Estimated size of the clinical medical imaging physics workforce in the United States.

There is no current authoritative accounting of the number of clinical imaging physicists practicing in the United States. Information about the workforce is needed to inform future efforts to secure training pathways and opportunities. In this study, the AAPM Diagnostic Demand and Supply Projection Working Group collected lists of medical physicists from several state registration and licensure programs and the Conference of Radiation Control Program Directors (CRCPD) registry. By cross-referencing individuals among these lists, we were able to estimate the current imaging physics workforce in the United States by extrapolating based on population. The imaging physics workforce in the United States in 2019 consisted of approximately 1794 physicists supporting diagnostic X-ray (1073 board-certified) and 934 physicists supporting nuclear medicine (460 board-certified), with a number of individuals practicing in both subfields. There were an estimated 235 physicists supporting nuclear medicine exclusively (150 board-certified). The estimated total workforce, accounting for overlap, was 2029 medical physicists. These estimates are in approximate agreement with other published studies of segments of the workforce.

Lower limit of iron quantification using dual-energy CT - a phantom study.

PURPOSE: Dual-energy computed tomography (DECT) has been proposed for quantification of hepatic iron concentration (IC). However, the lower limit of quantification (LLOQ) has not been established, limiting the clinical adoption of this technology. In this study, we aim to (a) establish the LLOQ using phantoms and (b) investigate the effects of patient size, dose level, energy combination, and reconstruction method. METHODS: Three phantom sizes and eight vials of ferric nitrate solution with IC ranging from 0 to 10 mg/ml were used. DECT scans were performed at 80/140 and 100/140Sn kVp, and using five different levels of CT dose index (CTDI). An image-domain three-material-decomposition algorithm was used to calculate the IC. The LLOQ was determined based on the coefficient of variation from repeated measurements. RESULTS: The measured IC correlated strongly with the true IC in the small and medium phantoms (R2 of linear regression > 0.99) and moderately in the large phantom (0.8 < R2 <0.9). The LLOQ improved with increased CTDI. At 30 mGy, the LLOQ was found to be 0.50/1.73/6.25 mg/ml in the small/medium/large phantoms, respectively. 80/140Sn kVp resulted in superior LLOQ for all phantom sizes compared to 100/140Sn kVp, primarily due to the difference in their iron enhancement ratios (1.94 and 1.55, respectively). Iterative reconstruction was found to further improve the LLOQ (by ~ 11%), whereas reconstruction kernel smoothness had negligible effect. The LLOQ of iron was significantly higher than that of iodine due to its lack of a useful k-edge and lower enhancement ratio. CONCLUSION: Iron quantification at clinically important levels was achieved in a small- and a medium-sized phantom using DECT, but proved challenging in a large phantom. Wide spectral separation and accurate calibration were found to be critical to the success of the technology.

Three-Dimensional Printing for Construction of Tissue-Equivalent Anthropomorphic Phantoms and Determination of Conceptus Dose.

OBJECTIVE: The purpose of this study was to develop a road map for rapid construction of anthropomorphic phantoms from computational human phantoms for use in diagnostic imaging dosimetry studies. These phantoms are ideal for performing pregnant-patient dosimetry because the phantoms imitate the size and attenuation properties of an average-sized pregnant woman for multiple gestational periods. MATERIALS AND METHODS: The method was derived from methods and materials previously described but adapted for 3D printing technology. A 3D printer was used to transform computational models into a physical duplicate with small losses in spatial accuracy and to generate tissue-equivalent materials characterized for diagnostic energy x-rays. A series of pregnant abdomens were selected as prototypes because of their large size and complex modeling. The process involved the following steps: segmentation of anatomy used for modeling; transformation of the computational model into a printing file format; preparation, characterization, and introduction of phantom materials; and model removal and phantom assembly. RESULTS: The density of the homogenized soft tissue-equivalent substitute was optimized by combining 9.0% by weight of urethane filler powder and 91.0% urethane polymer, which resulted in a mean density of 1.041 g/cm3 measured over 20 samples. Density varied among all of the samples by 0.0026 g/cm3. The total variation in density was 0.00261 g/cm3. The half-value layer of the bone material was measured to be 1.7 mm of bone material at 120 kVp and when simulated by use of the density of the bone tissue-equivalent substitute (1.60 g/cm3) was determined to be 1.61 mm of bone tissue. For dosimetry purposes the phantom provided excellent results for evaluating a site's protocol based on scan range. CONCLUSION: The 3D printing technology is applicable to the fabrication of phantoms used for performing dosimetry. The tissue-equivalent materials used to substitute for the soft tissue were developed to be highly adaptable for optimization based on the dosimetry application. Use of this method resulted in more automated phantom construction with decreased construction time and increased out-of-slice spatial resolution of the phantoms.

