| 1. |
- Kaveckyte, Vaiva, et al.
(författare)
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Investigation of a synthetic diamond detector response in kilovoltage photon beams
- 2020
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Ingår i: Medical physics (Lancaster). - : Wiley-Blackwell Publishing Inc.. - 0094-2405 .- 2473-4209. ; 47:3, s. 1268-1279
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Tidskriftsartikel (refereegranskat)abstract
- Purpose An important characteristic of radiation dosimetry detectors is their energy response which consists of absorbed-dose and intrinsic energy responses. The former can be characterized using Monte Carlo (MC) simulations, whereas the latter (i.e., detector signal per absorbed dose to detector) is extracted from experimental data. Such a characterization is especially relevant when detectors are used in nonrelative measurements at a beam quality that differs from the calibration beam quality. Having in mind the possible application of synthetic diamond detectors (microDiamond PTW 60019, Freiburg, Germany) for nonrelative dosimetry of low-energy brachytherapy (BT) beams, we determined their intrinsic and absorbed-dose energy responses in 25-250 kV beams relative to a Co-60 beam, which is usually the reference beam quality for detector calibration in radiotherapy. Material and Methods Three microDiamond detectors and, for comparison, two silicon diodes (PTW 60017) were calibrated in terms of air-kerma free in air in six x-ray beam qualities (from 25 to 250 kV) and in terms of absorbed dose to water in a Co-60 beam at the national metrology laboratory in Sweden. The PENELOPE/penEasy MC radiation transport code was used to calculate the absorbed-dose energy response of the detectors (modeled based on blueprints) relative to air and water depending on calibration conditions. The MC results were used to extract the relative intrinsic energy response of the detectors from the overall energy response. Measurements using an independent setup with a single ophthalmic BEBIG I25.S16 I-125 BT seed (effective photon energy of 28 keV) were used as a qualitative check of the extracted intrinsic energy response correction factors. Additionally, the impact of the thickness of the active volume as well as the presence of extra-cameral components on the absorbed-dose energy response of a microDiamond detector was studied using MC simulations. Results The relative intrinsic energy response of the microDiamond detectors was higher by a factor of 2 in 25 and 50 kV beams compared to the Co-60 beam. The variation in the relative intrinsic energy response of silicon diodes was within 10% over the investigated photon energy range. The use of relative intrinsic energy response correction factors improved the agreement among the absorbed dose to water values determined using microDiamond detectors and silicon diodes, as well as with the TG-43 formalism-based calculations for the I-125 seed. MC study of microDiamond detector design features provided a possible explanation for inter-detector response variation at low-energy photon beams by differences in the effective thickness of the active volume. Conclusions MicroDiamond detectors had a non-negligible variation in the relative intrinsic energy response (factor of 2) which was comparable to that in the absorbed-dose energy response relative to water at low-energy photon beams. Silicon diodes, in contrast, had an absorbed-dose energy dependence on photon energy that varied by a factor of 6, whereas the intrinsic energy dependence on beam quality was within 10%. It is important to decouple these two responses for a full characterization of detector energy response especially when the user and reference beam qualities differ significantly, and MC alone is not enough.
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| 2. |
- Kaveckyte, Vaiva, et al.
