Polymer gel dosimetry, in conjunction with x-ray computed tomography (x-ray CT) imaging, is a three-dimensional dosimetric tool that shows promise in the verification of complex radiation therapy treatments. Previous studies have shown that x-ray CT imaging of gel dosimeters is robust, easy-to-use, and has wide clinical accessibility. The effects of x-ray CT dose imparted to the gel dosimeter, during imaging of the delivered therapy dose distributions, is not well understood. This thesis quantifies the effects of CT dose on normoxic polyacrylamide gel (nPAG) dosimeters. The investigation is comprised of four parts. First, quantification of the x-ray CT dose given during CT imaging of nPAG gels was measured using ion chamber measurements and filmed dose profiles for a range of typical gel dosimetry imaging protocols (200 mAs (current-time), 120-140 kVp (peak potential energy of photons), 2-10 mm slice thickness). It was found that CT doses ranged from 0.007 Gy/slice (120 kVp, 2 mm) to 0.021 Gy/slice (140 kVp, 10 mm) for volumetric phantoms. Second, Raman spectroscopy was used to determine the effect of photon energy on the dose response of nPAG dosimeters exposed to photon energies from a CT scanner (140 kVp photons) and from a Linac (6 MV photons). A weaker response was exhibited within the gels irradiated with kV photons than MV photons. Thirdly, the measurements of the given x-ray CT dose as established in the first study and the dose response of the polymer gel to different photon energies in the second study were correlated to estimate the induced changes of the nPAG CT number ("NCT ), caused by x-ray CT imaging of the polymer gel. (CT number is defined to be the measured attenuation coefficient normalized to water.) For typical gel imaging protocols (as above with 16-32 image averages), it was found that "NCT <0.2 H is induced in active nPAG gel dosimeters. This "NCT is below the current threshold of detectability of CT nPAG gel dosimetry. Finally, the traditional method of chemically fixing the dose response mechanism of nPAG gels by passive oxygenation of the gel, is investigated to determine if oxygenation would mitigate the changes caused by x-ray CT imaging of the gels. It was determined that oxygen diffusion was too slow to cause fixation of nPAG dosimeters, as the diffusion constant was 1.2 ± 0.2 × 10−6cm2/s, or 25% of the diffusion constant for anoxic PAG gel dosimeters. In conclusion, it was found that x-ray CT dose in polymer gel dosimeters is not a concern for standard gel imaging protocols. X-ray CT dose can potentially be a concern when large numbers of image averages (e.g. >60 image averages) are utilized, as in gel imaging protocols for high-resolution scans.

During my time as a PhD student at the Physics of Medical Imaging group at KTH, I have taken part in the work of developing a photon counting spectrally resolved silicon detector for clinical computed tomography. This work has largely motivated the direction of my research, and is the main reason for my focus on certain issues. Early in the work, a need to quantify and optimize the performance of a spectrally resolved detector was identified. A large part of my work have thus consisted of reviewing conventional methods used for performance quantification and optimization in computed tomography, and identifying which are best suited for the characterization of a spectrally resolved system. In addition, my work has included comparisons of conventional systems with the detector we are developing. The collected result after a little more than four years of work are four publications and three conference papers. This compilation thesis consists of five introductory chapters and my four publications. The introductory chapters are not self-contained in the sense that the theory and results from all my published work are included. Rather, they are written with the purpose of being a context in which the papers should be read. The first two chapters treat the general purpose of the introductory chapters, and the theory of computed tomography including the distinction between conventional, non-spectral, computed tomography, and different practical implementations of spectral computed tomography. The second chapter consists of a review of the conventional methods developed for quantification and optimization of image quality in terms of detectability and signal-to-noise ratio, part of which are included in my published work. In addition, the theory on which the method of material basis decomposition is based on is presented, together with a condensed version of the results from my work on the comparison of two systems with fundamentally different practical solutions for material quantification. In the fourth chapter, previously unpublished measurements on the photon counting spectrally resolved detector we are developing are presented, and compared to Monte Carlo simulations. In the fifth and final chapter, a summary of the appended publications is included. / <p>QC 20150303</p>

In brachytherapy, radiation therapy is performed by placing the radiation source into or very close to the tumour. When calculating the absorbed dose, water is often used as the radiation transport and dose scoring medium for soft tissues and this leads to inaccuracies. The iterative reconstruction algorithm DIRA is under development at the Center for Medical Imaging Science and Visualization, Linköping University. DIRA uses dual-energy CT to decompose tissues into different doublets and triplets of base components for a better absorbed dose estimation. To accurately determine mass fractions of these base components for different tissues, the tissues needs to be identified in the image. The aims of this master thesis are: (i) Find an automated segmentation algorithm in CT that best segments the male pelvis. (ii) Implement a segmentation algorithm that can be used in DIRA. (iii) Implement a fully automatic segmentation algorithm. Seven segmentation methods were tested in Matlab using images obtained from Linköping University Hospital. The methods were: active contours, atlas based registration, graph cuts, level set, region growing, thresholding and watershed. Four segmentation algorithms were selected for further analysis: phase based atlas registration, region growing, thresholding and active contours without edges. The four algorithms were combined and supplemented with other image analysis methods to form a fully automated segmentation algorithm that was implemented in DIRA. The newly developed algorithm (named MK2014) was sufficiently stable for pelvic image segmentation with a mean computational time of 45.3 s and a mean Dice similarity coefficient of 0.925 per 512×512 image. The performance of MK2014 tested on a simplified anthropomorphic phantom in DIRA gave promising result. Additional tests with more realistic phantoms are needed to confirm the general applicability of MK2014 in DIRA.

