Mika Kortesniemi, Finland 1

HELSINKI UNIVERSITYDEPARTMENT OF PHYSICS

Mika KortesniemiAdjunct Professor, Chief Physicist, PhDHUS Medical Imaging CenterUniversity of HelsinkiMeilahti Hospital, Dept. of Radiology

Dosimetrinen tutkimusdiagnostiikassa ja hoidoissa

Helsingin yliopistossa ja Helsinginyliopistollisessa sairaalassa

(HYKS)Helsinki 2014

Potilas saaBPA-Fkantaja-aineeninfuusion

BPA-F leviääverenkiertoonja kudoksiin

Boorin optimaalinenkerääntyminenhoidettavaankasvaimeen

Oikein kohdistettu jaajoitettu neutronisäteilytys

10B[n,a]7Lireaktio

neutroni

alfa-hiukkanen

7Li -rekyyliydin

10B -ydin

Mikrotaso

BNCT – kantaja-aineen infuusiostaneutronisäteilytykseen ja boori-neutronikaappausreaktioon

Solun sisällä tapahtuvassa boori-neutronikaappaus-reaktiossa syntyvät alfahiukkanen ja litiumrekyyli rikkovatsolurakenteita muutaman mikrometrin matkalla ja näintuhoavat kasvainsolun.

~2h

mika.kortesniemi@hus.fi

Data flow during the BNCT treatment

Beam data

Ref. beammonitor (N1)

count ratedNBM, ref/dt

Treatment planning data

Ref. boron doserate, dWBDB/dt

Gy(W)/h

Ref. totaldose rate, dDW/dt

Gy(W)/h

Prescribednormal tissue

dose limit, DLNTGy(W)

Simulated bloodboron level, CS

mg/kg

Irradiation fieldweights, WF(i),and aperture

sizes

Boron data

Experimentalblood boron data

ICP-AESmg/kg

Estimated bloodboron level, CB

mg/kg

Irradiation time, ITmin

Normal tissuedose rate, dDNT/dt

Gy(W)/h

Beam monitor(N1) counts, NBM

mika.kortesniemi@hus.fi

List of contributorsThis report has been compiled byHannu Järvinen, STUK, Finland andWillem P. Voorbraak, NRG, The Netherlandsfrom drafting by:•Iiro Auterinen, VTT, Finland•Isabel C. Gonçalves, ITN, Portugal•Stuart Green, Uni-Birmingham, United Kingdom•Antti Kosunen, STUK, Finland•Milan Marek, NRI, Czech Republic•Ben J. Mijnheer, NKI, The Netherlands•Raymond L. Moss, JRC Petten, The Netherlands•Jürgen Rassow, Uni-Essen, Germany•Wolfgang Sauerwein, Uni-Essen, Germany•Sauli Savolainen, Uni-Helsinki, Finland•Tom Serén, VTT, Finland•Finn Stecher Rasmussen, NRG, The Netherlands•Jouni Uusi-Simola, Uni-Helsinki, Finland•Eva M. Zsolnay, BUTE, Hungary

List of partnersThis report is a joint project of:•The Nuclear Research and consultancy Group NRG, Petten, The Netherlands (coordination)•The Netherlands Cancer Institute, Amsterdam NKI, The Netherlands•The Institute for Energy of the Joint Research Centre of the Commission of the European Communities,Petten, The Netherlands•The Radiation and Nuclear Safety Authority STUK, Helsinki, Finland•The University of Helsinki, Finland•The University of Birmingham, United Kingdom•The Nuclear and Technological Institute ITN, Sacavém, Portugal•The Budapest University of Technology and Economics (BUTE) Budapest, Hungary (INCO partner)•The Nuclear Research Institute NRI, Řež, Czech Republic (INCO partner)•VTT Processes, Espoo, Finland•Universitätsklinikum Essen, Germany

The project was organised within the EU 4th framework program of Standards, Measurements and Testing andwas sponsored by the European Commission under contract numbers SMT4-CT98-2145 and IC20-CT98-0013.

Recommendations for theDosimetry of Boron NeutronCapture Therapy (BNCT)

mika.kortesniemi@hus.fi

Simulations in radiation dosimetry

Photon beam to Pb-target(photons and secondary particles)

Two point sources in water cylinder(activity from gamma image, attenuationvalues from CT image)

Eero Hippeläinen

Radiation therapy

Collaboration (HYKS-TAYS-STUK) within European Metrology project concerningdosimetry in radiation therapy.

Separate activity between HUS and IAEA concerning audit in IMRT dosimetry.

1. Kapanen M, Bly R, Sipilä P, Järvinen H, Tenhunen M. How can a cost/benefit ratio be optimized for an output measurementprogram of external photon radiotherapy beams? Phys Med Biol. 2011 Apr 7;56(7):2119-30.

2. Keyriläinen J, Fernández M, Bravin A, Karjalainen-Lindsberg ML, Leidenius M, von Smitten K, Tenhunen M, Kangasmäki A, SipiläP, Nemoz C, Virkkunen P, Suortti P. Comparison of in vitro breast cancer visibility in analyser-based computed tomographywith histopathology, mammography, computed tomography and magnetic resonance imaging. J Synchrotron Radiat. 2011Sep;18(Pt 5):689-96.

