Table of contents

The publishers of Physics in Medicine and Biology (PMB), IOP Publishing, in association with the journal owners, the Institute of Physics and Engineering in Medicine (IPEM), jointly award an annual prize for the 'best' paper published in PMB during the previous year.

The procedure for deciding the winner has been made as thorough as possible, to try to ensure that an outstanding paper wins the prize. We started off with a shortlist of the 10 research papers published in 2008 which were rated the best based on the referees' quality assessments. Following the submission of a short 'case for winning' document by each of the shortlisted authors, an IPEM college of jurors of the status of FIPEM assessed and rated these 10 papers in order to choose a winner, which was then endorsed by the Editorial Board.

It was a close run thing between the top two papers this year. The Board feel that we have a very worthy winner, but that the runner-up also deserves to be commended. We have much pleasure in advising the readers of PMB that the 2008 Roberts Prize is awarded to J P Schlomka et al for their paper on multi-energy CT. The runners-up are C Wang et al for their paper on arc therapy.

1) Experimental feasibility of multi-energy photon-counting K-edge imaging in pre-clinical computed tomography J P Schlomka, E Roessl, R Dorscheid, S Dill, G Martens, T Istel, C Bäumer, C Herrmann, R~Steadman, G Zeitler, A Livne and R Proksa 2008 Phys. Med. Biol.53 4031–47

2) Arc-modulated radiation therapy (AMRT): a single-arc form of intensity-modulated arc therapy C Wang, S Luan, G Tang, D Z Chen, M A Earl and C X Yu 2008 Phys. Med. Biol.53 6291–303

Our congratulations go to these authors. Of course all of the shortlisted papers were of great merit, and the full top-10 is listed below (in alphabetical order).

Steve Webb Editor-in-Chief

Simon HarrisPublisher

References

Cho S, Ahn S, Li Q and Leahy R M 2008 Analytical properties of time-of-flight PET data Phys. Med. Biol.53 2809–21

Hamann M, Aldridge M, Dickson J, Endozo R, Lozhkin K and Hutton B F 2008 Evaluation of a low-dose/slow-rotating SPECT-CT system Phys. Med. Biol.53 2495–508

Kim E, Bowsher J, Thomas A S, Sakhalkar H, Dewhirst M and Oldham M 2008 Improving the quantitative accuracy of optical-emission computed tomography by incorporating an attenuation correction: application to HIF1 imaging Phys. Med. Biol.53 5371–83

Kimstrand P, Traneus E, AhnesjBöumer A and Tilly N 2008 Parametrization and application of scatter kernels for modelling scanned proton beam collimator scatter dose Phys. Med. Biol.53 3405–29

Kyriakou Y, Lapp R M, Hillebrand L, Ertel D and Kalender W A 2008 Simultaneous misalignment correction for approximate circular cone-beam computed tomography Phys. Med. Biol.53 6267–89

Schlomka J P, Roessl E, Dorscheid R, Dill S, Martens G, Istel T, Bäumer C, Herrmann C, Steadman R, Zeitler~G, Livne A and Proksa R 2008 Experimental feasibility of multi-energy photon-counting K-edge imaging in pre-clinical computed tomography Phys. Med. Biol.53 4031–47

Serduc R, van de Looij Y, Francony G, Verdonck O, van der Sanden B, Laissue J, Farion R, Bräuer-Krisch~E, Siegbahn E A, Bravin A, Prezado Y, Segebarth C, Rémy C and Lahrech H 2008 Characterization and quantification of cerebral edema induced by synchrotron x-ray microbeam radiation therapy Phys. Med. Biol.53 1153–66

Vignal C, Boumans T, Montcel B, Ramstein S, Verhoye M, Van Audekerke J, Mathevon N, Van der Linden A and Mottin S 2008 Measuring brain hemodynamic changes in a songbird: responses to hypercapnia measured with functional MRI and near-infrared spectroscopy Phys. Med. Biol.53 2457–70

Wang C, Luan S, Tang G, Chen D Z, Earl M A and Yu C X 2008 Arc-modulated radiation therapy (AMRT): a single-arc form of intensity-modulated arc therapy Phys. Med. Biol.53 6291–303

Wunderlich A and Noo F 2008 Image covariance and lesion detectability in direct fan-beam x-ray computed tomography Phys. Med. Biol.53 2471–93

