Neck Phantom Research Articles

Experimental Study on Noise-Reduced Propagation Characteristics of the Parametric Acoustic Array Field in a Neck Phantom

The electrolarynx (EL) is a common device for voice reconstruction in laryngectomy patients, but its mechanical sound source generates significant radiation noise, affecting the naturalness and acceptability of the speech. The parametric acoustic array (PAA), which produces directionally propagated difference-frequency sound waves, presents a promising alternative for creating a more natural glottal-like voice source in the trachea while reducing radiation noise. In this study, we developed a tissue-mimicking phantom to simulate human neck tissue and used a single-transducer-based PAA platform to generate modulated ultrasound signals with glottal waveform characteristics. Ultrasonic microphones captured sound signals fromthe trachea and surrounding air, and signal processing was used to isolate the difference-frequency signals. The results demonstrated that difference-frequency signals were successfully detected in the phantom’s trachea, with time-domain waveforms and frequency spectra closely resembling the designed glottal waveform (Pearson correlation coefficient = 0.9438). Additionally, radiation noise produced by the PAA was significantly lower (23 dB, p < 0.0001) compared to the traditional EL. These findings demonstrate the potential of PAA for voice source reconstruction in laryngectomy patients and suggest its capacity to enhance speech rehabilitation outcomes. Further research is required to refine the frequency range and evaluate clinical applicability.

Analisis Distribusi Dosis Pada Terapi Alpha dengan Teknik Pencil Beam Scanning Pada Tumor Kraniofaringioma Menggunakan Software MCNP6

This study was conducted with simulation modeling on alpha therapy for the treatment of craniopharyngioma tumors using the reference head and neck phantom geometry from Lazarine (2006), which was equipped with spherical target cell geometry. The target cell geometry with a radius of 1.05 cm contains 27 partitions located at the base of the brain close to the spine. This simulation was performed using pencil beam scanning which has a beam size of 0.35 cm and was irradiated from the left direction as far as 25 cm from the skin surface by giving 5 variations of energy ranges 425, 430, 440, 445 and 450 MeV. The results of the simulation obtained an average absorbed dose of (1.30 ± 0.01) x 10-9 Gy/α with an isodosis rate of 62%. In addition, this study also takes into account the dose received by healthy cells around the tumor. The brain organ received the largest dose of (2.69 ± 0.01) x 10-13 Gy/α, when compared to the brain tumor cells received a dose of 0.021%. From the dose distribution to tumor cells, the irradiation time for craniofaringioma tumors is (13.3 ± 0.01) s with an α particle current of 1nA.

Is the IROC H&N credentialing phantom an effective surrogate for different anatomical sites?: Using IROC's H&N phantom for various sites

PURPOSEThe IROC head and neck phantom is used to credential institutions for IMRT delivery for all anatomical sites where delivery of modulated therapy is a primary challenge. This study evaluated how appropriate the use of this phantom is for varied clinical anatomy by evaluating how closely the IROC head and neck phantom described clinical dose errors from beam modeling compared to various anatomical sites. METHODSThe MLC offset, transmission, PDD and seven additional beam modeling parameters for a Varian accelerator were modified in RayStation to match community data at the 2.5, 25, 50, 75 and 97.5 percentile levels. Modifications were evaluated on 25 H&N phantom cases and 25 clinical cases (H&N, prostate, lung, mesothelioma, and brain), generating 2,000 plan perturbations. Differences in mean dose delivered to clinical target volumes (CTV) and organs at risk (OAR) were compared between phantom and clinical plans to assess the relationship between dose deviations in phantom versus clinical CTVs, and as a function of 18 different complexity metrics. RESULTSPerturbations to MLC offset and transmission parameters demonstrated the greatest impact on dose accuracy for phantom and clinical plans (for all anatomic sites). The phantom demonstrated equivalent or greater sensitivity to these parameter perturbations when compared to clinical sites, largely aligning with treatment complexity. The mean MLC Gap best described the impact of errors in TPS beam modeling parameters in phantoms plan and clinical plans from various anatomical sites. CONCLUSIONWhen compared across various anatomical sites, the IROC H&N credentialing phantom exhibited similar or greater sensitivity to errors in the treatment planning system. As such, it is a suitable surrogate device for assessing institutional performance across various anatomical sites. If an institution successfully irradiates the phantom, that result confers confidence that IMRT to a wide range of anatomical sites can be successfully delivered by the institution.