Shielding a high-sensitivity digital detector from electromagnetic interference.

PURPOSE: To document a study in shielding a high-sensitivity digital mammography system detector from AC magnetic fields of magnitudes great enough to induce imaging artifacts. METHODS/MATERIALS: Preliminary evaluation of AC magnetic fields at a site designated for a digital breast tomosynthesis (DBT) system raised concerns that the magnetic component of electromagnetic interference (EMI) may be great enough to induce imaging artifacts. Subsequent measurements using digital detector arrays from two separate manufacturers verified this concern, and AC magnetic fields were mapped, spatially and temporally, throughout the area of concern. A simple shielding model was developed to elucidate the physics of extremely low-frequency (ELF) EMI shielding and independently verify a commercial group's proposed shielding design and installation. Postshielding measurements were performed to demonstrate that the EMI fields were reduced to acceptable levels. RESULTS: Preshielding measurements showed AC magnetic fields significantly exceeding manufacturers' tolerances for artifact-free imaging in DBT. Continuous measurements demonstrated that the EMI fields varied significantly over time. Some locations in the room routinely averaged above 30 mG and occasionally exceeded 100 mG. The source was attributed to an adjacent electrical supply room, and temporal changes of the EMI were attributed to variations of the building electrical loads. The proposed shielding primarily consisted of continuous aluminum (6.35 mm thickness) and was installed by a group specializing in electromagnetic field shielding. Postshielding measurements demonstrated that the EMI fields were significantly reduced, generally to less than 0.5 mG, and that the shielding effectively dampened the large variations due to dynamic building electrical loads. Subsequent installation and evaluation of a DBT system revealed no issues with imaging artifacts. CONCLUSIONS: The successful shielding of ELF EMI involves physical principles that are not commonly encountered by medical physicists. Modern high-sensitivity digital detectors may be successfully shielded against imaging artifacts with careful application of these principles.

Super-size me: adipose tissue-equivalent additions for anthropomorphic phantoms.

Physical anthropomorphic phantoms have been utilized for a variety of dosimet- ric studies across a range of procedures utilizing diagnostic imaging equipment. Unfortunately, these phantoms are often limited to a single reference size, which often may not be representative of the patient population at large. This work set out to develop an adipose tissue-equivalent substitute material that could be used to create low cost physical additions for existing anthropomorphic phantoms. Using commercially available products, a methodology was developed to accomplish this, and an addition was built to create a 90th percentile by weight phantom from an existing 50th percentile model. This methodology can easily be used to expand the utility of existing anthropomorphic phantoms in order to better represent patients of various body morphologies, and investigate the effects of patient size in diagnostic procedures. 

A methodology for direct quantification of over-ranging length in helical computed tomography with real-time dosimetry.

In helical computed tomography (CT), reconstruction information from volumes adjacent to the clinical volume of interest (VOI) is required for proper reconstruction. Previous studies have relied upon either operator console readings or indirect extrapolation of measurements in order to determine the over-ranging length of a scan. This paper presents a methodology for the direct quantification of over-ranging dose contributions using real-time dosimetry. A Siemens SOMATOM Sensation 16 multislice helical CT scanner is used with a novel real-time "point" fiber-optic dosimeter system with 10 ms temporal resolution to measure over-ranging length, which is also expressed in dose-length-product (DLP). Film was used to benchmark the exact length of over-ranging. Over-ranging length varied from 4.38 cm at pitch of 0.5 to 6.72 cm at a pitch of 1.5, which corresponds to DLP of 131 to 202 mGy-cm. The dose-extrapolation method of Van der Molen et al. yielded results within 3%, while the console reading method of Tzedakis et al. yielded consistently larger over-ranging lengths. From film measurements, it was determined that Tzedakis et al. overestimated over-ranging lengths by one-half of beam collimation width. Over-ranging length measured as a function of reconstruction slice thicknesses produced two linear regions similar to previous publications. Over-ranging is quantified with both absolute length and DLP, which contributes about 60 mGy-cm or about 10% of DLP for a routine abdominal scan. This paper presents a direct physical measurement of over-ranging length within 10% of previous methodologies. Current uncertainties are less than 1%, in comparison with 5% in other methodologies. Clinical implantation can be increased by using only one dosimeter if codependence with console readings is acceptable, with an uncertainty of 1.1% This methodology will be applied to different vendors, models, and postprocessing methods--which have been shown to produce over-ranging lengths differing by 125%.