For more information on this article see medicalphysicsweb.org

The technical performance of an integrated three-dimensional carbon ion pencil beam tracking system that was developed at GSI was investigated in phantom studies. Aim of the beam tracking system is to accurately treat tumours that are subject to respiratory motion with scanned ion beams. The current system provides real-time control of ion pencil beams to track a moving target laterally using the scanning magnets and longitudinally with a dedicated range shifter. The system response time was deduced to be approximately 1 ms for lateral beam tracking. The range shifter response time has been measured for various range shift amounts. A value of 16 ± 2 ms was achieved for a water equivalent shift of 5 mm. An additional communication delay of 11 ± 2 ms was taken into account in the beam tracking process via motion prediction. Accuracy of the lateral beam tracking was measured with a multi-wire position detector to ⩽0.16 mm standard deviation. Longitudinal beam tracking accuracy was parameterized based on measured responses of the range shifter and required time durations to maintain a specific particle range. For example, 5 mm water equivalence (WE) longitudinal beam tracking results in accuracy of 1.08 and 0.48 mm WE in root mean square for time windows of 10 and 50 ms, respectively.

A two-pronged approach, review and measurement, has been adopted to characterize the conductivity of tissues at frequencies below 1 MHz. The review covers data published in the last decade and earlier data not included in recent reviews. The measurements were carried out on pig tissue, in vivo, and pig body fluids in vitro. Conductivity data have been obtained for skeletal and myocardial muscle, liver, skull, fat, lung and body fluids (blood, bile, CSF and urine). A critical analysis of the data highlights their usefulness and limitations and enables suggestions to be made for measuring the electrical properties of tissues.

A technique is presented to allow a breathing pattern to be obtained from any multi-slice CT, cone-beam or other series of sequential chest x-ray image sets. The technique requires no extra signals to be recorded and does not need specific external or internal oscillating structures to be visible in the field of view. The breathing pattern is instead acquired from analysing the variation in pixel values between projection images. For cone-beam image sets, slowly varying changes, due to an angular attenuation dependence, must be corrected before the breathing trace analysis can begin. All the results of the new technique were checked visually and were in good agreement. If the studied image set could be analysed using the existing 'Amsterdam shroud' technique, then the results it provided were also used for comparison. In cases that allowed comparison by both techniques, the results were in agreement. The new technique was also shown to provide a usable signal when applied to cardiac motion.

The preferential accumulation of gold nanoparticles within tumors and the increased photoelectric absorption due to the high atomic number of gold cooperatively account for the possibility of significant tumor dose enhancement during gold nanoparticle-aided radiation therapy (GNRT). Among the many conceivable ways to implement GNRT clinically, a brachytherapy approach using low-energy gamma-/x-ray sources (i.e. E_avg < 100 keV) appears to be highly feasible and promising, because it may easily fulfill some of the technical and clinical requirements for GNRT. Therefore, the current study investigated the dosimetric feasibility of implementing GNRT using the following sources: ¹²⁵I, 50 kVp and ¹⁶⁹Yb. Specifically, Monte Carlo (MC) calculations were performed to determine the macroscopic dose enhancement factors (MDEF), defined as the ratio of the average dose in the tumor region with and without the presence of gold nanoparticles during the irradiation of the tumor, and the photo/Auger electron spectra within a tumor loaded with gold nanoparticles. The current study suggests that a significant tumor dose enhancement (e.g. >40%) could be achievable using ¹²⁵I, 50 kVp and ¹⁶⁹Yb sources and gold nanoparticles. When calculated at 1.0 cm from the center of the source within a tumor loaded with 18 mg Au g⁻¹, macroscopic dose enhancement was 116, 92 and 108% for ¹²⁵I, 50 kVp and ¹⁶⁹Yb, respectively. For a tumor loaded with 7 mg Au g⁻¹, it was 68, 57 and 44% at 1 cm from the center of the source for ¹²⁵I, 50 kVp and ¹⁶⁹Yb, respectively. The estimated MDEF values for ¹⁶⁹Yb were remarkably larger than those for ¹⁹²Ir, on average by up to about 70 and 30%, for 18 mg Au and 7 mg Au cases, respectively. The current MC study also shows a remarkable change in the photoelectron fluence and spectrum (e.g. more than two orders of magnitude) and a significant production (e.g. comparable to the number of photoelectrons) of the Auger electrons within the tumor region due to the presence of gold nanoparticles during low-energy gamma-/x-ray irradiation. The radiation sources considered in this study are currently available and tumor gold concentration levels considered in this investigation are deemed achievable. Therefore, the current results strongly suggest that GNRT can be successfully implemented via brachytherapy with low energy gamma-/x-ray sources, especially with a high dose rate ¹⁶⁹Yb source.

