A PENELOPE-based system for the automated Monte Carlo simulation of clinacs and voxelized geometries-application to far-from-axis fields

Monte Carlo simulations in radiotherapy dosimetry

BACKGROUND

The use of the Monte Carlo (MC) method in radiotherapy dosimetry has increased almost exponentially in the last decades. Its widespread use in the field has converted this computer simulation technique in a common tool for reference and treatment planning dosimetry calculations.

METHODS

This work reviews the different MC calculations made on dosimetric quantities, like stopping-power ratios and perturbation correction factors required for reference ionization chamber dosimetry, as well as the fully realistic MC simulations currently available on clinical accelerators, detectors and patient treatment planning.

CONCLUSIONS

Issues are raised that include the necessity for consistency in the data throughout the entire dosimetry chain in reference dosimetry, and how Bragg-Gray theory breaks down for small photon fields. Both aspects are less critical for MC treatment planning applications, but there are important constraints like tissue characterization and its patient-to-patient variability, which together with the conversion between dose-to-water and dose-to-tissue, are analysed in detail. Although these constraints are common to all methods and algorithms used in different types of treatment planning systems, they make uncertainties involved in MC treatment planning to still remain "uncertain".

Monte Carlo verification of radiotherapy treatments with CloudMC

Background

A new implementation has been made on CloudMC, a cloud-based platform presented in a previous work, in order to provide services for radiotherapy treatment verification by means of Monte Carlo in a fast, easy and economical way. A description of the architecture of the application and the new developments implemented is presented together with the results of the tests carried out to validate its performance.

Methods

CloudMC has been developed over Microsoft Azure cloud. It is based on a map/reduce implementation for Monte Carlo calculations distribution over a dynamic cluster of virtual machines in order to reduce calculation time. CloudMC has been updated with new methods to read and process the information related to radiotherapy treatment verification: CT image set, treatment plan, structures and dose distribution files in DICOM format. Some tests have been designed in order to determine, for the different tasks, the most suitable type of virtual machines from those available in Azure. Finally, the performance of Monte Carlo verification in CloudMC is studied through three real cases that involve different treatment techniques, linac models and Monte Carlo codes.

Results

Considering computational and economic factors, D1_v2 and G1 virtual machines were selected as the default type for the Worker Roles and the Reducer Role respectively. Calculation times up to 33 min and costs of 16 € were achieved for the verification cases presented when a statistical uncertainty below 2% (2σ) was required. The costs were reduced to 3–6 € when uncertainty requirements are relaxed to 4%.

Conclusions

Advantages like high computational power, scalability, easy access and pay-per-usage model, make Monte Carlo cloud-based solutions, like the one presented in this work, an important step forward to solve the long-lived problem of truly introducing the Monte Carlo algorithms in the daily routine of the radiotherapy planning process.

Feasibility of estimating volumetric breast density from mammographic x-ray spectra using a cadmium telluride photon-counting detector

PURPOSE

Mammographic density of glandular breast tissue has a masking effect that can reduce lesion detection accuracy and is also a strong risk factor for breast cancer. Therefore, accurate quantitative estimation of breast density is clinically important. In this study, we investigate experimentally the feasibility of quantifying volumetric breast density with spectral mammography using a CdTe-based photon-counting detector.

METHODS

To demonstrate proof-of-principle, this study was carried out using the single pixel Amptek XR-100T-CdTe detector. The total number of x rays recorded by the detector from a single pencil-beam projection through 50%/50% of adipose/glandular mass fraction-equivalent phantoms was measured. Material decomposition assuming two, four, and eight energy bins was then applied to characterize the inspected phantom into adipose and glandular using log-likelihood estimation, taking into account the polychromatic source, the detector response function, and the energy-dependent attenuation.

RESULTS

Measurement tests were carried out for different doses, kVp settings, and different breast sizes. For dose of 1 mGy and above, the percent relative root mean square (RMS) errors of the estimated breast density was measured below 7% for all three phantom studies. It was also observed that some decrease in RMS errors was achieved using eight energy bins. For 3 and 4 cm thick phantoms, performance at 40 and 45 kVp showed similar performance. However, it was observed that 45 kVp showed better performance for a phantom thickness of 6 cm at low dose levels due to increased statistical variation at lower photon count levels with 40 kVp.

CONCLUSION

The results of the current study suggest that photon-counting spectral mammography systems using CdTe detectors have the potential to be used for accurate quantification of volumetric breast density on a pixel-to-pixel basis, with an RMS error of less than 7%.

Evaluation of target dose inhomogeneity in breast cancer treatment due to tissue elemental differences

BACKGROUND

Monte Carlo simulations were run to estimate the dose variations generated by thedifference arising from the chemical composition of the tissues.

METHODS

CT datasets of five breast cancer patients were selected. Mammary gland was delineated as clinical target volume CTV, as well as CTV_lob and CTV_fat, being the lobular and fat fractions of the entire mammary gland. Patients were planned for volumetric modulated arc therapy technique, optimized in the Varian Eclipse treatment planning system. CT, structures and plans were imported in PRIMO, based on Monte Carlo code Penelope, to run three simulations: AdiMus, where the adipose and muscle tissues were automatically assigned to fat and lobular fractions of the breast; Adi and Mus, where adipose and muscle, respectively were assigned to the whole mammary gland. The specific tissue density was kept identical from the CT dataset. Differences in mean doses in the CTV_lob and CTV_fat structures were evaluated for the different tissue assignments. Differences generated by the tissue composition and estimated by Acuros dose calculations in Eclipse were also analysed.

