bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improvement in CT image resolution due to the use of focal spot deflection and increased sampling
Authors: Rubert Nicholas , Szczykutowicz Timothy , Ranallo Frank 
Published: February 2017

When patient anatomy is positioned away from a CT scanner's isocenter, scans of limited diagnostic value may result. Yet in some cases, positioning of patient anatomy far from isocenter is unavoidable. This study examines the effect of position and reconstruction algorithm on image resolution achieved by a CT scanner operating in a high resolution (HR) scan mode which incorporates focal spot deflection and acquires an increased number of projections per rotation. Images of a metal bead contained in a phantom were acquired on a GE CT750 HD scanner with multiple reconstruction algorithms, in the normal and HR scan mode, and at two positions, scanner isocenter and 15 cm directly above isocenter. The images of the metal bead yielded two‐dimensional point spread functions which were averaged along two perpendicular directions to yield line spread functions. Fourier transforms of the line spread functions yielded radial and azimuthal modulation transfer functions (MTFs). At isocenter, the radial and azimuthal MTFs were averaged. MTF improvement depended on image position and modulation direction. The results from a single algorithm, Edge, can be generalized to other algorithms. At isocenter, the 10% MTF cutoff was 14.4 cycles/cm in normal and HR mode. At 15 cm above isocenter, the 10% cutoff was 6.0 and 8.5 cycles/cm for the azimuthal and radial MTFs in normal mode. In HR mode, the azimuthal and radial MTF 10% cutoff was 8.3 and 10.3 cycles/cm. Our results indicate that the best image resolution is achieved at scanner isocenter and that the azimuthal resolution degrades more significantly than the radial resolution. For the GE CT750 HD CT scanner, the resolution is significantly enhanced by the HR scan mode away from scanner isocenter, and the use of the HR scan mode has much more of an impact on image resolution away from isocenter than the choice of algorithm.PACS number(s): 87.57.Q‐
One‐year analysis of Elekta CBCT image quality using NPS and MTF
Authors: Nakahara Satomi , Tachibana Masayuki , Watanabe Yoichi 
Published: February 2017

The image quality (IQ) of imaging systems must be sufficiently high for image‐guided radiation therapy (IGRT). Hence, users should implement a quality assurance program to maintain IQ. In our routine IQ tests of the kV cone‐beam CT system (Elekta XVI), image noise was quantified by noise standard deviation (NSD), which was the standard deviation of CT numbers measured in a small area in an image of an IQ test phantom (Catphan), and the high spatial resolution (HSR) was evaluated by the number of line‐pairs (LPN) visually recognizable in the image. We also measured the image uniformity, the low contrast resolution, and the distances of two points for geometrical accuracy. For this study, we did an additional evaluation of the XVI data for 12 monthly IQ tests by using noise power spectrum (NPS) for noise, modulation transfer function (MTF) for HSR, and CT number‐to‐density relationship. NPS was obtained by applying Fourier analysis in a small area on the uniformity test section of Catphan. The MTF analysis was performed by applying the Droege‐Morin (D‐M) method to the line‐pair bar regions in the phantom. The CT number‐to‐density relationship was obtained for insert materials in the low‐contrast test section of the phantom. All the quantities showed a noticeable change over the one‐year period. Especially the noise level improved significantly after a repair of the imager. NPS was more sensitive to the IQ change than NSD. MTF could provide more quantitative and objective evaluation of HSR. The CT number was very different from the expected CT number, but the CT number‐to‐density curves were constant within 5% except for two months. Since the D‐M method is easy to implement, we recommend using MTF instead of LPN even for routine QA. The IQ of the imaging systems was constantly changing; hence, IQ tests should be periodically performed. Additionally, we found the importance of IQ tests after every service work, including detector calibration as well as preventive maintenance.PACS number(s): 87.56Da, 87.57.C‐, 87.57.N‐, 8757.Q‐
MR image‐based synthetic CT for IMRT prostate treatment planning and CBCT image‐guided localization
Authors: Chen Shupeng , Quan Hong , Qin An , Yee Seonghwan , Yan Di 
Published: February 2017

