Table of contents

Quantitative imaging data obtained from multiple modalities may be integrated into mathematical models of tumor growth and treatment response to achieve additional insights of practical predictive value. We show how this approach can describe the development of tumors that appear realistic in terms of producing proliferating tumor rims and necrotic cores. Two established models (the logistic model with and without the effects of treatment) and one novel model built a priori from available imaging data have been studied. We modify the logistic model to predict the spatial expansion of a tumor driven by tumor cell migration after a voxel's carrying capacity has been reached. Depending on the efficacy of a simulated cytoxic treatment, we show that the tumor may either continue to expand, or contract. The novel model includes hypoxia as a driver of tumor cell movement. The starting conditions for these models are based on imaging data related to the tumor cell number (as estimated from diffusion-weighted MRI), apoptosis (from ^99mTc-Annexin-V SPECT), cell proliferation and hypoxia (from PET). We conclude that integrating multi-modality imaging data into mathematical models of tumor growth is a promising combination that can capture the salient features of tumor growth and treatment response and this indicates the direction for additional research.

Spinal metastases are a common and serious manifestation of cancer, and are often treated with vertebroplasty/kyphoplasty followed by external beam radiation therapy (EBRT). As an alternative, we have introduced radioactive bone cement, i.e. bone cement incorporated with a radionuclide. In this study, we present a Monte Carlo radiation transport modeling method to calculate dose distributions within vertebrae containing radioactive cement. Model accuracy was evaluated by comparing model-predicted depth–dose curves to those measured experimentally in eight cadaveric vertebrae using radiochromic film. The high-gradient regions of the depth–dose curves differed by radial distances of 0.3–0.9 mm, an improvement over EBRT dosimetry accuracy. The low-gradient regions differed by 0.033–0.055 Gy/h/mCi, which may be important in situations involving prior spinal cord irradiation. Using a more rigorous evaluation of model accuracy, four models predicted the measured dose distribution within the experimental uncertainty, as represented by the 95% confidence interval of the measured log-linear depth–dose curve. The remaining four models required modification to account for marrow lost from the vertebrae during specimen preparation. However, the accuracy of the modified model results indicated that, when this source of uncertainty is accounted for, this modeling method can be used to predict dose distributions in vertebrae containing radioactive cement.

To apply high-quality hyperthermia treatment to tumours at deep locations in the head and neck (H&N), we have designed and built a site-specific phased-array applicator. Earlier, we demonstrated its features in parameter studies, validated those by phantom measurements and clinically introduced the system. In this paper we will critically review our first clinical experiences and demonstrate the pivotal role of hyperthermia treatment planning (HTP). Three representative patient cases (thyroid, oropharynx and nasal cavity) are selected and discussed. Treatment planning, the treatment, interstitially measured temperatures and their interrelation are analysed from a physics point of view. Treatments lasting 1 h were feasible and well tolerated and no acute treatment-related toxicity has been observed. Maximum temperatures measured are in the range of those obtained during deep hyperthermia treatments in the pelvic region but mean temperatures are still to be improved. Further, we found that simulated power absorption correlated well with measured temperatures illustrating the validity of our treatment approach of using energy profile optimizations to arrive at higher temperatures. This is the first data proving that focussed heating of tumours in the H&N is feasible. Further, HTP proved a valuable tool in treatment optimization. Items to improve are (1) the transfer of HTP settings into the clinic and (2) the registration of the thermal dose, i.e. dosimetry.

Heavy charged particle beam radiotherapy for cancer is of increasing interest because it delivers a highly conformal radiation dose to the target volume. Accurate knowledge of the range of a heavy charged particle beam after it penetrates a patient's body or other materials in the beam line is very important and is usually stated in terms of the water equivalent thickness (WET). However, methods of calculating WET for heavy charged particle beams are lacking. Our objective was to test several simple analytical formulas previously developed for proton beams for their ability to calculate WET values for materials exposed to beams of protons, helium, carbon and iron ions. Experimentally measured heavy charged particle beam ranges and WET values from an iterative numerical method were compared with the WET values calculated by the analytical formulas. In most cases, the deviations were within 1 mm. We conclude that the analytical formulas originally developed for proton beams can also be used to calculate WET values for helium, carbon and iron ion beams with good accuracy.