Effects of Patient Size and Radiation Dose on Iodine Quantification in Dual-Source Dual-Energy CT.

RATIONALE AND OBJECTIVES: The purpose of this study was to investigate the potential effects of patient size and radiation dose on the accuracy of iodine quantification using dual-source dual-energy computed tomography (CT). MATERIALS AND METHODS: Three phantoms representing different patient sizes were constructed, containing iodine inserts with concentrations from 0 to 20 mg/ml. Dual-energy CT scans were performed at six dose levels from 2 to 30 mGy. Iodine concentrations were measured using a three-material-decomposition algorithm and their accuracy was assessed. RESULTS: In a small phantom, iodine quantification was accurate and consistent at all dose levels. In a medium phantom, minor underestimations were observed, and the results were consistent except at low dose. In the large phantom, more significant underestimation of iodine concentration was observed at higher doses (≥15 mGy), which was attributed to the beam-hardening effect. At lower doses, increasing upward bias was observed in the CT number, leading to significant overestimations of both iodine concentration and fat fraction, which was attributed to the photon-starvation effect. The severity of the latter effect was determined by mA instead of mAs, suggesting that the electronic noise, rather than the quantum noise, was responsible for the bias. Using higher kVp for the low-energy tube was found to alleviate these effects. CONCLUSION: Reliable iodine quantification can be achieved using dual-source CT, but the result can be affected by patient size and dose rate. In large patients, biases may occur due to the beam-hardening and the photon-starvation effects, in which case higher dose rate and higher kVp are recommended to minimize these effects.

Estimation of organ doses from kilovoltage cone-beam CT imaging used during radiotherapy patient position verification.

PURPOSE: The purpose of this study was to develop a practical method for estimating organ doses from kilovoltage cone-beam CT (CBCT) that can be performed with readily available phantoms and dosimeters. The accuracy of organ dose estimates made using the ImPACT patient dose calculator was also evaluated. METHODS: A 100 mm pencil chamber and standard CT dose index (CTDI) phantoms were used to measure the cone-beam dose index (CBDI). A weighted CBDI (CBDI(W)) was then calculated from these measurements to represent the average volumetric dose in the CTDI phantom. By comparing CBDI(W) to the previously published organ doses, organ dose conversion coefficients were developed. The measured CBDI values were also used as inputs for the ImPACT calculator to estimate organ doses. All CBDI dose measurements were performed on both the Elekta XVI and Varian OBI at three clinically relevant locations: Head, chest, and pelvis. RESULTS: The head, chest, and pelvis protocols yielded CBDI(W) values of 0.98, 16.62, and 24.13 mGy for the XVI system and 5.17, 6.14, and 21.57 mGy for the OBI system, respectively. Organ doses estimated with the ImPACT CT dose calculator showed a large range of variation from the previously measured organ doses, demonstrating its limitations for use with CBCT. CONCLUSIONS: The organ dose conversion coefficients developed in this work relate CBDI(W) values to organ doses previously measured using the same clinical protocols. Ultimately, these coefficients will allow for the quick estimation of organ doses from routine measurements performed using standard CTDI phantoms and pencil chambers.

An organ and effective dose study of XVI and OBI cone-beam CT systems.

