10-MV x-ray primary and scatter dose calculation using convolutions

Three-dimensional (3-D) forward and backward primary dose spread functions in water were developed for 10-MV x rays. Three-dimensional forward and backward primary dose spread functions in a heterogeneous medium were constructed from the ones in water using the density scaling theorem. Each of the forward and backward primary dose components were calculated using a method of convolving the primary water collision kerma distribution with the forward or backward primary dose spread function. Scatter dose was separated into forward and backward components. Each scatter dose component was calculated using a differential scatter method, a kind of convolution method, where the primary water collision kerma distribution was convolved with a differential scatter-maximum ratio or differential backscatter factor equation. From the dose calculation and measurement results obtained for water phantoms containing a cork or aluminum slab, it was found that the 3-D forward and backward primary dose functions were effective especially in regions where there was a loss of longitudinal and/or lateral electronic equilibrium.     

Shortening the calculation time of photon dose distributions in an inhomogeneous medium

A procedure is described for calculating photon dose distributions using convolutions of radiation interaction kernels with calculated fluence distributions. The advantages and disadvantages of the concept are discussed.     

Generation and use of measurement-based 3-D dose distributions for 3-D dose calculation verification.

A 3-D radiation therapy treatment planning system calculates dose to an entire volume of points and therefore requires a 3-D distribution of measured dose values for quality assurance and dose calculation verification. To measure such a volumetric distribution with a scanning ion chamber is prohibitively time consuming. A method is presented for the generation of a 3-D grid of dose values based on beam's-eye-view (BEV) film dosimetry. For each field configuration of interest, a set of BEV films at different depths is obtained and digitized, and the optical densities are converted to dose. To reduce inaccuracies associated with film measurement of megavoltage photon depth doses, doses on the different planes are normalized using an ion-chamber measurement of the depth dose. A 3-D grid of dose values is created by interpolation between BEV planes along divergent beam rays. This matrix of measurement-based dose values can then be compared to calculations over the entire volume of interest. This method is demonstrated for three different field configurations. Accuracy of the film-measured dose values is determined by 1-D and 2-D comparisons with ion chamber measurements. Film and ion chamber measurements agree within 2% in the central field regions and within 2.0 mm in the penumbral regions.     

The impact of photon dose calculation algorithms on expected dose distributions in lungs under different respiratory phases

A planning study was carried out on a cohort of CT datasets from breast patients scanned during different respiratory phases. The aim of the study was to investigate the influence of different air filling in lungs on the calculation accuracy of photon dose algorithms and to identify potential patterns of failure with clinical implications. Selected respiratory phases were free breathing (FB), representative of typical end expiration, and deep inspiration breath hold (DIBH), a typical condition for clinical treatment with respiratory gating. Algorithms investigated were the pencil beam (PBC), the anisotropic analytical algorithm (AAA) and the collapsed cone (CC) from the Varian Eclipse or Philips Pinnacle planning system. Reference benchmark calculations were performed with the Voxel Monte Carlo (VMC++). An analysis was performed in terms of physical quantities inspecting either dose-volume or dose-mass histograms and in terms of an extension to three dimensions of the gamma index of Low. Results were stratified according to a breathing phase and algorithm. Collectives acquired in FB or DIBH showed well-separated average lung density distributions with mean densities of 0.27 +/- 0.04 and 0.16 +/- 0.02 g cm(-3), respectively, and average peak densities of 0.17 +/- 0.03 and 0.09 +/- 0.02 g cm(-3). Analysis of volume-dose or mass-dose histograms proved the expected deviations on PBC results due to the missing lateral transport of electrons with underestimations in the low dose region and overestimations in the high dose region. From the gamma analysis, it resulted that PBC is systematically defective compared to VMC++ over the entire range of lung densities and dose levels with severe violations in both respiratory phases. The fraction of lung voxels with gamma > 1 for PBC reached 25% in DIBH and about 15% in FB. CC and AAA performed, in contrast, similarly and with fractions of lung voxels with gamma > 1 in average inferior to 2% in FB and 4-5% (AAA) or 6-8% (CC) in DIBH. In summary, PBC proved to be severely defective in calculations involving lungs and particularly for cases where specific respiratory phases (e.g. DIBH) are assumed for treatment. In contrast, CC and AAA manifested a high degree of consistency against the Monte Carlo method and provided stable results over the entire range of clinically relevant densities.     