Preliminary study of feasibility of surface-guided radiotherapy with concurrent tumor treating fields for glioblastoma: region of interest

ObjectiveTo evaluate the impact of the residual setup errors from differently shaped region of interest (ROI) and investigate if surface-guided setup can be used in radiotherapy with concurrent tumor treating fields (TTFields) for glioblastoma.MethodsFifteen patients undergone glioblastoma radiotherapy with concurrent TTFields were involved. Firstly, four shapes of region of interest (ROI) (strip-shaped, T-shaped, ⊥\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\perp$$\\end{document}-shaped and cross-shaped) with medium size relative to the whole face were defined dedicate for patients wearing TTFields transducer arrays. Then, ROI-shape-dependent residual setup errors in six degrees were evaluated using an anthropomorphic head and neck phantom taking CBCT data as reference. Finally, the four types of residual setup errors were converted into corresponding dosimetry deviations (including the target coverage and the organ at risk sparing) of the fifteen radiotherapy plans using a feasible and robust geometric-transform-based method.ResultsThe algebraic sum of the average residual setup errors in six degrees (mm in translational directions and ° in rotational directions) of the four types were 6.9, 1.1, 4.1 and 3.5 respectively. In terms of the ROI-shape-dependent dosimetry deviations, the D98% of PTV dropped off by (3.4 ± 2.0)% (p < 0.05), (0.3 ± 0.5)% (p < 0.05), (0.9 ± 0.9)% (p < 0.05) and (1.1 ± 0.8)% (p < 0.05). The D98% of CTV dropped off by (0.5 ± 0.6)% (p < 0.05) for the strip-shaped ROI while remained unchanged for others.ConclusionSurface-guided setup is feasible in radiotherapy with concurrent TTFields and a medium-sized T-shaped ROI is appropriate for the surface-based guidance.

Comparison of Thyroid Uptake Values Measured from 131I Scintigraphy and Uptake Probe in Hyperthyroid Patients

Objective: Thyroid uptake test plays an important role in diagnosis, treatment planning and radioiodine dose determination in patients with hyperthyroidism. The aim of this study was to compare the % uptake values calculated with gamma camera and uptake probe after diagnostic 131I application in hyperthyroid patients. Materials and Methods: In this study, % uptake values were measured using a thyroid uptake probe and gamma camera in 32 patients who underwent thyroid radioiodine uptake measurement in our Nuclear Medicine center. Thyroid uptake measurements were prepared in the neck phantom with 0.74–0.925 MBq activity of 131I radionuclide. After counting the phantom with 131I separately in the uptake probe and gamma camera, 131I sample was orally administered to the patient. % uptake values were calculated by the uptake probe measurements and drawing regions of interest (ROI) from scintigraphic images at 2 and 24 h. Results: The 2-h mean % uptake values in the probe and gamma camera were calculated as 30.5 ± 20.4 and 27.1 ± 18.6, respectively. The 24-h mean % uptake values in the thyroid probe and gamma camera were calculated as 57.6 ± 21.9 and 55.3 ± 21.5, respectively. Linear regression analyses for the 2- and 24-h % uptake values calculated with the probe and gamma camera were found as R2 = 0.8412 and R2 = 0.7313, respectively. Conclusion: The 2- and 24-h % uptake values with the probe and gamma camera were found to be consistent with each other, indicating that they can be safely used interchangeably in patients with hyperthyroidism.

3D-printed neck phantoms with detailed anatomy for ultrasound-guided procedure and device testing.

