Fluence-to-dose conversion coefficients from monoenergetic neutrons below 20 MeV based on the VIP-man anatomical model

A new set of fluence-to-absorbed dose and fluence-to-effective dose conversion coefficients have been calculated for neutrons below 20 MeV using a whole-body anatomical model, VIP-Man, developed from the high-resolution transverse colour photographic images of the National Library of Medicine's Visible Human Project. Organ dose calculations were performed using the Monte Carlo code MCNP for 20 monoenergetic neutron beams between 1 x 10(-9) MeV and 20 MeV under six different irradiation geometries: anterior-posterior, posterior-anterior, right lateral, left lateral, rotational and isotropic. The absorbed dose for 24 major organs and effective dose results based on the realistic VIP-Man are presented and compared with those based on the simplified MIRD-based phantoms reported in the literature. Effective doses from VIP-Man are not significantly different from earlier results for neutrons in the energy range studied. There are, however, remarkable deviations in organ doses due to the anatomical differences between the image-based and the earlier mathematical models.     

An analysis of dependency of counting efficiency on worker anatomy for in vivo measurements: whole-body counting

In vivo radiobioassay is integral to many health physics and radiological protection programs dealing with internal exposures. The Bottle Manikin Absorber (BOMAB) physical phantom has been widely used for whole-body counting calibrations. However, the shape of BOMAB phantoms-a collection of plastic, cylindrical shells which contain no bones or internal organs-does not represent realistic human anatomy. Furthermore, workers who come in contact with radioactive materials have rather different body shape and size. To date, there is a lack of understanding about how the counting efficiency would change when the calibrated counter is applied to a worker with complicated internal organs or tissues. This paper presents a study on various in vivo counting efficiencies obtained from Monte Carlo simulations of two BOMAB phantoms and three tomographic image-based models (VIP-Man, NORMAN and CNMAN) for a scenario involving homogeneous whole-body radioactivity contamination. The results reveal that a phantom's counting efficiency is strongly dependent on the shape and size of a phantom. Contrary to what was expected, it was found that only small differences in efficiency were observed when the density and material composition of all internal organs and tissues of the tomographic phantoms were changed to water. The results of this study indicate that BOMAB phantoms with appropriately adjusted size and shape can be sufficient for whole-body counting calibrations when the internal contamination is homogeneous.     

Simulation of organ-specific patient effective dose due to secondary neutrons in proton radiation treatment

Cancer patients undergoing radiation treatment are exposed to high doses to the target (tumour), intermediate doses to adjacent tissues and low doses from scattered radiation to all parts of the body. In the case of proton therapy, secondary neutrons generated in the accelerator head and inside the patient reach many areas in the patient body. Due to the improved efficacy of management of cancer patients, the number of long term survivors post-radiation treatment is increasing substantially. This results in concern about the risk of radiation-induced cancer appearing at late post-treatment times. This paper presents a case study to determine the effective dose from secondary neutrons in patients undergoing proton treatment. A whole-body patient model, VIP-Man, was employed as the patient model. The geometry dataset generated from studies made on VIP-Man was implemented into the GEANT4 Monte Carlo code. Two proton treatment plans for tumours in the lung and paranasal sinus were simulated. The organ doses and ICRP-60 radiation and tissue weighting factors were used to calculate the effective dose. Results show whole body effective doses for the two proton plans of 0.162 Sv and 0.0266 Sv, respectively, to which the major contributor is due to neutrons from the proton treatment nozzle. There is a substantial difference among organs depending on the treatment site.     

SAF values for internal photon emitters calculated for the RPI-P pregnant-female models using Monte Carlo methods

Estimates of radiation absorbed doses from radionuclides internally deposited in a pregnant woman and her fetus are very important due to elevated fetal radiosensitivity. This paper reports a set of specific absorbed fractions (SAFs) for use with the dosimetry schema developed by the Society of Nuclear Medicine's Medical Internal Radiation Dose (MIRD) Committee. The calculations were based on three newly constructed pregnant female anatomic models, called RPI-P3, RPI-P6, and RPI-P9, that represent adult females at 3-, 6-, and 9-month gestational periods, respectively. Advanced Boundary REPresentation (BREP) surface-geometry modeling methods were used to create anatomically realistic geometries and organ volumes that were carefully adjusted to agree with the latest ICRP reference values. A Monte Carlo user code, EGS4-VLSI, was used to simulate internal photon emitters ranging from 10 keV to 4 MeV. SAF values were calculated and compared with previous data derived from stylized models of simplified geometries and with a model of a 7.5-month pregnant female developed previously from partial-body CT images. The results show considerable differences between these models for low energy photons, but generally good agreement at higher energies. These differences are caused mainly by different organ shapes and positions. Other factors, such as the organ mass, the source-to-target-organ centroid distance, and the Monte Carlo code used in each study, played lesser roles in the observed differences in these. Since the SAF values reported in this study are based on models that are anatomically more realistic than previous models, these data are recommended for future applications as standard reference values in internal dosimetry involving pregnant females.     