A two-dimensional pencil-beam algorithm for calculation of arc electron dose distributions

A two-dimensional pencil-beam algorithm is presented for the calculation of arc electron dose distributions in any plane that is perpendicular to the axis of rotation. The dose distributions are calculated by modelling the arced beam as a single broad beam defined by the irradiated surface of the patient. The algorithm is two-dimensional in that the anatomical cross section of the patient and the skin collimators are assumed identical in parallel planes outside the plane of calculation. The broad beam is modelled as a collection of strip beams, each strip beam being characterised by its planar fluence, mean projected angular direction and a root-mean-square spread about the mean direction. Using these parameters, the dose distribution is calculated using pencil-beam theory. Examples of strip-beam parameters and resulting dose distributions for patient geometries are presented. Features of the algorithm, which include (1) incorporation of pencil-beam theory for the calculation of dose in heterogeneous tissue, (2) run times of only about twice that of comparable-sized fixed electron fields and (3) the input requirement of only a single depth dose and four off-axis dose profiles of measured data, make the algorithm practical for clinical use.     

Comparison of in-phantom dose distributions for coronary angiography using an x-ray machine and synchrotron radiation

Coronary cineangiography using synchrotron radiation is anticipated, owing to the high intensity and availability of monoenergy. To investigate allowable dose levels in clinical application, absorbed dose distribution in a tissue substitute phantom for a conventional x-ray machine was measured with thermoluminescent dosimeters at the University of Tsukuba under the practical conditions used for digital angiography. The dose rate at a 0.5-cm depth was 0.145 Gy/s, and the dose per frame was 0.725 mGy for the irradiation period of 5 ms per frame. For synchrotron radiation, the dose distribution measurement was made at a 5-GeV AR (Accumulation Ring) of the High Energy Accelerator Research Organization, in which a polymethylmethacrylate (PMMA) phantom was irradiated with the strongest beam available at the facility, which was 33.32 keV, 5.2 x 6.2 cm2 beam. Using this beam, a 1-mm-diameter coronary artery has been visualized at 1% iodine concentration at the AR. Nonhomogeneous strength distribution in the beam was observed in the vertical direction. The maximum dose rate was 0.556 Gy/s, and it attenuated to 1/3000 at a 30-cm depth in the beam center. At the deep positions, the doses were influenced by the high harmonics, which was confirmed with an EGS4 Monte Carlo calculation. Outside the beam, beam contamination on both sides of the main beam affected the doses. For comparison to the x-ray machine, the measured dose was analytically converted to that needed for a 5.2 x 16 cm2 beam that is used for clinical application. The dose rate at 0.5-cm depth was found to be 0.215 Gy/s, which is 1.48 times larger than that for x-rays. Moreover, the attenuation rate in the phantom was significantly greater than that of the x-ray machine, because of the difference of the energy spectra between the x-rays and synchrotron radiation used.     