With rapid advances in ultrasound-guided procedures, there is an unmet need for echogenic phantoms with sufficient anatomical details for artificial intelligence and ultrasound-guided device testing. We developed a method for creating neck phantoms for novel otolaryngology-related device testing. To achieve accurate representation of the anatomy, we utilized CT scans and 3D printing technology to create customized agar molds, thus providing high-fidelity yet cost-effective tools. Based on previous studies, the key components in our neck phantom include the cervical vertebrae, trachea, common carotid arteries, internal jugular veins, thyroid gland, and surrounding soft tissue. Open-source image analysis software were employed to process CT data to generate high fidelity 3D models of the target structures. Resin molds were 3D printed and filled with various agar mixtures to mimic anatomical echogenicity. Following the method proposed, we successfully assembled the neck phantom which provided a detailed representation of the target structures. To evaluate the results, ultrasound data was collected on the phantom and living tissue and analyzed with ImageJ. We were able to demonstrate echogenicity comparable to that of living tissue. The proposed method for building neck phantoms with detailed anatomical features offers a valuable, detailed, low-cost tool for medical training and device testing in otolaryngology, particularly for novel devices that involve artificial intelligence (AI) guidance and robotic-based needle insertion. Additional anatomical refinements and validation studies could further enhance the consistency and accuracy, thus paving the way for future advancements in ultrasound training and research, and ultimately benefiting patient care and safety.

Low-contrast lesion detection in neck CT: a multireader study comparing deep learning, iterative, and filtered back projection reconstructions using realistic phantoms

BackgroundComputed tomography (CT) reconstruction algorithms can improve image quality, especially deep learning reconstruction (DLR). We compared DLR, iterative reconstruction (IR), and filtered back projection (FBP) for lesion detection in neck CT.MethodsNine patient-mimicking neck phantoms were examined with a 320-slice scanner at six doses: 0.5, 1, 1.6, 2.1, 3.1, and 5.2 mGy. Each of eight phantoms contained one circular lesion (diameter 1 cm; contrast -30 HU to the background) in the parapharyngeal space; one phantom had no lesions. Reconstruction was made using FBP, IR, and DLR. Thirteen readers were tasked with identifying and localizing lesions in 32 images with a lesion and 20 without lesions for each dose and reconstruction algorithm. Receiver operating characteristic (ROC) and localization ROC (LROC) analysis were performed.ResultsDLR improved lesion detection with ROC area under the curve (AUC) 0.724 ± 0.023 (mean ± standard error of the mean) using DLR versus 0.696 ± 0.021 using IR (p = 0.037) and 0.671 ± 0.023 using FBP (p < 0.001). Likewise, DLR improved lesion localization, with LROC AUC 0.407 ± 0.039 versus 0.338 ± 0.041 using IR (p = 0.002) and 0.313 ± 0.044 using FBP (p < 0.001). Dose reduction to 0.5 mGy compromised lesion detection in FBP-reconstructed images compared to doses ≥ 2.1 mGy (p ≤ 0.024), while no effect was observed with DLR or IR (p ≥ 0.058).ConclusionDLR improved the detectability of lesions in neck CT imaging. Dose reduction to 0.5 mGy maintained lesion detectability when denoising reconstruction was used.Relevance statementDeep learning enhances lesion detection in neck CT imaging compared to iterative reconstruction and filtered back projection, offering improved diagnostic performance and potential for x-ray dose reduction.Key PointsLow-contrast lesion detectability was assessed in anatomically realistic neck CT phantoms.Deep learning reconstruction (DLR) outperformed filtered back projection and iterative reconstruction.Dose has little impact on lesion detectability against anatomical background structures.Graphical

Calibration for in vivo monitoring of thyroid of exposed population at risk of intakes of radioiodine isotopes due to a nuclear or radiological emergency