(författare)
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Suitability of microDiamond detectors for the determination of absorbed dose to water around high-dose-rate Ir-192 brachytherapy sources
- 2018
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Ingår i: Medical physics (Lancaster). - : WILEY. - 0094-2405 .- 2473-4209. ; 45:1, s. 429-437
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Experimental dosimetry of high-dose-rate (HDR) Ir-192 brachytherapy (BT) sources is complicated due to high dose and dose-rate gradients, and softening of photon energy spectrum with depth. A single crystal synthetic diamond detector microDiamond (PTW 60019, Freiburg, Germany) has a small active volume, high sensitivity, direct readout, and nearly water-equivalent active volume. The purpose of this study was to evaluate the suitability of microDiamond detectors for the determination of absorbed dose to water around HDR Ir-192 BT sources. Three microDiamond detectors were used, allowing for the comparison of their properties. Methods: In-phantom measurements were performed using microSelectron and VariSource iX HDR Ir-192 BT treatment units. Their treatment planning systems (TPSs), Oncentra (v. 4.3) and BrachyVision (v. 13.6), respectively, were used to create irradiation plans for a cubic PMMA phantom with the microDiamond positioned at one of three source-to-detector distances (SDDs) (1.5, 2.5, and 5.5 cm) at a time. The source was stepped in increments of 0.5 cm over a total length of 6 cm to yield absorbed dose of 2 Gy at the nominal reference-point of the detector. Detectors were calibrated in Co-60 beam in terms of absorbed dose to water, and Monte Carlo (MC) calculated beam quality correction factors were applied to account for absorbed-dose energy dependence. Phantom correction factors were applied to account for differences in dimensions between the measurement phantom and a water phantom used for absorbed dose calculations made with a TPS. The same measurements were made with all three of the detectors. Additionally, dose-rate dependence and stability of the detectors were evaluated in Co-60 beam. Results: The percentage differences between experimentally determined and TPS-calculated absorbed doses to water were from -1.3% to +2.9%. The values agreed to within experimental uncertainties, which were from 1.9% to 4.3% (k = 2) depending on the detector, SDD and treatment delivery unit. No dose-rate or intrinsic energy dependence corrections were applied. All microDiamonds were comparable in terms of preirradiation dose, stability of the readings and energy response, and showed a good agreement. Conclusions: The results indicate that the microDiamond is potentially suitable for the determination of absorbed dose to water around HDR Ir-192 BT sources and may be used for independent verification of TPSs calculations, as well as for QA measurements of HDR Ir-192 BT treatment delivery units at clinical sites. (C) 2017 American Association of Physicists in Medicine
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| 3. |
- Adolfsson, Emelie, et al.
(författare)
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Response of lithium formate EPR dosimeters at photon energies relevant to the dosimetry of brachytherapy
- 2010
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Ingår i: Medical physics (Lancaster). - : American Association of Physicists in Medicine. - 0094-2405. ; 37:9, s. 4946-4959
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE:To investigate experimentally the energy dependence of the detector response of lithium formate EPR dosimeters for photon energies below 1 MeV relative to that at 60Co energies. High energy photon beams are used in calibrating dosimeters for use in brachytherapy since the absorbed dose to water can be determined with high accuracy in such beams using calibrated ion chambers and standard dosimetry protocols. In addition to any differences in mass-energy absorption properties between water and detector, variations in radiation yield (detector response) with radiation quality, caused by differences in the density of ionization in the energy imparted (LET), may exist. Knowledge of an eventual deviation in detector response with photon energy is important for attaining high accuracy in measured brachytherapy dose distributions.METHODS:Lithium formate EPR dosimeters were irradiated to known levels of air kerma in 25-250 kV x-ray beams and in 137Cs and 60Co beams at the Swedish Secondary Standards Dosimetry Laboratory. Conversions from air kerma free in air into values of mean absorbed dose to the detectors were made using EGSnrc MC simulations and x-ray energy spectra measured or calculated for the actual beams. The signals from the detectors were measured using EPR spectrometry. Detector response (the EPR signal per mean absorbed dose to the detector) relative to that for 60Co was determined for each beam quality.RESULTS:Significant decreases in the relative response ranging from 5% to 6% were seen for x-ray beams at tube voltages < or = 180 kV. No significant reduction in the relative response was seen for 137Cs and 250 kV x rays.CONCLUSIONS:When calibrated in 60Co or MV photon beams, corrections for the photon energy dependence of detector response are needed to achieve the highest accuracy when using lithium formate EPR dosimeters for measuring absorbed doses around brachytherapy sources emitting photons in the energy range of 20-150 keV such as 169Yb and electronic sources.
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| 4. |
- Antonovic, Laura, et al.
