Table of contents

3D-microCT images of vertebral bodies from three different individuals have been segmented into trabecular bone, bone marrow and bone surface cells (BSC), and then introduced into the spongiosa voxels of the MAX06 and the FAX06 phantoms, in order to calculate the equivalent dose to the red bone marrow (RBM) and the BSC in the marrow cavities of trabecular bone with the EGSnrc Monte Carlo code from whole-body exposure to external photon radiation. The MAX06 and the FAX06 phantoms consist of about 150 million 1.2 mm cubic voxels each, a part of which are spongiosa voxels surrounded by cortical bone. In order to use the segmented 3D-microCT images for skeletal dosimetry, spongiosa voxels in the MAX06 and the FAX06 phantom were replaced at runtime by so-called micro matrices representing segmented trabecular bone, marrow and BSC in 17.65, 30 and 60 µm cubic voxels. The 3D-microCT image-based RBM and BSC equivalent doses for external exposure to photons presented here for the first time for complete human skeletons are in agreement with the results calculated with the three correction factor method and the fluence-to-dose response functions for the same phantoms taking into account the conceptual differences between the different methods. Additionally the microCT image-based results have been compared with corresponding data from earlier studies for other human phantoms.

For more information on this article, see medicalphysicsweb.org

We study the effects of interstitial fluid flow and interstitial fluid drainage on the spatio-temporal response of soft tissue strain. The motivation stems from the ability to measure in vivo strain distributions in soft tissue via elastography, and the desire to explore the possibility of using such techniques to investigate soft tissue fluid flow. Our study is based upon a mathematical model for soft tissue mechanics from the literature. It is a simple generalization of biphasic theory that includes coupling between the fluid and solid phases of the soft tissue, and crucially, fluid exchange between the interstitium and the local microvasculature. We solve the mathematical equations in two dimensions by the finite element method (FEM). The finite element implementation is validated against an exact analytical solution that is derived in the appendix. Realistic input tissue properties from the literature are used in conjunction with FEM modelling to conduct several computational experiments. The results of these lead to the following conclusions: (i) different hypothetical flow mechanisms lead to different patterns of strain relaxation with time; (ii) representative tissue properties show fluid drainage into the local microvasculature to be the dominant flow-related stress/strain relaxation mechanism; (iii) the relaxation time of strain in solid tumours due to drainage into the microvasculature is on the order of 5–10 s; (iv) under realistic applied pressure magnitudes, the magnitude of the strain relaxation can be as high as approximately 0.4% strain (4000 microstrains), which is well within the range of strains measurable by elastography.

In the current work, EPR (electron paramagnetic resonance) dosimetry using alanine films (134 µm thick) was utilized for dose measurements in inhomogeneous phantoms irradiated with radiotherapy photon beams. The main phantom material was PMMA, while either Styrofoam or aluminium was introduced as an inhomogeneity. The phantoms were irradiated to a maximum dose of about 30 Gy with 6 or 15 MV photons. The performance of the alanine film dosimeters was investigated and compared to results from ion chamber dosimetry, Monte Carlo simulations and radiotherapy treatment planning calculations. It was found that the alanine film dosimeters had a linear dose response above approximately 5 Gy, while a background signal obscured the response at lower dose levels. For doses between 5 and 60 Gy, the standard deviation of single alanine film dose estimates was about 2%. The alanine film dose estimates yielded results comparable to those from the Monte Carlo simulations and the ion chamber measurements, with absolute differences between estimates in the order of 1–15%. The treatment planning calculations exhibited limited applicability. The current work shows that alanine film dosimetry is a method suitable for estimating radiotherapeutical doses and for dose measurements in inhomogeneous media.

In radiotherapy a common method used to compensate for patient setup error and organ motion is to enlarge the clinical target volume (CTV) by a 'margin' to produce a 'planning target volume' (PTV). Using weighted power loss functions as a measure of performance for a treatment plan, a simple method can be developed to calculate the ideal spatial dose distribution (one that minimizes expected loss) when there is uncertainty. The spatial dose distribution is assumed to be invariant to the displacement of the internal structures and the whole patient. The results provide qualitative insights into the suitability of using a margin at all, and (if one is to be used) how to select a 'good' margin size. The common practice of raising the power parameters in the treatment loss function, in order to enforce target dose requirements, is shown to be potentially counter-productive. These results offer insights into desirable dose distributions and could be used, in conjunction with well-established inverse radiotherapy planning techniques, to produce dose distributions that are robust against uncertainties.

