SAF values for internal photon emitters calculated for the RPI-P pregnant-female models using Monte Carlo methods

Validation of the DoseCalcs Monte Carlo code for estimating the 18F S-values for ICRP adult and 15-year-old male and female phantoms

Internal radiation exposure using radiopharmaceuticals, as in nuclear medicine procedures, necessitates the estimation of the S-value to determine and improve the estimates of absorbed doses in at-risk organs and tissues. The S value is defined as the absorbed dose in the target organ per unit of nuclear transformation in the source organ. It is calculated using the specific absorbed fraction, which is an important quantity that connects the deposited energy in the target and emitting source organs. In this study, we applied DoseCalcs, a new Geant4-based tool, to estimate the S values of [Formula: see text]F using nuclear data from ICRP Publication 107. Geometrical data from ICRP Publications 110 and 143 were used to select four models representing male and female phantoms for adults and 15 years old to study the variability in the S-values arising from variations in anatomy and initial energy validations, because we used the [Formula: see text] mean energy instead of the full beta spectrum. The [Formula: see text]F-released photons and [Formula: see text] from 26 source organs were tracked using the Geant4 Livermore package. Accordingly, the S-values were calculated for 141 target organs. The results for the adult male and female phantoms were compared with the OpenDose reference data. These results agreed well with OpenDose, the average ratio for self-absorption S-values was 1.015, and the average ratios for the cross-irradiation were 1.2 and 1.22 for the AM and AF, respectively. This indicates the accuracy of DoseCalcs for subsequent use in estimating [Formula: see text]F S-values using voxelized geometries.

18F-Fludeoxyglucose absorbed dose estimation in fetus during early pregnancy

The purpose of this study is to assess a rare case of fetal radiation absorbed dose here through ¹⁸F-Fludeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in early pregnancy (5-week-old fetus). The fetal absorbed dose due to the radiation emitted from the mother's body, the fetus self-dose, and the dose received from CT were computed. The 35-year-old patient, weighing 85 kg, was injected with 370 MBq of ¹⁸F-FDG. Imaging started at 1 h with CT acquisition followed by PET imaging. The photon and positron self-dose was calculated by applying the Monte Carlo (MC) GATE (GEANT 4 Application for Tomographic Emission) code. The volume of absorbed dose from the mother's body organs and the absorbed dose from the CT were added to the self-dose to obtain the final dose. The volume of self-dose obtained through MC simulation for the fetus was 3.3 × 10^-2 mGy/MBq, of which 2.97 × 10^-2 mGy/MBq was associated with positrons and 0.33 × 10^-2 mGy/MBq was associated with photons. Biologically, the absorbed dose from CT, 7.3 mGy, had to be added to the total dose. The absorbed dose by the fetus during early pregnancy was higher than the standard value of 2.2 × 10^-2 mGy/MBq (MIRD DER) because, during the examinations, the mother's bladder was full. This issue was a concern during updating standards.

Innovations in Computer Technologies Have Impacted Radiation Dosimetry Through Anatomically Realistic Phantoms and Fast Monte Carlo Simulations

Radiological physics principles have not changed in the past 60 y when computer technologies advanced exponentially. The research field of anatomical modeling for the purpose of radiation dose calculations has experienced an explosion in activity in the past two decades. Such an exciting advancement is due to the feasibility of creating three-dimensional geometric details of the human anatomy from tomographic imaging and of performing Monte Carlo radiation transport simulations on increasingly fast and cheap personal computers. The advent of a new type of high-performance computing hardware in recent years-graphics processing units-has made it feasible to carry out time-consuming Monte Carlo calculations at near real-time speeds. This paper introduces the history of three generations of computational human phantoms (the stylized medical internal radiation dosimetry-type phantoms, the voxelized tomographic phantoms, and the boundary representation deformable phantoms) and new development of the graphics processing unit-based Monte Carlo radiation dose calculations. Examples are given for research projects performed by my students in applying computational phantoms and a new Monte Carlo code, ARCHER, to problems in radiation protection, imaging, and radiotherapy. Finally, the paper discusses challenges and future opportunities for research.

New Fetal Radiation Doses for 18F-FDG Based on Human Data

Current standard values of fetal dosimetry deriving from ¹⁸F-FDG injection in pregnant women are estimated from animal data. The present communication offers a revision of fetal dosimetry values calculated from recently published human data, in which fetal ¹⁸F-FDG uptake was directly observed in vivo. The final doses were obtained from the observed time-integrated activity coefficients and a new generation of anthropomorphic voxel-based pregnancy phantoms.