This work presents an improvement of the calibration of a broad energy germanium detector (BEGe) using age dependent neck-thyroid phantoms for thyroid monitoring of exposed individuals (workers and members of the public), allowing the detection and quantification of incorporated radioiodine isotopes in a nuclear medicine frame or in case of accident of a nuclear reactor.A BEGe detector was calibrated using a family of age-dependent thyroid-neck phantoms that simulate thyroids of 1, 5, 10, 15 year-old children and (male and female) adults, based in ICRP Publication 8 (ICRP, 2002) and ANSI 13.44 Standard (ANSI, 2014).The calibration of the BEGe detector for all neck phantoms was performed with the same counting geometry, centered under the BE Ge detector and at the same distance of 15 cm. Using same counting parameters allows to compare efficiency curves of thyroid monitoring depending with age. The in vivo measurements with the BE Ge detector allow to identify X rays and gamma emissions between 10 and 1000 keV with a great resolution and to quantify activities of radioiodine isotopes in the thyroid of exposed population.Calibration curves have been obtained for different sizes of the thyroid, depending with age. This study of counting efficiency using the main energies of the most important radioiodine isotopes result in accurate activity calculations. Detection limits were obtained for each radioiodine isotope, using blank phantoms of each age.

The feasibility of CT simulation-free adaptive radiation therapy.

Novel on-board CBCT allows for improved image quality and Hounsfield unit accuracy. When coupled with online adaptive tools, this may have potential to allow for simulation and treatment to be completed in a single on-table session. To study the feasibility of a high-efficiency radiotherapy treatment workflow without the use of a separate session for simulation imaging. The dosimetric accuracy, overall efficiency, and technical feasibility were used to evaluate the clinical potential of CT simulation-free adaptive radiotherapy. Varian's Ethos adaptive radiotherapy treatment platform was upgraded with a novel CBCT system, HyperSight which reports image quality and Hounsfield unit accuracy specifications comparable to standard fan-beam CT. Using in-house developed MATLAB software, CBCT images were imported into the system and used for planning. Two test cases were completed on anthropomorphic phantoms equipped with small volume ion chambers (cross-calibrated to an ADCL traceable dose standard) to evaluate the feasibility and accuracy of the workflows. A simulated palliative spine treatment was planned with 8Gy in one fraction, and an intact prostate treatment was planned with 60Gy in 20 fractions. The CBCTs were acquired using HyperSight with default thorax and pelvis imaging protocols and reconstructed using an iterative algorithm with scatter removal, iCBCT Acuros. CBCTs were used for contouring and planning, and treatment was delivered via an online adaptive workflow. In addition, an external dosimetry audit was completed using only on-board CBCT imaging in an end-to-end head and neck phantom irradiation. An extended-field CBCT acquisition can be acquired in 12s, in addition to the time for longitudinal table shifts, and reconstructed in approximately 1min. The superior-inferior extent for the CBCT planning images was 38.2cm, which captured the full extent of relevant anatomy. The contouring and treatment planning for the spine and prostate were completed in 30 and 18min, respectively. The dosimetric agreement between ion chamber measurements and the treatment plan was within a range of -1.4 to 1.6%, and a mean and standard deviation of 0.41±1.16%. All metrics used in the external audit met the passing criteria, and the dosimetric comparison between fan-beam and CBCT techniques had a gamma passing rate of 99.0% with a criteria of 2%/2mm. Using an in-house workflow, CT simulation-free radiation therapy was shown to be feasible with acceptable workflow efficiency and dosimetric accuracy. This approach may be particularly applicable for urgent palliative treatments. With the availability of software to enable this workflow, and the continued advancement of on-treatment adaptation, single-visit radiation therapy may replace current practice for some clinical indications.

Design and evaluation of an anthropomorphic neck phantom for improved ultrasound diagnostics of thyroid gland tumors.