Magnetic resonance (MR)-based multimodality imaging systems, such as single-photon emission tomography (SPECT)/magnetic resonance imaging (MRI) or positron emission tomography (PET)/MRI, face many difficulties because of problems with the compatibility of the nuclear detector system with the MR system. However, several studies have reported on the design considerations of MR-compatible nuclear detectors for combined SPECT/MRI. In this study, we developed a new radiofrequency (RF) coil and γ-ray radiation shielding assembly to advance the practical implementation of SPECT/MRI in providing high sensitivity while minimizing the interference between the MRI and SPECT systems. The proposed assembly consists of a three-channel receive-only RF coil and γ-ray radiation shields made of a specialized lead composite powder designed to reduce conductivity and thus minimizing any effect on the magnetic field arising from the induced eddy currents. A conventional birdcage RF coil was also tested for comparison with the proposed RF coil. Quality (Q)-factors were measured using both RF coils without any shielding, with solid lead shielding, and with our composite lead shielding. Signal-to-noise ratios (SNRs) were calculated using 4 T MR images of phantoms both with and without the new γ-ray radiation shields. The Q-factor and SNR measurements demonstrate the improved MRI performance due to the new RF coil/γ-ray radiation shield assembly designed for SPECT/MRI, making it a useful addition to multimodality imaging technology not only for animal studies but also for in vivo study of humans.

Algorithms for direct tumor tracking in rotational cone-beam projections and for reconstruction of phase-binned 3D tumor trajectories were developed. The feasibility of the algorithm was demonstrated on a digital phantom, a physical phantom and two patients. Tracking results were obtained by comparing reference templates generated from 4DCT to rotational cone-beam projections. The 95th percentile absolute errors (e₉₅) in phantom tracking results did not exceed 1.7 mm in either imager dimension, while e₉₅ in the patients was 3.3 mm or less. Accurate phase-binned trajectories were reconstructed in each case, with 3D maximum errors of no more than 1.0 mm in the phantoms and 2.0 mm in the patients. This work shows the feasibility of a direct tumor tracking technique for rotational images, and demonstrates that an accurate 3D tumor trajectory can be reconstructed from relatively less accurate tracking results. The ability to reconstruct the tumor's average trajectory from a 3D cone-beam CT scan on the day of treatment could allow for better patient setup and quality assurance, while direct tumor tracking in rotational projections could be clinically useful for rotational therapy such as volumetric modulated arc therapy (VMAT).

A penalized-likelihood (PL) SPECT reconstruction method using a modified regularizer that accounts for anatomical boundary side information was implemented to achieve accurate estimates of both the total target activity and the activity distribution within targets. In both simulations and experimental I-131 phantom studies, reconstructions from (1) penalized likelihood employing CT-side information-based regularization (PL-CT), (2) penalized likelihood with edge preserving regularization (no CT) and (3) penalized likelihood with conventional spatially invariant quadratic regularization (no CT) were compared with (4) ordered subset expectation maximization (OSEM), which is the iterative algorithm conventionally used in clinics for quantitative SPECT. Evaluations included phantom studies with perfect and imperfect side information and studies with uniform and non-uniform activity distributions in the target. For targets with uniform activity, the PL-CT images and profiles were closest to the 'truth', avoided the edge offshoots evident with OSEM and minimized the blurring across boundaries evident with regularization without CT information. Apart from visual comparison, reconstruction accuracy was evaluated using the bias and standard deviation (STD) of the total target activity estimate and the root mean square error (RMSE) of the activity distribution within the target. PL-CT reconstruction reduced both bias and RMSE compared with regularization without side information. When compared with unregularized OSEM, PL-CT reduced RMSE and STD while bias was comparable. For targets with non-uniform activity, these improvements with PL-CT were observed only when the change in activity was matched by a change in the anatomical image and the corresponding inner boundary was also used to control the regularization. In summary, the present work demonstrates the potential of using CT side information to obtain improved estimates of the activity distribution in targets without sacrificing the accuracy of total target activity estimation. The method is best suited for data acquired on hybrid systems where SPECT-CT misregistration is minimized. To demonstrate clinical application, the PL reconstruction with CT-based regularization was applied to data from a patient who underwent SPECT/CT imaging for tumor dosimetry following I-131 radioimmunotherapy.

