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.     

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.     

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.     

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 newborn patients during helical multislice computed tomography examination

In this study, two computational phantoms of the newborn patient were used to assess individual organ doses and effective doses delivered during head, chest, abdomen, pelvis, and torso examinations using the Siemens SOMATOM Sensation 16 helical multi-slice computed tomography (MSCT) scanner. The stylized phantom used to model the patient anatomy was the revised ORNL newborn phantom by Han et al (2006 Health Phys.90 337). The tomographic phantom used in the study was that developed by Nipper et al (2002 Phys. Med. Biol. 47 3143) as recently revised by Staton et al (2006 Med. Phys. 33 3283). The stylized model was implemented within the MCNP5 radiation transport code, while the tomographic phantom was incorporated within the EGSnrc code. In both codes, the x-ray source was modelled as a fan beam originating from the focal spot at a fan angle of 52 degrees and a focal-spot-to-axis distance of 57 cm. The helical path of the source was explicitly modelled based on variations in collimator setting (12 mm or 24 mm), detector pitch and scan length. Tube potentials of 80, 100 and 120 kVp were considered in this study. Beam profile data were acquired using radiological film measurements on a 16 cm PMMA phantom, which yielded effective beam widths of 14.7 mm and 26.8 mm for collimator settings of 12 mm and 24 mm, respectively. Values of absolute organ absorbed dose were determined via the use of normalization factors defined as the ratio of the CTDI(100) measured in-phantom and that determined by Monte Carlo simulation of the PMMA phantom and ion chamber. Across various technique factors, effective dose differences between the stylized and tomographic phantoms ranged from +2% to +9% for head exams, -4% to -2% for chest exams, +8% to +24% for abdominal exams, -16% to -12% for pelvic exams and -7% to 0% for chest-abdomen-pelvis (CAP) exams. In many cases, however, relatively close agreement in effective dose was accomplished at the expense of compensating errors in individual organ dose. Per cent differences in organ dose between the stylized and tomographic phantoms at 120 kVp and 12 mm collimator setting ranged from -25% (skin) to +164% (muscle) for head exams, -92% (thyroid) to +98% (ovaries) for chest exams, -144% (uterus) to +112% (ovaries) for abdominal exams, -98% (SI wall) to +20% (thymus) for pelvic exams and -60% (extrathoracic airways) to +13% (ovaries) for CAP exams. Better agreement was seen between the two phantom types for organs entirely within the scan field. In these cases, corresponding per cent differences in organ absorbed dose did not vary more than 17%. For all scans, the effective dose was found to range approximately 1-13 mSv across the scan parameters and scan regions. The largest effective dose occurred for CAP scans at 120 kVp.     

Comparison of internal dosimetry factors for three classes of adult computational phantoms with emphasis on I-131 in the thyroid

The S values for 11 major target organs for I-131 in the thyroid were compared for three classes of adult computational human phantoms: stylized, voxel and hybrid phantoms. In addition, we compared specific absorbed fractions (SAFs) with the thyroid as a source region over a broader photon energy range than the x- and gamma-rays of I-131. The S and SAF values were calculated for the International Commission on Radiological Protection (ICRP) reference voxel phantoms and the University of Florida (UF) hybrid phantoms by using the Monte Carlo transport method, while the S and SAF values for the Oak Ridge National Laboratory (ORNL) stylized phantoms were obtained from earlier publications. Phantoms in our calculations were for adults of both genders. The 11 target organs and tissues that were selected for the comparison of S values are brain, breast, stomach wall, small intestine wall, colon wall, heart wall, pancreas, salivary glands, thyroid, lungs and active marrow for I-131 and thyroid as a source region. The comparisons showed, in general, an underestimation of S values reported for the stylized phantoms compared to the values based on the ICRP voxel and UF hybrid phantoms and relatively good agreement between the S values obtained for the ICRP and UF phantoms. Substantial differences were observed for some organs between the three types of phantoms. For example, the small intestine wall of ICRP male phantom and heart wall of ICRP female phantom showed up to eightfold and fourfold greater S values, respectively, compared to the reported values for the ORNL phantoms. UF male and female phantoms also showed significant differences compared to the ORNL phantom, 4.0-fold greater for the small intestine wall and 3.3-fold greater for the heart wall. In our method, we directly calculated the S values without using the SAFs as commonly done. Hence, we sought to confirm the differences observed in our S values by comparing the SAFs among the phantoms with the thyroid as a source region for selected target organs--small intestine wall, lungs, pancreas and breast--as well as illustrate differences in energy deposition across the energy range (12 photon energies from 0.01 to 4 MeV). Differences were found in the SAFs between phantoms in a similar manner as the differences observed in S values but with larger differences at lower photon energies. To investigate the differences observed in the S and SAF values, the chord length distributions (CLDs) were computed for the selected source--target pairs and compared across the phantoms. As demonstrated by the CLDs, we found that the differences between phantoms in those factors used in internal dosimetry were governed to a significant degree by inter-organ distances which are a function of organ shape as well as organ location.     

