{"title":"Imaging dose and image quality of kilovoltage imaging implemented on a helical tomotherapy unit.","authors":"Eric D Ehler, Parham Alaei","doi":"10.1016/j.zemedi.2024.12.003","DOIUrl":"https://doi.org/10.1016/j.zemedi.2024.12.003","url":null,"abstract":"<p><p>The purpose of this work was to evaluate the imaging dose for the Accuray Radixact ClearRT system. Low-contrast resolution and CT number consistency was evaluated as well. CTDI measurements were compared to vendor supplied values, and similar measurements were done on a Varian TrueBeam kV cone-beam CT (CBCT) and a Philips Big Bore CT scanner. In-field imaging doses were measured using various protocols in an anthropomorphic phantom, while out-of-field doses were measured 10 cm from the imaging field edge. Comparison of the CTDI and the in-field doses showed considerable disagreement when the patient anatomy size was not congruent with the size of the CTDI phantom. While that is an expected outcome, this work provides an estimate of the differences for a variety of ClearRT protocols when this situation arises. The CNR was measured for all combinations of ClearRT settings for comparisons within the system, as well as for a comparison with a CBCT and fan-beam CT system. The CNR and dose information provided in this work can be used to aid in selecting a ClearRT imaging protocol. The CT number stability was tracked over 27 months; two instances where the CT number constancy exceeded tolerance were observed after service.</p>","PeriodicalId":101315,"journal":{"name":"Zeitschrift fur medizinische Physik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143026273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eva Peschke, Mariya S Pravdivtseva, Olav Jansen, Naomi Larsen, Jan-Bernd Hövener
{"title":"Black-blood MRI at 7T using 2D RARE MRI: In vitro testing and in vivo demonstration.","authors":"Eva Peschke, Mariya S Pravdivtseva, Olav Jansen, Naomi Larsen, Jan-Bernd Hövener","doi":"10.1016/j.zemedi.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.zemedi.2024.11.002","url":null,"abstract":"<p><p>Vessel walls play a crucial role in many inflammatory vascular diseases. Vessel wall imaging (VWI) using mangnetic resonance imaging (MRI) is one of the few methods by which vessel walls and inflammation can be visualized noninvasively, in vivo, and without ionizing radiation. VWI is based on black-blood (BB) MRI, where the signal from flowing blood is suppressed and contrast agent accumulation in the (inflamed) vessel wall is highlighted. Here, high resolution, T1 weighting, suppression of fat and flowing spins is essential. Whereas VWI is often applied in humans, only very few reports describe its use in small animals. Here, we investigated whether BB MRI for rodents can be implemented using a state-of-the-art, but commercially available, preclinical MRI system and imaging sequence. We identified 2D spin-echo (RARE)-based BB-MRI as a promising sequence that is widely available and not vendor dependent. First, we investigated the properties of the sequence in vitro with respect to image contrast, resolution, the suppression of signal of flowing spins and fat using a newly developed, 3D-printed model setup (cylindrical model with exchangeable nuclear magnetic resonance tubes and flow tube in agarose, printed with stereolithography). For example, good signal-to-noise ratio, BB and T1 contrast were obtained for TE = 5 ms for slice thickness equal or below 0.352 mm or slice thickness = 0.8 mm with TE at least 25 ms. In vivo, we obtained a pronounced BB effect for both intracranial and abdominal vessels of healthy rats down to a 0.25 mm diameter in no more than 1:36 min with TE = 12 ms, TR = 750 ms, voxel 156 × 156 × 800 µm<sup>3</sup>, and 11 slices. Compared to in vitro, we were able to reduce TE without apparent artifacts likely because the flow was faster in vivo than in vitro. Additionally, we needed to increase the resolution to image small vessels. Thus, we found that BB-MRI with 2D spin-echo sequences is feasible on rodents with state-of-the-art, commercially available preclinical MRI systems. We believe that these results will facilitate the development and application of rodent VWI in longitudinal studies, which, in comparison to histology, may reduce the number of needed animals and intersubject variability at the same time.</p>","PeriodicalId":101315,"journal":{"name":"Zeitschrift fur medizinische Physik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dominik Kornek, Cordelia Hoinkis, Natasa Milickovic, Ailine Lange, Alena Knak, Manuel März, Mieke L Möller, Markus Buchgeister
