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Volume 61

Number 12, 21 June 2016

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SPECIAL SECTION: RECENT PROGRESS IN LOW-FREQUENCY DOSIMETRY MODELING: FROM INDUCTION TO ELECTROSTIMULATION

Editorial

Topical Review

R138

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This article treats unsettled issues in the use of numerical models of electrical dosimetry as applied to international limits on human exposure to low-frequency (typically  <  100 kHz) electromagnetic fields and contact current. The perspective in this publication is that of Subcommittee 6 of IEEE-ICES (International Committee on Electromagnetic Safety) Technical Committee 95. The paper discusses 25 issues needing attention, fitting into three general categories: induction models; electrostimulation models; and human exposure limits. Of these, 9 were voted as 'high priority' by members of Subcommittee 6. The list is presented as a research agenda for refinements in numerical modeling with applications to human exposure limits. It is likely that such issues are also important in medical and electrical product safety design applications.

Special Section Papers

4346

This paper evaluates results of a survey of electrostimulation models of myelinated nerve. Participants were asked to determine thresholds of excitation for 18 cases involving different characteristics of the neuron, the stimulation waveform, and the electrode arrangement. Responses were received from 7 investigators using 10 models. Excitation thresholds differed significantly among these models. For example, with a 2 ms monophasic stimulus pulse and an electrode/fiber distance of 1 cm, thresholds from the least to greatest value differed by a factor of 8.3; with a 5 μs pulse, thresholds differed by the factor 3.8. Significant differences in reported simulations point to the need for experimental validation. Additional efforts are needed to develop computational models for unmyelinated C-fibers, A-delta fibers, CNS neurons, and CNS Synapses.

4364

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The electrostimulation excitation threshold of a nerve depends on temporal and frequency parameters of the stimulus. These dependences were investigated in terms of: (1) strength-duration (SD) curve for a single monophasic rectangular pulse, and (2) frequency dependence of the excitation threshold for a continuous sinusoidal current. Experiments were performed on the single-axon measurement setup based on Lumbricus terrestris having unmyelinated nerve fibers. The simulations were performed using the well-established SENN model for a myelinated nerve. Although the unmyelinated experimental model differs from the myelinated simulation model, both refer to a single axon. Thus we hypothesized that the dependence on temporal and frequency parameters should be very similar. The comparison was made possible by normalizing each set of results to the SD time constant and the rheobase current of each model, yielding the curves that show the temporal and frequency dependencies regardless of the model differences. The results reasonably agree, suggesting that this experimental setup and method of comparison with SENN model can be used for further studies of waveform effect on nerve excitability, including unmyelinated neurons.

4376

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Novel data for the conductivities of the tissues composing the skin, which are the epidermis, dermis and subcutaneous tissue, were obtained at intermediate frequencies by in vitro measurement. The conductivity of the epidermis was determined from those of the dermis and bulk skin. The conductivities of the dermis and subcutaneous tissue were almost constant from 10 kHz to 1 MHz. On the other hand, a frequency dependence was observed for the epidermis; the conductivity decreases with decreasing frequency. It was found that the conductivity of bulk skin is not determined by that of the dermis but by that of the epidermis. The presented data are expected to contribute to the assessment of safety and to the research and development of medical applications.

4390

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The understanding of interactions between electromagnetic (EM) fields and nerves are crucial in contexts ranging from therapeutic neurostimulation to low frequency EM exposure safety. To properly consider the impact of in vivo induced field inhomogeneity on non-linear neuronal dynamics, coupled EM-neuronal dynamics modeling is required. For that purpose, novel functionalized computable human phantoms have been developed. Their implementation and the systematic verification of the integrated anisotropic quasi-static EM solver and neuronal dynamics modeling functionality, based on the method of manufactured solutions and numerical reference data, is described. Electric and magnetic stimulation of the ulnar and sciatic nerve were modeled to help understanding a range of controversial issues related to the magnitude and optimal determination of strength-duration (SD) time constants. The results indicate the importance of considering the stimulation-specific inhomogeneous field distributions (especially at tissue interfaces), realistic models of non-linear neuronal dynamics, very short pulses, and suitable SD extrapolation models. These results and the functionalized computable phantom will influence and support the development of safe and effective neuroprosthetic devices and novel electroceuticals. Furthermore they will assist the evaluation of existing low frequency exposure standards for the entire population under all exposure conditions.