Thyroid cancer is one of the most common cancers worldwide, with ultrasound-guided biopsy being the method of choice for its early detection. The accuracy of diagnostics directly depends on the qualifications of the ultrasonographers, whose performance can be enhanced through training with phantoms. The aim of this study is to propose a reproducible methodology for designing a neck phantom for ultrasound training and research from widely available materials and to validate its applicability. The phantom was made using polyvinyl chloride mixed with additives to reproduce different levels of brightness on ultrasound screens. 3D printing and casting were used to create the neck model and various structures of the neck, including bones, cartilage, arteries, veins, lymph nodes, thyroid gland, and soft tissues. The small objects, such as tumor and lymph node models, were shaped manually. All the phantom's materials were carefully selected to match the ultrasonic speed and attenuation values of real soft tissues and bones. The thyroid gland contains models of a cancerous and cystic nodule. In the neck, there are models of carotid arteries and jugular veins filled with ultrasound-transparent gel. Additionally, there are replicas of lymph nodes and bone structures such as hyoid bone, thyroid cartilage, trachea, and vertebrae. The resulting phantom covers the entire neck area and has been positively received by practicing ultrasound specialists. The proposed manufacturing technology offers a reliable and cost-effective approach to produce an anthropomorphic neck phantom for ultrasound diagnosis of the thyroid gland. The realistic simulation provided by the phantom enhances the quality and accuracy of ultrasound examinations, contributing to better training for medical professionals and improved patient care. Subsequent research efforts can concentrate on refining the fabrication process and exploring additional features to enhance the phantom's capabilities.

Performance Evaluation of Deformable Image Registration Systems - SmartAdapt® and Velocity™.

To commission and validate commercial deformable image registration (DIR) systems (SmartAdapt® and Velocity™) using task group 132 (TG-132) digital phantom datasets. Additionally, the study compares and verifies the DIR algorithms of the two systems. TG-132 digital phantoms were obtained from the American Association of Physicists in Medicine website and imported into SmartAdapt® and Velocity™ systems for commissioning and validation. The registration results were compared with known shifts using rigid registrations and deformable registrations. Virtual head and neck phantoms obtained online (DIR Evaluation Project) and some selected clinical data sets from the department were imported into the two DIR systems. For both of these datasets, DIR was carried out between the source and target images, and the contours were then propagated from the source to the target image data set. The dice similarity coefficient (DSC), mean distance to agreement (MDA), and Jacobian determinant measures were utilised to evaluate the registration results. The recommended criteria for commissioning and validation of DIR system from TG-132 was error <0.5*voxel dimension (vd). Translation only registration: Both systems met TG-132 recommendations except computed tomography (CT)-positron emission tomography registration in both systems (Velocity ~1.1*vd, SmartAdapt ~1.6*vd). Translational and rotational registration: Both systems failed the criteria for all modalities (For velocity, error ranged from 0.6*vd [CT-CT registration] to 3.4*vd [CT-cone-beam CT (CBCT) registration]. For SmartAdapt® the range was 0.6*vd [CT-CBCT] to 3.6*vd [CT-CT]). Mean ± standard deviation for DSC, MDA and Jacobian metrics were used to compare the DIR results between SmartAdapt® and Velocity™. The DIR algorithms of SmartAdapt® and Velocity™ were commissioned and their deformation results were compared. Both systems can be used for clinical purpose. While there were only minimal differences between the two systems, Velocity™ provided lower values for parotids, bladder, rectum, and prostate (soft tissue) compared to SmartAdapt. However, for mandible, spinal cord, and femoral heads (rigid structures), both systems showed nearly identical results.

Gamma camera-specific reference standards for radioactive iodine uptake measurements

BackgroundCurrent guidelines of the radioiodine uptake (RAIU) test allow the use of different equipment, isotopes, activity and region-of-interest (ROI). We evaluated presence and extent of these differences in clinical practice and evaluated the effect of some of these variations on RAIU outcomes. Also, gamma camera-specific reference standards were calculated and retrospectively compared with measurements obtained during clinical RAIU tests.Materials and methodsFirst, questionnaires were sent to Dutch nuclear medicine departments requesting information about equipment usage, isotope, isotope formulation, activity and measurement techniques. Secondly, a neck phantom containing a range of activities in capsule or water-dissolved formulation was scanned. Counts were measured using automatic ROI, square box ROI or all counts in the image. Thirdly, clinical RAIU data were collected during 2015–2018 using three different gamma cameras. Reference standards for each scanner were calculated using regression analysis between reference activity and measured counts. Uptake measurements using this gamma camera-specific reference standard were compared with original measurements.ResultsThe survey demonstrated significant differences in isotope, isotope formulation, activity, use of neck phantoms, frequency and duration of reference measurements, distance to collimator, use of background measurements and ROI delineation. The phantom study demonstrated higher counts for the water-dissolved formulation than capsules using both automatic and square box ROI. Also, higher counts were found using a square box ROI than an automatic ROI. The retrospective study showed feasibility of RAIU calculations using camera-specific reference standards and good correlation with the original RAIU measurements.ConclusionsThis study demonstrated considerable technical variation in RAIU measurement in clinical practice. The phantom study demonstrated that these differences could result in differences in count measurements, potentially resulting in different dose calculations for radioactive iodine therapy. Retrospective data suggest that camera-specific reference standards may be used instead of individual reference measurements using separate activity sources, which may thus eliminate some sources of variation.