Numerical modelling of magnetic stimulation in the spine is a scarce subject in the literature, although it has been gaining clinical acceptance. In the present work we present the results from a simplified computational model of the spine. The results indicate that it is necessary to use a numerical technique for solving the problem, which takes into account tissue dispersion and both dielectric properties (conductivity and permittivity), since a difference of 14% in the induced electric fields was found when displacement currents were included. With respect to the role of tissues in stimulation efficiency, it was confirmed that water-rich tissues lead to a shielding effect of the spinal cord. However, this effect becomes smaller at the height of the intervertebral discs, resulting in an increase of the field inside the spine.

A hybrid Monte Carlo transport scheme combining event-by-event and condensed-history simulation with a full account of energy-loss straggling was used to study the dosimetric characteristics of the Auger-emitting radionuclides ⁶⁷Ga, ^99mTc, ¹¹¹In, ¹²³I, ¹²⁵I and ²⁰¹Tl at the single-cell level. The influence of the intracellular localization of the Auger radionuclide upon cellular S-values, radial dose rate profiles and dose-volume-histograms (DVHs) was investigated. For the case where the radiopharmaceutical was either internalized into the cytoplasm or remained bound onto the cell surface (non-internalized), the dose to the cell nucleus was found to differ significantly from the MIRD values and other published data. In this case, the assumption of a homogeneous distribution throughout the cell is shown to significantly overestimate the nuclear dose. A dosimetric case study relevant to the radioimmunotherapy of single lymphoma B-cells with ¹²⁵I and ¹²³I is presented.

A PET block detector module using an array of sub-millimeter lutetium oxyorthosilicate (LSO) crystals read out by an array of surface-mount, semiconductor photosensors has been developed. The detector consists of a LSO array, a custom acrylic light guide, a 3 × 3 multi-pixel photon counter (MPPC) array (S10362-11-050P, Hamamatsu Photonics, Japan) and a readout board with a charge division resistor network. The LSO array consists of 100 crystals, each measuring 0.8 × 0.8 × 3 mm³ and arranged in 0.86 mm pitches. A Monte Carlo simulation was used to aid the design and fabrication of a custom light guide to control distribution of scintillation light over the surface of the MPPC array. The output signals of the nine MPPC are multiplexed by a charge division resistor network to generate four position-encoded analog outputs. Flood image, energy resolution and timing resolution measurements were performed using standard NIM electronics. The linearity of the detector response was investigated using gamma-ray sources of different energies. The 10 × 10 array of 0.8 mm LSO crystals was clearly resolved in the flood image. The average energy resolution and standard deviation were 20.0% full-width at half-maximum (FWHM) and ±5.0%, respectively, at 511 keV. The timing resolution of a single MPPC coupled to a LSO crystal was found to be 857 ps FWHM, and the value for the central region of detector module was 1182 ps FWHM when ±10% energy window was applied. The nonlinear response of a single MPPC when used to read out a single LSO was observed among the corner crystals of the proposed detector module. However, the central region of the detector module exhibits significantly less nonlinearity (6.5% for 511 keV). These results demonstrate that (1) a charge-sharing resistor network can effectively multiplex MPPC signals and reduce the number of output signals without significantly degrading the performance of a PET detector and (2) a custom light guide to permit light sharing among multiple MPPC and to diffuse and direct scintillation light can reduce the nonlinearity of the detector response within the limited dynamic range of a typical MPPC. As a result, the proposed PET detector module has the potential to be refined for use in high-resolution PET insert applications.

