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  • 1.
    Andersson, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Johansson, Erik
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Tölli, Heikki
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    On the property of measurements with the PTW microLion chamber in continuous beam2012In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 39, no 8, p. 4775-4787Article in journal (Refereed)
    Abstract [en]

    Purpose: The performance of liquid ionization chambers, which may prove to be useful tools in the field of radiation dosimetry, is based on several chamber and liquid specific characteristics. The present work investigates the performance of the PTW microLion liquid ionization chamber with respect to recombination losses and perturbations from ambient electric fields at various dose rates in continuous beams.

    Methods: In the investigation, experiments were performed using two microLion chambers, containing isooctane (C8H18) and tetramethylsilane (Si(CH3)4) as the sensitive media, and a NACP-02 monitor chamber. An initial activity of approximately 250 GBq 18F was employed as the radiation source in the experiments. The initial dose rate in each measurement series was estimated to 1.0 Gy min-1 by Monte Carlo simulations and the measurements were carried out during the decay of the radioactive source. In the investigation of general recombination losses, employing the two-dose-rate method for continuous beams, the liquid ionization chambers were operated at polarizing voltages 25, 50, 100, 150, 200 and 300 V. Furthermore, measurements were also performed at 500 V polarizing voltage in the investigation of the sensitivity of the microLion chamber to ambient electric fields.

    Results: The measurement results from the liquid ionization chambers, corrected for general recombination losses according to the two-dose-rate method for continuous beams, had a good agreement with the signal to dose linearity from the NACP-02 monitor chamber for general collection efficiencies above 70%. The results also displayed an agreement with the theoretical collection efficiencies according to the Greening theory, except for the liquid ionization chamber containing isooctane operated at 25 V. At lower dose rates, perturbations from ambient electric fields were found in the microLion chamber measurement results. Due to the perturbations, measurement results below an estimated dose rate of 0.2 Gy min-1 were excluded from the present investigation of the general collection efficiency. The perturbations were found to be more pronounced when the chamber polarizing voltage was increased.

    Conclusions: By using the two-dose-rate method for continuous beams, comparable corrected ionization currents from experiments in low- and medium energy photon beams can be achieved. However, the valid range of general collection efficiencies has been found to vary in a comparison between experiments performed in continuous beams of 120 kVp x-ray, and the present investigation of 511 keV annihilation photons. At very high dose rates in continuous beams, there are presently no methods that can be used to correct for general recombination losses and at low dose rates the microLion chamber may be perturbed by ambient electric fields. Increasing the chamber polarizing voltage, which diminishes the general recombination effect, was found to increase the microLion chamber sensitivity to ambient electric fields. Prudence is thus advised when employing the microLion chamber in radiation dosimetry, as ambient electric fields of the strength observed in the present work may be found in many common situations. Due to uncertainties in the theoretical basis for recombination losses in liquids, further studies on the underlying theories for the initial and general recombination effect are needed if liquid ionization chambers are to become a viable option in high precision radiation dosimetry.

  • 2.
    Andersson, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Tölli, Heikki
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Modeling ion recombination in liquid ionization chambers: Improvement and analysis of the two-dose-rate method2017In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 44, no 11, p. 5977-5987Article in journal (Refereed)
    Abstract [en]

    Purpose: The use of liquid ionization chambers can provide useful information to endeavors with radiation dosimetry for highly modulated beams. Liquid ionization chambers may be particularly suitable for computed tomography applications where conventional ionization chambers do not present a high enough sensitivity for the spatial resolution required to characterize common X-ray beams. Due to the sensitivity, which leads to high charge densities, liquid ionization chambers can suffer from large recombination losses leading to degradation in signal to dose rate linearity. To solve this problem, a two-dose-rate method for general recombination correction has been proposed for liquid ionization chambers. However, the valid range of recombination losses that the method can accurately account for has been found to vary depending on radiation quality. The present work provides an in-depth analysis of the performance of the two-dose-rate method. Furthermore, the soundness of applying gas theory to liquids is investigated by using the two-dose-rate method.

    Methods: In the present work, the two-dose-rate method for general recombination correction of liquid ionization chambers used in continuous beams is studied by employing theory for gas-filled ionization chambers. An approximate relation for the general collection efficiency containing a material-specific parameter that is traceable to liquids has been derived for theoretical and experimental investigation alongside existing theory. Furthermore, the disassociation between initial and general recombination in the method is analyzed both theoretically and experimentally.

    Results: The results indicate that liquids and gases share general recombination characteristics, where the liquids investigated (isooctane and tetramethylsilane) to a large extent mimic the behavior theoretically expected in gases. Furthermore, it is shown that the disassociation between initial and general recombination in the two-dose-rate method is an approximation that depends on the relation between initial recombination and the collecting electric field strength at the dose rates used.

    Conclusions: Due to the approximation used to separate initial and general recombination the valid range of collection efficiencies for the two-dose-rate method will not only depend on the model used to describe general recombination but also on the type of liquid and radiation beam quality. As there is no robust theory for initial recombination in liquids to apply, the valid range of general collection efficiencies for the two-dose-rate method should be experimentally evaluated for each radiation dosimetry application.

  • 3.
    Bayisa, Fekadu
    et al.
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Liu, Xijia
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Garpebring, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Yu, Jun
    Umeå University, Faculty of Science and Technology, Department of Mathematics and Mathematical Statistics.
    Statistical learning in computed tomography image estimation2018In: Medical physics (Lancaster), ISSN 0094-2405Article in journal (Refereed)
    Abstract [en]

    Purpose: There is increasing interest in computed tomography (CT) image estimations from magneticresonance (MR) images. The estimated CT images can be utilized for attenuation correction, patientpositioning, and dose planning in diagnostic and radiotherapy workflows. This study aims to introducea novel statistical learning approach for improving CT estimation from MR images and to compare theperformance of our method with the existing model-based CT image estimation methods.

    Methods: The statistical learning approach proposed here consists of two stages. At the trainingstage, prior knowledge about tissue types from CT images was used together with a Gaussian mixturemodel (GMM) to explore CT image estimations from MR images. Since the prior knowledge is notavailable at the prediction stage, a classifier based on RUSBoost algorithm was trained to estimatethe tissue types from MR images. For a new patient, the trained classifier and GMMs were used topredict CT image from MR images. The classifier and GMMs were validated by using voxel-leveltenfold cross-validation and patient-level leave-one-out cross-validation, respectively.

