Design and Implementation of a Complementary Treatment Planning Software for the GZP6 HDR Brachytherapy System (GZP6 CTPS)

Introduction: Brachytherapy is one of the most common treatment modalities for gynecological cancer. The GZP6 brachytherapy system is one of the devices utilized in Iran. It has been considered particularly due to its low cost compared to other more complete and established systems. This system has some deficiencies including lack of a treatment planning software for non-predefined treatments, inability to change the gradually changeable dosimetric variables and using a point source estimation in dose calculation. This report presents a complementary treatment planning software (CTPS) to the system’s own dedicated program. Material and Methods: First, the dosimetric characteristics of three GZP6 sources were calculated based on the TG-43 protocol using the MCNP4C Monte Carlo code. Then, the calculated dose distribution around the implanted applicators, based on the selected dwell positions and dwell times, was shown in a graphical user interface (GUI) written using the MATLAB software. Results: The computation uncertainty in the resulting TG-43 parameters was about 1% and the calculated parameters were in good agreement with similar studies on cobalt-60 source dosimetry. Furthermore, the GUI is prepared as a user-friendly executable file which can be installed on any operating system. Discussion and Conclusion: Since different patients have distinct anatomy and physical conditions, a program for non-predefined situations of source arrangement is necessary. Using GZP6 CTPS can satisfy this requirement

Monte Carlo modeling of a triple photon energy absorptiometry technique

Introduction: Osteoporosis is a bone disease in which there is a reduction in the amount of bone mineral content leading to an increase in the risk of bone fractures. The affected individuals not only have to go through lots of pain and suffering but this disease also results in high economic costs to the society due to a large number of fractures.  A timely and accurate diagnosis of this disease makes it possible to start a treatment and thus preventing bone fractures as a result of osteoporosis. Radiographic methods are particularly well suited for in vivo determination of bone mineral density (BMD) due to the relatively high x-ray absorption properties of bone mineral compared to other tissues. Materials and Methods: Monte Carlo simulation has been conducted to explore the possibilities of triple photon energy absorptiometry (TPA) in the measurement of bone mineral content. The purpose of this technique is to correctly measure the bone mineral density in the presence of fatty and soft tissues. The same simulations have been done for a dual photon energy absorptiometry (DPA) system and an extended DPA system. Results: Using DPA with three components improves the accuracy of the obtained result while the simulation results show that TPA system is not accurate enough to be considered as an adequate method for the measurement of bone mineral density. Discussion: The reason for the improvement in the accuracy is the consideration of fatty tissue in TPA method while having attenuation coefficient as a function of energy makes TPA an inadequate method. Conclusion: Using TPA method is not a perfect solution to overcome the problem of non uniformity in the distribution of fatty tissue

Detection of Cardiac Artery Disease by Using the DCAD (b) Module

Introduction: In patients with cardiac artery disease, a myocardial perfusion scan, which is a non-invasive method, is utilized. This study is conducted to develop an advantageous software applicable to quantitative myocardial SPECT perfusion. Material and Methods: Each cross-section of the left ventricle was segmented by applying a fuzzy clustering method. After obtaining the myocardial skeleton of the left ventricle from its short axis cross sections, we made use of fuzzy logic to decide whether the pixel belongs to the myocardial muscle and any perfusion perturbation or not. The reconstructed image was divided into 18 equivolume sectors. The features were extracted in each sector and, finally, were compared with a normal data bank. Results: Abnormal critical conditions in rest and stress studies and coronary artery disease diagnosis were investigated in a set of about 317 images. Measurement and allocation of different myocardial sectors to specific coronary arteries were accomplished by utilizing collected information about the patients (75 men and 62 women), and the validity of the artery obstruction diagnosis has been proven in 40 patients undergoing coronary angiography. Conclusion: Our developed software DCAD (b) has demonstrated a considerably good performance in the diagnosis of coronary artery occlusion and can be a promising method aiding nuclear medicine specialists in their diagnosis

Strategies for deep learning‐based attenuation and scatter correction of brain ¹⁸F‐FDG PET images in the image domain