MR imaging of nuclei other than hydrogen has been used to investigate metabolism in humans and animals. However, MRI observable nuclei other than hydrogen are not as abundant and as a result the image SNR is lower. Dual-tuned radio frequency (RF) coils are developed for these studies in which high-resolution structural images are acquired using hydrogen and metabolic information is acquired by exciting the other nucleus. Using a dual-tuned coil, the experimenter avoids the inconvenience of moving the patient out and replacing the RF coil for imaging different nuclei. This also eliminates image registration problems. However, the common scheme of using trap circuits for dual-tuned operation results in increased coil losses as well as problems in obtaining optimal tuning and matching at both frequencies. Here, a new approach is presented using PIN diodes to switch the coil between two resonance frequencies. This design eliminates the need for the trap circuit and associated losses from the self-resistance of the trap circuit inductors. At the operating frequencies we used, the equivalent series resistance of an inductor is higher than that of the PIN diodes. In order to test the efficacy of this new approach, we first built two surface coils of identical geometry, one with the conventional trap circuits and one with the PIN diode switches. We also studied the performances of both coils when the coils are divided into shorter conductors segments by adding more tuning elements. It is known that dividing the coil into shorter conductor segments helps reduce radiation and electric field losses. We explored this effect for both coils at both operating frequencies. Finally, a dual-tuned receive-only phased array was designed and built with the PIN diode circuit to switch between two resonance frequencies. A conventional dual-tuned birdcage coil was designed and built to transmit RF power. A unique feature of this coil is that the RF power is fed through two separate sets of four ports for more uniform 1H and 23Na excitation. We demonstrated that the performance is significantly improved at both frequencies with the PIN diode switched dual-frequency operation compared to an identical coil with a trap circuit.

A new radiochromic film, the yellow Gafchromic EBT2, has been marketed as a drop-in replacement for the discontinued blue EBT film. In order to verify the manufacturer's claims prior to clinical use, EBT2 was characterized in transmission, and the less commonly used, reflection modes with an Epson Expression 10000XL A3 flatbed scanner. The red channel was confirmed to provide the greatest sensitivity and was used for all measurements. The post-irradiation darkening of the film was investigated, and the relative response was found to be dose dependent with higher doses stabilizing earlier than lower doses. After 13 h all dose levels had stabilized to within 1% of their value at 24 h. Uniformity of irradiated EBT2 films was within 0.8% and 1.2% (2SD of signal), in reflection and transmission modes, respectively. The light scattering effect, arising from the structure and thickness of EBT2, was found to give rise to an apparent scanner non-uniformity of up to 5.5% in signal. In reflection mode, differences of up to 1.2% were found between the signal obtained from a small film fragment (5 × 5 cm²) and the signal obtained from the same fragment bordered by extra film. Further work is needed to determine the origin of this effect, as there will be implications for reflection dosimetry of intensity modulated fields; reflection mode cannot yet be regarded as a viable alternative to transmission mode. Our results suggest that EBT2 film is a valid alternative, rather than a direct replacement for EBT film.

Dual-energy x-ray absorptiometry (DXA) is widely applied for estimating body fat. The percentage of body mass as fat (%fat) is predicted from a DXA-estimated R_ST value defined as the ratio of soft tissue attenuation at two photon energies (e.g., 40 keV and 70 keV). Theoretically, the R_ST concept depends on the mass of each major element in the human body. The DXA R_ST values, however, have never been fully evaluated by measured human elemental composition. The present investigation evaluated the DXA R_ST value by the total body mass of 11 major elements and the DXA %fat by the five-component (5C) model, respectively. Six elements (i.e. C, N, Na, P, Cl and Ca) were measured by in vivo neutron activation analysis, and potassium (i.e. K) by whole-body ⁴⁰K counting in 27 healthy adults. Models were developed for predicting the total body mass of four additional elements (i.e. H, O, Mg and S). The elemental content of soft tissue, after correction for bone mineral elements, was used to predict the R_ST values. The DXA R_ST values were strongly associated with the R_ST values predicted from elemental content (r = 0.976, P < 0.001), although there was a tendency for the elemental-predicted R_ST to systematically exceed the DXA-measured R_ST (mean ± SD, 1.389 ± 0.024 versus 1.341 ± 0.024). DXA-estimated %fat was strongly associated with 5C %fat (24.4 ± 12.0% versus 24.9 ± 11.1%, r = 0.983, P < 0.001). DXA R_ST is evaluated by in vivo elemental composition, and the present study supports the underlying physical concept and accuracy of the DXA method for estimating %fat.