4402

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In this study we focus on the validity of the skin layer currently implemented in up-to-date human-body anatomical models employed in low frequency (LF) numerical dosimetry. Indeed, the several layers of the skin structure, i.e. the stratum corneum (SC), dermis, and epidermis are in these models embedded into a unique fairly-thick (2–3 mm) layer encompassing all of them. While a previous work from the authors showed that for normal-standing (or limb-non-touching) postures a single-layer skin model could conservatively estimate the peak electric field induced in the skin, at least a two-layer skin model comprising of the SC and the remaining skin layers should be used for limb-touching exposure scenarios. This implies notable efforts to discretize the tiny SC layer questioning the validity of current anatomical models. A novel strategy based on the homogenization of the several skin layers has been therefore proposed in order to eliminate the SC from the computational domain opening the doors to future LF magnetic applications even for limb-touching scenarios.

4412

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The reference levels and maximum permissible exposure values for magnetic fields that are currently used have been derived from basic restrictions under the assumption of upright standing body models in a standard posture, i.e. with arms laterally down and without contact with metallic objects. Moreover, if anatomical modelling of the body was used at all, the skin was represented as a single homogeneous tissue layer. In the present paper we addressed the possible impacts of posture and skin modelling in scenarios of exposure to a 50 Hz uniform magnetic field on the in situ electric field strength in peripheral tissues, which must be limited in order to avoid peripheral nerve stimulation. We considered different body postures including situations where body parts form large induction loops (e.g. clasped hands) with skin-to-skin and skin-to-metal contact spots and compared the results obtained with a homogeneous single-layer skin model to results obtained with a more realistic two-layer skin representation consisting of a low-conductivity stratum corneum layer on top of a combined layer for the cellular epidermis and dermis. Our results clearly indicated that postures with loops formed of body parts may lead to substantially higher maximum values of induced in situ electric field strengths than in the case of standard postures due to a highly concentrated current density and in situ electric field strength in the skin-to-skin and skin-to-metal contact regions. With a homogeneous single-layer skin, as is used for even the most recent anatomical body models in exposure assessment, the in situ electric field strength may exceed the basic restrictions in such situations, even when the reference levels and maximum permissible exposure values are not exceeded. However, when using the more realistic two-layer skin model the obtained in situ electric field strengths were substantially lower and no violations of the basic restrictions occurred, which can be explained by the current-limiting effect of the low-conductivity stratum corneum layer.

4438
The following article is Open access

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Most results regarding induced current in the human body related to electric field dosimetry have been calculated under uniform field conditions. We have found in previous work that a contact current is a more suitable way to evaluate induced electric fields, even in the case of exposure to non-uniform fields. If the relationship between induced currents and external non-uniform fields can be understood, induced electric fields in nervous system tissues may be able to be estimated from measurements of ambient non-uniform fields. In the present paper, we numerically calculated the induced electric fields and currents in a human model by considering non-uniform fields based on distortion by a cubic conductor under an unperturbed electric field of 1 kV m−1 at 60 Hz. We investigated the relationship between a non-uniform external electric field with no human present and the induced current through the neck, and the relationship between the current through the neck and the induced electric fields in nervous system tissues such as the brain, heart, and spinal cord. The results showed that the current through the neck can be formulated by means of an external electric field at the central position of the human head, and the distance between the conductor and the human model. As expected, there is a strong correlation between the current through the neck and the induced electric fields in the nervous system tissues. The combination of these relationships indicates that induced electric fields in these tissues can be estimated solely by measurements of the external field at a point and the distance from the conductor.