{"title":"Systematizing the risk management process in clinical radiotherapy practice: Recommendations of the working group on risk management of the DGMP.","authors":"Dominik Kornek, Cordelia Hoinkis, Natasa Milickovic, Ailine Lange, Alena Knak, Manuel März, Mieke L Möller, Markus Buchgeister","doi":"10.1016/j.zemedi.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.zemedi.2024.11.001","url":null,"abstract":"<p><strong>Purpose: </strong>The Deutsche Gesellschaft für Medizinische Physik [German Society of Medical Physics] has recently published two coherent reports, No. 25 and No. 28, detailing the design and implementation of a risk management (RM) process for German radiotherapy (RT) departments. This study offers an overview and background of the efforts behind these reports.</p><p><strong>Methods and materials: </strong>For three years, up to nine medical physicists (MPs) with practical RM experience held weekly meetings to develop recommendations for a clinical RM process. Care was taken to ensure that the recommendations were equally applicable to RT departments of various sizes. A process-based method derived from the failure mode and effects analysis (FMEA) was created to identify and address risks from unintentional radiation exposure. This method was applied to exemplarily analyze the hazardous scenarios in breast RT using surface guidance and deep inspiration breath hold (DIBH) techniques. Three common criticality methods-risk matrix, risk priority number, and action priority-were applied, and each step was schematically explained for first-time users. Each report was peer-reviewed by two radiation oncologists and 11 MPs.</p><p><strong>Results: </strong>In report No. 25, basic requirements were outlined for running the RM process, conducting risk assessments, and monitoring clinical procedures. A three-year plan-do-check-act cycle was proposed for continuous improvement. In report No. 28, general process lists for external beam radiotherapy (EBRT), brachytherapy, and radionuclide therapy were designed. Based on the EBRT process list, 45 hazardous scenarios in the surface-guided breast RT in DIBH were identified. Two scenarios were used to illustrate handling instructions for the three criticality methods.</p><p><strong>Conclusions: </strong>The recommendations provide clinical MPs and other health professionals with a pragmatic approach to RM, balancing both the needs of smaller practices and larger clinics in Germany. The risk of unintended exposures of patients is viewed acceptable once it has been lowered to a state that is as low as reasonably achievable.</p>","PeriodicalId":101315,"journal":{"name":"Zeitschrift fur medizinische Physik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lena Heuchel, Stephan Garbe, Armin Lühr, Maya Shariff
{"title":"Large-field irradiation techniques in Germany: A DGMP Working Group survey on the current clinical implementation of total body irradiation, total skin irradiation and craniospinal irradiation.","authors":"Lena Heuchel, Stephan Garbe, Armin Lühr, Maya Shariff","doi":"10.1016/j.zemedi.2024.09.002","DOIUrl":"https://doi.org/10.1016/j.zemedi.2024.09.002","url":null,"abstract":"<p><p>In 2023, a Germany-wide survey on the current clinical practice of three different large field irradiation techniques (LFIT), namely total body irradiation (TBI), total skin irradiation (TSI) and craniospinal irradiation (CSI), was conducted covering different aspects of the irradiation process, e.g., the irradiation unit and technique, dosimetrical aspects and treatment planning as well as quality assurance. The responses provided a deep insight into the applied approaches showing a high heterogeneity between participating centers for all three large field irradiation techniques. The highest heterogeneity was found for TBI. Here, differences between centers were found in almost every aspect of the irradiation process, e.g., the irradiation technique, the prescription dose, the spared organs at risk and the applied treatment planning method. For TBI, the only agreement was found in the fractionation scheme (2 Gy/fraction, 2 fractions/day) and the dose reduction to the lung. TSI was the rarest of the three LFITs. For TSI, the only agreement was found in the use of 6 MeV when irradiating with electrons. The reported approaches of CSI were closest to standard radiotherapy, using no CSI-specific irradiation techniques or treatment planning methods. For CSI, the only agreement was found in the prescribed dose to the brain (50 - 60 Gy). When asking for future requirements, participating centers considered the lack of standardization as the most important future challenge and suggested to perform (retrospective) patient studies. The results of such studies can then serve as a basis for new and improved guidelines.</p>","PeriodicalId":101315,"journal":{"name":"Zeitschrift fur medizinische Physik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Quazi Muhammad Rashed Nizam, Asif Ahmed, Iftekhar Ahmed, Lembit Sihver