(författare)
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Evaluation of a lithium formate EPR dosimetry system for dose measurements around Ir-192 brachytherapy sources
- 2009
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Ingår i: MEDICAL PHYSICS. - : Wiley. - 0094-2405. ; 36:6, s. 2236-2247
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Tidskriftsartikel (refereegranskat)abstract
- A dosimetry system using lithium formate monohydrate (HCO2Li center dot H2O) as detector material and electron paramagnetic resonance (EPR) spectroscopy for readout has been used to measure absorbed dose distributions around clinical Ir-192 sources. Cylindrical tablets with diameter of 4.5 mm, height of 4.8 mm, and density of 1.26 g/cm(3) were manufactured. Homogeneity test and calibration of the dosimeters were performed in a 6 MV photon beam. Ir-192 irradiations were performed in a PMMA phantom using two different source models, the GammaMed Plus HDR and the microSelectron PDR-v1 model. Measured absorbed doses to water in the PMMA phantom were converted to the corresponding absorbed doses to water in water phantoms of dimensions used by the treatment planning systems (TPSs) using correction factors explicitly derived for this experiment. Experimentally determined absorbed doses agreed with the absorbed doses to water calculated by the TPS to within +/- 2.9%. Relative standard uncertainties in the experimentally determined absorbed doses were estimated to be within the range of 1.7%-1.3% depending on the radial distance from the source, the type of source (HDR or PDR), and the particular absorbed doses used. This work shows that a lithium formate dosimetry system is well suited for measurements of absorbed dose to water around clinical HDR and PDR Ir-192 sources. Being less energy dependent than the commonly used thermoluminescent lithium fluoride (LiF) dosimeters, lithium formate monohydrate dosimeters are well suited to measure absorbed doses in situations where the energy dependence cannot easily be accounted for such as in multiple-source irradiations to verify treatment plans. Their wide dynamic range and linear dose response over the dose interval of 0.2-1000 Gy make them suitable for measurements on sources of the strengths used in clinical applications. The dosimeter size needs, however, to be reduced for application to single-source dosimetry.
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| 5. |
- Carlsson Tedgren, Åsa, 1968-, et al.
(författare)
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Determination of absorbed dose to water around a clinical HDR 192-Ir source using LiF:Mg,Ti TLDs demonstrates an LET dependence of detector response
- 2012
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Ingår i: Medical physics (Lancaster). - USA : American Association of Physicists in Medicine. - 0094-2405. ; 39:2, s. 1133-1140
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Experimental radiation dosimetry with thermoluminescent dosimeters (TLDs), calibrated in a (60)Co or megavoltage (MV) photon beam, is recommended by AAPM TG-43U1for verification of Monte Carlo calculated absorbed doses around brachytherapy sources. However, it has been shown by Carlsson Tedgren et al. [Med. Phys. 38, 5539-5550 (2011)] that for TLDs of LiF:Mg,Ti, detector response was 4% higher in a (137)Cs beam than in a (60)Co one. The aim of this work was to investigate if similar over-response exists when measuring absorbed dose to water around (192)Ir sources, using LiF:Mg,Ti dosimeters calibrated in a 6 MV photon beam.Methods: LiF dosimeters were calibrated to measure absorbed dose to water in a 6 MV photon beam and used to measure absorbed dose to water at distances of 3, 5, and 7 cm from a clinical high dose rate (HDR) (192)Ir source in a polymethylmethacrylate (PMMA) phantom. Measured values were compared to values of absorbed dose to water calculated using a treatment planning system (TPS) including corrections for the difference in energy absorption properties between calibration quality and the quality in the users' (192)Ir beam and for the use of a PMMA phantom instead of the water phantom underlying dose calculations in the TPS.Results: Measured absorbed doses to water around the (192)Ir source were overestimated by 5% compared to those calculated by the TPS. Corresponding absorbed doses to water measured in a previous work with lithium formate electron paramagnetic resonance (EPR) dosimeters by Antonovic et al. [Med. Phys. 36, 2236-2247 (2009)], using the same irradiation setup and calibration procedure as in this work, were 2% lower than those calculated by the TPS. The results obtained in the measurements in this work and those obtained using the EPR lithium formate dosimeters were, within the expanded (k = 2) uncertainty, in agreement with the values derived by the TPS. The discrepancy between the results using LiF:Mg,Ti TLDs and the EPR lithium formate dosimeters was, however, statistically significant and in agreement with the difference in relative detector responses found for the two detector systems by Carlsson Tedgren et al. [Med. Phys. 38, 5539-5550 (2011)] and by Adolfsson et al. [Med. Phys. 37, 4946-4959 (2010)].Conclusions: When calibrated in (60)Co or MV photon beams, correction for the linear energy transfer (LET) dependence of LiF:Mg,Ti detector response will be needed as to measure absorbed doses to water in a (192)Ir beam with highest accuracy. Such corrections will depend on the manufacturing process (MTS-N Poland or Harshaw TLD-100) and details of the annealing and read-out schemes used.
