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1.
  • Fonslet, J., et al. (författare)
  • 135La as an Auger-electron emitter for targeted internal radiotherapy
  • 2018
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 63:1
  • Tidskriftsartikel (refereegranskat)abstract
    • 135La has favorable nuclear and chemical properties for Auger-based targeted internal radiotherapy. Here we present detailed investigations of the production, emissions, and dosimetry related to 135La therapy. 135La was produced by 16.5 MeV proton irradiation of metallic natBa on a medical cyclotron, and was isolated and purified by trap-and-release on weak cation-exchange resin. The average production rate was 407 19 MBq A-1 (saturation activity), and the radionuclidic purity was 98% at 20 h post irradiation. Chemical separation recovered > 98 % of the 135La with an effective molar activity of 70 20 GBq mol-1. To better assess cellular and organ dosimetry of this nuclide, we have calculated the x-ray and Auger emission spectra using a Monte Carlo model accounting for effects of multiple vacancies during the Auger cascade. The generated Auger spectrum was used to calculate cellular S-factors. 135La was produced with high specific activity, reactivity, radionuclidic purity, and yield. The emission spectrum and the dosimetry are favorable for internal radionuclide therapy.
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2.
  • Andersson, Martin, et al. (författare)
  • A biokinetic and dosimetric model for ionic indium in humans
  • 2017
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 62:16, s. 6397-6407
  • Tidskriftsartikel (refereegranskat)abstract
    • This paper reviews biokinetic data for ionic indium, and proposes a biokinetic model for systemic indium in adult humans. The development of parameter values focuses on human data and indium in the form of ionic indium(III), as indium chloride and indium arsenide. The model presented for systemic indium is defined by five different pools: plasma, bone marrow, liver, kidneys and other soft tissues. The model is based on two subsystems: one corresponding to indium bound to transferrin and one where indium is transported back to the plasma, binds to red blood cell transferrin and is then excreted through the kidneys to the urinary bladder. Absorbed doses to several organs and the effective dose are calculated for 111In- and 113mIn-ions. The proposed biokinetic model is compared with previously published biokinetic indium models published by the ICRP. The absorbed doses are calculated using the ICRP/ICRU adult reference phantoms and the effective dose is estimated according to ICRP Publication 103. The effective doses for 111In and 113mIn are 0.25 mSv MBq-1 and 0.013 mSv MBq-1 respectively. The updated biokinetic and dosimetric models presented in this paper take into account human data and new animal data, which represent more detailed and presumably more accurate dosimetric data than that underlying previous models for indium.
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3.
  • Andersson, Martin, et al. (författare)
  • Lifetime attributable risk as an alternative to effective dose to describe the risk of cancer for patients in diagnostic and therapeutic nuclear medicine
  • 2017
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 62:24, s. 9177-9188
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study is to implement lifetime attributable risk (LAR) predictions of cancer for patients of various age and gender, undergoing diagnostic investigations or treatments in nuclear medicine and to compare the outcome with a population risk estimate using effective dose and the International Commission on Radiological Protection risk coefficients. The radiation induced risk of cancer occurrence (incidence) or death from four nuclear medicine procedures are estimated for both male and female between 0 and 120 years. Estimations of cancer risk are performed using recommended administered activities for two diagnostic (18F-FDG and 99mTc-phosphonate complex) and two therapeutic (131I-iodide and 223Ra-dichloride) radiopharmaceuticals to illustrate the use of cancer risk estimations in nuclear medicine. For 18F-FDG, the cancer incidence for a male of 5, 25, 50 and 75 years at exposure is 0.0021, 0.0010, 0.0008 and 0.0003, respectively. For 99mTc phosphonates complex the corresponding values are 0.000 59, 0.000 34, 0.000 27 and 0.000 13, respectively. For an 131I-iodide treatment with 3.7 GBq and 1% uptake 24 h after administration, the cancer incidence for a male of 25, 50 and 75 years at exposure is 0.041, 0.029 and 0.012, respectively. For 223Ra-dichloride with an administration of 21.9 MBq the cancer incidence for a male of 25, 50 and 75 years is 0.31, 0.21 and 0.09, respectively. The LAR estimations are more suitable in health care situations involving individual patients or specific groups of patients than the health detriment based on effective dose, which represents a population average. The detriment consideration in effective dose adjusts the cancer incidence for suffering of non-lethal cancers while LAR predicts morbidity (incidence) or mortality (cancer). The advantages of these LARs are that they are gender and age specific, allowing risk estimations for specific patients or subgroups thus better representing individuals in health care than effective dose.
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4.
  • Arboled, C., et al. (författare)
  • Assessing lesion malignancy by scanning small-angle x-ray scattering of breast tissue with microcalcifications
  • 2019
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 64:15
  • Tidskriftsartikel (refereegranskat)abstract
    • Scanning small-angle x-ray scattering (SAXS) measurements were performed on 36 formalin-fixed breast tissue biopsies obtained from two patients. All samples contained microcalcifications of type II, i.e. formed by hydroxyapatite. We demonstrate the feasibility of classifying breast lesions by scanning SAXS of tissues containing microcalcifications with a resolution of 35 mu m x 30 mu m We report a characteristic Bragg peak found around q = 1.725 nm(-1) that occurs primarily for malignant lesions. Such a clear SAXS fingerprint is potentially linked to structural changes of breast tissue and corresponds to dimensions of about 3.7 nm. This material property could be used as an early indicator of malignancy development, as it is readily assessed by SAXS. If this fingerprint is combined with other known SAXS features, which also indicate the level of malignancy, such as lipid spacing and collagen periodicity, it could complement traditional pathology-based analyses. To confirm the SAXS-based classification, a histopathological workup and a gold standard histopathological diagnosis were conducted to determine the malignancy level of the lesions. Our aim is to report this SAXS fingerprint, which is clearly related to malignant breast lesions. However, any further conclusion based on our dataset is limited by the low number of patients and samples. Running a broad study to increase the number of samples and patients is of great importance and relevance for the breast-imaging community.
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5.
  • Edvardsson, A., et al. (författare)
  • Breathing-motion induced interplay effects for stereotactic body radiotherapy of liver tumours using flattening-filter free volumetric modulated arc therapy
  • 2019
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 64:2
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of this study was to investigate breathing-motion induced interplay effects for stereotactic body radiotherapy (SBRT) of liver tumours treated with flattening-filter free (FFF) volumetric modulated arc therapy (VMAT). Ten patients previously treated with liver SBRT were included in this study. All patients had four-dimensional computed tomography (4DCT) scans acquired prior to treatment. The 4DCT was sorted into 8-10 phases covering an equal time interval. A FFF VMAT plan was created for one fraction in the mid-ventilation phase for each patient. To generate dose distributions including both interplay effects and dose blurring, a sub-plan was calculated for each phase. The total dose distributions were accumulated to the mid-ventilation phase using the deformed vector fields (DVF) from deformable image registration between the corresponding CT and the mid-ventilation phase CT. A blurred dose distribution, not including interplay effects, was also obtained by distributing the delivery of the whole plan uniformly on all phases, and was similarly accumulated to the mid-ventilation phase. To isolate interplay effects, this blurred dose distribution was subtracted from the total dose distribution with interplay effects. The near minimum dose (D-98%), mean dose (D-mean), heterogeneity index (HI), and the near minimum dose difference (Delta D-98%) between the accumulated dose distributions with and without interplay effects were calculated within the gross tumour volume (GTV) for each patient. Comparing the accumulated dose distributions with and without interplay effects, the D-98(%) decreased for nine of the ten patients and the HI increased for all patients. The median and minimum differences in D-98(%) were -2.1% and -5.0% (p = 0.006), respectively, and the median HI significantly increased from 6.2% to 12.2% (p = 0.002). The median Delta D-98% was -4.0% (range - 7% to - 1.5%). In conclusion, statistically significant breathing-induced interplay effects were observed for a single fraction of FFF VMAT liver SBRT, resulting in heterogeneous dose distributions within the GTV.
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6.
