Extension of RPI-adult male and female computational phantoms to obese patients and a Monte Carlo study of the effect on CT imaging dose

Although it is known that obesity has a profound effect on x-ray computed tomography (CT) image quality and patient organ dose, quantitative data describing this relationship are not currently available. This study examines the effect of obesity on the calculated radiation dose to organs and tissues from CT using newly developed phantoms representing overweight and obese patients. These phantoms were derived from the previously developed RPI-adult male and female computational phantoms. The result was a set of ten phantoms (five males, five females) with body mass indexes ranging from 23.5 (normal body weight) to 46.4 kg m(-2)?(morbidly obese). The phantoms were modeled using triangular mesh geometry and include specified amounts of the subcutaneous adipose tissue and visceral adipose tissue. The mesh-based phantoms were then voxelized and defined in the Monte Carlo N-Particle Extended code to calculate organ doses from CT imaging. Chest-abdomen-pelvis scanning protocols for a GE LightSpeed 16 scanner operating at 120 and 140 kVp were considered. It was found that for the same scanner operating parameters, radiation doses to organs deep in the abdomen (e.g., colon) can be up to 59% smaller for obese individuals compared to those of normal body weight. This effect was found to be less significant for shallow organs. On the other hand, increasing the tube potential from 120 to 140 kVp for the same obese individual resulted in increased organ doses by as much as 56% for organs within the scan field (e.g., stomach) and 62% for those out of the scan field (e.g., thyroid), respectively. As higher tube currents are often used for larger patients to maintain image quality, it was of interest to quantify the associated effective dose. It was found from this study that when the mAs was doubled for the obese level-I, obese level-II and morbidly-obese phantoms, the effective dose relative to that of the normal weight phantom increased by 57%, 42% and 23%, respectively. This set of new obese phantoms can be used in the future to study the optimization of image quality and radiation dose for patients of different weight classifications. Our ultimate goal is to compile all the data derived from these phantoms into a comprehensive dosimetry database defined in the VirtualDose software.     

Development of the two Korean adult tomographic computational phantoms for organ dosimetry

Following the previously developed Korean tomographic phantom, KORMAN, two additional whole-body tomographic phantoms of Korean adult males were developed from magnetic resonance (MR) and computed tomography (CT) images, respectively. Two healthy male volunteers, whose body dimensions were fairly representative of the average Korean adult male, were recruited and scanned for phantom development. Contiguous whole body MR images were obtained from one subject exclusive of the arms, while whole-body CT images were acquired from the second individual. A total of 29 organs and tissues and 19 skeletal sites were segmented via image manipulation techniques such as gray-level thresholding, region growing, and manual drawing, in which each of segmented image slice was subsequently reviewed by an experienced radiologist for anatomical accuracy. The resulting phantoms, the MR-based KTMAN-1 (Korean Typical MAN-1) and the CT-based KTMAN-2 (Korean Typical MAN-2), consist of 300 X 150 X 344 voxels with a voxel resolution of 2 X 2 X 5 mm3 for both phantoms. Masses of segmented organs and tissues were calculated as the product of a nominal reference density, the prevoxel volume, and the cumulative number of voxels defining each organs or tissue. These organs masses were then compared with those of both the Asian and the ICRP reference adult male. Organ masses within both KTMAN-1 and KTMAN-2 showed differences within 40% of Asian and ICRP reference values, with the exception of the skin, gall bladder, and pancreas which displayed larger differences. The resulting three-dimensional binary file was ported to the Monte Carlo code MCNPX2.4 to calculate organ doses following external irradiation for illustrative purposes. Colon, lung, liver, and stomach absorbed doses, as well as the effective dose, for idealized photon irradiation geometries (anterior-posterior and right lateral) were determined, and then compared with data from two other tomographic phantoms (Asian and Caucasian), and stylized ORNL phantom. The armless KTMAN-1 can be applied to dosimetry for computed tomography or lateral x-ray examination, while the whole body KTMAN-2 can be used for radiation protection dosimetry.     

