and memory capacity of computers made it possible to create so-called voxel phantoms, which are a far more realistic representation of the human body. Voxel (Volume pixel) phantoms are built from segmented CT and/or MRI images of real persons. A complete set of such images can be joined to a 3-dimensional representation of the human body, which can be linked to a Monte Carlo code allowing for particle transport calculations. A modified version of the VOX_TISS8 human voxel phantom (Yale University) has been connected to the EGS4 Monte Carlo code. The paper explains the modifications, which have been made, the method of coupling the voxel phantom with the code, and presents results as conversion coefficients between organ equivalent dose and kerma in air for external photon radiation. A comparison of the results with published data shows good agreement.