4452

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An accurate dosimetry is a key issue to understanding brain stimulation and related interaction mechanisms with neuronal tissues at the basis of the increasing amount of literature revealing the effects on human brain induced by low-level, low frequency pulsed magnetic fields (PMFs).

Most literature on brain dosimetry estimates the maximum E field value reached inside the tissue without considering its time pattern or tissue dispersivity. Nevertheless a time-resolved dosimetry, accounting for dispersive tissues behavior, becomes necessary considering that the threshold for an effect onset may vary depending on the pulse waveform and that tissues may filter the applied stimulatory fields altering the predicted stimulatory waveform's size and shape.

In this paper a time-resolved dosimetry has been applied on a realistic brain model exposed to the signal presented in Capone et al (2009J. Neural Transm. 11625765), accounting for the broadband dispersivity of brain tissues up to several kHz, to accurately reconstruct electric field and current density waveforms inside different brain tissues.

The results obtained by exposing the Duke's brain model to this PMF signal show that the E peak in the brain is considerably underestimated if a simple monochromatic dosimetry is carried out at the pulse repetition frequency of 75 Hz.

4466

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An intricate network of a variety of nerves is embedded within the complex anatomy of the human body. Although nerves are shielded from unwanted excitation, they can still be stimulated by external electromagnetic sources that induce strongly non-uniform field distributions. Current exposure safety standards designed to limit unwanted nerve stimulation are based on a series of explicit and implicit assumptions and simplifications. This paper demonstrates the applicability of functionalized anatomical phantoms with integrated coupled electromagnetic and neuronal dynamics solvers for investigating the impact of magnetic resonance exposure on nerve excitation within the full complexity of the human anatomy. The impact of neuronal dynamics models, temperature and local hot-spots, nerve trajectory and potential smoothing, anatomical inhomogeneity, and pulse duration on nerve stimulation was evaluated. As a result, multiple assumptions underlying current safety standards are questioned. It is demonstrated that coupled EM-neuronal dynamics modeling involving realistic anatomies is valuable to establish conservative safety criteria.

4479

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The in situ electric field in the peripheral nerve of the skin is investigated to discuss the selective stimulation of nerve fibres. Coaxial planar electrodes with and without intra-epidermal needle tip were considered as electrodes of a stimulator. From electromagnetic analysis, the tip depth of the intra-epidermal electrode should be larger than the thickness of the stratum corneum, the electrical conductivity of which is much lower than the remaining tissue. The effect of different radii of the outer ring electrode on the in situ electric field is marginal. The minimum threshold in situ electric field (rheobase) for free nerve endings is estimated to be 6.3 kV m−1. The possible volume for electrostimulation, which can be obtained from the in situ electric field distribution, becomes deeper and narrower with increasing needle depth, suggesting that possible stimulation sites may be controlled by changing the needle depth. The injection current amplitude should be adjusted when changing the needle depth because the peak field strength also changes. This study shows that intra-epidermal electrical stimulation can achieve stimulation of small fibres selectively, because Aβ-, Aδ-, and C-fibre terminals are located at different depths in the skin.

4491

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This study proposes a methodology for computationally estimating resistive properties of tissue in multi-scale computational models, used for studying the interaction of electromagnetic fields with neural tissue, with applications to both dosimetry and neuroprosthetics. Traditionally, models at bulk tissue- and cellular-level scales are solved independently, linking resulting voltage from existing resistive tissue-scale models as extracellular sources to cellular models. This allows for solving the effects that external electric fields have on cellular activity. There are two major limitations to this approach: first, the resistive properties of the tissue need to be chosen, of which there are contradicting measurements in literature; second, the measurements of resistivity themselves may be inaccurate, leading to the mentioned contradicting results found across different studies. Our proposed methodology allows for constructing computed resistivity profiles using knowledge of only the neural morphology within the multi-scale model, resulting in a practical implementation of the effective medium theory; this bypasses concerns regarding the choice of resistive properties and accuracy of measurement setups. A multi-scale model of retina is constructed with an external electrode to serve as a test bench for analyzing existing and resulting resistivity profiles, and validation is presented through the reconstruction of a published resistivity profile of retina tissue. Results include a computed resistivity profile of retina tissue for use with a retina multi-scale model used to analyze effects of external electric fields on neural activity.