Consideration of the ICRP 2006 revised tissue weighting factors on age-dependent values of the effective dose for external photons

The effective dose recommended by the International Commission on Radiological Protection (ICRP) is the sum of organ equivalent doses weighted by corresponding tissue weighting factors, w(T). ICRP is in the process of revising its 1990 recommendations on the effective dose where new values of organs and tissue weighting factors have been proposed and published in draft form for consultation by the radiological protection community. In its 5 June 2006 draft recommendations, new organs and tissues have been introduced in the effective dose which do not exist within the 1987 Oak Ridge National Laboratory (ORNL) phantom series (e.g., salivary glands). Recently, the investigators at University of Florida have updated the series of ORNL phantoms by implementing new organ models and adopting organ-specific elemental composition and densities. In this study, the effective dose changes caused by the transition from the current recommendation of ICRP Publication 60 to the 2006 draft recommendations were investigated for external photon irradiation across the range of ICRP reference ages (newborn, 1-year, 5-year, 10-year, 15-year and adult) and for six idealized irradiation geometries: anterior-posterior (AP), posterior-anterior (PA), left-lateral (LLAT), right-lateral (RLAT), rotational (ROT) and isotropic (ISO). Organ-absorbed doses were calculated by implementing the revised ORNL phantoms in the Monte Carlo radiation transport code, MCNPX2.5, after which effective doses were calculated under the 1990 and draft 2006 evaluation schemes of the ICRP. Effective doses calculated under the 2006 draft scheme were slightly higher than estimated under ICRP Publication 60 methods for all irradiation geometries exclusive of the AP geometry where an opposite trend was observed. The effective doses of the adult phantom were more greatly affected by the change in tissue weighting factors than that seen within the paediatric members of the phantom series. Additionally, dose conversion coefficients for newly identified radiosensitive organs--salivary glands, gall bladder, heart and prostate--were reported, as well as the brain, which was originally considered in ICRP Publication 60 as a member of the remainder category of the effective dose.     

A comparison of newborn stylized and tomographic models for dose assessment in paediatric radiology

Establishment of organ doses from diagnostic and interventional examinations is a key component to quantifying the radiation risks from medical exposures and for formulating corresponding dose-reduction strategies. Radiation transport models of human anatomy provide a convenient method for simulating radiological examinations. At present, two classes of models exist: stylized mathematical models and tomographic voxel models. In the present study, organ dose comparisons are made for projection radiographs of both a stylized and a tomographic model of the newborn patient. Sixteen separate radiographs were simulated for each model at x-ray technique factors typical of newborn examinations: chest, abdomen, thorax and head views in the AP, PA, left LAT and right LAT projection orientation. For AP and PA radiographs of the torso (chest, abdomen and thorax views), the effective dose assessed for the tomographic model exceeds that for the stylized model with per cent differences ranging from 19% (AP abdominal view) to 43% AP chest view. In contrast, the effective dose for the stylized model exceeds that for the tomographic model for all eight lateral views including those of the head, with per cent differences ranging from 9% (LLAT chest view) to 51% (RLAT thorax view). While organ positioning differences do exist between the models, a major factor contributing to differences in effective dose is the models' exterior trunk shape. In the tomographic model, a more elliptical shape is seen thus providing for less tissue shielding for internal organs in the AP and PA directions, with corresponding increased tissue shielding in the lateral directions. This observation is opposite of that seen in comparisons of stylized and tomographic models of the adult.     

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.     

