Theoretical and experimental determination of phantom scatter factors for photon fields with different radial energy variation

The output factor used for monitor unit determination in radiotherapy can be divided into two factors: the head scatter factor and the phantom scatter factor. Theoretical and experimental phantom scatter factors have been compared for different beam qualities between 4 MV and 50 MV and field sizes from 5 cm x 5 cm to 30 cm x 30 cm. The theoretical data were obtained through a convolution method based on Monte Carlo calculated energy spectra and dose kernels. The calculations have been performed both for accelerators with a rather large energy variation within the field and for accelerators with a constant energy distribution in the field. Deviations between theoretical and experimental data were found to be less than 1%.     

Physicians'' refusal to provide life-prolonging medical interventions

Phantom scatter factors, for square fields of various sizes, have been determined at a fixed reference depth of 10 cm, separately in different institutes, for a large number of linear accelerators under the auspices of the Netherlands Commission on Radiation Dosimetry. The method used for these measurements has been described in a previous paper. The present article describes the conversion of the measured values into a comprehensive and consistent data set, that gives the phantom scatter factor as a function of field size (from 4 cm up to 40 cm) and quality index (from 0.600 up to 0.800).     

The effect of the nasopharyngeal air cavity on x-ray interface doses

We investigated the impact of air cavities in head and neck cancer patients treated by photon beams based on clinical set-ups. The phantom for investigation was constructed with a cubic air cavity of 4 x 4 x 4 cm3 located at the centre of a 30 x 30 x 16 cm3 solid water slab. The cavity cube was used to resemble an extreme case for the nasal cavity. Apart from measuring the dose profiles and central axis percentage depth dose distribution, the dose values in 0.25 x 0.25 x 0.25 cm3 voxels at regions around the air cavity were obtained by Monte Carlo simulations. A mean dose value was taken over the voxels of interest at each depth for evaluation. Single-field results were added to study parallel opposed field effects. For 10 x 10 cm2 parallel opposed fields at 4, 6 and 8 MV, the mean dose at regions near the lateral interfaces of the cavity cube were decreased by 1 to 2% due to the lack of lateral scatter, while the mean dose near the proximal and distal interfaces was increased by 2 to 4% due to the greater transmission through air. Secondary build-up effects at points immediately beyond the air cavity cube are negligible using field sizes greater than 4 x 4 cm2. For most head and neck treatment, the field sizes are usually 6 x 6 cm2 or greater, and most cavity volumes are smaller than our chosen dimensions. Therefore, the influence of closed air cavities on photon interface doses is not significant in clinical treatment set-ups.     

A dual source photon beam model used in convolution/superposition dose calculations for clinical megavoltage x-ray beams

A realistic photon beam model based on Monte Carlo simulation of clinical linear accelerators was implemented in a convolution/superposition dose calculation algorithm. A primary and an extra-focal sources were used in this beam model to represent the direct photons from the target and the scattered photons from other head structures, respectively. The effect of the finite size of the extra-focal source was modeled by a convolution of the source fluence distribution with the collimator aperture function. Relative photon output in air (Sc) and in phantom (Scp) were computed using the convolution method with this new photon beam model. Our results showed that in a 10 MV photon beam, the Sc, Sp (phantom scatter factor), and Scp factors increased by 11%, 10%, and 22%, respectively, as the field size changed from 3 x 3 cm2 to 40 x 40 cm2. The variation of the Sc factor was contributed mostly by an increase of the extra-focal radiation with field size. The radiation backscattered into the monitor chamber inside the accelerator head affected the Sc by about 2% in the same field range. The output factors in elongated fields, asymmetric fields, and blocked fields were also investigated in this study. Our results showed that if the effect of the backscattered radiation was taken into account, output factors in these treatment fields can be predicted accurately by our convolution algorithm using the dual source photon beam model.     

Blocked field effects on collimator scatter factors

In routine dosimetry we assume separability of the collimator (Sc) and phantom (Sp) scatter components that together comprise the total scatter factor (Sc,p). In practice, the addition of blocking also affects the photon fluence attributable to the treatment head and flattening filter in a complicated way. The reduced aperture blocks out some of the head scatter contribution, while the block and tray add back secondary scatter. In the following we present techniques for directly measuring the aperture effect on Sc in air or in a full-scatter phantom. The change in Sc is found to be a scaleable quantity that can be modelled as a simple linear fit to the ratio of projected open-to-blocked equivalent square fields. Measurements have been made for 6, 18 and 24 MV photon beams on one Varian 2500 and two Varian 2100c accelerators. Results indicate a progressive loss of collimator scatter contribution with increased field blocking that is amplified with increasing energy. Block and tray scatter only contribute significantly to Sc for large fields and treatment distances of 80 cm or less. Application of these corrections in monitor unit calculations is presented.     