In inverse treatment planning for intensity-modulated radiation therapy (IMRT), beamlet intensity levels in fluence maps of high-energy photon beams are optimized. Treatment plan evaluation criteria are used as objective functions to steer the optimization process. Fluence map optimization can be considered a multi-objective optimization problem, for which a set of Pareto optimal solutions exists: the Pareto efficient frontier (PEF). In this paper, a constrained optimization method is pursued to iteratively estimate the PEF up to some predefined error. We use the property that the PEF is convex for a convex optimization problem to construct piecewise-linear upper and lower bounds to approximate the PEF from a small initial set of Pareto optimal plans. A derivative-free Sandwich algorithm is presented in which these bounds are used with three strategies to determine the location of the next Pareto optimal solution such that the uncertainty in the estimated PEF is maximally reduced. We show that an intelligent initial solution for a new Pareto optimal plan can be obtained by interpolation of fluence maps from neighbouring Pareto optimal plans. The method has been applied to a simplified clinical test case using two convex objective functions to map the trade-off between tumour dose heterogeneity and critical organ sparing. All three strategies produce representative estimates of the PEF. The new algorithm is particularly suitable for dynamic generation of Pareto optimal plans in interactive treatment planning.

Multi-modality imaging is rapidly becoming a valuable tool in the diagnosis of disease and in the development of new drugs. Functional images produced with PET fused with anatomical structure images created by MRI will allow the correlation of form with function. Our group is developing a system to acquire MRI and PET images contemporaneously. The prototype device consists of two opposed detector heads, operating in coincidence mode. Each MRI–PET detector module consists of an array of LSO detector elements coupled through a long fibre optic light guide to a single Hamamatsu flat panel position-sensitive photomultiplier tube (PSPMT). The use of light guides allows the PSPMTs to be positioned outside the bore of a 3T MRI scanner where the magnetic field is relatively small. To test the device, simultaneous MRI and PET images of the brain of a male Sprague Dawley rat injected with FDG were successfully obtained. The images revealed no noticeable artefacts in either image set. Future work includes the construction of a full ring PET scanner, improved light guides and construction of a specialized MRI coil to permit higher quality MRI imaging.

Static magnetic field perturbations generated by variations of magnetic susceptibility within samples reduce the quality and integrity of magnetic resonance measurements. These perturbations are difficult to predict in vivo where wide variations of internal magnetic susceptibility distributions are common. Recent developments have provided rapid computational means of estimating static field inhomogeneity within the small susceptibility limits of materials typically studied using magnetic resonance. Such a predictive mechanism could be a valuable tool for sequence simulation, field shimming and post-acquisition image correction. Here, we explore this calculation protocol and demonstrate its predictive power in estimating in vivo inhomogeneity within the human brain. Furthermore, we quantitatively explore the predictive limits of the computation. For in vivo comparison, a method of magnetic susceptibility registration using MRI and CT data is presented and utilized to carry out subject-specific inhomogeneity estimation. Using this algorithm, direct comparisons in human brain and phantoms are made between field map acquisitions and calculated inhomogeneity. Distortion correction in echo-planar images due to static field inhomogeneity is also demonstrated using the computed field maps.