Age-dependent organ and effective dose coefficients for external photons: a comparison of stylized and voxel-based paediatric phantoms

This present study investigates the anatomical realism of conventional stylized models of children by comparing organ dose conversion coefficients for the ORNL paediatric phantom series with those determined in the UF (University of Florida) voxel paediatric phantoms. The latter includes whole-body models of a 9 month male, 4 year female, 8 year female, 11 year male and a 14 year male. Of these phantoms, the 1 year, 5 year and 10 year ORNL phantoms, and 9 month male, 4 year female and 11 year male UF voxel phantoms were selected for side-by-side comparisons under idealized external photon irradiation. Organ absorbed dose per unit air kerma (Gy/Gy) for various radiosensitive organs and tissues were calculated for monoenergetic photons over the energy range of 15 keV to 10 MeV and for six irradiation geometries: anterior-posterior (AP), posterior-anterior (PA), right lateral (RLAT), left lateral (LLAT), rotational (ROT) and isotropic (ISO). Differences in organ dose conversion coefficients for the gonads, bone marrow, colon, lung and stomach, to which prominent tissue weighting factors are assigned, were depicted and analysed. Two major causes of observed differences were suggested: differences in organ shape and position and the differences in tissue shielding by overlying tissue regions within the phantoms. Significant discrepancies caused by anatomical differences between the two types of phantoms are also reported for several organs, and in particular, the thyroid and urinary bladder. The results of this study suggest that the paediatric series of ORNL phantoms also have less realistic internal organ and body anatomy and that dose conversion coefficients from these stylized phantoms should be re-evaluated using paediatric voxel phantoms.     

The UF series of tomographic computational phantoms of pediatric patients

Two classes of anthropomorphic computational phantoms exist for use in Monte Carlo radiation transport simulations: tomographic voxel phantoms based upon three-dimensional (3D) medical images, and stylized mathematical phantoms based upon 3D surface equations for internal organ definition. Tomographic phantoms have shown distinct advantages over the stylized phantoms regarding their similarity to real human anatomy. However, while a number of adult tomographic phantoms have been developed since the early 1990s, very few pediatric tomographic phantoms are presently available to support dosimetry in pediatric diagnostic and therapy examinations. As part of a larger effort to construct a series of tomographic phantoms of pediatric patients, five phantoms of different ages (9-month male, 4-year female, 8-year female, 11-year male, and 14-year male) have been constructed from computed tomography (CT) image data of live patients using an IDL-based image segmentation tool. Lungs, bones, and adipose tissue were automatically segmented through use of window leveling of the original CT numbers. Additional organs were segmented either semiautomatically or manually with the aid of both anatomical knowledge and available image-processing techniques. Layers of skin were created by adding voxels along the exterior contour of the bodies. The phantoms were created from fused images taken from head and chest-abdomen-pelvis CT exams of the same individuals (9-month and 4-year phantoms) or of two different individuals of the same sex and similar age (8-year, 11-year, and 14-year phantoms). For each model, the resolution and slice positions of the image sets were adjusted based upon their anatomical coverage and then fused to a single head-torso image set. The resolutions of the phantoms for the 9-month, 4-year, 8-year, 11-year, and 14-year are 0.43 x 0.43 x 3.0 mm, 0.45 x 0.45 x 5.0 mm, 0.58 x 0.58 x 6.0 mm, 0.47 X 0.47 x 6.00 mm, and 0.625 x 0.625 x 6.0 mm, respectively. While organ masses can be matched to reference values in both stylized and tomographic phantoms, side-by-side comparisons of organ doses in both phantom classes indicate that organ shape and positioning are equally important parameters to consider in accurate determinations of organ absorbed dose from external photon irradiation. Preliminary studies of external photon irradiation of the 11-year phantom indicate significant departures of organ dose coefficients from that predicted by the existing stylized phantom series. Notable differences between pediatric stylized and tomographic phantoms include anterior-posterior (AP) and right lateral (RLAT) irradiation of the stomach wall, left lateral (LLAT) and right lateral (RLAT) irradiation of the thyroid, and AP and posterior-anterior (PA) irradiation of the urinary bladder.     