A boundary-representation method for designing whole-body radiation dosimetry models: pregnant females at the ends of three gestational periods--RPI-P3, -P6 and -P9

Fetuses are extremely radiosensitive and the protection of pregnant females against ionizing radiation is of particular interest in many health and medical physics applications. Existing models of pregnant females relied on simplified anatomical shapes or partial-body images of low resolutions. This paper reviews two general types of solid geometry modeling: constructive solid geometry (CSG) and boundary representation (BREP). It presents in detail a project to adopt the BREP modeling approach to systematically design whole-body radiation dosimetry models: a pregnant female and her fetus at the ends of three gestational periods of 3, 6 and 9 months. Based on previously published CT images of a 7-month pregnant female, the VIP-Man model and mesh organ models, this new set of pregnant female models was constructed using 3D surface modeling technologies instead of voxels. The organ masses were adjusted to agree with the reference data provided by the International Commission on Radiological Protection (ICRP) and previously published papers within 0.5%. The models were then voxelized for the purpose of performing dose calculations in identically implemented EGS4 and MCNPX Monte Carlo codes. The agreements of the fetal doses obtained from these two codes for this set of models were found to be within 2% for the majority of the external photon irradiation geometries of AP, PA, LAT, ROT and ISO at various energies. It is concluded that the so-called RPI-P3, RPI-P6 and RPI-P9 models have been reliably defined for Monte Carlo calculations. The paper also discusses the needs for future research and the possibility for the BREP method to become a major tool in the anatomical modeling for radiation dosimetry.     

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.     

Development of a 30-week-pregnant female tomographic model from computed tomography (CT) images for Monte Carlo organ dose calculations

Assessment of radiation dose and risk to a pregnant woman and her fetus is an important task in radiation protection. Although tomographic models for male and female patients of different ages have been developed using medical images, such models for pregnant women had not been developed to date. This paper reports the construction of a partial-body model of a pregnant woman from a set of computed tomography (CT) images. The patient was 30 weeks into pregnancy, and the CT scan covered the portion of the body from above liver to below pubic symphysis in 70 slices. The thickness for each slice is 7 mm, and the image resolution is 512x512 pixels in a 48 cm x 48 cm field; thus, the voxel size is 6.15 mm3. The images were segmented to identify 34 major internal organs and tissues considered sensitive to radiation. Even though the masses are noticeably different from other models, the three-dimensional visualization verified the segmentation and its suitability for Monte Carlo calculations. The model has been implemented into a Monte Carlo code, EGS4-VLSI (very large segmented images), for the calculations of radiation dose to a pregnant woman. The specific absorbed fraction (SAF) results for internal photons were compared with those from a stylized model. Small and large differences were found, and the differences can be explained by mass differences and by the relative geometry differences between the source and the target organs. The research provides the radiation dosimetry community with the first voxelized tomographic model of a pregnant woman, opening the door to future dosimetry studies.     

An anatomically realistic whole-body pregnant-woman model and specific absorption rates for pregnant-woman exposure to electromagnetic plane waves from 10 MHz to 2 GHz

The numerical dosimetry of pregnant women is an important issue in electromagnetic-field safety. However, an anatomically realistic whole-body pregnant-woman model for electromagnetic dosimetry has not been developed. Therefore, we have developed a high-resolution whole-body model of pregnant women. A new fetus model including inherent tissues of pregnant women was constructed on the basis of abdominal magnetic resonance imaging data of a 26-week-pregnant woman. The whole-body pregnant-woman model was developed by combining the fetus model and a nonpregnant-woman model that was developed previously. The developed model consists of about 7 million cubical voxels of 2 mm size and is segmented into 56 tissues and organs. This pregnant-woman model is the first completely anatomically realistic voxel model that includes a realistic fetus model and enables a numerical simulation of electromagnetic dosimetry up to the gigahertz band. In this paper, we also present the basic specific absorption rate characteristics of the pregnant-woman model exposed to vertically and horizontally polarized electromagnetic waves from 10 MHz to 2 GHz.     

