Assessment of PCXMC for patients with different body size in chest and abdominal x ray examinations: a Monte Carlo simulation study

Abstract

A PC Program for x ray Monte Carlo (PCXMC) has been used to calculate organ doses in patient dosimetry and for the exposure assessment in epidemiological studies of radiogenic health related risks. This study compared the dosimetry from using the built-in stylized phantoms in the PCXMC to that of a newer hybrid phantom library with improved anatomical realism. We simulated chest and abdominal x ray projections for 146 unique body size computational phantoms, 77 males and 69 females, with different combinations of height (125-180 cm) and weight (20-140 kg) using the built-in stylized phantoms in the PCXMC version 2.0.1.4 and the hybrid phantom library using the Monte Carlo N-particle eXtended transport code 2.7 (MCNPX). Unfortunately, it was not possible to incorporate the hybrid phantom library into the PCXMC. We compared 14 organ doses, including dose to the active bone marrow, to evaluate differences between the built-in stylized phantoms in the PCXMC and the hybrid phantoms (Cristy and Eckerman 1987 Technical Report ORNL/TM-8381/V1, Oak Ridge National Laboratory, Eckerman and Ryman 1993 Technical Report 12 Oak Ridge, TN, Geyer et al 2014 Phys. Med. Biol. 59 5225-42). On average, organ doses calculated using the built-in stylized phantoms in the PCXMC were greater when compared to the hybrid phantoms. This is most prominent in AP abdominal exams by an average factor of 2.4-, 2.8-, and 2.8-fold for the 10-year-old, 15-year-old, and adult phantoms, respectively. For chest exams, organ doses are greater by an average factor of 1.1-, 1.4-, and 1.2-fold for the 10-year-old, 15-year-old, and adult phantoms, respectively. The PCXMX, due to its ease of use, is often selected to support dosimetry in epidemiological studies; however, it uses simplified models of the human anatomy that fail to account for variations in body morphometry for increasing weight. For epidemiological studies that use PCXMC dosimetry, associations between radiation-related disease risks and organ doses may be underestimated, and to a greater degree in pediatric, especially obese pediatric, compared to adult patients.

Monte Carlo-based patient internal dosimetry in fluoroscopy-guided interventional procedures: A review

“…Studying the MC-based applications shown in Table 2, applications up to the early 2000s all utilised simple geometries to define the human body contour and organ structures, as they require the least amount of computational resources. However, such stylised phantoms are very limited in their representation of anatomical structures, which can lead to high levels of error in patient dose estimation [77,78].…”

Impact of body part thickness on AP pelvis radiographic image quality and effective dose

“…With the simulations the weight of the phantom was modified for each one cm increase in fat thickness (one kg increase per 0.96 cm increase in AP diameter). This formula was based on the study conducted by Miyatake 23 assuming a linear relationship between increasing waist circumferences and weight 13,24,25 .…”

Visual Evaluation of Image Quality of a Low Dose 2D/3D Slot Scanner Imaging System Compared to Two Conventional Digital Radiography X-ray Imaging Systems

“…PCXMC Monte Carlo simulation software version 2.0.1 (the Finnish Radiation and Nuclear Safety Authority, STUK; Helsinki, Finland) was used to calculate the effective dose to patients. The PCXMC Monte Carlo program is currently one of the most suitable simulation software for estimating organ doses in medical imaging [29].…”