    Results: The proposed approach has outperformance in CT estimation quality in comparison withthe existing model-based methods, especially on bone tissues. Our method improved CT image estimationby 5% and 23% on the whole brain and bone tissues, respectively.

    Conclusions: Evaluation of our method shows that it is a promising method to generate CTimage substitutes for the implementation of fully MR-based radiotherapy and PET/MRI applications

  • 4.
    Brynolfsson, Patrik
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Axelsson, Jan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Holmberg, August
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Jonsson, Joakim
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Goldhaber, David
    Jian, Yiqiang
    Illerstam, Fredrik
    Engström, Mathias
    Zackrisson, Björn
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Technical note: adapting a GE SIGNA PET/MR scanner for radiotherapy2018In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 45, no 8, p. 3546-3550Article in journal (Refereed)
    Abstract [en]

    Purpose: Simultaneous collection of PET and MR data for radiotherapy purposes are useful for, for example, target definition and dose escalations. However, a prerequisite for using PET/MR in the radiotherapy workflow is the ability to image the patient in treatment position. The aim of this work was to adapt a GE SIGNA PET/MR scanner to image patients for radiotherapy treatment planning and evaluate the impact on signal-to-noise (SNR) of the MR images, and the accuracy of the PET attenuation correction. Method: A flat tabletop and a coil holder were developed to image patients in the treatment position, avoid patient contour deformation, and facilitate attenuation correction of flex coils. Attenuation corrections for the developed hardware and an anterior array flex coil were also measured and implemented to the PET/MR system to minimize PET quantitation errors. The reduction of SNR in the MR images due to the added distance between the coils and the patient was evaluated using a large homogenous saline-doped water phantom, and the activity quantitation errors in PET imaging were evaluated with and without the developed attenuation corrections. Result: We showed that the activity quantitation errors in PET imaging were within ±5% when correcting for attenuation of the flat tabletop, coil holder, and flex coil. The SNR of the MRI images were reduced to 74% using the tabletop, and 66% using the tabletop and coil holders. Conclusion: We present a tabletop and coil holder for an anterior array coil to be used with a GE SIGNA PET/MR scanner, for scanning patients in the radiotherapy work flow. Implementing attenuation correction of the added hardware from the radiotherapy setup leads to acceptable PET image quantitation. The drop in SNR in MR images may require adjustment of the imaging protocols.

  • 5.
    Brynolfsson, Patrik
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Nilsson, David
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Henriksson, Roger
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Hauksson, Jon
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Garpebring, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Birgander, Richard
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Trygg, Johan
    Umeå University, Faculty of Science and Technology, Department of Chemistry.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Asklund, Thomas
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    ADC texture-An imaging biomarker for high-grade glioma?2014In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 41, no 10, p. 101903-Article in journal (Refereed)
    Abstract [en]

    Purpose:

    Survival for high-grade gliomas is poor, at least partly explained by intratumoral heterogeneity contributing to treatment resistance. Radiological evaluation of treatment response is in most cases limited to assessment of tumor size months after the initiation of therapy. Diffusion-weighted magnetic resonance imaging (MRI) and its estimate of the apparent diffusion coefficient (ADC) has been widely investigated, as it reflects tumor cellularity and proliferation. The aim of this study was to investigate texture analysis of ADC images in conjunction with multivariate image analysis as a means for identification of pretreatment imaging biomarkers.

    Methods:

    Twenty-three consecutive high-grade glioma patients were treated with radiotherapy (2 Gy/60 Gy) with concomitant and adjuvant temozolomide. ADC maps and T1-weighted anatomical images with and without contrast enhancement were collected prior to treatment, and (residual) tumor contrast enhancement was delineated. A gray-level co-occurrence matrix analysis was performed on the ADC maps in a cuboid encapsulating the tumor in coronal, sagittal, and transversal planes, giving a total of 60 textural descriptors for each tumor. In addition, similar examinations and analyses were performed at day 1, week 2, and week 6 into treatment. Principal component analysis (PCA) was applied to reduce dimensionality of the data, and the five largest components (scores) were used in subsequent analyses. MRI assessment three months after completion of radiochemotherapy was used for classifying tumor progression or regression.

    Results:

    The score scatter plots revealed that the first, third, and fifth components of the pretreatment examinations exhibited a pattern that strongly correlated to survival. Two groups could be identified: one with a median survival after diagnosis of 1099 days and one with 345 days, p = 0.0001.

    Conclusions:

    By combining PCA and texture analysis, ADC texture characteristics were identified, which seems to hold pretreatment prognostic information, independent of known prognostic factors such as age, stage, and surgical procedure. These findings encourage further studies with a larger patient cohort. (C) 2014 Author(s).

  • 6. Christensen, Jeppe Brage
    et al.
    Tolli, Heikki
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Bassler, Niels
    A general algorithm for calculation of recombination losses in ionization chambers exposed to ion beams2016In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 43, no 10Article in journal (Refereed)
    Abstract [en]

    Purpose: Dosimetry with ionization chambers in clinical ion beams for radiation therapy requires correction for recombination effects. However, common radiation protocols discriminate between initial and general recombination and provide no universal correction method for the presence of both recombination types in ion beams of charged particles heavier than protons. The advent of multiple field optimization in ion beams, allowing for complex patterns of dose delivery in both temporal and spatial domains, results in new challenges for recombination correction where the resulting recombination depends on the plan delivered. Here, the authors present the open source code IonTracks version 1.0, where the combined initial and general recombination effects in principle can be predicted for any ion beam with arbitrary particle-energy spectrum and temporal structure. Methods: IonTracks uses track structure theory to distribute the charge carriers in ion tracks. The charge carrier movements are governed by a pair of coupled differential equations, based on fundamental physical properties as charge carrier drift, diffusion, and recombination, which are solved numerically while the initial and general charge carrier recombination is computed. A space charge screening of the electric field is taken into account and the algorithm furthermore allows an inclusion of a free-electron component. Results: The algorithm is numerically stable and in accordance with experimentally validated theories for initial recombination in heavy ion tracks and general recombination in a proton beam. Conclusions: Given IonTracks' ability to handle arbitrary inputs, IonTracks can in principle be applied to any complex particle field in the spatial and temporal domain. IonTracks is validated against the Jaffe's and Boag's theory of recombination in pulsed beams of multiple ion species. IonTracks is able to calculate the correction factor for initial and general recombination losses in parallel-plate ionization chambers. Even if only few experimental data on recombination effects in ionization chambers are available today, the universal concept of IonTracks is not limited to the ions investigated here. Future experimental investigations of recombination in pulsed and possibly also continuous ion beams may be conducted with IonTracks, which ultimately may lead to a more precise prediction of recombination factors in complex radiation fields. 