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.     

Hybrid computational phantoms of the male and female newborn patient: NURBS-based whole-body models

Anthropomorphic computational phantoms are computer models of the human body for use in the evaluation of dose distributions resulting from either internal or external radiation sources. Currently, two classes of computational phantoms have been developed and widely utilized for organ dose assessment: (1) stylized phantoms and (2) voxel phantoms which describe the human anatomy via mathematical surface equations or 3D voxel matrices, respectively. Although stylized phantoms based on mathematical equations can be very flexible in regard to making changes in organ position and geometrical shape, they are limited in their ability to fully capture the anatomic complexities of human internal anatomy. In turn, voxel phantoms have been developed through image-based segmentation and correspondingly provide much better anatomical realism in comparison to simpler stylized phantoms. However, they themselves are limited in defining organs presented in low contrast within either magnetic resonance or computed tomography images-the two major sources in voxel phantom construction. By definition, voxel phantoms are typically constructed via segmentation of transaxial images, and thus while fine anatomic features are seen in this viewing plane, slice-to-slice discontinuities become apparent in viewing the anatomy of voxel phantoms in the sagittal or coronal planes. This study introduces the concept of a hybrid computational newborn phantom that takes full advantage of the best features of both its stylized and voxel counterparts: flexibility in phantom alterations and anatomic realism. Non-uniform rational B-spline (NURBS) surfaces, a mathematical modeling tool traditionally applied to graphical animation studies, was adopted to replace the limited mathematical surface equations of stylized phantoms. A previously developed whole-body voxel phantom of the newborn female was utilized as a realistic anatomical framework for hybrid phantom construction. The construction of a hybrid phantom is performed in three steps: polygonization of the voxel phantom, organ modeling via NURBS surfaces and phantom voxelization. Two 3D graphic tools, 3D-DOCTOR and Rhinoceros, were utilized to polygonize the newborn voxel phantom and generate NURBS surfaces, while an in-house MATLAB code was used to voxelize the resulting NURBS model into a final computational phantom ready for use in Monte Carlo radiation transport calculations. A total of 126 anatomical organ and tissue models, including 38 skeletal sites and 31 cartilage sites, were described within the hybrid phantom using either NURBS or polygon surfaces. A male hybrid newborn phantom was constructed following the development of the female phantom through the replacement of female-specific organs with male-specific organs. The outer body contour and internal anatomy of the NURBS-based phantoms were adjusted to match anthropometric and reference newborn data reported by the International Commission on Radiological Protection in their Publication 89. The voxelization process was designed to accurately convert NURBS models to a voxel phantom with minimum volumetric change. A sensitivity study was additionally performed to better understand how the meshing tolerance and voxel resolution would affect volumetric changes between the hybrid-NURBS and hybrid-voxel phantoms. The male and female hybrid-NURBS phantoms were constructed in a manner so that all internal organs approached their ICRP reference masses to within 1%, with the exception of the skin (-6.5% relative error) and brain (-15.4% relative error). Both hybrid-voxel phantoms were constructed with an isotropic voxel resolution of 0.663 mm--equivalent to the ICRP 89 reference thickness of the newborn skin (dermis and epidermis). Hybrid-NURBS phantoms used to create their voxel counterpart retain the non-uniform scalability of stylized phantoms, while maintaining the anatomic realism of segmented voxel phantoms with respect to organ shape, depth and inter-organ positioning.     