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| 6. |
- Carlsson Tedgren, Åsa, et al.
(författare)
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Influence of phantom material and dimensions on experimental Ir-192 dosimetry
- 2009
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Ingår i: MEDICAL PHYSICS. - : Wiley. - 0094-2405. ; 36:6, s. 2228-2235
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Tidskriftsartikel (refereegranskat)abstract
- In treatment planning of brachytherapy, absorbed dose is calculated by superposing predetermined distributions of absorbed dose to water in water for the single source according to the irradiation pattern [i.e., placement of the source(s) or dwelling position(s)]. Single-source reference water data are derived from Monte Carlo (MC) simulations and/or experiments. For reasons of positional accuracy, experimental brachytherapy dosimetry is most often performed in plastic phantoms. This work investigates the water equivalence of phantoms made from polystyrene, PMMA, and solid water for Ir-192 dosimetry. The EGSnrc MC code is used to simulate radial absorbed dose distributions in cylindrical phantoms of dimensions ranging in size from diameter and height of 20 cm to diameter and height of 40 cm. Water equivalence prevails if the absorbed dose to water in the plastic phantom is the same as the absorbed dose to water in a water phantom at equal distances from the source. It is shown that water equivalence at a specified distance from the source depends not only on the size of the plastic phantom but also on the size of the water phantom used for comparison. Compared to equally sized water phantoms, phantoms of polystyrene are less water equivalent than phantoms of PMMA and solid water but compared to larger water phantoms they are the most water equivalent. Although phantom dimension is the most important single factor influencing the dose distributions around Ir-192 sources, the effect of material properties is non-negligible and becomes increasingly important as phantom dimensions increase. The importance of knowing the size of the water phantom whose data underlies treatment planning systems, when using such data as a reference in, e.g., detector evaluation studies, is discussed. To achieve the highest possible accuracy in experimental dosimetry, phantom-specific correction factors should be used.
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| 7. |
- Carlsson Tedgren, Åsa, et al.
(författare)
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Response of LiF:Mg,Ti thermoluminescent dosimeters at photon energies relevant to the dosimetry of brachytherapy (andlt; 1 MeV)
- 2011
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Ingår i: Medical physics (Lancaster). - : American Association of Physicists in Medicine. - 0094-2405. ; 38:10, s. 5539-5550
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: High energy photon beams are used in calibrating dosimeters for use in brachytherapy since absorbed dose to water can be determined accurately and with traceability to primary standards in such beams, using calibrated ion chambers and standard dosimetry protocols. For use in brachytherapy, beam quality correction factors are needed, which include corrections for differences in mass energy absorption properties between water and detector as well as variations in detector response (intrinsic efficiency) with radiation quality, caused by variations in the density of ionization (linear energy transfer (LET) -distributions) along the secondary electron tracks. The aim of this work was to investigate experimentally the detector response of LiF:Mg, Ti thermoluminescent dosimeters (TLD) for photon energies below 1 MeV relative to (60)Co and to address discrepancies between the results found in recent publications of detector response. less thanbrgreater than less thanbrgreater thanMethods: LiF:Mg,Ti dosimeters of formulation MTS-N Poland were irradiated to known values of air kerma free-in-air in x-ray beams at tube voltages 25-250 kV, in (137)Cs- and (60)Co-beams at the Swedish Secondary Standards Dosimetry Laboratory. Conversions from air kerma free-in-air into values of mean absorbed dose in the dosimeters in the actual irradiation geometries were made using EGSnrc Monte Carlo simulations. X-ray energy spectra were measured or calculated for the actual beams. Detector response relative to that for (60)Co was determined at each beam quality. less thanbrgreater than less thanbrgreater thanResults: An increase in relative response was seen for all beam qualities ranging from 8% at tube voltage 25 kV (effective energy 13 keV) to 3%-4% at 250 kV (122 keV effective energy) and (137)Cs with a minimum at 80 keV effective energy (tube voltage 180 kV). The variation with effective energy was similar to that reported by Davis [Radiat. Prot. Dosim. 106, 33-43 (2003)] with our values being systematically lower by 2%-4%. Compared to the results by Nunn [Med. Phys. 35, 1861-1869 (2008)], the relative detector response as a function of effective energy differed in both shape and magnitude. This could be explained by the higher maximum read-out temperature (350 degrees C) used by Nunn [Med. Phys. 35, 1861-1869 (2008)], allowing light emitted from high-temperature peaks with a strong LET dependence to be registered. Use of TLD-100 by Davis [Radiat. Prot. Dosim. 106, 33-43 (2003)] with a stronger super-linear dose response compared to MTS-N was identified as causing the lower relative detector response in this work. less thanbrgreater than less thanbrgreater thanConclusions: Both careful dosimetry and strict protocols for handling the TLDs are required to reach solid experimental data on relative detector response. This work confirms older findings that an over-response relative to (60)Co exists for photon energies below 200-300 keV. Comparison with the results from the literature indicates that using similar protocols for annealing and read-out, dosimeters of different makes (TLD-100, MTS-N) differ in relative detector response. Though universality of the results has not been proven and further investigation is needed, it is anticipated that with the use of strict protocols for annealing and read-out, it will be possible to determine correction factors that can be used to reduce uncertainties in dose measurements around brachytherapy sources at photon energies where primary standards for absorbed dose to water are not available.