The main purpose of this work was to quantify patient organ doses from the two kilovoltage cone beam computed tomography (CBCT) systems currently available on medical linear accelerators, namely the X-ray Volumetric Imager (XVI, Elekta Oncology Systems) and the On-Board Imager (OBI, Varian Medical Systems). Organ dose measurements were performed using a fiber-optic coupled (FOC) dosimetry system along with an adult male anthropomorphic phantom for three different clinically relevant scan sites: head, chest, and pelvis. The FOC dosimeter was previously characterized at diagnostic energies by Hyer et al. [Med Phys 2009;36(5):1711-16] and a total uncertainty of approximately 4% was found for in-phantom dose measurements. All scans were performed using current manufacturer-installed clinical protocols and appropriate bow-tie filters. A comparison of image quality between these manufacturer-installed protocols was also performed using a Catphan 440 image quality phantom. Results indicated that for the XVI, the dose to the lens of the eye (1.07 mGy) was highest in a head scan, thyroid dose (19.24 mGy) was highest in a chest scan, and gonad dose (29 mGy) was highest in a pelvis scan. For the OBI, brain dose (3.01 mGy) was highest in a head scan, breast dose (5.34 mGy) was highest in a chest scan, and gonad dose (34.61 mGy) was highest in a pelvis scan. Image quality measurements demonstrated that the OBI provided superior image quality for all protocols, with both better spatial resolution and low-contrast detectability. The measured organ doses were also used to calculate a reference male effective dose to allow further comparison of the two machines and imaging protocols. The head, chest, and pelvis scans yielded effective doses of 0.04, 7.15, and 3.73 mSv for the XVI, and 0.12, 1.82, and 4.34mSv for the OBI, respectively.

Characterization of a water-equivalent fiber-optic coupled dosimeter for use in diagnostic radiology.

This work reports on the characterization of a new fiber-optic coupled (FOC) dosimeter for use in the diagnostic radiology energy range. The FOC dosimeter was constructed by coupling a small cylindrical plastic scintillator, 500 microm in diameter and 2 mm in length, to a 2 m long optical fiber, which acts as a light guide to transmit scintillation photons from the sensitive element to a photo-multiplier tube (PMT). A serial port interface on the PMT permits real-time monitoring of light output from the dosimeter via a custom computer program. The FOC dosimeter offered excellent sensitivity and reproducibility, allowing doses as low as 0.16 mGy to be measured with a coefficient of variation of only 3.64%. Dose linearity was also excellent with a correlation coefficient of 1.000 over exposures ranging from 0.16 to 57.29 mGy. The FOC dosimeter exhibited little angular dependence from axial irradiation, varying by less than 5% over an entire revolution. A positive energy dependence was observed and measurements performed within a scatter medium yielded a 10% variation in sensitivity as beam quality changed due to hardening and scatter across a 16 cm depth range. The current dosimetry system features an array of five PMTs to allow multiple FOC dosimeters to be monitored simultaneously. Overall, the system allows for rapid and accurate dose measurements relevant to a range of diagnostic imaging applications.

Construction of anthropomorphic phantoms for use in dosimetry studies.

This paper reports on the methodology and materials used to construct anthropomorphic phantoms for use in dosimetry studies, improving on methods and materials previously described by Jones et al. [Med Phys. 2006;33(9):3274-82]. To date, the methodology described has been successfully used to create a series of three different adult phantoms at the University of Florida (UF). All phantoms were constructed in 5 mm transverse slices using materials designed to mimic human tissue at diagnostic photon energies: soft tissue-equivalent substitute (STES), lung tissue-equivalent substitute (LTES), and bone tissue-equivalent substitute (BTES). While the formulation for BTES remains unchanged from the previous epoxy resin compound developed by Jones et al. [Med Phys. 2003;30(8):2072-81], both the STES and LTES were redesigned utilizing a urethane based compound which forms a pliable tissue-equivalent material. These urethane based materials were chosen in part for improved phantom durability and easier accommodation of real-time dosimeters. The production process has also been streamlined with the use of an automated machining system to create molds for the phantom slices from bitmap images based on the original segmented computed tomography (CT) datasets. Information regarding the new tissue-equivalent materials as well as images of the construction process and completed phantom are included.

Characterization of a fiber-optic-coupled radioluminescent detector for application in the mammography energy range.