3. Kapanen M, Sipilä P, Bly R, Järvinen H, Tenhunen M. Accuracy of central axis dose calculations for photon external radiotherapybeams in Finland: the quality of local beam data and the use of averaged data. Radiother Oncol. 2008 Feb;86(2):264-71.

4. Bravin A, Keyriläinen J, Fernández M, Fiedler S, Nemoz C, Karjalainen-Lindsberg ML, Tenhunen M, Virkkunen P, Leidenius M,von Smitten K, Sipilä P, Suortti P. High-resolution CT by diffraction-enhanced x-ray imaging: mapping of breast tissue samplesand comparison with their histo-pathology. Phys Med Biol. 2007 Apr 21;52(8):2197-211.

5. Kapanen M, Tenhunen M, Parkkinen R, Sipilä P, Järvinen H. The influence of output measurement time interval and toleranceon treatment dose deviation in photon external beam radiotherapy. Phys Med Biol. 2006 Oct 7;51(19):4857-67.

6. Kapanen M, Tenhunen M, Hämäläinen T, Sipilä P, Parkkinen R, Järvinen H. Analysis of quality control data of eight modernradiotherapy linear accelerators: the short- and long-term behaviours of the outputs and the reproducibility of quality controlmeasurements. Phys Med Biol. 2006 Jul 21;51(14):3581-92.

Mika Kortesniemi, Finland 2

Optimisation research in digital radiology

mika.kortesniemi@hus.fi 8

Part of MATRENA, University of HelsinkiDoctoral Programme in Materials Researchand Nanosciences

Example : CT dose simulation for 3D organ dosimetry

Mean organ doses (mGy)Thyroid 0.4Breasts 15.8Lungs 12.4Heart 12.5Liver 14.7Kidneys 14.7Skin 6.6Uterus 11.9Effective dose11.4 mSvSegmented

human model

3Dabsorbed

dosedistribution

Organ dosevolume histograms

Dose

Volu

me

CT scanwith tubecurrent

modulation

Example: experimental CT dosimetryin anthropomorphic pediatric model

Pediatric 5y antropomorphic phantom with inserted MOSFET dosimeters.

Point organ doses (mGy)Thyroid 0.3Breasts 6.5Lungs 6.2Heart 6.5Liver 7.9Kidneys 7.2

Effective dose3.4 mSv

Ref.dosedetermination

Dosemetercalibration

Example: simulated CT image quality and resolution metrics

Reference image

SPECTRUM

DOSELEVEL

RESOLUTIONMETRICS

10 mAs 800 mAs

80 kV

140 kV

Iterativemethod

FBP Bonekernel

3D-MTFcontour

2D NPSdistribution

IMAGERECON-

STRUCTION

10 Recent publications – optimisation in radiology1. Koivisto J, Wolff J, Järnstedt J, Dastidar P, Kortesniemi M. Assessment of the effective dose in supine, prone, and oblique

positions in the maxillofacial region using a novel combined extremity and maxillofacial cone beam computed tomographyscanner. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Sep;118(3):355-62.

2. Kelaranta A, Toroi P, Timonen M, Komssi S, Kortesniemi M. Conformance of mean glandular dose from phantom and patientdata in mammography. Radiat Prot Dosimetry. 2014 Aug 11. pii: ncu261. [Epub ahead of print]

3. Kaasalainen T, Palmu K, Reijonen V, Kortesniemi M. Effect of patient centering on patient dose and image noise in chest CT. AJRAm J Roentgenol. 2014 Jul;203(1):123-30.

4. Koivisto J, Kiljunen T, Wolff J, Kortesniemi M. Assessment of effective radiation dose of an extremity CBCT, MSCT andconventional X ray for knee area using MOSFET dosemeters. Radiat Prot Dosimetry. 2013 Dec;157(4):515-24.

5. Koivisto J, Kiljunen T, Wolff J, Kortesniemi M. Characterization of MOSFET dosimeter angular dependence in three rotationalaxes measured free-in-air and in soft-tissue equivalent material. J Radiat Res. 2013 Sep;54(5):943-9.

6. Kaasalainen T, Palmu K, Lampinen A, Kortesniemi M. Effect of vertical positioning on organ dose, image noise and contrast inpediatric chest CT-phantom study. Pediatr Radiol. 2013 Jun;43(6):673-84.

7. Koskinen SK, Haapamäki VV, Salo J, Lindfors NC, Kortesniemi M, Seppälä L, Mattila KT. CT arthrography of the wrist using anovel, mobile, dedicated extremity cone-beam CT (CBCT). Skeletal Radiol. 2013 May;42(5):649-57.

8. Seuri R, Rehani MM, Kortesniemi M. How tracking radiologic procedures and dose helps: experience from Finland. AJR Am JRoentgenol. 2013 Apr;200(4):771-5.

9. Toroi P, Könönen N, Timonen M, Kortesniemi M. Aspects of forward scattering from the compression paddle in the dosimetryof mammography. Radiat Prot Dosimetry. 2013;154(4):439-45.

10. Kuttner S, Bujila R, Kortesniemi M, Andersson H, Kull L, Østerås BH, Thygesen J, Tarp IS. A proposed protocol for acceptanceand constancy control of computed tomography systems: a Nordic Association for Clinical Physics (NACP) work group report.Acta Radiol. 2013 Mar 1;54(2):188-98.