The purpose of this study was to propose and evaluate a method of creating a synthetic CT (S‐CT) from MRI simulation for dose calculation and daily CBCT localization. A pair of MR and CT images was obtained in the same day from each of 10 prostate patients. The pair of MR and CT images was preregistered using the deformable image registration (DIR). Using the corresponding displacement vector field (atlas‐DVF), the CT image was deformed to the MR image to create an atlas MR‐CT pair. Regions of interest (ROI) on the atlas MR‐CT pair were delineated and used to create atlas‐ROI masks. ‘Leave‐one‐out’ test (one pair of MR and CT was used as subject‐MR and subject‐CT for evaluation, and the remaining 9 pairs were in the atlas library) was performed. For a subject‐MR, autosegmentation and DVFs were generated using DIR between the subject‐MR and the 9 atlas‐MRs. An S‐CT was then generated using the corresponding 9 paired atlas‐CTs, the 9 atlas‐DVFs and the corresponding atlas‐ROI masks. The total 10 S‐CTs were evaluated using the Hounsfield unit (HU), the calculated dose distribution, and the auto bony registration to daily CBCT images with respect to the 10 subject‐CTs. HU differences were , , , , and for prostate, bladder, rectal wall, soft tissue outside all ROIs, and bone, respectively. The discrepancy of dose‐volume parameters calculated using the S‐CT for treatment planning was small ( with 95% confidence). Gamma pass rate (2% & 2 mm) was higher than 99.86% inside PTV and 98.45% inside normal structures. Using the 10 S‐CTs as the reference CT for daily CBCT localization achieved the similar results compared to using the subject‐CT. The translational vector differences were within 1.08 mm , and the rotational differences were within 1.1° in all three directions. S‐CT created from a simulation MR image using the proposed approach with the preconstructed atlas library can replace the planning CT for dose calculation and daily CBCT image guidance.PACS number(s): 87.57.nf, 87.57.nm
EPID based in vivo dosimetry system: clinical experience and results
Authors: Celi Sofia , Costa Emilie , Wessels Claas , Mazal Alejandro , Fourquet Alain , Francois Pascal 
Published: February 2017

Mandatory in several countries, in vivo dosimetry has been recognized as one of the next milestones in radiation oncology. Our department has implemented clinically an EPID based in vivo dosimetry system, EPIgray, by DOSISOFT S.A., since 2006. An analysis of the measurements per linac and energy over a two‐year period was performed, which included a more detailed examination per technique and treatment site over a six‐month period. A comparison of the treatment planning system doses and the doses estimated by EPIgray shows a mean of the differences of 1.9% () for the two‐year period. The 3D conformal treatment plans had a mean dose difference of 2.0% (), while for intensity‐modulated radiotherapy and volumetric‐modulated arc therapy treatments the mean dose difference was () and (), respectively. In addition, root cause analyses were conducted on the in vivo dosimetry measurements of two breast cancer treatment techniques, as well as prostate treatments with intensity‐modulated radiotherapy and volumetric‐modulated arc therapy. During the breast study, the dose differences of breast treatments in supine position were correlated to patient setup and EPID positioning errors. Based on these observations, an automatic image shift correction algorithm is developed by DOSIsoft S.A. The prostate study revealed that beams and arcs with out‐of‐tolerance in vivo dosimetry results tend to have more complex modulation and a lower exposure of the points of interest. The statistical studies indicate that in vivo dosimetry with EPIgray has been successfully implemented for classical and complex techniques in clinical routine at our institution. The additional breast and prostate studies exhibit the prospects of EPIgray as an easy supplementary quality assurance tool. The validation, the automatization, and the reduction of false‐positive results represent an important step toward adaptive radiotherapy with EPIgray.PACS number(s): 87.53.Bn, 87.55.Qr, 87.56.Fc, 87.57.uq
Comparison of manual and automatic MR‐CT registration for radiotherapy of prostate cancer
Authors: Korsager Anne Sofie , Carl Jesper , Østergaard Lasse Riis 
Published: February 2017