Fast implementations of reconstruction-based scatter compensation in fully 3D SPECT image reconstruction

Accurate scatter compensation in SPECT can be performed by modelling the scatter response function during the reconstruction process. This method is called reconstruction-based scatter compensation (RBSC). It has been shown that RBSC has a number of advantages over other methods of compensating for scatter, but using RBSC for fully 3D compensation has resulted in prohibitively long reconstruction times. In this work we propose two new methods that can be used in conjunction with existing methods to achieve marked reductions in RBSC reconstruction times. The first method, coarse-grid scatter modelling, significantly accelerates the scatter model by exploiting the fact that scatter is dominated by low-frequency information. The second method, intermittent RBSC, further accelerates the reconstruction process by limiting the number of iterations during which scatter is modelled. The fast implementations were evaluated using a Monte Carlo simulated experiment of the 3D MCAT phantom with 99mTc tracer, and also using experimentally acquired data with 201Tl tracer. Results indicated that these fast methods can reconstruct, with fully 3D compensation, images very similar to those obtained using standard RBSC methods, and in reconstruction times that are an order of magnitude shorter. Using these methods, fully 3D iterative reconstruction with RBSC can be performed well within the realm of clinically realistic times (under 10 minutes for 64 x 64 x 24 image reconstruction).     

Intracerebroventricular administration of neuropeptide Y to normal rats increases obese gene expression in white adipose tissue

Dose planning programs originally intended for use with symmetric fields have been adapted for use with asymmetric fields. An accurate representation of the change in primary beam quality with off-axis distance and depth is essential for accurate dose calculation and is usually represented in the computer as a primary radiation profile or primary off-center ratio (POCR). The original field edge correction (FEC) method described by Cadman [Med. Phys. 22, 457 (1995)] to determine POCRs has been extended to allow accurate POCR values to be obtained to an off-axis distance defined by the corners of the largest field, typically at an off-axis distance of 28.3 cm. This technique requires only routine symmetric field measurements including beam profiles, TMRs, and collimator and phantom scatter factors. The POCRs obtained using the FEC technique were used to generate off-center ratios (OCRs) using the boundary factor technique of Chui et al. [Med. Phys. 15, 92 (1988)]. Excellent agreement with measured values was obtained for cross-beam OCRs using a 10 x 10-cm2 field defined by a single set of asymmetric jaws with a field center offset of 15 cm and for diagonal OCRs using a 20 x 20-cm2 field with each pair of jaws in a half-blocked configuration.     

Head scatter modelling for irregular field shaping and beam intensity modulation

Scattered radiation from within the treatment head can contribute significant dose to all parts of a radiotherapy treatment field. A multileaf collimator may be used to create an arbitrarily shaped field, and may also be used, under dynamic control, to modulate the beam intensity over the field. This method of intensity modulation is effectively a superposition of a large number of fields which have the same beam direction, but different shapes, and some of these shapes may have unusually small dimensions, particularly in the direction of the leaf movement. Two models for predicting the head scatter under these conditions have been investigated. These are a first-order Compton scatter approximation from the flattening filter, and an empirical fit to measured data using an exponential function. The first model only considers scatter from the flattening filter and has been applied to field sizes between 2 cm by 2 cm and 10 cm by 10 cm, where agreements are all within 1%. However it is not satisfactory at larger field sizes where small scatter contributions, from scattering sources other than the flattening filter, are integrated over large areas. The second model uses measured data between 4 cm by 4 cm and 30 cm by 30 cm to optimize the exponential function and is used to calculate the head scatter contribution for all field sizes. In this case good agreement is achieved over the full field size range, and hence this is a more generally applicable model. Results are presented for static irregularly shaped fields and intensity modulated beams created using a Philips multileaf collimator.     