  • 7. Georg, Dietmar
    et al.
    Olofsson, Jörgen
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Künzler, Thomas
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    On empirical methods to determine scatter factors for irregular MLC shaped beams2004In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 31, no 8, p. 2222-2229Article in journal (Refereed)
    Abstract [en]

    Multileaf collimators (MLCs) are in clinical use for more than a decade and are a well accepted tool in radiotherapy. For almost each MLC design different empirical or semianalytical methods have been presented for calculating output ratios in air for irregularly shaped beams. However, until now no clear recommendations have been given on how to handle irregular fields shaped by multileaf collimators for independent monitor unit (MU) verification. The present article compares different empirical methods, which have been proposed for independent MU verification, to determine (1) output ratios in air (S-P) and (2) phantom scatter factors (Sp) for irregular MLC shaped fields. Ten dedicated field shapes were applied to five different types of MLCs (Elekta, Siemens, Varian, Scanditronix, General Electric). All calculations based on empirical relations were compared with measurements and with calculations performed by a treatment planning system with a fluence based algorithm. For most irregular MLC shaped beams output ratios in air could be adequately modeled with an accuracy of about 1%-1.5% applying a method based on the open field aperture defined by the leaf and jaw setting combined with the equivalent square formula suggested by Vadash and Bjarngard [P. Vadash and B. E. Bjarngard, Med. Phys. 20, 733-734 (1993)]. The accuracy of this approach strongly depends on the inherent head scatter characteristics of the accelerator in use and on the irregular field under consideration. Deviations of up to 3% were obtained for fields where leaves obscure central parts of the flattening filter. Simple equivalent square methods for S-P calculations in irregular fields did not provide acceptable results (deviations mostly >3%). S-P values derived from Clarkson integration, based on published tables of phantom scatter correction factors, showed the same accuracy level as calculations performed using a pencil beam algorithm of a treatment planning system (in a homogeneous media). The separation of head scatter and phantom scatter contributions is strongly recommended for irregular MLC shaped beams as both contributions have different factors of influence. With rather simple methods S, and SP can be determined for independent MU calculation with an accuracy better than 1.5% for most clinical situations encountered in conformal radiotherapy. (C) 2004 American Association of Physicists in Medicine.

  • 8. Gustafsson, Christian
    et al.
    Korhonen, Juha
    Persson, Emilia
    Gunnlaugsson, Adalsteinn
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Olsson, Lars E
    Registration free automatic identification of gold fiducial markers in MRI target delineation images for prostate radiotherapy2017In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 44, no 11, p. 5563-5574Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The superior soft tissue contrast of magnetic resonance imaging (MRI) compared to computed tomography (CT) has urged the integration of MRI and elimination of CT in radiotherapy treatment (RT) for prostate. An intraprostatic gold fiducial marker (GFM) appears hyperintense on CT. On T2-weighted (T2w) MRI target delineation images, the GFM appear as a small signal void similar to calcifications and post biopsy fibrosis. It can therefore be difficult to identify the markers without CT. Detectability of GFMs can be improved using additional MR images, which are manually registered to target delineation images. This task requires manual labor, and is associated with interoperator differences and image registration errors. The aim of this work was to develop and evaluate an automatic method for identification of GFMs directly in the target delineation images without the need for image registration.

    METHODS: T2w images, intended for target delineation, and multiecho gradient echo (MEGRE) images intended for GFM identification, were acquired for prostate cancer patients. Signal voids in the target delineation images were identified as GFM candidates. The GFM appeared as round, symmetric, signal void with increasing area for increasing echo time in the MEGRE images. These image features were exploited for automatic identification of GFMs in a MATLAB model using a patient training dataset (n = 20). The model was validated on an independent patient dataset (n = 40). The distances between the identified GFM in the target delineation images and the GFM in CT images were measured. A human observatory study was conducted to validate the use of MEGRE images.

    RESULTS: The sensitivity, specificity, and accuracy of the automatic method and the observatory study was 84%, 74%, 81% and 98%, 94%, 97%, respectively. The mean absolute difference in the GFM distances for the automatic method and observatory study was 1.28 ± 1.25 mm and 1.14 ± 1.06 mm, respectively.

    CONCLUSIONS: Multiecho gradient echo images were shown to be a feasible and reliable way to perform GFM identification. For clinical practice, visual inspection of the results from the automatic method is needed at the current stage.

  • 9.
    Häggström, Ida
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics. Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA.
    Beattie, Bradley J
    Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA.
    Schmidtlein, C Ross
    Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, USA.
    Dynamic PET simulator via tomographic emission projection for kinetic modeling and parametric image studies2016In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 43, no 6, p. 3104-3116Article in journal (Refereed)
    Abstract [en]

    Purpose: To develop and evaluate a fast and simple tool called dPETSTEP (Dynamic PET Simulator ofTracers via Emission Projection), for dynamic PET simulations as an alternative to Monte Carlo (MC), useful for educational purposes and evaluation of the effects of the clinical environment,postprocessing choices, etc., on dynamic and parametric images.

    Methods: The tool was developed in PETSTEP using both new and previously reported modules of PETSTEP (PET Simulator of Tracers via Emission Projection). Time activity curves are generated foreach voxel of the input parametric image, whereby effects of imaging system blurring, counting noise,scatters, randoms, and attenuation are simulated for each frame. Each frame is then reconstructed intoimages according to the user specified method, settings, and corrections. Reconstructed images werecompared to MC data, and simple Gaussian noised time activity curves (GAUSS).

    Results: dPETSTEP was 8000 times faster than MC. Dynamic images from dPETSTEP had a root meansquare error that was within 4% on average of that of MC images, whereas the GAUSS images werewithin 11%. The average bias in dPETSTEP and MC images was the same, while GAUSS differed by 3% points. Noise profiles in dPETSTEP images conformed well to MC images, confirmed visually by scatterplot histograms, and statistically by tumor region of interest histogram comparisons that showed nosignificant differences (p < 0.01). Compared to GAUSS, dPETSTEP images and noise properties agreedbetter with MC.

    Conclusions: The authors have developed a fast and easy one-stop solution for simulationsof dynamic PET and parametric images, and demonstrated that it generates both images andsubsequent parametric images with very similar noise properties to those of MC images, in afraction of the time. They believe dPETSTEP to be very useful for generating fast, simple, andrealistic results, however since it uses simple scatter and random models it may not be suitablefor studies investigating these phenomena. dPETSTEP can be downloaded free of cost from https://github.com/CRossSchmidtlein/dPETSTEP.