In image‐guided radiotherapy (IGRT) of prostate cancer, delineation of the clinical target volume (CTV) often relies on magnetic resonance (MR) because of its good soft‐tissue visualization. Registration of MR and computed tomography (CT) is required in order to add this accurate delineation to the dose planning CT. An automatic approach for local MR‐CT registration of the prostate has previously been developed using a voxel property‐based registration as an alternative to a manual landmark‐based registration. The aim of this study is to compare the two registration approaches and to investigate the clinical potential for replacing the manual registration with the automatic registration. Registrations and analysis were performed for 30 prostate cancer patients treated with IGRT using a Ni‐Ti prostate stent as a fiducial marker. The comparison included computing translational and rotational differences between the approaches, visual inspection, and computing the overlap of the CTV. The computed mean translational difference was 1.65, 1.60, and 1.80 mm and the computed mean rotational difference was 1.51°, 3.93°, and 2.09° in the superior/inferior, anterior/posterior, and medial/lateral direction, respectively. The sensitivity of overlap was 87%. The results demonstrate that the automatic registration approach performs registrations comparable to the manual registration.PACS number(s): 87.57.nj, 87.61.‐c, 87.57.Q‐, 87.56.J‐
Dosimetric properties of equivalent‐quality flattening filter‐free (FFF) and flattened photon beams of Versa HD linear accelerator
Authors: Meshram Mukesh N. , Pramanik Srimanta , Ranjith C.P. , Gopal Saravana K. , Dobhal Rishabh 
Published: February 2017

This study presents the basic dosimetric properties of photon beams of a Versa HD linear accelerator (linac), which is capable of delivering flattening filter‐free (FFF) beams with a beam quality equivalent to the corresponding flattened beams based on comprehensive beam data measurement. The analyzed data included the PDDs, profiles, penumbra, out‐of‐field doses, surface doses, output factors, head and phantom scatter factors, and MLC transmissions for both FFF and flattened beams of 6 MV and 10 MV energy from an Elekta Versa HD linac. The 6MVFFF and 10MVFFF beams had an equivalent mean energy to the flattened beams and showed less PDD variations with the field sizes. Compared with their corresponding flattened beams, was deeper for FFF beams for all field sizes; the ionization ratio variations with the field size were lower for FFF beams; the out‐of‐field doses were lower and the penumbras were sharper for the FFF beams; the off‐axis profile variations with the depths were lesser for the FFF beams. Further, the 6MVFFF and 10MVFFF beams had 35.7% and 40.9% less variations in output factor with the field size, respectively. The collimator exchange effect was reduced in the FFF mode. The head scatter factor showed 59.1% and 73.6% less variations, on average, for the 6MVFFF and 10MVFFF beams, respectively; the variations in the phantom scatter factor were also smaller. The surface doses for all beams increased linearly with the field size. The 6MVFFF and 10MVFFF beams had higher surface doses than the corresponding flattened beams for field sizes of up to but had lower surface doses for larger fields. Both FFF beams had lower average MLC transmissions than the flattened beams. The finding that the FFF beams were of equivalent quality to the corresponding flattened beams indicates a significant difference from the data on unmatched FFF beams.PACS number(s): 87.56.bd, 87.55.Qr
Physically constrained voxel‐based penalty adaptation for ultra‐fast IMRT planning
Authors: Wahl Niklas , Bangert Mark , Kamerling Cornelis P. , Ziegenhein Peter , Bol Gijsbert H. , Raaymakers Bas W. , Oelfke Uwe 
Published: February 2017

Conventional treatment planning in intensity‐modulated radiation therapy (IMRT) is a trial‐and‐error process that usually involves tedious tweaking of optimization parameters. Here, we present an algorithm that automates part of this process, in particular the adaptation of voxel‐based penalties within normal tissue. Thereby, the proposed algorithm explicitly considers a priori known physical limitations of photon irradiation. The efficacy of the developed algorithm is assessed during treatment planning studies comprising 16 prostate and 5 head and neck cases. We study the eradication of hot spots in the normal tissue, effects on target coverage and target conformity, as well as selected dose volume points for organs at risk. The potential of the proposed method to generate class solutions for the two indications is investigated. Run‐times of the algorithms are reported. Physically constrained voxel‐based penalty adaptation is an adequate means to automatically detect and eradicate hot‐spots during IMRT planning while maintaining target coverage and conformity. Negative effects on organs at risk are comparably small and restricted to lower doses. Using physically constrained voxel‐based penalty adaptation, it was possible to improve the generation of class solutions for both indications. Considering the reported run‐times of less than 20 s, physically constrained voxel‐based penalty adaptation has the potential to reduce the clinical workload during planning and automated treatment plan generation in the long run, facilitating adaptive radiation treatments.PACS number(s): 87.55.de
Monte Carlo calculations and experimental measurements of the TG‐43U1‐recommended dosimetric parameters of 125I (Model IR‐Seed2) brachytherapy source
Authors: Sheikholeslami Sahar , Nedaie Hassan Ali , Sadeghi Mahdi , Pourbeigy Hosein , Shahzadi Sohrab , Zehtabian Mehdi , Hasani Mohsen , Meigooni Ali S. 
Published: February 2017