4506

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Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique that applies low amplitude current via electrodes placed on the scalp. Rather than directly eliciting a neuronal response, tDCS is believed to modulate excitability—enhancing or suppressing neuronal activity in regions of the brain depending on the polarity of stimulation. The specificity of tDCS to any therapeutic application derives in part from how electrode configuration determines the brain regions that are stimulated. Conventional tDCS uses two relatively large pads (>25 cm2) whereas high-definition tDCS (HD-tDCS) uses arrays of smaller electrodes to enhance brain targeting. The 4  ×  1 concentric ring HD-tDCS (one center electrode surrounded by four returns) has been explored in application where focal targeting of cortex is desired. Here, we considered optimization of concentric ring HD-tDCS for targeting: the role of electrodes in the ring and the ring's diameter. Finite element models predicted cortical electric field generated during tDCS. High resolution MRIs were segmented into seven tissue/material masks of varying conductivities. Computer aided design (CAD) model of electrodes, gel, and sponge pads were incorporated into the segmentation. Volume meshes were generated and the Laplace equation ($\nabla $ · (σ$\nabla $ V)  =  0) was solved for cortical electric field, which was interpreted using physiological assumptions to correlate with stimulation and modulation. Cortical field intensity was predicted to increase with increasing ring diameter at the cost of focality while uni-directionality decreased. Additional surrounding ring electrodes increased uni-directionality while lowering cortical field intensity and increasing focality; though, this effect saturated and more than 4 surround electrode would not be justified. Using a range of concentric HD-tDCS montages, we showed that cortical region of influence can be controlled while balancing other design factors such as intensity at the target and uni-directionality. Furthermore, the evaluated concentric HD-tDCS approaches can provide categorical improvements in targeting compared to conventional tDCS. Hypothesis driven clinical trials, based on specific target engagement, would benefit by this more precise method of stimulation that could avoid potentially confounding brain regions.

4522

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The electromagnetic interference (EMI) imposed on active implantable medical devices by wireless power transfer systems (WPTSs) is discussed based upon results of in vitro experiments. The purpose of this study is to present comprehensive EMI test results gathered from implantable-cardiac pacemakers and implantable cardioverter defibrillators exposed to the electromagnetic field generated by several WPTSs operating in low-frequency (70 kHz–460 kHz) and high-frequency (6.78 MHz) bands. The constructed in vitro experimental test system based upon an Irnich's flat torso phantom was applied. EMI test experiments are conducted on 14 types of WPTSs including Qi-compliant system and EV-charging WPT system mounted on current production EVs. In addition, a numerical simulation model for active implantable medical device (AIMD) EMI estimation based on the experimental test system is newly proposed. The experimental results demonstrate the risk of WPTSs emitting intermittent signal to affect the correct behavior of AIMDs when operating at very short distances. The proposed numerical simulation model is applicable to obtain basically the EMI characteristics of various types of WPTSs.

Fast Track Communication

L20

Medical ultrasound imaging scanners typically display the envelope of the reflected signal on a log scale. The properties of this image and speckle patterns from collections of scatterers have a number of well-known disadvantages. One is the inability to differentiate between different scatterers that may have fundamentally different frequency-dependent scattering cross sections. This study proposes a framework for characterizing scattering behavior and visualizing the results as color coding of the B-scan image. The methodology matches a model of pulse-echo formation from typical situations to the mathematics of Gaussian weighted Hermite functions. The results show an ability to reveal some of the information otherwise hidden in the conventional envelope display, and can be generalized to more conventional bandlimited pulse functions. This new class of images is termed H-scan where 'H' stands for 'Hermite' or 'hue' to distinguish it from conventional B-scan format.