Fetal organ dosimetry for the Techa River and Ozyorsk Offspring Cohorts, part 2: radionuclide S values for fetal self-dose and maternal cross-dose

One of the many objectives of the European Union's SOLO (Epidemiological Studies of Exposed Southern Urals Populations) project is to quantify the radiation dose-response following chronic in utero exposures to ionizing radiation. The project is presently conducting a pooled analysis of two cohorts of individuals born to exposed mothers-the Techa River Offspring Cohort (TROC) and the Ozyorsk Offspring Cohort (OOC). The TROC includes the offspring of mothers with external exposures to contaminated riverbanks and internal ingestions of (89)Sr, (90)Sr/(90)Y, and (137)Cs/(137m)Ba, while the OOC includes the offspring of mothers with external exposures seen within the Mayak plutonium production facilities and internal inhalation of (239)Pu and possibly (131)I. In the present study, a newly created Urals-based series of fetal and maternal models is employed to assess S values for all seven radionuclides. Among all fetal ages, S values ranged in magnitude from 10(-14) to 10(-10) Gy per Bq-s for fetal source organs and from 10(-18) to 10(-14) Gy per Bq-s from maternal source organs, depending upon particle type, particle energy, and fetal age. For a given radionuclide and fetal age, S values for fetal source organs were approximately two orders of magnitude higher than for maternal source organs. Little variation in S values was observed among fetal source organs, while variations of over 100 % with respect to the mean were observed for maternal source organs near the fetus. S value variations from maternal cross-fire were highly dependent on fetal position and separation distance from the maternal source organ. These radionuclide S values have been coupled with biokinetic models for use in cohort dose assessment within the SOLO project.

An exponential growth of computational phantom research in radiation protection, imaging, and radiotherapy: a review of the fifty-year history

Radiation dose calculation using models of the human anatomy has been a subject of great interest to radiation protection, medical imaging, and radiotherapy. However, early pioneers of this field did not foresee the exponential growth of research activity as observed today. This review article walks the reader through the history of the research and development in this field of study which started some 50 years ago. This review identifies a clear progression of computational phantom complexity which can be denoted by three distinct generations. The first generation of stylized phantoms, representing a grouping of less than dozen models, was initially developed in the 1960s at Oak Ridge National Laboratory to calculate internal doses from nuclear medicine procedures. Despite their anatomical simplicity, these computational phantoms were the best tools available at the time for internal/external dosimetry, image evaluation, and treatment dose evaluations. A second generation of a large number of voxelized phantoms arose rapidly in the late 1980s as a result of the increased availability of tomographic medical imaging and computers. Surprisingly, the last decade saw the emergence of the third generation of phantoms which are based on advanced geometries called boundary representation (BREP) in the form of Non-Uniform Rational B-Splines (NURBS) or polygonal meshes. This new class of phantoms now consists of over 287 models including those used for non-ionizing radiation applications. This review article aims to provide the reader with a general understanding of how the field of computational phantoms came about and the technical challenges it faced at different times. This goal is achieved by defining basic geometry modeling techniques and by analyzing selected phantoms in terms of geometrical features and dosimetric problems to be solved. The rich historical information is summarized in four tables that are aided by highlights in the text on how some of the most well-known phantoms were developed and used in practice. Some of the information covered in this review has not been previously reported, for example, the CAM and CAF phantoms developed in 1970s for space radiation applications. The author also clarifies confusion about 'population-average' prospective dosimetry needed for radiological protection under the current ICRP radiation protection system and 'individualized' retrospective dosimetry often performed for medical physics studies. To illustrate the impact of computational phantoms, a section of this article is devoted to examples from the author's own research group. Finally the author explains an unexpected finding during the course of preparing for this article that the phantoms from the past 50 years followed a pattern of exponential growth. The review ends on a brief discussion of future research needs (a supplementary file '3DPhantoms.pdf' to figure 15 is available for download that will allow a reader to interactively visualize the phantoms in 3D).

RADAR reference adult, pediatric, and pregnant female phantom series for internal and external dosimetry

A new generation of reference computational phantoms, based on image-based models tied to the reference masses defined by the International Commission on Radiological Protection (ICRP) for dose calculations, is presented.

METHODS

Anatomic models based on nonuniform rational b-spline modeling techniques were used to define reference male and female adults, 15-y-olds, 10-y-olds, 5-y-olds, 1-y-olds, newborns, and pregnant women at 3 stages of gestation, using the defined reference organ masses in ICRP publication 89. Absorbed fractions and specific absorbed fractions for internal emitters were derived using standard Monte Carlo radiation transport simulation codes.