A new design of (Model IR‐Seed2) brachytherapy source has been manufactured recently at the Applied Radiation Research School, Nuclear Science and Technology Research Institute in Iran. The source consists of six resin beads (0.5 mm diameter) that are sealed in a cylindrical titanium capsule of 0.7 mm internal and 0.8 mm external diameters. This work aims to evaluate the dosimetric parameters of the newly designed source using experimental measurements and Monte Carlo (MC) simulations. Dosimetric characteristics (dose rate constant, radial dose function, and 2D and 1D anisotropy functions) of the IR‐Seed2 were determined using experimental measurements and MC simulations following the recommendations by the Task Group 43 (TG‐43U1) report of the American Association of Physicists in Medicine (AAPM). MC simulations were performed using the MCNP5 code in water and Plexiglas, and experimental measurements were carried out using thermoluminescent dosimeters (TLD‐GR207A) in Plexiglas phantoms. The measured dose to water in Plexiglas data were used for verification of the accuracy of the source and phantom geometry in the Monte Carlo simulations. The final MC simulated data to water in water were recommended for clinical applications. The MC calculated dose rate constant (Λ) of the IR‐Seed2 seed in water was found to be . Additionally, its radial dose function by line and point source approximations, and , calculated for distances from 0.1 cm to 7 cm. The values of at radial distances from 0.5 cm to 5 cm were measured in a Plexiglas phantom to be between 1.212 and 0.413. The calculated and measured of values for 2D anisotropy function, , were obtained for the radial distances ranging from 1.5 cm to 5 cm and angular range of 0°‐90° in a Plexiglas phantom. Also, the 2D anisotropy function was calculated in water for the clinical application. The results of these investigations show that the uncertainty of the experimental data is within between the measured and simulated data in Plexiglas. Based on these results, the MC‐simulated dosimetric parameters of the new source model in water are presented for its clinical applications in brachytherapy treatments.PACS number(s): 87.56.bg
Development of a Monte Carlo model for treatment planning dose verification of the Leksell Gamma Knife Perfexion radiosurgery system
Authors: Yuan Jiankui , Lo Simon S. , Zheng Yiran , Sohn Jason W. , Sloan Andrew E. , Ellis Rodney , Machtay Mitchell , Wessels Barry 
Published: February 2017

Detailed Monte Carlo (MC) modeling of the Leksell Gamma Knife (GK) Perfexion (PFX) collimator system is the only accurate ab initio approach appearing in the literature. As a different approach, in this work, we present a MC model based on film measurement. By adjusting the model parameters and fine‐tuning the derived fluence map for each individual source to match the manufacturer's ring output factors, we created a reasonable virtual source model for MC simulations to verify treatment planning dose for the GK PFX radiosurgery system. The MC simulation model was commissioned by simple single shots. Dose profiles and both ring and collimator output factors were compared with the treatment planning system (TPS). Good agreement was achieved for dose profiles especially for the region of plateau (), while larger difference () came from the penumbra region. The maximum difference of the calculated output factor was within 0.7%. The model was further validated by a clinical test case. Good agreement was obtained. The DVHs for brainstem and the skull were almost identical and, for the target, the volume covered by the prescription (12.5 Gy to 50% isodose line) was 95.6% from MC calculation versus 100% from the TPS.PACS number(s): 87.55.dk
Out‐of‐field doses and neutron dose equivalents for electron beams from modern Varian and Elekta linear accelerators
Authors: Cardenas Carlos E. , Nitsch Paige L. , Kudchadker Rajat J. , Howell Rebecca M. , Kry Stephen F. 
Published: February 2017