RESULTS

From Monte Carlo simulations, the dose in the lobular fraction of the breast, when adipose tissue is assigned in place of muscle, is overestimated by 1.25 ± 0.45%; the dose in the fat fraction of the breast with muscle tissue assignment is underestimated by 1.14 ± 0.51%. Acuros showed an overestimation of 0.98 ± 0.06% and an underestimation of 0.21 ± 0.14% in the lobular and fat portions, respectively. Reason of this dissimilarity resides in the fact that the two calculations, Monte Carlo and Acuros, differently manage the range of CT numbers and the material assignments, having Acuros an overlapping range, where two tissues are both present in defined proportions.

CONCLUSION

Although not clinically significant, the dose deposition difference in the lobular and connective fat fraction of the breast tissue lead to an improved knowledge of the possible dose distribution and homogeneity in the breast radiation treatment.

Comparison of methods for H*(10) calculation from measured LaBr3(Ce) detector spectra

The Universitat Politecnica de Catalunya (UPC) and the Centro de Investigaciones Energéticas, Medioambientales y Tecnológicas (CIEMAT) have evaluated methods based on stripping, conversion coefficients and Maximum Likelihood Estimation using Expectation Maximization (ML-EM) in calculating the H*(10) rates from photon pulse-height spectra acquired with a spectrometric LaBr₃(Ce)(1.5″ × 1.5″) detector. There is a good agreement between results of the different H*(10) rate calculation methods using the spectra measured at the UPC secondary standard calibration laboratory in Barcelona. From the outdoor study at ESMERALDA station in Madrid, it can be concluded that the analysed methods provide results quite similar to those obtained with the reference RSS ionization chamber. In addition, the spectrometric detectors can also facilitate radionuclide identification.

Characterization and validation of the thorax phantom Lungman for dose assessment in chest radiography optimization studies

This work concerns the validation of the Kyoto-Kagaku thorax anthropomorphic phantom Lungman for use in chest radiography optimization. The equivalence in terms of polymethyl methacrylate (PMMA) was established for the lung and mediastinum regions of the phantom. Patient chest examination data acquired under automatic exposure control were collated over a 2-year period for a standard x-ray room. Parameters surveyed included exposure index, air kerma area product, and exposure time, which were compared with Lungman values. Finally, a voxel model was developed by segmenting computed tomography images of the phantom and implemented in PENELOPE/penEasy Monte Carlo code to compare phantom tissue-equivalent materials with materials from ICRP Publication 89 in terms of organ dose. PMMA equivalence varied depending on tube voltage, from 9.5 to 10.0 cm and from 13.5 to 13.7 cm, for the lungs and mediastinum regions, respectively. For the survey, close agreement was found between the phantom and the patients' median values (deviations lay between 8% and 14%). Differences in lung doses, an important organ for optimization in chest radiography, were below 13% when comparing the use of phantom tissue-equivalent materials versus ICRP materials. The study confirms the value of the Lungman for chest optimization studies.

INFLUENCE OF RADON PROGENY ON DOSE RATE MEASUREMENTS STUDIED AT PTB'S RADON REFERENCE CHAMBER

The responses of electronic dose rate meters were investigated in a large volume radon chamber at PTB in a wide range of radon activity concentrations. The measurements were conducted under controlled laboratory conditions and measured dose rate data are compared with Monte-Carlo simulations. Consequences concerning environmental monitoring are described. A further result is that the direct measurement of the dose rates produced by radon progeny in air is hardly possible in radon atmospheres with high activity concentrations, because the major contribution of measured dose rates is produced by radon progeny on the housing of the dose rate instruments. The latter effect largely depends on the ability of surfaces to absorb radon progeny. The Monte-Carlo simulations revealed quantitative results on the height of the single contributions to the total dose rate measured in the radon chamber. When environmental dose rate measurements are performed, the plate-out on detectors can be neglected.

Modelling the transport of optical photons in scintillation detectors for diagnostic and radiotherapy imaging

Computational modelling of radiation transport can enhance the understanding of the relative importance of individual processes involved in imaging systems. Modelling is a powerful tool for improving detector designs in ways that are impractical or impossible to achieve through experimental measurements. Modelling of light transport in scintillation detectors used in radiology and radiotherapy imaging that rely on the detection of visible light plays an increasingly important role in detector design. Historically, researchers have invested heavily in modelling the transport of ionizing radiation while light transport is often ignored or coarsely modelled. Due to the complexity of existing light transport simulation tools and the breadth of custom codes developed by users, light transport studies are seldom fully exploited and have not reached their full potential. This topical review aims at providing an overview of the methods employed in freely available and other described optical Monte Carlo packages and analytical models and discussing their respective advantages and limitations. In particular, applications of optical transport modelling in nuclear medicine, diagnostic and radiotherapy imaging are described. A discussion on the evolution of these modelling tools into future developments and applications is presented.