Papers

4537
The following article is Open access

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High-Z nano materials have been previously shown to increase the amount of dose deposition within the tumour due to an increase in secondary electrons.

This study evaluates the effects of high-Z nano materials in combination with protons, and the impact of proton energy, nanoparticle material and concentration. These effects were studied in silico through Monte Carlo simulation and experimentally through a phantom study, with particular attention to macroscale changes to the Bragg peak in the presence of nanoparticles. Three nanoparticle materials were simulated (gold, silver and platinum) at three concentrations (0.01, 0.1 and 6.5 mg ml−1) at two clinical proton energies (60 and 226 MeV). Simulations were verified experimentally using Gafchromic film measurements of gold nanoparticles suspended in water at two available high concentrations (5.5 mg ml−1 and 1.1 mg ml−1). A significant change to Bragg peak features was evident, where at 226 MeV and 6.5 mg ml−1, simulations of gold showed a 4.7 mm longitudinal shift of the distal edge and experimentally at 5.5 mg ml−1, a shift of 2.2 mm. Simulations showed this effect to be material dependent, where platinum having the highest physical density caused the greatest shift with increasing concentration. A dose enhancement of 6%  ±  0.05 and 5%  ±  0.15 (60 MeV and 226 MeV, respectively) was evident with gold at 6.5 mg ml−1 to water alone, compared to the 21%  ±  0.53 observed experimentally as dose to film with 5.5 mg ml−1 of gold nanoparticles suspended in water at 226 MeV. The introduction of nanoparticles has strong potential to enhance dose in proton therapy, however the changes to the Bragg peak distribution that occur with high concentrations need to be accounted for to ensure tumour coverage.

4551

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To investigate the linear energy transfer (LET) dependence of the response of a PTW-60019 Freiburg microDiamond detector, its response was compared to the response of a plane-parallel Markus chamber in a 62 MeV/n mono-energetic carbon ion beam. Results obtained with two different experimental setups are in agreement. As recommended by IAEA TRS-398, the response of the Markus chamber was corrected for temperature, pressure, polarity effects and ion recombination. No correction was applied to the response of the microDiamond detector. The ratio of the response of the Markus chamber to the response of the microDiamond is close to unity in the plateau region. In the Bragg peak region, a significant increase of the ratio is observed, which increases to 1.2 in the distal edge region. Results indicate a correlation between the under-response of the microDiamond detector and high LET values. The combined relative standard uncertainty of the results is estimated to be 2.38% in the plateau region and 12% in the distal edge region. These values are dominated by the uncertainty of alignment in the non-uniform beam and the uncertainty of range determination.

4564
The following article is Open access

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To evaluate the 3D Grid-based Boltzmann Solver (GBBS) code ATTILA® for coupled electron and photon transport in the nuclear medicine energy regime for electron (beta, Auger and internal conversion electrons) and photon (gamma, x-ray) sources. Codes rewritten based on ATTILA are used clinically for both high-energy photon teletherapy and 192Ir sealed source brachytherapy; little information exists for using the GBBS to calculate voxel-level absorbed doses in nuclear medicine.

We compared DOSXYZnrc Monte Carlo (MC) with published voxel-S-values to establish MC as truth. GBBS was investigated for mono-energetic 1.0, 0.1, and 0.01 MeV electron and photon sources as well as 131I and 90Y radionuclides. We investigated convergence of GBBS by analyzing different meshes (${{M}_{0}},{{M}_{1}},{{M}_{2}}$ ), energy group structures (${{E}_{0}},{{E}_{1}},{{E}_{2}}$ ) for each radionuclide component, angular quadrature orders ($\left. {{S}_{4}},{{S}_{8}},{{S}_{16}}\right)$ , and scattering order expansions (${{P}_{0}}$ ${{P}_{6}}$ ); higher indices imply finer discretization. We compared GBBS to MC in (1) voxel-S-value geometry for soft tissue, lung, and bone, and (2) a source at the interface between combinations of lung, soft tissue, and bone.