  • 10.
    Johansson, Adam
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Garpebring, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Asklund, Thomas
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Tufve, Nyholm
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    CT substitutes derived from MR images reconstructed with parallel imaging2014In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 41, no 8, p. 474-480Article in journal (Refereed)
    Abstract [en]

    Purpose: Computed tomography (CT) substitute images can be generated from ultrashort echo time (UTE) MRI sequences with radial k-space sampling. These CT substitutes can be used as ordinary CT images for PET attenuation correction and radiotherapy dose calculations. Parallel imaging allows faster acquisition of magnetic resonance (MR) images by exploiting differences in receiver coil element sensitivities. This study investigates whether non-Cartesian parallel imaging reconstruction can be used to improve CT substitutes generated from shorter examination times.

    Methods: The authors used gridding as well as two non-Cartesian parallel imaging reconstruction methods, SPIRiT and CG-SENSE, to reconstruct radial UTE and gradient echo (GE) data into images of the head for 23 patients. For each patient, images were reconstructed from the full dataset and from a number of subsampled datasets. The subsampled datasets simulated shorter acquisition times by containing fewer radial k-space spokes (1000, 2000, 3000, 5000, and 10 000 spokes) than the full dataset (30 000 spokes). For each combination of patient, reconstruction method, and number of spokes, the reconstructed UTE and GE images were used to generate a CT substitute. Each CT substitute image was compared to a real CT image of the same patient.

    Results: The mean absolute deviation between the CT number in CT substitute and CT decreased when using SPIRiT as compared to gridding reconstruction. However, the reduction was small and the CT substitute algorithm was insensitive to moderate subsampling (≥5000 spokes) regardless of reconstruction method. For more severe subsampling (≤3000 spokes), corresponding to acquisition times less than aminute long, the CT substitute quality was deteriorated for all reconstructionmethods but SPIRiT gave a reduction in the mean absolute deviation of down to 25 Hounsfield units compared to gridding.

    Conclusions: SPIRiT marginally improved the CT substitute quality for a given number of radial spokes as compared to gridding. However, the increased reconstruction time of non-Cartesian parallel imaging reconstruction is difficult to motivate from this improvement. Because the CT substitute algorithm was insensitive to moderate subsampling, data for a CT substitute could be collected in as little as minute and reconstructed with gridding without deteriorating the CT substitute quality.

  • 11.
    Johansson, Adam
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    CT substitute derived from MRI sequences with ultrashort echo time2011In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 38, no 5, p. 2708-2714Article in journal (Refereed)
    Abstract [en]

    Purpose: Methods for deriving computed tomography (CT) equivalent information from MRI are needed for attenuation correction in PET/MRI applications, as well as for patient positioning and dose planning in MRI based radiation therapy workflows. This study presents a method for generating a drop in substitute for a CT image from a set of magnetic resonance (MR)images.

    Methods:A Gaussian mixture regression model was used to link the voxel values in CT images to the voxel values in images from three MRI sequences: one T2 weighted 3D spin echo based sequence and two dual echo ultrashort echo time MRI sequences with different echo times and flip angles. The method used a training set of matched MR and CT data that after training was able to predict a substitute CT (s-CT) based entirely on the MR information for a new patient. Method validation was achieved using datasets covering the heads of five patients and applying leave-one-out cross-validation (LOOCV). During LOOCV, the model was estimated from the MR and CT data of four patients (training set) and applied to the MR data of the remaining patient (validation set) to generate an s-CT image. This procedure was repeated for all five training and validation data combinations.

    Results: The mean absolute error for the CT number in the s-CT images was 137 HU. No large differences in method accuracy were noted for the different patients, indicating a robust method. The largest errors in the s-CT images were found at air–tissue and bone–tissue interfaces. The model accurately discriminated between air and bone, as well as between soft tissues and nonsoft tissues.

    Conclusions: The s-CT method has the potential to provide an accurate estimation of CT information without risk of geometrical inaccuracies as the model is voxel based. Therefore, s-CT images could be well suited as alternatives to CT images for dose planning in radiotherapy and attenuation correction in PET/MRI.

  • 12.
    Johansson, Adam
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Yu, Jun
    SLU, Centre of Biostochastics.
    Asklund, Thomas
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Voxel-wise uncertainty in CT substitute derived from MRI2012In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 39, no 6, p. 3283-3290Article in journal (Refereed)
    Abstract [en]

    Purpose: In an earlier work, we demonstrated that substitutes for CT images can be derived from MR images using ultrashort echo time (UTE) sequences, conventional T2 weighted sequences, and Gaussian mixture regression (GMR). In this study, we extend this work by analyzing the uncertainties associated with the GMR model and the information contributions from the individual imaging sequences.

    Methods: An analytical expression for the voxel-wise conditional expected absolute deviation (EAD) in substitute CT (s-CT) images was derived. The expression depends only on MR images and can thus be calculated along with each s-CT image. The uncertainty measure was evaluated by comparing the EAD to the true mean absolute prediction deviation (MAPD) between the s-CT and CT images for 14 patients. Further, the influence of the different MR images included in the GMR model on the generated s-CTs was investigated by removing one or more images and evaluating the MAPD for a spectrum of predicted radiological densities.

    Results: The largest EAD was predicted at air-soft tissue and bone-soft tissue interfaces. The EAD agreed with the MAPD in both these regions and in regions with lower EADs, such as the brain. Two of the MR images included in the GMR model were found to be mutually redundant for the purpose of s-CT generation.

    Conclusions: The presented uncertainty estimation method accurately predicts the voxel-wise MAPD in s-CT images. Also, the non-UTE sequence previously used in the model was found to be redundant.

  • 13.
    Karlsson, M G
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Electron beam collimation with focused and curved leaf end MLCs - Experimental verification of Monte Carlo optimized designs2002In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 29, no 4, p. 631-637Article in journal (Refereed)
    Abstract [en]

    In general, electron beams, from conventional accelerators using applicators with lead alloy inserts are not suitable for advanced conformal radiation therapy. However, interesting electron treatments have been demonstrated on a few advanced accelerators. These accelerators have been equipped with helium filled treatment heads and computer controlled MLCs that produce clinically useful energy modulated electron beams or mixed photon electron beams in an automated sequence. This study analyzes the characteristics of different MLC designs, curved and focused leaf ends in helium filled treatment heads, with respect to their effect on electron beams. In addition, this study analyzes the effects that different treatment head designs have on the output factor due to collimator scattering and shielding of secondary sources during treatment. The investigation of the different treatment head designs was performed with the Monte Carlo package BEAM and was verified by experimental methods. The results show that the difference between curved leaf ends and focused ends is negligible in most practical cases. The results also show the importance of scattering foil optimization in the optimization of parameters such as penumbra. virtual source position, and in the reduction of the output variation. In all cases, the experimental data verifies the calculations. (C) 2002 American Association of Physicists in Medicine.