Technical Note: A simulation study on the feasibility of radiotherapy dose enhancement with calcium tungstate and hafnium oxide nano- and microparticles

PURPOSE

To assess the radiotherapy dose enhancement (RDE) potential of calcium tungstate (CaWO₄ ) and hafnium oxide (HfO₂ ) nano- and microparticles (NPs). A Monte Carlo simulation study was conducted to gauge their respective RDE potentials relative to that of the broadly studied gold (Au) NP. The study was warranted due to the promising clinical and preclinical studies involving both CaWO₄ and HfO₂ NPs as RDE agents in the treatment of various types of cancers. The study provides a baseline RDE to which future experimental RDE trends can be compared to.

METHODS

All three materials were investigated in silico with the software Penetration and Energy Loss of Positrons and Electrons (PENELOPE 2014) developed by Francesc Salvat and distributed in the United States by the Radiation Safety Information Computational Center (RSICC) at Oak Ridge National Laboratory. The work utilizes the extensively studied Au NP as the "gold standard" for a baseline. The key metric used in the evaluation of the materials was the local dose enhancement factor (DEF_loc ). An additional metric used, termed the relative enhancement ratio (RER), evaluates material performance at the same mass concentrations.

RESULTS

The results of the study indicate that Au has the strongest RDE potential using the DEF_loc metric. HfO₂ and CaWO₄ both underperformed relative to Au with lower DEF_loc of 2-3 × and 4-100 ×, respectively.

CONCLUSIONS

The computational investigation predicts the RDE performance ranking to be: Au > HfO₂ > CaWO₄ .

Dose evaluation of Grid Therapy using a 6 MV flattening filter-free (FFF) photon beam: A Monte Carlo study

PURPOSE

Spatially fractionated radiotherapy is a strategy to overcome the main limitation of radiotherapy, i.e., the restrained normal tissue tolerances. A well-known example is Grid Therapy, which is currently performed at some hospitals using megavoltage photon beams delivered by Linacs. Grid Therapy has been successfully used in the management of bulky abdominal tumors with low toxicity. The aim of this work was to evaluate whether an improvement in therapeutic index in Grid Therapy can be obtained by implementing it in a flattening filter-free (FFF) Linac. The rationale behind is that the removal of the flattening filter shifts the beam energy spectrum towards lower energies and increase the photon fluence. Lower energies result in a reduction of lateral scattering and thus, to higher peak-to-valley dose ratios (PVDR) in normal tissues. In addition, the gain in fluence might allow using smaller beams leading a more efficient exploitation of dose-volume effects, and consequently, a better normal tissue sparing.

METHODS

Monte Carlo simulations were used to evaluate realistic dose distributions considering a 6 MV FFF photon beam from a standard medical Linac and a cerrobend mechanical collimator in different configurations: grid sizes of 0.3 × 0.3 cm² , 0.5 × 0.5 cm² , and 1 × 1 cm² and a corresponding center-to-center (ctc) distance of 0.6, 1, and 2 cm, respectively (total field size of 10 × 10 cm² ). As figure of merit, peak doses in depth, PVDR, output factors (OF), and penumbra values were assessed.

RESULTS

Dose at the entrance is slightly higher than in conventional Grid Therapy. However, it is compensated by the large PVDR obtained at the entrance, reaching a maximum of 35 for a grid size of 1 × 1 cm² . Indeed, this grid size leads to very high PVDR values at all depths (≥ 10), which are much higher than in standard Grid Therapy. This may be beneficial for normal tissues but detrimental for tumor control, where a lower PVDR might be requested. In that case, higher valley doses in the tumor could be achieved by using an interlaced approach and/or adapting the ctc distance. The smallest grid size (0.3 × 0.3 cm² ) leads to low PVDR at all depths, comparable to standard Grid Therapy. However, the use of very thin beams might increase the normal tissue tolerances with respect to the grid size commonly used (1 × 1 cm² ). The gain in fluence provided by FFF implies that the important OF reduction (0.6) will not increase treatment time. Finally, the intermediate configuration (0.5 × 0.5 cm² ) provides high PVDR in the first 5 cm, and comparable PVDR to previous Grid Therapy works at depth. Therefore, this configuration might allow increasing the normal tissue tolerances with respect to Grid Therapy thanks to the higher PVDR and thinner beams, while a similar tumor control could be expected.

CONCLUSIONS

The implementation of Grid Therapy in an FFF photon beam from medical Linac might lead to an improvement of the therapeutic index. Among the cases evaluated, a grid size of 0.5 × 0.5 cm² (1-cm-ctc) is the most advantageous configuration from the physics point of view. Radiobiological experiments are needed to fully explore this new avenue and to confirm our results.

Monte Carlo Estimation of Absorbed Dose Distributions Obtained from Heterogeneous 106Ru Eye Plaques

BACKGROUND

The distribution of the emitter substance in ¹⁰⁶Ru eye plaques is usually assumed to be homogeneous for treatment planning purposes. However, this distribution is never homogeneous, and it widely differs from plaque to plaque due to manufacturing factors.

METHODS

By Monte Carlo simulation of radiation transport, we study the absorbed dose distribution obtained from the specific CCA1364 and CCB1256 ¹⁰⁶Ru plaques, whose actual emitter distributions were measured. The idealized, homogeneous CCA and CCB plaques are also simulated.