Electrode displacement elastography is a strain imaging method that can be used for in-vivo imaging of radiofrequency ablation-induced lesions in abdominal organs such as the liver and kidney. In this technique, tissue motion or deformation is introduced by displacing the same electrode used to create the lesion. Minute displacements (on the order of a fraction of a millimetre) are applied to the thermal lesion through the electrode, resulting in localized tissue deformation. Ultrasound echo signals acquired before and after the electrode-induced displacements are then utilized to generate strain images. However, these local strains depend on the modulus distribution of the tissue region being imaged. Therefore, a quantitative evaluation of the conversion efficiency from modulus contrast to strain contrast in electrode-displacement elastograms is warranted. The contrast-transfer efficiency is defined as the ratio (in dB) of the observed elastographic strain contrast and the underlying true modulus contrast. It represents a measure of the efficiency with which elastograms depict the underlying modulus distribution in tissue. In this paper, we develop a contrast-transfer efficiency formalism for electrode displacement elastography (referred to as contrast-transfer improvement). Changes in the contrast-transfer improvement as a function of the underlying true modulus contrast and the depth of the inclusion in the simulated phantom are studied. We present finite element analyses obtained using a two-dimensional mechanical deformation and tissue motion model. The results obtained using finite element analyses are corroborated using experimental analysis and an ultrasound simulation program so as to incorporate noise artifacts.

The correction for charge recombination was determined for different plane-parallel ionization chambers exposed to clinical electron beams with low and high dose per pulse, respectively. The electron energy was nearly the same (about 7 and 9 MeV) for any of the beams used. Boag's two-voltage analysis (TVA) was used to determine the correction for ion losses, k_s, relevant to each chamber considered. The presence of free electrons in the air of the chamber cavity was accounted for in determining k_s by TVA. The determination of k_s was made on the basis of the models for ion recombination proposed in past years by Boag, Hochhäuser and Balk to account for the presence of free electrons. The absorbed dose measurements in both low-dose-per-pulse (less than 0.3 mGy per pulse) and high-dose-per-pulse (20–120 mGy per pulse range) electron beams were compared with ferrous sulphate chemical dosimetry, a method independent of the dose per pulse. The results of the comparison support the conclusion that one of the models is more adequate to correct for ion recombination, even in high-dose-per-pulse conditions, provided that the fraction of free electrons is properly assessed. In this respect the drift velocity and the time constant for attachment of electrons in the air of the chamber cavity are rather critical parameters because of their dependence on chamber dimensions and operational conditions. Finally, a determination of the factor k_s was also made by zero extrapolation of the 1/Q versus 1/V saturation curves, leading to the conclusion that this method does not provide consistent results in high-dose-per-pulse beams.

Thermoacoustic tomography (TAT) is a technique that measures microwave-induced thermoacoustic waves at the boundary of biological tissue and generates images of internal microwave absorption distributions from the measurements. Existing reconstruction algorithms for TAT are based on the assumption that the acoustic properties in the tissue are homogeneous. Biological tissue, however, has heterogeneous acoustic properties, which lead to distortion and blurring of small buried objects in the reconstructed images. In this paper we develop a correction method based on ultrasonic transmission tomography (UTT) to improve the image quality of TAT. Numerical simulations and phantom experiments verify the effectiveness of this correction method.

¹³¹I therapy is used in the treatment of differentiated thyroid cancer both to ablate the post-surgical thyroid remnant and to treat recurrent or metastatic cancer. The optimum administered activity for ablation remains controversial: the most commonly used method is the administration of a fixed radioiodine activity (1110–3700 MBq or more); an alternative is the administration of an activity individually calculated to deliver a prescribed absorbed dose (usually 300 Gy for remnant ablation and 80 Gy for treatment of metastasis). Neither of these two approaches is based on a theoretical model and for this reason the debate on the optimization of ¹³¹I therapy of thyroid cancer could have a weak grounding. In this paper, the meaning of the fixed value of target absorbed dose (Gy) is discussed and a mathematical model for remnant/metastasis optimum absorbed dose calculation is presented. This model is based on the desired reduction of the volume of the target (remnant or metastasis) and allows one to calculate individually the value of the optimum target absorbed dose (Gy) and consequently the optimum therapeutic activity to administer to the patient.