  • Edvardsson, Anneli, et al. (författare)
  • Motion induced interplay effects for VMAT radiotherapy
  • 2018
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 63:8
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of this study was to develop a method to simulate breathing motion induced interplay effects for volumetric modulated arc therapy (VMAT), to verify the proposed method with measurements, and to use the method to investigate how interplay effects vary with different patient-and machine specific parameters. VMAT treatment plans were created on a virtual phantom in a treatment planning system (TPS). Interplay effects were simulated by dividing each plan into smaller sub-arcs using an in-house developed software and shifting the isocenter for each sub-arc to simulate a sin(6) breathing motion in the superior-inferior direction. The simulations were performed for both flattening-filter (FF) and flattening-filter free (FFF) plans and for different breathing amplitudes, period times, initial breathing phases, dose levels, plan complexities, CTV sizes, and collimator angles. The resulting sub-arcs were calculated in the TPS, generating a dose distribution including the effects of motion. The interplay effects were separated from dose blurring and the relative dose differences to 2% and 98% of the CTV volume (Delta D-98% and Delta D-2%) were calculated. To verify the simulation method, measurements were carried out, both static and during motion, using a quasi-3D phantom and a motion platform. The results of the verification measurements during motion were comparable to the results of the static measurements. Considerable interplay effects were observed for individual fractions, with the minimum Delta D-98% and maximum Delta D-2% being - 16.7% and 16.2%, respectively. The extent of interplay effects was larger for FFF compared to FF and generally increased for higher breathing amplitudes, larger period times, lower dose levels, and more complex treatment plans. Also, the interplay effects varied considerably with the initial breathing phase, and larger variations were observed for smaller CTV sizes. In conclusion, a method to simulate motion induced interplay effects was developed and verified with measurements, which allowed for a large number of treatment scenarios to be investigated. The simulations showed large interplay effects for individual fractions and that the extent of interplay effects varied with the breathing pattern, FFF/FF, dose level, CTV size, collimator angle, and the complexity of the treatment plan.
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7.
  • Guillaume, Florian, et al. (författare)
  • Neutron microtomography to investigate the bone-implant interface - Comparison with histological analysis
  • 2021
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 66:10
  • Tidskriftsartikel (refereegranskat)abstract
    • Bone properties and especially its microstructure around implants are crucial to evaluate the osseointegration of prostheses in orthopaedic, maxillofacial and dental surgeries. Given the intrinsic heterogeneous nature of the bone microstructure, an ideal probing tool to understand and quantify bone formation must be spatially resolved. X-ray imaging has often been employed, but is limited in the presence of metallic implants, where severe artifacts generally arise from the high attenuation of metals to x-rays. Neutron tomography has recently been proposed as a promising technique to study bone-implant interfaces, thanks to its lower interaction with metals. The aim of this study is to assess the potential of neutron tomography for the characterisation of bone tissue in the vicinity of a metallic implant. A standardised implant with a bone chamber was implanted in rabbit bone. Four specimens were imaged with neutron tomography and subsequently compared to non-decalcified histology to stain soft and mineralised bone tissues, used here as a ground-truth reference. An intensity-based image registration procedure was performed to place the 12 histological slices within the corresponding 3D neutron volume. Significant correlations (p < 0.01) were obtained between the two modalities for the bone-implant contact (BIC) ratio (R = 0.77) and the bone content inside the chamber (R = 0.89). The results indicate that mineralised bone tissue can be reliably detected by neutron tomography. However, the BIC ratio and bone content were found to be overestimated with neutron imaging, which may be explained by its sensitivity to non-mineralised soft tissues, as revealed by histological staining. This study highlights the suitability of neutron tomography for the analysis of the bone-implant interface. Future work will focus on further distinguishing soft tissues from bone tissue, which could be aided by the adoption of contrast agents.
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8.
  • Gustafsson, C, et al. (författare)
  • Assessment of dosimetric impact of system specific geometric distortion in an MRI only based radiotherapy workflow for prostate
  • 2017
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 1361-6560 .- 0031-9155. ; 62:8, s. 2976-2989
  • Tidskriftsartikel (refereegranskat)abstract
    • Dosimetric errors in a magnetic resonance imaging (MRI) only radiotherapy workflow may be caused by system specific geometric distortion from MRI. The aim of this study was to evaluate the impact on planned dose distribution and delineated structures for prostate patients, originating from this distortion. A method was developed, in which computer tomography (CT) images were distorted using the MRI distortion field. The displacement map for an optimized MRI treatment planning sequence was measured using a dedicated phantom in a 3 T MRI system. To simulate the distortion aspects of a synthetic CT (electron density derived from MR images), the displacement map was applied to CT images, referred to as distorted CT images. A volumetric modulated arc prostate treatment plan was applied to the original CT and the distorted CT, creating a reference and a distorted CT dose distribution. By applying the inverse of the displacement map to the distorted CT dose distribution, a dose distribution in the same geometry as the original CT images was created. For 10 prostate cancer patients, the dose difference between the reference dose distribution and inverse distorted CT dose distribution was analyzed in isodose level bins. The mean magnitude of the geometric distortion was 1.97 mm for the radial distance of 200-250 mm from isocenter. The mean percentage dose differences for all isodose level bins, were ⩽0.02% and the radiotherapy structure mean volume deviations were <0.2%. The method developed can quantify the dosimetric effects of MRI system specific distortion in a prostate MRI only radiotherapy workflow, separated from dosimetric effects originating from synthetic CT generation. No clinically relevant dose difference or structure deformation was found when 3D distortion correction and high acquisition bandwidth was used. The method could be used for any MRI sequence together with any anatomy of interest.
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9.
  • Gustafsson, Christian Jamtheim, et al. (författare)
  • Development and evaluation of a deep learning based artificial intelligence for automatic identification of gold fiducial markers in an MRI-only prostate radiotherapy workflow
  • 2020
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 1361-6560 .- 0031-9155. ; 65:22
  • Tidskriftsartikel (refereegranskat)abstract
    • Identification of prostate gold fiducial markers in magnetic resonance imaging (MRI) images is challenging when CT images are not available, due to misclassifications from intra-prostatic calcifications. It is also a time consuming task and automated identification methods have been suggested as an improvement for both objectives. Multi-echo gradient echo (MEGRE) images have been utilized for manual fiducial identification with 100% detection accuracy. The aim is therefore to develop an automatic deep learning based method for fiducial identification in MRI images intended for MRI-only prostate radiotherapy. MEGRE images from 326 prostate cancer patients with fiducials were acquired on a 3T MRI, post-processed with N4 bias correction, and the fiducial center of mass (CoM) was identified. A 9 mm radius sphere was created around the CoM as ground truth. A deep learning HighRes3DNet model for semantic segmentation was trained using image augmentation. The model was applied to 39 MRI-only patients and 3D probability maps for fiducial location and segmentation were produced and spatially smoothed. In each of the three largest probability peaks, a 9 mm radius sphere was defined. Detection sensitivity and geometric accuracy was assessed. To raise awareness of potential false findings a 'BeAware' score was developed, calculated from the total number and quality of the probability peaks. All datasets, annotations and source code used were made publicly available. The detection sensitivity for all fiducials were 97.4%. Thirty-six out of thirty-nine patients had all fiducial markers correctly identified. All three failed patients generated a user notification using the BeAware score. The mean absolute difference between the detected fiducial and ground truth CoM was 0.7 ± 0.9 [0 3.1] mm. A deep learning method for automatic fiducial identification in MRI images was developed and evaluated with state-of-the-art results. The BeAware score has the potential to notify the user regarding patients where the proposed method is uncertain.
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10.
  • Gustafsson, Johan, et al. (författare)
  • Feasibility and limitations of quantitative SPECT for 223Ra
  • 2020
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 65:8
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this paper is to investigate the feasibility and limitations of activity-concentration estimation for 223Ra using SPECT. Phantom measurements are performed using spheres (volumes 5.5 mL to 26.4 mL, concentrations 1.6 kBq mL-1 to 4.5 kBq mL-1). Furthermore, SPECT projections are simulated using the SIMIND Monte Carlo program for two geometries, one similar to the physical phantom and the other being an anthropomorphic phantom with added lesions (volumes 34 mL to 100 mL, concentrations 0.5 kBq mL-1 to 4 kBq mL-1). Medium-energy and high-energy collimators, 60 projections with 55 s per projection and a 20% energy window at 82 keV are employed. For the Monte Carlo simulated images, Poisson-distributed noise is added in ten noise realizations. Reconstruction is performed (OS-EM, 40 iterations, 6 subsets) employing compensation for attenuation, scatter, and collimator-detector response. The estimated concentrations in the anthropomorphic phantom are also corrected using recovery coefficients. Errors for the largest sphere in the physical phantom range from -25% to -34% for the medium-energy collimator and larger deviations for smaller spheres. Corresponding results for the high-energy collimator are -15% to -31%. The corresponding Monte Carlo simulations show standard deviations of a few percentage points. For the anthropomorphic phantom, before application of recovery coefficients the bias ranges from -16% to -46% (medium-energy collimator) and -10% to -28% (high-energy collimator), with standard deviations of 2% to 14% and 1% to 16%. After the application of recovery coefficients, the biases range from -3% to -35% (medium energy collimator) and from 0% to -18%. The errors decrease with increasing concentrations. Activity-concentration estimation of 223Ra with SPECT is feasible, but problems with repeatability need to be further studied.