{"title":"Monte Carlo calculations of target fragments from helium and carbon ion interactions with water.","authors":"Quazi Muhammad Rashed Nizam, Asif Ahmed, Iftekhar Ahmed, Lembit Sihver","doi":"10.1016/j.zemedi.2024.09.003","DOIUrl":"https://doi.org/10.1016/j.zemedi.2024.09.003","url":null,"abstract":"<p><p>When high energetic heavy ions interact with any target, short range, high linear energy transfer (LET) target fragments are produced. These target fragments (TFs) can give a significant dose to the healthy tissue during heavy ion cancer therapy, and when cosmic radiation interacts with astronauts. This paper presents Monte Carlo simulations, using the Particle and Heavy Ion Transport code System (PHITS), to characterize target fragments from reactions of helium and carbon ions with water. The calculated ranges, LET, doses, and production cross sections are presented. It is shown that protons, deuterons, tritons, alpha particles, <sup>3</sup>He, <sup>6</sup>He, nitrogen, oxygen, and fluorine ions are the most probable target fragments when carbon and helium ions collide with water. Among the produced target fragments, alpha particles and nitrogen ions give the highest dose to the targets, since the combination of fluence and LETs of these TFs are highest among the produced fragments. The production cross sections of proton and oxygen are the highest among the target fragments cross sections when helium and carbon ions imping on water, because these TFs can be produced through more reaction channels compared to other fragments. These findings are helpful for accurate dose measurement during heavy ion cancer therapy and for shielding of space radiation.</p>","PeriodicalId":101315,"journal":{"name":"Zeitschrift fur medizinische Physik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Orso Pusterla, Corin Willers, Robin Sandkühler, Simon Andermatt, Sylvia Nyilas, Philippe C Cattin, Philipp Latzin, Oliver Bieri, Grzegorz Bauman
{"title":"An automated pipeline for computation and analysis of functional ventilation and perfusion lung MRI with matrix pencil decomposition: TrueLung.","authors":"Orso Pusterla, Corin Willers, Robin Sandkühler, Simon Andermatt, Sylvia Nyilas, Philippe C Cattin, Philipp Latzin, Oliver Bieri, Grzegorz Bauman","doi":"10.1016/j.zemedi.2024.08.001","DOIUrl":"https://doi.org/10.1016/j.zemedi.2024.08.001","url":null,"abstract":"<p><strong>Purpose: </strong>To introduce and evaluate TrueLung, an automated pipeline for computation and analysis of free-breathing and contrast-agent free pulmonary functional magnetic resonance imaging.</p><p><strong>Materials and methods: </strong>Two-dimensional time-resolved ultra-fast balanced steady-state free precession acquisitions were transferred to TrueLung, which included image quality checks, image registration, and computation of perfusion and ventilation maps with matrix pencil decomposition. Neural network whole-lung and lobar segmentations allowed quantification of impaired relative perfusion (R<sub>Q</sub>) and fractional ventilation (R<sub>FV</sub>). TrueLung delivered functional maps and quantitative outcomes, reported for clinicians in concise documents. We evaluated the pipeline using 1.5T data from 75 children with cystic fibrosis by assessing the feasibility of functional MR imaging, average scan time, and the robustness of the functional outcomes. Whole-lung and lobar segmentations were manually refined when necessary, and the impact on R<sub>Q</sub> and R<sub>FV</sub> was quantified.</p><p><strong>Results: </strong>Functional imaging was feasible in all included CF children without any dropouts. On average, 7.9 ± 1.8 (mean±SD) coronal slice positions per patient were acquired, resulting in a mean scan time of 6min 20s per patient. The whole pipeline required 20min processing time per subject. TrueLung delivered the functional maps of all the subjects for radiological assessment. Quality controlling maps and segmentations lasted 1min 12s per patient. The automated segmentations and quantification of whole-lung defects were satisfying in 88% of patients (97% of slices) and the lobar quantification in 73% (93% of slices). The segmentations refinements required 16s per patient for the whole-lung, and 2min 10s for the lobe masks. The relative differences in R<sub>FV</sub> and R<sub>Q</sub> between fully-automated and manually refined data were 0.7% (1.2%) and 2.0% (2.9%) for whole-lung quantification (median, [third quartile]), and excluding two outliers, 1.7% (3.9%) and 1.2% (3.8%) for the lobes, indicating the refinements could be potentially omitted in several patients.</p><p><strong>Conclusions: </strong>TrueLung quickly delivers functional maps and quantitative outcomes in an objective and standardized way, suitable for radiological and pneumological assessment with minimal manual input. TrueLung can be used for clinical research in cystic fibrosis and might be applied across various lung diseases.</p>","PeriodicalId":101315,"journal":{"name":"Zeitschrift fur medizinische Physik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Fröhlich, Torsten Rahne, Alexander Müller, Oliver Dziemba