A new method to design MRI RF coils that are optimized for SENSE (sensitivity encoding) imaging is introduced. In this approach, the inverse problem was solved where the surface current density distribution on a coil former was calculated to maximize the SNR_sense within a volume of interest (VOI). For that purpose, an analytic relationship was formulated between the SNR_sense and surface current density on the coil former. The SNR at pixel ρ in a SENSE-MR image, SNR_sense,ρ, is inversely proportional to the g-factor: therefore, the g-factor was formulated in terms of the B1 distribution of the coils. Then, by specifying the geometry of the desired coil former and using a finite element mesh (FEM), the surface current distribution was calculated to maximize the SNR_sense, by minimizing (1/SNR_sense) in the VOI using a least squares procedure. A simple two-coil array was designed and built to test the method and phantom images were collected. The results show that the new coil design method yielded better uniformity and SNR in SENSE images compared to those of standard coils.

In critical organ in vivo x-ray dosimetry, the relative contaminating electron contribution to the total dose and total detector response outside the field will be different to the corresponding contributions at the central axis detector calibration position, mainly due to the effects of shielding in the linear accelerator head on the electron and x-ray energy spectrum. To investigate these contributions, the electron energy response of a Scanditronix PFD diode was measured using electrons with mean energies from 0.45 to 14.6 MeV, and the Monte Carlo code MCNP-4C was used to calculate the electron energy spectra on the central axis, and at 1 and 10 cm outside the edge of a 4 × 4, 10 × 10 and a 15 × 15 cm² 6 MV x-ray field. The electron contribution to the total dose varied from about 8% on the central axis of the smallest field to about 76% at 10 cm outside the edge of the largest field. The electron contribution to the total diode response varied from about 7–8% on the central axis of all three fields to about 58% at 10 cm outside the edge of the smallest field. The results indicated that a near surface x-ray dose measurement with a diode outside the treatment field has to be interpreted with caution and requires knowledge of the relative electron contribution specific to the measurement position and field size.

This study deals with the most challenging numerical aspect for solving the quantification problem in magnetic resonance spectroscopy (MRS). The primary goal is to investigate whether it could be feasible to carry out a rigorous computation within finite arithmetics to reconstruct exactly all the machine accurate input spectral parameters of every resonance from a synthesized noiseless time signal. We also consider simulated time signals embedded in random Gaussian distributed noise of the level comparable to the weakest resonances in the corresponding spectrum. The present choice for this high-resolution task in MRS is the fast Padé transform (FPT). All the sought spectral parameters (complex frequencies and amplitudes) can unequivocally be reconstructed from a given input time signal by using the FPT. Moreover, the present computations demonstrate that the FPT can achieve the spectral convergence, which represents the exponential convergence rate as a function of the signal length for a fixed bandwidth. Such an extraordinary feature equips the FPT with the exemplary high-resolution capabilities that are, in fact, theoretically unlimited. This is illustrated in the present study by the exact reconstruction (within machine accuracy) of all the spectral parameters from an input time signal comprised of 25 harmonics, i.e. complex damped exponentials, including those for tightly overlapped and nearly degenerate resonances whose chemical shifts differ by an exceedingly small fraction of only 10⁻¹¹ ppm. Moreover, without exhausting even a quarter of the full signal length, the FPT is shown to retrieve exactly all the input spectral parameters defined with 12 digits of accuracy. Specifically, we demonstrate that when the FPT is close to the convergence region, an unprecedented phase transition occurs, since literally a few additional signal points are sufficient to reach the full 12 digit accuracy with the exponentially fast rate of convergence. This is the critical proof-of-principle for the high-resolution power of the FPT for machine accurate input data. Furthermore, it is proven that the FPT is also a highly reliable method for quantifying noise-corrupted time signals reminiscent of those encoded via MRS in clinical neuro-diagnostics.

Although the quality and speed of MR images have vastly improved with the development of novel RF coil technologies, the engineering expertise required to implement them is often not available in many animal in vivo MR laboratories. We present here an open birdcage coil design which is easily constructed with basic RF coil expertise and produces high quality images. The quality and advantages of mouse cardiac MR images acquired with open birdcage coils were evaluated and compared to images acquired with a bent single loop surface, and standard birdcage coils acquired at 4.7 Tesla. Two low pass open birdcage coils, two single loop surface coils, and a low pass volume birdcage coil were constructed and their B₁ distributions were evaluated and compared. The calculated average signal-to-noise ratio for the left ventricular wall was 10, 23 and 32 for the volume birdcage coil, single loop surface coil and open birdcage coil, respectively. The results demonstrate that the open birdcage coil provides greater sensitivity than the volume coil and a higher signal/contrast-to-noise ratio and B₁ homogeneity than the single loop surface coil. The open birdcage coil offers easy access and better quality mouse cardiac imaging than both the single loop surface coil and volume birdcage coil and does not require extensive RF engineering expertise to construct.