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11.
  • Gustafsson, Johan, et al. (författare)
  • Monte Carlo-based SPECT reconstruction within the SIMIND framework
  • 2018
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 63:24
  • Tidskriftsartikel (refereegranskat)abstract
    • This paper presents the development and validation of a Monte Carlo-based singe photon emission computed tomography reconstruction program for parallel-hole collimation contained within the SIMIND Monte Carlo framework. The Monte Carlo code is used as an accurate forward-projector and is combined with a simplified back-projector to perform iterative tomographic reconstruction using the Maximum Likelihood Expectation Maximization and Ordered Subsets Expectation Maximization algorithms, together forming a program called SIMREC. The Monte Carlo simulation transforms the estimated source distribution directly from activity to counts in its projections. Hence, the reconstructed image is expressed in activity without reference to an external calibration. The program is tested using phantom measurements of spheres filled with 99mTc, 177Lu and 131I placed in air and centrally and peripherally in a water-filled elliptical phantom. The feasibility of applying the reconstruction to patients is also demonstrated for a range of radiopharmaceuticals. The deviation in total activity in the spheres ranged between -4.1% and 6.2% compared with the activity determined when preparing the phantom. The SIMREC program was found to be accurate with respect to activity estimation and to reconstruct visually acceptable images within a few hours when applied to patient examples.
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12.
  • Gustafsson, Johan, et al. (författare)
  • Theoretical aspects on the use of single-time-point dosimetry for radionuclide therapy
  • 2022
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 67:2
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. This study considers the error distributions for time-integrated activity (TIA) of single-time-point (STP) methods for patient-specific dosimetry in radionuclide therapy. Approach. The general case with the same pharmaceutical labelled with different radionuclides for imaging and therapy are considered for a mono-exponential time-activity curve. Two methods for STP dosimetry, both based on the combination of one activity estimate with the population-mean effective decay constant, are investigated. The cumulative distribution functions (CDFs) and the probability density functions for the two methods are analytically derived for arbitrary distributions of the biological decay constant. The CDFs are used for determining 95% coverage intervals of the relative errors for different combinations of imaging time points, physical decay constants, and relative standard deviations of the biological decay constant. Two examples, in the form of kidney dosimetry in [177Lu]Lu-DOTA-TATE therapy and tumour dosimetry for Na[131I]I therapy for thyroid cancer with dosimetry based on imaging of Na[124I]I, are also studied in more detail with analysis of the sensitivity with respect to errors in the mean biological decay constant and to higher moments of the distribution. Main results. The distributions of the relative errors are negatively skewed, potentially leading to the situation that some TIA estimates are highly underestimated even if the majority of estimates are close to the true value. Significance. The main limitation of the studied STP dosimetry methods is the risk of large underestimations of the TIA.
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13.
  • Medin, Joakim, et al. (författare)
  • Experimental determination of k Qfactors for two types of ionization chambers in scanned proton beams
  • 2022
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 67:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. Experimental determination of beam quality k Q factors for two types of Farmer ionization chambers, NE2571 and IBA FC65-G, in a scanned proton beam for three nominal energies (140 MeV, 180 MeV and 220 MeV) based on water calorimetry. Approach. Beam quality correction factors were determined comparing the results obtained with water calorimetry and ionometry. Water calorimetry was performed to determine the absorbed dose at a depth of measurement in water of 5 g cm-2, limited by the extension of the calorimeter glass vessel used. For the ionometry, two chambers of each type were included in the study. The ionization chambers were calibrated in terms of absorbed dose to water in 60Co at the Swedish Secondary Standard Dosimetry Laboratory, directly traceable to the BIPM, and were used according to the IAEA TRS-398 Code of Practice. Main results. The k Q values determined in the present work have been compared with the values tabulated in TRS-398 and its forthcoming update and also with those obtained in previous water calorimetric measurements and Monte Carlo calculations. All results were found to agree within the combined uncertainties of the different data. Significance. It is expected that the present work will serve as an experimental contribution to k Q -factors for the two chamber types and three scanned proton beam qualities used.
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14.
  • Palmans, Hugo, et al. (författare)
  • Current best estimates of beam quality correction factors for reference dosimetry of clinical proton beams
  • 2022
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 67:19
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. To review the currently available data on beam quality correction factors, kQ, for ionization chambers in clinical proton beams and derive their current best estimates for the updated recommendations of the IAEA TRS-398 Code of Practice. Approach. The reviewed data come from 20 publications from which kQ values can be derived either directly from calorimeter measurements, indirectly from comparison with other chambers or from Monte Carlo calculated overall chamber factors, fQ. For cylindrical ionization chambers, a distinction is made between data obtained in the centre of a spread-out Bragg peak and those obtained in the plateau region of single-energy fields. For the latter, the effect of depth dose gradients has to be considered. To this end an empirical model for previously published displacement correction factors for single-layer scanned beams was established, while for unmodulated scattered beams experimental data were used. From all the data, chamber factors, fQ, and chamber perturbation correction factors, pQ, were then derived and analysed. Main results. The analysis showed that except for the beam quality dependence of the water-to-air mass stopping power ratio and, for cylindrical ionization chambers in unmodulated beams, of the displacement correction factor, there is no remaining beam quality dependence of the chamber perturbation correction factors pQ. Based on this approach, average values of the beam quality independent part of the perturbation factors were derived to calculate kQ values consistent with the data in the literature. Significance. The resulting data from this analysis are current best estimates of kQ values for modulated scattered beams and single-layer scanned beams used in proton therapy. Based on this, a single set of harmonized values is derived to be recommended in the update of IAEA TRS-398.
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15.
  • Rix, Kristian R., et al. (författare)
  • Super-resolution x-ray phase-contrast and dark-field imaging with a single 2D grating and electromagnetic source stepping
  • 2019
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 1361-6560 .- 0031-9155. ; 64:16, s. 1-8
  • Tidskriftsartikel (refereegranskat)abstract
    • Here we report a method for increased resolution of single exposure three modality x-ray images using super-resolution. The three x-ray image modalities are absorption-, differential phase- contrast-, and dark-field-images. To create super-resolution, a non-mechanically movable micro- focus x-ray source is used. A series of almost identical x-ray projection images is obtained while the point source is translated in a two-dimensional grid pattern. The three image modalities are extracted from fourier space using spatial harmonic analysis, also known as the single-shot method. Using super-resolution on the low-resolution series of the three modalities separately results in high- resolution images for the modalities. This approach allows to compensate for the inherent loss in resolution caused by the single-shot method without increasing the need for stability or algorithms accounting for possible motion.
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16.
  • Said, M., et al. (författare)
  • Analysis of dose heterogeneity using a subvolume-DVH
  • 2017
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 62:21, s. 517-524
  • Tidskriftsartikel (refereegranskat)abstract
    • The dose-volume histogram (DVH) is universally used in radiation therapy for its highly efficient way of summarizing three-dimensional dose distributions. An apparent limitation that is inherent to standard histograms is the loss of spatial information, e.g. it is no longer possible to tell where low- and high-dose regions are, and whether they are connected or disjoint. Two methods for overcoming the spatial fragmentation of low- and high-dose regions are presented, both based on the gray-level size zone matrix, which is a two-dimensional histogram describing the frequencies of connected regions of similar intensities. The first approach is a quantitative metric which can be likened to a homogeneity index. The large cold spot metric (LCS) is here defined to emphasize large contiguous regions receiving too low a dose; emphasis is put on both size, and deviation from the prescribed dose. In contrast, the subvolume-DVH (sDVH) is an extension to the standard DVH and allows for a qualitative evaluation of the degree of dose heterogeneity. The information retained from the two-dimensional histogram is overlaid on top of the DVH and the two are presented simultaneously. Both methods gauge the underlying heterogeneity in ways that the DVH alone cannot, and both have their own merits - the sDVH being more intuitive and the LCS being quantitative.