RESULTS

The largest discrepancy in depth dose distribution observed between the heterogeneous and the homogeneous plaques was 7.9 and 23.7% for the CCA and CCB plaques, respectively. In terms of isodose lines, the line referring to 100% of the reference dose penetrates 0.2 and 1.8 mm deeper in the case of heterogeneous CCA and CCB plaques, respectively, with respect to the homogeneous counterpart.

CONCLUSIONS

The observed differences in absorbed dose distributions obtained from heterogeneous and homogeneous plaques are clinically irrelevant if the plaques are used with a lateral safety margin of at least 2 mm. However, these differences may be relevant if the plaques are used in eccentric positioning.

Collision-kerma conversion between dose-to-tissue and dose-to-water by photon energy-fluence corrections in low-energy brachytherapy

The AAPM TG-43 brachytherapy dosimetry formalism, introduced in 1995, has become a standard for brachytherapy dosimetry worldwide; it implicitly assumes that charged-particle equilibrium (CPE) exists for the determination of absorbed dose to water at different locations, except in the vicinity of the source capsule. Subsequent dosimetry developments, based on Monte Carlo calculations or analytical solutions of transport equations, do not rely on the CPE assumption and determine directly the dose to different tissues. At the time of relating dose to tissue and dose to water, or vice versa, it is usually assumed that the photon fluence in water and in tissues are practically identical, so that the absorbed dose in the two media can be related by their ratio of mass energy-absorption coefficients. In this work, an efficient way to correlate absorbed dose to water and absorbed dose to tissue in brachytherapy calculations at clinically relevant distances for low-energy photon emitting seeds is proposed. A correction is introduced that is based on the ratio of the water-to-tissue photon energy-fluences. State-of-the art Monte Carlo calculations are used to score photon fluence differential in energy in water and in various human tissues (muscle, adipose and bone), which in all cases include a realistic modelling of low-energy brachytherapy sources in order to benchmark the formalism proposed. The energy-fluence based corrections given in this work are able to correlate absorbed dose to tissue and absorbed dose to water with an accuracy better than 0.5% in the most critical cases (e.g. bone tissue).

Optimization of photon beam energies in gold nanoparticle enhanced arc radiation therapy using Monte Carlo methods

As a recent area of development in radiation therapy, gold nanoparticle (GNP) enhanced radiation therapy has shown potential to increase tumour dose while maintaining acceptable levels of healthy tissue toxicity. In this study, the effect of varying photon beam energy in GNP enhanced arc radiation therapy (GEART) is quantified through the introduction of a dose scoring metric, and GEART is compared to a conventional radiotherapy treatment. The PENELOPE Monte Carlo code was used to model several simple phantoms consisting of a spherical tumour containing GNPs (concentration: 15 mg Au g^-1 tumour, 0.8 mg Au g^-1 normal tissue) in a cylinder of tissue. Several monoenergetic photon beams, with energies ranging from 20 keV to 6 MeV, as well as 100, 200, and 300 kVp spectral beams, were used to irradiate the tumour in a 360° arc treatment. A dose metric was then used to compare tumour and tissue doses from GEART treatments to a similar treatment from a 6 MV spectrum. This was also performed on a simulated brain tumour using patient computed tomography data. GEART treatments showed potential over the 6 MV treatment for many of the simulated geometries, delivering up to 88% higher mean dose to the tumour for a constant tissue dose, with the effect greatest near a source energy of 50 keV. This effect is also seen with the inclusion of bone in a brain treatment, with a 14% increase in mean tumour dose over 6 MV, while still maintaining acceptable levels of dose to the bone and brain.

Transit dose comparisons for 60Co and 192Ir HDR sources

The goal of this study is to evaluate the ambient dose due to the transit of high dose rate (HDR) ⁶⁰Co sources along a transfer tube as compared to ¹⁹²Ir ones in a realistic clinical scenario. This goal is accomplished by evaluating air-kerma differences with Monte Carlo calculations using PENELOPE2011. Scatter from both the afterloader and the patient was not taken into account. Two sources, mHDR-v2 and Flexisource Co-60, (Elekta Brachytherapy, Veenendaal, the Netherlands) have been considered. These sources were simulated within a standard transfer tube located in an infinite air phantom. The movement of the source was included by displacing their positions along the connecting tube from z  =  -75 cm to z  =  +75 cm and combining them. Since modern afterloaders like Flexitron (Elekta) or Saginova (BEBIG GmbH) are able to use equally ¹⁹²Ir and ⁶⁰Co sources, it was assumed that both sources are displaced with equal speed. Typical HDR source activity content values were provided by the manufacturer. 2D distributions were obtained with type-A uncertainties (k  =  2) less than 0.01%. From those, the air-kerma ratio ⁶⁰Co/¹⁹²Ir was evaluated weighted by their corresponding typical activities. It was found that it varies slowly with distance (less than 10% variation at 75 cm) but strongly in time due to the shorter half-life of the ¹⁹²Ir (73.83 d). The maximum ratio is located close to the tube. It reaches a value of 0.57 when the typical activity of the sources at the time when they were installed by the vendor was used. Such ratio increases up to 1.28 at the end of the recommended working life (90 d) of the ¹⁹²Ir source. ⁶⁰Co/¹⁹²Ir air-kerma ratios are almost constant (0.51-0.57) in the vicinity of the source-tube with recent installed sources. Nevertheless, air-kerma ratios increase rapidly (1.15-1.29) whenever the ¹⁹²Ir is approaching the end of its life. In case of a medical event requiring the medical staff to access the treatment room, these ratios indicate that the dosimetric impact on the medical team will be lower, with a few exceptions, in the case of ⁶⁰Co-based HDR brachytherapy as compared to ¹⁹²Ir-based one when typical air-kerma strength values are considered.