Excluding Auger and conversion electrons, MC agreed within  ≈5% of published source voxel absorbed doses. For the finest discretization, most GBBS absorbed doses in the source voxel changed by less than 1% compared to the next finest discretization along each phase space variable indicating sufficient convergence. For the finest discretization, agreement with MC in the source voxel ranged from  −3% to  −20% with larger differences at lower energies (−3% for 1 MeV electron in lung to  −20% for 0.01 MeV photon in bone); similar agreement was found for the interface geometries. Differences between GBBS and MC in the source voxel for 90Y and 131I were  −6%.

The GBBS ATTILA was benchmarked against MC in the nuclear medicine regime. GBBS can be a viable alternative to MC for voxel-level absorbed doses in nuclear medicine. However, reconciliation of the differences between GBBS and MC at lower energies requires further investigation of energy deposition cross-sections.

4583

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The imaging technology magnetic particle imaging allows the detection of magnetic material, in particular superparamagnetic nanoparticles, by remagnetization of the material via magnetic fields. The application is aimed at medical imaging where the particles are applied as tracer directly into the blood stream. Medical safety considerations such as peripheral nerve stimulation limit the maximal amplitude of the magnetic fields and in turn the field of view size. To handle this constraint the concept of patches was introduced, which allows a shift of a field of view to different positions in order to enlarge the imaging area. If this is done statically an overlap of patches can be used to reduce truncation artifacts occurring at the adjacent edges. In this contribution, a differentiation of two different kinds of patch overlaps, i.e. a trajectory and a system matrix overlap, is made. Further, different concepts to combine the resulting redundant information are investigated with respect to the reduction of truncation artifacts. The methods are analyzed in detail in a simulation study and validated on experimental data.

4599

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In this work, we propose a framework for optimizing spectral CT imaging parameters and hardware design with regard to material classification tasks. Compared with conventional CT, many more parameters must be considered when designing spectral CT systems and protocols. These choices will impact material classification performance in a non-obvious, task-dependent way with direct implications for radiation dose reduction.

In light of this, we adapt Hotelling Observer formalisms typically applied to signal detection tasks to the spectral CT, material-classification problem. The result is a rapidly computable metric that makes it possible to sweep out many system configurations, generating parameter optimization curves (POC's) that can be used to select optimal settings.

The proposed model avoids restrictive assumptions about the basis-material decomposition (e.g. linearity) and incorporates signal uncertainty with a stochastic object model. This technique is demonstrated on dual-kVp and photon-counting systems for two different, clinically motivated material classification tasks (kidney stone classification and plaque removal). We show that the POC's predicted with the proposed analytic model agree well with those derived from computationally intensive numerical simulation studies.