An algorithm was developed to estimate the 3D lung tumor position using the projection data forming a cone beam CT sinogram and a template registration method. A pre-existing respiration-correlated CT image was used to generate templates of the target, which were then registered to the individual cone beam CT projections, and estimates of the target position were made for each projection. The registration search region was constrained based on knowledge of the mean tumor position during the cone beam CT scan acquisition. Several template registration algorithms were compared, including correlation coefficient and robust methods such as block correlation, robust correlation coefficient and robust gradient correlation. Robust registration metrics were found to be less sensitive to occlusions such as overlying tissue and the treatment couch. The mean accuracy of the position estimation was 1.4 mm in phantom with a robust registration algorithm. In two research subjects with peripheral tumors, the mean position and mean target excursion were estimated to within 2.0 mm compared to the results obtained with a '4D' registration of 4D image volumes.

System latency introduces geometric errors in the course of real-time target tracking radiotherapy. This effect can be minimized, for example by the use of predictive filters, but cannot be completely avoided. In this work, we present a convolution technique that can incorporate the effect as part of the treatment planning process. The method can be applied independently or in conjunction with the predictive filters to compensate for residual latency effects. The implementation was performed on TrackBeam (Initia Ltd, Israel), a prototype real-time target tracking system assembled and evaluated at our Cancer Institute. For the experimental system settings examined, a Gaussian distribution attributable to the TrackBeam latency was derived with σ = 3.7 mm. The TrackBeam latency, expressed as an average response time, was deduced to be 172 ms. Phantom investigations were further performed to verify the convolution technique. In addition, patient studies involving 4DCT volumes of previously treated lung cancer patients were performed to incorporate the latency effect in the dose prediction step. This also enabled us to effectively quantify the dosimetric and radiobiological impact of the TrackBeam and other higher latency effects on the clinical outcome of a real-time target tracking delivery.

Compared to single energy CT, which only provides information for x-ray linear attenuation coefficients, dual-energy CT is able to obtain both the electron density and effective atomic number for different materials in a quantitative way. In this study, as an alternative to dual-energy CT, a novel quantitative imaging method based on phase contrast CT is presented. Rather than requiring two projection data sets with different x-ray energy spectra, diffraction-grating-based phase contrast CT is capable of reconstructing images of both linear attenuation and refractive index decrement from the same projection data using a single x-ray energy spectra. From the two images, quantitative information of both the electron density and effective atomic number can be extracted. Two physical phantoms were constructed and used to validate the presented method. Experimental results demonstrate that (1) electron density can be accurately determined from refractive index decrement through a linear relationship, and (2) the effective atomic number can be explicitly derived from the ratio of the linear attenuation to refractive index decrement using a power function plus a constant. The presented method will provide insight into the technique of material separation and find its use in medical and industrial applications.

