Radiation exposure and associated radiation risks are major concerns for fetal development for pregnant patients who undergo radiation therapy or diagnostic imaging procedures. In order to accurately estimate the radiation dose to the fetus and assess the uncertainty of fetal position and rotation, three hybrid computational fetus phantoms were constructed using magnetic resonance imaging (MRI) for each fetus model as a starting point to construct a complete anatomically accurate fetus, gravid uterus, and placenta. A total of 27 fetal organs were outlined from radiological images via the Velocity Treatment Planning System. The DICOM-Structure set was imported to Rhinoceros software for further reconstruction of 3D fetus phantom model sets. All fetal organ masses were compared with ICRP-89 reference data. Our fetal model series corresponds to 20, 31, and 35 weeks of pregnancy, thus covering the second and third trimester. Fetal positions and locations were carefully adapted to represent the real fetus locations inside the uterus for each trimester of pregnancy. The new series of hybrid computational fetus models together with pregnant female models can be used in evaluating fetal radiation doses in diagnostic imaging and radiotherapy procedures.
The number of patients undergoing diagnostic radiology and radiation therapy procedures has increased drastically owing to improvements in cancer diagnosis and treatment and, consequently, patient survival. However, the risk of the occurrence of secondary malignancies due to radiation exposure remains a matter of concern. There are concerns about the fetus's health when pregnant women are exposed to and/or treated with ionizing radiation at various stages of pregnancy. We previously published three hybrid computational fetus phantoms, which contained 27 fetal organs, as a beginning point for developing the whole hybrid computational pregnant phantom set, which is the second objective of this study. An ICRP reference female voxel model was converted to a non-uniform rational basis spline (NURBS) surface model in order to construct a hybrid computational female phantom as a pregnant mother to each fetus model. Both the fetal and maternal organs were matched with ICRP-89 reference data. In order to create a complete standard pregnant computational phantom set at 20, 30, and 35 weeks of pregnancy, the model mother’s reproductive organs were removed, and the fetus phantoms with appropriate placental and uterine models were added female pelvis using a 3D-modeling software. With the aid of radiological image sets that had been initially used to construct the fetus models, each fetus’ position and rotation inside the uterus were carefully adjusted to represent the real fetal locations inside the uterus. The resulting fetus phantom was positioned in the appropriate location, matching the original radiological image sets. An obstetrician-gynecologist reviewed the complete internal anatomy of all fetus phantoms and the pregnant female for accuracy, and suggested changes were implemented as needed. This new set of hybrid computational pregnant phantom models has realistic anatomical details that can help evaluate fetal radiation doses where realistic fetal computational human phantoms are needed.
Purpose: To reconstruct major organ doses for the Wilms tumor pediatric patients treated with radiation therapy using pediatric computational phantoms, treatment planning system (TPS), and Monte Carlo (MC) dose calculation methods. Methods: A total of ten female and male pediatric patients (15–88 months old) were selected from the National Wilms Tumor Study cohort and ten pediatric computational phantoms corresponding to the patient's height and weight were selected for the organ dose reconstruction. Treatment plans were reconstructed on the computational phantoms in a Pinnacle TPS (v9.10) referring to treatment records and exported into DICOM‐RT files, which were then used to generate the input files for XVMC MC code. The mean doses to major organs and the dose received by 50% of the heart were calculated and compared between TPS and MC calculations. The same calculations were conducted by replacing the computational human phantoms with a series of diagnostic patient CT images selected by matching the height and weight of the patients to validate the anatomical accuracy of the computational phantoms. Results: Dose to organs located within the treatment fields from the computational phantoms and the diagnostic patient CT images agreed within 2% for all cases for both TPS and MC calculations. The maximum difference of organ doses was 55.9 % (thyroid), but the absolute dose difference in this case was 0.33 Gy which was 0.96% of the prescription dose. The doses to ovaries and testes from MC in out‐of‐field provided more discrepancy (the maximum difference of 13.2% and 50.8%, respectively). The maximum difference of the 50% heart volume dose between the phantoms and the patient CT images was 40.0%. Conclusion: This study showed the pediatric computational phantoms are applicable to organ doses reconstruction for the radiotherapy patients whose three‐dimensional radiological images are not available.
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