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17.
  • Törnquist, Elin, et al. (författare)
  • Dual modality neutron and x-ray tomography for enhanced image analysis of the bone-metal interface
  • 2021
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 66:13
  • Tidskriftsartikel (refereegranskat)abstract
    • The bone tissue formed at the contact interface with metallic implants, particularly its 3D microstructure, plays a pivotal role for the structural integrity of implant fixation. X-ray tomography is the classical imaging technique used for accessing microstructural information from bone tissue. However, neutron tomography has shown promise for visualising the immediate bone-metal implant interface, something which is highly challenging with x-rays due to large differences in attenuation between metal and biological tissue causing image artefacts. To highlight and explore the complementary nature of neutron and x-ray tomography, proximal rat tibiae with titanium-based implants were imaged with both modalities. The two techniques were compared in terms of visualisation of different material phases and by comparing the properties of the individual images, such as the contrast-to-noise ratio. After superimposing the images using a dedicated image registration algorithm, the complementarity was further investigated via analysis of the dual modality histogram, joining the neutron and x-ray data. From these joint histograms, peaks with well-defined grey value intervals corresponding to the different material phases observed in the specimens were identified and compared. The results highlight differences in how neutrons and x-rays interact with biological tissues and metallic implants, as well as the benefits of combining both modalities. Future refinement of the joint histogram analysis could improve the segmentation of structures and tissues, and yield novel information about specimen-specific properties such as moisture content.
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18.
  • Kaveckyte, Vaiva, 1991-, et al. (författare)
  • Impact of the I-value of diamond on the energy deposition in different beam qualities
  • 2021
  • Ingår i: Physics in Medicine and Biology. - : Institute of Physics (IOP). - 0031-9155 .- 1361-6560. ; 66:12
  • Tidskriftsartikel (refereegranskat)abstract
    • Diamond detectors are increasingly employed in dosimetry. Their response has been investigated by means of Monte Carlo (MC) methods, but there is no consensus on what mass density ρ, mean excitation energy I and number of conduction electrons per atom nce to use in the simulations. The ambiguity occurs due to its seeming similarity with graphite (both are carbon allotropes). Contrary to diamond, graphite has been well-characterized. Except for the difference in ρ between crystalline graphite (2.265 g cm-3) and diamond (3.515 g cm-3), their dielectric properties are assumed to be identical. This is incorrect, and the two materials should be distinguished: (ρ = 2.265 g cm-3, I = 81.0 eV, nce = 1) for graphite and (ρ = 3.515 g cm-3, I = 88.5 eV, nce = 0) for diamond. Simulations done with the MC code PENELOPE show that the energy imparted in diamond decreases by up to 1% with respect to 'pseudo-diamond' (ρ = 3.515 g cm-3, I = 81.0 eV, nce = 0) depending on the beam quality and cavity thickness. The energy imparted changed the most in cavities that are small compared with the range of electrons. The difference in the density-effect term relative to graphite was the smallest for diamond owing to an interplay effect that ρ, I and nce have on this term, in contrast to pseudo-diamond media when either ρ or I alone were adjusted. The study also presents a parameterized density-effect correction function for diamond that may be used by MC codes like EGSnrc. The ESTAR program assumes that nce = 2 for all carbon-based materials, hence it delivers an erroneous density-effect correction term for graphite and diamond. Despite the small changes of the energy imparted in diamond simulated with two different I values and expected close-to-negligible deviation from the published small-field output correction data, it is important to pay attention to material properties and model the medium faithfully.
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19.
  • Bernchou, Uffe, et al. (författare)
  • End-to-end validation of the geometric dose delivery performance of MR linac adaptive radiotherapy
  • 2021
  • Ingår i: Physics in Medicine and Biology. - : Institute of Physics Publishing (IOPP). - 0031-9155 .- 1361-6560. ; 66:4
  • Tidskriftsartikel (refereegranskat)abstract
    • The clinical introduction of hybrid magnetic resonance (MR) guided radiotherapy (RT) delivery systems has led to the need to validate the end-to-end dose delivery performance on such machines. In the current study, an MR visible phantom was developed and used to test the spatial deviation between planned and delivered dose at two 1.5 T MR linear accelerator (MR linac) systems, including pre-treatment imaging, dose planning, online imaging, image registration, plan adaptation, and dose delivery. The phantom consisted of 3D printed plastic and MR visible silicone rubber. It was designed to minimise air gaps close to the radiochromic film used as a dosimeter. Furthermore, the phantom was designed to allow submillimetre, reproducible positioning of the film in the phantom. At both MR linac systems, 54 complete adaptive, MR guided RT workflow sessions were performed. To test the dose delivery performance of the MR linac systems in various adaptive RT (ART) scenarios, the sessions comprised a range of systematic positional shifts of the phantom and imaging or plan adaptation conditions. In each workflow session, the positional translation between the film and the adaptive planned dose was determined. The results showed that the accuracy of the MR linac systems was between 0.1 and 0.9 mm depending on direction. The highest mean deviance observed was in the posterior-anterior direction, and the direction of the error was consistent between centres. The precision of the systems was related to whether the workflow utilized the internal image registration algorithm of the MR linac. Workflows using the internal registration algorithm led to a worse precision (0.2-0.7 mm) compared to workflows where the algorithm was decoupled (0.2 mm). In summary, the spatial deviation between planned and delivered dose of MR-guided ART at the two MR linac systems was well below 1 mm and thus acceptable for clinical use.
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20.
  • Speight, Richard, et al. (författare)
  • IPEM Topical Report : an international IPEM survey of MRI use for external beam radiotherapy treatment planning
  • 2021
  • Ingår i: Physics in Medicine and Biology. - : Institute of Physics (IOP). - 0031-9155 .- 1361-6560. ; 66:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction/Background: Despite growing interest in magnetic resonance imaging (MRI), integration in external beam radiotherapy (EBRT) treatment planning uptake varies globally. In order to understand the current international landscape of MRI in EBRT a survey has been performed in 11 countries. This work reports on differences and common themes identified.Methods: A multi-disciplinary Institute of Physics and Engineering in Medicine working party modified a survey previously used in the UK to understand current practice using MRI for EBRT treatment planning, investigate how MRI is currently used and managed as well as identify knowledge gaps. It was distributed electronically within 11 countries: Australia, Belgium, Denmark, Finland, France, Italy, the Netherlands, New Zealand, Sweden, the UK and the USA.Results: The survey response rate within the USA was <1% and hence these results omitted from the analysis. In the other 10 countries the survey had a median response rate of 77% per country. Direct MRI access, defined as either having a dedicated MRI scanner for radiotherapy (RT) or access to a radiology MRI scanner, varied between countries. France, Italy and the UK reported the lowest direct MRI access rates and all other countries reported direct access in ≥82% of centres. Whilst ≥83% of centres in Denmark and Sweden reported having dedicated MRI scanners for EBRT, all other countries reported ≤29%. Anatomical sites receiving MRI for EBRT varied between countries with brain, prostate, head and neck being most common. Commissioning and QA of image registration and MRI scanners varied greatly, as did MRI sequences performed, staffing models and training given to different staff groups. The lack of financial reimbursement for MR was a consistent barrier for MRI implementation for RT for all countries and MR access was a reported important barrier for all countries except Sweden and Denmark.Conclusion: No country has a comprehensive approach for MR in EBRT adoption and financial barriers are present worldwide. Variations between countries in practice, equipment, staffing models, training, QA and MRI sequences have been identified, and are likely to be due to differences in funding as well as a lack of consensus or guidelines in the literature. Access to dedicated MR for EBRT is limited in all but Sweden and Denmark, but in all countries there are financial challenges with ongoing per patient costs. Despite these challenges, significant interest exists in increasing MR guided EBRT planning over the next 5 years.
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21.