Fiber-optic-coupled radioluminescent (FOC) dosimeters are members of a new family of dosimeters that are finding increased clinical applications. This study provides the first characterization of a Cu doped quartz FOC dosimeter at diagnostic energies, specifically across the range of x-ray energies and intensities used in mammographies. We characterize the calibration factors, linearity, angular dependence, and reproducibility of the FOC dosimeters. The sensitive element of each dosimeter was coupled to a photon counting photomultiplier module via 1 m long optical fibers. A computer controlled interface permitted real-time monitoring of the dosimeter output and rapid data acquisition. The axial-angular responses for all dosimeter models show nearly uniform response without any marked decrease in sensitivity. However, the normal-to-axial angular response showed a marked decrease in sensitivity of about 0 degrees C and 180 degrees C. In most clinical applications, appropriate dosimeter positioning can minimize the contributions of the varying normal-to-axial response. The FOC dosimeters having the greatest sensitive length provided the greatest sensitivity, with greatest to lowest sensitivity observed for 4.0, 1.9, 1.6, and 1.1 mm length sensitive elements. The average sensitivity of the dosimeters varies linearly with sensitive volume (R2=95%) and as a function of tube potential and target/filter combinations, generally exhibiting an increased sensitivity for higher energies. The dosimeter sensitivity as a function of tube potential had an average increase of 4.72 +/- 2.04% for dosimeter models and three target-filter combinations tested (Mo/Mo, Mo/Rh, and Rh/Rh) over a range of 25-31 kVp. All dosimeter models exhibited a linear response (R2 > or = 0.997) to exposure for all target-filter combinations, tube potentials, and tube current-time product stations evaluated and demonstrated reproducibility within 2%. All of the dosimeters examined in this study provided a response adequate for the accurate measurement of doses in clinical mammography applications.

Organ and effective doses in newborns and infants undergoing voiding cystourethrograms (VCUG): a comparison of stylized and tomographic phantoms.

The time-sequence videotape-analysis methodology, developed [Sulieman et al., Radiology 178, 653-658 (1991)] for use in tissue dose estimations in adult fluoroscopy examinations and utilized [Bolch et al., Med. Phys. 30, 667-680 (2003)] for analog fluoroscopy in newborn patients, has been extended to the study of digital fluoroscopic examinations of the urinary bladder in newborn and infant female patients. Individual frames of the fluoroscopic and radiographic video were analyzed with respect to unique combinations of field size, field center, projection, tube potential, and tube current (mA), and integral tube current (mAs), respectively. The dosimetry study was conducted on five female patients of ages ranging from four-days to 66 days. For each patient, three different phantoms were utilized: a stylized computational phantom of the reference newborn (3.5 kg), a tomographic computational phantom of the reference newborn (3.5 kg), and (3) a tomographic computational phantom uniformly rescaled to match patient total-body mass. The latter phantom set circumvented the need for mass-dependent rescaling of recorded technique factors (kVp, mA, mAs, etc.), and thus represented the highest degree of patient specificity in the individual organ dose assessment. Effective dose values for the voiding cystourethrogram examination ranged from 0.6 to 3.2 mSv, with a mean and standard deviation of 1.8+/-0.9 mSv. The ovary and colon equivalent doses contributed in total approximately 65%-80% of the effective dose in these fluoroscopy studies. Percent differences in the effective dose assessed using the two tomographic phantoms (one fixed at 3.5 kg with rescaled technique factors rescaled and one physically rescaled to individual patient masses with no adjustment of recorded technique factors) ranged for -49% to +15%. Percent differences in effective dose found using the 3.5 kg stylized phantom and the 3.5 kg tomographic phantom, both with patient-specific rescaling of technique factors, ranged from -10% to +17%. These differences are due in part to a reduced ovary dose in the tomographic phantom for right posterior oblique (RPO) views when compared to those seen in the stylized phantom.

Organ and effective doses in infants undergoing upper gastrointestinal (UGI) fluoroscopic examination.

To provide more detailed data on organ and effective doses in digital upper gastrointestinal (UGI) fluoroscopy studies of newborns and infants, the present study was conducted employing the time-sequence videotape-analysis technique used in a companion study of newborn and infant voiding cystourethrograms (VCUG). This technique was originally pioneered [O. H. Suleiman, J. Anderson, B. Jones, G. U. Rao, and M. Rosenstein, Radiology 178, 653-658 (1991)] for adult UGI examinations. Individual video frames were analyzed to include combinations of field size, field center, x-ray projection, image intensifier, and magnification mode. Additionally, the peak tube potential and the mA or mAs values for each segment/subsegment or digital photospot were recorded for both the fluoroscopic and radiographic modes of operation. The data from videotape analysis were then used in conjunction with a patient-scalable newborn tomographic computational phantom to report both organ and effective dose values via Monte Carlo radiation transport. The study includes dose estimates for five simulated UGI examinations representative of patients ranging from three to six months of age. Effective dose values for UGI examinations ranged from 1.17 to 6.47 mSv, with a mean of 3.14 mSv and a large standard deviation of 2.15 mSv. The colon, lungs, stomach, liver, and esophagus absorbed doses in sum were found to constitute between 63 and 75% of the effective dose in these UGI studies. Representing 23-30% of the effective dose, the lungs were found to be the most significant organ in the effective dose calculation. Approximately 80-95% of the effective dose is contributed by the dynamic fluoroscopy segments with larger percentages found in longer studies. The mean effective dose for newborn UGI examinations was not found to be statistically different from that seen in newborn VCUG examinations.

