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Sökning: L773:0094 2405 OR L773:2473 4209 > Karolinska Institutet

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  • Andersson, Karin M., 1989-, et al. (författare)
  • Evaluation of two commercial CT metal artifact reduction algorithms for use in proton radiotherapy treatment planning in the head and neck area
  • 2018
  • Ingår i: Medical physics (Lancaster). - : Wiley-Blackwell Publishing Inc.. - 0094-2405 .- 2473-4209. ; 45:10, s. 4329-4344
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: To evaluate two commercial CT metal artifact reduction (MAR) algorithms for use in proton treatment planning in the head and neck (H&N) area.METHODS: An anthropomorphic head phantom with removable metallic implants (dental fillings or neck implant) was CT-scanned to evaluate the O-MAR (Philips) and the iMAR (Siemens) algorithms. Reference images were acquired without any metallic implants in place. Water equivalent thickness (WET) was calculated for different path directions and compared between image sets. Images were also evaluated for use in proton treatment planning for parotid, tonsil, tongue base, and neck node targets. The beams were arranged so as to not traverse any metal prior to the target, enabling evaluation of the impact on dose calculation accuracy from artifacts surrounding the metal volume. Plans were compared based on γ analysis (1 mm distance-to-agreement/1% difference in local dose) and dose volume histogram metrics for targets and organs at risk (OARs). Visual grading evaluation of 30 dental implant patient MAR images was performed by three radiation oncologists.RESULTS: In the dental fillings images, ΔWET along a low-density streak was reduced from -17.0 to -4.3 mm with O-MAR and from -16.1 mm to -2.3 mm with iMAR, while for other directions the deviations were increased or approximately unchanged when the MAR algorithms were used. For the neck implant images, ΔWET was generally reduced with MAR but residual deviations remained (of up to -2.3 mm with O-MAR and of up to -1.5 mm with iMAR). The γ analysis comparing proton dose distributions for uncorrected/MAR plans and corresponding reference plans showed passing rates >98% of the voxels for all phantom plans. However, substantial dose differences were seen in areas of most severe artifacts (γ passing rates of down to 89% for some cases). MAR reduced the deviations in some cases, but not for all plans. For a single patient case dosimetrically evaluated, minor dose differences were seen between the uncorrected and MAR plans (γ passing rate approximately 97%). The visual grading of patient images showed that MAR significantly improved image quality (P < 0.001).CONCLUSIONS: O-MAR and iMAR significantly improved image quality in terms of anatomical visualization for target and OAR delineation in dental implant patient images. WET calculations along several directions, all outside the metallic regions, showed that both uncorrected and MAR images contained metal artifacts which could potentially lead to unacceptable errors in proton treatment planning. ΔWET was reduced by MAR in some areas, while increased or unchanged deviations were seen for other path directions. The proton treatment plans created for the phantom images showed overall acceptable dose distributions differences when compared to the reference cases, both for the uncorrected and MAR images. However, substantial dose distribution differences in the areas of most severe artifacts were seen for some plans, which were reduced by MAR in some cases but not all. In conclusion, MAR could be beneficial to use for proton treatment planning; however, case-by-case evaluations of the metal artifact-degraded images are always recommended.
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  • Beaulieu, Luc, et al. (författare)
  • AAPM WGDCAB Report 372: A joint AAPM, ESTRO, ABG, and ABS report on commissioning of model-based dose calculation algorithms in brachytherapy
  • 2023
  • Ingår i: Medical physics (Lancaster). - : WILEY. - 0094-2405. ; 50:8, s. E946-E960
  • Tidskriftsartikel (refereegranskat)abstract
    • The introduction of model-based dose calculation algorithms (MBDCAs) in brachytherapy provides an opportunity for a more accurate dose calculation and opens the possibility for novel, innovative treatment modalities. The joint AAPM, ESTRO, and ABG Task Group 186 (TG-186) report provided guidance to early adopters. However, the commissioning aspect of these algorithms was described only in general terms with no quantitative goals. This report, from the Working Group on Model-Based Dose Calculation Algorithms in Brachytherapy, introduced a field-tested approach to MBDCA commissioning. It is based on a set of well-characterized test cases for which reference Monte Carlo (MC) and vendor-specific MBDCA dose distributions are available in a Digital Imaging and Communications in Medicine-Radiotherapy (DICOM-RT) format to the clinical users. The key elements of the TG-186 commissioning workflow are now described in detail, and quantitative goals are provided. This approach leverages the well-known Brachytherapy Source Registry jointly managed by the AAPM and the Imaging and Radiation Oncology Core (IROC) Houston Quality Assurance Center (with associated links at ESTRO) to provide open access to test cases as well as step-by-step user guides. While the current report is limited to the two most widely commercially available MBDCAs and only for Ir-192-based afterloading brachytherapy at this time, this report establishes a general framework that can easily be extended to other brachytherapy MBDCAs and brachytherapy sources. The AAPM, ESTRO, ABG, and ABS recommend that clinical medical physicists implement the workflow presented in this report to validate both the basic and the advanced dose calculation features of their commercial MBDCAs. Recommendations are also given to vendors to integrate advanced analysis tools into their brachytherapy treatment planning system to facilitate extensive dose comparisons. The use of the test cases for research and educational purposes is further encouraged.