The introduction of Magnetic Resonance (MR) Imaging in treatment planning for radiotherapy of prostate cancer give rise to new challenges in defining the treatment volume, or the target. Imaging with MR have several advantages, especially better soft-tissue contrast, compared with the standard image modality, Computed Tomography (CT). The purpose of this project was to determine how the target definition varies with the choice of image modality and the systematic differences between them. The purpose was also to determine how the inter- and intra physician variability influences the delineation, depending on which image modality that is used. In the project, five physicians delineated the prostate gland on CT and MR images for nine patients. The physicians had no information of which image series that was connected, and were thus delineating independent. After the delineation, the CT and MR image series was set in the same geometrical coordinate system in the treatment planning system Oncentra. The target delineations were analysed by comparing the radial distances from the centre of mass in different directions, such as anterior, posterior, etc. The radial distances were later used to evaluate the variability of the delineations and to determine the inter and intra physician variability in different directions of the targets. ANOVA was also preformed to determine if there is a significant difference between the parameters, as the image modality and the image modalities influence on the physicians delineations. A model was made to investigate how the MR delineations differ from a CT defined volume that 95% of the delineations cover, called the ideal CT delineation. From this, the median deviation in different directions  was analysed and it was found that the median value of the MR delineations in different directions was between -0.10-2.27 mm larger than the ideal CT delineation. The fluctuations between the delineations was, however, large. The target volume was larger for CT defined volumes in 87% of the cases, compared with MR targets. The inter physician variability was found to be between 0.54-2.17 mm for the CT based delineations and 0.68-2.08 mm for the MR based target delineations. The intra physician variability was larger than the inter physician variability, between 0.74-2.51 mm for CT based delineations and 0.85-1.45 mm for MR based delineations. The median variability of the delineations were not uniform around the target volume but were larger for example in the superior and inferior directions and had its minimum in the posterior direction. The ANOVA tests showed a significant difference between MR and CT based target delineations, it also shows a relation between the delineating physician and the image modality, meaning that the physicians are delineating different on CT and MR images. Target volumes defined on MR images are in general smaller than the CT defined targets. The soft tissue contrast in MR images makes the delineating process easier, however, the analysis of the variability in this project indicates that the variations of MR based target delineations are larger than the CT based. The large variation of the delineations implies that clinical tests should be made to ensure a proper dose coverage before MR could be used as the only image modality in radiotherapy treatment planning of prostate cancer.

No description available.

The importance of root systems for soil-based resource acquisition by plants has long motivated researchers to quantify the complexity of root system structures. However, most of those studies proceeded from 2-D spatial data, and thus lacked the relevance of a 3-D analysis. In this project, helical CT scanning was applied to study root systems with an unprecedented level of accuracy, using non-destructive and non-invasive 3-D imaging that allowed for a spatio-temporal analysis. The appropriate CT scan parameters and configuration were determined for root systems of maize seedlings grown in sand and loamy sand. It was found that the soil conditions allowing for better visualization were sand before watering and loamy sand after watering. Root systems were CT scanned and visualized either at a single moment in time or repeatedly on successive days. Complexity analysis was performed by estimating the fractal dimension on skeletonized 3-D images of root systems.

Previous research has shown that the sample preparation method used to reconstitute specimens for granular materials can have a significant impact on its mechanistic behavior. As the Discrete Element Method becomes a more popular choice for modeling multiphysics problems involving granular materials, the sample heterogeneity should be correctly characterized in order to obtain accurate results. In order to capture the effect of sample preparation on the homogeneity of the sample, standard procedures were used to reconstitute samples composed of a homogeneous granular material. X-ray computed tomography and image analysis techniques were then used to characterize the spatial heterogeneity of a typical sample. The sample preparation method was modeled numerically using the Discrete Element program PFC3D. The resulting microstructure of the numerical sample was compared to the results of the image analysis to determine if the heterogeneity of the sample could be reproduced correctly for use in Discrete Element Modeling.