Organ and effective doses in pediatric patients undergoing helical multislice computed tomography examination.

As multidetector computed tomography (CT) serves as an increasingly frequent diagnostic modality, radiation risks to patients became a greater concern, especially for children due to their inherently higher radiosensitivity to stochastic radiation damage. Current dose evaluation protocols include the computed tomography dose index (CTDI) or point detector measurements using anthropomorphic phantoms that do not sufficiently provide accurate information of the organ-averaged absorbed dose and corresponding effective dose to pediatric patients. In this study, organ and effective doses to pediatric patients under helical multislice computed tomography (MSCT) examinations were evaluated using an extensive series of anthropomorphic computational phantoms and Monte Carlo radiation transport simulations. Ten pediatric phantoms, five stylized (equation-based) ORNL phantoms (newborn, 1-year, 5-year, 10-year, and 15-year) and five tomographic (voxel-based) UF phantoms (9-month male, 4-year female, 8-year female, 11-year male, and 14-year male) were implemented into MCNPX for simulation, where a source subroutine was written to explicitly simulate the helical motion of the CT x-ray source and the fan beam angle and collimator width. Ionization chamber measurements were performed and used to normalize the Monte Carlo simulation results. On average, for the same tube current setting, a tube potential of 100 kVp resulted in effective doses that were 105% higher than seen at 80 kVp, and 210% higher at 120 kVp regardless of phantom type. Overall, the ORNL phantom series was shown to yield values of effective dose that were reasonably consistent with those of the gender-specific UF phantom series for CT examinations of the head, pelvis, and torso. However, the ORNL phantoms consistently overestimated values of the effective dose as seen in the UF phantom for MSCT scans of the chest, and underestimated values of the effective dose for abdominal CT scans. These discrepancies increased with increasing kVp. Finally, absorbed doses to select radiation sensitive organs such as the gonads, red bone marrow, colon, and thyroid were evaluated and compared between phantom types. Specific anatomical problems identified in the stylized phantoms included excessive pelvic shielding of the ovaries in the female phantoms, enhanced red bone marrow dose to the arms and rib cage for chest exams, an unrealistic and constant torso thickness resulting in excessive x-ray attenuation in the regions of the abdominal organs, and incorrect positioning of the thyroid within the stylized phantom neck resulting in insufficient shielding by clavicles and scapulae for lateral beam angles. To ensure more accurate estimates of organ absorbed dose in multislice CT, it is recommended that voxel-based phantoms, potentially tailored to individual body morphometry, be utilized in any future prospective epidemiological studies of medically exposed children.

Physical validation of a Monte Carlo-based, phantom-derived approach to computed tomography organ dosimetry under tube current modulation.

PURPOSE: To physically validate the accuracy of a Monte Carlo-based, phantom-derived methodology for computed tomography (CT) dosimetry that utilizes organ doses from precomputed axial scans and that accounts for tube current modulation (TCM). METHODS: The output of a Toshiba Aquilion ONE CT scanner was modeled, based on physical measurement, in the Monte Carlo radiation transport code MCNPX (v2.70). CT examinations were taken of two anthropomorphic phantoms representing pediatric and adult patients (15-yr-old female and adult male) at various energies, in which physical organ dose measurements were made using optically stimulated luminescence dosimeters (OSLDs). These exams (chest-abdomen-pelvis) were modeled using organ dose data obtained from the computationally equivalent phantom of each anthropomorphic phantom. TCM was accounted for by weighting all organ dose contributions by both the relative attenuation of the phantom and the image-derived mA value (from the DICOM header) at the same z-extent (cranial-caudal direction) of the axial dose data. RESULTS: The root mean squares of percent difference in organ dose when comparing the physical organ dose measurements to the computational estimates were 21.2, 12.1, and 15.1% for the uniform (no attenuation weighting), weighted (computationally derived), and image-based methodologies, respectively. CONCLUSIONS: Overall, these data suggest that the Monte Carlo-based dosimetry presented in this work is viable for CT dosimetry. Additionally, for CT exams with TCM, local attenuation weighting of organ dose contributions from precomputed axial dosimetry libraries increases organ dose accuracy.