RESULTS

Differences were notable between many pairs of organs in specific absorbed fractions because of the improved realism of the models, with adjacent organs usually closer and sometimes touching. Final estimates of absorbed dose for radiopharmaceuticals, for example, were only slightly different overall, as many of the differences were small and most pronounced at low radiation energies. Some new important organs were defined (salivary glands, prostate, eyes, and esophagus), and the identity of a few gastrointestinal tract organs changed.

CONCLUSION

A new generation of reference models for standardized internal and external dose calculations has been defined. The models will be implemented in standardized software for internal dose calculations and be used to produce new standardized dose estimates for radiopharmaceuticals and other applications.

Comparison of internal dosimetry factors for three classes of adult computational phantoms with emphasis on I-131 in the thyroid

The S values for 11 major target organs for I-131 in the thyroid were compared for three classes of adult computational human phantoms: stylized, voxel and hybrid phantoms. In addition, we compared specific absorbed fractions (SAFs) with the thyroid as a source region over a broader photon energy range than the x- and gamma-rays of I-131. The S and SAF values were calculated for the International Commission on Radiological Protection (ICRP) reference voxel phantoms and the University of Florida (UF) hybrid phantoms by using the Monte Carlo transport method, while the S and SAF values for the Oak Ridge National Laboratory (ORNL) stylized phantoms were obtained from earlier publications. Phantoms in our calculations were for adults of both genders. The 11 target organs and tissues that were selected for the comparison of S values are brain, breast, stomach wall, small intestine wall, colon wall, heart wall, pancreas, salivary glands, thyroid, lungs and active marrow for I-131 and thyroid as a source region. The comparisons showed, in general, an underestimation of S values reported for the stylized phantoms compared to the values based on the ICRP voxel and UF hybrid phantoms and relatively good agreement between the S values obtained for the ICRP and UF phantoms. Substantial differences were observed for some organs between the three types of phantoms. For example, the small intestine wall of ICRP male phantom and heart wall of ICRP female phantom showed up to eightfold and fourfold greater S values, respectively, compared to the reported values for the ORNL phantoms. UF male and female phantoms also showed significant differences compared to the ORNL phantom, 4.0-fold greater for the small intestine wall and 3.3-fold greater for the heart wall. In our method, we directly calculated the S values without using the SAFs as commonly done. Hence, we sought to confirm the differences observed in our S values by comparing the SAFs among the phantoms with the thyroid as a source region for selected target organs--small intestine wall, lungs, pancreas and breast--as well as illustrate differences in energy deposition across the energy range (12 photon energies from 0.01 to 4 MeV). Differences were found in the SAFs between phantoms in a similar manner as the differences observed in S values but with larger differences at lower photon energies. To investigate the differences observed in the S and SAF values, the chord length distributions (CLDs) were computed for the selected source--target pairs and compared across the phantoms. As demonstrated by the CLDs, we found that the differences between phantoms in those factors used in internal dosimetry were governed to a significant degree by inter-organ distances which are a function of organ shape as well as organ location.

Impact on 141Ce, 144Ce, 95Zr, and 90Sr beta emitter dose coefficients of photon and electron SAFs calculated with ICRP/ICRU reference adult voxel computational phantoms

The current dose coefficients for internal dose assessment of occupationally exposed persons and the general public were derived using the methodology of the International Commission on Radiological Protection (ICRP), which is similar to the Medical Internal Radiation Dose (MIRD)-type methodology. One component of this methodology is the mathematical representation of the human body (so-called MIRD-type phantoms) developed at the Oak Ridge National Laboratory for calculations of photon specific absorbed fractions (SAFs). Concerning the beta emissions, it is assumed in general that they irradiate only the organ where the radionuclide resides, whereas for walled organs, a fixed fraction of the emitted energy is absorbed within the wall. For the active marrow and bone surface targets, absorbed fractions were explicitly provided in ICRP Publication 30. The ICRP Publications 66 and 100 contain further detailed energy-dependent absorbed fraction data for the airways and the segments of the alimentary tract. In the present work, the voxel phantoms representing the reference male and female adults, recently developed at the Helmholtz Zentrum München-German Research Center for Environmental Health (HMGU) in collaboration with the Task Group DOCAL of ICRP Committee 2, were used for the Monte Carlo computation of photon as well as electron SAFs. These voxel phantoms, being constructed from computed tomography (CT) scans of individuals, are more realistic in shape and location of organs in the body than the mathematical phantoms; therefore, they provide photon SAFs that are more precise than those stemming from mathematical phantoms. In addition, electron SAFs for solid and walled organs as well as tissues in the alimentary tract, the respiratory tract, and the skeleton were calculated with Monte Carlo methods using these phantoms to complement the data of ICRP Publications 66 and 100 that are confined to self-irradiation. The SAFs derived for photons and electrons are then used to calculate the dose coefficients of the beta emitters 141Ce, 144Ce, 95Zr, and 90Sr. It is found that the differences of the dose coefficients due to the revised SAFs are much larger for injection and ingestion than for inhalation. The equivalent doses for colon and ingestion with the new voxel-based SAFs are significantly smaller than the values with the MIRD-type photon SAFs and simplifying assumptions for electrons. For lungs and inhalation, no significant difference was observed for the equivalent doses, whereas for injection and ingestion, an increase of the new values is observed.