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  • Benmakhlouf, Hamza, et al. (författare)
  • Output correction factors for nine small field detectors in 6 MV radiation therapy photon beams : A PENELOPE Monte Carlo study
  • 2014
  • Ingår i: Medical physics (Lancaster). - : Wiley. - 0094-2405 .- 2473-4209. ; 41:4, s. 041711-
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To determine detector-specific output correction factors, k(Qclin,Qmsr)(fclin,fmsr) in 6 MV small photon beams for air and liquid ionization chambers, silicon diodes, and diamond detectors from two manufacturers. Methods: Field output factors, defined according to the international formalism published by Alfonso et al. [Med. Phys. 35, 5179-5186 (2008)], relate the dosimetry of small photon beams to that of the machine-specific reference field; they include a correction to measured ratios of detector readings, conventionally used as output factors in broad beams. Output correction factors were calculated with the PENELOPE Monte Carlo (MC) system with a statistical uncertainty (type-A) of 0.15% or lower. The geometries of the detectors were coded using blueprints provided by the manufacturers, and phase-space files for field sizes between 0.5 x 0.5 cm(2) and 10 x 10 cm(2) from a Varian Clinac iX 6 MV linac used as sources. The output correction factors were determined scoring the absorbed dose within a detector and to a small water volume in the absence of the detector, both at a depth of 10 cm, for each small field and for the reference beam of 10 x 10 cm(2). Results: The Monte Carlo calculated output correction factors for the liquid ionization chamber and the diamond detector were within about +/- 1% of unity even for the smallest field sizes. Corrections were found to be significant for small air ionization chambers due to their cavity dimensions, as expected. The correction factors for silicon diodes varied with the detector type (shielded or un-shielded), confirming the findings by other authors; different corrections for the detectors from the two manufacturers were obtained. The differences in the calculated factors for the various detectors were analyzed thoroughly and whenever possible the results were compared to published data, often calculated for different accelerators and using the EGSnrc MC system. The differences were used to estimate a type-B uncertainty for the correction factors. Together with the type-A uncertainty from the Monte Carlo calculations, an estimation of the combined standard uncertainty was made, assigned to the mean correction factors from various estimates. Conclusions: The present work provides a consistent and specific set of data for the output correction factors of a broad set of detectors in a Varian Clinac iX 6 MV accelerator and contributes to improving the understanding of the physics of small photon beams. The correction factors cannot in general be neglected for any detector and, as expected, their magnitude increases with decreasing field size. Due to the reduced number of clinical accelerator types currently available, it is suggested that detector output correction factors be given specifically for linac models and field sizes, rather than for a beam quality specifier that necessarily varies with the accelerator type and field size due to the different electron spot dimensions and photon collimation systems used by each accelerator model. (C) 2014 American Association of Physicists in Medicine.