Organ Doses to Airline Passengers Screened by X-Ray Backscatter Imaging Systems.

Advanced imaging technologies (AIT) are being developed for passenger airline transportation. They are designed to provide enhanced security benefits by identifying objects on passengers that would not be detected by methodologies now used for routine surveillance. X-ray backscatter imaging is one AIT system being considered. Since this technology is based on scanning passengers with ionizing radiation, concern has been raised relating to the health risks associated with these exposures. Recommendations for standards of radiation safety have been proposed by the American National Standards Institute published in ANSI/HPS N43.17-2009. A Monte Carlo based methodology for estimating organ doses received from an X-ray backscatter AIT system is presented. Radiological properties of a reference scanner including beam intensity, geometry and energy spectra were modeled based on previous studies and physical measurements. These parameters were incorporated into a Monte Carlo source subroutine and validated with comparison of simulated versus measured data. One extension of this study was to calculate organ and effective dose on a wide range of potential passengers. Computational phantoms with realistic morphologies were used including adults of 5th, 25th, 50th, 75th and 95th percentile weight, children of 5th, 50th and 95th percentile weight, and the developing fetus of 15, 25, and 38 weeks after conception. Additional sensitivity studies were performed to evaluate effects of passenger positioning within the scanner, energy spectrum and beam geometry, as well as failure mode analyses. Results for routine operations yielded a maximum effective dose to the adult and pediatric passengers of 15 and 25 nSv per screen, respectively. The developing fetus received a maximum organ dose and whole body dose of 16 nGy and 8.5 nGy per screen, respectively. The sensitivity analyses indicated that variations in positioning, energy spectra, and beam geometry yielded a range of effective doses per screen that were an order of magnitude below the ANSI recommendation.

Characterization of metal oxide semiconductor field effect transistor dosimeters for application in clinical mammography.

Five high-sensitivity metal oxide semiconductor field effect transistor dosimeters in the TN-502 and 1002 series (Thomson Nielsen Electronics Ltd., 25B, Northside Road, Ottawa, ON K2H8S1, Canada) were evaluated for use in the mammography x-ray energy range (22-50 kVp) as a tool to assist in the documentation of patient specific average glandular dose. The dosimeters were interfaced with the Patient Dose Verification System, model No. TN-RD 15, which consisted of a dosimeter reader and up to four dual bias power supplies. Two different dual bias power supplies were evaluated in this study, model No. TN-RD 22 in high-sensitivity mode and a very-high sensitivity prototype. Each bias supply accommodates up to five dosimeters for 20 dosimeters per system. Sensitivity of detectors, defined as the mV/C kg(-1), was measured free in air with the bubble side of the dosimeter facing the x-ray field with a constant exposure. All dosimeter models' angular response showed a marked decrease in response when oriented between 120 degrees and 150 degrees and between at 190 degrees and 220 degrees relative to the incident beam. Sensitivity was evaluated for Mo/Mo, Mo/Rh, and Rh/Rh target-filter combinations. The individual dosimeter model sensitiVity was 4.45 x 10(4) mV/C kg(-1) (11.47 mV R(-1)) for TN-502RDS(micro); 5.93 x 10(4) mV per C kg(-1) (15.31 mV R(-1)) for TN-1002RD; 6.06 x 10(4) mV/C kg(-1) (15.63 mV R(-1)) for TN-1002RDI; 9.49 x 10(4) mV per C kg(-1) (24.49 mV R(-1)) for TN-1002RDM (micro); and 11.20 x 10(4) mV/C kg(-1) (28.82 mV R(-1)) for TN-1002RDS (micro). The energy response is presented and is observed to vary with dosimeter model, generally increasing with tube potential through the mammography energy range. An intercomparison of the high-sensitivity mode of TN-RD-22 was made to the very-high sensitivity bias power supply using a Mo/Mo target-filter. The very-high sensitivity-bias power supply increased dosimeter response by 1.45 +/- 0.04 for dosimeter models TN-1002RD and TN-1002RDM. The responses of all dosimeter models were found to be linear for tube potentials of between 24 and 48 kVp. Dosimeters showed a reproducibility varying from 15.5% to 31.8%. depending on the model of dosimeter. Micro MOSFETS model Nos. TN-1002RDS and TN-1002RDM used in conjunction with their respective high-sensitivity and ultrahigh-sensitivity bias supplies provided the highest sensitivity response of the models evaluated. Either micro MOSFETS model No. TN-1002RDS or TN-1002RDM used in conjunction with the appropriate bias supply provide the best choice for clinical mammography applications. Under these conditions, MOSFET dosimeters can provide a viable option as a dosimeter in the mammography energy range (22-50 kVp). The clinical application of MOSFET dosimeters must take into account the energy dependence and reproducibility to ensure accurate measurements.