Monte Carlo systems used for treatment planning and dose verification

General-purpose radiation transport Monte Carlo codes have been used for estimation of the absorbed dose distribution in external photon and electron beam radiotherapy patients since several decades. Results obtained with these codes are usually more accurate than those provided by treatment planning systems based on non-stochastic methods. Traditionally, absorbed dose computations based on general-purpose Monte Carlo codes have been used only for research, owing to the difficulties associated with setting up a simulation and the long computation time required. To take advantage of radiation transport Monte Carlo codes applied to routine clinical practice, researchers and private companies have developed treatment planning and dose verification systems that are partly or fully based on fast Monte Carlo algorithms. This review presents a comprehensive list of the currently existing Monte Carlo systems that can be used to calculate or verify an external photon and electron beam radiotherapy treatment plan. Particular attention is given to those systems that are distributed, either freely or commercially, and that do not require programming tasks from the end user. These systems are compared in terms of features and the simulation time required to compute a set of benchmark calculations.

Monte Carlo reference data sets for imaging research: Executive summary of the report of AAPM Research Committee Task Group 195

The use of Monte Carlo simulations in diagnostic medical imaging research is widespread due to its flexibility and ability to estimate quantities that are challenging to measure empirically. However, any new Monte Carlo simulation code needs to be validated before it can be used reliably. The type and degree of validation required depends on the goals of the research project, but, typically, such validation involves either comparison of simulation results to physical measurements or to previously published results obtained with established Monte Carlo codes. The former is complicated due to nuances of experimental conditions and uncertainty, while the latter is challenging due to typical graphical presentation and lack of simulation details in previous publications. In addition, entering the field of Monte Carlo simulations in general involves a steep learning curve. It is not a simple task to learn how to program and interpret a Monte Carlo simulation, even when using one of the publicly available code packages. This Task Group report provides a common reference for benchmarking Monte Carlo simulations across a range of Monte Carlo codes and simulation scenarios. In the report, all simulation conditions are provided for six different Monte Carlo simulation cases that involve common x-ray based imaging research areas. The results obtained for the six cases using four publicly available Monte Carlo software packages are included in tabular form. In addition to a full description of all simulation conditions and results, a discussion and comparison of results among the Monte Carlo packages and the lessons learned during the compilation of these results are included. This abridged version of the report includes only an introductory description of the six cases and a brief example of the results of one of the cases. This work provides an investigator the necessary information to benchmark his/her Monte Carlo simulation software against the reference cases included here before performing his/her own novel research. In addition, an investigator entering the field of Monte Carlo simulations can use these descriptions and results as a self-teaching tool to ensure that he/she is able to perform a specific simulation correctly. Finally, educators can assign these cases as learning projects as part of course objectives or training programs.

Technical Note: An investigation of polarity effects for wide-angle free-air chambers

PURPOSE

Wide-angle free-air chambers (WAFACs) are used as primary standard measurement devices for establishing the air-kerma strength of low-energy, low-dose rate brachytherapy seeds. The National Research Council of Canada (NRC) is commissioning a primary standard wide-angle free-air chamber (NRC WAFAC) to serve the calibration needs of Canadian clients. The University of Wisconsin has developed a similar variable-aperture free-air chamber (UW VAFAC) to be used as a research tool. As part of the NRC commissioning, measurements were carried out for both polarities of the applied bias voltage and the resulting effects were observed to be very large. Similar effects were identified with the UW VAFAC. The authors describe the measurements carried out to determine the underlying causes of the polarity effect and the approach used to eliminate it.

METHODS

The NRC WAFAC is based on the WAFAC design developed at the National Institute of Standards and Technology in the USA. Charge measurements for (125)I and (241)Am sources were carried out for both negative and positive polarities on the NRC WAFAC and UW VAFAC. Two aperture sizes were also investigated with the UW VAFAC. In addition, measurements on the NRC WAFAC were carried out with a small bias between the collecting electrode and the shield foil at the downstream end of the chamber. To mitigate all of the polarity effects, the downstream surface of the collecting electrode was covered with a thin layer of graphite on both the NRC and UW chambers.

RESULTS

Both chamber designs showed a difference of more than 30 % between the charge collected with positive and negative bias voltages for the smallest electrode separation. It was shown for the NRC WAFAC that charge could be collected in the small gap downstream of the collecting volume by applying a voltage between the shield foil and the collecting electrode, even though an insulating foil (Mylar or polyimide film) separated the conducting surface from the small gap region. The unwanted additional current was shown to be proportional to the size of the aperture for the UW VAFAC. The extra ionization produced in the small gap region was eliminated for both chambers by covering the insulating side of the collecting electrode with a grounded conducting layer.

