Monte Carlo evaluation of occupational exposure during uterine artery embolization.

PURPOSE: Uterine fibroids affect women mainly of childbearing age, an alternative for the treatment of these fibroids is uterine artery embolization (UAE), a minimally invasive procedure which uses fluoroscopy, providing radiation doses often high, due to the fact that professionals remain in the room throughout the procedure. In this work, equivalent and effective doses were evaluated for the main physician, for the assistant and for the patient during the UAE procedure. METHODS: Doses were calculated using computer simulation with the Monte Carlo Method, and virtual anthropomorphic phantoms, in a typical scenario of interventional radiology with field sizes of 20 × 20, 25 × 25 and 32 × 32 cm2, tube voltages of 70, 80, 90 and 100 kV, and projections of LAO45, RAO45 and PA. RESULTS: The results showed that the highest doses received by the professionals were for the LAO45 projection with 32 × 32 cm2 field size and 100 kV tube voltage, which is in accordance with the existing literature. The highest equivalent doses, without the protective equipment, were in the eyes, skin, breast and stomach for the main physician, and for the assistant they were in the eyes, breast, thyroid and skin. When she used the protective equipment, the highest equivalent doses for the main physician were on the skin, brain, bone marrow and bone surface, and for the assistant they were on the skin, brain, red bone marrow and bone surface. CONCLUSIONS: Effective doses increased up to 3186% for the main physician, and 2462% for the assistant, without protective equipment, thus showing their importance.

Dosimetry in Digital Breast Tomosynthesis Evaluated by Monte Carlo Technique.

ABSTRACT: The influence of the angular deviation of the tube during digital breast tomosynthesis (DBT) acquisition to the dose in the examined breast and in other organs and tissues is not well known. In this work, the Monte Carlo method was used with an adult female virtual anthropomorphic phantom to investigate the impact of this angular variation on the breast dose. The absorbed dose in the examined breast was normalized by the air kerma, which resulted in an absorbed dose coefficient (DT/Kair) for the breast. The absorbed dose in each organ was normalized by the glandular dose in the breast, resulting in the relative organ dose (ROD). An adult female virtual anthropomorphic phantom (FSTA_M50_H50) was incorporated into a scenario containing tomosynthesis equipment with Mo/Mo, Mo/Rh, and W/Rh target/filter combinations and tube voltages of 28 kV. The comparison between the results of the simulations considering digital mammography (DM) and DBT data showed that the DT/Kair values for the examined breast obtained with the DBT parameters were up to 24 times higher than with the DT/Kair obtained with DM parameters. A DT/Kair of 0.97 × 10-1 mGy mGy-1 was obtained in a DBT exam of the right breast. Considering the other organs, the highest ROD values were observed in the thyroid (6.45 × 10-4), eyes (3.87 × 10-4), liver (1.95 × 10-5), and eye lenses (3.21 × 10-3). A variation in the absorbed dose values for the breast and other organs was observed for all projections different from 0°.

Estimated risk of radiation-induced cancer following breast screening employing tomosynthesis and digital mammography.

The objective of this study was to estimate the risk of radiation-induced injury to the organs due to ionizing radiation following breast screening recommendations employing digital breast tomosynthesis (DBT) and digital mammography (DM). Using the Monte Carlo method, absorbed doses in the tissues and organs were calculated on an adult female phantom, considering two-view craniocaudal (CC) and mediolateral oblique (MLO) projections for each breast. The results showed differences in the total effective risk due to DM (CC + MLO) and DBT (CC + MLO) examinations in Brazil, ranging from 20.73 cases 10-5(DM) to 27.19 cases 10-5(DBT). Significant differences were also observed in the total effective risk of cancer incidence in the lungs due to DM (CC + MLO) and DBT (CC + MLO), ranging from 1.75×10-01cases 10-5(DM) to 1.76×10-01cases 10-5(DBT). The results indicate that the total effective risk of incidence should be considered as an additional parameter for the evaluation of DBT or DBT + DM program performance.

Dosimetric evaluation of individuals to 238U series, 232Th series and 40K radionuclides present in Brazilian ornamental rocks using computational simulation.

Granites are widely used in construction and they may be potential sources of ionizing radiation, due to the presence of radionuclides such as 40Kand decay products from 238Useries and 232Thseries. These radionuclides occur in the minerals constituting the rocks. To evaluate the doses in humans exposed to 40K, and decay products from 238Useries and 232Thseries γ radiation, a room with dimensions of 4.0 × 5.0 × 2.8 m3, with uniformly distributed radiation source on the floor of granitic rocks, was computationally modeled. Adult individuals were represented in the virtual scenario by two virtual anthropomorphic phantoms FASH3 and MASH3, incorporated simultaneously in the software MCNPX 2.7.0. The mean energy deposited on each organ and tissue of FASH3 and MASH3 phantoms was determined using the MCNPX F6 tally (MeV/g/particle), while the photon flux within the room was calculated with the MCNPX F4 tally (MeV/cm2/particle). The organs that obtained the highest conversion coefficients CC[HT](Sv/Gy) were the red bone marrow (0.94), skin (0.90), breast (0.81) and bladder (0.73) for the FASH3; skin (0.89), gonads (0.88), breast (0.79) and bladder (0.70) for the MASH3. The simulated air absorbed dose rates varied between 23.4 (11%) and 25.8 (12%) nGy/h, and the annual dose rates were 0.10 (6%) and 0.11 (6%) mSv/year. These results presented acceptable statistical uncertainties and they are in agreement with the literature. Fluency of photons pointed to the central region of the room floor as the place of greatest exposure. The results showed that the organs closer to the radiation source had the highest deposited energy values. Based on the annual effective dose data obtained, it was possible to note that the values are within the literature. We believe that the methodology used will allow the investigation of any ornamental material that emits natural radiation.