Activation products have been identified by in situ gamma spectroscopy at the isocentre of a medical linear accelerator shortly after termination of a high energy photon beam irradiation with 15 × 15 cm field size. Spectra have been recorded either with an open or with a closed collimator. Whilst some activation products disappear from the spectrum with closed collimator or exhibit reduced count rates, others remain with identical intensity. The former isotopes are neutron-deficient and mostly decay by positron emission or electron capture; the latter have neutron excess and decay by β⁻ emission. This new finding is consistent with the assumption that photons in the primary beam produce activation products by (γ, n) reactions in the treatment head and subsequently the neutrons created in these processes undergo (n, γ) reactions creating activation products in a much larger area. These findings are expected to be generally applicable to all medical high energy linear accelerators.

Treatment planning of heavy-ion radiotherapy involves predictive calculation of not only the physical dose but also the biological dose in a patient body. The biological dose is defined as the product of the physical dose and the relative biological effectiveness (RBE). In carbon-ion radiotherapy at National Institute of Radiological Sciences, the RBE value has been defined as the ratio of the 10% survival dose of 200 kVp x-rays to that of the radiation of interest for in vitro human salivary gland tumour cells. In this note, the physical and biological dose distributions of a typical therapeutic carbon-ion beam are calculated using the GEANT4 Monte Carlo simulation toolkit in comparison with those with the biological dose estimate system based on the one-dimensional beam model currently used in treatment planning. The results differed between the GEANT4 simulation and the one-dimensional beam model, indicating the physical limitations in the beam model. This study demonstrates that the Monte Carlo physics simulation technique can be applied to improve the accuracy of the biological dose distribution in treatment planning of heavy-ion radiotherapy.

In a recently published paper (Nioutsikou et al 2005 Phys. Med. Biol.50 L17) the authors showed that the use of the dose–mass histogram (DMH) concept is a more accurate descriptor of the dose delivered to lung than the traditionally used dose–volume histogram (DVH) concept. Furthermore, they state that if a functional imaging modality could also be registered to the anatomical imaging modality providing a functional weighting across the organ (functional mass) then the more general and realistic concept of the dose-functioning mass histogram (D[F]MH) could be an even more appropriate descriptor. The comments of the present letter to the editor are in line with the basic arguments of that work since their general conclusions appear to be supported by the comparison of the DMH and DVH concepts using radiobiological measures. In this study, it is examined whether the dose–mass histogram (DMH) concept deviated significantly from the widely used dose–volume histogram (DVH) concept regarding the expected lung complications and if there are clinical indications supporting these results. The problem was investigated theoretically by applying two hypothetical dose distributions (Gaussian and semi-Gaussian shaped) on two lungs of uniform and varying densities. The influence of the deviation between DVHs and DMHs on the treatment outcome was estimated by using the relative seriality and LKB models using the Gagliardi et al (2000 Int. J. Radiat. Oncol. Biol. Phys.46 373) and Seppenwoolde et al (2003 Int. J. Radiat. Oncol. Biol. Phys.55 724) parameter sets for radiation pneumonitis, respectively. Furthermore, the biological equivalent of their difference was estimated by the biologically effective uniform dose and equivalent uniform dose (EUD) concepts, respectively. It is shown that the relation between the DVHs and DMHs varies depending on the underlying cell density distribution and the applied dose distribution. However, the range of their deviation in terms of the expected clinical outcome was proven to be very large. Concluding, the effectiveness of the dose distribution delivered to the patients seems to be more closely related to the radiation effects when using the DMH concept.

The PDF file provided contains web links to all articles in this volume.