CONCLUSIONS

The small gap region downstream of the collecting electrode in the NRC WAFAC and UW VAFAC can serve as an unwanted source of ion current. It is concluded that a residual electric field in the small gap region may lead to ion transport and to charge being trapped on the surface of the foil. The foil then acts as a capacitor with an equal charge, but of opposite sign, being attracted to the conducting surface. Covering the back of the collecting electrode surface with a grounded conducting layer eliminated the polarity effect.

VALIDATION OF A SIMULATION PROCEDURE FOR GENERATING BREAST TOMOSYNTHESIS PROJECTION IMAGES

In order to achieve optimal diagnostic performance in breast tomosynthesis (BT) imaging, the parameters of the imaging chain should be evaluated. For the purpose of such evaluations, a simulation procedure based on the Monte Carlo code system Penelope and the geometry of a Siemens BT system has been developed to generate BT projection images. In this work, the simulation procedure is validated by comparing contrast and sharpness in simulated images with contrast and sharpness in real images acquired with the BT system. The results of the study showed a good agreement of sharpness in real and simulated reconstructed image planes, but the contrast was shown to be higher in the simulated compared with the real projection images. The developed simulation procedure could be used to generate BT images, but it is of interest to further investigate how the procedure could be modified to generate more realistic image noise and contrast.

VOLUMETRIC LOCALISATION OF DENSE BREAST TISSUE USING BREAST TOMOSYNTHESIS DATA

This study attempted to use combined data from reconstructed digital breast tomosynthesis (DBT) volumes and density estimation of projection images to localise dense tissue inside the breast, using the assumption that the breast can be treated as consisting of only two types of tissue: fibroglandular (dense) and adipose (fatty). To be able to verify results, software breast phantoms generated using fractal Perlin noise were employed. Projection images were created using the PENELOPE Monte Carlo package. Dense tissue volume was estimated from the central projection image. The density image was used to determine the number of dense voxels at each pixel location, which were then placed using the DBT image as a template. The method proved capable of accurately determining the composition of 75±5 % of voxels.

Bowtie filters for dedicated breast CT: theory and computational implementation

PURPOSE

To design bowtie filters with improved properties for dedicated breast CT to improve image quality and reduce dose to the patient.

METHODS

The authors present three different bowtie filters designed for a cylindrical 14-cm diameter phantom with a uniform composition of 40/60 breast tissue, which vary in their design objectives and performance improvements. Bowtie design #1 is based on single material spectral matching and produces nearly uniform spectral shape for radiation incident upon the detector. Bowtie design #2 uses the idea of basis material decomposition to produce the same spectral shape and intensity at the detector, using two different materials. Bowtie design #3 eliminates the beam hardening effect in the reconstructed image by adjusting the bowtie filter thickness so that the effective attenuation coefficient for every ray is the same. All three designs are obtained using analytical computational methods and linear attenuation coefficients. Thus, the designs do not take into account the effects of scatter. The authors considered this to be a reasonable approach to the filter design problem since the use of Monte Carlo methods would have been computationally intensive. The filter profiles for a cone-angle of 0° were used for the entire length of each filter because the differences between those profiles and the correct cone-beam profiles for the cone angles in our system are very small, and the constant profiles allowed construction of the filters with the facilities available to us. For evaluation of the filters, we used Monte Carlo simulation techniques and the full cone-beam geometry. Images were generated with and without each bowtie filter to analyze the effect on dose distribution, noise uniformity, and contrast-to-noise ratio (CNR) homogeneity. Line profiles through the reconstructed images generated from the simulated projection images were also used as validation for the filter designs.

RESULTS

Examples of the three designs are presented. Initial verification of performance of the designs was done using analytical computations of HVL, intensity, and effective attenuation coefficient behind the phantom as a function of fan-angle with a cone-angle of 0°. The performance of the designs depends only weakly on incident spectrum and tissue composition. For all designs, the dynamic range requirement on the detector was reduced compared to the no-bowtie-filter case. Further verification of the filter designs was achieved through analysis of reconstructed images from simulations. Simulation data also showed that the use of our bowtie filters can reduce peripheral dose to the breast by 61% and provide uniform noise and CNR distributions. The bowtie filter design concepts validated in this work were then used to create a computational realization of a 3D anthropomorphic bowtie filter capable of achieving a constant effective attenuation coefficient behind the entire field-of-view of an anthropomorphic breast phantom.

CONCLUSIONS

Three different bowtie filter designs that vary in performance improvements were described and evaluated using computational and simulation techniques. Results indicate that the designs are robust against variations in breast diameter, breast composition, and tube voltage, and that the use of these filters can reduce patient dose and improve image quality compared to the no-bowtie-filter case.