4624
The following article is Open access

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Recent advances in dynamic positron emission tomography (PET) reconstruction have demonstrated that it is possible to achieve markedly improved end-point kinetic parameter maps by incorporating a temporal model of the radiotracer directly into the reconstruction algorithm. In this work we have developed a highly constrained, fully dynamic PET reconstruction algorithm incorporating both spectral analysis temporal basis functions and spatial basis functions derived from the kernel method applied to a co-registered T1-weighted magnetic resonance (MR) image. The dynamic PET image is modelled as a linear combination of spatial and temporal basis functions, and a maximum likelihood estimate for the coefficients can be found using the expectation-maximization (EM) algorithm. Following reconstruction, kinetic fitting using any temporal model of interest can be applied. Based on a BrainWeb T1-weighted MR phantom, we performed a realistic dynamic [18F]FDG simulation study with two noise levels, and investigated the quantitative performance of the proposed reconstruction algorithm, comparing it with reconstructions incorporating either spectral analysis temporal basis functions alone or kernel spatial basis functions alone, as well as with conventional frame-independent reconstruction. Compared to the other reconstruction algorithms, the proposed algorithm achieved superior performance, offering a decrease in spatially averaged pixel-level root-mean-square-error on post-reconstruction kinetic parametric maps in the grey/white matter, as well as in the tumours when they were present on the co-registered MR image. When the tumours were not visible in the MR image, reconstruction with the proposed algorithm performed similarly to reconstruction with spectral temporal basis functions and was superior to both conventional frame-independent reconstruction and frame-independent reconstruction with kernel spatial basis functions. Furthermore, we demonstrate that a joint spectral/kernel model can also be used for effective post-reconstruction denoising, through the use of an EM-like image-space algorithm. Finally, we applied the proposed algorithm to reconstruction of real high-resolution dynamic [11C]SCH23390 data, showing promising results.

4646

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The highly conformal planned dose distribution achievable in intensity modulated proton therapy (IMPT) can severely be compromised by uncertainties in patient setup and proton range. While several robust optimization approaches have been presented to address this issue, appropriate methods to accurately estimate the robustness of treatment plans are still lacking. To fill this gap we present Polynomial Chaos Expansion (PCE) techniques which are easily applicable and create a meta-model of the dose engine by approximating the dose in every voxel with multidimensional polynomials. This Polynomial Chaos (PC) model can be built in an automated fashion relatively cheaply and subsequently it can be used to perform comprehensive robustness analysis. We adapted PC to provide among others the expected dose, the dose variance, accurate probability distribution of dose-volume histogram (DVH) metrics (e.g. minimum tumor or maximum organ dose), exact bandwidths of DVHs, and to separate the effects of random and systematic errors. We present the outcome of our verification experiments based on 6 head-and-neck (HN) patients, and exemplify the usefulness of PCE by comparing a robust and a non-robust treatment plan for a selected HN case. The results suggest that PCE is highly valuable for both research and clinical applications.

4665

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Proton pencil beam scanning (PBS) treatment plans are made of numerous unique spots of different weights. These weights are optimized by the treatment planning systems, and sometimes fall below the deliverable threshold set by the treatment delivery system. The purpose of this work is to investigate a Greedy reassignment algorithm to mitigate the effects of these low weight pencil beams. The algorithm is applied during post-processing to the optimized plan to generate deliverable plans for the treatment delivery system. The Greedy reassignment method developed in this work deletes the smallest weight spot in the entire field and reassigns its weight to its nearest neighbor(s) and repeats until all spots are above the minimum monitor unit (MU) constraint. Its performance was evaluated using plans collected from 190 patients (496 fields) treated at our facility. The Greedy reassignment method was compared against two other post-processing methods. The evaluation criteria was the γ-index pass rate that compares the pre-processed and post-processed dose distributions. A planning metric was developed to predict the impact of post-processing on treatment plans for various treatment planning, machine, and dose tolerance parameters. For fields with a pass rate of 90  ±  1% the planning metric has a standard deviation equal to 18% of the centroid value showing that the planning metric and γ-index pass rate are correlated for the Greedy reassignment algorithm. Using a 3rd order polynomial fit to the data, the Greedy reassignment method has 1.8 times better planning metric at 90% pass rate compared to other post-processing methods. As the planning metric and pass rate are correlated, the planning metric could provide an aid for implementing parameters during treatment planning, or even during facility design, in order to yield acceptable pass rates. More facilities are starting to implement PBS and some have spot sizes (one standard deviation) smaller than 5 mm, hence would require small spot spacing. While this is not the only parameter that affects the optimized plan, the perturbation due to the minimum MU constraint increases with decreasing spot spacing. This work could help to design the minimum MU threshold with the goal to keep the γ-index pass rate above an acceptable value.