  • 14.
    Karlsson, M G
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Ma, C M
    Treatment head design for multileaf collimated high-energy electrons1999In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 26, no 10, p. 2161-2167Article in journal (Refereed)
    Abstract [en]

    This paper describes how a conventional treatment head can be modified for use of multileaf collimated electron beams. Automatic and dynamic beam delivery are possible for both electrons and photons by using the computer controlled multileaf collimator (MLC) for both photon and electron beams. Thereby, the electron beams can be mixed more freely into the treatment to take advantage of the specific depth modulation characteristics of electrons. The investigation was based on Monte Carlo calculations using the software package BEAM. The physical parameters used in this optimization were the beam penumbra and the virtual/effective point source position. These parameters are essential for shaping beams, beam matching and for dosimetry calculations. The optimization was carried out by modifying a number of parameters: replacing the air atmosphere in the treatment head with helium, adding a helium bag below the MLC, changing the position of the scattering foils, modifying the monitor chamber, and adjusting the position of the MLC. The beam characteristics for some of these designs were found to fulfil our criteria for clinically useful beams down to at least 9 MeV. (C) 1999 American Association of Physicists in Medicine. [S0094-2405(99)00610-0].

  • 15.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    A multileaf delineator system for a radiotherapy simulator1994In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 21, no 1, p. 83-84Article in journal (Refereed)
    Abstract [en]

    Multileaf collimators are offered as an accessory to many accelerators for conformal radiotherapy and the dose planning systems are capable of calculating multileaf collimated beams. There is further a frequent desire to verify the radiation fields on a radiotherapy simulator prior to the actual treatment. For this purpose,an accessory to the simulator was developed (the multileaf delineator). With this unit the front end of the individual leaves are indicated both on the skin of the patient and in the x-ray image. All anatomical structures both outside and inside the field edge are, however, still fully visible.

  • 16.
    Karlsson, Mikael
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Nyström, Håkan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Svensson, Hans
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Electron beam characteristics of the 50-MeV racetrack microtron1992In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 19, no 2, p. 307-315Article in journal (Refereed)
    Abstract [en]

    Electron beams in the MM50 racetrack microtron are generated by computer controlled scanning of a well-focused electron pencil beam. The treatment head is optimized to give a minimum of scatter between the source position and the collimator plane by a general minimization of all scattering material in the beam and by replacement of the air in the treatment head by helium, which has a much lower linear scattering power than air. A double-focused multileaf collimator with a 31-cm collimator to patient distance is used both for electron and photon collimation. In general, no extra electron collimation is needed for the standard SSD of 100 cm. To make irregular field collimation at a distance this far from the patient possible, a number of requirements have to be fulfilled regarding the virtual source position and the spatial and angular distribution of the initial electron beam. The virtual source position has been found to be at a fixed position for different irradiation parameters. This is important for the use of the light field in electron beam treatment but also for achieving a high degree of accuracy in the dosimetry. Scatter from the multileaf collimator has not been found to give any significant contribution to the radiation field or to the monitor output factor of the MM50. Experimental dose distribution data on the MM50 have been compared to data both from other types of treatment units and to Monte Carlo simulations.

  • 17.
    Karlsson, Mikael
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Nyström, Håkan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Svensson, Hans
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Photon beam characteristics on the MM50 racetrack microtron and a new approach for beam quality determination1993In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 20, no 1, p. 143-149Article in journal (Refereed)
    Abstract [en]

    The photon beams of the MM50 racetrack microtron have special characteristics which make them more suitable than conventional photon beams for precision radiation therapy with good dosimetric control. The beam flattening is obtained by the scanning of an elementary beam instead of using a flattening filter. This will give a number of advantages such as the possibility to optimize field flattening to individual field forms and field sizes. The radiation quality is the same across the whole beam, which gives smaller changes in dose profiles with depth and also makes it easier to perform careful dose planning. Beam collimation is mainly performed by a multileaf collimator and the special design of the treatment head gives nearly ideal characteristics for dose determination in an arbitrary point in the treatment fields. The output factor has been shown to depend almost solely on scattering within the treatment field. The conventional methods for beam quality characterization have been found less suitable at high energies and a new method based on HVL measurements in water is proposed.

  • 18. Källman, Hans-Erik
    et al.
    Holmberg, Rickard
    Andersson, Jonas
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Kull, Love
    Tranéus, Erik
    Ahnesjö, Anders
    Source modeling for Monte Carlo dose calculation of CT examinations with a radiotherapy treatment planning system2016In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 43, no 11, p. 6118-6128Article in journal (Refereed)
    Abstract [en]

    Purpose:

    Radiation dose to patients undergoing examinations with Multislice Computed Tomography (MSCT) as well as Cone Beam Computed Tomography (CBCT) is a matter of concern. Risk management could benefit from efficient replace rational dose calculation tools. The paper aims to verify MSCT dose calculations using a Treatment Planning System (TPS) for radiotherapy and to evaluate four different variations of bow-tie filter characterizations for the beam model used in the dose calculations.

    Methods:

    A TPS (RayStation™, RaySearch Laboratories, Stockholm, Sweden) was configured to calculate dose from a MSCT (GE Healthcare, Wauwatosa, WI, USA). The x-ray beam was characterized in a stationary position the by measurements of the Half-Value Layer (HVL) in aluminum and kerma along the principal axes of the isocenter plane perpendicular to the beam. A Monte Carlo source model for the dose calculation was applied with four different variations on the beam-shaping bow-tie filter, taking into account the different degrees of HVL information but reconstructing the measured kerma distribution after the bow-tie filter by adjusting the photon sampling function. The resulting dose calculations were verified by comparison with measurements in solid water as well as in an anthropomorphic phantom.