宫颈癌放疗中计算网格尺寸对物理剂量和生物剂量的影响

目的:定量分析剂量计算网格尺寸（DCGS）对宫颈癌放疗中物理剂量和生物剂量的影响。方法:选取Pinnacle3治疗计划系统中宫颈癌的治疗方案12例,取默认值DCGS=4.0 mm的计算网格,优化调整宫颈癌治疗方案,再改变DCGS（1.0～7.0 mm）,重新计算靶区和危及器官（OAR）的剂量,探讨靶区和OAR的物理剂量和生物剂量随DCGS的变化情况。结果:靶区和OAR的物理剂量随DCGS的变大而减小,在体积剂量直方图上表现出曲线整体向低剂量区平移。除左右股骨头外,靶区的肿瘤控制概率（TCP）和OAR的正常组织并发症概率（NTCP）也随DCGS增大而缓慢降低。PGTVnd的TCP下降率约为0.7%/mm,PTV的TCP下降率约为0.6%/mm,而膀胱和直肠的NTCP下降速度相对较快,膀胱NTCP下降率最大值为15.0%,直肠NTCP下降率最大值为13.5%。结论:宫颈癌放疗中物理剂量和生物剂量随DCGS变大而减少,靶区和OAR的物理剂量在体积剂量直方图上表现出整体向低剂量区平移,这种变化趋势会诱导研究者低估靶区的TCP及OAR的NTCP。     

金标伪影对射波刀剂量计算及分布的影响

目的:分析金标伪影对射波刀剂量计算及分布的影响。方法:采用能谱CT的GSI扫描技术和MARS重建技术获取Lucy模体的原始CT图像和去除金标伪影后的CT图像,利用射波刀Multiplan?划系统对两组CT图像进行等中心计划设计计算,分析金标伪影对剂量计算及分布的影响。结果:金标伪影使CT图像伪影区域的CT值发生改变,最大可达63.22%,金标伪影低估了金标周围（伪影区域）正常重要组织的最大剂量值,高估了金标周围（伪影区域）正常重要组织的最小剂量值,高估了PTV的剂量覆盖率。结论:使用能谱CT可降低金标伪影对射波刀剂量计算及分布的影响。 【关键词】射波刀;金标伪影;剂量计算;剂量分布     

Monte Carlo calculation of dose rate distributions around the Walstam CDC.K-type 137Cs sources

Basic dosimetric data for the Walstam CDC.K-type low dose rate 137Cs sources in water have been calculated using Monte Carlo techniques. These sources, CDC.K1 -K3 and CDC.K4, are widely used in a range of applicators and moulds for the treatment of intracavitary and superficial cancers. Our purpose is to improve existing data about these sources using the Monte Carlo simulation code GEANT3. Absolute dose rate distributions in water have been calculated around these sources and are presented as conventional 2D Cartesian look-up tables. Also the AAPM Task Group 43 formalism for dose calculation has been applied. The calculated dose rate constant for the CDC.K1-K3 source is A = 1.106 +/- 0.001 cGy h(-1) U(-1), and for the CDC.K4 source, A = 1.092 +/- 0.001 cGy h(-1) U(-1). The anisotropy of the sources are accurately studied and F(r, theta) tables are given. Also phi an(r) factors are presented. The radial dose functions are given as a polynomial fit to the calculated data up to 15 cm. Best-fit values of coefficients suitable for use in Sievert integral calculations have been derived.     

Effects of bone- and air-tissue inhomogeneities on the dose distributions of the Leksell Gamma Knife calculated with PENELOPE

Monte Carlo simulation with PENELOPE (version 2003) is applied to calculate Leksell Gamma Knife dose distributions for heterogeneous phantoms. The usual spherical water phantom is modified with a spherical bone shell simulating the skull and an air-filled cube simulating the frontal or maxillary sinuses. Different simulations of the 201 source configuration of the Gamma Knife have been carried out with a simplified model of the geometry of the source channel of the Gamma Knife recently tested for both single source and multisource configurations. The dose distributions determined for heterogeneous phantoms including the bone- and/or air-tissue interfaces show non-negligible differences with respect to those calculated for a homogeneous one, mainly when the Gamma Knife isocentre approaches the separation surfaces. Our findings confirm an important underdosage (approximately 10%) nearby the air-tissue interface, in accordance with previous results obtained with the PENELOPE code with a procedure different from ours. On the other hand, the presence of the spherical shell simulating the skull produces a few per cent underdosage at the isocentre wherever it is situated.     