The development of phantom materials for elasticity imaging is reported in this paper. These materials were specifically designed to provide nonlinear stress/strain relationship that can be controlled independently of the small strain shear modulus of the material. The materials are mixtures of agar and gelatin gels. Oil droplet dispersions in these materials provide further control of the small strain shear modulus and the nonlinear parameter of the material. Since these materials are mostly water, they are assumed to be incompressible under typical experimental conditions in elasticity imaging. The Veronda–Westman model for strain energy density provided a good fit to all materials used in this study. Materials with a constant gelatin concentration (3.0% dry weight) but varying agar concentration (0.6–2.8% dry weight) demonstrated the same power law relationship between elastic modulus and agar concentration found for pure agar (1.89 ± 0.02), consistent with percolation theory, and provided a consistent nonlinearity parameter of 4.5 ± 0.3. The insights provided by this study will form the basis for stable elastography phantoms with stiffness and nonlinear stress/strain relationships in the background that differ from those in the target.

Following the assembly of a triple-modality SPECT-CT-OT small animal imaging system providing intrinsically co-registered projection data of all three submodalities and under the assumption and investigation of dual-labeled probes consisting of both fluorophores and radionuclides, a novel multi-modal reconstruction strategy is presented in this paper aimed at improving fluorescence-mediated tomography (FMT). The following reconstruction procedure is proposed: firstly, standard x-ray CT image reconstruction is performed employing the FDK algorithm. Secondly, standard SPECT image reconstruction is performed using OSEM. Thirdly, from the reconstructed CT volume data the surface boundary of the imaged object is extracted for finite element definition. Finally, the reconstructed SPECT data are used as a priori information within a Bayesian reconstruction framework for optical (FMT) reconstruction. We provide results of this multi-modal approach using phantom experimental data and illustrate that this strategy does suppress artifacts and facilitates quantitative analysis for optical imaging studies.

A new gamma-camera architecture named HiSens is presented and evaluated. It consists of a parallel hole collimator, a pixelated CdZnTe (CZT) detector associated with specific electronics for 3D localization and dedicated reconstruction algorithms. To gain in efficiency, a high aperture collimator is used. The spatial resolution is preserved thanks to accurate 3D localization of the interactions inside the detector based on a fine sampling of the CZT detector and on the depth of interaction information. The performance of this architecture is characterized using Monte Carlo simulations in both planar and tomographic modes. Detective quantum efficiency (DQE) computations are then used to optimize the collimator aperture. In planar mode, the simulations show that the fine CZT detector pixelization increases the system sensitivity by 2 compared to a standard Anger camera without loss in spatial resolution. These results are then validated against experimental data. In SPECT, Monte Carlo simulations confirm the merits of the HiSens architecture observed in planar imaging.

Pinhole collimators are widely used for single photon emission computed tomography (SPECT) imaging of small organs and animals. There has also been renewed interest in using pinhole arrays for clinical cardiac SPECT imaging to achieve high sensitivity and complete data sampling. Overall sensitivity of a pinhole array is critical in determining a system's performance. Conventionally, a point source model has been used to evaluate the sensitivity and optimize the system design. This model is simple but far from realistic. This work addresses the use of more realistic source models to assess the sensitivity performance of pinhole collimation. We have derived an analytical formula for pinhole collimation sensitivity with a general source distribution model using spherical harmonics. As special cases of this general model, we provided the pinhole sensitivity formulae for line, disk and sphere sources. These results show that the point source model is just the zeroth-order approximation of the other source models. The point source model overestimates or underestimates the sensitivity relative to the more realistic model. The sphere source model yields the same sensitivity as a point source located at the center of the sphere when attenuation is not taken into account. In the presence of attenuation, the average path length of emitted gamma rays is 3/4 of the radius of the sphere source. The calculated sensitivities based on these formulae show good agreement with separate Monte Carlo simulations in simple cases. The general and special sensitivity formulae derived here can be useful for the design and optimization of SPECT systems that utilize pinhole collimators.