    Results:

    The calculated depth dose in solid water as well as the relative dose profiles was in agreement with the corresponding measured values. Doses calculated in the anthropomorphic phantom in the range 26–55 mGy agreed with the corresponding thermo luminescence dosimeter (TLD) measurements. Deviations between measurements and calculations were of the order of the measurement uncertainties. There was no significant difference between the different variations on the bow-tie filter modeling.

    Conclusions:

    Under the assumption that the calculated kerma after the bow-tie filter replicates the measured kerma, the central specification of the HVL of the x-ray beam together with the kerma distribution can be used to characterize the beam. Thus, within the limits of the study, a flat bow-tie filter with an HVL specified by the vendor suffices to calculate the dose distribution. The TPS could be successfully configured to replicate the beam movement and intensity modulation of a spiral scan with dose modulation, on the basis of the specifications available in the metadata of the digital images and the log file of the CT.

  • 19.
    Nyholm, Tufve
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Olsson, C.
    Skönevik, Johan
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Gunnlaugsson, A.
    Valdman, A.
    Johnsson, S.
    Zackrisson, Björn
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Nationwide Collection of Structured RT Data in Sweden2017In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 44, no 6, p. 3241-3241Article in journal (Other academic)
  • 20.
    Nyholm, Tufve
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Svensson, Stina
    Andersson, Sebastian
    Jonsson, Joakim
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Sohlin, Maja
    Gustafsson, Christian
    Kjellén, Elisabeth
    Söderström, Karin
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Albertsson, Per
    Blomqvist, Lennart
    Umeå University, Faculty of Medicine, Department of Radiation Sciences. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
    Zackrisson, Björn
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Olsson, Lars E.
    Gunnlaugsson, Adalsteinn
    MR and CT data with multiobserver delineations of organs in the pelvic area: Part of the Gold Atlas project2018In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 45, no 3, p. 1295-1300Article in journal (Refereed)
    Abstract [en]

    Purpose: We describe a public dataset with MR and CT images of patients performed in the same position with both multiobserver and expert consensus delineations of relevant organs in the male pelvic region. The purpose was to provide means for training and validation of segmentation algorithms and methods to convert MR to CT like data, i.e., so called synthetic CT (sCT).

    Acquisition and validation methods: T1- and T2-weighted MR images as well as CT data were collected for 19 patients at three different departments. Five experts delineated nine organs for each patient based on the T2-weighted MR images. An automatic method was used to fuse the delineations. Starting from each fused delineation, a consensus delineation was agreed upon by the five experts for each organ and patient. Segmentation overlap between user delineations with respect to the consensus delineations was measured to describe the spread of the collected data. Finally, an open-source software was used to create deformation vector fields describing the relation between MR and CT images to further increase the usability of the dataset.

    Data format and usage notes: The dataset has been made publically available to be used for academic purposes, and can be accessed from . Potential applicationsThe dataset provides a useful source for training and validation of segmentation algorithms as well as methods to convert MR to CT-like data (sCT). To give some examples: The T2-weighted MR images with their consensus delineations can directly be used as a template in an existing atlas-based segmentation engine; the expert delineations are useful to validate the performance of a segmentation algorithm as they provide a way to measure variability among users which can be compared with the result of an automatic segmentation; and the pairwise deformably registered MR and CT images can be a source for an atlas-based sCT algorithm or for validation of sCT algorithm.

  • 21.
    Olofsson, Jörgen
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Ahnesjö, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Dose uncertainties in photon pencil kernel calculations at off-axis positions2006In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 33, no 9, p. 3418-3425Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to investigate the specific problems associated with photon dose calculations in points located at a distance from the central beam axis. These problems are related to laterally inhomogeneous energy fluence distributions and spectral variations causing a lateral shift in the beam quality, commonly referred to as off-axis softening (OAS). We have examined how the dose calculation accuracy is affected when enabling and disabling explicit modeling of these two effects. The calculations were performed using a pencil kernel dose calculation algorithm that facilitates modeling of OAS through laterally varying kernel properties. Together with a multisource model that provides the lateral energy fluence distribution this generates the total dose output, i.e., the dose per monitor unit, at an arbitrary point of interest. The dose calculation accuracy was evaluated through comparisons with 264 measured output factors acquired at 5, 10, and 20 cm depth in four different megavoltage photon beams. The measurements were performed up to 18 cm from the central beam axis, inside square fields of varying size and position. The results show that calculations including explicit modeling of OAS were considerably more accurate, up to 4%, than those ignoring the lateral beam quality shift. The deviations caused by simplified head scatter modeling were smaller, but near the field edges additional errors close to 1% occurred. When enabling full physics modeling in the dose calculations the deviations display a mean value of -0.1%, a standard deviation of 0.7%, and a maximum deviation of -2.2%. Finally, the results were analyzed in order to quantify and model the inherent uncertainties that are present when leaving the central beam axis. The off-axis uncertainty component showed to increase with both off-axis distance and depth, reaching 1% (1 standard deviation) at 20 cm depth. (c) 2006 American Association of Physicists in Medicine.

  • 22.
    Olofsson, Jörgen
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Georg, Dietmar
    Ahnesjö, Anders
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Evaluation of uncertainty predictions and dose output for model-based dose calculations for megavoltage photon beams2006In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 33, no 7, p. 2548-2556Article in journal (Refereed)
    Abstract [en]

    In many radiotherapy clinics an independent verification of the number of monitor units (MU) used to deliver the prescribed dose to the target volume is performed prior to the treatment start. Traditionally this has been done by using methods mainly based on empirical factors which, at least to some extent, try to separate the influence from input parameters such as field size, depth, distance, etc. The growing complexity of modern treatment techniques does however make this approach increasingly difficult, both in terms of practical application and in terms of the reliability of the results. In the present work the performance of a model-based approach, describing the influence from different input parameters through actual modeling of the physical effects, has been investigated in detail. The investigated model is based on two components related to megavoltage photon beams; one describing the exiting energy fluence per delivered MU, and a second component describing the dose deposition through a pencil kernel algorithm solely based on a measured beam quality index. Together with the output calculations, the basis of a method aiming to predict the inherent calculation uncertainties in individual treatment setups has been developed. This has all emerged from the intention of creating a clinical dose/MU verification tool that requires an absolute minimum of commissioned input data. This evaluation was focused on irregular field shapes and performed through comparison with output factors measured at 5, 10, and 20 cm depth in ten multileaf collimated fields on four different linear accelerators with varying multileaf collimator designs. The measurements were performed both in air and in water and the results of the two components of the model were evaluated separately and combined. When compared with the corresponding measurements the resulting deviations in the calculated output factors were in most cases smaller than 1% and in all cases smaller than 1.7%. The distribution describing the calculation errors in the total dose output has a mean value of -0.04% and a standard deviation of 0.47%. In the dose calculations a previously developed correction of the pencil kernel was applied that managed to contract the error distribution considerably. A detailed analysis of the predicted uncertainties versus the observed deviations suggests that the predictions indeed can be used as a basis for creating action levels and tracking dose calculation errors in homogeneous media. (C) 2006 American Association of Physicists in Medicine.