Calculation of organ doses in x-ray examinations of premature babies

Lung disease represents one of the most life-threatening conditions in prematurely born children. In the evaluation of the neonatal chest, the primary and most important diagnostic study is the chest radiograph. Since prematurely born children are very sensitive to radiation, those radiographs may lead to a significant radiation detriment. Knowledge of the radiation dose is therefore necessary to justify the exposures. To calculate doses in the entire body and in specific organs, computational models of the human anatomy are needed. Using medical imaging techniques, voxel phantoms have been developed to achieve a representation as close as possible to the anatomical properties. In this study two voxel phantoms, representing prematurely born babies, were created from computed tomography- and magnetic resonance images: Phantom 1 (1910 g) and Phantom 2 (590 g). The two voxel phantoms were used in Monte Carlo calculations (MCNPX) to assess organ doses. The results were compared with the commercially available software package PCXMC in which the available mathematical phantoms can be downsized toward the prematurely born baby. The simple phantom-scaling method used in PCXMC seems to be sufficient to calculate doses for organs within the radiation field. However, one should be careful in specifying the irradiation geometry. Doses in organs that are wholly or partially outside the primary radiation field depend critically on the irradiation conditions and the phantom model.     

A review of US anthropometric reference data (1971-2000) with comparisons to both stylized and tomographic anatomic models

Two classes of anatomic models currently exist for use in both radiation protection and radiation dose reconstruction: stylized mathematical models and tomographic voxel models. The former utilize 3D surface equations to represent internal organ structure and external body shape, while the latter are based on segmented CT or MR images of a single individual. While tomographic models are clearly more anthropomorphic than stylized models, a given model's characterization as being anthropometric is dependent upon the reference human to which the model is compared. In the present study, data on total body mass, standing/sitting heights and body mass index are collected and reviewed for the US population covering the time interval from 1971 to 2000. These same anthropometric parameters are then assembled for the ORNL series of stylized models, the GSF series of tomographic models (Golem, Helga, Donna, etc), the adult male Zubal tomographic model and the UF newborn tomographic model. The stylized ORNL models of the adult male and female are found to be fairly representative of present-day average US males and females, respectively, in terms of both standing and sitting heights for ages between 20 and 60-80 years. While the ORNL adult male model provides a reasonably close match to the total body mass of the average US 21-year-old male (within approximately 5%), present-day 40-year-old males have an average total body mass that is approximately 16% higher. For radiation protection purposes, the use of the larger 73.7 kg adult ORNL stylized hermaphrodite model provides a much closer representation of average present-day US females at ages ranging from 20 to 70 years. In terms of the adult tomographic models from the GSF series, only Donna (40-year-old F) closely matches her age-matched US counterpart in terms of average body mass. Regarding standing heights, the better matches to US age-correlated averages belong to Irene (32-year-old F) for the females and Golem (38-year-old M) for the males. Both Helga (27-year-old F) and Donna, however, provide good matches to average US sitting heights for adult females, while Golem and Otoko (male of unknown age) yield sitting heights that are slightly below US adult male averages. Finally, Helga is seen as the only GSF tomographic female model that yields a body mass index in line with her average US female counterpart at age 26. In terms of dose reconstruction activities, however, all current tomographic voxel models are valuable assets in attempting to cover the broad distribution of individual anthropometric parameters representative of the current US population. It is highly recommended that similar attempts to create a broad library of tomographic models be initiated in the United States and elsewhere to complement and extend the limited number of tomographic models presently available for these efforts.     

Organ and effective doses in newborns and infants undergoing voiding cystourethrograms (VCUG): a comparison of stylized and tomographic phantoms