In this work we have simulated the absorbed equivalent doses to various organs distant to the field edge assuming proton therapy treatments of brain or spine lesions. We have used computational whole-body (gender-specific and age-dependent) voxel phantoms and considered six treatment fields with varying treatment volumes and depths. The maximum neutron equivalent dose to organs near the field edge was found to be approximately 8 mSv Gy⁻¹. We were able to clearly demonstrate that organ-specific neutron equivalent doses are age (stature) dependent. For example, assuming an 8-year-old patient, the dose to brain from the spinal fields ranged from 0.04 to 0.10 mSv Gy⁻¹, whereas the dose to the brain assuming a 9-month-old patient ranged from 0.5 to 1.0 mSv Gy⁻¹. Further, as the field aperture opening increases, the secondary neutron equivalent dose caused by the treatment head decreases, while the secondary neutron equivalent dose caused by the patient itself increases. To interpret the dosimetric data, we analyzed second cancer incidence risks for various organs as a function of patient age and field size based on two risk models. The results show that, for example, in an 8-year-old female patient treated with a spinal proton therapy field, breasts, lungs and rectum have the highest radiation-induced lifetime cancer incidence risks. These are estimated to be 0.71%, 1.05% and 0.60%, respectively. For an 11-year-old male patient treated with a spinal field, bronchi and rectum show the highest risks of 0.32% and 0.43%, respectively. Risks for male and female patients increase as their age at treatment time decreases.

Electroporation, the increased permeability of cell membranes due to a large transmembrane voltage, is an important clinical tool. Both reversible and irreversible in vivo electroporation are used for clinical applications such as gene therapy and solid malignant tumor ablation, respectively. The primary advantage of in vivo electroporation is the ability to treat tissue in a local and minimally invasive fashion. The drawback is the current lack of control over the process. This paper is the first report of a new method for real-time three-dimensional imaging of an in vivo electroporation process. Using two needle electrodes for irreversible electroporation and a set of electrodes for reconstructing electrical impedance tomography (EIT) images of the treated tissue, we were able to demonstrate electroporation imaging in rodent livers. Histology analysis shows good correlation between the extent of tissue damage caused by irreversible electroporation and the EIT images. This new method may lead the way to real-time control over genetic treatment of diseases in tissue and tissue ablation.

The motivation behind this study is to assess whether angular dispersive x-ray diffraction (ADXRD) data, processed using multivariate analysis techniques, can be used for classifying secondary colorectal liver cancer tissue and normal surrounding liver tissue in human liver biopsy samples. The ADXRD profiles from a total of 60 samples of normal liver tissue and colorectal liver metastases were measured using a synchrotron radiation source. The data were analysed for 56 samples using nonlinear peak-fitting software. Four peaks were fitted to all of the ADXRD profiles, and the amplitude, area, amplitude and area ratios for three of the four peaks were calculated and used for the statistical and multivariate analysis. The statistical analysis showed that there are significant differences between all the peak-fitting parameters and ratios between the normal and the diseased tissue groups. The technique of soft independent modelling of class analogy (SIMCA) was used to classify normal liver tissue and colorectal liver metastases resulting in 67% of the normal tissue samples and 60% of the secondary colorectal liver tissue samples being classified correctly. This study has shown that the ADXRD data of normal and secondary colorectal liver cancer are statistically different and x-ray diffraction data analysed using multivariate analysis have the potential to be used as a method of tissue classification.