Characterizing the interplay of treatment parameters and complexity and their impact on performance on an IROC IMRT phantom using machine learning

Aim of the StudyTo elucidate the important factors and their interplay that drive performance on IMRT phantoms from the Imaging and Radiation Oncology Core (IROC). MethodsIROC’s IMRT head and neck phantom contains two targets and an organ at risk. Point and 2D dose are measured by TLDs and film, respectively. 1,542 irradiations between 2012–2020 were retrospectively analyzed based on output parameters, complexity metrics, and treatment parameters. Univariate analysis compared parameters based on pass/fail, and random forest modeling was used to predict output parameters and determine the underlying importance of the variables. ResultsThe average phantom pass rate was 92% and has not significantly improved over time. The step-and-shoot irradiation technique had significantly lower pass rates that significantly affected other treatment parameters’ pass rates. The complexity of plans has significantly increased with time, and all aperture-based complexity metrics (except MCS) were associated with the probability of failure. Random forest-based prediction of failure had an accuracy of 98% on held-out test data not used in model training. While complexity metrics were the most important contributors, the specific metric depended on the set of treatment parameters used during the irradiation. ConclusionWith the prevalence of errors in radiotherapy, understanding which parameters affect treatment delivery is vital to improve patient treatment. Complexity metrics were strongly predictive of irradiation failure; however, they are dependent on the specific treatment parameters. In addition, the use of one complexity metric is insufficient to monitor all aspects of the treatment plan.

Technical note: Flat panel proton radiography with a patient specific imaging field for accurate WEPL assessment.

Proton radiography (PR) uses highly energetic proton beams to create images where energy loss is the main contrast mechanism. Water-equivalent path length (WEPL) measurements using flat panel PR (FP-PR) have potential for in vivo range verification. However, an accurate WEPL measurement via FP-PR requires irradiation with multiple energy layers, imposing high imaging doses. A FP-PR method is proposed for accurate WEPL determination based on a patient-specific imaging field with a reduced number of energies (n) to minimize imaging dose. Patient-specific FP-PRs were simulated and measured for a head and neck (HN) phantom. An energy selection algorithm estimated spot-wise the lowest energy required to cross the anatomy (Emin) using a water-equivalent thickness map. Starting from Emin, n was restricted to certain values (n=26, 24, 22, …, 2 for simulations, n=10 for measurements), resulting in patient-specific FP-PRs. A reference FP-PR with a complete set of energies was compared against patient-specific FP-PRs covering the whole anatomy via mean absolute WEPL differences (MAD), to evaluate the impact of the developed algorithm. WEPL accuracy of patient-specific FP-PRs was assessed using mean relative WEPL errors (MRE) with respect to measured multi-layer ionization chamber PRs (MLIC-PR) in the base of skull, brain, and neck regions. MADs ranged from 2.1mm (n=26) to 21.0mm (n=2) for simulated FP-PRs, and 7.2mm for measured FP-PRs (n=10). WEPL differences below 1mm were observed across the whole anatomy, except at the phantom surfaces. Measured patient-specific FP-PRs showed good agreement against MLIC-PRs, with MREs of 1.3±2.0%, -0.1±1.0%, and -0.1±0.4% in the three regions of the phantom. A method to obtain accurate WEPL measurements using FP-PR with a reduced number of energies selected for the individual patient anatomy was established in silico and validated experimentally. Patient-specific FP-PRs could provide means of in vivo range verification.