Organ and effective doses in pediatric patients undergoing helical multislice computed tomography examination

As multidetector computed tomography (CT) serves as an increasingly frequent diagnostic modality, radiation risks to patients became a greater concern, especially for children due to their inherently higher radiosensitivity to stochastic radiation damage. Current dose evaluation protocols include the computed tomography dose index (CTDI) or point detector measurements using anthropomorphic phantoms that do not sufficiently provide accurate information of the organ-averaged absorbed dose and corresponding effective dose to pediatric patients. In this study, organ and effective doses to pediatric patients under helical multislice computed tomography (MSCT) examinations were evaluated using an extensive series of anthropomorphic computational phantoms and Monte Carlo radiation transport simulations. Ten pediatric phantoms, five stylized (equation-based) ORNL phantoms (newborn, 1-year, 5-year, 10-year, and 15-year) and five tomographic (voxel-based) UF phantoms (9-month male, 4-year female, 8-year female, 11-year male, and 14-year male) were implemented into MCNPX for simulation, where a source subroutine was written to explicitly simulate the helical motion of the CT x-ray source and the fan beam angle and collimator width. Ionization chamber measurements were performed and used to normalize the Monte Carlo simulation results. On average, for the same tube current setting, a tube potential of 100 kVp resulted in effective doses that were 105% higher than seen at 80 kVp, and 210% higher at 120 kVp regardless of phantom type. Overall, the ORNL phantom series was shown to yield values of effective dose that were reasonably consistent with those of the gender-specific UF phantom series for CT examinations of the head, pelvis, and torso. However, the ORNL phantoms consistently overestimated values of the effective dose as seen in the UF phantom for MSCT scans of the chest, and underestimated values of the effective dose for abdominal CT scans. These discrepancies increased with increasing kVp. Finally, absorbed doses to select radiation sensitive organs such as the gonads, red bone marrow, colon, and thyroid were evaluated and compared between phantom types. Specific anatomical problems identified in the stylized phantoms included excessive pelvic shielding of the ovaries in the female phantoms, enhanced red bone marrow dose to the arms and rib cage for chest exams, an unrealistic and constant torso thickness resulting in excessive x-ray attenuation in the regions of the abdominal organs, and incorrect positioning of the thyroid within the stylized phantom neck resulting in insufficient shielding by clavicles and scapulae for lateral beam angles. To ensure more accurate estimates of organ absorbed dose in multislice CT, it is recommended that voxel-based phantoms, potentially tailored to individual body morphometry, be utilized in any future prospective epidemiological studies of medically exposed children.     

The effect of lead attenuators on dose in homogeneous phantoms

In radiotherapy, the radiation beam is sometimes shaped so as to deliver different doses to different organs or give a homogeneous dose to structures of different densities. This objective is achieved by the use of attenuating materials introduced into the beam. These attenuators alter the primary as well as the scattered radiation components of the beam. There is at present no accurate method of dose calculation for these situations. Most calculations are performed considering only the effect of the attenuators on the primary radiation beam and can produce large errors in dosimetry. In the present study, the broad beam attenuation is investigated in homogeneous phantoms for various radiation field sizes, photon beam energies, and depths in phantom. A calculational method taking account of primary as well as first scatter radiation is developed. This method predicts reasonably well the transmission through lead attenuators for the various experimental conditions investigated.     

Adaptation de l’irradiation à l’activité tumorale en radiothérapie conformationnelle avec modulation d’intensité pour les cancers tête et cou. Étude préliminaire sur fantômes

The aim of this study was to index delivered doses of irradiation to tumor activity and not only to tumor geometry. The elaboration of a new highly precise treatment protocol, based on tumor activity required a specific configuration in order to use this type of irradiation. Using a Treatment Planning System and two head and neck phantoms specially created, we have performed system characterization according to different treatment plans. Two models were created and used: a simplistic and an anatomical model. Our results showed that high-precision radiotherapy in limited zones is possible with intensity modulated radiation therapy when several conditions are met such as location, number of organs at risk, distance between Planning Target Volume and organs at risk, presence, volume and location of the tumor activity, number of fields. In order to use this irradiation method adapted to the tumor activity, a precise geometry will be necessary. However such high total and fractionated doses should be carefully evaluated before being prescribed clinically.     