{"title":"Influence of skin flap thickness on the transmission characteristics of middle ear implant audio processors.","authors":"Laura Fröhlich, Torsten Rahne, Alexander Müller, Oliver Dziemba","doi":"10.1016/j.zemedi.2024.08.002","DOIUrl":"https://doi.org/10.1016/j.zemedi.2024.08.002","url":null,"abstract":"<p><strong>Objective: </strong>To measure signal transmission characteristics for audio processors of an active middle ear implant as a function of skin flap thickness, i.e., distance between audio processor and the implant's receiver coil.</p><p><strong>Methods: </strong>Output sound pressure levels for 90 dB input sound pressure level (OSPL90), reference test gains as function of frequency for an input sound pressure level of 60 dB (RTG60), and reference test gains (RTG - high frequency averages) were recorded in a hearing aid test box for Samba 2 Hi, Samba 2 Lo, and AP404 audio processors (MED-EL, Innsbruck, Austria) positioned on an implant-in-the-box and distances of 0-10 mm between audio processors and the receiver coil.</p><p><strong>Results: </strong>For all audio processors, the OSPL90 and RTG decreased linearly with increasing distance. The effect was dependent on audio processor type and the strongest reduction was observed for Samba 2 Lo. Between distances of 0 mm and 10 mm, the relative change of RTG was - 9,9 dB for Samba 2 Hi, -10,3 dB for AP404, and -27,7 dB for Samba 2 Lo.</p><p><strong>Conclusions: </strong>Skin thickness is a clinically significant factor which has to be considered in VSB treatment. In combination with insufficient transducer coupling or in patients with hearing thresholds close to the indication criteria limit, a thick skin flap could lead to loss of transmitted energy resulting in insufficient audiological outcome with the active middle ear implant.</p>","PeriodicalId":101315,"journal":{"name":"Zeitschrift fur medizinische Physik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of iterative reconstruction implementations for multislice helical CT.","authors":"Zsolt Adam Balogh, Zsofia Barna, Eva Majoros","doi":"10.1016/j.zemedi.2024.04.001","DOIUrl":"https://doi.org/10.1016/j.zemedi.2024.04.001","url":null,"abstract":"<p><p>The most mature image reconstruction algorithms in multislice helical computed tomography are based on analytical and iterative methods. Over the past decades, several methods have been developed for iterative reconstructions that improve image quality by reducing noise and artifacts. In the regularization step of iterative reconstruction, noise can be significantly reduced, thereby making low-dose CT. The quality of the reconstructed image can be further improved by using model-based reconstructions. In these reconstructions, the main focus is on modeling the data acquisition process, including the behavior of the photon beams, the geometry of the system, etc. In this article, we propose two model-based reconstruction algorithms using a virtual detector for multislice helical CT. The aim of this study is to compare the effect of using a virtual detector on image quality for the two proposed algorithms with a model-based iterative reconstruction using the original detector model. Since the algorithms are implemented using multiple GPUs, the merging of separately reconstructed volumes can significantly affect image quality. This issue is often referred to as the \"long object\" problem, for which we also present a solution that plays an important role in the proposed reconstruction processes. The algorithms were evaluated using mathematical and physical phantoms, as well as patient cases. The SSIM, MS-SSIM and L<sub>1</sub> metrics were utilized to evaluate the image quality of the mathematical phantom case. To demonstrate the effectiveness of the algorithms, we used the CatPhan 600 phantom. Additionally, anonymized patient scans were used to showcase the improvements in image quality on real scan data.</p>","PeriodicalId":101315,"journal":{"name":"Zeitschrift fur medizinische Physik","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Hatamikia, Soraya Elmirad, H. Furtado, G. Kronreif, Elisabeth Steiner, W. Birkfellner
{"title":"Intra-fractional lung tumor motion monitoring using arbitrary gantry angles during radiotherapy treatment.","authors":"S. Hatamikia, Soraya Elmirad, H. Furtado, G. Kronreif, Elisabeth Steiner, W. Birkfellner","doi":"10.1016/j.zemedi.2024.03.004","DOIUrl":"https://doi.org/10.1016/j.zemedi.2024.03.004","url":null,"abstract":"","PeriodicalId":101315,"journal":{"name":"Zeitschrift fur medizinische Physik","volume":"68 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140764797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}