The dose coverage of low dose rate (LDR)-brachytherapy for localized prostate cancer is monitored 4–6 weeks after intervention by contouring the prostate on computed tomography and/or magnetic resonance imaging sets. Dose parameters for the prostate (V100, D90 and D80) provide information on the treatment quality. Those depend strongly on the delineation of the prostate contours. We therefore systematically investigated the contouring process for 21 patients with five examiners. The prostate structures were compared with one another using topological procedures based on Boolean algebra. The coincidence number C_V measures the agreement between a set of structures. The mutual coincidence C(i, j) measures the agreement between two structures i and j, and the mean coincidence C(i) compares a selected structure i with the remaining structures in a set. All coincidence parameters have a value of 1 for complete coincidence of contouring and 0 for complete absence. The five patients with the lowest C_V values were discussed, and rules for contouring the prostate have been formulated. The contouring and assessment were repeated after 3 months for the same five patients. All coincidence parameters have been improved after instruction. This shows objectively that training resulted in more consistent contouring across examiners.

The signal-to-noise ratio (SNR) in x-ray imaging can be increased using a photon counting detector which could allow for rejecting electronics noise and for weighting x-ray photons according to their energies. This approach, however, was not feasible for a long time because photon counting x-ray detectors with very high count rates, good energy resolution and a large number of small pixels were required. These problems have been addressed with the advent of new detector materials, fast readout electronics and powerful computers. In this work, we report on the experimental evaluation of projection x-ray imaging with a photon counting cadmium–zinc–telluride (CZT) detector with energy resolving capabilities. The detector included two rows of pixels with 128 pixels per row with 0.9 × 0.9 mm² pixel size, and a 2 Mcount pixel⁻¹ s⁻¹ count rate. The x-ray tube operated at 120 kVp tube voltage with 2 mm Al-equivalent inherent filtration. The x-ray spectrum was split into five regions, and five independent x-ray images were acquired at a time. These five quasi-monochromatic x-ray images were used for x-ray energy weighting and material decomposition. A tissue-equivalent phantom was used including contrast elements simulating adipose, calcifications, iodine and air. X-ray energy weighting improved the SNR of calcifications and iodine by a factor of 1.32 and 1.36, respectively, as compared to charge integrating. Material decomposition was performed by dual energy subtraction. The low- and high-energy images were generated in the energy ranges of 25–60 keV and 60–120 keV, respectively, by combining five monochromatic image data into two. X-ray energy weighting was applied to low- and high-energy images prior to subtraction, and this improved the SNR of calcifications and iodine in dual energy subtracted images by a factor of 1.34 and 1.25, respectively, as compared to charge integrating. The detector energy resolution, spatial resolution, linearity, count rate, noise and image uniformity were investigated. The limitations of this technology were emphasized and possible solutions were discussed.

Synchronized moving aperture radiation therapy (SMART) has been proposed to account for tumor motions during radiotherapy in prior work. The basic idea of SMART is to synchronize the moving radiation beam aperture formed by a dynamic multileaf collimator (DMLC) with the tumor motion induced by respiration. In this paper, a two-dimensional (2D) superimposing leaf sequencing method is presented for SMART. A leaf sequence optimization strategy was generated to assure the SMART delivery under realistic delivery conditions. The study of delivery performance using the Varian LINAC and the Millennium DMLC showed that clinical factors such as collimator angle, dose rate, initial phase and machine tolerance affect the delivery accuracy and efficiency. An in-house leaf sequencing software was developed to implement the 2D superimposing leaf sequencing method and optimize the motion-corrected leaf sequence under realistic clinical conditions. The analysis of dynamic log (Dynalog) files showed that optimization of the leaf sequence for various clinical factors can avoid beam hold-offs which break the synchronization of SMART and fail the SMART dose delivery. Through comparison between the simulated delivered fluence map and the planed fluence map, it was shown that the motion-corrected leaf sequence can greatly reduce the dose error.

In fundamental studies of low-energy ion irradiation effects on DNA, calculation of the low-energy ion range, an important basic physical parameter, is often necessary. However, up to now a unified model and approach for range calculation is still lacking, and reported data are quite divergent and thus unreliable. Here we describe an approach for calculation of the ion range, using a simplified mean-pseudoatom model of the DNA target. Based on ion stopping theory, for the case of low-energy (⩽ a few keV) ion implantation into DNA, the stopping falls in the low reduced energy regime, which gives a cube-root energy dependence of the stopping (E^1/3). Calculation formulas of the ion range in DNA are obtained and presented to unify the relevant calculations. The upper limits of the ion energy as a function of the atomic number of the bombarding ion species are proposed for the low-energy case to hold. Comparison of the results of this approach with the results of some widely used computer simulation codes and with results reported by other groups indicates that the approach described here provides convincing and dependable results.