  • Fredenberg, Erik, PhD, 1979-, et al. (författare)
  • Measurement of breast-tissue x-ray attenuation by spectral imaging: fresh and fixed normal and malignant tissue
  • 2018
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 63:23
  • Tidskriftsartikel (refereegranskat)abstract
    • Knowledge of x-ray attenuation is essential for developing and evaluating x-ray imaging technologies. In mammography, measurement of breast density, dose estimation, and differentiation between cysts and solid tumours are example applications requiring accurate data on tissue attenuation. Published attenuation data are, however, sparse and cover a relatively wide range. To supplement available data we have previously measured the attenuation of cyst fluid and solid lesions using photon-counting spectral mammography. The present study aims to measure the attenuation of normal adipose and glandular tissue, and to measure the effect of formalin fixation, a major uncertainty in published data. A total of 27 tumour specimens, 7 fibro-glandular tissue specimens, and 15 adipose tissue specimens were included. Spectral (energy-resolved) images of the samples were acquired and the image signal was mapped to equivalent thicknesses of two known reference materials, from which x-ray attenuation as a function of energy can be derived. The spread in attenuation between samples was relatively large, partly because of natural variation. The variation of malignant and glandular tissue was similar, whereas that of adipose tissue was lower. Formalin fixation slightly altered the attenuation of malignant and glandular tissue, whereas the attenuation of adipose tissue was not significantly affected. The difference in attenuation between fresh tumour tissue and cyst fluid was smaller than has previously been measured for fixed tissue, but the difference was still significant and discrimination of these two tissue types is still possible. The difference between glandular and malignant tissue was close-to significant; it is reasonable to expect a significant difference with a larger set of samples. We believe that our studies have contributed to lower the overall uncertainty of breast tissue attenuation in the literature due to the relatively large sample sets, the novel measurement method, and by clarifying the difference between fresh and fixed tissue.
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22.
  • Almhagen, Erik, et al. (författare)
  • Handling of beam spectra in training and application of proton RBE models
  • 2021
  • Ingår i: Physics in Medicine and Biology. - : Institute of Physics Publishing (IOPP). - 0031-9155 .- 1361-6560. ; 66:18
  • Tidskriftsartikel (refereegranskat)abstract
    • Published data from cell survival experiments are frequently used as training data for models of proton relative biological effectiveness (RBE). The publications rarely provide full information about the primary particle spectrum of the used beam, or its content of heavy secondary particles. The purpose of this paper is to assess to what extent heavy secondary particles may have been present in published cell survival experiments, and to investigate the impact of non-primary protons for RBE calculations in treatment planning. We used the Monte Carlo code Geant4 to calculate the occurrence of non-primary protons and heavier secondary particles for clinical protons beams in water for four incident energies in the [100, 250] MeV interval. We used the resulting spectra together with a conservative RBE parameterization and an RBE model to map both the rise of RBE at the beam entry surface due to heavy secondary particle buildup, and the difference in estimated RBE if non-primary protons are included or not in the beam quality metric. If included, non-primary protons cause a difference of 2% of the RBE in the plateau region of an spread out Bragg peak and 1% in the Bragg peak. Including non-primary protons specifically for RBE calculations will consequently have a negligible impact and can be ignored. A buildup distance in water of one millimeter was sufficient to reach an equilibrium state of RBE for the four incident energies selected. For the investigated experimental data, 83 out of the 86 data points were found to have been determined with at least that amount of buildup material. Hence, RBE model training data should be interpreted to include the contribution of heavy secondaries.
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23.
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24.
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25.
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26.
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27.
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28.
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29.
  • Bengtsson, Ivar, et al. (författare)
  • Implications of using the clinical target distribution as voxel-weights in radiation therapy optimization
  • 2023
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 68:9
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. Delineating and planning with respect to regions suspected to contain microscopic tumor cells is an inherently uncertain task in radiotherapy. The recently proposed clinical target distribution (CTD) is an alternative to the conventional clinical target volume (CTV), with initial promise. Previously, using theCTDin planning has primarily been evaluated in comparison to a conventionally defined CTV. Wepropose to compare theCTDapproach against CTVmargins of various sizes, dependent on the threshold at which the tumor infiltration probability is considered relevant. Approach. First, a theoretical framework is presented, concerned with optimizing the trade-off between the probability of sufficient target coverage and the penalties associated with high dose. From this framework we derive conventional CTV-based planning and contrast it with theCTDapproach. The approaches are contextualized further by comparison with established methods for managing geometric uncertainties. Second, for both one- and three-dimensional phantoms, we compare a set of CTDplans created by varying the target objective function weight against a set of plans created by varying both the target weight and the CTVmargin size. Main results. The results show that CTD-based planning gives slightly inefficient trade-offs between the evaluation criteria for a case in which near-minimum target dose is the highest priority. However, in a case when sparing a proximal organ at risk is critical, theCTDis better at maintaining sufficiently high dose toward the center of the target. Significance. Weconclude that CTD-based planning is a computationally efficient method for planning with respect to delineation uncertainties, but that the inevitable effects on the dose distribution should not be disregarded.
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30.
  • Berggren, Karl, et al. (författare)
  • In vivo measurement of the effective atomic number of breast skin using spectral mammography
  • 2018
  • Ingår i: Physics in Medicine and Biology. - : Institute of Physics Publishing (IOPP). - 0031-9155 .- 1361-6560. ; 63:21
  • Tidskriftsartikel (refereegranskat)abstract
    • X-ray characteristics of body tissues are of crucial importance for developing and optimizing x-ray imaging techniques, in particular for dosimetry and spectral imaging applications. For breast imaging, the most important tissues are fibro-glandular, adipose and skin tissue. Some work has and is being done to better characterize these tissue types, in particular fibro-glandular and adipose tissue. In the case of breast skin, several recent studies have been published on the average skin thickness, but with regards to x-ray attenuation, the only published data, to the knowledge of the authors, is the elemental composition analysis of Hammerstein et al (1979 Radiology 130 485-91). This work presents an overview of breast skin thickness studies and a measurement of the effective atomic number (Z(eff)) of breast skin using spectral mammography. Z(eff), which together with the density forms the attenuation, is used to validate the work by Hammerstein et al, and the dependence of clinical parameters on Z(eff) is explored. Measurements were conducted on the skin edge of spectral mammograms using clinical data from a screening population (n = 709). The weighted average of breast skin thickness reported in studies between 1997 and 2013 was found to be 1.56 +/- 0.28 mm. Mean Z(eff) was found to be 7.365 (95% CI: 7.364,7.366) for normal breast skin and 7.441 (95% CI: 7.440,7.442) for the nipple and areola. Z(eff) of normal breast skin is in agreement with Hammerstein et al, despite the different methods and larger sample size used. A small but significant increase in Z(eff) was found with age, but the increase is too small to be relevant for most applications. We conclude that normal breast skin is well described by a 1.56 mm skin layer and the elemental composition presented by Hammerstein et al (1979 Radiology 130 485-91) and recommend using these characteristics when modelling breast skin.
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31.
  • Bertilson, M., et al. (författare)
  • Analyzer-free hard x-ray interferometry
  • 2024
  • Ingår i: Physics in Medicine and Biology. - : Institute of Physics. - 0031-9155 .- 1361-6560. ; 69:4
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. To enable practical interferometry-based phase contrast CT using standard incoherent x-ray sources, we propose an imaging system where the analyzer grating is replaced by a high-resolution detector. Since there is no need to perform multiple exposures (with the analyzer grating at different positions) at each scan angle, this scheme is compatible with continuous-rotation CT apparatus, and has the potential to reduce patient radiation dose and patient motion artifacts. Approach. Grating-based x-ray interferometry is a well-studied technique for imaging soft tissues and highly scattering objects embedded in such tissues. In addition to the traditional x-ray absorption-based image, this technique allows reconstruction of the object phase and small-angle scattering information. When using conventional incoherent, polychromatic, hard x-ray tubes as sources, three gratings are usually employed. To sufficiently resolve the pattern generated in these interferometers with contemporary x-ray detectors, an analyzer grating is used, and consequently multiple images need to be acquired for each view angle. This adds complexity to the imaging system, slows image acquisition and thus increases sensitivity to patient motion, and is not dose efficient. By simulating image formation based on wave propagation, and proposing a novel phase retrieval algorithm based on a virtual grating, we assess the potential of a analyzer-grating-free system to overcome these limitations. Main results. We demonstrate that the removal of the analyzer-grating can produce equal image contrast-to-noise ratio at reduced dose (by a factor of 5), without prolonging scan duration. Significance. By demonstrating that an analyzer-free CT system, in conjuction with an efficient phase retrieval algorithm, can overcome the prohibitive dose and workflow penalties associated grating-stepping, an alternative path towards realizing clinical inteferometric CT appears possible.