Monte Carlo modeling of radiation dose distributions in intravascular radiation therapy

Radiation dose distributions are developed for balloon and wire sources of radioactivity within coronary arteries. The Monte Carlo codes MCNP 4B and EGS4 were used to calculate dose distributions for photons and electrons at discrete energies around such sources, with and without the presence of a high-density atherosclerotic plaque. An interactive computer program was developed which then calculates dose distributions for many radionuclides by applying the emission spectra to the discrete energy grids calculated by the Monte Carlo codes, weighting appropriately for electron energy and abundance. Results for Re-186 and Re-188 balloon sources are shown in comparison to an Ir-192 wire source. The program provides dose distributions as well as estimates of activity levels needed to deliver prescribed doses to the vessel wall at selected distances from the lumen in a selected time interval. In addition, dose calculations are presented in this paper for other organs in the body, from photon radiation as well as from possible loss of liquid activity into the bloodstream in the case of a balloon rupture. These results, especially the interactive computer program permitting easy comparison of various radionuclides and their physical characteristics, will greatly facilitate the comparison process and aid in the selection of the best candidate(s) for clinical use.     

An EGS4-ready tomographic computational model of a 14-year-old female torso for calculating organ doses from CT examinations.

Fifty-four consecutive CT scans have been used to construct a tomographic computational model of a 14-year-old female torso suitable for the determination of organ doses from CT. The model, known as ADELAIDE, is in the form of an input file compatible with user codes based on XYZDOS.MOR from the readily available EGS4 Monte Carlo radiation transport code. ADELAIDE's dimensions are close to the Australian averages for her age so the model is representative of a 14-year-old girl. The realistic anatomy in the model differs considerably from that in Cristy's 15-year-old mathematical computational model by having realistically shaped organs that are appropriately located within a real external contour. Average absorbed dose to organs from simulated CT examinations of the chest and abdomen have been calculated for ADELAIDE using EGS4 within a geometry specific to the General Electric Hi-Speed Advantage CT scanner and using an x-ray spectrum calculated using data from the scanner's x-ray tube. The simulations include the scanner's beam shaping filter and patient table. It is suggested that the resulting values have fewer possible sources of uncertainty than organ doses derived from dose coefficients calculated for a MIRD style model with mathematical anatomy and a spectrum that may not match that of the scanner. The organ doses were normalized using the scanner's CTDI measured free-in-air and an EGS4 simulation of the CTDI measurement. Effective dose to the torso from 26-slice chest and 24-slice abdomen examinations (at 120 kV, 200 mAs, 7 mm slices) is 4.6 +/- 0.1 mSv and 4.3 +/- 0.1 mSv respectively.     

A standard timing benchmark for EGS4 Monte Carlo calculations.

A Fortran 77 Monte Carlo source code built from the EGS4 Monte Carlo code system has been used for timing benchmark purposes on 29 different computers. This code simulates the deposition of energy from an incident electron beam in a 3-D rectilinear geometry such as one would employ to model electron and photon transport through a series of CT slices. The benchmark forms a standalone system and does not require that the EGS4 system be installed. The Fortran source code may be ported to different architectures by modifying a few lines and only a moderate amount of CPU time is required ranging from about 5 h on PC/386/387 to a few seconds on a massively parallel supercomputer (a BBN TC2000 with 512 processors).     

Monte Carlo simulations for external neutron dosimetry based on the visible Chinese human phantom

A group of Monte Carlo simulations has been performed for external neutron dosimetry calculation based on a whole-body anatomical model, the visible Chinese human (VCH) phantom, which was newly developed from high-resolution cryosectional color photographic images of a healthy Chinese adult male cadaver. Physical characteristics of the VCH computational phantom that consists of 230 x 120 x 892 voxels corresponding to an element volume of 2 x 2 x 2 mm(3) are evaluated through comparison against a variety of other anthropomorphic models. Organ-absorbed doses and the effective doses for monoenergic neutron beams ranging from 10(-9) MeV to 10 GeV under six idealized irradiation geometries (AP, PA, LLAT, RLAT, ROT and ISO) were calculated using the Monte Carlo code MCNPX2.5. Absorbed dose results for selected organs and the effective doses are presented in the form of tables. Dose results are also compared with currently available neutron data form ICRP Publication 74 and those of VIP-Man. Anatomical variations between different models, as well as their influence on dose distributions, are explored. Detailed information derived from the VCH phantom is able to lend quantitative references to the widespread application of human computational models in radiology.     