Dual-Tracer Parathyroid Imaging Using Joint SPECT Reconstruction.

We assessed the lesion detection performance of the dual-tracer parathyroid SPECT imaging using the joint reconstruction method. Thirty-six noise realizations were created from SPECT projections collected from an in-house neck phantom to emulate 99mTc-pertechnetate/99mTc-sestamibi parathyroid SPECT datasets. Difference images representing parathyroid lesions were reconstructed using the subtraction and the joint methods whose corresponding optimal iteration was defined as the iteration which maximized the channelized Hotelling observer signal-to-noise ratio (CHO-SNR). The joint method whose initial estimate was derived from the subtraction method at optimal iteration (the joint-AltInt method) was also assessed. In a study of 36 patients, a human-observer lesion-detection study was performed using difference images from the three methods at optimal iteration and the subtraction method with four iterations. The area under the receiver operating characteristic curve (AUC) was calculated for each method. In the phantom study, both the joint-AltInt method and the joint method improved SNR compared to the subtraction method at their optimal iteration by 444% and 81%, respectively. In the patient study, the joint-AltInt method yielded the highest AUC of 0.73 as compared with 0.72, 0.71, and 0.64 from the joint method, the subtraction method at optimal iteration, and the subtraction method at four iterations. At a specificity of at least 0.70, the joint-AltInt method yielded significantly higher sensitivity than the other methods (0.60 vs 0.46, 042, and 0.42; p < 0.05). The joint reconstruction method yielded higher lesion detectability than the conventional method and holds promise for dual-tracer parathyroid SPECT imaging.

Evaluation of surface dose calculations using monaco treatment planning system in an indigenously developed head and neck phantom

Objective: The objective of this study is to evaluate the surface doses for 3-dimensional conformal radiation therapy (3DCRT), intensity-modulated radiation therapy (IMRT), and volumetric-modulated arc therapy (VMAT) treatment planning techniques using an inhouse designed head and neck (HN) phantom and to compare the measured surface doses with the doses calculated using the Monaco treatment planning system (TPS). Materials and Methods: An arbitrary clinical target volume was defined with 5 mm planning target volume (PTV) expansion on computed tomography images of an in house designed heterogeneous HN phantom. 3DCRT, IMRT, and VMAT plans were created using Monaco TPS for prescribed dose of 60Gy in 30 fractions to cover 95% of PTV volume. Dose measurements were performed using EBT3 Gafchromic films at 10 selected points on the surface of HN phantom, especially inside the treatment area. Percentage mean dose differences were evaluated between the TPS calculated doses and measured dose values at these identified points. Results: The average dose difference between the TPS calculated doses and film measurements were found to be varying from 11.66% to 19.73%. It was observed that TPS overestimated the surface doses in comparison to measured doses. The results also shows that Gafchromic films can be used for surface dose measurements in patients for in vivo dosimetry in areas where high skin dose is expected during radiotherapy treatment. Conclusion: The limitations of TPS should be considered while evaluating surface doses in radiotherapy plans.

Assessment of the Absorbed Dose Variations in the Thyroid Gland Exposed to Orthopantomography (OPG) while Swallowing: A Novel Approach to Radiation Protection.

The reliance on specialized diagnostic techniques is on the rise across various medical fields, including dentistry. While orthopantomogram (OPG), offers many advantages in terms of dental diagnosis, it also poses potential risks to sensitive organs, notably the thyroid gland. This study aimed to evaluate the fluctuations in the absorbed dose within the thyroid gland during swallowing while undergoing an OPG procedure. In this computational simulation study, the BEAMnrc Monte Carlo code was employed to model an OPG machine, using 700 million particles across the energy range of 60-75 keV, which is standard for OPG procedures. The Monte Carlo (MC) model was cross-verified by comparing the derived spectra with those in the IPEM Report 78. A head and neck phantom was constructed using CT scan images with a slice thickness of 5 mm. This phantom underwent simulated beam exposure under two conditions: pre-swallow and post-swallow. Subsequently, the percentage depth dose was measured and contrasted across different depths. After swallowing, there was an increase in the absorbed dose across all three regions of the thyroid (right, left, and center). Notably, regions near the hyoid bone exhibited a particularly significant increase in dose. In certain areas, the absorbed dose even tripled when compared to the pre-swallowing state. The findings indicate that during OPG imaging, swallowing can lead to an increased radiation dose to the thyroid gland. Given the thyroid's heightened sensitivity to radiation, such an increase in dosage is noteworthy.