CALDose_X-a software tool for the assessment of organ and tissue absorbed doses, effective dose and cancer risks in diagnostic radiology

CALDose_X is a software tool that provides the possibility of calculating incident air kerma (INAK) and entrance surface air kerma (ESAK), two important quantities used in x-ray diagnosis, based on the output of the x-ray equipment. Additionally, the software uses conversion coefficients (CCs) to assess the absorbed dose to organs and tissues of the human body, the effective dose as well as the patient's cancer risk for radiographic examinations. The CCs, ratios between organ or tissue absorbed doses and measurable quantities, have been calculated with the FAX06 and the MAX06 phantoms for 34 projections of 10 commonly performed x-ray examinations, for 40 combinations of tube potential and filtration ranging from 50 to 120 kVcp and from 2.0 to 5.0 mm aluminum, respectively, for various field positions, for 29 selected organs and tissues and simultaneously for the measurable quantities, INAK, ESAK and kerma area product (KAP). Based on the x-ray irradiation parameters defined by the user, CALDose_X shows images of the phantom together with the position of the x-ray beam. By using true to nature voxel phantoms, CALDose_X improves earlier software tools, which were mostly based on mathematical MIRD5-type phantoms, by using a less representative human anatomy.     

The GSF family of voxel phantoms

Voxel phantoms are human models based on computed tomographic or magnetic resonance images obtained from high-resolution scans of a single individual. They consist of a huge number of volume elements (voxels) and are at the moment the most precise representation of the human anatomy. The purpose of this paper is to introduce the GSF voxel phantoms, with emphasis on the new ones and highlight their characteristics and limitations. The GSF voxel family includes at the moment two paediatric and five adult phantoms of both sexes, different ages and stature and several others are under construction. Two phantoms made of physical calibration phantoms are also available to be used for validation purposes. The GSF voxel phantoms tend to cover persons of individual anatomy and were developed to be used for numerical dosimetry of radiation transport but other applications are also possible. Examples of applications in patient dosimetry in diagnostic radiology and in nuclear medicine as well as for whole-body irradiations from idealized external exposures are given and discussed.     

Organ dose calculations by Monte Carlo modeling of the updated VCH adult male phantom against idealized external proton exposure

The voxel-based visible Chinese human (VCH) adult male phantom has offered a high-quality test bed for realistic Monte Carlo modeling in radiological dosimetry simulations. The phantom has been updated in recent effort by adding newly segmented organs, revising walled and smaller structures as well as recalibrating skeletal marrow distributions. The organ absorbed dose against external proton exposure was calculated at a voxel resolution of 2 x 2 x 2 mm(3) using the MCNPX code for incident energies from 20 MeV to 10 GeV and for six idealized irradiation geometries: anterior-posterior (AP), posterior-anterior (PA), left-lateral (LLAT), right-lateral (RLAT), rotational (ROT) and isotropic (ISO), respectively. The effective dose on the VCH phantom was derived in compliance with the evaluation scheme for the reference male proposed in the 2007 recommendations of the International Commission on Radiological Protection (ICRP). Algorithm transitions from the revised radiation and tissue weighting factors are accountable for approximately 90% and 10% of effective dose discrepancies in proton dosimetry, respectively. Results are tabulated in terms of fluence-to-dose conversion coefficients for practical use and are compared with data from other models available in the literature. Anatomical variations between various computational phantoms lead to dose discrepancies ranging from a negligible level to 100% or more at proton energies below 200 MeV, corresponding to the spatial geometric locations of individual organs within the body. Doses show better agreement at higher energies and the deviations are mostly within 20%, to which the organ volume and mass differences should be of primary responsibility. The impact of body size on dose distributions was assessed by dosimetry of a scaled-up VCH phantom that was resized in accordance with the height and total mass of the ICRP reference man. The organ dose decreases with the directionally uniform enlargement of voxels. Potential pathways to improve the VCH phantom have also been briefly addressed. This work pertains to VCH-based systematic multi-particle dose investigations and will contribute to comparative dosimetry studies of ICRP standardized voxel phantoms in the near future.     