A method for converting dose-to-medium to dose-to-tissue in Monte Carlo studies of gold nanoparticle-enhanced radiotherapy

Gold nanoparticles (GNPs) have shown potential in recent years as a means of therapeutic dose enhancement in radiation therapy. However, a major challenge in moving towards clinical implementation is the exact characterisation of the dose enhancement they provide. Monte Carlo studies attempt to explore this property, but they often face computational limitations when examining macroscopic scenarios. In this study, a method of converting dose from macroscopic simulations, where the medium is defined as a mixture containing both gold and tissue components, to a mean dose-to-tissue on a microscopic scale was established. Monte Carlo simulations were run for both explicitly-modeled GNPs in tissue and a homogeneous mixture of tissue and gold. A dose ratio was obtained for the conversion of dose scored in a mixture medium to dose-to-tissue in each case. Dose ratios varied from 0.69 to 1.04 for photon sources and 0.97 to 1.03 for electron sources. The dose ratio is highly dependent on the source energy as well as GNP diameter and concentration, though this effect is less pronounced for electron sources. By appropriately weighting the monoenergetic dose ratios obtained, the dose ratio for any arbitrary spectrum can be determined. This allows complex scenarios to be modeled accurately without explicitly simulating each individual GNP.

The relative biological effectiveness of out-of-field dose

PURPOSE

using simulations and models derived from existing literature, this work investigates relative biological effectiveness (RBE) for out-of-field radiation and attempts to quantify the relative magnitudes of different contributing phenomena (spectral, bystander, and low dose hypersensitivity effects). Specific attention is paid to external beam radiotherapy treatments for prostate cancer.

MATERIALS AND METHODS

using different biological models that account for spectral, bystander, and low dose hypersensitivity effects, the RBE was calculated for different points moving radially out from isocentre for a typical single arc VMAT prostate case. The RBE was found by taking the ratio of the equivalent dose with the physical dose. Equivalent doses were calculated by determining what physical dose would be necessary to produce the same overall biological effect as that predicted using the different biological models.

RESULTS

spectral effects changed the RBE out-of-field less than 2%, whereas response models incorporating low dose hypersensitivity and bystander effects resulted in a much more profound change of the RBE for out-of-field doses. The bystander effect had the largest RBE for points located just outside the edge of the primary radiation beam in the cranial caudal (z-direction) compared to low dose hypersensitivity and spectral effects. In the coplanar direction, bystander effect played the largest role in enhancing the RBE for points up to 8.75 cm from isocentre.

CONCLUSIONS

spectral, bystander, and low dose hypersensitivity effects can all increase the RBE for out-of-field radiation doses. In most cases, bystander effects seem to play the largest role followed by low dose hypersensitivity. Spectral effects were unlikely to be of any clinical significance. Bystander, low dose hypersensitivity, and spectral effect increased the RBE much more in the cranial caudal direction (z-direction) compared with the coplanar directions.

Experimental HPGe coaxial detector response and efficiency compared to Monte Carlo simulations

The peak efficiency for photons hitting the frontal surface of a medium volume n-type HPGe coaxial detector is mapped using acutely collimated beams of energies between 31 and 383 keV from a (133)Ba radioactive source. Simulated values obtained with the Monte Carlo radiation transport code penelope, using a model that respected actual detector dimensions and physical constants while varying dead-layer thicknesses, allowed us to fit the experimental results in the detector bulk but not near its rim. The spectra of a (137)Cs source were measured using the detector shielded from the natural background radiation, with and without a broad angle collimator. The corresponding simulated spectra, using the fitted dead-layer thicknesses, underestimate the continuum component of the spectra and overestimate the peak efficiency, by less than ten percent in the broad angle collimator arrangement. The simulated results are sensitive to the photon attenuation coefficients.

An analytic linear accelerator source model for GPU-based Monte Carlo dose calculations

Recently, there has been a lot of research interest in developing fast Monte Carlo (MC) dose calculation methods on graphics processing unit (GPU) platforms. A good linear accelerator (linac) source model is critical for both accuracy and efficiency considerations. In principle, an analytical source model should be more preferred for GPU-based MC dose engines than a phase-space file-based model, in that data loading and CPU-GPU data transfer can be avoided. In this paper, we presented an analytical field-independent source model specifically developed for GPU-based MC dose calculations, associated with a GPU-friendly sampling scheme. A key concept called phase-space-ring (PSR) was proposed. Each PSR contained a group of particles that were of the same type, close in energy and reside in a narrow ring on the phase-space plane located just above the upper jaws. The model parameterized the probability densities of particle location, direction and energy for each primary photon PSR, scattered photon PSR and electron PSR. Models of one 2D Gaussian distribution or multiple Gaussian components were employed to represent the particle direction distributions of these PSRs. A method was developed to analyze a reference phase-space file and derive corresponding model parameters. To efficiently use our model in MC dose calculations on GPU, we proposed a GPU-friendly sampling strategy, which ensured that the particles sampled and transported simultaneously are of the same type and close in energy to alleviate GPU thread divergences. To test the accuracy of our model, dose distributions of a set of open fields in a water phantom were calculated using our source model and compared to those calculated using the reference phase-space files. For the high dose gradient regions, the average distance-to-agreement (DTA) was within 1 mm and the maximum DTA within 2 mm. For relatively low dose gradient regions, the root-mean-square (RMS) dose difference was within 1.1% and the maximum dose difference within 1.7%. The maximum relative difference of output factors was within 0.5%. Over 98.5% passing rate was achieved in 3D gamma-index tests with 2%/2 mm criteria in both an IMRT prostate patient case and a head-and-neck case. These results demonstrated the efficacy of our model in terms of accurately representing a reference phase-space file. We have also tested the efficiency gain of our source model over our previously developed phase-space-let file source model. The overall efficiency of dose calculation was found to be improved by ~1.3-2.2 times in water and patient cases using our analytical model.

