Development of a 9-months pregnant hybrid phantom and its internal dosimetry for thyroid agents

As a consequence of fetal radiosensitivity, the estimation of internal dose received by a fetus from radiopharmaceuticals applied to the mother is often important in nuclear medicine. A new 9-months pregnant phantom based on magnetic resonance (MR) images tied to the International Commission on Radiological Protection (ICRP) reference voxel phantom has been developed. Maternal and fetal organs were segmented from a set of pelvic MR images of a 9-months pregnant subject using 3D-DOCTOR(TM) and then imported into the 3D modeling software package Rhinoceros(TM) for combining with the adult female ICRP voxel phantom and further modeling. Next, the phantom organs were rescaled to match with reference masses described in ICRP Publications. The internal anatomy of previous pregnant phantom models had been limited to the fetal brain and skeleton only, but the fetus model developed in this study incorporates 20 different organs. The current reference phantom has been developed for application in comprehensive dosimetric study in nuclear medicine. The internal dosimetry calculations were performed for thyroid agents using the Monte Carlo transport method. Biokinetic data for these radiopharmaceuticals were used to estimate cumulated activity during pregnancy and maternal and fetal organ doses at seven different maximum thyroid uptake levels. Calculating the dose distribution was also presented in a sagittal view of the pregnant model utilizing the mesh tally function. The comparisons showed, in general, an overestimation of the absorbed dose to the fetus and an underestimation of the fetal thyroid dose in previous studies compared with the values based on the current hybrid phantom.

Hybrid computational phantoms for medical dose reconstruction

As outlined in NCRP Report No. 160 of the US National Council on Radiation Protection and Measurements (NCRP), the average value of the effective dose to exposed individuals in the United States has increased by a factor of 1.7 over the time period 1982-2006, with the contribution of medical exposures correspondingly increasing by a factor of 5.7. At present, medical contributors to effective dose include computed tomography (50% of total medical exposure), nuclear medicine (25%), interventional fluoroscopy (15%), and conventional radiography and diagnostic fluoroscopy (10%). An increased awareness of medical exposures has led to a gradual shift in the focus of radiation epidemiological studies from traditional occupational and environmental exposures to those focusing on cohorts of medical patients exposed to both diagnostic and therapeutic sources. The assignment of organ doses to patients in either a retrospective or a prospective study has increasingly relied on the use of computational anatomic phantoms. In this paper, we review the various methods and approaches used to construct patient models to include anthropometric databases, cadaver imaging, prospective volunteer imaging studies, and retrospective image reviews. Phantom format types--stylized, voxel, and hybrid--as well as phantom morphometric categories--reference, patient-dependent, and patient-specific--are next defined and discussed. Specific emphasis is given to hybrid phantoms-those defined through the use of combinations of polygon mesh and non-uniform rational B-spline (NURBS) surfaces. The concept of a patient-dependent phantom is reviewed, in which phantoms of non-50th percentile heights and weights are designed from population-based morphometric databases and provided as a larger library of phantoms for patient matching and lookup of refined values of organ dose coefficients and/or radionuclide S values. We close with two brief examples of the use of hybrid phantoms in medical dose reconstruction--diagnostic nuclear medicine for pediatric subjects and interventional fluoroscopy for adult patients.

Hybrid computational phantoms of the 15-year male and female adolescent: applications to CT organ dosimetry for patients of variable morphometry

Currently, two classes of the computational phantoms have been developed for dosimetry calculation: (1) stylized (or mathematical) and (2) voxel (or tomographic) phantoms describing human anatomy through mathematical surface equations and three-dimensional labeled voxel matrices, respectively. Mathematical surface equations in stylized phantoms provide flexibility in phantom design and alteration, but the resulting anatomical description is, in many cases, not very realistic. Voxel phantoms display far better anatomical realism, but they are limited in terms of their ability to alter organ shape, position, and depth, as well as body posture. A new class of computational phantoms--called hybrid phantoms-takes advantage of the best features of stylized and voxel phantoms-flexibility and anatomical realism, respectively. In the current study, hybrid computational phantoms representing reference 15-year male and female body anatomy and anthropometry are presented. For the male phantom, organ contours were extracted from the University of Florida (UF) 14-year series B male voxel phantom, while for the female phantom, original computed tomography (CT) data from two 14-year female patients were used. Polygon mesh models for the major organs and tissues were reconstructed for nonuniform rational B-spline (NURBS) surface modeling. The resulting NURBS/polygon mesh models representing body contour and internal anatomy were matched to anthropometric data and reference organ mass data provided by the Centers for Disease Control and Prevention (CDC) and the International Commission on Radiation Protection (ICRP), respectively. Finally, two hybrid 15-year male and female phantoms were completed where a total of eight anthropometric data categories were matched to standard values within 4% and organ masses matched to ICRP data within 1% with the exception of total skin. To highlight the flexibility of the hybrid phantoms, 10th and 90th weight percentile 15-year male and female phantoms were further developed from the 50th percentile phantoms through adjustments in the body contour to match the total body masses given in CDC pediatric growth curves. The resulting six NURBS phantoms, male and female phantoms representing their 10th, 50th, and 90th weight percentiles, were used to investigate the influence of body fat distributions on internal organ doses following CT imaging. The phantoms were exposed to multislice chest and abdomen helical CT scans, and in-field organ absorbed doses were calculated. The results demonstrated that the use of traditional stylized phantoms yielded organ dose estimates that deviate from those given by the UF reference hybrid phantoms by up to a factor of 2. The study also showed that use of reference, or 50th percentile, phantoms to assess organ doses in underweight 15-year-old children would not lead to significant organ dose errors (typically less than 10%). However, more significant errors were noted (up to approximately 30%) when reference phantoms are used to represent overweight children in CT imaging dosimetry. These errors are expected to only further increase as one considers CT organ doses in overweight and obese individuals of the adult patient population, thus emphasizing the advantages of patient-sculptable phantom technology.