The aim of magnetic resonance electrical impedance tomography (MREIT) is to visualize the electrical properties, conductivity or current density of an object by injection of current. Recently, the prolonged data acquisition time when using the injected current nonlinear encoding (ICNE) method has been advantageous for measurement of magnetic flux density data, Bz, for MREIT in the signal-to-noise ratio (SNR). However, the ICNE method results in undesirable side artifacts, such as blurring, chemical shift and phase artifacts, due to the long data acquisition under an inhomogeneous static field. In this paper, we apply the ICNE method to a gradient and spin echo (GRASE) multi-echo train pulse sequence in order to provide the multiple k-space lines during a single RF pulse period. We analyze the SNR of the measured multiple B_z data using the proposed ICNE-Multiecho MR pulse sequence. By determining a weighting factor for B_z data in each of the echoes, an optimized inversion formula for the magnetic flux density data is proposed for the ICNE-Multiecho MR sequence. Using the ICNE-Multiecho method, the quality of the measured magnetic flux density is considerably increased by the injection of a long current through the echo train length and by optimization of the voxel-by-voxel noise level of the B_z value. Agarose-gel phantom experiments have demonstrated fewer artifacts and a better SNR using the ICNE-Multiecho method. Experimenting with the brain of an anesthetized dog, we collected valuable echoes by taking into account the noise level of each of the echoes and determined B_z data by determining optimized weighting factors for the multiply acquired magnetic flux density data.

We studied the performance of a dual-panel positron emission tomography (PET) camera dedicated to breast cancer imaging using Monte Carlo simulation. The proposed system consists of two 4 cm thick 12 × 15 cm² area cadmium zinc telluride (CZT) panels with adjustable separation, which can be put in close proximity to the breast and/or axillary nodes. Unique characteristics distinguishing the proposed system from previous efforts in breast-dedicated PET instrumentation are the deployment of CZT detectors with superior spatial and energy resolution, using a cross-strip electrode readout scheme to enable 3D positioning of individual photon interaction coordinates in the CZT, which includes directly measured photon depth-of-interaction (DOI), and arranging the detector slabs edge-on with respect to incoming 511 keV photons for high photon sensitivity. The simulation results show that the proposed CZT dual-panel PET system is able to achieve superior performance in terms of photon sensitivity, noise equivalent count rate, spatial resolution and lesion visualization. The proposed system is expected to achieve ∼32% photon sensitivity for a point source at the center and a 4 cm panel separation. For a simplified breast phantom adjacent to heart and torso compartments, the peak noise equivalent count (NEC) rate is predicted to be ∼94.2 kcts s⁻¹ (breast volume: 720 cm³ and activity concentration: 3.7 kBq cm⁻³) for a ∼10% energy window around 511 keV and ∼8 ns coincidence time window. The system achieves 1 mm intrinsic spatial resolution anywhere between the two panels with a 4 cm panel separation if the detectors have DOI resolution less than 2 mm. For a 3 mm DOI resolution, the system exhibits excellent sphere resolution uniformity (σ_rms/mean) ⩽ 10%) across a 4 cm width FOV. Simulation results indicate that the system exhibits superior hot sphere visualization and is expected to visualize 2 mm diameter spheres with a 5:1 activity concentration ratio within roughly 7 min imaging time. Furthermore, we observe that the degree of spatial resolution degradation along the direction orthogonal to the two panels that is typical of a limited angle tomography configuration is mitigated by having high-resolution DOI capabilities that enable more accurate positioning of oblique response lines.

We have previously assessed the use of the diaphragm as a surrogate for predicting real-time tumor position with linear models built with training data extracted from the same treatment fraction (Cerviño et al2009 Phys. Med. Biol.54 3529–41). However, practical use in the clinical setting requires the capability of predicting tumor position throughout the treatment course using a model built at the beginning of the course. We evaluate the inter-fraction applicability of linear models to predict superior–inferior tumor position based on diaphragm position using 21 fluoroscopic sequences from five lung cancer patients. Tumor position is predicted with models built during the first fluoroscopic sequence of each patient. Other fluoroscopic sets are registered to the first set with five different methods. The mean localization prediction error and maximum error at a 95% confidence level averaged over all patients are found to be 1.2 mm and 2.9 mm, respectively, for bony registration and 1.2 mm and 2.8 mm, respectively, for registration based on the mean position of the tumor in the first two breathing cycles. Other registration methods produce larger prediction errors. In the clinical setting, this prediction error could be added as a margin to the target volume. We therefore conclude that it is feasible to predict lung tumor motion with diaphragm with sufficient accuracy in the clinical setting.