Effects of heart rate on vulnerability to fibrillation in a computer model

The SET-2400W is a newly designed whole-body PET scanner with a large axial field of view (20 cm). Its physical performance was investigated and evaluated. The scanner consists of four rings of 112 BGO detector units (22.8 mm in-plane x 50 mm axial x 30 mm depth). Each detector unit has a 6 (in-plane) x 8 (axial) matrix of BGO crystals coupled to two dual photomultiplier tubes. They are arranged in 32 rings giving 63 two-dimensional image planes. Sensitivity for a 20-cm cylindrical phantom was 6.1 kcps/kBq/ml (224 kcps/microCi/ml) in the 2D clinical mode, and to 48.6 kcps/kBq/ml (1.8 Mcps/microCi/ml) in the 3D mode after scatter correction. In-plane spatial resolution was 3.9 mm FWHM at the center of the field-of-view, and 4.4 mm FWHM tangentially, and 5.4 mm FWHM radially at 100 mm from the center. Average axial resolution was 4.5 mm FWHM at the center and 5.8 mm FWHM at a radial position 100 mm from the center. Average scatter fraction was 8% for the 2D mode and 40% for the 3D mode. The maximum count rate was 230 kcps in the 2D mode and 350 kcps in the 3D mode. Clinical images demonstrate the utility of an enlarged axial field-of-view scanner in brain study and whole-body PET imaging.     

Insertion of pea lectin into a phospholipid monolayer

Scattered radiation is one of several physical perturbations that limit the accuracy of quantitative measurements in single-photon emission computed tomography (SPECT). Improvement in detector energy resolution leads to a reduction of scatter counts and a corresponding improvement in the quantitative accuracy of the SPECT measurement. In this study, simulated SPECT projections of a simple myocardial perfusion phantom were used to investigate the effect of detector energy resolution on the data. The phantom consists of a spherical shell of radionuclide within a 15 cm radius water-filled cylinder. Each projection contains on the order of 3 x 10(5) counts. The results demonstrate that a full-width, half-maximum energy resolution of 3-4 keV is sufficient to render the error due to scatter insignificant compared to the uncertainty due to photon statistics in this case. Further simulations verify that because smaller objects produce less scatter, they can be imaged accurately with degraded energy resolution. These results are useful when designing prototype systems that utilize solid-state detectors and low-noise electronics to achieve improved energy resolution.     

Efficient scatter modelling for incorporation in maximum likelihood reconstruction

Definition of a simplified model of scatter which can be incorporated in maximum likelihood reconstruction for single-photon emission tomography (SPET) continues to be appealing; however, implementation must be efficient for it to be clinically applicable. In this paper an efficient algorithm for scatter estimation is described in which the spatial scatter distribution is implemented as a spatially invariant convolution for points of constant depth in tissue. The scatter estimate is weighted by a space-dependent build-up factor based on the measured attenuation in tissue. Monte Carlo simulation of a realistic thorax phantom was used to validate this approach. Further efficiency was introduced by estimating scatter once after a small number of iterations using the ordered subsets expectation maximisation (OSEM) reconstruction algorithm. The scatter estimate was incorporated as a constant term in subsequent iterations rather than modifying the scatter estimate each iteration. Monte Carlo simulation was used to demonstrate that the scatter estimate does not change significantly provided at least two iterations OSEM reconstruction, subset size 8, is used. Complete scatter-corrected reconstruction of 64 projections of 40?128 pixels was achieved in 38 min using a Sun Sparc20 computer.     

Calculated energy response correction factors for LiF thermoluminescent dosemeters employed in the seventh EULEP dosimetry intercomparison

Several dosimetry intercomparisons for whole body irradiation of mice have been organized by the European Late Effects Project Group (EULEP). These studies were performed employing a mouse phantom loaded with LiF thermoluminescent dosemeters (TLDs). In-phantom, the energy response of the LiF TLDs differs from free-in-air, due to spectral differences caused by attenuation and scatter of x-rays. From previous studies, energy response correction factors in-phantom relative to free-in-air were available for full scatter conditions. In the more recent intercomparisons, however, full scatter conditions were not always employed by the participants. Therefore, Monte Carlo calculations of radiation transport were performed to verify the LiF TLD energy response correction factors in-phantom relative to free-in-air for full scatter conditions and to obtain energy response correction factors for geometries where full scatter conditions are not met. For incident x-rays with HVLs in the 1 to 3.5 mm Cu range, the energy response correction factor in-phantom deviates by 2 to 4 per cent from that measured free-in-air. This is in reasonable agreement with previously published results. The energy response correction factors obtained from the present study refer to a calibration in terms of muscle tissue dose in-phantom using 60Co gamma rays. For geometries where full scatter conditions are not fulfilled, the energy response correction factors are different by up to about 3 per cent at maximum from that at full scatter conditions. The dependence of the energy response correction factor as a function of the position in-phantom is small, i.e. about 1 per cent at maximum between central and top or bottom positions.     