Energy and angular distributions of photons from medical linear accelerators

For accurate three-dimensional treatment planning, new models of dose calculations are being developed which require the knowledge of the energy spectra and angular distributions of the photons incident on the surface of the patient. Knowledge of the spectra is also useful in other applications, including the design of filters and beam modifying devices and determination of factors to convert ionization chamber measurements to dose. We have used Monte Carlo code (EGS) to compute photon spectra for a number of different linear accelerators. Both the target and the flattening filter have been accurately modeled. We find the mean photon energy to have a value lower than the generally perceived value of one-third the maximum energy. As expected, the spectra become softer as the distance from the central axis increases. Verification of the spectra is performed by computing dose distributions and half-value layers in water using the calculated spectra and comparing the results with measured data. We also examined the angular distributions of photons incident on the surface of the phantom. In currently used models of dose computations, it is assumed that the angular distribution of photons with respect to fan lines emanating from the source is negligible. Although the angular spread of photons with respect to the incident direction has been found to be small, its contribution to the diffuseness of the beam boundaries is significant.     

A new theory of phase-contrast x-ray imaging based on Wigner distributions

There is a pressing need for a comprehensive theory for phase-contrast x-ray imaging to guide its development and clinical applications. This work presents such a theory as the foundation for deriving these guidelines. The new theory is based on the Wigner-distributions for the parabolic wave equations, and it is more general than the present theories based on the Fresnel-Kirchhoff diffraction theory. The new theory shows for the first time how the complex degree of coherence (CDC) of the incident x-ray beam determines the phase-contrast visibility in general, and how the reduced complex degree of coherence (RCDC) for an anode-source is equal to the system's optical transfer function for geometric unsharpness in particular. The role of detector resolution in phase visibility has been clarified as well. Computer simulations based on the new theory were conducted and optimal design parameters were derived for phase-contrast mammography systems.     

Effects of baclofen on the angular vestibulo-ocular reflex

The purpose of this study was to determine the effect of baclofen, a GABA_B agonist on the angular vestibulo-ocular reflex (aVOR). Model studies have shown that the aVOR comprises a “direct” pathway, which determines its high frequency gain g ₁, and an indirect “velocity storage” pathway, which determines its low frequency characteristics. Velocity storage can be characterized by an integrator with a dominant time constant, T _VOR, and a gain g ₀ that couples afferent information from the semicircular canals to the integrator. Baclofen preferentially shortens the velocity storage time constant in monkeys, but its effect on T _VOR, g ₀, and g ₁ in humans is unknown. Six subjects were tested after administration of a placebo or of 10, 20, or 30 mg of baclofen in a double-blind design. The aVOR was elicited in darkness with steps of rotation at 138°/s, and g ₁, g ₀, and T _VOR were determined from model fits of the slow phase velocity of the per- and post-rotatory nystagmus. Baclofen significantly reduced both T _VOR and g ₀ at dosages of 20 and 30 mg, but had no effect on g ₁. Small reductions in g ₀ were associated with large reductions in vestibular output. Thus, baclofen does not affect the direct aVOR pathway in humans, but controls the low frequency aVOR in two ways: it limits the input to velocity storage and modulates its time constant. We speculate that pre-synaptic GABA_B terminals in the vestibular nuclei are responsible for the control of the afferent input to velocity storage through g ₀, while the post-synaptic GABA_B terminals are responsible for altering the duration of activity that reflects the time constant. The lack of effect of baclofen on the aVOR gain suggests that only GABA_A receptors are utilized in the direct aVOR pathway.     