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32.
  • Bläckberg, Lisa, 1982-, et al. (författare)
  • Simulation study of light transport in laser-processed LYSO:Ce detectors with single-side readout
  • 2017
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 62:21, s. 8419-8440
  • Tidskriftsartikel (refereegranskat)abstract
    • A tightly focused pulsed laser beam can locally modify the crystal structure inside the bulk of a scintillator. The result is incorporation of so-called optical barriers with a refractive index different from that of the crystal bulk, that can be used to redirect the scintillation light and control the light spread in the detector. We here systematically study the scintillation light transport in detectors fabricated using the laser induced optical barrier technique, and objectively compare their potential performance characteristics with those of the two mainstream detector types: monolithic and mechanically pixelated arrays. Among countless optical barrier patterns, we explore barriers arranged in a pixel-like pattern extending all-the-way or half-way through a 20 mm thick LYSO:Ce crystal. We analyze the performance of the detectors coupled to MPPC arrays, in terms of light response functions, flood maps, line profiles, and light collection efficiency. Our results show that laser-processed detectors with both barrier patterns constitute a new detector category with a behavior between that of the two standard detector types. Results show that when the barrier-crystal interface is smooth, no DOI information can be obtained regardless of barrier refractive index (RI). However, with a rough barrier-crystal interface we can extract multiple levels of DOI. Lower barrier RI results in larger light confinement, leading to better transverse resolution. Furthermore we see that the laser-processed crystals have the potential to increase the light collection efficiency, which could lead to improved energy resolution and potentially better timing resolution due to higher signals. For a laser-processed detector with smooth barrier-crystal interfaces the light collection efficiency is simulated to  >42%, and for rough interfaces  >73%. The corresponding numbers for a monolithic crystal is 39% with polished surfaces, and 71% with rough surfaces, and for a mechanically pixelated array 35% with polished pixel surfaces and 59% with rough surfaces.
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33.
  • Brombal, Luca, et al. (författare)
  • Edge-illumination spectral phase-contrast tomography
  • 2024
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 69:7
  • Tidskriftsartikel (refereegranskat)abstract
    • Following the rapid, but independent, diffusion of x-ray spectral and phase-contrast systems, this work demonstrates the first combination of spectral and phase-contrast computed tomography (CT) obtained by using the edge-illumination technique and a CdTe small-pixel (62 mu m) spectral detector. A theoretical model is introduced, starting from a standard attenuation-based spectral decomposition and leading to spectral phase-contrast material decomposition. Each step of the model is followed by quantification of accuracy and sensitivity on experimental data of a test phantom containing different solutions with known concentrations. An example of a micro CT application (20 mu m voxel size) on an iodine-perfused ex vivo murine model is reported. The work demonstrates that spectral-phase contrast combines the advantages of spectral imaging, i.e. high-Z material discrimination capability, and phase-contrast imaging, i.e. soft tissue sensitivity, yielding simultaneously mass density maps of water, calcium, and iodine with an accuracy of 1.1%, 3.5%, and 1.9% (root mean square errors), respectively. Results also show a 9-fold increase in the signal-to-noise ratio of the water channel when compared to standard spectral decomposition. The application to the murine model revealed the potential of the technique in the simultaneous 3D visualization of soft tissue, bone, and vasculature. While being implemented by using a broad spectrum (pink beam) at a synchrotron radiation facility (Elettra, Trieste, Italy), the proposed experimental setup can be readily translated to compact laboratory systems including conventional x-ray tubes.
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34.
  • Cervino, L. I., et al. (författare)
  • An in vitro study for the dosimetric and radiobiological validation of respiratory gating in conventional and hypofractionated radiotherapy of the lung: effect of dose, dose rate, and breathing pattern
  • 2019
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 64:13
  • Tidskriftsartikel (refereegranskat)abstract
    • Stereotactic body radiotherapy (SBRT) of the lung has become a standard of care for early-stage inoperable non-small cell lung cancer (NSCLC). A common strategy to manage respiratory motion is gating, which inevitably results in an increase in treatment time, especially in irregularly-breathing patients. Flattening-filter free (FFF) beams allow for delivery of the treatment at a higher dose rate, therefore counteracting the lengthened treatment time due to frequent interruption of the beam during gated radiotherapy. In this study, we perform our in vitro evaluation of the dosimetric and radiobiological effect of gated lung SBRT with simultaneous integrated boost (SIB) using both flattened and FFF beams. A moving thorax-shaped phantom with inserts and applicators was used for simulation, planning, gated treatment delivery measurements and in vitro tests. The effects of gating window, dose rate, and breathing pattern were evaluated. Planned doses represented a typical conventional fractionation, 200 cGy per fraction with SIB to 240 cGy, flattened beam only, and SBRT, 800 cGy with SIB to 900 cGy, flattened and FFF beams. Ideal, as well as regular and irregular patient-specific breathing patterns with and without gating were used. A survival assay for lung adenocarcinoma A549 cell line was performed. Delivered dose was within 6% for locations planned to receive 200 and 800 cGy and within 4% for SIB locations. Time between first beam-on and last beam-off varied from approximately 1.5 min for conventional fractionation, 200/240 cGy, to 10.5 min for gated SBRT, 800/900 cGy doses, flattened beam and irregular breathing motion pattern. With FFF beams dose delivery time was shorter by a factor of 2-3, depending on the gating window and breathing pattern. We have found that, for the most part, survival depended on dose and not on dose rate, gating window, or breathing regularity.
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35.
  • Christensen, Jeppe Brage, et al. (författare)
  • Ionization quenching in scintillators used for dosimetry of mixed particle fields
  • 2019
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 64:9
  • Tidskriftsartikel (refereegranskat)abstract
    • Ionization quenching in ion beam dosimetry is often related to the fluence- or dose-averaged linear energy transfer (LET). Both quantities are however averaged over a wide LET range and a mixed field of primary and secondary ions. We propose a novel method to correct the quenched luminescence in scintillators exposed to ion beams. The method uses the energy spectrum of the primaries and accounts for the varying quenched luminescence in heavy, secondary ion tracks through amorphous track structure theory. The new method is assessed against more traditional approaches by correcting the quenched luminescence response from the BCF-12, BCF-60, and 81-0084 plastic scintillators exposed to a 100 MeV pristine proton beam in order to compare the effects of the averaged LET quantities and the secondary ions. Calculations and measurements show that primary protons constitute more than 92% of the energy deposition but account for more than 95% of the luminescence signal in the scintillators. The quenching corrected luminescence signal is in better agreement with the dose measurement when the secondary particles are taken into account. The Birks model provided the overall best quenching corrections, when the quenching corrected signal is adjusted for the number of free model parameters. The quenching parameter kB for the BCF-12 and BCF-60 scintillators is in agreement with literature values and was found to be kB = (10.6 +/- 0.1) x 10(-2) mu m keV(-1) for the 81-0084 scintillator. Finally, a fluence threshold for the 100 MeV proton beam was calculated to be of the order of 10(10) cm(-2), corresponding to 110 Gy, above which the quenching increases non-linearly and the Birks model no longer is applicable.
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36.
  • Christensen, J. B., et al. (författare)
  • Mapping initial and general recombination in scanning proton pencil beams
  • 2020
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 65:11
  • Tidskriftsartikel (refereegranskat)abstract
    • The ion recombination is examined in parallel-plate ionization chambers in scanning proton beams at the Danish Centre for Particle Therapy and the Skandion Clinic. The recombination correction factor k(s) is investigated for clinically relevant energies between 70 MeV and 244 MeV for dose rates below 400 Gy min(-1) in air. The Boutillon formalism is used to separate the initial and general recombination. The general recombination is compared to predictions from the numerical recombination code IonTracks and the initial recombination to the Jaffe theory. k(s) is furthermore calculated with the two-voltage method (TVM) and extrapolation approaches, in particular the recently proposed three-voltage (3VL) method. The TVM is in agreement with the Boutillon method and IonTracks for dose rates above 100 Gy min(-1). However, the TVM calculated k(s) is closer related to the Jaffe theory for initial recombination for lower dose rate, indicating a limited application in scanning light ion beams. The 3VL is in turn found to generally be in agreement with Boutillon's method. The recombination is mapped as a function of the dose rate and proton energy at the two centres using the Boutillon formalism: the initial recombination parameter was found to be A = (0.10 +/- 0.01) V at DCPT and A = (0.22 +/- 0.13) V at Skandion, which is in better agreement with the Jaffe theory for initial recombination than previously reported values. The general recombination parameter was estimated to m2=(4.7 +/- 0.1).103V2nA-1cm-1m2=(7.2 +/- 0.1).103V2nA-1cm-1
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37.