Estimation of effective dose equivalent to staff in diagnostic radiology

The irradiation of staff in diagnostic radiology was simulated for conditions commonly encountered in fluoroscopy. Scattered radiation distributions were produced from diagnostic x-ray beams generated at tube potentials in the range 60-120 kVp, using the abdomen sections of a Rando phantom. Doses to a number of organs in the head and neck were measured using a Rando phantom loaded with lithium fluoride thermoluminescent dosemeters. The torso sections were placed on a water phantom on top of a stand, with film badge dosemeters positioned on the surface of the phantom at the forehead, neck, chest and waist, and the phantom was placed in the radiation field. Doses to organs in the torso were calculated from the waist-level film badge dosemeter reading using normalised organ dose data. Radiation doses to organs below a lead apron, when worn, were estimated from the unshielded dose values using a transmission factor appropriate to the quality of the scattered radiation. The effective dose equivalent (EDE) to the phantom was calculated for various x-ray beam qualities and lead apron thicknesses and compared with the film badge doses. The results indicate that a dosemeter worn at the waist/chest level under a lead apron generally underestimates the EDE. Conversely, dosemeters worn at the forehead/neck tend to overestimate the EDE. It is recommended that a dosemeter is positioned under a lead apron, if worn.     

Organ doses from environmental exposures calculated using voxel phantoms of adults and children

This paper presents effective and organ dose conversion coefficients for members of the public due to environmental external exposures, calculated using the ICRP adult male and female reference computational phantoms as well as voxel phantoms of a baby, two children and four adult individual phantoms--one male and three female, one of them pregnant. Dose conversion coefficients are given for source geometries representing environmental radiation exposures, i.e. whole body irradiations from a volume source in air, representing a radioactive cloud, a plane source in the ground at a depth of 0.5?g?cm(-2), representing ground contamination by radioactive fall-out, and uniformly distributed natural sources in the ground. The organ dose conversion coefficients were calculated employing the Monte Carlo code EGSnrc simulating the photon transport in the voxel phantoms, and are given as effective and equivalent doses normalized to air kerma free-in-air at height 1?m above the ground in Sv Gy(-1). The findings showed that, in general, the smaller the body mass of the phantom, the higher the dose. The difference in effective dose between an adult and an infant is 80-90% at 50?keV and less than 40% above 100?keV. Furthermore, dose equivalent rates for photon exposures of several radionuclides for the above environmental exposures were calculated with the most recent nuclear decay data. Data are shown for effective dose, thyroid, colon and red bone marrow. The results are expected to facilitate regulation of exposure to radiation, relating activities of radionuclides distributed in air and ground to dose of the public due to external radiation as well as the investigation of the radiological effects of major radiation accidents such as the recent one in Fukushima and the decision making of several committees.     

Analysis of genomic instability in the offspring of fathers exposed to low doses of ionizing radiation

Transgenerational genomic instability was studied in nonirradiated children born from fathers who were irradiated with low doses of ionizing radiation while working as clean-up workers at the Chernobyl Nuclear Power Plant (liquidators) and nonirradiated mothers from nuclear families. Aberrant cell frequencies (ACFs), chromosomal type aberration frequencies, and chromatid break frequencies (CBFs) in the lymphocytes of fathers-liquidators, and their children were significantly higher when compared with the control group (P < 0.05). Individual ACFs, aberration frequencies, and CBFs were independent of the time between irradiation of the father and conception of the child (1 month to 18 years). Chromosomes were categorized into seven groups (A through G). Analysis of aberrant chromosomes within these groups showed no differences in the average frequency of aberrant chromosomes between children and fathers-liquidators. However, significant differences were observed in the average frequency of aberrant chromosomes in groups A, B, and C between children and mothers in the families of liquidators. These results suggest that low doses of radiation induce genomic instability in fathers. Moreover, low radiation doses might be responsible for individual peculiarities in transgenerational genomic instability in children (as a consequence of response to primary DNA damage). Thus, genomic instability may contribute to increased morbidity over the lifetime of these children.     