Characterisation of flavodoxin NADP+ oxidoreductase and flavodoxin; key components of electron transfer in Escherichia coli

The phantom scatter correction factor Sp of megavoltage photon beams can be accurately described using a three-Gaussian fit. The model leads to six parameters, with which Sp(r) is described as a smooth function of the field radius r for beam qualities in the range from 60Co up to 25 MV. The parameters allow Sp values to be calculated at intermediate beam energies and for any field shape. Calculated Sp(X, Y) values for rectangular fields (X, Y) can be subsequently used as reference values to compare with measured Sp(X, Y) values, for example when appraising a new beam.     

An equivalent square field formula for determining head scatter factors of rectangular fields

A simple formula is derived for the calculation of an equivalent square field that gives the same head scatter factor as a given rectangular field. This formula is based strictly on the configuration of a medical linear accelerator treatment head. The geometric parameters used are the distances between the target and the top of each field-defining aperture. The formula accounts for both the effect of field elongation and the collimator exchange effect. This method predicts the output to within 1% accuracy for both open and wedged fields and does not require any new measured data other than the field size dependence of head scatter for a range of square field sizes. Interestingly, the formula we derived has the same format as the formula that was empirically obtained by Vadash and Bj?rngard [Med. Phys. 20, 733-734 (1993)].     

The variation in output of symmetric, asymmetric and irregularly shaped wedged radiotherapy fields

A model for calculating the variation in output of symmetric, asymmetric and irregularly shaped wedged radiotherapy fields is presented. The variation in output from the treatment head when a wedge is used is calculated by dividing the output into a primary component and one due to scattered radiation. The scatter component is then further subdivided into contributions from elements which have a 1 cm x 1 cm cross-sectional area at the isocentre. The scatter from each element is determined as the contribution from the head scatter component modified by the presence of the wedge and a contribution due to additional scattered radiation from the wedge. The relative intensity of the scattered radiation from the wedge is modelled using a simple first scatter approximation. In this approximation the magnitude of the scatter is given by a t exp(-mu t) function where t is the thickness of the wedge for the selected element. The magnitude of the primary component and the relative intensity of scatter from each element are then obtained by an iterative fit to measured data. The technique has been applied to two different internally mounted wedge designs, for a standard treatment head, two asymmetric treatment heads and two similar multileaf collimators, over a range of energies between 4 and 20 MV. Calculations agree with measured values over a range of field sizes and shapes to within 1.5%.     

Calculation of backscatter factors for diagnostic radiology using Monte Carlo methods

Backscatter factors were determined for x-ray beams relevant to diagnostic radiology using Monte Carlo methods. The phantom size considered most suitable for calibration of dosimeters is a cuboid of 30 x 30 cm2 front surface and 15 cm depth. This phantom size also provides a good approximation to adult patients. Three different media were studied: water, PMMA and ICRU tissue; the source geometry was a point source with varying field size and source-to-phantom distance. The variations of the backscatter factor with phantom medium and field geometry were examined. From the obtained data, a set of backscatter factors was selected and proposed for adoption as a standard set for the calibration of dosimeters to be used to measure diagnostic reference doses.     

Monitor unit calculation in 6 MV irregularly shaped beams--accuracy in clinical practice

The results of an investigation of the accuracy of monitor unit (MU) calculation in clinical shaped beams are presented. Measured doses at the reference depth on the beam central axis (isocentre) or on a beam axis representative of the irradiated area (when the isocentre lies under a block or near the edges of the block's shadow) were compared with the expected doses when calculating MUs, by applying different methods normally used in clinical practice. Empirical (areas weighted, Wrede) and scatter summation (Clarkson) methods as well as a pencil-beam based algorithm were applied. 40 irregular fields (6 MV X-rays, CLinac, Varian 6/100), divided into six categories, were considered. Dose measurements were performed with a NE2571 ionization chamber in an acrylic 30 x 30 x 30 cm3 phantom. The depths in acrylic were converted into water-equivalent depths through a correction factor derived from TMR measurements. The method of dose measurements in acrylic was found to be sufficiently accurate for the purpose of this study by comparing expected and measured doses in open square and rectangular fields (mean deviation +0.2%, SD = 0.5%). Results show that all the considered methods are sufficiently reliable in calculating MUs in clinical situations. Mean deviations between measured and expected dose values are around 0 for all the methods; standard deviations range from 1% for the Wrede method to 0.75% for the pencil-beam method. The differences between expected and measured doses were within 1% for about 3/4 of the fields when calculating MUs with all the considered methods. Maximum deviations range from 1.6% (pencil-beam) to 3% (Wrede). Slight differences among the methods of MU calculation were revealed within the different categories of blocked fields analysed. The surprising agreement between measured and expected dose values obtained by using empirical methods (area weighted and Wrede) is probably due to the fact that the reference points were positioned in a "central" region of the unblocked areas.     