4679

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A new method for obtaining depth of interaction (DOI) information in PET detectors is presented in this study, based on sharing and redirection of scintillation light among multiple detectors, together with attenuation of light over the length of the crystals. The aim is to obtain continuous DOI encoding with single side readout, and at the same time without the need for one-to-one coupling between scintillators and detectors, allowing the development of a PET scanner with good spatial, energy and timing resolutions while keeping the complexity of the system low. A prototype module has been produced and characterized to test the proposed method, coupling a LYSO scintillator matrix to a commercial SiPMs array. Excellent crystal separation is obtained for all the scintillators in the array, light loss due to depolishing is found to be negligible, energy resolution is shown to be on average 12.7% FWHM. The mean DOI resolution achieved is 4.1 mm FWHM on a 15 mm long crystal and preliminary coincidence time resolution was estimated in 353 ps FWHM.

4699

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The coincidence resolving time (CRT) of scintillation detectors is the parameter determining noise reduction in time-of-flight PET. We derive an analytical CRT model based on the statistical distribution of photons for two different prototype scintillators. For the first one, characterized by single exponential decay, CRT is proportional to the decay time and inversely proportional to the number of photons, with a square root dependence on the trigger level. For the second scintillator prototype, characterized by exponential rise and decay, CRT is proportional to the square root of the product of rise time and decay time divided by the doubled number of photons, and it is nearly independent of the trigger level. This theory is verified by measurements of scintillation time constants, light yield and CRT on scintillator sticks. Trapping effects are taken into account by defining an effective decay time. We show that in terms of signal-to-noise ratio, CRT is as important as patient dose, imaging time or PET system sensitivity. The noise reduction effect of better timing resolution is verified and visualized by Monte Carlo simulation of a NEMA image quality phantom.

4711

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X-ray imaging coupled with recently emerged energy-resolved photon counting detectors provides the ability to differentiate material components and to estimate their respective thicknesses. However, such techniques require highly accurate images. The presence of scattered radiation leads to a loss of spatial contrast and, more importantly, a bias in radiographic material imaging and artefacts in computed tomography (CT). The aim of the present study was to introduce and evaluate a partial attenuation spectral scatter separation approach (PASSSA) adapted for multi-energy imaging. This evaluation was carried out with the aid of numerical simulations provided by an internal simulation tool, Sindbad-SFFD. A simplified numerical thorax phantom placed in a CT geometry was used. The attenuation images and CT slices obtained from corrected data showed a remarkable increase in local contrast and internal structure detectability when compared to uncorrected images. Scatter induced bias was also substantially decreased. In terms of quantitative performance, the developed approach proved to be quite accurate as well. The average normalized root-mean-square error between the uncorrected projections and the reference primary projections was around 23%. The application of PASSSA reduced this error to around 5%. Finally, in terms of voxel value accuracy, an increase by a factor  >10 was observed for most inspected volumes-of-interest, when comparing the corrected and uncorrected total volumes.

Note

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Radioguided surgery through the use of a gamma probe is an established practice, and has been widely applied in the case of sentinel lymph node biopsies. A wide range of intraoperative gamma probes is commercially available. The primary characteristics of the gamma probes include their sensitivity, spatial resolution, and energy resolution. We present the results obtained from a prototype of a new wireless gamma probe. This prototype is composed of a 20 mm thick cerium-doped gadolinium aluminum gallium garnet (Ce:GAGG) inorganic scintillation crystal from Furukawa Denshi and a Hamamatsu S12572-100C multi-pixel photon counter equipped with a designed electronics. The measured performance characteristics include the energy resolution, energy linearity, angular aperture, spatial resolution and sensitivity. Measurements were carried out using 57Co, 133Ba, 22Na, and 137Cs sources. The energy resolutions for 0.122 and 0.511 MeV were 17.2% and 6.9%, respectively. The designed prototype consumes an energy of approximately 4.4 W, weighs about 310 g (including battery) having a dimension of 20 mm (D)  ×  130 mm (L).