Estimating the dose distribution in a victim's body is a relevant indicator in assessing biological damage from exposure in the event of a radiological accident caused by an external source. When the dose distribution is evaluated with a numerical anthropomorphic model, the posture and morphology of the victim have to be reproduced as realistically as possible. Several years ago, IRSN developed a specific software application, called the simulation of external source accident with medical images (SESAME), for the dosimetric reconstruction of radiological accidents by numerical simulation. This tool combines voxel geometry and the MCNP(X) Monte Carlo computer code for radiation–material interaction. This note presents a new functionality in this software that enables the modelling of a victim's posture and morphology based on non-uniform rational B-spline (NURBS) surfaces. The procedure for constructing the modified voxel phantoms is described, along with a numerical validation of this new functionality using a voxel phantom of the RANDO tissue-equivalent physical model.

The present study quantified the volume-averaged in situ electric field in nerve tissues of anatomically based numeric Japanese male and female models for exposure to extremely low-frequency electric and magnetic fields. A quasi-static finite-difference time-domain method was applied to analyze this problem. The motivation of our investigation is that the dependence of the electric field induced in nerve tissue on the averaging volume/distance is not clear, while a cubical volume of 5 × 5 × 5 mm³ or a straight-line segment of 5 mm is suggested in some documents. The influence of non-nerve tissue surrounding nerve tissue is also discussed by considering three algorithms for calculating the averaged in situ electric field in nerve tissue. The computational results obtained herein reveal that the volume-averaged electric field in the nerve tissue decreases with the averaging volume. In addition, the 99th percentile value of the volume-averaged in situ electric field in nerve tissue is more stable than that of the maximal value for different averaging volume. When including non-nerve tissue surrounding nerve tissue in the averaging volume, the resultant in situ electric fields were not so dependent on the averaging volume as compared to the case excluding non-nerve tissue. In situ electric fields averaged over a distance of 5 mm were comparable or larger than that for a 5 × 5 × 5 mm³ cube depending on the algorithm, nerve tissue considered and exposure scenarios.

Among Monte Carlo simulation codes in medical imaging, the GATE simulation platform is widely used today given its flexibility and accuracy, despite long run times, which in SPECT simulations are mostly spent in tracking photons through the collimators. In this work, a tabulated model of the collimator/detector response was implemented within the GATE framework to significantly reduce the simulation times in SPECT. This implementation uses the angular response function (ARF) model. The performance of the implemented ARF approach has been compared to standard SPECT GATE simulations in terms of the ARF tables' accuracy, overall SPECT system performance and run times. Considering the simulation of the Siemens Symbia T SPECT system using high-energy collimators, differences of less than 1% were measured between the ARF-based and the standard GATE-based simulations, while considering the same noise level in the projections, acceleration factors of up to 180 were obtained when simulating a planar 364 keV source seen with the same SPECT system. The ARF-based and the standard GATE simulation results also agreed very well when considering a four-head SPECT simulation of a realistic Jaszczak phantom filled with iodine-131, with a resulting acceleration factor of 100. In conclusion, the implementation of an ARF-based model of collimator/detector response for SPECT simulations within GATE significantly reduces the simulation run times without compromising accuracy.

We comment on a previous article by Zhang and Newhauser (2009 Phys. Med. Biol.54 1383–95) which presents several approximate ways of computing the water equivalent of an arbitrary degrader. First, we present a simple exact method which depends only on the range-energy relation of water and of the degrader material. Second, we point out that any theoretical method, approximate or exact, ultimately depends on the range-energy relation, that is to say, the correct value of the mean excitation energy I for the materials in question. Unfortunately I is particularly problematic for water. Therefore, at the present state of knowledge, we should measure water equivalent, rather than computing it, whenever an accurate value is needed.