Research on sex and gender in chronic obstructive pulmonary disease (COPD) has primarily focused on differences in pulmonary function. Detailed gender- and sex-based analyses of other aspects of COPD, including epidemiology, risk factors other than cigarette smoke, pathophysiology, and measurement tools are warranted. In Chapter Two we analyzed administrative health services data to compare the prevalence, mortality and use of drugs and spirometry in men and women with COPD. Contrary to recent predictions, we did not detect a dramatic increase in the prevalence or mortality of COPD over time in women compared to men. We discuss how different coding practices in medical billing can impact the results. In Chapter Three we examined sex differences in COPD phenotypes. We hypothesized that male smokers would have more emphysema whereas female smokers would have more airway wall remodeling using data from high resolution computed tomography (HRCT) scans. We did detect more emphysema in male smokers but there was no evidence of increased airway remodeling in women. We discuss the limits of HRCT to detect airway differences in women and men. In Chapter Four we examined the use of HRCT in assessing emphysema. We hypothesized that the computer-derived estimates of emphysema (the fractal value and the % low attenuation area (%LAA)) would differentiate COPD from non-COPD as accurately as the radiologist’s emphysema scores, and would provide similar predictions in both men and women. Instead, we found that the subjective rating of emphysema best differentiated COPD, and the fractal value (a measure of emphysematous lesion size) better differentiated COPD compared with an established objective measurement, the %LAA. These results were generally the same in men and women. In Chapter Five we examined characteristics of COPD in women exposed to biomass smoke. We hypothesized that biomass smoke would induce an airway disease-predominant phenotype. We found that women with biomass smoke-exposed COPD had greater airway remodeling and less emphysema than women with tobacco smoke-exposed COPD. In summary, these findings suggest that sex and gender differences are present in COPD epidemiology and pathophysiology. However, current research measurement tools may limit the ability to accurately measure these differences.

Aim: The past two decades have seen a large body of work dedicated to the development of a three dimensional gel dosimetry system for the recording of radiation dose distributions in radiation therapy. The purpose of much of the work to date has been to improve methods by which the absorbed dose information is extracted. Current techniques include magnetic resonance imaging (MRI), optical tomography, Raman spectroscopy, x-ray computed tomography (CT) and ultrasound. This work examines CT imaging as a method of evaluating polymer gel dosimeters. Apart from publications resulting from this work, there has been only two other journal articles to date reporting results of CT gel dosimetry. This indicates that there is still much work required to develop the technique. Therefore, the aim of this document is to develop CT gel dosimetry to the extent that it is of use to clinical and research physicists. Scope: Each chapter in this document describes an aspect of CT gel dosimetry which was examined; with Chapters 2 to 7 containing brief technical backgrounds for each aspect. Chapter 1 contains a brief review of gel dosimetry. The first step in the development of any method for reading a signal is to determine whether the signal can actually be obtained. However, before polymer gel dosimeters can be imaged using a CT scanner, imaging techniques are required which are employable to obtain reliable readings. Chapter 2 examines the various artifacts inherent in CT which interfere with the quantitative analysis of gel dosimeters and a method for their removal is developed. The method for artifact reduction is based on a subtraction technique employed previously in a feasibility study and a system is designed to greatly simplify the process. The simplification of the technique removes the requirement for accurate realignment of the phantom within the scanner and the imaging of calibration vials is enabled. Having established a method by which readings of polymer gel dosimeters can be obtained with CT, Chapter 3 examines the CT dose response. A number of formulations of polymer gel dosimeter are studied by varying the constituent chemicals and their concentrations. The results from this chapter can be employed to determine the concentration of chemicals when manufacturing a polymer gel dosimeter with a desired CT dose response. With the CT dose response characterised in Chapter 3, the macroscopic cause of the CT signal is examined in Chapter 4. To this end direct measurement of the linear attenuation coefficient is obtained with a collimated radiation source and detector. Density is measured by Archimedes' principle. Comparison of the two results shows that the cause of the CT signal is a density change and the implications for polymer gel dosimetry are discussed. The CT scanner is revisited in Chapter 5 to examine the CT imaging techniques required for optimal performance. The main limitation of the use of CT in gel dosimetry to date has been image noise. In Chapter 5 stochastic noise is investigated and reduced. The main source of non-stochastic noise in CT is found and imaging techniques are examined which can greatly reduce this residual noise. Predictions of computer simulations are verified experimentally. Although techniques for the reduction of noise are developed in Chapter 5, there may be situations where the noise must be further reduced. An image processing algorithm is designed in Chapter 6 which employs a combination of commonly available image filters. The algorithm and the filters are tested for their suitability in gel dosimetry through the use of a simulated dose distribution and by performing a pilot study on an irradiated polymer gel phantom. Having developed CT gel dosimetry to the point where a suitable image can be obtained, the final step is to investigate the uncertainty in the dose calibration. Methods used for calibration uncertainty in MRI gel dosimetry to date have either assumed a linear response up to a certain dose, or have removed the requirement for linearity but incorrectly ignored the reliability of the data and fit of the calibration function. In Chapter 7 a method for treatment of calibration data in CT gel dosimetry is proposed which allows for non-linearity of the calibration function, as well as the goodness of its fit to the data. Alternatively, it allows for the reversion to MRI techniques if linearity is assumed in a limited dose range. Conclusion: The combination of the techniques developed in this project and the newly formulated normoxic gels (not extensively studied here) means that gel dosimetry is close to becoming viable for use in the clinic. The only capital purchase required for a typical clinic is a suitable water tank, which is easily and inexpensively producible if the clinic has access to a workshop.

Tez (Tıpta Uzmanlık) - Süleyman Demirel Üniversitesi, Tıp Fakültesi, Nükleer Tıp Anabilim Dalı, 2007. / Bibliyografya var.