Optimization of Intraventricular Radioactive Concentration for 13N ammonia PET with Time-of-Flight Scanner

Background: Myocardial blood flow quantification (MBF) is one of the distinctive features for cardiac positron emission tomography. The MBF calculation is mostly obtained by estimating the input function from the time activity curve in dynamic scan. However, there is a substantial risk of count-loss because the high radioactivity pass through the left ventricular (LV) cavity within a short period. We aimed to determine the optimal intraventricular activity using the noise equivalent count rate (NECR) analysis with simplified phantom model. Methods: Positron emission tomography computed tomography scanner with LYSO crystal and time of flight was used for phantom study. 150 MBq/mL of 13N was filled in 10 mL of syringe, placed in neck phantom to imitate end-systolic small LV. 3D list-mode acquisition was repeatedly performed along radioactive decay. Net true and random count rate were calculated and compared to the theoretical activity in the syringe. NECR curve analysis was used to determine the optimal radioactive concentration. Result: The attenuation curves showed good correlation to the theoretical activity between 20 to 370, and 370 to 740 MBq (r2=1.0 ± 0.0001, p<0.0001; r2=0.99 ± 0.0001, p<0.0001 for 20 to 370, and 370 to 740, respectively), while did not over 740 MBq (p=0.62). NECR analysis revealed that the peak rate was at 2.9 Mcps, there at the true counts were significantly suppressed. The optimal radioactive concentration was determined as 36 MBq/mL. Conclusion: Simulative analysis for high-dose of 13N using the phantom imitating small LV confirmed that the risk of count-loss was increased. The result can be useful information in assessing the feasibility of MBF quantification in clinical routine.

Initial Experimental Tests of an ANN-Based Microwave Imaging Technique for Neck Diagnostics

In this letter, a microwave imaging strategy based on an artificial neural network (ANN) is applied, for the first time, to experimental data gathered from simplified neck phantoms. The ANN is used for solving the underlying inverse scattering problem, with the aim of retrieving the dielectric properties of the neck for monitoring and diagnostic purposes. The ANN is trained using simulated phantoms, to overcome the limited availability of experimental data. First, a simple configuration with a liquid-filled glass beaker is tested. Then, simplified 3-D-printed models of the human neck are considered. The preliminary findings indicate the possibility of training the network with numerical simulations and testing it against experimental measurements.

Evaluating the Quality of Patient-Specific Deformable Image Registration in Adaptive Radiotherapy Using a Digitally Enhanced Head and Neck Phantom

Despite the availability of national and international guidelines, an accurate and efficient, patient-specific, deformable image registration (DIR) validation methodology is not yet established, and several groups have found an incompatibility of the various digital phantoms with the commercial systems. To evaluate the quality of the computed tomography (CT) and on-board cone-beam CT (CBCT) DIRs, a novel methodology was developed and tested on 10 head and neck (HN) patients, using CT and CBCT anthropomorphic HN phantom images, digitally reprocessed to include the common organs at risk. Reference DVFs (refDVFs) were generated from the clinical patient CT-CBCT fused images using an independent registration software. The phantom CT images were artificially deformed, using the refDVFs, and registered with the phantom CBCT images, using the clinical registration software, generating a test DVF (testDVF) dataset. The clinical plans were recalculated on the daily patient ‘deformed’ CTs, and the dose maps transferred to the patient-planning CT, using both the refDVF and testDVF. The spatial and dosimetric errors were quantified and the DIR performance evaluated using an established operative tolerance level. The method showed the ability to quantify the DIR spatial errors and assess their dose impact at the voxel level and could be applied to patient-specific DIR evaluation during adaptive HN radiotherapy in routine practice.