Evaluation of physician eye lens doses during permanent seed implant brachytherapy for prostate cancer.

Treatment of low grade prostate cancer with permanent implant of radioactive seeds has become one of the most common brachytherapy procedures in use today. The implant procedure is usually performed with fluoroscopy image guidance to ensure that the seeds are deployed in the planned locations. In this situation the physician performing the transperineal implant is required to be close to the fluoroscopy unit and dose to the eye lens may be of concern. In 1991 the International Commission on Radiological Protection (ICRP) provided a recommended dose limit of 150 mSv yr(-1) for occupational exposures to the lens of the eye. With more long term follow-up data, this limit was revised in 2011 to 20 mSv yr(-1). With this revised limit in mind, we have investigated the dose to the lens of the eye received by physicians during prostate brachytherapy seed implantation. By making an approximation of annual workload, we have related the dose received to the annual background dose. Through clinical and phantom measurements with thermoluminescent dosimeters, it was found that the excess dose to the physician's eye lens received for a conservative estimate of annual workload was never greater than 100% of the annual background dose.

Total variation superiorization schemes in proton computed tomography image reconstruction.

PURPOSE: Iterative projection reconstruction algorithms are currently the preferred reconstruction method in proton computed tomography (pCT). However, due to inconsistencies in the measured data arising from proton energy straggling and multiple Coulomb scattering, the noise in the reconstructed image increases with successive iterations. In the current work, the authors investigated the use of total variation superiorization (TVS) schemes that can be applied as an algorithmic add-on to perturbation-resilient iterative projection algorithms for pCT image reconstruction. METHODS: The block-iterative diagonally relaxed orthogonal projections (DROP) algorithm was used for reconstructing GEANT4 Monte Carlo simulated pCT data sets. Two TVS schemes added on to DROP were investigated; the first carried out the superiorization steps once per cycle and the second once per block. Simplifications of these schemes, involving the elimination of the computationally expensive feasibility proximity checking step of the TVS framework, were also investigated. The modulation transfer function and contrast discrimination function were used to quantify spatial and density resolution, respectively. RESULTS: With both TVS schemes, superior spatial and density resolution was achieved compared to the standard DROP algorithm. Eliminating the feasibility proximity check improved the image quality, in particular image noise, in the once-per-block superiorization, while also halving image reconstruction time. Overall, the greatest image quality was observed when carrying out the superiorization once per block and eliminating the feasibility proximity check. CONCLUSIONS: The low-contrast imaging made possible with TVS holds a promise for its incorporation into future pCT studies.

A more accurate reconstruction system matrix for quantitative proton computed tomography.

An accurate system matrix is required for quantitative proton CT (pCT) image reconstruction with iterative projection algorithms. The system matrix is composed of chord lengths of individual proton path intersections with reconstruction pixels. In previous work, reconstructions were performed assuming constant intersection chord lengths, which led to systematic errors of the reconstructed proton stopping powers. The purpose of the present work was to introduce a computationally efficient variable intersection chord length in order to improve the accuracy of the system matrix. An analytical expression that takes into account the discrete stepping nature of the pCT most likely path (MLP) reconstruction procedure was created to describe an angle-dependent effective mean chord length function. A pCT dataset was simulated with GEANT4 using a parallel beam of 200 MeV protons intersecting a computerized head phantom consisting of tissue-equivalent materials with known relative stopping power. The phantom stopping powers were reconstructed with the constant chord length, exact chord length, and effective mean chord length approaches, in combination with the algebraic reconstruction technique. Relative stopping power errors were calculated for each anatomical phantom region and compared for the various methods. It was found that the error of approximately 10% in the mean reconstructed stopping power value for a given anatomical region, resulting from a system matrix with a constant chord length, could be reduced to less than 0.5% with either the effective mean chord length or exact chord length approaches. Reconstructions with the effective mean chord length were found to be approximately 20% faster than reconstructions with an exact chord length. The effective mean chord length method provides the possibility for more accurate, computationally efficient quantitative pCT reconstructions.

A maximum likelihood proton path formalism for application in proton computed tomography.

The limited spatial resolution in proton computed tomography (pCT) in comparison to x-ray CT is related to multiple Coulomb scattering (MCS) within the imaged object. The current generation pCT design utilizes silicon detectors that measure the position and direction of individual protons prior to and post-traversing the patient to maximize the knowledge of the path of the proton within the imaged object. For efficient reconstruction with the proposed pCT system, one needs to develop compact and flexible mathematical formalisms that model the effects of MCS as the proton traverses the imaged object. In this article, a compact, matrix-based most likely path (MLP) formalism is presented employing Bayesian statistics and a Gaussian approximation of MCS. Using GEANT4 simulations in a homogeneous 20 cm water cube, the MLP expression was found to be able to predict the Monte Carlo tracks of 200 MeV protons to within 0.6 mm on average when employing 3sigma cuts on the relative exit angle and exit energy. These cuts were found to eliminate the majority of events not conforming to the Gaussian model of MCS used in the MLP derivation. M riszwana Banu