  • 23.
    Olofsson, Lennart
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Magnus G
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Photon and electron collimator effects on electron output and abutting segments in energy modulated electron therapy2005In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 32, no 10, p. 3178-3184Article in journal (Refereed)
    Abstract [en]

    In energy modulated electron therapy a large fraction of the segments will be arranged as abutting segments where inhomogeneities in segment matching regions must be kept as small as possible. Furthermore, the output variation between different segments should be minimized and must in all cases be well predicted. For electron therapy with add-on collimators, both the electron MLC (eMLC) and the photon MLC (xMLC) contribute to these effects when an xMLC tracking technique is utilized to reduce the x-ray induced leakage. Two add-on electron collimator geometries have been analyzed using Monte Carlo simulations: One isocentric eMLC geometry with an isocentric clearance of 35 cm and air or helium in the treatment head, and one conventional proximity geometry with a clearance of 5 cm and air in the treatment head. The electron fluence output for 22.5 MeV electrons is not significantly affected by the xMLC if the shielding margins are larger than 2-3 cm. For small field sizes and 9.6 MeV electrons, the isocentric design with helium in the treatment head or shielding margins larger than 3 cm is needed to avoid a reduced electron output. Dose inhomogeneity in the matching region of electron segments is, in general, small when collimator positions are adjusted to account for divergence in the field. The effect of xMLC tracking on the electron output can be made negligible while still obtaining a substantially reduced x-ray leakage contribution. Collimator scattering effects do not interfere significantly when abutting beam techniques are properly applied.

  • 24. Persson, Mats
    et al.
    Bujila, Robert
    Nowik, Patrik
    Andersson, Henrik
    Kull, Love
    Andersson, Jonas
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Bornefalk, Hans
    Danielsson, Mats
    Upper limits of the photon fluence rate on CT detectors: case study on a commercial scanner2016In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 43, no 7, p. 4398-4411Article in journal (Refereed)
    Abstract [en]

    Purpose: The highest photon fluence rate that a computed tomography (CT) detector must be able to measure is an important parameter. The authors calculate the maximum transmitted fluence rate in a commercial CT scanner as a function of patient size for standard head, chest, and abdomen protocols.

    Methods: The authors scanned an anthropomorphic phantom (Kyoto Kagaku PBU-60) with the reference CT protocols provided by AAPM on a GE LightSpeed VCT scanner and noted the tube current applied with the tube current modulation (TCM) system. By rescaling this tube current using published measurements on the tube current modulation of a GE scanner [N. Keat, “CT scanner automatic exposure control systems,” MHRA Evaluation Report 05016, ImPACT, London, UK, 2005], the authors could estimate the tube current that these protocols would have resulted in for other patient sizes. An ECG gated chest protocol was also simulated. Using measured dose rate profiles along the bowtie filters, the authors simulated imaging of anonymized patient images with a range of sizes on a GE VCT scanner and calculated the maximum transmitted fluence rate. In addition, the 99th and the 95th percentiles of the transmitted fluence rate distribution behind the patient are calculated and the effect of omitting projection lines passing just below the skin line is investigated.

    Results: The highest transmitted fluence rates on the detector for the AAPM reference protocols with centered patients are found for head images and for intermediate-sized chest images, both with a maximum of 3.4 ⋅ 108 mm−2 s−1, at 949 mm distance from the source. Miscentering the head by 50 mm downward increases the maximum transmitted fluence rate to 5.7 ⋅ 108 mm−2 s−1. The ECG gated chest protocol gives fluence rates up to 2.3 ⋅ 108 − 3.6 ⋅ 108 mm−2 s−1 depending on miscentering.

    Conclusions: The fluence rate on a CT detector reaches 3 ⋅ 108 − 6 ⋅ 108 mm−2 s−1 in standard imaging protocols, with the highest rates occurring for ECG gated chest and miscentered head scans. These results will be useful to developers of CT detectors, in particular photon counting detectors.

  • 25.
    Satherberg, A
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Calculation of photon energy and dose distributions in a 50 MV scanned photon beam for different target configurations and scan patterns1998In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 25, no 2, p. 236-240Article in journal (Refereed)
    Abstract [en]

    A method to characterize the energy distribution in the whole photon field is valuable when designing an accelerator for choosing target and flattening filter or scan pattern. Another field of application is beam characterization for treatment planning systems or other dosimetric purposes. This work is focused on the energy distribution in different 50 MV bremsstrahlung beams with different scanning of electrons on three different targets. Fluence differential in energy and angle at the exit of each target has been determined by Monte Carlo calculations for a narrow beam. Data for broad beams were obtained by convolution of the narrow beams with different scan patterns. Photon energy fluence differential in energy at SSD 100 were thus found to be rather different for the targets studied. The results are presented as mean energy profiles and narrow beam half-value layer (HVL) in water. Two different experimental setups were used to measure HVL at the central axis and at off-axis positions. The two methods gave results which differ by 5%-6% and the calculated data where within these experimental results. In conclusion, the presented method for characterization of the photon field energy distribution is well within the experimental results and can thus be used to improve accelerator design or dosimetric calculations, e.g., for treatment planning. (C) 1998 American Association of Physicists in Medicine.