Dosimetric evaluation of new approaches in GRID therapy using nonconventional radiation sources

PURPOSE

Spatial fractionation of the dose has proven to be a promising approach to increase the tolerance of healthy tissue, which is the main limitation of radiotherapy. A good example of that is GRID therapy, which has been successfully used in the management of large tumors with low toxicity. The aim of this work is to explore new avenues using nonconventional sources: GRID therapy by using kilovoltage (synchrotron) x-rays, the use of very high-energy electrons, and proton GRID therapy. They share in common the use of the smallest possible grid sizes in order to exploit the dose-volume effects.

METHODS

Monte Carlo simulations (penelope/peneasy and geant4/GATE codes) were used as a method to study dose distributions resulting from irradiations in different configurations of the three proposed techniques. As figure of merit, percentage (peak and valley) depth dose curves, penumbras, and central peak-to-valley dose ratios (PVDR) were evaluated. As shown in previous biological experiments, high PVDR values are requested for healthy tissue sparing. A superior tumor control may benefit from a lower PVDR.

RESULTS

High PVDR values were obtained in the healthy tissue for the three cases studied. When low energy photons are used, the treatment of deep-seated tumors can still be performed with submillimetric grid sizes. Superior PVDR values were reached with the other two approaches in the first centimeters along the beam path. The use of protons has the advantage of delivering a uniform dose distribution in the tumor, while healthy tissue benefits from the spatial fractionation of the dose. In the three evaluated techniques, there is a net reduction in penumbra with respect to radiosurgery.

CONCLUSIONS

The high PVDR values in the healthy tissue and the use of small grid sizes in the three presented approaches might constitute a promising alternative to treat tumors with such spatially fractionated radiotherapy techniques. The dosimetric results presented here support the interest of performing radiobiology experiments in order to evaluate these new avenues.

Bowtie filters for dedicated breast CT: Analysis of bowtie filter material selection

PURPOSE

For a given bowtie filter design, both the selection of material and the physical design control the energy fluence, and consequently the dose distribution, in the object. Using three previously described bowtie filter designs, the goal of this work is to demonstrate the effect that different materials have on the bowtie filter performance measures.

METHODS

Three bowtie filter designs that compensate for one or more aspects of the beam-modifying effects due to the differences in path length in a projection have been designed. The nature of the designs allows for their realization using a variety of materials. The designs were based on a phantom, 14 cm in diameter, composed of 40% fibroglandular and 60% adipose tissue. Bowtie design #1 is based on single material spectral matching and produces nearly uniform spectral shape for radiation incident upon the detector. Bowtie design #2 uses the idea of basis-material decomposition to produce the same spectral shape and intensity at the detector, using two different materials. With bowtie design #3, it is possible to eliminate the beam hardening effect in the reconstructed image by adjusting the bowtie filter thickness so that the effective attenuation coefficient for every ray is the same. Seven different materials were chosen to represent a range of chemical compositions and densities. After calculation of construction parameters for each bowtie filter design, a bowtie filter was created using each of these materials (assuming reasonable construction parameters were obtained), resulting in a total of 26 bowtie filters modeled analytically and in the penelope Monte Carlo simulation environment. Using the analytical model of each bowtie filter, design profiles were obtained and energy fluence as a function of fan-angle was calculated. Projection images with and without each bowtie filter design were also generated using penelope and reconstructed using FBP. Parameters such as dose distribution, noise uniformity, and scatter were investigated.

RESULTS

Analytical calculations with and without each bowtie filter show that some materials for a given design produce bowtie filters that are too large for implementation in breast CT scanners or too small to accurately manufacture. Results also demonstrate the ability to manipulate the energy fluence distribution (dynamic range) by using different materials, or different combinations of materials, for a given bowtie filter design. This feature is especially advantageous when using photon counting detector technology. Monte Carlo simulation results from penelope show that all studied material choices for bowtie design #2 achieve nearly uniform dose distribution, noise uniformity index less than 5%, and nearly uniform scatter-to-primary ratio. These same features can also be obtained using certain materials with bowtie designs #1 and #3.

CONCLUSIONS

With the three bowtie filter designs used in this work, the selection of material is an important design consideration. An appropriate material choice can improve image quality, dose uniformity, and dynamic range.

A simple analytical method for heterogeneity corrections in low dose rate prostate brachytherapy

In low energy brachytherapy, the presence of tissue heterogeneities contributes significantly to the discrepancies observed between treatment plan and delivered dose. In this work, we present a simplified analytical dose calculation algorithm for heterogeneous tissue. We compare it with Monte Carlo computations and assess its suitability for integration in clinical treatment planning systems. The algorithm, named as RayStretch, is based on the classic equivalent path length method and TG-43 reference data. Analytical and Monte Carlo dose calculations using Penelope2008 are compared for a benchmark case: a prostate patient with calcifications. The results show a remarkable agreement between simulation and algorithm, the latter having, in addition, a high calculation speed. The proposed analytical model is compatible with clinical real-time treatment planning systems based on TG-43 consensus datasets for improving dose calculation and treatment quality in heterogeneous tissue. Moreover, the algorithm is applicable for any type of heterogeneities.