Improved lung dose calculation using tissue-maximum ratios in the Batho correction

We have reexamined the Batho power law for computing the dose within and beyond lung irradiated with small and large fields of cobalt-60 and 6-MV x rays. Using slab phantoms consisting of two materials, agreement between calculated and measured doses was within 2% inside lung for 6-MV x irradiation, but much poorer (9%) for cobalt-60 irradiation. For cobalt-60 irradiation, tissue-air ratios (TARs) were used initially in the Batho equation, while for 6-MV x rays, tissue-maximum ratios (TMRs) were used. When we substituted TMR values instead of TAR values for cobalt-60, we found marked improvement by nearly 5% in the accuracy of dose calculated within lung. This was confirmed by numerical comparison of the Batho expression with an analytic solution of the primary and first-scattered radiation. We therefore encourage the use of TMRs for cobalt-60 radiation, especially for larger radiation fields, and provide measured data tables for field sizes up to 50 X 50 cm2, and depths up to 30 cm. In addition to unifying the dosimetry for all megavoltage irradiation, this approach improves the accuracy of doses calculated within lung.     

The effect of anatomical modeling on space radiation dose estimates: a comparison of doses for NASA phantoms and the 5th, 50th, and 95th percentile male and female astronauts

The National Aeronautics and Space Administration (NASA) performs organ dosimetry and risk assessment for astronauts using model-normalized measurements of the radiation fields encountered in space. To determine the radiation fields in an organ or tissue of interest, particle transport calculations are performed using self-shielding distributions generated with the computer program CAMERA to represent the human body. CAMERA mathematically traces linear rays (or path lengths) through the computerized anatomical man (CAM) phantom, a computational stylized model developed in the early 1970s with organ and body profiles modeled using solid shapes and scaled to represent the body morphometry of the 1950 50th percentile (PCTL) Air Force male. With the increasing use of voxel phantoms in medical and health physics, a conversion from a mathematical-based to a voxel-based ray-tracing algorithm is warranted. In this study, the voxel-based ray tracer (VoBRaT) is introduced to ray trace voxel phantoms using a modified version of the algorithm first proposed by Siddon (1985 Med. Phys. 12 252-5). After validation, VoBRAT is used to evaluate variations in body self-shielding distributions for NASA phantoms and six University of Florida (UF) hybrid phantoms, scaled to represent the 5th, 50th, and 95th PCTL male and female astronaut body morphometries, which have changed considerably since the inception of CAM. These body self-shielding distributions are used to generate organ dose equivalents and effective doses for five commonly evaluated space radiation environments. It is found that dosimetric differences among the phantoms are greatest for soft radiation spectra and light vehicular shielding.     

MAX meets ADAM: a dosimetric comparison between a voxel-based and a mathematical model for external exposure to photons

The International Commission on Radiological Protection intends to revise the organ and tissue equivalent dose conversion coefficients published in various reports. For this purpose the mathematical human medical internal radiation dose (MIRD) phantoms, actually in use, have to be replaced by recently developed voxel-based phantoms. This study investigates the dosimetric consequences, especially with respect to the effective male dose, if not only a MIRD phantom is replaced by a voxel phantom, but also if the tissue compositions and the radiation transport codes are changed. This task will be resolved by systematically replacing in the mathematical ADAM/GSF exposure model, first the radiation transport code, then the tissue composition and finally the phantom anatomy, in order to arrive at the voxel-based MAX/EGS4 exposure model. The results show that the combined effect of these replacements can decrease the effective male dose by up to 25% for external exposures to photons for incident energies above 30 keV for different field geometries, mainly because of increased shielding by a heterogeneous skeleton and by the overlying adipose and muscle tissue, and also because of the positions internal organs have in a realistically designed human body compared to their positions in the mathematically constructed phantom.