Effect of x-ray filtration on dose and image performance of CT scanners

X-ray source filtration as a means to reduce patient dose while maintaining image quality was investigated for CT scanners. The CT values, their variances for various materials, and the surface dose to a cylindrical phantom were calculated for different filter thicknesses and composition as well as for different tube potentials. Thermoluminescent dosimetry indicated that the maximum dose could be predicted by calculation with an accuracy of 10% (+/- 2 s.d.). The product of the variance of the CT values times surface dose was used to establish the appropriate thickness and composition of the filter, a figure of merit that was independent of dose and noise when the sole source of noise was Poisson statistics. This analysis indicated that source filter materials with an atomic number from 29 to 40 are optimum, and if aluminum is used, the minimum thickness, at 120 kVp, should be 4 mm.     

Direct navigation on 3D rotational x-ray data acquired with a mobile propeller C-arm: accuracy and application in functional endoscopic sinus surgery

Recently, three-dimensional (3D) rotational x-ray imaging has been combined with navigation technology, enabling direct 3D navigation for minimally invasive image guided interventions. In this study, phantom experiments are used to determine the accuracy of such a navigation set-up for a mobile C-arm with propeller motion. After calibration of the C-arm system, the accuracy is evaluated by pinpointing divots on a special-purpose phantom with known geometry. This evaluation is performed both with and without C-arm motion in between calibration and registration for navigation. The variation caused by each of the individual transformations in the calibration and registration process is also studied. The feasibility of direct navigation on 3D rotational x-ray images for functional endoscopic sinus surgery has been evaluated in a cadaver navigation experiment. Navigation accuracy was approximately 1.0 mm, which is sufficient for functional endoscopic sinus surgery. C-arm motion in between calibration and registration slightly degraded the registration accuracy by approximately 0.3 mm. Standard deviations of each of the transformations were in the range 0.15-0.31 mm. In the cadaver experiment, the navigation images were considered in good correspondence with the endoscopic images by an experienced ENT surgeon. Availability of 3D localization information provided by the navigation system was considered valuable by the ENT surgeon.     

On the de-noising of Monte Carlo calculated dose distributions

This paper presents an algorithm for de-noising Monte Carlo calculated dose distributions for use in radiation treatment planning. The algorithm is a three-dimensional generalization of a Savitzky-Golay digital filter and uses an adaptive smoothing window size to reduce the probability for systematic bias. The paper also introduces five accuracy criteria that are relevant for the expected clinical use of Monte Carlo techniques, which can be used to evaluate the performance of smoothing algorithms. Using these accuracy criteria it is demonstrated that the smoothing algorithm presented here decreases the uncertainty of Monte Carlo calculated dose distributions. The corresponding decrease in necessary particle tracks ranges from a factor of 2 to a factor of 20, depending on the accuracy criterion used. It is shown that very short Monte Carlo simulations combined with smoothing deliver satisfactory dose distributions and may therefore be extremely valuable for the initial trial and error phase of the radiation treatment planning process.     

The influence of the size of the grid used for dose calculation on the accuracy of dose estimation

The standard presentation of a dose distribution as an isodose map is based on interpolation between dose values calculated on a matrix of equally spaced points. We explored the question of how the spacing of the grid used for the dose matrix affects the error due to interpolating the dose at any point. We defined two types of errors: the dose error, which is the difference between the interpolated and true dose at a given point; and the position error, which is the distance between the point of interest and the nearest point which has, in fact, the dose value estimated for the point of interest. We examine the problem using both an analytical beam profile (a Fermi function) and measured 60Co, x-ray and proton beam profiles. Our analysis showed that the interpolation errors are proportional to the curvature of the dose distribution and are relatively high in regions on either side of, but not including, the steepest part of the penumbra. Our results showed how big an interpolation error one should expect for a given size of the calculation grid. The specification of accuracy should be cast in the form of a pair of requirements, one for dose and the other for position. At a given point, only one of the two requirements needs to be satisfied. The position requirement is almost always the less demanding in clinical practice and permits the use of a larger grid spacing than if only a dose requirement is applied.(ABSTRACT TRUNCATED AT 250 WORDS)