Improving dose calculation accuracy in preclinical radiation experiments using multi-energy element resolved cone-beam CT.

Objective.Cone-beam CT (CBCT) in modern pre-clinical small-animal radiation research platforms provides volumetric images for image guidance and experiment planning purposes. In this work, we implemented multi-energy element-resolved (MEER) CBCT using three scans with different kVps on a SmART platform (Precision x-ray Inc.) to determine images of relative electron density (rED) and elemental composition (EC) that are needed for Monte Carlo-based radiation dose calculation.Approach.We performed comprehensive calibration tasks to achieve sufficient accuracy for this quantitative imaging purpose. For geometry calibration, we scanned a ball bearing phantom and used an analytical method together with an optimization approach to derive gantry angle specific geometry parameters. Intensity calibration and correction included the corrections for detector lag, glare, and beam hardening. The corrected CBCT projection images acquired at 30, 40, and 60 kVp in multiple scans were used to reconstruct CBCT images using the Feldkamp-Davis-Kress reconstruction algorithm. After that, an optimization problem was solved to determine images of rED and EC. We demonstrated the effectiveness of our CBCT calibration steps by showing improvements in image quality and successful material decomposition in cases with a small animal CT calibration phantom and a plastinated mouse phantom.Main results.It was found that artifacts induced by geometry inaccuracy, detector lag, glare, and beam hardening were visually reduced. CT number mean errors were reduced from 19% to 5%. In the CT calibration phantom case, median errors in H, O, and Ca fractions for all the inserts were below 1%, 2%, and 4% respectively, and median error in rED was less than 5%. Compared to the standard approach deriving material type and rED via CT number conversion, our approach improved Monte Carlo simulation-based dose calculation accuracy in bone regions. Mean dose error was reduced from 47.5% to 10.9%.Significance.The MEER-CBCT implemented on an existing CBCT system of a small animal irradiation platform achieved accurate material decomposition and significantly improved Monte Carlo dose calculation accuracy.

Human health risk assessment of groundwater nitrate at a two geomorphic units transition zone in northern China.

To assess groundwater nitrate contamination and its human health risks, 489 unconfined groundwater samples were collected and analyzed from Zhangjiakou, northern China. The spatial distribution of principle hydrogeochemical results showed that the average concentrations of ions in descend order was HCO3-, SO42-, Na+, Ca2+, Cl-, NO3-, Mg2+ and K+, among which the NO3- concentrations were between 0.25 and 536.73 mg/L with an average of 29.72 mg/L. In total, 167 out of 489 samples (~ 34%) exceeded the recommended concentration of 20 mg/L in Quality Standard for Groundwater of China. The high NO3- concentration groundwater mainly located in the northern part and near the boundary of the two geomorphic units. As revealed by statistical analysis, the groundwater chemistry was more significantly affected by anthropogenic sources than by the geogenic sources. Moreover, human health risks of groundwater nitrate through oral and dermal exposure pathways were assessed by model, the results showed that about 60%, 50%, 32% and 26% of the area exceeded the acceptable level (total health index>1) for infants, children, adult males and females, respectively. The health risks for different groups of people varied significantly, ranked: infants> children> adult males>adult females, suggesting that younger people are more susceptible to nitrate contamination, while females are more resistant to nitrate contamination than males. To ensure the drinking water safety in Zhangjiakou and its downstream areas, proper management and treatment of groundwater will be necessary to avoid the health risks associated with nitrate contamination.

Experimental and numerical studies on kV scattered x-ray imaging for real-time image guidance in radiation therapy.

Motion management is a critical component of image guided radiotherapy for lung cancer. We previously proposed a scheme using kV scattered x-ray photons for marker-less real-time image guidance in lung cancer radiotherapy. This study reports our recent progress using the photon counting detection technique to demonstrate potential feasibility of this method and using Monte Carlo (MC) simulations and ray-tracing calculations to characterize the performance. In our scheme, a thin slice of x-ray beam was directed to the target and we measured the outgoing scattered photons using a photon counting detector with a parallel-hole collimator to establish the correspondence between detector pixels and scatter positions. Image corrections of geometry, beam attenuation and scattering angle were performed to convert the raw image to the actual image of Compton attenuation coefficient. We set up a MC simulation system using an in-house developed GPU-based MC package modeling the image formation process. We also performed ray-tracing calculations to investigate the impacts of imaging system geometry on resulting image resolution. The experiment demonstrated feasibility of using a photon counting detector to measure scattered x-ray photons and generate the proposed scattered x-ray image. After correction, x-ray scattering image intensity and Compton scattering attenuation coefficient were linearly related, with R 2 greater than 0.9. Contrast to noise ratios of different objects were improved and the values in experimental results and MC simulation results agreed with each other. Ray-tracing calculations revealed the dependence of image resolution on imaging geometry. The image resolution increases with reduced source to object distance and increased collimator height. The study demonstrated potential feasibility of using scattered x-ray imaging as a real-time image guidance method in radiation therapy.