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| 8. |
- Gustafsson, Johan, et al.
(författare)
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Averaging of absorbed doses : How matter matters
- 2023
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Ingår i: Medical Physics. - : WILEY. - 0094-2405. ; 50:10, s. 6600-6613
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Tidskriftsartikel (refereegranskat)abstract
- Background: Dosimetry in radionuclide therapy often requires the calculation of average absorbed doses within and between spatial regions, for example, for voxel-based dosimetry methods, for paired organs, or across multiple tumors. Formation of such averages can be made in different ways, starting from different definitions. Purpose: The aim of this study is to formally specify different averaging strategies for absorbed doses, and to compare their results when applied to absorbed dose distributions that are non-uniform within and between regions. Methods: For averaging within regions, two definitions of the average absorbed dose are considered: the simple average over the region (the region average) and the average when weighting by the mass density (density-weighted region average). The latter is shown to follow from the definition of mean absorbed dose according to the ICRU, and to be consistent with the MIRD formalism. For averaging between different spatial regions, three definitions follow: the volume-weighted, the mass-weighted, and the unweighted average. With respect to characterizing non-uniformity, the different average definitions lead to the use of dose-volume histograms (DVHs) (region average), dose-mass histograms (DMHs) (density-weighted region average), and unweighted histograms (unweighted average). Average absorbed doses are calculated for three worked examples, starting from the different definitions. The first, schematic, example concerns the calculation of the average absorbed dose between two regions with different volumes or mass densities. The second, stylized, example concerns voxel-based dosimetry, for which the average absorbed-dose rate within a region is calculated. The geometries studied include three 177Lu-filled voxelized spheres, where the sphere masses are held constant while the material compositions, densities, and volumes are varied. For comparison, the mean absorbed-dose rates obtained using unit-density sphere S-values are also included. The third example concerns SPECT/CT-based tumor dosimetry for five patients undergoing therapy with 177Lu-PSMA and six patients undergoing therapy with 177Lu-DOTA-TATE, for which the average absorbed-dose rates across multiple tumors are calculated. For the second and third examples, analyses also include representations by histograms. Results: Example 1 shows that the average absorbed doses, calculated using different definitions, can differ considerably if the masses and absorbed doses for two regions are markedly different. From example 2 it is seen that the density-weighted region average is stable under different activity and density distributions and is also in line with results using S-values. In contrast, the region average varies as function of the activity distribution. In example 3, the absorbed dose rates for individual tumors differ by (1.1 ± 4.3)% and (−0.1 ± 0.4)% with maximum deviations of +34.4% and −1.4% for 177Lu-PSMA and 177Lu-DOTA-TATE, respectively, when calculated as region averages or density-weighted region averages, with largest deviations obtained when the density is non-uniform. The average absorbed doses calculated across all tumors are similar when comparing mass-weighted and volume-weighted averages but these differ substantially from unweighted averages. Conclusion: Different strategies for averaging of absorbed doses within and between regions can lead to substantially different absorbed-dose estimates. At reporting of radionuclide therapy dosimetry, it is important to specify the averaging strategy applied.