Energy-based scatter corrections for scintillation camera images of iodine-131

The use of high-dose 131I antibody therapy requires accurate measurement of normal tissue uptake to optimize the therapeutic dose. One of the factors limiting the accuracy of such measurements is scatter and collimator septal penetration. This study evaluated two classes of energy-based scatter corrections for quantitative 131I imaging: window-based and spectrum-fitting. METHODS: The window-based approaches estimate scatter from data in two or three energy windows placed on either side of the 364-keV photopeak using empirical weighting factors. A set of images from spheres in an elliptical phantom were used to evaluate each of the window-based corrections. The spectrum-fitting technique estimates detected scatter at each pixel by fitting the observed energy spectrum with a function that models the photopeak and scatter, and which incorporates the response function of the camera. This technique was evaluated using a set of Rollo phantom images. RESULTS: All of the window-based methods performed significantly better than a single photopeak window (338-389 keV), but the weighting factors were found to depend on the object being imaged. For images contaminated with scatter, the spectrum-fitting method significantly improved quantitation over photopeak windowing. Little difference, however, between any of the methods was observed for images containing small amounts of scatter. CONCLUSION: Most clinical 131I imaging protocols will benefit from qualitative and quantitative improvements provided by the spectrum-fitting scatter correction. The technique offers the practical advantage that it does not require phantom-based calibrations. Finally, our results suggest that septal penetration and scatter in the collimator and other detector-head components are important sources of error in quantitative 131I images.     

Microdosimetric analysis of radiation from a clinical mammography machine using realistic breast phantoms and a miniature proportional counter

We have measured the microdosimetric spectra of a Senographe 600T mammography machine employing an Mo target with 0.8 mm Be inherent filtration and 0.03 mm Mo added filtration, giving a half-value layer of 0.35 mm A1 at 28 kVp. In all of our measurements a large collimator producing a 24 cm x 30 cm field at 65 cm was used. Two different phantom compositions differing in the ratio of adipose to fibroglandular tissue were compared, using simulated breast material from Nuclear Associates. Spectra were taken at various depths and locations in simulated breasts of 3.4 and 5 cm thickness. The detector used was a miniature proportional counter having outer dimensions of 5 cm x 1.8 cm diameter, with a sensitive volume 0.5 mm x 0.5 mm. The small dimensions of the counter and the cavity allowed total embedding in the breast material with minimal disturbance of the photon and secondary electron spectrum. Our results show that there can be changes in the radiation quality amounting to as much as 17% (as measured by the dose mean lineal energy. yD) between breasts of different thickness, at the same relative position within the breast. There is little difference due to breast composition.     

Monte Carlo calculation of single-beam dose profiles used in a gamma knife treatment planning system

The accuracy of single-beam dose profiles used in the algorithm of the Gamma Knife treatment planning system (Leksell GammaPlan) is verified. EGS4 Monte Carlo calculation was employed to calculate the dose distributions of single-beams in a spherical water phantom with diameter 160 mm. The beams were directed to the center of the phantom. Collimators of 4, 8, 14, and 18 mm sizes were studied. The single-beam dose profiles provided by Elekta (Manufacturer of Leksell Gamma Knife) were excellently consistent with the results of Monte Carlo for the 4, 14, and 18 mm collimators. The maximum discrepancy was less than 3% at all radial distances. For the 8 mm collimator, the maximum discrepancy was 8% in the relative dose in the radial distance range from 4.3 mm to 5.2 mm. Excellent agreement in dose profiles along x, y, and z axes for all collimator helmets by summing over all 201 sources was observed between the cases using the default single-beam dose profiles and the calculated Monte Carlo results, except for the 8 mm collimator helmet along z axis. Such difference may however be too small to give a clinical significance.