Fetal dose estimates for (18)F-fluoro-L-thymidine using a pregnant monkey model

Estimating the radiation dose received by the fetus from nuclear medicine procedures is important because of the greater sensitivity of rapidly developing fetal tissues to ionizing radiation. (18)F-fluoro-L-thymidine (FLT) uptake is related to cellular proliferation and is currently used to monitor tumor progression and response to therapy. This study was undertaken to estimate-on the basis of biodistribution data obtained by PET/CT in pregnant rhesus monkeys-radiation absorbed dose to a human fetus administered (18)F-FLT.

METHODS

Three pregnant rhesus macaques (gestational age, 113 +/- 8 d) were administered (18)F-FLT and imaged for 2 h on a PET/CT scanner. Time-activity curves for maternal and fetal organs were generated in anatomic regions of interest identified via CT. Doses were estimated using OLINDA/EXM and the 6-mo-pregnant human model.

RESULTS

The extrapolated whole-body maternal dose obtained, 11.4 microGy/MBq, is similar to the previously reported adult female dose of 15.6 microGy/MBq. The estimated total-body dose to a human fetus is 24 microGy/MBq. Significant long-term (18)F-FLT accumulation in fetal liver resulted in a fetal liver dose of 53 microGy/MBq.

CONCLUSION

The fetal dose estimate in a 6-mo-pregnant human using (18)F-FLT is slightly greater than that reported for (18)F-FDG. (18)F-FLT trapping in the fetal liver should be considered in the risk-benefit analysis of (18)F-FLT PET examination in pregnant patients.

Specific absorbed fractions for internal electron emitters derived for a set of anatomically realistic reference pregnant female models

The specific absorbed fraction (Phi), defined by the Medical Internal Radiation Dose Committee, is generally applied to evaluate the average absorbed dose in a target organ as a result of radioactive materials deposited in a source organ. This paper reports a new set of Phi values for internal electron emitters ranging from 10 keV to 4 MeV from various internal organs of the mother to the fetus based on three newly developed pregnant female tomographic models, called RPI-P3, RPI-P6 and RPI-P9. The results show a linear log relationship between Phi values and electron energy. The linear log coefficients have been derived and reported. The relationship between Phi values and mean distances between source organs and the fetus were also determined to allow for individual dosimetry. Since the RPI-P models have finer details of human anatomy and more realistic organ volumes and geometries, which follow the latest ICRP reference values, the newly derived Phi values could be used as reference values in determination of the dose to the fetus from internal electron emitters.

Foetal dose conversion coefficients for ICRP-compliant pregnant models from idealised proton exposures

Protection of pregnant women and their foetus against external proton irradiations poses a unique challenge. Assessment of foetal dose due to external protons in galactic cosmic rays and as secondaries generated in aircraft walls is especially important during high-altitude flights. This paper reports a set of fluence to absorbed dose conversion coefficients for the foetus and its brain for external monoenergetic proton beams of six standard configurations (the antero-posterior, the postero-anterior, the right lateral, the left lateral, the rotational and the isotropic). The pregnant female anatomical definitions at each of the three gestational periods (3, 6 and 9 months) are based on newly developed RPI-P series of models whose organ masses were matched within 1% with the International Commission on Radiological Protection reference values. Proton interactions and the transport of secondary particles were carefully simulated using the Monte Carlo N-Particle eXtended code (MCNPX) and the phantoms consisting of several million voxels at 3 mm resolution. When choosing the physics models in the MCNPX, it was found that the advanced Cascade-Exciton intranuclear cascade model showed a maximum of 9% foetal dose increase compared with the default model combination at intermediate energies below 5 GeV. Foetal dose results from this study are tabulated and compared with previously published data that were based on simplified anatomy. The comparison showed a strong dependence upon the source geometry, energy and gestation period: the dose differences are typically less than 20% for all sources except ISO where systematically 40-80% of higher doses were observed. Below 200 MeV, a larger discrepancy in dose was found due to the Bragg peak shift caused by different anatomy. The tabulated foetal doses represent the latest and most detailed study to date offering a useful set of data to improve radiation protection dosimetry against external protons.