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| 9. |
- Hedtjärn, Håkan, 1964-, et al.
(författare)
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Monte Carlo-aided dosimetry of the symmetra model I25.S06 125I, interstitial brachytherapy seed
- 2000
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Ingår i: Medical physics (Lancaster). - : Wiley. - 0094-2405. ; 27:5, s. 1076-1085
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Tidskriftsartikel (refereegranskat)abstract
- A dosimetric study of a new 125I seed for permanent prostate implant, the Symmetra 125I Seed model I25.S06, has been undertaken utilizing Monte Carlo photon transport calculations. All dosimetric quantities recommended by the AAPM Task Group 43 (TG-43) report have been calculated. Quantities determined are dose rate constant, radial dose function, anisotropy function, anisotropy factor, and anisotropy constant. The recently (January 1999) revised NIST (National Institute of Standards and Technology) 125I standard for air kerma strength calibration was taken into account as well as updated interaction cross-section data. Calculations were done for the competing model 6702 source for the purpose of comparison. The calculated dose-rate constants for the two seeds are 1.010 and 1.016 cGyh−1U−1 for the Symmetra and model 6702 seeds, respectively. The latter value deviates from the value, 1.039 cGyh−1U−1, recommended in the TG-43 report. The calculated radial dose function for the Symmetra new seed is more penetrating than that of the model 6711 seed (by 20% at 5 cm distance) but agrees closely (within statistical errors) with that of the model 6702 seed up to distances of 10 cm. The anisotropy function for the seed is also close to that for the 6702 seed with a tendency of somewhat more pronounced anisotropy (lower values at small angles from the longitudinal axis). Compared to the model 6711 seed, the Symmetra new seed is more isotropic. The anisotropy constants (the anisotropy function averaged with respect to angle and distance) for the three seed models are within 2%.
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| 10. |
- Malusek, Alexandr, et al.
(författare)
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A model-based iterative reconstruction algorithm DIRA using patient-specific tissue classification via DECT for improved quantitative CT in dose planning
- 2017
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Ingår i: Medical physics (Lancaster). - : WILEY. - 0094-2405. ; 44:6, s. 2345-2357
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To develop and evaluate-in a proof-of-concept configuration-a novel iterative reconstruction algorithm (DIRA) for quantitative determination of elemental composition of patient tissues for application to brachytherapy with low energy (amp;lt; 50 keV) photons and proton therapy. Methods: DIRA was designed as a model-based iterative reconstruction algorithm, which uses filtered backprojection, automatic segmentation and multimaterial tissue decomposition. The evaluation was done for a phantom derived from the voxelized ICRP 110 male phantom. Soft tissues were decomposed to the lipid, protein and water triplet, bones were decomposed to the compact bone and bone marrow doublet. Projections were derived using the Drasim simulation code for an axial scanning configuration resembling a typical DECT (dual-energy CT) scanner with 80 kV and Sn140 kV x-ray spectra. The iterative loop produced mono-energetic images at 50 and 88 keV without beam hardening artifacts. Different noise levels were considered: no noise, a typical noise level in diagnostic imaging and reduced noise level corresponding to tenfold higher doses. An uncertainty analysis of the results was performed using type A and B evaluations. The two approaches were compared. Results: Linear attenuation coefficients averaged over a region were obtained with relative errors less than 0.5% for all evaluated regions. Errors in average mass fractions of the three-material decomposition were less than 0.04 for no noise and reduced noise levels and less than 0.11 for the typical noise level. Mass fractions of individual pixels were strongly affected by noise, which slightly increased after the first iteration but subsequently stabilized. Estimates of uncertainties in mass fractions provided by the type B evaluation differed from the type A estimates by less than 1.5% for most cases. The algorithm was fast, the results converged after 5 iterations. The algorithmic complexity of forward polyenergetic projection calculation was much reduced by using material doublets and triplets. Conclusions: The simulations indicated that DIRA is capable of determining elemental composition of tissues, which are needed in brachytherapy with low energy (amp;lt; 50 keV) photons and proton therapy. The algorithm provided quantitative monoenergetic images with beam hardening artifacts removed. Its convergence was fast, image sharpness expressed via the modulation transfer function was maintained, and image noise did not increase with the number of iterations. c 2017 American Association of Physicists in Medicine
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