A tomographic physical phantom of the newborn child with real-time dosimetry. II. Scaling factors for calculation of mean organ dose in pediatric radiography.

Following the recent completion of a tomographic physical newborn dosimetry phantom with incorporated metal-oxide-semiconductor field effect transistor (MOSFET) dosimetry system, it was necessary to derive scaling factors in order to calculate organ doses in the physical phantom given point dose measurements via the MOSFET dosimeters (preceding article in this issue). In this study, we present the initial development of scaling factors using projection radiograph data. These point-to-organ dose scaling factors (SF(POD)) were calculated using a computational phantom created from the same data set as the physical phantom, but which also includes numerous segmented internal organs and tissues. The creation of these scaling factors is discussed, as well as the errors associated when using only point dose measurements to calculate mean organ doses and effective doses in physical phantoms. Scaling factors for various organs ranged from as low as 0.70 to as high as 1.71. Also, the ability to incorporate improvements in the computational phantom into the physical phantom using scaling factors is discussed. An comprehensive set of SF(POD) values is presented in this article for application in pediatric radiography of newborn patients.

Organ and effective doses in newborn patients during helical multislice computed tomography examination.

In this study, two computational phantoms of the newborn patient were used to assess individual organ doses and effective doses delivered during head, chest, abdomen, pelvis, and torso examinations using the Siemens SOMATOM Sensation 16 helical multi-slice computed tomography (MSCT) scanner. The stylized phantom used to model the patient anatomy was the revised ORNL newborn phantom by Han et al (2006 Health Phys.90 337). The tomographic phantom used in the study was that developed by Nipper et al (2002 Phys. Med. Biol. 47 3143) as recently revised by Staton et al (2006 Med. Phys. 33 3283). The stylized model was implemented within the MCNP5 radiation transport code, while the tomographic phantom was incorporated within the EGSnrc code. In both codes, the x-ray source was modelled as a fan beam originating from the focal spot at a fan angle of 52 degrees and a focal-spot-to-axis distance of 57 cm. The helical path of the source was explicitly modelled based on variations in collimator setting (12 mm or 24 mm), detector pitch and scan length. Tube potentials of 80, 100 and 120 kVp were considered in this study. Beam profile data were acquired using radiological film measurements on a 16 cm PMMA phantom, which yielded effective beam widths of 14.7 mm and 26.8 mm for collimator settings of 12 mm and 24 mm, respectively. Values of absolute organ absorbed dose were determined via the use of normalization factors defined as the ratio of the CTDI(100) measured in-phantom and that determined by Monte Carlo simulation of the PMMA phantom and ion chamber. Across various technique factors, effective dose differences between the stylized and tomographic phantoms ranged from +2% to +9% for head exams, -4% to -2% for chest exams, +8% to +24% for abdominal exams, -16% to -12% for pelvic exams and -7% to 0% for chest-abdomen-pelvis (CAP) exams. In many cases, however, relatively close agreement in effective dose was accomplished at the expense of compensating errors in individual organ dose. Per cent differences in organ dose between the stylized and tomographic phantoms at 120 kVp and 12 mm collimator setting ranged from -25% (skin) to +164% (muscle) for head exams, -92% (thyroid) to +98% (ovaries) for chest exams, -144% (uterus) to +112% (ovaries) for abdominal exams, -98% (SI wall) to +20% (thymus) for pelvic exams and -60% (extrathoracic airways) to +13% (ovaries) for CAP exams. Better agreement was seen between the two phantom types for organs entirely within the scan field. In these cases, corresponding per cent differences in organ absorbed dose did not vary more than 17%. For all scans, the effective dose was found to range approximately 1-13 mSv across the scan parameters and scan regions. The largest effective dose occurred for CAP scans at 120 kVp.