X-ray imaging optimization using virtual phantoms and computerized observer modelling

This study develops and demonstrates a realistic x-ray imaging simulator with computerized observers to maximize lesion detectability and minimize patient exposure. A software package, ViPRIS, incorporating two computational patient phantoms, has been developed for simulating x-ray radiographic images. A tomographic phantom, VIP-Man, constructed from Visible Human anatomical colour images is used to simulate the scattered portion using the ESGnrc Monte Carlo code. The primary portion of an x-ray image is simulated using the projection ray-tracing method through the Visible Human CT data set. To produce a realistic image, the software simulates quantum noise, blurring effects, lesions, detector absorption efficiency and other imaging artefacts. The primary and scattered portions of an x-ray chest image are combined to form a final image for computerized observer studies and image quality analysis. Absorbed doses in organs and tissues of the segmented VIP-Man phantom were also obtained from the Monte Carlo simulations. Approximately 25,000 simulated images and 2,500,000 data files were analysed using computerized observers. Hotelling and Laguerre-Gauss Hotelling observers are used to perform various lesion detection tasks. Several model observer tasks were used including SKE/BKE, MAFC and SKEV. The energy levels and fluence at the minimum dose required to detect a small lesion were determined with respect to lesion size, location and system parameters.     

A comparison between EGS4 and MCNP computer modeling of an in vivo X-ray fluorescence system

The Monte Carlo computer codes EGS4 and MCNP were used to develop a theoretical model of a 180 degrees geometry in vivo X-ray fluorescence system for the measurement of platinum concentration in head and neck tumors. The model included specification of the photon source, collimators, phantoms and detector. Theoretical results were compared and evaluated against X-ray fluorescence data obtained experimentally from an existing system developed by the Swansea In Vivo Analysis and Cancer Research Group. The EGS4 results agreed well with the MCNP results. However, agreement between the measured spectral shape obtained using the experimental X-ray fluorescence system and the simulated spectral shape obtained using the two Monte Carlo codes was relatively poor. The main reason for the disagreement between the results arises from the basic assumptions which the two codes used in their calculations. Both codes assume a "free" electron model for Compton interactions. This assumption will underestimate the results and invalidates any predicted and experimental spectra when compared with each other.     

Monte Carlo calculations of the dose backscatter factor for monoenergetic electrons

Recently, there has been growing interest in beta emitters for therapeutic uses, especially in connection with so-called endovascular (or intravascular) brachytherapy. Since accurate dose estimation is necessary for the success of such applications, some problems in beta-ray dosimetry need further study. Among these problems, we have investigated the effect of electron backscattering on dose, which has significance not only for accurate dose estimation but also for new source design. In this study, an empirical measure of electron backscattering, known as the dose backscatter factor, was calculated using EGS4 Monte Carlo calculations for monoenergetic electrons and various scattering materials. Electron energies were 0.1, 0.5, 1.0, 2.0 and 3.0 MeV in combination with Al (Z = 13), Ti (Z = 22), Sr (Z = 38), Ag (Z = 47) and Pt (Z = 78) scatterers. The dose backscatter factor ranged from 10% to 60%, depending on electron energy and material, and was found to increase with the atomic number Z by a log(Z + 1) relationship. A method is presented for calculating the beta-ray dose backscatter factors using the results of this study. To demonstrate the efficacy of this method, a dose backscatter factor depth profile for 32P near a water/aluminium interface was calculated and these calculated results were found to generally reproduce the depth profile obtained from direct EGS4 calculations using the 32P spectrum. The data presented in this study can be used to calculate dose backscatter factors for any combination of beta emitter/scatterer whose atomic number ranges from 13 to 78.     

Off-axis x-ray spectra: a comparison of Monte Carlo simulated and computed x-ray spectra with measured spectra

The off-axis x-ray spectra from a constant potential x-ray generator were measured with a high purity germanium spectrometer cooled to liquid nitrogen temperature. The measured spectra were compared with off-axis x-ray spectra calculated using a code based on the semiempirical model developed by Tucker et al. and Monte Carlo simulated x-ray spectra using the EGS4 code system. In this study, both the Tucker model, and the EGS4 code system, were found to produce off-axis bremsstrahlung x-ray spectra which agreed well with the spectra measured at three emerging angles. In the measured and the EGS4 generated spectra the total K-characteristic peaks were in increasing order, as observed in the anode to cathode direction, whereas the Tucker model produced maximum total K-characteristic peaks at the 6 degrees anode side, and lesser amounts at the central axis and the 6 degrees cathode side. Large differences in the total K-characteristic lines is seen among the three different methods. The EGS4 code system was able to produce x-ray spectra for a combination of target materials.     