  • 26. Siversson, Carl
    et al.
    Nordström, Fredrik
    Nilsson, Terese
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Jonsson, Joakim
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Gunnlaugsson, Adalsteinn
    Olsson, Lars E.
    Technical Note: MRI only prostate radiotherapy planning using the statistical decomposition algorithm2015In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 42, no 10, p. 6090-6097Article in journal (Refereed)
    Abstract [en]

    Purpose: In order to enable a magnetic resonance imaging (MRI) only workflow in radiotherapy treatment planning, methods are required for generating Hounsfield unit (HU) maps (i.e., synthetic computed tomography, sCT) for dose calculations, directly from MRI. The Statistical Decomposition Algorithm (SDA) is a method for automatically generating sCT images from a single MR image volume, based on automatic tissue classification in combination with a model trained using a multimodal template material. This study compares dose calculations between sCT generated by the SDA and conventional CT in the male pelvic region. Methods: The study comprised ten prostate cancer patients, for whom a 3D T2 weighted MRI and a conventional planning CT were acquired. For each patient, sCT images were generated from the acquired MRI using the SDA. In order to decouple the effect of variations in patient geometry between imaging modalities from the effect of uncertainties in the SDA, the conventional CT was nonrigidly registered to the MRI to assure that their geometries were well aligned. For each patient, a volumetric modulated arc therapy plan was created for the registered CT (rCT) and recalculated for both the sCT and the conventional CT. The results were evaluated using several methods, including mean average error (MAE), a set of dose-volume histogram parameters, and a restrictive gamma criterion (2% local dose/1 mm). Results: The MAE within the body contour was 36.5 +/- 4.1 (1 s.d.) HU between sCT and rCT. Average mean absorbed dose difference to target was 0.0% +/- 0.2% (1 s.d.) between sCT and rCT, whereas it was -0.3% +/- 0.3% (1 s.d.) between CT and rCT. The average gamma pass rate was 99.9% for sCT vs rCT, whereas it was 90.3% for CT vs rCT. Conclusions: The SDA enables a highly accurate MRI only workflow in prostate radiotherapy planning. The dosimetric uncertainties originating from the SDA appear negligible and are notably lower than the uncertainties introduced by variations in patient geometry between imaging sessions.

  • 27.
    Sjogren, R
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, M G
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Methods for the determination of effective monitor chamber thickness1999In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 26, no 9, p. 1871-1873Article in journal (Refereed)
    Abstract [en]

    There are a number of models, both analytical and Monte Carlo, which are used to describe the fluence from the treatment head of accelerators. One common problem in these simulations is to find relevant information about details in the treatment head. A complex unit in the treatment head for which reliable data is seldom given is the monitor chamber. In this work two methods are described for obtaining this information by analyzing the increased scattering of an electron beam when the monitor chamber is introduced in the beam. It was found that the effective thickness of the electrodes in a monitor chamber can be determined with sufficient accuracy by using experimental results combined with Fermi-Eyges theory or Monte Carlo simulations. (C) 1999 American Association of Physicists in Medicine. [S0094-2405(99)01009-3].

  • 28.
    Sjogren, R
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Influence of electron contamination on in vivo surface dosimetry for high-energy photon beams1998In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 25, no 6, p. 916-921Article in journal (Refereed)
    Abstract [en]

    The influence of the electron contamination at in vivo dosimetry with diodes on the patient surface has been investigated by introducing different accessories in the beam path and by changing the field size and SSD. The results show a clear correlation between the electron contamination at an effective measuring depth of the diode and the signal from the patient diode. When the electron contamination is taken into account the agreement between the diode values and the absorbed dose is greatly improved. More accurate in vivo dosimetry with less error margins is therefore possible if better predictions of the electron contamination in high-energy photon beams can be performed. (C) 1998 American Association of Physicists in Medicine. [S0094-2405(98)00606-3].

  • 29.
    Sjögren, Rickard
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Electron contamination in clinical high energy photon beams1996In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 23, no 11, p. 1873-1881Article in journal (Refereed)
    Abstract [en]

    The electron contamination in photon beams has been investigated by means of contaminating lepton depth doses and dose profiles in different geometries with two 20 MV beams. Different components of this contamination have been investigated separately by systematically adding contamination to a ''clean'' reference field. At 20 MV, the air generated electrons were found to be almost negligible compared to the electrons originating from the accelerator head when measurements were performed in standard fields at SSDs between 80 and 120 cm. The total electron part of the depth dose curve was then almost the same, i.e., independent of SSD, when the collimator opening was held fixed. However, when different accessories such as a shaping block and different attenuating plates were located in the beam path below the collimators, a large SSD dependence of the electron contamination was noticed. A comparison was also made between two machines, one equipped with a multileaf collimator, with similar beam qualities at 20 MV. These measurements indicate that the interior view of the treatment head seen by the detector (mainly the flattening filter, monitor chamber, or other electron generating material) influences the magnitude of the electron contamination. When the collimator opening is decreased the electron contamination will also decrease as parts of the electron source will be shielded by the collimator blocks.

  • 30.
    Sätherberg, Anders
    et al.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Andreo, Pedro
    IAEA Dosimetry Section, P.O. Box 200, Vienna, Austria.
    Karlsson, Mikael
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
    Bremsstrahlung production at 50 MeV in different target materials and configurations1996In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 23, no 4, p. 495-503Article in journal (Refereed)
    Abstract [en]

    A combination of Monte Carlo, convolution, and experimental techniques have been used to investigate bremsstrahlung production at 50 MeV in full-range targets to produce narrow elementary photon beams for scanning. Calculations using the ITS 3.0 Monte Carlo system for various target designs, including particle transport through the treatment head of an MM50 racetrack microtron and a water phantom, have been compared to experimental dose profiles from narrow photon beams at 10-cm depth in water. A reduction in the ITS 3.0 default substep size has been found necessary even for incomplete agreement, in consistency with the findings of Faddegon and Rogers [Nucl. Instrum. Meth. A 327, 556-565 (1993)] for a different experimental setup and energy using the previous version of ITS. Results show that the calculated shape of the tail of dose distributions from narrow photon beams agrees well with measurements, but CYLTRAN/ITS 3.0 fails to reproduce the central part of the distribution. The discrepancy at small angles, reported previously for EGS4 and ITS 2.1 simulations, possess a limitation to Monte Carlo simulations of narrow photon beams used in scanned systems of clinical accelerators. Radial dose profiles have been calculated by convolution of the energy fluence at the exit of the target with one polyenergetic Monte Carlo calculated dose kernel and also a database consisting of ten different dose kernels corresponding to different monoenergetic photon pencil beams for comparison. The agreement with the much slower fully detailed Monte Carlo calculations was better when using the database kernels than the polyenergetic kernel. Results for the mean energy, mean polar angle, and energy fluence at different depths within various targets have been obtained. These are discussed in the context of the design characteristics of bremsstrahlung targets with emphasis on their utilization for scanning photon beam techniques.

  • 31. Tian, X.
    et al.
    Segars, P.
    Andersson, Jonas
    Umeå University.
    Pavlicek, W.
    Samei, E.
    A Reference Organ Dose Database for Body CT Examination Based On AAPM 2462015In: Medical physics (Lancaster), ISSN 0094-2405, Vol. 42, no 6, p. 3746-3746Article in journal (Other academic)
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