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  • Candela-Juan, C., et al. (författare)
  • Dosimetric characterization of two radium sources for retrospective dosimetry studies
  • 2015
  • Ingår i: Medical physics (Lancaster). - : American Association of Physicists in Medicine: Medical Physics. - 0094-2405 .- 2473-4209. ; 42:5, s. 2132-2142
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: During the first part of the 20th century, Ra-226 was the most used radionuclide for brachytherapy. Retrospective accurate dosimetry, coupled with patient follow up, is important for advancing knowledge on long-term radiation effects. The purpose of this work was to dosimetrically characterize two Ra-226 sources, commonly used in Sweden during the first half of the 20th century, for retrospective dose-effect studies. Methods: An 8 mg Ra-226 tube and a 10 mg Ra-226 needle, used at Radiumhemmet (Karolinska University Hospital, Stockholm, Sweden), from 1925 to the 1960s, were modeled in two independent Monte Carlo (MC) radiation transport codes: GEANT4 and MCNP5. Absorbed dose and collision kerma around the two sources were obtained, from which the TG-43 parameters were derived for the secular equilibrium state. Furthermore, results from this dosimetric formalism were compared with results from a MC simulation with a superficial mould constituted by five needles inside a glass casing, placed over a water phantom, trying to mimic a typical clinical setup. Calculated absorbed doses using the TG-43 formalism were also compared with previously reported measurements and calculations based on the Sievert integral. Finally, the dose rate at large distances from a Ra-226 point-like-source placed in the center of 1 m radius water sphere was calculated with GEANT4. Results: TG-43 parameters [including gL(r), F(r,theta), Lambda, and s(K)] have been uploaded in spreadsheets as additional material, and the fitting parameters of a mathematical curve that provides the dose rate between 10 and 60 cm from the source have been provided. Results from TG-43 formalism are consistent within the treatment volume with those of a MC simulation of a typical clinical scenario. Comparisons with reported measurements made with thermoluminescent dosimeters show differences up to 13% along the transverse axis of the radium needle. It has been estimated that the uncertainty associated to the absorbed dose within the treatment volume is 10%-15%, whereas uncertainty of absorbed dose to distant organs is roughly 20%-25%. Conclusions: The results provided here facilitate retrospective dosimetry studies of Ra-226 using modern treatment planning systems, which may be used to improve knowledge on long term radiation effects. It is surely important for the epidemiologic studies to be aware of the estimated uncertainty provided here before extracting their conclusions.
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  • Dasu, Alexandru, et al. (författare)
  • Impact of variable RBE on proton fractionation
  • 2013
  • Ingår i: Medical physics (Lancaster). - : Wiley. - 0094-2405 .- 2473-4209. ; 40:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To explore the impact of variable proton RBE on dose fractionation for clinically-relevant situations. A generic RBE=1.1 is generally used for isoeffect calculations, while experimental studies showed that proton RBE varies with tissue type, dose and LET.Material and methods: An analytical expression for the LET and α/β dependence of the LQ model has been used for proton simulations in parallel with the assumption of a generic RBE=1.1. Calculations have been performed for ranges of LET values and fractionation sensitivities to describe clinically-relevant cases, like the treatment of H&N and prostate tumors. Isoeffect calculations were compared with predictions from a generic RBE value and reported clinical results.Results: The generic RBE=1.1 appears to be a reasonable estimate for the proton RBE of rapidly growing tissues irradiated with low LET radiation. However, the use of a variable RBE predicts larger differences for tissues with low α/β (both tumor and normal) and at low doses per fraction. In some situations these differences may appear in contrast to the findings from photon studies highlighting the importance of accurate accounting for the radiobiological effectiveness of protons. Furthermore, the use of variable RBE leads to closer predictions to clinical results. Conclusions: The LET dependence of the RBE has a strong impact on the predicted effectiveness of fractionated proton radiotherapy. The magnitude of the effect is modulated by the fractionation sensitivity and the fractional dose indicating the need for accurate analyses both in the target and around it. Care should therefore be employed for changing clinical fractionation patterns or when analyzing results from clinical studies for this type of radiation.
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  • Fan, Peng, et al. (författare)
  • Scatter and crosstalk corrections for (99m)Tc/(123)I dual-radionuclide imaging using a CZT SPECT system with pinhole collimators.
  • 2015
  • Ingår i: Medical Physics. - : Wiley. - 0094-2405 .- 2473-4209. ; 42:12, s. 6895-6911
  • Tidskriftsartikel (refereegranskat)abstract
    • The energy spectrum for a cadmium zinc telluride (CZT) detector has a low energy tail due to incomplete charge collection and intercrystal scattering. Due to these solid-state detector effects, scatter would be overestimated if the conventional triple-energy window (TEW) method is used for scatter and crosstalk corrections in CZT-based imaging systems. The objective of this work is to develop a scatter and crosstalk correction method for (99m)Tc/(123)I dual-radionuclide imaging for a CZT-based dedicated cardiac SPECT system with pinhole collimators (GE Discovery NM 530c/570c).
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