Occupational exposures during abdominal fluoroscopically guided interventional procedures for different patient sizes - A Monte Carlo approach.

In this study we evaluated the occupational exposures during an abdominal fluoroscopically guided interventional radiology procedure. We investigated the relation between the Body Mass Index (BMI), of the patient, and the conversion coefficient values (CC) for a set of dosimetric quantities, used to assess the exposure risks of medical radiation workers. The study was performed using a set of male and female virtual anthropomorphic phantoms, of different body weights and sizes. In addition to these phantoms, a female and a male phantom, named FASH3 and MASH3 (reference virtual anthropomorphic phantoms), were also used to represent the medical radiation workers. The CC values, obtained as a function of the dose area product, were calculated for 87 exposure scenarios. In each exposure scenario, three phantoms, implemented in the MCNPX 2.7.0 code, were simultaneously used. These phantoms were utilized to represent a patient and medical radiation workers. The results showed that increasing the BMI of the patient, adjusted for each patient protocol, the CC values for medical radiation workers decrease. It is important to note that these results were obtained with fixed exposure parameters.

Exposures in interventional radiology using Monte Carlo simulation coupled with virtual anthropomorphic phantoms.

In this work we investigated the way in which conversion coefficients from air kerma-area product for effective doses (CCE) and entrance skin doses (CCESD) in interventional radiology (IR) are affected by variations in the filtration, projection angle of the X-ray beam, lead curtain attached to the surgical table, and suspended shield lead glass in regular conditions of medical practice. Computer simulations were used to model an exposure scenario similar to a real IR room. The patient and the physician were represented by MASH virtual anthropomorphic phantoms, inserted in the MCNPX 2.7.0 radiation transport code. In all cases, the addition of copper filtration also increased the CCE and CCESD values. The highest CCE values were obtained for lateral, cranial and caudal projections. In these projections, the X-ray tube was located above the table, and more scattered radiation reached the middle and upper portions of the physician trunk, where most of the radiosensitive organs are located. Another important result of this study was to show that the physician's protection is 358% higher when the lead curtain and suspended shield lead glasses are used. The values of CCE and CCESD, presented in this study, are an important resource for calculation of effective doses and entrance skin doses in clinical practice.

Two-dimensional simulations of displacement accumulation incorporating shear strain.

Using ultrasound images to track large tissue deformations usually requires breaking up the deformation into steps and then summing the resulting displacement estimates. The accumulated displacement estimation error therefore depends not only on the error in each step but also on the statistical relationships between estimation steps. These relationships have not been thoroughly studied. Building on previous work with one-dimensional (1-D) simulations, the work reported here measured error variance for single-step and accumulated displacement estimates using two-dimensional (2-D) numerical simulations of ultrasound echo signals, subjected to both normal and axial shear strain as well as electronic noise. Previous results from 1-D simulations were confirmed, showing that errors due to electronic noise are negatively correlated between steps and accumulate slowly, while errors due to strain are positively correlated and accumulate quickly. These properties hold for both normal and axial shear strain. An analysis of 2-D kernel size for tissue under normal and axial shear strain was also performed. Under axial shear strain, error variance tends to increase with larger lateral kernel sizes but decrease for larger axial kernel sizes; the opposite relationship holds under normal strain. A combination of these two types of strain limits the practical kernel size in both dimensions.

Characterization of an extrapolation chamber for low-energy X-rays: experimental and Monte Carlo preliminary results.

The extrapolation chamber is a parallel-plate ionization chamber that allows variation of its air-cavity volume. In this work, an experimental study and MCNP-4C Monte Carlo code simulations of an ionization chamber designed and constructed at the Calibration Laboratory at IPEN to be used as a secondary dosimetry standard for low-energy X-rays are reported. The results obtained were within the international recommendations, and the simulations showed that the components of the extrapolation chamber may influence its response up to 11.0%.

Evaluation of the voltage quantities measured with different noninvasive meters for quality control at a calibration laboratory.

In this work the peak kilovoltage (kVp), practical peak voltage (PPV) and air kerma rate were measured with the noninvasive meters Radcal Accu-kV® Diagnostic Sensor™ model 40×12-W, and PTW Diavolt. The results were compared in order to ensure the quality control, compare the meters and establish the new quantity PPV, at the Calibration Laboratory of IPEN. These tests were performed using the standard diagnostic radiology quality beam RQR5, and the results are in good agreement.

Characterization of a homemade ionization chamber for radiotherapy beams.

A homemade cylindrical ionization chamber was studied for routine use in therapy beams of (60)Co and X-rays. Several characterization tests were performed: leakage current, saturation, ion collection efficiency, polarity effect, stability, stabilization time, chamber orientation and energy dependence. All results obtained were within international recommendations. Therefore the homemade ionization chamber presents usefulness for routine dosimetric procedures in radiotherapy beams.

Characterization of a CT ionization chamber for radiation field mapping.

A pencil-type ionization chamber, developed at Instituto de Pesquisas Energéticas e Nucleares (IPEN), was characterized with the objective to verify the possibility of its application in radiation field mapping procedures. The characterization tests were evaluated, and the results were satisfactory. The results obtained for the X radiation field mapping with the homemade chamber were compared with those of a PTW Farmer-type chamber (TN 30011-1). The maximum difference observed in this comparison was only 1.25%, showing good agreement.