Simultaneous determination of equivalent dose to organs and tissues of the patient and of the physician in interventional radiology using the Monte Carlo method

This study presents the results of computations of organ equivalent doses and effective doses for the patient and the primary physician during an interventional cardiological examination. The simulations were carried out for seven x-ray spectra (between 60 kVp and 120 kVp) using the Monte Carlo code MCNP. The voxel-based whole-body model VIP-Man was employed to represent both the patient and the physician, the former lying on the operation table while the latter standing 15 cm from the patient at about waist level behind a lead apron. The x-rays, which were generated by a point source positioned around the table and were directed with a conical distribution, irradiated the patient's heart under five major projections used in a coronary angiography examination. The mean effective doses under LAO45, PA, RAO30, LAO45/CAUD30 and LLAT irradiation conditions were calculated as 0.092, 0.163, 0.161, 0.133 and 0.118 mSv/(Gy cm2) for the patient and 1.153, 0.159, 0.145, 0.164 and 0.027 microSv/(Gy cm2) for the shielded physician. The effective doses for the patient determined in this study were usually lower than the literature data obtained through measurements and/or calculations and the discrepancies could be attributed to the fact that this study computes the effective doses specific to the VIP-Man body model, which lacks an ovarian contribution to the gonadal equivalent dose. The effective doses for the physician agreed reasonably well with the literature data.     

Comparisons between MCNP, EGS4 and experiment for clinical electron beams

Understanding the limitations of Monte Carlo codes is essential in order to avoid systematic errors in simulations, and to suggest further improvement of the codes. MCNP and EGS4, Monte Carlo codes commonly used in medical physics, were compared and evaluated against electron depth dose data and experimental backscatter results obtained using clinical radiotherapy beams. Different physical models and algorithms used in the codes give significantly different depth dose curves and electron backscattering factors. The default version of MCNP calculates electron depth dose curves which are too penetrating. The MCNP results agree better with experiment if the ITS-style energy-indexing algorithm is used. EGS4 underpredicts electron backscattering for high-Z materials. The results slightly improve if optimal PRESTA-I parameters are used. MCNP simulates backscattering well even for high-Z materials. To conclude the comparison, a timing study was performed. EGS4 is generally faster than MCNP and use of a large number of scoring voxels dramatically slows down the MCNP calculation. However, use of a large number of geometry voxels in MCNP only slightly affects the speed of the calculation.     

Generation and use of photon energy deposition kernels for diagnostic quality x rays.

Accurately determining the dose from low energy x rays is becoming increasingly important. This is especially so because of high doses in interventional radiology procedures and also because of the desire to model accurately the dose around low energy brachytherapy sources. Various methods to estimate the dose from specific procedures are available but they only give a general idea of the true dose to various organs. The use of sophisticated three-dimensional (3D) dose deposition algorithms designed originally for radiation therapy treatment planning can be extended to lower photon energy regions. The majority of modern 3D treatment planning systems use a variation of the convolution algorithm to calculate dose distributions. This could be extended into the diagnostic energy range with the availability of lower energy deposition kernels ( < 100 keV). We have used version four of the Electron Gamma Shower (EGS4) system of Monte Carlo codes to generate photon energy deposition kernels in the energy range of 20-110 keV and have implemented them in a commercial 3D treatment planning system (Pinnacle, ADAC Laboratories, Milpitas, CA). The kernels were generated using the "SCASPH" EGS4 user code by selecting the appropriate transport parameters suitable for the relative low energy of the incident photons. The planning system was subsequently used to model diagnostic quality beams and to calculate depth dose and cross profile curves. Comparisons of the calculated curves have been made with measurements performed in a homogeneous water phantom.     

Biological effects of the Auger emitter iodine-125: a review. Report No. 1 of AAPM Nuclear Medicine Task Group No. 6.

The biological implications of Auger electron cascades following inner shell ionization of atoms have been of interest for over 25 years. By virtue of their decay via orbital electron capture and/or internal conversion, several biomedical radionuclides emit numerous low-energy electrons spontaneously. The biological effects of such radionuclides incorporated into tissues cannot be predicted a priori because of the highly localized patterns of energy deposition by the electrons. Results of extensive research using Iodine-125 as a model Auger electron emitter are now available. This article presents an up-to-date review of the physical and radiobiological data on this Auger emitter. Valuable concepts concerning the action of internal Auger emitters are identified phenomenologically, and questions that need to be answered are indicated. The present understanding provides a scientific basis toward estimation of risk associated with Auger emitters used in diagnosis, and suggests potential applications to therapy.