  • Christensen, Jeppe Brage, et al. (författare)
  • Quenching-free fluorescence signal from plastic-fibres in proton dosimetry : understanding the influence of Cerenkov radiation
  • 2018
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 63:6
  • Tidskriftsartikel (refereegranskat)abstract
    • The origin of photons emitted in optical fibres under proton irradiation has been attributed to either entirely Cerenkov radiation or light consisting of fluorescence with a substantial amount of Cerenkov radiation. The source of the light emission is assessed in order to understand why the signal from optical fibres irradiated with protons is reportedly quenching-free. The present study uses the directional emittance of Cerenkov photons in 12 MeV and 20 MeV electron beams to validate a Monte Carlo model for simulating the emittance and transmission of Cerenkov radiation in optical fibres. We show that fewer than 0.01 Cerenkov photons are emitted and guided per 225 MeV proton penetrating the optical fibre, and that the Cerenkov signal in the optical fibre is completely negligible at the Bragg peak. Furthermore, on taking the emittance and guidance of both fluorescence and Cerenkov photons into account, it becomes evident that the reported quenching-free signal in PMMA-based optical fibres during proton irradiation is due to fluorescence.
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38.
  • Conti, Maurizio, et al. (författare)
  • Characterization of Lu-176 background in LSO-based PET scanners
  • 2017
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 62:9, s. 3700-3711
  • Tidskriftsartikel (refereegranskat)abstract
    • LSO and LYSO are today the most common scintillators used in positron emission tomography. Lutetium contains traces of Lu-176, a radioactive isotope that decays beta(-) with a cascade of. photons in coincidence. Therefore, Lutetium-based scintillators are characterized by a small natural radiation background. In this paper, we investigate and characterize the Lu-176 radiation background via experiments performed on LSO-based PET scanners. LSO background was measured at different energy windows and different time coincidence windows, and by using shields to alter the original spectrum. The effect of radiation background in particularly count-starved applications, such as Y-90 imaging, is analysed and discussed. Depending on the size of the PET scanner, between 500 and 1000 total random counts per second and between 3 and 5 total true coincidences per second were measured in standard coincidence mode. The LSO background counts in a Siemens mCT in the standard PET energy and time windows are in general negligible in terms of trues, and are comparable to that measured in a BGO scanner of similar size.
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39.
  • Danielsson, Mats, Professor, et al. (författare)
  • Photon-counting x-ray detectors for CT
  • 2021
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 66:3, s. 03TR01-
  • Forskningsöversikt (refereegranskat)abstract
    • The introduction of photon-counting detectors is expected to be the next major breakthrough in clinical x-ray CT. During the last decade, there has been considerable research activity in the field of photon-counting CT, in terms of both hardware development and theoretical understanding of the factors affecting image quality. In this article, we review the recent progress in this field with the intent of highlighting the relationship between detector design considerations and the resulting image quality. We discuss detector design choices such as converter material, pixel size, and readout electronics design, and then elucidate their impact on detector performance in terms of dose efficiency, spatial resolution, and energy resolution. Furthermore, we give an overview of data processing, reconstruction methods and metrics of imaging performance; outline clinical applications; and discuss potential future developments.
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40.
  • Dobsicek Trefna, Hana, 1979, et al. (författare)
  • Hydrogels as a water bolus during hyperthermia treatment
  • 2019
  • Ingår i: Physics in medicine and biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 64:11
  • Tidskriftsartikel (refereegranskat)abstract
    • The feasibility of using hydrogels as a water bolus during hyperthermia treatment was assessed. Three types of gels, high methoxyl (HM) pectin/alginate, xanthan/locust bean gum (LBG) and xanthan/LBG/agarose were evaluated based on their dielectric, rheological and mechanical properties. The most suitable, xanthan/LBG/agarose gel was further used as a water bolus in a hyperthermia array applicator. The gels composed of polysaccharides carrying low charge displayed dielectric properties close to those of water, while the dielectric properties of HM pectin/alginate gel was deemed unsuitable for the current application. The mechanical examination shows that the xanthan/LBG gel has a non-brittle behaviour at room temperature, in contrast to the agarose gel. The moduli of the xanthan/LBG gel weaken however considerably between the temperature range of 40 °C and 50 °C, reducing its potential to be used as water bolus. The ternary system of xanthan/LBG/agarose had advantageous behaviour as it was dominated by the thermal hysteresis typical of agarose upon temperature increase, but governed by the typical non-brittle behaviour of the xanthan/LBG at low temperatures. The final evaluation within the hyperthermia applicator showed excellent signal transmission from the antennas. The agarose/xanthan/LBG gel reduced the scattering of electromagnetic waves, enabled a tight closure between the body and the antennas, and offered a less bulky solution than the currently used water-filled plastic bags. The results presented here open up a new application area for hydrogels in improving heat delivery during hyperthermia treatment and other near-field microwave applications.
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41.
  • Engberg, Lovisa, et al. (författare)
  • Increased accuracy of planning tools for optimization of dynamic multileaf collimator delivery of radiotherapy through reformulated objective functions
  • 2018
  • Ingår i: Physics in Medicine and Biology. - : IOP PUBLISHING LTD. - 0031-9155 .- 1361-6560. ; 63:12
  • Tidskriftsartikel (refereegranskat)abstract
    • The purpose of this study is to examine in a clinical setting a novel formulation of objective functions for intensity-modulated radiotherapy treatment plan multicriteria optimization (MCO) that we suggested in a recent study. The proposed objective functions are extended with dynamic multileaf collimator (DMLC) delivery constraints from the literature, and a tailored interior point method is described to efficiently solve the resulting optimization formulation. In a numerical planning study involving three patient cases, DMLC plans Pareto optimal to the MCO formulation with the proposed objective functions are generated. Evaluated based on pre-defined plan quality indices, these DMLC plans are compared to conventionally generated DMLC plans. Comparable or superior plan quality is observed. Supported by these results, the proposed objective functions are argued to have a potential to streamline the planning process, since they are designed to overcome the methodological shortcomings associated with the conventional penalty-based objective functions assumed to cause the current need for time-consuming trial-and-error parameter tuning. In particular, the increased accuracy of the planning tools imposed by the proposed objective functions has the potential to make the planning process less complicated. These conclusions position the proposed formulation as an alternative to existing methods for automated planning.
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42.
  • Fetty, Lukas, et al. (författare)
  • Investigating conditional GAN performance with different generator architectures, an ensemble model, and different MR scanners for MR-sCT conversion
  • 2020
  • Ingår i: Physics in Medicine and Biology. - : Institute of Physics Publishing (IOPP). - 0031-9155 .- 1361-6560. ; 65:10
  • Tidskriftsartikel (refereegranskat)abstract
    • Recent developments in magnetic resonance (MR) to synthetic computed tomography (sCT) conversion have shown that treatment planning is possible without an initial planning CT. Promising conversion results have been demonstrated recently using conditional generative adversarial networks (cGANs). However, the performance is generally only tested on images from one MR scanner, which neglects the potential of neural networks to find general high-level abstract features. In this study, we explored the generalizability of the generator models, trained on a single field strength scanner, to data acquired with higher field strengths. T2-weighted 0.35T MRIs and CTs from 51 patients treated for prostate (40) and cervical cancer (11) were included. 25 of them were used to train four different generators (SE-ResNet, DenseNet, U-Net, and Embedded Net). Further, an ensemble model was created from the four network outputs. The models were validated on 16 patients from a 0.35T MR scanner. Further, the trained models were tested on the Gold Atlas dataset, containing T2-weighted MR scans of different field strengths; 1.5T(7) and 3T(12), and 10 patients from the 0.35T scanner. The sCTs were dosimetrically compared using clinical VMAT plans for all test patients. For the same scanner (0.35T), the results from the different models were comparable on the test set, with only minor differences in the mean absolute error (MAE) (35-51HU body). Similar results were obtained for conversions of 3T GE Signa and the 3T GE Discovery images (40-62HU MAE) for three of the models. However, larger differences were observed for the 1.5T images (48-65HU MAE). The overall best model was found to be the ensemble model. All dose differences were below 1%. This study shows that it is possible to generalize models trained on images of one scanner to other scanners and different field strengths. The best metric results were achieved by the combination of all networks.