A systematic study of cellular S-factors and absorbed fractions for monoenergetic electrons of initial energy from 1 keV to 1 MeV is presented. The calculations are based on our in-house Monte Carlo codes which have been developed to simulate electron transport up to a few MeV using both event-by-event and condensed-history techniques. An extensive comparison with the MIRD tabulations is presented for spherical volumes of 1–10 µm radius and various source-to-target combinations relevant to the intracellular localization of the emitted electrons. When the primary electron range is comparable to the sphere radius, we find significantly higher values from the MIRD, while with increasing electron energy the escape of δ-rays leads gradually to the opposite effect. The largest differences with the MIRD are found for geometries where the target region is at some distance from the source region (e.g. surface-to-nucleus or cytoplasm-to-nucleus). The sensitivity of the results to different transport approximations is examined. The grouping of inelastic collisions is found adequate as long as δ-rays are explicitly simulated, while the inclusion of straggling for soft collisions has a negligible effect.

We present a robust method to register three-dimensional echocardiography (echo) images to magnetic resonance images (MRI) based on anatomical features, which is designed to be used in the registration pipeline for overlaying MRI-derived roadmaps onto two-dimensional live x-ray images during cardiac catheterization procedures. The features used in image registration are the endocardial surface of the left ventricle and the centre line of the descending aorta. The MR-derived left ventricle surface is generated using a fully automated algorithm, and the echo-derived left ventricle surface is produced using a semi-automatic segmentation method provided by the QLab software (Philips Healthcare) that it is routinely used in clinical practice. We test our method on data from six volunteers and four patients. We validated registration accuracy using two methods: the first calculated a root mean square distance error using expert identified anatomical landmarks, and the second method used catheters as landmarks in two clinical electrophysiology procedures. Results show a mean error of 4.1 mm, which is acceptable for our clinical application, and no failed registrations were observed. In addition, our algorithm works on clinical data, is fast and only requires a small amount of manual input, and so it is applicable for use during cardiac catheterization procedures.

Our newly developed method using spatially and time-resolved reflectances can easily estimate the absorption coefficients of each layer in a two-layered medium if the thickness of the upper layer and the reduced scattering coefficients of the two layers are known a priori. We experimentally validated this method using phantoms and examined its possibility of estimating the absorption coefficients of the tissues in human heads. In the case of a homogeneous plastic phantom (polyacetal block), the absorption coefficient estimated by our method agreed well with that obtained by a conventional method. Also, in the case of two-layered phantoms, our method successfully estimated the absorption coefficients of the two layers. Furthermore, the absorption coefficients of the extracerebral and cerebral tissue inside human foreheads were estimated under the assumption that the human heads were two-layered media. It was found that the absorption coefficients of the cerebral tissues were larger than those of the extracerebral tissues.

Radiotracers labeled with high-energy positron emitters, such as those commonly used for positron emission tomography studies, emit visible light immediately following decay in a medium. This phenomenon, not previously described for these imaging tracers, is consistent with Cerenkov radiation and has several potential applications, especially for in vivo molecular imaging studies. Herein we detail a new molecular imaging tool, Cerenkov Luminescence Imaging, the experiments conducted that support our interpretation of the source of the signal, and proof-of-concept in vivo studies that set the foundation for future application of this new method.

Electron monitor unit (MU) calculation requires measured beam data such as the relative output factor (ROF) of a cone, insert correction factor (ICF) and effective source-to-surface distance (ESD). Measuring the beam data to cover all possible clinical cases is not practical for a busy clinic because it takes tremendous time and labor. In this study, we propose a practical approach to reduce the number of data measurements without affecting accuracy. It is based on two findings of dosimetric properties of electron beams. One is that the output ratio of two inserts is independent of the cone used, and the other is that ESD is a function of field size but independent of cone and jaw opening. For the measurements to prove the findings, a parallel plate ion chamber (Markus, PTW 23343) with an electrometer (Cardinal Health 35040) was used. We measured the outputs to determine ROF, ICF and ESD of different energies (5–21 MeV). Measurements were made in a Plastic Water™ phantom or in water. Three linear accelerators were used: Siemens MD2 (S/N 2689), Siemens Primus (S/N 3305) and Varian Clinic 21-EX (S/N 1495). With these findings, the number of data set to be measured can be reduced to less than 20% of the data points.