The time-sequence videotape-analysis methodology, developed [Sulieman et al., Radiology 178, 653-658 (1991)] for use in tissue dose estimations in adult fluoroscopy examinations and utilized [Bolch et al., Med. Phys. 30, 667-680 (2003)] for analog fluoroscopy in newborn patients, has been extended to the study of digital fluoroscopic examinations of the urinary bladder in newborn and infant female patients. Individual frames of the fluoroscopic and radiographic video were analyzed with respect to unique combinations of field size, field center, projection, tube potential, and tube current (mA), and integral tube current (mAs), respectively. The dosimetry study was conducted on five female patients of ages ranging from four-days to 66 days. For each patient, three different phantoms were utilized: a stylized computational phantom of the reference newborn (3.5 kg), a tomographic computational phantom of the reference newborn (3.5 kg), and (3) a tomographic computational phantom uniformly rescaled to match patient total-body mass. The latter phantom set circumvented the need for mass-dependent rescaling of recorded technique factors (kVp, mA, mAs, etc.), and thus represented the highest degree of patient specificity in the individual organ dose assessment. Effective dose values for the voiding cystourethrogram examination ranged from 0.6 to 3.2 mSv, with a mean and standard deviation of 1.8+/-0.9 mSv. The ovary and colon equivalent doses contributed in total approximately 65%-80% of the effective dose in these fluoroscopy studies. Percent differences in the effective dose assessed using the two tomographic phantoms (one fixed at 3.5 kg with rescaled technique factors rescaled and one physically rescaled to individual patient masses with no adjustment of recorded technique factors) ranged for -49% to +15%. Percent differences in effective dose found using the 3.5 kg stylized phantom and the 3.5 kg tomographic phantom, both with patient-specific rescaling of technique factors, ranged from -10% to +17%. These differences are due in part to a reduced ovary dose in the tomographic phantom for right posterior oblique (RPO) views when compared to those seen in the stylized phantom.     

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.     

Absorbed dose estimates to structures of the brain and head using a high-resolution voxel-based head phantom

The purpose of this article is to demonstrate the viability of using a high-resolution 3-D head phantom in Monte Carlo N-Particle (MCNP) for boron neutron capture therapy (BNCT) structure dosimetry. This work describes a high-resolution voxel-based model of a human head and its use for calculating absorbed doses to the structures of the brain. The Zubal head phantom is a 3-D model of a human head that can be displayed and manipulated on a computer. Several changes were made to the original head phantom which now contains over 29 critical structures of the brain and head. The modified phantom is a 85 x 109 x 120 lattice of voxels, where each voxel is 2.2 x 2.2 x 1.4 mm3. This model was translated into MCNP lattice format. As a proof of principle study, two MCNP absorbed dose calculations were made (left and right lateral irradiations) using a uniformly distributed neutron disk source with an 1/E energy spectrum. Additionally, the results of these two calculations were combined to estimate the absorbed doses from a bilateral irradiation. Radiobiologically equivalent (RBE) doses were calculated for all structures and were normalized to 12.8 Gy-Eq. For a left lateral irradiation, the left motor cortex receives the limiting RBE dose. For a bilateral irradiation, the insula cortices receive the limiting dose. Among the nonencephalic structures, the parotid glands receive RBE doses that were within 15% of the limiting dose.     

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.     

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.     

A polygon-surface reference Korean male phantom (PSRK-Man) and its direct implementation in Geant4 Monte Carlo simulation

Even though the hybrid phantom embodies both the anatomic reality of voxel phantoms and the deformability of stylized phantoms, it must be voxelized to be used in a Monte Carlo code for dose calculation or some imaging simulation, which incurs the inherent limitations of voxel phantoms. In the present study, a voxel phantom named VKH-Man (Visible Korean Human-Man), was converted to a polygon-surface phantom (PSRK-Man, Polygon-Surface Reference Korean-Man), which was then adjusted to the Reference Korean data. Subsequently, the PSRK-Man polygon phantom was directly, without any voxelization process, implemented in the Geant4 Monte Carlo code for dose calculations. The calculated dose values and computation time were then compared with those of HDRK-Man (High Definition Reference Korean-Man), a corresponding voxel phantom adjusted to the same Reference Korean data from the same VKH-Man voxel phantom. Our results showed that the calculated dose values of the PSRK-Man surface phantom agreed well with those of the HDRK-Man voxel phantom. The calculation speed for the PSRK-Man polygon phantom though was 70-150 times slower than that of the HDRK-Man voxel phantom; that speed, however, could be acceptable in some applications, in that direct use of the surface phantom PSRK-Man in Geant4 does not require a separate voxelization process. Computing speed can be enhanced, in future, either by optimizing the Monte Carlo transport kernel for the polygon surfaces or by using modern computing technologies such as grid computing and general-purpose computing on graphics processing units programming.     

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.