Background: Attenuation and scatter correction is crucial for quantitative positron emission tomography (PET) imaging. Direct attenuation correction (AC) in the image domain using deep learning approaches has been recently proposed for combined PET/MR and standalone PET modalities lacking transmission scanning devices or anatomical imaging. Purpose: In this study, different input settings were considered in the model training to investigate deep learning-based AC in the image space. Methods: Three different deep learning methods were developed for direct AC in the image space: (i) use of non-attenuation-corrected PET images as input (NonAC-PET), (ii) use of attenuation-corrected PET images with a simple two-class AC map (composed of soft-tissue and background air) obtained from NonAC-PET images (PET segmentation-based AC [SegAC-PET]), and (iii) use of both NonAC-PET and SegAC-PET images in a Double-Channel fashion to predict ground truth attenuation corrected PET images with Computed Tomography images (CTAC-PET). Since a simple two-class AC map (generated from NonAC-PET images) can easily be generated, this work assessed the added value of incorporating SegAC-PET images into direct AC in the image space. A 4-fold cross-validation scheme was adopted to train and evaluate the different models based using 80 brain 18 F-Fluorodeoxyglucose PET/CT images. The voxel-wise and region-wise accuracy of the models were examined via measuring the standardized uptake value (SUV) quantification bias in different regions of the brain. Results: The overall root mean square error (RMSE) for the Double-Channel setting was 0.157 ± 0.08 SUV in the whole brain region, while RMSEs of 0.214 ± 0.07 and 0.189 ± 0.14 SUV were observed in NonAC-PET and SegAC-PET models, respectively. A mean SUV bias of 0.01 ± 0.26% was achieved by the Double-Channel model regarding the activity concentration in cerebellum region, as opposed to 0.08 ± 0.28% and 0.05 ± 0.28% SUV biases for the network that uniquely used NonAC-PET or SegAC-PET as input, respectively. SegAC-PET images with an SUV bias of -1.15 ± 0.54%, served as a benchmark for clinically accepted errors. In general, the Double-Channel network, relying on both SegAC-PET and NonAC-PET images, outperformed the other AC models. Conclusion: Since the generation of two-class AC maps from non-AC PET images is straightforward, the current study investigated the potential added value of incorporating SegAC-PET images into a deep learning-based direct AC approach. Altogether, compared with models that use only NonAC-PET and SegAC-PET images, the Double-Channel deep learning network exhibited superior attenuation correction accuracy.</p

Investigation of the Spatial Resolution and Field of View with Change of Magnification in VRX CT

Introduction: Variable resolution x-ray (VRX) CT is a new type of CT that can image objects at various spatial resolutions. In a VRX CT scanner, the spatial resolution increases at the cost of reduction in the field of view (FOV). An important factor that limits the spatial resolution of the VRX CT is the effect of focal spot size. Also, the optimum magnification is different at each incident angle. Material and Methods: To investigate the spatial resolution and the FOV in VRX CT, we used the numerical parameters of an actual VRX CT scanner. The effects of decreasing the focal spot size and optimizing magnification on the spatial resolution and the FOV of the system were studied theoretically. Results: The focal spot size was found to greatly limit the spatial resolution of the VRX CT at the small incident angles. By decreasing the focal spot size, the spatial resolution was comparatively improved. Optimization of the system magnification without decreasing the focal spot size could greatly increase the spatial resolution of the system. After optimization of magnification, the FOV of the system decreased significantly. Discussion and Conclusion: The spatial resolution of the system after optimizing the magnification increased from 7.5 to more than 35 cycles/mm and also the effect of the focal spot no longer limited the spatial resolution at incident angles smaller than 13˚. The disadvantage of optimization of magnification was a great decrease in the FOV of the system. The optimization of magnification has the reverse effect on the spatial resolution and the FOV of the system so at each incident angle, according to the importance of spatial resolution or FOV, the system magnification can be set to lead to the desirable condition

Sensitivity Optimization for a New Radio-Chromic Dosimeter (PRESAGE)