Out‐of‐field doses from radiotherapy can cause harmful side effects or eventually lead to secondary cancers. Scattered doses outside the applicator field, neutron source strength values, and neutron dose equivalents have not been broadly investigated for high‐energy electron beams. To better understand the extent of these exposures, we measured out‐of‐field dose characteristics of electron applicators for high‐energy electron beams on two Varian 21iXs, a Varian TrueBeam, and an Elekta Versa HD operating at various energy levels. Out‐of‐field dose profiles and percent depth‐dose curves were measured in a Wellhofer water phantom using a Farmer ion chamber. Neutron dose was assessed using a combination of moderator buckets and gold activation foils placed on the treatment couch at various locations in the patient plane on both the Varian 21iX and Elekta Versa HD linear accelerators. Our findings showed that out‐of‐field electron doses were highest for the highest electron energies. These doses typically decreased with increasing distance from the field edge but showed substantial increases over some distance ranges. The Elekta linear accelerator had higher electron out‐of‐field doses than the Varian units examined, and the Elekta dose profiles exhibited a second dose peak about 20 to 30 cm from central‐axis, which was found to be higher than typical out‐of‐field doses from photon beams. Electron doses decreased sharply with depth before becoming nearly constant; the dose was found to decrease to a depth of approximately E(MeV)/4 in cm. With respect to neutron dosimetry, Q values and neutron dose equivalents increased with electron beam energy. Neutron contamination from electron beams was found to be much lower than that from photon beams. Even though the neutron dose equivalent for electron beams represented a small portion of neutron doses observed under photon beams, neutron doses from electron beams may need to be considered for special cases.PACS number(s): 87.55.N‐, 87.55.ne, 87.56.bd, 87.56.jf
A cross‐sectional study of the radiation dose and image quality of X‐ray equipment used in IVR
Authors: Inaba Yohei , Chida Koichi , Kobayashi Ryota , Zuguchi Masayuki 
Published: February 2017

There are case reports of injuries caused by the radiation from interventional radiology (IVR) X‐ray systems. Therefore, the management of radiation doses in IVR is important. However, no detailed report has evaluated image quality for a large number of IVR X‐ray systems. As a result, it is unclear whether the image quality of the X‐ray equipment currently used in IVR procedures is optimal. We compared the entrance surface doses and image quality of multiple IVR X‐ray systems. This study was conducted in 2014 at 13 medical facilities using 18 IVR X‐ray systems. We evaluated image quality and simultaneously measured the radiation dose. Entrance surface doses for fluoroscopy (duration, 1 min) and cineradiography (duration, 10 s) are measured using a 20‐cm‐thick acrylic plate and skin dose monitor. The image quality (such as spatial resolution and low‐contrast detectability) of both fluoroscopy and cineradiography was evaluated using a QC phantom. For fluoroscopy, the average entrance surface dose using the 20‐cm‐thick acrylic plate was 13.9 (range 2.1–28.2) mGy/min. For cineradiography, the average entrance surface dose was 24.6 (range 5.1–49.3) mGy/10 s. We found positive correlations between radiation doses and image quality scores, in general, especially for fluoroscopy. The differences in surface dose among the 18 IVR X‐ray systems were high (max/min, 9.7‐fold for cineradiography; 13.4‐fold for fluoroscopy). The differences in image quality scores (spatial resolution, low‐contrast detectability, and dynamic range) were also very large. In general, there tended to be a correlation between radiation dose and image quality. Periodical measurements of the radiation dose and image quality of the X‐ray equipment used for cineradiography and fluoroscopy in IVR are necessary. The need to minimize patient exposure requires that the dose be reduced to the minimum level that will generate an image with an acceptable degree of noise.PACS number(s): 87.57.C, 87.57.uq, 87.59.B, 87.59.bf, 87.59.C, 87.59.cf, 87.59.Dj
Characterization and evaluation of 2.5 MV electronic portal imaging for accurate localization of intra‐ and extracranial stereotactic radiosurgery
Authors: Song Kwang Hyun , Snyder Karen Chin , Kim Jinkoo , Li Haisen , Ning Wen , Rusnac Robert , Jackson Paul , Gordon James , Siddiqui Salim M. , Chetty Indrin J. 
Published: February 2017

2.5 MV electronic portal imaging, available on Varian TrueBeam machines, was characterized using various phantoms in this study. Its low‐contrast detectability, spatial resolution, and contrast‐to‐noise ratio (CNR) were compared with those of conventional 6 MV and kV planar imaging. Scatter effect in large patient body was simulated by adding solid water slabs along the beam path. The 2.5 MV imaging mode was also evaluated using clinically acquired images from 24 patients for the sites of brain, head and neck, lung, and abdomen. With respect to 6 MV, the 2.5 MV achieved higher contrast and preserved sharpness on bony structures with only half of the imaging dose. The quality of 2.5 MV imaging was comparable to that of kV imaging when the lateral separation of patient was greater than 38 cm, while the kV image quality degraded rapidly as patient separation increased. Based on the results of patient images, 2.5 MV imaging was better for cranial and extracranial SRS than the 6 MV imaging.PACS number(s): 87.57.C