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43.
  • Garpebring, Anders, et al. (författare)
  • Density Estimation of Grey-Level Co-Occurrence Matrices for Image Texture Analysis
  • 2018
  • Ingår i: Physics in Medicine and Biology. - : Institute of Physics and Engineering in Medicine. - 0031-9155 .- 1361-6560. ; 63:19, s. 9-15
  • Tidskriftsartikel (refereegranskat)abstract
    • The Haralick texture features are common in the image analysis literature, partly because of their simplicity and because their values can be interpreted. It was recently observed that the Haralick texture features are very sensitive to the size of the GLCM that was used to compute them, which led to a new formulation that is invariant to the GLCM size. However, these new features still depend on the sample size used to compute the GLCM, i.e. the size of the input image region-of-interest (ROI).The purpose of this work was to investigate the performance of density estimation methods for approximating the GLCM and subsequently the corresponding invariant features.Three density estimation methods were evaluated, namely a piece-wise constant distribution, the Parzen-windows method, and the Gaussian mixture model. The methods were evaluated on 29 different image textures and 20 invariant Haralick texture features as well as a wide range of different ROI sizes.The results indicate that there are two types of features: those that have a clear minimum error for a particular GLCM size for each ROI size, and those whose error decreases monotonically with increased GLCM size. For the first type of features, the Gaussian mixture model gave the smallest errors, and in particular for small ROI sizes (less than about 20×20).In conclusion, the Gaussian mixture model is the preferred method for the first type of features (in particular for small ROIs). For the second type of features, simply using a large GLCM size is preferred.
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44.
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45.
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46.
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47.
  • Guha, Indranil, et al. (författare)
  • A comparative study of trabecular bone micro-structural measurements using different CT modalities
  • 2020
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 65:23, s. 235029-
  • Tidskriftsartikel (refereegranskat)abstract
    • Osteoporosis, characterized by reduced bone mineral density and micro-architectural degeneration, significantly enhances fracture-risk. There are several viable methods for trabecular bone micro-imaging, which widely vary in terms of technology, reconstruction principle, spatial resolution, and acquisition time. We have performed an excised cadaveric bone specimen study to evaluate different computed tomography (CT)-imaging modalities for trabecular bone micro-structural analysis. Excised cadaveric bone specimens from the distal radius were scanned using micro-CT and four in vivo CT imaging modalities: high-resolution peripheral quantitative computed tomography (HR-pQCT), dental cone beam CT (CBCT), whole-body multi-row detector CT (MDCT), and extremity CBCT. A new algorithm was developed to optimize soft thresholding parameters for individual in vivo CT modalities for computing quantitative bone volume fraction maps. Finally, agreement of trabecular bone micro-structural measures, derived from different in vivo CT imaging, with reference measures from micro-CT imaging was examined. Observed values of most trabecular measures, including trabecular bone volume, network area, transverse and plate-rod micro-structure, thickness, and spacing, for in vivo CT modalities were higher than their micro-CT-based reference values. In general, HR-pQCT-based trabecular bone measures were closer to their reference values as compared to other in vivo CT modalities. Despite large differences in observed values of measures among modalities, high linear correlation (r ∈ [0.94 0.99]) was found between micro-CT and in vivo CT-derived measures of trabecular bone volume, transverse and plate micro-structural volume, and network area. All HR-pQCT-derived trabecular measures, except the erosion index, showed high correlation (r ∈ [0.91 0.99]). The plate-width measure showed a higher correlation (r ∈ [0.72 0.91]) among in vivo and micro-CT modalities than its counterpart binary plate-rod characterization-based measure erosion index (r ∈ [0.65 0.81]). Although a strong correlation was observed between micro-structural measures from in vivo and micro-CT imaging, large shifts in their values for in vivo modalities warrant proper scanner calibration prior to adopting in multi-site and longitudinal studies.
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48.
  • Holstensson, Maria, et al. (författare)
  • Comparison of acquisition protocols for ventilation/perfusion SPECT - a Monte Carlo study
  • 2019
  • Ingår i: Physics in Medicine and Biology. - : Institute of Physics (IOP). - 0031-9155 .- 1361-6560. ; 64:23
  • Tidskriftsartikel (refereegranskat)abstract
    • One of the most commonly used imaging techniques for diagnosing pulmonary embolism (PE) is ventilation/perfusion (V/P) scintigraphy. The aim of this study was to evaluate the performance of the currently used imaging protocols for V/P single photon emission computed tomography (V/P SPECT) at two nuclear medicine department sites and to investigate the effect of altering important protocol parameters. &#13; &#13; The Monte Carlo technique was used to simulate 4D digital phantoms with perfusion defects. Six imaging protocols were included in the study and a total of 72 digital patients were simulated. Six dually trained radiologists/nuclear medicine physicians reviewed the images and reported all perfusion mismatch findings. The radiologists also visually graded the image quality. &#13; &#13; No statistically significant differences in diagnostic performance were found between the studied protocols, but visual grading analysis pointed out one protocol as significantly superior to four of the other protocols. Considering the study results, we have decided to harmonize our clinical protocols for imaging patients with suspected PE. The administered Technegas and macro aggregated albumin activities have been altered, a low energy all purpose collimator is used instead of a low energy high resolution collimator and the acquisition times have been lowered.
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49.
  • Høye, Ellen Marie, et al. (författare)
  • Chemically tuned linear energy transfer dependent quenching in a deformable, radiochromic 3D dosimeter
  • 2017
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 62:4, s. N73-N89
  • Tidskriftsartikel (refereegranskat)abstract
    • Most solid-state detectors, including 3D dosimeters, show lower signal in the Bragg peak than expected, a process termed quenching. The purpose of this study was to investigate how variation in chemical composition of a recently developed radiochromic, silicone-based 3D dosimeter influences the observed quenching in proton beams. The dependency of dose response on linear energy transfer, as calculated through Monte Carlo simulations of the dosimeter, was investigated in 60 MeV proton beams. We found that the amount of quenching varied with the chemical composition: peak-to-plateau ratios (1 cm into the plateau) ranged from 2.2 to 3.4, compared to 4.3 using an ionization chamber. The dose response, and thereby the quenching, was predominantly influenced by the curing agent concentration, which determined the dosimeter's deformation properties. The dose response was found to be linear at all depths. All chemical compositions of the dosimeter showed dose-rate dependency; however this was not dependent on the linear energy transfer. Track-structure theory was used to explain the observed quenching effects. In conclusion, this study shows that the silicone-based dosimeter has potential for use in measuring 3D-dose-distributions from proton beams.
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50.
  • Jin, Zihui, et al. (författare)
  • First experimental evaluation of count-rate performance for micrometre resolution deep silicon detector
  • 2024
  • Ingår i: Physics in Medicine and Biology. - : IOP Publishing. - 0031-9155 .- 1361-6560. ; 69:3
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. An ultra-fine-pitch deep silicon detector has been developed for clinical photon-counting computed tomography (CT). With a small pixel size of 14 × 650 μm2, it has shown potential to reach micrometre spatial resolution in previous simulation studies. A detector prototype with such geometry has been manufactured, and we report on the first experimental evaluation of its count-rate performance. Approach. The measurement was carried out at MAX IV synchrotron laboratory with 35 keV monochromatic x-rays. By inserting tungsten attenuators of 50, 75, 100, 150, 200, 225, 325 μ m-thicknesses into the beam, the response of the detector to fluence rates from 3.3 × 107 to 1.3 × 1011 mm−2 s−1 was characterized. Main results. The measurement result showed that the detector exhibited count rate linearity up to 6.66 × 108 mm−2 s−1 with 13% count loss and was still functional at count rate up to 2.9 × 1010 mm−2 s−1. A semi-nonparalyzable dead-time model was fitted to the count-rate behaviour of the detector, showing great agreement with the measured data, with an estimated nonparalyzable dead time of 2.9 ns. Significance. This is the first experimental evaluation of the count-rate performance for a deep silicon detector with such small pixel geometry. The results suggest that this type of detector shows the potential to be used at fluence rates encountered in clinical CT with little count loss due to pile-up.
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