Introduction: Different dosimetric modalities (e.g., ionization chambers, semiconductors, TLDs, radiographic films) often have some problems determining isodose curves and percentage depth doses in high dose gradient regions. Research has been ongoing to develop portable high resolution dosimetry devices with accurate absolute dosimetry capabilities and easy data analysis. The ‘PRESAGE’ dosimeter is a type of polymer dosimeters with improved characteristics in comparison with older polymer dosimeters. It is solid, insensitive to oxygen, and can be made in different shapes. This work presents the fabrication process for a PRESAGE dosimeter and optimization of its radiation sensitivity. Material and Methods: The PRESAGE gel was formed in two steps. In the first step, Leuco Malachite Green was dissolved in a free radical initiator (carbon tetrachloride; CCl4) and a polyol, referred to as ‘Part B’ was added to the solution. The second step consisted of mixing the Leuco dye, a free radical initiator, and a catalyst with ‘Part B’ (a commercially available polyol), then blending them with Part A in equal proportions, placing the blended materials in an appropriate mold, and incubating at an optimal temperature under a pressure of 60 psi for 18 to 24 hours. After this period, the solution turned solid and was subsequently exposed using a cobalt-60 unit. Finally, the PRESAGE gel was read using a spectrophotometer. Results: The results showed that by changing the percentage of both Leuco dye and CCl4 to 4%, an optimum sensitivity of 0.0144 units/Gy can be reached. Discussion and Conclusion: Our results showed that the response function of the PRESAGE dosimeter is linear between 2.5 to 55 Gy. Using different material percentages to make the PRESAGE gel can result in a sensitivity variation ranging from 0.0099 to 0.0144 units/Gy

Gamma Knife Simulation Using the MCNP4C Code and the Zubal Phantom and Comparison with Experimental Data

Introduction: Gamma Knife is an instrument specially designed for treating brain disorders. In Gamma Knife, there are 201 narrow beams of cobalt-60 sources that intersect at an isocenter point to treat brain tumors. The tumor is placed at the isocenter and is treated by the emitted gamma rays. Therefore, there is a high dose at this point and a low dose is delivered to the normal tissue surrounding the tumor. Material and Method: In the current work, the MCNP simulation code was used to simulate the Gamma Knife. The calculated values were compared to the experimental ones and previous works. Dose distribution was compared for different collimators in a water phantom and the Zubal brain-equivalent phantom. The dose profiles were obtained along the x, y and z axes. Result: The evaluation of the developed code was performed using experimental data and we found a good agreement between our simulation and experimental data. Discussion: Our results showed that the skull bone has a high contribution to both scatter and absorbed dose. In other words, inserting the exact material of brain and other organs of the head in digital phantom improves the quality of treatment planning. This work is regarding the measurement of absorbed dose and improving the treatment planning procedure in Gamma-Knife radiosurgery in the brain

Design and Manipulation 3D Imaging System by using Photodiode Grid

Introduction: Radiation imaging is one of the applicable methods in diagnostic medicine and nondestructive testing for industrial applications. In nondestructive 3D imaging, in addition to the radiation source, there is a requirement for a suitable detection system, data acquisition system, mechanical sections for moving objects, reconstruction algorithm and finally a computer for processing and control. Method and Materials: One of the most important components of a digital radiation imaging system is its detector. Light photodiode is a new light sensor which is used in digital imaging systems because of its high efficiency. In the present research, a photodiode grid has been implemented to design and make a detection system. The photodiode grid has an array of 10×10 photodiodes in a 50×50 mm2 area. Beside the photodiode grid, a control board has been designed. Furthermore, a mechanical system has been designed to move the objects in the horizontal and vertical directions, and also rotate it around its own axis. The maximum displacement in the horizontal and vertical directions is 60 cm with step accuracy of about 0.015 mm. Step accuracy of the rotational movement is about 0.9 degrees.  Results: After the imaging system was constructed, background and uniformity of the system were tested. All the photodiodes in the imaging system showed good uniformity. The image data was transferred to a computer and processed using a MATLAB program to display the images on a monitor. As the physical resolution of the system is about the pixel size (5 mm), only the overall images of the object's dimensions were expected to be produced. Discussion and Conclusion: The fidelity of the detection system has been successfully tested using a visible light source and several test samples. The presented system is able to reconstruct 3D images and obtain cross-sectional images of the objects, by using the image processing algorithm specifically designed for it

Evaluating the Application of Tissue-Specific Dose Kernels Instead of Water Dose Kernels in Internal Dosimetry: A Monte Carlo Study

The aim of this work is to evaluate the application of tissue-specific dose kernels instead of water dose kernels to improve the accuracy of patient-specific dosimetry by taking tissue heterogeneities into consideration