Spatial distribution of pollution characteristics and human health risk assessment of exposure to heavy elements in road dust from different functional areas of Zhengzhou, China.

Road dust from different sources directly contacts the human body and has potential effects on public health. In this study, a total number of 87 road dust samples were collected at 29 sampling sites from five different functional areas (commercial area (CA), residential area (RA), educational area (EA), industrial area (IA), and park area (PA)) in Zhengzhou to study the contamination status, distribution, source identification, ecological risk assessment, and spatial distribution of human health risks due to eight heavy elements. The geo-accumulation index (Igeo) and pollution index (PI) revealed that there was very high contamination with Cd and Hg caused by atmospheric deposition, which should be paid special attention. Additionally, the source identification indicated that Cr, Ni, Cu, Zn, Cd, and Pb originate from anthropogenic activities related to traffic, and Hg can originate from medical equipment and agricultural chemicals, while the extremely low level of pollution with As could be explained by geographic sources. Moreover, the calculated ecological risk index values were increased in the order of CA > RA > EA > IA > PA in different functional areas. According to the human health risks of the whole city, children exposed to Pb have the highest health risk, especially for CA and IA, as calculated by the noncarcinogenic hazard index (HI). For adults and children, health risks caused by Cu, Zn, and Pb were higher in the CA, RA, and PA of the downtown area, whereas Cr and Ni had the highest noncarcinogenic exposure risk in northwestern Zhengzhou due to point source pollution. Calculations of the carcinogenic risk (CR) values for Cr, Ni, As, and Cd indicate that the value of Cr is highest (1.17 × 10-7), especially inside the industrial area (8.55 × 10-7), which is close to the lower limit of the threshold values (10-6 to 10-4). These results can provide a theoretical basis and data support for air treatment, pollution control, and the implementation of public prevention in different functional areas of Zhengzhou.

Full Monte Carlo-Based Biologic Treatment Plan Optimization System for Intensity Modulated Carbon Ion Therapy on Graphics Processing Unit.

PURPOSE: One of the major benefits of carbon ion therapy is enhanced biological effectiveness at the Bragg peak region. For intensity modulated carbon ion therapy (IMCT), it is desirable to use Monte Carlo (MC) methods to compute the properties of each pencil beam spot for treatment planning, because of their accuracy in modeling physics processes and estimating biological effects. We previously developed goCMC, a graphics processing unit (GPU)-oriented MC engine for carbon ion therapy. The purpose of the present study was to build a biological treatment plan optimization system using goCMC. METHODS AND MATERIALS: The repair-misrepair-fixation model was implemented to compute the spatial distribution of linear-quadratic model parameters for each spot. A treatment plan optimization module was developed to minimize the difference between the prescribed and actual biological effect. We used a gradient-based algorithm to solve the optimization problem. The system was embedded in the Varian Eclipse treatment planning system under a client-server architecture to achieve a user-friendly planning environment. We tested the system with a 1-dimensional homogeneous water case and 3 3-dimensional patient cases. RESULTS: Our system generated treatment plans with biological spread-out Bragg peaks covering the targeted regions and sparing critical structures. Using 4 NVidia GTX 1080 GPUs, the total computation time, including spot simulation, optimization, and final dose calculation, was 0.6 hour for the prostate case (8282 spots), 0.2 hour for the pancreas case (3795 spots), and 0.3 hour for the brain case (6724 spots). The computation time was dominated by MC spot simulation. CONCLUSIONS: We built a biological treatment plan optimization system for IMCT that performs simulations using a fast MC engine, goCMC. To the best of our knowledge, this is the first time that full MC-based IMCT inverse planning has been achieved in a clinically viable time frame.

Burden of total and cause-specific mortality related to tobacco smoking among adults aged ≥ 45 years in Asia: a pooled analysis of 21 cohorts.

BACKGROUND: Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest. METHODS AND FINDINGS: We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan-accounting for ∼71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37-1.51) and 1.48-fold (1.38-1.58) elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%-17.2%) and 3.3% (2.6%-4.0%) of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ∼1,575,500 (95% CI = 1,398,000-1,744,700). Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: a 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y. CONCLUSIONS: Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented. Please see later in the article for the Editors' Summary.